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1.
Diabetes Res Clin Pract ; 166: 108288, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32615277

RESUMO

BACKGROUND: The prevalence and incidence of Type 2 Diabetes mellitus (T2DM) are significantly increasing in Nigeria. Effective management of the condition, in clinical settings, can be achieved with a minimal financial cost, but this is often overlooked. It is crucial to understand organisational factors influencing non-pharmacological management of T2DM in Nigerian public hospitals for effective management of patients diagnosed with the condition. AIM: To examine healthcare delivery services influencing patient management and seek approaches to heighten optimisation of patient health outcomes. METHODS: Adopting a qualitative case study design, we used the Constant Comparative Method and semi-structured questions to interview17 nurses in public hospitals across Lagos. Using the five stages of the Framework Analysis process, the transcribed interviews were thematically analysed. RESULTS: Nurses suggested that a complex, multifaceted system constituted organisational factors influencing T2DM management in public hospitals across Lagos, Nigeria. Specific factors identified were levels of available information and knowledge, relationship, policy and decision-making management. These factors were, in turn, linked to political, infrastructural, health professional and the environments within which patients were given health services. CONCLUSIONS: The study revealed a significant gap in the organisation of care for individuals diagnosed with T2DM in public hospitals across Lagos. Timely and affordable strategies have been highlighted to secure effective care delivery to patients.


Assuntos
Assistência à Saúde/organização & administração , Diabetes Mellitus Tipo 2/terapia , Serviços de Saúde/normas , Hospitais Públicos/organização & administração , Enfermeiras e Enfermeiros , Percepção , Adulto , Atitude do Pessoal de Saúde , Tomada de Decisões Gerenciais , Assistência à Saúde/normas , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/enfermagem , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Hospitais Públicos/normas , Hospitais Públicos/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Enfermeiras e Enfermeiros/organização & administração , Enfermeiras e Enfermeiros/psicologia , Enfermeiras e Enfermeiros/normas , Enfermeiras e Enfermeiros/estatística & dados numéricos , Padrões de Prática em Enfermagem/organização & administração , Padrões de Prática em Enfermagem/normas , Padrões de Prática em Enfermagem/estatística & dados numéricos , Pesquisa Qualitativa , Fatores Socioeconômicos , Inquéritos e Questionários , Resultado do Tratamento
2.
Medicine (Baltimore) ; 99(27): e20967, 2020 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-32629706

RESUMO

BACKGROUND: Hypertension is a silent disease of the masses with an increasing prevalence and poor control rates. This study aims to establish and test the efficacy of a nurse-led hypertension management model in the community. METHODS: A single-blind, randomized controlled trial was performed. 156 hypertensive patients with uncontrolled blood pressure were equally and randomly allocated into 2 groups. Patients in the study group received a 12-week period of hypertension management. Blood pressure, self-care behaviors, self-efficacy, and satisfaction were assessed at the start of recruitment, 12 and 16 weeks thereafter. RESULTS: After the intervention, blood pressure of patients in the study group had greater improvement in self-care behaviors and a higher level of satisfaction with the hypertensive care compared to the control group (both P < .05). CONCLUSIONS: The nurse-led hypertension management model is feasible and effective for patients with uncontrolled blood pressure in the community.


Assuntos
Serviços de Saúde Comunitária/organização & administração , Hipertensão/enfermagem , Padrões de Prática em Enfermagem/normas , Idoso , Anti-Hipertensivos/uso terapêutico , Feminino , Humanos , Hipertensão/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Autocuidado , Autoeficácia , Método Simples-Cego
3.
Nurs Outlook ; 68(4): 385-387, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32593461

RESUMO

Nurse practitioner (NP) employment in specialty practice areas, such as subspecialty ambulatory practices and inpatient units is growing substantially. The Consensus Model provides guidelines to help states aligning NP education and certification with specialty practice area. Despite expansion of the Consensus Model, significant misalignment exists between specialty NPs' education, certification, and practice location. Therefore, further implementation of the Consensus Model across states could have significant impact on health systems and NPs working in specialty settings. More than 10 years after its introduction, it is time to evaluate the policy and practice implications of the Consensus Model. Important next steps include examination of the impact of the Consensus Model and how to help health systems with alignment when and if the Model is more widely implemented.


