Nurse-patient communication while performing home dialysis: The patients' perceptions

This study aimed at describing patients' perception of their communication with nurses when performing home dialysis. Data were collected from interviews guided by the question: What is communication like, between you and nurses, during home dialysis treatment? Results show participants' perception of treatment during home peritoneal dialysis [Continuous ambulatory peritoneal dialysis (CAPD)]; relationship with nurses and family and the effects of treatment on one's existence. Patients can be self-caring and they learn to value the autonomy in their own care. However, some are unable to assume the responsibility for self-care. It was discovered that the connotation of inspection that some participants attributed to the nurse's visits, led to an alienation from the education process in the CAPD education. Findings suggest that effective communication and the development of the relationship of a working partnership with patients is crucial. Improvement in the nurses' communication, aiming at adapting it to the characteristics, limitations and specific needs of each patient, is significant for achieving better outcomes. © 2010 European Dialysis and Transplant Nurses Association/European Renal Care Association.

Nurse likelihood to report a pediatric medication error: Examination of the "pre-reporting" period

Each year, hospitalized patients experience 1.5 million preventable injuries from medication errors and hospitals incur an additional $3.5 billion in cost (Aspden, Wolcott, Bootman, & Cronenwatt; (2007). It is believed that error reporting is one way to learn about factors contributing to medication errors. And yet, an estimated 50% of medication errors go unreported. This period of medication error pre-reporting, with few exceptions, is underexplored. The literature focuses on error prevention and management, but lacks a description of the period of introspection and inner struggle over whether to report an error and resulting likelihood to report. Reporting makes a nurse vulnerable to reprimand, legal liability, and even threat to licensure. For some nurses this state may invoke a disparity between a person‘s belief about him or herself as a healer and the undeniable fact of the error.^ This study explored the medication error reporting experience. Its purpose was to inform nurses, educators, organizational leaders, and policy-makers about the medication error pre-reporting period, and to contribute to a framework for further investigation. From a better understanding of factors that contribute to or detract from the likelihood of an individual to report an error, interventions can be identified to help the nurse come to a psychologically healthy resolution and help increase reporting of error in order to learn from error and reduce the possibility of future similar error.^ The research question was: "What factors contribute to a nurse's likelihood to report an error?" The specific aims of the study were to: (1) describe participant nurses' perceptions of medication error reporting; (2) describe participant explanations of the emotional, cognitive, and physical reactions to making a medication error; (3) identify pre-reporting conditions that make it less likely for a nurse to report a medication error; and (4) identify pre-reporting conditions that make it more likely for a nurse to report a medication error.^ A qualitative research study was conducted to explore the medication error experience and in particular the pre-reporting period from the perspective of the nurse. A total of 54 registered nurses from a large private free-standing not-for-profit children's hospital in the southwestern United States participated in group interviews. The results describe the experience of the nurse as well as the physical, emotional, and cognitive responses to the realization of the commission of a medication error. The results also reveal factors that make it more and less likely to report a medication error.^ It is clear from this study that upon realization that he or she has made a medication error, a nurse's foremost concern is for the safety of the patient. Fear was also described by each group of nurses. The nurses described a fear of several things including physician reaction, manager reaction, peer reaction, as well as family reaction and possible lack of trust as a result. Another universal response was the description of a struggle with guilt, shame, imperfection, blaming oneself, and questioning one's competence.^

Pediatric nurse practitioners : report /

"June, 1976"--Cover.

Understanding the role of knowledge in the practice of expert nephrology nurses in Australia

This paper, which is abstracted from a larger study into the acquisition and exercise of nephrology nursing expertise, aims to explore the role of knowledge in expert practice. Using grounded theory methodology, the study involved 17 registered nurses who were practicing in a metropolitan renal unit in New South Wales, Australia. Concurrent data collection and analysis was undertaken, incorporating participants' observations and interviews. Having extensive nephrology nursing knowledge was a striking characteristic of a nursing expert. Expert nurses clearly relied on and utilized extensive nephrology nursing knowledge to practice. Of importance for nursing, the results of this study indicate that domain-specific knowledge is a crucial feature of expert practice.

