Nursing Practice Model Research Articles

Using mixed methods to understand the healing trajectory for rural Irish women years after leaving abuse

Research on effectiveness and satisfaction with domestic violence (DV) services is aimed at women who have accessed these services, leaving us little information about those who believe they cannot or choose not to do so. In addition, this research focuses exclusively on the structural barriers to access of information, or navigating systems to escape the abusive situation. Few studies have examined the sociocultural barriers to help seeking, either for escape from violence or for healing after safety has been established. This study uses mixed qualitative and quantitative methods to understand the healing journeys of 21 women receiving DV services in a rural region of Ireland. Qualitative findings reveal persistent physical and emotional symptoms years after establishing safety, feeling “frozen,” stigma and social conflict, and social isolation. Quantitative analysis to determine the relationship of symptoms, social support, and social conflict to help-seeking barriers finds no relationship with structural barriers. However, sociocultural barriers such as shame, hopelessness, social conflict, and feeling “frozen” were related. A trauma-informed nursing practice model is proposed, and implications for intervention and health policy are suggested.

Development and Psychometric Testing of the Iceland-Family Illness Beliefs Questionnaire.

Illness beliefs affect how individuals and families deal with illness. A valid and reliable instrument has not yet been developed to measure "illness beliefs" in family nursing research and clinical practice. This article describes the purpose, reliability, validity, and the potential clinical and research applications of a new instrument, the Iceland-Family Illness Beliefs Questionnaire (ICE-FIBQ). The ICE-FIBQ is a short, self-report measure of an individual's beliefs about illness. Drawing from an advanced nursing practice model called the Illness Beliefs Model, the instrument was developed to measure illness beliefs about (a) cause of illness, that is, etiology; (b) control of illness on family and control of family on illness; (c) effect of illness on the individual and family; (d) illness suffering; and (e) support received from health care professionals during illness. The instrument was tested on 139 family caregivers of adolescents/youth with an illness or a disorder. Exploratory factor analysis reduced the original questionnaire from eight to seven items with a one-factor solution (Cronbach's α = .780). Confirmatory factor analysis supported the one-factor solution (Cronbach's α = .789). Further research is needed to determine concurrent validity with other illness belief/illness perception scales and if the instrument is sensitive to capture change in illness beliefs following family nursing intervention.

Caring Across the Continuum: A Call to Nurse Leaders to Manifest Values Through Action With Community Outreach.

As health reform continues to advance, there is a need for nurse leaders to broaden their perspective related to possible nursing practice models and potential community partners in order to successfully address caring, accomplish the triple aim mandate, and achieve suitable metrics for maximum reimbursement. Intentional efforts must be made by nurse leaders to maximize caring and ensure that professional nurses are responding to the key drivers shifting health care delivery in the 21st century. Academic-practice collaboration (APC) and community-based participatory action research (CBPAR) align well. Together, they provide an ideal mechanism to pursue endeavors that extend evidence for caring services across the health care continuum. One APC/CBPAR model for community outreach that can maximize individual and population health outcomes is highlighted in this article. Furthermore, useful action steps are offered that could be taken by a nurse leader to develop and maintain any form of APC/CBPAR in order to manifest values through caring action across the health care continuum.

Clinical Nurse Specialists Guide Staff Nurses to Promote Practice Accountability Through Peer Review.

The aim of the study was to describe the clinical nurse specialist role in developing and implementing a staff nurse education program to promote practice accountability using peer review principles. Peer review is essential for professional nursing practice demanding a significant culture change. Clinical nurse specialists in a Magnet-designated community hospital were charged with developing a staff nurse peer review education program. Peer review is a recognized mechanism of professional self-regulation to ensure delivery of quality care. The American Nurses Association strongly urges incorporating peer review in professional nursing practice models. Clinical nurse specialists play a critical role in educating staff nurses about practice accountability. Clinical nurse specialists developed an education program guided by the American Nurses Association's principles of peer review. A baseline needs assessment identified potential barriers and learning needs. Content incorporated tools and strategies to build communication skills, collaboration, practice change, and peer accountability. The education program resulted in increased staff nurse knowledge about peer review and application of peer review principles in practice. Clinical nurse specialists played a critical role in helping staff nurses understand peer review and its application to practice. The clinical nurse specialist role will continue to be important in sustaining the application of peer review principles in practice.