Assuntos
Certificação/estatística & dados numéricos , Consenso , Emprego/estatística & dados numéricos , Profissionais de Enfermagem/educação , Profissionais de Enfermagem/normas , Padrões de Prática em Enfermagem/estatística & dados numéricos , Padrões de Prática em Enfermagem/normas , Adulto , Certificação/normas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos de Enfermagem , Estados Unidos
4.
Enferm. clín. (Ed. impr.) ; 30(supl.5): 96-98, jun. 2020.
Artigo em Inglês | IBECS | ID: ibc-196484

RESUMO

Maternity illness and death rate is high in many developing countries, including Indonesia due to bleeding in the post childbirth (28%), miscarriage complication (12%), and sepsis (9%). The main reason for maternity illness in implementation of APN which is in accordance with midwife competence standard is carried out. The objective of the research was to find out the implementation of midwife competence standard in APN implementation behavior. The research used qualitative narrative method. It was conducted at RSU Ridos, Medan. The informants were 4 midwives, 1 owner, and 2 childbirth women. The data were analyzed qualitatively by interpreting the data in the form of sentences. The result of the research showed that the implementation of midwife competence standard in carrying out normal childbirth care in RSU was good. Midwives' knowledge was good since all of them were D-III midwifery graduates. Senior midwives' skill was better than that of young ones although the latter were controlled by their seniors and bay the hospital owner. The skilled midwives had participated in APN training, while the unskilled ones had not. Midwives behavior, especially the seniors' was good in implementing APN in RSU Ridos, but young midwives still needed experience in implementing APN so that their behavior was in accordance with midwife competence standard and to oath of office. It is recommended that the hospital management increase midwives' knowledge and skill in Normal Childbirth Care, and make midwives who not yet followed training participate in it


No disponible


Assuntos
Humanos , Masculino , Feminino , Adulto , Tocologia/normas , Comportamento Infantil/psicologia , Enfermeiras Obstétricas/normas , Competência Profissional/normas , Enfermeiras Obstétricas/psicologia , Padrões de Prática em Enfermagem/normas
5.
PLoS One ; 15(6): e0234854, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32569338

RESUMO

BACKGROUND: Umbilical cord clamping is a crucial step during the third stage of labour that separates the newborn from the placenta. Despite the available evidence that delayed umbilical cord clamping is more beneficial to infants, as well as the existence of 2014 WHO recommendation that the umbilical cord should be clamped between 1 and 3 minutes, its implementation is still low in many countries including Tanzania. OBJECTIVE: This study describes the experiences and perceptions of nurse-midwives`and obstetricians`about the timing of umbilical cord clamping at a regional referral hospital in Tanzania. METHODS: A descriptive qualitative study design that adopted a purposeful sampling strategy to recruit 19 participants was used. Nine semi-structured interviews with six nurse-midwives`and three obstetricians`, as well as one focus group discussion with ten nurse-midwives`were conducted. Thematic analysis guided the analysis of data. RESULTS: Three main themes generated from the data, each having 2 to 5 subthemes. 1. Experiences about the timing of umbilical cord clamping. 2. Perceptions about the umbilical cord clamping. 3. Factors influencing the practice of delayed umbilical cord clamping to improve newborn health outcomes. CONCLUSION: Although the nurse-midwives`and obstetricians`commonly practiced clamping the umbilical cord immediately after delivery, they understood that delayed cord clamping has a potential benefit of oxygenation to the newborn in the event of the need for resuscitation. To move forward with the good practice in maternal and newborn care, proper pre-service and providers training on matters underlying childbirth is essential to address the gap of knowledge. Delayed cord clamping should be practiced widely to improve the health outcomes of the newborn.


