Knowledge about the rncci: an exploratory study about the perception of nursing students

The National Network of Continuing Care (RNCCI) was created in 2006 by Decree Law nr. 101/2006. Its mission is to supply adequate health and social care to all people who, independent of their age, are in a situation of dependence, and its action is articulated with the already existing health and social services, being a multidisciplinary team needed composed out of medical doctors, nurses, social workers and psychologists. Given the aforementioned it’s pertinent to perform research, with nurses and nursing students, about this new valence of care.

Exploring the potential of Mask-Ed™ (KRS simulation) to teach both the art and science of nursing : a discussion paper

Which Reality? Interactions at the southern border of Mexico as fieldwork of creative practice

El siguiente ensayo sintetiza y describe el proyecto de investigación creación ¿Cuál realidad? cuyo objetivo es la creación y análisis de una práctica artística como forma de entender y generar conocimiento a partir de las manifestaciones y acontecimientos sociales y culturales en diversos lugares de la frontera sur de México. Lo que se busca es reflexionar acerca de las fronteras, no sólo como lo que delimita el fin o el principio de los territorios de estados nacionales o geográficos, sino como productoras simbólicas de las diferencias entre las personas, recalcando todo aquello en lo que no son iguales por encima de lo que tienen en común. Los espacios geopolíticos que delimitan el territorio de un estado-nación son el repertorio palpable de la movilidad de personas, cosas y acontecimientos. Estas prácticas son efectuadas de manera más o menos visible y demuestran que existen y han estado ahí constantemente redes de comunicación y formas de acción común, que tienen como fin procurar bienestar y elevar la calidad de vida de los partícipes. El proyecto ¿Cuál realidad? en su materialidad y visibilidad fue planteado como una serie de intervenciones en sitio, tales como esculturas públicas, instalaciones, acciones participativas, fotografía y video, a partir de la interacción en algunas ciudades fronterizas en los estados de Chiapas, Tabasco y Quintana Roo y su colindancia con los países de Guatemala y Belice. La producción a girado entorno a las siguientes tres líneas de búsqueda temática: La línea fronteriza, el espacio físico; las personas y grupos que confluyen en estos territorios; el contrabando de cosas y el trasiego de las personas entre los países o en el interior del territorio nacional (entre ciudades del mismo estado, inmigrantes rurales etc.). Los lugares seleccionados son significativos de la frontera sur y tanto las esculturas como las intervenciones han sido construidas con objetos y/o procesos que funcionen simbólicamente para los grupos o habitantes de la zona y en colaboración con ellos: objetos útiles para el trabajo, procesos de transformación de materiales, técnicas de fabricación artesanal, ropa, donaciones, entre muchas otras construcciones.

Determination of factors related to the abandonment of the practice of swimming by former costa rican swimmers

The objective of this study was to determine the importance of different dimensions as the possible causes for the abandonment of the practice of swimming by former Costa Rican swimmers.  Subjects: 51 former swimmers participated, including 17 men (22 ±3.4 years of age) and 34 women (22.5 ±3.4 years of age) from different Costa Rican swimming teams.  The Questionnaire of Reasons for Attrition in the Practice of Sports (Gould et al, 1982; cited by Salguero, Tuero, and Márquez, 2003) was used.  Results:  A positive relationship was noted between perceptions of low skill and low performance (r: 0.372), while negative relationships were noted between years of practice and low skill (r:-0.337), years of practice and influence from others (r:-0.286), and years of practice and starting age for swimming (r:-0.622).  A significant interaction was found in the dimensions gender of participants (F: 2.952; p<0.05) and starting age for swimming (F: 3.147; p<0.01).  An interaction was also found between dimensions and the desire to swim again (F: 2.485; p>0.05).  There were also significant differences in the years of practice; that is, subjects who started before the age of 10 had a higher average of years of practice than those who started later (F: 21.465; p<0.05).  Additionally, a significant interaction was found in weekly hours of swimming practice (F: 2.072; p<0.05).  There were no significant differences (F: 2.535; p>0.05) according to weekly hours of training when subjects were actively swimming. Conclusions: Possible reasons for dropping out were lack of enjoyment and poor physical condition for men and perception of lack of team spirit for women.  The group that started after the age of ten gives similar importance to all the dimensions as possible reasons for dropping out, while the group that began swimming before the age of ten sees lack of team spirit, lack of enjoyment, and poor physical condition as the key reasons for dropping out.  The most important dimensions that represented the reasons for abandonment in subjects who wanted to swim again were lack of team spirit, poor physical condition and low skill, while lack of enjoyment was the most important reason for subjects who do not want to swim again.  In the group of subjects who would swim less than six hours, lack of team spirit is the most important cause, while the dimension lack of enjoyment was the most important reason for subjects who would swim 6 to 12 hours.  Additionally, the highest dropout percentages were observed in the transition from secondary school to college.

