Morality in perioperative nurses

This study examined nurses' moral motivation, character, and action using a Model of Morality for Perioperative Nurses. Influences on moral actions and selected outcomes for surgical patients and perioperative nurses were examined. Results indicate that motivation and character are related directly to the moral actions of perioperative nurses (R =.13 to .31, P <.001). Fourteen percent of the variance in action was explained by motivation, character, self-perceived level of practice, and ethics education. Results suggest that current models do not describe the moral behavior of perioperative nurses adequately. Future research should examine constructs that explain the moral actions of nurses in the perioperative setting. AORN J 15 (March 2001) 532-549.     

The perceptions of patient safety culture: A difference between physicians and nurses in Taiwan

AimsIn order to pursue a better patient safety culture and provide a superior medical service for patients, this study aims to respectively investigate the perceptions of patient safety from the viewpoints of physicians and nurses in Taiwan.BackgroundLittle knowledge has clearly identified the difference of perceptions between physicians and nurses in patient safety culture. Understanding physicians and nurses' attitudes toward patient safety is a critical issue for healthcare organizations to improve medical quality.MethodsConfirmatory factor analysis (CFA) is used to verify the structure of data (e.g. reliability and validity), and Pearson's correlation analysis is conducted to demonstrate the relationships among seven patient safety culture dimensions.ResultsResearch results illustrate that more teamwork is exhibited among team members, the more safety of a patient is committed. Perceptions of management and emotional exhaustion are important components that contribute to a better patient safety. More importantly, working conditions and stress recognition are found to be negatively related from the perceptions of nurses. Compared to physicians, nurses reported higher stress and challenges which result from multi-task working conditions in the hospital.ConclusionsThis study focused on the contribution of a better patient safety culture from different viewpoints of physicians and nurses for healthcare organizations in Taiwan. A different attitudes toward patient safety is found between physicians and nurses. The results enable the hospital management to realize and design appropriate implications for hospital staffs to establish a better patient safety culture.     

Balancing intertwined responsibilities: A grounded theory study of teamwork in everyday intensive care unit practice

ABSTRACT

This study aimed to describe and explain teamwork and factors that influence team processes in everyday practice in an intensive care unit (ICU) from a staff perspective. The setting was a Swedish ICU. Data were collected from 38 ICU staff in focus groups with registered nurses, assistant nurses, and anaesthetists, and in one individual interview with a physiotherapist. Constant comparative analysis according to grounded theory was conducted, and to identify the relations between the emerged categories, the paradigm model was applied. The core category to emerge from the data was “balancing intertwined responsibilities.” In addition, eleven categories that related to the core category emerged. These categories described and explained the phenomenon’s contextual conditions, causal conditions, and intervening conditions, as well as the staff actions/interactions and the consequences that arose. The findings indicated that the type of teamwork fluctuated due to circumstantial factors. Based on the findings and on current literature, strategies that can optimise interprofessional teamwork are presented. The analysis generated a conceptual model, which aims to contribute to existing frameworks by adding new dimensions about perceptions of team processes within an ICU related to staff actions/interactions. This model may be utilised to enhance the understanding of existing contexts and processes when designing and implementing interventions to facilitate teamwork in the pursuit of improving healthcare quality and patient safety.     

Caring for the frail elderly at home: toward a theoretical explanation of the dynamics of poor quality family caregiving

Using the grounded theory approach, 39 family caregivers were theoretically sampled using newspaper advertising to explore their perceptions of providing home care for frail elders and to generate a theoretical model that describes the dynamics of good quality and poor quality family caregiving; explains the relationships among certain contextual and perceptual variables and the behaviors exchanged by elders and caregivers; and identifies points where interventions by nurses could be effective. The model consists of five constructs that were identified from the data and were staged within the framework provided by symbolic interactionism and social exchange theory. The five constructs and two related driving forces provide a partial explanation for the quality of family caregiving and a beginning explanation for the phenomenon of elder abuse.     

Nurses’ perceptions and experiences of robotic assisted surgery (RAS): An integrative review

AimTo identify and review published literature on the perceptions and experience of nurses working with RAS.BackgroundRobotic assisted surgery (RAS) is rapidly becoming accepted as the elite modality for surgery since its introduction in the 1980 s, more recently there has been a rising trend of use with several specialities operating using this technology. The role of nurses in perioperative care has been described as maintaining the momentum of the patient’s journey. Patients undergoing RAS require nursing care throughout their journey, therefore knowledge of nurses’ experiences and perceptions of RAS is important to identifying nurse education and development needs.DesignIntegrative literature reviewDatabase sourcesDatabases searched for peer reviewed studies included CINAHL, Academic Search Complete, EMBASE, Scopus, ADA Psycinfo, Medline.Review methodsA comprehensive database search was conducted following PRISMA guidelines. Six databases were searched with 523 screened for eligibility. Ten studies were included in the review seven qualitative and three quantitative.ResultsTen studies were identified, critically appraised and synthesised using thematic analysis. All studies were conducted with nurses in the perioperative environment. Key findings were that nurses education regarding RAS is limited with more emphasis placed on surgeon education and training. There was evidence that nurses experienced a lack of education, training and information as barriers to their role which subsequently raised their stress levels.ConclusionEvidence suggests a clear need for education and training for nurses working with RAS. In addition, nurses working with RAS provide care preoperatively, intraoperatively, postoperatively and post discharge in the community. However, no research has been conducted with nurses outside of the perioperative environment. Further research is required to understand the experiences and perceptions of nurses working with RAS patients in all care settings to identify their education and development needs.     

