Single Therapeutic Project and Nursing Process from an interdisciplinary care perspective. / Projeto Terapêutico Singular e Processo de Enfermagem em uma perspectiva de cuidado interdisciplinar.

OBJECTIVE: To analyze the single therapeutic project and the nursing process regarding its specificities and intersection points from the interdisciplinary care perspective. METHODIntegrative review of the literature from articles available in the Lilacs, SciELO, MEDLINE and PubMed databases, published in Portuguese, English and Spanish from 2005 to 2015. RESULTS: It was identified 23 articles. From these, 17 on the nursing process, six on the single therapeutic project and one about multiprofessional residency. From the analysis, their specificities and intersection points that describe the alignment and similarities between them were identified in the primary and mental health cares. CONCLUSIONS: The single therapeutic project and the nursing process are aligned in health practices in primary and mental health cares. The multiprofessional residency allows this alignment among them, and the nurse contributes to the interdisciplinary care with the nursing process.

Projeto Terapêutico Singular e Processo de Enfermagem em uma perspectiva de cuidado interdisciplinar / Proyecto Singular Terapéutico y Proceso de Enfermería en una perspectiva el cuidado interdisciplinario / Single Therapeutic Project and Nursing Process from an interdisciplinary care perspective

Resumo OBJETIVO Analisar o Projeto Terapêutico Singular e o Processo de Enfermagem quanto as suas especificidades e pontos de interseções, na perspectiva do cuidado interdisciplinar. MÉTODO Revisão integrativa da literatura de artigos disponíveis nas bases de dados Lilacs, SciELO, MEDLINE e PubMed, em português, inglês e espanhol, publicados no período de 2005 a 2015. RESULTADOS Foram identificados 23 artigos. Destes, 17 sobre o Processo de Enfermagem, seis sobre o Projeto Terapêutico Singular e um sobre residência multiprofissional. Da análise identificaram-se as suas especificidades e pontos de interseções que descrevem o alinhamento e similaridades entre os mesmos, nos serviços de atenção básica e saúde mental. CONCLUSÕES O Projeto Terapêutico Singular e o Processo de Enfermagem se alinham nas práticas de saúde nos serviços de atenção básica e saúde mental. A residência multiprofissional possibilita esse alinhamento dos mesmos, e o enfermeiro contribui para o cuidado interdisciplinar justamento com o processo de enfermagem.

Resumen OBJETIVO Analizar el Proyecto Singular Terapéutico y el Proceso de Enfermería como sus características específicas y puntos de intersecciones, desde la perspectiva de la atencíon interdisciplinaria. MÉTODO Revisión integradora de los artículos disponibles en las bases de datos LILACS, SciELO, MEDLINE y PubMed, en portugués, Inglés y Español, publicado en el período 2005-2015. RESULTADOS Se identificaron 23 artículos. De éstos, 17 del proceso de enfermería, seis en el Proyecto Singular Terapéutico y uno residência multiprofesional. El análisis identificó si sus especificidades y puntos de intersecciones que describen la alineación y similitudes entre ellos en la atención primaria de salud y salud mental. CONCLUSIONES El Proyecto Singular Terapéutico y el Proceso de Enfermería se alinean en las prácticas de salud en la atención primaria de salud y salud mental. La residência multiprofesional permite esta alineación de los mismos, y la enfermera contribuye a la atención interdisciplinaria desde justo al PE.

Abstract OBJECTIVE To analyze the single therapeutic project and the nursing process regarding its specificities and intersection points from the interdisciplinary care perspective. METHODIntegrative review of the literature from articles available in the Lilacs, SciELO, MEDLINE and PubMed databases, published in Portuguese, English and Spanish from 2005 to 2015. RESULTS It was identified 23 articles. From these, 17 on the nursing process, six on the single therapeutic project and one about multiprofessional residency. From the analysis, their specificities and intersection points that describe the alignment and similarities between them were identified in the primary and mental health cares. CONCLUSIONS The single therapeutic project and the nursing process are aligned in health practices in primary and mental health cares. The multiprofessional residency allows this alignment among them, and the nurse contributes to the interdisciplinary care with the nursing process.

