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1.
Background
Deep tissue injuries are severe damages underneath the intact skin caused by long-endured, unrelieved pressure or shear forces. Empirical evidence regarding the magnitude of this health problem is limited.Objective
Investigation of the prevalence, characteristics of persons affected and identification of the most affected body locations.Design
Two cross-sectional studies in 2008 and 2009.Settings
Nursing homes and hospitals throughout Germany.Participants
6919 (year 2008) and 8451 (year 2009) hospital patients and nursing home residents.Methods
Trained nurses conducted full skin assessments and collected demographic data based on written data collection forms. The Braden scale was used to measure pressure ulcer risk.Results
Pressure ulcer prevalence including grades 1-4 and deep tissue injuries ranged from 4.3% (95% CI 3.8-4.9) in nursing homes to 7.1% (95% CI 6.2-8.0) in hospitals. Point prevalence rates of deep tissue injuries were 0.4% (95% CI 0.2-0.5) in hospitals and less than 0.1% in nursing homes. In total, 30 persons were affected by 38 deep tissue injuries. The mean age was 73.4 and the mean Braden scale sum score was 12.8. The most frequently affected anatomic sites were heels (n = 24) and ischial tuberosities (n = 6).Conclusions
Nurses must be aware that deep tissue injuries exist in clinical practice. Deep tissue injuries seem to be more common in hospitals than in nursing homes and heels are more prone to this kind of injuries than other body sites. Whenever such a lesion is suspected, optimal pressure relief is required to enable the affected tissue to heal. 相似文献2.
Background
Implementation of evidence-based care for pressure ulcer prevention is lacking. As the hospital organization is complex, more knowledge is needed to understand how nursing care in this area can be improved.Objectives
The present study investigated the associations between variables on different levels in the healthcare setting (patient, unit, hospital) and the documentation of (1) risk assessment and (2) skin assessment within 24 h of admission, the use of (3) pressure-reducing mattresses and (4) planned repositioning in bed.Design
A cross-sectional study.Settings
One university hospital and one general hospital.Participants
Geriatric (n = 8), medical (n = 24) and surgical (n = 19) units. All adult patients (>17 years), in total 825, were included.Methods
A one-day prevalence study was conducted using the methodology specified by the European Pressure Ulcer Advisory Panel, together with the established methods used by the Collaborative Alliance for Nursing Outcomes. Independent variables were patient characteristics, hospital type, unit type, nurse staffing and workload. Dependent variables were documented risk and skin assessment within 24 h of admission, pressure-reducing mattresses and planned repositioning in bed. The data were analysed with Logistic regression using the Generalized Estimating Equation (GEE) approach.Results
Patients at risk of developing pressure ulcers (Braden < 17) had higher odds of having risk assessment documented, and of receiving pressure-reducing mattresses and planned repositioning. Patients at the general hospital were less likely to have risk and skin assessment documented and to receive pressure-reducing mattresses. On the other hand, planned repositioning was more likely to be used at the general hospital. When total hours of nursing care was lower, patients had higher odds of having pressure-reducing mattresses but were less likely to have planned repositioning.Conclusion
Patient characteristics (high age and risk score) and hospital type were associated with pressure ulcer prevention. Surprisingly, nurse staffing played only a minor role. Leaders in healthcare organizations should establish routines on different levels that support evidence-based pressure ulcer prevention, and registered nurses need to assume responsibility for bedside care. 相似文献3.
4.
