Current Issue : January - March Volume : 2018 Issue Number : 1 Articles : 6 Articles
Background: Alarms in the critical areas are an important component of most of the machines as they alert nurses\non the change in the patients� condition. Most patients in the critical care units cannot speak for themselves hence\ncannot pinpoint when their condition changes. It is therefore important to assess the nurses� interventions when\nmanaging clinical alarms. The purpose of this study was to assess interventions employed by nurses in the management\nof clinical alarms in the care of patients in the Critical Care Unit (CCU), Kenyatta National Hospital (KNH).\nMethods: A descriptive cross sectional study was carried out in the month of June 2014 where 87 nurses were recruited\nas study respondents. KNH/ University of Nairobi (UoN) Ethics and Research committee approved the research. A structured\nself administered questionnaire was used to collect data. The questionnaire contained some questions in a Likert\nscale in relation to the actions the nurses would take in the management of clinical alarms and some on whether\npolicies on alarm management existed in the hospital, if they filled alarm checklists and how often and the types\nof alarms they would respond to first.\nResults: The respondents� responses were scored and from the results it was clear that there were some gaps in\nthe management of clinical alarms. Majority of the nurses reported that they respond to alarms of all durations\nand do not fill alarm checklists as neither alarm checklists nor protocols are provided. From the findings there\nwas a statistically significant association (p = 0.06) between age and whether the respondents assessed the cause\nof the alarm beep.\nDiscussion: Respondents in this study respond to alarms of all durations in contrast to other studies where the\nfindings indicate that nurses respond to alarms for different reasons, not just that the alarm sounds. Majority of\nthe respondents scored averagely on the questions on whether they carry out most of the interventions or\nactions. This is inline with previous studies which have shown that healthcare personnel respond to alarms\ndepending on the patient�s physiological status.\nConclusions: Nurses in the unit carry out the standard nursing interventions on clinical alarms and, respond to\nalarms of all durations and do not fill alarm checklists. Alarm protocols should therefore be developed in the\nhospital, the nurses should be trained on management of clinical alarms and more nurses employed...
Introduction: Intraoperative care includes a unique knowledge of how to\nperform a safe and effective surgery procedure. Surgery performed under regional\nor local anaesthesia allows the patient to remain conscious during the\nprocedure and is rather common in Swedish healthcare today. Aim: The aim\nwas to obtain a deeper understanding of the main concerns of operating theatre\nnurses (OTN) when caring for conscious patients during the intraoperative\nphase. Methods: Interviews were conducted with 23 OTNs from five different\nhospitals in Sweden and analysed according to grounded theory. Findings:\nThe main concern among the OTNs was to take the patient in consideration.\nThe core category ââ?¬Å?achieve and maintain ethical treatment of patientsââ?¬Â\nin the operating theatre (OT) was a strategy used throughout the intraoperative\nprocess. Ethical treatment was described as moral behaviour at\ndifferent levels and included the teamââ?¬â?¢s behaviour, respectful and individualised\npatientcare, and the working-morale of the professionals. Being vigilant\nand being flexible were the categories related to the core category. The OTNs\nconstantly assessed where to pay most attention as they balanced between the\nneeds of the patient, the team, and the surgery procedure. Conclusion: It is\nimportant that every patient is taken into consideration and that ethical principles\nare held to the highest standards in the OT. A familiar team can facilitate\nthat. The complex skills that operating theatre nurses develop can be\nadded to explain important competencies within the profession....
Background: Few studies have empirically investigated factors that define residential aged care units that are\nperceived as being highly person-centred. The purpose of this study was to explore factors characterising\nresidential aged care units perceived as being highly person-centred, with a focus on organisational and\nenvironmental variables, as well as residents� and staff� characteristics.\nMethods: A cross-sectional design was used. Residents (n = 1460) and staff (n = 1213) data from 151 residential care\nunits were collected, as well as data relating to characteristics of the organisation and environment, and data measuring\ndegree of person-centred care. Participating staff provided self-reported data and conducted proxy ratings on residents.\nDescriptive and comparative statistics, independent samples t-test, Chi2 test, Eta Squared and Phi coefficient were used to\nanalyse data.\nResults: Highly person-centred residential aged care units were characterized by having a shared philosophy of care, a\nsatisfactory leadership, interdisciplinary collaboration and social support from colleagues and leaders, a dementiafriendly\nphysical environment, staff having time to spend with residents, and a smaller unit size. Residential aged care\nunits with higher levels of person-centred care had a higher proportion of staff with continuing education in dementia\ncare, and a higher proportion of staff receiving regular supervision, compared to units with lower levels of personcentred\ncare.\nConclusions: It is important to target organisational and environmental factors, such as a shared philosophy of care,\nstaff use of time, the physical environment, interdisciplinary support, and support from leaders and colleagues, to\nimprove person-centred care in residential care units. Managers and leaders seeking to facilitate person-centred care in\ndaily practice need to consider their own role in supporting, encouraging, and supervising staff....
