The biobehavioral effects of gentle human touch on preterm infants

This study examined the physiological and behavioral effects of a gentle human touch nursing intervention on medically fragile preterm infants (27 to 32 weeks gestational age). The Roy adaptation model of nursing was the framework for the study. The results of this study suggest that the immediate and short-term effects of a gentle human touch nursing intervention were not aversive or stressful to preterm infants of 27 to 32 weeks gestational age; furthermore, the findings document several positive, beneficial behavioral effects of the intervention on preterm infants and indicate this type of touching may be appropriate for infants in the neonatal intensive care unit.     

Communication between nurses and physicians: Strategies to surviving in the emergency department trenches

The emergency department (ED) is a challenging and stressful work environment where communication lapses can lead to negative health outcomes. This article offers strategies to Emergency Medicine residents, nurses and staff physicians on how to improve communication to optimize patient care.     

A TEAM approach to NICU care

The NICU can be a very stressful place not only for the infants who need intensive care, but also for their parents. By implementing family-centered care using the TEAM model described here, nurses can make baby's stay less upsetting, promote bonding between parents and child, and help improve postpartum care.     

Personality,stress and coping in intensive care nurses: a descriptive exploratory study

Aim: The aim of the study was to investigate the relationship between personality traits, perception of workplace stress and coping among intensive care unit (ICU) nurses. Background: Research has indicated that ICUs are stressful environments. There is a tendency for research studies to investigate causes of stress and ways of coping, but few studies, particularly in recent years, have considered the personality traits of the staff who thrive in this challenging environment, the work stress they perceive and the coping strategies they use. Method: A convenience sample of critical care nurses (n = 46) completed three standardised questionnaires during September 2007: the revised NEO personality inventory (NEO‐PI‐R); the nurses stress scale (NSI) and the Brief Coping Orientations to Problems Experienced (COPE) scale. Findings: ICU nurses did not perceive their workplaces to be stressful. Certain personality traits, openness, agreeableness and conscientiousness, were associated with problem‐solving coping strategies such as active planning and reframing. Openness and extraversion were associated with less perceived stress from the ‘patients and relatives' dimension of the NSI; there were also negative correlations between conscientiousness and the ‘workload stress' and stress from lack of ‘confidence and competence’ dimensions of the NSI. Conclusion: Certain personality traits may have a buffering effect on workplace stress. Pre‐employment screening to identify staff that exhibit personality and coping traits associated with low perceived stress may be considered as part of the recruitment strategy to address problems relating to stress, sickness and retention. Relevance to clinical practice: The retention and recruitment of staff who have lower perceived workplace stress and who utilise problem‐focused coping may result in less reported absences and fewer critical incidents and errors.     

A training program for managing agitation of residents in long-term care facilities: description and preliminary findings

The purpose of this article is to describe a training program for managing agitation of long-term care residents and to report results of a pilot study. The program emphasizes the development of behavioral skills for the assessment, prevention, and reduction of both aggressive and non-aggressive agitated behavior. It includes 8 hours of class instruction followed by 8 hours of weekly supervision by the trainers. The nursing staff of all working shifts of a unit located in a large nursing home and the residents of this unit participated in the pilot study. Residents and staff were assessed prior to and after the 2-month training program. Staff members reported using behavioral techniques to a greater extent and feeling more effective in managing agitation after training. More than 90% of staff members were satisfied with the training program. During the supervision period, the staff developed and implemented individualized interventions for two residents. The interventions involved providing more attention to these residents and, in one case, modifying some aspects of the direct environment which seemed to trigger agitation. Both residents were less agitated after the interventions were implemented. Moreover, there was a reduction in the number and frequency of agitated behaviors for the other residents of the trainees' unit following staff training.     

Exploring person-centredness in emergency departments: A literature review

Person-centred approaches to care delivery have been increasingly promoted in international policy and strategy, but despite this there is evidence of failings within healthcare systems that negatively impact on the care experience for patients and staff. This paper explores the international literature on person-centredness within emergency departments (EDs). The Person-centred Practice Framework was used as the underpinning theoretical framework. This theory contends that staff must possess certain attributes to manage the care environment appropriately to deliver effective care processes in order to achieve effective person-centred outcomes for patients and staff. An initial search of the literature identified no relevant papers that discussed person-centredness as a concept within EDs. A further search using terms drawn from a definition of person-centredness revealed literature that reflected components of person-centredness. Themes that emerged included medical-technical intervention, a culture of worthiness, managing the patient journey, nurse/doctor relationships, patients' and relatives' experience of care, and ED as a stressful environment. The themes can be mapped onto the Person-centred Practice Framework, suggesting that components of person-centred practice have emerged from studies in a fragmented fashion, without consideration of person-centredness as a whole within an ED context.     

