Nurses' Perceptions (nurse + perception)

Distribution by Scientific Domains


Selected Abstracts


Nurses' Perceptions of Safety Culture in Long-Term Care Settings

JOURNAL OF NURSING SCHOLARSHIP, Issue 2 2009
Laura M. Wagner RN
Abstract Purpose: To describe perceptions of workplace safety culture among nurses employed in long-term care (LTC) settings. Design: A cross-sectional survey. Respondents were licensed nurses (N=550) with membership in gerontological nursing professional organizations in the United States (n=296), Canada (n=251), and other (n=3). Methods: An anonymous, self-administered, mail-in questionnaire, which included the Hospital Survey on Patient Safety Culture as well as questions about individual and institutional characteristics. The survey included key aspects of safety culture, such as work setting, supervisor support, communication about errors, and frequency of events reported. Findings: Nurse-managers reported significantly more positive safety culture perceptions compared with licensed staff nurses. Additionally, licensed nurses employed in government-run facilities had significantly less positive safety culture perceptions compared with those working in nonprofit organizations. Conclusions: Interventions designed to improve safety culture in LTC settings should be focused on the concerns of licensed staff nurses and the improvement of communication between these nurses and their managers. Clinical Relevance: Enhancing safety culture in long-term care settings may facilitate improvements in resident safety. Assessment of workplace safety culture is the first step in identifying barriers that nurses face to provide safe resident care. [source]


Patients' Sexual Health: A Qualitative Research Approach on Greek Nurses' Perceptions

THE JOURNAL OF SEXUAL MEDICINE, Issue 8 2009
Evangelia Nakopoulou MSc
ABSTRACT Introduction., Health care professionals, especially nurses, through their contact with patients, play an important role in encouraging discussions about sexual concerns. Aim., To explore perceptions on sexual health issues and how these might inhibit or enhance Greek nurses' ability to incorporate sexual health assessment into everyday practice. Main Outcome Measures., A discussion guide was used as checklist to ensure that the basic issues would be addressed. Topics related to the areas of interest were either brought up from the participants or introduced by the moderator. Methods., The study recruited a purposive sample of 44 Greek staff nurses (SN) attending a course leading to their professional upgrading. A qualitative research design was employed using seven focus groups. Discussions started with nurses' perceived definitions of sexual health and proceeded with open-ended questions. Transcripts were analyzed using thematic analysis based on the principles of grounded theory. Results., Three central themes were identified from transcripts' thematic analysis: subjective perception of sexual health, discussing sexual problems, and educational and training needs. Participants' perceptions of sexual health centred mainly on the emotional and somatic dimensions. Regarding clinical practice, a variety of personal and contextual reasons limit nurses' willingness to talk about sexuality with patients, such as gender and age differences, familial upbringing, lack of time and privacy, and restricted perception of nursing role. All nurses stressed the need for further specialized training not only in physiology issues related to sexuality, but also most importantly in communication skills. Conclusions., Although Greek nurses acknowledge the importance of sexual health assessment, they believe that sexual history taking is not within the range of their professional tasks. Since holistic care demands sexual health assessment and intervention to be an integral part of nursing practice, it is necessary to introduce courses in their curriculum and experiential workshops addressing the multidimensionality of sexuality. Nakopoulou E, Papaharitou S, and Hatzichristou D. Patients' sexual health: A qualitative research approach on Greek nurses' perceptions. J Sex Med 2009;6:2124,2132. [source]


Nurses' perception of the quality of care they provide to hospitalized drug addicts: Testing the Theory of Reasoned Action

INTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 6 2009
Merav Ben Natan PhD RN
A correlational design was used to examine nursing staff attitudes and subjective norms manifested in intended and actual care of drug users based on the Theory of Reasoned Action. One hundred and thirty-five nursing staff from three central Israeli hospitals completed a questionnaire examining theory-based variables as well as sociodemographic and professional characteristics. Most respondents reported a high to very high level of actual or intended care of drug users. Nurses' stronger intentions to provide quality care to drug users were associated with more positive attitudes. Nursing staff members had moderately negative attitudes towards drug users. Nurses were found to hold negative stereotypes of drug addict patients and most considered the management of this group difficult. Positive attitudes towards drug users, perceived expectations of others and perceived correctness of the behaviour are important in their effect on the intention of nurses to provide high-quality care to hospitalized patients addicted to drugs. [source]


