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Stone EL. Best Practices in Nursing: Advocacy and Empowerment. Nurs Clin North Am 2021; 56:ix-x. [PMID: 34366164 DOI: 10.1016/j.cnur.2021.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Erica L Stone
- Vanderbilt University School of Nursing, 461 21st Avenue South, Office #436, Nashville, TN 37240, USA.
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Moorer A, Klatt E, Thornton O, Groves TN, Eisenach B, Soholt K, Haylett WJ, Hessler KL, Zwink J. SOS in a pandemic: Staffing strategies for COVID-19. Nurs Manag (Harrow) 2021; 52:22-30. [PMID: 33789329 DOI: 10.1097/01.numa.0000733628.46685.bc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Amanda Moorer
- In Colo., Amanda Moorer is a nurse residency program manager at UCHealth in Aurora, Elizabeth Klatt is an oncology/gynecologic-oncology/medicine unit nurse manager at the University of Colorado Hospital in Aurora, Olivia Thornton is a medical ICU and wound care associate nurse manager at the University of Colorado Hospital in Aurora, Thu-Nhi Groves is a resource office nurse manager at the University of Colorado Hospital in Aurora, Bree Eisenach is a resource management center nurse manager at the Medical Center of the Rockies in Loveland, Kate Soholt is a float pool/PRN pool/women and family support team nurse manager at Poudre Valley Hospital in Fort Collins, Wendy J. Haylett is a research nurse scientist at UCHealth in Aurora, Karen L. Hessler is a research nurse scientist at UCHealth in Windsor, and Jennifer Zwink is the vice president of nursing and ACNO at the University of Colorado Hospital in Aurora
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Liu TY, Sun JJ, Hsiao CT. [Novel Coronavirus: Applying Transformational Leadership to the Combat of COVID-19 in Nursing Practice]. Hu Li Za Zhi 2021; 68:92-98. [PMID: 33792023 DOI: 10.6224/jn.202104_68(2).12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Cases in the current novel coronavirus (COVID-19) pandemic continue to increase, bringing tremendous psychological pressures to frontline caregivers and threating the ability of existing medical care systems in many countries to cope with related demands. In this situation, nursing leaders have a heightened responsibility to assist nursing staff to remain at their jobs and feel secure, to strengthen safety systems, to provide adequate equipment and personnel training, and to proactively lead nursing staff. In this article, leadership strategies implemented under the COVID-19 pandemic are presented from the perspective of transformational leadership in nursing practice. This article is divided into the following five themes: 1. Leadership makes the vision more vivid; 2. Demonstrating charismatic leadership; 3. Leaders who stimulate intellectual potential; 4. Paying attention to spiritual inspiration; 5. Providing individualized sincere care. Leaders should promote the professional role of nursing staff and provide a safe and secure practice environment.
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Affiliation(s)
- Tsui-Yao Liu
- MSN, RN, Director, Department of Nursing, Taipei City Hospital, Heping Fuyou Branch, Taiwan, ROC
| | - Jia-Jing Sun
- MSN, RN, Department of Community Nursing, Taipei City Hospital, Heping Fuyou Branch, Taiwan, ROC.
| | - Chun-Ting Hsiao
- MSN, RN, Department of Community Nursing, Taipei City Hospital, Heping Fuyou Branch, Taiwan, ROC
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Bourzeau M. [Experimentation of a night shift nursing position in EHPAD]. Rev Infirm 2021; 70:33-36. [PMID: 33742591 DOI: 10.1016/j.revinf.2021.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The Nouvelle-Aquitaine Regional Health Agency is experimenting with a night nurse position shared between several accommodation facilities for dependent elderly.
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Affiliation(s)
- Madeleine Bourzeau
- Ehpad Le Chant des rivières, rue Germeau-Baraillon, 23170 Chambon-sur-Voueize, France; Ehpad Le Bois joli, 8, rue du Docteur-Mazeron, 23700 Auzances, France; Ehpad Gaston-Rimareix, 1, rue des Aînés, 23700 Mainsat, France; Centre hospitalier Les Genêts d'or, Ouches-de-Budelle, 23110 Évaux-les-Bains, France.
