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Establishing competency in the use of North American Nursing Diagnosis Association, Nursing Outcomes Classification, and Nursing Interventions Classification terminology.

The purpose of this study was to evaluate a 16-hour intervention designed to build clinician competency in the use of North American Nursing Diagnosis Association (NANDA), Nursing Outcome Classification (NOC), and Nursing Interventions Classification (NIC) (hereinafter: N3) among nurses with limited N3 knowledge. Each of 19 pairs of nurses independently selected N3 terms and rated the outcomes applicable to an actual patient for a specified time. A pair-through discussion then created a single consensus patient profile of the applicable terms. Before discussion, pairs agreed on 46% of the NANDA diagnoses, 30% of the NOC outcomes, and 20% of the NIC interventions selected. Eighty-nine percent of NOC label pair ratings were within 1 point. Building competency in N3 requires consistent use in written and oral communication with peers across time. Inter-rater reliabilities (IRRs) for NOC label ratings support previous findings.

Clinical Competence↗

Surviving the nursing shortage: developing a nursing orientation program to prepare and retain intensive care unit nurses.

The shortage of nurses has reached crisis proportions around the world. In response to a critical shortage of qualified neonatal intensive care nurses, one institution developed an educational program so comprehensive that they were able to increase their nursing staff by 20% and staff the neonatal intensive care unit with well-prepared and proficient nurses. This strategy has also resulted in high retention rates, a decrease in overtime, and a relatively low error rate by new nurses.

Attitude of Health Personnel↗

Nurses, nursing and representation: an exploration of the effect of viewing positions on the textual portrayal of nursing.

Textual portrayals of nursing can be 'read' from a number of possible viewing positions, which play a very real part in the way that our reality is constructed and understood. The image depends on which viewing position is chosen by or constructed for the viewer, and how the viewer interacts with that position. Thus without the viewer the image is incomplete. This paper is a beginning exploration of the nature of texts that portray nursing, and what Kaplan has termed the 'delicate negotiation' between the reader and the text in producing, in this case, understandings of nursing. Consequently the discussion focuses on how texts represent nursing, not in terms of what they portray, but how understandings of that portrayal are arrived at. This is to move exploration of portrayals of nursing from the descriptive to the discursive realm. In so doing the aim is to begin to explore and uncover the way in which we are positioned, and position ourselves, as readers of portrayals of nursing in text.

Attitude↗

A nurse is a nurse? A systematic review of the effectiveness of specialised nursing in breast cancer.

The effectiveness of specialised nursing in breast cancer has received limited attention. This systematic literature review aims at (i) presenting and discussing role models of specialised nursing in the area of breast cancer and (ii) suggesting avenues for future research in this field. The ten studies included in the review differ with respect to the roles of specialised nurses as well as the measured outcome variables; thus, the comparability and generalisability of results are limited. Nevertheless, the review indicates that specialised nursing in breast cancer may contribute to improved physical and psycho-social well-being. In view of the limited comparability, the authors call for (i) a more uniform definition of models of specialised nursing in breast cancer care, as well as (ii) rigorous confirmatory studies to evaluate their effectiveness. These two aspects are pivotal in providing a reliable basis for future health care strategies.

Breast Neoplasms↗

[The importance of cultural coding in nursing practice, nursing research and nursing science--components of a critical concept of culture].

Based on the question, on which conditions the understanding of the strange is possible at all, this article points out--illustrated by research material on nursing practice, nursing education and nursing science--collective interpretative patterns that are based on binary codings like "nature-culture", "body-mind", "female-male", "strange-familiar", foreign-native", "you-we", "sick-healthy", "black people-white people", etc. These patterns and the value judgements expressed by them are social constructions within specific in certain historical and cultural contexts. Yet people neither experience collective interpretative patterns nor recognize them as such, but deal with them as if they were natural facts. This (unrecognised) process of naturalization of social-cultural phenomena provokes contradictions and conflicts in all fields of practical life--in nursing practice and nursing education too, which will be shown by examples. To describe and analyse these complex circumstances, an approach to a critical concept of culture is developed in this article. The approach includes social-cultural events, processes and structures as well as their implicated symbolization. However, this heuristic construct itself must not be naturalized and "essentialized".

