Improving the use of the nursing process: the impact of charting methodology developed from King's conceptual framework on the use of the nursing process

The purpose of this study was to assess the effects of changing a nursing documentation system, developed from King's Conceptual Framework, on the use of the nursing process. The null hypothesis was that there would be no significant increase in the reflection of the use of the nursing process on the nursing care plan or nurses' notes, as a result of using a nursing documentation system developed using King's Conceptual Framework (1981). The design involved the development of a questionnaire that was used to review health records pre and post implementation of a documentation system developed based on King's Conceptual Framework and Theory of Goal Attainment (1981). A Record Completeness Score was obtained from some of the questions. The null hypothesis was rejected. The results of the study have implications for nursing administration and the evaluation of nursing practice. If the use of a documentation system developed from a conceptual framework increases the reflection of the nursing process on the patient's health record, nursing will have the means to measure patient outcomes/goal attainment. All health care organizations and levels of government are focusing on methods to monitor and control the health-care dollar. In order for nursing to clearly determine the costs associated with nursing care, measurement of patient outcomes/goal attainment will need to be possible. In order to measure patient outcomes/goals attainment nurses will need to be able to collect data on their practice. It will be critical that nursing have a documentation system in place which facilitates the reflection of the nursing process within a theoretical framework.

Management decision-making in nursing

This study developed a new, valid and reliable evaluation instrument to measure the level, type and pattern of management decisions of fifteen nursing students. The management decision score achieved using this instrument was correlated with two psychological determinants of management decision making: creativity and problem-solving ability. The instrument was a written patient management problem in case format, answered by a free form written response. The student responses were classified for type of management decision according to the sub-categories of technical, inter-personal, environmental and unique. Using statistical analysis a significant difference was found in the type of management decisions most frequently selected by the study sample. The students predominantly selected technical type decisions. This preference for one type of management decision may be due to a number of psychological and environmental factors. These factors may program and mold the type of management decisions student nurses make early in their career. Low but positive correlations were found between the total management score and the two psychological tests. This finding supports the authors cited in the literature who state that although creativity augments the type of management decision making, it is not present or encouraged widely in the nursing profession. These factors are worth considering when the profession becomes concerned over ritualization and lack of individuality in patient care. The tool is easy to administer, lends itself to a variety of professional settings and shows promise with further refinement for computer application.

Nursing staffs' perceptions of a generic service manager position

The recent reengineering within the health care industry has challenged many assumptions regarding traditional structures and roles. Within a product-line management structure, the traditional viewpoint that those who manage patient care areas must have a nursing background, is an example of one such assumption being challenged. The nursing profession is often seen as the greatest obstacle to the implementation of a product-line management structure and generic manager positions (does not require a nursing background), due to the perceived loss of professional identity. This qualitative study focused on how nursing staff within a chronic care and rehabilitation facility perceived a generic service manager position. Focus groups were conducted in three phases, over a 14 month period of time. The data collected from the focus groups were then coded according to common themes. Each phase was analyzed independently, with the study concluding with an analysis and interpretation of the collective results. The results of this study revealed a significant shift in how the nursing staff perceived their professional identity and accountability in light of the implementation of the generic Service Manager position. Initial reactions of personal and professional vulnerability and resentment were seen to transform into an increased ability to explicitly articulate the role of nursing. Changes in behavior that were described included: increased consultation and collaboration with other

The examination of assumptions in clinical nursing practice

This was a study designed to identify and explore the assumptions that Registered Nurses have about their current nursing role and practice. A qualitative case study approach was used to gather descriptive data. Thirteen study participants completed the indicators of critical thinking exercise and participated in a group session in which they identified positive and negative critical incidents in their clinical practice. The analysis of the anecdotes that were generated from the critical incident exercises revealed ten assumptions held by the Registered Nurses about their nursing practice. The ten assumptions were reflected back to the study participants to determine their level of agreement with each assumption. The ten assumptions were supported by the majority of the respondents. The Registered Nurses in this study appraised themselves affirmatively on eight out of nine indicators of critical thinking.

The person inside the nurse : the professional socialization of baccalaureate nursing students

The goal ofthis research was to gain an understanding ofthe process ofprofessional socialization by accessing role meaning ofstudents engaged in a BScN program. Students from each ofthe four years and faculty members from the school ofnursing volunteered as participants. G. Kelly's (1955) Personal Construct Theory provided the framework to determine awareness and constructed meanings. A reflective tool, called LifeMapping, was adapted and utilized to relate student experiences within education that have attributed to nurse role meaning. Focus group interviews verified data interpretation. Students are informed oftheir choice to study nursing through part-time and volunteer work, secondary school cooperative placements. Descriptions reveal that choices are tested and both positive and negative aspects ofthe role observed. Bipolar images of good and bad nurses seem to be context-related. These images may establish biases in choices related to learning experiences. The person inside ofeach aspiring nurse interprets, revises and understands experiences to incorporate individual meaning into their value and belief structures. Students are aware ofchanges and descnbe them as developments that occur personally up to Year ill and role-image changes that begin in Year II. The major difficulty that students encountered was descnbed as negative attitudes towards their anticipated role. Humanistic-interactionist philosophies are echoed in student accounts of learning experiences. Growth and role development corresponds to process factors of small group, problem-base learning.