La aplicación del proceso informático de enfermería: revisión integradora / A aplicação do processo de enfermagem informatizado: revisão integrative / The application of computerized nursing process: integrative review

Objetivo: Identificar en la literatura la evidencia del proceso de enfermería (PE) que se aplica al software. Metodología: Una revisión integradora, la búsqueda se realizó en las bases de datos PubMed, Lilacs y CINAHL y búsqueda inversa en el período de 28 de agosto al 09 de septiembre de 2016. Se utilizaron los descriptores enfermería, proceso de enfermería, sistemas de información en hospital, informática médica, aplicaciones de informática médica, informática en salud pública e informática aplicada a la enfermería. Muestra de 23 artículos. Resultados: Hubo un aumento en la producción a partir de 2000, la mayor parte se originó en Brasil, se caracterizaron por estudios descriptivos. Nos mostraron dos categorías de análisis: el desarrollo y uso del software. La mayoría de las publicaciones contemplan todas las etapas del PE, dos mencionan la teórica y tres utilizan el sistema para las dimensiones de atención y gestión. Las taxonomías utilizadas fueron CIPE, NANDA, NIC, NOC. Conclusión: El uso de software con el PE fortalece la práctica basada en la evidencia y consolida la enfermería como ciencia (AU)

Objetivo: Identificar na literatura evidências sobre o processo de enfermagem (PE) aplicado à softwares. Metodologia: Revisão integrativa, busca realizada nas bases de dados PubMed, LILACS e CINAHL e busca reversa, no período de 28 de agosto a 09 de setembro de 2016. Os descritores foram enfermagem, processo de enfermagem, sistemas de informação hospitalar, informática médica, aplicação de informática médica, informática em saúde pública, e informática em enfermagem. Amostra composta por 23 artigos. Resultados: Houve aumento nas produções a partir de 2000, a maioria das publicações originada do Brasil e caracterizados por estudos descritivos. Evidenciou-se duas categorias de análise: desenvolvimento e utilização de softwares. A maioria contemplava todas as etapas do PE, dois citam o referencial teórico e três utilizam o sistema para as dimensões assistencial e gerencial. As taxonomias utilizadas foram a CIPE, NANDA, NIC, NOC. Conclusão: o uso de softwares com o PE fortalece a prática baseada em evidência e consolida a enfermagem como ciencia (AU)

Objective: To identify in the literature evidences about the nursing process (PE) applied to software. Method: Integrative review, search performed in PubMed, LILACS and CINAHL databases and reverse search, from August 28 to September 9, 2016. The descriptors used were nursing, nursing process, hospital information systems, medical informatics, medical informatics application, public health informatics, and nursing informatics. The sample consisted of 23 articles. Results: There was an increase in productions from 2000, most of the publications originated in Brazil and characterized by descriptive studies. There were two categories of analysis: software development and its usage. Most contemplated all stages of the NP, two cite the theoretical reference and three use the system for the assistance and management dimensions. The taxonomies used were ICNP, NANDA, NIC, NOC. Conclusion: the software’s usage with the EP strengthens evidence-based practice and consolidates nursing as a science (AU)

¿Cómo ayuda la aplicación del proceso enfermero a las mujeres con diagnóstico ansiedad? / How can the application of the nursing process help to women with anxiety nursing diagnosis?

