Nurses' perceptions of parental involvement in hospital care

Parental involvement is an essential element of quality of care for children in hospital. However, there is often confusion in role perception between parents and nurses which may be affected by nurses' attitudes, their ability to provide information, their communication and interpersonal skills and willingness to relinquish control. AIM: This study examined nurses' perceptions of parental involvement and communication with parents of children in hospital and explored differences in perceptions of recent graduate nurses and more experienced nurses. METHOD: Two focus groups were carried out at a university paediatric hospital in Sweden, one with experienced paediatric nurses (n = 7) and one with recent nursing graduates (n = 6). FINDINGS: Analysis of the discussions identified five themes: clarifying roles, information, work environment, support and clinical competence. These nurses confirmed the belief that involving parents in the child's care is an important part of nursing in paediatric care and suggested that the nurses should play the role of being the communicator with the parents. CONCLUSION: Nurses need to be aware of the impact their communication has on parents and help them to clarify their role as parents in hospital.     

Nurses' knowledge and beliefs about continence interventions in long-term care

Incontinence in nursing homes is a prevalent condition requiring a programmatic approach due to its diverse aetiology Awareness of antecedent factors, such as knowledge and beliefs about incontinence and its treatment by the individuals responsible for establishing and maintaining a continence programme, is important prior to implementation A questionnaire was administered to licensed nurses who attended a workshop on urinary incontinence in nursing homes One purpose of the questionnaire was to elicit information about beliefs regarding the effects of continence programmes on residents and staff and potential staff reaction to implementation of a continence programme in then- facility Responses by licensed practical nurses (LPNs) were compared to the responses of registered nurses (RNs) Attribution for causes of incontinence differed between LPNs and RNs There were no significant differences in the report of current routine nursing care which included scheduled toileting, changing clothing when necessary, and use of adult briefs and underpads Most nurses anticipated a favourable reaction by the staff to the implementation of a continence programme However, at least 20% responded that the nursing staff would be apathetic or resistant to a programme Administrative support was infrequently chosen as the most important factor in the implementation of a programme. The implications of these findings to continence programmes that are integrated into the organization and provide comprehensive services, including preventive interventions, are discussed     

Nurses' beliefs and values about doing cue-based care in an NICU in Taiwan

Although advances in medical technology have increased the survival rate of preterm infants, science is no cure-all for these high-risk patients. A growing number of studies report that caregiving interventions cause physiological and behavioral distress in such infants. The results have prompted changes in caregiving practices, attempting to reduce stress and strengthen protection for the infants, in order to promote their stability and development in the neonatal intensive care unit (NICU) . This study uses qualitative research methods to grasp the richness and diversity of nurses' beliefs and experience in the taking care of preterm infants. Ten groups of questions explore how NICU nurses take care of premature infants, nurses' perspectives on cue-based care, and the extent to which NICU nurses practice cue-based care. The results generated three themes: (1) timely and skillful management of the preterm infants; (2) compassionate and holistic care for the infants and their highly stressed families; and (3) the relationship between good nursing care and meeting the needs of preterm infants, families, physicians, units, and the environment. It is apparent that the approach to care delivery in NICU practice is still clinical-based, and that there are some obstacles to the delivery of cue-based care. The reasons for this include lack of knowledge, incomplete collaboration with team members, and insufficient support from the administrative systems. To improve the quality of nursing care and preterm infant outcomes, it will be necessary to educate NICU nurses on cue-based care, to enhance collaboration among all team members, to reduce their non-nursing workload, and to re-design NICUs for optimal cue-based care.     

Nurses' beliefs about their abilities to delegate within changing models of care

Changing models of nursing care have resulted in a more diverse work force composition. Nurses (RNs and licensed practical and vocational nurses) have greater responsibilities for delegation and supervision of unlicensed assistive personnel providing direct nursing care. This study describes nurses' beliefs about their abilities to delegate and supervise direct nursing activities and explores differences based on professional and job-related factors. A national sample of 148 licensed nurses working in three practice settings was surveyed. In general, nurses reported a high level of comfort, frequency, preparedness, confidence, competence, and control. Differences found in nurses' beliefs were based on education, practice setting, and type of work responsibilities.     

Nurses' perceptions about patient safety culture in public hospital in Vietnam

AimThis paper is aimed to assess nurses' perceptions of patient safety culture in four public general hospitals in Hanoi, Vietnam.BackgroundPatient safety culture is a vital component in ensuring high quality and safe patient care. Assessment of nurses' perceptions on existing hospital patient safety culture (PSC) is the first step to promote PSC.MethodsThe cross-sectional study surveyed 705 nurses utilizing the validated Hospital Survey on Patient Safety Culture (HSOPSC) in an online format.ResultsThe average positive response rate was high at 72.8 % and varied from 52.9 % to 93.4 %. The strongest areas are teamwork within units (93.7 %) and supervisor/manager expectations and actions promoting patient safety (85.0 %). The areas for improvement are staffing (52.9 %) and non-punitive response to error (57.6 %). The communication openness, staffing, frequency of events reported, lengths of services in hospital and unit are significant factors that predict the overall patient safety grade.ConclusionsInitiatives are necessary to improve response to errors, staffing, and error reporting. Nurse managers could develop and implement interventions and program to improve patient safety, including providing education related to patient safety culture, encouraging staff to notify incidents and avoiding punitive responses.     