Nurses' perception of disaster: implications for disaster nursing curriculum

JOURNAL OF CLINICAL NURSING, Issue 22 2009
Fung WM Olivia
Aims and objectives., The aims of the study were to identify nurses' perception of disaster, whether they considered some of the events that have occurred in Hong Kong to be disasters and the types of disastrous events that they considered likely in Hong Kong. Background., The frequent occurrence of disasters has caused concern internationally. When disaster strikes, the demands on nursing staff are much higher than those on other healthcare professionals. There is little understanding of the concept of disaster among nurses in Hong Kong. Design., This was a descriptive study. A questionnaire was used to explore nurses' perception of disaster. Method., The questionnaire was distributed to all registered nurses studying in a master's degree programme in a university in Hong Kong. Findings., Only 123 out of the 164 respondents (75%) gave a description of disaster in the open-ended question. Sixty-one per cent of them described unfortunate events with large numbers of victims as disasters. The ,Lan Kwai Fong tragedy , stampede caused by over-crowdedness' (90·9%) and the severe acute respiratory syndrome outbreak (89·6%) were commonly referred to as disasters in Hong Kong. Fires in tall buildings (61·6%), infectious disease outbreaks (61%) and stampedes caused by overcrowding (48·8%) were rated as the events most likely to happen in Hong Kong. Conclusion., Understanding how nurses perceive disaster and the likelihood of disastrous events is the initial step for disaster planning and the development of a disaster nursing curriculum in Hong Kong. Relevance to clinical practice., All nurses around the world should be equipped with knowledge and skills for disaster care. This study provides information and implications for related research and the development of a disaster nursing curriculum to meet the global demand for disaster preparedness. [source]


Perceived adverse patient outcomes correlated to nurses' workload in medical and surgical wards of selected hospitals in Kuwait

JOURNAL OF CLINICAL NURSING, Issue 4 2009
Fatimah Al-Kandari
Aim., This study was carried out to identify the perceived adverse patient outcomes as related to nurses' workload. It also assessed nurses' perception of variables contributing to the workload and adverse patient outcomes. Background., Several studies have been published on adverse patient outcomes in which a correlation was found between nurses' workload and some adverse patient outcomes. Design., A cross-sectional survey was conducted between registered nurses (n = 780) working in medical and surgical wards of five general governmental hospitals in Kuwait. Data collection instruments., Data were collected using a self-administered questionnaire consisting of three sections to elicit information about the sample characteristics, perception of workload and perceived adverse patient outcomes during the last shift and last working week. Results., The three major perceived adverse outcomes reported by the nurses while on duty during their last shift were: complaints from patients and families (2%), patients received a late dose or missed a dose of medication (1·8%) and occurrences of pressure ulcer (1·5%). Similarly, the reported adverse outcomes over the past week were complaints from patients and families (5%), patients received a late dose or missed a dose of medication (5·3%) and discovery of a urinary tract infection (3·7%). Increases in nurse-patient load, bed occupancy rate, unstable patients' condition, extra ordinary life support efforts and non-nursing tasks; all correlated positively with perceived adverse patient outcomes. Conclusion., This study sheds light on an important issue affecting patient safety and quality of care as perceived by the nurses themselves as caregivers. Relevance to clinical practice., Nurses' perception of variables contributing to adverse patient outcomes and their workload could significantly affect the provided nursing care and nursing care recipients. The findings could help in policy formulation and planning strategies to decrease adverse patient outcomes in many countries with a health care structure similar to that of Kuwait. [source]


Nurses' perceptions of care and caring

INTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 1 2002
BA(Hons), Chris Bassett RN
Care and caring have been identified as inherently difficult concepts to define, but many authors believe that care is the central and unifying core of nursing. It is vital that nurses understand what care is, with the current issues about measuring and justifying exactly what they do for patients in order to be clear about what good care is. If nurses are to constantly improve the care they give, they need to be clearer about how to care for patients. Nurses need to make sure that they are giving the patients what they want and not what the nurses want. This review of the literature explores nurses' perceptions of care and compares it with what patients want in terms of care. It also highlights some important and interesting differences between what patients and nurses perceive as good care. [source]


Nurses' perceptions of individualized care

JOURNAL OF ADVANCED NURSING, Issue 5 2010
Riitta Suhonen
suhonen r., gustafsson m.-l., katajisto j., välimäki m. & leino-kilpi h. (2010) Nurses' perceptions of individualized care. Journal of Advanced Nursing,66(5), 1035,1046. Abstract Title.,Nurses' perceptions of individualized care. Aim., This paper is a report of a study of nurses' perceptions of individualized care, the factors associated with these perceptions, and nurses' perceptions of the provision of individualized care in different types of healthcare organization. Background., Although individualized care has been an internationally-challenging and long-standing research topic in nursing, the current literature on individualized care from the perspective of nurses is limited. Methods., A cross-sectional, descriptive and exploratory design using a questionnaire (Individualised Care Scale,Nurse) was employed to survey a stratified sample of 544 nurses (response rate 59%) working as Registered or Enrolled Nurses in one hospital district in Finland in 2008. Data were analysed using descriptive and inferential statistics (General Linear Model, one-way analysis of variance) and Cronbach's alpha coefficients for reliability analysis. Results., Nurses perceived that they supported patient individuality well and that the care they provided took into account patient individuality. Based on the General Linear Model, nurses' background variables were not associated with their perceptions of individualized care delivery. However, between-organization differences were found in all study variables: mental health ward nurses had the most positive perceptions, and nurses working in primary health centre long-term care wards the lowest. Conclusion., Healthcare organizations and work environments need to be evaluated as they may have an influence on individualized care provision. The Individualised Care Nurse instrument is sensitive to healthcare working environments and can be used in evaluating nurses' perceptions of individualized care. [source]


