Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 19 de 19
Filtrar
1.
J Nurs Adm ; 51(9): 439-447, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34432736

RESUMO

OBJECTIVE: The purpose of this study was to develop and test a tool to monitor a nursing orientee's progress to competence. BACKGROUND: The literature suggests that, during orientation, consistent documentation and communication among educators, preceptors, and nurse leaders facilitate a timely progression to independent practice for new nurses. METHODS: A 2-phase methodological study was conducted. Nurse educators clarified goals, identified essential competencies, and developed the Baptist Health Lexington Nursing Orientation Progression Tool (OPT). The tool was used to monitor orientees' progression through orientation. RESULTS: Content validity assessment of the OPT (content validity index = 0.98) demonstrated strong validity. Testing of the tool revealed 31 nurses completed orientation early, 12 completed orientation on time, and 18 nurses required extended orientation time. All requiring an extension were new graduates. CONCLUSION: The OPT guided preceptors to facilitate timely completion of orientation among newly hired nurses. Findings suggest that new graduates may need more assistance than experienced nurses.


Assuntos
Competência Clínica , Capacitação em Serviço , Liderança , Recursos Humanos de Enfermagem , Bacharelado em Enfermagem , Humanos , Preceptoria
2.
J Nurs Adm ; 51(7-8): 374-378, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34260439

RESUMO

OBJECTIVE: The goal of this qualitative phenomenological study was to explore in-depth, critical care nurses' (CCNs) lived experience while caring for coronavirus disease 2019 (COVID-19) patients during the pandemic. BACKGROUND: CCNs play an important role during pandemics characterized by highly contagious, life-threatening disease. Understanding the experience of CCNs during a pandemic is particularly important because of the high rate of burnout within this group, as well as a shortage of these caregivers across the globe. METHODS: Using Heidegger's interpretive phenomenological approach, interviews were conducted with 10 CCNs caring for COVID-19 patients. The goal of the interviews was to access a deep layer of understanding regarding participants' lived experience. RESULTS: Themes of role frustration, emotional and physical exhaustion, and the importance of presence were revealed. CONCLUSION: Themes revealed suggest a number of actions hospital administrators could take to support CCNs as they experience the challenges of a pandemic.


Assuntos
COVID-19/enfermagem , Enfermagem de Cuidados Críticos , Recursos Humanos de Enfermagem no Hospital/psicologia , Adulto , Emoções , Fadiga , Feminino , Humanos , Masculino , Papel do Profissional de Enfermagem , Pesquisa Qualitativa , SARS-CoV-2
3.
J Nurses Prof Dev ; 37(5): 268-277, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34138804

RESUMO

Role transition from clinical nurse to charge nurse can be challenging. The purpose of this quasi-experiment was to evaluate a charge nurse orientation and development program, designed to increase nurses' confidence regarding this role. Patients' response to care as a result of this program was also assessed. It appears that nurse confidence regarding this transition improves following a formal intervention. Regarding patient satisfaction, charge nurse visits to patients increased as well.

4.
J Nurs Adm ; 51(5): 240-241, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-33882550

RESUMO

Strategies used to change an annual statewide research symposium from a face-to-face experience to a virtual event at a 434-bed Magnet® redesignated community hospital are described. The program met with success and increased access for attendees. For the 1st time, credited to the virtual format, representatives from all 9 hospitals in the system were able to attend. Feedback following the symposium suggested that participants who live at a distance from the hospital appreciated being able to attend the meeting without traveling, technical issues were promptly resolved, and presenters received positive evaluations.


Assuntos
Congressos como Assunto/organização & administração , Educação à Distância/organização & administração , Realidade Virtual , Pesquisa Biomédica/organização & administração , COVID-19/epidemiologia , Humanos , Interface Usuário-Computador
5.
J Perinat Neonatal Nurs ; 35(1): 92-99, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33528192

RESUMO

Parental stress is high when infants are admitted to a neonatal intensive care unit in community-based hospital. This quasi-experimental study explored the effect of implementing the "Creating Opportunities for Parent Empowerment" (COPE) program on parental stress, postpartum depression, parental satisfaction with care, and length of stay in a community-based hospital. A cohort of nurses completed a 1-day "COPE for HOPE" parent empowerment training session. A nurse implemented the COPE parent training at the bedside soon after birth and extended throughout hospitalization. The following instruments were used to collect data: a demographic data sheet, Parental Stress Scale: Neonatal Intensive Care Unit, Edinburgh Postnatal Depression Scale, and an investigator-designed parent satisfaction survey. Forty-nine parent sets participated in the study (29 in the intervention group, 20 in the comparison group). A significant difference was found between the groups related to lower parental stress. There was no difference in terms of parental depression scores or length of hospital stay. However, clear trends revealed that parents in the COPE group exhibited lower depression scores. Parents in both groups reported being greater than 95% satisfied with care across all items. These findings may motivate administrators in other community-based hospitals to implement this intervention.