Building research capacity and productivity among advanced practice nurses: an evaluation of the Community of Practice model.

The aim of this study was to evaluate Wenger's Community of Practice as a framework for building research capacity and productivity. While research productivity is an expected domain in influential models of advanced nursing practice, internationally it remains largely unmet. Establishment of nursing research capacity precedes productivity and consequently, there is a strong imperative to identify successful capacity-building models for nursing-focussed research in busy clinical environments. Prospective, longitudinal, qualitative descriptive design was used in this study. Bruyn's participant observation framed evaluation of a Community of Practice comprising 25 advanced practice nurses. Data from focus groups, education evaluations, blog/email transcripts and field observations, collected between 2007 and 2014, were analysed using a qualitative descriptive method. The Community of Practice model invited differing levels of participation, allowed for evolution of the research community and created a rhythm of research-related interactions and enduring research relationships. Participants described the value of research for their patients and families and the significance of the developing research culture in providing richness to their practice and visibility of their work to multidisciplinary colleagues. Extensive examples of research dissemination and enrolment in doctoral programmes further confirmed this value. A Community of Practice framework is a powerful model enabling research capacity and productivity evidenced by publication. In developing a solid foundation for a nursing research culture, it should be recognized that research skills, confidence and growth develop over an extended period of time and success depends on skilled coordination and leadership.

The construction effects analysis of "Trinity" medical nursing practice teaching system

Objective To explore the effects of Trinity medical nursing practice teaching system on core competence of nursing students. Methods We utilized sampling method to select 280 undergraduate students of 2010 grade which was divided into experimental group ( Trinity medical nursing practice teaching system) and control group (traditional practice teaching method). After the course, we compared the examination scores of 'Medical Nursing’, self-assessment of nursing students, and feedback of doctors and teachers from interning departments. Results In the experimental group, the theory and skill scores of 'Medical Nursing’ were (82.5±6.5) and (83.6±7.2) that all were higher than those of the control group (t=8.26, 7.67; P<0.01); the nursing students of experimental group was better than that of the control group at aspects of self-assessment and feedback of doctors and teachers from interning departments (P<0.05). Conclusions The Trinity medical nursing practice teaching system can optimize instructional resources and promote the core competence of nursing students. Key words: Medicine, nursing; Nursing practice model; Core competence

The Effectiveness of Nursing Care: Social Isolation Implementation in Mental PMHNPM to Patient’s Capability

Introduction: Nursing care: social isolation is one of the pillars in Professional Mental Health Nursing Practice Model (PMHNPM). This study was aimed to determine the relationship between the implementation of nursing care in PMHNPM with the ability of clients and families client’s.Methods: This study was used a correlational design with cross-sectional approach. Samples were associate nurse who already follow PMHNPM training 58 respondents, client with social isolation problem who hospitalized at RSJD Prov. Jambi 32 respondents, and client’s family 12 respondents. Independent variable was PMHNPM implementation by associate nurse, while dependent variables were the result of nursing care to client with social isolation problem and family. Data were collected by using questionnaire. Data were then analyzed by using frequency distribution for categoric data, central tendency for numeric data, and pearson correlation.Results: The results showen that nursing management capabilities signifi cantly associated (p &lt; 0.05) with the client’s ability and the ability of the family. The ability of nurses in providing nursing care social isolation were signifi cantly associated (p &lt; 0.05) with a decrease in signs and symptoms of client upgrades.Conclusion: Associate nurses ability on nursing care and PMHNPM implementation could reduce a signs and symptoms, improve an ability of the client and families client’s social isolation.

