Exploratory study to evaluate staff attitudes towards geriatric psychiatry

This work is part of a larger study carried out at the Murray Royal and Murthly Hospitals within the Tayside Health District. The survey was concerned with staff attitudes towards geriatric psychiatry patients and shows that the nurses in these peripheral hospitals hold a positive attitude towards this area of nursing. These findings appear to contradict the popular opinion held throughout the nursing service, that the geriatric psychiatry nursing area is very unpopular with trained, untrained and learner nurses. In the study by Hooper [ Nursing Times (1981) 77 37–40/43–44], anxiety levels among learners towards the geriatric nursing areas were found to be very high. This appears to correlate with Kogan [ Journal of Abnormal and Social Psychology (1961) 62, 616–622], which summarized is as follows: Young subjects were imputed to have a more consistently negative view of old people.' By using a series of two precoded questionnaires that the subjects completed, an overview of staff attitudes towards the geriatric psychiatry areas was obtained. The hypothesis on which the study was based was as follows: that a negative view towards geriatric psychiatry would be found among the staff of the Murray Royal and Murthly Hospitals.' However, the findings of this study did not support the hypothesis on any counts and gave a highly positive attitude scale.     

Boosting morale and improving performance in the nursing setting

AIM AND BACKGROUND: While the importance of morale is well researched in the nursing literature, strategies and interventions are not so prolific. The complexities of interpersonal relationships within the clinical domain, and the critical issues faced by nurses on a daily basis, indicate that morale, job satisfaction and motivation are essential components in improving workplace efficiency, output and communication amongst staff. Drawing on educational, organizational and psychological literature, this paper argues that the ability to inspire morale in staff is a fundamental indicator of sound leadership and managerial characteristics. EVALUATION AND KEY ISSUES: Four practical concepts that could be implemented in the clinical setting are proposed. These include: role preparation for managers, understanding internal and external motivation, fostering internal motivation in nursing staff, and the importance of attitude when investing in relationships.     

Reasons for uses of physical restraint and alternatives to them in geriatric nursing: a questionnaire study among nursing staff

This study is part of a major research project that is concerned with disruptive behaviour among elderly patients and the use of physical restraint in geriatric nursing. The purpose of this study was to describe the use of physical restraint and alternatives as reported by professional nurses. The data were collected by a structured questionnaire. Nursing staff (n=287) from a geriatric unit of a health centre, a nursing home, and the medical and psychiatric clinics of a university hospital in one city in central Finland, volunteered for the study. The clear majority (85%) of the nurses stated that physical restraint had been used on the ward during the week preceding the questionnaire. Reasons cited most often for restraint use were reduced physical and cognitive capacity of demented patients. The most common alternative was to try to understand the reasons for the elderly patient's disruptive behaviour. A major challenge for future research and for field experiments is to provide new alternatives to the use of physical restraint in geriatric nursing.     

Fall occurrence in a geriatric psychiatry setting before and after a fall prevention program

A fall prevention program providing staff education, quantitative assessment of gait and balance, risk factors assessment, and evidence-based interventions was introduced on two geriatric wards of a regional psychiatric hospital. A within-subjects comparison was made of fall occurrence during the 4-month pre-intervention phase and the 4-month post-intervention phase using Fisher's exact test. Among those (N = 23) who survived the duration of the study, significantly fewer falls occurred in the post-intervention time period than in the pre-intervention time period (p < 0.01). Comprehensive assessment, problem identification, and intervention planning by nurses may serve to reduce the number of falls among elderly individuals with severe psychiatric disorders.     

A comparison of primary nursing and team nursing in a geriatric long-term care setting

The purpose of this study was to evaluate primary and team nursing on two 45-bed geriatric units. A 2 year longitudinal study with a quasi-experimental ABA cross-over design and a staff survey, permitted comparisons of the two nursing systems on indices of patient well-being, nursing practice, staff morale and costs. Differences in nursing practice, in selected measures of patient well-being and in responses to the staff survey were positively associated with primary nursing. No differences emerged in relation to staff morale or costs. The benefits of primary nursing and implications for further research are discussed.     

Effectiveness of a geriatric urinary incontinence educational program for nursing staff

Incontinence is becoming an increasingly widespread phenomenon. Individuals who suffer from incontinence-related problems, as well as their loved ones, must learn to live with daily situations that are often extremely demanding. In recent years, it has become evident that incontinence can be cured, or at least successfully managed. Many nurses, however, lack sufficient knowledge and skills to intervene appropriately in dealing with problems associated with a lack of bladder control. Therefore, the continence team of the Sherbrooke Geriatric University Institute developed a urinary incontinence educational program for nurses who care for older persons with this problem. An assessment of the impact of this program on nurses' knowledge, intervention skills and attitudes was conducted. A quasi-experimental protocol based on single-group with repeated-measures design was used for this study. A convenience sample was made up of 10 staff members at the Sherbrooke Geriatric University Institute. The study demonstrated a significant improvement in participants' knowledge, skills and attitudes (p=0.005, p=0.005 and p=0.017, respectively). Furthermore, the effects of the program in regard to the acquisition of skills and knowledge by nurses were still evident nine weeks after the program. The value of the present study lies in the development and positive evaluation of a new incontinence educational program for nurses based on a problem-solving approach.     

