Philosophiae Doctor - PhD / The purpose of this research study is to develop and describe a model to enhance the empowerment professional nurses to promote the recovery of people who have been diagnosed with depression. Depression is a prevalent psychiatric disorder that despite its increase worldwide, often goes undetected or inadequately treated. The biomedical model's reductionist and dualistic approach proves to be inadequate for nursing practice to address depression and calls for the examination of a multifaceted holistic approach. A multifaceted holistic approach views disease as having multiple causes that are amenable to multiple therapeutic interventions. Despite research evidence about the effectiveness of such an approach, an in-dept literature search did not reveal the availability of such a model to enhance the empowerment of professional nurses to promote the recovery of people who have been diagnosed with depression. The research question that emerged was: • How can professional nurses in the Western Cape be empowered to promote the recovery of people who have been diagnosed with depression? The assumption is that this question was necessary to address. To realise the purpose of this research study, the following objectives were formulated: • To explore and describe the self reported attributes needed by professional nurses to promote the recovery of people who have been diagnosed with depression. • To explore and describe how these self reported attributes can be facilitated in the work environment. • To propose a model to enhance the empowerment of professional nurses to promote the recovery of people who have been diagnosed with depression. • To develop guidelines for the operationalisation of the model. The theoretical framework for this research study was adopted from the Critical Social Theory. The research design and method used was qualitative, explorative, descriptive and contextual in nature. The research was done in two phases. In phase one the researcher did semi- structured interviews with a purposive and convenient sample of fourteen (14) professional nurses who were working in the Cape Town Metropolitan area and the West Coast. Each interview was transcribed from the tape recordings, verbatim and open coding was used to identify and analyse the content. In phase two the model was designed based on the findings of phase one. The six components, namely goals, concepts, definitions, relationships, structure and assumptions as described by Chinn and Jacobs, were used to develop the model. The guidelines for critical reflection as described by Chinn and Kramer were used to evaluate the model. A purposive sample that consisted of a group of psychiatric nurse specialists was asked to validate the model during a group discussion. As a result of their daily interaction with people who have been diagnosed with depression, professional nurses identified increased workload, lack of professional development and a lack of organizational support as barriers to implement the identified attributes support, positive approach, interpersonal skills and awareness of structure to promote the characteristics of the recovery approach. After the data analysis an empowerment model that would support professional nurses to promote a recovery approach in their working environments was developed. To ensure trustworthiness, Lincoln and Guba's model was used throughout the study. Ethical considerations were maintained throughout this qualitative research study.

Background: With the current nursing shortage there are fewer experienced nurses and more newly licensed registered nurses (NLRNs) in the workplace. This shortage may be due in part to inconsistencies between role expectations learned in school and the practice environment. These inconsistencies may make it challenging to transition from nursing school into professional healthcare organizations. Nurses with certain person-level traits, including resilience and emotional intelligence, may be more likely to make a successful transition into practice. Findings may improve our understanding of what person-level traits are important for making the successful transition to the workforce. Purpose: The current study explored whether emotional intelligence (EI) and resilience influenced transition into professional roles. Theoretical Framework: Understanding how cultural shock and adaptation are challenging for many NLRNs is important. Duchscher transition theory provided an overview of how NLRNs engaged in the professional practice role as they are confronted with the realities of the work environment. Methods: A non-experimental research design with descriptive cross-sectional study is used to determine if EI and resilience have any effect on NLRNs transitioning into their professional roles. Results: With a sample size of 63, there is a direct positive linear relationship between resilience and global trait EI and its subscales for NLRNs. The correlation is significant with the exception of the EI subscale emotionality. Also there was no significance with NLRNs who transitioned in a critical care setting and those in other specialty care areas. Conclusions: There is a need for further exploration of this relationship with a larger sample size and the need to investigate person-level characteristics in NLRNs who successfully transition to their professional role.

No description available.