Attitude to Health↗

Developing nurse practitioners to develop practice: the experiences of nurses working on a nursing development unit.

AIM: To elicit nurses' accounts of their involvement with nursing research and their interpretations of the meaning of these projects for their practice. BACKGROUND: The links between research and practice development in health care are poorly understood and require further exploration in the light of the emerging research and development agenda within the National Health Service. METHODS: Semi-structured interviews were conducted with 15 qualified nurses working on a Nursing Development Unit. The interviews were tape recorded, transcribed and analysed thematically. FINDINGS: Data analysis identified two distinct groups--a core group of nurses actively engaged in the research projects and a peripheral group involved in data collection. The characteristics of the core group mirror the characteristics of those involved in nonresearch-based practice development activities. CONCLUSIONS: Engaging in research activities does not always result in the development of practice, however, there appears to be a link between practice development and critical thinking.

Attitude of Health Personnel↗

Summary report on American nurse career-pattern study: baccalaureate degree nurses ten years after graduation: National League for Nursing, Division of Research, New York, U.S.A., March 1979.

The Nurse Career-Pattern Study, conducted by NLN's Division of Research, is a longitudinal study of nurses at 1, 5, 10, and 15 years after graduation from the four types of nursing education programmes. Participants in the study are individuals who entered a sample of associate degree, baccalaureate, diploma and practical nursing programmes in the autumn of 1962; and associate degree, baccalaureate and diploma programmes in the autumn of 1965 and 1967. Each group is followed separately, and the data collection for the four concurrent studies is staggered because of the varying lengths of programmes and times of graduations. According to project director Lucille Knopf, the study is designed to describe the career patterns of participants, their contributions to the health labour force, and the factors influencing their nursing careers.

Career Mobility↗

Creating consensus about nursing outcomes. II. Nursing outcomes as agreed by patients, nurses and other health professionals.

The questions 'what is it that you want from nursing?' and 'how would you know when you have got what you want from nursing?' were put to patients, nurses and other health professionals. The patients identified essential qualities of nurses. Problems within the nursing group are identified. The view of each group on the other's work is discussed. Areas of consensus related to respect, communication, competence, co-operation and context. Indicators or measures of the consensus areas are reported.

Attitude of Health Personnel↗

The transition of elderly patients between hospitals and nursing homes. Improving nurse-to-nurse communication.

Lack of patient information is a particular problem when a patient is transferred from one health care facility to another. The lack of information needed to develop a timely and effective plan of care for an older adult transferred to the nursing home facility may exacerbate disruptions in the older adult's care. Also, adjustment or readjustment to the nursing home or hospital environment may be prolonged. Persistence of problems or difficulty in adjustment may then lead to exacerbation of the disease processes and, ultimately, hospital readmissions. Evidence suggests that elderly patients discharged from the hospital have high readmission rates. Although the patient is most affected by a breakdown in communication, everyone in the nursing home involved in the resident's care is also affected. All staff who provide care to the resident, including nursing, medicine, nutrition, pharmacy, social work, and physical therapy staff members, must be cognizant of issues related to communication for patients being transferred. In this article, the authors discuss the development, implementation, and results of a model designed to increase the communication surrounding the transition of elderly patients from an inpatient unit to and from nursing homes.

Aged↗

Two models of restorative nursing care in the nursing home: designated versus integrated restorative nursing assistants.

A 6-month clinical trial was conducted to evaluate two models of restorative nursing care designed to improve mobility in nursing home residents. The models were compared on number of residents enrolled, documentation of nursing assistant (NA) compliance, and nursing staff satisfaction. The designated model, which relied on one specially trained NA to perform restorative activities on the unit, resulted in higher rates of enrollment, compliance, and staff satisfaction compared with the integrated model, which relied on regular staff NAs who were trained to incorporate restorative activities into their daily routines.

Activities of Daily Living↗

Nursing informatics in nursing education: a challenge to nurse teachers.

The use of computers in education has become commonplace. In this study with 162 nurse teachers, we found that although most nursing colleges in Finland have the necessary hardware for teaching informatics, teachers are not familiar with the software that is available for nursing education purposes. Teachers also lack confidence in their own abilities to cope with computer-assisted education. The information systems used in practical nursing are often inaccessible to nurse teachers. The teachers themselves say they would regularly need further training in their own computer skills.

