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1.
Nurse Pract ; 45(5): 48-54, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32332233

RESUMO

Infertility is a growing issue for couples. Primary care NPs can manage initial treatment as well as address the emotional and financial burdens of patients experiencing infertility. NPs can provide timely access to investigations and treatment, helping patients achieve their goal of pregnancy sooner.


Assuntos
Infertilidade/enfermagem , Profissionais de Enfermagem , Enfermagem de Atenção Primária , Técnicas de Laboratório Clínico , Feminino , Humanos , Infertilidade/tratamento farmacológico , Masculino , Anamnese , Exame Físico/enfermagem , Encaminhamento e Consulta
2.
Br J Nurs ; 29(4): 204-210, 2020 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-32105532

RESUMO

A child presenting with decreased level of conscious (dLOC) is of great concern due to the wide range of possible causes, and potential for death or serious long-term sequelae. It is therefore vital that health professionals can recognise a child with dLOC quickly, intervene appropriately and escalate for senior review as a matter of urgency. This article provides an explanation for the mechanisms of decreased consciousness, outlines the different causative pathologies, and provides a simple and logical approach to the first-line recognition and management that a health professional may apply when faced with such a patient. Illustrative case studies have been included, to demonstrate how children with dLOC may present in clinical practice.


Assuntos
Transtornos da Consciência/enfermagem , Diagnóstico de Enfermagem , Criança , Transtornos da Consciência/epidemiologia , Transtornos da Consciência/fisiopatologia , Diagnóstico Diferencial , Enfermagem em Emergência , Feminino , Humanos , Lactente , Masculino , Papel do Profissional de Enfermagem , Exame Físico/enfermagem
3.
J Clin Nurs ; 29(9-10): 1539-1551, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32043689

RESUMO

AIMS AND OBJECTIVES: To gain knowledge of prevention and use of restraints in provision of medical care to people with intellectual disability. To this end, we explore how learning disability nurses in community services support the individual through medical examinations when facing resistance. BACKGROUND: Despite increased focus on limiting restraints, there is a lack of knowledge of how restraints are prevented and used in the delivery of physical health care to people with intellectual disability. DESIGN: We used an ethnographic comparative case design (n = 6). METHODS: The study was carried out in Norway. The analysis is based on data from semi-structured interviews, participant observation and document studies, in addition to health sociological perspectives on how to support individuals to make their body available for medical examination and intervention. The SRQR checklist was used. RESULTS: Learning disability nurses strove to ensure that examinations were carried out on the individual's terms, supporting the individual in three phases: preparing for the examination, facilitating the examination and, when facing resistance, intervening to ensure safe and compassionate completion of the examination. CONCLUSIONS: Supporting the person was a precarious process where professionals had to balance considerations of voluntariness and coercion, progress and breakdown, safety and risk of injury, and dignity and violation. Through their support, learning disability nurses helped to constitute the "resistant" individual as "a cooperative patient," whose body could be examined within the knowledge and methods of medicine, but who could also be safeguarded as a human being through the strain of undergoing examination. RELEVANCE TO CLINICAL PRACTICE: The article sheds light on how restraints are used in the medical examination and treatment of people with intellectual disabilities and demonstrates the significance of professional support workers' contributions, both in facilitating safe and efficient medical care and in ensuring the least restrictive and most compassionate care possible.


Assuntos
Deficiência Intelectual/enfermagem , Deficiências da Aprendizagem/enfermagem , Aceitação pelo Paciente de Cuidados de Saúde , Exame Físico/enfermagem , Adulto , Coerção , Humanos , Masculino , Noruega , Pesquisa Qualitativa , Restrição Física/métodos
4.
Nursing ; 50(2): 48-55, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31977806

RESUMO

Low back pain (LBP) is one of the most frequent patient complaints in primary care. This article discusses the assessment and treatment of patients with LBP, including nonpharmacologic and pharmacologic approaches.


Assuntos
Dor Lombar/enfermagem , Atenção Primária à Saúde , Adulto , Humanos , Anamnese , Avaliação em Enfermagem , Exame Físico/enfermagem , Fatores de Risco
6.
Nurse Pract ; 44(6): 21-28, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31045695

RESUMO

Although aging and urinary incontinence are often associated, urinary incontinence is not a normal part of aging. As the population ages, the challenge of urinary incontinence will place a greater demand on the healthcare system. NPs can effectively direct treatments to mitigate the symptoms of urinary incontinence, improving patient quality of life.


