Central venous catheters (CVCs) are commonly used as vascular access for patients who require hemodialysis. Infectious complications are a serious clinical problem, and they are associated with high rates of morbidity and mortality, prolonged hospital stay, and increased medical treatment costs. The purpose of theproject was to evaluate the effectiveness of educating registered dialysis nurses regarding CVC maintenance care to reduce catheter-related bloodstream infection (CRBSI) in a hemodialysis unit. The project question focused on the educational program derived from the evidence-based guidelines recommended by the Centers for Disease Control and Prevention (CDC) to improve registered dialysis nurses' knowledge regarding CVC maintenance care. The theoretical foundation of the study was based on Donabedian's structure-process-outcomes model. In this project, nurses considered a structural element and used a self-study module to improve the process of providing CVC maintenance care. A paired-samples ttest was conducted to compare knowledge scores of the participants in the posttest (n = 56) and knowledge scores of participants in the pretest (n = 57). The ttest was significantly higher for the posttest than scores for the pretest. The results suggested a statistically significant improvement in the registered dialysis nurses' knowledge following the educational intervention. This study contributes to social change by identifying an educational intervention that helped improving nurses' knowledge in hemodialysis unit, thus helping hemodialysis patients stay safer and possibly reducing infectious complications.

The purpose of this study was to explore the knowledge and attitudes of hospital postpartum and public health nurses towards postpartum depression (PPD) using interpretive description. Postpartum depression is the leading complication after childbirth and impacts negatively on the health of the mother and her child. The nurses in this study participated in focus groups and/or participant observation. The five patterns that describe participants experiences related to PPD were: “Nurses understand PPD in different ways”, “Nurses recognize that women need support”, “Nurses reported that teaching about PPD makes a difference”, “Strong relationships with a primary care provider is essential in the post partum period”, and “a key role of the nurse is to listen”. The nurses in this study revealed a rich understanding of PPD leading to recommendations for practice by hospital and public health nurses related to PPD contributing to better care for women experiencing PPD.

No description available.

The purpose of this dissertation is to explore potential barriers nurses experience in providing effective pain management for preterm and critically ill infants in neonatal intensive care units (NICUs). The specific aims of the study conducted are to examine (a) NICU caregivers’ knowledge about pain, (b) scales used to evaluate pain in infants, (c) NICU nurses’ documented pain practices, and (d) bias in treating pain of certain types of infants. This dissertation is comprised of three manuscripts. The first manuscript is an integrated review of the literature describing caregiver knowledge, barriers, and bias in the management of pain in neonates. The second manuscript is a systematic review of multidimensional pain scales developed for use in preterm and critically ill infants. The final manuscript reports a descriptive exploratory study designed to examine nurses’ knowledge of pain, knowledge of intensity and appropriate management of procedural pain, bias in treating pain of certain types of infants, and documented pain management practices. Over the past 25 years, caregiver knowledge of pain in preterm and critically ill infants has advanced from beliefs that neonates do not feel pain, to the knowledge that preterm infants experience more pain than term infants, older children, and adults. Nine multidimensional pain scales with varying levels of reliability and validity have been developed, yet a gold standard for pain assessment in preterm and critically ill neonates has not emerged. In this study, baccalaureate prepared nurses (BSN) and nurses with higher total years of nursing experience had better knowledge of pain in this population than associate degree nurses (ADN). However, pain management was inconsistent, resulting in pain that was untreated as often as 80% of the time. Nurses reported that physician practice was the primary obstacle to providing effective pain management. Additional concerns included knowledge deficits of nurses and physicians, lack of communication and teamwork, and rushed care. Nurses reported biases in managing pain and were less likely to invest time and energy treating the pain of infants experiencing neonatal abstinence syndrome.

