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1.
Int J Med Inform ; 134: 104035, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31862610

RESUMEN

BACKGROUND: Currently, it is rare for nursing data to be available in data repositories due to the quality of nursing data collected in clinical practice. To improve the quality of nursing data, the American Nurses Association recommends the use of Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) for coding nursing problems, interventions, and observations in electronic health records. OBJECTIVE: To determine "what is known about the use of SNOMED terminology (Pre-SNOMED CT and SNOMED CT) in nursing". METHODS: We searched four databases and two search engines. We identified 29 articles for review. A modified version of System Development Life Cycle (SDLC), and Mapping Evaluation Assessment (MEA), created by the authors were used for quality assessment. RESULTS: All 29 studies mapped standardized (n = 19) or local nursing terms (n = 10) to the SNOMED terminology. MEA scores ranged from 2-8 (range 0-11) with 25 receiving scores from 5-8. On the modified SDLC (range 0-5), all studies exhibited activities of stage 0 (pre-application integration), with two studies describing integration and preliminary testing of SNOMED CT coded nursing content in applications (stage 2). CONCLUSION: Though efforts are underway to ensure adequate coverage of nursing in SNOMED CT, there were no studies indicating use in nursing practice. The authors offer recommendations for achieving the widespread collection of interoperable SNOMED CT coded nursing data in clinical applications to evaluate nursing's impact on patient outcomes. These include creating a clear professional vision and path to our data goals that builds on sound rationale and evidence, abundant stakeholder engagement, and sufficient resources.


Asunto(s)
Registros Electrónicos de Salud/normas , Proceso de Enfermería/normas , Guías de Práctica Clínica como Asunto/normas , Systematized Nomenclature of Medicine , Medicina Clínica , Humanos , Vocabulario Controlado
2.
J Nurs Adm ; 50(1): 34-39, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31804410

RESUMEN

OBJECTIVE: An Automated Data Entry Process Technology tool was developed to free nurses from data entry tasks, thus creating time for patient care and other activities associated with improvements in performance and job satisfaction. BACKGROUND: Manually transferring data from patient measurement devices to electronic health records (EHRs) is an intensive, error-prone task that diverts nurses from patient care while adversely affecting job performance and employee satisfaction. METHODS: Performance improvement analytics were used to compare matched sets of manual and automated EHR data entries for 1933 consecutive vital signs records created by 49 RNs and certified nursing assistants in a 23-bed medical-surgical unit at a large tertiary hospital. Performance and quality effects were evaluated via nurses' responses to a postintervention survey. RESULTS: Data errors decreased from approximately 20% to 0; data transfer times were reduced by 5 minutes to 2 hours per measurement event; nurses had more time for direct patient care; and job satisfaction improved. CONCLUSION: Data entry automation eliminates data errors, substantially reduces delays in getting data into EHRs, and improves job satisfaction by giving nurses more time for direct patient care. Findings are associated with improvements in quality, work performance, and job satisfaction, key goals of nursing leaders.


Asunto(s)
Benchmarking , Registros Electrónicos de Salud , Satisfacción en el Trabajo , Proceso de Enfermería/normas , Personal de Enfermería en Hospital , California , Unidades Hospitalarias , Humanos , Proceso de Enfermería/economía
3.
Rev Esc Enferm USP ; 53: e03471, 2019 Aug 19.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-31433013

RESUMEN

OBJECTIVE: To identify the prevalence of nursing process documentation in hospitals and outpatient clinics administered by the São Paulo State Department of Health. METHOD: A descriptive study conducted through interviews with nurses responsible for 416 sectors of 40 institutions on the documentation of four phases of the Nursing Process (data collection, diagnosis, prescription and evaluation) and nursing annotations. RESULTS: Of the 416 sectors studied, 89.9% documented at least one phase; 56.0% documented the four phases; 4.3% only documented nursing annotations; 5.8% did not document any phase, nor did the nursing notes. The types of sectors which were less documented were: ambulatory, diagnostic support, surgical center and obstetric center; while the ones which were most documented included: intensive care units, emergency rooms and hospitalization units. The data collection and diagnosis were the least documented phases, both in 78.8% of the sectors. CONCLUSION: Most of the studied sectors document the Nursing Process and do nursing annotations, but there are sectors where documentation does not meet formal requirements. The viability of documentation of all the Nursing Process phases in certain types of sectors needs to be better studied.


