Responsibilities Of Nurses Research Articles

Nurses in the lead: a qualitative study on the development of distinct nursing roles in daily nursing practice

BackgroundTransitions in healthcare delivery, such as the rapidly growing numbers of older people and increasing social and healthcare needs, combined with nursing shortages has sparked renewed interest in differentiations in nursing staff and skill mix. Policy attempts to implement new competency frameworks and job profiles often fails for not serving existing nursing practices. This study is aimed to understand how licensed vocational nurses (VNs) and nurses with a Bachelor of Science degree (BNs) shape distinct nursing roles in daily practice.MethodsA qualitative study was conducted in four wards (neurology, oncology, pneumatology and surgery) of a Dutch teaching hospital. Various ethnographic methods were used: shadowing nurses in daily practice (65h), observations and participation in relevant meetings (n=56), informal conversations (up to 15 h), 22 semi-structured interviews and member-checking with four focus groups (19 nurses in total). Data was analyzed using thematic analysis.ResultsHospital nurses developed new role distinctions in a series of small-change experiments, based on action and appraisal. Our findings show that: (1) this developmental approach incorporated the nurses’ invisible work; (2) nurses’ roles evolved through the accumulation of small changes that included embedding the new routines in organizational structures; (3) the experimental approach supported the professionalization of nurses, enabling them to translate national legislation into hospital policies and supporting the nurses’ (bottom-up) evolution of practices. The new roles required the special knowledge and skills of Bachelor-trained nurses to support healthcare quality improvement and connect the patients’ needs to organizational capacity.ConclusionsConducting small-change experiments, anchored by action and appraisal rather than by design, clarified the distinctions between vocational and Bachelor-trained nurses. The process stimulated personal leadership and boosted the responsibility nurses feel for their own development and the nursing profession in general. This study indicates that experimental nursing role development provides opportunities for nursing professionalization and gives nurses, managers and policymakers the opportunity of a ‘two-way-window’ in nursing role development, aligning policy initiatives with daily nursing practices.

Cuidando do cuidador: Um relato de experiência de intervenções de boas práticas de saúde para profissionais da atenção primária da linha frente na COVID-19

Introdução: Relata-se a experiência da intervenção em saúde denominada: “Cuidando do cuidador”, junto a profissionais da equipe mínima de um Centro de Saúde da Família (CSF). A aplicação desta intervenção teve como objetivo propiciar incentivo, apoio e autocuidado aos profissionais da unidade da linha de frente da pandemia da Covid-19. Metodologia: Trata-se de estudo descritivo e qualitativo, realizado no Centro de Saúde da Família, Dr. Grijalba Mendes Carneiro, localizado em Sobral, zona Norte do Ceará, no mês de outubro de 2020. A intervenção dividiu-se em momentos de aplicação técnicas de relaxamento, com alongamentos, massagens, musicoterapia e meditação guiada, além de educação em saúde com residentes da unidade. Participaram da intervenção: agentes comunitários de saúde, enfermeiros, auxiliares administrativos, técnicos de enfermagem e médico. Resultados: Após a intervenção, foi perceptível a diminuição da tensão destes profissionais, pois precisavam de autocuidado, relaxamento físico e mental após a sobrecarga exaustiva do trabalho na pandemia Covid-19. Os participantes relataram desejo que tais práticas acontecessem com regularidade no CSF. Conclusão: A intervenção mostrou-se relevante ao melhor bem-estar físico e mental desses profissionais, ao reduzir estresse e tensão decorrentes da sobrecarga laboral pandêmica. Assim, promoveu-se autocuidado àqueles que tanto se doam para cuidar do outro.

PENGARUH BEBAN KERJA DAN STRES KERJA TERHADAP KINERJA PERAWAT DI UNIT PELAYANAN RAWAT INAP RSU ANDI MAKKASAU KOTA PAREPARE