Reliability of Computerized Emergency Triage

ACADEMIC EMERGENCY MEDICINE, Issue 3 2006
Sandy L. Dong MD
Objectives: Emergency department (ED) triage prioritizes patients based on urgency of care. This study compared agreement between two blinded, independent users of a Web-based triage tool (eTRIAGE) and examined the effects of ED crowding on triage reliability. Methods: Consecutive patients presenting to a large, urban, tertiary care ED were assessed by the duty triage nurse and an independent study nurse, both using eTRIAGE. Triage score distribution and agreement are reported. The study nurse collected data on ED activity, and agreement during different levels of ED crowding is reported. Two methods of interrater agreement were used: the linear-weighted , and quadratic-weighted ,. Results: A total of 575 patients were assessed over nine weeks, and complete data were available for 569 patients (99.0%). Agreement between the two nurses was moderate if using linear , (weighted ,= 0.52; 95% confidence interval = 0.46 to 0.57) and good if using quadratic , (weighted ,= 0.66; 95% confidence interval = 0.60 to 0.71). ED overcrowding data were available for 353 patients (62.0%). Agreement did not significantly differ with respect to periods of ambulance diversion, number of admitted inpatients occupying stretchers, number of patients in the waiting room, number of patients registered in two hours, or nurse perception of busyness. Conclusions: This study demonstrated different agreement depending on the method used to calculate interrater reliability. Using the standard methods, it found good agreement between two independent users of a computerized triage tool. The level of agreement was not affected by various measures of ED crowding. [source]


Causes and management of nursing practice errors: a questionnaire survey of hospital nurses in Iran

INTERNATIONAL NURSING REVIEW, Issue 3 2008
M. Anoosheh rn
Background:, Some human error in health care is inevitable. Research into the predisposing factors for these errors is an important step in their management. Aim:, To survey nurse perceptions of the contributing factors to nursing practice errors. Methods:, A descriptive survey was carried out in three selected educational hospitals in Tehran city. Data were collected by questionnaire and analysed using descriptive statistics. The study sample consisted of 96 nurses and nursing managers. A multistage sampling strategy was used. Results:, Results showed that from nurses' and nursing managers' perspectives, various factors could contribute to the occurrence of nursing errors in the ,management', ,environment' and ,nursing care' sections. In addition, there were differences between nurses working on various wards about the causes of nursing errors in each section. Conclusion:, A culture of safety recognizes that safety is ,no accident'. Rather, it requires a change in management practices, providing a suitable environment with the requisite supply of resources and infrastructure, and increasing nurses' knowledge. Outcomes that are identified from the process of practice error management should promote interventions designed to prevent future practice errors based on the above contributing factors. Limitations:, The study relied on self-report by a sample of nurses. These responses should now be tested by empirical research into actual nursing practice errors in order to test whether the nurses' perceived ideas of causation are substantiated. [source]


School nurse perceptions of barriers and supports for children with diabetes

JOURNAL OF SCHOOL HEALTH, Issue 4 2005
Laura Nabors
These youth often do not receive the support needed to manage their diabetes during or after school. Nurses (n = 110) from 3 states responded to a survey examining perceptions of barriers to and supports for diabetes management during school and after school activities. Results indicated that adolescents need more support at school. Support could be facilitated by education of school staff; improved communication among youth, parents, school nurses, teachers, and physicians; and more communication from adolescents to others about what they need to manage well in school. Open-ended questions allowed nurses to provide recommendations for supporting youth and ideas for addressing barriers to management at school. Future studies should address ways to enable adolescents to communicate about their diabetes and ways to educate the school team. (J Sch Health. 2005;75(4):119-124) [source]


Changes in patients' need of nursing care reflected in the Zebra system

JOURNAL OF NURSING MANAGEMENT, Issue 4 2002
A.-K. Levenstam RN, MSc (business administration)
During 1995,97, many head nurses stated that they had perceived an increase in patients' need of nursing care. A questionnaire was designed to determine the reasons for this. The purpose of the investigation was to answer two questions, ,What were the reasons for head nurses perception of an increase in patients need of nursing care from 1995 to May 1997?' and, ,Does patient classification in the Zebra system reflect the underlying changes in patients' need of nursing care? The results show that there are several reasons behind changes in the patients need of nursing care. The main reasons are a decreased general level of health among patients and that treatments are more time-consuming. After comparing statistics concerning patient classification with the answers received from the questionnaire, a good level of agreement could be seen in these. [source]


