Abstract The paper explains why accurate nursingdocumentation is vital for quality care. The paper explores the problems with documentation, some of which are based on a distorted nursing perspective and others that are of a systemic nature. The paper provides a number of solutions and recommendations to these problems.
From the Paper "Nursing documentation is a highly significant issue since documentation is a fundamental feature of nursing care. Patient records are legally valid, and need to be accurate and comprehensive so that care can be communicated effectively to the health care team. Unless the content of documentation provides an accurate depiction of patient and family care, quality of care may not be possible. Many nurses do not realize that what they document or fail to record can produce an enormous effect on the care that is provided by other members of the health care team. More importantly, the nurse's attitude as documentation proceeds, determines how other members of the interdisciplinary team will react to the patient and/or family."
Tags: care, content, standardization, communication, patient, perspective
Abstract This paper discusses computerization of the nursing professing, as it pertains to the documentation of patient information. The paper describes the process involved and why health care documentation is an important aspect of nurse care of the patient. The paper also looks at why computer-based data collection is more productive that other means.
An examination of the nursing philosophy of the Strong Memorial Hospital at the University of Rochester Medical Center and School of Medicine in Rochester, New York (Rochester/Strong).
Abstract This paper looks at the nursing philosophy of the Strong Memorial Hospital and sets forth the context in which the nursing organization's fundamental principles become relevant. It critiques a core aspect of the principles articulated in publicly available organization documents and discusses the extent to which those principles incorporate a specific theory of nursing. It evaluates the evidence of nursing-staff inputs into such principles and the evidence of how the articulation may reflect the reality of nursing practice, with a view toward evaluating the document's influence on nursing practice.
From the Paper "This does not appear to mean that nursing is less important as a discipline than other health-care inputs at Rochester/Strong. It does, however, go to evidence that medical research is in both the foreground and the background of nursing praxis and nursing education there. Commitment to research is embedded as a first principle and a factor of uniqueness at Rochester/Strong, a point driven home again and again in its documentation. Further, where nursing practice per se is a feature of hands-on treatment and patient care, the evidence of the Rochester/Strong policy statements is very much that nursing practice is presumptively a part of--or perhaps more exactly collapsed into--the notion that patient care is a physician's responsibility (Healing Power, 1999). Where nursing is mentioned as a feature of health-care teams, other caregiving disciplines are also mentioned; social work is given particular prominence (Burn/Trauma Health Care Team, 1999)."
Abstract The paper discusses the subject of portfolios for the nursing profession and states that the portfolio is an evolving document that needs to be continuously updated to reflect changes in the individual nurse herself and changes evolving in the nursing profession. The paper concludes that based on past experience in the UK, the use of portfolios in the nursing profession is an excellent method of both professional and personal evaluation. The paper states that many educators are required to use professional portfolios and the results have been positive, leading one to conclude that similar results would occur if implemented in the nursing profession.
From the Paper "For example, Annette Jinks spend years conducting national surveys and interviews throughout the United Kingdom in order to explore the intricate relationship between student-centered teaching and learning and patient-centered nursing care. The central question asked was whether student nurses are taught using the principles of student-centered learning theories will replicate the behaviors they have learned when they begin delivering nursing care services. Based on this study, Jinks recommends that when teaching nursing, the teaching nurse should use methods of hands on learning, similar to those used in a student-centered curriculum. In order guarantee that the classroom concepts are being transferred to the field-experience, Jinks recommends the use of portfolios, both for the nursing student and for the nursing teacher. By using a portfolio, the student will be forced to show how they are utilizing the classroom theories and skills when dealing with patients, thus making a deeper connection and leading to better nursing practice. Likewise, the nursing teacher will be able to ensure that all the theories they teach have a direct application to the nursing practice of their students."
Abstract This paper looks at problem of Registered Nurses (RNs) delegating tasks and activities to unlicensed personnel. The paper documents which tasks/activities can be delegated and which cannot, and attempts to elucidate who determines these rights and responsibilities -- that states or the boards of nursing.
