No description available.

No description available.

Objective: To determine the readiness of registered nurses (RNs) who provide care for patients with diabetes in a primary care setting for RN prescribing. Setting: Canadian provinces and territories. Participants: Canadian RNs working in primary care settings who provide care to patients with diabetes. Methods: A cross-sectional survey design was used to examine the readiness of RNs by measuring the attributes of readiness (value, confidence and willingness). The survey included questions on the demographic profile of participants including their age, education level and whether or not they had obtained additional certifications. This data was used to describe the sample and to determine whether there were differences between RNs who were ready to prescribe and RNs who were not ready to prescribe. Results: Almost 75% of the respondents were "ready" for RN prescribing. There were high positive correlations between "value" and "confidence", "value" and "willingness", and "confidence" and "willingness". There were no statistically significant differences in age, level of education and certifications for respondents who were ready to prescribe compared to those who were not ready to prescribe. Conclusions: The results of the present study indicate that RNs who provide care for patients with diabetes in a primary care setting are ready for prescribing. This practice has the potential to make more effective use of health human resources, allowing RNs to work to their full potential and increase accessibility to care for patients with diabetes.

Background: Sports-related concussions (SRC) are very common in youth in the US and represent a major clinical challenge. Clinical Practice Guidelines (CPG) have been developed to help guide the health care provider (HCP) in the diagnosis and management of SRC. Seventy-three percent of HCPs report that they deviate from current concussion CPGs in their clinical practices. The Protection of Athletes with Head Injuries Law in Utah requires HCPs caring for youth with concussions receive continuing education (CE) regarding SRC every three years. Currently, there are no CE modules on SRC developed for nurse practitioners (NPs) in the state of Utah. Project Purpose: The purpose of this DNP project was to develop and pilot an evidence-based educational module for primary care NPs in Utah on the evaluation and management of SRC in children and adolescents under the age of 18 years old. Methods: The education module integrates the concussion education curriculum developed by Pamela Mapstone DNP, PCNP. The module incorporates current CPGs and an extensive literature search. Following development of the module three clinical experts in SRC independently reviewed the module. Modifications were made accordingly and a pilot study evaluating the quality and usability of the education module was conducted. Sixteen NPs working in Utah were invited to complete the module followed by a short survey related to user satisfaction. The final version of the education module was modified based on the results of the pilot study. Results: An education module on SRC in youth for NPs working in primary care in Utah was successfully developed and piloted for quality and usability. The results of the pilot study support the content addressing the learning objectives; and that the module was easy to use. Conclusion: The education module tailored to the needs of NPs working in primary care in Utah has the potential to improve NPs’ knowledge of SRC in youth. Further study is recommended to evaluate the effects of the education module on clinical practice outcomes.

Introduction: Prescribing by non medical personnel (NMP) has been introduced in the UK. The objectives of this study were to a) describe pharmacist discharge prescription transcription service (PDPTS) provided in UK hospitals prior to NMP, b) investigate the implementation of supplementary prescribing (SP) by pharmacists in England, c) explore patient opinions on development of pharmacists and nurses as independent prescribers (IP). Methods: Two postal questionnaires were undertaken, one of hospital clinical pharmacy managers (Q1) and one of PCTPs and CPs (Q2). Depth interviews with patients were also used. Ethics approval was obtained. Key Findings: For Q1 the response rate was 66% (135/206). PDPTS was offered by 49/135 (36%) of hospitals and was the most common prescribing activity undertaken. The majority of pharmacists wrote

