Professional Nursing Practice Research Articles

Leading the Development of a Network-Wide Professional Practice Model: The Role of the Contemporary Nurse Executive.

The health care settings of today are rapidly evolving in form and function, challenging nurse executives to adopt, adapt, and develop new ways to lead and find professional fulfillment in their roles. The organizational design of many health care settings has changed from a functional to a matrix structure to facilitate more effective and efficient operations. While the structures and reporting relationship of contemporary nurse executives may have changed significantly, the primary responsibility of championing the advancement of the profession of nursing remains essential. The mastery of change management methods is critical for the nurse executive to successfully lead in today's dynamic health care settings. A well-developed and actualized nursing professional practice model is a foundational tool for the nurse executive to employ to advance the profession of nursing in any health care setting or structure. This article describes how a nurse executive used change management methods and principles to lead the development of a new network-wide unifying nursing professional practice model in a highly matrixed health care setting.

The Role of Transformational Leadership and Effective Communication on the Implementation of Patient Safety With Trust as Mediation at X Hospital Jakarta

Patient safety has become a global issue in the field of health service including hospital. Implementation of patient safety in the hospital requires the involvement of leadership, effective communication and patient’s trust. At X Hospital Jakarta, the root case that frequently occurs on patient safety incident is communication matter. This has an impact on the reoccurrence of patient safety incident. This research aims to analyze the influence of transformational leadership and effective communication towards the implementation of patient safety by trust as mediation. The method of this research is causal associative with quantitative approach. There are 37 nurses as samples counted with G-Power Statistics application. The technique of collecting data uses primary data questionnaires and is processed by path analysis. The result shows that there is a great influence on transformational leadership towards trust. Therefore, in implementing patient safety in hospital, it needs program development on transformational leadership; controlling, and evaluating the implementation of effective communication; and improving nursing care as a form of professional nursing practice to create and to maintain patient’s trust towards nurse.

Effectiveness of internship program as perceived by intern nurses and its relation to their professional role at technical nursing institutes

Background: Nursing internship program is a system of instruction and experience coordinated within an academic setting and leading to the acquisition of the knowledge, skills, and attributes essential to the practice of professional nursing. Aim: examine the relationship between the effectiveness of the internship program (established via intern nurse's points of view) and intern nurse's professional role at the technical institutes of nursing. Subjects and Method: Design: A descriptive research design was carried out. Setting: The study was carried out at technical nursing institutes at Damietta and associated hospitals at Damietta governorate . Subjects: All nurses 147 nurse interns from the aforementioned setting who enrolled in the internship program. Tools: Tool I: A structured questionnaire including Part 1: intern nurse personal data. Part 2: intern nurse's evaluation of the internship program, Tool II: Six-dimensions scale of nursing performance. Results: 90.5% of the nurse interns were female, the mean score of internship environment was 72.0, the internship site supervisor 80.3, while internship learning experience was 78.3, a highly statistically significant relation was revealed between the internship program effectiveness and the professional role. Conclusion: the internship program was efficient in improving nursing intern nurses’ professional role of the intern nurses at technical institutes of nursing, the professional role of the intern nurses was good, and there was a relation between the internship program effectiveness and the intern nurses' professional role. Recommendations: more emphasis should be given to the feedback on the intern nurses' performance, leadership, mathematical skills required for the profession.

Working at a cultural interface: co-creating Aboriginal health curriculum for health professions

ABSTRACT Historical exclusion of Aboriginal people and Aboriginal epistemologies in Australian higher education, including health professions education, has produced generations of healthcare professionals who are ill-equipped and lack confidence to provide culturally safe care for Aboriginal communities. This article recounts efforts undertaken at a university in Melbourne to foreground Aboriginal ways of knowing and being through co-creating curriculum for undergraduate and postgraduate health professions programmes with Aboriginal expert partners. The intended learning outcome was to develop students’ cultural capability for professional practice in occupational therapy, dietetics, or nursing. Herein, we present two co-created Aboriginal curriculum projects. The first describes two sequential, blended learning modules co-created and delivered in discipline-specific classes; the second is an interprofessional simulation involving students from multiple health professions. We use Nakata’s cultural interface to reflect on the process of working together in this contested space as non-Aboriginal academics and expert Aboriginal partners and conclude by presenting considerations for navigating curriculum development at the intersection of two knowledge systems.