From the Paper "The NCSBN is working on a position paper on the delegation of duties by nurses to unlicensed assistive personnel. The Board of Nursing regulates nursing practice and the State Nurse Practice Acts determine what level of licensed nurse is authorized to delegate..."
Abstract The paper discusses how modern nursing legislation has been proposed to Congress that would address serious concerns in the nursing profession. These concerns have a direct affect on every individual that utilizes health care today. The paper further discusses how Clark and Clark contend that nurses in the twenty-first century are commonly having to work extended overtime hours to meet the nursing shortage, as well as contend with low wages, and insufficient working conditions. The paper describes how, because nurses are forced into positions of care that can result in medical errors to patients, many nurses are therefore leaving the profession. The paper analyzes how the Quality of Nursing Care Act of 2004, and the Safe Nursing and Patient Care Act of 2005 were introduced as legislation in the United States Congress to address these issues.
Abstract In this article, the writer discusses that as the demands on nurses and the nursing profession have increased over the last several decades, it became evident to many nursing professionals that the ideology related to nursing practice had to be changed. The writer notes that cultural, environmental and mind-body considerations were significantly important because these factors were known to impact patients and their health. However, the writer points out that as more information became available through practice, it was also apparent that each person had to be evaluated independently in order for health care professionals to have a clear idea of all issues that affected the patient's well being. The writer then discusses that Roy, Neuman and Leininger each developed approaches to nursing practice that were intended to provide a well established vision of the person, which could be used in preventative medicine, as well as in the event of illness. These theories lead nurses to be capable of treating the whole individual, while providing the quality care that nursing is intended to ensure.
Outline:
Introduction
Leininger and the Transcultural Nursing Model
Application of Lieninger's Sunrise Model
Environment and Population
Cultural Values
Religious and Philosophical Factors
Kinship and Social Factors
Political and Legal Factors
Economic Factors
Educational Factors
Health Care System
Roy Adaptation Model
Application of the Roy Adaptation Model
Scientific and Philosophical Elements
Self-Concept and Group Identity
Role Function
Environment
Health and Adaptation
Nursing Neuman Systems Model
Application of the Neuman Systems Model
Basic Structure/Energy Resources
Stressors
Line of Resistance
Optimal System Stability
Prevention/Intervention and Nursing
From the Paper "The transcultural model, therefore, is comprised of numerous factors that must be taken into consideration if the proper care is to be presented for each individual patient. The most significant of these factors is culture. According to Leininger, the culture that an individual belongs to affects every aspect of that individual's existence. The elements associated with a culture are taught to the person from the time of birth and consistently impact thought, religious beliefs, behaviors and how the person relates to the health care environment."
Abstract In this paper, the author examines the four concepts (person, health, nurse, and environment) that have been considered essential when describing the parameters of the nursing profession. In addition,
the paper discusses the relevance of these four concepts to the future of nursing as a whole and specifically to persons considering taking up nursing as a profession.
Outline:
My Philosophy of Nursing and How it Fits the Future
The Nursing Metaparadigm
Interrelationships of Concepts
Nursing Profession: Knowledge
The Nursing Process or Critical Thinking?
What About Research?
Nursing Profession: Practice
Challenges in the 21st Century: What is the Ultimate Goal?
References
From the Paper "Nursing is a combination practice combining the fine art of caring with the scientific knowledge and skills acquired through education and career experience. Professional nurses have a vast knowledge base, as represented in the diagram and description below.
Nursing Foundation (NF) is a combination of knowledge from both the sciences and humanities. Methodology (M) applies to problem solving such as in clinical practice the staff nurse uses the nursing process strategic thinking for nursing administration, scientific inquiry for nursing research, or adult learning theory for nursing education. Nursing Essence (NE) represents the evolution of nursing as a profession. NE includes the principles of the science of nursing, legal parameters, the definition of person, environment, health, and nursing; technical skills; and all other esoteric components of nursing practice. Additionally, nursing essence accounts for the various existing nursing conceptual models and nursing theories. Disciplined Inquiry (DI) refers to investigation or experimentation aimed at the discovery and interpretation of facts, revision of accepted theories or law in the light of new data, and the practical application of new or revised theories or laws. Nursing knowledge is influenced by disciplined inquiry (or research) from the nursing sciences and associated disciplines."