Assuntos
Parto Obstétrico/normas , Padrões de Prática em Enfermagem/normas , Padrões de Prática Médica/normas , Cordão Umbilical/cirurgia , Adulto , Atitude do Pessoal de Saúde , Constrição , Feminino , Humanos , Masculino , Tocologia , Enfermeiras Obstétricas , Obstetrícia , Médicos , Gravidez , Pesquisa Qualitativa , Encaminhamento e Consulta , Inquéritos e Questionários , Tanzânia , Fatores de Tempo
6.
J Clin Nurs ; 29(15-16): 2820-2833, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32279369

RESUMO

AIMS AND OBJECTIVES: To review the literature related to the outcomes and experience of people receiving nurse-led care for chronic wounds in the community. BACKGROUND: Chronic wounds lead to a poor quality of life and are an economic burden to the Australian healthcare system. A lack of awareness into the significance of chronic wounds leads to limited resources being available to facilitate the provision of evidence-based care. The majority of chronic wounds are managed by nurses in the community, and a better understanding into current models of care is required to inform future practice. DESIGN: A systematic quantitative literature review. METHODS: A systematic search was conducted in four electronic databases, and the inclusion criteria were as follows: English language, peer-reviewed, published from 2009-2019 and primary research. The data were compiled into an Excel database for reporting as per the Pickering and Byrne (Higher Education Research & Development, 33, 534.) method of systematic quantitative literature review. This review used the PRISMA checklist. The Mixed Methods Appraisal Tool was used for quality appraisal. RESULTS: Twelve studies were included in the review. Home nursing care, social community care and nursing within a wound clinic were identified as three types of nurse-led care in the literature. The findings demonstrate that nurse-led care was cost-effective, reported high levels of client satisfaction and contributed to improved wound healing and reduced levels of pain. CONCLUSIONS: Nurse-led care is a positive experience for people with chronic wounds and leads to better outcomes. The findings suggested a need for further client education and specialised training for healthcare practitioners managing chronic wounds. RELEVANCE TO CLINICAL PRACTICE: This review demonstrates that nurse-led care for people with chronic wounds in the community is cost-effective and improves client outcomes. Raising awareness into the significance of chronic wounds aims to promote the resources required to facilitate evidence-based care.


Assuntos
Enfermagem em Saúde Comunitária/normas , Padrões de Prática em Enfermagem/normas , Ferimentos e Lesões/enfermagem , Austrália , Doença Crônica/enfermagem , Humanos , Enfermeiras Clínicas/organização & administração , Avaliação de Processos e Resultados em Cuidados de Saúde , Satisfação do Paciente , Padrões de Prática em Enfermagem/economia , Qualidade de Vida , Cicatrização
7.
Nursing ; 50(5): 61-62, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32332508

RESUMO

Some nurses continue to routinely dilute I.V. push medications, a practice associated with a high risk of errors. This article reviews correct practices for administering I.V. push medications.


Assuntos
Tratamento Farmacológico/enfermagem , Injeções Intravenosas/enfermagem , Erros de Medicação/enfermagem , Humanos , Injeções Intravenosas/efeitos adversos , Injeções Intravenosas/métodos , Erros de Medicação/estatística & dados numéricos , Guias de Prática Clínica como Assunto , Padrões de Prática em Enfermagem/normas
8.
Support Care Cancer ; 28(11): 5381-5395, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32144583