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Alhassan RK, Karley QOB, Ackah EF, Adodoaji I. Implementation of the policy protocol for management of surgical and non-surgical wounds in selected public health facilities in Ghana: An analytic case study. PLoS One 2020; 15:e0234874. [PMID: 32574200 PMCID: PMC7310699 DOI: 10.1371/journal.pone.0234874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 06/03/2020] [Indexed: 11/20/2022] Open
Abstract
Background It is estimated that millions of patients are affected by healthcare associated infections (HAIs) each year. In Ghana, high prevalence of HAIs in relation to non-surgical (also called contaminated wounds) and surgical wounds (also called sterile wounds) is largely attributed to poor adherence to policy protocols for wound management by frontline clinical staff especially nurses. Objective Investigate the extent to which nursing staff adhere to the policy protocol for management of non-surgical and surgical wounds in selected public health facilities in Ghana. Methodology This is an analytic case study among nursing staff (n = 140) in three government facilities in the Volta region of Ghana. Subjective and objective performance scores of staff on adherence proxies were compared using the Wilcoxon Signed-rank test, and univariate ordered logistic regression analysis used to predict staff likelihood of adherence to policy protocols on non-surgical and surgical wound management. Findings Overall, staff self-rated themselves higher on subjective performance proxies relative to their objective scores (p<0.05). Staff with more years of work experience did not translate into a higher likelihood of adhering to standard protocol on wound management (Coef. = -0.49, CI = -0.93–0.05, p = 0.036). Being a senior nursing officer relative to lower nursing ranks increased staff likelihood of complying particularly with standard policy protocol for management of non-surgical wounds (Coef. 5.27, CI = 0.59 9.95, p = 0.027). Conclusion There is the need for accelerated in-service training for staff on standard protocols for wound management coupled with supportive supervisions. Staff adherence to standard quality care protocols should be a pre-requisite for licensing of health facilities by regulatory bodies like Health Facilities Regulatory Agency and National Health Insurance Authority.
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Affiliation(s)
- Robert Kaba Alhassan
- Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
- * E-mail: ,
| | | | - Ennin Francis Ackah
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Irene Adodoaji
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
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Abstract
Most research on resilience in healthcare systems such as the NHS is based on organisational crises, such as nurse shortages, an ageing workforce and financial restrictions. However, nursing can learn lessons from the past to consider how to become more resilient, particularly considering the 2020 COVID-19 pandemic. This article briefly looks at previous pandemics and disasters that have affected healthcare systems, as well as the 2020 COVID-19 pandemic, and considers how nurse leaders can support staff and show organisational resilience during such emergencies. The article also discusses how nurse leaders can develop their own resilience.
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Affiliation(s)
- Deborah Louise Duncan
- Education (nursing), Medical Biology Centre, Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland
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Mongardi M, Fortuna D, Sciolino L. [Nursing sensitive outcomes: the results of a multicentre study]. Assist Inferm Ric 2019; 38:117-137. [PMID: 31593149 DOI: 10.1702/3227.32045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
. Nursing sensitive outcomes: the results of a multicentre study. INTRODUCTION The relationship between staffing characteristics and nursing sensitive outcomes has been explored in several studies. AIMS To assess the effect of staffing characteristics, nurses' wellbeing at work and hours of care on pressure sores, falls and physical restrains occurrence. METHODS Longitudinal study including from February 2014 to June 2015 a total of 24110 consecutive patients and 2606 nurses of 134 units (geriatrics and medicine (GM), orthopedic-traumatology (OT) and rehabilitation and long-term care (LR) of 12 Italian regions. Data was collected up to 15 days for each included patient, and regarding the staff of each shift by ad hoc trained personnel. RESULTS There is a large variability in both patients and nurses' characteristics across wards, as well as of outcomes, even in the same area (e.g., GM). Patients in GM received a mean of 144±35 minutes of care/day; 186±146 in OT and 140±40 in LR. The incidence of pressure sores was 5.3%±4.8% in GM; 5.1%±5.6% in OT and 8.6%±10.1% in LR. The incidence of falls was 1.9%±2.1% in GM, 0.8%±1% in OT and 2.9%±3.8% in LR. Restraints were used in 41.4%±30.3% of patients in GM, among 24.8%±23.4% in OT and 54.7%±29.7% in LR. The multilevel analyses confirmed the importance of clinical factors but also the positive effects of staff characteristics such as the number of expert nurses and the negative effects of a negative work environment, although with wide variations across settings have emerged. CONCLUSIONS Staff characteristics related to work environment affect patient outcomes but the large variability across wards would require further stratification of the data to better understand and interpret the findings.
