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1.
J Nurs Adm ; 49(10): 503-508, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31517758

RESUMO

OBJECTIVE: To examine changes in new nurses' competencies across the 1st year of practice. BACKGROUND: Competency assessment is a challenge for nurse residency programs and often focuses on skills checklists and confidence self-reports. The Appraisal of Nursing Practice, an observational rating based on Quality and Safety in Nursing Education standards, was developed to help evaluate an RN residency program. METHODS: Preceptors, nurse educators, and/or unit managers from various units rated new nurse residents. Ratings were compared for 353 nurses at 3 points: within the 1st month in the program (T1), at 5 months (T2), and at month 11 (T3). RESULTS: Competency ratings increased significantly for all subscales from T1 to T2. Ratings continued to increase significantly from T2 to T3, although at a slightly slower rate. Teamwork and evidence-based practice increased the most. CONCLUSIONS: Future studies should explore factors affecting the trajectory in developing nursing competencies within various settings.


Assuntos
Competência Clínica/normas , Avaliação de Desempenho Profissional/normas , Guias como Assunto , Cuidados de Enfermagem/normas , Recursos Humanos de Enfermagem/normas , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Estados Unidos
2.
BMC Health Serv Res ; 19(1): 547, 2019 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-31382968

RESUMO

BACKGROUND: Effective hand hygiene is one of the most important measures for protecting nursing home residents from nosocomial infections. Infections with multi-resistant bacteria's, associated with healthcare, is a known problem. The nursing home setting differs from other healthcare environments in individual and organisational factors such as knowledge, behaviour, and attitude to improve hand hygiene and it is therefore difficult to research the influential factors to improve hand hygiene. Studies have shown that increasing knowledge, behaviour and attitudes could enhance hand hygiene compliance in nursing homes. Therefore, it may be important to examine individual and organisational factors that foster improvement of these factors in hand hygiene. We aim to explore these influences of individual and organisational factors of hand hygiene in nursing home staff, with a particular focus on the function of role modelling by nursing managers. METHODS: We conducted a mixed-methods study surveying 165 nurses and interviewing 27 nursing managers from nursing homes in Germany. RESULTS: Most nurses and nursing managers held the knowledge of effective hand hygiene procedures. Hygiene standards and equipment were all generally available but compliance to standards also depended upon availability in the immediate work area and role modelling. Despite a general awareness of the impact of leadership on staff behaviour, not all nursing managers fully appreciated the impact of their own consistent role modelling regarding hand hygiene behaviours. CONCLUSION: These results suggest that improving hand hygiene should focus on strategies that facilitate the provision of hand disinfectant materials in the immediate work area of nurses. In addition, nursing managers should be made aware of the impact of their role model function and they should implement this in daily practice.


Assuntos
Higiene das Mãos/normas , Conhecimentos, Atitudes e Prática em Saúde , Recursos Humanos de Enfermagem/normas , Adulto , Idoso , Idoso de 80 Anos ou mais , Competência Clínica/normas , Infecção Hospitalar/enfermagem , Infecção Hospitalar/prevenção & controle , Estudos Transversais , Feminino , Alemanha , Desinfecção das Mãos/normas , Higiene das Mãos/métodos , Humanos , Liderança , Masculino , Pessoa de Meia-Idade , Enfermeiras Administradoras/normas , Casas de Saúde/normas , Inquéritos e Questionários , Adulto Jovem
3.
Res Nurs Health ; 42(5): 349-357, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31310012

