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1.
Background
There is limited information about the careers, roles and views of doctor of nursing practice (DNP) graduates.Method
This study describes the labor participation, post-graduation work activities, and perceptions of 1,308 DNP members of three professional nursing organizations who completed a 2017 survey (32% response rate).Findings
More than 70% of respondents reported substantial improvements in quality improvement, evidenced based practice and leadership abilities. Twenty-two percent of respondents noted the degree was required by their employer and most of these held educational positions. Postgraduate participation in activities associated with DNP education, assessment of personal impact and degree necessity varied by position title and organization membership.Discussion
These differences have implications for nursing associations and professional solidarity. 相似文献2.
Kimberly D. Shea Barbara B. Brewer Jane M. Carrington Mary Davis Sheila Gephart Anne Rosenfeld 《Nursing outlook》2019,67(1):39-48
Background
Building on the efforts of the American Association of Colleges of Nursing, we developed a model to infuse data science constructs into doctor of philosophy (PhD) curriculum. Using this model, developing nurse scientists can learn data science and be at the forefront of data driven healthcare.Purpose
Here we present the Data Science Curriculum Organizing Model (DSCOM) to guide comprehensive doctoral education about data science.Methods
Our team transformed the terminology and applicability of multidisciplinary data science models into the DSCOM.Findings
The DSCOM represents concepts and constructs, and their relationships, which are essential to a comprehensive understanding of data science. Application of the DSCOM identified areas for threading as well as gaps that require content in core coursework.Discussion
The DSCOM is an effective tool to guide curriculum development and evaluation towards the preparation of nurse scientists with knowledge of data science. 相似文献3.
Tener Goodwin Veenema Roberta Proffit Lavin Annah Bender Clifton P. Thornton Sarah Schneider-Firestone 《Nursing outlook》2019,67(1):54-88
Background
Little is known regarding the capacity of U.S. nurses to respond following a large-scale radiation release, despite its relevance to our National Security Strategy.Purpose
To conduct a systematic review of the literature to assess nurse readiness for radiation emergencies and nuclear events.Methods
A systematic review of publications identified through a comprehensive search of four relevant databases (Embase, PubMed/Medline, Scopus, and Web of Science) was conducted (n?=?62).Findings
Limited evidence exists to support that nurses are prepared or willing to respond to a large-scale emergency resulting from a radiation release or nuclear-level event.Discussion
History suggests nurses will be expected to perform triage, minimize radiation exposure, decontaminate, manage trauma, treat burns, and coordinate care for patients. Research is needed to identify the specific roles and responsibilities of nurses in radiation emergencies and nuclear response and to ascertain quantitative measurement of the level of national nurse readiness for these large-scale radiation emergency and nuclear events. 相似文献4.
Background
Disclosure of prognosis-related information is an essential aspect of communication with pediatric patients with cancer and their families. The nurse is believed to play an important role in this process, but nurse perceptions and experiences have not been well-described.Purpose
Provide an exploration of pediatric oncology nurses’ experiences with prognosis-related communication (PRC).Method
Mixed-methods, multiphase design. This paper highlights the qualitative portion of the study.Findings
Three themes were identified: Importance of collaboration, impact of PRC, and delivery of prognostic information.Discussion
Collaboration is a critical element of PRC. Nurses are often not included in the disclosure process, which limits the ability of nurses to fully function in their roles, compromising patient, family, and nurse outcomes. A paradigm shift is required to empower nurses to be more active participants. More education of physicians and nurses is necessary to consistently engage nurses in PRC and prepare nurses for critical conversations. 相似文献5.
Rachel F. Schiffman Susan G. Dorsey Donna J. McCloskey Patricia A. Grady 《Nursing outlook》2019,67(1):13-20
Background
Logic models are tools to evaluate the effectiveness of programs. In 2013, the National Institute of Nursing Research (NINR) Logic Model for Center Sustainability was developed.Purpose
The purpose of this paper is to describe the process of revision and implementation of the NINR Logic Model across a continuum of NINR Exploratory Centers and Centers of Excellence.Methods
The process for incorporating common data elements for symptom, self-management, biomarker science and precision health in the logic model is outlined. Information about the NINR Logic Model was gleaned from the National Institutes of Health Reporter, annual NINR Center Directors meetings, and from individual Center Directors.Findings
Centers utilized the model for funding applications and to guide Core administration, evaluation, Center sustainability, and/or other Center metrics.Discussion
The revised NINR Logic Model for Center Sustainability can be a useful tool for planning and implementing center activities for center impact and sustainability. 相似文献6.