This study aims to carefully examine the desired effect of typical workload and work stress on the effective performance of responsible nurses in the Inpatient Service Unit of the Andi Makkasau Hospital, Kota Parepare. This empirical research was carefully conducted for two typically completed typical months, namely February to March 2020. The specific population in that social study in common was all competent nurses in the Inpatient Service Unit of the Andi Makkasau Hospital, Kota Parepare. The active population typically consisted of 161 nurses with a selected sample of 62 nurses. The data analysis tool typically using SPPS. The published results typically showed that 1.) The characteristic work typically causes a direct and significant effect on the used capability of them in the Inpatient Service Unit of the Andi Makkasau Hospital, Kota Parepare, meaning that the increasing efforts to typically handle typical workloads will also increase the effective performance of practical nurses, 2.) Work stress causes a direct and significant effect on work. Nurses in the Inpatient Service Unit of the Andi Makkasau Hospital, Kota Parepare, meaning that the increasing efforts to deal severely with job stress will also increase the efficient performance of them, 3) Of the two independent variables used in obstinately determining the local level of nursey performance, it instantly turns out that work stress variables typically include a dominant influence on nurse performance. In the Inpatient Service Unit of the Andi Makkasau Hospital, Kota Parepare, because it typically has a beta value that is greater than the workload variable.

A IMPORTÂNCIA DO CONHECIMENTO DO ENFERMEIRO NA PREVENÇÃO DAS LESÕES POR PRESSÃO EM PACIENTES SUBMETIDOS À POSIÇÃO PRONA

The aim was to describe the importance of nurses' knowledge in the prevention of pressure injuries in patients submitted to the prone position. The study presents an integrative literature review of an exploratory-descriptive nature. Eleven articles related to the subject of the study were selected. For better understanding, the discussion was divided into categories and subcategories and presented as follows: Integumentary System and Pressure Injury, Factors predisposing to PL, Pronation Position, Nurse's Responsibilities in patients submitted to pronation, The importance of the Nurse's knowledge regarding prevention of pressure injury during the pronation technique, Care plan and nursing interventions in patient management under the pronation technique. Some nursing care is prescribed through care planning, such as: promoting small changes in position and evaluating skin conditions; regularly monitor the tension of invasive device fixtures; keep the skin free of moisture; perform control records of the ventilatory response parameters of the safe pronation technique.

Yöneticilerin Etik Liderlik Davranışları ve Hemşirelerin Örgütsel Adalet Algıları

INTRODUCTION: The study was carried out in order to determine the ethical leadership behaviors of managers and the perceptions of nurses related to organizational justice. METHODS: The universe of this descriptive research was composed of 177 nurses, who were working in a University Hospital. Data were collected through Sociodemographic question form, Ethical Leadership Scale and Organizational Justice Perception Scale. Data, frequency, percentage, arithmetic mean and standard deviation were evaluated with Mann- Whitney U test, Kruskal -Wallis-H test and Spearman correlation analysis. RESULTS: According to the results, the average scores of ethical leadership scale and Organizational Justice Perception Scale of the responsible nurses were significantly higher than the clinical nurses (p<0,05). There was a statistically significanty moderate and positive correlation between nurses’ average scores of Organizational Justice Perception Scale and Ethical Leadership Scale (r=0,645, p<0,05) DISCUSSION AND CONCLUSION: In the study, it was concluded that the nurses found their managers ethical leadership behaviors at a medium level and that nurses’ perceptions of organizational justice are at a moderate level.

Effects of nursing intervention based on forgetting curve theory on disease knowledge and self-management ability in primary liver cancer patients

Objective To explore the effects of nursing intervention based on forgetting curve theory on disease knowledge and self-management ability in primary liver cancer patients. Methods From January 2017 to January 2019, we selected 159 primary liver cancer patients at Beijing Friendship Hospital of Capital Medical University by convenience sampling. All patients were divided into control group (n=75) and experimental group (n=84) with the method of digital grasping. Patients of control group received routine nursing by responsible nurses. Experimental group carried out forgetting curve-based nursing according to different intervention time, 1, 2, 4, 7 and 15 days after being admitted. Knowledge and self-management ability of patients between two groups was evaluated with the Primary Liver Cancer Knowledge Questionnaire and the Self-Management Scale before, 30 days and 3 months after intervention. Results Before intervention, there was no statistical difference in the score of the primary liver cancer knowledge questionnaire of patients between two groups (t=0.496, P>0.05) . A total of 30 days and 3 months after intervention, the scores of the Primary Liver Cancer Knowledge Questionnaire of patients in experimental group were higher than those in control group with statistical differences (t=-8.366, -6.201; P 0.05) . A total of 30 days and 3 months after intervention, the scores of the Self-Management Scale of patients in experimental group were higher than those in control group with statistical differences (t=-6.203, -9.278; P<0.01) . Conclusions Nursing intervention based on forgetting curve theory can improve the disease knowledge and self-efficacy of primary liver cancer patients which is conducive to patients' long-term memory of health knowledge. Key words: Liver neoplasms; Forgetting curve; Nursing intervention; Self-management

