Practice Patterns Of Nurses Research Articles

Nursing practice patterns in advanced kidney care

The Association of Nephrology Nurses Advanced Kidney Care (AKC) Nurses Community of Practice provides a summary of a recent audit of advanced kidney care nursing services, roles and activity.

Role delineation of advanced practice nursing: A cross-sectional study.

To identify the roles and activities of nurses, including advanced practice nursing (APN), and to determine nursing practice patterns across health facilities in Saudi Arabia. A descriptive cross-sectional design was used to collect data from 207 nurses working in the Saudi health sector between November 2021 and March 2022 through an online questionnaire. The Advanced Practice Role Delineation tool was used to measure and delineate nursing practice patterns and activities. Data were analysed using descriptive statistics and analysis of variance. The study followed the Strengthening the Reporting of Observational Studies in Epidemiology reporting guidelines. Findings showed that participants, regardless of their current role, reported high scores across all domains of practice. The highest average score was obtained for the Clinical Care domain. Except for the leadership domain, findings showed that those reported working as advanced practice nurses had higher average scores across all domains than those working as staff nurses or being in managerial/administrative positions. There were significant differences in the average Clinical Care scores between advanced practice nurses and staff nurses. Advanced practice nursing roles and activities are being practised in Saudi Arabia; however, there is no clear delineation of these roles and activities according to a unified and national-level APN scope of practice. Advanced practice nursing roles are evolving in Saudi Arabia; however, no study has examined the existing patterns of APN activities in Saudi Arabia. This study highlights the practice patterns of advanced practice nurses and adds to the international evidence base on the need for delineating APN activities under a unified scope of practice. The findings of this study are beneficial to practitioners, researchers, and stakeholders as well as the legislative and regulatory bodies. No patient or public contribution.

Differentiating Specialized and Advanced Nursing Roles: The Pathway to Role Optimization.

We aimed to differentiate the practice patterns of nurses in specialized and advanced roles in a cross-sectional study. Canadian nurses completed a self-report questionnaire (June 2017-September 2017). Demographic data and time spent in five domains of advanced practice were compared across three nurse groups. Regression analysis examined factors associated with domain involvement. Respondents (n = 1,107) represented all provinces/territories, including 396 specialized nurses (SNs), 211 clinical nurse specialists (CNSs) and 490 nurse practitioners (NPs). Nurses across all groups were the most involved in direct comprehensive care and the least involved in research. NPs were more involved in direct comprehensive care compared to CNSs (p < 0.001) and SNs (p < 0.001). CNSs were more involved than SNs and NPs in support of systems, education, research and professional leadership (p < 0.001). Role type, years as an advanced practice nurse and specialist certification were modest predictors of domain involvement. Distinguishing how specialized and advanced nursing roles contribute to healthcare can inform policies to support their optimal utilization in healthcare systems.

Progress in research of nursing practice patterns for patients with nonalcoholic fatty liver disease

Progress in research of nursing practice patterns for patients with nonalcoholic fatty liver disease

A Preliminary Study of Nursing Practice Patterns Concerning Dysphagia Diet Modification: Implications for Interprofessional Education With SLPs

Purpose Speech-language pathologists (SLPs) are trained to evaluate and treat dysphagia. One treatment method is to modify diet consistency or viscosity to compensate for swallowing dysfunction and promote a safer intake; this typically involves softening solids and thickening liquids. Thickening liquids is not safer for all patients, and modification of dysphagia diets without adequate training may reduce the quality of dysphagia patient care. Over 90% of SLPs working in health care report exposure to nurses who regularly downgrade dysphagia diets without an SLP consult. This study explores dysphagia diet modification practices of nursing staff with and without dysphagia training. Method Practicing nurses and student nurses ( N = 298) in the United States were surveyed regarding their dysphagia diet modification training and practice patterns. Additionally, a pre-/posttest design was used to determine the efficacy of a short general tutorial on willingness to modify diets without an SLP consult. Results Downgrading diets without an SLP consult is a common practice. Fewer than one third of nurses (31.41%) would avoid it, whereas 73.65% would avoid upgrading without SLP consult. Formal dysphagia training made little difference to this practice. The short general tutorial also had no beneficial effect, in fact slightly reducing the willingness to consult SLPs. Conclusions Dysphagia diet modification practice by nurses is pervasive in U.S. health care. This is a previously unexplored but common issue SLPs face in work settings. This study identifies a need to clarify guidelines and increase interprofessional education between both professions to improve patient care.

