Thesis (Ph. D.)--University of Washington, 1997. / Vita. Includes bibliographical references (leaves [151]-164).

It is not sufficient to just make changes in a nursing curriculum without a plan to evaluate the impact on program outcomes. This study sought to determine the outcomes of teaching the nursing process to Foundation of Nursing students in an Associate Degree Nursing program using a factorial design study. Four groups of students were taught the nursing process as follows: case study and concept mapping; case study, concept mapping with a pocket reference; case study, two hours HFHS, concept mapping with a pocket reference, or four hours of HFHS, concept mapping with a pocket reference. The Simulation Design Scale (SDS) measured the perceptions of the simulation groups for design elements. The four hour group mean was significantly lower on both the importance of the objectives and information and importance of fidelity design elements (p < .05). This suggests that as time in a simulation increases more attention to these elements is required. There was not a significant difference between the four study groups on the Nursing Process or the Assessment Technology Institute (ATI) RN Fundamentals 2010 Assessment Form B examinations individual scores. Two sub-categories on the ATI were significant. Planning was significantly higher for fall 2012 cohort (p = .024) and analysis/diagnosis was almost significant for fall 2011 cohort (p = .054). The results for Factorial Groups was not significant. The National League for Nursing (NLN) PAX-RN entrance examination had a significant correlation with students passing onto the second semester in a nursing program (p < .001). The ATI results of students were the same without regard to the Factorial Group assigned in relation to instructor employment status of full time versus part time. / School of Nursing; / Nursing / PhD; / Dissertation;

The nursing process is the espoused problem solving framework that forms the basis of the way in which patient care is determined, delivered, and communicated in a multiplicity of health care settings. Although its use is widespread in educational and clinical settings, some nurse clinicians display negative attitudes towards the use of the nursing process. They claim that both the structure and language that underpins this process is cumbersome and unreflective of the way in which nursing care is planned and delivered. To date, there has been no study cited that has examined its use within a clinical setting and determined if and how the nursing process is being used and whether there is substance in the clinicians' claims. Additionally, some of the research on problem solving has used laboratory based designs that are limited as they are not sensitive to contextual factors that affect the use of a problem solving process, nor are they sensitive to the efficacy of the communication process. As patient care involves many nurses working under diverse contextual conditions, these factors need to be taken into consideration when studying this phenomenon.Using grounded theory methodology, this study examined the clinical application of the nursing process in acute care hospital settings. Specifically, it sought to answer the following two questions: (1) How is the nursing process used by nurse clinicians in acute care hospital settings? and in the absence of its use, (2) How is nursing care determined, delivered, and communicated in acute care hospital settings in Western Australia?Data were obtained from semi-structured interviews with predominantly nurse clinicians, patients, and patients' relatives, as well as participant field observations of nurse clinicians, and in-depth audits of patient records. Textual data were managed using NUD-IST and analysed using constant ++ / comparative method. Data generation and analysis proceeded simultaneously using open coding, theoretical coding, and selective coding techniques until saturation was achieved. This resulted in the generation of a substantive theory explaining clinical nursing in acute care hospital settings.The findings of this study revealed several problems with the clinical application of the nursing process. It also revealed a process used by nurses to overcome many difficulties they experienced as they tried to determine, deliver, and communicate patient care. Specifically, nurses in this study experienced the basic social problem of being in a state of "Unknowing". Properties and dimensions of unknowing were found consistently in the data and this problem was labelled as the core category. This state of "unknowing" was linked to a number of factors, such as, the existence of a fragmented and inconsistent method of determining and communicating patient care and work conditions of immense change and uncertainty. In order to deal with this problem, the nurses in this study used a basic social process termed: "Enabling Care: Working through obscurity and uncertainty". The first phase of the core process, termed: Putting the pieces together: making sense, involved four subprocesses. These subprocesses were labelled: drawing on the known, collecting and combining information, checking and integrating information, and sustaining communication. The second phase of the core process was termed Minimising uncertainty. It involved three subprocesses which were named: adapting work practices, taking control, and backing-up.The findings of this study have implications for nursing practice, research, theory, and education, as it exposes problems with the clinical application of the nursing process in acute care settings. In addition, it further explicates a substantive theory that describes a ++ / process of nursing used by nurses in these settings. As the articulated process was supported by a number of studies and opinions of nurse scholars it is worthy of being considered as being foundational to an understanding of a process of nursing used in acute care hospital settings in Western Australia.

