Developing and sustaining nurses' service improvement capability: a phenomenological study.

BACKGROUND: Service improvement to enhance care quality is a key nursing responsibility and developing sustainable skills and knowledge to become confident, capable service improvement practitioners is important for nurses in order to continually improve practice. How this happens is an under-researched area. AIM: A hermeneutic, longitudinal study in Northern England aimed to better understand the service improvement lived experiences of participants as they progressed from undergraduate adult nursing students to registrants. METHOD: Twenty year 3 student adult nurses were purposively selected to participate in individual semi-structured interviews just prior to graduation and up to 12 months post-registration. Hermeneutic circle data analysis were used. FINDINGS: Themes identified were service improvement learning in nursing; socialisation in nursing practice; power and powerlessness in the clinical setting; and overcoming service improvement challenges. At the end of the study, participants developed seven positive adaptive behaviours to support their service improvement practice and the 'model of self-efficacy in service improvement enablement' was developed. CONCLUSION: This study provides a model to enable student and registered nurses to develop and sustain service improvement capability.

[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.

Thoughts About Recognizing Excellence in Nursing.

The purpose of this essay is to outline two strategies that can be used to increase recognition of nursing excellence-in research, education, and practice. The first strategy is to gain recognition for excellence in nursing in and beyond universities, to collaborate with members of other disciplines, and to publicize what we study and what we teach. The second strategy is to gain recognition for excellence in nursing in and beyond clinical agencies, to publicize what we do when interacting with people who seek our services, and to implement the standards of the Pathway to Excellence Program® and/or the Magnet Recognition Program®.

La enfermería: una reflexión sobre su futuro y su razón de ser / Nursing: A reflection about its future and its reason to be

La enfermería es una disciplina que ha experimentado diversos cambios a lo largo de su historia. No obstante, las nuevas transformaciones en la forma de hacer sanidad pueden cambiar la idea de lo que hoy es esta profesión. Para intentar afrontar este futuro hemos optado por potenciar la labor de la filosofía de la enfermería, tratando de reflexionar sobre la razón de ser de esta: los cuidados. De este modo, nos hemos apoyado en el libro "El futuro del cuidado. Comprensión de la ética del cuidado y práctica enfermera" de Carmen Domínguez Alcón, Helen Kohlen y Joan Tronto, así como de otros libros y artículos de diferentes autores de interés. Este recorrido nos ayudará a comprender cómo los cuidados pueden ser una herramienta útil para situar a la enfermería en el rumbo de los nuevos cambios del presente

Nursing is a discipline that has undergone several changes along its story. Nevertheless, the new transformations in the way of doing health service can change the idea of what profession is today. With the purpose of facing this future we have opted to strengthen the task of the nursing's philosophy, trying to ponder on its reason to be: care. In this way, we have supported our ideas in the book "El futuro del cuidado. Comprensión de la ética del cuidado y práctica enfermera" by Carmen Domínguez Alcón, Helen Kohlen and Joan Tronto, as well as other books and articles of different authors of interest. This journey will help us to comprehend how the care can be an useful tool to place nursing into the course of the new changes of the present

Nurse safety culture in the services of a university hospital.

OBJECTIVE: To evaluate nurse safety culture in a teaching hospital, as well as to verify differences in the safety culture dimensions between services. METHOD: cross-sectional, quantitative study, conducted from October to December 2015, in a university hospital. The instrument Hospital Survey on Patient Safety Culture was applied. RESULTS: A total of 195 nurses from four different services participated in the study. Significant difference between services were identified for five dimensions of safety culture: organizational learning (P=0.012); return of information and communication about error (P=0.014); management support for patient safety (P=0.001); general perceptions about patient safety (P=0.005); and frequency of event notification (P=0.003). CONCLUSION: The medical clinic service had the highest statistical difference between the dimensions. These evaluations allow managers to identify the differences between the same hospital's services, serving as a warning and assisting in the services' improvement.

Nurse safety culture in the services of a university hospital / La cultura de seguridad de enfermeros entre servicios en un hospital universitario / Cultura de segurança dos enfermeiros entre os serviços de um hospital universitário

ABSTRACT Objective: To evaluate nurse safety culture in a teaching hospital, as well as to verify differences in the safety culture dimensions between services. Method: cross-sectional, quantitative study, conducted from October to December 2015, in a university hospital. The instrument Hospital Survey on Patient Safety Culture was applied. Results: A total of 195 nurses from four different services participated in the study. Significant difference between services were identified for five dimensions of safety culture: organizational learning (P=0.012); return of information and communication about error (P=0.014); management support for patient safety (P=0.001); general perceptions about patient safety (P=0.005); and frequency of event notification (P=0.003). Conclusion: The medical clinic service had the highest statistical difference between the dimensions. These evaluations allow managers to identify the differences between the same hospital's services, serving as a warning and assisting in the services' improvement.