RESUMO

Cross-cultural competence is an essential component of the nursing profession, but little is known about the specific psychosocial work characteristics that potentially promote or hinder such competence. In the present study, psychosocial work characteristics were based on Karasek's Job Demand-Control Model. The researchers examined whether Karasek's psychosocial work characteristics, such as high-strain jobs, high-strain isolated jobs, active jobs, and active collective jobs, are associated with cross-cultural competence (empathy, skills, positive attitudes, and motivation), and whether there are differences between native and foreign-born registered nurses (RN) in these potential associations. A random sample of 744 native RNs (91.0% women) and a total sample (n = 212) of foreign-born RNs (94.3% women) working in Finland were used. Data were collected using a questionnaire and analyzed with a series of multiple linear regression analyses. High-strain and high-strain isolated jobs were negatively associated with all four dimensions of cross-cultural competence. Active collective jobs, but not active jobs, were positively associated with cross-cultural skills. There were no differences between native and migrant nurses in these associations. The psychosocial work environment is associated with cross-cultural competence in both native and migrant nurses. Improvements in psychosocial working conditions, especially minimizing negative factors in the work environment, such as high-strain and high-strain isolated jobs, may need to be considered as a part of the efforts aimed to enhance cross-cultural competence among nursing personnel.


Assuntos
Competência Clínica , Competência Cultural , Pessoal Profissional Estrangeiro/psicologia , Recursos Humanos de Enfermagem/psicologia , Recursos Humanos de Enfermagem/normas , Local de Trabalho/psicologia , Adulto , Atitude do Pessoal de Saúde , Feminino , Finlândia , Humanos , Masculino , Pessoa de Meia-Idade , Estresse Psicológico , Inquéritos e Questionários
4.
Comput Inform Nurs ; 37(8): 420-429, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30741730

RESUMO

In 2015, the Finnish Ministry of Social Affairs and Health published an eHealth and eSocial strategy with key objectives that by 2020 health information systems will be smart and providers will be able to maximize their use. Measures include improving system usability and decision support, involving professionals in system and service development, and increasing professionals' training in information management, electronic documentation, data protection, and data security. The aim of this study was to explore the level of nurses' informatics competencies and sufficiency of in-house training regarding technology-induced changes in work practices. An electronic questionnaire produced by the National Institute of Health and Welfare was sent in February to April 2017 to 29 283 Finnish working-age nurses, community nurses, and midwives; 3607 replies were received. Respondents rated their overall informatics competency relatively high, with the lowest competency scores on terminology-based documentation (Finnish Care Classification) and patient-related digital work. Education, electronic health record system used, experience using electronic health record systems, sufficiency of training, higher levels of technical functionality, ease of use, and usefulness were all associated with competency and remained significant after all adjustments. One-third of the respondents felt that they had not received sufficient training. Age and participation in system development were associated with experiences of sufficiency of training.


Assuntos
Registros Eletrônicos de Saúde/normas , Informática Médica , Recursos Humanos de Enfermagem/normas , Interface Usuário-Computador , Feminino , Finlândia , Humanos , Masculino , Pessoa de Meia-Idade , Recursos Humanos de Enfermagem/educação , Recursos Humanos de Enfermagem/psicologia , Inquéritos e Questionários
5.
Br J Nurs ; 28(4): 264-265, 2019 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-30811228

RESUMO

The revised Nursing and Midwifery Council education curriculum, which came into force in January, has the potential to revolutionise nursing, says Barry Hill, Senior Lecturer, Northumbria University ( barry.hill@northumbria.ac.uk ).


Assuntos
Competência Clínica , Currículo , Assistência à Saúde/organização & administração , Bacharelado em Enfermagem/organização & administração , Recursos Humanos de Enfermagem/normas , Humanos , Identificação Social , Sociedades de Enfermagem , Reino Unido
6.
BMC Geriatr ; 19(1): 17, 2019 01 21.
Artigo em Inglês | MEDLINE | ID: mdl-30665362

