贴合住院患者生活护理需求的护理级别分类方法探讨

目的 探讨更贴合住院患者实际生活护理需求的护理级别分类方法,为分级护理改革提供依据.方法 采用整群抽样法选择内科、外科住院患者共502例,医生按常规开分级护理医嘱,责任护士应用Barthel指数对住院患者进行日常生活活动能力(activities of daily living,ADL)评估和护理分级,并采用生活护理问卷调查患者的生活护理需求.结果 502例患者中,医嘱护理分级与ADL护理分级经Spearman秩相关分析显示有统计学意义(rs=0.209,P<0.01);生活护理需求排序在2种分类方法中差别不大,但ADL护理分级方法比医嘱护理分级法与患者的生活护理需求一致性程度更高.结论 与医嘱护理分级相比,ADL护理级别分类法更能体现住院患者生活护理需求的个性化.     

Nursing Intervention Classification Systems

Purpose: To analyze the features, development, and research of the Omaha System, the Iowa Nursing Intervention Classification, and the Home Health Care Classification and provide a critical review of the unique components of each.
Organizing Framework: Five elements: achievement of original purpose, language used, ease of computerizing format, clinical utility, and linkage of the Nursing Minimum Data Set (NMDS) nursing care elements.
Conclusions: Further testing and development of nursing classification systems should be done to determine the general value of nursing classification, the extent to which the original goals and purposes of classification are met, and to identify the unique features and contributions of each system. Further testing is important to determine the strengths, weaknesses, and applicability of the various systems for capturing the elements of the NMDS for different care settings, care givers, and patient populations.
Implications: Nursing classification may eventually lead to naming and describing the work of nurses. Research findings will continue to provide information leading to a unified nursing language system that describes the practice of nursing in local, regional, national, and international health-care data sets used for research, clinical, education, policy, and administrative purposes.     

Studying and Using Conceptual Models of Nursing

This national survey used an investigator-developed questionnaire to explore how and when graduate nursing students and faculty members learned about conceptual models of nursing and how they regarded them. Of the 691 respondents, 477 (69%) were familiar with 3 or more models. Formal course work, independent studies and continuing education programs were the most frequent sources of knowledge about models. The students reported exposure to models earlier in their educations than did the faculty members. Users of models in practice and research were enthusiastic about their value. Most respondents (87%) regarded the development of conceptual models of nursing as being highly important to the advancement of nursing.     

Analysis and Evaluation of Conceptual Models of Nursing

Books review in this article: Behind the Mask Nurses, Their Unions and Nursing Policy by Christopher Hart Family Partnership in Hospital Care The Co-Operative Care Concept edited by A J Grieco, M L McClure, B K Komiske & R F Menard Health Psychology An Introduction for Nurses and Other Health Care Professionals 2nd edn by Neil Niven Clinical Handbook for Continence Care by B Roe & K Williams Issues in Accident and Emergency edited by Lynn Baih Nursing Practice Hospital and Home — The Adult edited by M F Alexander, J N Fawcett & P J Runciman Reshaping Dementia Care Practice and Policy in Lang-Term Care by Miriam K Aronson Developing Professional Knowledge and Competence by Michael Eraut Being Human Ordinariness in Nursing by Beverley J Taylor Psychiatric Nursing Consulting editor Christine A Grant, reviewers, Bruce P Mericle     

Oncology Nursing Considerations when Developing Outpatient Staffing and Acuity Models

ObjectivesObjectives include review of existing benchmarks and nurse-sensitive indicators relevant to the ambulatory care setting. Applying the data to existing ambulatory staffing models with consideration of multiple clinic settings that include medical oncology, infusion, and stem cell transplant clinics. And to describe key considerations needed to optimize oncology care efficiently with an acuity-based staffing model.Data SourcesPublished literature indexed in PubMed, CINAHL, textbooks.ConclusionIn today's complex oncology environment, optimization and utilization of outpatient facilities is essential in providing high-quality care and improving satisfaction of patients as well as providers and staff.Implications for Nursing PracticeNurse leaders should utilize benchmarking data to ensure staffing levels are appropriate, given the size and scope of their facility. Staff nurses should be engaged to ensure that acuity tools are developed in accordance with their experiences and perceptions of patient care.     

Emotional Development in Infancy: Theoretical Models and Nursing Implications

TOPIC. Theories of emotional development in infancy that are relevant to clinical practice.
PURPOSE. A discussion of the complementary theories such as EmdeS (1989) psycho-analytically based developmental model of early socioemotional reorganizations and Stern's (1985a) model of the developing self, with the goal of presenting an integrated view of key socioemotional processes and their developmental foundations during infancy. Concepts such as "emotional availability" and "affect attunement" are examined as vehicles for early socioemotional organization and adaptation.
SOURCES. Relevant literature from nursing, child psychiatry, and developmental psychology.
CONCLUSIONS. Implications are drawn from clinical assessment of high-risk caregiver-infant relationships and early causal pathways for later socioemotional dysfunction. Nurses should focus on the importance of assessing interpersonal variables and their ongoing contribution to internalizing patterns of dysfunctional behavior in children.     