RESUMO

BACKGROUND: In spite of the necessity of implementing spiritual care practices for cancer patients, there is no clear process in this regard in palliative care programs of the health system of countries. The present study was designed with the aim of developing a clinical practice guideline of spiritual care in cancer patients for oncology nurses in the current context. METHODS: This is a multi-method study which was conducted in five stages within the framework of the National Institute for Health and Care Excellence (NICE) guideline. A research committee consisting of four focal and 16 secondary members was formed. The stages included determining the scope of the study, developing guideline (a qualitative study and a systematic review, triangulation of the data, and producing a preliminary draft), consultation stage (validation of the guideline in three rounds of the Delphi study), as well as revision and publication stages. RESULTS: The clinical guideline of spiritual care with 84 evidence-based recommendations was developed in three main areas, including the human resources, care settings, and the process of spiritual care. CONCLUSIONS: We are hoping by applying this clinical guideline in oncology settings to move towards an integrated spiritual care plan for cancer patients in the context of our health system. Healthcare organizations should support to form spiritual care teams under supervision of the oncology nurses with qualified healthcare providers and a trained clergy. Through holistic care, they can constantly examine the spiritual needs of cancer patients alongside their other needs by focusing on the phases of the nursing process.


Assuntos
Neoplasias/enfermagem , Enfermagem Oncológica , Cuidados Paliativos , Guias de Prática Clínica como Assunto , Padrões de Prática em Enfermagem , Terapias Espirituais/normas , Atitude do Pessoal de Saúde , Clero , Aconselhamento Diretivo/normas , Aconselhamento Diretivo/estatística & dados numéricos , Prática Clínica Baseada em Evidências/estatística & dados numéricos , Pessoal de Saúde/psicologia , Pessoal de Saúde/estatística & dados numéricos , Humanos , Irã (Geográfico)/epidemiologia , Oncologia/normas , Oncologia/estatística & dados numéricos , Neoplasias/psicologia , Enfermagem Oncológica/normas , Enfermagem Oncológica/estatística & dados numéricos , Cuidados Paliativos/métodos , Cuidados Paliativos/psicologia , Cuidados Paliativos/normas , Cuidados Paliativos/estatística & dados numéricos , Padrões de Prática em Enfermagem/normas , Padrões de Prática em Enfermagem/estatística & dados numéricos , Pesquisa Qualitativa , Terapias Espirituais/psicologia , Espiritualidade
9.
Am J Nurs ; 120(3): 48-54, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32079799

RESUMO

The National Institutes of Health Stroke Scale (NIHSS) is considered the standard for assessing neurologic status after an acute stroke. Currently, there is no guideline for when this assessment should be completed, nor is there consensus on how frequently or for how long.We initiated a quality improvement project that sought first to determine when and how often nurses at a variety of institutions in our multisite health care system completed the NIHSS assessment and then to identify the minimum frequency at which nurses should complete the assessment. After reviewing the literature and current practices and observing internal and external benchmarks, we set a new standard for all institutions in the system to follow.The new assessment frequency was based on patient condition and level of care, although that frequency would change if a patient showed new or worsening neurologic changes. The new standard was successfully implemented at all the primary and comprehensive certified stroke centers in our network. Ongoing monitoring confirmed that the frequency of NIHSS assessment met the needs of our patients and ensured staff adherence to the new practice.


Assuntos
Exame Neurológico/enfermagem , Padrões de Prática em Enfermagem/normas , Acidente Vascular Cerebral/enfermagem , Benchmarking/métodos , Humanos , National Institutes of Health (U.S.) , Melhoria de Qualidade , Inquéritos e Questionários , Estados Unidos
10.
J Nurs Adm ; 50(3): 120-121, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32068620

RESUMO

Innovations in patient care, nursing, and the practice environment are the hallmark of Magnet organizations. Establishing new ways of achieving high-quality care is the result of transformational leadership, empowering structures and processes, and exemplary professional practice in nursing. From coast to coast, clinical nurses take advantage of these opportunities to change care for the better, improve the patient experience, and drive the science of nursing forward. American Nurses Credentialing Center's National Magnet Nurse of the Year Awards recognize and reward this work. Five outstanding clinical nurses are honored, 1 in each of the Magnet Model components: transformational leadership; structural empowerment; exemplary professional practice; new knowledge, innovations, and improvements; and empirical outcomes. This month's Magnet Perspectives column spotlights the 2019 award winners and their achievements and examines how Magnet environments support and encourage their success.