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Di Giulio P, Clari M, Conti A, Campagna S. [The problems in the interpretation of the studies on the relationship between staffing and patients' outcomes: the case of the RN4CAST studies]. Assist Inferm Ric 2019; 38:138-145. [PMID: 31593150 DOI: 10.1702/3227.32046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Affiliation(s)
- Maureen Kroning
- Maureen Kroning is the chair of nursing at Rockland Community College and a per-diem nursing supervisor at Good Samaritan Hospital in Suffern, N.Y
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Dragoon N, Nadeau M, Toolin S, Gagne M, FitzPatrick K. Nursing professional governance: Patient- and family-centered design. Nurs Manag (Harrow) 2019; 50:15-19. [PMID: 31567821 DOI: 10.1097/01.numa.0000579032.78599.b2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Nicole Dragoon
- At the University of Vermont Medical Center in Burlington, Vt., Nicole Dragoon is a hematology and oncology clinical nurse; Michelle Nadeau is a medical ICU clinical nurse and chair of nursing professional governance; Susan Toolin is a medical ICU nurse educator; Margaret Gagne is nursing director of medicine, oncology, and mental health; and Kate FitzPatrick is the CNO
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Affiliation(s)
- Kirsten Drake
- Director, Med/Surg, Renal/Oncology Services, Texas Health Harris Methodist Hospital Fort Worth
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Medina-Garzón M. Effectiveness of a Nursing Intervention to Diminish Preoperative Anxiety in Patients Programmed for Knee Replacement Surgery: Preventive Controlled and Randomized Clinical Trial. Invest Educ Enferm 2019; 37:e07. [PMID: 31487444 PMCID: PMC7871492 DOI: 10.17533/udea.iee.v37n2e07] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 06/04/2019] [Indexed: 05/02/2023]
Abstract
OBJECTIVES This work was conducted to determine the effectiveness of a nursing intervention, based on the motivational interview, to diminish preoperative anxiety in patients programmed for knee replacement surgery. METHODS Preventive type controlled and randomized clinical trial, on a sample of 56 patients programmed for knee replacement surgery in a clinic in Girardot (Colombia). Random assignment was made: an intervention group (n=28) and a control group (n=28). The six-question Amsterdam Preoperative Anxiety and Information Scale was applied before and after the intervention. The scale has a total score ranging from 5 to 30; the higher the score, the greater the preoperative anxiety. The nursing intervention was conducted in three sessions of motivational interview each lasting 40 min, during the six weeks prior to the surgical procedure; the control group received conventional management of education in the health institution. RESULTS The mean score of preoperative anxiety was equal in the pre-intervention evaluation in both groups (19.76 in the experimental versus 22.02 in the control =22.02; p<0.226), while during the post-intervention, the anxiety score was lower in the intervention group compared with the control group (15.56 and 20.30, respectively; p <0.013). CONCLUSIONS Nursing intervention based on the motivational interview was effective in diminishing preoperative anxiety in patients programmed for knee replacement surgery.
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Boosting the nursing workforce. Br J Nurs 2019; 28:487. [PMID: 31002550 DOI: 10.12968/bjon.2019.28.8.487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Daly BM, Arroll B, Honey M, Scragg RKR. Trends in the primary health care nursing workforce providing diabetes care in Auckland, New Zealand: A cross-sectional survey. Prim Care Diabetes 2018; 12:491-500. [PMID: 30145189 DOI: 10.1016/j.pcd.2018.07.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 07/25/2018] [Accepted: 07/26/2018] [Indexed: 10/28/2022]
Abstract
AIMS To describe trends from 2006-8 to 2016 in demographic, education and work settings of the primary health care nursing workforce who provide diabetes care in the Auckland region. METHODS A total of 1416 practice, Accident and Medical, district and diabetes specialist nurses were identified who provide community-based care. Of those, 459 were randomly selected and 336 were interviewed in 2016, and were compared with 287 nurses interviewed in 2006-8. RESULTS A 73% response rate was attained in 2016. Compared with nurses in 2006-8, primary health care nurses in 2016 were younger, less experienced, more likely to be Asian, undertook more post-graduate education, worked more in Accident and Medical Clinics and worked in larger practices with ≥4 doctors. However, less worked with a dietitian or received visits from specialist nurses compared with nurses in 2006-8. Significantly more nurses in 2016 had their own room for administrative work and the ability to email patients suggesting greater autonomy. CONCLUSIONS Major demographic, educational and workplace changes have occurred in the Auckland primary health care nursing workforce from 2006-8 to 2016. A significant increase in practice nurses and a large decrease in the number of diabetes specialist nurses were evident, in the Auckland region.
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Affiliation(s)
- Barbara M Daly
- School of Nursing, Faculty of Medical and Health Sciences, University of Auckland, New Zealand.