The Effectiveness of Nursing Care: Social Isolation Implementation in Mental PMHNPM to Patient’s Capability

Introduction: Nursing care: social isolation is one of the pillars in Professional Mental Health Nursing Practice Model (PMHNPM). This study was aimed to determine the relationship between the implementation of nursing care in PMHNPM with the ability of clients and families client’s. Method: This study was used a correlational design with cross-sectional approach. Samples were associate nurse who already follow PMHNPM training 58 respondents, client with social isolation problem who hospitalized at RSJD Prov. Jambi 32 respondents, and client’s family 12 respondents. Independent variable was PMHNPM implementation by associate nurse, while dependent variables were the result of nursing care to client with social isolation problem and family. Data were collected by using questionnaire. Data were then analyzed by using frequency distribution for categoric data, central tendency for numeric data, and pearson correlation. Result: The results showen that nursing management capabilities signifi cantly associated (p &lt; 0.05) with the client’s ability and the ability of the family. The ability of nurses in providing nursing care social isolation were signifi cantly associated (p &lt; 0.05) with a decrease in signs and symptoms of client upgrades. Discussion: Associate nurses ability on nursing care and PMHNPM implementation could reduce a signs and symptoms, improve an ability of the client and families client’s social isolation.Keywords: PMHNPM, nursing care: social isolation, associate nurse

The Lived Experience of Community-Dwelling Older Adults With Chronic Obstructive Pulmonary Disease (COPD) in a Rural Community in Northern Thailand

The purpose of this study was to describe the experience of community-dwelling older adults living with chronic obstructive pulmonary disease (COPD) in a rural community in Northern Thailand. The study was grounded in Parker and Barry’s model of community nursing practice model based on the concepts and values of respect, persons in their wholeness, and caring in nursing. Data were generated and analyzed using Giorgi’s phenomenological approach. Four themes were revealed: confronting a life-threatening illness, caring for self, keeping meaningful relationships, and living guided by spiritual beliefs. The meaning of the experience was synthesized as finding balance between living with a threatening illness and living meaningful lives.

The Lived Experience of Community-Dwelling Older Adults With Chronic Obstructive Pulmonary Disease (COPD) in a Rural Community in Northern Thailand

The purpose of this study was to describe the experience of community-dwelling older adults living with chronic obstructive pulmonary disease (COPD) in a rural community in Northern Thailand. The study was grounded in Parker and Barry's model of community nursing practice model based on the concepts and values of respect, persons in their wholeness, and caring in nursing. Data were generated and analyzed using Giorgi's phenomenological approach. Four themes were revealed: confronting a life-threatening illness, caring for self, keeping meaningful relationships, and living guided by spiritual beliefs. The meaning of the experience was synthesized as finding balance between living with a threatening illness and living meaningful lives.

The emergence of forensic nursing and advanced nursing practice in Switzerland: an innovative case study consultation.

The objectives of this article were to systematically describe and examine the novel roles and responsibilities assumed by nurses in a forensic consultation for victims of violence at a University Hospital in French-speaking Switzerland. Utilizing a case study methodology, information was collected from two main sources: (a) discussion groups with nurses and forensic pathologists and (b) a review of procedures and protocols. Following a critical content analysis, the roles and responsibilities of the forensic nurses were described and compared with the seven core competencies of advanced nursing practice as outlined by Hamric, Spross, and Hanson (2009). Advanced nursing practice competencies noted in the analysis included "direct clinical practice," "coaching and guidance," and "collaboration." The role of the nurse in terms of "consultation," "leadership," "ethics," and "research" was less evident in the analysis. New forms of nursing are indeed practiced in the forensic clinical setting, and our findings suggest that nursing practice in this domain is following the footprints of an advanced nursing practice model. Further reflections are required to determine whether the role of the forensic nurse in Switzerland should be developed as a clinical nurse specialist or that of a nurse practitioner.

Critical Theory as a Framework for Academic Nursing Practice

In academic centers of nursing, faculty or academic practice has become more widespread and integrated into the expectations and criteria for appointment and promotion. Yet, the concept of academic practice is not fully embraced among all schools of nursing. Numerous models of academic nursing practice have evolved and vary widely according to the clinical site, the roles of the practitioners, and the systems for generating revenue. Although most models are related to the mission statements of the schools of nursing, few seem to be based on a distinct philosophy of practice. In this article, a consideration of critical theory that provides a framework for practice-based nursing education is presented. By applying the philosophical underpinnings and assumptions of practice that are guided by critical theory, educators may begin to better identify the values of academic nursing practice and incorporate this activity more fully into the educational environment.