RESUMO

BACKGROUND: Elderly living in a Nursing Home (NH) are frequently transferred to an Emergency Department when they need acute medical care. A proportion of these transfers may be considered inappropriate and may be avoidable. METHODS: Systematic review. Literature search performed in September 2018 using PubMed, Web of Science, the Cochrane Library and the Cumulative Index to Nursing and Allied Health Literature database. Titles and abstracts were screened against inclusion and exclusion criteria. Full-texts of the selected abstracts were read and checked for relevance. All years and all languages were included provided there was an English, French, Dutch or German abstract. RESULTS: Seventy-seven articles were included in the systematic review: 1 randomised control trial (RCT), 6 narrative reviews, 9 systematic reviews, 7 experimental studies, 10 qualitative studies and 44 observational studies. Of all acute transfers of NH residents to an ED, 4 to 55% were classified as inappropriate. The most common reasons for transfer were trauma after falling, altered mental status and infection. Transfers were associated with a high risk of complications and mortality, especially during out-of-hours. Advance directives (ADs) were usually not available and relatives often urge NH staff to transfer patients to an ED. The lack of availability of GPs was a barrier to organise acute care in the NH in order to prevent admission to the hospital. CONCLUSIONS: The definition of appropriateness is not uniform across studies and needs further investigation. To avoid inappropriate transfer to EDs, we recommend to respect the patient's autonomy, to provide sufficient nursing staff and to invest in their education, to increase the role of GPs in the care of NH residents both in standard and in acute situations, and to promote interprofessional communication and collaboration between GPs, NH staff and EDs.


Assuntos
Serviço Hospitalar de Emergência/normas , Hospitalização , Casas de Saúde/normas , Transferência de Pacientes/normas , Diretivas Antecipadas , Idoso , Idoso de 80 Anos ou mais , Assistência à Saúde/métodos , Assistência à Saúde/normas , Humanos , Recursos Humanos de Enfermagem/normas , Transferência de Pacientes/métodos , Pesquisa Qualitativa
7.
J Clin Nurs ; 28(5-6): 882-893, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30357971

RESUMO

AIMS: To assess the knowledge of nurses of national guidelines for emergency maternity, routine newborn and small and sick newborn care in Nairobi County, Kenya. BACKGROUND: The vast majority of women deliver in a health facility in Nairobi. Yet, maternal and neonatal mortality remain high. Ensuring competency of health workers, in providing essential maternal and newborn interventions in health facilities will be key if further progress is to be made in reducing maternal and neonatal mortality in low-resource settings. DESIGN: Cross-sectional survey. METHODS: Questionnaires comprised of clinical vignettes and direct questions and were administered in 2015-2016 to nurses (n = 125 in 31 facilities) on duty in maternity and newborn units in public and private facilities providing 24/7 inpatient neonatal services. Composite knowledge scores were calculated and presented as weighted means. Associations were explored using regression. STROBE guidelines were followed. RESULTS: Nurses scored best for knowledge on active management of the mother after birth and immediate routine newborn care. Performance was worst for questions on infant resuscitation, checking signs and symptoms of sick newborns, and managing hypertension in pregnancy. Overall knowledge of care for sick newborns was particularly low (score 0.62 of 1). Across all areas assessed, nurses who had received training since qualifying performed better than those who had not. Poorly resourced and low case-load facilities had lower average knowledge scores compared with better-resourced and busier facilities. CONCLUSION: Overall, we estimate that 31% of maternity patients, 3% of newborns and 39% of small and sick newborns are being cared for in an environment where nursing knowledge is very low (score <0.6). RELEVANCE TO CLINICAL PRACTICE: Focus on periodic training, ensuring retention of knowledge and skills among health workers in low-case load setting, and bridging the know-do gap may help to improve the quality of care delivered to mothers and newborns in Kenya.


Assuntos
Competência Clínica , Conhecimentos, Atitudes e Prática em Saúde , Serviços de Saúde Materno-Infantil/normas , Recursos Humanos de Enfermagem/educação , Adulto , Estudos Transversais , Feminino , Fidelidade a Diretrizes , Humanos , Lactente , Recém-Nascido , Doenças do Recém-Nascido/enfermagem , Quênia , Recursos Humanos de Enfermagem/normas , Gravidez , Inquéritos e Questionários , População Urbana
8.
Int J Health Care Qual Assur ; 31(8): 1030-1043, 2018 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-30415626