Show Me the Nursing Shortage: Location Matters in Missouri Nursing Shortage

<h3>Background</h3> Across the United States, data show that nursing shortages exist in many parts of the country. <h3>Purpose</h3> This descriptive research study seeks to identify nursing shortage and nurse age differences by county in Missouri and aims to determine whether the distribution of nurses is even across rural and urban areas. <h3>Methods</h3> Using nursing workforce data based on licensed nurses, geographic mapping was performed to show nurse distribution and age cohorts at the county level in Missouri. The number of nurses per 10,000 residents was the ratio used to show nursing population density by county. <h3>Results</h3> Eleven metropolitan, 4 micropolitan, and 12 rural counties had the lowest ratio of nurses to 10,000 population at 18 to 49. By comparison, 2 metropolitan, 2 micropolitan, and 0 rural areas had the highest ratio at 198 to 327. There were several counties in which 42% to 58% of nurses were older than 54 years. <h3>Conclusion</h3> There is a disparity in both the number of nurses and the age of nurses in metropolitan, micropolitan, and rural areas. Understanding the factors that contribute to differential nurse practice patterns by geographic regions in states such as Missouri is essential to inform nursing policy and craft workforce solutions.

Swallowing screening practice patterns for nurses in the cardiac surgery intensive care unit.

The current study surveyed nurse practice patterns for performing swallowing screens in an academic cardiac intensive care unit (ICU). It aimed to index: training and levels of confidence in conducting dysphagia screens; screening methods employed; timing and frequency of implement; and subsequent plan of care in identified high-risk patients. Swallowing impairment (dysphagia) is common following cardiac surgery and associated with significant morbidity and mortality. Early and accurate detection of dysphagia is therefore critical to afford implementation of interventions to optimise patient care. Currently, no validated instruments or guidelines exist for nursing screening of dysphagia in this setting. An anonymous and voluntary 10-item mixed-methods online survey was conducted using Qualtrics software. Nonprobability purposive sampling was utilised to recruit nurses working in an academic 24-bed cardiac ICU. Thematic analysis using operationally defined coding, SRQR checklist and descriptive statistics were employed. Sixty-nine nurses completed the survey during a 1-month period, representing an 84% response rate. Formal training in performing swallowing screens was reported in 18.6% of nurses. In rank order, reported level of confidence was the following: "moderately" (49%); "somewhat" (35%); "not" (13%); and "very" (3%). The majority of nurses performed screens within 1hr (40.6%) or between 1-4hr (43.8%) of extubation. Fifteen different methods were utilised to screen swallowing function by nurses who reported a total of 31 different clinical signs indicative of dysphagia. Survey data of practicing nurses in an academic cardiac ICU revealed limited formal training in swallowing screening methodology, a high degree of variability in screening methods employed and low levels of agreement for dysphagia signs. Data highlight a knowledge gap and need for the development of formal education and validated rapid nursing dysphagia screening tools for standardised implementation in the cardiac surgery ICU setting.

Public School Nursing Practice in the United States.

School nursing practice has changed dramatically over the past 20 years, yet few nationally representative investigations describing the school nursing workforce have been conducted. The National School Nurse Workforce Study describes the demographic and school nursing practice patterns among self-reported public school nurses and the number and full-time equivalent (FTE) positions of all school nurses in the United States. Using a random sample stratified by public/private, region, school level, and urban/rural status from two large national data sets, we report on weighted survey responses of 1,062 public schools. Additional questions were administered to estimate the school nurse population and FTEs. Findings reported illustrate differences by strata in public school nurse demographics, practice patterns, and nursing activities and tasks. We estimate approximately 132,300 self-identified practicing public and private school nurses and 95,800 FTEs of school nurses in the United States. Research, policy, and school nursing practice implications are discussed.