6.
J Cancer Surviv ; 2021 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-33481161

RESUMO

PURPOSE: A work group from the American Physical Therapy Association Academy of Oncologic Physical Therapy developed and published a clinical practice guideline (CPG) to aid clinicians in identifying interventions for individuals with breast cancer-related lymphedema (BCRL). This guideline reviewed the evidence for risk mitigation and volume reduction beginning at cancer diagnosis and continuing through survivorship. Application of CPGs can be challenging due to the variability of clinical settings, heterogeneous patient populations, and range of rehabilitation clinician expertise. The purpose of this paper is to assist these clinicians in implementing the recommendations from the CPG to develop a patient-centered, evidence-based plan of care. METHODS/RESULTS: This publication presents important considerations for the implementation of recommended rehabilitation interventions across the trajectory of BCRL. CONCLUSION: Current evidence supports specific interventions to treat or mitigate the risk for the various stages of BCRL. As clinicians implement these recommendations into practice, they also need to address other impairments that may exist in every individual. Continued collaboration between clinicians and researchers is necessary to further develop optimal treatment modalities and parameters. IMPLICATIONS FOR CANCER SURVIVORS: By implementing evidence-based interventions as outlined in the CPG, clinicians can improve the quality of care for survivors of breast cancer.

7.
Nurs Forum ; 56(2): 249-254, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33231874

RESUMO

PURPOSE: To examine the effect of education on nursing personnel's knowledge and attitudes regarding the use of hand massage, breathing techniques, and essential oils with hospice and palliative care patients. BACKGROUND: Unrelieved, end of life pain is common among hospitalized patients on hospice and palliative care units. Integrative care techniques such as hand massage, breathing techniques, and essential oils can be available to use with these individuals. Nursing personnel are often unaware of other techniques that are not a traditional pharmacology approach to pain. METHODS: A quasi-experiment was conducted to evaluate the effect of an educational intervention on nursing personnel's knowledge and attitudes regarding the use of three integrative care techniques (hand massage, breathing techniques, and essential oils) with hospice and palliative care patients in an acute care setting. Data on knowledge and attitudes were collected pre- and postintervention. RESULTS: Following the intervention, improvements in nursing personnel's attitudes and knowledge toward the use of the three techniques were found. CONCLUSION: Results of this study suggest that education of nursing personnel may positively influence knowledge and attitudes toward providing hand massage, breathing techniques, and essential oil for end of life patients.

8.
Rehabil Nurs ; 45(6): 367-373, 2020 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-33332798

RESUMO

PURPOSE: The aim of the study was to develop and test the Groppo-Lawless nurse-initiated screen designed to identify patients diagnosed with pneumonia who are at risk for dysphagia. DESIGN: This is a two-phase methodological study. METHODS: Phase 1 involved three steps. First, risk factors (n = 27) for dysphagia were identified from the literature. Next, frequency of these risk factors was calculated from a chart review of patients diagnosed with pneumonia (N = 301). Finally, frequency of risk factors among those patients who failed the 3-oz water trial (n = 56) were calculated, and a five-item instrument, the Groppo-Lawless Dysphagia Screen, was constructed. In Phase 2, nurses' results using the screen were compared to blinded results of speech-language pathologists. FINDINGS: Sensitivity (81.1%), specificity (96.4%), and diagnostic odds ratio (22.43) were calculated. CONCLUSIONS/CLINICAL RELEVANCE: Given the strong psychometric properties of this screen, its use by nurses may increase the number of appropriate speech-language pathologist referrals among patients diagnosed with pneumonia.