RESUMO

PURPOSE: The last few years have seen a stronger emphasis on patient-centred care within the international healthcare setting. Patient-centred care is clearly perceived to be important to optimise the satisfaction and well-being of patients. The purpose of this paper is to review current patient-centred practices for outpatients in both private clinics and public hospitals in Dubai. Such a comparison contributes to the identification of best management practices as a means of enhancing healthcare delivery. DESIGN/METHODOLOGY/APPROACH: This study is based on an independent survey consisting of self-administered questionnaires, in which patients were asked to rate several aspects of private clinics or government hospitals in Dubai. The questionnaire used has been drawn from the Consumer Assessment of Healthcare Providers and Systems Clinician and Group Survey, Version 3.0. Responses from 420 patients form a data set that is analysed quantitatively. FINDINGS: In total, 420 respondents took part in this survey. The results of the survey show that there is a considerable difference between the expectation levels of patients from government hospitals and patients from private clinics. Patients from government hospitals consistently show that time is a critical aspect of the service received, with 68 per cent of the respondents reporting this issue. Additionally, poor customer care, as reported by 14 per cent of the respondents, is also a critical issue. Timely service and appointments are among the main factors that contribute to patient satisfaction. Patients in private clinics, instead, particularly value clear explanations from doctors and nurses - this is corroborated by the fact that 11 per cent of the respondents reported appreciation of this type of service. PRACTICAL IMPLICATIONS: This paper draws attention to a patient-centric perspective of healthcare, and highlights the importance of educating patients through clear explanations. ORIGINALITY/VALUE: Little evidence exists on the standards of healthcare in Dubai. The authors explore this area and present direct evidence on quality standard implementation, identify implementation shortcomings and make recommendations for future research and practice.


Assuntos
Assistência Ambulatorial/normas , Hospitais Públicos/normas , Satisfação do Paciente , Setor Privado/normas , Qualidade da Assistência à Saúde/normas , Adolescente , Adulto , Idoso , Criança , Comunicação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recursos Humanos de Enfermagem/normas , Assistência Centrada no Paciente/normas , Melhoria de Qualidade/organização & administração , Indicadores de Qualidade em Assistência à Saúde , Fatores de Tempo , Emirados Árabes Unidos , Adulto Jovem
9.
J Contin Educ Nurs ; 49(12): 555-557, 2018 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-30496597

RESUMO

BACKGROUND: Traditional nursing uniforms have evolved and influenced nursing image, but professional image in nursing is unique and unclear. Institutional policies dictate uniform and appearance standards that portray professionalism in health care environments. METHOD: Nurses were questioned using three structured open-ended questions about the nursing uniform and its effects on patients' perceptions of professionalism. Qualitative line-by-line analyses of transcribed data were conducted to identify emerging themes using van Manen's phenomenology. RESULTS: Participants wore varying uniforms while in nursing school. The influences of uniform evolution on patients' perceptions of professionalism were acknowledged along with current challenges in maintaining a professional image in nursing. CONCLUSION: Findings will be used for future exploration of the concept of professional image to improve educational practices that promote a professional work environment and professional image for the discipline. [J Contin Educ Nurs. 2018;49(12):555-557.].


Assuntos
Vestuário/normas , Recursos Humanos de Enfermagem/normas , Competência Profissional/normas , Papel Profissional , Adulto , Vestuário/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recursos Humanos de Enfermagem/estatística & dados numéricos , Competência Profissional/estatística & dados numéricos
10.
Tunis Med ; 96(6): 366-370, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30430475