Background
Online medical information has transformed the way patients obtain information.Purpose
The present study examined patients' informational needs and the patient- Healthcare Provider (HCP) relationship from the perceptions of both patients and HCP.Methods
The study was a cross-sectional study; data were collected in Israel from100 HCPs (nurses and physicians) and 184 e-patients.Findings
E-patients were comfortable sharing e-information with their HCP and expected them to consider the e-information in treatment decision-making. Physicians thought they provided more information than the patients considered that they received from them, while both nurses and patients were in agreement about their interactions. Patients thought that there was a higher concordance between the e-information and the information they received from the physician/nurse as compared to what physicians and nurses reported.Discussion and Conclusions
E-health information does not disrupt the patient-nurse/physician relationship. To promote compliance to treatment, it is important that HCPs consider information presented by patients when preparing the treatment plan. 相似文献7.
Abraham Aizer Brody Ashley Leak Bryant G. Adriana Perez Donald E. Bailey 《Nursing outlook》2019,67(2):133-139
Background
Nurse scientists are highly sought after and find satisfaction in serving as members of interdisciplinary research teams. These teams also tend to be highly productive. However, nurse scientists in academia also have to reach certain productivity milestones to be promoted and receive tenure that may be incongruent with team science principles.Purpose
This study therefore sought to examine whether APT documents in research intensive nursing schools incorporate team science principles.Methods
Qualitatively analyzed the appointment, promotion and tenure documents of 18 U.S. based research intensive schools of nursing with over $2 million in NIH funding in fiscal year 2014.Findings
The study found that only 8 of 18 documents included any reference to team science principles and even these mentions were largely negligible. There were few best practices to recommend across documents. By not recognizing team science within these documents, nursing risks marginalization within the larger scientific community by limiting mentorship and learning opportunities for early career nurse scientists.Discussion
Schools of nursing should revisit their promotion and tenure criteria and include a greater commitment to encouragement of team science. 相似文献8.
Kasey B. Jackman Jordon D. Bosse Michele J. Eliason Tonda L. Hughes 《Nursing outlook》2019,67(1):21-38
Background
Sexual and gender minorities (SGMs) experience substantial health disparities. Evidence suggests nurses may be unprepared to work with these populations. A previous literature review of top-ranked nursing journals found that 0.16% of published articles addressed SGM health.Purpose
To evaluate changes in coverage of SGM health in the top-ranked nursing journals since the earlier review using a scoping approach.Methods
Electronic search of articles published between December 2009 and December 2017 in 20 nursing journals with the highest 5-year impact factors.Findings
Thirty-three articles (0.19%) in the top-ranked nursing journals focused on SGM health. There is increasing attention to SGM health recently, evidenced by the numbers of empirical and nonempirical research articles published, as well as nonresearch articles about SGM health.Discussion
In light of well-documented health disparities affecting SGM people, it is essential that nurses continue to conduct and disseminate research related to the health of these populations. 相似文献9.
Hye Yoon Park Young Ae Kim Jin-Ah Sim Jihye Lee Hyewon Ryu Jung Lim Lee Chi Hoon Maeng Jung Hye Kwon Yu Jung Kim Eun Mi Nam Hyun-Jeong Shim Eun-Kee Song Kyung Hae Jung Eun Joo Kang Jung Hun Kang Young Ho Yun 《Journal of pain and symptom management》2019,57(4):774-782
Context
To respect a patient's wish for end-of-life care, “the Act on Decisions on Life-Sustaining Treatment for Patients at the End-of-Life” was enacted in South Korea in 2016. Current understanding of people who would be involved in advance care planning (ACP) is crucial to disseminate it systematically.Objectives
The objective of this study was to investigate awareness and attitudes toward ACP in South Korea.Methods
A multicenter, nationwide cross-sectional study was conducted, a survey regarding ACP among four groups that would have different positions and experiences: 1001 cancer patients, 1006 family caregivers, 928 physicians, and 1241 members of the general public.Results
A total of 15% of the general population, 33% of the patients and caregivers, and 61% of the physicians had knowledge of advance directives. More than 64% of the general population, above 72% of the patients and caregivers, and 97% of the physicians were willing to do so when the disease status was aggravated or terminal. The possibility for changing the plan, uncertainty as to whether directives would actually be followed, and psychological discomfort were common reasons for not wanting to engage in ACP. Routine recommendations for a specific medical condition, heightened accessibility, and health insurance support were common factors that could help facilitate ACP.Conclusion
Our findings suggest that strategies for promoting ACP should reflect different perspectives among the general public, patients, family caregivers, and physicians. Public advocacy, resources for approaching and integrating ACP into routine health care, as well as systematic support provisions are needed. 相似文献10.
