Current Issue : July - September Volume : 2016 Issue Number : 3 Articles : 6 Articles
The aim of this systematic review was to illuminate intuition in clinical nursing. Frequently described\nas a defining characteristic of professional expertise, intuition is gaining acceptance as a\nlegitimate form of knowledge in clinical nursing. A total of 352 abstracts were read and eight\nquantitative studies included. A thematic analysis was performed to one main theme, two themes,\nand four sub-themes emerged. The main theme was: Sensing an unconscious and conscious state\nof mind, and the two themes were: A sudden emotional awareness and reflection, and arousal of\nconscious thought processes. The first theme included two sub-themes: Sensing spiritual connections\nwith patients and experiencing physical sensations; worrying and reassuring feelings. The\nsecond theme comprised two sub-themes: Willingness to act on personal, interpersonal, and clinical\nexperiences; the influence of maturity and social support in clinical decision-making. An implication\nfor clinical nursing was the need to develop sensitivity as a key to understanding the patient�s\nillness. In conclusion, leadership and management could facilitate discussions about intuition\nas a legitimate method of processing information and making decisions about patient\ncare....
Background: Clinical specialist (CS) and advanced practitioner (AP) roles have increased in nursing and midwifery\ninternationally. This study explored clinical practice in sites with and without clinical nurse or midwife specialists or\nadvanced nurse practitioners in Ireland.\nMethods: Using a case study design, interview, observational and documentary data from postholding sites (CSs or APs\nemployed) were compared with data from non-postholding sites (no CSs or APs employed). Interviews and observations\nwere conducted with postholders (n = 23), and compared with data from healthcare professionals (nurses or midwives,\ndoctors) (n = 23) in matched services. Interviews were held with Directors of Nursing and Midwifery (n = 23), healthcare\nprofessionals (n = 41), service users (n = 41) with experience of receiving care or working with postholders, and nonpostholders\nin matched services. The data were analysed using Nvivo (Version 8).\nResults: The findings suggest that postholders� practice appeared to differ from non-postholders� in relation to case\nmanagement and service provision. Postholders were seen as having an impact on readmission rates, waiting lists/times,\ncollaborative decision-making, continuity of care and workload management. Postholders� autonomy to manage\ncaseloads was perceived to lead to smoother transition of patients/clients through the healthcare system. Service-users�\nself-reports appeared to appreciate the individualised holistic care provided by postholders. Postholders� role in facilitating\nperson-centred care and promoting inter professional team working, are essential elements in quality care provision and\nin global healthcare workforce planning.\nConclusions: To meet changing healthcare demands, promote person-centred care, and improve service delivery, more\nspecialist and advanced practice posts in nursing and midwifery should be developed and supported within healthcare....
Background: The nurse practitioner is a growing clinical role in Australia and internationally, with an expanded\nscope of practice including prescribing, referring and diagnosing. However, key gaps exist in nurse practitioner\neducation regarding governance of specialty clinical learning and teaching. Specifically, there is no internationally\naccepted framework against which to measure the quality of clinical learning and teaching for advanced specialty\npractice.\nMethods: A case study design will be used to investigate educational governance and capability theory in nurse\npractitioner education. Nurse practitioner students, their clinical mentors and university academic staff, from an\nAustralian university that offers an accredited nurse practitioner Master�s degree, will be invited to participate in the\nstudy.\nSemi-structured interviews will be conducted with students and their respective clinical mentors and university\nacademic staff to investigate learning objectives related to educational governance and attributes of capability\nlearning. Limited demographic data on age, gender, specialty, education level and nature of the clinical healthcare\nlearning site will also be collected. Episodes of nurse practitioner student specialty clinical learning will be observed\nand documentation from the students� healthcare learning sites will be collected.\nDescriptive statistics will be used to report age groups, areas of specialty and types of facilities where clinical\nlearning and teaching is observed. Qualitative data from interviews, observations and student documents will be\ncoded, aggregated and explored to inform a framework of educational governance, to confirm the existing\ncapability framework and describe any additional characteristics of capability and capability learning.\nDiscussion: This research has widespread significance and will contribute to ongoing development of the\nAustralian health workforce. Stakeholders from industry and academic bodies will be involved in shaping the\nframework that guides the quality and governance of clinical learning and teaching in specialty nurse practitioner\npractice. Through developing standards for advanced clinical learning and teaching, and furthering understanding\nof capability theory for advanced healthcare practitioners, this research will contribute to evidence-based models of\nadvanced specialty postgraduate education....