RESUMEN Objetivo: Analizar la cultura de seguridad de los enfermeros de un hospital escuela y examinar las diferencias de los aspectos de esa cultura entre los servicios realizados. Método: Estudio transversal y cuantitativo, realizado de octubre a diciembre de 2015, en un hospital universitario. Se utilizó el instrumento Hospital Survey on Patient Safety Culture. Resultados: Participaron 195 enfermeros de cuatro servicios. Se identificó una diferencia significativa entre los servicios en los cinco aspectos de la cultura de seguridad: el aprendizaje organizacional (p = 0,012); la información de retorno y la comunicación con respecto al error (p = 0,014); el soporte de la gestión para la seguridad del paciente (p = 0,001); las percepciones generales sobre la seguridad del paciente (p = 0,005); y la frecuencia de comunicación de eventos (p = 0,003). Conclusión: El servicio en clínica médica presentó una mayor diferencia estadística entre los aspectos identificados. Estas evaluaciones pueden permitir que los gestores identifiquen las diferencias entre los servicios del mismo hospital, sirviendo como advertencia y perfeccionando los servicios.

RESUMO Objetivo: Avaliar a cultura de segurança dos enfermeiros de um hospital de ensino e verificar as diferenças das dimensões dessa cultura entre os serviços. Método: Estudo transversal e quantitativo, realizado em outubro a dezembro de 2015, em um hospital universitário. Foi aplicado o instrumento Hospital Survey on Patient Safety Culture. Resultados: Participaram 195 enfermeiros de quatro serviços. Identificou-se diferença significativa entre os serviços para cinco dimensões de cultura de segurança: aprendizado organizacional (p = 0.012); retorno da informação e comunicação a respeito de erro (p = 0.014); suporte da gestão para segurança do paciente (p = 0.001); percepções gerais sobre segurança do paciente (p = 0.005); e frequência da notificação de eventos (p = 0.003). Conclusão: O serviço de clínica médica apresentou maior diferença estatística entre as dimensões. Essas avaliações permitem que os gestores identifiquem as diferenças entre os serviços do mesmo hospital, servindo de alerta e aperfeiçoando os serviços.

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.

Nursing consultation for people with diabetes mellitus: experience with an active methodology.

OBJECTIVE: to describe our experience with a methodology for teaching nursing consultation in support of people with diabetes mellitus at a Family Health Unit. METHOD: experience report with four moments-submission of the proposal to the team; theorizing; nursing care for people with diabetes mellitus at home and at the health unit, and evaluation of learning. RESULTS: the pedagogical process favored the integration between service and users, contributed to implement and apply the nursing process and strengthened professional training, based on the epidemiological profile of chronic diseases and its implications for nursing in primary care. FINAL CONSIDERATIONS: the active methodology discussed here allowed for a resignification of knowledge and a qualification of nursing care, demonstrating to be an important instrument for integrating clinical practice and epidemiology in accordance to experienced reality.

Nursing consultation for people with diabetes mellitus: experience with an active methodology / Consulta de enfermería a las personas con diabetes mellitus: experiencia con metodología activa / Consulta de enfermagem às pessoas com Diabetes Mellitus: experiência com metodologia ativa

ABSTRACT Objective: to describe our experience with a methodology for teaching nursing consultation in support of people with diabetes mellitus at a Family Health Unit. Method: experience report with four moments—submission of the proposal to the team; theorizing; nursing care for people with diabetes mellitus at home and at the health unit, and evaluation of learning. Results: the pedagogical process favored the integration between service and users, contributed to implement and apply the nursing process and strengthened professional training, based on the epidemiological profile of chronic diseases and its implications for nursing in primary care. Final considerations: the active methodology discussed here allowed for a resignification of knowledge and a qualification of nursing care, demonstrating to be an important instrument for integrating clinical practice and epidemiology in accordance to experienced reality.

