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Reporting on radiographic images in after-hours trauma units :Experiences of radiographers and medical practitionersVan der Venter, Riaan January 2016 (has links)
Globally there is a lack of radiologists, which results in unreported radiographic examinations, or a delay in reporting on radiographic images even in emergency situations. In order to mitigate and alleviate the situation, and optimise the utilisation of radiographers a red dot system was introduced in the United Kingdom, which later aided in the transformation of the role of radiographers in terms of formal reporting of various radiographic examinations. Although there is a shortage of medical practitioners and radiologists in South Africa the extended role of radiographers has not been yet realised for radiographers. At present, radiographers and medical practitioners work in collaboration to interpret and report on radiographic examinations informally, to facilitate effective and efficient patient management, but this is done illegally because the regulations defining the scope of the profession of radiography does not allow for such practice, putting radiographers and organisations at risk of litigation. In order to gain an in-depth knowledge of the phenomena, to enable the researcher to provide recommendations to the Professional Board of Radiography and Clinical Technology (PBRCT) of the Health Professions Council of South Africa (HPCSA), a qualitative, exploratory, descriptive, and contextual research study was undertaken. Radiographers and medical practitioners were interviewed in order to elicit rich descriptions of their experiences regarding reporting of trauma related radiographic images in the after-hours trauma units. Data were gathered using in-depth semi-structured interviews, and the data were analysed using kesch’s method of thematic synthesis. Three themes emerged from the data, namely the challenges radiographers and medical practitioners face in the after-hours trauma units respectively, with regards to reporting of trauma related adiographs, and suggestions were proposed to optimize the participation of radiographers with regard to trauma related radiographs in these units. A thick description and literature control was done using quotes from participants. Measures to ensure trustworthiness and ethical research practices were also implemented. Thereafter, recommendations were put forward for the PBRCT of the HPCSA, using current literature and inferences made from the findings of the study.
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Adaptação cultural e validação do Organizational Culture Assessment Instrument para uma amostra de profissionais de enfermagem brasileiros / Cultural adaptation and validation of the Organizational Culture Assessment Instrument for a sample of brazilian nursing professionalsCzempik, Thamiris Cavazzani Vegro 17 August 2018 (has links)
Este estudo teve por objetivo traduzir, adaptar culturalmente e validar o Organizational Culture Assessment Instrument - OCAI para uma amostra de trabalhadores de enfermagem brasileiros. Trata-se de um estudo observacional do tipo transversal com amostragem não probabilística. O processo de adaptação cultural seguiu as etapas: tradução, síntese e consenso das traduções, avaliação da versão traduzida por Comitê de Juízes, retrotradução, análise semântica e pré-teste. A tradução foi realizada por dois tradutores e a síntese das traduções por um terceiro tradutor. Estas versões foram analisadas por um Comitê de Juízes, gerando uma versão consensual que foi retrotraduzida e enviada para os autores do instrumento original, os quais a aprovaram. A análise semântica e o pré-teste foram realizadas por 30 profissionais de enfermagem e, após a realização das alterações sugeridas, foi gerada a versão adaptada para o contexto brasileiro do OCAI em uma amostra de trabalhadores de enfermagem (OCAI-Nurs). Em relação à avaliação das propriedades psicométricas, foram estimadas: a sensibilidade psicométrica dos itens; a validade de construto fatorial, por meio da Análise Fatorial Confirmatória e do método da máxima verossimilhança, utilizando-se os índices de qualidade de ajustamento ?2/gl, GFI, CFI e RMSEA; a validade de construto convergente, estimada pela Variância Extraída Média; a invariância fatorial, avaliada pela análise multigrupos (teste da diferença de qui-quadrado em amostras independentes); e a confiabilidade do instrumento, avaliada por meio da consistência interna dos fatores (alfa de Cronbach e confiabilidade composta). O processo de validação foi realizado com 277 profissionais de enfermagem de quatro hospitais do interior do Estado de São Paulo. Observou-se predominância de mulheres (82,3%); a média de idade foi de 36,25 anos; o tempo médio de atuação nos hospitais foi de seis anos e de atuação profissional de 12 anos. Os resultados obtidos na adaptação cultural mostraram que o OCAI-Nurs é compreensível, fácil de ser respondido e adequado para a amostra de profissionais de enfermagem brasileiros. No processo de validação, os resultados mostraram que a sensibilidade psicométrica dos itens foi considerada adequada; a validade de construto fatorial apresentou propriedades psicométricas insatisfatórias nos itens CD1A, GC3B, CD1Bf, EE5Bf, CD1C, GC3D, LO2D e LO2Df e, portanto, foram excluídos; a validade de construto convergente apresentou limitação em todos os perfis, exceto no Perfil de Controle (presente); houve invariância estrita dos modelos fatoriais para todos os perfis, exceto no perfil Colaboração (futuro) e Competitivo (presente); quanto à confiabilidade, o OCAI-Nurs apresentou ? adequado no perfil Competitivo no presente e CC adequada nos perfis de Controle e Competitivo no presente. Deste modo, o OCAI-Nurs