Nursing Model Research Articles

Student Nurses' Experiences of Critical Events in the Clinical Setting: A Grounded Theory.

Nursing students often experience critical events in the clinical setting and clinical instructors may not be prepared to adequately support them. These students often feel alone and abandoned, increasing their risk of psychological distress. A grounded theory study was conducted to explore pre-licensure nursing students' experiences of critical events in the clinical setting. Specific attention was paid to understanding how they are prepared for and supported before, during, and after critical events, and their experiences of psychological distress and psychological recovery. Strauss and Corbin's Grounded Theory methodology was used for this study. Fourteen undergraduate student nurses from universities in the western United States were interviewed. Ten concepts were identified, and a theory of Student Nurses' Experiences of Critical Events in the Clinical Setting emerged. Findings indicate that student nurses need active instructor and/or staff support during critical events, and pre-briefing whenever possible. Debriefing positively affected students' post-event stress response and lack of debrief was associated with post-event psychological distress. Support for students exposed to critical events during clinical experiences should continue in the days, weeks, and months following the event; clinical instructors need to be prepared to provide this support. All faculty members should monitor students for signs of psychological distress and better support students' mental health and emotional wellbeing.

Application of vitamin A palmitate eye gel and nurse value of Watson's theory of caring in children with dry eye after strabismus surgery: a randomized trial.

BackgroundAfter strabismus surgery, the local swelling of conjunctival wound will affect the uniform distribution of tears on the ocular surface, and the inflammatory reaction will affect the stability of tear film, which will easily lead to iatrogenic dry eye. This study aimed to investigate the effect of vitamin A palmitate (VAP) eye gel application in dry eye and the advantages of Watson’s theory of caring.MethodsTwo hundred and forty children with dry eye after strabismus surgery treated in our hospital from September 2018 to September 2020 were selected as the study subjects, and were randomly divided into control group and observation group according to the allocation ratio of 1:1. Watson’s theory of care nursing was applied in the observation group, and VAP eye gel was additionally dropped into the eye. Mouse conjunctival goblet cells (GCs) were used to detect the effect of VAP on the growth of GCs. Treatment compliance, improvement of dry eye symptoms [Schirmer I test (SIT), tear film break-up time (BUT), and fluorescent staining (FL) score], inflammatory factor levels in tears, clinical efficacy, and parents’ satisfaction were compared.ResultsIt was found that VAP eye gel could better promote the proliferation of GCs. After nursing and clinical treatment, the dry eye symptoms were improved in all included children, and improvements in the SIT, BUT, and FL scores were more obvious in the observation group. Watson’s theory of care nursing could effectively improve the children’s treatment compliance and parents’ satisfaction.ConclusionsAs a result, the application of VAP eye gel and Watson’s theory of care nursing could effectively reduce the occurrence of dry eye after strabismus surgery, and were of great importance for improving the relationship between nurses and patients and building a harmonious hospital.Trial RegistrationChinese Clinical Trial Registry ChiCTR2100049136.

Experience of the patient's success in facing post-stroke urinary incontinence: the patient's perspective

Abstract Objective Post-stroke urinary incontinence (UI) is one of the sequelae of stroke. This situation affects all aspects of the patient's life – physically, psychologically, socially, and spiritually. This study aimed to investigate the experience of patients’ success in facing a post-stroke UI. Methods A qualitative study using the Rapid Assessment Procedure (RAP) approach was used in this study. Informants were selected using purposive sampling. In-depth interviews with as many as 8 patients who had recovered from post-stroke UI and living in the greater area of Southeast Sulawesi (Indonesia) were conducted. In-depth interviews were also conducted with 8 caregivers and 2 nurses. Data were analyzed using a thematic analysis approach and interpretation of data was based on Humanbecoming theory and Self-care deficit theory of nursing. Results Five successful things the patients experienced during post-stroke UI were identified. The five successes were as follows: they provided information to get to know and understand post-stroke UI, followed the procedures to overcome post-stroke UI, conducted self-control exercises and stayed motivated, performed daily activities independently according to ability, and made use of family support and peers’ attention. Conclusions These findings indicated that persistence, belief, independence, and social support (family and peer) made patients to successfully face their post-stroke UI and improved their quality of life. These findings also became the basis for developing a post-stroke UI management model based on Humanbecoming theory and Self-care deficit theory of nursing.