Nancy L. Young Lianne A. Anselmo Tricia A. Burke Anna McCormick Shubhra Mukherjee 《Archives of physical medicine and rehabilitation》2014
Objective
To describe current patterns of health care utilization of youth and young adults who have spina bifida (SB) and provide evidence to guide the development of health care for this growing population.Design
We conducted a secondary analysis of health services utilization data from the Canadian Institute for Health Information to determine the rates and patterns of health care utilization, because comprehensive health care has been recognized as critical to positive health outcomes.Setting
Participants were identified from 6 publicly funded children's treatment centers.Participants
Health records from youth (n=164; age range, 13.0–17.9y) and adults (n=120; age range, 23.0–32.9y) with SB contributed to this study.Interventions
Not applicable.Main Outcome Measures
The rates of outpatient physician visits and hospital admissions for the youth and adult groups were calculated. The proportion with a “medical home” was also calculated.Results
The annual rates of outpatient physician visits per 1000 persons were 8031 for youth and 8524 for adults with SB. These rates were approximately 2.9 and 2.2 times higher, repectively, than for their age-matched peers. On average, 12% of youth and 24% of adults with SB had a medical home. The annual rates of hospital admissions per 1000 persons were 329 for youth and 285 for adults with SB. Rates of admissions were 19.4 and 12.4 times higher, respectively, for these groups than for the general population.Conclusions
It appears that persons with SB are accessing health services more often than their age-matched peers, and few have a medical home. We recommend that seamless medical care be provided to all adults with SB, coordinated by a primary care provider, to facilitate comprehensive care. 相似文献5.
Objectives/background
Based on structure-process-outcome approach, this study examined the association of registered nurse (RN) staffing hours and five quality indicators, including two process measures (catheter use and antipsychotic drug use) and three outcome measures (pressure ulcers, urinary tract infections, and weight loss).Setting/participants
We used data on resident assessments, RN staffing, organizational characteristics, and market factors to examine the quality of 195 nursing homes operating in a rural state of United States — Colorado.Design/methods
Two-stage least squares regression models were performed to address the endogenous relationships between RN staffing and the outcome-related quality indicators, and ordinary least squares regression was used for the process-related ones. This analysis focused on the relationship of RN staffing to nursing home quality indicators, controlling for organizational characteristics, resources, resident casemix, and market factors with clustering to control for geographical differences.Results
Higher RN hours were associated with fewer pressure ulcers, but RN hours were not related to the other quality indicators.Conclusions
The study finding shows the importance of understanding the role of ‘nurse staffing’ under nursing home care, as well as the significance of associated/contextual factors with nursing home quality even in a small rural state. 相似文献6.
Jennifer M. Ryan Vivion E. Crowley Owen Hensey Ailish McGahey John Gormley 《Archives of physical medicine and rehabilitation》2014
Objective
To report the prevalence of cardiometabolic risk factors in a cohort of adults with cerebral palsy (CP) and to investigate the ability of anthropometric measures to predict these factors.Design
Cross-sectional study.Setting
Testing took place in a laboratory setting.Participants
Adults with CP (N=55; mean age, 37.5±13.3y; Gross Motor Function Classification System levels, I–V) participated in this study.Interventions
Not applicable.Main Outcome Measures
Total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, glucose, insulin, and C-reactive protein levels were measured from a fasting venous blood sample. Insulin resistance was calculated using the Homeostasis Model Assessment (HOMA-IR) index. Blood pressure, body mass index (BMI), waist circumference (WC), waist-hip ratio, and waist-height ratio were also measured. The metabolic syndrome (MetS) was defined according to the 2009 Joint Interim Statement.Results
The prevalence of the MetS was 20.5% in ambulatory adults and 28.6% in nonambulatory adults. BMI was associated with HOMA-IR only (β=.451; P<.01). WC was associated with HOMA-IR (β=.480; P<.01), triglycerides (β=.450; P<.01), and systolic blood pressure (β=.352; P<.05). Receiver operating characteristic curve analysis revealed that WC provided the best indication of hypertensive blood pressure, dyslipidemia, HOMA-IR, and the presence of multiple risk factors (area under the curve, .713–.763).Conclusions
A high prevalence of the MetS was observed in this relatively young sample of adults with CP. WC was a better indicator of a number of risk factors than was BMI and presents as a clinically useful method of screening for cardiometabolic risk among adults with CP. 相似文献7.
8.
