Care Unit Nurses Research Articles

Factors that guide nurse managers regarding the staffing of agency nurses in intensive care units at private hospitals in Pretoria

Staffing needs affect the nursing department's budget, staff productivity, the quality of care provided to patients and even the retention of nurses. It is unclear how the role players (the nursing agency manager, the nurse manager and the agency nurse) perceive the staffing of agency nurses in intensive care units (ICUs). The purpose of this study was to explore and describe the factors that guide nurse managers regarding the staffing of agency nurses in ICUs at private hospitals in Pretoria. A quantitative exploratory and descriptive design was used. A survey by means of a structured questionnaire was carried out. Probability sampling was implemented to obtain a study sample (n=124). One similar self-administered 5-point scale instrument was completed by the participants. Data was analysed by means of descriptive and inferential statistics. The principles of validity and reliability were adhered to and ethical considerations were also taken into account. The results indicated limitations in the determining of posts, recruitment and advertising, as well as the selection and appointment of agency nurses in ICUs at private hospitals in Pretoria. Recommendations on staffing are made to nurse managers in ICUs.

Attitudes of Neonatal Intensive Care Nurses and Physicians Regarding Quality and Value of Life: Preliminary Results of a Turkish Survey

This study aimed to find out about the importance attached to maintaining the duration of life and to maintaining the quality of life by physicians and nurses in Turkish neonatal intensive care units (NICU), and how the relation between the two priorities (duration and quality) affected their clinical-ethical decisions. In this study two self-administered questionnaires were used. The questionnaires, the adaptation of the ETTHICAT questionnaire for neonates, were developed by the researchers. The study involved soliciting the views of 66 physicians and 94 nurses in a random selection of 24 research and education hospitals in Turkey. The majority of Turkish NICU practitioners (60.6%) were concerned to maintain life itself if possible, but not at the expense of its quality. In particular, nurses (p=0,037) and neonatologists (p=0,020) placed greater emphasis on protecting the quality of life of the baby. However physicians who described themselves as religious generally preferred maintaining life in all circumstances (p=0,003). In the event of their own child being a high risk neonate, a greater number of NICU practitioners (46%) wanted to maintain the life of the baby even at the expense of its quality of life.

Urinary Incontinence and Physician's Attitude

Urinary Incontinence and Physician's Attitude

Jordanian nurses’ perceptions of their roles toward the families of hospitalised critically ill patients

The primary purpose of this study was to identify Jordanian nurses’ perceptions of their roles toward the families of hospitalised critically ill patients. Second, to examine the relationship between nurses’ role expectations and perceived role performance toward the families of hospitalised critically ill patients. A descriptive, correlational design was used. A convenience sample of 127 intensive care unit (ICU) nurses was recruited from ICUs located in four different hospitals in Jordan. Data were collected using a demographic data form, a Role Performance Subscale with 19 items and a Role Expectation Subscale with 14 items. Results indicated that Jordanian ICU nurses expected and performed interventions that required more time, emotion and communication skills less than interventions that required less time, emotion and communication skills.

A survey study of nursing contributions to medication management with special attention to health information technology

Little detail is known about the types of activities intensive care unit (ICU) nurses perform to support medication management in ICUs in order to contribute to patient safety and quality of care. To understand nurses’ perceptions of the frequency and importance of medication management activities, including those related to using health information technologies (IT). A survey was developed, pilot tested, and administered to ICU nurses in two hospitals. Nurses perceived that they dealt with health IT problems infrequently and that those problems were only moderately important to patient care. Nurses perceived that they engaged in complex cognitive activities frequently and that those were highly important to patient care. Despite considerable focus on health IT problems in extant literature, this study found that nurses do not perceive these problems as frequent or very important. Instead, this study highlights the important role of complex cognitive activities for high quality nursing care, which is a departure from the simplistic notion that nurses only engage in prescribed nursing tasks. Importantly, the survey can be used to identify activities that are value and non-value added, which may lead to better tailored interventions to support nursing work.

