During their clinical practicum, nursing students are involved in making decisions about the care for their patient or group of patients. The purpose of this study was to ascertain nursing students' perceptions of the variety and magnitude of factors that influence them as they are making decisions about patient care. For the study a nonexperimental approach utlizing a cross-sectional descriptive design was used. Thirty-three second year and thirty-one third year nursing students from a diploma nursing school responded to a questionnaire designed to reflect perceived domains of influence in thier clinical decision making. A subset of 18 subjects were interviewed. Some of the major findings include: 1) More second year than third year students perceived stress as a factor affecting their clinical decision making. Third year students most often mentioned the instructor-student relationship as a source of stress. Second year students most often referred to their workload and fatigue as contributing to their stress. 2) More third year than second year students preceived decision making theory and the nursing process to be an influencing factor in decision making. 3) Previous life and health-related work experience was indicated to be an influencing factor in clinical decision making more often by second year students than by third year students. 4) When asked to choose and rank five from a list of sixteen influencing factors in clinical decision making, the combined group chose the following in order; knowledge of patients and their condition, level of self confidence, knowledge of nursing proces, relationship with instructor, previous nursing experience, and previous life experience. 5) In the interviews the two most frequently mentioned guiding forces in decision making were: (a)what they (the student) or someone close to them would want and (b)patient preference. The study encourages nursing instructors to be cognizant of the variety of forces impacting student decision making in the clinical setting. It also suggests that students who are encouraged to incorporate their personal reality in an atmosphere that provides some latitude in decision making will be more likely to assume decision-making responsibility. / viii, 96 leaves ; 28 cm.

Globalization has opened international borders thereby creating a culturally diverse healthcare environment worldwide. Skills necessary to manage this diverse group extend beyond technical knowledge, expertise or excellent leadership skills. This study sought to determine the role of Emotional Intelligence (EI) in leading a diverse nursing team. A Quantitative, exploratory and descriptive design was applied, using a questionnaire as data collection instrument, to collect data from 390 nurses working in a large training hospital in the United Arab Emirates. The aim was to ascertain subordinates’ views of their nurse managers’ personal competence (self-awareness and self-management skills), and social competencies (social awareness and relationship management skills). The results indicated that the majority of respondents considered their leaders to be effective and emotionally competent. A significant relationship was found between effective leadership and the nurse manager’s self-confidence, self control, empathetic skills and culturally sensitive communication. An in-service training programme was developed and recommended for the further development of emotional intelligence in all nursing managers at this hospital. / Health Studies / M.A. (Health Studies)

Background Instillation of nonnal saline before suctioning is a common nursing intervention although little research supports the practice. Objectives To detennine when and how often saline is used during suctioning and to assess the knowledge of nurses and respiratory therapists of the advantages and dangers of using saline during endotracheal suctioning. Methods A survey of nurses and respiratory therapists working in adult and neonatal intensive care units was conducted in three large teaching hospitals in the UAE. Results Of the 81 respondents, 38 (47%) rarely instil saline before suctioning, whereas 20 (25%) frequently use saline. Seventy-four percent use saline to enhance retrieval of secretions, and 72% use it to stimulate cough. Nurses and respiratory therapists differ in their use and understanding of saline instillation. Most nurses (56%) rarely use saline before suctioning, whereas most respiratory therapists (37%) frequently use saline. Respiratory therapists (93%) were more aware than were nurses (61%) of the benefit of using nonnal saline to stimulate a cough. Respiratory therapists considered oxygen desaturation as a major adverse effect of saline instillation in comparison to nurses who stressed on pulmonary infection as a major side effect. Conclusion The results of the survey indicates that the practice of these professionals are not in line with most recent research results in the area and indicate a need for in-service education. / Thesis (M.Cur.)-University of Natal,Durban, 2002.