Assuntos
Distinções e Prêmios , Liderança , Serviço Hospitalar de Enfermagem/normas , Recursos Humanos de Enfermagem no Hospital/normas , Padrões de Prática em Enfermagem/normas , Qualidade da Assistência à Saúde/normas , Humanos , Cultura Organizacional , Estados Unidos
11.
NASN Sch Nurse ; 35(1): 35-42, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31161869

RESUMO

The purpose of this article is to demonstrate how the Framework for 21st Century School Nursing Practice™ can provide a structure for evaluation using the School Nursing: Scope and Standards of Practice (3rd ed.), thus allowing the school nurse and school nurse evaluators to gain a better understanding of school nursing practice. According to NASN's Position Statement Supervision and Evaluation of the School Nurse, standards should be used to evaluate the clinical practice of school nurses. Our project accomplishes this integration of the Framework, the standards, and the evaluation of school nursing practice.


Assuntos
Modelos de Enfermagem , Padrões de Prática em Enfermagem/normas , Serviços de Enfermagem Escolar/normas , Criança , Humanos
12.
NASN Sch Nurse ; 35(1): 10-14, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31777312

RESUMO

Strong school-based vision and eye health systems include 12 key components to be implemented before, during, and after the actual vision screening event. The National Center for Children's Vision and Eye Health (NCCVEH) at Prevent Blindness partnered with the National Association of School Nurses (NASN) to provide guidance for school nurses for each of the 12 key components via a Vision and Eye Health webpage on the NASN website ( https://www.nasn.org/nasn-resources/practice-topics/vision-health ). This online resource is designed to support school nurses accountable for vision screening and maintaining the eye health of preschool- and school-age children. This NCCVEH/NASN webpage addresses key activities that provide overall support for a child's vision and eye health-beginning with parent/caregiver education and ending with an annual evaluation of the school's vision and eye health system. NASN School Nurse is publishing information about each of these 12 components. The May 2019 installment provided details about the 12 Components approach as a whole and Components 1 and 2: Family Education and a Comprehensive Communication/Approval Process. The July 2019 edition described Components 3 and 4: Vision Screening Tools and Procedures and Vision Health for Children With Special Health Care Needs. This article describes Component 5: Standardized Approach for Rescreening.


Assuntos
Padrões de Prática em Enfermagem/normas , Transtornos da Visão/diagnóstico , Seleção Visual/normas , Criança , Humanos , Serviços de Saúde Escolar/normas , Serviços de Enfermagem Escolar/normas , Transtornos da Visão/enfermagem
13.
Cult. cuid ; 23(57): 210-218, 2020.
Artigo em Português | IBECS | ID: ibc-195914

RESUMO

OBJETIVO: Refletir sobre a prática clínica do enfermeiro junto às juventudes. MÉTODO: Estudo do tipo ensaio reflexivo, produzido a partir de leituras da literatura disponível sobre distinções nos conceitos de adolescência, juventude, juventudes e cuidado de enfermagem. Visou desvelar o cuidado clínico de enfermagem as juventudes, tecendo reflexões sobre a prática profissional/relacional para com essa população. DISCUSSÃO: O entendimiento sobre os vários fatores que envolvem a vida do jovem faz o termo juventude exigir a pluralização, utilizando assim "juventudes" para determinar diversas realidades que se encontram esses grupos juvenis. CONCLUSÃO: Ao se referir as juventudes, o conhecer destes jovens em seus distintos cenários de existência permite ao enfermeiro o traçar diagnósticos de cuidados voltados as necessidades próprias dessa faixa etária levando em conta sua realidade, tornando possível elencar os principais problemas que acometem essa população, proporcionando o cuidado clínico pautado nas múltiplas necessidades desta população


