Critically ill patients experience overwhelming communication problems; caused by intubation and cognitive, sensory or language deficits that distance the patients from communicating their needs and wants from nurses and loved ones. The purpose of this study was to explore communication patterns and strategies with the aim of implementing intervention strategies for nurse/patient communication in the intensive care units. The American Association of Critical Care Nurses’ Synergy Model for Patient Care was used to guide the study. A mixed method approach using quasi-experimental design combining quantitative and qualitative data collections and analysis was used. Concurrent data collection for quantitative and qualitative data was used. Auditing of patient’s files, protocols, family counselling conference and in-service books and a survey for nurses was used for quantitative data. Qualitative data collection was through interviewing nurses and nurse managers. Lack of documentation and use of other communication strategies were the key findings of the study. In accordance with the model used for the study clinical judgment and moral distress were found to be common among nurses. Lack of collaboration between nurses and other health care workers was also attributed to poor communication with mechanically ventilated patients. Conclusions derived from the study are that nurses need to be supported through informal and formal training on documentation and use of communication methods available / Health Studies / D. Litt. et Phil. (Health Studies)

Critically ill patients experience overwhelming communication problems; caused by intubation and cognitive, sensory or language deficits that distance the patients from communicating their needs and wants from nurses and loved ones. The purpose of this study was to explore communication patterns and strategies with the aim of implementing intervention strategies for nurse/patient communication in the intensive care units. The American Association of Critical Care Nurses’ Synergy Model for Patient Care was used to guide the study. A mixed method approach using quasi-experimental design combining quantitative and qualitative data collections and analysis was used. Concurrent data collection for quantitative and qualitative data was used. Auditing of patient’s files, protocols, family counselling conference and in-service books and a survey for nurses was used for quantitative data. Qualitative data collection was through interviewing nurses and nurse managers. Lack of documentation and use of other communication strategies were the key findings of the study. In accordance with the model used for the study clinical judgment and moral distress were found to be common among nurses. Lack of collaboration between nurses and other health care workers was also attributed to poor communication with mechanically ventilated patients. Conclusions derived from the study are that nurses need to be supported through informal and formal training on documentation and use of communication methods available / Health Studies / D. Litt. et Phil. (Health Studies)

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Unplanned extubation is premature removal of endotracheal tube, is an adverse event; which can either, be accidental during a nursing procedure or self deliberate by the patient. The AACN Synergy Model for Patient Care was used as conceptual model for this study. A retrospective descriptive design revealed that over a period of two years, 327 patients admitted to the intensive care unit require intubation of which 40.4% were self-deliberate extubation and 59.4% accidental extubation. Of the accidental extubated patients, 29.8% had physical restrains, 57.6% received sedation, 43.9% had analgesic infusion and 38.9% were on neuromuscular blockade. A means Glasco Coma Scale was 9.4 and 56% of the patients were reported as being. Most patients (89.9%) required re-intubation. The findings also revealed that 49.1% of the nurses who cared for the patients when the extubation occured had one patient at the time. Also, 84.2% of nurses had 0-6 years of nursing experience and 74% of nurses had less than five years of ICU experience. / Health Studies / M.A. (Health Studies)

In today’s world healthcare all over the world is profoundly challenged by rapid technological advancements, violence, terrorism, diverse cultures, proliferating chronic diseases, and the worst nursing shortage. In addition to these complex and daunting challenges healthcare continue to focus the attention on hospitals to review and modify the way care is delivered to patients. As key role players and consistent members of the multidisciplinary team critical care nurses are uniquely positioned to modify and review the quality of patient care through synergy between the patients’ needs, the nurses’ competencies, and the critical care environment. A collaborative approach towards enhancing synergy in a CCU was undertaken in a CCU in a private hospital in Gauteng. The study was guided by the American Association for Critical Care Nurses Synergy Model for Patient Care and conducted within the critical social theory paradigm. The nature of the research was descriptive, explorative and contextual and both qualitative and quantitative approaches were used. Action research cycles were followed to assess existing synergy between the patients’ needs, the nurses’ competencies and the characteristics of the environment in the CCU. An action plan was formulated and implemented towards enhancing synergy in the CCU. The implemented plan was adjusted based on observations and reflections following each of the five cycles of the project / Health Studies / D. Litt. et Phil. (Health Studies)