A peripherally inserted central catheter (PICC line) is a catheter that is inserted through a peripheral vein in the arm and then on to a central vein in the chest. It is used to give injections and infusions and to take blood samples of patients who need treatment for longer periods.The aim of this study was to investigate nurses' perceived knowledge of the care and use of PICC line in wards where PICC line does not occur daily. The aim was also to investigate if the nurses expressed a need and wished for more knowledge to be able to use PICC line, and if PICC line is not used investigate the cause of that.The study was of a descriptive design with quantitative approach. An online survey was answered by 40 nurses from five wards at a university hospital in central Sweden.A large number of the nurses who responded to the survey reported that they lacked knowledge of the care and use of PICC line. Despite this, three-quarters of the nurses usually use PICC line at the infusion / injection / blood tests on patients with PICC line, if they are cared for in their ward. Most of the nurses wanted more knowledge on PICC line and the majority of them wanted to get this knowledge through education in the ward. Nearly one-third of the nurses had not received any training on PICC line.The conclusion is that nurses who often care for patients with PICC line largely lack knowledge about the use and care of PICC line. Despite this, most nurses use PICC line if they are caring for a patient who has one. To avoid complications in patients with PICC line nurses need to get more training on the use and care of these. Most nurses want more training and knowledge of PICC line. / En perifert inlagd central venkateter (PICC-line) är en kateter som läggs in via en perifer ven i armen och sedan vidare till en central ven i bröstkorgen. Den används för att ge injektioner och infusioner och för att ta blodprover på patienter som behöver en längre tids behandling.Syftet med denna studie var att undersöka sjuksköterskors uppfattade kunskap om skötsel och användning av PICC-line på vårdavdelningar där PICC-line inte förekommer dagligen. Syftet var också att undersöka om sjuksköterskorna tyckte sig behöva och önskade mer kunskap för att kunna använda PICC-line och i de fall den inte används undersöka orsaken till det.Studien var av deskriptiv design med kvantitativ ansats. En webbenkät besvarades av 40 sjuksköterskor från fem vårdavdelningar vid ett universitetssjukhus i Mellansverige.En stor del av de sjuksköterskor som besvarat enkäten uppgav att de saknade kunskap om skötsel och användning av PICC-line. Trots detta använder tre fjärdedelar av sjuksköterskorna oftast PICC-line vid infusion/injektion/blodprovstagning om patienter med PICC-line vårdas på deras avdelning. De flesta sjuksköterskorna ville ha mer kunskap om PICC-line och majoriteten av dem ville få den kunskapen genom utbildning på avdelningen. Nästan en tredjedel av sjuksköterskorna hade inte fått någon utbildning om PICC-line.Slutsatsen är att sjuksköterskor som sällan vårdar patienter med PICC-line i hög grad saknar kunskap om användning och skötsel av PICC-line. Trots detta använder de flesta PICC-line om de vårdar en patient som har en sådan. För att undvika komplikationer hos patienter med PICC-line behöver sjuksköterskorna få mer utbildning om användning och skötsel av dessa. De flesta sjuksköterskorna önskar få mer utbildning och kunskap om PICC-line.

