Embracing a Competency‐Based Specialty Curriculum for Community‐Based Nursing Roles

The Quad Council competencies for public health nursing (PHN) provide guidance in developing curricula at both the generalist and specialist level. However, these competencies are based on nursing roles in traditional public health agencies and community/public health is defined more broadly than official agency practice. The question arises as to whether community‐based specialties require largely the same knowledge and skill set as PHN. The purpose of the competency cross‐mapping project reported here was to (a) assess the intersection of the Quad Council competencies with four community‐based specialties and (b) ensure the appropriateness of a Quad Council‐based curriculum to prepare graduates across these four specialties (home health, occupational health, environmental health, and school nursing). This article details the multistep cross‐mapping process, including validation with practice leaders. Results indicate strong alignment of community‐based specialty competencies with Quad Council competencies. Community‐based specialty‐specific content that did not align well is identified, along with examples of didactic and clinical strategies to address gaps. This work indicates that a Quad Council‐based curriculum is appropriate to prepare graduates in community‐based specialties when attention to the specialty‐specific competencies in the clinical setting is included. This work guides the development of a doctorate of nursing practice curriculum in PHN, encompassing the four additional community‐based specialties.     

Final year Australian nursing students’ experiences with bioscience: A cross‐sectional survey

Nursing students have reported bioscience to be challenging and difficult to understand. This might have a negative impact upon their ability to understand patients’ clinical conditions and nursing practice. We sought information about students’ experiences with bioscience. A total of 126 final year nursing students completed a questionnaire. The findings showed that the majority of participants considered bioscience subjects to require more work compared to nursing subjects (65.9%), and that they would like a better understanding of bioscience (73.8%), but understood that bioscience forms the foundation of nursing practice (76.2%). Younger participants without secondary school science rated bioscience harder than nursing subjects and spent more time studying bioscience compared to older participants. Participants without any secondary school science lacked an ability to apply bioscience concepts to patient conditions. These results showed that nursing students, especially those without secondary school science, would benefit from improved bioscience integration with nursing practice. Nursing and bioscience educators should consider greater alignment of bioscience with nursing practice subjects, especially earlier in the curriculum.     

基于专科护理门诊的“互联网+护理服务”模式实践

依托医院现有专科护理门诊资源,引入第三方信息技术平台,成立以专科护理门诊为基础的“互联网+护理服务”平台,开展伤口护理、造口护理、PICC维护、糖尿病足护理、胃管置管、尿管置管等17个护理服务项目,采取“线上申请、线下服务”的模式,对出院患者及孕产妇、新生儿、失能患者、高龄老人、癌症晚期等居家人群实施延续护理服务。2019年12月-2021年8月共进行“互联网+护理服务”509人次,服务对象满意度为88.80%,且有81.54%的服务对象表示愿意继续使用该平台进行网约护士服务。以专科护理门诊为基础的“互联网+护理服务”模式,满足了居家服务对象个体化、多元化护理需求,提高了网约护士的综合能力与自我价值感。     

‘The self‐destruction force is so strong’: male survivors’ experience of suicidal thoughts following sexual violence

Suicidal thoughts are common among male sexual violence survivors. However, very few studies have focused specifically on this aspect. The purpose of this study was to explore the experience of male survivors themselves of suicidal thoughts following sexual violence within the framework of men and masculinity. The research methodology was The Vancouver School of Doing Phenomenology, and a total of 17 interviews were conducted with seven male survivors. The main findings of the study are that the source of the suicidal thoughts after sexual violence is based on an experienced strong self‐destruction force that involves almost unbearable and unexpressed suffering. The strong self‐destruction force appeared among other things in risk behaviour and negligence towards own life and health. Participants all agreed that the thought of suicide was a certain escape route, that is to be constantly trying to escape from oneself and inner suffering. Negative thoughts that were difficult to suppress developed into suicidal thoughts that developed into thinking about the best possible way to commit suicide. Shattered self‐esteem, shame and loneliness characterised the lives of participants, and they felt disgusting and worthless as human beings. Much self‐degradation was characteristic. Perceived common societal norms about male masculinity had major negative impact on participants, for example that they should not show emotions because they were men and therefore should not express emotional pain or disclose their traumas. This resulted in emotional silencing. Disclosing the violence proved extremely difficult for all participants, but they experienced a high level of positive energy following disclosure. Participants experienced lack of knowledge, understanding and appropriate support from healthcare professionals and felt that sexual violence survivors’ trauma history needed to be better explored within health care. It is important that professionals acquire knowledge and understanding of male sexual violence survivors, and their suicidal thoughts, and become able to provide trauma‐specific support.     

Response to S. Beyea's “Nursing Diagnosis or Patient Problem?”

