Clinical Nursing Experience Research Articles

A phenomenological study of the shift change experiences of clinical nurses in Taiwan

The process of changing shifts requires that clinical nurses engage in critical communication and interaction activities. Little research has examined the shift-change phenomenon. How Taiwanese nurses interpret their lived shift-change experiences deserves further exploration. This study explores the meaning of the shift-change experiences of nurses in Taiwan. A hermeneutic phenomenological design was used. Data from interviews, participant observations, and field notes were analyzed. Twenty-six nurses with shift-change experience volunteered in a snowball sampling process. Data were collected using in-depth interviews. Hermeneutical analysis was used to explain the meaning of the nursing shift-change experience. The shift-change experiences of participants revealed their existential meaning and struggles toward self-transformation, adaptation, and self-settlement for survival. The meaning of the shift-change experience of clinical nurses in Taiwan are characterized by three themes: (a) 'A relay for accomplishing collective nursing goals', (b) 'An associated duties to be carried out jointly', and (c) 'An experience transmission as well as power practice'. Our study highlights the cultural implications and existential meaning of the clinical shift change experience to nurses in hospitals in Taiwan. These findings provide a better understanding of the nursing shift-change experience in terms of both practical issues and nurses' perceptions. Findings may be used to improve in-service training programs and to suggest solutions to problems encountered during the shift-change period.

The effect of critical care nursing and organizational characteristics on pediatric cardiac surgery mortality in the United States.

This study explored pediatric critical care nursing and organizational factors that impact in-hospital mortality for cardiac surgery patients across children's hospitals in the United States. Congenital heart disease is the most common birth defect and the no. 1 cause of death for infants with a congenital defect. Little is known about the impact of pediatric critical care nursing and organizational factors on pediatric mortality. Nursing leaders from 38 children's hospitals that contribute data to the Pediatric Health Information System data set completed an organizational assessment for years 2009 and 2010. These data were linked with patient-level data. The Risk Adjustment for Congenital Heart Surgery method was used to adjust for baseline patient differences in patients younger than 18 years. The odds of death increased as the institutional percentage of pediatric critical care unit nurses with 2 years' clinical experience or less increased. The odds of mortality were highest when the percentage of RNs with 2 years' clinical experience or less was 20% or greater. The odds of death decreased as the institutional percentage of critical care nurses with 11 years' clinical experience or more increased and for hospitals participating in national quality metric benchmarking. Clinical experience was independently associated with in-hospital mortality. These data are the 1st to link clinical nursing experience with pediatric patient outcomes. A cut point of 20% RNs or greater with 2 years' clinical experience or less was determined to significantly affect inpatient mortality. Participation in national quality metric benchmarking programs was significantly associated with improved mortality.

Clinical nursing experience of secondary PICC indwelling catheter in VLBWI

Objective Cluster nursing intervention can effectively ensure the treatment of very low birth weight infant (VLBWI) who was placed PICC secondary at particular insertion sites.Methods Retrospectively analyzed the information of clinical PICC secondary placement.A total of 56 VLBWIs were randomly divided into cluster nursing intervention group and conventional nursing group.Compared indwelling time of different insertion sites and complications of two groups to observe the difference of nursing mode.56 VLBWIs were compared with 30 children who were inserted from elbow to define the effect of nursing intervention.Result Cluster nursing care could significantly lengthen PICC indwelling time and reduce complications.Conclusion Cluster nursing care perfects the technology of PICC,improves the quality of treatment of VLBWI. Key words: PICC; Very low birth weight infant; Cluster nursing intervention; Individual nursing

Knowledge, attitudes, and practice behaviors (KAPb) of nurses and the effectiveness of a training program in psychosocial cancer care

Psychosocial distress in oncology patients may significantly interfere with their health outcomes and quality of life. Nurses work closely with their patients and are in the best position to screen for distress and provide timely intervention. It is thus important for nurses working in oncology settings to be equipped and prepared to address distressing psychosocial issues. The present study aims to investigate the impact of a training program in psychosocial care on nurses' knowledge, attitudes, and clinical practice behaviors. A total of 180 nurses working in medical oncology and radiation oncology departments at the National University Cancer Institute Singapore underwent a training program in psychosocial care as part of their continuing nursing education curriculum. One hundred fifty four of these nurses completed a self-designed questionnaire on nurses' knowledge, attitudes, and practice behaviors (KAPb) at all four time points: baseline, post-training, and at 6 and 12 weeks post-training, respectively. The self-designed KAPb questionnaire proved adequate for this study. Positive gains on applied knowledge and practice behaviors were sustained over a 12-week period. There were no changes in theoretical knowledge. A decreasing trend in attitudes was noted, although this was specific to the participants' attitudes toward the importance of emotional concerns as compared to physical concerns in cancer treatment. Enrolled nurses seemed to have higher starting levels of theoretical knowledge than their registered counterparts were. There were no other differences on demographic variables in relation to the efficacy of the training program. The training program was successful in improving the applied knowledge and practice behaviors of nurses in providing psychosocial care for cancer patients. However, further refinement to the program, with particular attention to nurses' existing training and years of clinical nursing experience, would enhance staff empowerment and care improvement.

