Components of Professional Practice Models.

OBJECTIVE: This study describes common components of nursing professional practice models (NPPMs) of Magnet ® -designated nursing service organizations. BACKGROUND: Components of professional practice models have not been consistently analyzed, suggesting a need to identify their concepts. Evidence-based guidelines may be unavailable to assist in the creation and revision of models. METHODS: A checklist was used to analyze 56 Web-based NPPMs of Magnet-designated nursing departments. RESULTS: Checklist items showed a match with parent organizations, an emphasis on patient- or family-centered care, a commitment to quality nursing services, and nursing's professional distinctiveness. Responses indicated engagement in shared governance and support of nursing staff's professional development. The concepts of health, care of sick and well people, and scope of nursing services were inconsistently addressed and call for further research. CONCLUSION: Nurse leaders should examine concepts in NPPMs and the extent they distinguish nursing's professional identity both within and externally to the organization.

A blueprint for nursing innovation centers.

BACKGROUND: The interest in and demand for healthcare innovation has heightened amid the COVID-19 pandemic. Organizations are challenged to balance the goals of daily operations with innovation to stay relevant and compete in the marketplace. Innovation is critical for not only the success and sustainability of organizations, but the well-being of the faculty, staff, and clients they serve. PURPOSE: In this article, we present an overview of several Nursing Innovation Centers in the United States as well as examples of colleges without formal innovation centers but who are addressing innovation in their programs. METHODS: We examined the subjective experience of nursing innovation in seven colleges of nursing using semi-structured intervieweds and thematic analysis. FINDINGS: We discuss four themes for creating an innovation center or innovation focus and six themes important for sustainability and impact. In addition, we provide a working model for these themes and provide lessons learned along with trends and recommendations for the future. DISCUSSION: This information provides guidance and a framework for academic and practice organizations aspiring to create opportunities for innovation to flourish in their institutions. We also encourage leadership to critically evaluate and address biases in faculty hiring, research evaluation, publication practices, educational opportunities and mentoring to overcome the diversity innovation paradox.

The development of inpatient cost and nursing service weights in a tertiary hospital in Malaysia.

BACKGROUND: The current healthcare sector consists of diverse services to accommodate the high demands and expectations of the users. Nursing plays a major role in catering to these demands and expectations, but nursing costs and service weights are underestimated. Therefore, this study aimed to estimate the nursing costs and service weights as well as identify the factors that influence these costs. METHODS: A retrospective cross-sectional descriptive study was conducted at Universiti Kebangsaan Malaysia Medical Centre (UKMMC) using 85,042 hospital discharges from 2009 to 2012. A casemix costing method using the step-down approach was used to derive the nursing costs and service weights. The cost analysis was performed using the hospital data obtained from five departments of the UKMMC: Finance, Human Resource, Nursing Management, Maintenance and Medical Information. The costing data were trimmed using a low trim point and high trim point (L3H3) method. RESULTS: The highest nursing cost and service weights for medical cases were from F-4-13-II (bipolar disorders including mania - moderate, RM6,129; 4.9871). The highest nursing cost and service weights for surgical cases were from G-1-11-III (ventricular shunt - major, RM9,694; 7.8880). In obstetrics and gynaecology (O&G), the highest nursing cost and service weights were from O-6-10-III (caesarean section - major, RM2,515; 2.0467). Finally, the highest nursing cost and service weights for paediatric were from P-8-08-II (neonate birthweight > 2499 g with respiratory distress syndrome congenital pneumonia - moderate, RM1,300; 1.0582). Multiple linear regression analysis showed that nursing hours were significantly related to the following factors: length of stay (ß = 7.6, p < 0.05), adult (ß = - 6.0, p < 0.05), severity level I (ß = - 3.2, p < 0.05), severity level III (ß = 7.3, p < 0.05), male gender (ß = - 4.2, p < 0.05), and the elderly (ß = - 0.5, p < 0.05). CONCLUSIONS: The results showed that nursing cost and service weights were higher in surgical cases compared to other disciplines such as medical, O&G and paediatric. This is possible as there are significant differences in the nursing activities and work processes between wards and specialities.

Community nursing services during the COVID-19 pandemic: the Singapore experience.

