A causal modeling non-experimental design was used to test the influence of professional nursing practice (autonomy, control over nursing practice, group cohesion, and organizational commitment) on job satisfaction and anticipated turnover. A sample of 79 active duty Air Force nurses provided the convenience sample for the study. The concepts of control over nursing practice and organizational commitment had a positive influence on job satisfaction. Job satisfaction and organizational commitment had a negative influence on anticipated turnover. Neither autonomy nor group cohesion influenced either job satisfaction or anticipated turnover. Higher level of control over nursing practice, stronger organizational commitment and decreased anticipated turnover were found with field grade officers in comparison with company grade officers.

A descriptive study was conducted to explore the relationship among three measures of decision making capacity: (1) clinicians' opinions, (2) Pfeiffer's (1975) SPMSQ, and (3) a developmental instrument by Fitten et al. (1990) designed to measure patient clinical decision making ability. Another purpose of the study was to replicate portions of the work by Fitten et al. (1990). A convenience sample of 41 patients, four physicians, and three nurse practitioners was studied. Quantitative research techniques were employed for data collection and analysis. Significant correlations were found among all measurements of decision making capacity indicating that the developmental instrument appears to be a valid method of determining decision making capacity according to results obtained for convergent validity. The findings of this study support those reported by Fitten et al. (1990).

A descriptive correlational study was conducted to examine the relationship between sleep characteristics and fatigue in persons with cancer, receiving chemotherapy. Twenty-five adult patients, receiving chemotherapy in outpatient and inpatient hospital settings, participated in the study. The Verran and Snyder-Halpern (VAS) Sleep Scale (1989) was used to measure the sleep characteristics of subjects and the Piper Fatigue Scale (PFS) (1992) was used to measure characteristics of fatigue. Demographic data were also collected. Significant relationships (p 0.05) were found between the dimension of Sleep Disturbance and the fatigue dimensions of Sensory, Temporal, and Affective. A positive correlation was demonstrated between Sleep Supplementation and the Temporal dimension of fatigue. Gender differences were evident in the relationships between sleep and fatigue. Nurses are in a unique position to assist patients in coping with the side-effects of cancer treatment. Patient education can assist patients in understanding the limitations and self-care actions appropriate for sleep and fatigue.

This study explored the experience of third and fourth stage cancer patients going through the dying process. Grounded theory methodology was used to interview six adults with third or fourth stage cancer, and to describe their experience of the dying process. A beginning theory, Paradox of Living and Dying, emerged from the data analysis as six interconnected categories: Life Philosophy, Changes in Status, Accept Death but Maintain Hope, Preparation for Death, Living With Cancer, and People Caring. Subjects described their perspective of the dying process, and the paradoxical and synonymous relationship between living and dying. Identifying aspects of the dying process enables oncology nurses to develop effective interventions to address the needs of people with advanced cancer.

The purpose of this study was to compare the clinical usefulness and efficiency of two postpartum assessment tools: an empirically based postpartum assessment tool and the theory-based Roy-postpartum adaptation assessment tool (R-PAAT). Thirty mother-infant pairs were sequentially assigned to the control or experimental group for a postpartum home visit. Secondary analysis of the data involved (1) identification of nursing diagnoses generated from each assessment tool's data, (2) comparison of the number of nursing diagnoses generated using the empiric postpartum assessment tool versus the R-PAAT, and (3) comparison of the efficiency, measured by time required for a home visit, using the respective tools. Two of the 18 possible postpartum nursing diagnoses were identified significantly (p < .05) more often using the R-PAAT and two additional diagnoses approached significance. Home visits using the R-PAAT required significantly longer time to complete.

This study had three purposes: (1) to examine the differences and similarities between intensive care and medical-surgical RNs' self-reports of professional nursing practice and job satisfaction. (2 & 3) to explore the influence of professional nursing practice on nurse satisfaction in intensive care RNs and medical-surgical RNs, respectively. A two-group, cross-sectional descriptive design with a sample of 340 RNs was utilized to perform a secondary analysis of baseline data from the Differentiated Group Professional Practice project. Self-reports of RNs evidenced significantly higher levels of autonomy and control over nursing practice among intensive care subjects as opposed to medical-surgical subjects. The concepts of organizational commitment, autonomy, control over nursing practice, and group cohesion had a positive influence on total job satisfaction for the medical-surgical subjects. The above concepts with the exception of autonomy had a positive influence on total job satisfaction for the intensive care subjects.