Assuntos
Incontinência Urinária/enfermagem , Testes Diagnósticos de Rotina/enfermagem , Feminino , Humanos , Masculino , Programas de Rastreamento/enfermagem , Profissionais de Enfermagem , Diagnóstico de Enfermagem , Exame Físico/enfermagem , Incontinência Urinária/epidemiologia , Incontinência Urinária/fisiopatologia
7.
J Clin Nurs ; 28(1-2): 330-339, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30091493

RESUMO

AIMS AND OBJECTIVES: To explore the accomplishment of physical examination on a health helpline. By focusing on the ways in which callers are asked to examine themselves and report information to nurses, we aim to provide insight into how physical examination at a distance is achieved. BACKGROUND: Physical examination is a routine feature of healthcare encounters. In face-to-face settings, patients are subject to professional scrutiny through talk, touch and observation. Health professionals working on helplines face challenges in assessing signs of illness when they do not have physical access to patients. DESIGN AND METHODS: Conversation analysis was used to explore sequences of interaction between nurses and callers that involved physical examination. ANALYSIS: Analysis examined how physical examination was routinely accomplished in a helpline environment. Nurses typically guided callers in self-examination by drawing on gross categorisations that required reporting of large-scale characteristics of symptoms (e.g., whether a body part looked "normal"). Physical examination was also regularly accomplished by nurses through two-component speaking turns: a prefacing component that involved instructions about self-examination; followed by a second component that included an information-soliciting question. These practices resulted in callers successfully accomplishing physical examination, despite their lack of professional medical knowledge. CONCLUSIONS: This study identifies the communicative practices used by nurses to accomplish physical examination in helpline calls. Such practices involved asking questions that sought general, rather than specific, information and the prefacing of questions with simple instructions on how to undertake self-examination. RELEVANCE TO CLINICAL PRACTICE: Previous research indicates that physical examination in telehealth can be challenging, particularly in environments where clinicians need patients to examine themselves. This study identifies how nurses on a helpline manage this challenge. The findings highlight ways in which nurses can recruit patients to undertake tasks that would typically be undertaken by clinicians in physically co-present consultations.


Assuntos
Relações Enfermeiro-Paciente , Exame Físico/enfermagem , Telemedicina , Adulto , Feminino , Comportamento de Busca de Ajuda , Linhas Diretas , Humanos , Masculino
9.
Rev Bras Enferm ; 71(suppl 4): 1572-1579, 2018.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30088626

RESUMO

OBJECTIVE: To identify critical incidents (situations, behaviors and feelings) during practical activities, involving knowledge and skills related to the discipline of Semiology and Semiotics. METHOD: Descriptive research using the critical incident technique, with the Snow Ball technique for the selection of participants and an instrument for collection of data. The reports were categorized according to the elements of the critical incident (situations, behaviors and feelings). RESULTS: A total of 62 reports from senior (n = 46), sophomore and junior (n = 16) students were analyzed. The students were predominantly female (90.3%). The majority described a situation of a physical examination, expressed mastery of the skills necessary for the activity and reported positive feelings. CONCLUSION: The reports showed that the knowledge and skills acquired in the discipline allowed for a development of practical activities with familiarity and positive feelings. The importance that the students attribute to the recognition of the activities by the professor, the patient and family stands out.


Assuntos
Competência Clínica/normas , Exame Físico/normas , Estudantes de Enfermagem/psicologia , Adulto , Brasil , Bacharelado em Enfermagem/métodos , Bacharelado em Enfermagem/normas , Feminino , Humanos , Masculino , Exame Físico/enfermagem , Análise e Desempenho de Tarefas
10.
J Forensic Nurs ; 14(3): 162-166, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29697523

RESUMO

Stigma and discrimination toward overweight and obese people pose consequences to their psychological and physical health. In the United States, overweight and obesity and affects over 34% of the population. This frequently ignored public health issue often sees overweight and obese individuals blamed for their weight, thereby justifying the bias. During a post-sexual-assault examination, sexual assault nurse examiners and other forensic examiners must be cognizant of the specific issues and challenges related to the care of these victims. Forensic nurses may need to refine their techniques such as positioning overweight and obese patients on an appropriate-sized table, obtaining equipment for better visualization, and requiring assistance during the examination (e.g., lifting the victim's pendulous skin folds for assessment and evidence collection). Moreover, they may need to recognize and reflect on their own weight related biases. Addressing these important issues may lead to decreasing stigmatization during examinations, thereby providing quality care to victims of sexual assault, regardless of their weight.