Nurses' involvement in end-of-life decisions

In Dutch healthcare, patients and physicians are responsible for medical end-of-life decisions. These include nontreatment decisions, withholding or withdrawing parenteral hydration and nutrition where the patient can no longer drink or eat, relieving pain and other symptoms with drugs that might shorten life, euthanasia, and physician-assisted suicide. The objective of this study is to investigate the views of nurses on their role with regard to discussing these kinds of decisions, as well as their actual role in the decision-making process. Nurses (n = 489) involved in palliative terminal care answered questions about their preferred and actual role in end-of-life decision-making processes. Nurses want to be involved in making end-of-life decisions, but this depends partly on the kind of decision that has to be taken. When caring for terminal patients, 62% of the nurses usually talk about such decisions with patients or their families. Three-quarters of the nurses had been involved in an end-of-life decision-making process in the previous 2 years, mostly by talking with the physician and the patient's family. It is concluded that physicians should discuss these decisions with nurses more often. The finding that characteristics of the nurses influence their role in end-of-life decision-making processes emphasizes the importance of developing mechanisms to ensure that end-of-life decisions are made in a consistent manner and do not depend on the demographic characteristics of nurses.     

It's OK having asthma ... young children's beliefs about illness

Hospitals and illness can be bewildering and frightening for children. To minimise the distress caused to them, health professionals need to communicate effectively. This involves assessing the child's level of development and the amount of knowledge the child needs.     

Nurses' assessment of elderly patients in hospital.

Nurses' assessment of patients' mobility in hospital provided the focus for an inductive qualitative study which examined how an everyday aspect of nursing practice was carried out. The study described assessment practices in both long-term care and acute care wards for elderly patients as a situated activity. Interviews with nurses, as well as observation of their activities and records, resulted in explanations of their behaviour as deriving from their conceptions of ward functions. These conceptions arose from their adoption of the values of cure and discharge and so, in the different types of ward, assessment held different meanings and was carried out in different ways. The findings have implications for nursing practice in different settings but also for the care of elderly and chronically ill patients, where cure is an inappropriate end goal of care. This example of developing explanatory theory inductively also has implications for the development of mid-range nursing theory and suggestions are made for its extension.     

Nurses' role in children's environmental health protection

There is a growing body of evidence regarding the presence of toxic pollutants in the air, water, soil, food, and indoor environments, and the health effects of these pollutants on humans. Children have special vulnerabilities to environmental risks in their homes, schools, and communities. Children's susceptibility to environmental risks stem from biological, behavioral, and socio-economic factors. Environmental standards are not always protective of children's health, and in some instances, no standards exist. Addressing children's vulnerabilities and decreasing their exposures require a multi-faceted and multi-disciplinary approach with clinical, public health, and policy interventions. Preventing exposure to hazardous levels of pollution is largely the role of the public health community, environmental protection agencies, and the policy makers who create the enabling laws. The Institute of Medicine (IOM) (1995) has recommended the integration of environmental health into nursing practice, education, research, and policy/advocacy work. This article identifies areas in each of these categories in which nurses can enhance their practice regarding children's environmental health. In addressing children's environmental health, nurses' expanded roles can include a range of activities, such as anticipatory guidance, health education, public health interface, improved health tracking, environmental health research, and legislative/regulatory engagement.     

Psychiatry. Nurses' reactions to hospital closure.

The second article dealing with the effects of psychiatric hospital closure explores how the transition from the role of hospital nurse to community nurse occasioned by closure is proving an extremely difficult process. Some of the feelings evoked resemble the grief experienced after the death of a loved one. This article focuses on the reactions of 22 nurses to the closure of a large mental hospital. Nurses with many years' experience were found to be suffering a bereavement reaction which threatened their emotional and physical wellbeing. The author suggests that this 'institutional loss' has important implications for the successful rehabilitation of large numbers of mentally ill patients.     

Nurses' political involvement: responsibility versus privilege.

Nursing apathy toward participation in the political process is pandemic. Never more so than today has the profession needed a strong united stand within the political arena. Political involvement encompasses being knowledgeable about issues, laws, and health policy. Barriers to political activism are thought to encompass several spectra including heavy workloads, feelings of powerlessness, time constraints, sex issues, and lack of understanding of a complex political process. The implementation of a political role for a nurse is based on three levels of commitment including survival, success, and significance. Survival includes individual involvement within communities. Success accepts challenges in addressing injustices especially within the health-care arena. Significant involvement uses visionary nurses toward the betterment of the nurse profession. Strategies for involvement include political awareness, incorporation of course/program expectations on both undergraduate and graduate levels and teamwork. As patient advocates, nurses cannot continue to be spectators in the political arena.     

Nurses' involvement in international research collaborations

Nurses are becoming increasingly involved in collaborative international research teams. This article describes a European-wide research consortium that is implementing research across Europe. The experiences of members of a cross-national research consortium and some of the challenges are discussed. Cross-national research consortia should pay attention to preparatory, methodological, financial, operational and structural challenges. Ownership of data and dissemination of research findings are also explored. Consortia need to find a balance between a consistent organisational structure and communication styles, and respecting the differences between members of the consortium.