obteve índices de ajustamento bons, indicando que o instrumento é adequado para a amostra estudada, porém, mostrou pesos fatoriais baixos e confiabilidade comprometida, os quais podem ser justificados pelas diferenças entre os valores que caracterizam a cultura dos hospitais e da enfermagem e aqueles que determinam os perfis culturais do OCAI. Por este motivo, sugerese a realização de estudos futuros na tentativa de se obter uma estrutura fatorial mais estável do OCAI-Nurs e o desenvolvimento de instrumentos que sejam capazes de captar as especificidades do trabalho em saúde e de enfermagem / This study aimed to translate, culturally adapt and validate the Organizational Culture Assessment Instrument - OCAI for a sample of Brazilian nursing workers. This is an observational cross-sectional study with non-probabilistic sampling. The process of cultural adaptation followed the steps: translation, synthesis and consensus of translations, evaluation of the version translated by Committee of Judges, back-translation, semantic analysis and pre-test. The translation was done by two translators and the synthesis of the translations by a third translator. These versions were analyzed by a Committee of Judges, generating a consensual version that was backtranslated and sent to the authors of the original instrument, which approved it. Semantic analysis and pre-test were performed by 30 nursing professionals and, after the proposed changes were made, the adapted version to the Brazilian context of OCAI in a sample of nursing workers (OCAINurs) was generated. In relation to the evaluation of the psychometric properties, the psychometric sensitivity of the items were estimated; the factorial construct validity, using the Confirmatory Factor Analysis and the maximum likelihood method, using the quality indexes of adjustment ?2/gl, GFI, CFI and RMSEA; the convergent construct validity, estimated by Average Extraction Variance; factorial invariance, assessed by multi-group analysis (chi-square test in independent samples); and the reliability of the instrument, evaluated through the internal consistency of the factors (Cronbach\'s alpha and composite reliability). The validation process was performed with 277 nursing professionals from four hospitals in the interior of the State of São Paulo. A predominance of women (82.3%) was observed; the mean age was 36.25 years; the average time of operation in the hospitals was six years and of professional performance was 12 years. The results obtained in the cultural adaptation showed that OCAI-Nurs is understandable, easy to answer and suitable for the sample of Brazilian nursing professionals. In the validation process, the results showed that the psychometric sensitivity of the items was considered adequate; the factorial construct validity showed unsatisfactory psychometric properties in items CD1A, GC3B, CD1Bf, EE5Bf, CD1C, GC3D, LO2D and LO2Df and, therefore, were excluded; the convergent construct validity presented limitation in all the profiles, except in the Control Profile (present); there was a strict invariance of the factorial models for all profiles, except in the Collaborate (future) and Compete profile (present); as to reliability, OCAI-Nurs presented adequate ? in the Competitive profile in the present and adequate CC in the Control and Compete profiles in the present. Thus, the OCAI-Nurs obtained good adjustment indexes, indicating that the instrument is adequate for the studied sample, but showed low factorial weights and compromised reliability, which can be justified by the differences between the values that characterize the hospitals and nursing culture and those who determine the cultural profiles of OCAI. For this reason, it is suggested to carry out future studies in an attempt to obtain a factorial structure of OCAI-Nurs more stable and the development of instruments that are able to capture the specificities of work in health and nursing
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Polycystic Ovary Syndrome TreatmentPatterson, Moneka Angilene 01 January 2017 (has links)
Polycystic ovary syndrome (PCOS) is an endocrine system disorder that affects women of reproductive age. If not treated properly, PCOS can lead to infertility. Lack of proper treatment of PCOS may also result in medical complications such as diabetes or heart disease. The rural clinic where this project took place did not have a mandatory guideline for treatment of PCOS; therefore, no standardized method of diagnosis or treatment of PCOS existed. The purpose of this project, guided by the IOWA evidence-based practice model, was to educate providers on the evidence-based guideline for diagnosis and treatment of PCOS outlined by the Endocrine Society Taskforce. The guideline was selected after a comprehensive literature review and was used to develop an educational program that was provided to 5 nurse practitioners, the medical director and staff. A pre-test post-test design was used to determine if the participants understood the content from the guideline that was presented. Results showed that the researcher-developed test administered to participants yielded scores of 74 on the pre-test and increased after the education program with all participants scoring 100 on the post-test. The guideline used for the education was then presented to the clinic for implementation with the assistance of the medical director's support. The project provided an evidence-based guideline for diagnosing and treating PCOS and raised awareness of PCOS among all staff in a rural clinic where many patients with PCOS are treated. Positive social change may result as providers are better prepared to deliver evidence-based care for PCOS and as infertility and complications of untreated PCOS are reduced.
