老年病房临床护理人员关怀能力调查分析

目的：分析老年病房护理人员关怀能力现状,为培养护理人员关怀能力提供依据。方法：采用方便抽样法,对某三级医院老年病房100名护理人员关怀能力进行问卷调查。结果：调查对象关怀能力评分低于常模;不同职称、不同护龄的护理人员在认知、勇气、耐心3个维度上差异有统计学意义（均P〈0.05）,其中主管护师显著优于护师和护士（均P〈0.05）;护龄≥11年的护理人员高于1～5年和6～10年两组护理人员（P〈0.05）。68.18%的主管护师、护龄≥11年的68.00%的护士在日常护理工作中总是实施关怀护理。结论：护理人员整体关怀能力较差,尤其是低职称、低护龄的护理人员,护理管理部门应加强关怀能力相关的讲课与培训,以增强护理人员的关怀意识以及提高其能力。     

农村老人健康状况和医疗保健的调查分析

目的:了解农村老人健康及其医疗保健现状。方法:对295位农村老人进行问卷调查,内容包括老人所患疾病、就医现状和保健常识等。结果:在农村老人中慢性疾病的患病率达100％,其中患4种以上疾病的占69.8％,老人对自身健康的满意度只有28.1％,对医疗保健的满意度只有22.7％。结论:改善农村卫生环境、建立新型农村合作医疗制度、合理控制医疗卫生费用、培养农村医疗保健专业队伍、开展敬老活动、协调家庭关系和健康宣教等活动,有助于提高农村老人的健康水平和生活质量。     

Factors affecting the performance of public health nurses in family nursing care

Objective

To determine factors that influence the nurses’ performance in family nursing care in public health centers in Jambi City.

The quality of care in Norwegian nursing homes

BACKGROUND: Promoting the quality of life is an importing aim of the long-term care for the elderly, and the quality of life is related to quality of care (QoC). This way the QoC in nursing homes, and its correlates, is an interesting subject. AIM: To describe to what degree Norwegian nursing homes provide services in line with the core areas of the 'regulation of care' and whether patient or ward characteristics are associated with the QoC. METHODS AND MATERIAL: Cross-sectional study where data were collected in structured interview of the nursing staff in 251 wards regarding 1926 patients. RESULTS: Most of the patients receive good basic care in Norwegian nursing homes, but taking part in leisure activities and having the opportunity to go out for a walk are more often neglected. Acceptable QoC had a strongly negative association with patient characteristics such as low function in mental capacity, low function in activities of daily living and aggressive behaviour. In most of the measured areas of QoC, ward characteristics, such as type of ward, size of ward and staffing ratio, do have an influence on QoC.     

人文关怀在老年病房中的实践与效果

目的探讨人文关怀在老年病房中的实践与效果。方法改善病房环境,开展优质服务,提高护士的技术操作水平及与病人沟通的能力,并将人文关怀体现在护理服务的每个细节。结果病人的满意度明显提高,增加了社会效益和经济效益。结论人文关怀在临床中的应用,有利于提高病人满意度,降低医疗纠纷的发生率,增强医院竞争力。     

农村老年人健康状况及卫生保健需求调查

目的了解农村老年人的健康状况和卫生保健需求。方法采用自设问卷对528名60岁及以上的农村老年人进行调查。结果59．28％的老年人患有一种或几种慢性疾病,56．82％的老年人常有孤独感、衰老感、抑郁感、无能为力感等负性情绪;65．63％的老年人支付医疗费用困难。卫生保健需求依次是定期体格检查、急救处理、上门服务、健康教育、定期家访。结论农村老年人存在不同程度的身心健康问题,对卫生保健有较大需求,应根据老年人的经济状况和需求提供多种形式、多层次的卫生保健服务。     

石河子市老年人健康状况和护理需求现状调查

目的了解新疆石河子市老年人的健康状况及护理服务需求,为老年人的健康保健及医疗服务提供参考依据。方法采用自制问卷对500名社区老年人的一般人口学资料、健康状况、个人健康行为和护理服务需求等进行调查。结果老年人慢性病患病率为72．60％,其中46．60％的老年人患有2种及以上的慢性病;近2周患病率为49．40％;前10位慢性病依次为高血压、冠心病、风湿性关节炎、糖尿病、骨质增生、慢性支气管炎、胆道疾病、脑梗塞、胃肠疾病、前列腺疾病。老年人中有吸烟史者占28．20％,有饮酒史者占18．20％;62．80％的老年人从未体检;老年人所需的保健知识依次为安全用药、慢性病、饮食指导、传染病和常见病等;老年人急需的卫生服务项目：建立健康档案（47．80％）、定期体检（46．60％）、健康指导（43．80％）、社区紧急救护（37．40％）。结论社区老年人慢性病患病率高,针对社区老年人的健康状况和护理服务需求,开展健康教育及社区卫生服务,提高社区老年人的健康水平和生活质量。     

