Current Issue : October - December Volume : 2018 Issue Number : 4 Articles : 6 Articles
Chief Nursing Officers (CNOs) have a demanding, complex role that commands\naccountability in leading the nursing profession and achieving quality patient outcomes. The purpose\nof this study was to understand the CNO�s view of meeting the needs of the Registered Nurse (RN) at\npoint of care and how this could affect quality patient outcomes. In two qualitative studies twenty-five\nCNOs were individually interviewed in eight states including: Florida, Tennessee, Kentucky, Maine,\nNew Hampshire, Vermont, Massachusetts, and New Jersey. The majority of these CNOs interviewed\nbelieved they were doing the best for their nurses and their healthcare facility. After analyzing their\nresponses, it was apparent that some CNOs actually encouraged peer pressure among nurses to\nachieve compliance and felt patient acuity is being addressed adequately, since most patients were\ndischarged within three to four days and those that were more critical were admitted to the critical\ncare units. The average length of stay, which is the number of paid days a patient remained in the\nhospital, was an important metric. A large amount of nurses felt they were unable to deliver the\ncare needed for their patients due to patient load, lack of collaboration among the health care team,\nhigher patient acuity and absence of decision-making and autonomy. Many of the CNOs trusted\nthat patient care outcomes, meaning relatively short hospital stays, demonstrated that the nursing\npractice was successful; rather than first having the nurse being set up for success to provide the best\ncare possible to their patients....
Background: While mental and substance use disorders are common worldwide, the treatment gap is enormous\nin low and middle income countries. Primary health care is considered to be the most important way for people to\nget mental health care. Cambodia is a country with a long history of war and has poor mental health and limited\nresources for care. The aim of this study was to conduct a situational analysis of the mental health services in the rural\ndistrict of Lvea Em, Kandal Province, Cambodia.\nMethods: A cross-sectional situational analysis was done to understand the mental health situation in Lvea Em District\ncomparing it with the national one. The Programme for improving mental health care (PRIME) tool was used to\ncollect systematic information about mental health care from 14 key informants in Cambodia. In addition, a separate\nquestionnaire based on the PRIME tool was developed for the district health care centres (12 respondents). Ethical\napproval was obtained from the National Ethics Committee for Health Research in Cambodia.\nResults: Mental health care is limited both in Lvea Em District and the country. Though national documents containing\nguidelines for mental health care exist, the resources available and health care infrastructure are below what\nis recommended. There is no budget allocated for mental health in the district; there are no mental health specialists\nand the mental health training of health care workers is insufficient. Based on the limited knowledge from the\nrespondents in the district, mental health disorders do exist but no documentation of these patients is available.\nRespondents discussed how community aspects such as culture, history and religion were related to mental health.\nThough there have been improvements in understanding mental health, discrimination and abuse against people\nwith mental health disorders seems still to be present.\nConclusions: There are very limited mental health care services with hardly any budget allocated to them in Lvea Em\nDistrict and Cambodia overall. There is dire need for scaling up and integrating mental health into primary health care\nto improve the population�s access to and quality service of Cambodian mental care....
A Fracture Liaison Service (FLS) has been calculated to be a cost-effective model of care\nfor patients with fragility fracture (FF). Cost-effectiveness can be achieved when adherence to bone\nhealth recommendations from FLS staff is high. This prospective study combined participants�\ntelephone longitudinal survey data (intervention group, n = 354) and interviews with 16 individuals\nfrom FLS in three health regions of the province of Quebec (Canada). Participants were recruited\nbetween January 2013 and April 2015. Regression models were fit to examine the relationship\nbetween participant-related factors and adherence at 12 months to osteoporosis medication, vitamin\nD supplementation, and participation in physical activity. Participants acknowledging FF as a\nconsequence of osteoporosis were more likely to adhere to medication (odds ratio (OR) 2.5; p = 0.001)\nand vitamin D supplementation (OR 2.3; p = 0.01). Paradoxically, the same participants were less\nprone to engage in physical activity (OR 0.5, p = 0.01). Qualitative interviews suggested that feedback\nfrom FLS coordinators helped participants understand the underlying cause of their FF. This study\nhighlighted the key roles of FLS staff in helping patients to recognize FF as a sign of underlying bone\ndisease and encouraging adherence to care recommendations....