Faculty of Health Sciences School of Therapelitics 0009448d jasmin@tiscali.co.za / Currently the role of the Emergency Nurse in South Africa is not clearly defined. Nursing legislation does not effectively guide these nurses to enable them to cope with the high expectations and increasing demands for emergency care. Nor does it provide adequate legislative protection especially with regard to the responsibilities within the prehospital environment. This creates role confusion and conflict, which has a negative impact on the patient who requires emergency care, the advanced nurse practitioner and the emergency team. . The purpose of this research was to explore and describe the role of the South African emergency nurse in the prehospital environment and the emergency room and to formulate an instrument that can be used for policy formation, education, training and evaluation. The purpose was addressed though an action research process where data was collected in four phases that included both qualitative and quantitative methods. The process involved a group of experts who utilized their expert knowledge, skills and attitudes to explore and describe the phenomena being researched. They confirmed that the environment in which emergency nurses worked included the pre-hospital environment and emergency room. The data/roles identified and analysed were weighted to provide a weighting scale by means of a methodology referred to as “ Modelling of Human Judgement”. A competency rating was done to provide a three-point competency rating. The data/roles obtained was developed into a questionnaire and sent to the rest of the emergency nurse population for validation and verification. After validation and verification the information gathered was reduced, organized and with the assistance of a statistician (throughout all the phases) the data was analysed and an instrument developed for use as a policy framework for e.g. a scope of practice and unit standards. The instrument was quantified for educational and evaluation purposes. The instruments can be used to develop high levels of competency to encourage interdependent and autonomous decision-making, which is based on the knowledge of role expectations and sound professional decision making, which in turn is supported by appropriate legislation.

Sepsis is a life-threatening organ dysfunction disease process that costs the healthcare system millions of dollars each year. By using existing assets, the number of patients admitted to the hospital suffering from sepsis secondary to community-acquired pneumonia can be reduced. The purpose of this project was to improve and expand the scope of practice of the registered nurse working in a private medical office to initiate treatment for suspected CAP using evidence-based practice. Data from the last quarter of 2017 and the first quarter of 2018 were compared. The purpose of comparing these data sets was to examine outcomes of patients who received empirical treatment for CAP using both the complaint-specific protocol (CSP) and algorithm to see if these patients had lower rates of hospitalization than those who received the standard treatment. None of the patients who were treated using the CSP and algorithm were admitted to the hospital. Two patients were diagnosed with CAP before the implementation of the CSP and algorithm in the last quarter of 2017. The implications for social change resulting from the project are expansion of the scope of practice of the RN to work collaboratively with the physician in empirically treating CAP in the patients at the clinic to prevent hospitalization for pneumonia.

National trends in nurse education have changed from the Nightingale system of on-the-job training to a professional preparation in institutions of higher learning. Western Australia was one of the first States in Australia to commence a professional preparation of nurses at an institution of higher education in 1975. Graduates of the program were presented with their Bachelor of Applied Science from the Western Australian Institute of Technology (now Curtin University of Technology), in March 1979. This thesis seeks to answer the question concerning the genesis of such an event. The focus of the study is primarily to follow the progress of general nurse education in Western Australia and to highlight the accompanying influences that shaped its development. The purpose of this study was to explore, analyse, interpret and describe the history of nurse education in Western Australia from 1962-1975. The study used a pluralistic approach employing a variety of historical methods. The research commenced with broad questions and ideas developed from documents and people. The process of data collection, historical criticism and analysis took place simultaneously. The synthesis was written as a chronological narrative. The material of the study thus 'spoke' for itself by providing answers to questions raised during the investigation. The history of nurse education from 1962 to 1975 revealed visible milestones that represented nurse education reform. Beginning from the antecedents of the study these were the sanctioning of a review of nurse training in 1960 together with the commencement of the Western Australian Nursing Survey and the appointment of the Nurses Registration Board Education Officer. In 1962 the survey was completed. / It exposed the deficits of nurse training which led to the development of a new Hospital Based Diploma curriculum and an Associate Diploma in Nursing in 1966. The establishment of the College of Nursing Australia Western Australian Branch in 1966 paved the way to solve the shortage of tutors to implement the Hospital Based Diploma. The Nurses Act in 1970 enhanced the plans for implementing the Hospital Based Diploma and conferred autonomy to the Nurses Registration Board. In 1973 the first independent school of nursing came into being. The Western Australian School of Nursing carried the hopes of a continuation of hospital nurse training. In 1974, however, the entry of students to the Western Australian Institute of Technology School of Nursing saw a turn of events that led to a degree for nurses in 1975 and a decision for the transfer of all nurse education in Western Australia to the Western Australian Institute of Technology. These milestones did not emerge as an accident of history. There were forces that facilitated and impeded the perceptibility of the reform landmarks. These were crucial in the shaping the history of nurse education in Western Australia from 1962-1975.