DETERMINATION OF OCCUPATIONAL COMPUTER USAGE LEVELS OF NURSES IN MEDICAL INSTITUTIONS: A REAL HOSPITAL CASE STUDY

With the development of technology, the role and responsibility of nurses in various health institutions have diversified. The main purpose of this change is to provide better quality health services to individuals. This research aims to investigate Information Technology Readiness of Public Health Nurses in Turkey. A survey was done with a total of 104 nurses. To measure IT readiness, technological skills readiness, attitude readiness, task-ready information technology readiness and institutional support readiness were evaluated using a five-point Likert scale. The scores of the participants were evaluated as technological skills readiness was 3.83 (76,6 %); attitude readiness was 3.67 (73,4 %), task-ready information technology readiness was 3.85 (77%) and institutional support readiness was 3.65 (73 %). The results of the dimensions show that nurses are extremely prone to use technology in their work. The overall results show that the information technology readiness for nurses has been found at 3.75 (75 %) and needs a few improvements.

Influence of nursing lack on burden of main caregivers among children hospitalized

Objective To explore the influence of nursing lack of nurses at one children's hospital on burden of family members among children hospitalized so as to provide a theoretical basis for lowering the burden of main caregivers in children hospitalized. Methods From June 2018 to April 2019, we selected main caregivers of children hospitalized and responsible nurses at Children's Hospital of Nanjing Medical University as subjects by convenience sampling. The Miss Care Survey and Caregiver Burden Inventory (CBI) were used to investigate the nursing lack of nurses and burdens of family members. Pearson correlation was used to analyze the influence of nursing lack on burden of main caregivers in children hospitalized. A total of 150 questionnaires were sent out and 146 valid questionnaires were collected with 97.33% for the valid recovery rate. Results Among those 146 nurses, the score of the missed nursing care was (99.11±12.85) . A total of 146 nurses were divided into group of nursing lack (n=65) and group of non-nursing lack (n=81) by taking 96 as cutoff value. The scores of the missed nursing care of group of nursing lack and group of non-nursing lack were (92.97±11.37) and (102.31±14.72) respectively. The term scores of the reasons for missed care from low to high were the labor resources, material resources and communication. There were statistical differences in the total score of CBI and scores of time-dependence, developmental, physical, social burden of main caregivers between group of nursing lack and group of non-nursing lack (P 0.05) . Pearson correlation analysis showed that scores of time-dependence, developmental, physical, emotional and social burden had negative correlations with the total score of the miss care survey (P<0.05) . Conclusions The missed nursing care of nurses at Nanjing Children's Hospital is widespread. The missed nursing care has negative correlations with burden of main caregivers in children. Hospital managers should take measures to reduce the missed nursing care so as to lower the burden of main caregivers in children and contradictions between nurses and patients. Key words: Child, hospitalized; Nursing lack; Main caregivers; Burden

A Stepwise Pharmacist-Led Medication Review Service in Interdisciplinary Teams in Rural Nursing Homes.

Background: The provision of responsible medication therapy to old nursing home residents with comorbidities is a difficult task and requires extensive knowledge about optimal pharmacotherapy for different conditions. We describe a stepwise pharmacist-led medication review service in combination with an interdisciplinary team collaboration in order to identify, resolve, and prevent medication related problems (MRPs). Methods: The service included residents from four rural Norwegian nursing homes during August 2016–January 2017. All residents were eligible if they (or next of kin) supplied oral consent. The interdisciplinary medication review service comprised four steps: (1) patient and medication history taking; (2) systematic medication review; (3) interdisciplinary case conference; and (4) follow-up of pharmaceutical care plan. The pharmacist collected information about previous and present medication use, and clinical and laboratory values necessary for the medication review. The nurses collected information about possible symptoms related to adverse drug reactions. The pharmacist conducted the medication reviews, identified medication-related problems (MRPs) which were discussed at case conferences with the responsible physician and the responsible nurses. The main outcome measures were number and types of MRPs, percentage agreement between pharmacists and physicians and factors associated with MRPs. Results: The service was delivered for 151 (94%) nursing home residents. The pharmacist identified 675 MRPs in 146 (97%) medication lists (mean 4.0, SD 2.6, range 0–13). The MRPs most frequently identified concerned ‘unnecessary drug’ (22%), ‘too high dosage’ (17%) and ‘drug interactions’ (16%). The physicians agreed upon 64% of the pharmacist recommendations, and action was taken immediately for 32% of these. We identified no association between the number of MRPs and sex (p = 0.485), but between the number of MRPs, and the number of medications and the individual nursing homes. Conclusion: The pharmacist-led medication review service in the nursing homes was highly successfully piloted with many solved and prevented MRPs in interdisciplinary collaboration between the pharmacist, physicians, and nurses. Implementation of this service as a standard in all four nursing homes seems necessary and feasible. If such a service is implemented, effects related to patient outcomes, interdisciplinary collaboration, and health economy should be studied.

