Provision Of High Quality Nursing Care Research Articles

Self-care nursing interventions: A qualitative study into electronic health records' contents.

This study aims to (1) analyse all self-care-related interventions Portuguese nurses documented, (2) determine potential issues that may impair semantic interoperability and (3) propose a new set of interventions representing nursing actions regarding self-care that may integrate any HER application. As populations age and chronic diseases increase, self-care concerns rise. Individuals who seek healthcare, regardless of context, need prompt access to accurate health information. Healthcare professionals need to understand the information in all placeswhere care is provided, creating the need for semantic interoperability within electronic health records. A qualitative descriptive and exploratory study was conducted in two phases: (1) a content analysis of nursing interventions e-documentation and (2) a focus group with fifteen registered nurses exploring latent criteria or insights gleaned from the findings of content analysis. The COREQ statement was used to guide research reporting. We extracted 1529 nursing intervention sentences from the electronic health records and created 209 intervention categories. We identified the main issues with semantic interoperability in nursing intervention identification. According to the findings, nurses cooperate with clients, offering physical aid and encouraging them to overcome functional limitations to self-care tasks hampered by their conditions. This article provides evidence to warn policy makers against decisions to use locally customised electronic health records, as well as evidence on the importance of policy promoting the adoption of a nursing ontology for electronic health records. And, as a result, the harmonisation and effective provision of high-quality nursing care and the reduction of healthcare costs across nations.

The effects of high-fidelity simulation training on empathy and attitudes toward older people among undergraduate nursing students: A quasi-experimental study

AimTo evaluate the effects of high-fidelity simulation training on attitudes towards older people and empathy among undergraduate nursing students. BackgroundPeople worldwide are living longer and, consequently, the number of older people is increasing globally. Geriatric syndromes are highly prevalent and associated with increased morbidity and mortality in this population. Positive attitudes towards older people and high levels of empathy are necessary for the provision of high-quality nursing care, which will contribute towards improving the quality of life of older patients affected by these syndromes. MethodsA quasi-experimental study was conducted using a longitudinal design with a single group and a pre- and post-intervention evaluation. The development of attitudes towards older people and empathy skills were evaluated using high-fidelity simulation-based training, comparing the levels obtained in these skills at baseline and after the simulation experience. The simulated scenarios recreated the great geriatric syndromes in older patients: instability, immobility, intellectual impairment and incontinence. ResultsAfter the simulation sessions, nursing students significantly improved their total scores for both attitudes toward older people and empathy, moreover, improvements were found in the three subscales of empathy. The effect size was large for the total scores of both the attitudes towards older people and the empathy scales and the ‘perspective taking’ subscale. The obtained effect size was small for the ‘compassionate care’ subscale, whereas for the ‘standing in the patient’s shoes’ subscale, the obtained effect size was medium. ConclusionsOur high-fidelity simulation-based training allows undergraduate nursing students to improve their empathy levels and positive attitudes toward older people. The development of these skills may provide benefits directly related to high-quality care for older patients. Therefore, the inclusion of simulation training programs in geriatric nursing study plans is necessary to train nursing students in the care of older people and to prepare them for real clinical practice.

Collaboration among nurses when transitioning older adults between hospital and community settings: a scoping review.

The transitioning of older patients between healthcare sectors requires the provision of high-quality nursing care. Collaboration among nurses is identified as an essential element of transitional care, yet nurse-nurse collaboration has received little attention. The aim of this study was to examine the extent, range and nature of nurse-nurse collaboration when transitioning older patients between hospital and community settings, and to identify gaps in the literature. Arksey and O'Malley's (International Journal of Social Research Methodology, 8, 2005 and 19) framework was used to undertake a scoping review to answer the research questions: how do nurses collaborate together when transitioning older patients from hospital to community settings and what are the facilitators, barriers and outcomes of nurse-nurse collaboration when transitioning older patients between sectors? The Nurse-Nurse Collaboration Scale (NNCS) subdomains informed the identification of selected studies. Twelve papers were included with most coming from Scandinavian countries and the majority using qualitative methodologies. Communication, coordination and professionalism were found to be both facilitators and barriers of nurse-nurse collaboration. Gaps in the literature included conflict management, and the outcomes of collaboration which was only reported in one study. The findings indicate there is limited study of collaboration among nurses when transitioning older patients between hospital and community settings. Future research should address the impact of conflict on nurses working in collaborative practice as well as conducting intervention studies to examine the outcomes of nurse-nurse collaboration.