Application and innovation of humanistic solicitude in the teaching of nursing practice

The humanistic solicitude in nursing means that the medical staffs take sincerely the patients' life, health, basic rights, needs, personalities and dignities into account with humanitarian spirit, which plays an important part in nursing practice. To implant humanistic solicitude in teaching and to innovate its model in multiple ways by using related theories of pedagogy, learning advanced experiences from hospitals domestic and abroad can cultivate students' sustained and stable concept of humanistic solicitude and motivate their empathy and caring emotions, thereby expanding their knowledge and promoting the abilities of utilizing humanistic solicitude in nursing practice. Key words: Nurse's practice patterns; Teaching; Nursing staff; Humanistic solicitude; Innovation

Practice and evaluation of creating magnetic nursing work environment in hospital

Objective To explore the moves that creating magnetic work environment in hospital, in order to improve the nurses job satisfaction and reduce the turnover rate then stable the nursing team. Methods Through a series of measures such as the establishment of scientific rational allocation of human resources, implementing fair performance evaluation and allocation mechanism, carrying out the nurse grading management system to create magnetic nursing work environment, the nurse job satisfaction and turnover rate were compared before and after the measures. Results In January 2014 a total of 520 questionnaireswere issued, 519 valid questionnaires, and the effective recovery rate was 99.81%(519/520); And 559 were valid of 577 issued questionnaires, which was 96.88%(559/577). The overall score of nurses' job satisfaction increased from(3.20±0.46)points in 2013 to(3.41±0.52)points in 2014(t = 9.40, P= 0.000); The nurse turnover rate fell to 1.97%(13/661)from 5.13%(30/585)(χ2= 10.27, P= 0.003). Conclusions That is very important for remain stable and high quality nursing team to carry out scientific and fine management according to the demand of nurses, so as to create a safe, harmonious, positive, cooperative magnetic nursing work environment which have development direction and space. Key words: Nursing care; Nurse's practice patterns; Work environment; Magnet

The satisfaction survey on clinical practice content of nursing postgraduates

Objective To analyze satisfaction of the clinical practice content of nursing postgraduates with different characteristic, and to provide transformative suggestions for the construction of clinical practice scheme of nursing postgraduates. Methods Using judgment sampling and snowball sampling, the questionnaire survey was conducted among 101 nursing postgraduates, and comparing satisfaction of clinical practice content of postgraduates with different age, work experience and teaching mode. SPSS 17.0 software package was used for data description and t test. Results The total satisfaction of clinical practice content of nursing postgraduates was low, and different postgraduates' satisfaction was different. On practical operation opportunity, > 30 years old of postgraduates' satisfaction was (3.95±0.87), which was higher than those 20~30 years old, (3.35±0.90), and the difference was statistically significant, t=2.748, P<0.01. On clinical practice assessment methods and frequency, the satisfaction of postgraduates with a fixed teacher was higher than those without a fixed teacher (3.40±0.74) vs. (2.83±0.87), and the difference was statistically significant, t=3.310, P<0.01. Conclusions At present, the clinical practice content of nursing postgraduates is in shortage, and need to be further improved. Key words: Education, nursing, graduate; Nurse's practice patterns; Satisfaction

Understanding RN and LPN Patterns of Practice in Nursing Homes

Understanding how nurse regulators can ensure optimal registered nurse-licensed practical/vocational nurse (RN-LPN) collaborations for patient safety and care quality is critically important.To aid this understanding, researchers conducted a comparative, multiple-case study on RN and LPN practice in the areas of assessment, care planning, supervision, and delegation in two states, Minnesota and North Carolina. The researchers identified three factors that differentiated nursing practice patterns in nursing homes: the quality of the connections between RNs and LPNs, the degree of interchangeability between RNs and LPNs, and RN-to-LPN staffing ratios. Findings indicate several levers for improving RN-LPN collaborations and the capacity to provide higher quality care.

ASPMN Survey—Nurses' Practice Patterns Related to Monitoring and Preventing Respiratory Depression

The American Society for Pain Management Nursing convened a taskforce to develop guidelines on monitoring for opioid-induced sedation and respiratory depression. Part of the guideline development was the determination of nursing practice patterns related to monitoring and preventing respiratory depression during the administration of analgesics for pain. One hundred and forty-seven responses were received from 90 unique institutions across the United States. Monitoring adults with intermittent pulse oximetry while using intravenous patient-controlled analgesia (IV PCA) was 58%. Adults were monitored with continuous pulse oximetry by 25% of respondents. When using continuous epidural analgesia, 56% of patients were monitored intermittently, and 40% were monitored continuously. The use of end tidal CO2 (ETCO2) monitoring was much less, with 2.2% patients on epidural therapy, and 1.5% of institutions were using ETCO2 with IV PCA. The survey also included the location of the alarm, respiratory parameters for alarms, changes in procedures reported by institutions, and definitions of high-risk patients.

