Nursing

In 2003, the John A. Hartford Foundation Institute for Geriatric Nursing (Hartford Institute), in collaboration with the American Association of Colleges of Nursing, conducted a survey of baccalaureate schools of nursing in the United States to compare gerontological content to baseline data collected by the Hartford Institute in 1997. Since last surveyed in 1997, baccalaureate nursing programs have been the recipients of substantial new resources and initiatives focused on gerontological curriculum enhancement. While these initiatives are ongoing, and some are in an early stage of development, resurveying baccalaureate programs was seen as a means of taking a midcourse "pulse" as to the effectiveness of these efforts. Data suggest that there has been a fundamental shift in baccalaureate curriculum toward incorporation of a greater amount of gerontological content, integration of gerontological content in a greater number of nursing courses, and more diversity of clinical ...

The author considers that whilst nurse tutors teach theory, nurse practitioners go on nursing in the same way that they always have done. There appears to be a chasm dividing theory and practice. This paper describes an attempt to leap that chasm. The paper identifies the problem, inherent in the nursing process that creates such difficulties in its implementation. The nursing process alone does not provide an adequate framework for nursing practice. The paper then describes how the translation of theory into practice took place on a ward in Brighton General Hospital, Brighton, England. The barrier between theory and practice is highlighted, along with a description of how the problems this presents to ward staff were overcome. The author considers that the attribution of cause is a key concept in the problem-solving approach, since it generates the question — Why?— and therefore that attribution of cause must be a concept in any model of nursing that is being used to implement the nursing process. The paper provides an example of how nursing models may be adapted, at ward level, to guide everyday practice, whilst retaining the conceptual framework ofthe model. The inference of the paper is that such a process could be applied to other models resulting in a greater use of theory in everyday nursing practice.

Increasingly, nurse scientists are incorporating "omics" measures (e.g., genomics, transcriptomics, proteomics, and metabolomics) in studies of biologic determinants of health and behavior. The role of omics in nursing science can be conceptualized in several ways: (a) as a portfolio of biological measures (biomarkers) to monitor individual risk, (b) as a set of combined data elements that can generate new knowledge based on large and complex patient data sets, (c) as baseline information that promotes health education and potentially personalized interventions, and (d) as a platform to understand how environmental parameters (e.g., diet) interact with the individual's physiology. In this article, we provide exemplars of nursing scientists who use omics to better understand specific health conditions. We highlight various ongoing nursing research investigations incorporating omics technologies to study chronic pain vulnerability, risk for a pain-related condition, card...

This article aims to initiate a discussion on the demarcation of the ethics of care. This discussion is necessary because the ethics of care evolves by making use of insights from varying disciplines. As this involves the risk of contamination of the care ethical discipline, the challenge for care ethical scholars is to ensure to retain a distinct care ethical perspective. This may be supported by an open and critical debate on the criteria and boundaries of the ethics of care. As a contribution, this article proposes a tentative outline of the care ethical discipline. What is characteristic of this outline is the emphasis on relational programming, situation-specific and context-bound judgments, a political-ethical perspective, and empirical groundedness. It is argued that the ethics of care is best developed further by means of an intradisciplinary approach. Two intradisciplinary examples show how within the frame of one discipline, other disciplines are absorbed, both with their body of knowledge and their research methodology.

To determine the elements of quality clinical and field placements through the eyes of paramedic instructors. Qualitative study. Two large paramedic services in two countries where the entry to practice qualification for paramedics has been set at the Bachelors degree level. Fifteen purposively selected paramedic instructors were invited to voluntarily participate. The criterion for inclusion was that they had supervised at least one university paramedicine student on a field placement. Recruitment ceased when saturation was reached. Face to face semi-structured interviews were conducted with participants who were asked their views and expectations of paramedicine student clinical and field placements. Inductive thematic analysis of the transcripts was completed using Nvivo software. The elements of quality clinical and field placements from the perspective of paramedic instructors were identified. With no agreed clinical and field placement paramedicine standards in the countries s...

In recent years mature students have been encouraged into nurse education for the valuable qualities they are known to possess, along with their ability to assist in providing a sustainable solution to the current health care crisis. Unfortunately corresponding resources and ...