Background Spirituality is within into every person even though the spiritual experience is always individual. Well-being and happiness are related to the amount of spirituality influencingone’s life. Patients spiritual distress and needs often emerge from their experience of suffering. Acknowledging patients’ spirituality needs, and possessing skills to meet suchneeds, are crucial to provide holistic care; unmet spiritual needs can could increase patient ́s suffering. Spiritual care is included in registered nurses’ responsibility, althoughthe focus and involvement of spiritual care, depends on their personal experiences. Aim The aim was to examine registered nurses’ experiences of meeting patients’ spiritual needsin a hospital setting in Peru. Method A qualitative design was performed with semi-structured interviews. Nine registered nurses were interviewed, the collected data was analysed with a qualitative content analysis. Findings Three categories were found in the analysis; Recognition of professional responsibilities in providing spiritual care, Integrating spiritual care into clinical practice and Impact of spiritual care. The findings show how holding a holistic view impacted the delivery of spiritual care. Conclusion It is difficult to use specific strategies to meet spiritual needs since needs areindividual. Meeting spiritual needs must always be done with respect for the patients’ waysof expressing their spirituality. Being available and listening are important elements ofmeeting patients’ spiritual needs. Spiritual care is recognised as an inseparable part ofholistic care and the involvement of spiritual care is essential for patients healing.

Lack of full practice authority (FPA) for advanced practice registered nurses (APRNs) is a barrier to the provision of efficient, cost-effective, high-quality, and comprehensive health care services for some of our most vulnerable citizens ( Agency for Healthcare Research and Quality, 2014 , Buerhaus et al., 2015 , Pohl et al., 2010a , Seibert et al., 2004 ). APRNs have the education, knowledge, skills, and experience necessary to provide basic and comprehensive primary care services; they are a ready workforce, ideally positioned to improve access to care, contribute to health disparities reduction efforts, and lower the cost of providing such care ( National Center for Workforce Analysis 2013 , Perloff et al., 2016 ). However, barriers at the state and national levels continue to prevent these highly qualified health care providers from practicing to the full extent to which their education and training have prepared them. It is the position of the American Academy of Nursing (academy) that FPA of APRNs is essential to achieving health equity.

Abstract: Introduction: To explore the information seeking behavior of Internationally Educated Nurses (IENs) and to investigate their exposure to libraries and library training in both their home countries and after being hired in Saskatchewan. Methods: This two-phase multi-method project was carried out in Saskatchewan, Canada. A questionnaire was developed based on survey instruments used in previously conducted studies on the topic. Librarians in two academic institutions assisted with validation of the survey. In Phase 1, data were collected via an online questionnaire from IENs in three health regions: Saskatoon, Regina, and Sunrise. In Phase 2, the study was expanded to IENs in all the health regions in the province. The same questionnaire from Phase 1 was used during telephone interviews with participants. Results: A total of 17 IENs responded (Phase 1, n = 9, Phase 2, n = 8). Results show that IENs, although interested in looking for information for their practice, are hindered by a lack of knowledge of how and where to seek relevant clinical information as well as a lack of library training. As a result, their main source of information is the Internet (Google). Discusion: Despite barriers such as time to information seeking, results revealed that given the opportunity IENs would like to receive library training to enhance their information seeking skills.

The overall aim of this thesis was to study palliative end-of-life care outside specialist palliative care settings, from an organizational perspective and from professionals’ and relatives’ experiences. In Study I 174 individuals were identified retrospectively from nursing records and palliative care identification forms as being in a palliative phase. Data were analyzed with descriptive and analytic statistical methods. In Study II a total of nine nurses working in primary home care, community care, and hospitals were interviewed. Phenomenological methodology was used to analyze data. In Study III 17 enrolled nurses, who worked in community or primary care and in a sitting service organization, participated in four focus group interviews. Data were analyzed with qualitative content analysis. In Study IV seven relatives from four families were interviewed twice. They had each cared in the private home for a dying family member who had received sitting service. Direct interpretation and categorical aggregation were used to analyze data. The results highlight challenges in palliative care, vulnerable situations, and a need of support (I–IV). Individuals’ needs for both palliative care and sitting service were identified, including those of a smaller part of the population who actually received the sitting service. (I). Registered nurses’ responsibilities included care at the same time for individuals in both palliative and curative phases. This created vulnerable situations for the nurses, since their ambitions concerning the care did not correspond to available resources (II). The enrolled nurses’ task was to manage ongoing life and dying in different care settings, to meet individual needs and still provide equivalent care. Despite experiences of vulnerable situations, they felt safe (III). Relatives experienced care situations differently, related to differences in families, the illness trajectory, the need for support, and the support offered. Without sufficient support, vulnerable situations occurred, which made the relatives feel insecure (IV). Thus, care situations in palliative end-of-life care can be experienced in different ways, with different levels of vulnerability. One implication of the research might be to suggest that professional caregivers, to supplement the relatives’ own resources with support tailored to the individual’s and the family’s needs