Abstract This paper is based on a phone interview with an experienced Clinical Psychologist. It specifically focuses on the use of writing in counseling profession and the documentation required in professional records.
From the Paper "Information for this project was obtained in a phone interview with Mrs. Mary Boyce. M. A. Mrs. Boyce has been a practicing Clinical Psychologist for 25 years specializing in Marriage, Family, and Child Psychology. Her experience includes families, couples, children, adolescents, small ones, and a variety of disorders. The interview focused on the amount and types of writing involved in the Clinical Counseling profession, specifically Childhood Counseling. Mrs. Boyce runs her own private clinical practice."
Abstract This paper considers the reasons for using non-nursing personnel to perform nursing tasks and then takes a look at the advantages and disadvantages of doing so. The paper also discusses the outlook for using non-nursing personnel in the nursing profession as well as the decline in qualified nurses in the labor pool.
From the Paper "Much has been written about the nursing shortage that plagues physicians, hospitals and nursing homes in the United States. At the same time that there are fewer qualified nurses available in the work force a number of states and municipalities have passed regulations regarding the nurse-to-patient ratio that is making the situation even more acute. As a result, healthcare providers have been forced to be innovative in the way that they attract nurses to their institutions and recruiting efforts..."
Abstract In this article the writer discusses that minimum nurse-to-patient ratios represent the minimal amount of nurses required to care for the maximum number of patients, without compromising patient or nurse safety. The writer points out that both the public and physicians rank nurse under-staffing as one of the most serious threats to patient safety. The writer notes that nurse safety advocates are beginning to question how inadequate ratios impact job satisfaction and the ability of nursing staff to improve quality of care. While a problem at all healthcare facilities, the issue is even larger at nursing homes where minimum staffing ratios are very low. The writer concludes that much research is in progress to help nurses maintain a safe environment to practice and to determine how to adequately define what nurse-to-patient ratios should be.
From the Paper "A history of nurse staffing and patient outcomes dates as far back as a study by Moses and Mosteller. They found nurse staffing among the significant determinants of mortality. Later, publicly available Medicare data for U.S. hospitals generated more studies on the factors related to mortality. Authors of these studies reported that nurse staffing was significantly related to mortality. Aiken, Clarke, Sloane, Sochalski, and Silber produced the first study to specifically quantify the impact of nurse-to-patient ratios on death rates. They reported that reducing the number of patients that a registered nurse takes care of results in better patient outcomes. A reduction in mortality rates and infections were among the findings. Aiken, Sochalski, and Lake demonstrated that nursing presence, whether measured as RN ratios or as RN hours relative to other nursing personnel hours, is significantly correlated to mortality. Adequate staffing levels allow nurses time to make comprehensive patient assessments, attend to routine nursing duties and effectively respond to emergencies. Specifically, Aiken, Clarke, Sloane, Sochalski, and Silber found that each additional patient assigned to a nurse resulted in a 7% increase in the likelihood of the patient dying within 30 days of admission to the hospital."
Abstract A study designed to examine the learning styles of nursing students in undergraduate programs at the baccalaureate and associate level. Student age, gender, and academic performance in nursing courses is also investigated to determine the way in which these factors are associated with student learning styles. The purpose of the study is to assess the degree to which such factors represent important variables for nursing educators to consider in developing and implementing plans for retaining nursing students. As it has been suggested that a major factor responsible for student success or failure is the effectiveness of the teaching-learning process, it is hoped that the findings of the study will be useful in aiding nursing education programs to more fully respond to the learning needs of student nurses.