Asunto(s)
Documentación/estadística & datos numéricos , Proceso de Enfermería/normas , Registros de Enfermería/normas , Instituciones de Atención Ambulatoria/normas , Brasil , Estudios Transversales , Servicio de Urgencia en Hospital/normas , Hospitales/normas , Humanos , Unidades de Cuidados Intensivos/normas , Entrevistas como Asunto , Salud Pública
4.
Rev Esc Enferm USP ; 53: e03489, 2019 Aug 19.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-31433019

RESUMEN

OBJECTIVE: To identify work process-related causes associated with nursing errors reported in newspapers. METHOD: This was a documentary and qualitative study based on the work process theory and hermeneutic analysis that examined 112 news articles published between 2012 and 2016 in 21 high-circulation Brazilian newspapers, organized and codified using Atlas.ti software. RESULTS: The causes associated with the reported errors were associated with workforce (lack of professionals and training, turnover, work overload, lack of information, recklessness, negligence, and distraction); work instruments (similar labels or packages, storage, lack of product identification and information, and medical prescriptions); and the object of nursing work (overcrowding and specific characteristics of patient). CONCLUSION: Analysis of the possible causes of reported errors identified the negative outcomes of nursing work, while also identifying elements of the work process that influenced these results. The findings emphasize the importance of understanding these errors so they can be avoided and of reviewing nursing work conditions to guarantee quality and safety of care.


Asunto(s)
Errores Médicos/estadística & datos numéricos , Proceso de Enfermería/organización & administración , Enfermería/organización & administración , Brasil , Hermenéutica , Humanos , Enfermería/normas , Proceso de Enfermería/normas , Investigación Cualitativa
5.
J Clin Nurs ; 28(21-22): 4053-4061, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31287603

RESUMEN

AIMS AND OBJECTIVES: To evaluate the opinion of hospital nurses on a group of recommendations aimed at reducing low-value nursing care and, based on these results, to detect low-value practices probably existing in the hospital. BACKGROUND: Low-value nursing care refers to clinical practices with poor or no benefit for patients that may be harmful and a waste of resources. Detecting these practices and understanding nurses' perceptions are essential to developing effective interventions to reduce them. METHODS: We conducted a survey in a tertiary hospital. STROBE guidelines were followed. The questionnaire appraised nurses' agreement, subjective adherence and perception of usefulness of a group of recommendations to reduce low-value nursing care from Choosing Wisely and other initiatives. Practices described in recommendations with an agreement over 70% and a subjective adherence under 70% were categorised as low-value practices probably existing in the hospital. RESULTS: A total of 265 nurses from eight areas of care participated in the survey. The response rate by area ranged between 2%-55%. From the 38 recommendations evaluated, agreement was 96% (95% confidence interval [95%CI], 95%-97%), median subjective adherence was 80% (95%CI, 80%-85%), and usefulness was 90% (95%CI, 89%-92%). Based on these results, we detected seven (0-15) low-value practices probably existing in our hospital, mostly on general practice, pregnancy care and wound care. CONCLUSIONS: We found a great understanding of low-value care between nurses, given the high agreement to recommendations and perception of usefulness. However, several low-value practices may be present in nursing care, requiring actions to reduce them, for instance, reviewing institutional protocols and involving patients in de-implementation. RELEVANCE TO CLINICAL PRACTICE: Hospitals and other settings should be aware of low-value practices and take actions to identify and reduce them. A survey may be a simple and helpful way to start this process.


Asunto(s)
Personal de Enfermería en Hospital/normas , Estudios Transversales , Prestación de Atención de Salud/normas , Humanos , Proceso de Enfermería/normas , Pautas de la Práctica en Enfermería/normas , Encuestas y Cuestionarios
6.
Orthop Nurs ; 38(4): 234-241, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31343626