Community nurses in Singapore support vulnerable older persons with chronic health condition(s). In the situation of scaled-down community health and social services during the COVID-19 outbreak, the community nursing team adopted measures for pandemic preparedness. This report is to share the Singapore General Hospital community nursing experience, preparation and transforming efforts during the pandemic. Team segregation, active screening and triage before visits and other precautionary measures were executed to minimise the risk of exposure to COVID-19. There was a shift from face-to-face to teleconsultation to meet the requirement of safe social-distancing. Community nursing teams continued to play an active role in supporting older persons during the pandemic, despite the challenges. Moving to the lockdown phase ('circuit breaker'), teleconsultation, virtual meetings and integrated partnerships were essential to ensure healthcare accessibility and continuity of care. The experience gleaned was valuable to advance future community nursing services in the evolving healthcare landscape. Structured teleconsultation and technology advancement are useful to complement the service.

[KEY INDICATORS OF PERFORMANCE AS A METHOD FOR MONITORING NURSING SERVICE].

Key indicators of performance (KPI) can be used to show the contribution of each employee or department/department to productivity in areas where quality or effectiveness can be measured. Performance indicators are usually agreed at the national or local level. When choosing a performance indicator for a nursing service, an analysis of the recommendations for testing effectiveness was required. As part of the introduction of a new model of management of nursing services in the Republic of Kazakhstan in 2018, the working group developed key indicators of performance assessment of the nursing service in order to try to demonstrate the impact of nursing on the quality of care. In 2019, in order to monitor the activities of nursing specialists in pilot medical organizations, work was carried out to assess the performance indicators of nursing specialists. These indicators were aimed at assessing the structure of nursing services, nursing process and the results of activities of nursing specialists in organizations providing outpatient and inpatient care.

Whose centre is it anyway? Defining person-centred care in nursing: An integrative review.

AIM: The aims of this literature review were to better understand the current literature about person-centred care (PCC) and identify a clear definition of the term PCC relevant to nursing practice. METHOD/DATA SOURCES: An integrative literature review was undertaken using The Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Scopus and Pubmed databases. The limitations were English language, full text articles published between 1998 and 2018 within Australian, New Zealand, Canada, USA, Europe, Ireland and UK were included. The international context off PCC is then specifically related to the Australian context. REVIEW METHODS: The review adopted a thematic analysis to categorise and summarise themes with reference to the concept of PCC. The review process also adhered to the Preferred Reporting System for Meta-Analysis (PRISMA) and applied the Critical Appraisal Skills Programme (CASP) tools to ensure the quality of the papers included for deeper analysis. RESULTS: While definitions of PCC do exist, there is no universally used definition within the nursing profession. This review has found three core themes which contribute to how PCC is understood and practiced, these are People, Practice and Power. This review uncovered a malalignment between the concept of PCC and the operationalisation of the term; this misalignment was discovered at both the practice level, and at the micro, meso and micro levels of the healthcare service. CONCLUSION: The concept of PCC is well known to nurses, yet ill-defined and operationalised into practice. PCC is potentially hindered by its apparent rhetorical nature, and further investigation of how PCC is valued and operationalised through its measurement and reported outcomes is needed. Investigation of the literature found many definitions of PCC, but no one universally accepted and used definition. Subsequently, PCC remains conceptional in nature, leading to disparity between how it is interpreted and operationalised within the healthcare system and within nursing services.

Gestión y liderazgo de los servicios de enfermería en el plan de emergencia de la pandemia COVID-19: La experiencia del Hospital Clínic de Barcelona / Management and leadership of nursing services in the emergency plan for the pandemic COVID-19: the experience of the clinic hospital of Barcelona