M.Cur. / Various factors influence the process of organ donation. As a result there is a shortage of organs for transplant. Poor communication and cooperation between transplant coordinators and intensive care nursing staff can lead to the non-referral of potential organ donors, which is detrimental to the process. The purpose of the research is to ascertain the attitude and knowledge of the transplant coordinators and intensive care nursing staff who work in intensive care units during organ donation and to draw up guidelines for the improvement of communication and cooperation between them. Contextual descriptive research was done by compiling literature based questionnaires, one each for the transplant coordinators and intensive care nursing staff and then analysing responses. The indications are that problem areas exist between the role players in the organ transplant process. This results in the insufficient referrals from intensive care units which are detrimental to the organ donation process. From this research, the following guidelines can be drawn up to promote organ donation: To provide a policy manual regarding organ donation for every intensive care unit. The respective roles of the transplant coordinator and intensive care nursing staff in the organ donation process must be clarified. Awareness campaigns should be held to promote organ donation. Feedback should be given by transplant coordinators and intensive care nursing staff regarding transplant occurrences. Role models in practical situations should be identified. An education programme regarding organ donation should be implemented. Emotional support programmes should be available to health personnel.

Text in English / Health Studies / M.A. (Nursing Science)

The implantable cardioverter defibrillator (ICD) is an electronic medical device that was invented by Dr. Michael Mirowski and his team in 1980. The purpose of the ICD, which is implanted in a person's chest, is to sense and shock the heart when detecting a lethal cardiac arrhythmia into a rhythm that can sustain life. While the ICD saves lives, it also has the potential to deliver painful shocks when it is activated. The ICD was initially inserted in people who had survived a sudden cardiac arrest; the device is now being implanted in older adults with heart failure and no known history of cardiac arrhythmias. When talking with patients and personal family members who had an ICD, it was unclear what influenced their decision to have an ICD implanted. Understanding the experience of decision-making for older adults who had an ICD has added to nursing knowledge, practice, and education when working with people who had an ICD inserted. To understand the lived experience, the researcher conducted a phenomenological research study, guided by the theoretical lens of Paterson and Zderad's (1976/1988) humanistic nursing and analyzed the data as outlined by Giorgi (2009). The results of the study indicated the participants' lived experience of decision-making for older adults who had an implantable cardioverter defibrillator inserted was influenced by the following : trust in their physician's decision; accepting the device was necessary; the decision was easy to make; and hope and desire to live longer. / by Louise A. Lucas. / Thesis (Ph.D.)--Florida Atlantic University, 2011. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2011. Mode of access: World Wide Web.

Purpose: The purpose of this study was to identify the stressors that affecting the critical care nurses in Abu Dhabi hospitals in order for the managers to take action to decrease or control these stressors where possible, or to take other appropriate action. Design: A cross sectional survey design was adopted in this study, as the phenomena of stress in CCNs was surveyed at one point of time . Sample: A convenient sample of 50 CCNs was included in the study. The participants were working as a CCNs in Abu Dhabi hospitals for a minimum one-year. Instruments: Two questionnaires were utilized to collect the data for this study; The Critical Care Stressors Scale and The Hamilton Anxiety Scale. Results: Results showed that The CCNs did not show a high level of anxiety according to the adopted scale. The most frequent stressors perceived by the CCNs were the stressors related to the critical care unit environment and the nursing responsibilities. On the other hand, the most severe stressors perceived by the CCNs were also under the categories of the critical care unit environment and Nurse-Health care workers conflicts. Conclusion: The hospital/nursing administrations were asked to revise the policies of visiting , dealing with infectious hazards, and portable X-rays . Also, the results showed that hiring more rton-nurses staff to deal with non-nursing jobs, and more male staff to carry out the heavy jobs such as changing position will aid in decreasing the stress perceived by the CCNs. / Thesis (M.Cur.)-University of Natal, Durban, 2003.

Text in English / Health Studies / M.A. (Nursing Science)

Indiana University-Purdue University Indianapolis (IUPUI) / Healthcare workers are responsible for providing evidence-based care to patients; however, many patients receive unnecessary or harmful care. Successful implementation of evidence-based guidelines can improve patient outcomes, particularly among vulnerable neuroscience patients. Focused efforts to improve nursing knowledge of and adherence to these guidelines are warranted. The purpose of this dissertation was to determine the most effective strategies for implementing evidence-based guidelines into nursing practice. First, an integrative review of the literature was conducted to explore studies addressing implementation of evidence-based guidelines in nursing. Implications from the review suggested further research to better understand which strategies should be utilized to best implement evidence-based nursing practices. Two pre- and posttest studies were then designed to identify a bundle of implementation strategies to improve neurocritical care nurses' knowledge of and adherence to stroke and spinal cord injury guidelines. The tailored, multi-faceted strategies consisted of local opinion leaders, printed educational materials, and educational outreach. Improvements in nursing knowledge of and adherence to these guidelines were noted. Lastly, program evaluations were conducted using a mixed-methods study to understand neurocritical care nurses' perceptions of the usefulness of the strategies employed during the two studies. Findings from this research provided support for the most effective implementation strategies to enhance knowledge development and guideline adherence among neurocritical care nurses for implementation of stroke and spinal cord guidelines.