RESUMEN

BACKGROUND: The Orthopaedic Nurses Certification Board (ONCB) conducts a role delineation study (RDS), also known as a job task analysis, every 5 years. Results identify tasks performed by orthopaedic registered nurses and nurse practitioners, as well as musculoskeletal health conditions commonly experienced by their patients. PURPOSE: The purpose of this study was to define current practice patterns among orthopaedic nurses and nurse practitioners to determine content for future certification examinations. METHOD: An online survey methodology was used to identify task and knowledge statements representative of orthopaedic nursing practice. FINDINGS: Of 6,462 e-mails sent, 904 valid responses were returned (response rate 13.9%). This is lower than results of the Orthopaedic Nurses Certification Board's 2010 RDS (22.7% response rate) but is considered acceptable for an RDS. CONCLUSION: Survey results were analyzed by ONCB Test Committee members with guidance from psychometric staff at PSI/AMP. PSI/AMP staff were used to review and revise examination specifications for the Orthopaedic Nurse Certified (ONC) and Orthopaedic Nurse Practitioner-Certified (ONP-C) certification programs. New examination specification and passing points were implemented with April 2018 testing.


Asunto(s)
Rol de la Enfermera/psicología , Proceso de Enfermería/normas , Enfermería Ortopédica/tendencias , Adulto , Anciano , Certificación/métodos , Práctica Clínica Basada en la Evidencia/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proceso de Enfermería/tendencias , Encuestas y Cuestionarios
8.
Nurse Educ Pract ; 37: 109-114, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-31132586

RESUMEN

This paper discusses the findings from the observation phase of a more extensive, appreciative inquiry qualitative study exploring registered nurses' experiences of administering medications. The observations aimed to explore the participants' application of the five-rights of medication administration in practice. Twenty registered nurses working in inpatient medical/surgical units at a regional Australian hospital were observed administering medications from the commencement to the completion of their shift. A data collection tool based on the five-rights of medication administration was used. The findings indicated that medication administration was not as routine as the rights framework suggests. Indeed, what was observed rarely reflected all the criteria of the rights framework. Notably, in practice, some of the rights were unable to be observed because the critical thinking that underpins the rights are implicit. However, the participants were observed to implement strategies beyond those described by the rights framework that ensured safe and timely medication administration. In brief, medication administration in contemporary healthcare settings is more complicated than the linear process suggested by the rights framework. So more attention is warranted, to the safe practice strategies of nurses who, to deal with complex clinical contexts. Their person-centred strategies respond to patient circumstances and maintain safety.


Asunto(s)
Errores de Medicación/enfermería , Errores de Medicación/prevención & control , Proceso de Enfermería/normas , Seguridad del Paciente/normas , Australia , Competencia Clínica/normas , Hospitales , Humanos , Personal de Enfermería en Hospital , Investigación Cualitativa , Pensamiento
9.
Nurs Leadersh (Tor Ont) ; 32(SP): 98-107, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-31099750

RESUMEN

A commitment to best practice guidelines (BPGs) is crucial for ensuring the safety of patients. Recognizing the power of information technology, Humber River Hospital has integrated BPGs into the electronic medical record (EMR) infrastructure. The large-scale implementation institutes a uniform standard of care and ensures adherence to BPGs through a forcing function designed to require nurses to complete and document the necessary assessments. The initiative strengthens the audit process and provides the opportunity to identify long-term trends. The implications of the quality improvement initiative are discussed. Due to the widespread use of EMRs, the replication of this initiative is economically feasible in other healthcare settings.


Asunto(s)
Registros Electrónicos de Salud/normas , Guías como Asunto/normas , Proceso de Enfermería/normas , Registros Electrónicos de Salud/tendencias , Humanos , Guías de Práctica Clínica como Asunto/normas
10.
Rev. esp. quimioter ; 32(2): 130-136, abr. 2019. tab, graf
Artículo en Inglés | IBECS | ID: ibc-182814

