Nursing Home Institution Research Articles

Perirenal Fluid Collection: An Uncommon Cause of Septic Shock

An 83-year-old woman was brought by ambulance to the Emergency Department (ED) with worsening dyspnea, hypotension, fever, and diffuse abdominal pain for 2–3 days. Her past medical history was significant for vascular dementia. She was a resident in a nursing home institution. She was taking no medications. Upon arrival at the ED, the patient was unresponsive, hemodynamically unstable, and febrile. Vital signs were: heart rate 130 beats/min, right arm blood pressure 80/55 mm Hg, temperature 39 C (102.2 F), and respiratory rate 30 breaths/min. Oxygen saturation was 92% on room air. The physical examination revealed abdominal tenderness in the upper-right quadrant with no rebound and normoactive bowel sounds. There were no palpable mass lesions or renal bruits. The lung sounds were clear and symmetrical with no wheezes or crackles. The heart sounds were regular but tachycardic and without murmurs. Femoral pulses were thready and equal. The

Tracing Error-Related Knowledge in Interview Data: Negative Knowledge in Elder Care Nursing

This paper empirically investigates elder care nurses' negative knowledge. This form of experiential knowledge is defined as the outcome of error-related learning processes, focused on how something is not, on what not to do in certain situations or on deficits in one's knowledge or skills. Besides this definition, we presume the existence of other forms of negative knowledge that relate to elder care nurses' professional competence and practice. Data were collected by means of the prompting-task methodology, which was applied among 37 elder care nurses from a nursing home institution. Content analysis confirmed declarative, procedural, and self-reflective negative knowledge to be relevant in the investigated domain. Additionally, the elder care nurses voiced vicarious negative knowledge. This knowledge was focused on what certain nursing home residents' are not able to do or are not aware of. For each of these forms of negative knowledge, different subfacets are identified and illustrated through sample statements. Moreover, the relationship of different types of workplace errors is outlined. We conclude that negative knowledge represents failure-critical aspects of work situations and, thus, represents a valuable resource for professionals' competence and practice.