Stress in the professional practice of oncology nurses

Oncology nurses have been identified as a group at risk for stress. This project aimed at identifying stress-generating situations. There was an attempt at identifying stressful situations through the application of a stress evaluation scale (Stressor Scale for Pediatric Oncology Nursing) (Hinds et al, Cancer Nurs. 1990;13:354-360). In the opinion of 35 oncology nurses, 88.57% of whom were women and 73% of whom had more than 24 months of experience, 38 out of the 50 analyzed statements involving work situations were considered stressful in some way. Fifty-four percent of the statements disclosed a medium or high stressor capacity, and 22% were seen as extremely high stressors. These situations were included in the categories "work organization," "relationships among staff members," and "care restrictions." It is reiterated that the set of activities developed by oncology nurses is stressful, and that there is a need for institutional intervention, due to the narrow relation between work environment and care results.     

Mental health nurses' and allied health professionals' perceptions of the role of the Occupational Health Service in the management of work‐related stress: how do they self‐care?

Higher rates of stress-related sickness are found in health care professionals when compared with other sectors. The annual direct cost of absence to the National Health Service is ￡1.7 billion. Increased clinical demand, long hours, low staffing and a lack of support from colleagues and management are contributing to absenteeism, somatic complaints and mental health problems. Mental health work is inherently stressful and levels of work stress experienced by mental health nurses are especially high. The study investigated mental health nurses' and allied health professionals' (AHPs) awareness and knowledge of the service provided by the Occupational Health Service (OHS) and identified work-related stress and self-care strategies within these two groups. Nurses and AHP staff employed in mental health services in a Scottish healthboard area were invited to complete an anonymous questionnaire. Results demonstrated that staff found their contact with the OHS to be a positive experience. They considered direct patient care to be less stressful than the organizational constraints they work under, and they reported a lack of support from both their peer groups and management. There should be recognition of the increased stress that hospital-based nurses and AHPs experience. These areas should be scrutinized and reviewed further to support staff within these environments in accordance with organizational objectives.     

Jack

As nurses work longer hours with less staff to care for sicker patients, our profession has become more stressful than ever. Sometimes we leave work with hearts as achy as our feet. This nurse's story reminds us of what makes it all worthwhile: our patients and their families.     

An assessment tool for screening ROP in the preterm infant

An increased incidence of retinopathy of prematurity (ROP) parallels the increased incidence of viable births at earlier gestational ages. However, advancements in laser therapy can treat ROP and ultimately prevent blindness. This paper describes the development, implementation, and evaluation of a tool that consistently documents ROP assessments by medical staff, as well as pertinent medical history necessary to safely manage this critical population. The assessment tool was designed for an outpatient ophthalmology clinic. The outpatient population included all infants delivered at or transferred to the neonatal intensive care unit of a large university hospital located in the Midwestern United States. The infants were considered at risk for ROP if they weighed less than 1500 grams or if they had a gestational age of less than or equal to 34 weeks. At any given time, the outpatient clinic manages from 50 to 70 infants. Implementation of the tool increased consistency in documentation by medical staff and guided the initial assessment for nursing and technical staff members.     

Techniques to comfort children during stressful procedures

Medical procedures can be unpleasant experiences for children, their parents, and health care providers. We present this model of working with children having invasive procedures with the aim of helping to increase the comfort of infants and children and also parents and medical staff. The model has five parts: (1) Preparing the child and parent for the procedure and for their role during the procedure; (2) inviting the parent/caregiver to be present; (3) utilizing the treatment room for stressful procedures; (4) positioning the child in a comforting manner; and (5) maintaining a calm, positive atmosphere.     

Preterm infant behavioral and heart rate responses to antenatal phenobarbital

The effects of antenatal phenobarbital on behavioral state and heart rate (HR) were examined in a randomized sample of 49 preterm infants > 24 and < 34 weeks postconceptional age. Behavioral state and HR observations were made during a routine care giving procedure on Days 1, 2, and 3 of life. There were no differences in behavioral state and HR responses between control and experimental subjects, suggesting that antenatal phenobarbital did not have a sedative effect on experimental subjects. Infants in both study groups responded to caregiving with changes to fussy/cry behavior and increases in HR. Older infants and nonventilated infants were more often in fussy/cry states during care giving than younger infants and ventilated infants. The HR increases were not clinically important, but the behavioral changes were, suggesting that behavioral response may be a more sensitive sign of distress than HR in very young preterm infants.     

