Nursing Care Assistance Research Articles

Hearing in the elderly: Employees' perspectives on hearing care in long-term care facilities. A qualitative study

Hearing in the elderly: Employees' perspectives on hearing care in long-term care facilities. A qualitative study Abstract: Background: Hearing impairment is common among the elderly. More than half of individuals 80 years and older exhibit severe hearing loss, and few retain good hearing performance. This impairment significantly affects both community participation and nursing care. Aim: This study aimed to examine the impact of hearing impairment on everyday life of employees and residents at long-term care facilities. We further sought to identify how employees perceive hearing care in order to identify potential for improvement. Methods: This sub-project of a larger study comprised guided focus groups with employees of long-term care facilities. The sample included six focus groups of nurses and nursing care assistants from long-term care facilities (n = 42). Collected data were analyzed using qualitative content analysis. Results: Hearing impairment hinders elderly resident participation in the nursing process and complicates daily communication between residents and nursing staff. Hearing impaired residents are less able to take part in group activities and tend to withdraw from the community. Lack of an effective hearing support structure renders hearing care services inaccessible to some residents. Conclusions: Optimized service structures, targeted assistance and training opportunities for employees specific to hearing impairment can provide sustainable hearing care for the elderly.

Pendampingan Asuhan Keperawatan Medikal Bedah pada Klien dengan Gangguan Sistem Pencernaan: Gastroenteritis Akut

Introduction: Acute gastroenteritis is a disease that occurs when there is a change in the consistency of the stool apart from the frequency of bowel movements. Gastroenteritis is caused by a viral infection. There are two types of viruses that are the main causes of gastroenteritis, namely Norovirus and Rotavirus. In addition to these two types of viruses, gastroenteritis can also be caused by Adenovirus and Astrovirus. Objective: The purpose of this case study is to identify and implement nursing care for patients with acute gastroenteritis in the Melati Room, 3rd floor of RSUD dr. Soekarjo, City of Tasikmalaya. Method: Nursing assessment is a process carried out by nursing staff to patients continuously to collect information or data in determining nursing problems experienced by patients. Nursing diagnoses are clinical assessments of individual, family, or community responses to actual or potential health problems/life processes. Nursing intervention is a guide for the specific behavior expected of the client, and/or actions that must be taken by the nurse. Nursing implementation is a category of a series of nurse behaviors that coordinate with patients, families, and other members of the health team to assist patients' health problems in accordance with predetermined planning and outcome criteria. Evaluation is an attempt to measure and evaluate objectively the achievement of the results that have been previously planned. Result: The results of the case study on the patient Mr. H with acute gastroenteritis found one nursing problem, namely fluid volume deficit related to active fluid loss. The interventions specified are monitoring hydration status, mucosal moisture, adequate pulse, orthostatic blood pressure, monitoring vital signs, recording accurate intake and output and collaborative intravenous fluid administration. Conclusion: This nursing care assistance has obtained the necessary data for nursing intervention plans. After nursing diagnoses are established, nursing interventions are implemented and evaluated.

COVID-19 and student nurses: A view from England.

COVID-19 and student nurses: A view from England.

Factors associated with lift equipment use during patient lifts and transfers by hospital nurses and nursing care assistants: A prospective observational cohort study

