Nurses' perception of the nursing process and its relationship with leadership.

OBJECTIVES: to describe Nurses' perception of the Nursing Process and its relationship with leadership. METHODS: action research conducted between September/2021 and April/2022 with nurses from a medium-sized hospital in southern Brazil. The data investigated, one of the stages of the method, was collected using the Focus Group technique and submitted to Strategic Focus Analysis. RESULTS: three categories emerged from the organized and analyzed data, namely: Nursing Process: a tool that qualifies nursing care; Conditions that weaken the Nursing Process; and Strategies that enhance the Systematization of Nursing Care. FINAL CONSIDERATIONS: the perception of the Nursing Process and its relationship with leadership are not always understood as complementary themes. Although they recognize that the Nursing Process is sometimes imposed as normative, nurses do not perceive the importance of the role of the leader, who is considered a key player in conducting and boosting the Systematization of Nursing Care.

Aplicabilidad del proceso de enfermería en un hospital general de Maranhão / Applicability of the Nursing Process in a General Hospital of Maranhão

Introducción: El proceso de enfermería es un instrumento sistemático y estructurado en cinco fases que tiene el propósito de dirigir a las enfermeras en la práctica de la atención para la clientela asistida. Dado lo anterior, es esencial que el proceso se aplique de manera efectiva durante la atención hospitalaria. Objetivo: Conocer la aplicabilidad del proceso de enfermería a pacientes en las clínicas médicas y quirúrgicas de un hospital general en Maranhão. Métodos: Estudio cualitativo descriptivo, transversal, realizado en el Hospital General de Bacabal, Brasil, durante octubre-noviembre de 2019. La población fueron 20 enfermeras de las que 12 fueron incluidas por cumplir los criterios, se realizó una entrevista semiestructurada sobre el Proceso de Enfermería. Los datos objetivos se tabularon en hojas de cálculo de Microsoft Excel y se presentaros en porcentaje simples. Para analizar los datos recopilados, se utilizó análisis de contenido de Bardin. Resultados: La mayoría de las enfermeras conocían el proceso de enfermería, así como su importancia, pero su implementación ocurre en parte debido a las diversas dificultades enfrentadas en la rutina de enfermaría, lo que refleja la necesidad de proporcionar medidas que puedan suplir estas deficiencias. Conclusión: Las fallas en la aplicación del proceso de enfermería pueden estar relacionadas con la acumulación de servicios, la devaluación profesional y la ausencia de un instrumento específico para este propósito. Haciendo necesario desarrollar estrategias en conjunto con la gerencia para mejorar las condiciones de trabajo, capacitar a las enfermeras y desarrollar un instrumento estandarizado para facilitar su uso(AU)

Introduction: The nursing process is a systematic instrument structured in five stages, which has the purpose of directing nurses in the practice of care for assisted clients. Given this, it is essential that the process be applied effectively during hospital care. Objective: To know the applicability of the nursing process on patients in the medical and surgical clinics of a general hospital in Maranhão. Methods: Qualitative, descriptive and cross-sectional study carried out, during October-November 2019, at the General Hospital of Bacabal, Brazil. The population was twenty nurses, twelve of whom were included for meeting the criteria. A semistructured interview about the nursing process was conducted. The objective data were tabulated in Microsoft Excel spreadsheets and presented in simple percentages. To analyze the collected data, Bardin's content analysis was used. Results: Most of the nurses were aware of the nursing process, as well as its importance. However, its implementation occurs, in part, due to the various difficulties faced in the nursing routine, which reflects the need to provide measures that can substitute for these deficiencies. Conclusion: The failures in the application of the nursing process may be related to accumulation of services, professional devaluation and the absence of a specific instrument for this purpose. All this makes it necessary to develop strategies in conjunction with management, in order to improve working conditions, train nurses and develop a standardized instrument to facilitate its use(AU)

Nursing surveillance and immediate jeopardy in Veteran Health Administration community living centers unannounced survey program 2018 to 2019.