The impact of an ICU liaison nurse: a case study of ward nurses' perceptions

JOURNAL OF CLINICAL NURSING, Issue 6 2005
Wendy Chaboyer MN
Aims and objectives., To provide a description of ward nurses perceptions of the intensive care unit liaison nurse role. Background., Critical care outreach services have become commonplace over recent years. In Australia, the intensive care unit liaison nurse, developed at a local level by healthcare providers, has emerged as a way of improving the continuity of care offered to this patient group. As a relatively new development in critical care services, evaluation of this role has been limited, particularly in relation to the perceptions of ward nurses who receive patients on discharge from intensive care unit. Design., Case study of one Australian hospital that utilizes an intensive care unit liaison nurse. Methods., Ten ward nurses were purposefully selected for their representativeness of the population and for their experience with the intensive care unit liaison nurse role. Each of these nurses participated in semi-structured in-depth interviews. Thematic analysis was used to analyse the data. Findings., Three major themes emerged from the interviews, highlighting role behaviours, contextual demands and outcomes associated with the intensive care unit liaison nurse role. The role behaviours of the liaison nurse included the professional characteristics of the individual and the primacy of clinical liaison as a role descriptor. Contextual demands were environmental characteristics relevant to providing patient, family and staff support. Outcomes of the role were perceived to include environmental preparation and education. Conclusions., This qualitative study has presented an overview of ward nurses perceptions of the intensive care unit liaison nurse role within one Australian hospital, illustrating the educative and empathic support that the liaison nurse role can provide to ward nurses. Relevance to clinical practice., Collaboration with ward nurses in developing specialist roles such as the intensive care unit liaison nurse is essential in ensuring improvements in patient and family care across the continuum. [source]


Service quality in hospital wards with different nursing organization: nurses' ratings

JOURNAL OF ADVANCED NURSING, Issue 2 2009
Ingeborg S. Sjetne
Abstract Title.,Service quality in hospital wards with different nursing organization: nurses' ratings. Aim., This paper is a report of a study to assess: (1) the relations between nursing organization models in hospital wards and nurses' perception of the quality of patient care and dimensions of the practice environment, and (2) if these relations were modified by variations in local conditions at the ward level. Background., Previous literature is inconclusive concerning what model of nursing organization maximizes the quality of nursing services. Method., A cross-sectional survey was carried out in a representative sample of Norwegian hospital wards in 2005. Intra-ward organization models were classified as: (1) Team leader (n = 30), characterized by extensive responsibilities for team leaders, (2) Primary nurse (n = 18), with extensive responsibilities for named nurses, and (3) Hybrid (n = 37), (1) and (2) combined. We prepared multilevel regression models using scales describing quality of patient care, learning climate, job satisfaction, and relationships with physicians as dependent variables. As independent variables, we used variables representing local ward conditions. Results., Eighty-seven wards and 1137 nurses (55% response rate) provided complete data. The ward level proportion of variance ranged from 0·10 (job satisfaction) to 0·22 (relationships with physicians). The univariate effect of organization models on quality ratings was not statistically significant. Introducing local ward conditions led to a statistically significant effect of primary nurse organization on relationships with physicians, and to a substantial proportional reduction in ward level variance, ranging from 32% (quality of patient care) to 24% (learning climate). Conclusion., Caution is needed about using service quality arguments when considering the possible benefits and drawbacks of different organizational models. [source]


Nurses' perception of disaster: implications for disaster nursing curriculum

JOURNAL OF CLINICAL NURSING, Issue 22 2009
Fung WM Olivia
Aims and objectives., The aims of the study were to identify nurses' perception of disaster, whether they considered some of the events that have occurred in Hong Kong to be disasters and the types of disastrous events that they considered likely in Hong Kong. Background., The frequent occurrence of disasters has caused concern internationally. When disaster strikes, the demands on nursing staff are much higher than those on other healthcare professionals. There is little understanding of the concept of disaster among nurses in Hong Kong. Design., This was a descriptive study. A questionnaire was used to explore nurses' perception of disaster. Method., The questionnaire was distributed to all registered nurses studying in a master's degree programme in a university in Hong Kong. Findings., Only 123 out of the 164 respondents (75%) gave a description of disaster in the open-ended question. Sixty-one per cent of them described unfortunate events with large numbers of victims as disasters. The ,Lan Kwai Fong tragedy , stampede caused by over-crowdedness' (90·9%) and the severe acute respiratory syndrome outbreak (89·6%) were commonly referred to as disasters in Hong Kong. Fires in tall buildings (61·6%), infectious disease outbreaks (61%) and stampedes caused by overcrowding (48·8%) were rated as the events most likely to happen in Hong Kong. Conclusion., Understanding how nurses perceive disaster and the likelihood of disastrous events is the initial step for disaster planning and the development of a disaster nursing curriculum in Hong Kong. Relevance to clinical practice., All nurses around the world should be equipped with knowledge and skills for disaster care. This study provides information and implications for related research and the development of a disaster nursing curriculum to meet the global demand for disaster preparedness. [source]


Perceived adverse patient outcomes correlated to nurses' workload in medical and surgical wards of selected hospitals in Kuwait

