Nursing agency: the link between practical nursing science and nursing practice

The relationship of nursing science and nursing practice has been the topic of numerous discussions over the past decades. According to Orem, nursing science is a practical science, meaning that knowledge is developed for the sake of nursing practice. Within Orem's self-care deficit nursing theory, the concept of nursing agency links nursing science and nursing practice. Nursing agency refers to the power or ability of the nurse to design and produce systems of care. The relationship of practical nursing science, nursing practice, and nursing agency is examined in this article. Suggestions for further work related to nursing agency are provided.     

A personal nursing philosophy in practice

The use of a nursing philosophy as the basis for nursing practice promotes the proper application of nursing knowledge as well as the development of further nursing theory and knowledge. My personal philosophy of nursing seeks to encompass the art of conveying nursing science holistically with compassion and dignity. To illustrate this nursing philosophy, the four nursing metaparadigm concepts are described in relation to nursing as both a science and an art. Nursing science and art are also discussed in relation to nursing as a profession. The concepts of family-centered care and developmental care highlight the practice of nursing as an art. The use of nursing knowledge in practice is discussed through the use of nursing's five ways of knowing, nursing theories, borrowed theories, and nursing's paradigms. The concept of the nurse scholar and the further development of nursing knowledge is identified as a priority. Supportive examples from my nursing experience working in a Neonatal Intensive Care Unit (NICU) are utilized to highlight the importance of nursing knowledge development and the provision of optimal patient care.     

护理督导制在护理管理中的作用

现代护理倡导以人的健康为中心的护理观，护理健康教育是整体护理实践成功的重要环节之一，精神科整体护理往往重视患者的健康教育，却忽略了家属的健康教育需求，以至不能及时有效地缓解家属的激惹、恐惧、焦虑情绪，     

丹麦护理历史博物馆

丹麦护理历史博物馆开创于1999年,是世界三大护理博物馆之一,其面积大于英国伦敦南丁格尔博物馆,内容也不局限于某个历史人物,而是以护理历史发展的时间脉络为主线,扩展到护理学科的进展。馆内分16个区域,展出物品有海报、照片、原始档案、文件、实物模型。展出的形式包含护理历史和各专科发展,如人道救援、精神科护理、社区护理、护理教育、护理处置和病房情景模拟等,其意义更具现代性。     

What is nursing science?

The enigma of defining nursing science is preceded by defining nursing, science, research, and nursing theory-guided practice. The context for exploring the meaning of nursing science is provided through examination of the totality and simultaneity paradigms. Differing views of nursing as a discipline are discussed. The position is taken that nursing is a basic science with various nursing schools of thought that constitute the substantive knowledge of the discipline. Finally, a definition of nursing science is presented that is broad enough to encompass all disciplinary knowledge. Despite current challenges, an optimistic vision is emerging. The nurse theorists and other nurse scholars who are furthering the development of this work are considered to be the cultural creatives of nursing and contributors to a larger movement toward wholeness in science and in society.     

护理工作缺陷原因分析及管理对策

目的预防和减少护理缺陷的发生,提高护理管理水平。方法将护理工作“零缺陷”作为工作目标,对2003年2月～2005年1月上交护理部的护理缺陷记录表进行分析、比较,总结处理对策。结果2004年护理缺陷发生率比2003年下降了65.22%,2004年全年没有发生违反操作规程、报告医生不及时和预见性问题等护理缺陷,发生的事件对患者的影响程度明显降低。结论护理工作缺陷与护理管理密切相关,护理缺陷的防范措施重在落实,只有做好事前防范,事后及时分析并完善制度与程序等才能保障护理“零缺陷”。     

多学科协作模式急性乳腺脓肿产妇的中西医护理

目的报道一产褥期急性乳腺炎患者的多学科协作模式下的中西医护理,提高护理质量,制定相关护理常规。方法从疾病知识、病情汇报、护理诊断、护理措施、护理重点与难点、个案经验与教训、多学科协作讨论的步骤进行案例分析,探讨多学科协作模式的护理方案,探讨中西医护理对于急性乳腺脓肿产妇的护理效果。结果各学科护理专家共同实践多学科协作工作模式;制定急性乳腺脓肿护理常规,完善标准化沟通话术,展望中西医结合的多学科协作模式在产褥期乳腺炎护理中的实践。结论急性乳腺疾病的中西医结合护理,在产褥期护理中需大力推广应用。多学科协作模式是医学发展、护理学进步的必由之路,也是中西医结合护理的服务路径。同时能培养护理人员规范的护理思路,制定专业的护理计划,有利于提高整个专科护理团队的水平。护理质量持续改进,值得临床推广。     