Objetivo: Evaluar las intervenciones grupales de enfermería en mujeres con diagnóstico enfermero ansiedad mediante el resultado NOC autocontrol de la ansiedad. Material y método: Estudio pre-experimental del tipo pretest-postest de un solo grupo realizado en un Centro de Salud Mental de la Región de Murcia a un grupo de 12 mujeres en edad adulta que presentan el diagnóstico enfermero ansiedad. Se realizó a cada paciente la valoración de enfermería por Patrones Funcionales de Salud (PFS) antes y después de la asistencia a las 8 sesiones de intervenciones enfermeras grupales. Al comenzar y al finalizar el grupo, se cumplimentó el criterio de resultado NOC autocontrol de la ansiedad. Las intervenciones enfermeras fueron a) disminución de la ansiedad (5820), terapia de relajación simple (6040), educación sanitaria (5510), enseñanza grupo (5604) y grupo de apoyo (5430). Se tomó como variable independiente las intervenciones enfermeras y como variable dependiente las puntuaciones del resultado NOC, empleándose como instrumento de evaluación. Resultados: El análisis del resultado NOC autocontrol de la ansiedad nos muestra diferencias significativas. Antes de las intervenciones, la media presenta el valor 22.5 y tras las mismas de 37.8 con una desviación típica de 3.22 y 7.11 respectivamente. La mediana antes y después de las intervenciones corresponde con los valores 21 y 37.5. El parámetro del test de los rangos de Wilcoxon corresponde con un valor de Z igual a -2.98 con una p igual a 0.003. Conclusiones: El estado, conducta y percepciones de las pacientes del grupo medido con el resultado autocontrol de la ansiedad, mejora tras recibir las intervenciones enfermeras. La puntuación global de los indicadores empleados en este resultado ha sido apropiada como medida de los efectos de las intervenciones (AU)

Purpose: To evaluate nursing group interventions in women with anxiety nursing diagnosis by self NOC result of anxiety. Methodology: Pre-experimental pretest-posttest study composed by a single group of twelve women in a Mental Health Center of the Region of Murcia. The participants were a group of women in adulthood presenting the nursing diagnosis anxiety. Each patient received 8 group nursing interventions. Before and after the group intervention, a nursing outcome criteria is filled for each patient. The following nursing interventions were used: Anxiety reduction (5820), simple relaxation therapy (6040), health education (5510), group education (5604) and support group (5430). The independent variable was nursing interventions and the dependent variable was NOC punctuations, being used as an assessment tool. Results: The analysis of the NOC result anxiety self-control shows significant differences. Before the intervention, the mean was 22.5 and 37.8 after it with standard deviations of 3.22 and 7.11 for each one. The median was 21 before interventions and 37.5 after them. The Wilcoxon test shows a Z value of -2.98 with p 0.003. Conclusion: The state, behaviour and perception of patients improve with nursing interventions received. The global punctuation of used clinical indicators is a good tool to measure nursing intervention effects (AU)

The visualisation of clinical leadership in the content of nursing education--a qualitative study of nursing students' experiences.

OBJECTIVE: The aim of this study was to describe nursing students' experiences of clinical leadership during their last year of education. BACKGROUND: Work as a nurse is complex with several demands from stakeholders who are colleagues, managers, patients and relatives. Therefore, it is important to provide students with tools for a forthcoming professional life as a nurse. SETTING, PARTICIPANTS AND METHOD: A qualitative descriptive study was carried out in Jordan. Narratives (n=20) written by nursing students in their last year before graduation as a registered nurse were collected. The data were analysed by a manifest content analysis. RESULTS: The results formed one category: (Clinical leadership-safety in being a nurse), and three subcategories (eye-opener, a role model and bridging the gap) described the students' clinical leadership experiences due to the preparation process for being a nurse. Clinical leadership applies theory to practice by using a holistic view in nursing. CONCLUSION: Clinical leadership is a valuable tool for bridging the gap between theory and practice in nursing education. Skills within nursing management clarify and simplify nursing activities, which facilitates the transition from student to nurse. Focus on learning needs in nursing management is needed for stakeholders within education and health care organisations to facilitate graduation of well skilled nurses.

