Holisitic nursing: taking your practice to the next level

The goal of holistic nursing is to enhance healing of the whole person from birth to death. The new American Holistic Nursing Association's (AHNAs) Standards of Holistic Nursing Practice defines the ways to accomplish this goal, describing the scope of holistic nursing practice and the level of care expected from a holistic nurse. Nurses can reduce the devastating effects of crisis and illness in individuals by using the AHNA standards of practice. As nurses integrate interdiciplinarity into their work and think at the intersections, the human story enfolds in a new way, and health moves into the domain of healing.     

Higher level practice in community nursing: part 1

Part one of this article describes the development of the nurse practitioner role in the UK. Part two reports on a research study examining whether or not community nurse practitioners were able to achieve a 'higher level of practice' as envisaged by the United Kingdom Central Council and will be published in next week's Nursing Standard.     

The professional practice of nursing administration. Integrated nursing practice

The role of the nurse executive is dynamic, requiring a high degree of leadership skill and managerial competence linked with clinical nursing knowledge and research. Preparation for the role requires an integrated curriculum in nursing administration and life span leadership development. Recognition of the professional level of differentiated practice as nursing administration is essential if professional nursing is to remain vital in the 21st century. Transformed schools should be named schools of nursing administration, and the new product should be the nurse executive who has the ability to function in a wide variety of settings on earth and in space.     

Improving perceptions of patient care--a nursing education and nursing practice initiative.

In January 2005, the University of Texas Medical Branch (UTMB) School of Nursing and the UTMB Hospitals and Clinics launched the first phase of a project to improve perceptions of patient care on the part of nursing faculty and nursing clinicians. A finding on the UTMB annual employee satisfaction survey that nursing faculty and clinicians tended to rate quality of UTMB patient care lower than other UTMB employees provided the impetus for the initiative. When UTMB colleagues noticed the findings, various entities including human resources and the Faculty Senate called for explanations from the dean of the School of Nursing, the chief nursing officer, and the CEO for the hospitals and clinics. In the process of attempting to give reasons for the findings, each of us determined we would take definitive action to address the situation. This article describes our accomplishments for Phase 1 of the initiative. Beginning with a vision for a productive professional community characterized by a pedagogical partnership between nursing education and practice, we share the processes we followed to (1) achieve mutual understanding among task force members, (2) obtain input on perceptions from nursing colleagues, (3) identify the clinical and nursing education aspects of the perceptions, (4) reach consensus on target perceptions for Phase 2 of the project, and (5) outline the next steps for the project.     

Barriers to addressing patient sexuality in nursing practice.

Sexuality assessment and counseling are part of the nurse's professional role, but few nurses integrate this awareness into practice. Findings of this study suggest that educational programs are needed to help nurses develop confidence and comfort in dealing with patient sexuality.     

The impact of reimbursement issues on rehabilitation nursing practice and patient care.

Rehabilitation nursing practice and patient care are affected profoundly by reimbursement trends. This article provides a basic understanding of current and proposed reimbursement issues in Medicare, Medicaid, and private insurance--information that should help the rehabilitation nurse make the changes necessary to provide patient care within the constraints of the reimbursement systems. Furthermore, an understanding of these economic issues should assist nurses in working collaboratively and positively with administration while reducing their level of frustration. Nurses can play an important role in managing length of stay, using ancillary services, and moving the patient along the continuum of care, all of which are critical financial factors in a facility's successful management of its payer mix.     

Standards of perianesthesia nursing practice: advocating patient safety.

The practice continuum of perianesthesia nursing interacts in concert with other nursing and medical professional organizations. Professional standards of care establish frameworks that guide these practitioners in the delivery of care. ASPAN is charged with the ethical responsibility of defining and promulgating minimum standards of perianesthesia nursing practice. This article discusses the various definitions and uses of standards, as well as the vital importance of using ASPAN Standards. How standards differ from position statements, laws, and regulations, and how standards advocate for patient safety and protect the nurses in their specialty practice are also discussed. In addition, case scenarios will be presented to show how the American Society of Anesthesiologists' (ASA) standards play a major role in the surgical patient's care.     

护理专业本科生从事护理工作积极意愿及影响因素研究

目的调查护理本科生从事护理专业积极意愿的现状,并分析其影响因素。方法采用一般资料问卷和从事护理专业积极意愿调查问卷,对145名护理本科生进行问卷调查。结果护理本科生从事护理专业的积极意愿条目均分为(3.62±0.51)分,其中66.2%(96/145)积极意愿较高,20.0%(29/145)积极意愿一般,13.8%(20/145)积极意愿较低。多元线性回归分析显示,入学时选择护理专业的原因、在社团任职、年级是影响护理本科生从事护理专业积极意愿的主要因素(R2=0.165,F=9.255,P0.001)。结论一半以上的护理本科生有从事护理专业的积极意愿,与选择专业的原因、在校任职情况、年级等因素有关。     

Policies that drive the nursing practice of postoperative observations

Postoperative nursing care traditionally has involved the utilisation of regulated, routine patient observation to monitor patient progress. This study was designed to review the policy/procedure documentation that drives this practice and to determine who contributes to policy development. In all, 75 surgical hospitals were surveyed, producing 47 procedures for content analysis. Findings suggest that there is a great diversity in procedures between organisations. The most common pattern of postoperative vital sign collection is hourly for 4 h and then 4 hourly in 27% of the regimes. On average a patient receives 10 sets of observation in the first 24 h, with neurovascular, wound and drain checks the most frequent observations collected in addition to vital signs.     

Clarifying higher level roles in nursing practice

There is widespread confusion about the titles nurse practitioner and clinical nurse specialist. A number of broad similarities in and differences between the roles has been identified. A robust, nationally recognised method of regulating these titles is needed.     

Innovative nursing practice models and patient outcomes

The definition of patient outcome measures has broadened from the traditional ones of mortality, morbidity, and disability to those that include quality of life, length of stay, health status, and patient satisfaction. Three models of innovative nursing practice in Arizona, New York, and Baltimore, are currently being evaluated in terms of these new outcome measures.