RESUMO

BACKGROUND: Infection of surgical wounds is the main cause of nosocomial infections. In the event of a defect in the care chain, in particular, during the change of the postoperative dressings, the infectious risk would be increased. AIM: To evaluate the gestures of change of dressing practiced by nurses of a university hospital department of surgery, in order to observe the insufficiencies. METHODS: We conducted a two-month-duration prospective, descriptive study having a qualitative approach, consisting of a protocol for observing nursing procedures carried out during the implementation of postoperative dressings in a university hospital surgery department from Tunis. A five-item observation grid was developed based on the nursing procedures that should be performed during dressing rehabilitation. RESULTS: This observation was made on 48 changes of dressings made by 13 nurses (eight women and five men). Inadequacies were noted during the preparation of the gesture, the preparation of the equipment, the execution of the act, the storage of the equipment and the transmission of the care to the rest of the nursing staff. CONCLUSION: The results of our study are consistent with a deficiency of the quality of repair of wounds by the nurses. They show a poor application of the rules of asepsis when repairing surgical wounds. This would be only partly due to inadequate staff training, as the majority of participating nurses were found to be familiar with the basics of the means and methods used to prevent infection of a wound. Other causes are lack of staff and work overload, lack of adequate material for the given care as well as lack of self-responsibility for its nursing practice. The resolution of these problems requires the setting up of an epidemiological surveillance system and the in-service training of the staff involved.


Assuntos
Bandagens , Infecção Hospitalar/prevenção & controle , Infecção da Ferida Cirúrgica/prevenção & controle , Ferida Cirúrgica/terapia , Adulto , Feminino , Hospitais Universitários , Humanos , Masculino , Recursos Humanos de Enfermagem/normas , Estudos Prospectivos , Ferida Cirúrgica/complicações , Tunísia
11.
Soins ; 63(830): 41-44, 2018 Nov.
Artigo em Francês | MEDLINE | ID: mdl-30449471

RESUMO

The best way to prevent psychosocial risk is to support the teams in terms of their dynamics and their difficulties. We need to take care of caregivers and other hospital staff. Management has an essential role to play to achieve this objective.


Assuntos
Esgotamento Profissional/prevenção & controle , Administração Hospitalar/métodos , Recursos Humanos de Enfermagem/psicologia , Esgotamento Profissional/epidemiologia , Administração Hospitalar/normas , Hospitais/normas , Hospitais/estatística & dados numéricos , Humanismo , Humanos , Recursos Humanos de Enfermagem/normas , Recursos Humanos de Enfermagem/estatística & dados numéricos , Fatores de Risco
12.
Contemp Nurse ; 54(4-5): 472-482, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30295135

RESUMO

BACKGROUND: The widespread use of telehealth brings benefits to improve access to healthcare for rural and remote populations. OBJECTIVE: This study explores what nurses considered important to confidently and competently participate in telehealth. DESIGN: A descriptive qualitative approach was selected. METHODS: Nine New Zealand Registered Nurses who worked in different clinical settings who use telehealth were identified through snowball sampling, and participated in single semi-structured interviews, which were thematically analysed using a general inductive approach. FINDINGS: The nurses' experience of using telehealth, from novice to becoming more proficient, was the main theme identified, with sub-themes of: Initial use of telehealth, hands-on training, specialty experience, mentorship and technological know-how. The confidence of nurses using telehealth in this study may reflect their clinical nursing experience. CONCLUSION: Recommendations include the need for more telehealth education and preparation, including incorporating telehealth in under and postgraduate nursing programmes. Additionally, specific telehealth nursing competencies are warranted.


Assuntos
Competência Clínica/estatística & dados numéricos , Competência Clínica/normas , Assistência à Saúde/métodos , Recursos Humanos de Enfermagem/psicologia , Recursos Humanos de Enfermagem/normas , Telemedicina/normas , Adulto , Feminino , Humanos , Masculino , Nova Zelândia , Pesquisa Qualitativa , Inquéritos e Questionários , Adulto Jovem
13.
Contemp Nurse ; 54(6): 603-616, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30319020

