<p>This dissertation aimed to investigate the use of electronic nursing documentation as a strategy to improve the quality of care provided to hospitalized patients. The literature to support the use of electronic nursing documentation on the quality of care delivered to patients is limited to date. Additionally, the literature describing the use of information for the delivery of care on paper-based nursing documentation is limited. This dissertation reviews the current literature, investigated the knowledge needed for nurses to know their patients and established categories of nurses' information needs as preliminary work to be able to descriptively compare the use of paper with electronic nursing documentation on inpatient care units within a hospital setting. The main study conducted for this investigation used a mixed-methods multiple case study design, to describe the processes of information use on two inpatient care units, while first using paper and subsequently electronic nursing documentation. Findings revealed the importance of the categories of nurses' information needs for both cases in addition to the use of verbal, paper-based and electronic information sources for the collection, communication and temporary storage of information needs. Additionally, the conversion to electronic nursing documentation introduced new challenges related to three quality metrics: efficiency, timeliness and safety. Recommendations are provided for further evaluation of electronic health records with additional consideration for appropriate hardware devices in the context of the care environment.</p> / Dissertation

Older patients comprise a large portion of patients in the acute care setting. Registered Nurses (RNs) are the main care providers in the hospital setting. RNs caring for older hospitalized patients are affected by many factors including workload pressures, issues related to the acute care environment and attitudes toward older patients. However, a literature review identified a limited number of studies exploring the RNs experience of caring for older patients in the acute care setting. This study explored the RNs experience of caring for older patients (age 65 and older) on an orthopedic unit in an acute care hospital. Saturation was reached with a purposive sample of nine RNs working on the orthopedic unit, including eight females and 1 male. Participants were interviewed using broad open-ended questions, followed by questions more specific to emerging themes. All interviews were audio-taped and transcribed verbatim. Data were analyzed using Glasers (1992) grounded theory approach. Participants described the basic social problem as dealing with the complexity of older patients. The basic social process identified was the concept of looking beyond. Looking beyond was described as looking at the big picture to find what lies outside the scope of the ordinary. Three sub-processes of looking beyond were identified as connecting, searching, and knowing. Connecting was described as getting to know patients as a person by taking time, respecting and understanding the individual. Searching was described as digging deeper, searching for the unknown by looking for clues and mining everywhere for information. Knowing was described as intuitively knowing what is going to happen and what the older patient needs by pulling it all together and knowing what to expect. These dynamic sub-processes provided the RN with the relationship and information required to look beyond to manage the older patients complexity. The results of this study have implications for nursing practice, education and research. These findings may provide RNs with a process to manage the complex care of a large portion of our population.

Diss. (sammanfattning) Umeå : Univ., 2006. / Härtill 4 uppsatser.

Thesis (M.S.)--University of Michigan, 1978.

Thesis (M.S.)--University of Michigan, 1991.

Thesis (M.S.)--University of Michigan, 1978.

Thesis (M.S.)--University of Wisconsin-Madison, 1993. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 89-93).

Thesis (M.S.)--University of Wisconsin, School of Nursing, 1966. / Typewritten. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 89-91).

Thesis (M.S.)--University of Michigan, 1991.

Trata-se de uma de pesquisa de caráter qualitativo, descritivo e exploratório, com abordagem fenomenológica, proposta por Paterson e Zderad. Esta pesquisa tem como objetivo geral: compreender a dimensão existencial do idoso em situação de hospitalização. E como objetivos específicos: descrever a percepção do idoso acerca do ambiente que o cerca. Entender a partir da ótica do idoso, quais são as melhores ferramentas para o estabelecimento de inter-relações com a equipe de enfermagem. E analisar o processo de cuidar a partir da perspectiva de Paterson e Zderad. Os sujeitos da pesquisa foram quinze idosos hospitalizados nos setores de clínica médica e cirúrgica e a unidade intermediária. O cenário foi um hospital público do interior do Estado do Rio de Janeiro. A coleta de dados aconteceu durante o ano de 2011, em um município que integra a Região dos Lagos. A técnica utilizada para a coleta de dados foi a entrevista não dirigida. Emergiram deste estudo oito categorias: ambiente hospitalar; enfermagem; acompanhantes; o que incomoda; agradecimentos; aprendizado e troca; religiosidade/espiritualidade; conselhos dos idosos para a equipe de enfermagem e imagem corporal. Espera-se que o presente estudo seja uma ferramenta para a melhoria da assistência de enfermagem aos idosos que vivenciam o processo de internação hospitalar, já que esta população possui características, especificidades e necessidades próprias, sendo seres singulares, com potencial de vir-a-ser, e necessitando do outro para a sua auto-realização. / It is a qualitative study descriptive and exploratory approach to phenomenological, proposed by Paterson e Zderad. Having as general objective: understand the existencial dimension from elderly in hospitalization. And specific objectives: Describe the perception of the elderly about the environment it is inserted. Understand from the perception of the elderly, what are the best tools to establish interrelationships with the nursing staff. And analyze the care process from the perspective of Paterson and Zderad. The subjects of study were fifteen elderly hospitalized in sectors of medical clinic and or surgical and the intermediate unit. The scenario was a public hospital in the state of Rio de Janeiro. The data collection happened during 2011, in a city that integrates the Região dos Lagos. The techiques use were interview an not directed. Emerged this study eight categories: ambient hospital; nursing; companions; what bothers; thanks; learning and exchange; religiosity and spirituality; advice the elderly for nursing staff and body image. It is expected that this study represents a tool to improve nursing care to elderly that experience the process of hospitalization since this population has characteristics, specificities, and needs, being unique people with potencial coming to be and requiring the other to self realization.