<p> An estimated 18-26% of adolescent females age 15-19 in the US diagnosed with <i>Chlamydia trachomatis</i> (CT) are re-infected within 3-12 months. Patient delivered expedited partner therapy (EPT) may reduce CT re-infection. A prospective, observational study was conducted to determine if adolescent females provide EPT to their partners, whether perceived self-efficacy correlated with success of EPT, and whether success of EPT was associated with decreased CT re-infection rates at 3 and 6 months post-treatment. Adolescent females with CT at two urban school based health centers were invited to participate. There were 4 study visits over 6 months (baseline, 7-10 days, 3 months, and 6 months). Forty-six study participants enrolled and 30 (65%) accepted EPT. Forty-one completed the 7-10 day visit, 19 (46%) accepted and delivered EPT, 7 (17%) accepted but did not deliver EPT. Eleven (30%) tested positive for CT at 3 months and four (15%) tested positive at 6 months. No correlation existed between adolescent females&rsquo; perceived self-efficacy and CT reinfection at 3 and 6 months. Acceptance of EPT at enrollment was associated with reductions in CT re-infection at 3 months post-treatment (p = 0.04), but not at 6 months (p = 0.10). Delivery of EPT was not associated with reductions in CT re-infection at 3 or 6 months post-treatment (p = 0.08 and p = 0.44, respectively). More in-depth qualitative research with adolescents should explore barriers to EPT. Larger studies are needed to assess the impact of EPT acceptance and CT re-infection beyond 3 months as well as EPT delivery and CT re-infection.</p>

<p>Abstract Critical care nursing is experiencing a high turnover and a global shortage crisis. The number of critical care nurses (CCNs) leaving the critical care environment is at an unprecedented high rate, negatively impacting the quality of care for the most critically ill of patients.. It is not known if and to what extent CCNs resiliency is affected by self-care and how it is associated with compassion satisfaction, interprofessional relationships, professional quality of life, psychological and psychosocial impairment (PPI), or intent to leave the critical care specialty area. The purpose of this quantitative, cross-sectional, descriptive project was to ascertain if the independent variable for CCNs self-care had an associative relationship among five dependent variables reflective of CCNs resilience: (a) compassion satisfaction, (b) interprofessional relationships, (c) professional quality of life, (d) PPI, or (e) intent to leave the critical care specialty area. An innovative, web-based CCN self-care intervention was introduced and outcomes measured through the administration of a descriptive survey pre- and post-assessment to determine relational association to the variables of CCNs resilience. The project, though limited by time constraints, inferred CCNs and non-CCNs respondents are interested in self-care and creating healthy critical care environments for safe patient care. Keywords: resilience, critical care, stress management, burnout, compassion

<p> Healthcare associated infections cause 75,000 to 80,000 deaths a year. Many are preventable with proper hand hygiene adherence (HHA). Worldwide, HHA range is between 40-60%, far below the 100% recommended. The purpose of this quantitative, cross-sectional, prospective study was to investigate any association between 15 demographic variables and HHA of ICU nurses. A convenience sample of 613 hand hygiene opportunities was collected by direct observation at each of 5ICUs (4 hospitals) in Texas for 8 consecutive hours each day for 3-5 days. The theoretical foundation guiding this study was the healthcare environment theory. The Statistical Package for Social Sciences software was used for descriptive and inferential analysis of data. An aggregated overall HHA rate of 64.09% was identified among all nurses, 66.88% among male nurses and 62.27% among female nurses. Number of children, age of the nurse, number of years of living in the U.S., and the number of years of active nursing practice were significantly associated with HHA (p = .000) using paired sample t-test. The potential social change impact of this study is identifying variables associated with HHA, identification and measurement of 4 barriers to HHA, measuring the Hawthorne Effect, identification of <i>Low Gelers, High Gelers,</i> and <i>Super Gelers,</i> average rate may not be indicative of what is happening in hospital, and call for standardization of surveillance methodology. Findings may lead to specific interventions to increase HHA among nurses with certain demographic characteristics.</p>

<p> The process of how nurses work in relationships to accomplish their work is presented in this dissertation. This study has made the relational work process of nurses explicit. While research demonstrates that increased nurse staffing is associated with better patient outcomes and with nurses experiencing less burnout and job dissatisfaction, the process is not explored in the empirical literature. The research question was: &ldquo;What is the process of relational work of the nurse?&rdquo; Data collection and analysis conformed to the process of classical grounded theory. Interviews were face to face with 23 registered nurses working as direct care staff nurses on inpatient units. Data analysis (constant comparison) occurred concurrently with data collection. </p><p> The core category, Coming Together to Get Through, emerged from the data as how nurses worked collectively to accomplish their work. Without the help from their nursing, and physician, colleagues they could not finish each day&rsquo;s work completely and do the best for their patients. The ten temporal categories of the process are: Spending Time, Knowing Other Nurses and Doctors, Asserting Authority, Trusting and Respecting, Being Approachable, Relying on One Another, Needing Each Other, Helping Each Other, Getting the Work Done, and Did the Best for Our Patients. This is the first study to empirically discover a basic social process that demonstrates how the nurse works in relationships. The importance of social and relational constructs and their creation in an organization posits relationships as work and the building blocks of work in organizations. Discovery of this substantive theory of relational work allowed for conceptualization of an explicit work process. This empirical knowledge fills a gap in the literature that may affect appropriate staffing levels which in turn impact both patient and professional outcomes. Future research will focus on creation of a scale of the relational work of nurses, the process of interprofessional relational work, and if high levels of relational work are a pathway to decreased levels of moral distress and burnout, as well as improved professional satisfaction, and better patient outcomes.</p>