Application effect of quality control circle activities in preseribing nursing order for critically ill patients

Objective To explore the effect of quality control circle activities on improving the correct rate of nursing orders for critically ill patients. Methods A total of 21 senior responsible nurses in ICU, Cardiology Department (CCU) , Cerebrovascular Disease Specialty and Respiratory Department of the Sixth Affiliated Hospital of Guangzhou Medical University were selected as the research objects. Meanwhile, 434 critically ill patients admitted in the above four departments in April 2018 were selected as the pre-activity group of quality control circle. The 419 critically ill patients admitted in October 2018 were compared and analyzed in the post-qcc group. The correct rate of nursing orders of critically ill patients, the qualified rate of basic nursing, posture nursing, the incidence of pressure sores, falls or falling out of bed, and incontinence related dermatitis, the mastery rate of senior responsible nurses on assessment knowledge and the time required for the first nursing order to be issued, the mastery rate of disease condition of critical patients by responsible nurses, and the comprehensive literacy scores of members of quality control circle team before and after quality control circle activities were compared. Results After QCC activities, the correct rate of nursing orders for critical patients, the qualified rate of basic nursing and postural nursing, the mastery rate of senior responsible nurses' knowledge of assessment and the mastery rate of nurses' conditions for critical patients were significantly higher than those before QCC activities, and the time needed for the first nurses' orders was less than that before QCC activities, with statistical difference (P 0.05) . After the activity, the nurses' abilities of quality control, team cohesion, sense of responsibility, coordination and communication, self-confidence and quality improvement were all improved, with statistical difference (P<0.01) . Conclusions The management based on the quality control circle can effectively improve the correct rate of nursing orders for critically ill patients, improve the nursing quality of critically ill patients, the working efficiency and overall literacy of nurses. Key words: Critical illness; Quality control circle; Nursing order; Prescribe; Nursing quality

A qualitative study on the work experience of responsible nurses in day surgery department based on ERAS concept

Objective To understand the working experience of responsible nurses after the day surgery in the ward under the concept of accelerated rehabilitation surgery, in order to provide reference for the development of targeted interventions. Methods In this study, 10 primary nurses in 4 departments of day surgery in Shanghai Tenth People′s Hospital were interviewed by using the method of objective sampling in April-May, 2018. The semi-structured interview was conducted using the phenomenological research method in the qualitative study, and the Colaizzi phenomenological data was used. The analysis method analyzes the interview data. Results Through the repeated refinement, analysis and extraction of the interview data, the following two themes reflecting the work experience of the daytime surgical department responsible nurses: own growth and harvest, difficulties and challenges. Conclusion Based on the concept of accelerated rehabilitation surgery, daytime surgery is carried out to encourage responsible nurses to continuously improve their knowledge level and interpersonal communication skills. The nurses' professional identity is continuously improved. At the same time, due to the increase in nursing workload, the increase in nurse training needs and the incomplete workflow make nursing management Facing new problems and challenges. Key words: Enhanced recovery after surgery; Day surgery; Responsible nurse; Work experience; Qualitative research

Nurses' perceptions and cancer patients' self-evaluation on symptom severity during chemotherapy: a comparative descriptive study