Johannes Wendsche Winfried Hacker Jürgen Wegge Nadine Schrod Katharina Roitzsch Anne Tomaschek Matthias Kliegel 《International journal of nursing studies》2014
Background
Various determinants of nurses’ work motivation and turnover behavior have been examined in previous studies. In this research, we extend this work by investigating the impact of care setting (nursing homes vs. home care services) and the important role of rest break organization.Objectives
We aimed to identify direct and indirect linkages between geriatric care setting, rest break organization, and registered nurses’ turnover assessed over a period of one year.Design
We designed a multimethod cross-sectional study.Setting
80 nursing units (n = 45 nursing homes, n = 35 home care) in 51 German geriatric care services employing 597 registered nurses.Methods
We gathered documentary, interview, and observational data about the organization of rest breaks, registered nurses’ turnover, and additional organizational characteristics (type of ownership, location, nursing staff, clients, and client-to-staff-ratio).Results
The findings show that the rest break system in geriatric nursing home units is more regularly as well as collectively organized and causes less unauthorized rest breaks than in home care units. Moreover, the feasibility of collective rest breaks was, as predicted, negatively associated with registered nurses’ turnover and affected indirectly the relation between care setting and registered nurses’ turnover. Care setting, however, had no direct impact on turnover. Furthermore, registered nurses’ turnover was higher in for-profit care units than in public or non-profit units.Conclusions
This study reveals significant differences in rest break organization as a function of geriatric care setting and highlights the role of collective rest breaks for nursing staff retention. Our study underlines the integration of organizational context variables and features of rest break organization for the analysis of nursing turnover. 相似文献9.
Background
Pressure ulcers continue to be a significant problem in hospitals, nursing homes and community care settings. Pressure ulcer incidence is widely accepted as an indicator for the quality of care. Negative attitudes towards pressure ulcer prevention may result in suboptimal preventive care. A reliable and valid instrument to assess attitudes towards pressure ulcer prevention is lacking.Aims and objectives
Development and psychometric evaluation of the Attitude towards Pressure ulcer Prevention instrument (APuP).Design
Prospective psychometric instrument validation study.Methods
A literature review was performed to design the instrument. Content validity was evaluated by nine European pressure ulcer experts and five experts in psychometric instrument validation in a double Delphi procedure. A convenience sample of 258 nurses and 291 nursing students from Belgium and The Netherlands participated in order to evaluate construct validity and stability reliability of the instrument. The data were collected between February and May 2008.Results
A factor analysis indicated the construct of a 13 item instrument in a five factor solution: (1) attitude towards personal competency to prevent pressure ulcers (three items); (2) attitude towards the priority of pressure ulcer prevention (three items); (3) attitude towards the impact of pressure ulcers (three items); (4) attitude towards personal responsibility in pressure ulcer prevention (two items); and (5) attitude towards confidence in the effectiveness of prevention (two items). This five factor solution accounted for 61.4% of the variance in responses related to attitudes towards pressure ulcer prevention. All items demonstrated factor loadings over 0.60. The instrument produced similar results during stability testing [ICC = 0.88 (95% CI = 0.84-0.91, P < 0.001)]. For the total instrument, the internal consistency (Cronbachs α) was 0.79.Conclusion
The APuP is a psychometrically sound instrument that can be used to effectively assess attitudes towards pressure ulcer prevention in patient care, education, and research. In further research, the association between attitude, knowledge and clinical performance should be explored. 相似文献10.