JOURNAL OF CLINICAL NURSING, Issue 4 2009
Fatimah Al-Kandari
Aim., This study was carried out to identify the perceived adverse patient outcomes as related to nurses' workload. It also assessed nurses' perception of variables contributing to the workload and adverse patient outcomes. Background., Several studies have been published on adverse patient outcomes in which a correlation was found between nurses' workload and some adverse patient outcomes. Design., A cross-sectional survey was conducted between registered nurses (n = 780) working in medical and surgical wards of five general governmental hospitals in Kuwait. Data collection instruments., Data were collected using a self-administered questionnaire consisting of three sections to elicit information about the sample characteristics, perception of workload and perceived adverse patient outcomes during the last shift and last working week. Results., The three major perceived adverse outcomes reported by the nurses while on duty during their last shift were: complaints from patients and families (2%), patients received a late dose or missed a dose of medication (1·8%) and occurrences of pressure ulcer (1·5%). Similarly, the reported adverse outcomes over the past week were complaints from patients and families (5%), patients received a late dose or missed a dose of medication (5·3%) and discovery of a urinary tract infection (3·7%). Increases in nurse-patient load, bed occupancy rate, unstable patients' condition, extra ordinary life support efforts and non-nursing tasks; all correlated positively with perceived adverse patient outcomes. Conclusion., This study sheds light on an important issue affecting patient safety and quality of care as perceived by the nurses themselves as caregivers. Relevance to clinical practice., Nurses' perception of variables contributing to adverse patient outcomes and their workload could significantly affect the provided nursing care and nursing care recipients. The findings could help in policy formulation and planning strategies to decrease adverse patient outcomes in many countries with a health care structure similar to that of Kuwait. [source]


Mental health student nurses' perception of the role of the mental health nurse

JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 6 2004
D. M. RUNGAPADIACHY phd msc bsc (hons) rmn rgn cert ed
Clear role definition is essential for directing the focus of nurse education and several studies have attempted to define the role of the mental health nurse (MHN). These, however, came to the conclusion that mental health nursing was difficult to articulate. The aim of this study was to understand how, during their transition to first level registration, mental health student nurses (MHSNs) perceived the role of the MHN. Semi-structured interviews were conducted with 14 MHSNs during the last 6 months of their transition to MHN. Transcripts were analysed using a qualitative approach based on grounded theory. Six key themes were identified, five of which were defined mental health nursing roles. The sixth theme related to non-therapeutic intervention on the part of some MHNs. Several areas of concern were identified. First, MHSNs expected to conduct more psychologically based interventions than were achievable in practice. Second, emphasis on drug administration can lead to a conflict of interest in the nurses' advocacy role with patients. Third, MHSNs sometimes observed poor role models in their placements, which could have a negative impact on the way in which future MHNs view the role of the MHN. [source]


An exploration of the contribution of the community nurse to rehabilitation

HEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 4 2003
Rosie Kneafsey RGN BSc
Abstract Effective hospital and community rehabilitation services are increasingly recognised as a means of meeting the changing pattern of health and social care need. While the district or community nurse has the potential to play a central part in community rehabilitation provision, this role has received relatively scant attention in the literature. This paper describes research findings on community nurses' perceptions of their role and potential contribution to rehabilitation. As part of a wider, 2-year, qualitative investigation of the role of the nurse in rehabilitation, fieldwork was undertaken with both district and community staff nurses. This comprised focus group discussions and interviews with staff recruited as a consequence of the follow-up of patients' experiencing rehabilitation. The findings indicate that community-based nurses contributed to patient rehabilitation by making assessments, referring on to other members of the multi-professional team, advocating for and liaising with other services, helping people to adapt, teaching and motivating patients and carers, supporting and involving families, and providing technical care. A number of challenges to community-based nursing roles were apparent, including feelings of exclusion, lack of recognition, a lack of time for rehabilitation and paucity of referrals for rehabilitation. Greater clarity and recognition is needed of the community-based nursing contribution to rehabilitation, and there is a need to ensure that community nursing assessments contribute to patients' rehabilitation goals and the promotion of independent living. [source]


,I think PCA is great, but . . .',Surgical nurses' perceptions of patient-controlled analgesia

INTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 5 2007
Sue King RGON MA(Appl)
This qualitative study investigated surgical nurses' perceptions of patient-controlled analgesia as a strategy for managing acute pain in a tertiary care hospital. Patient-controlled analgesia is commonly used and nurses play an essential role in caring for patients prescribed it. The study was divided into two parts. First, audiotaped semistructured interviews were conducted with 10 nurses. The interviews were followed by a postal questionnaire to 336 nurses with 171 returned. Thematic analysis was the chosen methodology. The audiotaped transcripts and questionnaires surfaced five themes, with the dominant one being ,I think PCA is great, but . . .'. The paper outlines and explores these themes and addresses the implications arising from the research for both clinical practice and education. [source]


Establishing an action research group to explore family-focused nursing in the intensive care unit

INTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 1 2007
Fiona Coyer RN ENB100 PGCEA PhD
This paper presents the first phase of a four-phase collaborative action research study which aimed to facilitate family-focused nursing in the intensive care environment. The purpose of phase one was to determine intensive care nurses' perceptions of family-focused critical care nursing and the appropriateness of family-focused nursing in the intensive care unit. A collaborative action research group was established with six registered nurses working in the intensive care unit of a metropolitan tertiary referral hospital. Data were collected through group discussions and analysed using open coding. Findings revealed two categories related to perceptions of family-focused intensive care nursing: partnership in care and maintaining a balance. The group unanimously agreed that family-focused nursing was appropriate in the intensive care environment. The three subsequent action research phases of this study are reported elsewhere. [source]