BACKGROUND: The VA Community Living Center (CLC) Unannounced Survey Program aims to assess standards of care set by the government to protect residents. PURPOSE: To describe patterns of practice failures in nursing surveillance causing or having potential to cause immediate jeopardy, as defined by the Centers for Medicare and Medicaid Services. METHODS: Using CLC survey data consisting of 200 statements of deficiency (SODs) for 2018 to 2019, we collected a SOD sample (n = 20) of immediate jeopardy events. They were described using descriptive statistics and discourse content analysis. FINDINGS: We identified clinical events, their duration, work shift, and nursing skill mix for each SOD. Most to least common themes about failures in nursing surveillance were acquisition/transfer of information; decision-making; and early recognition of problems. DISCUSSION: Our analysis of nursing surveillance failures in CLC immediate jeopardy SODs provides insight into opportunities for registered nurses and the nursing skill mix to reduce avoidable harms.

Guardians of humanity? The challenges of nursing practice in the digital age.

Digital technologies have become a crucial factor in nursing. Given the fact that many tasks could also be done by robots or AI systems, the place for the nurse in this scenario is unclear. In what way and to what extent will the implementation of ever more sophisticated technology affect nursing practice? It is the aim of this paper to analyse the potential challenges of nursing practice in the digital age. The analysis is conducted through the lens of new materialism, a set of theoretical models that understand the relationship between humans and technology as dynamic and performative. According to this view, there is no prefixed essence of technology. Rather, the meaning of technology is enacted in concrete practice. The analysis shows that in past debates on technology use in nursing, the nurses' role has been defined as guardians of humanity, defending the patient against the dehumanizing effects of technology. This role has been transferred to the digital age, where it is the duty of nurses to cushion the negative effects of digital technology. As an alternative to this outdated role, nurses should be included in processes of technology design and policymaking. Enabling nursing professionals to shape the circumstances of a digitally enhanced holistic practice may empower their status within the healthcare system and also benefit the patient by contributing to a more person-centred care.

Centro cirúrgico: percepção da equipe de enfermagem / Systematization of nursing care at the surgical center: perception of the nursing team / Sistematización de la atención de enfermería en el centro quirúrgico: percepción del equipo de enfermería

Objetivo: avaliar a atuação e a percepção da equipe de enfermagem quanto a Sistematização da Assistência de Enfermagem no centro cirúrgico de um hospital. Método: estudo exploratório, descritivo, documental, de abordagem mista, desenvolvido de janeiro a abril de 2019, em duas fases: análise de prontuários e entrevista com 14 profissionais de enfermagem. O cenário foi um centro cirúrgico de um hospital público no nordeste brasileiro. Organização dos dados pela análise estatística descritiva e análise temática. Resultados: a avaliação dos prontuários apontou que os registros da anamnese e exame físico são frágeis e em algumas fases não há registros da fase pré-operatória e pós-operatória. Verificou-se que para os profissionais o papel da equipe é prestar um cuidado holístico ao paciente e a fase mais dificultosa é a pós-operatória. Conclusão: a falta do planejamento para a implantação, execução e entendimento atrapalham o processo e dificulta uma assistência de qualidade ao paciente

Objective: to evaluate the performance and perception of the nursing team regarding the systematization of nursing care in the operating room of a hospital. Method: exploratory, descriptive, documentary study, with a mixed approach, developed from January to April 2019, in two phases: analysis of medical records and interview with 14 nursing professionals. The setting was a surgical center in a public hospital in northeastern Brazil. Data organization by descriptive statistical analysis and thematic analysis. Results: the evaluation of the medical records showed that the records of anamnesis and physical examination are fragile and in some phases there are no records of the preoperative and postoperative phase. It was found that for the professionals the role of the team is to provide holistic care to the patient and the most difficult phase is the post-operative. Conclusion: the lack of planning for the implementation, execution and understanding hinder the process and hinder quality patient care

