Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

Tratar sobre a temática da morte, o morrer e a finitude da vida faz parte do desenvolvimento humano, apesar de ser considerado um tabu sócio-cultural ocidental ou até mesmo um tema interdito ou silenciado. Abordar esse assunto com os profissionais da saúde, inserido na linha da educação para a saúde é de suma importância, pois possibilita o desenvolvimento humano pessoal e profissional. Pois, enfocar sobre a temática da morte estamos também falando de vida, de seus estilos, e a qualidade da mesma acaba sendo repensada, como também, a questão da morte digna. Objetivamos Identificar e verificar a visão cultural dos Docentes e Discentes em relação à Morte e Morrer e a finitude da vida, e construir um grupo de discussão sobre a temática, para auxiliar na formação dos profissionais de enfermagem, trabalhando coletivamente, ações educativas e planos de aula, para implementar a temática em foco. Trata- se de uma pesquisa qualitativa mediatizada pela metodologia da pesquisa-ação, de cunho humanista. Análise foi realizada por categorização, convergente/divergente, o público-alvo foram docentes que abordam essas temáticas, e discentes do 1º e 5º ano ambos do curso de enfermagem de uma universidade estadual do interior paulista. Após o levantamento dos temas geradores construímos as ações educativas que foram planos de aula abordando a morte e o morrer e a finitude da vida em suas várias faces, além da construção de uma oficina voltada para esse tema que foi realizada num congresso científico. No decorrer de todo esse processo de pesquisa depreendemos que estudar e abordar a temática sobre a morte, o morrer e a finitude da vida pode proporcionar e favorecer uma formação acadêmica diferenciada aos estudantes da área da saúde, preparando-os para lidarem com esse tema no seu cotidiano profissional. Para isso consideramos ser de grande importância a inserção dessa temática nos currículos escolares e nos cursos de atualização profissional e formação docente, com foco na abordagem crítico-social, na ação-reflexão-ação e na humanização do atendimento em saúde / Treating on the subject of death, dying and the finitude of life is part of human development, despite being considered a western socio-cultural taboo, or even an interdict or muted topic. Approach this subject with health professionals, inserted into the line of health education is extremely important, as it allows the personal and professional human development. Therefore, focusing on the theme of death, we are also talking about life, about their styles, and the quality of it turns out to be reconsidered, as well as, the issue of death with dignity. We aim to identify and verify the cultural vision of the teachers and students in relation to the Death and Dying and the finiteness of life, and create a discussion group about this theme, to assist in the formation of nursing professionals, by working collectively, educational activities and lesson plans, to implement the subject that is currently in focus. This is a qualitative research mediated by the methodology of action-research, of humanist nature. Analysis was performed by categorization, convergent/divergent, the target were teachers that approach these issues, and nursing students of the 1st and 5th year, both of the nursing course of a state university in São Paulo. After bringing up the generating themes, we build the educational activities that were lesson plans, addressing the death and the dying and the finitude of life in its many faces, and the construction of a workshop geared towards this theme, which was performed in a scientific congress. During the whole research process, we concluded that study and approach the issue about the death, the dying and the finitude of life can provide and promote a differentiated academic formation for students in the health area, preparing them to deal with this issue in their daily professional activities. For this, we consider to be of great importance the inclusion of this subject in the school curriculum and in the professional updating courses and the teacher formation, focusing on the critical-social approach, in action-reflection-action and the humanization of health care

Job dissatisfaction among nursing faculty could have a significant impact on nursing faculty retention and student enrollment in nursing programs. The purpose of this qualitative instrumental case study was to gain insight into the perspectives of faculty members who teach nursing education in a university program. This study used Herzberg, Mausner, and Snyderman's motivation-hygiene theory to explore employee satisfaction and dissatisfaction in the workplace. The research question focused on the perspectives of nursing educators and challenges they face. Data were collected through individualized interviews with 15 nurse educators, using open-ended questions and reviewing relevant documents. The data were analyzed by sorting and highlighting the participants' responses and using codes to categorize and develop themes. Six overarching themes (expectations, motivations, benefits, job fulfillment, challenges, and job dissatisfaction) and 3 subthemes (remuneration, excessive workload, and funding for advancing education, recruitment, and mentoring) emerged. These themes and subthemes identified critical aspects of job satisfaction that may help nursing faculty and nursing administrators strengthen the positive and diminish the negative aspects of the job for greater faculty satisfaction. Nursing leaders and health care administrators can use these findings to bring awareness to the nursing education community by creating realistic goals that address job satisfaction, retention, and recruitment of nursing faculty. These changes will improve student enrollment and increase the number of nurses available to provide quality care throughout the nurses' respective communities.