RESUMEN

Introduction: Evaluate the efficacy of an information system addressed to nursing staff to lower the blood culture contamination rate. Methods: A blind clinical trial was conducted at Internal Medicine and Emergency Departments during 2011. After following a reeducation program in BC extraction, participants were randomly selected in a 1:1 ratio. Every participant of the experimental group was informed of each worker's individual performance; whereas the control group was only informed of the global results. Results: A total of 977 blood extractions were performed in 12 months. Blood culture contamination rate was 7.5%. This rate was higher in the Emergency Department than in Internal Medicine (10% vs. 3.8%; p=0.001). Factors associated with the higher risk of contamination were, in the univariate analysis, the extraction through a recently implanted blood route and the time of professional experience, while those associated with a lower risk were the extraction in Internal Medicine and through a butterfly needle. On multivariate analysis, extraction through a recently placed access was an independent risk factor for an increased contamination rate (OR 2.29; 95%CI 1.18-4.44, p=0.014), while individual information about the blood culture results (OR 0.11; 95%CI 0.023-0.57; p=0.008), and more than 9 years of professional experience were asso-ciated with fewer contaminations (OR 0.30; 95%CI 0.12-0.77; p=0.012). In the intervention group the contamination rate diminished by a 26 %. Conclusions: Drawing blood cultures through a recently taken peripheral venous access increased their risk of contamination. The intervention informing the nurse staff of the contamination rate is effective to decrease it


Objetivos: Evaluar la eficacia de un sistema de información dirigido al personal de enfermería, en la reducción de la tasa de contaminación de los hemocultivos. Métodos: Durante el año 2011, se realizó un ensayo clínico en los servicios de Medicina Interna y de Urgencias. Después de seguir un programa de reeducación en la extracción de los hemocultivos, los participantes, fueron aleatorizados en una proporción de 1:1. En el grupo de intervención se informó del porcentaje de hemocultivos contaminados de cada profesional y en el grupo control se aportaba la información del porcentaje global de contaminaciones. Resultados: Durante un periodo de 12 meses se realizaron 977 extracciones. La tasa de contaminación de los hemocultivos fue del 7,5%. Esta tasa fue mayor en Urgencias que en Medicina Interna (10% versus 3,8%, p=0,001). Los factores asociados con mayor riesgo de contaminación fueron, en el análisis univariable: la extracción a través de una vía sanguínea recientemente implantada y el tiempo de experiencia profesional; mientras que los que se asociaron con menor riesgo fueron la extracción en Medicina Interna (versus en Urgencias) y a través de una palomilla. En el análisis multivariable, la extracción de los hemocultivos de una vía recientemente implantada se relacionó de forma independiente con un incremento de las contaminaciones (OR 2,29, IC 95% 1,18-4,44, p=0,014),mientras que la información individual sobre los resultados de los hemocultivos (OR 0.11; IC 95% 0,023-0,57; p=0,008) y la experiencia profesional mayor de 9 años, lo hizo con menos contaminaciones (OR 0,30, IC 95% 0,12-0,77, p=0,012). En el grupo de intervención la tasa de contaminaciones se redujo en un 26%. Conclusión: La extracción de hemocultivos a través de una vena periférica recientemente implantada aumentó el riesgo de contaminación de los mismos. La intervención informativa a los enfermeros de la tasa de contaminación de los hemocultivos, es eficaz para disminuirla


Asunto(s)
Humanos , Manejo de Especímenes/normas , Contaminación Biológica/prevención & control , Preservación de Muestras/métodos , Cultivo de Sangre/normas , Proceso de Enfermería/normas , Recolección de Muestras de Sangre/normas , Métodos Analíticos de la Preparación de la Muestra/normas , Contaminación de Equipos/prevención & control
11.
Nurs Philos ; 20(2): e12239, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-30821896

RESUMEN

The specific arrangements of power/knowledge that characterize nurse interactions with the electronic health record form a panopticon. As health care moves into the 21st century, sophisticated technologies like the electronic health record shape the terrain of professional possibilities. The longer it is in use, the more it is possible to excavate the inherent disciplinary function of electronic health record. A panopticon is a generalizable, replicable apparatus of power that cultivates discipline when similar behaviours are desired from a group of people. This paper traces the arrangements of power/knowledge that characterize nurse interactions with the electronic health record rooted in a trauma critical care setting. Examining the apparatuses of power/knowledge enforced through panopticism in nursing makes the invisible visible. This in turn enables nurses to address the intended and unintended consequences of the electronic health record. If nurses are to effectively shape the direction of their own futures and the future of health care, nurses will need to unpack the invisible techniques of power such as the electronic health record as a panopticon. In the process of building a visible identity, contextualizing nursing knowledge to better care for patients on the one hand and understand the relationships of power that limit us on the other, nurses are neither apolitical nor powerless. Considering the dialectic of power/knowledge in the healthcare setting helps to illuminate spaces to recharacterize nursing, reveal the contributions and knowledge of nurses, and consolidate the professional power of nurses to affect meaningful change and self-governance in the healthcare setting.