Investigation of anxiety status and stress coping style in intensive care unit and general ward nurses

Objective To explore the stress coping style and anxiety status of intensive care unit (ICU) and general ward( referred to as ward) nurses and the relation between stress coping style and anxiety status.Methods Totals of 84 ICU nurses and 77 ward nurses were investigated with general information questionnaire,coping style questionnaire(CSQ) and self rating anxiety scale ( SAS),and compared coping factors score,influencing factors,anxiety incidence and degree between ICU group and ward group,and analysed the relation between stress coping style and anxiety status.Results The “seeking help” (mature coping style)score of ICU nurses group was ( 0.694 ± 0.175 ) higher than ( 0.631 ± 0.212 ) in ward group,and the score of immature style “self-accusation” in ICU group was ( 0.262 ± 0.237 ) lower than ( 0.349 ± 0.262 ) in ward group,difference was statistically significant ( t =2.043,- 2.220,respectively; P ＜ 0.05 ).There was no significant difference in anxiety incidence was found,but anxiety score of ICU group was(39.37 ± 8.905 ) lower than ward group(42.53 ± 8.573 ),and the difference was statistically significant ( t =- 2.292,P ＜ 0.05 ).Coping style was no relation with age,professional title in ICU group( r =-0.060,-0.054,respectively;P ＞ 0.05),while coping style was negatively correlated with age,professional title in ward group( r =-0.237,-0.251,respectively; P ＜ 0.05 ).“solving problem”,“seeking help” were negatively correlated with anxiety (r=-0.267,-0.177,respectively; P ＜ 0.05 or P ＜ 0.01 ).“Shirk”,“self-accusation” and “illusion”( immature coping styles) and “rationalization” ( combined coping style) were positively correlated with anxiety (r =0.329,0.304,0.330,0.287,respectively;P ＜ 0.01 ).Conclusions Improving coping style of nurses can help to reduce nurses' psychological stress and anxiety. Key words: Nurse; Anxiety; Intensive care unit; Coping style ; General ward

Stellenwert von Scores in der Intensivpflege

For nurses in intensive care units (ICUs), the use of scoring instruments is a familiar and important part of their work. Frequently, condition-referred instruments are used to assess various conditions, e.g., pain intensity or degree of alertness. Furthermore, ICU nurses use instruments to assess the risk, e.g., of developing pressure ulcers or to fall. A third important group of instruments are those used to document resource utilization by nurses. However, the estimation of the overall benefit of such scores in the intensive care setting is problematic. In Germany, assessment instruments are mainly required for use within the range of the SGB XI. With regard to intensive care settings, the majority of publications address the presentation of scores or the development of new instruments. From the nursing perspective, no clear conceptual distinction can be made between scores and scales; many instruments lack scientific proof of their benefit for nursing care. Discrepancies with the physicians' viewpoint may exist in some cases.

Effects of Creative Nursing Practice on Hospital Nurses' Job Satisfaction and Organizational Commitment

Purpose: This study was done to: (a) examine relationships between creative nursing practice and job satisfaction, and organizational commitment that nurses perceive in a hospital, and (b) identify creative nursing practice factors affecting job satisfaction and organizational commitment. Method: Using self-report questionnaires including 25 items of the Creative Nursing Practice Index, a descriptive study was conducted with a sample of 387 nurses working in the nursing care units of a general hospital in Seoul, Korea. Data were analyzed, using independent t-test, ANOVA, Pearson correlation, and hierarchical multiple regression analysis. Result: The mean score for nurses performance of creative practice was (range 1 to 4). Creative nursing practice had positive correlation with nurses' job satisfaction (r=.427, p=.158, p=.010), making new knowledge (=.257, p=.209, p=.192, p=.002), making new knowledge (=.158, p=.028), searching ideas (=.254, p=.250, p=.003), and validating ideas (=.189, p=.036). Conclusions: The results indicate a need to develop nurses' creative competency to pursue quality care as well as increase nurses' job satisfaction and organizational commitment.

Practices of skin care among nurses in medical and surgical intensive care units: results of a self-administered questionnaire.