The purpose of this study was to determine the relationship between nurse faculty perceptions of role stress and faculty-to-faculty incivility using the stressor-emotion model of counterproductive work behaviors. A convenience sample of 79 nurse faculty from 39 undergraduate nursing programs in Iowa responded to an online survey. The survey consisted of two instruments: Workplace Incivility Civility Scale and Role Strain Scale. Findings revealed 76 participants perceived incivility as a problem and identified stress (n = 64) and demanding workloads (n = 54) as contributing factors. Pearson correlation results revealed a positive relationship between experienced incivility and nurse faculty perceptions of role stress (r = .509, p < .001), role conflict (r = .506, p < .001), role ambiguity (r = .560, p < .001) role overload (r = .298, p < .008). Pearson correlation results further revealed a positive relationship exists between three constructs of role stress (role conflict, role ambiguity, and role overload) and each of the three constructs of experienced faculty-to-faculty incivility (hostility towards individuals, self-serving behaviors, and hostility towards work environment). Limitations included a convenience sample limited to undergraduate programs in one state. Future research should replicate this study in larger diverse populations and educational settings. Positive social change includes the recruitment and retention of nurse faculty who can grow and advance in a healthy academic work environment.

The Joint Commission reported that communication failures in United States hospitals contribute to 30% of all malpractice claims, and in 2008, The Joint Commission listed the improvement of effective communication among healthcare providers as a National Patient Safety Goal. The purpose of this practice-focused project was to develop a scenario-based communication simulation for implementation approval by a panel of experts. The approved curriculum was designed to integrate a communication-based simulation scenario into the nurse residency program of a large, urban medical center to improve new graduate nurse communication skills, increase nurse communication competency and self-efficacy, and decrease communication errors. Kolb's experiential learning theory guided the simulation-based educational project. The Delphi technique was used to achieve consensus, which was achieved with 1 Delphi round. The education curriculum was presented to a 5-member expert panel that included chief nursing officers and the staff development directors. The curriculum received panel feedback and approval for implementation in the 2019 nurse residency program. Key comments from the expert panel indicated that the curriculum was approved without major changes. A simulation communication curriculum integrated into the nurse residency program may effect positive social change by decreasing errors and improving patient outcomes.

A need for improvement in nursing education regarding inpatient workflows and informatics skills was identified at this project site. Upon hire, nurses were required to complete a 4-hour basic class on the electronic health record (EHR) system, but this class did not include inpatient-nursing workflows needed to provide and facilitate care for patients. This project addressed the lack of EHR education on inpatient nursing workflows. The focus of this staff education project was an education class on inpatient nursing workflow provided to a nurse residency class. Sources of evidence were obtained through a literature search and pretest/post test data analysis. The literature used to support the project included articles on best practices for EHR education for nursing. The pretest and post test design was used to determine if there was an increase in EHR knowledge after the education. Benner's novice-to- expert model served as the framework. The mean total proficiency scores on inpatient nursing workflows in the EHR improved from pretesting to post testing, (6.8 to 7.8, p = 0.048). The study findings showed improvement in participants' average proficiency, knowledge, and clinical skills in the EHR. This project findings demonstrated the need for an inpatient nursing informatics workflow class for all nursing staff, and the findings supported an increase in education to facilitate workflow and care safety. This project promotes positive social change by improving curricula, raising awareness of how technology affects clinical care and practice, and encouraging continuous quality improvement through informatics education.

A sample of 22 registered nurses participated in an educational program to learn comprehensive physical assessment skills. This study investigated the effects of that program on their nursing practice. Administration of tests and questionnaires provided a measure of the: (a) use of physical assessment skills; (b) knowledge of physical assessment; (c) changes in nursing practice since learning the skills; (d) barriers to the use of the skills. The model used for the program's curriculum development was adult learning theory. The curriculum focused on this theory's key aspects. Namely, adult students build new skills on their past knowledge and already developed skills. Additionally, they must see the relevance of learning the skills and be able to apply them in their current life situation. The findings suggest this model was appropriate. The nurses in the study used the majority of learned skills after they completed the program. Their knowledge concerning these skills also showed dramatic improvement. The major findings regarding the increase in knowledge and use of physical assessment skills, positive changes in nursing practice and lack of barriers to the use of skills indicate that an educational program in physical assessment can be very beneficial to nurses. The results support those of previous studies in that nurses will use the physical assessment skills they have learned in continuing education programs. The implications for nursing practice and education were discussed. Suggestions were then made for future research in this area.