'Scraps': hidden nursing information and its influence on the delivery of care

What nurses commonly describe as 'scraps' are defined as the personalized recordings of information that is routinely made on any available piece of paper (hence scraps) or in small notebooks. The use of scraps is common in practice and has been noted in research from across the globe. Drawing on an empirical study it is argued that scraps are a unique combination of personal and professional knowledge that informs the delivery of care. The overall aim of the study was to discover how nurses define and communicate information about patients and the delivery of care to each other on an elderly care unit. The processes by which information was constructed and the organizational structure and interactions that influenced this were also identified. The research design was an ethnographic one that involved: observations of formal nursing end of shift reports (23 handovers) and informal interactions between nurses (146 hours); interviews (n + 34) with registered nurses, student nurses and nursing auxiliaries; and analysis of written records. Data were collected from five acute elderly care wards at a district general hospital in the south of England. A grounded theory analysis was undertaken which revealed that scraps may have a significant role in the communication of information and the delivery of care. Therefore a categorization of scraps within three main themes was undertaken. First, the analysis revealed the processes involved in the construction of scraps. Second, the content and role of scraps in influencing the delivery of care was exposed. Finally, the potentially confidential nature of scraps and consequent problems of storage and disposal was recognized. The findings are discussed in relation to a suggested model of the interrelationship between paperwork, scraps, handovers and the delivery of nursing care. It is concluded that scraps are significant in facilitating nursing care and that this should be recognized in research, education and practice.     

Healthcare professionals’ experiences with highly qualified nurses working in acute care teams in primary healthcare settings

ObjectiveStrengthening primary healthcare with highly qualified nurses in acute care units or teams is a new Danish initiative intended to detect acute diseases and the deterioration of chronic diseases and to develop treatment for outpatients. This study explores healthcare professionals’ experiences with this initiative.DesignQualitative semi-structured interviews conducted in 2019–2020. Analysis was conducted with a systematic text condensation.SettingThis study is based on an acute care team in one Danish municipality called Acute Team Odense (ATO). ATO delivers acute nursing in patients’ own homes (including nursing homes) in collaboration with different healthcare professionals.SubjectsIndividual interviews with general practitioners (GPs) (n = 15), five focus-group interviews with nurses and nursing assistants from the municipality (n = 19) and one focus-group interview with staff from the emergency department (ED) (n = 10).Main outcomesExperiences of different healthcare professionals’ experiences with ATO.ResultsIn general, all of the participants were very satisfied with the new acute care team and the cross-sectorial possibilities. The GPs usually referred ATO to assessments in which paraclinical equipment, competencies, accessibility, response time and communication were important. The municipal nurses and nursing assistants tended to use ATO if they needed second opinions or acute nurse assistance. The ED most often used ATO to assist with intravenous therapy after an ED visit. All participants reported that ATO increased what could be assessed and treated in patients’ homes, which is central to preventing unnecessary hospitalisations.ConclusionsATO created new possibilities in patient’s homes which potentially might prevent unnecessary hospitalisations.

KEY POINTS

• Acute care units or teams are mandatory in Danish health care, but limited knowledge in the area is found.
• Healthcare professionals found that the acute care teams provided new possibilities to assess and treat patients in their own homes.
• Healthcare professionals experienced that the acute care team potentially prevented hospitalisations by fast clinical nurse assessments with paraclinical tests.

     

Action research: A mechanism for active engagement of clinical nurses in a program of research

This study aimed to explore the outcomes of active participation in an action research project on building the research capacity of clinical nurses. In this qualitative research study, six registered nurses volunteered to participate in the action research team. None of the nurses reported having any prior research experience. This study was part of a larger three‐phase project. The nurses were required to reflect on the data about their medication practice of phase 1, develop and implement a bundle of interventions in phase 2 to improve medication safety, and evaluate the effectiveness of these interventions in phase 3. We report the nurses' participation in Action Research during phase 2. Meeting minutes and six semistructured interviews were thematically analyzed. The results showed that after receiving support to enhance their research skills from the research team, the nurses were empowered to perform and lead clinical nursing research project. Nurses were able to take ownership of the research process and outcomes and were then able to translate their new research knowledge and skills into their clinical practice by building their own research capacity.     