Objetivo: evaluar el desempeño y la percepción del equipo de enfermería con respecto a la sistematización de los cuidados de enfermería en el quirófano de un hospital. Método: estudio exploratorio, descriptivo, documental, con enfoque mixto, desarrollado de enero a abril de 2019, en dos fases: análisis de historias clínicas y entrevista con 14 profesionales de enfermería. El escenario era un centro quirúrgico en un hospital público en el noreste de Brasil. Organización de datos mediante análisis estadístico descriptivo y análisis temático. Resultados: la evaluación de los registros médicos mostró que los registros de anamnesis y examen físico son frágiles y en algunas fases no hay registros de la fase preoperatoria y postoperatoria. Se descubrió que para los profesionales, el papel del equipo es proporcionar atención integral al paciente y la fase más difícil es la postoperatoria. Conclusión: la falta de planificación para la implementación, ejecución y comprensión dificulta el proceso y dificulta la calidad de la atención al paciente

Percepción del estudiante del curso técnico en enfermería sobre la sistematización de la asistencia a la enfermería / Perception of the nursing technical course student of the nursing care systematization

Introducción: La forma en que se visualiza la sistematización del cuidado de enfermería implica el reconocimiento de la profesión y las prácticas de las acciones de enfermería. La compresión de esta herramienta por parte de los estudiantes en el curso de enfermería técnica es poco explorada, lo que constituye una de las brechas en el área de enfermería. Objetivo: Describir la percepción del estudiante del curso técnico en enfermería sobre la sistematización de la asistencia a la enfermería. Métodos: Estudio exploratorio y descriptivo con enfoque cualitativo. Participaron 18 (62,0 por ciento) estudiantes de 29 (27,8 por ciento), quienes cumplieron con los criterios de inclusión, en una Escuela de Enfermería Técnica en el noreste de Bahía, Brasil. Los datos fueron recogidos entre abril y mayo de 2018, por medio de un cuestionario con las siguientes variables: calidad del proceso de enseñanza-aprendizaje a través del cual los estudiantes vislumbran la sistematización de la asistencia a la enfermería; habilidades desarrolladas necesarias para el funcionamiento y la importancia atribuida en el contexto de la labor de los técnicos de enfermería. Se utilizó estadística descriptiva, seguida de un análisis de las características del fenómeno. Resultados: Se encontró que los estudiantes consideran el enfoque teórico de la sistematización de la asistencia de enfermería y las taxonomías insuficientes para apoyar la práctica profesional. Conclusión: La mayoría de estudiantes se manifestaron desconocer las características de la sistematización de la asistencia a la enfermería y del proceso de enfermería(AU)

Introduction: The way in which the Nursing Care Systematization is visualized implies the recognition of the profession and the practices of nursing actions. The understanding of this tool by students in the technical nursing course is little explored, which constitutes one of the gaps in the nursing area. Objective: To describe the perception of students of a nursing technical course about the Nursing Care Systematization. Methods: Exploratory and descriptive study, with a qualitative approach. Participated 18 (62,0 percent) students of the 29 (27,8 percent) who met the inclusion criteria, at a technical nursing school in Northeast Bahia, Brazil. The data were collected between April and May 2018, by means of a questionnaire with the following variables: quality of teaching-learning process through which students glimpse; developed skills necessary for the execution of the systematization of nursing assistance; and the importance attributed to in the context of the work of the nursing technician. Descriptive statistics was used, followed by analysis of the phenomenon's characteristics. Results: The students considered the theoretical approach of the Nursing Care Systematization and the taxonomies insufficient to support the professional practice. Conclusions: Most students showed unaware of the characteristics of the systematization of nursing assistance and of the Nursing Process(AU)

Ideas of caring in nursing practice.

In nursing practice, awareness of ethical inner values and a common understanding of nursing and caring are needed. It is therefore important to highlight ideas of caring in nursing practice. The aim of this paper was to illuminate nursing, caring and ethical inner values in caring and caring in nursing practice. By being attentive, open, respectful and treating the patient as a person, nurses can enhance both their own and the patient's sense of personal meaning in the caring relationship. Nurses can use self-reflection to create an awareness of nursing, caring and ethical inner values in caring.

