Enhancing adherence to infection control in Swedish community care: Factors of importance

Healthcare‐associated infections are the most frequent adverse event in healthcare delivery worldwide. The theory of planned behavior has proven helpful in hospital hygiene interventions and might be useful in community care. This study explored how medically‐responsible nurses in Swedish community care perceived and ranked the impact of factors related to the theory of planned behavior, the factors“ probability to change, enhancing the healthcare staff's adherence to infection control guidelines, and identified which theory of planned behavior subquestions should be focused on to enhance adherence to infection control. Medically‐responsible nurses (n = 268) in Swedish communities answered a Web‐based questionnaire regarding impact and probability to change theory of planned behavior factors in relation to infection control. Four theory of planned behavior factor constructs were found: (i) knowledge and encouragement from management; (ii) access and availability to materials and equipment, and interest among staff; (iii) influence by colleagues; and (iv) workload, and influence by patients and significant others. The theory of planned behavior factors are relevant for infection control in a home‐like environment, and findings could be used as a basis for interventions enhancing hygiene in community care.     

Primary care groups and trusts: a threat or an opportunity for the development of community-based nursing in England

AIMS OF THE STUDY: To examine the role of Primary Care Groups and Trusts (PCG/T) in relation to nurses working in general practice and community health services. BACKGROUND: Over the past two decades there have been rapid changes in the numbers and roles of nurses working in primary care and community based settings. The establishment of Primary Care Groups offers health care professionals, including nurses, the chance to develop local primary care services and to integrate community and primary care nursing. These developments may offer opportunities or pose threats to nursing staff. RESEARCH METHODS: Data are drawn from a longitudinal study of a randomly selected sample of Primary Care Groups in England (n = 72). In a second survey of Groups carried out in autumn/winter 2000, Primary Care Group chairs and chief officers were interviewed by telephone. RESULTS: Response rates were 97% for both chairs and chief officers (69 of each). Chairs indicated that in most areas Primary Care Groups were consulting with local nurses to develop policy. Fifty-seven (85%) reported that investment in nursing staff and nursing services was a high priority in their area. Twenty-eight (41%) indicated that nurse-led services designed to increase patient access had already been established in their area, and 20 (29%) were planning new nurse-led services. Many developments had been initiated by Primary Care Groups. Initiatives to integrate community and general practice based staff were underway in most areas. CONCLUSIONS: Primary Care Groups and Trusts are initiating changes in general practice and community based services which are likely to have long-term and important implications for nurses in terms of their roles, conditions of work and future careers. It is important that nurses are consulted and are involved in developing and implementing policy change.     

高血压病病人社区护理模式探讨

[目的]探讨社区高血压病防治护理工作模式,提高居民高血压的知晓率、治疗率及控制率。[方法]通过高血压俱乐部进行健康教育。[结果]高血压俱乐部的健康教育效果好,高血压病病人服药依从性提高。[结论]高血压俱乐部的社区护理工作模式能够在积极治疗高血压病病人的同时大力开展一级预防,因地制宜地进行宣教,提高居民的自我保健能力,使病人的医疗费用降低。     

Opening up to learning spiritual care of patients: a grounded theory study of nursing students

Aim. To determine undergraduate nursing students’ perspectives on spiritual care and how they learn to assess and provide spiritual care to patients. Background. Nursing is concerned with holistic care. Systematic teaching and supervision of students to prepare them to assist patients spiritually is a growing focus. However, there is limited consensus about the competences students need to develop and little is written related to students learning processes. Design. Grounded theory was used to identify students’ main concern and develop a substantive grounded theory. Method. Data collected during semi‐structured interviews at three Norwegian University Colleges in eight focus groups with 42 undergraduate nursing students were analysed through constant comparison of transcribed interviews until categories were saturated. Results. The participants’ main concern was ‘How to create a professional relationship with patients and maintain rapport when spiritual concerns were recognised’. Participants resolved this by ‘Opening up to learning spiritual care’. This basic social process has three iterative phases that develop as a spiral throughout the nursing programme: ‘Preparing for connection’, ‘Connecting with and supporting patients’ and ‘Reflecting on experiences’. Conclusion. Nurses need a wide range of competences to fulfil the nursing focus on holistic patient care. Nursing education should prepare students to recognise and act on spiritual cues. A trusting relationship and respectful and sensitive communication assist students to discover what is important to patients. An educational focus on spiritual and existential themes throughout the nursing programme will assist students to integrate theoretical learning into clinical practice. Relevance to clinical practice. Study participants reported seeing few role models in clinical settings. Making spiritual assessment and interventions more visible and explicit would facilitate student learning in clinical practice. Evaluative discussions in clinical settings that include spiritual concerns will enhance holistic care.     

以科研手段促进社区护理教学

[目的]探索高职高专社区护理实践教学的最佳方法.[方法]采用单纯随机抽样将护理专业实习学生分为两组,试验社区组除了完成社区护理实习大纲规定的常规实习内容外,还参与课题调查等研究,将社区护理科研活动与社区护理实习教学相结合;非试验社区组只进行常规社区护理实习.[结果]试验社区组在专业情感、实习满意度及社区带教老师对学生实习行为的评价均显著高于非试验社区组;开展科研活动后社区居民疾病防治知识、信念和预防行为均有显著改善,居民满意率达97.2%.[结论]社区护理科研与教学相结合的教学方式,能够提高教学质量,带动社区护理教学师资队伍建设,增强学生的专业情感.     