K. Balzer L. Kremer A. Junghans R.J.G. Halfens T. Dassen J. Kottner 《International journal of nursing studies》2014
Background
Nurses’ clinical judgement plays a vital role in pressure ulcer risk assessment, but evidence is lacking which patient characteristics are important for nurses’ perception of patients’ risk exposure.Objectives
To explore which patient characteristics nurses employ when assessing pressure ulcer risk without use of a risk assessment scale.Design
Mixed methods design triangulating observational data from the control group of a quasi-experimental trial and data from semi-structured interviews with nurses.Setting
Two traumatological wards at a university hospital.Participants
Quantitative data: A consecutive sample of 106 patients matching the eligibility criteria (age ≥18 years, no pressure ulcers category ≥2 at admission and ≥5 days expected length of stay). Qualitative data: A purposive sample of 16 nurses.Methods
Quantitative data: Predictor variables for pressure ulcer risk were measured by study assistants at the bedside each second day. Concurrently, nurses documented their clinical judgement on patients’ pressure ulcer risk by means of a 4-step global judgement scale. Bivariate correlations between predictor variables and nurses’ risk estimates were established. Qualitative data: In interviews, nurses were asked to assess fictitious patients’ pressure ulcer risk and to justify their risk estimates. Patient characteristics perceived as relevant for nurses’ judements were thematically clustered. Triangulation: Firstly, predictors of nurses’ risk estimates identified in bivariate analysis were cross-mapped with interview findings. Secondly, three models to predict nurses’ risk estimates underwent multiple linear regression analysis.Results
Nurses consider multiple patient characteristics for pressure ulcer risk assessment, but regard some conditions more important than others. Triangulation showed that these are measures reflecting patients’ exposure to pressure or overall care dependency. Qualitative data furthermore indicate that nurses are likely to trade off risk-enhancing conditions against conditions perceived to be protective. Here, patients’ mental capabilities like willingness to engage in one owns care seem to be particularly important. Due to missing information on these variables in the quantitative data, they could not be incorporated into triangulation.Conclusions
Nurses’ clinical judgement draws on well-known aetiological factors, and tends to expand conditions covered by risk assessment scales. Patients’ care dependency and self-care abilities seem to be core concepts for nurses’ risk assessment. 相似文献11.
Wendy A. Davis Gill Lewin Timothy M.E. Davis David G. Bruce 《International journal of nursing studies》2013
Background
Despite widespread use, there is little information on the extent and impact of community nursing to patients with type 2 diabetes.Objective
To determine the incidence, predictors and costs of community nursing provision to patients with type 2 diabetes in a large community-based representative study of diabetes in an urban Australian setting.Design
Prospective observational study utilising data linkage.Setting
Postcode defined region in Fremantle, Australia.Participants
All patients with type 2 diabetes enrolled in the Fremantle Diabetes Study between 1993 and 1996.Methods
Eligible patients were followed from July 1997, when home nursing data first became available, to death or census in November 2007. Home nursing data from the major community nursing service provider were linked with data from the Fremantle Diabetes Study. Cox and zero-inflated negative binomial (ZINB) regression modelling was used to identify predictors of incident home visits and visit frequency, respectively. Direct costs were estimated from the service provider's unit costs.Results
During a mean ± SD 8.6 ± 2.9 years of follow-up, 27.8% of 825 patients (aged 65.2 ± 10.3 years at study entry; 51.2% male) received 21,878 home nursing visits (median frequency 31 [interquartile range 9–85] visits, range 1–1446 visits). In Cox and ZINB models, predictors of home nursing included older age, physical disability measures and macrovascular and microvascular complications. Insulin use was an important predictor of the frequency of visits whilst ethnic and economic factors predicted lower frequency. The estimated cost of home nursing, extrapolated nationally, adds 5% to the total Australian direct health care costs of diabetes.Conclusions
Home nursing is frequently utilized in the management of type 2 diabetes with considerable individual variation in the use of this service. Given the associated costs, further research into how home nursing can best be employed is indicated. 相似文献12.