A practice-based model to guide nursing science and improve the health and well-being of patients and caregivers.

Aims and ObjectivesThe purpose of this paper is to describe a model to guide nursing science in a clinical practice‐based setting. Exemplars are provided to highlight the application of this nursing research model, which can be applied to other clinical settings that aim to fill evidence gaps in the literature.BackgroundNurse scientists are well positioned to develop new knowledge aimed at identifying global health solutions to multiple disparities. The generation and application of this knowledge are essential to inform and guide professional nursing practice. While a number of evidence‐based practice models exist to guide the integration of literature findings and other sources of evidence into practice, there is a need for additional models that serve as a guide and focus for the conduct of research in distinct scientific areas in practice‐based settings.DesignModel development and description.MethodsMayo Clinic is a large, comprehensive healthcare system with a mission to address unmet patient needs through practice, research and education. PhD‐prepared nurse scientists engage in practice‐based research as an integral component of Mayo Clinic's mission. A practice‐based nursing research model was developed with the intent to advance nursing research in a clinical setting.ResultsThe components of the Mayo Clinic Nursing Research model include symptom science, self‐management science and caregiving science. The generation of nursing science is focused on addressing needs of patients with complex health conditions, inclusive of caregivers.ConclusionsWhile clinical settings provide rich opportunities for the conduct of research, priorities need to be established in which to focus scientific endeavours. The Mayo Clinic Nursing Research model may be applicable to nurses around the globe who are engaged in the generation of knowledge to guide practice.Relevance to Clinical PracticeThe Mayo Clinic Nursing Research model can be used by nurse scientists embedded in healthcare settings to address clinically relevant questions, advance the generation of new nursing knowledge and ultimately improve the health and well‐being of patients and caregivers.

Documentation Practice and Associated Factors Among Nurses in Harari Regional State and Dire Dawa Administration Governmental Hospitals, Eastern Ethiopia.

BackgroundNursing documentation is an integral and vital professional nursing practice that refers to the process of recording nursing activities concerned with the care given to individual clients to ensure continual effective, safe, quality, evidence-based, and individualized care.ObjectiveTo assess documentation practice and identify its associated factors among nurses in six Governmental Hospitals of Harari Regional State and Dire Dawa Administration, Eastern Ethiopia.MethodologyAn institutional-based cross-sectional study was conducted among 430 nurses and 421 medical records. Simple random sampling was employed for the selection of nurses and charts after the total sample size had been allocated proportionally for each hospital. Data were collected by using a self-administered questionnaire and review of records, and entered and analyzed by using EpiData version 3.1 and statistical package for social sciences version 20.0, respectively. Logistic regression was used to identify the associated factors.ResultsIn this study, 47.5% of nurses were found to have good nursing documentation practice whereas good nursing documentation practice was found in 38.5% of medical records. Age (AOR, 95% CI 3.54, 1.170–10.8), attitude (AOR, 95% CI 5.66, 3.17–10.11), in-service training (AOR, 95% CI 2.53, 1.477–4.35), nurse to patient ratio (AOR, 95% CI 2.24, 1.24–4.047), motivation (AOR, 95% CI 4.60, 2.721–7.76), and familiarity with standards of nursing documentation (AOR, 95% CI 1.98, 1.137–3.44) were found to have a statistically significant positive association with documentation practice.ConclusionPoor documentation practice was due to the identified factors. So, it is better to put further effort toward improving documentation practice through providing training on standards of documentation and enhancing the favorable attitude of nurses toward documentation practice by motivating them regarding documentation activities.