An exploratory study: Student nurses' perceptions of professionalism

Aim of the studyTo explore final year nursing students' perceptions of professionalism using a reflective approach.DesignA phenomenological approach informed the study, and data was collected by a focus group and five individual semi-structured interviews.SubjectsParticipants were ten final year student nurses studying on the adult nursing education programme in the United Kingdom.Data analysisThematic analysis resulted in an extensive list of general statements or 'units of meaning', from which meaningful categories describing a phenomenon evolved.ResultsThe findings revealed that student nurse's perceived vulnerability, symbolic representation, role modelling, discontent and professional development as elements that informed their own professionalism. Additionally, being able to observe the behaviours of registered nurses appeared to be significant to the student in the development of their own sense of professional identity, using positive and negative role models constructively.ConclusionsIt appears that final year student nurses are cognisant of the impact of practice scenarios and observational influences, affecting their own perceptions of professionalism. They are able to clearly identify and make sense of experiences in practice, and constructively use this knowledge to positively inform their practice.     

An exploration of the grief experiences of neonatal nurses: A focus group study

AimTo explore the grief reactions of neonatal nurses caring for dying babies.MethodsThis study utilises a qualitative research design. Focus group methods explored neonatal nurses' beliefs, perceptions and experiences of death, dying, grief and loss associated with clinical practice in the neonatal intensive care unit. A deductive data analysis framework was employed to catalogue participant responses into corresponding constructs.ResultsData collected from the focus group interviews were aggregated in deductive analysis against three constructs: Acknowledgement of loss; recognition of the relationship; and inclusion of the griever.ConclusionThe findings from this research contribute to a definition of grief as a pervasive, highly individualized, dynamic process that often is discussed normatively within professional healthcare disciplines. Neonatal nurses routinely deal with grief and feelings of loss. It is important that a framework be developed to help understand the process and to guide appropriate interventions for ongoing support.     

Surgical nurses’ responses to worry: A qualitative focus-group study in the Netherlands

BackgroundHospital nurses observe and respond to deterioration using the ‘National Early Warning Score 2’. Surgical nurses are highly engaged in the early recognition of and response to deterioration. Responses to deterioration are based on deviating vital signs, while nurses also act on subjective indicators like worry. Scientific literature and (inter)national guidelines do not mention any information about acting upon worry.ObjectiveTo gain an in-depth understanding of the actions nurses on surgical wards undertake to generate an appropriate response to nurses’ worry when the ‘National Early Warning Score 2’ does not indicate deterioration.MethodA qualitative focus-group study with surgical nurses working at a hospital in the Netherlands. Data was collected by focus-group interviews supported by vignettes and analysed thematically.FindingsFour focus-group interviews with a total of 20 participants were conducted between February and April 2020. Two sequential themes emerged: ‘Searching for explanation and confirmation’ and ‘Responding by actively applying nursing interventions’. Nurses gathered additional information about the patient and searched for a reference point to place this information in perspective. Nurses also approached others for co-assessment and verification. However, nurses faced barriers in calling for medical assistance. They felt physicians did not take them seriously. After gathering additional information, nurses responded by applying nursing interventions to comfort the patient.ConclusionNurses mainly try to formalise an in-depth understanding of their feeling of worry to convince a physician to accurately treat the patient. Spending much time on a search to this understanding leads to delays in escalating care.     

Differences in employment,job characteristics,and work-related perceptions by sociodemographic factors among registered nurses of diverse race/ethnicity

BackgroundAvailable research on registered nurses (RNs) indicates that RNs with diverse race/ethnicity are more likely to work in disadvantaged workplaces.PurposeTo examine differences in employment, job characteristics and perceptions about work among RNs by sociodemographic characteristics.MethodsWe analyzed data from statewide random samples of California RNs (N=895).FindingsIncreased age was associated with increased likelihoods of working part-time, day-shift, and in non-hospital settings and having managerial positions. Asian and Black nurses were more likely to work in urban areas than White nurses. The levels of job demand, job control, job satisfaction, perceived organizational culture, and safety climate were significantly different by sociodemographic characteristics. Greater intention to leave the job was associated with younger age and working in non-hospital settings.DiscussionThe findings suggest that differences exist in nurses' employment, job characteristics, and perceptions about their work and work environment by sociodemographic characteristics among RNs of diverse race/ethnicity.