| | - Bruce Arroll
- School of Population Health, University of Auckland , New Zealand
| | - Michelle Honey
- School of Nursing, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
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Farley JE, Treston C. Nurses' Call to Action: Supporting a Strong Global HIV Nursing Workforce. J Assoc Nurses AIDS Care 2018; 27:741-744. [PMID: 27720061 DOI: 10.1016/j.jana.2016.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 08/16/2016] [Indexed: 11/30/2022]
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Abstract
BACKGROUND Current and expected problems such as ageing, increased prevalence of chronic conditions and multi-morbidity, increased emphasis on healthy lifestyle and prevention, and substitution for care from hospitals by care provided in the community encourage countries worldwide to develop new models of primary care delivery. Owing to the fact that many tasks do not necessarily require the knowledge and skills of a doctor, interest in using nurses to expand the capacity of the primary care workforce is increasing. Substitution of nurses for doctors is one strategy used to improve access, efficiency, and quality of care. This is the first update of the Cochrane review published in 2005. OBJECTIVES Our aim was to investigate the impact of nurses working as substitutes for primary care doctors on:• patient outcomes;• processes of care; and• utilisation, including volume and cost. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL), part of the Cochrane Library (www.cochranelibrary.com), as well as MEDLINE, Ovid, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and EbscoHost (searched 20.01.2015). We searched for grey literature in the Grey Literature Report and OpenGrey (21.02.2017), and we searched the International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov trial registries (21.02.2017). We did a cited reference search for relevant studies (searched 27.01 2015) and checked reference lists of all included studies. We reran slightly revised strategies, limited to publication years between 2015 and 2017, for CENTRAL, MEDLINE, and CINAHL, in March 2017, and we have added one trial to 'Studies awaiting classification'. SELECTION CRITERIA Randomised trials evaluating the outcomes of nurses working as substitutes for doctors. The review is limited to primary healthcare services that provide first contact and ongoing care for patients with all types of health problems, excluding mental health problems. Studies which evaluated nurses supplementing the work of primary care doctors were excluded. DATA COLLECTION AND ANALYSIS Two review authors independently carried out data extraction and assessment of risk of bias of included studies. When feasible, we combined study results and determined an overall estimate of the effect. We evaluated other outcomes by completing a structured synthesis. MAIN RESULTS For this review, we identified 18 randomised trials evaluating the impact of nurses working as substitutes for doctors. One study was conducted in a middle-income country, and all other studies in high-income countries. The nursing level was often unclear or varied between and even within studies. The studies looked at nurses involved in first contact care (including urgent care), ongoing care for physical complaints, and follow-up of patients with a particular chronic conditions such as diabetes. In many of the studies, nurses could get additional support or advice from a doctor. Nurse-doctor substitution for preventive services and health education in primary care has been less well studied.Study findings suggest that care delivered by nurses, compared to care delivered by doctors, probably generates similar or better health outcomes for a broad range of patient conditions (low- or moderate-certainty evidence):• Nurse-led primary care may lead to slightly fewer deaths among certain groups of patients, compared to doctor-led care. However, the results vary and it is possible that nurse-led primary care makes little or no difference to the number of deaths (low-certainty evidence).• Blood pressure outcomes are probably slightly improved in nurse-led primary care. Other clinical or health status outcomes are probably similar (moderate-certainty evidence).• Patient satisfaction is probably slightly higher in nurse-led primary care (moderate-certainty evidence). Quality of life may be slightly higher (low-certainty evidence).We are uncertain of the effects of nurse-led care on process of care because the certainty of this evidence was assessed as very low.The effect of nurse-led care on utilisation of care is mixed and depends on the type of outcome. Consultations are probably longer in nurse-led primary care (moderate-certainty evidence), and numbers of attended return visits are slightly higher for nurses than for doctors (high-certainty evidence). We found little or no difference between nurses and doctors in the number of prescriptions and attendance at accident and emergency units (high-certainty evidence). There may be little or no difference in the number of tests and investigations, hospital referrals and hospital admissions between nurses and doctors (low-certainty evidence).We are uncertain of the effects of nurse-led care on the costs of care because the certainty of this evidence was assessed as very low. AUTHORS' CONCLUSIONS This review shows that for some ongoing and urgent physical complaints and for chronic conditions, trained nurses, such as nurse practitioners, practice nurses, and registered nurses, probably provide equal or possibly even better quality of care compared to primary care doctors, and probably achieve equal or better health outcomes for patients. Nurses probably achieve higher levels of patient satisfaction, compared to primary care doctors. Furthermore, consultation length is probably longer when nurses deliver care and the frequency of attended return visits is probably slightly higher for nurses, compared to doctors. Other utilisation outcomes are probably the same. The effects of nurse-led care on process of care and the costs of care are uncertain, and we also cannot ascertain what level of nursing education leads to the best outcomes when nurses are substituted for doctors.
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Affiliation(s)
- Miranda Laurant
- Radboud Institute for Health Sciences, IQ healthcareRadboud University Medical CenterPO Box 9101NijmegenNetherlands6500 HB
- HAN University of Applied SciencesFaculty of Health and Social StudiesNijmegenNetherlands
| | - Mieke van der Biezen
- Radboud Institute for Health Sciences, IQ healthcareRadboud University Medical CenterPO Box 9101NijmegenNetherlands6500 HB
| | | | - Kanokwaroon Watananirun
- Faculty of Medicine, Siriraj Hospital, Mahidol UniversityDepartment of Obstetrics and GynaecologyMahidolThailand
| | - Evangelos Kontopantelis
- The University of ManchesterCentre for Health Informatics, Institute of Population HealthWilliamson Building, 5th FloorOxford RoadManchesterGreater ManchesterUKM13 9PL
| | - Anneke JAH van Vught
- HAN University of Applied SciencesFaculty of Health and Social StudiesNijmegenNetherlands
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Nicolas F, Delahaye A. [Prevention of psychological disorders after a road accident]. Rev Infirm 2018; 67:35-37. [PMID: 29426558 DOI: 10.1016/j.revinf.2017.11.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
A psychological intervention programme, set up within a trauma centre, revealed common factors contributing to the emotional upheaval felt by road accident victims. These factors are linked to the event itself, its medical management, the quality of family support and the patient's history. Early psychotherapy, the awareness of the nursing teams and the involvement of the families are the key elements ensuring coherent and effective prevention.