A nivel internacional, la enorme demanda para gestionar la pandemia del COVID-19 ha supuesto un reto tanto en la provisión de personal cómo en suministros y material sanitario. No existe precedente ni publicaciones relacionadas con la gestión y liderazgo de los servicios de enfermería en España dentro del plan de emergencia de la pandemia COVID-19. En este artículo se describe la experiencia del Hospital Clínico de Barcelona en las circunstancias extraordinarias actuales que constituyen, sin duda, una gestión enfermera de enorme magnitud y sin precedentes debido al elevado número de personas afectadas y el extraordinario riesgo del personal sanitario. Siguiendo las orientaciones nacionales e internacionales para paliar la pandemia, proteger la salud y prevenir la propagación del brote. La capacidad de trabajo en equipo, la gestión emocional y el respeto a las decisiones organizativas han hecho posible que se hayan podido afrontar los retos que la pandemia ha puesto por delante y que desde la Dirección de Enfermería se pueda liderar de forma serena y ordenada las diferentes acciones a realizar. Por último, será necesario continuar con un profundo análisis de la situación y de las acciones desarrolladas para poder identificar las áreas de mejora, así como evaluar la globalidad del proceso

At the international level, the enormous demand to manage the COVID-19 pandemic has posed a challenge both in the provision of personnel and in supplies and sanitary material. There is no precedent or publication related to the management and leadership of nursing services in Spain within the emergency plan for the COVID-19 pandemic. This article describes the experience of the Hospital Clinico de Barcelona in the current extraordinary circumstances that undoubtedly constitute a nursing management of enormous magnitude and unprecedented due to the high number of people affected and the extraordinary risk of healthcare personnel. Following national and international guidelines to alleviate the pandemic, protect health and prevent the spread of the outbreak. The ability to work as a team, emotional management and respect for organizational decisions have made it possible to face the challenges that the pandemic has put in place and that the Nursing Department can lead in a calm and orderly manner the different actions to perform. Lastly, it will be necessary to continue with an in-depth analysis of the situation and of the actions carried out in order to identify the areas for improvement as well as to evaluate the overall nature of the process

Innovación y gestión del cuidado / Innovation and care management

El tema de la innovación es uno de los aspectos recurrentes en el mundo actual y, en consecuencia, de enorme interés en el ámbito de la atención sanitaria y quizás, muy especialmente, en el de los cuidados enfermeros. Basta ver cualquier periódico profesional o sanitario en los que se encuentran multitud de noticias genéricas o específicas sobre este tema y sus implicaciones en la gestión o los resultados, o simplemente en la reputación de una determinada organización. También aparece frecuentemente en los medios de difusión general, si bien ligada más con la actividad médica u organizativa. Como toda palabra de moda, produce un cierto temor a su mal uso o banalización, cosa que ocurre a menudo. Así pues, se presenta una reflexión sobre su significado, su realidad y sus consecuencias para la gestión enfermera

The topic of innovation is one of the recurring aspects in the world today, and consequently it causes a huge interest in the healthcare setting and maybe particularly in the nursing care setting. In any professional or healthcare newspaper, there are plenty of general or specific news about this matter and its consequences in management or results, or simply in the reputation of a specific organization. It also appears frequently in the general media, but in this case more linked to medical or organizational activities. Just like any trendy word, it causes some fear in terms of its incorrect use or trivialization, which will frequently happen. Therefore, we present here some reflections on its meaning, its reality, and its consequences for nursing management

Twenty years of management of care in Chile: what we know, what we do not know, what is yet to come. An analysis of arguments.

For over 20 years, the notion of 'management of care' has been foregrounded as key in the jurisdiction of the nursing profession, with the aim of detaching itself from the wider medical umbrella. A number of voices have advocated such centrality. These include juridical, academic and occupational perspectives. Critical stances, although peripheral, have also been voiced. These have been received, at best, with a 'polite silence' in mainstream circles.By looking at the arguments surrounding the 'management of care' circulated in these two decades, this article reports the various forms of discursive practice that participate in the political process of autonomy building. Particularly, we focus on the validity of the arguments as well as the cohesion across arguments within the knowledge system. In doing so, we evaluate its main premises and foundations, the reach of the conceptualisation and its disjointed, differing and incomplete bases. Similarly, we used an inferential technique for the reconstruction of omitted and unexpressed assertions.The article introduces an approach of the humanities that is seldom seen in healthcare. It also proposes a research agenda in regard to management of care for the upcoming decades.

Nursing Consultation in a Public Bathhouse: A Community Resource for the Vulnerable Population in a European Capital.