Assuntos
Transtornos de Deglutição/diagnóstico , Programas de Rastreamento/instrumentação , Diagnóstico de Enfermagem/normas , Psicometria/normas , Adulto , Transtornos de Deglutição/enfermagem , Feminino , Humanos , Masculino , Programas de Rastreamento/métodos , Programas de Rastreamento/normas , Pessoa de Meia-Idade , Diagnóstico de Enfermagem/métodos , Diagnóstico de Enfermagem/estatística & dados numéricos , Estudos Prospectivos , Psicometria/instrumentação , Psicometria/métodos , Inquéritos e Questionários
9.
J Nurs Adm ; 50(12): 649-654, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33181525

RESUMO

OBJECTIVE: The aim of this study was to examine the effect of nurses' mobility plan use on patients' length of stay, discharge destination, falls, physical therapy consults, and nurses' knowledge, attitudes, and beliefs regarding patient mobility. BACKGROUND: Functional decline due to decreased mobility during hospitalization results in diminished quality of life. Sixty-five percent of older inpatients lose the ability to ambulate during hospitalization and 30% do not regain that capability. METHODS: Using a quasi-experimental design, nurses' use of a mobility assessment on 4 patient outcome variables was examined before (n = 2,259) and after (n = 3,649) use. Nurses' attitudes, knowledge, and beliefs regarding mobility were also examined. RESULTS: Positive changes in patient variables occurred. Limited change occurred relative to nurses' knowledge, attitudes, and beliefs. CONCLUSIONS: Implementing a nurse-led mobility plan enhances therapy resource utilization through identification of appropriate consults and improves patients' discharge home. In addition, nurses' knowledge, attitudes, and beliefs toward patient mobility planning can be positively influenced.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Serviços de Assistência Domiciliar , Pacientes Internados/estatística & dados numéricos , Recursos Humanos de Enfermagem no Hospital/organização & administração , Caminhada/estatística & dados numéricos , Idoso , Feminino , Humanos , Masculino , Alta do Paciente/estatística & dados numéricos , Qualidade de Vida/psicologia , Inquéritos e Questionários , Estados Unidos
10.
J Perinat Educ ; 29(3): 134-142, 2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-32760182

RESUMO

The purpose of this study was to examine the effect of a hospital-based childbirth class on fear of childbirth, anticipation regarding the birth experience, birth preferences and perception of the birth experience among first-time mothers. Expectant mothers (N = 207) completed an investigator-designed questionnaire before and after attending a prenatal hospital-based childbirth class held in the hospital where they intended to give birth. Statistically, significant changes postintervention included a decrease in fearfulness and an increase in birth anticipation. Shifts also occurred in birth preferences. Data collected from an open-ended question revealed the participants' increased excitement about birth. Findings provide evidence that attending hospital-based childbirth classes may influence women's perceptions and preferences regarding birth.

12.
Support Care Cancer ; 28(12): 5881-5888, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32270312

RESUMO

PURPOSE: Axillary web syndrome (AWS) presents as a common postsurgical complication in individuals with breast cancer. Breast cancer-related lymphedema (BCRL) contributes to the shoulder and arm morbidity common in breast cancer survivors and often associated to cancer treatment. A paucity of literature exists evaluating the risk factors for developing AWS and the association between AWS and BCRL. The purposes of this study were (1) to identify risk factors for AWS in individuals with breast cancer, (2) to examine the association between BCRL and AWS, and (3) to determine if AWS increases the risk for developing BCRL. METHODS: A retrospective study of 354 women who underwent breast cancer treatment and received physical therapy was included. RESULTS: Axillary web syndrome developed in a third of women and predominately occurred in the first 8 postoperative weeks. The odds of AWS development were 73% greater for participants over the age of 60 (OR = 1.73, CI 95% 1.05-2.84). Women with AWS had 44% greater risk to develop lymphedema during the first postoperative year (RR = 1.44, CI 95% 1.12-1.84, p = 0.002). If AWS developed within the first postoperative month, women were almost 3 times more likely to develop lymphedema within the first 3 postoperative months compared with other women with AWS (RR = 2.75, CI 95% 1.199-6.310, p = 0.007). CONCLUSIONS: Our findings suggest that 30% of breast cancer survivors will have AWS during the first year of survivorship. As institutions prioritize screening efforts, early postoperative prospective surveillance is needed for women over 60 due to high risk for AWS development and any women with AWS for increased risk of lymphedema development based on our findings.