Contents
Introduction
Statement of the Problem
Purpose of the Study
Research Questions
Theoretical Framework
Organization of the Thesis
Literature Review
Andragogical Model vs. Pedagogical Model
Learning Styles and the Learner-Centered Approach
Kolb's Learning Cycle
Research Methodology
Research Design
Research Method
Data Analysis
From the Paper "As evidenced throughout the literature, extensive efforts have not been implemented to study the degree to which teachers do actually use a different style when teaching adults. Two seminal studies (i.e., Beder & Darkenwald, 1982; Gorham 1984, 1985) examined this area by investigating the following questions: Do teachers teach adults in a different way, and if so, what are these differences? In both studies, subjects were teachers who taught both adults and preadults. In the Beder and Darkenwald study, information was collected solely through a self-report questionnaire. Gorham used an adaptation of Beder and Darkenwald's questionnaire for the initial phase of her study, followed up with classroom observations of a small number of her sample for a second phase."
Tags: research, psycholofy, medical, nurse, care, health, adult, education, development
Abstract The paper explores how the nursing shortage is a problem throughout the United States and the world, with disparities ranging from nurse to patient ratios of 1675 RNs for every 100,000, to physicians actually outnumbering nurses in South Africa. The problems associated with the nursing shortage are multiple. This paper highlights the many causes of the nursing shortage, cites current statistics, reviews recommended solutions, discusses perceived pros and cons of the nursing shortage and includes commentary on how the nursing shortage affects patients.
Abstract In this article, the writer focuses on the effect of the present and sustained shortage of nursing personnel within the medical community. The study also includes a discussion as to the present shortage of multidisciplinary nursing personnel; i.e., nurses trained in more than one specialty, gender disparity and retention and recruitment. Following a discussion of the identified nursing shortage and possible solutions, a Fishbone Chart is presented. This chart systematically lists the major different causes of the nursing shortage which contribute to the problem. Further, the chart relates to the shortage cause and effect situation and provides an informational data sheet presentation. The writer concludes that without a concentrated effort on the part of the medical community, educational institutions, and federal government the scarcity of nurses will continue to rise.
Outline:
Abstract
Introduction
Data Chart on Nursing Shortage
References
From the Paper "As nurses can no longer solely rely on the traditional nursing practices to deliver patient care, a resolution to the shortage issue is first found in the development of a health care marketing plan that targets individuals who have a basic interest in nursing. Such a plan must include all the components necessary to attract well- qualified people, namely image, diversity, employment stability, benefits, working conditions, and educational assistance. No longer is it a simple case, for example, that an institution may have 20 nursing positions to fill, but rather that they have specialized nursing positions to fill such as; 5 surgical nurse positions, 10 pediatric nurse positions and 4 oncology nurse positions. The fact is, many nursing positions are highly specialized, and simply adding additional functions to a nurses' ever-increasing list of responsibilities is not an adequate solution to the nursing shortage. In addition, failing to recognize the need for nurse specialties compounds the nursing shortage issue."
Abstract This paper discusses relational work beyond the nurse - patient dyad and how this affects professional relationships and provision of care. It explains that the primary duty of the nurse to put the needs of the patient first and foremost. The paper also looks at how collaboration and leadership are roles that transcend the nurse-patient dyad and are subject to different dynamics in that the nurse deals with peers and other professional that are, unlike the patient, transient in the hospital setting. The paper shows that from the ill-perceived role of the nurse performing mundane tasks for physicians more than half a century ago, the establishment of nursing as a distinct pillar in the health care system to the hybridization of the practice of both nursing and medicine, it is still to be determined what non-clinical roles may arise in the future health care system.
Outline:
Introduction
Conclusion
From the Paper "The different duties and responsibilities of the nurse are impossible to relegate to any one role. She may collaborate with an attending physician one moment and be expected to comfort a patient and family the next. One particular set of roles involve relating to colleagues and other health care professionals. These roles are different from nurse-patient roles in that they involve unique social dynamics inherent to any health care system."
Tags:nursing, health, care, professional, teamwork, leadership, collaboration