Violence to staff in a general hospital setting

The problem of aggression to staff in a general hospital was examined from the perspective of Poyner & Warne's (1986) model of workplace violence A total of 396 staff (39% response rate) provided information on their experience of violence in the past year and a subsample were additionally interviewed about their current levels of mental health (GHQ) Some 72 staff (21% of respondents) had been physically assaulted and 90% of these assaulted staff worked beyond the accident and emergency department, e g in medical wards Nurses were physically assaulted, threatened and verbally abused at higher rates than other professionals Employee factors (younger age, shorter National Health Service experience and attendance at violence training) were significantly associated with assault ( P < 0 05) Postoperative confusion, receiving treatment and delayed treatment were common precursors of aggression Mental health was significantly worse amongst staff exposed to threats (P < 0 01) This exploratory study establishes that violence is a problem across a number of general hospital departments and occupations and we argue that effective training should be made more available for staff at risk of assault     

Nursing staff member experiences with household model implementation in a nursing home setting

This qualitative study used conventional content analysis of interview data to examine nursing staff members’ experiences with Household Model implementation in a nursing home setting. Staff members were recruited from the skilled nursing center post implementation and completed individual interviews (N=16). Participants described the impact of implementation in relation to three categories: antecedents, explicit reactions and change consequences. Participants described barriers and facilitators to implementation as well as outcomes such as role strain, feelings of isolation and harder working conditions. This study provides opportunities for further examination of nursing staff members’ experiences with person centered care models in nursing homes, how those experiences may relate to effectiveness of implementation and the need for support of nursing home staff.     

Absenteeism of nursing staff in a nursing home

This study investigated absenteeism among nursing staff at a long-term care facility. Four absenteeism measures were calculated from personnel records for each month of the year: no pay, sum of unscheduled, unpaid-sick and leave without pay; part-day, sum of arrived late and left early; paid-sick; and total. Independent variables included job level, part/full-time status, shift, sex, marital status, number of tax exemptions, birth year, and year of employment. Absenteeism was lowest in winter; lower for higher level staff; higher the greater the number of exemptions taken; and most importantly, lower for staff with seniority.     

老年患者整体医疗模式的实践探索

老龄化社会的到来给老年急诊带来巨大挑战,本文通过回顾文献并结合本部门工作实践,对老年急诊的医疗模式及护理人员在老年急诊中角色转换的内涵进行探讨,以利于护理人员在老年急诊中发挥更大的作用。     

A survey of attitudes and perceptions toward oral hygiene among staff at a geriatric nursing home

The aim of this survey was to test the impact of an oral hygiene educational model on attitudes and perceptions toward oral hygiene among nursing home staff members. A pilot questionnaire was distributed to the nursing staff before and after a course on oral hygiene at a geriatric nursing home in Stockholm in 2008. The nursing staff was of the opinion that they had sufficient time to carry out oral hygiene tasks but considered such tasks unpleasant, mainly because of unwillingness and resistance from the residents. These attitudes and perceptions among the nursing staff did not change significantly after oral hygiene education. Future oral hygiene educational models need to be developed with an aim to alter the perceptions and behavior of the nursing home staff.     

优质护理服务在老年病房的实践与效果

目的：探讨优质护理服务在提高老年科护理满意度中的实践与效果。方法选择2012年1月~2012年12月入住本科的120例老年患者为研究对象,将其随机分为对照组（常规护理组）和观察组（优质护理组）,每组各60例,对照组予以常规护理,观察组予以优质护理。比较2组患者护理前后健康知识掌握情况、心理需求满足程度及对护理效果、护理态度的满意度。结果护理后观察组的健康知识掌握程度和心理需求满意度均较佳分别为86.67%和90%,均高于对照组,且对护理效果和护理态度的总满意率分别为91.67%和100%,高于对照组,比较差异有统计学意义（P＆lt;0.05）。结论优质护理可提高老年住院患者的满意度,提升医院护理质量。     

超声造影评价睾丸微血管损伤的实验研究

目的：探讨超声造影及其量化分析技术评价睾丸缺血再灌注微血管损伤的方法。方法将24只成年健康大白兔随机分为对照组和微血管轻、中、重度缺血损伤组(Ⅰ组,包括Ⅰ1、Ⅰ2、Ⅰ3组),每组6只。对照组暴露精索后穿线但不结扎,Ⅰ1、Ⅰ2、Ⅰ3组术侧睾丸分别完全缺血2h、4h、6h 后,复灌注2 h。术前、术后分别进行双侧睾丸超声造影,分析各组造影参数：峰值强度(PI)、达峰时间(TP)、曲率(Slope)、平均渡越时间(MTT)、峰值减半时间(DT/2)和曲线下面积(Area)的变化。各组造影结束后,实验室检测血浆vWF、NO、ET-1含量。取术侧睾丸,行 HE 染色及免疫组化检查,对比观察各组病理变化。使用 SPSS13.0软件进行统计学分析。结果术前各实验组、对照组间术侧睾丸超声造影各参数无显著差别(P >0.05)。术后,Ⅰ1组造影参数 PI、Slope 显著升高,TP、MTT 明显延长,Area 显著增大,与对照组相比有显著差别(P <0.05),造影时间-强度曲线峰值明显升高、后移。Ⅰ2组造影参数 PI、Slope 进一步升高,DT/2显著延长,TP 明显缩短,Area 进一步增大,与对照组、Ⅰ1组相比差异有统计学意义(P <0.05),造影曲线明显升高、前移且下降缓慢。Ⅰ3组术侧睾丸实质始终未见显影,造影曲线近似一条直线。各实验组血浆vWF、NO、ET-1含量均较对照组显著增高(P <0.05),以Ⅰ2组含量最高,较Ⅰ1、Ⅰ3组显著升高(P <0.05)。病理检查为各实验组随缺血程度加重,睾丸微血管扩张,红细胞淤积漏出、炎症细胞浸润逐渐增多,血管基底膜 MMP-9表达逐渐增强。结论超声造影及其量化分析技术能够有效评价睾丸微血管损伤的程度。