Assuntos
Axila/cirurgia , Linfedema Relacionado a Câncer de Mama/patologia , Neoplasias da Mama/cirurgia , Cicatriz/epidemiologia , Cicatriz/patologia , Excisão de Linfonodo/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Mama/patologia , Mama/cirurgia , Linfedema Relacionado a Câncer de Mama/etiologia , Neoplasias da Mama/reabilitação , Sobreviventes de Câncer/estatística & dados numéricos , Feminino , Humanos , Incidência , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Estudos Prospectivos , Estudos Retrospectivos , Fatores de Risco , Ombro/patologia , Adulto Jovem
13.
Support Care Cancer ; 28(11): 5307-5313, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32112354

RESUMO

PURPOSE: Survivors of breast cancer (BC) on the non-dominant side have more persistent deficits than those with cancer on the dominant limb. What is not known is whether those with BC use their involved upper limbs more, less, or at the same level as women without BC. Accelerometer use offers a quantifiable method to measure activity levels of upper limbs. The purpose of this study was to quantify the activity levels of the non-dominant involved limb among survivors of BC and compare these values to their dominant limb, as well as the non-dominant limb of a control group. METHODS: Participants (n = 30) were women with unilateral BC on the non-dominant limb, diagnosed between 6 and 24 months prior to data collection, and a matched healthy group of women as controls. Participants completed the following questionnaires: medical and demographics, Brief Fatigue Inventory, Brief Pain Inventory - Short form, Disabilities of the Arm, Shoulder and Hand (DASH), and Beck Depression Index. Participants wore an accelerometer on each wrist during waking hours for 7 days. Arm activity was measured using vector magnitude activity counts extracted from the accelerometers. RESULTS: There were no significant differences in total vector magnitude activity counts between groups for either limb. Within group dominant to non-dominant comparison was significantly different (p ≤ 0.001). No significant difference in pain was present but significant differences for fatigue (p = 0.002), depression (p = 0.004), and DASH scores (p = 0.035) were present. CONCLUSIONS: Women with non-dominant BC use their involved limb similar to healthy controls but less than their dominant limb.


Assuntos
Braço/fisiologia , Neoplasias da Mama , Sobreviventes de Câncer , Exercício Físico/fisiologia , Movimento/fisiologia , Acelerometria/estatística & dados numéricos , Adulto , Idoso , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/reabilitação , Sobreviventes de Câncer/estatística & dados numéricos , Estudos de Casos e Controles , Fadiga/epidemiologia , Fadiga/etiologia , Feminino , Humanos , Pessoa de Meia-Idade , Qualidade de Vida , Amplitude de Movimento Articular/fisiologia , Ombro/fisiologia , Inquéritos e Questionários , Extremidade Superior/fisiologia
14.
Clin Rehabil ; 34(2): 276-283, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31875692

RESUMO

OBJECTIVE: The aim of this study was to develop and test a tool, the Predictor of Appropriate Discharge Destination (PADD), used postoperative day zero by healthcare professionals to identify whether patients undergoing elective total knee arthroplasty or total hip arthroplasty should go directly home or to extended rehabilitation. A secondary objective was to examine the difference in readmissions pre and post use of the PADD. DESIGN: A two-phase methodological study. SETTING: This study was conducted in a 393-bed magnet re-designated community hospital. SUBJECTS: Adults undergoing a primary total knee or hip arthroplasty. METHODS: In Phase 1, retrospective data (n = 461) was analyzed to compare recommendations for discharge destination between the PADD and physical therapists. In Phase 2 (n = 521), the predictive validity of the PADD was assessed prospectively. RESULTS: In Phase 1, the PADD cut-off score of ⩽7 demonstrated good sensitivity (0.83) and specificity (0.68) in relation to the physical therapist's discharge destination recommendation. In Phase 2, sensitivity (0.75) and specificity (0.83) calculations were similar. Analysis of 30-day readmissions between the physical therapist's recommendation and the PADD score revealed 89.7% agreement. Readmission percentages among patients discharged to home and to rehabilitation facilities were 2.37% (n = 16) and 3.41% (n = 10), respectively. CONCLUSION: The PADD has good predictive validity in relation to appropriate discharge destination for patients undergoing a total knee or hip arthroplasty.


Assuntos
Artroplastia de Quadril/reabilitação , Artroplastia do Joelho/reabilitação , Alta do Paciente , Readmissão do Paciente , Adulto , Idoso , Idoso de 80 Anos ou mais , Procedimentos Cirúrgicos Eletivos , Feminino , Articulação do Quadril/fisiopatologia , Articulação do Quadril/cirurgia , Humanos , Articulação do Joelho/fisiopatologia , Articulação do Joelho/cirurgia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
15.
J Nurs Adm ; 49(12): 624-627, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31725521

RESUMO

Magnet designation requires that nurses be actively involved in activities that lead to obtaining evidence through conducting research. Unfortunately, several barriers limit nurses' ability to engage in research activities, including insufficient resources. This article explains how a community-based hospital implemented a fellowship model to circumvent some of these barriers. Two fellowship positions are described, 1 in research and 1 in library sciences. The method, outcomes, and cost of the fellowship model are discussed.