Satisfaction with the clinical practice among nursing students using regression models and qualitative comparative analysis

BackgroundClinical practice is considered fundamental in nursing studies for the effective education of nurses and students' satisfaction. Both the clinical environment and the clinical educator are key factors in students´ satisfaction. ObjectivesTo analyze the influence of the socio-demographic variables of clinical educators and nursing students on satisfaction with the clinical practice. DesignThis was an observational, cross-sectional study. SettingsA clinical practice course at a private university in Valencia, Spain. ParticipantsThe study included 527 nursing students enrolled on the clinical practice, supervised by 187 clinical educators. MethodsTwo statistical methodologies were used for data analysis: hierarchical regression models (HRM) and fuzzy-set qualitative comparative analysis model (fsQCA). ResultsThe results indicate that sociodemographic variables such as sex, being a woman, and being in the second grade year group, influence student satisfaction in both methodologies. ConclusionsAccording to our results, establishing specific academic plans for students in higher years (3rd and 4th) could improve nursing students' satisfaction with their clinical practice. Adequate training of students is a key factor in the provision of high-quality nursing care.

Recognising and assessing acute pain.

This article considers two areas of practice that are fundamental to the provision of high-quality nursing care for people experiencing acute pain: the initial recognition of pain, and the formal assessment of pain. The initial recognition of a patient's pain is a subject that is frequently overlooked in the literature. However, if nurses are unable to identify that a patient is experiencing pain, then a formal pain assessment may not take place, which in turn negatively affects the quality of any subsequent pain management. This article explores some of the barriers to the initial recognition of pain and examines how a formal pain assessment can support optimal patient care.

Missed nursing care and nurses' intention to leave: An integrative review.

To identify the factors that are associated with missed nursing care and the nurses' intention to leave. Errors and mistakes are an inevitable part of work, but there is increased evidence that missed care is a concerning issue affecting nurses' ability to effectively coordinate, provide and evaluate care interventions delivered to patients globally. An integrative review of qualitative and quantitative studies examining the consequences of missed nursing care, including intention to leave. Eight papers met the inclusion criteria. Thematic analysis generated three themes: Prevalence of missed nursing care, Factors associated with missed nursing care, Factors that impact on missed care and influence the intention to leave. The outcomes of this review demonstrate the need for critical interventions to address the factors that can impact the provision of high-quality nursing care. Missed nursing care is not only a patient safety issue but may also contribute to the inadequate staffing levels. And, better understanding of the factors that affect the intention to leave by nurse managers can stimulate the development of appropriate leadership styles in combination with adjustment of workplace to prevent intention to leave.

Greek nurses' knowledge on the prevention of surgical site infection: an investigation.

The aim of the study was to investigate nurses' knowledge regarding the prevention of surgical site infection (SSI), and to examine the relationship between nurses' demographic characteristics and educational level and their level of knowledge in prevention of SSIs. A further aim was to examine the differences in nurses' knowledge with respect to selected variables and to identify the most significant predictors of nurses' knowledge regarding the prevention of SSIs, to support the provision of high-quality nursing care. A prospective, observational study of a convenience sample of nurses and assistant nurses working in surgical departments, in a public general hospital for adults in Attica, during May to August 2016. For data collection, an anonymous self-completion questionnaire was developed and tested for comprehension and acceptability. Data was collected from 148 nurses and assistant nurses, 121 (81.8%) were female, 73.6% were aged 36-50 years and 43.9% had 11-20 years of experience. With regards to educational level, 66.2% had a degree from a technological educational institute and 10.1% had a Master's degree. Furthermore, 18.2% had a surgical specialty and 59.5% had received special training on surgical infections. The majority of respondents did not chose the correct definition of the time of occurrence of SSIs. Several statistically significant correlations were observed between knowledge on safer hair removal and respndent age (p=0.037), educational level (p=0.003), professional experience (p=0.048), and training in SSIs (p=0.009). The results of this study revealed that the majority respondents had a high level of knowledge regarding the prevention of SSIs, which contrasted with a low level of knowledge regarding their full definition of the time of occurrence.