Thesis (Mcur)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: A literature study showed that the topics of medication safety and medication error prevention have been studied in depth. Findings from the literature revealed that medication errors are reported to be common in neonatal and paediatric ICUs, that more than half of these errors are preventable and that risk reduction measures protect patients against untoward outcomes or adverse events (Clifton-Koeppel, 2008:72). If and when there is a failure in the process of safe medication administration, it results in a medication error, which is defined as a breach of one or more of the five rights of medication administration (Institute for Safe Medication Practices Alert, 2007:1). Medication administration, which is predominantly a nursing task, is of high risk and high volume in the intensive care unit (ICU). The accuracy of intravenous medication administration is critical for a neonatal and paediatric ICU patient since it can potentially heighten the patient’s vulnerability if further harm is caused. In view of the complexity of medication administration for neonatal and paediatric ICU patients, researchers confirm the diverse role of the registered nurse in safe medication administration practices. The purpose of the study was to describe the perceptions of registered nurses (RNs) regarding the factors that influence IV medication safety practice in the neonatal intensive care unit (NICU); paediatric intensive care unit (PICU); and paediatric cardiac intensive care unit (CSICU) in Saudi Arabia. The study objectives were set to describe the actual factors that have an influence on IV medication safety practices of RNs working in these ICUs; to determine the knowledge of registered nurses in the selected ICUs with regard to safe intravenous medication administration practices and to describe nursing medication administration strategies that are focused on medication error prevention. A quantitative research approach was selected for this study which had a descriptive, survey design. An 85% non-probability purposive sampling method was used to draw a sample (n=103) of the target population of NICU-, PICU- and CSICU-registered nurses (N=121) who were responsible for administering intravenous medication at King Faisal Specialist Hospital and Research Centre in Jeddah (KFSHRC-J). A self-administered questionnaire with closed-ended Likert and open-ended question was designed to describe the objectives under study. A pilot study was conducted to pre-test the questionnaire. A quantitative method was used to analyse the study data. MS Excel was used to capture the quantitative data after which it was analysed using descriptive statistics by means of STATISTICA 9 software. The open–ended questions (indicating “other” and Question 70) were also interpreted quantitatively after exploring the main aspects in the responses. The main findings were that multiple perceived factors influence the intravenous medication safety practices of RN’s working with neonatal and paediatric ICU patients in a particular Saudi Arabian tertiary hospital. It was found that these nurses’ had knowledge regarding safe medication administration practice that constitutes that all five medication rights have to be checked through nursing ‘double-checks’ in the steps of medication administration, as the method of checking as per hospital policy. However, from the findings, it is reflected that RNs perceptions of completely and correctly checking medication rights through complete and independent nursing ‘double-checks’, do not match the steps required by policy and that their knowledge is inadequate. It is evident from the perceptions of RNs that they are aware of the multiple factors influencing IV medication safety practice in this vulnerable patient setting. As perceived by RNs, it is possible to implement more safety strategies. Key recommendations on conclusion of the study include that there are more nursing medication administration strategies that could still be implemented for medication error prevention. These strategies relate to medication safety awareness, the role of the nurse and nursing managers, mandatory staff education, and review of knowledge and skills. / AFRIKAANSE OPSOMMING: Gebaseer op ʼn literatuurstudie blyk dit dat medikasieveiligheid en voorkoming van medikasiefoute reeds in diepte bestudeer are. Bevindings dui daarop dat medikasiefoute algemeen voorkom in neonatale en pediatriese intensiewesorgeenhede, dat meer as die helfte daarvan voorkombaar is, en dat maatreëls om risiko te vermindering pasiënte teen voorkombare uitkomste beskerm (Clifton-Koeppel, 2008:72). Indien en wanneer die proses vir veilige medikasietoediening faal, kom ʼn medikasiefout voor, wat gedefinieer word as die verbreking van een of meer van die vyf medikasieregte (Institute for Safe Medication Practices Alert, 2007:1). Medikasietoediening is hoofsaaklik ʼn verpleegtaak, wat ʼn hoërisiko- en hoëvolume-taak behels. Die akkuraatheid van intraveneuse medikasietoediening is kritiek vir neonatale en pediatriese intensiewesorgpasiënte, aangesien hul weerloosheid verhoog word indien verdere skade veroorsaak word. Omrede medikasietoediening vir neonatale en pediatriese intensiewesorgpasiënte kompleks is, bevestig navorsers dat geregistreerde verpleegkundiges se rol ten opsigte van veilige medikasietoediening veelsoortig is. Die doel van die studie was om die persepsies van geregistreerde verpleegkundiges aangaande die faktore wat medikasieveiligheid in die neonatale en paediatriese intensiewe eenhede in Saoedi-Arabië beinvloed, te beskryf. Studiedoelwitte is gestel om die spesifieke faktore te beskryf wat aanleiding gee tot medikasietoedieningsfoute in die genoemde intensiewesorgeenhede; om geregistreerde verpleegkundiges in die geselekteerde intensiewesorgeenhede se kennis van veilige medikasietoediening te bepaal; en die medikasietoedieningstrategieë wat op die voorkoming van medikasietoedieningsfoute fokus, te beskryf. ʼn Kwantitatiewe navorsingsbenadering is geselekteer vir die studie wat ʼn beskrywende navorsingsontwerp gehad het. ʼn 85% nie-waarskynlike gerieflikheidsteekproef is gebruik om ʼn steekproef (n=103) te selekteer vanuit die teikenpopulasie geregistreerde verpleegkundiges (N=121) wat verantwoordelik was vir medikasietoediening in die geselekteerde intensiewesorgeenhede by King Faisal Specialist Hospital and Research Centre, Jeddah (KFSHRC-J). ʼn Self-geadministreerde vraelys met geslote Likert- en oop-eindevrae is opgestel om die gestelde studiedoelwitte te ondersoek. ʼn Vooraf-toetsing van die vraelys is tydens die loodsstudie uitgevoer. ʼn Kombinasie van kwantitatiewe en kwalitatiewe metodes is gebruik vir die ontleding van die studie-data. Die kwantitatiewe data is op MS Excel ingevoer, waarna beskrywende statistiek deur middel van Statistica 9-sagteware gebruik is om dit te ontleed. Die studie het hoofsaaklik bevind dat veelvuldige faktore die veiligheidspraktyk ten opsigte van intraveneuse medikasie van geregistreerde verpleegkundiges wat met neonatal en pediatriese intensiewesorgpasiënte in ʼn spesifieke tersiêre hospitaal in Saoedi-Arabië werk, beïnvloed. Dit blyk dat hierdie verpleegkundiges se kennis voldoende is aangaande ‘n veilige medikasie toedieningspraktyk wat bestaan uit die kontrolering van al vyf medikasieregte deur verpleegkundige dubbel-kontrolering, soos beskryf is in die hospitaalbeleid. Volgens die bevindinge blyk dit egter dat die verpleegkundiges se persepsie van volledige and korrekte verpleegkundige dubbel-kontrolering, nie met die stappe volgens die hospitaalbeleid ooreenstem nie en dat hulle kennis onvoldoende is. Dit is duidelik dat die verpleegkundiges bewus is van die veelvuldige faktore wat intraveneuse medikasieveiligheidpraktyk vir weerlose pasiënte beïnvloed. Die verpleegkundiges se persepsie is dat daar meer verpleegkundige medikasietoedieningstrategieë is wat geïmplementeer kan word om medikasiefoute te voorkom, insluitende veiligheidsbewustheid ten opsigte van medikasie, die rol van verpleegkundiges en verpleegbestuurders, verpligte personeelopleiding, en hersiening van kennis en vaardighede.