Unplanned extubation is premature removal of endotracheal tube, is an adverse event; which can either, be accidental during a nursing procedure or self deliberate by the patient. The AACN Synergy Model for Patient Care was used as conceptual model for this study. A retrospective descriptive design revealed that over a period of two years, 327 patients admitted to the intensive care unit require intubation of which 40.4% were self-deliberate extubation and 59.4% accidental extubation. Of the accidental extubated patients, 29.8% had physical restrains, 57.6% received sedation, 43.9% had analgesic infusion and 38.9% were on neuromuscular blockade. A means Glasco Coma Scale was 9.4 and 56% of the patients were reported as being. Most patients (89.9%) required re-intubation. The findings also revealed that 49.1% of the nurses who cared for the patients when the extubation occured had one patient at the time. Also, 84.2% of nurses had 0-6 years of nursing experience and 74% of nurses had less than five years of ICU experience. / Health Studies / M.A. (Health Studies)

In today’s world healthcare all over the world is profoundly challenged by rapid technological advancements, violence, terrorism, diverse cultures, proliferating chronic diseases, and the worst nursing shortage. In addition to these complex and daunting challenges healthcare continue to focus the attention on hospitals to review and modify the way care is delivered to patients. As key role players and consistent members of the multidisciplinary team critical care nurses are uniquely positioned to modify and review the quality of patient care through synergy between the patients’ needs, the nurses’ competencies, and the critical care environment. A collaborative approach towards enhancing synergy in a CCU was undertaken in a CCU in a private hospital in Gauteng. The study was guided by the American Association for Critical Care Nurses Synergy Model for Patient Care and conducted within the critical social theory paradigm. The nature of the research was descriptive, explorative and contextual and both qualitative and quantitative approaches were used. Action research cycles were followed to assess existing synergy between the patients’ needs, the nurses’ competencies and the characteristics of the environment in the CCU. An action plan was formulated and implemented towards enhancing synergy in the CCU. The implemented plan was adjusted based on observations and reflections following each of the five cycles of the project / Health Studies / D. Litt. et Phil. (Health Studies)

Darbo aktualumas. 2000 m. Europos Taryba patvirtino Lisabonos strategiją, kuria nustatė Europos Sąjungos strateginius tikslus, siekiant žiniomis grindžiamoje ekonomikoje padidinti užimtumą, stiprinti ekonomines reformas ir socialinę sanglaudą. Per pirmuosius penkerius Lisabonos strategijos įgyvendinimo metus ES mastu norimų rezultatų nebuvo pasiekta, todėl buvo priimtas sprendimas orientuotis į nacionalinių Lisabonos strategijos įgyvendinimo programų kūrimą. Šiame darbe analizuojamos Lisabonos strategijos ir 4 pagrindinių Lietuvos ilgalaikių strategijų sąsajos. Šios strategijos dėl bendros kilmės, panašių vizijų ir siekių, Lisabonos procese turėtų būti įgyvendinamos kartu su Nacionaline Lisabonos strategijos įgyvendinimo programa, atsižvelgiant į bendrus prioritetus, koordinuojant veiksmus ir planuojant tikslingą projektų bei reformų finansavimą. Darbo objektas – Lisabonos strategija. Darbo tikslas – sukurti Nacionalinės Lisabonos strategijos įgyvendinimo sinergetinį modelį, kuris užtikrintų efektyvesnį Lisabonos strategijos įgyvendinimą atsižvelgiant į Lietuvos strateginius prioritetus. Praktinė darbo reikšmė grindžiama Lisabonos strategijos įgyvendinimo Lietuvoje sinergetinio modelio sukūrimu bei jo analize. Teorinė darbo reikšmė orientuota į tinkamą Lisabonos strategijos ir 4 pagrindinių Lietuvos ilgalaikių strategijų įgyvendinimo koordinavimą bei makroekonominės politikos suderinamumą siekiant sinergijos efekto. / The relevance of the study. European Council has confirmed Lisbon strategy in year 2000, according to this strategy European‘s Council strategical aims were set, by way of increasing business in economy, grounded by knowledge, consolidate economical reforms and social cohesion. There wasn‘t obtained desirable results in the degree of EU during the first five years of realization of Lisbon strategy, thus there was accepted a decision oriented around creation of programs of nacional Lisbon strategy realization. There are analized connections between Lisbon strategies and 4 general permanent Lithuania‘s strategies in this issue. In Lisbon process these strategies should be realized together with Nacional Lisbon‘s strategy realization program, because of their common origin, similar visions and objects. This should be realized considering to common priorities, cordinating actions and planning purposeful sponsorship to projects and reforms. The object of the study – Lisbon strategy. The aim of the study – to create a synergy model of realization of Nacional Lisbon strategy, whick will make the realization of Lisbon strategy more effetive, considering to Lithuania‘s strategical priorities. Practical import of this issue is going entirely by realization of Lisbon strategy in Lithuania, creation of synergy model and it‘s analyse. Theorical import of this issue is oriented to suitable cordination of Lisbon‘s strategy and 4 general permanent Lithuania‘s strategies realization and... [to full text]