Why do nurses migrate? – a review of recent literature

Aim  To identify the reasons why nurses continue migrating across international borders. Background  International nurse recruitment and migration have been increasing in the last decade and recent trends show an increase in the movement of nurses between developing and developed countries, resulting in a worldwide shortage of nurses. Methods  A manual and electronic database literature search was conducted from January 2004 to May 2010. Qualitative content analysis was completed for the final 17 articles that satisfied the inclusion criteria. Results  Motivators to nurse migration were linked to financial, professional, political, social and personal factors. Although economic factors were the most commonly reported, they were not the only reason for migration. This was especially evident among nurses migrating between developed countries. Conclusion  Nurses migrate for a wide variety of reasons as they respond to push and pull factors. Implications for nursing management  It is important for nurse managers in the source countries to advocate incentives to retain nurses. In the recipient countries the number of international nurses continues to increase implying the need for more innovative ways to mentor and orientate these nurses.

An exploration of the roles of nurses working in emergency care services in general hospitals in West Java, Indonesia : a grounded theory study

A review of literature on the role of emergency nurses in Indonesia revealed a dearth of research. Anecdotal evidence suggests a lack of clarity in role definition which has led to uncertainty and role ambiguity. Despite advances in the development of specialist nursing roles in Indonesia, that of the emergency nurse remains unclear. This study explored the role of nurses working in emergency care services in three general hospitals in West Java, Indonesia. The theoretical framework is grounded in Charmaz’s constructivist grounded theory. Data collection methods were observation, in-depth interviews and interrogation of related documents. Phase one of data collection involved 74 h of observation and nterviews with 35 nurses working in the three ED settings. For the purposes of theoretical sampling, a second phase of data collection was conducted. This involved a second nterview with eight participants from the three EDs. nterviews were also undertaken with the three key informants of nursing management of three related hospitals; key informants from the Indonesian Nurses Association; the Directorate of Nursing, Ministry of Health; and from the organization for ED nurses. Data analysis drew on Charmaz’s constructivist approach and the concepts of simultaneous data collection and analysis, constant comparison, coding, and theoretical sampling. The analysis generated four theoretical concepts that characterized the role of the emergency nurse: An arbitrary scope of practice, Struggling for recognition, Learning on the job and Looking to better practice. These concepts provided analytical direction for an exploration of the clinical and political dimensions of the role of the emergency nurse in Indonesia.

A smoking cessation intervention for people with chronic Hepatitis C : a randomised controlled trial

Purpose The purpose of this study was to examine the validity of current practice in smoking cessation for the general population i.e., a telephone counselling and nicotine replacement therapy (NRT) intervention and its applicability to people with chronic hepatitis-C. Methods A randomised controlled trial was conducted over twelve weeks. Following consent, ninety-two smokers (outpatients) with chronic hepatitis-C were recruited by the Nurse Practitioner hepatology, randomly assigned and stratified by number of cigarettes smoked (i.e., 15 and greater; <15) into the intervention group (telephone counselling and NRT) and control group (telephone counselling). Outcomes measured included socio-demographics, nicotine dependence, depression, anxiety and stress and quality of life (QOL). All statistical data were analysed using SPSS. Results After 12 weeks, the intervention group showed a sustained reduction of smoking i.e., 5.8(CI: 2.4,9.3) cigarettes less per day, whereas the control group showed 1.6(CI:-1.9,5.2) cigarette reduction. Although not statistically significantly different (F=2.9, p=0.090) the intervention group on average smoked 4.2 fewer cigarettes compared to the control group. After twelve weeks, seven patients in the intervention group and three patients in the control group reported quitting. Whilst not statistically significant (Fisher’s Exact, p=0.311) this was a clinically significant result. No differences were found for nicotine dependence or depression, anxiety and stress. The intervention group experienced no change in QOL (-0.1,CI:-0.9, 0.6), however, the environmental score for the control group decreased by 1.8(CI:1.0, 2.6,p= 0.001). This was statistically significant. Conclusion A telephone counselling and nicotine replacement therapy intervention from the nurse practitioner, hepatology reduced smoking in patients with chronic hepatitis-C. The intervention group showed a sustained reduction over the 12 weeks. A total of 10 patients quit smoking at the end of the study. QOL deteriorated in the environmental subscale for the control group. These results informed a nurse practitioner model of care for approaches to smoking cessation.