Bakgrund: Katastrofer kan vara orsakade av naturen eller av människan. Oavsett vad som orsakat katastrofen har sjuksköterskor en betydande roll i katastrofsjukvård och internationella humanitära insatser. Det är ett arbete som ställer höga krav på individens kompetens. Resultat från flera studier runt om i världen visar att sjuksköterskor ofta anser att deras utbildning inte är tillräcklig för att kunna hantera de problem som kan dyka upp i ett katastrofområde. Syfte: Studiens syfte var att undersöka vilken kunskap och kompetens sjuksköterskor anser vara nödvändiga för att kunna arbeta på bästa sätt i ett katastrofområde. Metod: I denna studie har tre intervjuer genomförts. För att undersöka vilken kunskap och kompetens sjuksköterskor behöver har insamlad data analyserats genom manifest innehållsanalys. Resultat: Genom analysen framkom tre huvudkategorier: Förberedande kunskaper & färdigheter; Situationer på plats samt Ledning på plats. I kategorin Förberedande kunskaper & färdigheter beskriver respondenterna den kunskap de anser vara nödvändig innan uppdragets början. Det var viktigt att ha teoretisk kunskap om bland annat vitala parametrar och infektionssjukvård. Erfarenhet av att vårda sjuka barn framkom som viktigt. Inom Situationer på plats beskrivs de olika arbetsuppgifter och roller respondenterna haft under respektive uppdrag. Varierande problem och utmaningar framkom, bland annat att behoven ofta översteg resurserna. Ledning på plats beskriver respondenternas återkommande roller som arbetsledare och chef. Det handlade bland annat om att kunna fatta beslut, att ha ansvar och kunna samverka med såväl kollegor som myndigheter. Slutsats: Resultatet i denna studie tyder på att ledarskap är en av de viktigaste kompetenserna i humanitära insatser. Grundutbildningen till sjuksköterska i Sverige är tillfredställande och ger rätt teoretiska kunskaper för att kunna arbeta med katastrofsjukvård. Utöver en god teoretisk kunskap anses erfarenhet av framförallt pediatrisk omvårdnad vara viktigt för arbetet i humanitära insatser. Klinisk betydelse: Resultatet i denna studie kan användas för att utveckla kursplaner i sjuksköterskeutbildningen och förberedande utbildningar för humanitära insatser. / Background: Disasters can be of natural cause or be man made. No matter the cause of the disaster nurses will play a significant role in disaster nursing and international humanitarian operations. The work sets high demands on the individual's competence. Results from several studies around the world show that nurses often feel their education is not sufficient to be able to deal with the problems that may arise in a disaster area. Aim: The purpose of this study was to explore what knowledge and competence nurses consider necessary in order to work optimally in a disaster area. Method: In this study, three interviews were conducted. To explore what knowledge and competence nurses need, the collected data was analyzed through manifest content analysis. Findings: The analysis revealed three main categories: Preparatory knowledge & skill; Situations on site and Management on site. In the category Preparatory knowledge & skills the respondents describe the knowledge they consider necessary before the beginning of the mission. It was important to have knowledge of, among other, vital parameters and infection care. Experience of caring for sick children emerged as important. Within Situations on site the different roles and tasks the respondents had during each mission was described. Various problems and challenges emerged, among other that needs often exceeded the resources. Management on site describes the respondents recurring roles as supervisors and managers. These included being able to make decisions, to have responsibility and to be able to interact with both peers and authorities. Conclusion: The result of this study suggests that leadership is one of the most important competencies in humanitarian operations. The nursing education in Sweden is satisfying and it provides the right theoretical knowledge to work with disaster nursing. In addition to good theoretical knowledge, experience of especially pediatric care is of importance for the work in humanitarian operations. Clinical impact: The result of this study can be used to develop curricula in nursing education and preparatory courses for humanitarian operations.

