During recent reforms to the Taiwanese health care system, discharge planning for hospital patients has become an issue of great concern as a result of shorter hospital stays, increased health care costs and a greater emphasis on community care. There are around five million patients visiting in emergency departments (ED) per year in Taiwan with up to 85% of these, 4,250,000 emergency patients, discharged directly from the emergency department. This significant number of ED visits highlights the need to implement discharge planning in the ED. ED nurses are not only responsible for providing appropriate assessments of a patient's future care needs but also for implementing effective discharge planning as a legal obligation; discharge planning is also a patient's right in Taiwan. For ED nurses to function effectively in the role of discharge planner, it is important that they have a comprehensive understanding of implementing discharge planning. To date, no published research focuses on nurses' experience of implementing discharge planning in the ED in Taiwan. This study is the first step in identifying the experience and understanding of nurses in implementing discharge planning in the ED in Taiwan and may have implications worldwide. The purpose of this study was to identify and describe the experience and understanding of the qualitatively different ways in which ED nurses’ experience of implementing discharge planning for emergency patients in Taiwan. In order to identify and describe the experience of implementing discharge planning, the qualitative approach of a phenomenography was chosen. Thirty-two ED nurses in Taiwan who matched the participant selection criteria were asked to describe their experience and understanding of the implementation of discharge planning in the ED. Semi-structured interviews were audio-taped and later transcribed verbatim. The data analysis process focused on identifying and describing ways ED nurses’ experience and understanding of implementing discharge planning in the ED. There were two major outcomes of this study: six categories of description and an outcome space. These six categories of description revealed the experience and understanding of implementing discharge planning in the ED. An outcome space portraying the logical relations between the categories of description was identified. The six categories of description were implementing discharge planning as ‘getting rid of my patients’; implementing discharge planning as completing routines; implementing discharge planning as being involved in patient education; implementing discharge planning as professional accountability; implementing discharge planning as autonomous practice; implementing discharge planning as demonstrating professional nursing care in ED. The outcome space mapped the three levels of hierarchical relationship between these six categories of description. The referential meaning of implementing discharge planning was the commitment to providing discharge services in the ED. The results of this research contribute to describing the nurses’ experience in the implementation of the discharge planning process in the emergency nursing field, in order to provide accurate and effective care to patients discharged from the ED. This study also highlights key insights into the provision of discharge services both in Taiwan and World-wide.

SUMMARY The aim of this study was to investigate the requirements for patients with dementia and optimization of activities for nursing. Methods of study – primary data were obtained from the databases of the K.Grinius nursing and supportive treatment hospital activities in 2002-2004, and using of nurses and patients relative’s interview data collected by the specific questionnaire. During 2002-2004 years all data was enrolled to the information database. Statistical analysis was performed using MS EXCEL 2000 standard statistical programming packets. Results. During 2002-2004, the part of patients with dementia among all patients statistically significantly increased, so significantly increased the part of bed-days. The duration of nursing and supportive treatment was without significant changes, but hospital lethality have tendency to increase in average by 2.3 % /yrs, while the number of patients have tendency to decrease during this years. During the investigated period, the expenses for one bed-day were without significant changes and in averaged per year accounted 50.61 Lt. The expenses of state for one bed-day during 2002-2004 accounted 41.54 Lt. The expenses of Lithuanian state for nutrition and drugs was without significant changes and respectively accounted 8.69 and 11.90 Lt. Detecting nursing personnel, working with dementive patients, occupational peculiarities evaluated, that majority of nursing respondents were in middle-age, majority of them working in night... [to full text]