Objectives
To offer practical guidance to nurse investigators interested in multidisciplinary research that includes assisting in the development of artificial intelligence (AI) algorithms for “smart” health management and aging-in-place.Methods
Ten health-assistive Smart Homes were deployed to chronically ill older adults from 2015 to 2018. Data were collected using five sensor types (infrared motion, contact, light, temperature, and humidity). Nurses used telehealth and home visitation to collect health data and provide ground truth annotation for training intelligent algorithms using raw sensor data containing health events.Findings
Nurses assisting with the development of health-assistive AI may encounter unique challenges and opportunities. We recommend: (a) using a practical and consistent method for collecting field data, (b) using nurse-driven measures for data analytics, (c) multidisciplinary communication occur on an engineering-preferred platform.Conclusions
Practical frameworks to guide nurse investigators integrating clinical data with sensor data for training machine learning algorithms may build capacity for nurses to make significant contributions to developing AI for health-assistive Smart Homes. 相似文献11.
Shannon Munro Cristina C. Hendrix Linda J. Cowan Catherine Battaglia Virginia D. Wilder Jill E. Bormann Constance R. Uphold Sheila Cox Sullivan 《Nursing outlook》2019,67(1):6-12
Background
In 1995, VA's Office of Research and Development launched the Nursing Research Initiative (NRI), to encourage nurses to apply for research funding and to increase the role of nurse investigators in the VA's research mission. This program provides novice nurse researchers the opportunity to further develop their research skills with the guidance of a mentor.Purpose
Since the NRI's inception, its impact on the research career trajectory of budding nurse researchers had never been fully explored.Methods
An electronic quality improvement survey was developed to collect information about the scope of work and research trajectory of VA nurse researchers undertaken since they received NRI funding.Findings
NRI awardees demonstrated research productivity in several areas including research funding, peer-reviewed publications; participation on journal editorial boards and grant review committees; and mentorship. The majority of past NRI grant recipients (78%) have maintained employment within the VA system and benefit from the expertise, mentoring, and support of other nurse researchers. NRI grant recipients confirm the value of the VA NRI mentored grant funding mechanism and its association with a productive research trajectory with survey respondents demonstrating an average return on investment of $7.7 million in research funding per person.Conclusion
The experiences derived from the NRI accelerated the professional growth and research productivity of this group and it guided future opportunities to design, implement, and test nurse-led interventions. 相似文献12.
Lauren J. Van Scoy Andrew G. Day Michelle Howard Rebecca Sudore Daren K. Heyland 《Journal of pain and symptom management》2019,57(5):980-988.e9
Context
Although measures that assess patient engagement in the advance care planning (ACP) process exist, there are no validated tools to assess surrogate decision makers' (SDMs') role in ACP.Objectives
The objective of this study was to adapt and begin to validate a patient-oriented questionnaire for use with SDMs of patients with chronic illness.Methods
Questions from the 55-item patient-oriented ACP engagement survey were adapted for SDMs and assessed for face validity. The resultant 47-item questionnaire was administered to 65 SDMs of patients with chronic illness. Responses were assessed and items were flagged for removal based on item redundancy, nonresponses, and ceiling effects. A preliminary exploratory factor analysis was performed, internal consistency was assessed, and domains were constructed based on findings.Results
The 47-item questionnaire was administered to 65 participants (mean age 51.8; 81% female; 96% Caucasian). Seventeen items were removed owing to redundancy (r > 0.80), and 13 items lacking face validity were removed. In a preliminary exploratory factor analysis of the resultant 17-item questionnaire, a three-factor solution was deemed most statistically and conceptually sound. Items were organized into domains: 1) serving as an SDM (seven items); 2) contemplation (four items); 3) readiness (six items). Internal consistency for each domain was high (Cronbach alpha 0.90–0.91).Conclusion
The 17-item ACP engagement survey for SDMs (ACP-17-SDM) is a conceptually sound and reliable questionnaire adaptation of the original ACP engagement survey. This questionnaire may be used by researchers in parallel with the patient-oriented ACP engagement survey to more fully understand the impact of ACP interventions on SDMs. Larger studies are needed to more closely examine construct validity. 相似文献13.