Asunto(s)
Registros Electrónicos de Salud/normas , Humanos , Errores Médicos/tendencias , Proceso de Enfermería/normas
12.
J Nurs Care Qual ; 34(3): E1-E6, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30817412

RESUMEN

BACKGROUND: Control over nursing practice (CONP) in the work setting is associated with several positive consequences such as increased job satisfaction, support of teamwork, decreased patient mortality, and improved quality of care. PURPOSE: The purpose of this study was to examine the level of perceived CONP among Jordanian registered nurses (RNs) and determine its relationship with their job satisfaction and quality of patient care. METHOD: A descriptive, cross-sectional correlational design was used. A convenience sample of 230 RNs was recruited from 4 hospitals. RESULT: The RNs had a moderate level of perceived CONP. This control was positively correlated with their work satisfaction and perception of the quality of patient care that they delivered. CONCLUSION: Nurse managers should be encouraged to take into consideration nurses' perceived CONP to improve working conditions for nurses.


Asunto(s)
Satisfacción en el Trabajo , Cultura Organizacional , Calidad de la Atención de Salud/normas , Adulto , Actitud del Personal de Salud , China , Estudios Transversales , Femenino , Humanos , Unidades de Cuidados Intensivos/organización & administración , Masculino , Proceso de Enfermería/normas , Psicometría/instrumentación , Psicometría/métodos , Calidad de la Atención de Salud/estadística & datos numéricos , Encuestas y Cuestionarios , Lugar de Trabajo/psicología , Lugar de Trabajo/normas
13.
Midwifery ; 71: 19-26, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-30640135

RESUMEN

BACKGROUND: Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance that is observed in the beginning of, or first acknowledged during pregnancy. The prevalence of GDM is estimated to be approximately 15% globally and is expected to increase due to growing numbers of overweight and obesity in women in their reproductive age. The nursing management of GDM in terms of lifestyle modifications (exercise, diet and nutrition) and the taking of diabetes medication, if required, and adherence thereto is crucial to prevent maternal and neonatal-perinatal complications. This qualitative study therefore aimed to explore and describe the experiences of women regarding the nursing management they received after being diagnosed with GDM; and the perceptions of nurse-midwives on their nursing management of GDM in Ghana. SETTING: This study was conducted in the military health institutions in Ghana, which includes one hospital and nine satellite clinics referred to as Medical Reception Stations providing antenatal and postnatal care to both military as well as civilian patients. Research on GDM in Ghana is extremely limited. DESIGN: We used a descriptive phenomenological approach to conduct 15 unstructured individual interviews with women that have been diagnosed with GDM (n = 7) and nurse-midwives (n = 8) providing nursing management of GDM during a six months period (December 2014 to May 2015). Audio-recorded data was transcribed, coded and analyzed using an adapted version of Tesch's eight steps for coding. PARTICIPANTS: Seven (n = 7) women between 28 and 45 years of age, with 1 to 3 offspring each, participated. Most women (n = 5) did not have a family history of diabetes. The eight (n = 8) nurse-midwives that participated were between 32 and 50 years old with between 2 and 12 years of experience. FINDINGS: Participants in this study reported similar issues that could assist in better management of GDM. The majority of participants indicated the need for education on GDM, but both women and nurse-midwives acknowledged that this education is hugely lacking. Participants generally felt that emotional support for women is critical and it was included in the nursing management of GDM. Both groups of participants acknowledged that involving women and their significant others in the nursing management of GDM is important. Cultural and socio-economic issues, such as cultural beliefs that clashed with diabetic diets, lack of financial and social grants and limited nurse-midwifery staff were mentioned by both groups to affect the nursing management of GDM. KEY CONCLUSIONS: The results demonstrate that, despite the reported challenges experienced by nurse-midwives and women, it was evident that the aim of nurse-midwives was to manage GDM as optimally as possible for women diagnosed with GDM, while considering the constraints established in the results. The challenges identified, specifically in terms of lack of education and cultural and socio-economic issues that affect the quality of and adherence to the nursing management of GDM, need to be addressed in order to optimize care for women diagnosed with GDM in Ghana. IMPLICATIONS FOR PRACTICE: Based on our findings, recommendations are provided that can assist nurse-midwives and other health practitioners to provide comprehensive nursing management to women that have been diagnosed with GDM.