Clinical efficacy of paclitaxel in the treatment of mid-stage and advanced malignant gastric cancer, and effect of nursing interventions

Purpose: To investigate the clinical efficacy of paclitaxel combined with additional chemotherapy for mid-stage and advanced malignant tumors, and the benefits afforded by scientific nursing. Methods: Patients with mid-stage and advanced gastric cancer were randomly divided into test and control groups. Control group was given intravenous chemotherapy (400 mg/m2 fluorouracil and 2500 mg/m2 cisplatin) and nursed conventionally, while the test group was additionally treated with 80 mg/m2 paclitaxel and underwent special scientific nursing. Clinical effects and changes in the rates of apoptosis and cell proliferation were recorded. The effect of applying scientific nursing on therapeutic outcomes was also evaluated. Results: The overall rate of treatment effectiveness, clinical control rate, mean apoptosis and proliferation rates in the test group were 56.40, 92.30, (7.10 ± 3.17 and 28.70 ± 3.22 %, respectively, while, in the control group, the values were 38.50, 64.10, 25.40 ± 2.67 and 32.60 ± 2.93 %, respectively. The differences were all statistically significant (p < 0.05). In terms of nursing efficacy, the test group had a lower pain score and higher quality-of-life scores (Karnofsky performance status score) than control group. There was no significant difference in the incidence of adverse reactions between the two groups (p > 0.05). Conclusion: Paclitaxel has a significant effect when used to treat mid-stage and advanced gastric cancer. Moreover, additional nursing not only enhances the therapeutic effect but also improves prognosis and quality-of-life.

Boardroom to classroom: the role of the corporate and philanthropic sectors in school education

This report delivers the findings of a research project carried out from 2008 to 2009 to explore the trends in corporate and philanthropic involvement in school education in Victoria, Australia and internationally that are supporting improved outcomes for students.

This included a search of the local and international literature and the collection of qualitative data through forums with the corporate and philanthropic sectors, school leaders, policy-makers and leading agencies as well as interviews with representatives of leading corporate and philanthropic sector organisations.

The research was guided by questions including:

1. What are the trends in corporate and philanthropic involvement in government school education, in Victoria, Australia and internationally, that support improved outcomes for students, including those students who are underperforming in literacy and numeracy, at risk of leaving school early, or who are less likely to enter university or to succeed in further or vocational education?

2. What is the scope of existing practice in Victoria?

3. What are some good examples of next practice at the system, regional and school level in Victoria, Australia and internationally?