El Proceso de Enfermería como estrategia para desarrollar la empatía en estudiantes de enfermería / The nursing process as a strategy to build empathy in nursing students

OBJETIVO PRINCIPAL: Describir la experiencia docente al implementar una estrategia didáctica innovadora para promover el fortalecimiento de la empatía en un escenario laboral a través de la autoconsciencia del estudiantado en un curso avanzado de grado. METODOLOGÍA: Se utilizó una combinación de estrategias didácticas (método de caso, articulación al proyecto ético de vida y proceso de enfermería) para trabajar en un proceso de enfermería centrado en el propio estilo de vida de los estudiantes. RESULTADOS PRINCIPALES: Aunque el estudiantado tuvo dificultades para implementar intervenciones relacionadas con estilo de vida en sí mismos, la estrategia didáctica les ayudó a experimentar en su propia vida lo que trabajan con los usuarios en relación a cambios de comportamientos en salud. CONCLUSIÓN PRINCIPAL: La apropiación del proceso de enfermería por parte de los estudiantes para cuidar de sí mismos se sugiere como una estrategia de fomentar actitudes vitales para brindar un cuidado humanizado de enfermería como la empatía

AIM: To describe the implementation of an innovative didactic strategy to promote the strengthening of empathy in an occupational setting through student's self-awareness in an advanced undergraduate course. METHODS: A combination of didactic strategies (case method, ethical project of life and nursing process) was implemented in an undergraduate course. Students developed a nursing process focused on their own lifestyles. MAIN RESULTS: Although students referred having difficulties implementing lifestyle-related interventions on themselves, the didactic strategy helped them to experience in their own life what they ask patients to do in a nursing intervention related to health behavior change. MAIN CONCLUSION: Students' appropriation of the nursing process to take care of their selves could be a strategy to promote vital attitudes to provide a humanized care such as empathy

Complexity Leadership in the Nursing Context.

Consolidation through mergers and acquisitions is occurring across health care as a strategic move to address the disruptive forces of complexity. While consolidation is improving the overall fitness and viability of health care organizations, it is having the opposite effect on the professionals working within them who are reporting increasing rates of burnout from ongoing complexity in the health care environment. This happens in all organizations that try to respond to complexity with traditional bureaucratic leadership approaches. What is needed is to replace bureaucratic leadership with the networked approach of complexity leadership. The idea is not to "do more with less" but to "do things better." In this article, we show how to do this by applying complexity leadership to the nursing context. Complexity leadership is a framework for enabling people and organizations for adaptability. It views leaders not as managerial implementers of top-down directives but as collaborators who work together to enhance the overall adaptability and fitness of the system. From a complexity leadership perspective, the role of nurse leaders should be not only to help the system run but also to help it run better by increasing organizational adaptability.

Nursing practices in a psychological care center.

OBJECTIVE: To analyze the practices developed by nursing professionals in a Psychosocial Care Center (CAPS). METHOD: A qualitative and evaluative research based on the Fourth Generation Assessment and conducted in a CAPS II of Santa Catarina State in 2014. For data collection, semi-structured interviews, field observation, and data recycling group were used with workers. Constant Comparative Method was used for data analysis. RESULTS: Practices aimed at the subject and their clinical, social, prevention, treatment and articulation with the health network were identified. Medication care is a specificity of nursing that aims to promote autonomy and social reintegration. There is a need for greater articulation between the nursing and pharmacy staff, as well as creating spaces for users to talk about medication. CONCLUSION: Nursing practices are focused on biopsychosocial care, aiming to deconstruct care models focused on the disease and symptoms.

Mapping nursing practices in rehabilitation units in Spain and the United Kingdom: A multiple case study.

Because of the crisis in the health sector with few employment opportunities, many Spanish nurses are looking for professional development abroad. No studies have mapped nursing practices across Europe. The aim of this research was to provide a comprehensive approach to understand nursing practices and features of the context in Spain and the United Kingdom within the rehabilitation unit and to discuss those practices from a patient safety point of view. Multiple case study design with thematic analysis was applied in this study. The methods for data collection were in-depth interviews, nonparticipant observations, and document analysis. Results were classified into six categories: resources, techniques and nursing procedures, patients' personal care, health education, documentation task, and attitudes and communication skills. This study concludes that differences exist between nursing practices despite both countries having similar nursing competences. In addition, the UK unit has a positive safety culture, recognizes that mistakes happen, and applies more barriers to avoid them. The study provides valuable information to help the decision-making process for Spanish nurses considering working in the UK.