Nurses' perceptions of care and caring

INTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 1 2002
BA(Hons), Chris Bassett RN
Care and caring have been identified as inherently difficult concepts to define, but many authors believe that care is the central and unifying core of nursing. It is vital that nurses understand what care is, with the current issues about measuring and justifying exactly what they do for patients in order to be clear about what good care is. If nurses are to constantly improve the care they give, they need to be clearer about how to care for patients. Nurses need to make sure that they are giving the patients what they want and not what the nurses want. This review of the literature explores nurses' perceptions of care and compares it with what patients want in terms of care. It also highlights some important and interesting differences between what patients and nurses perceive as good care. [source]


Developing person-centred practice: nursing outcomes arising from changes to the care environment in residential settings for older people

INTERNATIONAL JOURNAL OF OLDER PEOPLE NURSING, Issue 2 2010
BSc (Hons) Nursing, Brendan McCormack D.Phil (Oxon), PGCEA
mccormack b., dewing j., breslin l., coyne-nevin a., kennedy k., manning m., peelo-kilroe l., tobin c. & slater p. (2010) Developing person-centred practice: nursing outcomes arising from changes to the care environment in residential settings for older people. International Journal of Older People Nursing 5, 93,107 Aim., To present the nursing outcomes from the evaluation of developments in the care environment in residential settings for older people. Design., The evaluation data reported here is derived from a larger national programme of work that focused on the development of person-centred practice in residential services for older people using an emancipatory practice development framework. A multi-method evaluation framework was utilised. Outcome data were collected at three time points between December 2007 and September 2009. The data reported here were collected using an instrument called the ,Person-Centred Nursing Index'. Findings., Heavy workload was the main cause of stress among nurses. Personal and professional satisfaction with the job was scored highest by the total sample of nurses. Nineteen factors were examined using the Person-Centred Nursing Index. Statistically significant changes were observed in 12 of these. In addition, there were statistically significant changes in nurses' perceptions of caring, indicating a shift from a dominant focus on ,technical' aspects of care, to one where ,intimate' aspects of care were more highly valued. Relevance to clinical practice., The findings highlight the importance of the development of effective teamwork, workload management, time management and staff relationships in order to create a culture where there is a more democratic and inclusive approach to practice and space for the formation of person-centred relationships. [source]


Operating room nurses' perceptions of the effects of physician-perpetrated abuse

INTERNATIONAL NURSING REVIEW, Issue 3 2010
B.L. Higgins rn
HIGGINS B.L. & MACINTOSH J. (2010) Operating room nurses' perceptions of the effects of physician-perpetrated abuse. International Nursing Review57, 321,327 Background:, Operating room (OR) nurses experience abuse perpetrated by physicians; however, little research has been conducted to examine nurses' perceptions of the effects of such abuse. Aims:, The aim of this research was to understand participants' perceptions of physician-perpetrated abuse on their health and ability to provide patient care. Materials/Methods:, In this qualitative descriptive study, ten operating room nurses working in Eastern Canada participated in open-ended, individual audiotaped interviews that were transcribed for analysis using Boyatzis' method for code development. Results:, Three categories of factors contributing to abuse were developed. The first, culture of the OR, included environment and hierarchy. The second, catalysts of abuse, included nurses' positions and experience as well as non-nurse factors such as resources and interpersonal relationships among physicians. The third category, perceived effects, included psychological, physical and social health consequences for nurses. Effects on patient care consisted of safety and potential challenges to access. Discussion:, Nursing practice implications included mentoring, support and accountability for action. Educational implications related to interdisciplinary education and increased education on communication, assertiveness, and awareness of abuse. Implications for research included studying perceptions of other health-care providers including physicians, studying recruitment and retention in relation to abuse, and studying other abuse in health care such as horizontal violence. Conclusion:, We suggest a proactive approach for empowering OR nurses to address abuse and an increased focus on interdisciplinary roles. [source]


Barriers to, and facilitators of post-operative pain management in Iranian nursing: a qualitative research study

INTERNATIONAL NURSING REVIEW, Issue 4 2008
N. Rejeh bscn, mscn
Background:, Unrelieved post-operative pain continues to be a major clinical challenge, despite advances in management. Although nurses have embraced a crucial role in pain management, its extent is often limited in Iranian nursing practice. Aim:, To determine Iranian nurses' perceptions of the barriers and facilitators influencing their management of post-operative pain. Methods:, This study was qualitative with 26 participant nurses. Data were obtained through semi-structured serial interviews and analysed using the content analysis method. Findings:, Several themes emerged to describe the factors that hindered or facilitated post-operative pain management. These were grouped into two main themes: (1) barriers to pain management after surgery with subgroups such as powerlessness, policies and rules of organization, physicians leading practice, time constraints, limited communication, interruption of activities relating to pain, and (2) factors that facilitated post-operative pain management that included the nurse,patient relationship, nurses' responsibility, the physician as a colleague, and nurses' knowledge and skills. Conclusion:, Postoperative pain management in Iran is contextually complex, and may be controversial. Participants believed that in this context accurate pain management is difficult for nurses due to the barriers mentioned. Therefore, nurses make decisions and act as a patient comforter for pain after surgery because of the barriers to effective pain management. [source]