Background: Peripheral intravenous catheterization is a common invasive nursing procedure performed in healthcare institutions. It is a technique which involves insertion of a needle into the peripheral veins for various reasons. As one of the commonest nursing procedures being performed, it also brought significant risks to patients resulting to prolong hospital stay and delay in recovery period if not properly executed.\n\nObjectives: The study primarily aims to determine the incidence rate of peripheral intravenous cannula related local complications in the hospital.\n\nDesign: The study is a descriptive type of research since it mainly deals with identifying the incident rate of phlebitis, infiltration, extravasation and hematoma and its underlying causes.\n\nSettings: Study was conducted in one of the Ministry of Health hospitals in Jazan, Saudi Arabia.\n\nParticipants: All the patients admitted in the hospital during the data gathering period was included regardless of their demographic status. A total of 406 patients, with 458 peripheral cannula were assessed.\n\nMethods: The study is quantitative type of research since it mainly sought to find out the number of phlebitis, infiltration, extravasation and hematoma cases in the above mentioned healthcare institution.\n\nResult: The findings show that the rate of phlebitis, infiltration, extravasation and hematoma are 21, 7, 3.5, 12 percent respectively.\n\nConclusions: There were high incidence of intravenous cannula related complications in the hospital which needs to be reduced or completely eradicated in order to improve overall patient's health outcome....
This study is set in the context of the final phase of nurse specialist students�\n(NSS) postgraduate education in surgical, oncological, anaesthesia and intensive\ncare nursing at the University College in June 2015. The aim was to explore\nNSSs� experiences of clinical supervision (CS) during their postgraduate\nclinical education. 46 NSS answered open-ended questions and their responses\nwere analysed by means of a qualitative content analysis. The response rate\nwas 82%. One main theme emerged: CS as a prerequisite for professional development\nand two domains: A reflective way of growing and learning through\nCS and The meaning of being and acting in a reflective and professional\nmanner to ensure patient safety (PS). The results indicate that reflection is a\ncrucial part of the NSS� experiences of CS during their postgraduate clinical\neducation. The supervisor�s ability to confirm the students, mutual trust and\nfeeling safe in the relationship with the supervisor are of great importance.\nThe students highlighted the value of continuity in CS and being supported\nyet challenged. The supervisor has great responsibility for the NSS� development\nof professional clinical competence. The supervisor�s personal and professional\nskills, in addition to her/his ability to provide CS are important for\nPS as well as for professional and interdisciplinary teamwork. Acting in a reflective\nand professional manner is of great importance for ensuring PS. Although\nmost of the students reported being sufficiently competent to ensure\nPS and agreed that CS and reflection are of great importance for PS, they\nwanted more time to reflect on their actions together with their supervisor. In\nconclusion, CS has the potential to lead to quality improvement. However, in\norder to enhance reflective practice, which is a prerequisite for CS and PS, we\nrecommend closer cooperation between the university college and clinical supervisors,\nas well as a formal master level education for clinical supervisors....
Background: Clinical practice is a pivotal part of nursing education. It provides students with the opportunity to\nput the knowledge and skills they have acquired from lectures into practice with real patients, under the guidance\nof registered nurses. Clinical experience is also essential for shaping the nursing studentsââ?¬â?¢ identity as future\nprofessional nurses. There is a lack of knowledge and understanding of the ways in which students learn practical\nskills and apply knowledge within and across different contexts, i.e. how they apply clinical skills, learnt in the\nlaboratory in university settings, in the clinical setting. The aim of this study was therefore to explore how nursing\nstudents describe, and use, their prior experiences related to practical skills during their clinical practice.\nMethods: An ethnographic case study design was used. Fieldwork included participant observations (82 h),\ninformal conversations, and interviews (n = 7) that were conducted during nursing studentsââ?¬â?¢ (n = 17) clinical\npractice at an emergency department at a university hospital in Sweden.\nResults: The overarching theme identified was ââ?¬Å?Learning about professional identities with respect to situated\npowerââ?¬Â. This encompasses tensions in studentsââ?¬â?¢ learning when they are socialized into practical skills in the nursing\nprofession. This overarching theme consists of three sub-themes: ââ?¬Å?Embodied knowledgeââ?¬Â, ââ?¬Å?Divergent ways of\nassessing and evaluating knowledgeââ?¬Â and ââ?¬Å?Balancing approachesââ?¬Â.\nConclusions: Nursing students do not automatically possess the ability to transfer knowledge from one setting to\nanother; rather, their development is shaped by their experiences and interactions with others when they meet real\npatients. The study revealed different ways in which students navigated tensions related to power differentials.\nReflecting on actions is a prerequisite for developing and learning practical skills and professional identities. This\nhighlights the importance of both educatorsââ?¬â?¢ and the preceptorsââ?¬â?¢ roles for socializing students in this process....
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