META: Reflexionar sobre la práctica clínica de la enfermera por los jóvenes. MÉTODO: Estudio del tipo de ensayo reflexivo, producido a partir de las lecturas de la literatura disponible sobre distinciones en los conceptos de cuidado de enfermería, juventud, juventud y adolescencia. A la inauguración de la clínica de enfermería jóvenes cuidado, tejiendo reflexiones en práctica profesional, relacional con esta población. DISCUSIÓN: La comprensión de los diversos factores que involucran hace vida de jóvenes la juventud del término requieren pluralización, utilizando así "jóvenes" para determinar varias realidades que son estos grupos de jóvenes. CONCLUSIÓN: Para referirse a jóvenes, el encuentro de estos jóvenes en sus situaciones de existencia distinguido permite a la enfermera el seguimiento diagnóstico del cuidado centrado en las necesidades específicas de este grupo de edad, teniendo en cuenta su realidad, lo que es posible a la lista de los principales problemas que afectan a esta población al proporcionar atención clínica basada en las múltiples necesidades de esta población


OBJECTIVE: Reflect on the clinical practice of the nurse by the youths. METHOD: Study of reflective essay type, produced from readings of literature available about distinctions on the concepts of adolescence, youth, youth and nursing care. Aimed at unveiling the clinical nursing care youths, weaving reflections on professional practice/relational with this population. DISCUSSION: The understanding of the various factors that involve young's life makes the term youth require pluralization, using thus "youths" to determine several realities that are these youth groups. CONCLUSION: To refer youths, the meeting of these young people in its distinguished existence scenarios allows the nurse the trace Diagnostics of care focused on the specific needs of this age group taking into account your reality, making it possible to list the main problems that affect this population by providing clinical care based on the multiple needs of this population


Assuntos
Humanos , Adolescente , Padrões de Prática em Enfermagem/normas , Enfermagem Pediátrica/normas , Cuidados de Enfermagem/normas , Prática Profissional/normas , Saúde do Adolescente/normas
14.
J Nurs Adm ; 50(1): 52-58, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31804408

RESUMO

OBJECTIVE: To describe the impact of the implementation of interprofessional shared governance and a caring professional practice model (Relationship-Based Care [RBC]) on the staff's self-report of caring, work engagement, and workplace empowerment over a 4-year time frame. BACKGROUND: Shared or interprofessional governance has moved mainstream within healthcare settings, particularly within agencies seeking to sustain high reliability in the offering of quality patient care services and/or interest in meeting Magnet standards or embarking upon the Pathway to Excellence. Nurse leaders report that organizations having implemented shared governance thrive, citing professional governance as key to workplace engagement and empowerment, particularly related to quality care initiatives. Transition to interprofessional shared governance structures typically takes 2 to 3 years. It is unknown whether related outcome variables are sustainable over time. METHODS: Utilizing Watson's theory of human caring and appreciative inquiry as underlying frameworks, a longitudinal, quantitative study design was employed. Interprofessional focus groups and introductory sessions were offered to inform and engage all personnel within the medical center. Motivated units were identified, professional shared governance council members elected, and unit-specific education provided. Quality improvement initiatives were facilitated within unit councils, and formal leadership programs to enhance project guidance and to support staff empowerment skills for the managers of the units that were up-and-running were provided. Preimplementation and postimplementation measurements of staff's caring, workplace engagement and work empowerment were assessed, compared, and trended across units over time. RESULTS: Only work empowerment scores among staff working within RBC units were sustainable and increased progressively and significantly over time. Work engagement levels initially rose and then stabilized over time. Caring levels remained stable despite the implementation of a caring professional practice model. Statistically significant correlations were noted between work engagement and empowerment, followed by the relationship between work engagement and caring, followed by the relationship between empowerment and caring. CONCLUSIONS: The sustainability of work empowerment is likely related to the periodic provision of education for leaders regarding leading within an empowered work environment. A stronger focus on staff caring, particularly within quality improvement initiatives, with leadership guidance, will be paramount moving forward.