Nurses' perceptions of individualized care

JOURNAL OF ADVANCED NURSING, Issue 5 2010
Riitta Suhonen
suhonen r., gustafsson m.-l., katajisto j., välimäki m. & leino-kilpi h. (2010) Nurses' perceptions of individualized care. Journal of Advanced Nursing,66(5), 1035,1046. Abstract Title.,Nurses' perceptions of individualized care. Aim., This paper is a report of a study of nurses' perceptions of individualized care, the factors associated with these perceptions, and nurses' perceptions of the provision of individualized care in different types of healthcare organization. Background., Although individualized care has been an internationally-challenging and long-standing research topic in nursing, the current literature on individualized care from the perspective of nurses is limited. Methods., A cross-sectional, descriptive and exploratory design using a questionnaire (Individualised Care Scale,Nurse) was employed to survey a stratified sample of 544 nurses (response rate 59%) working as Registered or Enrolled Nurses in one hospital district in Finland in 2008. Data were analysed using descriptive and inferential statistics (General Linear Model, one-way analysis of variance) and Cronbach's alpha coefficients for reliability analysis. Results., Nurses perceived that they supported patient individuality well and that the care they provided took into account patient individuality. Based on the General Linear Model, nurses' background variables were not associated with their perceptions of individualized care delivery. However, between-organization differences were found in all study variables: mental health ward nurses had the most positive perceptions, and nurses working in primary health centre long-term care wards the lowest. Conclusion., Healthcare organizations and work environments need to be evaluated as they may have an influence on individualized care provision. The Individualised Care Nurse instrument is sensitive to healthcare working environments and can be used in evaluating nurses' perceptions of individualized care. [source]


Understanding nursing on an acute stroke unit: perceptions of space, time and interprofessional practice

JOURNAL OF ADVANCED NURSING, Issue 9 2009
Cydnee C. Seneviratne
Abstract Title.,Understanding nursing on an acute stroke unit: perceptions of space, time and interprofessional practice. Aim. This paper is a report of a study conducted to uncover nurses' perceptions of the contexts of caring for acute stroke survivors. Background. Nurses coordinate and organize care and continue the rehabilitative role of physiotherapists, occupational therapists and social workers during evenings and at weekends. Healthcare professionals view the nursing role as essential, but are uncertain about its nature. Method. Ethnographic fieldwork was carried out in 2006 on a stroke unit in Canada. Interviews with nine healthcare professionals, including nurses, complemented observations of 20 healthcare professionals during patient care, team meetings and daily interactions. Analysis methods included ethnographic coding of field notes and interview transcripts. Findings. Three local domains frame how nurses understand challenges in organizing stroke care: 1) space, 2) time and 3) interprofessional practice. Structural factors force nurses to work in exceptionally close quarters. Time constraints compel them to find novel ways of providing care. Moreover, sharing of information with other members of the team enhances relationships and improves ,interprofessional collaboration'. The nurses believed that an interprofessional atmosphere is fundamental for collaborative stroke practice, despite working in a multiprofessional environment. Conclusion. Understanding how care providers conceive of and respond to space, time and interprofessionalism has the potential to improve acute stroke care. Future research focusing on nurses and other professionals as members of interprofessional teams could help inform stroke care to enhance poststroke outcomes. [source]


John Heron's six-category intervention analysis: towards understanding interpersonal relations and progressing the delivery of clinical supervision for mental health nursing in the United Kingdom

JOURNAL OF ADVANCED NURSING, Issue 2 2001
Graham Sloan BSc DipN RMN RGN DipCogPsychotherapy
John Heron's six-category intervention analysis: towards understanding interpersonal relations and progressing the delivery of clinical supervision for mental health nursing in the United Kingdom Aims.,This paper provides a critique of how Heron's six-category intervention analysis framework has been adopted by nursing in the United Kingdom (UK) as a theoretical framework in nursing research and model for clinical supervision. From this, its merits as an analytic framework and model for clinical supervision in nursing are discussed. Background.,Heron's six-category intervention analysis has been acknowledged as a means by which nursing could develop its therapeutic integrity. It has also been used as a theoretical framework in nursing research focusing on nurses' perceptions of their interpersonal style. More recently descriptions of this framework have been proposed as a structure for clinical supervision. However, its use as a theoretical framework to underpin research investigating the interpersonal skills of nurses and as a model of clinical supervision must firstly be scrutinized. Findings.,Returning to Heron's original description and comparing this with its current adoption in the UK, misconceptions of this framework can be identified. Its value as an analytic tool investigating interpersonal relations in nursing has still to be evaluated. Furthermore, nursing's emphasis on certain intervention categories has undermined the potential potency of this framework and its contribution as a model for clinical supervision in nursing. Conclusion.,We argue that Heron's six-category intervention analysis as a framework to investigate the interpersonal competence of nurses, particularly mental health nurses, requires investigation. This, in turn, would provide an opportunity to challenge the framework's theoretical standpoint. In addition to its value as an analytic tool, all six categories of Heron's framework have equal relevance to its contribution in nursing as a supervision model. [source]


Cohesion among nurses: a comparison of bedside vs. charge nurses' perceptions in Australian hospitals