A Middle-Range Theory of Nurses' Psychological Trauma.

Vicarious trauma, secondary trauma, and workplace violence are the common forms of psychological trauma associated with nurses. Additional areas of nurses' trauma have not been adequately described, defined, or conceptually organized in the literature. In this article, a new middle-range theory of nurses' psychological trauma is presented with a novel discourse of nurse-specific traumas, theoretical statements, and outcomes of psychological traumas that are unique to nurses and the professional worlds in which they live. A middle-range theory is forwarded so that future scholars may test this theory and derive implications for practice, education, policy, and research.

Best Practices in Patient-Centered Care: Nursing Theory Reflections.

The utilization of nursing theories should serve as the foundation of policies that guide care for patients and those they love. The author of this paper explores linking conceptual elements within nursing theories to high-quality patient-centered care examples and policies. These linkages make clear how nursing knowledge may be utilized within healthcare systems that value patient-centered care. These patient-centered care policies need to be explicit about the contributions of nurses to healthcare, regardless of setting.

Sense of courage: The mediating role of courage between emotional reflexivity and work-life integration among nurses in Indian hospitals

ObjectivesThis study aimed to determine the relationship between emotional reflexivity and work-life integration through the mechanism of moral courage and enhance our understanding of the importance of these nursing concepts to enable the nurses to develop better coping strategies for work-life integration. MethodsA cross-sectional survey was performed with 249 nurses, including staff nurses, ICU and critical care nurses, operation theatre nurses, pediatric nurses from 17 hospitals. Emotional Reflexivity, work-life integration, and courage were measured using a demographic information questionnaire, Life Project Reflexivity Scale (LPRS), Nurse’s Moral Courage Scale (NMCS), and Work-Life Boundary Enactment (WLBE) scale. A series of multiple regressions analyzed the mediating effect. ResultsEmotional Reflexivity was positively correlated with work-life integration (β = 0.66, P < 0.01). There was a positive correlation between emotional reflexivity and moral courage. But the path did not get the necessary support in the structural equation modeling (SEM) (β = −0.13, P = 0.40). When controlling for courage (β = 0.42, P < 0.01), the association was significant between emotional reflexivity and work-life integration with partial mediation. ConclusionThe study reported a positive correlation between reflexivity and work-life integration. Thus, nurses’ work-life integration becomes better by reinforcing their emotional reflexivity and moral courage.