Assuntos
Empatia , Empoderamento , Padrões de Prática em Enfermagem/normas , Governança Compartilhada de Enfermagem , Local de Trabalho , Humanos , Melhoria de Qualidade , Inquéritos e Questionários , Estados Unidos
15.
J Nurs Adm ; 50(1): 22-27, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31809453

RESUMO

This article describes a practice improvement initiative (PII) demonstrating the impact of doctorate of nursing practice (DNP) skills beyond direct patient care. The Donna Wright Competency Assessment Model, AACN DNP Essentials, and National Organization of Nurse Practitioner Faculties nurse practitioner competencies framed the PII. The DNP graduates planned, implemented, and evaluated an assessment of 1,055 staff nurses on shift hand-off, physical assessment, and hand hygiene. Results indicated that 95% of the staff nurses scored 100% on competency assessment. The PII model was adopted for future competency evaluation.


Assuntos
Benchmarking , Modelos de Enfermagem , Profissionais de Enfermagem , Recursos Humanos de Enfermagem no Hospital/normas , Padrões de Prática em Enfermagem/normas , Humanos , Estados Unidos
16.
Support Care Cancer ; 28(1): 201-210, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30997595

RESUMO

INTRODUCTION: Fear of cancer recurrence (FCR) in people with breast cancer affects treatment recovery, quality of life, service utilisation and relationships. Our aim was to investigate how specialist breast cancer nurses (SBCN) respond to their patients' fears of cancer recurrence and analyse SBCN's views about embedding a new psychological intervention, the Mini-AFTERc, into their consultations. METHOD: A mixed methods sequential design was used, informed by normalisation process theory. Phase 1: UK SBCNs were emailed a web-based survey to investigate how breast cancer survivors' FCR is currently identified and managed, and their willingness to utilise the Mini-AFTERc. Phase 2: a purposive sample of respondents (n = 20) were interviewed to augment phase 1 responses, and explore views on the importance of addressing FCR, interest in the Mini-AFTERc intervention, its content, skills required and challenges to delivering the intervention. RESULTS: Ninety nurses responded to the survey. When SBCN's were asked to identify the proportion of patients experiencing FCR in their caseload, there was no consensus on the size of the problem or unmet need. They estimated that 20-100% people experience moderate FCR and 10-70% severe FCR. The interviews identified that clinical conversations are focused primarily on giving information about signs and symptoms of recurrence rather than addressing the psychological aspects of fear. CONCLUSION: Findings indicate wide variability in how FCR was identified, assessed and supported by a sample of UK SBCNs. The introduction of a structured intervention into practice was viewed favourably and has implications for nursing and health professional ways of working in all cancer services.


Assuntos
Neoplasias da Mama/enfermagem , Medo , Recidiva Local de Neoplasia/psicologia , Enfermeiras e Enfermeiros/psicologia , Percepção , Transtornos Fóbicos/enfermagem , Adulto , Idoso , Atitude do Pessoal de Saúde , Neoplasias da Mama/complicações , Neoplasias da Mama/patologia , Neoplasias da Mama/psicologia , Sobreviventes de Câncer/psicologia , Medo/psicologia , Feminino , Implementação de Plano de Saúde/normas , Humanos , Oncologia/métodos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/enfermagem , Recidiva Local de Neoplasia/prevenção & controle , Transtornos Fóbicos/etiologia , Padrões de Prática em Enfermagem/normas , Qualidade de Vida , Especialidades de Enfermagem , Inquéritos e Questionários
17.
AANA J ; 87(4): 307-312, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31587715