Identificar práticas de enfermagem de qualidade no ambulatório de pediatria: revisão sistemáticada literatura / dentify quality nursing practices in the pediatric outpatient care: a systematic review

Introduction: Outpatient care philosophy has been growing in the past years. Looking to the premise of pediatric healthcare, the establishing of outpatient treatment has advantage, like shortening the deep impact caused by familiar environment detachment, everyday routines and habits. This paradigm implies an adaptation of nursing care services and practices, where quality improvement should focus on continuity of care at home. Objective: to identify recommendations evidence-based of good practices to child / family nursing interventions in an outpatient setting, that allows the definition of standards / quality indicators. Methodology: A Systematic Review of Literature was performed, supported on the Cochrane Handbook orientations of studies published between 2004-2017. The research was conducted on EBSCO and PUBMED databases and resulted in 97 studies. After applying relevance tests, 80 were excluded and 17 included in the methodology critical assessment, done independently by two reviewers and based on defined criteria. At end, five articles1,2,3,4,5 were included. Results: The recommendations identified for the quality of outpatient nursing care are mainly directed to surgical situations, namely, prevention and control of infections, given the high turnover of children; use of digital strategies for preoperative preparation, avoiding anxiety and promoting early discharge, by empowering the family; telephone contact to support and ensuring continuity of care; assessment of the post-surgical condition using the Ped-PADSS checklist, ensuring the early discharge. Conclusion: The results of this study allowed us to obtain recommendations for use in nursing practice of outpatient care and enable to the consequent quality improvement of nursing care provided to child and family

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A mudança nas perceções dos enfermeiros de família sobre os pressupostos da intervenção familiar após o processo formativo MDAIF / Change in perceptions of family nurses about the assumptions of family intervention after the MDAIF formative process

The Dynamic Model of Family Assessment and Intervention (MDAIF) aims to constitute itself as a reference that promotes clinical decision processes based on systemic proposition. This study aimed to evaluate the changes in nurses' perceptions about the assumptions of family intervention after the training process centered on this referential. This is an exploratory and quantitative study with a sample of 553 family nurses who participated in the "MDAIF" training, organized by the Northern Regional Health Administration, until 2017. A 10 item Likert scale was used with responses between 1 "totally incompetent and 7" "fully compe-tent", based on MDAIF and applied in the pre and post training periods. T-test was performed for paired samples using SPSS version 23.0. There were very significant statistical changes regarding the perception of competence in all items evaluated, and participants after training perceived with higher competence on the assumptions of family intervention. The results confirm the importance of formative processes based on family health nursing theoretical references. May contribute to the development of family-centered practices as a client, as well as to investigate the health returns resulted from them

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Vital and enchanted: Jane Bennett and new materialism for nursing philosophy and practice.

Nursing theories are typically anthropocentric and emphasize caring for a person as a unitary whole. They maintain the dualisms of human-nonhuman, natural-social and material-ideal. Recent developments in nonhuman ontology question the utility of that approach. One important philosopher in this new materialism is political theorist Jane Bennett. In this paper, I explore Bennett's vital materialism and enchantment as two concepts arising from the nonhuman turn that should inform nursing philosophy. Vital materialism considers the lively power of matter to affect the world and be affected in relations. Enchantment refers to a sense of wonder and captivation with matter. While summarizing her important contributions, I also describe common criticisms and responses. I consider the human as an assemblage of matter as well as the agency or "thing power" of matter external to humans. This has implications for nursing thought and practice, and it can inform a more capacious research methodology. I also discuss how compassion fatigue or burnout and other professional issues may be seen as a form of disenchantment with the material world. I argue that embracing these and other elements of Bennett's new materialist philosophy can help nurses and other health professionals enrich their theories and practice to advance their disciplines and improve care for persons and populations.

Nursing practice in stroke rehabilitation: Perspectives from multi-disciplinary healthcare professionals.