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Affiliation(s)
- Florian Nicolas
- Hôpital d'Instruction des Armées Sainte-Anne, Service de psychiatrie, BP 600, 83 800 Toulon Cedex 9, France.
| | - Aline Delahaye
- Hôpital d'Instruction des Armées Sainte-Anne, Service de psychiatrie, BP 600, 83 800 Toulon Cedex 9, France
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Bolívar Murcia MP, Cruz González JP, Rodríguez Bello LA. Simulation of changes on the psychosocial risk in the nursing personnel after implementing the policy of good practices on the risk treatment. Invest Educ Enferm 2018; 36:e06. [PMID: 29898345 DOI: 10.17533/udea.iee.v36n1e06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 02/09/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES Evaluate the change over time of psychosocial risk management for the nursing personnel of an intermediate complexity clinic of Bogota (Colombia). METHODS Descriptive and correlational research performed under the approach of risk management (identification, analysis, assessment and treatment). The psychosocial risk of the nursing personnel was studied through 10-year system dynamics models (with and without the implementation of the policy of good practices on the risk treatment) in two scenarios: when the nursing personnel works shifts of 6 hours (morning or afternoon) and when they work over 12 hours (double shift or night shift). RESULTS When implementing a policy of good practices on the risk treatment, the double shift scenario shows an improvement among 25% to 88% in the variables of: health, labor motivation, burnout, service level and productivity; as well as in the variables of the organization associated to number of patients, nursing personnel and profit. Likewise, the single shift scenario with good practices improves in all the above-mentioned variables and generates stability on the variables of absenteeism and resignations. CONCLUSIONS The best scenario is the single shift scenario with the application of good practices of risk treatment in comparison with the double shift scenario with good practices, which allows concluding that the good practices have a positive effect on the variables of nursing personnel and on those associated to the organization.
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Højberg H, Rasmussen CDN, Osborne RH, Jørgensen MB. Identifying a practice-based implementation framework for sustainable interventions for improving the evolving working environment: Hitting the Moving Target Framework. Appl Ergon 2018; 67:170-177. [PMID: 29122188 DOI: 10.1016/j.apergo.2017.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 09/26/2017] [Accepted: 10/01/2017] [Indexed: 06/07/2023]
Abstract
Our aim was to identify implementation components for sustainable working environment interventions in the nursing assistant sector to generate a framework to optimize the implementation of workplace improvement initiatives. The implementation framework was informed by: 1) an industry advisory group, 2) interviews with key stakeholder, 3) concept mapping workshops, and 4) an e-mail survey. Thirty five stakeholders were interviewed and contributed in the concept mapping workshops. Eleven implementation components were derived across four domains: 1) A supportive organizational platform, 2) An engaged workplace with mutual goals, 3) The intervention is sustainably fitted to the workplace, and 4) the intervention is an attractive choice. The highest rated component was "Engaged and Active Management" (mean 4.1) and the lowest rated was "Delivered in an Attractive Form" (mean 2.8). The framework provides new insights into implementation in an evolving working environment and is aiming to assist with addressing gaps in effectiveness of workplace interventions and implementation success.
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Affiliation(s)
- Helene Højberg
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen Ø, Denmark.
| | | | - Richard H Osborne
- Health Systems Improvement Unit, Centre for Population Health Research, School of Health & Social Development, Deakin University, Geelong, Victoria 3220, Australia; Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Marie Birk Jørgensen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen Ø, Denmark.
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Affiliation(s)
- Sabrina Ehmke
- Sabrina Ehmke is a nursing professional development specialist and academic coordinator at the Mayo Clinic Health System Minnesota Southwest Region in Mankato, Minn
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Affiliation(s)
- Leslee H Shepard Battle
- Leslee H. Shepard Battle is the assistant dean for curriculum and instruction and an associate professor of nursing at Winston-Salem State University in Winston-Salem, N.C
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Affiliation(s)
- Katie Koerner
- Katie Koerner is the manager of nursing professional practice at Rush Copley Medical Center in Aurora, Ill
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Affiliation(s)
- Karen Robeano
- Karen Robeano is the CNO of FirstHealth Moore Regional Hospital in Pinehurst, N.C
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Jones-Schenk J. Fostering Personal Power During Change. J Contin Educ Nurs 2017; 48:343-344. [PMID: 28759689 DOI: 10.3928/00220124-20170712-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Managing change is a regular part of the role of professional development leaders. This overview of a model for change management includes the review of a tool leaders can use with their teams for understanding, discussing, and reflecting on change. Kotter's change model emphasizes the importance of personal empowerment within the process. Effective change agents recognize the value of diverse teams, different ways of thinking, and the transformative nature of change. J Contin Educ Nurs. 2017;48(8):343-344.
