Perception and performance of the nursing team in caring for patients with suicide behavior

Objective: to understand the perception and performance of the Nursing team in a hospital emergency service in the care of patients after attempting suicide. Methods: exploratorystudy, with a qualitative approach, carried out through semi-structured interviews with Nursing professionals who work in an Emergency Service. The interviews were transcribed and analyzed as to their content following Bardin's thematic model. Results: seven nurses and four Nursing technicians participated in the study, with an average age of 36 years, most of them female. Suicide attempts are often associated with 'psychic pain' that is opposed to the principles of life preservation; such an attitude has caused suicidal behavior to be misinterpreted by health professionals. Conclusion: most professionals demonstrated a stereotyped 'pre-concept' and full of taboos about patients who attempted suicide, which triggered a service more directed to physical needs and protocol formalities. Few professionals reported carrying out holistic and empathic care, which is so necessary for these people. In this sense, the importance and urgency of training the team in the identification of suicide risks and in the continuity of treatment of surviving individuals is emphasized.

Nursing team, family and hospitalized child interaction: an integrative review. / Interação equipe de enfermagem, família, e criança hospitalizada: revisão integrativa.

This study aims to present an integrative review of national and international scientific papers on nursing team, family, and hospitalized child interaction. Searches have been made to Bireme, Lilacs, Medline, IBECS, Psyc Info, Science Direct and Web of Science (2008-2013) databases, which allowed us to identify 31 papers represented by the following themes: Interpersonal relationship, Communication and Care. The establishment of interpersonal relationships in a technical and formal way causes difficulty in communication and in the actions aimed at providing care. Care has been the main theme in these researches. Companions demand increased attention to child and family needs from health professionals, and greater involvement of everyone in the process of care. Results suggest that health care teams need to recognize the dynamic experienced by the dyad (child/companion) in order to develop comprehensive care, encouraging family and child inclusion through humanization strategies.

Este estudo tem o objetivo de apresentar uma revisão integrativa de artigos científicos, referentes à produção nacional e internacional, sobre interação equipe de enfermagem, família, e criança hospitalizada. Foram realizadas consultas nas bases de dados Bireme, Lilacs, Medline, IBECS, Psyc Info, Science Direct, e Web of Science (2008-2013), o que permitiu identificar 31 artigos, os quais são representados pelos seguintes eixos temáticos: Relação interpessoal, Comunicação e Cuidado. O estabelecimento de relações interpessoais, de maneira técnica e formal, ocasiona dificuldades na comunicação e nas ações destinadas ao cuidado. O cuidado foi o tema predominante nestas pesquisas, acompanhantes reivindicam dos profissionais de saúde uma atenção ampliada às necessidades da criança e da família, e maior envolvimento de todos no processo de cuidado. Os resultados sugerem a necessidade da equipe de saúde reconhecer a dinâmica vivenciada pela díade (criança/acompanhante), para que possibilite desenvolver a atenção integral que favoreça a inclusão da família e da criança por meio de estratégias de humanização.

Interação equipe de enfermagem, família, e criança hospitalizada: revisão integrativa / Nursing team, family and hospitalized child interaction: an integrative review

Resumo Este estudo tem o objetivo de apresentar uma revisão integrativa de artigos científicos, referentes à produção nacional e internacional, sobre interação equipe de enfermagem, família, e criança hospitalizada. Foram realizadas consultas nas bases de dados Bireme, Lilacs, Medline, IBECS, Psyc Info, Science Direct, e Web of Science (2008-2013), o que permitiu identificar 31 artigos, os quais são representados pelos seguintes eixos temáticos: Relação interpessoal, Comunicação e Cuidado. O estabelecimento de relações interpessoais, de maneira técnica e formal, ocasiona dificuldades na comunicação e nas ações destinadas ao cuidado. O cuidado foi o tema predominante nestas pesquisas, acompanhantes reivindicam dos profissionais de saúde uma atenção ampliada às necessidades da criança e da família, e maior envolvimento de todos no processo de cuidado. Os resultados sugerem a necessidade da equipe de saúde reconhecer a dinâmica vivenciada pela díade (criança/acompanhante), para que possibilite desenvolver a atenção integral que favoreça a inclusão da família e da criança por meio de estratégias de humanização.

Abstract This study aims to present an integrative review of national and international scientific papers on nursing team, family, and hospitalized child interaction. Searches have been made to Bireme, Lilacs, Medline, IBECS, Psyc Info, Science Direct and Web of Science (2008-2013) databases, which allowed us to identify 31 papers represented by the following themes: Interpersonal relationship, Communication and Care. The establishment of interpersonal relationships in a technical and formal way causes difficulty in communication and in the actions aimed at providing care. Care has been the main theme in these researches. Companions demand increased attention to child and family needs from health professionals, and greater involvement of everyone in the process of care. Results suggest that health care teams need to recognize the dynamic experienced by the dyad (child/companion) in order to develop comprehensive care, encouraging family and child inclusion through humanization strategies.

Introducing community integrated nursing teams: How one Clinical Commissioning Group applied an evidence-based approach.