Measuring Nursing Practice Models using Multi-Attribute Utility theory

Nursing Practice Models (NPMs) represent the structural and contextual features that exist within any group practice of nursing. Currently, measurement of NPMs relies on costly and nonreproducible global judgments by experts. Quantitative measurement techniques are needed to provide a useful evaluation of nursing practice. Guided by Multi-Attribute Utility theory (MAU theory), an expert panel identified 24 factors representative of N PMs. The factors became elements in a computational index that, when summed, assigns a score to a given nursing unit reflecting the extent to which that unit's nursing practice model achieves the nursing professional ideal. Initial validation of the index and its elements consisted of comparing assessments of 40 nursing units generated by the index with a global evaluation provided by each of the expert panelists who proposed the model factors. Pearson correlations between the index-generated scores and the global assigned scores provided evidence supporting the preliminary validation of the index.     

Exploring the Use of Explanatory Models in Nursing Research and Practice

Purpose: To address the lack of information in nursing for delivering culturally appropriate care and provide a framework for nurses to incorporate diverse beliefs and health needs into research and practice. People interpret and react to health and illness events within a cultural system. However, the nursing literature contains little about how to elicit cultural beliefs.
Organizing Framework: Use of Kleinman's (1980) concept of explanatory models (EMs) is explored first, by describing the concept as it was developed by Kleinman, and second, by illustrating how it was used in three research studies conducted between 1990 and 1994.
Method: Individual in-depth interviews were conducted with community-based convenience samples. Data were analyzed using content analysis. Explanatory models were explored with healthy people, with people following illness, and with people having a condition with potential health risks, to illustrate their usefulness in nursing research and practice.
Conclusions: The findings provide a beginning understanding of the complex linkages between beliefs and actions and demonstrate the versatility and usefulness of EMs for nursing research and practice. Assessing models offers one means for researchers and clinicians to explore health beliefs and the linkages between beliefs and behaviors.     

Partnerships and New Learning Models to Create the Future Perioperative Nursing Workforce

To create new and sustainable approaches for development of the perioperative nursing workforce, perioperative nursing leaders at a hospital collaborated with administrators and faculty at a school of nursing to create an innovative learning model that reintroduces perioperative experiences to students in a nursing baccalaureate program. Key components of the initial approaches included an externship for nursing students and a revised internship for experienced nurses who wished to work in perioperative nursing. Project leaders then expanded the nursing student learning opportunity by adding two additional elective perioperative courses to the curriculum. Formation of perioperative clinical placement sites within the senior-level adult acute care course was an additional positive outcome of these initial initiatives. These initiatives resulted in decreased use of agency nurses at the clinical site where the externships take place and increased numbers of younger nurses working in the perioperative areas where they externed, with high levels of satisfaction reported by nurses involved in the program. Through this innovative collaboration, the perioperative nurse shortage at the hospital has abated, and the opportunity to continually recruit new colleagues into the practice of perioperative nursing has been established.     

Translational Potential of Systems‐Based Models of Inflammation

A critical goal of translational research is to convert basic science to clinically relevant actions related to disease prevention, diagnosis, and eventually enable physicians to identify and evaluate treatment strategies. Integrated initiatives are identified as valuable in uncovering the mechanism underpinning the progression of human diseases. Tremendous opportunities have emerged in the context of systems biology that aims at the deconvolution of complex phenomena to their constituent elements and the quantification of the dynamic nteractions between these components through the development of appropriate computational and mathematical models. In this review, we discuss the potential role systems‐based translation research can have in the quest to better understand and modulate the nflammatory response.     

我国临床护理教学师资构成及教学模式的分析

正确的当成错误的 ,或把错误的当成正确的。即使编辑了解了新旧标准 ,但实习和工作带来直接的影响 ,而教学质量的核心影响因素则取决于师资队伍的建设。近几年 ,我国护理教育在临床护理教学的教学模式、教学方法、课程设置以及师资队伍的建设等方面做了很多尝试与改革。本文就国内的临床护理课程授课师资组成与教学模式进行分析 ,拟探讨适应现代临床护理教学需求的师资结构和教学模式 ,以促进教学质量的提高。1　国内外临床护理教学历史与现状1 1　国外护理教育回顾。从南丁格尔创建护理教育至 2 0世纪初 ,各国的护理教育基本在医院实施 ,医…