In order to accept this Student Recruiter agreement with the College of Mental Health Counselling, you must believe in and agree with the value of learning about counselling through the online course described at www.ctihalifax.com, and you must act in good faith accepting that the College will remunerate you as per the terms of this agreement in #5 below. Because a Student Recruiter must communicate the following, therefore completing the below steps is considered a Skill Test in order to qualify. When the College receives full tuition from your first referral, you will be considered a Student Recruiter.

Aim.  To examine the relationship between nurse staffing and nurse-rated quality of nursing care and job outcomes.Background.  Nurse staffing has been reported to influence patient and nurse outcomes.Design.  A cross-sectional study with a survey conducted August–October 2007.Methods.  The survey included 1365 nurses from 65 intensive care units in 22 hospitals in Korea. Staffing was measured using two indicators: the number of patients per nurse measured at the unit level and perception of staffing adequacy at the nurse level. Quality of care and job dissatisfaction were measured with a four-point scale and burnout measured by the Maslach Burnout Inventory. Multilevel logistic regression models were used to determine the relationships between staffing and quality of care and job outcomes.Results.  The average patient-to-nurse ratio was 2·8 patients per nurse. A fifth of nurses perceived that there were enough nurses to provide quality care, one third were dissatisfied, half were highly burnt out and a quarter planned to leave in the next year. Nurses were more likely to rate quality of care as high when they cared for two or fewer patients (odds ratio, 3·26; 95% confidence interval, 1·14–9·31) or 2·0–2·5 patients (odds ratio, 2·44; 95% confidence interval, 1·32–4·52), compared with having more than three patients. Perceived adequate staffing was related to a threefold increase (odds ratio, 2·97; 95% confidence interval, 2·22–3·97) in the odds of nurses’ rating high quality and decreases in the odds of dissatisfaction (odds ratio, 0·30; 95% confidence interval, 0·23–0·40), burnout (odds ratio, 0·50; 95% confidence interval, 0·34–0·73) and plan to leave (odds ratio, 0·40; 95% confidence interval, 0·28–0·56).Conclusions.  Nurse staffing was associated with quality of care and job outcomes in the context of Korean intensive care units.Relevance to clinical practice.  Adequate staffing must be assured to achieve better quality of care and job outcomes.

This article reports an evidence-based practice project using the Iowa Model of Evidence-Based Practice to Promote Quality Care for a common nursing procedure, nasogastric tube placement verification in children. Little research exists regarding the care of nasogastric tubes in children, and traditional verification methods prevail. Auscultation of air insufflation over the abdomen is still used to check placement in many settings, despite research dating back to the 1980s questioning this approach. X-ray remains the only certain way to verify placement, but getting an X-ray before each feeding would be costly and impractical. Additional bedside methods are needed. Project results demonstrate a decrease (93.3% to 46.2%) in the use of auscultation and improved use of other, more reliable methods to determine nasogastric tube placement. Changing practice can be challenging. However, with persistence and re-infusion, this project provides an important example of how the evidence-based ...

"
Aim of Review:
This paper aims to review the Productive Ward literature, to extract key elements of best practice for successful implementation and assess the strength of the literature in relation to these elements. Each of the key elements will be examined and discussed with a view to learning what they can teach us about the implementation path for the productive ward in Ireland and elsewhere.

Search and review methodology:
An initial search in contemporary Nursing Journal databases (January 2006 until June 2012) was undertaken. Key search terms used were: Productive Ward, Productive Series, Releasing Time to Care. Articles that reported on multiple or eclectic initiatives (such as 'Lean' and ''Transforming Care at the bedside') were excluded. Once duplicate and non-relevant citations were removed, 109 potential references were screened for relevance and yielded 74 papers for consideration. The search then focused on references to 'Implementation/challenges/lessons learned', which yielded 53 relevant articles. These were then then arranged into a Taxonomic map which highlighted the key issues for reporting (Hart 2010).

Findings:
Seven common contextual characteristics for consideration during implementation were identified: Robust and Engaging Communication; Enabling and Empowering Roles; Appropriate Training; Project Planning and Management; Leadership; Corporate/Management Engagement and Support, and Financial and Human Resource Commitment.

Conclusions and Implications:
The literature suggests 7 interdependent key characteristics that directly impact on implementing the Productive Ward. These characteristics are contextual and specific to this initiative. The degree to which they interplay, depend or impact with each other warrants further investigation and reporting. In their current form they offer a practical reference-list for implementers.

"