P.86 Feedback of major obstetric haemorrhage simulation training

Introduction: Following an incidence at our hospital site, we developed a simulation programme in managing major obstetric haemorrhage (MOH) as a multi-disciplinary team. Obtaining feedback was essential for identifying the effectiveness of training and areas of improvement for future sessions and for the service of the trust. Methods: Training was delivered during the COVID-19 pandemic in July -September 2020. Anaesthetists, obstetricians, midwives, theatre nurses, clinical support staff and students were involved in managing a clinical scenario. Feedback was obtained post-simulation in a questionnaire adapted from the Joint Royal College of Physicians Training Board evaluation form.1 87 feedback forms were completed, which equates to 74.35% response rate. Results: Not all members were aware of trust MOH protocols nor how to access guidelines. On a five-point scale (very poor, poor, satisfactory, good and excellent), over 90% of staff thought the simulation training was ‘good’ or ‘excellent’ in the following categories: teaching environment (n = 84);learning objectives were met (n = 84);delivery of teaching was clear and effective (n = 79);candidates had learnt something today (n = 83);and the usefulness of the session (n = 83). Only 68 (78%) of staff knew how to access the local trust guidelines, however following this training 84 (97%) felt more confident in calling a MOH. General comments include greater appreciation of other team members’ roles, whilst developing better communication and team-working skills. Through general feedback and discussion we have also identified the staff members’ concerns which were not highlighted previously. We found due to recent changes in theatre facilities and staff role, O negative blood was no longer readily available within the theatre complex and required delivery from a separate hospital building (which would take around 15 min). This was investigated, only to find that the blood fridge was non- functional and had no direct internet connection (for remote site monitoring). These concerns were highlighted leading to (1) reinstatement of accessible and functionable fridge;(2) establishment of wired internet access for remote site monitoring of fridge temperature;(3) negotiation with biomedical scientists and transfusion practitioner to expand role in monitoring fridge by direct checks;and (4) training of local staff within the maternity department to monitor and maintain fridge conditions. Discussion: Having alleviated our staff concerns, improved their confidence and knowledge in managing a frequent obstetric complication as well as allowing better access to crucial blood products, we hope this reflects as an improvement in service provision by auditing in the future. We hope to replicate this activity over at our cross-site hospital with the intention of enhancing staff training, inter- departmental relationships and again identification of concerns which can be rectified to improve patient safety.

Divinity in nursing: The complexities of adopting a spiritual basis for care.

In this paper, the historical alignment of nursing with divinity-based perspectives and modern New Age nursing theories are explored. The nature of divinity in nursing is examined, together with the complexities and issues that arise in adopting a spiritual basis for care. The work of the key theorists in this area (Rogers, Newman, Parse, Watson, Dossey) is reconsidered and fundamental epistemological problems inherent in this approach reviewed. Specific concerns with the interpretation of holistic care, adoption of doxastic logic, faith-based rationales, influence of Caucasian Judeo-Christian and New Age values, misappropriation of science, use of pseudoscience and development of divinity as social consumer product are discussed. Practical problems with using a spiritual basis in contemporary nursing practice are also explored and the alignment of divinity-based nursing theories with the modern antiscience movement is examined. Overall, the re-emergence of divinity-based nursing and spiritual basis for care may be problematic, and would seem to counter the development of an inclusive profession. Additionally, the alignment of nursing with antiscience movements rejecting biomedicine has significant public health implications. This is argued as a regressive step for the advancement of the profession.

A grounded theory of clinical nurses' process of coping during COVID-19.

Aims and ObjectivesTo explore clinical nurses’ process of coping during COVID‐19 and develop a grounded theory that can be used by leaders to support clinical nurses during a disaster.BackgroundThe COVID‐19 pandemic has provoked widespread disruption to clinical nurses’ work. It is important to understand clinical nurses’ processes of coping during disasters to support the nursing workforce during events such as global pandemics.DesignWe employed the Corbin and Strauss variant of grounded theory methodology, informed by symbolic interactionism, and applied the EQUATOR guidelines for qualitative research publication (COREQ).MethodsData collection entailed semi‐structured interviews with experienced clinical nurses (n =20) across diverse settings. We analysed data by identifying key points in the nurses’ coping processes inductively building concepts around these points.ResultsThe predictor of nurses’ outcomes in this grounded theory was their confidence in their ability to cope during the pandemic. When nurses lacked confidence, they experienced working in the context of acute COVID—a state of chaos and anxiety, with negative consequences for nurses. However, when nurses were confident in their abilities to cope with the pandemic, they experienced working in the context of chronic COVID, a calmer state of acceptance. There were many workplace factors that influenced nurses’ confidence, including adequacy of personal protective equipment, clear information and guidance, supportive leadership, teamwork and adequate staffing.ConclusionsUnderstanding clinical nurses’ experience of coping during COVID‐19 is essential to maintain the nursing workforce during similar disasters.Relevance to clinical practiceNurse leaders can target areas that support nurses’ confidence, such as adequate PPE and staffing. In turn, increased confidence enables clinical nurses to cope during disasters such as a global pandemic.