Aims of the paper
To present a grounded theory of the nursing team involvement in the process of maintaining and promoting the mobility of hospitalised older adults.Background
Being able to mobilise is an important determinant of quality of life in late adulthood. However, advancing age is often accompanied by worsening mobility, which may deteriorate further as a result of illness and particularly hospitalisation. Targeted in-patient rehabilitation interventions may have the capacity to maintain and promote older adults’ mobility. Some authors suggest that the nursing team may have a central role in such activities.Objectives
The study set out to describe the involvement of the nursing team in the process of maintaining and promoting the mobility of hospitalised older adults. It also sought to understand how members of the nursing team viewed their work in relation to physiotherapists and in relation to hospital policy on patient handling.Design
Grounded theory provided the philosophical and structural underpinning to the study.Settings
Data collection centred on three clinical settings which included a general rehabilitation ward, a regional spinal injuries unit and stroke rehabilitation ward.Participants
Semi-structured interviews with 39 rehabilitation staff and 61 h of non-participant observation comprised the data set.Findings
The nursing team involvement in patients’ mobility maintenance and rehabilitation was explained by the core category ‘care to keep safe.’ This category identified how the nursing team focused primarily on preventing patient problems rather than focusing on rehabilitation goals. A number of contextual factors in the workplace meant that the nursing team found it difficult to engage in activities to support mobility maintenance and rehabilitation.Conclusions
Significant changes in the micro and macro context for rehabilitation practice are needed to enable the nursing team to engage more fully in the processes of mobility rehabilitation. Nurse-led initiatives which allow the nursing team to take an active role in implementing intentional strategies to maintain and promote mobility should be implemented and trialled for effectiveness. 相似文献13.
Esther Meesterberends Ruud JG Halfens Cornelia Heinze Christa Lohrmann Jos MGA Schols 《BMC nursing》2011,10(1):1-6
Background
Pressure ulcers are a common and serious health care problem in all health care settings. Results from annual national pressure ulcer prevalence surveys in the Netherlands and Germany reveal large differences in prevalence rates between both countries over the past ten years, especially in nursing homes. When examining differences in prevalence and incidence rates, it is important to take into account all factors associated with the development of pressure ulcers. Numerous studies have identified patient related factors, as well as nursing related interventions as risk factors for the development of pressure ulcers. Next to these more process oriented factors, also structural factors such as staffing levels and staff quality play a role in the development of pressure ulcers. This study has been designed to investigate the incidence of pressure ulcers in nursing homes in the Netherlands and Germany and to identify patient related factors, nursing related factors and structural factors associated with pressure ulcer development. The present article describes the protocol for this study.Methods/design
A prospective multicenter study is designed in which a cohort of newly admitted nursing home residents in 10 Dutch and 11 German nursing homes will be followed for a period of 12 weeks. Data will be collected by research assistants using questionnaires on four different levels: resident, staff, ward, and nursing home.Discussion
The results of the study will provide information on the incidence of pressure ulcers in Dutch and German nursing homes. Furthermore, information will be gathered on the influence of patient related factors, nursing related factors and structural factors on the incidence of pressure ulcers. The present article describes the study design and addresses the study's strengths and weaknesses. 相似文献14.
Objectives
To determine the prevalence of latent myofascial trigger points (MTrPs), specific diagnostic criteria and the association between gender and MTrP prevalence in the triceps surae and upper trapezius.Design
Cross-sectional study.Setting
University, Faculty of Health and Life Sciences.Participants
Two hundred and twenty healthy volunteers (132 females and 88 males; mean age 29.7 (SD 11.0).Interventions
Not applicable.Main outcome measures
Prevalence of latent MTrPs in the triceps surae and comparative upper trapezius; specific diagnostic criteria and pressure pain threshold (PPT).Results
Latent MTrPs were prevalent in all triceps surae (range: 13 to 30%), left upper trapezius (23%) and right upper trapezius (20%). No MTrPs (0%) identified in the middle fibres of deltoid. For each specific diagnostic criterion, taut bands were most prevalent in the right gastrocnemius medial head (81%); tender spot in left gastrocnemius medial head (52%) and nodules in the right upper trapezius (35%). Local twitch response (0.5%), the least frequent diagnostic criterion was only found in the left gastocnemius medial head. A significant increase in latent MTrP prevalence for females compared to males in five of the six triceps surae MTrP sites, with no significant association for gender and latent MTrP prevalence in the left or right upper trapezius.Conclusions
This study established the prevalence of latent MTrPs, specific diagnostic criteria and baseline normative data in the triceps surae. The middle fibres of deltoid were identified as a potential MTrP control site for future clinical research in the upper limb. 相似文献15.