The purpose of this study was to determine whether the job satisfaction and motivating potential of nursing jobs would be higher for nurses using Patient Focused Care (PFC) compared with nurses not using PFC. Nurses from a large metropolitan hospital served as subjects. Data were collected using three instruments designed to measure job satisfaction and motivating potential. Those instruments were the Job Diagnostic Survey, the Job Descriptive Inventory, and the McCloskey/Mueller Satisfaction Scale. It was hypothesized that nurses working on PFC nursing units would demonstrate greater job satisfaction and motivating potential than nurses working on non-PFC nursing units. The hypotheses were not supported. Results were explained by, among other things, accounting for the nature of the instruments used. The two instruments which gave data counter to the hypothesized direction were not nursing-oriented.

An associate degree in nursing is obtained in the community college setting and is designed to be completed in 2 years of full-time study. Approximately 70% of practicing registered nurses (RNs) are educated at the associate degree or diploma (vocational training) level with only 15% moving on to achieve a degree past the associate level. The purpose of this phenomenological research is to study the lived experiences of registered nurses who obtained an associate degree in nursing and, while working in a health care setting, returned to school to attain a baccalaureate degree in nursing (BSN). Data gathered during individual interviews will provide documentation of the benefits of attaining a BSN as well as identifying barriers that associate degree RNs must overcome to pursue a BSN education.