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The Intravenous Nurses Society (INS) believes that the intravenous trained licensed practical nurse and the licensed vocational nurse can aid in the delivery of some aspects of intravenous therapy under the supervision of the registered nurse; however, the registered nurse shall be the primary practitioner in this specialty.
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Before a general, nursing documentation model was implemented in one health care region of the Stockholm County Council the opinions which district nurses and nurses at the primary health care centers (PHCCs) had of nursing documentation were investigated. 164 nurses (94%) at all the 22 PHCCs within the region answered a questionnaire in October, 1995. The study showed that the nurses in general were dissatisfied with their own, as well as with their colleagues, nursing documentation. The lack of a common, patient-record model for nursing documentation was considered the greatest obstacle, followed by lack of time and lack of knowledge. Most of the nurses believed that patient records which clearly included all parts of the nursing process would promote patient care. However, according to the nurses themselves, less than one-fifth of them recorded nursing history and nursing outcomes for all or most of their patients. One-third of the nurses reported that documented planned nursing interventions, about one-fourth nursing status and about half of them implemented nursing interventions for all or most of their patients. The nurses said that nursing diagnoses, goals and epicrises were rarely documented. There was no significant correlation between the nurses' ages and their opinions of nursing documentation. Nurses who had completed their education after 1985 were more positive to further education in nursing documentation and to computerised patient records, and confirmed more than others that patient records which included the entire nursing process model would promote patient care. Nurses who worked only at PHCCs were more satisfied with their own documentation as well as with that at their centres and were more positive to computer support than district nurses. Nurses at PHCCs were less in favour of education in nursing documentation, compared with nurses working in home health care and child care. The nurses who were not satisfied with their own nursing documentation were not satisfied with their colleagues' documentation either, but they were positive to further nursing education. More than others, they were of the opinion that better patient care follows from patient records which include the entire nursing process model. The study shows the need for education and continuous support aimed at nurses within the primary health care system regarding nursing documentation.
PURPOSE/OBJECTIVES: To describe and compare barriers to research utilization faced by oncology staff nurses and nurse managers/clinical nurse specialists (CNSs) and to compare these to barriers identified by other nurses. DESIGN: Exploratory descriptive. SETTING: National. SAMPLE: Proportional random sample of 2,000 Oncology Nursing Society (ONS) staff nurses (n = 769) from seven practice settings. ONS participants recruited oncology staff nurses (n = 331) and nurse managers/CNSs involved in cancer care (n = 407). METHODS: Mailings, including a demographic questionnaire and Barriers Scale, were sent to ONS nurses, and reminder postcards were sent to increase the return rate. MAIN RESEARCH VARIABLES: Barrier categories: characteristics of the adopter (nurse), organization, innovation (research itself), and communication, individual item barriers. Nurse and worksite characteristics. FINDINGS: Differences existed in oncology nurses' perceptions of the extent to which the adopter, organization, and innovation characteristics served as obstacles to research utilization. Nurse managers/CNSs perceived that each of these acted as a greater barrier than did staff nurses. Both groups perceived communication characteristics as a moderate barrier. Oncology nurses, as a group, responded similarly to other nurse samples regarding research and communication characteristics. Perceptions of oncology nurse managers/CNSs were similar to those of administrators in other studies. Oncology staff nurses rated barriers lower than nurses, including clinicians, in other samples. CONCLUSIONS: For oncology nurses, organization, research, and communication barriers persist as impediments to research utilization. Nurse adopter characteristics may be diminishing as obstacles for staff nurses but not for nurse managers/CNSs. The decreased strength that oncology nurses attributed to barriers may reflect a benefit of practicing nursing in a specialty. IMPLICATIONS FOR NURSING PRACTICE: Decreasing known barriers would facilitate research-based practice in oncology. Nurse leaders can create environments conducive to research utilization by altering existing mechanisms, facilitating access to nursing research experts, supporting time for research utilization efforts, giving authority for practice changes, and offering continuing education related to research utilization processes. Nurse managers/CNSs need to increase their familiarity with research and research utilization, ensuring their awareness of pertinent clinical findings. Perceptual gaps between staff nurses and nurse managers/CNSs regarding research utilization require discussion and formal investigation. Researchers must communicate in clinician-friendly ways. All nurses need to demand and facilitate access to research findings.
PURPOSE: The purpose of this study was to compare the nursing activities delineated by interview of nurses with those on nursing notes. METHOD: The participants of interview were 18 nurses working in medical and surgical units of a large hospital in Seoul. Each nurse was asked to choose one patient who demand most nursing care among her patients. The nurse was then interviewed to describe what her nursing activities for the patient was that day. The audio-taped interview was transcribed and the content was analyzed by researchers. Nursing notes of each nurses' patients were copied and the content analyzed by researchers. Finally, themes from the interview data and those from nursing notes were compared. RESULT: Activities related to emotional or psychological nursing, education for patient and families, and problem solving related to treatment or nursing procedure were most often omitted in nursing notes. Most of the documentation in nursing notes were related to physical condition of patients or physician's orders. Nurses described that they will do better recording if they were given less patient care responsibility, had better nursing knowledge, had better recording system, and received more training on nursing record. CONCLUSION: Nursing notes did not reflect nursing activities properly. Few independent nursing roles were documented in the nursing notes. Development of nursing education program and nursing record system is needed for improvement of nursing record.