Progran Evaluasi Model Praktek Keperawatan Profesional

Model praktek keperawatan professional merupakan suatu model yang memberikan kesempatan bagi perawat untuk menunjukkan otonomi dan akuntabilitas dalam memberikan asuhan keperawatan kepada klien. Suatu program evaluasi bagi model praktek keperawatan professional diperlukan untuk mengkaji sejauh mana keefektifan model keperawatan ini terhadap peningkatan pelayanan keperawatan di ruang model ini. Evaluasi dapat diarahkan kepada aspek struktur dimana komitmen organisasi pelayanan keperawatan akan dikaji, aspek proses dimana factor pelibatan dan partisipasi dari seluruh komponen yang terlibat dalam pemberian asuhan keperawatan dinilai, serta aspek hasil dimana kepuasaan klien dapat diukur. Program evaluasi ini seyogyanya dapat dilaksanakan minimal dua kali dalam tiga tahun, dimana evaluasi pertama merupakan informasi dasar bagi evaluasi selanjutnya. AbstractA professional nursing practice model is an approach that enables nurses to demonstrate their autonomy and accountability in delivering their care to patients. An evaluation program for a professional nursing practice model is required to assess the effectiveness of this model toward an improvement of nursing service in this model unit. The evaluation plan is involved in three aspects: structure, process, and outcome. The aspect of structure is evaluated to assess a commitment of the nursing service organization. The aspect of process is directed to evaluate an involvement and participation of all components in a nursing care delivery system. And finally, the aspect of outcome is assessed to determine the satisfaction of patients and the staff. A program of evaluation is best to be conducted twice for a period of three years during which the first evaluation is used as a baseline data for an incoming evaluation.Keywords: A professional nursing practice model, a program evaluation, structure, process, outcome.

Anticoagulant therapy clinic: moving towards Advanced Nursing Practice

There is currently around one million people receiving oral anticoagulants in Spain. The drug most used is acenocoumarol, which requires coagulation monitoring to ensure that the patient is within its normal therapeutic range. Patients usually start this treatment in a hospital clinic and, when they are stabilised, they are referred to primary care, where they are followed-up by their community nurses. The usual practice is that nurses are responsible for changes in the dose when the patients are outside the range. This practice is not performed by hospital nurses, despite having sufficient experience and knowledge to adequately manage these types of patients. An Advanced Nursing Practice model has been introduced into the Haematology management unit of the Hospital Universitario Virgen de la Victoria, Málaga. This involves various aspects of attention and care of patients on anticoagulant therapy, and includes adjusting the doses of their treatment following a catalogue of therapeutic and diagnostic ranges.

Enfermeiro Clinico Especialista: um modelo de pratica avancada de enfermagem em oncologia pediatrica no Brasil

O objetivo deste artigo é relatar a experiência de implantação do modelo de prática avançada de enfermagem por meio da incorporação do enfermeiro clínico especialista na composição do quadro de enfermagem. As autoras apresentam o conceito desse modelo e descrevem seu processo de implantação em uma instituição de referência no cuidado à criança e ao adolescente com câncer da cidade de São Paulo, Brasil. Na avaliação das enfermeiras clínicas especialistas, o principal resultado obtido com a adoção do modelo refere-se ao fortalecimento do papel do enfermeiro como profissional de referência para a articulação das diferentes demandas de cuidado à criança, ao adolescente e ao adulto jovem com câncer e sua família. Também destacam a satisfação dos usuários com o estreitamento da relação paciente, família e enfermeira clínica, em todas as etapas do processo de cuidar.

Bedside Handover Enhances Completion of Nursing Care and Documentation

Bedside handover has been proposed as a patient-focused nursing practice model with the potential to reduce adverse events and improve standards of care. This pre-/postintervention study examined changes in completion of nursing care tasks and documentation after the implementation of bedside handover. Analysis of 754 cases revealed significant improvements in several nursing care tasks and documentation, whereas there was no variation in handover duration. Implementing bedside handover may enhance nursing care for hospitalized patients.