Assuntos
Vítimas de Crime , Obesidade/psicologia , Sobrepeso/psicologia , Exame Físico/enfermagem , Delitos Sexuais , Estigma Social , Feminino , Enfermagem Forense , Humanos
11.
Nurse Educ ; 43(4): 215-218, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-28837437

RESUMO

This research is an example of a service learning partnership between a prelicensure nursing program and local school district. Through this partnership, students participated in a thoughtfully organized project that met the needs of a community and promoted the humanizing of health care education. Nursing students, under the guidance of faculty, performed required physical examinations for Special Olympics athletes who represented a wide range of age, physical, social, and intellectual levels. Research findings indicated an increase in nursing students' affective and cognitive development after this activity.


Assuntos
Relações Comunidade-Instituição , Bacharelado em Enfermagem/organização & administração , Aprendizagem , Escolas de Enfermagem/organização & administração , Estudantes de Enfermagem/psicologia , Atletas , Humanos , Deficiência Intelectual , Pesquisa em Educação de Enfermagem , Pesquisa em Avaliação de Enfermagem , Exame Físico/enfermagem , South Carolina , Esportes
12.
Pak J Pharm Sci ; 30(5(Special)): 1911-1915, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29084666

RESUMO

The main problem of clinical prevention and control of multi drug resistant bacteria infection is to strengthen the monitoring of pathogenic bacteria spectrum, this study research on the multi drug-resistant bacteria infection and nursing quality management application in the department of physical examination. The results of this study showed that the number of patients with multiple drug resistant infections showed an increasing trend. Therefore, once the patients with multiple drug-resistant bacteria infection are found, the prevention and control of the patients with multiple drug-resistant bacteria should be strictly followed, and the patient's medication care should be highly valued. Also, the nurses need to be classified based on the knowledge and skill characteristics of the nurses in the department of physical examination, and compare the nursing effect before and after classification and grouping. The physicians and individuals receiving physical examinations in the department of physical examination had a higher degree of satisfaction for nursing effect after classification compared with those before classification. Classification and grouping management helps improve the nursing quality and overall quality of the nurses in the department of physical examination.


Assuntos
Farmacorresistência Bacteriana Múltipla , Conhecimentos, Atitudes e Prática em Saúde , Infecções/epidemiologia , Infecções/enfermagem , Recursos Humanos de Enfermagem/classificação , Recursos Humanos de Enfermagem/psicologia , Exame Físico/enfermagem , Qualidade da Assistência à Saúde , Adulto , China/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente
13.
J Forensic Nurs ; 13(4): 168-177, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29064859

RESUMO

INTRODUCTION: Texas SB 1191 was enacted in 2013 with the intent of increasing access to medical forensic examinations for sexual assault victims by requiring every hospital with an emergency department to be prepared to provide a medical forensic examination if requested by a sexual assault victim. To realize that goal, the law also required basic forensic training for medical professionals before conducting a medical forensic examination as well as a requirement that hospitals develop a "plan to train personnel on sexual assault forensic evidence collection." METHODS: Interviews were conducted in 18 healthcare facilities (five with sexual assault nurse examiner [SANE] programs and 13 without SANE programs) in Dallas, Lubbock, and Austin to determine their awareness and compliance with SB 1191. RESULTS: The data suggest that the law had a little effect on actual practice, and sexual assault survivors still sought a SANE program for a medical forensic examination. DISCUSSION: Although SB 1191 is an important state level effort to make forensic examinations more readily available, it did not fully account for the challenges faced by smaller hospitals that do not see enough sexual assault victims to justify training staff to SANE standards and did not adequately address the training required by medical professionals to feel prepared to conduct a medical forensic examination.


Assuntos
Vítimas de Crime/legislação & jurisprudência , Acesso aos Serviços de Saúde/legislação & jurisprudência , Legislação Hospitalar , Exame Físico/enfermagem , Delitos Sexuais , Atitude do Pessoal de Saúde , Medicina Legal/educação , Enfermagem Forense , Humanos , Capacitação em Serviço , Recursos Humanos de Enfermagem no Hospital/provisão & distribução , Aceitação pelo Paciente de Cuidados de Saúde , Texas , Recursos Humanos
14.
Cult. cuid ; 21(48): 233-241, mayo-ago. 2017. tab
Artigo em Português | IBECS | ID: ibc-167404

RESUMO

Trata-se de um estudo de caso, com o objetivo de descrever a aplicação do processo de enfermagem em um paciente com insuficiência cardíaca estágio IV. Realizado em um hospital universitário localizado no Nordeste do Brasil. Os dados foram coletados no mês outubro de 2012, por meio de um roteiro de entrevista e de exame físico. Os diagnósticos identificados foram: Integridade da pele prejudicada, Privação de sono, Constipação e Volume de líquidos excessivo. Foi traçado o resultado - Cicatrização de feridas: segunda intenção, e aplicou-se a intervenção de enfermagem - Cuidados com úlceras de pressão. Assim, por meio da implementação dos cuidados de enfermagem subsidiados pela sistematização da assistência de enfermagem, observou-se que os resultados almejados foram alcançados com exímio (AU)