The Relationship between Autonomy and Quality of Health Care among Staff Nurses

Autonomy is the main element of professional nursing practice, which leads to improve patient outcomes. Nurses who have a higher degree of autonomy in their practice provide high-quality patient care. Purpose of the study: Assess the relationship between autonomy and quality of health care among staff nurses. Design: A descriptive correlational research design was utilized for this study. Setting: Conducted at selected general departments and closed units of Teaching Hospital. Subjects: Convenience sample of 250 staff nurses and 100 patients were included at this study. Instruments: Two instruments were used for data collection: instrument I: Dempster Practice Behaviors Scale and instrument II:Patient's Quality of Health Care Questionnaire. Results: Revealed that the majority of studied nurses had moderate autonomy level (71.6%) In addition, nearly two thirds of studied patients had moderate health care quality (65%) Conclusion: There was a positive non-significant correlation between nurses' perception of autonomy and patients' perception of quality of health care. Recommendation: Encourage nurses to participate in decision-makings to create mutual trust between managers and super visors and staff, and provide continuous in service education to increase nurses' knowledge base.

Key Elements of Professional Nursing Practice: A Scoping Review

BACKGROUND: Professional nursing practice can be used as a standard reference for implementing nursing care to help nurses provide quality care in accordance with their authorities.
 AIM: The review is purposed to synthesis the pieces of literature telling the development and / or application and / or assessment of a professional nursing practice to determine the crucial elements.
 METHODS: This study was guided by the following framework for a scoping review, using electronic databases including ScienceDirect, EBSCO, ProQuest, Pubmed, and Google Scholar within keywords of professional nursing practice, model, nurse and conceptual framework.
 RESULTS: Of a total of 2870 paper found, 28 papers were selected. This study seven key elements: health system competency, professional value, reward and performance evaluation, leadership, nursing care, professional development, and basic care competency. CONCLUSION: A professional nursing practice would provide the minimum standard of quality nursing practice.

THE RELATIONSHIP BETWEEN CAREER LADDER AND NURSES JOB SATISFACTION AT A HOSPITAL

Background: Career ladder is given to nurses to encourage and maintain professional development and practice of nursing. Career ladder has an impact on raising clinical levels, promotion opportunities, competency complexity, rewards and recognition. In this study, the career ladder has started by mapping and conducting, credentials and competency assessment at the levels of pre Nurse Clinicians, Nurse Clinicians Level I and Nurse Clinicians Level II. Almost half of the nurses were dissatisfied (47.2%) with their career development.Aims: This study was to analyzed the relationship between the career ladder and nurses’ job satisfaction.Methods: This study was a quantitative correlational study with a cross-sectional approach. There were 108 nurses as samples selected using consecutive sampling techniques. These respondent who met the inclusion criteria came from Inpatient Room, (i.e VVIP, VIP, Class I, Class 2/3, Ophthalmology Inpatient), Polyclinic, Chemotherapy Unit, NICU (Neonatal Intensive Care Unit), ICU (Intensive Care Unit), Hemodialysis, Emergency room and COT (Centra Operation Theater). Data were analyzed using the Spearman test.Results: There was a significant relationship between career ladder (p=0.000) and nurse’ job satisfaction. The nurse were satisfied with her career development related to implementation of career ladder. Besides, career ladder allowed to be promoted as the heads of the rooms. Rewards and recognition of nurses’ competencies through job promotion affected nurses’ satisfaction.Conclusion: Career ladder affects nurse satisfaction. Nurses can advance their careers through a career promotion, competencies, rewards and recognition from other health professionals. Support from nurse manager is needed as a form of mentoring and evaluation of nurse performance in the career ladder. Keywords: career ladder, job satisfaction, nurses

When Crisis Strikes, Handle With CARE.