Objective To compare the evaluation result of 10 symptoms including poor appetite in cancer patients during chemotherapy from the patients and their nurses, in order to improve the assessment and judgment ability of the responsible nurses on the symptoms of patients undergoing chemotherapy through the analysis of the result. Methods The study was performed in the chemotherapy unit of a cancer ClassⅢ Grade A hospital in Beijing. By convenience sampling, a total of 192 patients undergoing chemotherapy from October 2017 to January 2018 and the nurses (n=16) who were primarily responsible for their care were selected as participants. Symptom assessments were completed by the use of the Edmonton Symptom Assessment System (ESAS) . Results Patients and nurses showed poor agreement in Depression, Anxiety and Shortness of breath (ICC<0.4) and moderate agreement (0.4≤ICC<0.75) in other symptoms. Wilcoxon signed rank test was used to compare the results of symptom assessment between patients and responsible nurses. Among the 10 entries in ESAS, there was no statistical difference between the results in poor quality of life (Z=-1.627, P=0.104) , however, there were statistical differences in all the rest 9 entries (P<0.05) among which the nurses scored higher than the patients in the entry of anxiety and depression. Conclusions Responsible nurses' perception on physical symptoms was better than that of psychological symptoms, and there was overestimation and underestimation in the severity of symptoms. It is necessary for the nurses to teach the patients how to use standard assessment tools and through health education, raise the patients' awareness of reporting their symptoms. Key words: Neoplasms; Chemotherapy, adjuvant; Symptom assessment; Edmonton Symptom Assessment System

Comparison of predicted incidence of chemotherapy induced nausea and vomiting by medical staff and patients with its actual incidence

Objective To compare predicted incidence of chemotherapy induced nausea and vomiting (CINV) by doctors, nurses and patients with its actual incidence. Methods We used the prospective paired design to select 320 patients with the induced vomiting plan of medicine department at Peking Union Medical College Cancer Hospital by convenience sampling, and we allocated 72 doctors and 48 responsibility nurses for patients. The predicted chemotherapy induced nausea and vomiting scale was filled in by doctors, nurses and patients as required to understand the incidence of CINV predicted by them. After patients completed their chemotherapy, the Chinese version of MASCC antiemesis tool (MAT) was filled out by nurses to investigate the actual incidence of CINV. Results The paired chi-square test showed that the incidence of acute and delayed CINV were 38.75% and 61.25% respectively. There was no statistical difference between the incidence of acute CINV predicted by doctors, nurses as well as patients and the actual incidence (P>0.05) . There was also no statistical difference between the incidence of delayed CINV predicted by nurses and the actual incidence (P>0.05) . Doctors and patients all underestimated the incidence of delayed CINV with a statistical difference (P<0.05) . The consistency between the incidence of acute as well as delayed CINV predicted by doctors, nurses, patients and the actual incidence was poor with Kappa value ranging from 0.02 to 0.34. A total of 54.93% to 57.77% of doctors and nurses predicted that CINV could be controlled well lower than that (about 70%) of patients with statistical differences (P<0.05) . Conclusions There is still much improvement space for control of delayed CINV. Medical staff should take effective measures to improve the level of estimate and the level of CINV symptom management, and to improve the quality of life among patients. Key words: Nausea; Vomiting; Drug therapy; Medical staff; Neoplasms patients

Nurse's social responsibility: A hybrid concept analysis in Iran.

Background: Social responsibility in nursing is a complex concept that is completely associated with the context and healthcare system of every society. This study was conducted to analyze the concept of nurse’s social responsibility in Iran. Methods: This analysis was done using a hybrid model, which consists of three phases: a literature review in the theoretical phase, semi-structured interviews in the fieldwork phase, and combination of the results of the two previous phases in a final analytical phase. Results: The four main themes extracted in the theoretical phase included: "Multi-dimensional and comprehensive approach", spirituality-based, learner-based and an evolutionary-process. In the fieldwork phase, all the themes obtained in the previous phase were confirmed, and one more theme emerged as "being relative". In the final phase, with the combination of the results of two previous phases, the final definition of the concept was presented. Conclusion: Clarifying the social responsibility of nurses and highlighting it in nursing will definitely lead to satisfaction in patients and clients, professional development and reduction of health care costs. Also, by identifying facilitators, inhibitors and social responsibility concepts, nursing managers and nursing educators will be able to design and implement their management and training activities based on scientific findings based on the findings that are necessary for the correct learning and implementation.