Laura C. Prater Thomas Wickizer Seuli Bose-Brill 《Journal of pain and symptom management》2019,57(4):731-737
Context
Opportunities for patients to receive unnecessary, costly, and potentially harmful care near the end of life abound. Advance care planning (ACP) can help to make this vulnerable period better for patients, caregivers, and providers.Objective
The objective of this study was to determine whether older age predicted the presence of certain forms of retrievable ACP documentation in the electronic health record (EHR) in a large sample of hospice-referred patients.Methods
This was a retrospective analysis of medical-record data on 3595 patients referred to hospice between January 1, 2013 and December 31, 2015. EHR documentation of an ACP note in the problem list, presence of a scanned advance directive, and the presence of a verified do-not-resuscitate order were the outcome measures. Logistic regression was used to assess the effect of age, education, race, gender, cancer diagnosis, dementia diagnosis, palliative encounter, and death on the outcome variables.Results
Our results suggest that when we control for prognosis, patients over age 70 years may experience gaps in ACP communication. We found that as patients age, the odds of having documentation of a conversation (odds ratio [OR] = 0.56; P < 0.001) or scanned advance directive decreased (OR = 0.63; P < 0.001), while the odds of having a verified do-not-resuscitate order increased (OR = 1.42; P < 0.001).Conclusion
The results of this study may imply some degree of unilateral and physician-driven decision making for end-of-life care among older adults. Collaborative efforts between an interdisciplinary medical team should focus on developing policies to address this potential disparity between younger and older adults at the end of life. 相似文献14.
Adrienne P. Hudson Amy J. Spooner Natasha Booth Robyn A. Penny Louisa G. Gordon Tai-Rae Downer Patsy Yates Robyn Henderson Natalie Bradford Aaron Conway Christopher O’Donnell Alanna Geary Raymond J. Chan 《Collegian (Royal College of Nursing, Australia)》2019,26(1):110-117
Background
Nurse navigator roles aim to assist patients and their carers with navigating the healthcare system and accessing services to enable them to take a more active role in their own health care.Aim
The aim of this study was to explore patients’ and carers’ experiences of receiving care from a nurse navigator.Methods
This was a qualitative study involving semi-structured interviews with 12 patients (adults and children) and 13 carers receiving care from a nurse navigator in Queensland, Australia. Thematic analysis was conducted.Findings
The nurse navigator was a central contact person for patients and carers within the complex healthcare system. They were described as approachable, available and knowledgeable about the medical condition and the healthcare system, enabling patients to take a more active role in their own healthcare. The navigators played a pivotal role in navigating the seemingly insurmountable obstacles of accessing advice, services, equipment and appointments in a seamless way. However, further work is required to ensure that patients and carers are connected with a nurse navigator earlier in their healthcare journey.Discussion
The nurse navigators’ understanding of the complex healthcare system coupled with their global overview of patients and carers provided the participants with a sense of direction, options and more control over their own healthcare trajectory.Conclusions
The nurse navigator role has the ability to improve the care experience of patients and carers of varying ages and with varying medical conditions as explored in this study. 相似文献15.
16.
Maureen E. Lyon Leah Squires Lawrence J. D&#x;Angelo Debra Benator Rachel K. Scott Isabella H. Greenberg Patricia Tanjutco Melissa M. Turner Tara E. Weixel Yao I. Cheng Jichuan Wang 《Journal of pain and symptom management》2019,57(3):607-616
Context
No prospective studies address disease-specific advance care planning (ACP) for adults living with HIV/AIDS.Objective
To examine the efficacy of FAmily-CEntered (FACE) ACP in increasing ACP and advance directive documentation in the medical record.Methods
Longitudinal, two-arm, randomized controlled trial with intent-to-treat design recruited from five hospital-based outpatient HIV clinics in Washington, DC. Adults living with HIV and their surrogate decision-makers (N = 233 dyads) were randomized to either an intensive facilitated two-session FACE ACP (Next Steps: Respecting Choices goals of care conversation and Five Wishes advance directive) or healthy living control (conversations about developmental/relationship history and nutrition).Results
Patients (n = 223) mean age: 51 years, 56% male, 86% African-American. One hundred ninety-nine dyads participated in the intervention. At baseline, only 13% of patients had an advance directive. Three months after intervention, this increased to 59% for the FACE ACP group versus 17% in the control group (P < 0.0001). Controlling for race, the odds of having an advance directive in the medical record in the FACE ACP group was approximately seven times greater than controls (adjusted odds ratio = 6.58, 95% CI: 3.21–13.51, P < 0.0001). Among African-Americans randomized to FACE, 58% had completed/documented advance directives versus 20% of controls (P < 0.0001).Conclusions
The FACE ACP intervention significantly improved ACP completion and advance directive documentation in the medical record among both African-American and non-African-American adults living with HIV in Washington, DC, providing health equity in ACP, which can inform best practices. 相似文献17.