Bien qu'il existe une abondante littérature scientifique sur les infirmières praticiennes spécialisées de première ligne (IPSPL), le soutien et les modalités d’encadrement de cette pratique restent très peu explorés. Au Québec, ces questions semblent d’autant plus importantes à étudier car la diversité des milieux de pratique, l’éloignement physique entre les acteurs-clés, le partage de l’encadrement et le cadre légal complexifient l’opérationnalisation de ce soutien. Par le biais d’une étude de cas multiples, ce mémoire propose une analyse des différentes structures d’encadrement et des mécanismes déployés pour soutenir le développement de la pratique IPSPL au Québec. Issu d’un projet de recherche plus large et multicentrique, ce mémoire de maîtrise a étudié trois milieux distincts par le biais de 18 entrevues auprès de professionnels de la santé et de gestionnaires. Grâce à un modèle en trois niveaux, les besoins en termes de soutien des IPSPL et des équipes ont été identifiés. Les principaux résultats de cette recherche démontrent la pertinence d’un encadrement par les acteurs de la Direction des soins infirmiers. De plus, le soutien aux professionnels des équipes qui incluent des IPSPL semble bonifié lorsque certaines structures organisationnelles sont présentes. Finalement, les comités décisionnels autour de l’implantation des IPSPL s’avèrent davantage bénéfiques lorsqu’ils tiennent compte de l’environnement et de l’expérience acquise par les milieux. / Although there is an abundant literature on primary health care nurse practitioners (PHCNP), the optimal structures and practices to support PHCNPs remain largely unexplored. In Quebec, this issue needs particular attention because of practice settings diversity and physical distance between major key players. Furthermore, the supervision role that seems to be shared by multiple professionals and the legal framework add to the complexity of the implementation of support structures and practices. Through a multiple case study, this paper aimed to explore the managerial structures in place and to analyze the mechanisms deployed to support the development of PHCNP practice. Issuing from a larger scale multicenter research, this study analyzed three separate cases, totaling 18 interviews with health professionals and managers. Based on a three levels model built on the central concept of support, the needs of PHCNP and their teams have been identified. The main results of this research demonstrate the relevance of supervision by the key players of the Department of Nursing. In addition, the coordination between professionals seems enhanced when some organizational structures are implemented. Finally, decision-making committees linked to the implementation of PHCNP appear to be more useful when the environment and experience of the organizations are taken into consideration.

Thesis submitted in fulfilment of the requirements for the degree Master of Technology: Diagnostic Radiography, Department of Nursing and Radiography in the Faculty of Health Wellness Sciences at Cape Peninsula University of Technology 2014 / Aim: The aim of this study was to record the values of CTDIw and DLP displayed on the Computed Tomography (CT) scanner monitors of patients undergoing CT examinations of the head as Diagnostic Reference Levels (DRL) for dose optimisation in Northern Nigeria. Background: A brain CT scan is the most common CT examination performed, and this modality is recognized as delivering a high dose. CT, therefore, contributes significantly to the total collective effective dose to the population. Elimination of unnecessary or unproductive radiation exposure is necessary. To achieve this, practitioners must adhere to the principles of the justification of practices, and optimisation of radiation protection. Furthermore, the development of DRLs for the local context is advised. These reference doses are a guide to the expected exposure dose from a procedure and are useful as an investigation tool to identify incidences where patient doses are unusually high. Methodology: The study was conducted in three radiology departments with CT centres in Northern Nigeria. Data was collected, using a purposive sampling technique, from 60 consenting adult participants (weighing 70 ±3 kg) that had brain CT scans on seventh generations 4&16-slice GE and 16-slice Philips CT scanners. Prior to commencement of the study the CT scanners were certified by the medical physicists. For each brain scan, patient information, exposure factors, weighted computed tomography dose index (CTDIw), volume computed tomography dose index (CTDIvol) and dose length product (DLP) values were recorded. The data were analysed using SPSS version (16) statistical software. The mean, standard deviation and third quartile values of the CTDIw and DLP were calculated. An inter-comparison of the measured doses from the three research sites was conducted. A combined dose for the three centres was calculated, and compared with the reported data from the international communities where there are established DRLs. Results: The mean CTDIw and DLP values were: centre A (88 mGy and 713 mGy.cm), centre B (68 mGy and 1098 mGy.cm), and centre C (70 mGy and 59 mGy.cm). Comparison of CTDIw and DLP for the scanners of the same manufacturers showed statistically significant differences (p=0.003) and (p=0.03) respectively. In the case of the scanners of a different model but the same number of slices, the comparison of DLP was statistically significant (p=0.005) while no significant difference was noted in the measured CTDIw. Third quartile values of the cumulative doses of CTDIw and DLP, for Northern Nigeria were determined as 77 mGy and 985 mGy.cm respectively. Conclusion: The study has established Local DRLs (LDRLs) which are significantly higher than most of the reported data in the literature. Also dose variation between centres was noted. Optimization is thus recommended. Keywords: Head Imaging, Radiation Dose, Dose optimization, Computed Tomography, Local Diagnostic Reference Levels, Radiation Protection

The purpose of this project is to develop a domestic violence consciousness raising-education program and a self-administered risk assessment for a population of community college nursing students. When the faculty became aware that attrition rates were rising and that a high number of requests to drop out of nursing school were disproportionately linked to recent incidences of domestic violence, a potential contributing cause of the high drop out rate was revealed.