Komunikazioaren eraginkortasuna haur ospitaleratuen estresa murrizteko

Lanaren helburuak haur ospitaleratu eta erizainen arteko komunikazioaren ezaugarriak eta hau hobetzeko neurriak eta haurren antsietatea eta sintomatologiaren kontrola hobetzeko komunikazioa eta honekin erlazionatutako estrategiak aztertzea dira. 6-12 urte bitarteko ume ospitaleratuek pairatzen duten antsietatea murrizteko komunikazioak duen eragina lantzen duten artikuluen berrikuspena egin da azken 10 urteetan idatzitako artikuluak bilatuz. Haurrek berez ospitalak eragindako estresa murrizteko gaitasunik ez dutenez, erizainarekin bideratzen duten komunikazioa eta honekin batera erabilitako beste teknika batzuk oso eraginkorrak direla antsietatearen murrizketan ondorioztatu da.

La relation infirmière-patiente dans un contexte d’hospitalisation pour anorexie mentale : état des connaissances et recommandations

Travail dirigé présenté à la Faculté des sciences infirmières en vue de l’obtention du grade de Maître ès sciences (M.Sc.) en sciences infirmières option expertise-conseil

När Viljan inte finns att Leva : Suicidbenägenhet ur ett sjuksköterske- och patient perspektivEn systematisk litteraturstudie

Syftet med denna systematiska litteraturstudie var att undersöka vilka attityder sjuksköterskor hade gentemot suicidala patienter, vilka upplevelser patienter hade efter ett suicidförsök och hur de upplevde omvårdnaden de fick. I syftet ingick även att undersöka vilka kunskaper som en sjuksköterska behöver ha i mötet med suicidala personer. Sökning av artiklar har gjorts på databaserna Elin@Dalarna och Blackwell Synergy där sökorden attitudes, care, caring, nursing, nurse, suicide användes i olika kombinationer. Artiklarna skulle vara vetenskapliga, inte publicerade före 1997 och svara på syfte och frågeställning. För att säkerställa att kvalitén på artiklarna var god granskades de med hjälp av en granskningsmall. Sammanlagt ligger tretton artiklar till grund för resultatet i denna litteraturstudie. Resultatet visade att sjuksköterskor ofta hade en negativ attityd i arbetet med suicidpatienter, och sjuksköterskor på akuta avdelningar tenderade att vara mera negativa än de på psykiatriska avdelningar. Suicidpatientens personlighet hade betydelse för vilken attityd sjuksköterskan hade. Utbildning visade sig medföra en mera positiv inställning. Resultatet visade också att suicidpatienter ofta kände skam och känslor av misslyckande efter suicidförsök. Attityden sjuksköterskan visade påverkade patientens väg tillbaka. Det var viktigt för dem att bli sedd, lyssnad på och inte bli fördömd. Litteraturstudien visade att sjuksköterskor behöver kunskap och utbildning för att kunna möta denna patientgrupp för att ge bästa tänkbara omvårdnad i behandlingsarbetet.