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Naburi H, Ekström AM, Mujinja P, Kilewo C, Manji K, Biberfeld G, Sando D, Chalamila G, Bärnighausen T. The potential of task-shifting in scaling up services for prevention of mother-to-child transmission of HIV: a time and motion study in Dar es Salaam, Tanzania. Hum Resour Health 2017; 15:35. [PMID: 28549434 PMCID: PMC5446714 DOI: 10.1186/s12960-017-0207-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Accepted: 05/03/2017] [Indexed: 05/13/2023]
Abstract
BACKGROUND In many African countries, prevention of mother-to-child transmission of HIV (PMTCT) services are predominantly delivered by nurses. Although task-shifting is not yet well established, community health workers (CHWs) are often informally used as part of PMTCT delivery. According to the 2008 World Health Organization (WHO) Task-shifting Guidelines, many PMTCT tasks can be shifted from nurses to CHWs. METHODS The aim of this time and motion study in Dar es Salaam, Tanzania, was to estimate the potential of task-shifting in PMTCT service delivery to reduce nurses' workload and health system costs. The time used by nurses to accomplish PMTCT activities during antenatal care (ANC) and postnatal care (PNC) visits was measured. These data were then used to estimate the costs that could be saved by shifting tasks from nurses to CHWs in the Tanzanian public-sector health system. RESULTS A total of 1121 PMTCT-related tasks carried out by nurses involving 179 patients at ANC and PNC visits were observed at 26 health facilities. The average time of the first ANC visit was the longest, 54 (95% confidence interval (CI) 42-65) min, followed by the first PNC visit which took 29 (95% CI 26-32) minutes on average. ANC and PNC follow-up visits were substantially shorter, 15 (95% CI 14-17) and 13 (95% CI 11-16) minutes, respectively. During both the first and the follow-up ANC visits, 94% of nurses' time could be shifted to CHWs, while 84% spent on the first PNC visit and 100% of the time spent on the follow-up PNC visit could be task-shifted. Depending on CHW salary estimates, the cost savings due to task-shifting in PMTCT ranged from US$ 1.3 to 2.0 (first ANC visit), US$ 0.4 to 0.6 (ANC follow-up visit), US$ 0.7 to 1.0 (first PNC visit), and US$ 0.4 to 0.5 (PNC follow-up visit). CONCLUSIONS Nurses working in PMTCT spend large proportions of their time on tasks that could be shifted to CHWs. Such task-shifting could allow nurses to spend more time on specialized PMTCT tasks and can substantially reduce the average cost per PMTCT patient.
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Affiliation(s)
- Helga Naburi
- Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
- Department of Public Health Sciences, Global Health (IHCAR), Karolinska Institutet, Stockholm, Sweden
| | - Anna Mia Ekström
- Department of Public Health Sciences, Global Health (IHCAR), Karolinska Institutet, Stockholm, Sweden
- Department of Infectious Diseases, Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - Phares Mujinja
- School of Public Health, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
| | - Charles Kilewo
- Department of Obstetrics and Gynaecology, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
| | - Karim Manji
- Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
| | - Gunnel Biberfeld
- Department of Public Health Sciences, Global Health (IHCAR), Karolinska Institutet, Stockholm, Sweden
| | - David Sando
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA United States of America
- Management and Development for Health (MDH), Dar es Salaam, Tanzania
| | - Guerino Chalamila
- Management and Development for Health (MDH), Dar es Salaam, Tanzania
| | - Till Bärnighausen
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA United States of America
- Africa Health Research Institute (AHRI), Somkhele, South Africa
- Institute for Public Health, University of Heidelberg, Heidelberg, Germany
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Affiliation(s)
- Angela S Prestia
- Angela S. Prestia is a corporate chief nurse at the GEO Group in Boca Raton, Fla
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Affiliation(s)
- Sharon Cox
- Founder and Principal Consultant, Cox & Associates, Brentwood, Tenn
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Widman K, Ritchey C. Meaningful interviewing for retention. Nurs Manag (Harrow) 2017; 48:7-8. [PMID: 28234758 DOI: 10.1097/01.numa.0000512509.24454.9a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Kalin Widman
- At Texas Health Resources in Arlington, Tex., Kalin Widman is an entity human resources officer and Clinton Ritchey is a workforce planning and employment compliance analyst
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Zúñiga F, Basinska K, Simon M. [in process]. Krankenpfl Soins Infirm 2017; 110:19. [PMID: 30299606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Fowler J. From staff nurse to nurse consultant. Br J Nurs 2016; 25:1272. [PMID: 27935340 DOI: 10.12968/bjon.2016.25.22.1272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
John Fowler, Independent education consultant, continues to explore the importance of leadership for clinically based nurses.
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Richards D. TESTED TO THE LIMITS. Aust Nurs Midwifery J 2016; 24:17. [PMID: 29251848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
For nurses and midwives, every new round of collective bargaining for the next enterprise agreement involves another series of tough negotiations and, more often than not, members take some form of industrial action in support of their claims to achieve a fair and reasonable outcome.