Effects of transcutaneous electrical acupoint stimulation on pain of patients in expansion process of skin soft tissue dilator on forehead by water injection

Objective: To explore the effects of transcutaneous electrical acupoint stimulation (TEAS) on pain of patients in expansion process of skin soft tissue dilator on forehead by water injection. Methods: From June 2016 to June 2017, 100 patients in expansion process of skin soft tissue dilator on forehead by water injection meeting the inclusion criteria were admitted to Outpatient Department of Orthopedic Surgery of Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. There were 43 men and 57 women among the patients, aged 27 to 55 years, and the prospective randomized controlled study was performed on them. The patients were divided into TEAS nursing group and routine nursing group according to the random number table, with 50 patients in each group. Patients in routine nursing group were performed with routine nursing in every water injection in outpatient department and 2 days later. On the basis of routine nursing, patients in TEAS nursing group were performed with TEAS treatment by responsible nurses in each water injection in outpatient department. The Shangxing, Diwei, and Hegu points were positioned accurately, and electrical stimulation was performed on the 3 points simultaneously by pulse acupuncture treatment instrument, with 30 minutes each time. Two days after every water injection of outpatient department, TEAS nursing was performed at home by patients and their family members under remote guidance of the responsible nurses, with 2 times each day and 30 minutes each time. Besides, follow-up was done by phone by the responsible nurses everyday. The nursing of patients in the 2 groups lasted the whole expansion process. After the expansion process, the overall pain degree and the most severe pain degree of patients during expansion process were scored by numerical rating scale, and the overall comfort degree and its dimensions of patients during expansion process were scored by the responsible nurses every day by simplified Comfort Status Scale. Data were processed with independent sample t test and chi-square test. Results: During expansion process, the overall pain score degree and the most severe pain degree score of patients in TEAS nursing group were (5.4±1.2) and (6.5±1.0) points, which were significantly lower than (6.1±1.3) and (7.5±1.4) points of patients in routine nursing group (t=-2.62, -4.00, P<0.05 or P<0.01). During expansion process, the physiological dimension, sociocultural dimension, psychological spirit dimension, environmental dimension, and total score of the overall comfort degree of patients in TEAS nursing group were (9.6±2.9), (20.1±2.8), (29.1±1.9), (22±3), and (80±6) points, significantly higher than (5.7±2.1), (16.8±2.8), (26.0±2.8), (21±4), and (69±8) points of patients in routine nursing group (t=8.03, 6.35, 7.60, 2.11, 10.64, P<0.05 or P<0.01). Conclusions: TEAS with appropriate intensity, frequency, and duration can alleviate the pain of patients during expansion process of skin soft tissue dilator on forehead by water injection and improve their comfort degree.

Knowledge of responsible technical nurses on management skills: a qualitative study.

To identify the knowledge of responsible technical nurses in relation to the general and management skills required to perform this function. Qualitative case study with 14 nurses. The semi-structured interviews were recorded and the data analyzed through the thematic content analysis. Two categories stood out: Main Responsibilities for the Position of Technical Manager: Leadership, Interpersonal Relationship and Systemic view; and Developing Skills: Dissociation between Theory and Practice. The fact that only three skills have been recognized as necessary for the exercise of the function of technical leader and the perception of the interviewees about the dissociation between theory and practice during graduation should be explored by the teaching and health institutions, because to exercise this nurses must develop the technical-scientific, socio-educational and ethical-political skills to be able to lead the organization to positive results..

Application of multidisciplinary combined intervention in rehabilitation and nursing of Parkinson's disease patients

Objective To explore the application effect of multidisciplinary combined intervention in rehabilitation nursing of patients with Parkinson's disease. Methods A total of 100 Parkinson's patients admitted from July 2016 to January 2017 were selected, and the eligible patients were randomly divided into the control group and the experimental group with 50 cases of each group. In the control group, routine rehabilitation nursing and health guidance were adopted, namely, propaganda and education were carried out after admission, and propaganda, education and guidance of disease and rehabilitation knowledge were carried out daily by the responsible nurses. The experimental group received rehabilitation training under the guidance of a professional group. After discharge and 6 months after discharge, the two groups of patients were evaluated for Parkinson's rehabilitation training effect and daily life ability, and the scores were compared. Results After rehabilitation training, two groups of patients with MDS-UPDRSS Ⅲ and ADL scores than before treatment improved(P<0.05). The experimental group MDS-UPDRSS Ⅲ and ADL scores were significantly higher than the control group(P<0.01). Conclusions Multidisciplinary combined intervention is a comprehensive nursing intervention method, which is helpful to improve the effect of rehabilitation nursing for Parkinson's disease patients and improve their quality of life. Key words: Multidisciplinary collaboration; Parkinson; Rehabilitation nursing

Evaluation of Attitude and Performance of Nurses Attending In-service Training courses Regarding the Use of Professional Ethics in Educational Healthcare Centers of Zanjan, Iran