Management styles employed in the adult mental health service

The recruitment and retention of NHS nursing staff in inner city mental health care is particularly challenging. When working with adults who have severe mental health problems, there are many factors that can contribute to a stressful and demanding working environment where staff can become dissatisfied. Managers need to tackle the source of any discontent before it reaches crisis point. The purpose of this study was to examine the management style of an inner city NHS trust that provided acute mental health services in order to identify the reasons behind the increasing leaving rates of its nursing staff. The study also explored job satisfaction and what other factors might contribute to the staff's decision to leave the organisation in the future.     

Parenting the post-NICU premature infant

The birth of a premature infant is stressful for family members who must adjust to unfamiliar surroundings, learn new vocabularies, cope with the infant's uncertain survival and outcome, maintain vigilance at the neonatal intensive care unit (NICU), and eventually assume care for a recovering infant at home. Nursing research has focused on many issues related to parenting prematurely born infants, including parenting during the initial hospitalization, concerns of mothers about infant discharge, the relationship between premature infants and their mothers during the first 2 years after hospital discharge, the quality of the home environment on premature infant outcomes, parenting after the first 2 years, and interventions to improve parenting. This article focuses on research about parenting the post-NICU discharge infant to assist nurses in giving comprehensive, evidence-based care.     

Parental perceptions of neonatal care

This qualitative study investigated retrospective experiences of parents whose infants (24–37 weeks’ gestation) required Neonatal Unit admission. Using semi-structured interviews, parents of 20 infants were recruited and 16 interviewed. Data analysis revealed several themes: Parental impressions, Care delivery; Impact on relationships and Parental control issues. Although parents generally found staff supportive and helpful, they highlighted difficulties they had experienced. Initial parental impressions and aspects of care delivery are presented here. Events preceding admission are often bewildering and unexpected. First impressions can be distressing and effective communication channels vital, if we are to allay parental fears. Recommendations include providing frequent updates for parents, Positive re-enforcement and support by staff as infants progress from intensive to special care and Provision of written information explaining the unique aspects of the neonatal environment. This small study provides insight into the experiences of a group of parents and valuable information for neonatal staff.     

超低出生体重儿精细化照护培训方案的构建及应用研究

目的 构建、实施并评价超低出生体重儿精细化照护培训方案的有效性.方法 构建超低出生体重儿精细化照护培训方案,包括课前预习、个体化发育支持护理评估程序、气道集束化照护技术、营养喂养技术、血管通路的建立和管理技术、家庭参与式照护技术.2019年3月对新生儿重症监护病房护士按超低出生体重儿精细化照护培训方案进行培训,应用柯氏...     

Occupational stress in neurosurgery: an exploratory study.

Occupational stress in nursing has been a popular topic for investigation. In particular, comparisons between practice areas such as the intensive care unit (ICU) and medical-surgical unit have attempted to identify what factors are stressful, and whether some nursing environments are more stressful than others. Such studies have led to inconclusive findings. While many practice areas have been studied, the neurosurgical ICU and neuromedical/neurosurgical units have largely been overlooked. Using interviews, this exploratory study examined aspects of nursing perceived as stressful by staff members working in ICU and medical-surgical units in a neuroscience center. Findings suggested that patient care, communication, workload, management and supervision, organizational and personal circumstances are major sources of stress. These findings are in keeping with studies of stress conducted in national and international non-neurosurgical nursing practice areas.     

Planning cognitive-behavioral management programs for long-term care

Recent changes in the nature and scope of nursing home practices challenge long-term care nurses to develop treatment programs that are both successful in enhancing residents' remaining quantity and quality of life, as well as cost-effective in treating specific problems. The characteristics of behavioral therapies make them ideal for the open, community environment that characterizes many long-term care (LTC) settings. Under the guidelines of the Omnibus Budget Reconciliation Act of 1987, LTC facilities are expected to initiate behavioral management programs and to train staff in behavioral management practices. The purpose of this article is to discuss five key issues that should be considered in planning behavioral management programs for LTC facilities.