Assuntos
Educação de Pós-Graduação em Enfermagem/organização & administração , Bolsas de Estudo/organização & administração , Hospitais Comunitários/organização & administração , Papel do Profissional de Enfermagem , Pesquisa em Enfermagem/organização & administração , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos de Casos Organizacionais , Sudeste dos Estados Unidos
16.
Rehabil Nurs ; 2019 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-31318741

RESUMO

PURPOSE: The aim of the study was to develop and test the Groppo-Lawless nurse-initiated screen designed to identify patients diagnosed with pneumonia who are at risk for dysphagia. DESIGN: This is a two-phase methodological study. METHODS: Phase 1 involved three steps. First, risk factors (n = 27) for dysphagia were identified from the literature. Next, frequency of these risk factors was calculated from a chart review of patients diagnosed with pneumonia (N = 301). Finally, frequency of risk factors among those patients who failed the 3-oz water trial (n = 56) were calculated, and a five-item instrument, the Groppo-Lawless Dysphagia Screen, was constructed. In Phase 2, nurses' results using the screen were compared to blinded results of speech-language pathologists. FINDINGS: Sensitivity (81.1%), specificity (96.4%), and diagnostic odds ratio (22.43) were calculated. CONCLUSIONS/CLINICAL RELEVANCE: Given the strong psychometric properties of this screen, its use by nurses may increase the number of appropriate speech-language pathologist referrals among patients diagnosed with pneumonia.

18.
Cancer Nurs ; 40(5): 361-368, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-27359379

RESUMO

BACKGROUND: In 2014, it is estimated that 232,670 new cases of breast cancer occurred in the United States. Unilateral or bilateral mastectomy is a frequently chosen option for treating this disease. OBJECTIVE: The purpose of this study was to explore, through an in-depth interview process, the lived experience of women immediately following mastectomy when they see their scars for the first time. METHODS: Purposeful sampling was used until saturation was reached. In-depth interviews were conducted with 10 women related to their mastectomy experience. The data were analyzed using a phenomenological approach. RESULTS: The following 8 themes emerged from the data; lasting impact, personal impact, relational impact, gratitude, support system, coping strategies, timing, and discomfort. CONCLUSIONS: The results of the study provide evidence that women face ongoing challenges following seeing their mastectomy scars for the first time that is not adequately addressed by healthcare professionals. IMPLICATIONS FOR PRACTICE: Nurses and other healthcare professionals need to gain a better understanding of the difficulties perceived by women following seeing the scars from mastectomy and implement strategies to assist in successful adaptation to the experience.


Assuntos
Adaptação Psicológica , Neoplasias da Mama/cirurgia , Cicatriz/psicologia , Mastectomia/psicologia , Adulto , Idoso , Neoplasias da Mama/psicologia , Feminino , Humanos , Pessoa de Meia-Idade , Pesquisa Qualitativa , Fatores de Tempo
19.
Artigo em Inglês | MEDLINE | ID: mdl-27022302

RESUMO

Hypersensitive scar tissue formation along the incision line and drain site is a common side effect following mastectomy. If this scar tissue is not addressed, it can lead to decreased flexibility and function in the involved upper quadrant. Astym(®) treatment is a new approach to soft tissue injuries, and is evidenced in animal studies to promote the healing and regeneration of soft tissues. It has also been found to reduce pain and increase function in people with soft tissue dysfunction. The aim of Astym treatment is to engage the regenerative mechanisms of the body in order to resorb scar tissue, stimulate tissue turnover, and regenerate soft tissues. Handheld instrumentation is applied topically to locate and treat the underlying dysfunctional soft tissue through specific protocols for the application of particular pressures and shear forces. The purpose of this study was to examine the effects of Astym treatment on activities of daily living in women who had undergone a mastectomy following a diagnosis of breast cancer. A quasi-experiment involving 40 women, following a mastectomy, evaluated five outcome measures pre- and post-Astym treatment. All five measurement scores: Disabilities of the Arm, Shoulder, and Hand Outcome Measure; a clothing questionnaire on their ability to wear a bra; Patient-Specific Functional Scale; active range of motion of shoulder flexion; and active range of motion of abduction were also measured and all demonstrated significant changes. In this study, Astym treatment improved active range of motion in the involved quadrant and also improved function in patients following a mastectomy.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...