Current Issue : April - June Volume : 2017 Issue Number : 2 Articles : 7 Articles
Background: Despite a lack of service provision for people with osteoarthritis (OA), each year 1 in 5 of the general\npopulation consults a GP about a musculoskeletal condition such as OA. Consequently this may provide an opportunity\nfor practice nurses to take an active role in helping patients manage their condition. A nurse led clinic for supporting\npatients with OA was developed for the MOSAICS study investigating how to implement the NICE 2014 OA Guideline\ncore recommendations. This paper has two main objectives, firstly to provide an overview of the nurse-led OA clinic,\nand secondly to describe the development, key learning objectives, content and impact of the training to support its\ndelivery.\nMethods: A training programme was developed and delivered to provide practice nurses with the knowledge and skill\nset needed to run the nurse-led OA clinic. The impact of the training programme on knowledge, confidence and OA\nmanagement was evaluated using case report forms and pre and post training questionnaires.\nResults: The pre-training questionnaire identified a gap between what practice nurses feel they can do and what they\nshould be doing in line with NICE OA guidelines. Evaluation of the training suggests that it enabled practice nurses to\nfeel more knowledgeable and confident in supporting patients to manage their OA and this was reflected in the clinical\nmanagement patients received in the nurse-led OA clinics.\nConclusions: A significant gap between what is recommended and what practice nurses feel they can currently provide\nin terms of OA management was evident. The development of a nurse training programme goes some way to develop\na system in primary care for delivering the core recommendations by NICE....
Purpose: The purpose of this study is to identify characteristics of work environments in psychiatric\nhospitals which are appealing to nurses. Understanding characteristics of work environments of\npsychiatric hospital nurses can lead to attracting nurses to work in this environment, thereby increasing\nhuman resources and alleviating nurse-staffing problems.\nMethods: Questionnaire copies focusing on staffing shortages of nurses in psychiatric hospitals were\nprovided to 277 psychiatric hospital nurse administrators in Japan from May-April 2016. Data analyses\nincluded descriptive and multivariate statistics. Factor analysis together with the Kaiser-Meyer-Olkin\nand the Bartlett�s test of Sphericity were used to assess adaptive validity. Factor loadings were set at 0.4\nor more for the configuration of items, while internal consistency and reliability of the assessment data\nscores were done using Cronbach�s alpha coefficient. Mean factor points were calculated and student's\nt-test and one-way analysis of variance were performed. Significance probability level was set at 0.001.\nResults: Factor analysis revealed nine factors: (1) Educational system, (2) Reputation at hospitals, (3)\nSupport system for acquisition of certificate of clinical nurse specialist/certified nurse, (4) Reputation\nat hospitals as places of employment, (5) Knowledge of nursing philosophy and of culture of working\nplaces, (6) Reputation of teaching for students� clinical practice, (7) Working hours and leave privileges,\n(8) Salary and other allowances, (9) Support system for license acquisition. Data revealed that nurse\nadministrators who employed new graduate registered nurses found their hospitals' attractive points\nwere: educational system, support system to acquire certificate of clinical nurse specialist, reputation\nof hospital as place of employment, knowledge of nursing philosophy and culture of working places,\nteaching students' clinical practice, and salary and other allowances.\nConclusion: Nurse administrators who have no difficulty recruiting nursing staff recognized that their\nhospital environments were considered appealing based on working hours and leave privileges....
The purposes of this study were to describe the decision making process and decision\nactivities of critical care nurses in natural clinical settings. An exploratory descriptive\napproach utilizing both interview and observation methods, was used for data collection.\nThe study involved twenty four critical care nurses from three hospitals in Jordan.\nParticipant observation was performed to understand the routine clinical decisions\nmade by Intensive Care nurses. About 150 hours of observations were spent in\nthe involved Intensive Care Units. Nurses were interviewed to elicit information\nabout how they made decisions about patient�s care. The study revealed that the most\ncommon model nurses tend to use was intuitive model in order to observe the cues\nrelating to the patient�s situation. Data revealed that the decision making process is\ncontinuous and that experience is one of the main factors that determine nurses�\nability to take decisions. Five themes were generated from the data: on-going process,\nautonomy, experience/power, joint/ethical decisions, and advocacy. Critical care\nnurses were seen to be sensitive to the patient�s verbal and non-verbal cues; they were\nable to respond to these evidences to ensure that the patient�s condition did not deteriorate.\nCritical care nurses are likely to be more confident and effective when dealing\nwith patient�s changing situations with more experience....