The decision to continue a career advancement program in midst of our health system's response to the COVID-19 pandemic was made after weighing the pros and cons. At a time when high priority was placed on educating the frontline nurses on rapidly changing protocols and supporting mental health, our organization reallocated resources and ways of doing things in order to maintain some form of normalcy. By doing so, we were able to demonstrate our commitment to professional development even in the face of adversity and highlight the resourcefulness of nursing professional development practitioners. As the COVID-19 crisis has laid bare, we live in an increasingly complex and interconnected world, and agility will be essential to future nursing professional development practice.

Scale for the Environment Evaluation of Professional Nursing Practice: Construct validation.

Testing the validity and reliability of the Scale for the Environments Evaluation of Professional Nursing Practice (SEE-Nursing Practice). The environment of professional nursing practice is key to achieve better results for clients, nurses and institutions. Therefore, instruments enabling the assessment of all its attributes are required. Cross-sectional methodological study. The SEE-Nursing Practice, based on a previous qualitative study and literature review, was applied as a questionnaire. Exploratory and confirmatory factor analyses were used to assess construct validity. A total of 752 nurses participated in the study. Exploratory factor analysis of the SEE-Nursing Practice led to a factor solution with 93 items and three subscales. The Structure, Process and Outcome subscales, respectively, have 43, 37 and 13 items, loaded in 6 factors, 6 factors and 2 factors and explaining 62.6%, 59.2% and 67.4% of the total variance. Cronbach's alpha of the overall scale and of the 3 subscales was greater than 0.90. Confirmatory factor analysis showed a good fit. SEE-Nursing Practice is a good valid and reliable instrument. The SEE-Nursing Practice enables assessing practice environments and is a tool for nursing managers in the definition of strategies ensuring favourable environments for nursing care quality.

Reducing Barriers and Achieving Success in Registration Examination Among Internationally Educated Nurses: A Participatory Action Research Project.

Multiple challenges impede the Internationally Educated Nurses (IENs) professional development and success in writing the registration examination. This paper aims to explore these challenges and describes the educational program which adopts a tailored mentoring approach to facilitate their successful completion of the registration exam.Methodology: Participatory Action Research model informed the development and revision of the educational process. For this qualitative study, individual 1:1 audiotaped and telephone interviews were conducted among the initial participants to explore their experiences in the program. Findings from this study provided more insights as to participants' success in passing registration examination and enhanced performance in their clinical practices. From the thematic analysis, we interpreted the IEN's journey in their knowledge transition into four major themes: Acknowledging the barriers, Learning the new culture, Making progress, Transitioning into power. This project demonstrated that the integration of a strong mentor-mentee relationship that gives voice to the participants' learning experience so as to meet their knowledge gaps, engenders a deeper understanding of Canadian professional nursing practice, positions them for success in writing the registration examination and builds a sense of empowerment among them.

Establishment of analysis groups of professional nursing practice in mental health

In mental health, as elsewhere, nurses are increasingly faced with clinical and organizational problems. At atime when the nursing profession is experiencing new perspectives through advanced practice, particularly in psychiatry and mental health, a cross-sectional view is proposed on the implementation of an experimentation of analysis groups of professional nursing practice at the Nancy psychotherapeutic center (54). The strengths, limits and perspectives of this system are presented for the teams, their management and for the clinical nurse specialist who leads the sessions.

Novice nurses' readiness to practice in an ICU: A qualitative study.