Nursing Leaders as Visionaries and Enablers of Action

ObjectivesThe engagement of nursing leaders is critical for the future of the cancer nursing profession, quality cancer care, and the overall health care system. The field of cancer care is facing enormous challenges, requiring strong nursing leadership. Cancer nursing leadership is needed to overcome the challenges caused by workforce shortages, restricted resources, historic and ongoing under-recognition of nursing, unsafe working conditions, and unequal access to education. The aim of this article is to contribute to the discussion about how cancer nursing leaders can act as visionaries and support transformation of cancer nursing for the future.Data SourcesAuthor experience, journal articles and organizational position papers were used.ConclusionTo improve the state of cancer nursing and the working conditions of the cancer nursing workforce, nursing leadership practices need to be embraced on all governance levels in clinical practice and academia. When effective and high-quality nursing leadership is enacted, positive outcomes for people affected by cancer, nursing, and health care systems can be achieved. Cancer nursing leadership needs to be supported through nursing scholarship, influencing national and global policies and strategies and by active involvement in national and international health care management.Implications for Nursing PracticeNursing leadership and governance is critical to strengthening the cancer nursing workforce. Strong nursing leadership is required to realize the vision for transforming the health care systems and cancer care. Therefore, collaboration among multidisciplinary leadership, health care organizations, academic institutions, professional organizations, and policy-making structures is warranted.     

民办高职院校护理专业学生对基础护理的认知现状

目的分析民办高职院校护理专业学生基础护理认知的现状及影响因素。方法 2012年6月采用整群抽样法选取上海市4所民办高职院校的328名护理专业学生作为调查对象,调查内容包括护生基本信息、护生对基础护理的认知情况、护生的专业价值理念及对实施基础护理操作的态度。结果民办高职护理专业学生对基础护理认知的总体得分为(79.70±13.15)分,不同学校的护生在基础护理的认知上差异具有统计学意义(P<0.01);护生认为治疗性护理工作是基础护理内容,对于剪指甲、处理大小便、更衣等生活护理操作则认为不是基础护理的内容,不应由护士完成;生源、学校、专业价值观念和实施基础护理的态度是影响学生基础护理认知水平的相关因素。结论民办高职护理专业学生在基础护理认知上存在偏颇,对生活护理的认知较差;需针对影响因素提出改进建议,以提高民办高职护理专业学生的基础护理认知水平。     

根据实际护理工作量探讨护理人力资源的合理配置

[目的]通过对住院病人进行护理工时测定,确定病区平均每日护理工作量,为合理配置护理人力资源提供依据。[方法]采用自行设计的护理工时测定表,选取咸宁市中心医院25个病区为调查现场。采用观察法和记录法,对课题组确定的83项直接护理项目和30项间接护理项目进行护理时间测定,计算每个病区的实际护理工作量。[结果]直接护理时间占护理总时间的65.18%,80.00%病区存在不同程度的缺编现象,日均护理时间4973.99 min（82.90 h）,适宜的床护比为1∶0.54。[结论]对护理工作量进行测定,以合理配置护理人力资源。     

陕西省12家养老机构护理员对老年护理知识认知与需求调查

目的了解养老机构护理员对老年护理知识的认知和需求情况,为规范培训提供依据。方法采用自行设计的调查量表,调查陕西省12家养老机构的225名专职养老护理员对老年护理知识的认知和需求情况。结果 225名养老护理员对老年护理知识的认知得分为(3.19±1.23)分,210名(93.3%)养老护理员认为自己需要学习老年护理相关知识,排在前5位的需求内容依次是疾病护理、心理护理、健康指导、生活护理和安全管理。结论养老护理员对相关老年护理知识掌握较为局限,知识面较窄,应重视与加强其培训工作,提供针对性的培训内容。     

临床护理人员对现行护理质量考评评价的质性研究

目的了解临床护理人员对护理质量评价现状的看法,分析现行护理质量考评存在的问题,为制订规范的护理质量评价体系提供依据。方法采用开放性、半结构式访谈法对25名临床护士长、护理人员进行深度访谈,应用现象学分析法进行分析。结果目前护理质量评价指标的敏感性不高,过度偏重护理技术,不同专科的护理评价在临床护理应用中依然欠缺。结论现存护理质量评价标准欠缺单病种的专科护理质量评价,不能适应专科护理的发展需求,亟待创建一套系统的专科护理质量指标体系。     

护理伦理至护理审美的逻辑趋向

从伦理学视野研究护理审美价值的意义,体现在护理美学和护理伦理学在对功利和社会效益的认识上是一致的;新护理模式的实施需要护士的人道伦理意识加以保证;引入审美情感机制,是实现护理道德与护理审美统一的有效途径;寻求护理伦理与护理审美的统一是护理美学发展的理论诉求。中外伦理学和美学研究都强调美与善的统一。护理伦理与护理审美是人之生命的两种精神性存在方式,在对人的终极关怀方面表现为一个逻辑的过程。即护理的关怀照顾通向审美超越,护理道德人格走向审美人格。     