Asunto(s)
Diabetes Gestacional/enfermería , Enfermeras Obstetrices/psicología , Proceso de Enfermería/normas , Adulto , Femenino , Ghana , Humanos , Persona de Mediana Edad , Relaciones Enfermero-Paciente , Embarazo , Investigación Cualitativa
14.
J Nurs Manag ; 27(4): 815-832, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-30615230

RESUMEN

AIM: To map the research methods, frameworks, structures, processes and outcomes investigated to date when implementing nursing bedside shift reports (BSRs). BACKGROUND: BSRs have become an area of increased interest among nurse managers (NMs) with several projects aiming at implementing bedside reports also as a strategy to increase nursing surveillance and reduce adverse events. However, to date, no summary of the available evidence has been provided with regard to research methods, theoretical frameworks underpinning BSR implementation and outcomes aiming at supporting NM decision-making in this field. EVALUATION: A scoping review including quantitative studies written in English and retrieved from five databases was performed in 2018. KEY ISSUES: Twenty-two studies originating from USA, Australia, Finland and Sweden, largely monocentric in nature and involving mainly medical/surgery units, have been performed to date. BSR implementation has been conducted mainly under organisational change theories, patient safety and nursing conceptual models. The BSR outcomes have been measured at the patient, nurse and organisational levels and reported positive trends. CONCLUSION: Professional reports-describing success transitions from traditional methods of handover to BSRs, and scientific studies aimed at improving evidence in the field, have been conducted to date, in order to document BSR implementation processes and outcomes. IMPLICATIONS FOR NURSING MANAGEMENT: BSRs should be designed and conducted under a theory of organisational change; moreover, clinical nurses should be trained and supported in the transition from the traditional shift report to the BSR; while implementing this transition, outcomes should be set at the patient, nurses and organisational levels with the aim of tracing the comprehensive effects of the change.


Asunto(s)
Proceso de Enfermería/normas , Pase de Guardia/normas , Humanos , Proceso de Enfermería/tendencias , Calidad de la Atención de Salud/normas , Calidad de la Atención de Salud/tendencias
15.
Jpn J Nurs Sci ; 16(2): 155-171, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-30156061

RESUMEN

AIM: To develop a competency assessment instrument for nurses who have completed an outcome-based educational program based on national standards and to assess the content-, construct-, and criterion-related validity of that instrument. METHODS: In the development stage, the competencies of nurses with 1-3 years' clinical experience after the completion of nursing education and training programs, based on national standards, were identified. A systematic literature review was conducted to derive the competencies in addition to the 12 national standard competencies. In the evaluation stage, the content-, construct-, and criterion-related validity of the developed tool were verified. For verification of the content validity at each stage, the participants were 10 nurse managers of general hospitals and 10 nurse professors. A factor analysis was conducted to assess the construct validity and the Cronbach's alpha coefficients and item-total correlation were used to assess the reliability of the developed scale. For the factor analysis, the participants were 141 nurses with 1-3 years' clinical experience who were recruited from four general hospitals. In order to evaluate the construct- and criterion-related validity, the correlations between a nursing performance measurement scale, a self-leadership tool, and the developed scale were examined. RESULTS: A competency assessment instrument, consisting of 19 items on a 4-point scale, was developed and validated for assessing the competencies among nurses with 1-3 years' experience. CONCLUSIONS: Nursing research, policy awareness, and leadership competencies were required by the Korean Accreditation Board of Nursing Education for nursing college graduates, but were removed due to poor content validity, indicating a need for nursing professionals to bridge the gap between educational standards in nursing colleges and clinical settings.