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Training for Advanced Practice Providers in a Heart Failure UnitChua, Merlyn 01 January 2018 (has links)
Information from anecdotal interviews at a practicum site indicated a lack of training for advanced practice providers (APPs) in core competencies critical for effective practice in a heart failure (HF) unit. The goal of this project was to assess the APPs' verbal reports and develop HF unit-specific training for APPs. The practice-focused question examined whether unit-specific training for HF APPs improved knowledge and skills in HF management. The Johns Hopkins nursing evidence-based practice model and Knowles's adult learning theory were used to create a survey, a focus group, and a pre/posttest assessment of knowledge and skills gap. Descriptive and inferential statistics could be used to analyze pre/post survey data, and thematic analysis could be used to analyze focus group data. Assessment data could be used to develop a targeted HF program based on identified skill deficiencies. The implications of this project related to social change are the potential to increase APPs' knowledge, job engagement, and retention. The program could affect length of stay and 30-day readmission of patients in the HF unit.
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Implementation of a Nurse Practitioner Residency Program in Critical Access HospitalsBolima, Anna Ngwisah 01 January 2016 (has links)
Access to health care in rural communities is challenged by workforce shortages. Nurse practitioners (NPs) have been filling the gap created by physician migration into specialty areas. Flex hospital legislation allows critical access hospitals (CAHs) to staff the emergency department with NPs without on-site physicians. NP education often lacks emergency and trauma curriculum, resulting in gaps in practice expectations and significant role transition stress and turnover. The purpose of this project was to construct from the scholarly literature a transition-to-practice residency program to support NP's in providing emergency department care in the CAH. The limbo to legitimacy theory guided the design and implementation of this project. Expected outcomes from this project include increased quality of care, increased patient safety, increased NP job satisfaction, and decreased turnover. The quality improvement initiative engaged an interprofessional team of 8 institutional leaders who designed the residency program and curriculum modules and the secondary products necessary to implement and evaluate the project. The project expands the understanding of the on-boarding needs of rural NPs and produces outcome data to evaluate results. Recommendations include collaboration between health care organizations and institutions of higher learning to promote postgraduate emergency care education leading to post-masters certificate or Doctor of Nursing Practice with emergency care subspecialization.
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Factors that influence professional nurses' time management at Mankweng Hospital campus,Limpopo Province, South AfricaMamabolo, Meriam Mmadipudi January 2011 (has links)
Thesis ( M.Cur.) --University of Limpopo, 2011 / The purpose of this study was to determine the factors that influence professional nurses’ time management at Mankweng Hospital campus, a tertiary hospital in Limpopo Province, South Africa. The objectives of this study were to identify and describe factors that influence professional nurses’ time management at a tertiary hospital campus and describe the recommendations on effective time management at a tertiary hospital campus to improve quality of patient care. A quantitative research method was used in this study to describe factors that influence professional nurses’ time management. Data were collected by means of a structured questionnaire and analyzed using the Statistical Package for Social Sciences (SPSS). The study revealed that professional nurses were unable to manage time due to interruptions in between work performance, and this affected their productivity. The study recommended there is a need for professional nurses to attend in-service education related to management of time.
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Carving a niche for Australian practice nurses in chronic heart failure managementHalcomb, Elizabeth, University of Western Sydney, College of Social and Health Sciences, School of Nursing, Family and Community Health January 2005 (has links)
Chronic and complex conditions are a significant concern within contemporary health care systems. The ageing population and improvements in survival from acute cardiac illness have seen an increasing incidence of heart failure (HF). Heart failure represents a significant burden on both the individual and the wider community. Despite effective pharmacotherapy and established evidence-based management guidelines, the overall prognosis from HR is poor. The complexity of the disease process and the highly developed evidence-base makes HR an excellent exemplar for the management of a range of chronic conditions. Studies undertaken as part of the ‘Carving a niche for Australian practice nurses’ project have led to the development of a model of care that integrates the role of the practice nurse with those of other health care providers to improve outcomes for people with chronic and complex conditions. Whilst the model of care developed from these studies requires empirical testing to validate its utility, it is currently being incorporated in clinical planning and ongoing pragmatic research. The systematic, sequential derivation of data from this ‘Carving a niche for Australian practice nurses’ project will inform the development of primary care and provide a conceptual framework for future intervention studies in Australian general practice. / Doctor of Philosophy (PhD)
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Nurse practitioners views on menopause : attitudes and prescribing practicesDeprey, Teresa Mona 09 May 1997 (has links)
Menopause is a critical life-cycle transition for women, and is associated with osteoporosis and cardiovascular disease, leading causes of morbidity and mortality in US women. Efforts to curb symptoms of menopause include HRT and ERT, although conflicting evidence exists linking ERT and HRT with the risk of breast cancer. Physicians attitudes and preferred mode of treatment have been extensively studied, but with the increased utilization of nurse practitioners in the field, a new paradigm is being established. The overall goal of this study was to assess the nurse practitioners knowledge and attitudes about menopause, hormone replacement therapy and estrogen replacement therapy. More specifically, the objectives include to: 1) determine methods of patient education for menopausal women; 2) examine whether attitudes of menopause are predictors of preferred modes of treatment; and 3) determine whether demographic factors of nurse practitioners are predictors of preferred modes of treatment.