以科研手段促进社区护理教学

[目的]探索高职高专社区护理实践教学的最佳方法。[方法]采用单纯随机抽样将护理专业实习学生分为两组．试验社区组除了完成社区护理实习大纲规定的常规实习内容外，还参与课题调查等研究，将社区护理科研活动与社区护理实习教学相结合；非试验社区组只进行常规社区护理实习。[结果]试验社区组在专业情感、实习满意度及社区带教老师对学生实习行为的评价均显著高于非试验社区组；开展科研活动后社区居民疾病防治知识、信念和预防行为均有显著改善，居民满意率达97．2％。[结论]社区护理科研与教学相结合的教学方式，能够提高教学质量，带动社区护理教学师资队伍建设，增强学生的专业情感。     

提升实习护生伤口护理知识与技能的培训方法研究

目的 探讨提升护生伤口护理知识与技能的最佳教学方法.方法 将104名护生分为实验组和对照组各52名,对照组采用先伤口护理理论学习,而后进行伤口护理实践及技能培训.实验组采用先伤口护理实践,再伤口护理理沦学习,而后继续伤口护理实践及技能培训.结果 培训后两组护生的伤口护理理论考核成绩均高于培训前(P＜0.01);实验组护...     

Case management in the community: identifying a role for nursing

• ? This paper describes the findings of” a questionnaire survey designed to create a picture of current case management practices as they relate to community nursing.
• ? Eighty-three questionnaires were analysed in order to identify client groups, nurse details, functions of case management adopted, other services involved, titles used and advantages and disadvantages of the ways of working adopted.
• ? Findings suggest that interpretation of, and involvement in, case management is variable and that the practice potential for this model of care warrants further research.

     

医疗机构照顾与社区服务结合家庭护理在社区优质护理中的应用

[目的]探讨医疗机构照顾、社区服务结合家庭护理在社区优质护理中的应用效果。[方法]将2013年12月—2014年11月收治的56例老年病人作为对照组,将2014年12月—2015年11月收治的56例老年病人作为观察组,对照组病人采取常规护理,观察组病人采用医疗机构照顾、社区服务结合家庭护理式的社区优质护理服务模式,比较两组病人不良护理事件发生率、自我护理能力和生活质量评分情况。[结果]观察组病人的护理不良事件发生率明显低于对照组(P0.05);观察组病人自我护理能力及生活质量评分均高于对照组(P0.05)。[结论]实施医疗机构照顾、社区服务和家庭护理相结合的社区延续性优质护理服务,能够提高护理安全度,提高病人自护能力,改善病人生活质量。     

远程信息护理对手外伤治疗的探讨

目的为护理对象提供准确、完整的信息知识,使护理对象有足够的方法处理、解决具体情况,提高病人的生活质量,增强医护患之间的信任度及责任感。方法对65例手损伤的患者进行了手术治疗,其中对34人实施了远程信息护理,把另外31人作为对照。结果实验组与对照组优良率差异有显著意义,X2=7．49,P<0．01。结论远程信息护理可应用于医学护理领域,具有先进性、实用性和可操作性,较其他护理有明显的优越性,值得在护理工作中推广。     

Wound care in the community setting: clinical decision making in context

Sixty-two community nurses in northern England of grades B and D to H were interviewed by a team of four researchers. The interviews were semi-structured, and were tape-recorded, fully transcribed and content analysed. They were conducted as part of a larger study, the aim of which was to examine community nurses' perceptions of quality in nursing care. One of the main themes the work focused on was decision-making as an element of quality. Data relating to wound care were considered from the perspective of the insights they offered into clinical decision-making. Data were interpreted in the light of a literature review in which a distinction had been made between theories which represented clinical decision-making as a linear or staged process and those which represented it as intuitive. Within the former category, three sub-categories were suggested: theorists could be divided into 'pragmatists', 'systematisers' and those who advocated 'diagnostic reasoning'. The interpretation of the data suggested that the clinical decisions made by community nurses in the area of wound care appeared largely intuitive, yet were also closely related to 'diagnostic reasoning'. They were furthermore based on a range of sources of information and justified by a number of different types of rationale.     

伤口护理管理的新进展

文章阐述了伤口的愈合受内在和外在因素的影响,慢性伤口的治疗需要在“伤口床准备”的原则下应用系统性的方法.伤口分为可愈合性、维持性和不可愈合性;目前,尚无证据表明压疮完全可以避免;对于慢性伤口患者要加强自我管理和社会心理干预,尤其对合并糖尿病等慢性疾病患者的管理涉及多层次干预、卫生政策修订和医疗保健机构的改革.护士是开展伤口优质护理服务的根本,要对护士进行结构化培训,以提高对急慢性伤口患者的服务质量.