Nasogastric Tube Feedings and Gastric Residual Volume

To maintain adequate nutrition for patients who are in need, enteral feeding via nasogastric tube (NGT) is necessary. Although the literature suggests the safety of continued NGT feeding at a gastric residual volume of <400 mL, inconsistencies in withholding tube feeding based on residual volume have been observed in clinical practice. We performed a regional survey to determine the range of current practice among nursing staff regarding the decision to withhold NGT feeding based on residual volume and the factors that influence the decision-making process. A questionnaire was designed to evaluate nursing practice patterns regarding the decision of withholding NGT feeding based on a certain residual volume, which was distributed to the nursing staff at all major hospitals in the Oklahoma City metropolitan area. Statistical analysis was done with the Fisher exact test. All of the statistical tests were carried out at α = 0.05. A total of 582 nurses completed the survey. Residual volumes (milliliters) resulting in the termination of NGT feeding occurred in 89% of nurses at volumes <300 mL and only 3% of nurses at volumes >400 mL. Three main reasons for nurses to withhold NGT feeding were risk of aspiration (90%), potential feeding intolerance (81%), and risk of regurgitation (67%). Other less common concerns were abdominal distension and abdominal discomfort. The decision of withholding NGT feeding varied among the nursing staff that were surveyed. A consensus is necessary for the standardization of withholding NGT feeding in clinical practice among nursing staff.

Practice patterns of heart failure nurses

ObjectiveLittle is known about the practice patterns of nurses who work in the specialty of heart failure (HF). This specialty includes inpatient and outpatient sites for practice that incorporate intensive care to rehabilitation. The purpose of this study was to describe the current practice of nurses who are members of the American Association of Heart Failure Nurses (AAHFN). MethodsA convenience sample of nurses attending the 2010 Annual Meeting of AAHFN was surveyed to determine current practice patterns. ResultsThe mean age of the nurses completing the survey was 48 years (standard deviation [SD] +10), and the majority were white (85%) and female (98%). Approximately half (48%) completed a Master’s degree. The mean time worked as a nurse was 23 years (SD +10), with a mean of 11 years (SD +8.2) caring for patients with HF. Both HF education and physical assessment were reported to be provided frequently. ConclusionThis survey provides insight into the practice patterns of HF nurses. Continued monitoring of this role is warranted and can serve to assist the AAHFN in advancing HF knowledge and skills.

Enteral Feeding Practices in the NICU

: The purpose of this study was to examine the current management of the enteral feeding regimens of premature infants cared for in the neonatal intensive care unit (NICU). : The study included responses from 70 neonatal nurses who participated in a 2009 Neonatal Enteral Feeding Survey distributed electronically to the National Association of Neonatal Nurses membership. These respondents were representative of both the United States and Canada, with 29 US states represented. The majority of respondents (95.7%) reported current nursing employment in a level III NICU. : Survey research was used in this exploratory study. The survey, Enteral Tube Feeding Practices in the Neonatal Intensive Care Unit, was developed in collaboration with expert neonatal nurses and nutritionists, pilot tested, and distributed via electronic means. : Survey research was conducted according to the Dillman methodology. Data analysis included descriptive statistics and univariate analysis of variance assessing for significant differences in specific neonatal feeding practices reported. Thematic analysis was used to analyze the qualitative data reported. : The outcome measures included the survey responses to the questions asked about the implementation of an enteral feeding protocol and various aspects of enteral feeding practices in the NICU. : The majority of participants (60.9%) reported that an enteral feeding protocol was implemented in practice, but that it was inconsistently followed because of individual physician or nurse practice patterns, or highly individualized feeding plans required of specific clinical care needs of the patient. Respondents indicated that gestational age was the leading criteria used to initiate feedings, and patent ductus arteriosis treatment was the primary contraindication to enteral feedings. The leading factor reported to delay or alter enteral feedings was the presence of gastric residuals. Survey data indicated that other contraindicating factors to enteral feeding are variable across NICUs and, as reported, are often inconsistent with the current research published to date. : Research is needed to provide a foundation on which to develop effective enteral feeding protocols that are appropriate for the diversity of infants cared for in the NICU. Such research findings will culminate in the development and implementation of enteral feeding protocols in the NICU, which will result in improved nutrition, growth, and development outcomes for premature infants.