Incidence of complications in men undergoing transurethral resection of the prostate

Objectives: To examine the link between medication use and the risk of bleeding complications following transurethral resection of the prostate from the second postoperative day until hospital discharge. Method: Using a retrospective observational study design, the medical records of all patients who underwent transurethral resection of the prostate over a 24-month period were examined. Comprehensive data regarding patients' medication history, comorbidities and complications that occurred either during or after surgery were collected from medical records. Inferential statistical analysis was used to examine associations between demographic and medication variables and the risk of complications. Results: Complications arising after surgery occurred in 48/135 (36%) of patients. The most common complications postoperatively were hematuria, occurring in 41/48 (85%) and hematuria with clot retention, occurring in 24/48 (50%) of patients who suffered complications. There was a significant association between the number of medications prescribed and postoperative complications; for hematuria, χ ² (12)=21.50, p =0.04; and for hematuria with clot retention χ ² (12)=24.97, p =0.015. Conclusions: Demographic data relating to patients' age, comorbid state and the number of standard medications prescribed is associated with an increase in macroscopic hematuria and macroscopic hematuria with clot retention after transurethral resection of the prostate. These findings emphasize the importance of nursing practice in both preoperative and postoperative care of patients undergoing surgery. Nurses need to be very vigilant in assessing patients at risk of increased bleeding from a transurethral resection of the prostate by examining their medication regimen.

A structured framework improves clinical patient assessment and nontechnical skills of early career emergency nurses: a pre-post study using full immersion simulation

AIMS AND OBJECTIVES: The aim of this study was to evaluate the effect of the new evidence-informed nursing assessment framework HIRAID (History, Identify Red flags, Assessment, Interventions, Diagnostics, reassessment and communication) on the quality of patient assessment and fundamental nontechnical skills including communication, decision making, task management and situational awareness. BACKGROUND: Assessment is a core component of nursing practice and underpins clinical decisions and the safe delivery of patient care. Yet there is no universal or validated system used to teach emergency nurses how to comprehensively assess and care for patients. DESIGN: A pre-post design was used. METHODS: The performance of thirty eight emergency nurses from five Australian hospitals was evaluated before and after undertaking education in the application of the HIRAID assessment framework. Video recordings of participant performance in immersive simulations of common presentations to the emergency department were evaluated, as well as participant documentation during the simulations. Paired parametric and nonparametric tests were used to compare changes from pre to postintervention. RESULTS: From pre to postintervention, participant performance increases were observed in the percentage of patient history elements collected, critical indicators of urgency collected and reported to medical officers, and patient reassessments performed. Participants also demonstrated improvement in each of the four nontechnical skills categories: communication, decision making, task management and situational awareness. CONCLUSION: The HIRAID assessment framework improves clinical patient assessments performed by emergency nurses and has the potential to enhance patient care. RELEVANCE TO CLINICAL PRACTICE: HIRAID should be considered for integration into clinical practice to provide nurses with a systematic approach to patient assessment and potentially improve the delivery of safe patient care.

Measuring nursing competencies in the operating theatre: instrument development and psychometric analysis using Item Response Theory

BACKGROUND: Concern about the process of identifying underlying competencies that contribute to effective nursing performance has been debated with a lack of consensus surrounding an approved measurement instrument for assessing clinical performance. Although a number of methodologies are noted in the development of competency-based assessment measures, these studies are not without criticism. RESEARCH AIM: The primary aim of the study was to develop and validate a Performance Based Scoring Rubric, which included both analytical and holistic scales. The aim included examining the validity and reliability of the rubric, which was designed to measure clinical competencies in the operating theatre. RESEARCH METHOD: The fieldwork observations of 32 nurse educators and preceptors assessing the performance of 95 instrument nurses in the operating theatre were used in the calibration of the rubric. The Rasch model, a particular model among Item Response Models, was used in the calibration of each item in the rubric in an attempt at improving the measurement properties of the scale. This is done by establishing the 'fit' of the data to the conditions demanded by the Rasch model. RESULTS: Acceptable reliability estimates, specifically a high Cronbach's alpha reliability coefficient (0.940), as well as empirical support for construct and criterion validity for the rubric were achieved. Calibration of the Performance Based Scoring Rubric using Rasch model revealed that the fit statistics for most items were acceptable. CONCLUSION: The use of the Rasch model offers a number of features in developing and refining healthcare competency-based assessments, improving confidence in measuring clinical performance. The Rasch model was shown to be useful in developing and validating a competency-based assessment for measuring the competence of the instrument nurse in the operating theatre with implications for use in other areas of nursing practice.