AIM: The aim of the study was to find out how nursing home residents, their families and nurses experienced the change to primary nursing in the nursing home. BACKGROUND: This study was carried out in a nursing home in Finland. Following years of functional nursing, the change to primary nursing had started 18 months prior to data collection. The transition was preceded by staff training, planning for the change to primary nursing and discussions with staff members. Meetings were also arranged with family members to inform them of what was happening and why. Staff implemented the changeover independently with the support of the institution's management. METHODS: The data were gathered in focused interviews. There were five interview themes: change in the nursing home, the position of the resident in the nursing home, the relationship between the resident and nurse, the relationship between family member and nurse, and the role of the nurse as provider of nursing care. FINDINGS: Residents reported no major changes in nursing care or in their relationship with nurses. However, family members had noticed changes in the behaviour of the nursing staff. Staff members had become friendlier, spent more time with the residents and showed a strong job motivation. Cooperation between nurses and family members had changed very little. Some nurses in the early stages of the change tended to show signs of resistance. Others said that there had been many changes during the past year, that they acted more independently and could use their own decision-making authority more freely than before. They treated residents as individuals and gave them a greater say in decision-making. They felt responsible for the development of the workplace as a collectivity. CONCLUSIONS: Primary nursing is one way in which nurses and family members can work more closely in the best interests of older residents. The findings of this study speak in favour of making the change from functional to primary nursing and at the same time highlight certain problems and possibilities in this process.
The results of the incorporation of a conceptual/theoretic framework in this nursing service setting have been an improvement in the service to consumers of nursing, an effective restructuring of the environment of the health care agency advantageous for the client and for nursing staff, and the differentiation of practice roles according to education, experiences, and client needs. It has fostered understanding, acceptance, and support of the contribution of theory development and nursing research to nursing and health care. It brought together nurse leaders in education and service to the benefit of both and with maximum benefit to the consumer of nursing services. The specification of the philosophy, outcome behaviors, and conceptual/theoretic frameworks has allowed nurses to have control over nursing. It has incorporated nurses in setting the pace for the future of nursing practice, promoted the development of peer activity and review, and demonstrated how nursing can make a difference. The benefit for the nurse includes increased job satisfaction, enhanced professional and personal development, increased self-esteem, and the realization that the service of nursing is a valued and valuable service to consumers. Promotion of the image of the nurse was another outcome, as was the realization that nurse educators and nurse supervisors share common goals. The timeframe may be different in that educators see a finished product years ahead while nurse supervisors see client outcomes on a daily basis. The gap between these two efforts is bridged by the use of common conceptual/theoretic frameworks for the design and administration of both the nursing education and nursing service units.(ABSTRACT TRUNCATED AT 250 WORDS)
Using a Holter electrocardiograph (ECG), we recorded the heart rates of ward nurses by working hours and nursing activity. Energy expenditure was calculated from the heart rate data and nurse work lord was evaluated. The following results were obtained. 1) Average heart rates were 77 (beats/min) for day-shift nurse in surgical ward, 76 for evening-shift nurse in mixed, ward, and 74 for night-shift nurse in mixed ward. 2) The energy expenditures per day were calculated to be 3,474 kcal for day-shift nurse in surgical ward, 3,060 kcal for evening-shift nurse in mixed ward, and 3,238 kcal for night-shift nurse in mixed ward. 3) The energy expenditures during working hours were 2,110 kcal/510 min for day-shift nurse in surgical ward, 1,805 kcal/495 min for evening shift nurse, and 2,014 kcal/570 min for night-shift nurse in mixed ward. 4) The highest energy expenditures of nurse engaged in direct nursing care were 834 kcal (39.5%) for day-shift nurse in surgical ward, 632 kcal (34.9%) for evening-shift nurse in mixed ward, and 790 kcal (39.2%) for night-shift nurse in mixed ward. 5) The longest working hours were 174 min (34.1%) in assisting with medical examinations and treatment by day-shift nurse, 155 min (31.3%) in direct care by evening-shift nurse, and 222 min (39.0%) by night-shift nurse. The results indicate that the energy expenditure calculated from the average heart rate of ward nurses in higher than that of other types of workers. The reason for this difference is discussed in this report. Also, this study showed that the energy expenditure determined by this method does not necessarily increase in proportion to working hours.
BACKGROUND: Two decades after the emergence of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), the infection remains enigmatic and shameful. In Sweden, many HIV-infected persons still encounter attitudes of avoidance. AIMS: The aims were to investigate differences between attitudes of nurses, assistant nurses, nursing students and assistant nursing students towards HIV-infected and homosexual HIV-infected patients; to measure their fear of contracting HIV; and to investigate whether nurses, assistant nurses, nursing students and assistant nursing students wanted to refrain from caring for HIV-infected patients. ETHICAL ISSUES: The participants were informed of the study orally and in writing. Completing and returning the anonymous questionnaires indicated the participants' tacit consent. RESEARCH METHOD: The study had a descriptive, comparative quantitative design. The AIDS Attitude Scale was used, along with a questionnaire specially designed for the study. The participants were nurses and assistant nurses from one infectious disease clinic in central Sweden [response rate was 67% (n = 57)]. Students enrolled in a university nursing programme and students of upper secondary assistant nurses' training [response rate was 62% (n = 165)] were also included. FINDINGS: In general, both the nursing staff and the nursing students expressed empathic attitudes towards HIV-infected and homosexual HIV-infected patients, as well as a low degree of fear of HIV contagion. The findings also showed, in the professional groups, that 36% would refrain from caring for HIV-infected patients if that possibility existed. The corresponding figure for the student groups was 26%. LIMITATIONS: The chosen sample was small and not randomly selected therefore precludes a generalization in a wider context. Furthermore, the questionnaire was untested for reliability and validity, and may have influenced the findings with respect to the wish to refrain from nursing HIV-infected patients. CONCLUSION: Suggested guidelines for nursing, mentor-ship by AIDS-dedicated nurses, and educational interventions, are given in 'Implications for nursing and nursing education'.