Viewpoint provides a forum for scholarly discussion about the theoretical, philosophical, and practical issues related to nursing language and classification systems. The sometimes controversial views are intended to stimulate readers' comments and perspectives. We welcome brief, informal responses to published viewpoints. If you have a viewpoint you want to submit, or if you want to discuss it beforehand, contact the column editor: judithwilkins@att.net ; 913.631.1089.     

Accuracy and Efficiency of Computer‐Aided Nursing Diagnosis

PURPOSE. This study aims to determine whether a computer‐aided nursing (CAN) diagnosis system improves diagnostic accuracy and efficiency. METHODS. A randomized crossover trial was performed using two kinds of case studies with 42 nurses as subjects. The subjects were divided into a group using the CAN diagnosis system and a group using a handbook of nursing diagnosis. Degree of accuracy was judged by using Lunney's seven‐point interval scale, while efficiency was evaluated by time required for diagnosis. FINDINGS. There was no significant difference between the two groups in terms of diagnostic accuracy; however, time required for diagnosis was significantly shorter for subjects who used the CAN diagnosis system than for those who did not. Multiple regression analysis showed that the use of the CAN diagnosis system was the only factor associated with the time required for making the nursing diagnosis. CONCLUSIONS. The use of the CAN diagnosis system improved the efficiency of the diagnostic process without reducing the level of accuracy of nursing diagnoses. PRACTICE IMPLICATIONS. The use of a computerized system should be a useful tool for implementation of standardized nursing terminologies.     

Geriatric Nursing Assessment—The Use of a Standardized Assessment Instrument in a Clinical Setting

The purpose of the present study was to investigate the content and focus of nursing assessment when using a well-known Swedish, commercially available, standarized structured multidimensional instrument in the assessment of nursing needs/problems in a geriatric rehabilitation department. Two hundred and fifty-six assessment forms were quantitatively and qualitatively analysed. In 113 cases the corresponding nursing care plans were also analysed. Although a few important areas, such as communication and I-ADL, were missing, the instrument enabled the nurses to make a fairly comprehensive nursing assessment. However, the data collected with the instrument were only partly used in the nursing care plans, and relevant nursing diagnosis could be formulated in only 36 cases. The conclusions are that the data collection must be more goal-oriented and that education in diagnostic reasoning should be meaningful. To choose wide assessment areas could probably also facilitate holistic nursing care.     

麻醉护理的探索与发展

本篇文章主要通过对美国麻醉护理历史、发展和现状的详细介绍和比较我国麻醉护理的现状,为开展我国麻醉护理工作提供参考。     

Missed nursing care as an ‘art form’: The contradictions of nurses as carers

This article draws on the free‐text commentaries from trans‐Tasman studies that used the MISSCARE questionnaire to explore the reasons why nurses miss care. In this paper, we examine the idea that nurses perpetuate a self‐effacing approach to care, at the expense of patient care and professional accountability, using what they describe as the art of nursing to frame their claims of both nursing care and missed nursing care. We use historical dialogue alongside a paradigmatic analysis to examine why nurses allow themselves to continue working within settings that put their professional/personal selves aside in an attempt to deliver care within constraints that make completing care an impossible task. The findings suggest an ambivalence and conflict confront nurses attempting to provide care within the New Public Management environment. This can be seen in the tensions that draw a line between care as an art, and care as a financial target, juxtaposed with the inherent clash of values arising from the way nursing care is conceptualised within two contradictory paradigms.     

盛俐君 顾妙娟 童音

为减少重症疟疾的并发症及死亡率,对1例典型输入型疟疾进行了临床分析,总结了本科室的护理经验。护理与观察的关键在于高热、乏力等症状和相关并发症的正确处理,并做好心理护理和健康宣教。针对患者被传染的过程,总结出疟疾的预防指导。     

Perspective: Implementation of Nursing Language in Long‐Term Care and Nursing Education

PURPOSE. This article describes one nurse's experiences of returning to school after a 10‐year absence, her introduction to nursing theory and terminology, and her subsequent implementation of nursing language in a long‐term care setting and later experiences in teaching nursing language to students. DATA SOURCES. A 21‐year career as a long‐term care nurse coincided with the evolution of the new organization North American Nursing Diagnosis Association International, and she found herself in a position to implement nursing diagnosis in the long‐term care setting. Practice experiences and pertinent nursing references and resources were used in clinical implementation and in teaching nursing students. DATA SYNTHESIS. The author reviewed the implementation and teaching of nursing language from a personal historical perspective. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE. The author's experiences and perspectives on implementation of nursing language in clinical practice and in teaching provide information and a perspective for nurses and students involved in these processes.