Dermatitis of hands is a problem among nurses. The aim of this prospective questionnaire based survey was to analyze practice and knowledge of skin care of medical and surgical nurses. 250 questionnaires were distributed. 49% of respondent stated that they perform skin care at least 1–2 times/day. After hand-wash 15% of participants perform skin protection, after hand-disinfection only 2%. 40% give skin care products less than 3 minutes to be applied. It was shown that this knowledge is lacking in many individuals, leading to wrong behavior at work and insufficient use of skin protection and skin care products.

Spirituality training for nurses in progressive care units

Spirituality training for nurses in progressive care units

Improvement and application of intensive care nursing record

Objective To reflect the condition of ICU patients in the process of care and to reduce the recording time of nurses. Methods Based on our former hospital care nursing records, more care items and the abbreviation letters or numbers instead of written were included. Results After a year of training, application and details of the changes, care unit nurses have all mastered the recording methods, and recording time was reduced. Conclusions The new version of intensive care nursing records was convenient and efficient;records can be implemented in time, workload of writing was reduced, so that nurses have more time and energy to provide direct care services to patients. Key words: Intensive care; Nursing record; Improvement

Reported Speech in Conversational Storytelling During Nursing Shift Handover Meetings

Shift handovers in nursing units involve formal transmission of information and informal conversation about non-routine events. Informal conversation often involves telling stories. Direct reported speech (DRS) was studied in handover storytelling in two nursing care units. The study goal is to contribute to a better understanding of conversation in handover and use of DRS in storytelling in institutional contexts. Content analysis revealed that the most frequent sources quoted were oneself and patients, followed by physicians and colleagues. Further, DRS utterances are preceded by reports of situations, actions, and other reported speech, often constituting the climax of a story. Conversation analysis revealed how DRS participates in multimodal reenactments, complaints about patients, and justifying deviations from medical protocols. Results inform understanding of the uses of DRS in institutional storytelling, show how they index relevant membership categories and related knowledge and expectations, and serve as resources for making sense of non-routine events.

Evaluation of antihypertensive therapy training for CCU nurse in hypertensive emergency

ObjectiveTo investigate the necessity and validity of professional training for antihypertensive therapy for hypertensive emergency for cardiac care unit (CCU) nurses. Methods The patients with hypertensive emergency were divided into control group and observation group according to before and after training, compare the therapeutic effect and the average length of stay of the two groups. Results the blood pressure in observed group reduced effectively and safely, the difference was statistically significant compared with control group ( P ＜ 0. 01 ). The present study also showed that the average length of stay in observed group was less than that of control group ( P ＜ 0. 05 ). Conclusions The targeted training for CCU nurses helps antihypertensive therapy for hypertensive emergency and can reduce the average length of stay and improve the prognosis of patients. Key words: CCU nurse; Hypertensive emergency; Antihypertensive therapy

Improving actual handover behavior with a simulation-based training intervention

A simulation-based training intervention to improve patient handovers between anesthesia providers (APs) and Post-Anesthesia Care Unit (PACU) nurses (RNs) in adult (VUH) and pediatric (VCH) PACUs, was developed, implemented, and evaluated. The intervention included didactic webinars, an electronic handover report tool, a 2-hour simulation-based training session and a 1-hr “refresher” course several months later. Training focused on interpersonal skills and overcoming obstacles to effective handovers. Trained nurses observed and evaluated 981 actual PACU handovers over 12 months using a standardized rating tool. A different blinded observer scored pre- and post-training simulated handovers. A culture survey was administered before and after the intervention. After training, handover quality improved significantly with more than 70% of handovers rated as “effective” in both PACUs (P<0.001). The training status of the handover giver (AP) was the critical determinant of handover effectiveness. Following full implementation, new (untrained) clinicians performed effective handovers suggesting culture change and/or implicit training.