Thesis (MCur)--Stellenbosch University, 2011. / ENGLISH ABSTRACT: The quality of care nurses provide to patients is done with the expectation that skills and knowledge of each registered nurse will result in quality patient care. Compliance statistics for quality indicators (level of service indicators) or (LSI’s) in the tertiary health care institution in Saudi Arabia varies, raising the following questions: “Do nurses understand the importance of quality indicators in clinical nursing and do they know how to use them to improve patient care?” No studies done on registered nurses’ knowledge and opinions of quality indicators could be found thus indicate the necessity of a research study to determinine the knowledge and opinions of registered nurses on quality indicators in clinical nursing in the tertiary healthcare system in Saudi Arabia. This is the focus of this research. The objectives of the study were: - To determine the current knowledge and opinions of the professional nurses regarding quality indicators in a tertiary hospital in Saudi Arabia - To identify the factors that influence identification of quality indicators in clinical nursing - To identify the need for a training program regarding nurse sensitive quality indicators Data was collected through a questionnaire handed to more than 200 nurses working in general wards and intensive care areas in a single Saudi Arabian hospital. Participants were selected through a randomised list. The registered nurses who have participated in the pilot study’s responses were excluded from the final data analysis. No patients were included or involved in the study. A descriptive design with a quantitative approach was applied to investigate the professional nurses’ knowledge and opinions on quality indicators (level of service indicators) or (LSI’s) in clinical nursing in Saudi Arabia. Research data suggests that the knowledge and opinions of registered nurses in the tertiary health care institution in Saudi Arabia are not supporting the expectations of quality assurance in clinical nursing. Registered nurses have strong opinions of quality indicators in clinical nursing but do not have the knowledge to support those opinions. Improving initial and recurring training on quality indicators provided to nursing staff with diverse backgrounds and high turnover was recommended as an essential component in using quality indicators to drive improvements in patient care. / AFRIKAANSE OPSOMMING: Die kwaliteit verpleegsorg wat verpleegkundiges op ‘n daaglikse basis aan kliente bied gaan gepaard met die verwagting dat hulle oor die kennis en bevoegtheid moet beskik om kwaliteit verpleegsorg aan te wend wat ‘n langdurige positiewe uitkoms met verwysing na pasientsorg kan bied. Die kwaliteits aanwyser statistieke in die tersiere gesondheidsorg sisteem verskil maandeliks en het die navorser geinspireer om ‘n studie te doen om te bepaal of geregistreerde verpleegkundiges verstaan wat die belangrikheid van kwaliteits aanwysers is en of hulle die kennis het oor die gebruik daarvan, in watter opsigte dit gebruik kan word en wat die voordele inhou wanneer kennis en applikasie daarvan vir kliniese verpleging toegepas word. Literatuur met betrekking tot vorige studies omtrent kennis en opinies van geregistreerde verpleegkundiges tot kwaliteits aanwysers in kliniese verpleeging kon nie deur die navorser gevind word wat gebruik kon word as agtergrond of ondersteuning tot die studie nie. Die fokus van die navorsings studie was om geregistreerde verpleegkundiges se kennis en opinies te bepaal met betrekking tot kwaliteits aanwysers in kliniese verpleging in die tersiere gesondheidsorg sisteem in Saudi Arabie. Die doelwitte van die studie was om: - Die huidige kennis en opinies van geregistreerde verpleegkundiges met betrekking tot kwaliteits aanwysers in die tersiere gesondheidsorg sisteem in Saudi Arabie te bepaal - Om faktore wat ‘n invloed op identifikasie van kwaliteits aanwysers het te identifiseer - Om die nodigheid van ‘n opleidings program met betrekking tot kwaliteits aanwysers te bepaal Die data van die studie was ingesamel deur middel van ‘n vraelys wat aan die geregistreerde verpleegkundiges meesal werksaam is in algemene sale of intensiewe sorgeenhede. Deelnemers was gekies deur middel van ‘n alternatiewe lys. Die deelnemers aan die loots studie was ge-ellimineer van die finale data analise. Geen pasiente was betrokke by die studie nie. ‘n Beskrywende ontwerp met ‘n kwantitatiewe benadering was toegepas om geregistreerde verpleegkundiges se kennis en opinies omtrent kwaliteits aanwysers in kliniese verpleging in die tersiere gesondheidsorg sisteem in Saudi Arabie te toets. Die navorsing het bewys dat die kennis en opinies van geregistreerde verpleegkundiges in die tersiere gesondheidsorg sisteem in Saudi Arabie nie op ‘n aanvaarbare standard kan geklassifiseer word nie asook nie die nodige kwaliteits versekering in kliniese verpleging ondersteun nie. Die studie bewys dat geregistreerde verpleegkundiges beskik oor genoegsame opinies omtrent kwaliteitaanwysers maar nie noodwendig oor die kennis om hulle opinies daaroor te ondersteun nie. Die studie is ook uitkoms gebaseerd omtrent die nodigheid van ‘n opleidings program met betrekking tot kwaliteits versekering in kliniese verpleegkunde te implimenteer, insluitend die vakgebied van kwaliteits aanwysers in kliniese verpleeging.