Background: Practice nurses (PNs) deliver much of the chronic disease management in primary care and have\nbeen highlighted as appropriately placed within the service to manage patients with long-term physical conditions\n(LTCs) and co-morbid depression.\nThis nested qualitative evaluation within a service development pilot provided the opportunity to examine the\nacceptability of a Brief Behavioural Activation (BBA) intervention within a collaborative care framework. Barriers and\nfacilitators to engaging with the intervention from the patient and clinician perspective will be used to guide future\nservice development and research.\nMethods: The study was conducted across 8 practices in one Primary Care Trust 1 in England. Through purposive\nsampling professionals (n = 10) taking part in the intervention (nurses, GPs and a mental health gateway worker)\nand patients (n = 4) receiving the intervention participated in semi-structured qualitative interviews. Analysis utilised\nthe four Normalisation Process Theory (NPT) concepts of coherence, cognitive participation, collective action and\nreflexive monitoring to explore the how this intervention could be implemented in practice.\nResults: Awareness of depression and the stigma associated with the label of depression meant that, from a\npatient perspective a PN being available to ââ?¬Ë?listenââ?¬â?¢ was perceived as valuable. Competing practice priorities,\nperceived lack of time and resources, and lack of engagement by the whole practice team were considered the\ngreatest barriers to the implementation of this intervention in routine primary care.\nConclusion: Lack of understanding of, participation in, and support from the whole practice team in the\ncollaborative care model exacerbated the pressures perceived by PNs. The need for formal supervision of PNs to\nenable them to undertake the role of case manager for patients with depression and long-term conditions is\nemphasised....
Background: Pressure ulcer prevention is a critical patient safety indicator for acute care hospitals. An innovative\npressure ulcer prevention care bundle targeting patient participation in their care was recently tested in a cluster\nrandomised trial in eight Australian hospitals. Understanding nurses� perspectives of such an intervention is\nimperative when interpreting results and translating evidence into practice. As part of a process evaluation for the\nmain trial, this study assessed nurses� perceptions of the usefulness and impact of a pressure ulcer prevention care\nbundle intervention on clinical practice.\nMethods: This qualitative descriptive study involved semi-structured interviews with nursing staff at four Australian\nhospitals that were intervention sites for a cluster randomised trial testing a pressure ulcer prevention care bundle.\nFour to five participants were purposively sampled at each site. A trained interviewer used a semi-structured\ninterview guide to question participants about their perceptions of the care bundle. Interviews were digitally\nrecorded, transcribed and analysed using thematic analysis.\nResults: Eighteen nurses from four hospitals participated in the study. Nurses� perceptions of the intervention are\ndescribed in five themes: 1) Awareness of the pressure ulcer prevention care bundle and its similarity to current\npractice; 2) Improving awareness, communication and participation with the pressure ulcer prevention care bundle;\n3) Appreciating the positive aspects of patient participation in care; 4) Perceived barriers to engaging patients in\nthe pressure ulcer prevention care bundle; and 5) Partnering with nursing staff to facilitate pressure ulcer\nprevention care bundle implementation.\nConclusions: Overall, nurses found the care bundle feasible and acceptable. They identified a number of benefits\nfrom the bundle, including improved communication, awareness and participation in pressure ulcer prevention care\namong patients and staff. However, nurses thought the care bundle was not appropriate or effective for all patients,\nsuch as those who were cognitively impaired. Perceived enablers to implementation of the bundle included\nfacilitation through effective communication and dissemination of evidence about the care bundle; strong\nleadership and ability to influence staff behaviour; and simplicity of the care bundle....
Overview of the clinical nurse specialist development history, current situation and\ntraining mode, and according to the current situation of the development of clinical nursing\nspecialist in China, proposed the convergence of clinical nurse specialist and master of nursing\nspecialist training, and put forward the new training mode of the \"four cards and one\" ,and\nanalyzes the feasibility and difficulties...
Registered nurses at the bedside are accountable for and oversee completion of patient care as well as directly leading and\nmanaging the provision of safe patient care. These nurses have an informal leadership role that is not associated with any given\nposition. Leadership is a complex and multifaceted concept and its meaning is unclear, especially in the staff nurse context.\nThe aim was to describe registered nurses� perceptions of what it entails to be the leader at the bedside in inpatient physical\ncare. A phenomenographic approach was employed. Interviews were performed with Swedish registered nurses (...
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