Se trata de un estudio de caso, con el objetivo de describir la aplicación del proceso de enfermería en un paciente con insuficiencia cardiaca en etapa IV. Realizado en un hospital universitario situado en el Nordeste del Brasil. Los datos fueron recolectados en el mes octubre 2012 a través de un guión de entrevista y examen físico. Se identificaron los diagnósticos: Integridad de la piel alterada, La privación del sueño, Constipación y Volumen excesivo de líquidos. Se elaboró el resultado - Cicatrización de heridas: segunda intención, y se aplicó la intervención de enfermería - Cuidado de las úlceras por presión. De este modo, a través de la implementación de la atención de enfermería subsidiada por la sistematización de la asistencia de enfermería, se observó que los resultados deseados se lograron con experto (AU)


This is a case study, with the objective of to describe the application of the nursing process in a patient with stage IV heart failure. Conducted in a university hospital located in Northeastern Brazil. Data were collected in the month October 2012, using a structured interview and physical examination. The diagnoses identified were: Impaired skin integrity, Deprivation of sleep, Constipation and excessive fluid volume. Was traced the result - Wound healing: second intention, and applied to the nursing intervention - Care with pressure ulcers. Thus, through the implementation of the nursing care subsidized by the systematization of nursing care, it was observed that the desired results were achieved with expert (AU)


Assuntos
Humanos , Feminino , Idoso , Cuidados de Enfermagem/organização & administração , Cuidados de Enfermagem/normas , Insuficiência Cardíaca/epidemiologia , Insuficiência Cardíaca/enfermagem , Lesão por Pressão/enfermagem , Exame Físico/enfermagem , Lesão por Pressão/prevenção & controle , Terminologia Padronizada em Enfermagem
15.
Nurse Pract ; 42(8): 41-47, 2017 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-28650350

RESUMO

Early vision care is critical for all children. If undetected, eye disorders such as amblyopia and strabismus may result in permanent vision loss. Vision exams should include a careful history and physical including fix and follow, red reflex, and cover/uncover testing. Photo screening and visual acuity exams should be administered whenever possible.


Assuntos
Oftalmopatias/diagnóstico , Exame Físico/enfermagem , Atenção Primária à Saúde , Seleção Visual/enfermagem , Adolescente , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido
16.
J Nurs Educ ; 56(5): 287-291, 2017 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-28467557

RESUMO

BACKGROUND: It has been nearly a decade since findings revealed that a sample of U.S. nurses routinely used only 30 physical assessment techniques in clinical practice. In a time of differentiating nice-to-know from need-to-know knowledge and skills, what has changed in nursing education? METHOD: This cross-sectional, descriptive study examines the physical assessment skills taught and used among nursing students at one baccalaureate nursing education program located in the midwestern United States. RESULTS: Findings highlight the similarities and differences from previous studies and offer insight as to how closely nursing education mirrors the skills needed for clinical practice. CONCLUSION: Nurse educators must continue to discriminate content taught in prelicensure nursing education programs and should consider the attainment of competency of those essential skills that most lend to optimal patient outcomes. [J Nurs Educ. 2017;56(5):287-291.].


Assuntos
Competência Clínica , Bacharelado em Enfermagem , Exame Físico/enfermagem , Adulto , Estudos Transversais , Currículo , Feminino , Humanos , Masculino , Adulto Jovem
17.
Workplace Health Saf ; 65(6): 236-239, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28414580

RESUMO

Falls can occur in any occupational setting. Occupational health professionals may focus on creating a safe work environment and training programs to prevent falls. However, an important aspect of safety management is identifying at-risk employees. The purpose of this article is to identify personal risk factors and offer interventions to prevent falls in the workplace.


Assuntos
Acidentes por Quedas/prevenção & controle , Enfermagem do Trabalho/métodos , Exame Físico/enfermagem , Local de Trabalho/organização & administração , Adulto , Idoso , Doença Crônica , Depressão Pós-Parto/tratamento farmacológico , Feminino , Humanos , Degeneração Macular/complicações , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Retorno ao Trabalho , Fatores de Risco , Gestão da Segurança , Inibidores de Captação de Serotonina/efeitos adversos
18.
J Nurs Care Qual ; 32(1): 71-76, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-27482874

RESUMO

Although the Awakening and Breathing Coordination, Delirium assessment, and Early exercise/mobility (ABCDE) bundle may be effective, individual components of ABCDE may not be implemented as intended. We examined the use of daily interruption of sedation (DIS) and early mobility, looking for an association between these bundle elements. Despite the growing use of DIS and early mobility, the two do not seem to be adopted together, with serious implications for the effectiveness of the ABCDE bundle.