Thesis (M.P.H.M.)--Mahidol University, 2000.

Thesis (M.S.)--University of Michigan, 1980.

Thesis (M.S.)--University of Wisconsin--Madison, 1984. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 53-56).

Thesis (M.S.)--University of Wisconsin--Madison, 1986. / Typescript. Thesis approval page has authors' names reversed. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 195-201).

In this study, I analyze a discourse that emerged during the 1970s and 1980s in German nursing. At that time, the German healthcare system underwent dramatic changes and economic reorganization, which can be understood as the emergence of the neoliberal rationale in Germany. The argument of cost explosion was used to restructure hospitals into enterprises that were to operate based on the logic of the market. At the same time, the nursing process was introduced into German nursing. The nursing process is a cybernetic, problem-solving cycle containing distinct steps of assessing the patient, planning nursing goals, executing and documenting nursing interventions, and evaluating performance. German nurses valued the nursing process as a central component of the professionalization of the nursing vocation. However, in neoliberalism, professions are seen as obstacles to free competition in marketized areas, and thus strategies such as accounting mechanisms were implemented to decrease their power. Using the historical approach of the history of the present, the perspective of governmentality and insights from critical accounting, this study analyzes the impact of the nursing process on the German nursing vocation. The nursing process needs to be understood as an accounting tool and hence, as a component of neoliberal strategies to make formerly intangible fields of work like nursing service calculable. As an accounting tool, the nursing process does not represent reality in a neutral manner but affects the areas to which it is applied in a constitutive way. As this study shows, the implementation of the nursing process led to reconstituting the nursing vocation into a calculable entity. And while German nurses valued the potential that the call for increased accountability and transparency in nursing care held for their professionalization, the findings suggest that a newly constituted accountable nursing vocation can instead be considered as de-professionalizing.

The dissertation is about nursing documentation in the Intensive Care Unit (ICU) and resuscitation units of Ústřední Vojenská Nemocnice (ÚVN). The paper describes the development of the nursing process and all required documentation used when completing this task. From a theoretical perspective the paper deals with the content and application of all nursing documentation in terms of the relevant legislation. From the practical perspective the research was completed utilizing a questionnaire approach. The questionnaire was delivered at ÚVN in Prague. The research focus is about getting the information about documentation, how information is interpreted between departments as well as the incidence or impact of incorrect documentation. One of the goals of the research was to determine the satisfaction of staff regarding nursing documentation. The research concluded that clear education regarding nursing documentation requirements is required when the nurse first is exposed to the area. Furthermore the research describes that nurses are well informed about the required documentation during the orientation process. It also demonstrates that nurses are kept informed regarding legislation changes as well as the consequences of incorrect documentation. Key words: nursing process, nursing documentation