Study project (Mnutr) -- University of Stellenbosch, 2005. / ENGLISH ABSTRACT: Quality nursing care is characterised by clinical decisions based on critical and analytical thinking. The assessment, planning and implementation information which is used as basis for decision making must be recorded in the patient's record/file. The questlon is rai_sed whetherthe patient's record does indeed reflect critical and analytical thinking. The focus on the midwife's practices during professional conduct hearings which relate to intrapartum service delivery, led to the specific choice of population, namely intrapartum services delivery in Levell hospitals in the Western Cape. A non-experimental study whereby qualitative and quantitative data were collected, was performed in six (6) Levell hospitals. Check lists were compiled to evaluate the structure and facilities in which midwifery practice is executed. The records of 128 patients were analysed to specifically investigate the nature and extent of critical and analytical decisionmaking by midwives, and the extent to which the midwife really applies reflective practices. The results showed that record-keeping is not done optimally; that the partogram, which - - ---- is a comprehensive evaluation of the progress of_lab_2~1isJ not used and that the records did not indicate that the midwife applies critical and analytical thinking and acts accordingly. Recommendationsare that the proposals for the improvement of intrapartum service delivery, as made by Odendal (2004: ii-iv) and the Department of Health (2000: 42), are to receive immediate attention. It appears as if protocols and guidelines for emergency action and general safe practices do exist, but are not enforced. Continued inservice training receive priority attention. Core words: critical analytical thinking; midwife's practice and practices; intrapartum care service delivery / AFRIKAANSE OPSOMMING: Gehalte verpleegsorg word deur kliniese besluite wat op kritiese en analitiese denke gegrond word gekenmerk. In die pasient se rekord moet die ramings-, beplannings- en implementeringsgegewens gerekordeer word wat gebruik is as basis vir besluitneming. Die vraag ontstaan egter of die pasient se rekord wei kritiese en analitiese denke weerspieel. Die fokus op die vroedvrou se praktyke in professionele gedragsake wat met intrapartumsorgdienslewering verband hou, het tot die spesifieke keuse van die populasie, naamlik intrapartumsorgdienste in vlak 1-hospitale in die Wes-Kaapaanleiding gegee. 'n Nie-eksperimentele studie waartydens kwalitatiewe en kwantitatiewe data ingesamel is, is in ses (6) vlak 1- hospitale uitgevoer. Kontrolelyste is opgestel om die struktuur en fasiliteite waarbinne vroedvroupraktyke plaasvind, te evalueer. Die rekords van 128 pasiente is ontleed om spesifiek ondersoek in te stel na die aard en omvang van kritiese en analitiese besluitneming deur die vroedvrou, en tot watter mate die vroedvrou wei weldeurdagte praktyke toepas. Die resultate toon dat rekordhouding nie optimaal gedoen word nie; dat die partogram wat 'n omvattende evaluering van die kraamverloop is, nie gebruik word nie, en dat daar uit die rekords nie 'n aanduiding gevind kan word dat vroedvroue wei krities en analities dink en optree nie. Aanbevelings is dat die voorstelle ter verbetering van intrapartumsorgdienslewering 5005 gemaak deur Odendal (2004: iii-v) en die Departement van Gesondheid (2000: 42), indringend aandag moet geniet. Dit wil voorkom asof protokolle en riglyne vir noodoptrede en algemene veilige praktykvoering wei bestaan, maar nie toegepas word nie. Voortgesette indiensopleiding moet as 'n prioritieit aangespreek word. Kernwoorde: kritiese analitiese denke; vroedvroupraktykvoering; vroedvroupraktyke, intrapartumsorgdienslewering.