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Abstract
Patient education is an important component in the management of patients with heart failure and nurses are increasingly involved in this area. This paper reviews the literature on education to patients with heart failure and the education and training for heart failure nurses. Patients with heart failure need education in order to adapt to their chronic syndrome and perform self-care. The education process often starts during the hospital admission, but must continue in the outpatient setting. Nurses need to be skilled in assessing the requirements and level of the education given to the individual. Computer-based education has been found to be a preferred and effective compliment to the education provided by health care professionals. The effect of new materials and methods needs to be evaluated in order to improve the overall effectiveness of the education provided. The patient with heart failure should have an active role in this development and evaluation. The heart failure nurse needs to be experienced in cardiac care, have an ability to work independently in order to be delegated responsibilities such as drug titration and patient assessment. This requires optimal experience, training and education for advanced practice. In order to develop and evaluate the education of patients with heart failure and the overall effectiveness of heart failure nurses in this regard, national and international collaborations are needed.
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Affiliation(s)
- Anna Strömberg
- Department of Cardiology, Linköping University Hospital, S-581 85, Linköping, Sweden.
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Abstract
The purpose of this exploratory research study was to survey Kansas school nurses to determine the impact of budget, delegation, and other variables on the future of school nursing. Issues of education and certification status, educational budget, delegation, school nurse-to-student ratio, number of school buildings assigned, Metropolitan Statistical Area, and years of school nursing experience were also investigated. The Budget Impact School Nurse Questionnaire online survey was used to gather data. Findings revealed that school nurses were well prepared academically, but that many school nurses lacked certification. The use of UAPs and the future of school nursing were significantly affected by budget constraints, delegation, number of buildings assigned, legislative contact, and Metropolitan Statistical Area (urban location). Education in delegation and years of experience as a school nurse significantly affected opportunities for health education. The findings depicted budget, school nurse staffing, delegation, and geographic areas as the main variables that have an impact on school nursing.
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Abstract
Children may have difficulty with schoolwork because of grief over the death of an important person in their lives. School nurses provide support to these children. This pilot study consisted of a Web-based survey completed by 6 school nurses in a 3-county area in Washington state. The purpose of this pilot study was to assess the need for additional support for bereaved children and the extent to which school nurses meet the needs of these students. Results indicated that many school nurses have large caseloads that preclude spending as much time with bereaved students as the nurses feel is necessary. Bereaved students exhibit a wide variety of grief symptoms that may interfere with learning. In addition, rural areas do not have adequate community bereavement resources that nurses can use to refer students who need help beyond that offered at school. Nurses must be more active in supporting students within the school setting despite limited resources.
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Affiliation(s)
- Janet A Lohan
- Washington State University Intercollegiate College of Nursing, Spokane, WA, USA
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Abstract
Most nurses are contracted to work 37.5 hours over five days, followed by two days off. But many areas of the health service are so short staffed that split days off, where nurses do not get two consecutive days off, are becoming more common as managers struggle to provide cover for shifts.
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Quaile A. Ensuring the district nursing role does not die out. Br J Community Nurs 2016; 21:430-432. [PMID: 27594056 DOI: 10.12968/bjcn.2016.21.9.430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Alistair Quaile
- Freelance Journalist; Former Editor, Journal of Paramedic Practice
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Abstract
Patients in nursing homes sometimes give accounts of episodes in which they feel their autonomy and/or self-respect are violated as a result of the care they receive from nursing staff. In these ethically difficult care situations nurses use strategies such as negotiation, explanation and, in some cases, restraint. This study investigates how nurses apply these strategies to resolve ethical dilemmas in such a way that patients experience respect rather than violation. Critical issues that will be discussed include the definition of ethically difficult care situations in nursing homes and the identification of strategies for resolving such situations. Examples of the use of three strategies are presented. The use of negotiation, restraint and explanation are discussed in order to ensure respect for patients’ autonomy and thus to optimize health care outcomes.
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Affiliation(s)
- Ashild Slettebø
- Oslo University College, Faculty of Nursing, Box 4, St Olavs plass, N-0130 Oslo, Norway.
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Foster S. Being positive about reshaping roles. Br J Nurs 2016; 25:777. [PMID: 27409793 DOI: 10.12968/bjon.2016.25.13.777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Sam Foster
- Chief Nurse at Heart of England NHS Foundation Trust, looks at the challenges and opportunities presented by workforce transformation, prompted by a recent Nuffield Trust report
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Jones-Berry S. Directors of nursing key to success of equality strategies. Nurs Manag (Harrow) 2016; 23:6. [PMID: 27369699 DOI: 10.7748/nm.23.4.6.s2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Senior nurses must help drive the organisational change needed to improve the experience of black and minority ethnic staff in the NHS, says a diversity expert.
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Abstract
The purpose of this study was to describe nurses’ knowledge, attitudes, and experiences regarding advance directives. A secondary purpose was to examine predictors of advance directive discussions between nurses and patients. Seven-hundred and nineteen respondents, randomly selected from a list of registered nurses in the state of Ohio, completed mailed questionnaires. Descriptive t test, chi-square, and logistic regression statistics were used in the data analyses. The respondents were knowledgeable and possessed positive attitudes about advance directives. Higher self-perceived confidence in advance directive discussion skills and the experience of caring for at least one patient with a current advance directive were found to be significant predictors of advance directive discussions. These findings suggest that experience with advance directives documents is critical for nurses’ comfort and that developing interventions to further nurses’ confidence in their discussion skills may increase advance directive discussions.