NURSING THEORIES APPLIED ON CLIENTS

Nursing Theories are a set of interrelated stereotypes that give a systematized view of a that's interpretive and prophetic in nature . These are composed of stereotypes, vignettes, models propositions &amp; are hung on assumptions. They're extrapolated through two high manners; derivable logic and inductive logic. Nursing interpreters use both of these manners. Proposition is " a creative and rigorous structuring of ideas that projects a conditional, purposeful and orderly view of miracles ".A proposition makes it possible to “ organize the relationship among the generalities to describe, explain, foretell, and control practice.”

Developing a Middle-Range Theory of Heart Failure Self-Care.

Middle-range nursing theories provide a bridge between the more abstract grand nursing theories, research, and clinical practice. As such, middle-range nursing theories derived from extant nursing theories are critical for developing and advancing both nursing science and practice. This paper describes the strategy used in developing a middle-range theory of heart failure self-care. After integrating theoretical and empirical literature, a hypothetico-deductive approach was used to develop the middle-range theory of heart failure self-care from Orem's theory of self-care. Theoretical substruction was used to provide a graphic representation of the conceptual-theoretical-empirical structure demonstrating the congruence between the theoretical and operational systems.

Concept analysis of the Four-Season-Symphony of Intellectuality-Spirituality-Ethics-Esthetics (FSS: I SEA) in nursing research.

The Four-Season-Symphony of intellectuality, spirituality, ethics, and esthetics (FSS: I SEA) in nursing research is a new concept that has not been addressed in previous nursing theories and studies. This study was conducted to clarify the concept of the FSS: I SEA in nursing research. Wilson's method of concept analysis was used. Empirical and conceptual literature. This study has been conducted based on Wilson's 11-step approach by searching keywords with Symphony, Rationality, Intellectuality, Spirituality, Ethics, Esthetics, and Nursing research in databases including Google Scholar, PubMed, Scopus, CINAHL, Sid, Oxford Dictionary, Dehkhoda Dictionary, and nursing theory textbook. Richness and elegance of the symphony in nursing research cannot be achieved by a single-tool benchmark; rather, a more integrated assessment can be achieved with the use of a tool combining different intellectuality, spirituality, ethics, and esthetics tools. This symphony contains a philosophical and deep understanding of the meanings of researcher, research problem, research process, and symphonic product. Through identifying the facilitators and barriers of this concept, nursing researchers, professors, and practitioners will be able to design and implement their research activities on FSS basis to pave the way for the continued transcendence of comprehensive nursing care.

Interactions between healthcare robots and older people in Japan: A qualitative descriptive analysis study.

This study aimed to describe the interactions between healthcare robots and older persons in two selected institutions. A qualitative descriptive analysis study using simultaneous observations of healthcare robot and older person interactions was conducted at two healthcare institutions in Japan. The Pepper robot equipped with Care Prevention Gymnastics Exercise programs was used in two situations: (a) exercise regimen led by Pepper; and (b) interactive dialogue between Pepper and older persons during the exercise process. These interactions were recorded using audiovisual equipment and analyzed using content analysis thereby revealing four thematic categories. Interpretation and discussion were structured based on assumptions of the Transactive Relationship Theory of Nursing. The analysis revealed four thematic categories: (a) intermediary participation of healthcare practitioners; (b) technologies of care for practice; (c) human-robot interactions involving artificial intelligence; and (d) valuing safety in nursing through technology. Interactions between healthcare robots and older persons may improve quality of care. However, issues regarding fidelity and functionality of dialogic conversations, and ensuring safety and security of using healthcare robots are recognized as critical nursing practice concerns in healthcare robot use in institutional settings.

Radiation Safety Knowledge and Practice in Urology Theaters: A Collaborative Multicenter Survey.