Nursing Practice Patterns: Timing of Insulin Administration and Glucose Monitoring in the Hospital

The purpose of this study was to describe diabetes nursing practice patterns related to the timing of morning insulin administration, blood glucose monitoring, and meal intake for patients with type 2 diabetes and to report how frequently nurses were able to meet the expected standard of care. Observations were made of 50 incidents of morning diabetes care on medical-surgical units in an acute care setting. Timeliness of rapid-acting insulin administration and glucose monitoring in relation to the morning meal were evaluated, as were the subsequent prelunch glucose levels. Patients did not receive rapid-acting insulin with in the standard recommended time of 10 minutes premeal/postmeal 84% of the time, nor did they receive glucose monitoring within the recommended 30 minutes premeal 57% of the time. There was no significant relationship found between timely insulin administration and glucose monitoring. There were no significant relationships found between care activities and prelunch glucose control or glucose variability. Coordinating insulin administration, glucose monitoring, and meal delivery within the tight time frames required for rapid-acting insulin is a significant challenge not being met. Timeliness of diabetes nursing care is not the sole determining factor to good glucose control in hospitalized patients. Standards regarding timing of these activities need to be evaluated.

Evaluation of ICU Nurses' Use of the Clinical Information System in Taiwan

With the fast development of computer software and hardware, technology application is ubiquitous, and many healthcare services have integrated a clinical information system into daily practice. With today's information technology, everyone should possess basic computer competency to meet on-the-job demands and especially to use an information system in healthcare. Thus, the purpose of this study was to explore Taiwanese nurses' computer competency, the interface usability, and any change in the nurses' practice pattern as a result of the technology use. The current study adopted a descriptive research design, recruiting 114 nurses in medical and surgical ICUs to survey their technology use. Additionally, a total of 6780 observation values were obtained by a work sampling method to investigate the applicability of the information system. The results indicated that nurses with a higher education can use more computer applications and had better computer competency than other nurses. Additionally, computer competency was related to interface usability, and interface usability in the surgical ICU was rated higher than those in the medical ICU. Finally, the nursing practice patterns observed were related to the technology use. The results could serve as a reference for information technology usage evaluation in nursing.

Patient whiteboards as a communication tool in the hospital setting: A survey of practices and recommendations

Patient whiteboards can serve as a communication tool between hospital providers and as a mechanism to engage patients in their care, but little is known about their current use or best practices. We surveyed bedside nurses, internal medicine housestaff, and hospitalists from the medical service at the University of California, San Francisco. A brief survey about self-reported whiteboard practices and their impact on patient care was administered via paper and a commercial online survey tool. Surveys were collected from 104 nurse respondents (81% response rate), 118 internal medicine housestaff (74% response rate), and 31 hospitalists (86% response rate). Nurses were far more likely to use and read whiteboards than physicians. While all respondents highly valued the utility of family contact information on whiteboards, nurses valued the importance of a "goal for the day" and an "anticipated discharge date" more than physicians. Most respondents believed that nurses should be responsible for accurate and updated information on whiteboards, that goals for the day should be created by a nurse and physician together, and that unavailability of pens was the greatest barrier to use. Despite differences in practice patterns of nurses and physicians in using whiteboards, our findings suggest that all providers value their potential as a tool to improve teamwork, communication, and patient care. Successful adoption of whiteboard use may be enhanced through strategies that emphasize a patient-centered focus while also addressing important barriers to use.

Impact of a Nursing Information System on Practice Patterns in Taiwan

The purpose of this study was to measure changes in nursing practice patterns between the beginning stage and a later phase of implementing the nursing information systems. The study was a two-stage data comparison analysis. The data were collected during the first 2 weeks and 1 year after installing the nursing information system. Nursing activities were checked from a list with 83 items. Data were collected by a work sampling strategy during two 2-week periods in November 2004 and November 2005. For both stages, nurses spent about 20% of their time on direct care, 25% on indirect care, 9% on unit-related activities, 30% on documentation, and 15% on personal time. After 1 year of using the nursing information system, nurses spent more time on documentation but less on indirect care and unit-related activities. When unit patient census was high, nurses spent more time on direct care. Issues regarding evaluating the impact of information systems on practice patterns were explored.