Problem: While the educational preparation of students in a tertiary nursing programme was the general focus of the study, the specific concern was with the degree to which students in the first and third year of the programme implemented all aspects of the nursing process in their delivery of patient care. The study developed out of a need to evaluate the effectiveness of theoretical teaching in regard to the students' ability to implement theoretical principles in clinical practice. The desired outcome of the study is that the data will be useful in developing more appropriate and effective teaching approaches that will result in improved clinical nursing practice. Methodology A survey of patients receiving nursing care from students in the first and third year of their programme was conducted on completion of a one week block of clinical experience for both groups of students. A questionnaire was the instrument of data collection. Factors included in the study were the patients' perceptions of the students' attention to four of the five phases of the nursing process: assessment, diagnosis, planning and evaluation. Questions addressing the degree of patient involvement in all of these phases were included throughout the questionnaire. Questionnaires were returned from twenty nine of the thirty one patients surveyed in the first year student group and from thirty of the thirty one patients surveyed in the third year student group; constituting a 93.5 percent and a 96.7 percent response respectively. Results The scores achieved by each group of students were compared against scores determined by the researcher to indicate realistic educational and professional standards of practice in each specified section and comparisons were also made between the two students groups to identify development of practice over the education programme. Scores indicated that: 1. Within each section of the study both student groups scored below the expected level on certain items, the most notable deficiencies being related to the aspects of patient empowerment through informing and involving. 2. The third year student group scored overall higher than the first year students in regard to attention to the more 'technical' aspects of the nursing process, but did not give the same degree of attention to the 'human' aspects, scoring equal to, or lower than their less experienced colleagues. Conclusions: 1. There are apparent philosophical differences between the graduates of the 'old style' training system and those involved in the tertiary nursing programme in regard to the individualization of patient care and the allocation of priorities within a time frame. 2. Clinical application of theoretical principles relies heavily on the reinforcement of these principles by the clinical teacher/supervisor. There is a need for these clinical supervisors to have: (a) a better understanding of the educational objectives for students in the clinical settings, and (b) assistance towards developing teaching/organizational strategies that will guide the student towards objective attainment when such abilities are not developed. Recommendations: Among the recommendations presented were: 1. that the nursing discipline within the university make formal and informal opportunities to inform all clinicians of the changes in nursing education and the implications these changes have on the overall approach to the delivery of patient care. 2. that there is an increased emphasis on the educational preparation of the clinical supervisors and that their commitment to the students' achievement of the clinical objectives is enhanced through involvement in programme planning and evaluation.

<p>Akut förvirring hos höftfrakturpatienter är vanlig. Den akuta förvirringen kan förebyggas eller kortas och rehabiliteringstiden kan då också kortas. Ett förvirringstillstånd innebär stora påfrestningar på kroppen. Syftet med denna litteraturstudie är att se hur litteraturen beskriver hur man kan ge en god postoperativ omvårdnad och ett gott bemötande till de patienter som drabbas eller riskerar att drabbas av postoperativ förvirring. Till grund för arbetet ligger ett antal vetenskapliga artiklar samt facklitteratur. Trots att den postoperativa förvirringen är mycket vanlig, att den orsakar stort lidande och stora vårdkostnader, saknas tillfredsställande studier som kan ligga till grund för farmakologiska behandlingsrekommendationer. Oaktat detta ges ofta farmaka till dessa patienter. Enligt litteraturen har sjuksköterskans möte med den deliriösa patienten stor betydelse för att förebygga och lindra ett förvirringsbeteende. Eftersom det saknas riktlinjer för omvårdnad av akut förvirrade patienter beror det på den enskilda sjuksköterskans bemötande hur mötet med patienten blir. Den postoperativa förvirringen måste lyftas fram eftersom antalet patienter med höftfrakturer ständigt ökar. Rutiner och vårdprogram måste tas fram eller ses över. Vi måste lära oss att bemöta dessa patienter på ett professionellt sätt. Att möta den förvirrade höftledspatienten på ett etiskt och förberett sätt är en förutsättning för en bra vård.</p>

<p>SAMMANFATTNING</p><p>Denna litteraturgranskning har utgått från ett intresse av psykosvård. I fem vetenskapliga artiklar, varav två från Australien och tre från United Kingdom, har jag granskat aspekter på bemötande vid psykos. Den fortbildning som har nått mitt arbete inom psykiatrin har grundat sig på forskning på området och har rört sig med liknande utgångspunkter och slutsatser som i den granskade litteraturen. Trots att den informationen har funnits och spritts bland psykiatripersonal används inte rekommenderade riktlinjer och handlingsplaner fullt ut. Svårigheter att starta nya arbetsmetoder och ändra attityder i mötet med psykospatienter har många förklaringsgrunder. Det är angeläget att identifiera obstruktionen och undanröja den till förmån för god och uppdaterad omvårdnad inom psykosvård. Tyngdpunkten i mitt intresse av omvårdnad ligger för mig, som sjuksköterska, i mötet med patienten. Det är också angeläget att det nationella kvalitetsregister för psykos som är under utarbetande, stött av Socialstyrelsen, snarast får genomslag i hela landet samt att handlingsplaner måste upprättas för att säkerställa att patienten i möjligaste mån är delaktig och engagerad i sin egen vård.</p>