Quality of life—a measure of the quality of nursing care?

Quality of life is a very complex phenomenon in the life of cancer patients. Individual perceptions might change with the state of disease and with necessary interventions. Some definitions seem to be more useful in cancer care than others. There has been considerable controversy in the quantity versus quality debate. Some confusion in the measurement of quality of life concerns objectivity and subjectivity, referring either to the content of information or to persons other than the patient eliciting it. The relation between quality of life and quality of care has to be further explored: some dimensions of care might be of little or of potential relevance to the patient's quality of life. The dimensions of proven relevance concern psychological well-being through, for example, promotion of self-care or an enhanced perception of self-worth. These findings emphasise the importance of the concept of care, which is the essence of nursing. Contemporary professional and political difficulties require critical analysis.     

Evidence-based nursing: a method for nursing practice?

Evidence-based nursing is the concept of critically appraising the best evidence from research. It integrates research evidence with clinical expertise into decision making in nursing care for patients. The method is derived from the new paradigm in medicine--evidence-based medicine, developed as a learning method by epidemiologists at the McMaster University in Canada. This article states the necessity of this method for nursing. With the help of a clinical scenario (fall prevention in the elderly) the author explains how to use evidence-based nursing in practice.     

Emotional intelligence: a primal dimension of nursing leadership?

Emotional intelligence, a concept well known in the world of business, is quickly gain ing recognition in the healthcare arena. Described as the primal aspect of leadership, emotional intelligence refers to the ability to monitor and discriminate among emotions, and to use the information to guide thought and action. This paper will explore the theoretical and empirical basis of emotional intelligence and its linkages to leadership. Readers will be informed of the origins and theoretical perspectives regarding emotional intelligence, evidence related to the existence of emotional intelligence, benefits and limitations of the concept and implications for nursing leadership.     

The rhetoric of rupture: nursing as a practice with a history?

In this paper we argue that nursing is consistently presented as a practice without a history, constantly reinventing itself within new professional and technical realms. This rupture with and repudiation of a past deemed to be pejorative, coupled with a rebirth in a "preferred present," raises recurrent problems in the construction of nursing's contemporary professional identity and search for social legitimacy. Furthermore, constituting new nursing knowledge and practice as discontinuous with the past produces a sense of historical dislocation of that nursing knowledge and practice that, in turn, reproduces the need for relocation through reinvention. This phenomenon, which we term the "rhetoric of rupture," in our view, arises from nursing's frustrated attempts to gain social status and legitimacy. Paradoxically, this constant reinvention in fact hampers nurses' attempts to gain that status and legitimacy.     

Applying to a nursing home is a way to maintain control of life—Experiences from Swedish nursing home applicants

Background

Swedish social policy enables ageing in place with support from home-based care services despite high age and/or declining health.

Aim

This study aims to describe the daily life experiences behind the decision to apply for a nursing home placement in older adults ageing in place.

Materials and Methods

A qualitative design was chosen, and 11 semi-structured interviews were conducted and analysed using inductive qualitative content analysis.

Results

The participants described a feeling of dependence in which they had to ignore their personal privacy when receiving home-based care. They reached a turning point when ageing in place was, for several reasons, no longer considered an acceptable option. This influenced their choice to apply to a nursing home where they expected that they could maintain control over their lives.

Discussion and Conclusion

The results indicate that when enhancing ageing in place it is important to enable older adults to receive support to maintain autonomy in daily activities and to have the opportunity to age in the right place.     

Development of a specialized nursing language from the nursing science perspective: why and what for?

Language is an essential part of communication. This article focusses on the development of a professional nursing language (taxonomy). It is discussed that nurses' communication with patients is determined by verbal and nonverbal interactions. In the development of a professional nursing language, nurses will primarily rely on the verbal communication with patients, by using a patient's information that is objective and embodies observable data, that can be numerically quantified and statistically processed. This "objective" information lends itself to be systematized and classified. However, there is also the domain of nonverbal communication, the "grey" area of interaction, in which the nurse has to rely on her clinical experience when interpreting a patient's body language and symbolic interaction. This "subjective" information can be complex in its meaning and requires sophisticated professional skills in the interpretation of symbols and sounds. Nurses' clinical expertise is particularly required in this nonverbal interaction domain. Whereas physicians' prime responsibility lies in the deductive reasoning of symptoms until a medical diagnosis can be determined, nurses' prime responsibility covers the inductive reasoning of a patient's reactions to disease and illness, the observation of interaction and behaviour through which a nursing diagnosis is derived. Somewhere the medical and nursing process overlap; a physician will also pay attention to a patient's reaction to illness, whereas the nurse has to rely on her knowledge and experience of disease and impairment. It is argued that the construction of a nursing taxonomy can be no more than a means toward the goal in providing comprehensive nursing care.     

Assessment of quality in psychiatric nursing documentation – a clinical audit

Background

Quality in nursing documentation facilitates continuity of care and patient safety. Lack of communication between healthcare providers is associated with errors and adverse events. Shortcomings are identified in nursing documentation in several clinical specialties, but very little is known about the quality of how nurses document in the field of psychiatry. Therefore, the aim of this study was to assess the quality of the written nursing documentation in a psychiatric hospital.

Method

A cross-sectional, retrospective patient record review was conducted using the N-Catch audit instrument. In 2011 the nursing documentation from 21 persons admitted to a psychiatric department from September to December 2010 was assessed. The N-Catch instrument was used to audit the record structure, admission notes, nursing care plans, progress and outcome reports, discharge notes and information about the patients’ personal details. The items of N-Catch were scored for quantity and/or quality (0–3 points).

Results

The item ‘quantity of progress and evaluation notes’ had the lowest score: in 86% of the records progress and outcome were evaluated only sporadically. The items ‘the patients’ personal details’ and ‘quantity of record structure’ had the highest scores: respectively 100% and 71% of the records achieved the highest score of these items.

Conclusions

Deficiencies in nursing documentation identified in other clinical specialties also apply to the clinical field of psychiatry. The quality of electronic written nursing documentation in psychiatric nursing needs improvements to ensure continuity and patient safety. This study shows the importance of the existence of a validated tool, readily available to assess local levels of nursing documentation quality.