Clinical nursing experience of patients complicated with tuberculosis during pregnancy or puerperal state

Objective To analyze the clinical nusing care methods and effects of patients complicated with tuberculosis during pregnancy or puerperal state.Methods Clinical data of 39 cases of patients complicated with tuberculosis during pregnancy or puerperal state were retrospective analyzed.Results After comprehensive treatment and nursing care,4 cases died,others got good prognosis.Conclusions Meticulous treatment and nursing can promote the rehabilitation of patients complicated with tuberculosis during pregnancy or puerperal state.For these patients,the cure rate can be improved and the recurrence rate can be reduced by choosing suitable treatment and nursing care programs,paying attention to psychological care and health education,ensuring patients taking medicine regularly. Key words: Pregnancy; Tuberculosis; Clinical care

Experiences of Clinical Nurses Aged over 40 as Shift Workers

Purpose: The purpose of this study was to explore the experiences of clinical nurses over 40 years of age who were shift workers. Methods: Data were collected from in-depth interviews with 10 clinical nurses over 40 years of age who had at least 10 years of clinical experience and who worked in 5 acute care hospitals. The data were analyzed using Braun & Clark’s thematic analysis. Results: One main theme, 3 themes, and 9 subthemes were derived. The main theme was “Sustaining a position still in conflict”, and themes were as follows; “Being trained as a professional nurse, “Having unfavorable working conditions and damaged self-esteem”, “Trying hard to get a sense of value as an experienced nurse” Conclusion: The results of this study show the issues of age and generational diversities in nurses in acute care hospitals. It is necessary to explore various ways to utilize the experience of older clinical nurses for the integrity of nursing organization and the development of the nursing profession.

循证护理在提高肾移植患者术后生活质量中的作用

目的：探讨循证护理在提高肾移植患者术后生活质量中的作用。方法：将2012年3月~2013年3月我中心实施肾移植术的111例患者随机分成两组，对照组实行常规护理，实验组在常规护理基础上加入循证护理，并于护理干预前和干预后12周，通过随访分别对两组患者的生活质量进行评价。结果：我中心循证护理小组以“如何提高肾移植患者的生活质量”作为循证护理问题，通过查阅国内外医学文献研究报告，寻找肾移植患者生活质量的主要影响因素，并结合临床护理知识及经验，做出符合病人需求的循证护理计划，经循证护理干预后，实验组患者生活质量得到了明显的提高(P Objective: To explore the effect of evidence-based nursing in improving the life quality of renal transplant recipients. Methods: 111 renal transplant patients in our hospital from 2012 March to 2013 March were randomly divided into two groups, the control group received routine nursing, and the case group received evidence-based nursing, evaluating the living quality of them before and after the nursing care. Results: Our center set “How to improve the quality of life in renal transplant patients” as evidence-based nursing problems, sought the main factors which affected the quality of life by reviewing the medical literature research report, and formulated the evi-dence-based nursing care plan combined with the clinical nursing knowledge and experience; after the evidence-based nursing intervention, the quality of life in patients of the case group was obviously increased (P

Perfil acadêmico, crenças e autoeficácia em pesquisa de enfermeiros clínicos: implicações para o Programa de Pesquisa de Enfermagem de um Hospital na Jornada Magnet®

ABSTRACTObjective:To describe the academic profile, research experience, beliefs, and self-efficacy in research of clinical nurses in a Magnet Journey™ hospital.Methods:Quantitative descriptive designed to assess research experience of clinical nurses. The survey was divided into demographics characteristics; scientific/academic profile (Nursing degree; membership in academic research groups, involvement in papers, teaching activities, scientific conferences, and posters presented); beliefs related to nursing research (about skills, benefits to career, reputation of institution, patient care; job satisfaction level); and Research Self-Efficacy (conducting literature review; evaluating quality of studies; using theory; understanding evidence; and scientific writing: putting ideas on paper easily; recognize and adapt the text to the reader; write to the standards required by science; write with objectivity, logical sequence, coherence, simplicity, clarity, and precision; insert the references in the text correctly; write the references appropriately; use correct spelling and grammar; write texts in English).Results:Most clinical nurses had low research experience, yet had positive beliefs in and perception of well-developed research skills.Conclusion:Our findings should contribute to the preparation of research programs aimed at facilitating the engagement of clinical nurses in the development of scientific projects.