RESUMO

AIM: To describe what is currently known about nurses' assessment decisions when providing care to patients at home or in their usual place of residence. METHODS: In August 2018, an integrative literature review using a systematic approach was conducted using specific search terms to search Informit, MEDLINE and Cumulative Index of Nursing and Allied Health Literature (CINAHL). The literature search was not limited by date, and included published papers or unpublished dissertations written between 1980 and 2018. RESULTS: In total 25 full papers were assessed for inclusion in this review; seven met the inclusion criteria. Three themes were identified from this review: i) nurse education and experience; ii) assessment informing decision-making and iii) knowing the patient. CONCLUSION: Nurses' education, experience, abilities, prior learning, beliefs, attitudes and values are key factors in the delivery of home-based nursing care, and strongly influence how assessments, clinical judgements and decisions are made. Impact Statement: An understanding of home based nurses' decisions and response to clinical deterioration is needed to inform Hospital in the Home nursing-specific curricula.


Assuntos
Competência Clínica/normas , Tomada de Decisões , Serviços de Assistência Domiciliar/normas , Recursos Humanos de Enfermagem/normas , Medição de Risco , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
14.
BMC Geriatr ; 18(1): 204, 2018 09 04.
Artigo em Inglês | MEDLINE | ID: mdl-30180821

RESUMO

BACKGROUND: Medication regimens in nursing home (NH) residents with severe dementia should be frequently reviewed to avoid inappropriate medication, overtreatment and adverse drug events, within a comfort care approach. This study aimed at testing the feasibility of an interdisciplinary knowledge exchange (KE) intervention using a medication review guidance tool categorizing medications as either "generally", "sometimes" or "exceptionally" appropriate for NH residents with severe dementia. METHODS: A quasi-experimental feasibility pilot study with 44 participating residents aged 65 years or over with severe dementia was carried out in three NH in Quebec City, Canada. The intervention comprised an information leaflet for residents' families, a 90-min KE session for NH general practitioners (GP), pharmacists and nurses focusing on the medication review guidance tool, a medication review by the pharmacists for participating residents with ensuing team discussion on medication changes, and a post-intervention KE session to obtain feedback from team staff. Medication regimens and levels of pain and of agitation of the participants were evaluated at baseline and at 4 months post-intervention. A questionnaire for team staff explored perceived barriers and facilitators. Statistical differences in measures comparing pre and post-intervention were assessed using paired t-tests and Cochran's-Q tests. RESULTS: The KE sessions reached 34 NH team staff (5 GP, 4 pharmacists, 6 heads of care unit and 19 staff nurses). Forty-four residents participated in the study and were followed for a mean of 104 days. The total number of regular medications was 372 pre and 327 post-intervention. The mean number of regular medications per resident was 7.86 pre and 6.81 post-intervention. The odds ratios estimating the risks of using any regular medication or a "sometimes appropriate" medication post-intervention were 0.81 (95% CI: 0.71-0.92) and 0.83 (95% CI: 0.74-0.94), respectively. CONCLUSION: A simple KE intervention using a medication review guidance tool categorizing medications as being either "generally", "sometimes" or "exceptionally" appropriate in severe dementia was well received and accompanied by an overall reduction in medication use by NH residents with severe dementia. Levels of agitation were unaffected and there was no clinically significant changes in levels of pain. Staff feedback provided opportunities to improve the intervention.


Assuntos
Demência/terapia , Erros de Medicação/prevenção & controle , Casas de Saúde , Recursos Humanos de Enfermagem/normas , Cuidados Paliativos/normas , Idoso , Idoso de 80 Anos ou mais , Demência/diagnóstico , Estudos de Viabilidade , Feminino , Humanos , Masculino , Projetos Piloto , Quebeque , Índice de Gravidade de Doença
16.
Inquiry ; 55: 46958018788686, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30027788