加强医院护理文化建设提升护理团队核心竞争力

护理文化决定护理团队的核心竞争力和团队间的差异,护理文化建设的理论和实践亟待探讨.笔者结合临床实践提出了护理文化建设集中体现在3个方面：一是从构建护理团队的护理价值观入手,确立护理团队的愿景及发展方向,建立一套行之有效的护理人员行为、语言副语言及服务规范,重塑护理人员的形象;二是探讨适应医院发展需要的护理管理模式,建立一支有务实创新精神的中层护理管理人员队伍;三是在护理实践中强调团队意识,倡导团队精神,不断强化护理人员的5种意识,将打造一支高绩效的护理团队作为护理文化建设的落脚点.     

A holistic-existential approach to health promotion

Health promotion seems to be implicit in many nursing theories, but the theoretical and philosophical basis of health promotion in nursing is not always explicitly stated. The interpretation of health promotion is closely related to the interpretation of man, health, illness and nursing. There is a need to clarify, refine and redefine health promotion in nursing because the concept is partly nonspecific and has not been used to identify a distinctive nursing focus. The aim of this study was to formulate a stipulative definition of health promotive nursing with a holistic-existential approach. A philosophical frame of reference in combination with conceptual analysis and theoretical synthesis were used as the methodological approach. The philosophical framework served as a basis in selecting the nursing theories and influenced the analysis. Two nursing theories and one nursing model were selected due to their influence on Norwegian nursing and because of their philosophical basis. Through analysis and synthesis of the selected nursing theories, the concepts man, health, illness/disease and nursing were analysed. The paper proposes a stipulative definition of health promotion in nursing based on a holistic-existential approach, supported by five necessary conditions. The definition and conditions needs to be further investigated by both empirical studies and by comparing with other relevant nursing theories, in order to formulate theoretical statements. The proposed definition may be the first step in a process of developing a theoretical framework of health promotive nursing with a holistic-existential approach.     

Correctional nursing and transformational leadership

Transformational leadership (TL) is a highly discussed approach in the literature for many professions. Likewise, the TL approach continues to be explored in a myriad of nursing contexts to demonstrate its advantages for practice and client health. The tension between custody and care is particular to correctional nursing practice, such as the correctional priorities of safety and security that often override caring‐focused nursing practice. Presented herein, is information relating to correctional nursing leadership as found in the minimal, available literature; and hypothetical examples of how correctional nursing leaders can use TL are provided. Measuring the influence of TL on practice and offender health can assist in determining if this approach is an appropriate “fit” for the correctional nursing context. The dearth of literature regarding correctional nursing leadership must be addressed to advance this subspecialty of nursing and promote offender health. The intent is not to argue that TL is the only applicable leadership approach for this subspecialty of nursing. Rather, introductory insight is offered regarding the suitability of TL in correctional nursing practice.     

我院护理病历质量评价指标体系的应用及效果

目的检验我院护理病历质量评价指标体系的实用性和可操作性,对护理病历的书写进行有效监督和指导。方法采用分层随机抽样的方法,对全院护理病历进行质量评价。结果护理病历质量评价指标体系指标科学,便于护理管理部门对病历质量进行全面了解,具有应用价值。结论护理病历质量评价指标体系适合对护理病历过程质量的全程管理,保证了护理病历的质量。     

现代护理艺术性简论

将护理学与艺术理论相结合 ,简要论述了护理的艺术特征。护理的艺术性表现为以下特征 :创造性 ,个性与风格 ,护理哲学与精神感染力 ,具有美感。它们是护理进入艺术化的标志 ,也是其成为艺术应具备的条件。对护理艺术性的探讨 ,对于护理未来发展方向的把握 ,从更高的角度认识护理 ,指导实践 ,提高护理水平和人类生存质量有重要和深远的意义     

The nursing process – is the title right?

The use of the term nursing process is traced from the 1950s. The author argues that the nursing process is now used as a substitute for nursing. In this paper questions are raised as to whether problem-solving is all there is to nursing and whether problem solving is peculiar to nursing. It is further argued that whilst the nursing process recognizes the purpose of the problem-solving aspects of the nurse's work, it ignores the subjective or intuitive aspects of nursing. It also ignores the role of experience, logic and expert opinion as bases for nursing practice, the author contends. She concludes that because the nursing process stresses a dominant and independent function for the nurse this may undermine the value of collaboration of health professionals and the development of the client's self reliance.