The impact of nursing care on client outcomes must be visible if nursing is to obtain its share of the health care dollar. The first step in substantiating nursing's input on health care is to describe the responsibilities for which nurses are accountable. The ANA Standards of Clinical Nursing Practice (1991a) identify those responsibilities, setting the stage for implementing practice guidelines.

American Nurses' Association↗

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Coming full circle: mentorship in HIV/AIDS care.

The role of the mentor has been found to be crucial for learning, yet mentorship in HIV/AIDS nursing care has not been well documented. The purpose of this study was to (a) examine the characteristics of a nurse mentor in HIV care as perceived by nursing and medical students and HIV staff, and (b) explore an HIV nurse mentor's perceptions of her role and responsibilities in the professional development of students and staff. Mentorship, as a process of "coming full circle," was highlighted by the mentor's accounts of early influences in her career as well as students' and staff members' intents to facilitate the professional development of the next generation. The legacy of excellent HIV nursing care can be continued if expert HIV nurse mentors are identified and encouraged to work with students, inexperienced nurses, and health care providers. Health care institutions have a responsibility to foster mentorship in HIV/AIDS care to assure quality health care for clients and the professional development of expert nurses in HIV/AIDS care.

Acquired Immunodeficiency Syndrome↗

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Mission, staffing, and budget data of flight programs in the United States.

INTRODUCTION: Manage care and other health care reform initiatives have forced all hospitals to evaluate their work processes. In this era of cost containment, many flight programs are examining the structure of their programs to determined whether they are functioning in an efficient, cost-effective fashion. METHODS: A survey was sent to the chief flight nurse of 240 flight programs in the United States. RESULTS: Eighty-five programs (35.4%) responded. Data were collected on demographics, management structure, mission information, staffing issues, and budgets. Results in each program varied widely. CONCLUSION: Benchmark data are available against which programs can compare themselves. Such comparisons may allow the discovery of opportunities to enhance program efficiency and cost-effectiveness.

Air Ambulances↗

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From silencing the self to action: experiences of women living with HIV/AIDS.

Feminist literature has demonstrated that women often maintain behaviors that support silencing of their voices. The critical issue is whether the silencing experience is (a) a destructive process of burying feelings and needs, (b) a protective strategy to preserve personal and professional relationships which they value, (c) a coping mechanism to divorce themselves from an androcentric/ethnocentric health care culture, or all of these. The transition from silence to action may be a process of reacting to a threat to self (i.e., HIV/AIDS diagnosis) where gender normative behaviors become irrelevant and self-advocacy becomes paramount for survival. Alternatively, the transition may be a conscious process of gaining insight into past behaviors that have been learned and culturally supported and making purposeful changes. Data for this study were extracted for secondary analysis from data from a larger study on experiences and needs of persons living with HIV/AIDS. Data were obtained from transcripts from three focus groups (N = 14 women) and six individual interviews. Women ranged in age from 21 to 55; 9 were European American, 7 were African American, and 4 were Latina American. Data were content analyzed and organized using four categories proposed by Jack (1991): (a) externalized self-perception, (b) care as self-sacrifice, (c) silencing the self, and (d) the divided self. Data supported that women with HIV/AIDS reported all four categories of silencing behaviors, particularly early in the HIV trajectory. For some women, an HIV/AIDS diagnosis ignited them to speak for themselves and to shape their own lives based on feelings and needs. For others, peer or professional support or both was the catalyst for the transition from silence to action. Findings suggest interventions that would assist women in judging themselves by internal versus external standards, putting their own needs before the perceived needs of others, expressing themselves toward action rather than avoidance, and feeling comfortable expressing anger.

Adaptation, Psychological↗

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Risk classification, clinical outcomes, and the use of nursing resources for cardiac surgery patients.

Several studies have used risk classification models to examine the effect of preoperative risk factors on operative morbidity and mortality. However, previous research has not linked risk classification models to factors such as frequency of postoperative complications, length of intensive care unit stay, mortality, and the use of nursing resources. This article reports on significant differences in clinical outcomes and hours of nursing care by risk classifications.

Aged↗

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Students' decisions to select HIV services for clinical experiences.

The ever-growing numbers of persons living with HIV/AIDS emphasizes the need for highly trained healthcare professionals to care for this population. Understanding why nursing and medical students would choose HIV services for clinical rotations, and the impact of those clinical experiences on their future professional practice, is key to recruiting healthcare providers to care for this population.

Adult↗

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Relationships between certification and job perceptions of oncology nurses.