The purpose of this study was to clarify and consider the instruction that is\nneeded in relation to nursing students� handling of patient information, as\nfelt by the people in charge of student clinical practicums in hospitals.\nSemi-structured interviews were conducted with 7 people in charge of organizing\npracticums at hospitals where they are carried out. These subjects were\nasked about problems they had experienced in relation to nursing students�\nhandling of patient information and the instruction that is needed so that\nproblems related to nursing students� handling of information do not occur.\nVarious problems were shown to occur in relation to nursing students� handling\nof patient information, such as handling the information outside of the\npracticum setting. Many students receive no instruction with regard to the\nethics of handling patient information in their classroom work, and their\nawareness regarding information is cannot be considered high, indicating the\nneed for more consistent and reliable education in this area. The findings also\nsuggest that instruction is needed with regard to the handling of sensitive information\nin accordance with the circumstances of individual patients....
Nursing leadership based on emotional intelligence is potential to improve\nnurse�s caring behavior in Indonesia. The purpose of this research was to find\nout the effectiveness of nursing leadership based on emotional intelligence of\nthe head nurse and its effect to the caring behavior of the associate nurses. The\nstudy occupied quasi experimental design with control group time series in\ntwo of General Hospital with equal management system in Pekalongan Regency,\nCentral Java, Indonesia. The nurses of hospital A declared that they\nwere ready to have training while hospital B nurses were not thus they were\ntreated as the control group. Proportional random sampling technique was\nused for the in-patients department nurses of both hospitals with 44 participants\nfrom each. The statistical analysis used general linear model of repeated\nANOVA to find out the difference of caring behavior on the intervention\ngroup and the control group and to gain the difference caring behavior on\neach measurement as well as to know the effect of their age and length of\nworking on associate nurse�s caring behavior. The result of this study showed\nthe score of the associate nurse�s caring behavior on intervention group was\nhigher than the control group with the P value = 0.020. The increase of the\nscore of associate nurse�s caring behavior on intervention group was significant\nwith the mean before and after the intervention were 135.5 and 142.1 respectively,\nwith the P value = 0.003. There was significant effects of the nursing\nleadership based on the emotional intelligent with the associate nurse�s\ncaring behavior. The nursing leadership based on emotional intelligent was\neffective to improve associate nurse�s caring behavior hence it is recommended\nto give the training for the implementation....
The efficacy of diabetes treatment should not be evaluated solely by HbA1c levels as\nthey should also focus on patient-reported outcomes (PROs), such as patient satisfaction, wellbeing\nand quality of life. The Diabetes Treatment Satisfaction Questionnaire (DTSQ) has been developed\nto assess patient satisfaction with diabetes treatment. DTSQ has been translated into more than\n100 languages and is widely used in many countries, since it is relatively easy to answer and is\nused for both patients with and without medical therapy. Novel therapeutic options, such as insulin\nanalogs, incretin-based therapy and sodium-glucose cotransporter 2 (SGLT2) inhibitors, have been\nshown to improve patient satisfaction using DTSQ for assessments. DTSQ is not only used for\ncomparisons between different medications or treatment strategies, but also can be used to assess\nthe quality of diabetes care in clinical settings. This is important as an improvement in treatment\nsatisfaction may enhance patients� self-efficacy and adherence to therapy, leading to the achievement\nof long-term stable glycemic control and reduced risk of diabetic complications. In this review,\nwe summarize the current topics in DTSQ, introducing our own experience, and discuss the role of\nPROs in diabetes treatment....
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