The Effect of Critical Care Nursing and Organizational Characteristics on Pediatric Cardiac Surgery Mortality in the United States

This study explored pediatric critical care nursing and organizational factors that impact in-hospital mortality for cardiac surgery patients across children's hospitals in the United States. Congenital heart disease is the most common birth defect and the no. 1 cause of death for infants with a congenital defect. Little is known about the impact of pediatric critical care nursing and organizational factors on pediatric mortality. Nursing leaders from 38 children's hospitals that contribute data to the Pediatric Health Information System data set completed an organizational assessment for years 2009 and 2010. These data were linked with patient-level data. The Risk Adjustment for Congenital Heart Surgery method was used to adjust for baseline patient differences in patients younger than 18 years. The odds of death increased as the institutional percentage of pediatric critical care unit nurses with 2 years' clinical experience or less increased. The odds of mortality were highest when the percentage of RNs with 2 years' clinical experience or less was 20% or greater. The odds of death decreased as the institutional percentage of critical care nurses with 11 years' clinical experience or more increased and for hospitals participating in national quality metric benchmarking. Clinical experience was independently associated with in-hospital mortality. These data are the 1st to link clinical nursing experience with pediatric patient outcomes. A cut point of 20% RNs or greater with 2 years' clinical experience or less was determined to significantly affect inpatient mortality. Participation in national quality metric benchmarking programs was significantly associated with improved mortality.

Does nurse manager education really matter?

Does nurse manager education really matter?

Participatory action research: Involving students in parent education

Competition for scarce clinical placements has increased requiring new and innovative models to be developed to meet the growing need. A participatory action research project was used to provide a community nursing clinical experience of involvement in parent education. Nine Hong Kong nursing students self-selected to participate in the project to implement a parenting program called Parenting Young Children in a Digital World. Three project cycles were used: needs identification, skills development and program implementation. Students were fully involved in each cycle's planning, action and reflection phase. Qualitative and quantitative data were collected to inform the project. The overall outcome of the project was the provision of a rich and viable clinical placement experience that created significant learning opportunities for the students and researchers. This paper will explore the student's participation in this PAR project as an innovative clinical practice opportunity.

Structured Learning and Self-Reflection: Strategies to Decrease Anxiety in the Psychiatric Mental Health Clinical Nursing Experience

Aim. The purpose of this qualitative study was to test a teaching-learning strategy to help nursing students decrease stress and anxiety that may be brought about by the psychiatric mental health clinical experience. Background. Undergraduate nursing students are known to experience affective stress prior to their first psychiatric mental health clinical practicum. A stressful learning environment can affect the success of the student's clinical performance. Method. Thirty nursing students participated in this study. A structured preclinical workshop combined with self-reflection provided insight into students' perceptions of the psychiatric mental health clinical experience. Results. Overall, students reported that participating in the teaching-learning strategy and self-reflection helped mitigate anxiety. Conclusion. Combining structured learning with self-reflection is a useful tool for helping nursing students increase self-awareness and ease anxiety that may interfere with learning.

Creating an Integrated Psychiatric-Mental Health Nursing Clinical Experience

Preparing baccalaureate nursing students to deliver care to an increasingly complex patient population is an ongoing challenge for nursing educators. Wanting to provide their students with a more holistic approach to patient care, undergraduate psychiatric-mental health nursing course faculty created a clinical rotation to address the needs of psychiatric patients who also had 1 or more medical comorbidities. In this article, we describe a pilot project in which students volunteered to participate in a 24-hour clinical experience focused on assessing and addressing the mental health needs of patients admitted to a medical or surgical clinical unit. Evaluation of this approach indicates that the predominant clinical and educational model of specialized healthcare undermines a single course approach to integrated care.

Nurses' Experience of Incivility in General Hospitals

This study was done to describe nurses' experience of incivility in hospitals and to consider nurses' work environment. Data were collected through in-depth interviews and analyzed using Colaizzi' phenomenological analysis methodology. Participants were seven experienced clinical nurses working on a general ward (2 nurses), or in an intensive care unit (2 nurses), emergency room (2 nurses), or operating room (1 nurse). The incivility that nurses experienced was categorized as follows: 'being afflicted as a weak person', 'being treated as less than a professional', 'being overwhelmed by shock and anger', 'experiencing an untenable situation', 'struggling to survive', and 'pursuing professional growth'. Behavior guidelines should be developed to reduce incivility, and incivility cases should be continuously monitored by the nursing department. Also, to handle incivility problems in clinical nursing areas, a reporting and counseling system and education programs are needed.