Hsiu-Li Huang Yea-Ing Lotus Shyu Huei-Ling Huang Sien-Tsong Chen Hsiao-Juan Li Ming-Neng Shiu Mei-Chi Pong 《International journal of nursing studies》2013
Background
The incremental prevalence of dementia is making dementia management a worldwide issue. The role of community health nurses must grow along with the increasing aging population and the resulting increase in dementia cases.Objectives
Explore the factors related to dementia care practices among the different types of community health nurses in Taiwan.Design
Cross-sectional study.Setting
Primary care centers or institutions in New Taipei City.Participants
Community health nurses who work in health care centers (district nurses), long-term care centers (care managers), or home care institutions (home health care nurses).Methods
Self-completion questionnaires sent by mail.Results
A total of 195 participants returned the questionnaires (response rate 81.9%). Although 65.8% of participants had experience in case finding, just 34.6% of them reported using validated cognitive testing tools. Only 15% of participants provided case management following dementia case findings. The regression models showed that the different types of community health nurses, number of years working as a nurse, and their level of confidence was significantly related to their dementia care practice. District nurses identified significantly less suspected dementia cases and provided less nursing care to caregivers of dementia patients than care managers and home health care nurses. Among community health nurses, the care managers most often used formal cognitive instruments. District nurses provided the least amount of supportive resources information, had the most negative attitude and the lowest level of confidence toward dementia care than care managers and home health care nurses.Conclusions
This study presented the profiles of dementia care practice in Taiwan. It showed the considerable variation in knowledge, attitude, confidence and dementia care practices among the different community health nurses. The professional roles regarding dementia care in Taiwan remain blurred. Future training must focus on promoting the level of confidence of community health nurses to identify and manage people with dementia and raise awareness about demented person's and their caregiver's need. The priority of the policy on dementia care in the community must be raised to high, and the professional responsibilities and roles of the different types of community health nurses for the ever increasing dementia population in Taiwan must be redefined and optimized. 相似文献16.
Deirdre DlugonskiLara A. Pilutti PhD Brian M. SandroffYoojin Suh MS Swathi BalantrapuRobert W. Motl PhD 《Archives of physical medicine and rehabilitation》2013
Objectives
To identify steps per day in a large sample of persons with multiple sclerosis (MS) and to describe variation by demographic and clinical characteristics and device type.Design
Cross-sectional design.Setting
General community.Participants
Convenience sample of persons with multiple sclerosis (N=645) recruited from the general community who were ambulatory and relapse free for 30 days. Mean age ± SD of the participants was 46.3±10.6 years old. Participants were mostly women (85%), white (93%), and employed (64%).Interventions
Not applicable.Main Outcome Measure
Step counts measured by a motion sensor during a 7-day period.Results
The average value for the entire sample was 5903±3185 steps per day. This value varied by demographic and clinical characteristics, but not device type, and indicated that men, participants who were unemployed, had a high school education or less, progressive MS, a longer disease duration, and higher disability were less physically active based on the metric of steps per day.Conclusions
This study provides an expected value for average steps per day among persons with MS. Such an expected value for this population is an important first step to help researchers and clinicians interested in improving the overall health of persons with MS through physical activity promotion. 相似文献17.
