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Biomedical subjects

Patricia R Ebright

Publications and source records attributed to Patricia R Ebright.

5 recordsLinked to original sources

Themes surrounding novice nurse near-miss and adverse-event situations.

OBJECTIVE: The study purpose was to identify human performance factors that characterized novice nurse near-miss/adverse-event situations in acute-care settings. BACKGROUND: Increased focus on recruitment and retention of newly graduated registered nurses (RNs) in light of patient safety improvement goals will challenge healthcare educators and administrators. What we are beginning to learn about human performance issues during real work situations from patient safety research provides information related to human performance in complex environments that may guide education and system supports for novice RNs. METHODS: Data collected during 8 retrospective interviews of novice RNs about details surrounding their individual near-miss or adverse event were analyzed for common themes. RESULTS: Nine themes were identified. Seven themes were present in at least 7 of the 8 cases and included environmental and social issues, as well as novice lack of expertise. CONCLUSIONS: Findings suggest that support for novice nurses in acute care environments requires attention to the following: consistent availability of expertise in light of workload unpredictability, the social climate regarding expectations of novice performers, realistic expectations of novice decision-making ability during complex situations even up to a year after graduation, and strategies to recognize and intervene when novices are at risk for error.

Adult↗

Understanding the complexity of registered nurse work in acute care settings.

Nursing shortages and patient safety mandates require nursing managers and administrators to consider new ways of understanding the complexity of healthcare provider work in actual situations. The authors report findings from a study guided by an innovative research approach to explore factors affecting registered nurse performance during real work on acute care medical-surgical units. Our findings suggest beginning targets for interventions to improve patient safety, as well as recruitment and retention, through support for registered nurse work.

Attitude of Health Personnel↗

The "New Look" approach to patient safety: a guide for clinical nurse specialist leadership.

This article describes a complex system model based on human performance factors that is borrowed from other industries but can be used by clinical nurse specialists for making progress in patient safety. Traditional approaches to investigation and follow-up of errors in healthcare organizations have not resulted in improvement in patient safety. The New Look approach described in this article emphasizes the complexity in which healthcare workers make decisions about patient c are every day and how increased learning about the resiliency of healthcare workers in the face of multiple system gaps and discontinuities will lead to long-lasting improvements in safety. The article describes how the clinical nurse specialist can lead efforts using the New Look human performance-based approach in 4 areas: changing to a nonpunitive culture, learning about system complexity, learning about healthcare worker resiliency, and preparing for the complexity of introducing change.

Humans↗

Understanding hope and factors that enhance hope in women with breast cancer.

PURPOSE/OBJECTIVES: To examine the extent to which antecedent variables and appraisals differentiate levels of hope in women during treatment for breast cancer. DESIGN: Descriptive, correlational. SETTING: Two large midwestern urban areas. SAMPLE: 73 Caucasian women between the ages of 20-73 with first-time diagnosis of breast cancer; recruited through five physician offices; within three months after surgical intervention with planned chemotherapy, radiation therapy, or tamoxifen; and able to read English. METHODS: Identical surveys mailed to participants 3 and 12 months after surgery. Instruments included Lazarus' Appraisal Components and Themes Scales, Herth Hope Index, Rosenberg's Self-Esteem Scale, Personal Resource Questionnaire 85-Part 2, Helpfulness of Religious Beliefs Scale, and demographics questionnaire. MAIN RESEARCH VARIABLES: Appraisal, hope, self-esteem, social support, and helpfulness of religious beliefs. FINDINGS: Variables influencing appraisals during breast cancer treatment on both surveys were self-esteem and helpfulness of religious beliefs. Potential for coping appraisals and self-esteem contributed to variation in hope at both time points. Social support was a significant contributor to hope in the 12-month survey. Appraisal themes reflected challenge but not fear. CONCLUSIONS: Self-esteem and helpfulness of religious beliefs influence women's appraisals regarding the potential for coping; appraisals and antecedent variables relevant for differentiating hope are beliefs about the potential for coping, self-esteem, and social support. IMPLICATIONS FOR NURSING: Care of women with breast cancer during the first year of treatment should include assessment of beliefs regarding the potential for coping. Results suggest that support for interventions related to self-esteem, social support, and helpfulness of religious beliefs increase confidence in coping abilities and hope.

Adaptation, Psychological↗