Este estudo de natureza qualitativa teve como objetivo compreender os significados atribuídos ao processo de enfermagem por enfermeiras da unidade clínica num hospital do México. A coleta dos dados foi realizada por meio de entrevistas semiestruturadas com 16 enfermeiras, complementada com observação de sua atuação num período de trabalho, nos diferentes turnos, e consulta documental. Os dados foram analisados tendo como referenciais teórico e metodológico o Interacionismo Simbólico e a Teoria Fundamentada nos Dados, que possibilitaram a construção de categorias, subcategorias e suas inter-relações, utilizando o paradigma de codificação de Strauss e Corbin (2002). A comparação constante dos dados resultou na categoria central \"o processo de enfermagem no contexto hospitalar: entre o fazer rotineiro e o pensar idealizado\", que permitiu compreender o significado atribuído pelas enfermeiras ao processo de enfermagem na sua prática cotidiana assistencial, explicitado nas concepções, idealizações e ações de cuidado rotineiro, despercebido, aplicado de forma diferente ao aprendido na escola, e seguindo protocolos de atenção estabelecidos, como base de seu trabalho, uma maneira de fazer os cuidados e ajudar os pacientes a solucionar seus desconfortos, instrumento e metodologia que lhes permite direcionar suas atividades e assumir a prática profissional autônoma. O processo de enfermagem se mostra como dissociação entre o pensar e fazer, indicando haver distanciamento entre a teoria e a prática. As ações de cuidado das enfermeiras estão orientadas, principalmente, à realização de procedimentos, conforme rotinas e protocolos de atenção. Estas ações consistem em: recepção e entrega de turno, administração de medicamentos, mensuração de sinais vitais, registros clínicos de enfermagem e encaminhamento de pacientes, visando a dar conta da investigação de suas necessidades, planejamento e realização das ações, na perspectiva do cuidado individualizado e uso do processo de enfermagem. Nesse espaço de tomada de decisões, o enfermeiro estabelece relacionamento humanizado refletido na sua satisfação pelo cuidado realizado, evidenciando sua capacidade de lidar com as condições contextuais em que há delimitação de funções, sobrecarga de trabalho, bem como, costumes, crenças e valores pessoais e profissionais, expressos como limitantes na utilização do processo de enfermagem. Com este estudo foi possível compreender o processo social em que as enfermeiras atribuem significados ao processo de enfermagem no contexto hospitalar, captando a intersubjetividade de suas experiências e a participação ativa na construção de uma prática de enfermagem diferente, firmando a proximidade humana nas múltiplas interações do cotidiano hospitalar. Esta proximidade pode vir a ser resgatada e potencializada como objeto sensibilizador de uma prática que questione o caráter instrumental da rotina, avançando na perspectiva do cuidado humanizado. / This qualitative study aimed to understand the meanings attributed to the nursing process by clinical unit nurses from a Mexican hospital. Data were collected through semistructured interviews with 16 nurses, in addition to observation of their activities during work hours, in different shifts, and consultation of documents. The theoretical and methodological frameworks for data analysis were Symbolic Interactionism and Grounded Theory, which permitted the construction of categories, subcategories and their interrelations, using the coding paradigm by Strauss and Corbin (2002). Constant data comparison resulted in the central category \"the nursing process in the hospital context: between routine actions and idealized thinking\", which permitted an understanding of the meaning nurses attributed to the nursing process in their daily care practice, expressed in conceptions, idealizations and routine care actions, unperceived, applied differently from what they had learned in school, and following established care protocols. This serves as the base of their work, as a way of delivering care and helping patients to solve their discomfort, as an instrument and methodology that allows them to direct their activities and assume an autonomous professional practice. The nursing process reveals itself as dissociation between thinking and doing, indicating a distance between theory and practice. The nurses\' care actions are mainly oriented towards the realization of procedures, according to routines and care protocols. These actions consist of: shift reception and transmission, medication administration, measurement of vital signs, clinical nursing records and patient referral, with a view to coping with needs assessment, action planning and performance, within the perspective of individualized care and use of the nursing process. In this decision making space, nurses establish humanized relations, reflected in their satisfaction with the delivered care, evidencing their capacity to deal with the contextual conditions of function delimitation, work overload, as well as personal and professional customs, beliefs and values, expressed as limiting factors in the use of the nursing process. This study allowed us to understanding the social process in which nurses attribute meanings to the nursing process in the hospital context, capturing the intersubjectivity of their experiences and their active participation in the construction of a different nursing practice, inscribing human proximity in the multiple interactions of daily hospital reality. This proximity can be recovered and potentialized as the sensitizing object of a practice that questions the instrumental nature of routine, advancing in the perspective of humanized care.