Improving networks between acute care nurses and an aged care assessment team

Background. Acute care nurses have an important role in the discharge planning of older people from hospital to home. However, few nurses understand the changing aged care system or the consequences of poor referral on the lives of older people postdischarge. Aims and objectives. This paper reports the findings of a research project, which aimed to investigate the possibilities for facilitating the transition of older people from hospital to home through improving the working relationship between nurses and members of a multidisciplinary aged care assessment team (ACAT). Design and methods. The paper reports one action research cycle from a larger project. Action research was chosen because its focus on knowledge development and action leads to practical solutions to clinical problems. The research approach included interactive forums designed to facilitate effective collaboration between the nurses and ACAT in the discharge planning of older people. Data collection strategies included audiotapes of ACAT research discussions, field notes, policy documents, referral forms and an evaluation tool. Results and conclusions. The findings illustrate that ward nurses have, at best, a limited knowledge and understanding of the aged care system, its function, or how to access services. They need assistance to develop their knowledge of services available to support older people following discharge. The conduct of interactive forums, which utilize a case study approach, facilitated such knowledge development and empowered the nurses to become more involved in discharge planning. Participation in the forums also facilitated new collaborative partnerships between the nurses and ACAT, which enhanced effective discharge planning. Relevance to clinical practice. The paper outlines practical strategies to support collaboration between ward nurses and community providers and/or multi disciplinary assessment services. It provides a list of key considerations for the development of effective ward/community networks to facilitate the discharge of older people.     

Encounters between children's nurses and culturally diverse parents in primary health care

The objective of this study was to analyze the healthcare encounters between nurses and parents of different cultural backgrounds in primary health care. An ethnographic study was carried out using participant observations in health centers and interviews with nurses. Data were analyzed using thematic content analysis and constant comparative method. Four main themes were identified when nurses met parents of other cultural backgrounds: lack of mutual understanding, electronic records hamper the interaction, lack of professionals' cultural awareness and skills, and nurses establish superficial or distant relationships. The concepts of ethnocentrism and cultural imposition are behind these findings, hampering the provision of culturally competent care in primary health services. There were difficulties in obtaining and registering culturally related aspects that influence children's health and development. This was due to e‐records, language barriers, and the lack of cultural awareness and skills in health professionals making the encounters difficult for both nurses and parents. These findings show that there is a clear threat for health equity and safety in primary care if encounters between nurses and parents do not improve to enable nursing care to be tailored to any individual family needs.     

老年服务机构护理人员现状分析及对策

优化老年服务机构护理人员队伍结构,提升专业化水平,对于推进我国社会养老服务体系建设,有效应对人口老龄化问题具有重要意义。本文通过对老年服务机构护理人员现状进行分析,提出相应对策,旨在进一步促进老年服务机构护理人员队伍建设。     

The experience and views of mental health nurses regarding nursing care delivery in an integrated, inpatient setting

Positive and effective consumer outcomes hinge on having in place optimal models of nursing care delivery. The aim of this study was to ascertain the experience and views of mental health nurses, working in hospitals in an area mental health service, regarding nursing care delivery in those settings. Surveys (n = 250) were sent to all mental health nurses working in inpatient settings and 118 (47%) were returned. Results showed that the quality of nursing care achieved high ratings (by 87%), and that two-thirds of respondents were proud to be a mental health nurse and would choose to be a mental health nurse again. Similarly, the majority (71%) would recommend mental health nursing to others. Concern was, however, expressed about the continuity and consistency of nursing work and information technology resources. Nurses with community experiences rated the importance of the following items, or their confidence, higher than those without previous community placements: the importance of interdisciplinary teamwork; the importance of participating in case review; the importance of collaborating with community staff; confidence in performing mental state examinations; and confidence in collaborating with community staff, suggesting that this placement had positive effects on acute care nursing.     

User participation in district psychiatry. The social construction of ‘users’ in handovers and meetings

An ideal in mental health care is user participation. This implies inclusion and facilitation by clinicians to enable users to participate in decisions about themselves and in the design of suitable treatment. However, much of the work of clinicians consists of handovers and other meetings where patients are not present. It is therefore interesting to study how the patient perspective is handled in such meetings and whether it forms a basis for user participation. We conducted fieldwork in three different inpatient wards in Norwegian District Psychiatric Centres. We used an interactional perspective in our analysis, where speech acts, framing and footing were key concepts. The findings show that the talk in the handovers and meetings contained five main themes and that there was a clear correlation between what was said and how it was said, and whether clinicians related to the content in a decisive, person‐centred or indecisive manner. We discuss potential participation statuses for patients and their limited opportunity to influence the talk and possible decisions about themselves. Our conclusion is that handover meetings primarily function as an aid in organising clinicians' work and could ultimately be seen as counteracting user participation.