Model of care and pattern of nursing practice in ambulatory oncology

The worldwide burden of cancer warrants more effective and efficient cancer care management strategies (World Health Organization, 2003). Model of ambulatory care, in particular, has tremendous implications on patient and administrative outcomes (Knight, 2007; Lynch, Marcone & Kagan, 2007; Moore, Johnson, Fortner & Houts, 2008). Nevertheless, little is known about the pattern of practices and the clinic operations in this setting. As part of the hospital's ambulatory redesign program, this survey aims to: a) review and describe existing models of ambulatory care employed by key national and international cancer centres; b) identify models or elements within the models that are appropriate to be adopted for best practice. Semi-structured interviews with 10 senior management members at 10 centres (N = 10) were conducted. Participants were asked to describe: a) model of ambulatory care employed by their institution (e.g., scope and model of ambulatory nursing practice); and b) strategies used to manage common patient care related issues in their institutions. Interviews were recorded and analyzed according to the objectives of this survey. A majority of cancer centres employed models of care similar to the existing Hospital model of ambulatory care and are encountering similar challenges in care delivery. Therefore, it was not deemed appropriate to adopt any models from participating centres. It is crucial for administrators to report and share best practices to ensure high-quality care. The survey of current practice did not yield sufficient data to adequately support the implementation of any specific models at the hospital's ambulatory care settings. Nevertheless, findings from the present review support the principles proposed for the new hospital model of ambulatory care.

Appropriate Staffing for a Healthy Work Environment

Appropriate Staffing for a Healthy Work Environment

Spirituality and spiritual care from a Careful Nursing perspective

To provide a brief historical background of spirituality in nursing and describe spiritual care from the perspective of the Careful Nursing philosophy and professional practice model. The previously overshadowed role of spirituality in modern nursing has re-emerged and been widely debated. Less attention has been given to how spiritual care is implemented in practice. Findings from historical research. Elaboration of a previously derived Careful Nursing concept and dimensions as a model of spiritual nursing practice values. In spite of the diversity of nurses' philosophical beliefs about spirituality, common ground can be found when these are translated into spiritual nursing practice values. Spiritual care in nursing is primarily expressed in the attitudes and actions of nursing practice guided by spiritual nursing values, particularly recognition of human dignity, kindness, compassion, calmness, tenderness, and nurses' caring for themselves and one another. Spirituality is timelessly interwoven with nursing and health. Careful Nursing suggests a spiritual values model that could be useful in assisting nurses to reach a shared understanding of spirituality and a spiritual approach to nursing practice. Spiritual nursing values can be shared and developed in practical ways so that they become truly integrated into everyday nursing practice.

The role of advanced nursing practice in occupational health

There is a concern that current specialist occupational health (OH) training programmes in the UK are not delivering nurses equipped to deal with the challenges of emerging practice. The development of new training programmes and advanced nurse practitioner (ANP) roles provide a potential solution. Although a model of advanced nursing practice has been developing, its relevance to OH has not been assessed. To collate information about OH nurses in the UK, their levels of training, and to collect their views on the relevance of ANP competencies to the specialty. An online questionnaire survey was carried out using a database of nurses working in OH. Each nurse received a direct invitation to participate with a link to the survey and one reminder. Nine hundred and ninety-eight responses were included in the analysis. Eighty nine per cent had a specialist qualification in OH. A large majority of respondents believed that almost all the generic ANP competencies were important in current and future OH nursing practice. Only a few competencies (examination, diagnosis, referral, treatment) were felt to be more important in the future than currently. Over half (57%) agreed that in the future where OH nurses were working as specialists they should be trained as advanced nurse practitioners. Seventy one per cent of OH nurses agreed that a new multi-disciplinary qualification would be beneficial. OH nurses recognize that ANP competencies are important to their current and future practice. There is enthusiasm in OH nursing for the introduction of advanced nursing practice and a new training programme.