In this study, I focus specifically on nurses’ actions related to pain. I establish how a different way of theorising ‘pain’ can assist in exploring how nurses’ subjectivity is constituted. I seek to open up possibilities for challenge and resistance by nurses to the dominant practices that influence how actions of nurses in relation to pain, come to exist. In challenging taken-for-granted representations of how pain is understood, I do not discount representations reported in literature, or as stated by people considered, for example, pain ‘experts’. Rather, I challenge how, these representations of pain and pain expertise, have come to exist as self-present truth, and seek to explore what other representations are marginalised as a consequence. I am aware that the interpretations of representations that I forward are open to this same critique. For my exploration of nurses’ actions related to pain for people having elective surgery, I undertook a poststructural analysis, informed by the works of Derrida, and Foucault. In particular, I constituted my thesis, in Derrida’s dictum ‘we are written as we write’, and Foucault’s analysis of three intersected topics: power, truth and the formation of selves. I analysed literature related to pain and management of that pain as text, and employed ethnographic techniques of observation, interviews and collection of documentary materials, to analyse nurses’ actions as text. I attempt to present a new text of nurses’ actions related to pain. I challenge the view that there is an essential true meaning that resides in pain, literature related to pain, or nurses’ actions aligned to that pain. Analysing how nurses’ subjectivity is written, in relation to pain, provides to nurses a means to read and write nurses’ actions in different ways. I reveal how a specific way of writing nurses’ actions, articulates a particular version of truth about pain, and how nurses are then positioned within this version of truth, and in turn, how nurses position people constituted as patients. I explore how, organisation as structure, is a way of thinking that continues to make invisible the power and politics dynamic in nurses’ actions related to pain. If the word ‘pain’ is taken as understood by nurses, that is, it is known what ‘pain’ means, this way of thinking will continue to privilege one meaning of pain in the hospital, and, maintain a traditional perspective of ‘organisation as structure’. In opening out alternate understandings of pain, and readings of nurses’ actions, the study allows for the possibility that pain, and the way that nurses act in relation to that pain, may indeed mean different things to different people. / thesis (PhD)--University of South Australia, 2000

The primary purpose of the study was to determine relationships between the variables of institution size, age, experience and education of nursing service administrators and self-perceived leadership behaviors of Initiating Structure and Consideration. A secondary purpose was to collect current demographic data of nurse administrators.The population of the study was 290 nurse administrators from all public and private JCAH hospitals of 300 or more beds located in the north-central division of the United States.A questionnaire requesting demographic information and containing two subscales, Initiating Structure and Consideration, of the LBDQ-Form XII was mailed to the nursediiri-nis trators . One hundred eighty-eight questionnaires were returned for a response rate of 65 percent. Analysis of data utilized both descriptive and inferential statistics.The demographic profile depicts the nurse administrator as a 40 to 49 year old married female vice-president of nursing, reporting to the hospital president, earning over $60,000 a year and having had experience as a staff nurse, head nurse, supervisor, assistant or associate director of nursing.The administrator graduated from a diploma program, received a master's degree, belongs to professional organizations, participates in priority setting and planning of the overall hospital budget, has major responsibility for establishing and managing the nursing service budget, works in a decentralized nursing service with responsibility for all nursing departments, and practices in a hospital with a computerized management information system.Statistical analysis of the hypotheses revealed no significant relationships between institution size, age, education and experience of the nurse administrators and leadership behaviors of Initiating Structure and Consideration.Additional analysis of data revealed significant (.05) relationships between the leadership behavior of Initiating Structure and: (1) title of the nurse administrator, and (2) accountability for all nursing departments decentralized system. Also significant (.05) were the relationships between the leadership behavior of Consideration and: (1) membership in the NLN, (2) participation in overall hospital budget planning and priority setting, and (3) the presence of computerized scheduling and computerized patient care.