Background and Objective: The healthcare system seeks responsible nurses, who are committed to professional ethics, which is a vital requirement in this area. Therefore, this study aimed to determine the role of in-service training courses in the attitude of nurses toward professional ethics and their performance in three educational healthcare centers of Zanjan, Iran. Materials and Methods: This descriptive and cross-sectional research was performed on 400 nurses in educational healthcare centers of Zanjan, including 362 female (90.5%) and 38 male (99.5%) individuals, who were selected via convenience sampling. Data collection was carried out using the standardized questionnaire of ethics in nursing profession by Eun-Ja Yeun (2004) in the spring of 2018. Reliability of the mentioned survey was estimated at the Cronbachs alpha of 0.76. Data analysis was performed in SPSS version 21 at two descriptive and inferential levels. Results: From 400 nurses assessed, 53.5% attended the educational courses on professional ethics. According to our findings, no significant difference was observed between the subjects who attended the courses and those who did not participate in the educational classes in terms of attitude toward professional ethics. Moreover, no significant association was found in the performance of participants who attended the mentioned classes before and after the intervention. Conclusion: According to the results of the study, participation in educational courses on professional ethics failed to make a significant difference in the attitude and performance of nurses. Therefore, more attention must be paid to the implementation of educations and place of work of nurses.

Comparing effects of sensory stimulation by nurses and family members on unconscious patients with severe traumatic brain injury

Objective To evaluate the clinical effects of sensory stimulation provided by nurses and family members respectively on waking up unconscious patients with severe traumatic brain injury. Methods A total of 92 unconscious patients with severe traumatic brain injury admitted in the Intensive Care Unit, Neurosurgery Department, Affiliated Hospital of Nantong University between May 2016 and May 2017 were selected and divided into two groups according to the random number table. Patients in the control group received sensory stimulation by nurses, while patients in the observation group received sensory stimulation by family members. The Glasgow Coma Scale (GCS), Western Neuro Sensory Stimulation Profile (WNSSP), Rancho Los Amigos Scale (RLA) and electroencephalogram examination (EEG) scores were compared between the two groups before and after the intervention. Results There was no statistical difference in the scores between the two groups before the sensory stimulation (P>0.05). Two weeks post the intervention, there were statistical differences between the control group and the observation group in GCS [(7.28±1.86) vs. (9.78±2.01)], WNSSP [(13.23±10.07) vs. (47.48±14.32)]and RLA [(2.15±0.98) vs. (3.20±1.30)]scores (P 0.05). Conclusions Sensory stimulation can enable the unconscious patients with severe traumatic brain injury to regain consciousness, cognitive and sensory functions. The sensory stimulation provided by caregivers is better than that by responsible nurses, and the former is better in accelerating the patients' rehabilitation. Key words: Brain injury; Coma, post-brain traumatic; Nurses; Caregivers; Sensory stimulation

Application of nursing outcomes classification in self-control of risk factors in elderly coronary heart disease patients

Objective To evaluate the ability of controlling risk factors in elderly patients with coronary heart disease (CHD) with nursing outcomes classification (NOC) . Methods A total of 146 elderly CHD patients treated in Daqing Longnan Hospital, the Fifth Affiliated Hospital of Qiqihar Medical School between January and June 2016 were enrolled in the study. All the study subjects were divided into control group (n=70) and experimental group (n=76) by random number table method. The control group was given routine nursing, while the experimental group was analyzed by the Risk Control: Cardiovascular Health and Cardiac Pumping Effect scales in NOC system 1 month after discharge and given interventions. The indicators of NOC of the patients and assessment of nursing staff were compared between the two groups. Results The differences in the scores of NOC indicators between control group and experimental group were statistically significant (P<0.05) . The indicators were angina pectoris, medication compliance, cognitive status, peripheral pulse, systolic blood pressure, diastolic blood pressure, recognition of cardiovascular risk, and monitoring of blood pressure, applying stress management techniques, participating in cholesterol screening, following recommendations for preventive measures related to over-the-counter drugs, participating in aerobic exercise, recognizing the ability to change behavior, and avoiding smoking. The relevant knowledge level and skill assessment of the responsible nurses in the experimental group were better than those in the control group (P<0.05) . Conclusions The ability to control risk factors in elderly patients with CHD needs to be strengthened from the perspective of patients. Individualized programs should be implemented according to patients' specific conditions. Key words: Aged; Coronary heart disease; Nursing outcomes classification