Communication in the tele-ICU

Objective: To systematically describe communication between tele-ICU (Intensive Care Unit) nurses and bedside nurses in multiple ICUs, the strengths and weaknesses of communication in the tele-ICU and possible solutions for improving communication. Background: Nurses in tele-ICUs function in virtual teams whose configuration and membership is constantly and rapidly changing. This research examines communication and technological support for communication in the multiple virtual teams formed by tele-ICU nurses and ICU nurses. Methods: A case study research approach using mixed data collection methods. One tele-ICU that monitors 16 ICUs in 12 hospitals across the US participated in this study. Results: Tele-ICU nurses spend 26% of their time in communication-related activities. Fifteen percent of tele-ICU nurses surveyed reported getting incorrect information from ICU nurses and 40% reported that they are not informed in a timely manner about a change in patient status. Frequency of communication between tele-ICU and ICU nurses depends on several factors such as time of day and intensivist coverage in the ICU. Tele-ICU nurses develop and employ unique strategies for communicating with ICU nurses. Conclusion: Tele-ICU nurses use many approaches and techniques when communicating with multiple ICUs. Additional research needs to generalize these findings.

Standards for Frequency of Measurement and Documentation of Vital Signs and Physical Assessments

Standards for Frequency of Measurement and Documentation of Vital Signs and Physical Assessments

Who is really caring for your environment of care? Developing standardized cleaning procedures and effective monitoring techniques

Health care facilities have procedures for cleaning patient care environments, but there is often confusion about the division of labor when it comes to cleaning responsibilities. In addition, systems to monitor cleaning effectiveness are frequently suboptimal. In 2007, a multidisciplinary task force revised policies outlining staff responsibilities for cleaning in-patient nursing care units and chose a monitoring system using a specialized adenosine triphosphate bioluminescence test.

Nursing Interventions for Critically Ill Traumatic Brain Injury Patients

Neuroscience intensive care unit (ICU) nurses deliver a number of interventions when caring for critically ill traumatic brain injury (TBI) patients. Yet, there is little research evidence documenting specific nursing interventions performed. As part of a larger study investigating ICU nurse judgments about secondary brain injury, ICU nurses were asked to identify interventions routinely performed when caring for TBI patients. Quantitative and qualitative analyses indicate that all nurses routinely monitored hemodynamic parameters such as oxygen saturation, blood pressure, and temperature. Nurses were responsible for monitoring intracranial pressure and cerebral perfusion pressure approximately 50% of the time. Qualitative analyses revealed that additional nursing interventions could be categorized as neurophysiological interventions, psychosocial interventions, injury prevention interventions, and interventions to maintain a therapeutic milieu. Findings from this study provide evidence of the multifaceted role of the neuroscience ICU nurse caring for TBI patients and can be used in future research investigating the impact of nursing interventions on patient outcomes.

Survey on ICU nurses' comprehensive assessment and influencing factors

Objective To survey the results of comprehensive assessments of Intensive Care Unit (ICU) nurses,and find out its influencing factors.Methods 98 ICU nurses were recruited and were surveyed using serf-design questionnaire.The results of self-evaluation, other-evaluation and annual theory and skills tests were collected and analyzed.Results There were significant differences in the self-evaluation and other-evaluation from different seniority.Furthermore, the group of graduated from junior colleges had a significantly higher score than the group of graduated from university.In addition, all the assessment results were different in different professional rifle.Conclusions ICU nurses need a multi-aspects assessment system. Key words: Intensive Care Unit; Assessment; Influencing Factor

Preliminary study about occupational stress of physicians and nurses in pediatric and neonatal intensive care units: the balance between effort and reward

This study compared the balance between effort (E) and reward (R) among physicians and nurses working in pediatric (PED) and neonatal (NEO) Intensive Care Units. This descriptive cross-sectional study was carried out with 37 physicians and 20 nurses. The Effort-Reward Imbalance Questionnaire was used. Statistically significant differences were not found among physicians (p>0.05) or nurses from PED and NEO in relation to E and R (p>0.05). No statistically significant differences were found between physicians and nurses in PED in the several studied variables. Comparison between the professionals working in NEO revealed that physicians presented more over-commitment than nurses (p=0.01). The organizational setting of NEO proved to be more demanding for physicians, exacting a greater commitment to their work, while demands presented in both units seemed to be the same for nurses.