In this qualitative, descriptive study, we explored the status of and factors related to nursing practice for stroke rehabilitation in China, considering the perspectives of multi-disciplinary healthcare professionals. Fifteen participants were interviewed in depth, followed by field observations at three healthcare institutions. Data were analyzed using ethnographic data analysis methods. Current nursing practice for patients with stroke emerged as a cultural domain that included nine patterns: coordination of nursing, basic nursing following nursing procedures, limited rehabilitation nursing care with varied functions, therapeutic function in rehabilitation care, the importance of nurses' involvement in rehabilitation, environments making rehabilitation nursing possible, inadequate staffing for the numerous clinical nursing practices, lack of effective communication with other healthcare professionals, and lack of policies regarding rehabilitation nursing practice. Nurses' role in stroke rehabilitation must be addressed by updating nursing practice. Further, stroke team leaders must recognize the constraints faced by nurses in fulfilling their stroke-rehabilitation roles.

Effect of a Systemwide Approach to a Reduction in Central Line-Associated Bloodstream Infections.

BACKGROUND: Unit-based initiatives were deployed independently creating silos in practice variability across the system with little impact on reduction of central line-associated bloodstream infections (CLABSI). PROBLEM: The goal was to decrease CLABSI systemwide by establishing standardized evidence-based practice (EBP) procedures to advance nursing practice. APPROACH: A new innovative method, the Ferrari Method for Practice Standardization, enhanced the quality infrastructure by merging EBP and lean methodology to translate nursing innovations into practice. Leveraging a culture of shared decision making to support autonomy, as well as collaborating interprofessionally, allowed the organization to standardize and sustain CLABSI prevention. OUTCOMES: The Ferrari Method for Practice Standardization successfully reduced CLABSI rates by 48% over a 1-year improvement cycle. Eight standardized EBP clinical procedures were developed and implemented across the organization. CONCLUSION: The implementation of the Ferrari Method for Practice Standardization swiftly moves new knowledge into clinical practice to improve outcomes. Using standardized improvement methodology, it eases the interprofessional approval processes, maximizes autonomy, and focuses on quality care.

Albert Mieczyslaw Krapiec's theory of the person for professional nursing practice.

This article presents the works of great Polish philosopher, Mieczyslaw Albert Krapiec, whose creative output can be applied to professional nursing practice. Krapiec's philosophical heritage is extensive and encompasses many philosophical fields: metaphysics, philosophical anthropology, philosophy of law, philosophy of culture, philosophy of politics and philosophy of language. Krapiec created an original philosophical synthesis characterized by a realistic approach. In this paper, I present only one of several original philosophical concepts developed by Krapiec: the theory of the person based on seven essential characteristics, that is the ability for cognition, love, freedom, religion, legal subjectivity, completeness and dignity. I attempt to show how these personal characteristics correspond to various patient needs. I argue that the qualitative deficit of any personal characteristics indicated by Krapiec corresponds to a patient's real need that must be satisfied. I also stress that the skilful diagnosing of all-not only selected-qualitative deficits of characteristics can be defined as holistic care in the nursing profession.

To dwell within: Bridging the theory-practice gap.

Nursing has a considerable history of theory development but has consistently struggled to reconcile theoretical reality and practice realities. Many authors have attempted to reconcile what has been called the "theory-practice gap," but the space where these two realities enmesh has remained problematic and contentious (Aimei, Macau Journal of Nursing, 14, 2015, 13; Factor, Matienzo, & de Guzman, Nurse Education Today, 57, 2017, 82). The idea of the theory-practice gap has a significant history in nursing, but also continues to have a significant presence within nursing literature and mythology up to the present (Aimei, Macau Journal of Nursing, 14, 2015, 13). In this paper, the space between theoretic reality and practice reality, as evidenced by the theory-practice gap, will be examined. A Heideggerian perspective of "dwelling" (Heidegger, 1971, Poetry, language, thought, New York, NY: Harper Colophon) will be used as a guiding discourse to move nursing away from this classic tension between theory and practice, towards a perspective where theory and practice are woven together as part of one reality.