Concept mapping: a nursing model for care planning

Concept mapping has many applications and has been used as an effective teaching strategy in nursing and other disciplines to evaluate both content knowledge and student thinking patterns. Previous applications related to nursing care planning usually organize client information around a medical diagnosis. The approach described is focused around the reason for nursing care and a holistic nursing view of the client, rather than a disease model. Students use a software program to cluster and sort assessment data to identify client problems and describe relationships between the problems. This results in a nonlinear "picture" of the client that can be used for nursing care planning. The process is dynamic and flexible, prompting students to identify gaps in information, consider salience, and understand the complexity of the particular client situation. It teaches critical thinking skills and nursing theory, develops competence with technology, and fosters effective interchange between faculty and students.     

Nursing models in a special hospital: a critical analysis of efficacity

Models of care from the general field of nursing applied in special hospitals appears to be unworkable in this type of environment in terms of their inability to affect patient care. It is argued that these external models, adopted due to a crisis of confidence in special hospitals, fail because their fundamental constructs clash with that of the institution's particular sociology. A historical analysis of the development of special hospitals and nursing models reveals a dichotomy of emergent values, highly complex in nature, which conflict from the notion of Parsonian role-adoption. From this position, it is suggested that the strength of value systems are such that this leads to a non-negotiable stalemate of forensic elements of client and institution, and the 'treatment' ethic as prescribed by the medicalization of criminology. This article critically analyses the six most commonly-used nursing models in special hospitals and pinpoints the areas of breakdown within this type of environment from a sociological perspective. Finally, it argues for a new direction away from 'generalist' ideals of nursing towards a theoretical construction of 'specialism' in forensic care.     

Getting on top of organizational change. Part 2. Trends in nursing service

Fundamental to all of the trends described in this article is the nurse executive's ability to influence organizational policy and planning. The value of nursing as a clinical practice discipline provides consistency in policy, planning, and goal achievement. Viewing nurses as salaried professionals, establishing organizational structures that foster professional behaviors, and achieving cost-effective quality care all depend on the top nurse executive's effective use of power. In the next and last section of this series, nursing in multihospital systems and corporate structures will be discussed, and these themes will be further developed in relation to corporate planning for change.     

Nursing care and understanding the experiences of others: a Gadamerian perspective

A personal and professional issue that confronts all nurses is that of attempting to understand the experiences of our patients or clients. The position taken here is that understanding another person as a human being is much more than being able to explain their experience according to a particular model of ill-health. Rather, it is an issue of human dignity and respectfulness. Gadamerian hermeneutics has been used in nursing research to articulate the process of understanding and to develop interpretations of particular experiences. Gadamer's exposition of understanding shows that we need to be aware that our understanding of other people is developed through a fusion of our own history, language and culture with that of the other person. This occurs through a hermeneutic question-answer dialogue in which we put our ideas at risk of being modified or rejected in the process. Understanding then, is a perceptual and conceptual process in which we fully participate. In this way, the experience of understanding those we nurse increases our understanding of ourselves as well as enhancing our ability to further understand others.     

What does expert nursing practice mean?

Becoming an expert practice nurse should be the goal of all nurses and those planning for such a career. But the meaning of what an expert nurse in clinical practice is, is not as easy to define or evaluate, as it is in nursing education or nursing research. The Royal College of Nursing's Expertise in Practice Project has studied nursing throughout the United Kingdom and has made a considerable contribution by re-defining expert nursing practice. This column explicates that contribution.     

The evaluation of the `stages of change'' model for use in counselling client''s undergoing predictive testing for Huntington''s disease

Nurses are increasingly working in new and novel situations which may be outside the realms of traditional nursing practice. Therefore when evaluating theories and models that may be utilized in these situations it may be necessary to look beyond established nursing theories and concepts. This paper therefore attempts to evaluate Prochaska & DiClemente's (1983) stages of change model for its goodness of fit when counselling people as part of the predictive testing programme for Huntington's disease. The model demonstrates that in order to provide effective communication it is important to recognize the particular stage a client is at in his/her decision-making process concerning predictive testing. The relevance of the model to generic genetic counselling in nursing practice is discussed and the importance of stage-matched nursing interventions is emphasized. The model's non-reliance on the medical model or the concept of illness means that it may also be a useful model when applied to other nursing situations.     

The nursing process: implications for curriculum planning

The focus of this paper is an exploration of the implications for curriculum planning of adopting the nursing process; which, it is suggested, represents the most far-reaching innovation in British nursing of recent years. An examination of the abilities required by nurses in order for them to deliver care in this way shows that to encompass the philosophy of the nursing process, fundamental changes need to be made in the way nurses are prepared in schools of nursing. In particular, to those elements of the curriculum dealing with content and teaching methods.     

The Clinical Placement Consortium: where education and practice meet.