Objective: To evaluate the knowledge and current radiation safety practice among health care professionals undertaking fluoroscopic procedures in urology. Materials and Methods: A 14-question survey was disseminated to multidisciplinary urology theater staff. Questions included demographic data, usual radiation safety practice, and knowledge. The questions were selected based on guidelines from the International Commission of Radiological Protection and Health and Safety Executive. The survey was disseminated through regional collaborators and social media. Results: The survey received a total of 309 completed responses, including 272 from the United Kingdom. Responses from the United Kingdom multidisciplinary team included 164 (60.3%) urologic surgeons, 68 (25.0%) theater nurses, 27 (9.9%) from the anesthetic team, and 13 (4.7%) radiographers. Results from the United Kingdom demonstrated use of lead aprons and thyroid shields as 99.3% and 52.2%, respectively. Lead glasses and lead glove use were 7.4% and 0.7%, respectively. Lack of availability was cited as a reason for noncompliance with shielding guidelines in 208 (76.5%) of the respondents. No form of training in radiation safety was reported by 120 (44.1%) respondents. However, there was no association between answering knowledge questions correctly and having completed some form of radiation safety training (p = 0.41). There was an association between dosimeter use and those who had received radiation safety training (p = 0.02). Consultant urologists were also more likely to use a dosimeter than training grade urologists (p = 0.035). Conclusion: Suboptimal compliance with radiation safety guidelines is prevalent in contemporary urologic practice, and presents a significant occupational health concern. Availability of protective equipment needs to be urgently addressed.

Application Research of the Moist Wound Theory in Chronic Wound Nursing

Objective — To explore the application value of observation of moist wound theory in chronic wound care. Methods — From February 2019 to May 2020, a total of 96 patients with chronic wounds were treated in this hospital. The patients were divided into two groups based on the two-color ball method, with 48 cases in each group. Routine wound nursing (48 patients, the control group) and moist wound theory (48 patients, the experimental group) were used to compare the wound healing between the two groups. Results — The wound healing rate of 48 patients in the experimental group was significantly higher than that in the control group, and there was a significant difference (P&lt;0.05). The incidence of chronic wound complications (wound pain, wound infection, tissue adhesion) of 48 patients in the experimental group was significantly lower than that in the control group, and there was a significant difference (P&lt;0.05). Conclusion — The application of moist wound theory in chronic wound nursing can promote the rehabilitation of patients with chronic wounds, improve the rate of wound healing, reduce the incidence of complications, and improve the patients' nursing efficacy.

Creative Theory in Psychiatric & Mental Health Nursing, Alternative Teaching Model, and a New Breakthrough in Psychiatric Home Care Nursing

Although many resources have been explored and applied in our environment, personal internal and external resources have yet to be adequately exploited. A nursing theory and model for internal and external resources may be developed and discussed deeply (Zauszniewski, 2018) to provide newer vision and direction, while helping face the challenges of caring for patients with psychiatric disorders or mental obstacles. Recently, many breaking news stories have highlighted the hidden worries affecting our society due to patients with psychiatric disorders who live in the community. This has resulted in people, including student nurses, to retain their stigma toward mental illnesses and psychiatric patients and express negative perceptions and fear toward psychiatric patients (Choi et al., 2016). Therefore, it has been a challenge of psychiatric nursing education to develop and use a new and more-acceptable teaching model to help student nurses better understand and hold a more-correct perception toward psychiatric patients. The practice of clinical nursing profession still needs to be focused while we remain committed to psychiatric nursing education. The number of psychiatric patients who need more continuous care in community settings has increased significantly. The needs of psychiatric home care nursing should be particularly emphasized, as the manpower / capabilities necessary for psychiatric nursing are limited in community health nursing practice (Huang & Wang, 2015). More resources and psychiatric practice nursing professionals should be made available to communities for continuous psychiatric care (Wu et al., 2016). Strong and authentic partnerships are very important to acute care, education, evidence-based research, and practical policy development in psychiatric & mental health nursing (McInnis-Perry et al., 2015). In this column, resourcefulness theory is introduced as a new theory that may be applied in the psychiatric and mental health nursing practice; alternative teaching models are recommended for psychiatric nursing education; and finally, the importance of overcoming the difficulties and addressing the needs in community psychiatric home care nursing is also emphasized. It is hoped that this approach will help facilitate the further, positive advance of psychiatric and mental health nursing.