PURPOSE/OBJECTIVES: To explore relationships between oncology nursing certification and oncology nurses' job perceptions. DESIGN: Descriptive, correlational. SETTING: Questionnaire mailed to homes of Oncology Nursing Society (ONS) members. SAMPLE: 703 certified and 514 noncertified ONS members (N = 1,217; 50% response rate). METHODS: Data were collected using survey methods and grouped by respondents' certification status for statistical analysis. MAIN RESEARCH VARIABLES: Certification, group cohesion, organizational commitment, and job satisfaction. FINDINGS: Certification was weakly correlated with cohesion, commitment, and satisfaction. Work setting, rather than certification, accounted for differences in job perceptions. Job perceptions were most positive in settings characterized by a high percentage of patients with cancer (> 75%), a high percentage of RNs (> or = 80%), and monetary support for continuing education. CONCLUSIONS: The hypothesis that oncology nurses' certification status is associated with job perceptions that are valued by employers was not supported. IMPLICATIONS FOR NURSING PRACTICE: Nurses' job perceptions have been linked to control over nursing practice and participation in organizational and clinical decision making. Managerial strategies that empower certified nurses to practice with more autonomy and participate in decisions that affect patient care should be emphasized.

Adult↗

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Recovery from coronary artery bypass surgery: age-related outcomes.

As people age, their incidence of coronary heart disease increases. The majority of persons undergoing invasive procedures such as coronary artery bypass surgery are 65 and older. Because of population trends related to aging, it is projected that there will be exponential increases in the numbers of people requiring treatment for this health problem in the future. Changes in health care reimbursement have significantly decreased hospital length of stay, resulting in many patients completing their recovery either in a rehabilitation facility or at home. Patients with multiple preoperative comorbidities are at risk for postoperative complications. Older patients usually have more health problems after coronary artery bypass surgery because they have more risk factors prior to the procedure. It is not known whether there are differences in outcomes between comparatively older and younger patients when they are matched by risk classification. Information on the recovery of patients at home will enable nurses to meet their care needs prior to surgery and after discharge from the hospital.

Age Factors↗

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Student contributions to clinical agencies: a comparison of adult health and psychiatric staff nurses' perceptions.

Clinical rotations in acute medical and psychiatric inpatient facilities are an essential component of the education for undergraduate nursing students. The benefits students receive from these clinical experiences have been documented, but no data have been reported regarding the advantages that students may bring to agencies. This exploratory study, which used a mail-back survey, asked adult health/medical-surgical nurses and mental health/psychiatric nurses in acute care units about the effects undergraduate nursing students had on staff time, staff development, quality of care, staff's personal satisfaction, and unit standards and practices during their clinical rotations. Results indicated that students contribute to the personal and professional satisfaction of the staff by offering opportunities for mentoring and reciprocal learning and allowing nurses to participate in students' professional development. Students also contribute to patient care.

Adult↗

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Food intake of women with breast cancer during their first six month of chemotherapy.

Significant alterations in the nutritional patterns of the patient with cancer can inhibit the patient's ability to combat the disease and withstand the impact of cancer treatments. This study compared the food intake patterns of women with breast cancer receiving adjuvant chemotherapy with those of healthy women to determine if significant alterations in food intake occurred during the first six months of treatment. Results indicated that, although alterations in taste did occur, food aversions did not develop. Throughout the study, women with breast cancer were eating a significantly greater number of calories and food servings than women who did not have breast cancer. The women with breast cancer were likely to report taste changes for foods such as beef, pork, chicken, coffee, and cakes. However, these taste changes could not account for alterations in dietary intake.

Adult↗

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Using statistical packages to analyze effectiveness.

Explore the source record for details and available documents.

Data Interpretation, Statistical↗

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Quality of life and nutritional support in patients with cancer.

Nutritional support is often initiated in patients with cancer who are unable to meet their nutritional needs by the oral route. Much has been written about the effect of nutritional support on physiological outcomes in patients with cancer. However, less is known about the relationship between improvement of nutritional status and quality of life. Trends in the treatment of cancer highlight the need for an examination of home nutrition support and quality of life. The purpose of this article is to describe the state of knowledge about the relationship of home enteral and parenteral nutrition support and quality of life. Research exploring the dimensions of quality of life (physical functioning, psychological status, interpersonal relationships and social functioning, financial concerns, and symptoms, and complications of nutritional support) is presented. Implications for clinical practice and research are identified. The trend for increased numbers of patients on home nutrition support emphasizes the need to understand the patient's and family's experience in managing this treatment in the home.

Enteral Nutrition↗

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Impact of risk classification on nursing resource utilization, postoperative length of stay, and hospital costs for cardiac surgical patients.

Outcomes after cardiac surgery are a concern for patients, health care providers, and insurers. Because of the current economic climate, there is a demand for positive outcomes and an evaluation of negative results. The results of this study showed significant differences in nursing resource utilization, postoperative length of stay, and hospital costs by risk classification group. Risk classification models could serve as a template for staffing patterns and reimbursement based on patients' clinical profiles.

Aged↗