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Community health nurses, like all other health professionals, are being called to develop new clinical practices based on collaboration and are faced with the demands of working both interprofessionally and interorganizationally (D’Amour et al., 2008). In Capital Health, public health nurses (PHNs), family practice nurses (FPNs) and nurse practitioners (NPs) are all working in different aspects of breastfeeding support and promotion. However, there is no formal structure for collaboration of services, despite the strong desire of these nurses to work together to improve breastfeeding outcomes. The purpose of this study was to explore the roles of PHNs, FPNs and NPs who work in breastfeeding support and promotion in Capital Health and the structures and processes needed to support the development of collaboration amongst these groups of nurses. Through the analysis of semi-structured focus group interviews and follow-up focus group interviews with a purposeful sample (n=10) of four PHNs, four FPNs and two NPs, four major themes and sub themes were identified that represented the nurses experience with collaboration between public health and primary care in breastfeeding support and promotion. The data generated revealed that participants had not experienced active collaboration, rather developing or potential collaboration (D’Amour et al., 2008). The first theme, Establishing Interpersonal Relationships, provided an overview of the precipitators and barriers to forming relationships and the outcomes of interpersonal relationships between public health and primary care nurses. The second major theme, The Organizational Context: Structures and Processes in the Everyday Work Environment outlines the impact of the organizational context of the nurses work environment on the development of collaboration. Benefits of Collaboration was the third theme identified in the study. Consistent with other studies on collaboration between primary care and public health nurses, the nurses interviewed believed that the development of collaboration in breastfeeding support and promotion would benefit health care professionals and the clients that they serviced. The last theme, Development of New Practices Grounded in Collaboration, described new initiatives or innovations that the participants explained were needed for the development of collaboration between PHNs, FPNs and NPs. Implications for practice include organizational support for PHNs, FPNs and NPs to work to the full scope of their competencies and providing them with opportunities to meet and establish relationships to facilitate joint planning initiatives related to breastfeeding support and promotion. Additionally, exploration of flexible roles and funding structures as alternatives to fee-for-service should be explored in primary care organizations. The development of a communication infrastructure is necessary for future development of collaboration between public health and primary care in breastfeeding support and promotion. Future research is needed in this area with a broader, more diverse sample, exploring organizational structures needed to improve breastfeeding outcomes and optimize FPN and NP roles. PHNs, FPNs and NPs have the opportunity to impact the model of care for breastfeeding families in the Capital Health District of Nova Scotia, optimizing their capacity to address issues in practice and ensuring that breastfeeding support and promotion activities address the complex social factors that influence the breastfeeding experience.

This research study aimed at determining the relationships between nurse staffing and nurse sensitive outcomes (urinary tract infection, pressure ulcers, pneumonia, missed dose, wrong dose, and wrong drug) in the University Central Teaching Hospital of Kigali. A retrospective, descriptive design guided the study. A purposive sampling method was used to select the unit of study. Patient files were selected (n =797) and reviewed from the medical and surgical wards in February and March 2006. A checklist format was used to collect the data. The first instrument for data collection on staffing included the shifts, the categories of nurses, the total number of nurses and the patient census. The second instrument on adverse events included all events under study. Data collection was done by the researcher. A quantitative method was used to analyze data. The results indicated a statistically significant relationship between pressure ulcers, pneumonia, and phlebitis and number of registered nurses. Risk of wound infection was statistically significant between both increased numbers of enrolled nurse and registered nurses as well as nurse: patient ratio. The findings also revealed a statistically significant protective relationship between pneumonia, missed dose, and phlebitis with increased nurse: patient ratio. The findings of this study revealed no statistically significant relationship were found between urinary tract infection, pneumonia, phlebitis, and missed medication dose and the mean number of enrolled nurses. There was no statistically significant relationship between urinary tract infection and missed medication dose and the mean number of registered nurses. The result of this study suggests that there is an impact of nursing workload and expertise on patient outcomes. / Thesis (M.A.)-University of KwaZulu-Natal, 2006.

Background: One in nine Canadian women will be diagnosed with breast cancer within their lifetime. In Manitoba, an estimated 810 women will be diagnosed with breast cancer in 2011, with approximately 160 of those aged 20 to 50. Younger women diagnosed with breast cancer may have unique needs and challenges due to a variety of factors that include caring for younger children, career demands, or in some cases, family planning. Many women face a heightened sense of vulnerability after their diagnosis which challenges their physical, emotional, and spiritual self as they attempt to navigate through the complexities of the health care system. One approach to alleviate health care systemic challenges has been the establishment of patient navigation programs. To date, the role of the oncology patient navigator has not been examined from the perspectives of patients experiencing the oncology system of care without the services of an established patient navigator. Method: Consistent with the purpose of this study, an interpretive, descriptive qualitative research approach was utilized to describe the role of the oncology patient navigator from the perspectives of younger women aged 20-50 (n=12) diagnosed with an invasive breast cancer within the last three years. Face-to-face interviews were conducted and audio-taped to capture their descriptions of the oncology patient navigator based on their own experiences. Results: The role of the oncology patient navigator includes two facets - personal attributes and essential processual needs – for which the navigator could provide assistance. Conclusion: The results of this study depict the oncology patient navigator’s vital attributes and processual facets based on the perspectives of younger women with breast cancer. This study can be utilized for the purposes of tailoring or expanding current roles in oncology or perhaps cultivating the development of new navigational programs to address the needs of younger women with breast cancer.

Access to abstract permanently restricted to Ball State community only / Access to thesis permanently restricted to Ball State community only / Department of Communication Studies

Background: One in nine Canadian women will be diagnosed with breast cancer within their lifetime. In Manitoba, an estimated 810 women will be diagnosed with breast cancer in 2011, with approximately 160 of those aged 20 to 50. Younger women diagnosed with breast cancer may have unique needs and challenges due to a variety of factors that include caring for younger children, career demands, or in some cases, family planning. Many women face a heightened sense of vulnerability after their diagnosis which challenges their physical, emotional, and spiritual self as they attempt to navigate through the complexities of the health care system. One approach to alleviate health care systemic challenges has been the establishment of patient navigation programs. To date, the role of the oncology patient navigator has not been examined from the perspectives of patients experiencing the oncology system of care without the services of an established patient navigator. Method: Consistent with the purpose of this study, an interpretive, descriptive qualitative research approach was utilized to describe the role of the oncology patient navigator from the perspectives of younger women aged 20-50 (n=12) diagnosed with an invasive breast cancer within the last three years. Face-to-face interviews were conducted and audio-taped to capture their descriptions of the oncology patient navigator based on their own experiences. Results: The role of the oncology patient navigator includes two facets - personal attributes and essential processual needs – for which the navigator could provide assistance. Conclusion: The results of this study depict the oncology patient navigator’s vital attributes and processual facets based on the perspectives of younger women with breast cancer. This study can be utilized for the purposes of tailoring or expanding current roles in oncology or perhaps cultivating the development of new navigational programs to address the needs of younger women with breast cancer.

No description available.

No description available.

No description available.