The present day collection of financial and demographic challenges confronted by health and social care mean that integrated services are undoubtedly essential to sustain adequate care. However, the impact of integrated care upon healthcare staff and patients as well as new ways of working will need to be demonstrated, with collaboration and engagement throughout any transition. This paper provides an overview of the evidence relating to the delivery of effective, integrated out-of-hospital care, with a discussion of the literature. It also considers how one Clinical Commissioning Group has begun the process of integration with the focus on community nursing services for the provision of better care for patients with an evidence-based approach.

Philosophy and conceptual framework: collectively structuring nursing care systematization. / Filosofia e marco conceitual: estruturando coletivamente a sistematização da assistência de enfermagem.

OBJECTIVE: To build the Nursing Philosophy and Conceptual Framework that will support the Nursing Care Systematization in a hospital in southern Brazil with the active participation of the institution's nurses. METHODS: Convergent Care Research Data collection took place from July to October 2014, through two workshops and four meetings, with 42 nurses. As a result, the nursing philosophy and conceptual framework were created and the theory was chosen. Data analysis was performed based on Morse and Field. RESULTS: The philosophy involves the following beliefs: team nursing; team work; holistic care; service excellence; leadership/coordination; interdisciplinary team commitment. The conceptual framework brings concepts such as: human being; nursing; nursing care, safe care. The nursing theory defined was that of Wanda de Aguiar Horta. CONCLUSIONS: As a contribution, it brought the construction of the institutions' nursing philosophy and conceptual framework, and the definition of a nursing theory.

Integrating Nurse Practitioners Into Intensive Care Units.

As demand for nurse practitioners in all types of intensive care units continues to increase, ensuring successful integration of these nurses into adult and pediatric general and specialty intensive care units poses several challenges. Adding nurse practitioners requires strategic planning to define critical aspects of the care delivery model before the practitioners are hired, develop a comprehensive program for integrating and training these nurses, and create a plan for implementing the program. Key strategies to ensure successful integration include defining and implementing the role of nurse practitioners, providing options for orientation, and supporting and training novice nurse practitioners. Understanding the importance of appropriate role utilization, the depth of knowledge and skill expected of nurse practitioners working in intensive care units, the need for a comprehensive training program, and a commitment to continued professional development beyond orientation are necessary to fully realize the contributions of these nurses in critical care.

The Dual Rounding Model: Forging Therapeutic Alliances in Oncology and Palliative Care.

Inpatients with solid tumors at Duke University Hospital in Durham, NC, are cared for in a dynamic integrated care model that incorporates medical oncology and palliative care. This has profound implications for patients, their loved ones, medical and surgical staff, and oncology nurses. As a nurse with less than three years of experience, my participation in a setting that uses the Dual Rounding Model has accelerated my professional and personal development. During a typical shift, I am an oncology nurse, a palliative care nurse, and a hospice nurse.
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Filosofia e marco conceitual: estruturando coletivamente a sistematização da assistência de enfermagem / Filosofía y marco conceptual: estructuración colectiva de la sistematización de enfermería / Philosophy and conceptual framework: collectively structuring nursing care systematization

RESUMO Objetivo Construir, com os enfermeiros, a Filosofia de Enfermagem e o Marco Conceitual que servirão como suporte para a implantação da Sistematização da Assistência de Enfermagem em um hospital do Sul do Brasil. Métodos Pesquisa Convergente Assistencial. A coleta de dados ocorreu de julho a outubro de 2014, através de duas oficinas e quatro encontros, com 42 enfermeiros. Foram criados a filosofia de enfermagem, o marco conceitual e foi feita a escolha da teórica. Para análise de dados foi utilizada a proposta de Morse e Field. Resultados A filosofia envolve as crenças de: equipe de enfermagem; trabalho em equipe; cuidado holístico; excelência no atendimento; liderança/coordenação; equipe interdisciplinar, comprometimento. O marco conceitual traz os conceitos de: ser humano; enfermagem; assistência de enfermagem, cuidado seguro. A teórica definida foi Wanda de Aguiar Horta. Conclusões Trouxe como contribuição a construção da filosofia de enfermagem e do marco conceitual da instituição e a definição da teoria de enfermagem.

RESUMEN Objetivo Construir con enfermeras Filosofía de la Enfermería, el marco conceptual que servirá de apoyo a la implementación de la sistematización de la atención de enfermería en un hospital en el sur de Brasil. Métodos Investigación Convergente Asistencial. Los datos fueron recolectados entre julio y octubre de 2014, a través de dos talleres y cuatro reuniones con 42 enfermeras. Se creó la filosofía de la enfermería, marco conceptual y teórico de la elección. Para el análisis de los datos se utilizaron para elaborar Morse y campo. Resultados La filosofía implica en la creencia: en el equipo de enfermería; en el trabajo en equipo; en la atención integral; en la excelencia en el servicio; liderazgo / coordinación; en el compromiso del equipo interdisciplinario. El marco conceptual que involucra los conceptos del ser humano; enfermería; cuidados de enfermería, atención segura. La teoría de conjuntos era Wanda de Aguiar Horta. Conclusiones traído como contribución a la construcción de la filosofía de enfermería y el marco conceptual de la institución y la definición de la teoría de enfermería.