A random selection of nurse practitioners from the state of Oregon were mailed a self-administered survey along with a stamped, addressed envelope. The questionnaire focused on knowledge of menopausal treatments, attitudes of menopause, continuing education in the menopause research, and methods of patient education. Follow-up surveys were mailed to non-responders at two and four-week intervals following the first mailing. Response rate was 60% with a sample size of 192.
Results describe the management practices of nurse practitioners and what influenced their prescribing and management practices. The influences included the following factors: perceptions about adequacy of formal education, continuing education and attitudes about menopause and managing menopause. Only 47.4% of the respondents felt that their formal education in menopause treatment and protocols was adequate. When asked how they treated women, a majority (64.6%) of the nurse practitioners depended on the women and her beliefs about menopause, HRT, and ERT when they considered how they cared for a menopausal women. Sixty-one percent were very likely to take time during a visit to discuss the changes a woman was going through, while 23.7% were most likely to answer questions if the client had any, otherwise leave the introduction of menopause to the client. When contraindications were present, all nurse practitioners were less likely to prescribe both ERT and HRT. A surprising trend was the high number of participants who were uncertain about how they would prescribe when contraindications were present.
In summary, this study describes Oregon nurse practitioners attitudes about menopause, the perceived adequacy of their formal education, and likelihood of prescribing ERT and HRT. Since almost 50% of the nurse practitioners felt their education was inadequate in menopause, a systematic analysis of masters level nurse practitioner programs in the area of menopause and menopausal treatments is needed. Ideally, a nationwide survey comparing physicians and nurse practitioners prescribing practices would help quantify differences between the two types of health care providers. / Graduation date: 1997
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Therapeutic commitment and care of persons with mental illness: a survey of nurse practitioners' role perceptionsCreamer, Anne Marie Unknown Date
No description available.
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Mentoring, self-efficacy, and nurse practitioner students : a modified replicationNeal, Terry I. January 2008 (has links)
Graduate nursing education is a combination of didactic and clinical instruction. Clinical instruction is achieved primarily by pairing a student with either an experienced physician or certified nurse practitioner (NP) who will serve as a preceptor. The student/preceptor relationship may be initiated by nursing faculty or by the student.
The quality of clinical instruction is crucial to the professional development of the NP. During this time of intense clinical instruction, students learn the process of applying the principles of diagnostic reasoning in a real world setting. Socialization into the role of the NP is an important component of the clinical education and may be impacted by the relationship established between the student and the preceptor.
Multiple factors may have an impact on the resulting experience and relationship. Attitudes of both student and preceptor define and shape the relationship that develops throughout the clinical rotation. The student’s perception of the quality of the clinical experience may impact the outcome of the experience including the student’s sense of self-efficacy and confidence in practice skills and socialization into the role.
This study focuses on the student’s perception of self-efficacy and confidence based on whether a mentoring relationship was established with at least one preceptor during the clinical experience. The study, a modified replication of Hayes’ 1997 study, demonstrated a strong sense of mentoring, self-efficacy and self-confidence in students enrolled in the final clinical course of a nurse practitioner program. The single most predictive factor for self-efficacy and self-confidence is length of time the student works with the preceptor as measured by months of clinical rotation.
Other predictors of self-efficacy and self-confidence included the students’ perception of a mentor and how that mentorship was instrumental in the development of the skills and abilities necessary for transition into the role of the nurse practitioner. Self-efficacy was found to correlate highly with feelings of self-confidence in beginning skills such as physical assessment as well as higher level skills of diagnostic reasoning.
As the students neared the end of clinical courses in the nurse practitioner program, most felt prepared to begin practice and cited traits similar to those attributed to preceptors as indicators of preparedness. / Department of Educational Studies
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