Asunto(s)
Competencia Clínica , Educación en Enfermería/normas , Proceso de Enfermería/normas , Concienciación , Análisis Factorial , Femenino , Humanos , Masculino , Psicometría , Reproducibilidad de los Resultados , República de Corea
16.
J Nurs Care Qual ; 34(3): 236-241, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30198954

RESUMEN

BACKGROUND: Hospital controlled drug processes are established to adhere to legislation, with little consideration of efficiency of processes. LOCAL PROBLEM: A controlled drug process existed, where nurses requested a porter to collect a hand-written order; however, only 19% of drug orders were processed this way. Instead, an unscheduled, ad hoc process led to an average of 17 nurse journeys to pharmacy daily. We aimed to reduce nurse journeys to the pharmacy by 25% to release nursing time. METHODS: A pre-/postintervention design was used with Lean Six Sigma methods. INTERVENTIONS: A multifaceted intervention involved process redesign, increasing the frequency of a porter-led delivery service, amending delivery times to reflect times of greatest need, and streamlining checking requirements. RESULTS: Following implementation, there was a statistically significant 44% decrease in nurse journeys to pharmacy for drug collections, which was maintained after 18 months. CONCLUSIONS: Interprofessional collaboration improving hospital-wide processes can have significant benefits for the release of nursing time.


Asunto(s)
Sustancias Controladas/administración & dosificación , Sistemas de Medicación/normas , Proceso de Enfermería/estadística & datos numéricos , Humanos , Sistemas de Medicación/legislación & jurisprudencia , Proceso de Enfermería/normas , Indicadores de Calidad de la Atención de Salud/estadística & datos numéricos , Factores de Tiempo , Gestión de la Calidad Total/métodos
17.
J Nurs Care Qual ; 34(3): 269-272, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30480610

RESUMEN

BACKGROUND: Despite evidence of the positive impact of the clinical nurse leader (CNL) role, implementation of supplemental nursing roles has proven to be challenging due to unclear role explanations and organizational unfamiliarity. PROBLEM: Nurses practice in a dynamic environment and need to cope with the rapid pace of change in practice roles. Outside of the preparation of the CNL, many nursing professionals are not educated or prepared on the essential aspects the CNL role. APPROACH: A graphic illustration was developed to facilitate discussion and provide insight into the CNL role, with the aim of creating consensus on the CNL role functions and expectations. OUTCOMES: Following the implementation of the CNL practice model illustration, participants reported a significant improvement in their understanding and importance of the CNL role. CONCLUSIONS: Professional practice model illustrations may be beneficial in developing a consensus of practice.


Asunto(s)
Enfermeras Clínicas , Rol de la Enfermera/psicología , Proceso de Enfermería/normas , Guías de Práctica Clínica como Asunto/normas , Humanos , Sudeste de Estados Unidos , Encuestas y Cuestionarios
18.
Nurse Educ Pract ; 34: 111-116, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30513455

RESUMEN

Registered Nurses (RNs) are regulated health professionals who are educated and accountable for safe medication administration (MA). Binding their practice are standards, policies, procedure and legislation. MA competence is taught and assessed during professional pre-registration education programs. However, different philosophies, theories and models are used by education providers making curriculum content disparate and competency frameworks diverse. Additionally, healthcare contexts are increasingly complex and clinical environments unpredictable. Competency models must respect contemporary practice. This paper focusses on the outcomes of Australian PhD research that combined Appreciative Inquiry (AI) principles with a qualitative study to identify MA safety strategies. In this 2-phase descriptive study, twenty RNs were observed then interviewed about their MA experiences. This paper discusses the interview findings. The participants explained how they assessed patient's needs and implemented strategies to administer medications safely. They presented their actions as being underpinned by a desire to do 'the right thing for the patient' despite their practice going beyond traditional procedural frameworks and not reflecting organisational protocols. Instead, they developed common strategies to enhance safe MA. The participants' described using clinical reasoning and patient-centredness during MA. This study contributes to the knowledge needed for future practice development by highlighting what works.


Asunto(s)
Sistemas de Medicación/normas , Proceso de Enfermería/normas , Australia , Competencia Clínica/normas , Humanos , Proceso de Enfermería/tendencias , Seguridad del Paciente/normas , Investigación Cualitativa
19.
Rev. gaúch. enferm ; 40: e20180142, 2019. tab, graf
Artículo en Portugués | LILACS | ID: biblio-1043034