BACKGROUND: In Portugal's capital, Lisbon, there are 19 public showers (PS) attended by a vulnerable population. AIM: To describe the assessment and interventions performed during nursing consultations. METHOD: This is a quantitative, observational, and cross-sectional study. FINDINGS: In a convenience sample of 77 users, 52% are females, 43% are single, 52% do not possess any economic resources, 87% have mental health issues, and 32% are homeless. The main nursing focuses found were: arterial hypertension, disease management skills, and emotional suffering. The most used nursing intervention is listening, followed by the expression of feelings, valuing the individual and his/her story, analyzing causes, providing support, and comforting. CONCLUSIONS: This study shows that the main focus of the nursing care in these facilities is the human being. The respect for individuality and dignity was the primary concern, in an attempt to empower the individual to better manage his/her health and illness processes.

Significant influencing factors and practical solutions in improvement of clinical nursing services: a Delphi study.

BACKGROUND: Clinical services evaluation with specific indicators are very helpful to identify improvable points. This study was conducted to analyze the factors affecting the quality of clinical nursing services and offer practical solutions for accreditation of clinical nursing services. METHODS: The present study was conducted using Delphi method with two rounds. At the beginning of the study a questionnaire was prepared using results of another project (clinical nursing services audit). This questionnaire was sent to 47 nursing and accreditation professionals. After the first round, causes and solutions were categorized. Then participants were asked to comment on the significance of each strategy on the prepared questionnaire. RESULTS: In the first round of Delphi in response to the question about the main causes and solutions of low quality of nursing clinical services, 394 causes and 212 solutions were mentioned by the participants. In the second round, considering moralists and specialization in the selection of nursing managers, staffing according to workload and attendance in comprehensive exam after graduation and before entering clinical fields attained the most importance. CONCLUSION: Mismatch of human resources with workload and lack of clarity with regard to duties have maximum correlation with poor quality of care. Organizational structure and communication program categories gained the highest and lowest importance respectively. This information could be used by nursing managers and policy makers to plan programs in order to improve the quality of clinical nursing services.

Representações de supervisão na perspectiva dos enfermeiros coordenadores de um hospital de ensino / Representaciones de supervisión en la perspectiva de enfermeros coordinadores de un hospital de enseñanza / Nursing supervision from the perspective of nurse coordinators of a teaching hospital

Objetivo compreender a percepção dos Coordenadores de Áreas Assistenciais de Enfermagem sobre a supervisão de enfermagem realizada pelos enfermeiros assistenciais no contexto hospitalar. Método estudo de abordagem qualitativa, fundamentado na Teoria das Representações Sociais. Foram entrevistados 16 coordenadores de enfermagem de um hospital de ensino. Os dados foram analisados pelo método Conteúdo Qualitativo-Temático. Emergiram três categorias empíricas: Supervisão de Enfermagem: Ferramenta Gerencial que Qualifica o Cuidado, Imbricamento entre Administrar e Cuidar e Supervisionar: Reflexo do Processo Formativo e Contexto Institucional. Resultados a significação dada pelo grupo social dos coordenadores sobre a supervisão de enfermagem praticada revela uma prática gerencial de controle e pouco educativa, porém com impacto positivo para a qualidade assistencial. Conclusão a percepção dos Coordenadores de Áreas Assistenciais de Enfermagem sobre a supervisão de enfermagem revelou deficiências na implementação atribuídas às lacunas da formação, às demandas excessivas no trabalho e à falta de capacitação em relação à prática da supervisão.

Objetivo comprender la percepción de Coordinadores de Áreas Asistenciales de Enfermería sobre supervisión de enfermería por enfermeros asistenciales en el contexto hospitalario. Método estudio cualitativo, basado en la Teoría de las Representaciones Sociales. Se entrevistaron a 16 coordinadores de enfermería de hospital de enseñanza. Datos analizados por el método Contenido Cualitativo-Temático. Emergieron tres categorías empíricas: Supervisión de Enfermería: Herramienta Gerencial que Qualifica la Atención, Imbricamiento entre Administrar y Cuidar y Supervisionar: Reflejo del Proceso Formativo y Contexto Institucional. Resultados la significación del grupo social de coordinadores sobre supervisión de enfermería practicada revela práctica gerencial de control y poco educativa, pero con impacto positivo para calidad asistencial. Conclusión la percepción de Coordinadores de Áreas Asistenciales de Enfermería sobre supervisión de enfermería reveló deficiencias en la implementación atribuidas a las lagunas de la formación, a las demandas excesivas en el trabajo y falta de capacitación en relación a la práctica de supervisión.