Factors associated with reporting nursing errors in Iran: a qualitative study

BackgroundReporting the professional errors for improving patient safety is considered essential not only in hospitals, but also in ambulatory care centers. Unfortunately, a great number of nurses, similar to most clinicians, do not report their errors. Therefore, the present study aimed to clarify the factors associated with reporting the nursing errors through the experiences of clinical nurses and nursing managers.MethodsA total of 115 nurses working in the hospitals and specialized clinics affiliated to Tehran and Shiraz Universities of Medical Sciences, Iran participated in this qualitative study. The study data were collected through a semi-structured group discussion conducted in 17 sessions and analyzed by inductive content analysis approach.ResultsThe main categories emerged in this study were: a) general approaches of the nurses towards errors, b) barriers in reporting the nursing errors, and c) motivators in error reporting.ConclusionError reporting provides extremely valuable information for preventing future errors and improving the patient safety. Overall, regarding motivators and barriers in reporting the nursing errors, it is necessary to enact regulations in which the ways of reporting the error and its constituent elements, such as the notion of the error, are clearly identified.

A Medieval Metaphor to Aid Use of the Neuman Systems Model in Simulation Debriefing

Patient simulation is an effective clinical nursing experience and debriefing is recognized as the most crucial phase for students to internalize learning. The Neuman systems model is an excellent organizing framework for simulation debriefing to maximize learning. However, due to the model's complexity, metaphor may be useful to help students to link simulation events with the model's concepts. A medieval metaphorical adaptation of the Neuman systems model was created as an educational debriefing tool to help students bridge this gap. Neuman's concepts are represented as medieval figures encountering and dealing with stressor dragons, with assistance (nursing intervention) as necessary. The companion questionnaire allows recording of student insights and becomes an evaluation tool for student comprehension.

Clinical nursing care experiences on visual electrophysiology test

Objective To investigate the clinical nursing experience on visual electrophysiological examination.Methods Psychological care and guidance were given to patients before,during and after the examination.Results Based on nursing care to 405 cases,making them master the method to cooperate,to pass the examination,and the results provided objective basis for the clinical diagnosis and treatment.Conclusion Effective nursing care can eliminate patients' anxiety,make them cooperate actively,and reduce the number of exogenous disturbance,and increase the accuracy of inspection results. Key words: Visual electrophysiology; Test; Nursing care

Clinical nursing experience on treating patients with pemphigus vulgaris

Objective To investigate the clinical feature and the effective nursing strategy on treatment for pemphigus vulgaris by clinical observation.Methods The clinical nursing data for 52 patients with pemphigus vulgaris from January 2008 to January 2011 were retrospectively analyzed.Results 1 elderly male patient (86 years old) with severe disease of internal medicine was transferred to other hospital for further treatment.1 male patient (57 years old) who had a history of gastric cancer died 1 month after discharge.No complication occurred in other patients.The clinical healing rate was 96.2％.Conclusions The effective psychological nursing,careful wound nursing,strict protection isolation,prevention against complication,reasonable dietary guidance and health education can be carried out to patients with pemphigus vulgaris during the whole hospitalization.These nursing measures can not only prevent and control a variety of infection,but also promote physiological and psychological rehabilitation. Key words: Pemphigus vulgaris; Clinical observation; Nursing strategy

Making a Difference: The Value of Preceptorship Programs in Nursing Education

The benefits of clinical nursing experience in nursing education cannot be overemphasized. Literature has shown that proficient clinical nursing education enhances nursing practice through the development of professional growth with opportunities for the application of theoretical knowledge. Clinical preceptorship has been shown to be an effective method in the development of professional nurses through clinical education. The role of a clinical nursing preceptor is complex and not necessarily applicable to all nurses. Understanding the clinical environment, comprehending individual learning styles, and dealing effectively with conflict are skills that an effective preceptor needs to acquire before participating in the role. This article describes the origin of the preceptor role in clinical nursing education and discusses how the role can be enhanced through a proficient and well-planned preceptorship education program.

A Transdisciplinary Approach to Developing a Web-Based Nursing Experiential Log System for Advanced Practice Nursing Clinical Experiences

This article describes a transdisciplinary project between the computer information systems department and the graduate nursing department of a higher education institution. The project is the planning, development, and implementation of a Web-based nursing experiential log system for advanced practice nursing clinical experiences, which was funded by a Nursing Education Practice and Retention grant from the Health Resources and Services Administration. The article explains the concept and benefits of the transdisciplinary nature of the project. The design team, project leadership, and roles within the team are reviewed, including the role of end-user faculty in the design process. The article describes the focus and scope of the Web-based experiential log system database that is used to document and track advanced practice nursing student clinical experiences, as well as a summary of the design process used to develop the log system and the specific functionality of the database system. The implementation process, including end-user training, pilot implementation, and modifications, lessons learned, and future directions of the project are addressed. The article concludes with the benefits to the clinical experience and graduate nursing program that have been noted since the implementation of the system.