RESUMO

Large for-profit nursing home chains in the United States have generally reported low nurse staffing levels. This historical case study examined a class action litigation case regarding staffing levels, resident rights, and quality outcomes in 12 Arkansas nursing homes owned by a large for-profit chain. The questions were as follows: (1) How did the residents' care needs compare with actual nurse staffing levels? (2) How did the staffing levels compare with federal and state nurse staffing requirements and professional staffing standards? (3) Did the facilities comply with state and federal residents' rights and quality of care requirements? The findings showed staffing levels marginally above state minimum standards, staffing shortages that violated state standards, staffing levels not adjusted for resident acuity, and shortages that resulted in omitted care. Staffing levels were lower than needed according to nursing directors, lower than average facilities in the state, and lower than professional standards. The findings showed many resident grievances regarding basic care and residents' rights, clinical measures of poor quality, and state deficiencies. A large settlement was agreed on to compensate the residents. The case shows that chain's management, as well as the regulatory system, failed to ensure adequate staffing levels that took into account regulatory requirements and professional standards and resulted in violations of residents' rights, health, safety, and well-being.


Assuntos
Casas de Saúde/legislação & jurisprudência , Casas de Saúde/estatística & dados numéricos , Recursos Humanos de Enfermagem/estatística & dados numéricos , Estudos de Casos Organizacionais , Propriedade/legislação & jurisprudência , Admissão e Escalonamento de Pessoal/estatística & dados numéricos , Arkansas , Humanos , Casas de Saúde/normas , Recursos Humanos de Enfermagem/legislação & jurisprudência , Recursos Humanos de Enfermagem/normas , Admissão e Escalonamento de Pessoal/legislação & jurisprudência , Admissão e Escalonamento de Pessoal/normas , Qualidade da Assistência à Saúde/organização & administração , Qualidade da Assistência à Saúde/normas
17.
J Adv Nurs ; 74(10): 2301-2311, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30019462

RESUMO

AIM: A discussion of key considerations related to selecting instruments and tools for evaluating healthcare professionals' evidence-based practice (EBP) competencies. DESIGN: A discussion paper. DATA SOURCES: Articles published in international peer-reviewed journals from January 2000 - November 2017 on validated instruments for assessing healthcare professionals' performance-based EBP competencies. IMPLICATIONS FOR NURSING: Validated EBP competency instruments based on actual performance to evaluate the EBP competencies of healthcare professionals are currently available in the field of medicine. Although some of these instruments have already been adapted for use in physical and occupational therapy, their modification for use in nursing has begun only in the last few months. CONCLUSION: A concerted effort on modifying and validating objective measures of actual performance for use in nursing should be commenced to evaluate directly measurable EBP competencies, instead of continuing to rely on nurses' self-assessments. Future studies focusing on development and validation of objective instruments to evaluate EBP competencies based on actual performance and exploring the modification of currently available objective instruments from medicine are urgently needed in nursing. IMPACT: Instead of measuring actual EBP competencies, the majority of competency evaluations in nursing are still being conducted via self-assessments, despite growing evidence of their poor accuracy in evaluating directly measurable constructs such as evidence-based practice knowledge and skills. Accurate measurement of nurses' EBP competencies is essential to increasing systematic implementation of EBP in healthcare organizations, thus promoting the attainment of improved care quality and patient outcomes in healthcare delivery.


Assuntos
Competência Clínica/normas , Enfermagem Baseada em Evidências/métodos , Enfermagem Baseada em Evidências/normas , Recursos Humanos de Enfermagem/normas , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Qualidade da Assistência à Saúde , Inquéritos e Questionários
18.
Am J Infect Control ; 46(11): 1211-1217, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-29866633

RESUMO

BACKGROUND: Infection is a leading cause of hospitalization among home healthcare patients. Nurses play an important role in reducing infection among home healthcare patients by complying with infection control procedures. However, few studies have examined the compliance of home healthcare nurses with infection control practices or the range of sociocultural and organizational factors that may be associated with compliance. METHODS: This study analyzed survey responses from nurses at 2 large, certified home healthcare agencies (n = 359), to explore levels of compliance with infection control practices and identify associated demographic, knowledge, and attitudinal correlates. RESULTS: Nurses reported a high level of infection control compliance (mean = 0.89, standard deviation [SD] = 0.16), correct knowledge (mean = 0.85, SD = 0.09), and favorable attitudes (mean = 0.81, SD = 0.14). Multivariate mixed regression analyses revealed significant positive associations of attitudinal scores with reported level of compliance (P < .001). However, knowledge of inflection control practices was not associated with compliance. Older (P < .05) and non-Hispanic black (P < .001) nurses reported higher compliance with infection control practices than younger and white non-Hispanic nurses. CONCLUSION: These findings suggest that efforts to improve compliance with infection control practices in home healthcare should focus on strategies to alter perceptions about infection risk and other attitudinal factors.