The process of planning the clinical rotations for nursing students can be challenging for both academia and the clinical service setting. This article will discuss a collaborative model that is used by one nursing community. Advantages and challenges will be presented from both views as well as lessons learned. The Clinical Placement Consortium (CPC) has served as a method to work toward a common goal of quality clinical experiences for all students.     

A stage planning programme model for health education/health promotion practice

AIM: To investigate the validity of a stage planning programme model for health education/health promotion practice in nursing settings and to develop a specific model for this purpose. Background/rationale. The last decade or so has seen a marked increase in the amount of health educational/health promotional activities that nurses are expected to undertake. This has followed concerted calls to make health promotion a familiar and recognized part of nursing practice. Despite this, however, current health-related practices are still unstructured, haphazard and under-evaluated. This state of affairs is further compounded by the lack of any generic and systematic nursing planning process model by which health education/health promotion programmes are applied in practice. This paper puts forward the case for such a model, develops it, and demonstrates its possible application in clinical settings. METHOD: A systematic literature review was conducted in order to develop a new theoretical perspective for health promotion/health education nursing practice. The proposed model has evolved from this new perspective. The process of developing this model has drawn on existing contemporary planning models--using them as a means to develop a conceptual framework. Consequently, the proposed model seeks to critique, adapt and adopt some of their components within a nursing context. CONCLUSION: If the current situation continues, in which planning process models are not adopted as a routine part of practice, then nursing may well remain a "bystander" in health promotion/health education.     

四钉头架在颈椎后路手术中的应用

目的探讨四钉头架在颈椎后路手术中的应用价值与护理体会。方法应用四钉头架作术中体位颈椎后路手术15例,观察其体位固定的确切性,操作与护理的灵活性,手术时间,出血量,术中并发症的发生率。结果15例手术中体位固定确切,操作灵活,护理方便,手术时间2～4.5h,出血量230～650ml,术中无并发症的发生。结论四钉头架在颈椎后路手术体位固定中固定确切,操作灵活,护理方便,安全可靠,值得推广。     

Nursing models: extant or extinct?

Although nursing models have always had their sceptics, they are now being subjected to more sustained criticism. Critiques have tended to focus mostly on the value of models for nursing practice but, increasingly, their place in nursing science is also being questioned. Reed believes that the growing disparagement of nursing models is symptomatic of the tensions between modernist and post-modernist perspectives on nursing. Drawing its title from Reed's discussion, this paper — from the opposite side of the Atlantic — reflects on the original purpose of nursing models and critically examines their relevance now, using the first and best-known British nursing model (the Roper-Logan-Tierney model for nursing) as the particular example for scrutiny. Although the popularity of this model is acknowledged, Fraser highlights the concern that it has not been tested. Can, and should, models be tested? This question is addressed in view of its apparent importance to the debate about whether or not nursing models have any continuing, legitimate role in theory or in practice.     

Wildlife planning using FORPLAN: a review and examples from Victorian forests

Victoria's Department of Conservation and Natural Resources is a natural resource agency charged with managing potentially conflicting forest uses and one tool employed for multiple use planning is the linear programming model, FORPLAN. This paper reviews the value of FORPLAN for integrated forest planning and wildlife conservation. As it is currently implemented in Victoria, FORPLAN has serious limitations when used as the sole planning tool for wildlife management. This is because there are practical limits on the construction of sufficiently complex models, it cannot model stochastic processes, the minimum spatial resolution of available data is too coarse, and it does not directly use spatial information. Over-confidence in the projections and expectations of models used in planning must be avoided. An array of tools is used for forest planning including FORPLAN, modelling environments of other kinds, iterative research and public participation. A model is implemented in FORPLAN that uses numbers of hollow bearing trees which are potential nest sites rather than yields of different species. Although the model's assumptions are unrealistic, the exercise was useful because a scarcity of data was highlighted in the classification of old forests used for management planning, and in the resource information for mixed species forests. Wildlife biologists and planners must be involved in, and understand the construction of, FORPLAN models. The most important uses of FORPLAN for wildlife planning are to aid the understanding of forest planning problems, to identify which pieces of critical information are not known, and to provide a forum for the statement of assumptions. The ultimate success of FORPLAN will depend on the way it is used to address forest issues.     

Media for an integrated nursing curriculum.

In conclussion, the media decision-making process for an integrated nursing curriculum is based upon the following steps: - An analysis of the philosophy and unifying strands in the conceptual framework of the curriculum model, - An evaluation of currently owned media in terms of the theoretical framework and educational objectives of the model, - An assessment of commercial media with realistic planning for purchase and/or production, and - The development of a systematic ongoing evaluation process by students, faculty, and nursing service personnel. The focus of this discussion has been clarification of the assessment and planning steps necessary in the media decision-making process for an integrated nursing curriculum. While these steps are applicable to any educational model, they have particular relevance to a curriculum model in which concept learning and interrelationships are stressed.     