Novice nurses (newly qualified within the first 3-year period of professional practice after registration) must first face the reality and complexity of caring for high-acuity patients in the critical care setting, which can be an unfamiliar and demanding environment. The successful transition from education to professional practice of novice nurses hired for intensive care must be supported. To explore Polish novice nurses' readiness to practice in an intensive care unit (ICU). Our study objectives included investigating pre-registration preparation for work in an ICU, identifying the most needed competencies to work in an ICU, and analysing organizational aspects of the professional orientation period. A qualitative phenomenology design was applied. We conducted qualitative content analysis based on individual semi-structured in-depth interviews. Study recruitment was performed using a purposeful and network sampling strategy. The final number of participants was 17 Polish novice nurses. The majority of responders replied that they were not prepared to work in an ICU after graduation. Professional orientation was planned-generally for a period of 3months; however, in most places it was shortened. The respondents identified the five competencies most needed to work in an ICU: communication, teamwork, professional self-confidence, and knowledge and its practical use. Their enhancement could be achieved through simulations during both pre-registration and professional training. Analysis of the novice nurses' orientation period revealed many difficulties that indicated a lack of readiness to practice in an ICU after graduation. Identifying novice nurses' strengths and weaknesses regarding clinical competence is important to guide the design of orientation programmes in ICU settings and nursing education programmes. Readiness for ICU work may be improved by enriching education with simulations that enable training in the practical use of knowledge and critical care procedures. A supportive work environment is crucial during professional orientation.

Recommendations From the Professional Advisory Committee on Nursing Practice in the Care of ECMO-Supported Patients.

By July 2020, the Extracorporeal Life Support Organization had documented more than 133 000 extracorporeal membrane oxygenation (ECMO) implementations, with more than 61 000 implementations in adult patients. No clear policies regarding the authority and responsibility of nursing staff in the treatment of ECMO-supported patients are currently available. To formulate evidence-based recommendations for nursing care of ECMO-supported patients. The National Head Nurse's office and the Professional Guidelines Department in the Nursing Division of Israel's Ministry of Health formed the Professional Advisory Committee on Nursing Practice in the Care of ECMO-Supported Patients to address concerns regarding the current state of professional nursing practice in the care of these patients. The Professional Advisory Committee brought together 15 senior Israeli ECMO nursing experts who explored the potential of registered nurses in caring for ECMO-supported patients, considered the competencies of nurses treating ECMO-supported patients, discussed training programs and health care policy, and examined nursing outcomes for quality assurance. The Professional Advisory Committee formulated recommendations regarding the following priority issues: (1) determining boundaries of professional authority and nurses' responsibilities, including designated activities for different professional ranks of registered nurses; (2) providing appropriate content for the training programs offered, such as generic/basic, above-basic, and clinical specialization nursing programs; and (3) defining relevant quality measures for nursing treatment of ECMO-supported patients. Introducing international standards would ensure the safety and effectiveness of nursing care for ECMO-supported patients through quality and risk management and establishment of new evidence-based nursing practices.

Note-taking by nursing students: the case for implementing writing strategies to encourage best practice.

Note-taking is an integral component of professional nursing practice. If students are to complete this effectively, a range of teaching, learning and assessment strategies are required to support their development of this skill. This study aimed to identify lecturers' perspectives of students' note-taking on placement to identify factors that limit the development of this skill; these perspectives could be used to explore strategies to support students to develop this skill while at university. A qualitative study taking a phenomenological approach was carried out. Three senior nursing practice visitors agreed to be interviewed. Semistructured interviews were carried out and thematic analysis carried out to explore lecturers' perspectives of students' experiences of note-taking while on placement. These interviews were intended to obtain detailed accounts of note-taking and allow challenges to be explored. Each participant observed and supported students' note-taking within practice placement settings. Three main themes emerged from the data: limitations to students' vocabulary and literacy; inconsistency between trusts resulting in an inability to articulate experience; and note-taking clarity and accuracy. Note-taking is central to nurses' education and professional documentation to support best practice and high-quality patient care. Variations in processes between trusts, stringency of standards required by the trusts where students attend placements, and students' writing abilities differ widely, which directly affect the consistency and accuracy of written notes.