Objective to report the opinions of nurse coordinators on supervisory activities performed by nursing assistants in the hospital setting. Method a qualitative study based on the theory of social representations. Sixteen nursing coordinators from a teaching hospital were interviewed. The data were analyzed using qualitative thematic content analysis. Nursing supervision was divided into three categories: 1. a management tool that qualifies care, 2. an activity that interconnects nursing management and health care practice, and 3. a reflection of the formative process and the institutional context. Results the opinions of nursing coordinators indicate that nursing supervision is a managerial practice based primarily on the exercise of authority but not on supervision training. However, this practice has a positive impact on the quality of care. Conclusion the opinions of nursing coordinators about nursing supervision revealed deficiencies related to educational gaps, excessive work demands, and lack of supervision training.

Nurses who work in rural and remote communities in Canada: a national survey.

BACKGROUND: In Canada, as in other parts of the world, there is geographic maldistribution of the nursing workforce, and insufficient attention is paid to the strengths and needs of those providing care in rural and remote settings. In order to inform workforce planning, a national study, Nursing Practice in Rural and Remote Canada II, was conducted with the rural and remote regulated nursing workforce (registered nurses, nurse practitioners, licensed or registered practical nurses, and registered psychiatric nurses) with the intent of informing policy and planning about improving nursing services and access to care. In this article, the study methods are described along with an examination of the characteristics of the rural and remote nursing workforce with a focus on important variations among nurse types and regions. METHODS: A cross-sectional survey used a mailed questionnaire with persistent follow-up to achieve a stratified systematic sample of 3822 regulated nurses from all provinces and territories, living outside of the commuting zones of large urban centers and in the north of Canada. RESULTS: Rural workforce characteristics reported here suggest the persistence of key characteristics noted in a previous Canada-wide survey of rural registered nurses (2001-2002), namely the aging of the rural nursing workforce, the growth in baccalaureate education for registered nurses, and increasing casualization. Two thirds of the nurses grew up in a community of under 10 000 people. While nurses' levels of satisfaction with their nursing practice and community are generally high, significant variations were noted by nurse type. Nurses reported coming to rural communities to work for reasons of location, interest in the practice setting, and income, and staying for similar reasons. Important variations were noted by nurse type and region. CONCLUSIONS: The proportion of the rural nursing workforce in Canada is continuing to decline in relation to the proportion of the Canadian population in rural and remote settings. Survey results about the characteristics and practice of the various types of nurses can support workforce planning to improve nursing services and access to care.

Efectos de la tecnología en los cuidados de enfermería / Efeitos da tecnologia na assistência da enfermagem / Effects of technology in nursing care

La visión de la tecnología como herramienta de ayuda destinada a mejorar las condiciones de las personas influye en múltiples aspectos de la asistencia y del cuidado. La tecnología en enfermería y en los cuidados abarca; el papel de la enfermera como nexo de unión entre la tecnología y el paciente, la aplicación de una ética del cuidado, la capacitación del manejo de la tecnología y la educación en distintos ámbitos. La falta de manejo junto a problemas de funcionamiento pueden provocar ansiedad y estrés en las enfermeras, el uso de la tecnología dentro de la formación de profesionales de enfermería, refuerza las habilidades con las que se llegue a la práctica clínica o a las instituciones, favoreciendo la adaptación al entorno laboral. El innovar no solo depende de las instituciones de salud, la implementación de las nuevas tecnologías, busca que los profesionales vean una oportunidad para el crecimiento profesional y que se interesen por el desarrollo de proyectos que vayan encaminadas al uso y su aplicación. La tecnología es un elemento neutro, son las actuaciones de la enfermera lo que determina la presencia de aspecto positivos o negativos asociados a la aplicación de tecnología (AU)