Hälso- och sjukvårdpersonals följsamhet till hygienföreskrifter avseende handhygien och faktorer som påverkar detta : En litteraturstudie

Syftet med föreliggande studie var att redogöra för hälso- och sjukvårdspersonalens följsamhet till hygienföreskrifter avseende handhygien och de faktorer som påverkar detta. Metod: Artiklar söktes via CINAHL, Pubmed och Scopus. Sökord som användes i olika kombinationer var: hand hygiene, adherence, hygiene guidelines, health care workers, compliance, hand disinfection, infection control, nursing, nurse och hand cleansing. Tretton vetenskapliga artiklar erhölls. Vidare gjordes en manuell sökning ifrån inkluderade artiklars referenslistor och genererade två artiklar som ingick i resultatet. Resultat: Resultatet visade att hälso- och sjukvårdspersonalens följsamhet till hygienföreskrifter avseende handhygien var låg. Vidare framkom av resultatet att det fanns sju kategorier av faktorer som påverkade följsamheten till hygienföreskrifterna. Dessa var: utbildning och kunskap, arbetsbelastning och tidsbrist, tillgänglighet, hudproblem och handskar. Slutsats: Följsamheten till hygienföreskrifter avseende handhygien är låg. Kontinuerlig utbildning i kombination med ökad tillgänglighet och minskad arbetsbelastning är de viktigaste förutsättningarna för att öka följsamheten till hygienföreskrifter gällande handhygien.

Más allá de las “indiciones”. Reflexión sobre la comunicación a partir de una vivencia

El propósito de este trabajo es describir una reflexión originada a partir de una vivencia. En ella, la interpretación del mensaje fue indispensable. El primer paso de la asistencia sanitaria es la entrevista con el paciente. Tras ello, podemos detectar sus necesidades y empezar a actuar adecuadamente. La interpretación inadecuada de los datos obtenidos mediante la entrevista puede conducir a resultados diferentes de los esperados. Con cierta frecuencia, los pacientes reinterpretan o incluso reinventan los nombres de los fármacos, de las enfermedades, etc. En ocasiones puede suceder también con la descripción de la patología subyacente. Estos hechos suelen estar influenciados por diversos factores (culturales, geográficos, etc.). Descifrar su verdadero significado puede llegar a suponer un verdadero reto en algunas ocasiones. Una conversación reciente con mi abuela me condujo a la reflexión sobre la relación profesional sanitario-paciente presentada en este trabajo.

SER PROFESSOR: UM ESTUDO SOBRE A CONSTITUIÇÃO IDENTITÁRIA PROFISSIONAL DO ENFERMEIRO DOCENTE

O presente estudo foi desenvolvido com o objetivo de compreender a construção da identidade profissional de enfermeiros docentes do curso de graduação em Enfermagem de uma instituição privada localizada na cidade de São Paulo. Para tanto, discute os processos de constituição identitária pautado nos estudos de Vera Placco de Souza, no âmbito nacional, e de Maurice Tardif e Claude Dubar, no âmbito internacional. Em uma etapa exploratória, foi aplicado um questionário semi-estruturado a cinco professoras da pós-graduação em Enfermagem e realizada uma entrevista semi-diretiva com dois desses participantes com o objetivo de refinar os instrumentos de coleta. A pesquisa principal fez uso de entrevista realizada com sete professores do curso de graduação em Enfermagem da mesma instituição. Os dados, tanto do estudo exploratório como da pesquisa principal, foram analisados tendo como referência os pressupostos da análise de conteúdo sistematizados por Laurence Bardin e Maria Laura P. B. Franco. Os resultados indicaram que os enfermeiros se tornam professores impelidos pelo desejo de ensinar e de compartilhar conhecimentos, oportunidade de trabalho, flexibilidade de horário e complementação da renda profissional, e são influenciados por professores de sua trajetória formativa e por familiares. As características valorizadas por eles em um professor foram: o domínio do conteúdo ensinado, sobretudo o saber técnico; a busca contínua do conhecimento; ética; profissionalismo; humanização. Nota-se um predomínio das características que envolvem o conhecimento dos conteúdos em detrimento das questões pedagógicas. A reflexão e preocupação com a Docência estão presentes em suas falas, assim como a busca constante para a superação das dificuldades existentes na profissão. Eles consideram a Docência uma profissão com um papel social de destaque do mesmo modo que a Enfermagem. Outro fator destacado nas respostas foi a forte representação do enfermeiro na carreira profissional dos pesquisados. Em seus relatos, foi possível perceber que sua construção como docentes ocorre de forma contínua ao longo da carreira, o que fica evidenciado em suas falas quando afirmam serem melhores professores agora do que no início de sua trajetória profissional e que, apesar de ser uma caminhada espinhosa inicialmente, tornou-se prazerosa e significativa com o passar do tempo. Ressalta-se aqui a importância de se valorizar os saberes do professor, partindo deles e trabalhando-os teórica e conceitualmente para que o docente amplie a compreensão do processo de ensino em saúde que, no mundo contemporâneo, tornou-se de alta complexidade.