RESUMO

The purpose of this project was to determine the impact of double gloving during the induction of general anesthesia on the incidence of cross-contamination by the anesthesia provider. In a representative sample of anesthesia providers, induction sequences were initially evaluated using the providers' standard technique (group 0). The same providers were reevaluated after being educated on the double gloving technique (group 1). One month later the providers were reevaluated to identify which ones continued the double gloving technique (group 2). For each sequence, all providers were asked to complete a general anesthesia induction following a standard sequence (n = 30). Every anesthesia workstation was cleaned before each induction using the same supplies, and a black light was used to iden-tify any contamination. The workstations included the anesthesia circuit/face mask, breathing bag, anesthesia machine (adjustable pressure-limiting valve/vaporizer), medication cart, intravenous (IV) stopcock, and IV fluid bag. Each group's workstation was evaluated before and after induction for foreign body changes. The 3 groups were compared using a related-samples Friedman test, which demonstrated that the double gloving technique significantly decreased contamination in most areas studied (P < .01). Use of a double gloving technique decreased cross-contamination by greater than 50%.


Assuntos
Anestesiologia/normas , Infecção Hospitalar/prevenção & controle , Luvas Cirúrgicas , Padrões de Prática em Enfermagem/normas , Adulto , Cidades , Connecticut , Infecção Hospitalar/enfermagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Enfermeiras Anestesistas , Estudos Prospectivos , Melhoria de Qualidade , Centros de Traumatologia
20.
Enferm. clín. (Ed. impr.) ; 29(5): 271-279, sept.-oct. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-184151

RESUMO

Objetivo: Conocer las opiniones de los tutores y de los estudiantes del Grado en Enfermería sobre las prácticas clínicas e identificar estrategias y propuestas de mejora para el desempeño de la labor docente. Método: Estudio cualitativo con perspectiva fenomenológica mediante grupos focales con enfermeros tutores de prácticas clínicas y estudiantes de Enfermería. Los participantes se segmentaron en 3 grupos: estudiantes, tutores del área médica y tutores del área quirúrgica. El número de grupos lo determinó la saturación de la información. Se transcribieron los discursos y se realizó un análisis manual sintáctico y semántico de los discursos para extraer las variables de análisis. Se obtuvieron los permisos del Comité de Ética de la Investigación Provincial y del centro correspondiente. Resultados: Tanto los tutores como los estudiantes destacan la necesidad de capacitar a los tutores en las habilidades formativas y proporcionarles herramientas que faciliten su labor, así como el reconocimiento formal de su función docente. En sus discursos, ambos colectivos proponen un cambio de visión y, sobre todo, de actitudes en el desarrollo de la enseñanza-aprendizaje. Y, por último, se manifiesta la necesidad de un cambio en el modelo de relaciones entre la Universidad y los servicios sanitarios. Conclusiones: Con base en lo anteriormente expuesto, se identifica la necesidad de incentivar y formar a los profesionales clínicos para la función tutorial y de plantear un cambio de modelo que propicie un acercamiento entre la Universidad y el sistema sanitario


Objective: To discover the opinions of the tutors and students of the Degree in Nursing on clinical practices and identify strategies and improvement proposals for teacher performance. Method: A qualitative study with a phenomenological perspective through focus groups with clinical nurse tutors and nursing students. The participants were divided into 3 groups: students, tutors from the medical area and tutors from the surgical area. The number of groups was determined by saturation of the information. The discourse was transcribed and a syntactic and semantic manual analysis of the discourse was made to extract the analysis variables. Permission was obtained from the Provincial Research Ethics Committee and the corresponding centre. Results: Both the tutors and the students emphasized the need to train tutors in teaching skills and provide them with tools that facilitate their work, as well as the need for formal recognition of their teaching function. In their discourse, both groups proposed a change of vision, and above all of attitudes, in the development of teaching-learning. Finally, there is a need for a change in the model of relations between the University and health services. Conclusions: Based on the above, the need to encourage and train clinical professionals as tutors is identified and a change of model proposed to bring the University and the health system closer together


Assuntos
Humanos , Estágio Clínico/organização & administração , Padrões de Prática em Enfermagem/organização & administração , Padrões de Prática em Enfermagem/normas , Melhoria de Qualidade , Mentores , 25783 , Estudantes de Enfermagem/estatística & dados numéricos , Educação em Enfermagem/organização & administração
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