BackgroundDespite wide availability of patient lift equipment in hospitals to promote worker and patient safety, nursing staff do not consistently use equipment. ObjectiveTo determine the influence of factors on the use or non-use of lift equipment during patient lifts/transfers. DesignProspective observational cohort study. SettingOne university teaching hospital and two community hospitals in a large health system in southeastern United States. Participants77 nurses and nursing care assistants with patient handling duties in critical care, step-down and intermediate care units. MethodsParticipants recorded information about all patient lifts/transfers during their shifts during a 1 week period per month for three months: type of lift/transfer, equipment use, type of equipment, and presence of 20 factors at the time of the lift/transfer. With the patient lift/transfer as the unit of analysis, the association (risk ratios (RR) and 95% confidence intervals (CI)) between factors and equipment use was examined using multivariate Poisson regression with generalized estimating equations. ResultsSeventy-seven participants (465 person-shifts) reported 3246 patient lifts/transfers. Frequent lifts/transfers included bed-to-toilet (21%), toilet-to-bed (18%), bed-to-chair (13%), chair-to-bed (13%), chair-to-toilet (6%), and toilet-to-chair (6%). Equipment was used for 21% of lifts/transfers including powered floor based dependent lift (41%), powered sit-to-stand lift (29%), non-powered sit-to-stand lift (17%), air-assisted lateral transfer device (6%), ceiling lift (3%), and air-assist patient lift (3%). Factors associated with equipment use included: availability of equipment supplies (RR = 9.61 [95%CI: 6.32, 14.63]), staff availability to help with equipment (6.64 [4.36, 10.12]), staff preference to use equipment (3.46 [2.48, 4.83]), equipment required for patient condition (2.38 [1.74, 3.25]), patient inability to help with lift/transfer (2.38 [1.71, 3.31]), equipment located in/by patient room (1.82 [1.08, 3.06]), sling already under patient (1.79 [1.27, 2.51]), and patient size/weight (1.38 [0.98, 1.95]). Lower patient mobility score (3.39 [2.19, 5.26]) and presence of physical or mental impairments (2.00 [1.40, 2.86]) were also associated with lift equipment use. Factors associated with non-use of equipment included: patient/family preference (0.31 [0.12, 0.80]), staff assisting with lift did not want to use equipment 0.34 ([0.17, 0.68]), patient condition (0.48 [0.20, 1.20]), and patient almost fell (0.66 [0.45, 0.97]). ConclusionsPatient, worker, equipment, and situational factors influence whether nursing staff used equipment to lift/transfer a patient. Quantifying and understanding these factors associated with lift equipment use and non-use provides specific information for hospitals and safety professionals to enhance effectiveness of future organizational and ergonomic intervention efforts to prevent work-related patient-handling injuries.

Influence of polypharmacy on heart rate variability in older adults at the Hiroshima Atomic Bomb Survivors Recuperation Research Center, Japan.

BackgroundMany studies have identified the risk of polypharmacy, but physiological evidence and methods of evaluation in these studies were poor. The relationship between polypharmacy and heart rate variability in older adults remains unclear. We investigated the relationship between polypharmacy in older adults, including atomic bomb survivors, and heart rate variability.MethodsWe surveyed 56 older adults who did not need nursing care assistance in the Hiroshima Atomic Bomb Survivors Recuperation Center. Chronic diseases, types of medication, and lifestyle were assessed, and heart rate variability at rest was measured. We calculated heart rate variability indices including standard deviation of normal-to-normal RR intervals (SDNN), total power (TP), and very low frequency (VLF) and analyzed the relationship between the number of daily medication types and heart rate variability indices in older adults. The differences in heart rate variability indices were analyzed using six medications as a cut-off point.ResultsParticipants included 36 atomic bomb survivors and 20 non-atomic bomb survivors. The mean number of medication types was 3.6±3.4 (mean±standard deviation). SDNN, TP, and VLF decreased with an increased number of medications in all participants (P<0.01). When the standard of polypharmacy was set to more than six types of medications, SDNN, TP, and VLF were significantly lower in older adults who took six or more medications. Additionally, the mean number of medication types among atomic bomb survivors was higher than that of non-atomic bomb survivors (P = 0.008). The SDNN was significantly lower when atomic bomb survivors took six or more medications (P<0.001).ConclusionsWe found that a lower heart rate variability in older adults, including atomic bomb survivors, is associated with polypharmacy. We showed physiological evidence of the influence of polypharmacy, which may be important for the healthy life expectancy and prognosis in older adults.