ABSTRACT Objective To build the Nursing Philosophy and Conceptual Framework that will support the Nursing Care Systematization in a hospital in southern Brazil with the active participation of the institution’s nurses. Methods Convergent Care Research Data collection took place from July to October 2014, through two workshops and four meetings, with 42 nurses. As a result, the nursing philosophy and conceptual framework were created and the theory was chosen. Data analysis was performed based on Morse and Field. Results The philosophy involves the following beliefs: team nursing; team work; holistic care; service excellence; leadership/coordination; interdisciplinary team commitment. The conceptual framework brings concepts such as: human being; nursing; nursing care, safe care. The nursing theory defined was that of Wanda de Aguiar Horta. Conclusions As a contribution, it brought the construction of the institutions’ nursing philosophy and conceptual framework, and the definition of a nursing theory.

The Benefits of a Nurse-Driven, Patient- and Family-Centered Pediatric Palliative Care Program.

This article describes the program and outcomes of a nurse driven, patient- and family-centered pediatric advanced comprehensive care team (PACCT) palliative program. This care delivery model improved patient outcomes by providing care across the healthcare continuum for pediatric patients. Since the inception of PACCT, no child has died on a ventilator in the pediatric ICU associated with end-of-life-related issues.

Transition to Adulthood for Young People with Medical Complexity: An Integrative Literature Review.

This article explores how the empirical literature on the transition to adulthood for young people with medical complexity can inform nursing and advanced practice nursing. An integrative literature review informed by Meleis' Transition Theory and Bronfenbrenner's Bioecological Theory of Human Development was conducted including 11 studies and yielded three themes: it's like falling off a cliff, the paradox of independence, and it takes a village. The findings demonstrated a need for an increased focus on the process of transition and transfer for this complex population. Recommendations for pediatric nurses and advanced practice nurses based on these findings focus on advocacy, capacity-building, education, and program development and evaluation. Recommendations for future research are offered with a focus on determinants of health, psychosocial concerns, and program development and evaluation.

Person centred nursing care in radiation oncology: a case study.

PURPOSE: The aim of this case study is to describe clinical staff perceptions of implementing a person-centred model of nursing in an outpatient radiotherapy treatment department, using a Primary Nursing/Collaborative Practice framework. The questions are: 1) what are the nursing and radiotherapy staff perspectives of the changed model of care, 2) what factors impacted on aspects of the evolving model?, and 3) how was interdisciplinary collaboration influenced by the new model? METHODS: An instrumental case study addressed the multiple perspectives of several radiotherapy health professionals, within a qualitative approach, to assess the new model of nursing care. Interview data were obtained from thirteen clinical staff over a six month period approximately one year after the model was implemented. RESULTS: The new model supports nurses to work more closely with the individual patient, with some perceived positive patient outcomes. Nurses reported increased satisfaction with their work, more autonomy and responsibility, and improved working relationships with medical staff. They also became more aware of the holistic approach to support positive patient outcomes. However, this study acknowledged that education was required for nurses to provide holistic care, especially in the context of complex interdisciplinary relationships. CONCLUSIONS: A person-centred nursing approach in radiotherapy represents a radical change to the functional approach, providing some benefits for patients. However, the challenges of providing holistic care in the context of complex interdisciplinary relationships are evident, and this study acknowledges the importance of a team approach to addressing changes in practice in the future.

Care coordination for patients with complex health profiles in inpatient and outpatient settings.

Patients with the most complex health profiles consume a disproportionate percentage of health care expenditures, yet often receive fragmented, suboptimal care. Since 2003, Wisconsin-based Gundersen Health has improved the quality of life and reduced the cost burden of patients with complex health profiles with an integrated care coordination program. Those results are consistent with data from the most successful care coordination demonstration projects funded by the Centers for Medicare and Medicaid Services. Specifically, Gundersen's program has been associated with reduced hospital stays, lower costs for inpatients, less use of inpatient services, and increased patient satisfaction. Gundersen's success is rooted in its team-based approach to coordinated care. Teams, led by a subspecialty-trained nurse, have regular, face-to-face contact with patients and their physicians in both inpatient and outpatient settings; involve patients deeply in care-related decisions; access a system-wide electronic medical record database that tracks patients' care; and take a macrolevel view of care-related factors and costs. Gundersen's model offers specific take-home lessons for institutions interested in coordinated care as they design programs aimed at improving quality and lowering costs. This institutional case study provides a window into well-executed care coordination at a large health care system in an era when major changes in health care provision and reimbursement mechanisms are on the horizon.

[Playing games to help deal with the end of life]. / Jouer pour apprivoiser la fin de la vie.

Allowing a child to play until the end of his/her life, such is the objective which a paediatric nursing team has set itself The games must enable the child and his family to organise psychologically the emotional chaos provoked by impending death. They question and provide an answer to an intolerable situation--the end of a child's life.