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Affiliation(s)
- Amy R Lipson
- Frances Payne Bolton School of Nursing, Case Western Reserve University, USA
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Smikle ML. The nursing associate role: have we been here before? Nurs Manag (Harrow) 2016; 23:14. [PMID: 27369716 DOI: 10.7748/nm.23.4.14.s19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
What should the nursing workforce of the future look like? It is a question all nurse leaders should ask themselves.
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Abstract
Mental health nursing in remote Australian Aboriginal communities provides opportunities and challenges unique from other experiences of nursing. The purpose of this article was to explore how mental health nurses experience working in remote communities and how they developed relevant knowledge and skills. Six remote area mental health nurses participated in audiotaped conversational style interviews. Narratives were transcribed and analyzed thematically. Themes identified were being focused on relationships, adapting to the culture, struggling with two contexts, being enraptured by place, and being transformed. The participants adapted and developed ways of working at the interface of another culture and also derived personal and professional benefit from the experience.
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Affiliation(s)
- Louise M O'Brien
- School of Nursing, University of Western Sydney, and Sydney West Area Health Service
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Abstract
Providing health care in developing nations results in cultural and ethical challenges for health care professionals. The authors’ intent is to raise readers’ awareness of how to maintain an ethical and culturally sensitive approach to practice in developing nations. Four practical approaches to ethical decision-making, developed from the literature and praxis, in conjunction with traditional moral theory and guidelines from professional and international organizations are discussed. Ethical multiculturalism, a view that combines universalism and multiculturalism undergirds culturally appropriate and ethically responsive decisions.
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Abstract
PURPOSE Heart failure (HF) care in the Netherlands is going through a lot of changes. Nurses have increasingly important roles in providing optimal care for these chronically ill patients. In this study, we describe the current number of HF management programs and the role of the nurses in these programs. METHOD Data were collected by a national survey as part of a European HF clinic survey of the UNITE study group of the Working Group on Cardiovascular Nursing between February and March 2003 to 142 hospitals in the Netherlands. RESULTS In 60% of the hospital locations, there is a HF management program. Most of the programs are organized as HF outpatient clinics. In all HF programs, cardiologists and nurses are involved. Other health care providers involved are, amongst others, general practitioners (29%), dieticians (59%), physical therapists (47%), social workers (30%) and psychologists (17%). All programs offer follow-up after discharge from the hospitals and in most of the programs patients have increased access to a health care provider. Behavioural interventions (68%), psychosocial counselling (64%), patient education (88%) and support of the informal caregivers (59%) are important components. In 90% of the programs (restricted), physical examination is the responsibility of the HF nurse and in 65% of the programs nurses are involved in optimizing medical treatment. Financial support and education of HF nurses is still unstructured and diverse. CONCLUSION There is a rise in the number of HF programs in the Netherlands. There is diversity in content and intensity of these programs and the role of the nurse is not clearly defined yet. Research and discussion on the subject of optimal effective HF care and the role of the HF nurse is still needed.
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Affiliation(s)
- T Jaarsma
- Department of Cardiology, University Hospital Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands.
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Abstract
The debate about how best to determine nurse staffing levels continues. The conventional wisdom is that determining staffing levels is something best left to local management, taking account of local workload and resources. This 'bottom up' philosophy has now been challenged by the use of a different approach – the use of 'top down'standardized, and mandatory, nurse:patient or nurse:bed ratios. This paper examines the characteristics and early results of the use of staffing ratios in the two health systems where nurse staffing ratios are now mandatory – the states of Victoria (Australia) and California (USA). It then discusses the policy implications of using ratios. The paper identifies the main weaknesses of the use of nurse:patient ratios as being their relative inflexibility and their potential inefficiency, if they are wrongly calibrated. Their strength is their simplicity and their transparency. Their impact will be most pronounced when ratios are mandatory and where they offer a mechanism to improve and then to maintain staffing levels at some pre-determined level. The biggest challenges in their use are calibration (what is 'safe'? or 'minimum'?) and achieving the support of all stake-holders. The paper concludes that nurse:patient ratios are a blunt instrument for achieving employer compliance, where reliance on alternative, voluntary (and often more sophisticated) methods of determining nurse staffing have not been effective.
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Affiliation(s)
- James Buchan
- Department of Management & Social Science, Queen Margaret University College, Edinburgh, UK.
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48
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Toft K. FINDING GRADS JOBS. Aust Nurs Midwifery J 2016; 23:54. [PMID: 27530038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Nursing Licensure Improvements. Nebr Nurse 2016; 49:13. [PMID: 27356456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Abstract
Better patient outcomes and experience, as well as better use of resources for nurses and patients, are the aspirations of a new NHS England strategy.
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