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Biomedical subjects

L M Janelli

Publications and source records attributed to L M Janelli.

At least 19 recordsLinked to original sources
PubMed1995

Physical restraint use in acute care settings.

Increasing reliance on physical restraint devices within hospital settings can be attributed to many reasons, perhaps including litigation. Restraint use represents a quality improvement issue; therefore, a review of all studies involving restraints in acute care settings was conducted. Results of a descriptive study using focus groups is also included. The focus groups explored the decision-making process nurses used in restraining or releasing a patient from a mechanical device.

Acute Disease↗
PubMed1995

Focus groups: nursing staff's experiences using restraints.

A phenomenological approach was used to examine nursing staff's experiences using physical restraints. A total of 12 nurses from a tertiary hospital participated in one of three focus groups. Exploring the attitudes of nurses can contribute to a better understanding of how decisions are made concerning restraints. An analysis of the focus group data resulted in a description of the lived experiences of nurses using restraints. Seven themes emerged from the data, one of which reflected that the nurses felt ambiguous about restraints, yet they made judgments and justified their decisions after assessing patient characteristics, environmental safety, and unit traditions. Nurse clinicians could use the focus group method to sensitize themselves to the staff's needs and to allow staff the opportunity to share ideas and to dispel misconceptions about restraints.

Attitude of Health Personnel↗
PubMed1994

Nursing administrators' perceptions of critical care CNSs.

The literature has demonstrated inconsistencies among nursing administrators in their perceptions of the CNS role functions. Nursing administrators from 198 hospitals were surveyed: (a) to determine the current use of the critical care CNS, (b) to identify the importance placed on the critical care CNS role functions (expert clinician, educator, consultant/change agent, researcher, manager), (c) to ascertain perceptions of specific activities related to each role function, and (d) to determine any differences in perception of role functions between administrators who employed critical care CNSs and those who did not. Nursing administrators who employed critical care CNSs ranked the role of expert clinician as most important, followed by educator, consultant/change agent, and researcher. The role of manager was ranked least important. Nursing administrators who did not employ critical care CNSs ranked the roles in the following order of importance: expert clinician, educator, consultant/change agent, manager, and researcher.

Attitude of Health Personnel↗
PubMed1994

Physical restraints: has OBRA made a difference?

1. A component of the Omnibus Budget Reconciliation Act of 1987 declared that nursing home residents have the right to be free from physical or chemical restraints that are not required to treat specific "medical symptoms." 2. The literature suggests that the use of restraints has a negative influence on the caregiving process by restricting creativity and individual treatment. 3. Decreased reliance on restraints can be accomplished in nursing homes without an increase in staffing. 4. Transition to limited restraint use requires an organized, planned effort to change attitudes, beliefs, practices, and policies of a facility.

Aged↗
PubMed1991

The nursing dilemma of restraints.

This study provides a data base for developing intervention strategies aimed at helping staff cope with concerns regarding restraints. Most respondents believe patients should be restrained for safety even if it means loss of dignity, and that a caring manner should be conveyed to restrained patients. A large percentage felt that family members did not have the right to refuse the use of restraints, but that they should have that right if they were patients, suggesting negative attitudes toward restraints, of which they are unaware. Personal and professional characteristics, such as knowledge about restraints, years in geriatrics, and experience with elderly family members, showed no significant relationship to attitudes.

Adult↗
PubMed1987

Motivational factors that affect the retention of reserve nurses in eight aeromedical evacuation flights.

The purpose of the study was to identify the motivational factors which contribute to the retention of reserve flight nurses in aeromedical evacuation flights. Almost all units experience some difficulty in retaining nurses, and with the reserve program becoming increasingly complex, this problem is likely to become more severe. The motivation maintenance theory developed by Frederich Herzberg contends that two sets of factors can impinge on job satisfaction. Hygiene factors such as salary and working conditions can lead to job dissatisfaction. Motivators, such as job content and professional achievement are job satisfaction factors. A convenience sample of 69 reserve flight nurses from 8 flights was utilized in the survey approach. Participants filled out a Demographic Questionnaire, and a Reserve Flight Nurse Satisfaction Questionnaire. The results confirmed the proposed hypotheses in that not only were the nurses able to identify motivational factors, but that these factors had more impact on job satisfaction than did the hygiene factors.

Adult↗
PubMedDate not supplied

Can a pulmonary health teaching program alter patients' ability to cope with COPD?

Many clinical nurse specialists (CNSs) are involved in providing group teaching programs for individuals with chronic obstructive pulmonary disease (COPD). Although knowledge levels often are enhanced by these programs, what is less well known is whether such programs also can affect the coping methods used by those with this disease. The exploratory study described here was part of a larger research project aimed at determining patients' knowledge, specific psychological parameters (anxiety, hostility, depression), and coping strategies. Thirty people agreed to participate in the study. The Jalowiec Coping Scale (JCS) (Jalowiec & Powers, 1981) was used so that participants could rate each coping method according to the degree of use and to determine whether the methods employed were affective or problem-solving approaches. There was very little change in the pre- and posttest scores on the JCS, indicating that there was little change in coping strategies used. There also were no significant correlations between the JCS scores and the demographic characteristics of age, educational level, and the length of time since diagnosis of COPD. The results of this study seem to indicate that pulmonary rehabilitation programs should place more emphasis on appropriate coping strategies that the COPD patient can incorporate into his or her lifestyle.

Adaptation, Psychological↗
PubMedDate not supplied

What nursing staff members really know about physical restraints.

Although the use of physical or mechanical restraints is decreasing in long-term care facilities, there always will be some patients who require them. If a restraint is to be employed at all, it needs to be used correctly. A convenience sample of 118 nursing staff members who work in a county nursing home was asked to complete an 18-item knowledge questionnaire regarding restraint usage. Scores ranged from 6 to 17 (potential range 0-18), with a mean score of 13.2 (SD = 2.1). Overall, the staff's knowledge level can be considered good; however, there were some areas of concern. For example, a majority of the respondents (82.2%) believed that it was appropriate to keep a patient restrained lying flat in bed. Implications for administrators and rehabilitation nurse clinicians are identified.

Adult↗
PubMedDate not supplied

Acute/critical care nurses' knowledge of physical restraints--implications for staff development.

The use of physical restraints in acute care facilities has become a routine practice. Although nursing home settings have been federally mandated to reduce reliance on restraints, there has been no indication of a reduction in hospital settings. Staff development educators can provide guidance in the proper use of restraints. A total of 235 acute/critical care nurses from 17 states were asked to complete an 18-item knowledge questionnaire about the proper use and application of restraints. A majority (n = 142; 60.4%) had 13 of the 18 questions correct. The results suggest variability in knowledge about restraints due most likely from lack of information rather than misinformation. One hundred fifty-four nurses (65.6%) stated they were unsure about caring for a restrained patient. The authors describe implications of the study findings for nursing staff development and offer an outline for an inservice program on restraint use.

Adult↗