Riskfaktorer och förebyggande omvårdnadsåtgärder för UVI hos äldre kvinnor : En litteraturöversikt

Bakgrund: Urinvägsinfektion (UVI) är en av de vanligaste infektionerna hos äldre kvinnor. Escherichia coli (E-coli) är den vanligaste bakterien vid UVI. Äldre kvinnor lider när de är drabbade av UVI och det är sjuksköterskans uppgift att bland annat förebygga sjukdom och lindra lidande. Syfte: Att beskriva riskfaktorer och förebyggande omvårdnadsåtgärder mot UVI hos äldre kvinnor. Metod: Litteraturstudie, med databassökning genom databaser speciellt inriktade på vård och omvårdnad, CINAHL, PubMed, WEB OF SCIENCE och Medline. 15 artiklar har använts till resultatet. Resultat: Recidiverande UVI, diabetes, urininkontinens, smittspridning och förstoppning är riskfaktorer att drabbas av UVI. God hygien och regelbunden tillförsel av vätska ses som god evidensbaserad omvårdnadsåtgärd mot UVI. Ökad tillförsel av vätska förkastas, Tranbärstillägg behöver ytterligare forskning. Slutsats. Hög hygieniskstandard genom de basala hygienrutinerna är en viktig förebyggande åtgärd mot UVI.

Building research capacity in the nursing workforce : the design and evaluation of the nurse researcher role

Objectives: The Nurse Researcher Project (NRP) was initiated to support development of a nursing research and evidence based practice culture in Cancer Care Services (CCS) in a large tertiary hospital in Australia. The position was established and evaluated to inform future directions in the organisation.---------- Background: The demand for quality cancer care has been expanding over the past decades. Nurses are well placed to make an impact on improving health outcomes of people affected by cancer. At the same time, there is a robust body of literature documenting the barriers to undertaking and utilising research by and for nurses and nursing. A number of strategies have been implemented to address these barriers including a range of staff researcher positions but there is scant attention to evaluating the outcomes of these strategies. The role of nurse researcher has been documented in the literature with the aim to provide support to nurses in the clinical setting. There is, to date, little information in relation to the design, implementation and evaluation of this role.---------- Design: The Donabedian’s model of program evaluation was used to implement and evaluate this initiative.---------- Methods: The ‘NRP’ outlined the steps needed to implement the nurse researcher role in a clinical setting. The steps involved the design of the role, planning for the support system for the role, and evaluation of outcomes of the role over two years.---------- Discussion: This paper proposes an innovative and feasible model to support clinical nursing research which would be relevant to a range of service areas.---------- Conclusion: Nurse researchers are able to play a crucial role in advancing nursing knowledge and facilitating evidence based practice, especially when placed to support a specialised team of nurses at a service level. This role can be implemented through appropriate planning of the position, building a support system and incorporating an evaluation plan.