Sesiones clínicas de cuidados para profundizar en el pensamiento enfermero / Clinical sessions on patient care in order to probe into what nurses think

Desde 2009 el Hospital Universitario Virgen de las Nieves (HUVN), en Granada, viene realizando sesiones clínicas de cuidados con el objetivo de profundizar en el uso de la metodología enfermera, y crear el hábito de la reflexión continua sobre la calidad de los cuidados que se aplican. Con este trabajo se pretende dar a conocer la experiencia desarrollada durante los años 2011-2012 en la realización de sesiones clínicas de cuidados. Durante el periodo estudiado se han desarrollado un total de 35 sesiones clínicas de este tipo, distribuidas en los centros asistenciales del complejo hospitalario, de las cuales 19 han sido casos clínicos, 12 actualizaciones en cuidados, tres revisiones de guías de práctica clínica y una revisión de proceso asistencial integrado. La media de asistencia a las sesiones ha sido de 16 profesionales por sesión. Los temas tratados incluyen situaciones de salud específicas de interés en las unidades asistenciales, la indagación en diagnósticos diferénciales y la incorporación de la evidencia científica. Como mejora se propone la incorporación de criterios para la evaluación del proceso enfermero y de la estructura de las sesiones clínicas de cuidados

Since 2009, the Hospital Universitario Virgen de las Nieves (HUVN) has been conducting clinical sessions on patient care, with the objective of achieving a deep understanding about the use of nursing methodology, and creating the habit of continuous reflection about the quality of careapplied. This paper intends to make public the experience developed during the years 2011-2012 in terms of clinical sessions on patient care. During the period studied, 35 clinical sessions on patient care have been conducted, distributed among the healthcare centres of the hospital complex; 19 of these have been clinical cases, 12 have been patient care updates, three reviews of clinical practice guidelines, and one review of integrated healthcare system. The average attendance to these sessions was of 16 professionals per session. The topics covered included specific health situations of interest for patient care units, investigation into differential diagnoses, and the incorporation of scientific evidence. As an improvement, it has been suggested to incorporate criteria forthe assessment of the nursing process, and of the structure of clinical sessions on patient care

A study of the relationship of nursing interventions and cognitions to the physiologic outcomes of care in a simulated task environment.

This study, based on the Expert Performance Approach, examined the clinical nursing performance of participants who were introduced into a simulated task environment requiring them to administer care to a client experiencing an exacerbation of Congestive Heart Failure. This was undertaken to identify cognitive and physiologic variables that differentiate performance levels among participants. Data on participant actions and verbal reports were coded to characterize their relationship with physiologic responses of the Human Patient Simulator. The results demonstrated that physiologic responses to nursing interventions reflect a reliable pattern that can be used to differentiate performance levels.

Depression: a psychiatric nursing theory of connectivity.

This paper presents a theory of connectivity, which was formulated from the findings of a Classical Grounded Theory study that was designed to capture a sample of people's perceptions of living with depression or caring for individuals with depression. Data were collected from: (1) a focus group consisting of people with depression (n = 7), of which five were patients in the community and two were nurses; (2) one-to-one interviews with patients in the community (n = 5) and nurses (n = 5), three of whom had experienced depression from both sides of the caring process; and (3) two 'happy accident' focus groups (n = 25; n = 18) comprising of healthcare workers with a shared understanding of depression. Purposeful sampling was used initially. Thereafter, in keeping with one of the key tenets of grounded theory, theoretical sampling was used until theoretical saturation occurred. Data were analysed using the constant comparative approach together with the NVivo qualitative analysis software package. The core category that emerged was 'connectivity' relating to the connections and disconnections, which people make in their lives. Six key categories emerged all of which were integrated with the core category. Hence, connectivity provided a significant platform for understanding and responding to the life experience of depression. They were: (1) life encounters on the journey to naming; (2) depression: What's in a name? The silent thief; (3) tentative steps to health care; (4) connective encounters and challenges; (5) connecting with self; and (6) self-connection maintenance. Subsequently, a theory, 'Depression: a psychiatric nursing theory of connectivity', surfaced from the overall findings. We argue that this theory of connectivity provides a framework that people working in the field of holistic treatment and care could use to better understand and respond to the life experience of people living with depression.