Background: Acquisition of psychomotor clinical skills has been shown to improve the quality of care provided to\npatients when care providers are competent. The aim of this study was to explore students, nurses and tutors experience\non factors affecting acquisition of psychomotor clinical skills.\nMethods: The study employed an exploratory qualitative research design. The population was students, clinical nurses\nand tutors from a nursing College and mission hospital in the southern region of Malawi. In depth interviews using a\nsemi structured guide was used to collect data. Thematic analysis method was employed to analyze the collected data.\nEthical principles of respect of human dignity, beneficence and justice were observed.\nResults: The findings have shown that acquisition of psychomotor skills is affected by: student motivation, lack of\nresources, learning environment, knowledge gap between the qualified nurses and tutors, and role modeling.\nConclusion: In principle when student nurses have acquired necessary skills the quality of care provided to\npatients improve. Basing on the findings of this study it is recommended that Student should be well prepared\nbefore clinical placement Nurses and tutors should also update their knowledge and clinical teaching skills for\nthem to adequately guide students. The clinical arena should have adequate resources....
Background: In healthcare research, results diffuse only slowly into clinical practice, and there is a need to bridge\nthe gap between research and practice. This study elucidates how healthcare professionals in a hospital setting\nexperience working with the implementation of research results.\nMethod: A descriptive design was chosen. During 2014, 12 interviews were carried out with healthcare\nprofessionals representing different roles in the implementation process, based on semi-structured interview\nguidelines. The analysis was guided by a directed content analysis approach.\nResults: The initial implementation was non-formalized. In the decision-making and management process, the\npattern among nurses and doctors, respectively, was found to be different. While nurses� decisions tended to be\nproblem-oriented and managed on a person-driven basis, doctors� decisions were consensus-oriented and\nmanaged by autonomy. All, however, experienced a knowledge-based execution of the research results, as the\nimplementation process ended.\nConclusion: The results illuminate the challenges involved in closing the evidence-practice gap, and may add to\nthe growing body of knowledge on which basis actions can be taken to ensure the best care and treatment\navailable actually reaches the patient....
Introduction. To produce competent, confident, critical thinker with the ability to lead, to question, and to be questioned is needed in\nnursing education.This study aimed to assess perceived clinical competence among nursing students. Methods.This cross-sectional\nstudy was conducted in two nursing schools in Ethiopia.Datawere collected using pretested, semistructured questionnaire. Clinical\ncompetence was measured by Short Nursing Competence Questionnaires. Binary logistic regression model was fitted to identify\nassociated factors. An adjusted odds ratio with 95% confidence interval was computed. Results. Overall, 48.7 % of the participants\nperceived themselves as clinically competent. Social support [moderate (AOR = 5.87, CI: 1.346, 9.586), high (AOR = 6.27, CI:\n1.741, 7.608)], type of institution [(AOR = 3.20, CI: 1.331, 7.694)], year of study [(AOR = 1.89 (4.760, 18.510)], attending theoretical\nclasses [(AOR = 0.83 CI: 0.017, 0.412)], and clinical environment [poor (AOR = 5.65, CI: 1.837, 13.453), fair (AOR = 7.31, CI: 2.790,\n15.356), good (AOR = 9.31, CI: 3.260, 19.967)] were associated with clinical competence. Conclusion. More than half of the study\nparticipants perceived themselves as incompetent. Social support, type of institution, year of study, attending theory classes, and\nclinical environment were associated with perceived clinical competence. Authors suggested that nursing students attend their\ntheoretical class and utilize the available resource....
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