Nursing students' adverse childhood experience scores: a national survey.

To determine the adverse childhood experience scores (ACES) of nursing students in the United States. Utilized the standardized Family Health History Questionnaire to determine the ACES of a national sample of nursing students. Simple descriptive statistics were used to analyze the findings. Nursing students ACES indicate that they enter academia with a much higher baseline of childhood trauma versus the general population. Over 40% of nursing students surveyed had an ACES of 4 or more versus the national average of 12.5-13.3% of the general population having an ACES of 4 or more. This data provides support for Conti-O'Hare's theory of nurses as wounded healer. Nursing faculty should consider nursing students to be members of a vulnerable population and revise curricula to support nursing students stress resileince.

USO DAS TEORIAS DE ENFERMAGEM NAS TESES BRASILEIRAS: ESTUDO BIBLIOMÉTRICO

Objetivo: caracterizar a produção científica que utiliza teorias de enfermagem a partir de teses realizadas por enfermeiros no Brasil.Método: estudo bibliométrico realizado no Banco de Teses da Coordenação de Aperfeiçoamento Pessoal de Nível Superior e na Plataforma Sucupira, em novembro de 2019. Foram selecionadas 63 teses lidas na íntegra para fichamento e extração de aspectos de interesse, a seguir: ano, universidade, autor, orientador, programa, teoria, modo de aplicação, tipo de estudo, natureza e temática.Resultados: o maior número de produções aconteceu em 2016 com 16 (25,4%) teses, com destaque para o Nordeste com 31 (49,2%). A teoria mais utilizada foi a Teoria do Cuidado Transcultural em oito (12,7%), com a temática mais investigada sendo o cuidado em 12 (13%) teses.Conclusão: a inclusão das teorias de enfermagem no ensino e na pesquisa ainda se mantêm obscuras. Pretende-se dar visibilidade à temática e sugerir o aprofundamento na discussão.

Safety precautions regarding Corona virus during surgery

Abstract Nurses and health care teams are the front lines of the coronavirus pandemic as they providing care and saving lives. Nurse should following the guidelines from CDC. And demonstrate competency in performing appropriate infection control practices and procedures. Operating room is very critical area that may cause death due to spreading infection to patient and health worker. Assume overall responsibility to ensure that all necessary preventive and protective measures are taken to minimize occupational safety and health risks. Hospitals need contingency planning. planning should include preparation for an unexpected patient surgery. This measure is evolving concomitantly with the implementation of the needed infection control rules. So present the experience in contingency planning at hospitals during this global pandemic, with a focus on dealing with COVID-19 patients who need to undergo surgery. The planning covers response measures required in the operating room and supporting units, including the administrative department, intensive care unit, and different sections of the surgical department with adequate safe environment to medical team,clients without. Influence the productivity of the organization. All the team members are informed of, trained about responsibilities and roles keep documentation updated and staff informed contact details of the core team and backups is compiled. The process through which the operating theatre nurses guided the patient began with the patient’s arrival for surgery and lasted throughout the completion of the procedure and until the patient was delivered to the next point of care, oversight of various aspects considerations regarding safety issues.

Theatre nurses : exclusive competencies finally recognised

Pivotal members of the operating theatre team, theatre nurses have seen their practice and training evolve to be able to offer a high quality and safe service when carrying out the new activities associated with the operating procedure. A 2015 decree recognised their new exclusive competencies in the area of theatre assistance. These activities are set to be applied to all operating rooms, thanks to initial and continuing training.