The vision of technology as an aid to improve the conditions of those influences multiple aspects of health and care. Technology in nursing and care covered; the role of the nurse as a link between technology and the patient, the application of an ethic of care, training of management of technology and education in various fields. Lack of management with performance problems can cause anxiety and stress on nurses, the use of technology within the training of nurses, reinforces the skills with which it comes to clinical practice or institutions, promoting adaptation to the workplace. The innovate depends not only on health institutions, implementation of new technologies, seeks that professionals see an opportunity for professional growth and is interested in the development of projects that are aimed to use and implementation. The technology is a neutral element, are the actions of the nurse which determine the presence of positive or negative associated with the application of technology aspect (AU)

A visão da tecnologia como uma ferramenta que auxilia a melhora das condições dos sujeitos influencia em múltiplos aspectos da atenção à saúde e dos cuidados. Tecnologia em enfermagem e no cuidado engloba o papel do enfermeiro como elo de ligação entre a tecnologia e o paciente, a aplicação de uma ética do cuidado e a formação em gestão de tecnologia e educação em distintos campos. A inabilidade de gestão relacionada aos problemas de desempenho tecnológicos podem causar ansiedade e estresse nos enfermeiros. A utilização de tecnologia no âmbito da formação de enfermeiros reforça as habilidades com as quais o profissional irá deparar-se na prática clínica ou instituições, favorecendo uma melhor adapta- ção ao local de trabalho. O inovar depende não só nas instituições de saúde, mas também da implementação de novas tecnologias, da busca por parte dos profissionais que veem uma oportunidade de crescimento profissional e se interessem no desenvolvimento de projetos que visam a utilização e implementação das mesmas. A tecnologia é um elemento neutro, são as ações do enfermeiro que determinarão a presença de positivo ou negativo associado com a aplicação da mesma (AU)

Nursing clinical teaching supervision: Portuguese students’ perception

BACKGROUND: Clinical training, in the nursing degree, represents half of the initial graduation time, constitutes an important learning period, where supervision plays a crucial role in the nurses' social structuring process. OBJECTIVES: To know the perception that the Portuguese nursing students have about supervision in clinical education. MATERIAL AND METHODS: Integrative review, led by PI[C]OD method, which search engines were Google Scholar, the Virtual Health Library and SciELO Portugal. After application of the Relevance Test, he stood up with a corpus sample of 11 studies. RESULTS: All studies were considered of quality, having obtained a final classification higher than 75%. Students highly value the clinical instruction context and a positive affective and relational atmosphere, for which it is essential that the supervisor leaves the positions of evaluator, authoritarian, intimidating and even verbal and non-verbal aggressiveness, in order to establish with students an informal relationship and proximity. CONCLUSION: The professional knowledge of the supervisors must match the professional act in a contextualized reality, allowing students learn to critically analyze, consolidating the knowledge acquired previously and becoming aware of the different roles and skills you need to develop not only in a cognitive and technical perspective but also in an affective and relational perspective

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Nursing tutors’ perception of clinical supervision Skills

INTRODUCTION: The evolution of science and technology, changes within the healthcare organizations and new healthcare emerging philosophies require an active participation from healthcare professionals in helping in their peers' training. The supervision process is therefore more and more important. OBJECTIVES: To identify specialist nursing instructors' perception of the clinical supervisor skills in child-health area and paediatrics. MATERIAL AND METHODS: Qualitative-descriptive and phenomenological study composed by a sample of ten nursing tutors in the Dr. Nélio Mendonça Hospital's Paediatrics Department. We used a semi-structured interview and recordings of the conversations. We performed a content analysis on the corpus of all the interviews, once we had defined subcategories and indicators. RESULTS: The category "clinical supervisor skills" emerged from our study and the subcategories which were the most commonly referred were "personal characteristics with a 38% record unit" and "professional skills" (25.7%). As far as the relevant aspects in the child-health area and paediatrics are concerned, personal and professional skills stood out once again, with a 40.4% rate each. The main facilitating factor in the supervision process was the fact that it is a structured process (21.6%), and the inhibition factor was the deficit that exists in interpersonal relationships (21.7%). Globally, there were more record units associated with inhibition factors. CONCLUSION: Knowing what supervisors' insights in such a specific area as child-healthcare and paediatrics are, we think that this study can be a contribution to improve the quality of the supervision process in nursing. A joint effort between supervisor and supervised nurse will be needed to improve the processes that link institutions and their actors, processes where knowledge, experiences and professional objectives are commonly shared

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