Eric D. Hansen Mary M. Mitchell Dulce M. Cruz Oliver Fahid A. Alghanim Michelle Walter Amy A. Case Tom Smith Amy R. Knowlton 《Journal of pain and symptom management》2019,57(5):961-965
Context
In the era of effective antiretroviral therapy, persons living with HIV/AIDS (PLWHA) are living longer, transforming HIV from a universally fatal disease to a serious chronic illness, warranting discussions between patients and their loved ones about advance care planning (ACP). Evidence is needed on factors associated with patients' likelihood to discuss ACP with loved ones.Objectives
To further characterize factors associated with successful ACP in PLWHAs with their loved ones, we examined associations between patients having ACP discussions with the need for assistance with personal care, chronic pain, life satisfaction, prior family disagreements over health care decisions, sex, age, and interference in daily routines due to memory problems.Methods
Data were from the Affirm Care study (N = 370), which examined social and environmental factors associated with health outcomes among PLWHAs and their informal caregivers.Results
Slightly more than half of respondents discussed ACP with loved ones (57%). In adjusted analysis, higher levels of chronic pain (odds ratio [OR] = 2.09, P = 0.045), needing assistance with personal care (OR = 1.63, P = 0.023), greater life satisfaction (OR = 1.02, P = 0.002), prior family arguments over health care decisions (OR = 2.80, P < 0.001), and female sex (OR = 2.22, P = 0.001) were associated with higher odds of discussing ACP with loved ones, whereas age, drug use, education level, depression, and memory problems were nonsignificant.Conclusion
These results suggest that interventions to increase ACP among PLWHAs and their loved ones should target males. The findings also suggest PLWHAs with chronic pain, the need for assistance with personal care, and those with a history of prior family arguments over health care decisions may be primed for ACP. 相似文献18.
Sara Greco Erica J. Lewis Julie Sanford Erika Metzler Sawin Allison Ames 《Journal of Professional Nursing》2019,35(2):124-132
Background
With disasters occurring often, nurses must understand and ethically implement disaster management and patient care coordination. Yet these topics are often not discussed in nursing education curricula. Simulations are a potential solution to this ethical educational deficit, allowing students to act as professional nurses in a realistic scenario with minimal threat of harm to themselves or others.Aim
This study investigates the effect of a high fidelity, multiple-casualty disaster simulation followed by a structured faculty-led debriefing session on perceived ethical reasoning confidence on senior Bachelor of Science in Nursing (BSN) students. Additionally, the effect of the intervention on students' perceived importance of ethical reasoning and perceptions of such skills was explored.Methods
Students were provided with preparatory materials on the START (Simple Triage and Rapid Treatment) System and The Madison Collaborative's Ethical Reasoning in Action Eight Key Questions (8KQ) frameworks one week before the simulation exercise. In total, 90 students worked in pairs during the 15-minute disaster simulation. Participants' ethical reasoning attitudes were measured before and after the exercise, employing the Survey of Ethical Reasoning (SER) to indicate the importance of each of the 8KQ in students' ethical reasoning process using a five-point Likert scale. The SER was administered electronically using Qualtrics and statistical analysis was completed using SPSS. The 8KQ was also used in the debriefing led by faculty.Results
Comparative assessment of pre and post-results demonstrate significant growth in students' ethical reasoning confidence scores (t(89)?=??6.609, p?<?0.001).Conclusions
Simulations are shown to be effective educational approaches in developing ethical reasoning confidence and promoting the development of students' ethical preparedness. 相似文献19.