FACTORS AFFECTING NURSES’ PERFORMANCE TOWARDS HEALTHCARE IMPROVEMENT: A CRITICAL REVIEW

Purpose: The study, therefore, seeks to establish the factors that influence the performance of nurses towards the overall healthcare improvement.Methodology: This study adopted a desk survey design. This involved an in-depth review of studies in relation to nurses’ performance and healthcare improvement. An in-depth search of the top keywords related to nurses’ performance and healthcare improvement was done in various databases. Thus, the seminar paper was purely qualitative, drawing its findings from secondary sources of information.Findings: The study finds that workload, payment and salaries, working conditions and leadership affect the performance of nurses towards the overall healthcare improvement. Unique contribution to theory, policy, and practice: Mismatch of human resources with workload and lack of clarity with regard to duties have maximum correlation with poor quality of care. Organizational structure and communication program categories gained the highest and lowest importance respectively. This information could be used by nursing managers and policy makers to plan programs in order to improve the quality of clinical nursing services. Clinical governance is considered as a framework for improving the quality of clinical services in nursing. Professional nursing practice standards are valid expression tasks that are expected of all nurses regardless of their roles and expertise in communities to be done with merit.

Paulo Freire's culture circles: contributions to nursing research, teaching, and professional practice.

to share the contributions of culture circles for teaching, research, and professional nursing practice, having as framework Paulo Freire's Research Itinerary. this is an experience report of a culture circle, with participation of three professors and ten students, enrolled in a course of a Graduate Program in Nursing in southern Brazil. In this culture circle, a tree was built in which the roots formed the thematic investigation, the stem, coding and decoding, and the leaves, the Research Itinerary critical unveiling. participants demonstrated empowerment of Paulo Freire's assumptions, and building a tree made it possible to discuss in a pleasant and playful way culture circle use in teaching, research, and professional nursing practice. the culture circle promoted reflection and action on nursing praxis, turning Freirean thoughts into something concrete and transforming realities.

Construction and validation of indicators for patient safety in intrahospital transport

ABSTRACT Objective: To construct and validate an indicator plan for measuring and assessing patient safety in intrahospital transport. Method: Methodological study, developed in three stages, between July 2018 and July 2019. The content validity included the participation of nurses from the State of Bahia and experts from different regions of the country. For data analysis and interpretation, descriptive statistics were used. Results: After a pre-test round and two rounds of expert consultations, using the Delphi technique, the general content validity index that assessed the clarity of the indicators was measured at 1.00 and the representativeness was 0.97. Conclusion: The indicators make a significant contribution to the field of health and nursing, as it constitutes an instrument that will contribute to the professional practice of nurses, to patient safety and will still be viable for the practice of auditing or assessing the intrahospital transport process.

Evaluation of health care quality among insured patients in Indonesian mother & child hospital: A secondary data analysis

ObjectiveThis study aimed to evaluate the health care quality among insured patients hospitalized in the Indonesian mother and child hospital. MethodA secondary data analysis was performed to evaluate the health care services received by the insured patients hospitalized in the Indonesian mother and child hospital. Data were extracted from the BPJS health insurance e-claim database from January 1 to December 31, 2019 and from January 1 to June 30, 2020. A descriptive and bivariate analysis were used to examine total patients and hospital admissions; INACBGs diagnoses, procedures by severity; types of inpatient wards; length of stay; discharge status; hospital costs; and 30-day readmissions. ResultsTotal inpatient unit admissions were 2870 in 2019 and 1533 in 2020. From total hospital admissions in 2019 and 2020, over 50% were admitted to the 3rd class of inpatient units, less than 10% had length of stays more than 5 days, and over 98% were discharged based on physician approval. However, hospital readmissions were also found for about 20.1% in 2019 and 2.9% in 2020 and about 42.9% in 2019 and 61.3% in 2020 were found causing hospital financial losses. Older patients, longer hospital stays, inpatient ward class 1 & 2, high hospital tariff, inadequate clinical pathway implementation, lack of interprofessional collaboration, and ineffective nurse manager supervision were identified as contributing factors to the hospital financial losses. ConclusionIntegrated clinical pathways with interprofessional collaboration that are implemented through professional nursing practice model are suggested for health care quality improvement.