Effective succession planning in nursing: a review of the literature

Aim This review summarizes and evaluates succession planning initiatives in nursing and proposes a new, comprehensive succession planning model for nursing. Background A major challenge facing nursing is maintaining leadership capital. In the USA and elsewhere, this challenge is complicated by current and projected nursing shortages and uncertainty associated with political, economic and social factors affecting health-care delivery. Evaluation Databases and the Internet contributed information to this review. Because the problems of identifying, recruiting, developing and retaining nursing leaders are related to the global nursing shortage, sources from several countries and international organizations were used. Key issues The current and projected global nursing shortage and economic, political and social factors affecting health-care delivery world-wide make effective succession planning an absolute necessity for the nursing profession. Conclusions Nursing leaders must plan for succession at all management levels. To validate benefits of this planning, three topics for future research are suggested. Implications for nursing management Succession planning should incorporate the identification, recruitment, retention, development, coaching and mentoring of potential nurse leaders as early as high school. Communication, cooperation and coordination between academia and practice that complements the academic preparation of new nurses is essential.     

The recognition and non-recognition of problem-solving stages in nursing practice

A requirement for high-quality individualized nursing care is that nurses must recognize and attempt to solve patients' health problems. In this study, it was decided to investigate problem solving using a model similar to the nursing process derived from the general literature. Insight into nurses' perceptions and understanding of problem solving was gained by interviewing 116 nurses using vignettes of clinical problem solving. Data analysis revealed that many informants failed to discuss some problem-solving stages, in particular planning and evaluation. Conversely, problem assessment and implementation attracted more comment. The implications for these variations in nurses' problem-solving behaviour are examined in relation to contemporary nursing issues.     

A paradigmatic glance on nursing care -- a walk to complex care

The text addresses the Cartesian paradigms (modern) and the complexity paradigm (post-modern of Edgar Morin) aiming to deepen reflection on the theme and understanding to improve nursing. To this end, the authors discuss the model of care of methodical nursing in the Cartesian paradigm defining it as producer of an authoritarian, fragmented and linear care. They point the need to rethink that model because it restricts the autonomy of the people/patient moving in the direction of complex care that provides for customers/actors' participation in their health care planning.     

Eliciting nursing knowledge from practice: the dualism of nursing

Nursing knowledge has traditionally been examined and developed through the main research approaches based on the positivist, interpretive or phenomenological philosophies. These approaches are used either from a single and individual stance or combined to address particular research questions. They all, however, retain a focus that deals primarily or exclusively with what can be measured, observed or expressed as a fundamental unit of analysis to reconstruct, interpret and explain nursing practice. In this paper, Vince Ramprogus challenges the traditional approach to how nursing knowledge is defined and the common understanding of the purpose of nursing research. It is argued that adhering to empirical rigour while investigating or measuring nursing practice interferes with the very act and experience of nursing. Indeed, it becomes an either/or situation. It is also argued that nursing is not an empirical subject, and, therefore, the purpose of researching nursing is not about seeking the truth but about improving practice to achieve better patient care. The arguments are intended to provoke discussion and debate rather than to present a set position.     

The Roper, Logan and Tierney (1996) model: perceptions and operationalization of the model in psychiatric nursing within a health board in Ireland

This study aimed to determine whether the Roper, Logan & Tierney model was an appropriate model for planning nursing care for clients who are mentally ill. Data were collected from two sources in one Health Board region in Ireland. A care plan audit was used to evaluate the extent to which the Roper, Logan & Tierney model was used to assess, plan and evaluate nursing care in nursing documentation. Qualitative interviews with nurses explored their experiences of using the model and their perceptions of the model's usefulness and appropriateness for planning care. Both data sets were complementary, the qualitative data often providing contextual information which helped put the findings into perspective. It was found that there was little evidence that the Roper, Logan and Tierney model guided care planning and that goals and nursing interventions were frequently not explicitly documented. Interviews with nurses indicated that they lacked educational preparation for using the model and found the model constraining and physically orientated. The appropriateness of the Roper, Logan and Tierney model for planning care for clients who are mentally ill is questioned. It is suggested that nurses need to be adequately prepared if they are to use a model appropriately. Consideration should be given when selecting a model as to its 'fit' with the needs of the client group and the ward team philosophy.     

护理本科生个人职业生涯规划现状及影响因素分析

目的 探讨护理本科生个人职业生涯规划现状及其影响因素.方法 2019年7月至9月采用一般资料调查表、护理本科生个人职业生涯规划调查问卷对西藏大学医学院267名护理本科生个人职业生涯规划进行调查,运用单因素法分析不同特征的护理本科生在个人职业生涯规划上的差异,运用多元线性回归法分析护理本科生个人职业生涯规划的影响因素.结...