Measuring spiritual care with informatics.

Nursing is at a critical juncture in creating data repositories that support nursing research and theory development, as health systems adopt and design electronic health records. This article discusses how informatics theory can be used to guide designing nursing documentation screens and analyzing the resulting data sets, while highlighting methods to maximize reliability and validity and to address measurement issues. Examples will be applied to spiritual care, a required dimension of care. These examples present methods to capture and study "soft" areas of nursing that have not traditionally been documented or measured.

Nursing care for adaptation.

The Roy adaptation model has been adopted as the frame of reference for the nursing curriculum at the Universidad de La Sabana School of Nursing in Colombia. The purpose of this paper is to discuss, through an example, the application process of the Roy model, the reflection that has been developed to study in great depth its central concepts and scientific and philosophic principles, and to explain the concept of nursing care for adaptation as a fundamental aspect for its application. Likewise, the process generated from the model's application in teaching and practice are presented.

Addressing cultural heterogeneity among Hispanic subgroups by using Campinha-Bacote's model of cultural competency.

Campinha-Bacote's model "The Process of Cultural Competence in Delivery of Health Care Services" is used to describe Hispanic cultural heterogeneity and to guide nurses in providing culturally competent and sensitive holistic care to individuals from different Hispanic subgroups. But for nurses to do so, healthcare organizations also must make the appropriate resources and structural supports available to them.

Spirituality: a dimension of holistic critical care nursing.

Although many patients face significant physical needs, their mind and spirit may be ill as well. Three facets make up an individual: physical, mental, and spiritual. To provide optimal holistic care, the critical care nurse must take into consideration each of these three aspects. But most importantly, the critical care nurse must recognize that spiritual care begins with oneself. Spirituality is one such area of patient care that, when addressed, can reap positive benefits for both the client and the healthcare provider. This article explores all aspects of spirituality for the critical care nurse.

From the sidelines: coaching as a nurse practitioner strategy for improving health outcomes.

PURPOSE: The purposes of this study were to explore coaching as a nurse practitioner (NP) strategy for improving patient health outcomes and to lay a foundation for validating coaching benefits. DATA SOURCES: Review of coaching literature in psychology, sports, business, and nursing. CONCLUSIONS: Coaching has been reported as successful in psychology, sports, business, and more recently nursing, for assisting people to achieve goals that are important to them. Coaching may be very effective in encouraging, inspiring, and empowering patients to reach their maximum health potential, particularly if lifestyle change is required; however, coaching research is in its early stages. Coaching is not well defined, so claims of coaching benefits must be viewed cautiously. Coaching is an expected NP role competency, but it is not well explicated in the literature. Defining the concept of coaching from multidisciplinary consensus, expanding knowledge of the coaching process, and consciously implementing coaching communication in the NP/patient primary care encounter may result in measurable outcomes that demonstrate coaching effectiveness. IMPLICATIONS FOR PRACTICE: Coaching fits well with the holistic, collaborative approach to patient care which NPs value. Coaching provides an opportunity to shift traditional thinking about patient/provider relationships and how to motivate patients toward behavior change. The challenge for NPs is to take the time to learn the coaching process, employ coaching communication strategies in the primary care encounter, and engage in research that measures coaching effectiveness.

Exploring the assessment process.

Assessment is a fundamental nursing skill that underpins decisions about interventions and priorities in care delivery. Rather than the holistic, individualised approach envisaged in the nursing process, nursing assessment of the sick child in hospital appears to focus mainly on quantitative data and preventing clinical failures. In this article, Carper's (1978) four 'patterns of knowing in nursing' are used to illustrate how assessment could be broadened to better inform nurses' decision making and to make child and family-centred care more of a reality.