RESUMEN

Resumo OBJETIVO Analisar a produção científica sobre o Método Tracer na área da enfermagem. MÉTODO Revisão integrativa, realizada com 22 artigos localizados nas bases de dados: Literatura Latino-Americana e do Caribe em Ciências e Saúde (LILACS); Medical Literature Analysis and Retrieval System Online(Medline/PubMed); Scientific Eletronic Library Online (SciELO); Cumulative Index to Nursing & Allied Health Literature (CINAHL) eWeb of Science. As estratégias de busca incluíram descritores e palavras-chave: Método Tracer, Método traçador, Método rastreador, Método de avaliação, Usuário Guia e Enfermagem correlacionados e combinados com operadores booleanos. RESULTADOS Organizaram-se os dados segundo os cenários de aplicação do método, a saber: agravos à saúde como condição traçadora para avaliar a qualidade dos cuidados, conformidades e não conformidades em relação aos protocolos institucionais, reflexão e capacitação para a acreditação. CONCLUSÃO O Método Tracer é utilizado para avaliação e melhoria da qualidade da assistência.


Resumen OBJETIVO Analizar la literatura científica sobre el Método Tracer en el área de enfermería. MÉTODO Revisión integrativa de la literatura, conducida con 22 artículos en las bases de datos: Literatura Latinoamericana y Caribe en Ciencias de la Salud (LILACS); Medical Literature Analysis and Retrieval System Online(Medline/PubMed); Scientific Electronic Library Online (SciELO); Cumulative Index to Nursing & Allied Health Literature (CINAHL) y Web of Science. La búsqueda incluyeron las palabras clave: trazador, método de evaluación, guía del usuario y enfermería relacionados y combinados con operadores booleanos. RESULTADOS Los datos se organizaron según los escenarios de aplicación del método: condición de salud estampados plotter para evaluar la calidad de atención, cumplimiento y no cumplimiento de protocolos, reflexión y formación para la acreditación. CONCLUSIÓN El Método Tracer se utiliza para mejorar la calidad de la atención.


Abstract OBJECTIVE To analyze the scientific literature about the Tracer Method in the area of nursing. METHOD Integrative literature review with 22 articles from the following databases: Latin American and Caribbean Literature in Health Sciences (LILACS); Medical Literature Analysis and Retrieval System Online(Medline/PubMed); Scientific Electronic Library Online (SciELO); Cumulative Index to Nursing & Allied Health Literature (CINAHL) and Web of Science. The search strategy included descriptors and keywords, as follows: Método Tracer, Método Traçador, Método Rastreador, Método de Avaliação, Usuário Guia amd Enfermagem correlated and combined with Boolean operators. RESULTS Data was organized according to the scenarios where the method was applied, namely: health condition as a tracer condition for assessing the quality of care, compliance and non-compliance regarding the institutional protocols, reflection and training for accreditation. CONCLUSION The Tracer Methodology is used for evaluating and improving the quality of care.


Asunto(s)
Humanos , Calidad de la Atención de Salud , Almacenamiento y Recuperación de la Información/métodos , Proceso de Enfermería/normas , Estados Unidos , Brasil , Joint Commission on Accreditation of Healthcare Organizations , Mejoramiento de la Calidad , Seguridad del Paciente , Necesidades y Demandas de Servicios de Salud , Acreditación
20.
Int J Palliat Nurs ; 24(12): 585-596, 2018 12 02.
Artículo en Inglés | MEDLINE | ID: mdl-30571248

RESUMEN

BACKGROUND: Most deaths occur in people over the age of 65 years, yet there is widespread evidence that older people have inequitable access to good palliative and end-of-life care. For people with dementia, there are further barriers to receiving palliative care. Identifying when older people with dementia are reaching the end of their lives is not straightforward. A palliative approach to care has been recognised as key in UK practice guidance; the National Institute of Health and Care Excellence recommends that, from diagnosis, people living with dementia should be offered flexible, needs-based palliative care that takes into account how unpredictable dementia progression can be. However there are still wide gaps in care in the dementia pathway, largely because commissioning is fragmented. METHOD: This paper describes the Admiral Nurse case management approach to palliative care by benchmarking its practice against the European Association of Palliative Care white paper recommendations for palliative care in dementia.


Asunto(s)
Benchmarking , Demencia/enfermería , Enfermería de Cuidados Paliativos al Final de la Vida/normas , Proceso de Enfermería/normas , Cuidado Terminal/normas , Anciano , Anciano de 80 o más Años , Femenino , Servicios de Salud para Ancianos , Humanos , Masculino , Medicina Estatal , Reino Unido
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