Recognising and responding to 'cutting corners' when providing nursing care: a qualitative study

AIMS AND OBJECTIVES: The aim of this study is to report on a key finding of a larger study investigating the 'gaps' in patient care that registered nurses encounter during the course of their practice. A key finding of this larger study was that 'cutting corners' was a gap discerned by nurses. BACKGROUND: 'Cutting corners' has been characterised as a 'violation' and threat to patient safety, although there is a paucity of research on this issue. DESIGN: Naturalistic inquiry using a qualitative exploratory descriptive approach. METHODS: Data were collected from a purposeful sample of 71 registered nurses from emergency department, critical care, perioperative, rehabilitation and transitional care and neurosciences settings in Australia and analysed using content and thematic analysis strategies. RESULTS: Cutting corners was a common practice that encompassed (1) the partial or complete omission of patient care, (2) delays in providing care and (3) the failure to do things correctly. Corners were cut in patient assessment, essential nursing care, the care of central venous catheters and medication administration. The practice of cutting corners was perceived as contributing to preventable adverse events. CONCLUSIONS: The study found that cutting corners created gaps that contributed to unfinished nursing care and preventable adverse events. The findings of the study raise the possibility that cutting corners is a salient but underinvestigated characteristic of nursing practice. Further research and inquiry are needed to deepen understanding of cutting corners and its impact on patient safety. RELEVANCE TO CLINICAL PRACTICE: Identifying the nature and implications of cutting corners when providing nursing care is an important contributing factor to improving patient safety and quality care.

Exploring the scope of asymmetric synthesis of β-Hydroxy-γ-lactams via Noyori-type reductions

Enantio- and diastereoselective hydrogenation of β-keto-γ-lactams with a ruthenium–BINAP catalyst, involving dynamic kinetic resolution, has been employed to provide a general, asymmetric approach to β-hydroxy-γ-lactams, a structural motif common to several bioactive compounds. Full conversion to the desired β-hydroxy-γ-lactams was achieved with high diastereoselectivity (up to >98% de) by addition of catalytic HCl and LiCl, while β-branching of the ketone substituent demonstrated a pronounced effect on the modest to excellent enantioselectivity (up to 97% ee) obtained.

Level of implementation of best practice policies for creating healthy food environments: assessment by state and non-state actors in Thailand

OBJECTIVE: To determine and compare the level of implementation of policies for healthy food environments in Thailand with reference to international best practice by state and non-state actors.
DESIGN: Data on the current level of implementation of food environment policies were assessed independently using the adapted Healthy Food Environment Policy Index (Food-EPI) by two groups of actors. Concrete actions were proposed for Thai Government. A joint meeting between both groups was subsequently held to reach consensus on priority actions.
SETTING: Thailand.
SUBJECTS: Thirty state actors and twenty-seven non-state actors.
RESULTS: Level of policy implementation varied across different domains and actor groups. State actors rated implementation levels higher than non-state actors. Both state and non-state actors rated level of implementation of monitoring of BMI highest. Level of implementation of policies promoting in-store availability of healthy foods and policies increasing tax on unhealthy foods were rated lowest by state and non-state actors, respectively. Both groups reached consensus on eleven priority actions for implementation, focusing on food provision in public-sector settings, food composition, food promotion, leadership, monitoring and intelligence, and food trade.
CONCLUSIONS: Although the implementation gaps identified and priority actions proposed varied between state and non-state actors, both groups achieved consensus on a comprehensive food policy package to be implemented by the Thai Government to improve the healthiness of food environments. This consensus is a platform for continued policy dialogue towards cross-sectoral policy coherence and effective actions to address the growing burden of non-communicable diseases and obesity in Thailand.