Assuntos
Fidelidade a Diretrizes , Serviços de Assistência Domiciliar/normas , Controle de Infecções/normas , Recursos Humanos de Enfermagem/normas , Estudos Transversais , Coleta de Dados , Humanos
19.
J Nurs Manag ; 26(5): 531-539, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29573023

RESUMO

AIMS: To examine how nurse managers' leadership styles, and nurses' organisational commitment in Saudi Arabia relate. BACKGROUND: Effective leadership is influential in staff retention; however, recruiting and maintaining nurses is an increasing problem in Saudi Arabia. METHODS: Using a survey design, the Multifactor Leadership Questionnaire and the Organisational Commitment Questionnaire were distributed to a sample of 219 nurses and nurse managers from two hospitals in Saudi Arabia. RESULTS: Transformational leadership was the most dominant leadership style. After controlling for the influence of manager/staff status, nationality and hospitals, transformational leadership was the strongest contributor to organisational commitment. Perceptions of both transformational and transactional leadership styles, increased with age for nurse managers and nursing staff. CONCLUSION: Introducing the Full Range of Leadership model to the Saudi nursing workforce could help to prepare Saudi nurses for positions as nurse managers and leaders. IMPLICATIONS FOR NURSING MANAGEMENT: The study provides insight into the type of leadership that is best suited to the dynamic and changing health care system in Saudi Arabia. It is possible that transformational leaders could influence and induce positive changes in nursing.


Assuntos
Enfermeiras Administradoras/psicologia , Recursos Humanos de Enfermagem/psicologia , Adulto , Feminino , Humanos , Satisfação no Emprego , Liderança , Masculino , Enfermeiras Administradoras/normas , Recursos Humanos de Enfermagem/normas , Psicometria/instrumentação , Psicometria/métodos , Arábia Saudita , Inquéritos e Questionários
20.
J Gerontol Nurs ; 44(6): 10-14, 2018 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-29596709

RESUMO

Nursing homes use team nursing, with minimal RN presence, leaving the majority of direct care to licensed practical/vocational nurses (LPNs/LVNs) and unlicensed assistive personnel (UAP), including medication aides. The current article describes challenges faced by nursing home directors of nursing (DONs) leading and managing a team nursing approach, including consideration of scope of practice, delegation and supervision regulations, and related policy implications. A secondary data analysis was performed of qualitative data from a study to develop and test DON guidelines for delegation in nursing home practice. A convenience sample (N = 29) of current or previous DONs and other nursing home leaders with knowledge and expertise in the DON role participated in in-depth, guided interviews. The findings highlight a core concern to nursing licensure policy and regulation: knowledge and practice gaps related to scope of practice and delegation and supervision among DONs, RNs, and LPNs/LVNs, as well as administrators, and the role of nursing leaders in supporting appropriate delegation practices. The findings offer directions for research and practice in addressing challenges in aligning team nursing practices with regulatory standards as well as the related gaps in knowledge among DONs, administrators, and nursing staff. [Journal of Gerontological Nursing, 44(6), 10-14.].


Assuntos
Enfermagem Geriátrica/normas , Pessoal de Saúde/normas , Instituição de Longa Permanência para Idosos/normas , Liderança , Casas de Saúde/normas , Recursos Humanos de Enfermagem/normas , Equipe de Enfermagem/normas , Humanos , Enfermeiras Administradoras , Papel do Profissional de Enfermagem , Estados Unidos
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