Processo de enfermagem e sistematização da assistência de enfermagem – intenção de uso por profissionais de enfermagem

A Enfermagem tem se voltado para a revisão de termos empregados na prática profissional, bem como o seu significado e uso. Entre eles, estão “sistematização da assistência de enfermagem” e “processo de enfermagem”.Sistematização pressupõe a organização em um sistema, que por sua vez implica em um conjunto de elementos, dinamicamente inter-relacionados. Estes elementos podem ser compreendidos, no caso da sistematização da assistência, por um conjunto de ações, uma seqüência de passos, para alcance de um determinado fim.Existem diversos modos de sistematizar a assistência de enfermagem, entre as quais podemos citar os planos de cuidados, os protocolos, a padronização de procedimentos e o processo de enfermagem. Trata-se de diferentes formas de se desenvolver a assistência, ou seja, diversos métodos podem ser utilizados para se solucionar uma dada situação, em um dado contexto, em um determinado tempo, com a finalidade de produzir resultados positivos para a saúde das pessoas que cuidamos. Estas modalidades de agir não são excludentes e têm naturezas distintas.O processo de enfermagem envolve uma seqüência de etapas específicas (obtenção de informações multidimensionais sobre o estado de saúde, identificação das condições que requerem intervenções de enfermagem, planejamento das intervenções necessárias, implementação e avaliação das ações), com a finalidade de prestar atendimento profissional ao cliente, seja ele indivíduo, família ou comunidade, de forma a considerar suas singularidades e de modo ampliado. Requer bases teóricas do campo da Enfermagem e de fora dela. Podemos dizer que se trata da expressão do método clínico na nossa profissão.As diferentes formas de sistematização da assistência pressupõem a organização das condições, dos recursos materiais e humanos além da competência técnico-legal e valorização dada à sua contribuição, seja pela instituição, seja pelo profissional.Dentre esses aspectos, destacamos a predisposição ou intenção de uso desses métodos. Do ponto de vista dos modelos motivacionais(1), o comportamento é função da intenção de agir e da percepção de controle sobre o comportamento; por sua vez a intenção de agir é determinada pela atitude relacionada ao comportamento (avaliações que o indivíduo faz em face dos resultados prováveis ou esperados), a norma subjetiva (pressão social percebida pela realização ou não do comportamento), e o controle comportamental percebido (percepções pessoais sobre sua capacidade para o desempenho do comportamento).Cada um desses componentes tem um valor distinto segundo o comportamento em análise, situação ou grupo de pessoas. Tais elementos tem se mostrado efetivos para predizer a intenção de um dado comportamento. Ainda, deve se considerar, além da motivação para o comportamento, a implementação do comportamento, isto é a ação ou tarefa, a partir de seu planejamento, que contempla as respostas a quando, como e onde agir; pessoas que formulam tal planejamento apresentam maiores chances de agir conforme pretendido(2).Assim, podemos apontar iniciativas bem sucedidas de pessoas e instituições que buscam criar condições para utilizar os métodos de organizar a assistência de enfermagem(3), não como um fim em si mesmo, mas como meios para alcançar a maior de nossas finalidades: prestar atendimento digno, sensível, competente e resolutivo, de modo a contribuir para a melhoria da situação de saúde da população.

NTI: Willing to Teach: Eager to Learn

Background: In our heart failure unit front-line nurses identified poor understanding of key patient outcomes among nursing care assistants (NCAs), resulting in under-reporting of changes in patient status. We recognized the need to better integrate NCAs into patient care processes. Our goal was to improve NCAs ability to understand the challenges of our patients, recognize changes in patient status, and report concerns to the nurse. A secondary purpose was to enhance staff collaboration and teambuilding.

Israel.

Credit crunch hits pensioners The credit crunch is hitting older people in Jerusalem particularly hard, say several organisations who work with this age group. They are calling for the government to cancel plans to raise the income threshold for eligibility for nursing care assistance, as they say this could deprive 30,000 senior citizens of home help.