Barriers preventing high-quality nursing care of people with disabilities within acute care settings: a thematic literature review

This literature review was conducted to identify obstacles in the provision of quality nursing care to people with disabilities within acute care settings. Research in 2006 by the Disability Rights Commission found that people with disabilities have healthcare needs that are not being adequately met with the quality of care expected or anticipated. Obstacles to the provision of high-quality nursing care are a matter of concern to nursing clinicians, educators and researchers involved with establishing and maintaining professional standards of care for nursing practice. Therefore, this review has identified three major themes illustrating barriers to provision of high-quality nursing care in the acute care setting to people with disabilities. Themes identified were: professional competence, professional attitudes and organisational management. Nurses have an obligation to take into account the concerns and needs of individual clients with a disability.

Families and health-care professionals' perspectives and expectations of family-centred care: hidden expectations and unclear roles.

Family-centred care (FCC) is viewed as a pivotal concept in the provision of high-quality nursing care for children and their families, yet implementation continues to be problematic worldwide. This research investigated how FCC was enacted from families and nurses' perspectives. Descriptive qualitative approach using elements of analysis from grounded theory method. Data were collected though individual interviews with 18 children aged 7-16 years, their parents (n = 18) and 18 nurses from two children's hospital and one children's unit in a large general hospital in Ireland. Four key themes were identified: expectations; relying on parents' help; working out roles; and barriers to FCC. Nurses wholeheartedly endorsed FCC because of the benefits for families and their reliance on parents' contribution to the workload. There was minimal evidence of collaboration or negotiation of roles which resulted in parents feeling stressed or abandoned. Nurses cited busy workload, under-staffing and inappropriate documentation as key factors which resulted in over-reliance on parents and hindered their efforts to negotiate and work alongside parents. Families are willing to help in their child's care but they require clear guidance, information and support from nurses. Hidden expectations and unclear roles are stressful for families. Nurses need skills training, adequate resources and managerial support to meet families' needs appropriately, to establish true collaboration and to deliver optimal family-centred care.

Current Knowledge Related to Intelligence and Thinking With Implications for the Development and Use of Case Studies

This paper reviews current knowledge regarding intelligence and thinking, and relates this knowledge to learning to diagnose human responses and to select health outcomes and nursing interventions. Knowledge from relevant literature sources was summarized. The provision of high-quality nursing care requires use of critical thinking with three elements of nursing care: nursing diagnosis, health outcomes, and nursing interventions. Metacognition (thinking about thinking) should be used with knowledge of the subject matter and repeated practice in using the knowledge. Because there are limited clinical opportunities to practice using metacognition and knowledge of these nursing care elements, case studies can be used to foster nurses' expertise. Simulations of clinical cases are needed that illustrate application of the nursing knowledge represented in NANDA International, Nursing Outcomes Classification, and Nursing Interventions Classification. The International Journal of Nursing Terminologies and Classifications will promote the dispersion of case studies as a means of facilitating the implementation and use of nursing languages and classifications.

PREP hindering nurse advancement?

While our profession recognises that the provision of high-quality nursing care to the general practice population is essential, the UKCC’s recent Post- Education registration and Practice (PREP) proposals seem to hinder practice nurses from attaining specialist and advance-level qualifications.