JOURNAL OF ADVANCED NURSING, Issue 4 2001
Wendy Chaboyer PhD RN
Cohesion among nurses: a comparison of bedside vs. charge nurses' perceptions in Australian hospitals Aim.,This study examines the extent to which hospital nurses view their working environment in a positive sense, working as a cohesive group. Background.,Despite the fact that nursing in Australia is now considered a profession, it has been claimed that nurses are an oppressed group who use horizontal violence, bullying and aggression in their interactions with one and other. Methods.,After ethical approval, a random sample of 666 nurses working directly with patients and all 333 critical care nurses employed in three large tertiary Australian hospitals were invited to participate in the study in the late 1990s. A mailed survey examined the perceptions of interaction nurses had with each other. The hypothesis, that level of employment (either Level I bedside nurses or Level II/III clinical leaders) and area of work (either critical care or noncritical care) would influence perceptions of cohesion, as measured by the cohesion amongst nurses scale (CANS) was tested. Results.,In total 555 (56%) surveys were returned. Of these, 413 were returned by Level I and 142 by Level II/III nurses. Of this sample, 189 were critical care and 355 noncritical care nurses. There was no difference between Level I and II/III nurses in mean CANS scores. It is interesting to note that the item rated most positively was ,nurses on the units worked well together', however, the item rated least positive was ,staff can be really bitchy towards each other' for both Level I and II/III nurses. There was no difference in CANS scores between critical care and noncritical care nurses. Conclusions.,Nurses working in Australian hospitals perceived themselves to be moderately cohesive but, as would be expected in other work settings, some negative perceptions existed. [source]


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

JOURNAL OF ADVANCED NURSING, Issue 4 2000
Christine E. Hallett PhD BNurs BA Hons RGN HVCert DNCert PGDE
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. [source]


Organisational climate, organisational commitment and intention to leave amongst hospital nurses in Taiwan

JOURNAL OF CLINICAL NURSING, Issue 11-12 2010
Shwu-Ru Liou
Aims and objectives., To examine: (1) Taiwanese nurses' perceptions of organisational climate, levels of organisational commitment and intention to leave, as well as relationships between these three variables; (2) demographic differences in the levels of these variables; and (3) mediating effects of organisational commitment on the relationship between organisational climate and intention to leave. Background., Organisational climate is related to organisational commitment and affects nurses' performances and attitudes towards an organisation. Design., A cross-sectional, descriptive design. Method., Registered nurses working in eight hospitals in southern Taiwan for more than six months were recruited. Data were collected using the Litwin and Stringer's Organisational Climate Questionnaire, Organizational Commitment Questionnaire and a five-item scale measuring intention to leave. Questionnaires were distributed to 612 potential participants; 486 valid returned questionnaires were analysed. Results., The study's participants were generally satisfied with their hospital's climate and yet claimed low commitment to their organisation and, nevertheless, reported low intention to leave their job. Single nurses were more satisfied with their hospital's climate and were more committed to their hospital and had a lower intention to leave their job compared to married nurses. Nurses working in district hospitals perceived a better hospital climate and had a lower intention to leave than nurses working in teaching or regional hospitals. Staff nurses perceived a better organisational climate than did nurse managers. Organisational climate, organisational commitment and intention to leave were intercorrelated. Organisational climate had almost 60% indirect effect on organisational commitment related to intention to leave. Conclusions., Creating a good organisational climate may increase nurses' organisational commitment and, in turn, decrease their intention to leave. Relevance to clinical practice., To motivate nurses' positive organisational behaviours and to address their diverse needs, hospital administrators are encouraged to understand nurses' work-climate perceptions and to address nurses' varied demographic factors. [source]


Incongruence between nurses' and patients' understandings and expectations of rehabilitation

JOURNAL OF CLINICAL NURSING, Issue 12 2009
Julie Pryor
Aims and objectives., To explore nurses' understandings and expectations of rehabilitation and nurses' perceptions of patients' understandings and expectations of rehabilitation. Background., Within the context of a broadening appreciation of the benefits of rehabilitation, interest in the nature of rehabilitation is growing. Some believe that rehabilitation services do not adequately meet the needs of patients. Others are interested in the readiness of patients to participate in rehabilitation. Design., Qualitative. Method., Grounded theory using data collected during interviews with nurses in five inpatient rehabilitation units and during observation of the nurses' everyday practice. Findings., According to nurses working in inpatient rehabilitation units, there is a marked incongruence between nurses' understandings and expectations of rehabilitation and what they perceive patients to understand and expect. Conclusion., Given these different understandings, an important nursing role is the education of patients about the nature of rehabilitation and how to optimise their rehabilitation. Relevance to clinical practice., Before patients are transferred to rehabilitation, the purpose and nature of rehabilitation, in particular the roles of patients and nurses, needs to be explained to them. The understandings of rehabilitation that nurses in this study possessed provide a framework for the design of education materials and orientation programmes that inform patients (and their families) about rehabilitation. In addition, reinforcement of the differences between acute care and rehabilitation will assist patients new to rehabilitation to understand the central role that they themselves can play in their recovery. [source]