RESUMEN Objetivo: Describir la experiencia con la metodología de la problematización para la enseñanza de la consulta de enfermería a las personas con diabetes mellitus en una Unidad de Salud de la Familia. Método: Relato de experiencia realizado en cuatro momentos -presentar la propuesta al equipo; teorizar; dar asistencia de enfermería a las personas con diabetes mellitus en los domicilios y en la unidad de salud; y evaluar el aprendizaje. Resultados: El proceso de enseñanza-aprendizaje favoreció la integración entre servicio y usuarios, contribuyó a implantar y aplicar el proceso de enfermería, y fortaleció la formación a partir del reconocimiento del perfil epidemiológico para el cuidado de enfermería a las enfermedades crónicas en la atención primaria. Consideraciones finales: La metodología activa propició la resignificación del conocimiento y la cualificación del cuidado de enfermería, constituyéndose como importante instrumento para unir la clínica a la epidemiología a partir de la realidad experimentada.

RESUMO Objetivo: Descrever a experiência da utilização de metodologia da problematização para o ensino da Consulta de Enfermagem junto a pessoas com Diabetes Mellitus de uma Unidade de Saúde da Família. Método: Relato de experiência realizado em quatro momentos: apresentação da proposta à equipe, teorização, aplicação da sistematização da assistência de enfermagem às pessoas com diabetes mellitus no domicilio dos usuários e na Unidade de Saúde e avaliação da aprendizagem. Resultados: O processo ensino-aprendizagem favoreceu a integração do ensino com o serviço e usuários, contribuiu para a implantação e aplicação do processo de enfermagem e fortaleceu a formação a partir do reconhecimento do perfil epidemiológico para o cuidado de enfermagem às doenças crônicas na atenção primária. Considerações finais: A utilização da metodologia ativa propiciou a ressignificação do conhecimento e a qualificação do cuidado de enfermagem, constituindo-se como um importante instrumento para a união da clínica à epidemiologia a partir da realidade vivenciada.

Panorama de la enfermería en Estados Unidos / No disponible

No disponible

XLII Congreso Nacional de la SEEIUC / XLII National Congress SEEIUC

No disponible

Clinical Management of Antipsychotic-Induced Hyperprolactinemia.

PURPOSE: This article describes the physiology and mechanisms of prolactin and the assessment and clinical management strategies of antipsychotic-induced hyperprolactinemia. CONCLUSIONS: Hyperprolactinemia is a disorder of the hypothalamic-pituitary axis which can be caused by several mechanisms. Typical antipsychotic agents are more likely to cause hyperprolactinemia than atypical antipsychotic agents, with the exception of amisulpride, paliperidone, and risperidone. PRACTICE IMPLICATIONS: Switching from prolactin-elevating to prolactin-sparing agents is recommended. Providing adjunctive treatment and prescribing substitutive hormones are alternatives. Education and lifestyle modification should be a major health promotion strategy. Taking patients' history and conducting physical examinations should be done during follow-up.

Retos de la enfermera como profesional europea / Challenges of the nursing profession at european level

La enfermería es una profesión de reclamo internacional, en especial bajo los marcos de la cooperación estudiantil y profesional promovidos por la Unión Europea. El alto porcentaje de movilidad de los profesionales pone de manifiesto la necesidad de facilitar su preparación e integración en un mercado laboral más allá de las fronteras nacionales. La Escola Superior de Saúde del Instituto Politécnico de Portalegre organizó el 2 y 3 de septiembre de 2015 la Reunión Internacional de Ciencias de la Salud ESS 2015 («Promoviendo lazos - Un nuevo reto para el futuro de las profesiones de la salud en Europa») para favorecer el intercambio y discutir los retos de la enfermera a nivel europeo. La diversidad laboral a la que se enfrentan las enfermeras en los distintos países pone de manifiesto la necesidad de crear una conciencia europea de la profesión que facilite la creación de lazos, la formación y una plataforma científica de intercambio para abordar la realidad actual del mercado laboral en la enfermería (AU)

Professional nurses are internationally sought after, a fact reinforced under the frames of exchange and cooperation promoted by the European Union. Given the high percentage of mobility shown by health professionals, nurses need a thorough preparation to facilitate their integration in the countries where they are likely to develop their professional careers. In order to promote exchange and facilitate discussion between nurses from different European countries, the Health School of the Polytechnic Institute of Portalegre (Portugal), organized on the 2nd and 3rd of September the International Health Sciences Meeting ESS 2015 («Promoting bonds - A new challenge for the future of health professions in Europe»). The diverse working conditions that nurses are faced with in different countries highlight the need to foster awareness of the profession at European level, facilitating ties, exchange and scientific platforms to address the current reality of the labor market (AU)