Letter from the Secretary of War, transmitting documents containing the information required by the resolution of Mr. Wright, on the 22d inst. relative to the execution of the act fixing the military peace establishment. --

14th Congress, 1st session, 1815-1816. House. Document no. 33.

Letter from the Secretary of War, transmitting a return of the arms and military stores furnished to the respective states, under the provisions of the law of one thousand eight hundred and twelve.

At head of title: [107].

Report of the Committee on Military Affairs, on the differences that exist, between the United States and some of the individual States, respecting the relative powers of the general and state governments over the militia.--

February 28, 1815. Printed by order of the Senate of the United States.

Resolutions reported by the Military Committee, expressive of the thanks of Congress to Major General Jackson, and the troops under his command, for their gallantry and good conduct, in the defence of New Orleans.--

February 13, 1815. Printed by order of the Senate of the United States.

Military Appointment

George Ridout (1791-1871) was a member of the York volunteers during the War of 1812. He served as 3rd lieutenant in the grenadier company of the York militia, fought in the Battle of Queenston Heights, and was taken prisoner of war in April, 1813 when the Americans occupied York. Ridout studied law, and was admitted to the bar in Janurary 1813. He was an active member of the Law Society of Upper Canada, becoming a bencher in 1820, serving as treasurer for several years, and assisting in the development of the library. In 1828 he was appointed judge of the Niagara District Court and reappointed in 1832. In 1836, Sir Francis Bond Head, Lieutenant-Governor, charged Ridout with insult to the person and office of the Lieutenant Governor and disloyalty to the policies of the crown, and dismissed him from his offices. Ridout denied the charges and was eventually ordered to be reinstated by Lord Glenelg, the colonial secretary. Sir Francis Bond Head refused to do so, and instead chose to resign.

Letter Regarding Ensign Daniel Shannon's Military Pay from the Commissariat Office- 30 May 1817

A letter stating that Military Half Pay would from then on be paid from the Commissariat Office. As a result, they require a new letter of attorney. It also states the half pay amount of Daniel Shannon.

Page from Non-Military Ledger- 1811

A page from a non-military ledger that contains the prices of domestic items around the year 1811.

The Military Monitor and American Register- 31 August 1812

The Military Monitor was a weekly periodical that was published every Monday. The first issue was printed for August 17, 1812 and is believed to have ceased in 1814, as the last issue located was April 2, 1814. The periodical was suspended with the November 23, 1812 issue and resumed with the December 14, 1812 issue. The quote at the top of the first page is "The public good our end". The periodical's various authors included: Desnoues, Joseph, 1794?-1837. O'Connor, Thomas, 1770-1855. Hardcastle, John, 1778?-1835. Van Pelt, Peter, 1779?-1843. Wall, Stephen. Van Riper, Nicholas. Other authors are believed to be the American Antiquarian Society. Proprietors: T. O'Connor and S. Wall, 1812; T. O'Connor, 1812- . Printers: Hardcastle and Van Pelt, for T. O'Connor and S. Wall, Sept. 14-Oct. 5, 1812; J. Desnoues, Oct. 12, 1812- ; N. Van Riper, Nov. 6, 1813- . This issue was included in a bound volume of the Military Monitor and American Register. Other Dates included are: 1812 October 12 1812 October 19 1812 November 23 1812 December 14 1812 December 21 1813 January 11 1813 February 1 1813 March 29 1813 April 5 1813 April 12 1813 April 26 1813 May 31

The Military Monitor and American Register- 14 December 1812

The Military Monitor was a weekly periodical that was published every Monday. The first issue was printed for August 17, 1812 and is believed to have ceased in 1814, as the last issue located was April 2, 1814. The periodical was suspended with the November 23, 1812 issue and resumed with the December 14, 1812 issue. The quote at the top of the first page is "The public good our end". The periodical's various authors included: Desnoues, Joseph, 1794?-1837. O'Connor, Thomas, 1770-1855. Hardcastle, John, 1778?-1835. Van Pelt, Peter, 1779?-1843. Wall, Stephen. Van Riper, Nicholas. Other authors are believed to be the American Antiquarian Society. Proprietors: T. O'Connor and S. Wall, 1812; T. O'Connor, 1812- . Printers: Hardcastle and Van Pelt, for T. O'Connor and S. Wall, Sept. 14-Oct. 5, 1812; J. Desnoues, Oct. 12, 1812- ; N. Van Riper, Nov. 6, 1813- . This issue was included in a bound volume of the Military Monitor and American Register. Other Dates included are: 1812 August 31 1812 October 12 1812 October 19 1812 November 23 1812 December 21 1813 January 11 1813 February 1 1813 March 29 1813 April 5 1813 April 12 1813 April 26 1813 May 31