Attitude of Health Personnel↗

Specialisation in nursing. A survey of reactions of Victorian nurses to the national review of specialist nurse education.

This article reports on the opinions of specialist nurses practising in Victoria toward recommendations proposed in the National Review of Specialist Nurse Education (Specialist Review) (Russell et al 1997). Seventy-five nurses undertaking a range of specialist nursing courses offered by three educational providers (a university, major teaching hospital and professional organisation) completed a survey questionnaire to establish the extent to which they agreed with the major recommendations from the Specialist Review. Results showed strong endorsement for most recommendations but with less agreement about issues of minimum credentials and future provisions. Comparison of responses across age, experience, employment and professional education subgroups identified significant differences of opinions on some recommendations. Findings from this study are discussed in relation to the Specialist Review and to implications for the future development of specialist nursing education in Australia.

Adult↗

Urban outpost nursing: the nature of the nurses' work in the AIDS prevention street nurse program.

The AIDS Prevention Street Nurse Program in Vancouver, Canada focuses on HIV and sexually transmitted diseases (STD) prevention within a context of harm reduction and health promotion targeted at marginalized, hard to reach, high-risk populations. As part of a large evaluation project that included interviews with street nurses, clients, and other service providers together with document analysis, the nature of the street nurses' work and its fit within the provision of health care were described. The street nurses' work reflected the following themes: reaching the marginalized high-risk populations for HIV/STDs; building and maintaining trust, respect, and acceptance; doing HIV/AIDS and STD prevention, early detection, and treatment work; helping clients connect with and negotiate the health care system; and influencing the system and colleagues to be responsive. The findings and their implications for community health nursing practice are examined.

British Columbia↗

Nurse practitioners: need for and willingness to hire as viewed by nurse administrators, nurse practitioners, and physicians.

The problem investigated in this project was the identification of need for and desire to hire nurse practitioners in a rural western state. Participants included licensed nurse practitioners, nurse administrators of licensed agencies, and licensed physicians in the state of Nevada. The survey examined the participant groups' views of the need for and their desire to hire nurse practitioners. The findings showed differences among the groups in relation to their education levels and whether they were practicing in rural or urban areas. The most pronounced finding was the indicated need for more information related to the role and functions of nurse practitioners before hiring them. Recommendations for future study are also included.

Attitude of Health Personnel↗

[Nurses' uniforms as seen by patients, nurses and nursing faculty].

The exact role of the way people dress up on the nonverbal communication is still unknown. Nevertheless, we know that it influences the interpersonal answers and, in some situations, they are the main determinants of those answers. The objective of this study was to determinate differences between the perception os the nurse uniform through the answers of 100 patients, 30 nurses and 15 nursing school faculty. The data were collected by showing nine photographs of hospitals of the city of São Paulo (Brazil). White trousers and blouse was the favorite one among patients, nurses and nursing school faculty regarding personal care. White skirt above knees, white blouse and blazer was the most rejected one by three groups.

Attitude to Health↗

[Nursing: idealism and realism. Perspectives of nursing students on the nursing profession].

Exploratory and descriptive study with the following objectives: to identify the nursing students' feelings related to the undergraduate course and their perception towards the nursing profession. After the four-year course, 57.4% of students perceived nursing in a positive way as a profession for the future, valued, recognised, compensating even with some limitations. However, 25% of students still perceived nursing as a mechanical, manual and sacrificed profession, with a limited scientific vision and with a gap between theory and practice and as a consequence a lower recognition by the society. If current trends are maintained, the nurse's value would be much greater in the next decades within the Brazilian society according to 61% of respondents.

Adult↗

[Social representation of nursing workers who are not nurses (nursing technicians and aids) on the work at the intensive care unit in a teaching hospital].

The study identifies and analyses social representations of Intensive Care Unit (ICU) nursing staff about their work and how they express feelings of sorrow and pleasure associated to their job. The theoretical and methodological reference used by this study was the Theory of Social Representations. Interviews were carried out with auxiliary nursing personnel (licensed practical nurse and nurse technician). The data were analyzed by analysis-of-content technique, in particular the enunciation. The results indicate that ICU units causes much suffering, forcing nursing staff to utilize, individually, several defense mechanisms traditionally described by psychoanalysis and psychopathology.

Brazil↗