Assuntos
Fidelidade a Diretrizes/normas , Hipnóticos e Sedativos/uso terapêutico , Exame Físico/métodos , Delírio/diagnóstico , Enfermagem Baseada em Evidências/métodos , Enfermagem Baseada em Evidências/normas , Humanos , Hipnóticos e Sedativos/farmacologia , Cultura Organizacional , Segurança do Paciente/normas , Exame Físico/enfermagem , Inquéritos e Questionários
19.
J Clin Nurs ; 26(13-14): 2025-2035, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27717061

RESUMO

AIMS AND OBJECTIVES: To explore multiple perspectives on the use of physical assessment skills by advanced nurse practitioners in the UK. BACKGROUND: Physical assessment skills practices are embedded in advanced nursing practice roles in the UK. There is little evidence on how these skills are used by advanced nurse practitioners in the community. DESIGN: Case study. METHODS: A qualitative interpretative single-embedded case study of 22 participants from South of England. A framework method analysed interview data collected by the researcher between March-August 2013. Participants included nurses, doctors, nurse educators and managers. FINDINGS: Physical assessment skills education at universities is part of a policy shift to develop a flexible workforce in the UK. Shared physical assessment practices are less to do with role substitution and more about preparing practitioners with skills that are fit for purpose. Competence, capability and performance with physical assessment skills are an expectation of advanced nursing practice. CONCLUSIONS: These skills are used successfully by community advanced nurse practitioners to deliver a wide range of services in response to changing patient need. The introduction of physical assessment skills education to undergraduate professional preparation would create a firm foundation to develop these skills in postgraduate education. RELEVANCE TO CLINICAL PRACTICE: Physical assessment education prepares nurses with the clinical competencies to carry out healthcare reforms in the UK. Shared sets of clinical assessment competencies between disciplines have better outcomes for patients. Levels of assessment competence can depend on the professional attributes of individual practitioners. Unsupportive learning cultures can hinder professional development of advanced nursing practice.


Assuntos
Prática Avançada de Enfermagem/métodos , Competência Clínica , Profissionais de Enfermagem/educação , Exame Físico/enfermagem , Inglaterra , Humanos , Pesquisa Qualitativa
20.
J Clin Nurs ; 26(19-20): 3067-3078, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27874983

RESUMO

AIMS AND OBJECTIVES: To explore nurses' views of their role in the screening and monitoring of the physical care needs of people with serious mental illness in a mental health service provider. BACKGROUND: There is increasing awareness through research that people with serious mental illness disproportionately experience and die early from physical health conditions. Mental health nurses are best placed as front-line workers to offer screening, monitoring and interventions; however, their views on physical care interventions are not studied often. DESIGN: Qualitative exploratory study. METHODS: The study was carried out in a mental health inpatient centre in England. Volunteer sampling was adopted for the study with a total target sample of (n = 20) nurses from three inpatient wards. Semistructured interviews were conducted with (n = 10) registered mental health nurses who had consented to take part in the study. Inductive data analysis and theme development were guided by a thematic analytic framework. RESULTS: Participants shared a clear commitment regarding their role regarding physical health screening and monitoring in mental health settings. Four themes emerged as follows: features of current practice and physical health monitoring; perceived barriers to physical health monitoring; education and training needs; and strategies to improve physical health monitoring. CONCLUSIONS: Nurses were unequivocal in their resolve to ensure good standard physical health monitoring and screening interventions in practice. However, identified obstacles have to be addressed to ensure that physical health screening and monitoring is integrated adequately in everyday clinical activities. Achieving this would require improvements in nurses' training, and an integrated multiservice and team-working approach. RELEVANCE TO CLINICAL PRACTICE: Attending to the physical health needs of people with serious mental illness has been associated with multiple improvements in both mental and physical health; nurses have a vital role to play in identifying and addressing causes of poor physical health to improve physical health outcomes in people with serious mental illness.


Assuntos
Atitude do Pessoal de Saúde , Nível de Saúde , Transtornos Mentais/enfermagem , Papel do Profissional de Enfermagem , Exame Físico/enfermagem , Enfermagem Psiquiátrica , Centros Comunitários de Saúde Mental/organização & administração , Inglaterra , Humanos , Serviços de Saúde Mental , Pesquisa Qualitativa
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