Rebecca Sharp Adrian Esterman Helen McCutcheon Neville Hearse Melita Cummings 《International journal of nursing studies》2014
Background
Intravenous antibiotics are the cornerstone of treatment for patients with cystic fibrosis (CF). Midlines are a type of vascular access device (VAD) used exclusively in one treatment facility within Australia, most other centres use peripherally inserted central catheters (PICCs).Objective
To ascertain the safety and efficacy of midlines for CF patients receiving intravenous antibiotics.Design
Retrospective observational.Setting
A large, major metropolitan teaching hospital in Adelaide, South Australia.Participants
Adult patients with a diagnosis of CF, who had a PICC or midline inserted for the commencement of antibiotic therapy during the period 2004–2010 to treat a respiratory exacerbation.Methods
Medical records and hospital reports were used to record rates of adverse events and unexpected removal of VADs. The primary outcome was a composite measure of adverse events (catheter-related blood stream infection, deep vein thrombosis, occlusion, pain, infiltration, bleeding, phlebitis, catheter leakage and dislodgement) and whether the VAD was removed unexpectedly.Results
There were 231 midlines and 97 PICCs inserted into 64 patients (39 male and 25 female; age range 18–47 years old). Presented as per 1000 VAD days, patients with PICCs and midlines had similar rates of adverse events (14 and 11 adverse events per 1000 VAD days, respectively). Unexpected removal was higher for patients with midlines (6.90 per 1000 VAD days) than for PICCs (2.89 per 1000 VAD days). Incident rate ratios (IRRs) showed that patients with midlines and PICCs had similar rates of adverse events (IRR 1.18, P = 0.617, CI 0.62–2.22) although the removal rate of patients with midlines was twice that of patients with PICCs (IRR 2.24, P = 0.079, CI 0.91–5.56). As an absolute risk there were only 4.09 more cases of removal for patients with midlines per 1000 VAD days than those with PICCs.Conclusions
Midlines may be an alternative to PICCs for adult CF patients although further research is required with a larger sample size to enable definitive conclusions. 相似文献18.
Elisabeth Carlson Margareta RämgårdIngrid Bolmsjö Mariette Bengtsson 《International journal of nursing studies》2014
Background
In Sweden, as well as in most industrialised countries, an increasing older population is expected to create a growing demand for health care staff. Previous studies have pointed to lack of proficient medical and nursing staff specialised in geriatric care, which poses serious threats to the care of a vulnerable population. At the same time, there are studies describing elderly care as a low-status career choice, attracting neither nurses nor student nurses. Judging from previous research it was deemed important to explore how nurses in elderly care perceive their work, thus possibly provide vital knowledge that can guide nurse educators and unit managers as a means to promote a career in elderly care.Objective
The aim of the present study was to illuminate how nurses, working in nursing homes and home-based care, perceived their professional work.Method
This was a qualitative study using focus groups. 30 registered nurses in seven focus groups were interviewed. The participants worked in nursing homes and home-based care for the elderly in rural areas and in a larger city in southern Sweden. The interviews were analysed in line with the tradition of naturalistic inquiry.Results
Our findings illustrate how nurses working in elderly care perceived their professional work as holistic and respectful nursing. Three categories of professional work emerged during analysis: (1) establishing long-term relationships, (2) nursing beyond technical skills, and (3) balancing independence and a sense of loneliness.Conclusions
The findings are important as they represent positive alternatives to the somewhat prevailing view on elderly care as depressing and undemanding. Nurse educators might use the key aspects as good examples, thus influencing student nurses’ attitudes towards elderly care in a positive way. Elderly care agencies might find them helpful when recruiting and retaining nurses to a much needed area. 相似文献19.
Background & objective
Approximately 8 million adverse events occur annually in nursing homes (NHs). The focus of this research is to determine barriers and health information technology (HIT)-related facilitators to adverse event reporting among U.S. NHs.Methods
Surveys were returned by 399 nursing home administrators using a mailed survey approach. Respondents were asked to report on their adverse event reporting processes focusing on barriers and role of HIT facilitators.Results
About 15% of NHs had computerized entry by the nurse on the unit and almost 18% used no computer technology to track, monitor, or maintain adverse event data. One-third of nursing directors conducted data analysis “by-hand.” NHs without HIT were more likely to not be accredited (p = 0.04) and not part of a chain/corporation (p = 0.03). Two of the top three barriers focused on fears of reporting as a barrier.Conclusions
This study found numerous barriers and few HIT-related facilitators to assist with adverse event reporting. Improvements in facilitating adverse event reporting through the use of HIT approaches may be warranted. 相似文献20.
Kihye Han Alison M. Trinkoff Carla L. Storr Nancy Lerner Meg Johantgen Kyungsook Gartrell 《International journal of nursing studies》2014