This diploma thesis is focused on self-evaluation of knowledge of nurses in intensive care and rescue workers' working at ICU and AIC in area of monitoring and interpretation of ECG. The aim of this diploma thesis was to map how nurse in intensive care and rescue workers evaluate themselves in issue of ECG, at what level are their knowledge and abilities to be able to discribe what strategies were contributive for gaining knowledge and what motivation did they have and what barriers they had to face. Quantitative research took place by means of anonymous questionnaire survey. In total, there were 120 respondents from population of nurses in intensive care and rescue workers working at ICU and AIC. As emerged from the questionnaire survey, nurses in intensive care and rescue workers who were included in this survey, evaluate their ECG knowledge on average. Those who passed certificated course of ECG evaluate themselves above average. Respondets said that they must be able to evaluate ECG curvve in their job and it belongs to their competence. It is evident from survey, that they do not have or they do not know they have nursing standart for ECG, and if they have then they get and evaluate acoording to this standart. The most common source of knowledge and abilities in ECG area they gained when...

<p>Everyday thousands of nurses are rendering bedside nursing care in health care settings as a result they are exposed to blood, body fluids and sharp objects that are contaminated with Hepatitis B, Hepatitis C and HIV. Therefore they are at risk of getting infected. In 1996, standard precautions were implemented by the Centre of Disease Control to reduce the risk of transmission of micro-organisms from any source of infection in the hospital. In the year 2008, the three tertiary hospitals together in the Western Cape reported that they had 733 needle prick injuries. Therefore the aim of the study was to determine if nurses comply with and have adequate knowledge of standard precautions. A non-experimental design and a self administered questionnaire were used to collect the data for the study. The study was done at Tygerberg Hospital and the participants (n=143) that were involved in the study were all nursing categories (professional, enrolled nurse and auxiliary nurse). Stratified random sampling was used to ensure that there was a representation of all the nurses working in the different modules at Tygerberg Hospital. Therefore three wards were randomly selected from each module and all the nurses on duty working in the three selected wards were given a questionnaire by the Assistant Director of the specific module. After the data was collected it was analysed through the statistical package for social sciences. The findings of the study showed that nurses have inadequate knowledge regarding standard precautions and the mean score of the nurses overall self reported compliance of standard precautions was 87.5%. The results also showed that when patients are HIV positive nurses intend to over comply the use of personal protective equipment. No association was found between the nurses&rsquo / knowledge and compliance regarding standard precautions. It is therefore important that every nurse should be educated about the basic principles of standard precautions and also the policies and protocols of infection control in order to prevent each nurse from getting infected. Training needs to be implemented starting in the wards through the unit manager to improve all the nurses&rsquo / knowledge and practice.</p>

<p>Everyday thousands of nurses are rendering bedside nursing care in health care settings as a result they are exposed to blood, body fluids and sharp objects that are contaminated with Hepatitis B, Hepatitis C and HIV. Therefore they are at risk of getting infected. In 1996, standard precautions were implemented by the Centre of Disease Control to reduce the risk of transmission of micro-organisms from any source of infection in the hospital. In the year 2008, the three tertiary hospitals together in the Western Cape reported that they had 733 needle prick injuries. Therefore the aim of the study was to determine if nurses comply with and have adequate knowledge of standard precautions. A non-experimental design and a self administered questionnaire were used to collect the data for the study. The study was done at Tygerberg Hospital and the participants (n=143) that were involved in the study were all nursing categories (professional, enrolled nurse and auxiliary nurse). Stratified random sampling was used to ensure that there was a representation of all the nurses working in the different modules at Tygerberg Hospital. Therefore three wards were randomly selected from each module and all the nurses on duty working in the three selected wards were given a questionnaire by the Assistant Director of the specific module. After the data was collected it was analysed through the statistical package for social sciences. The findings of the study showed that nurses have inadequate knowledge regarding standard precautions and the mean score of the nurses overall self reported compliance of standard precautions was 87.5%. The results also showed that when patients are HIV positive nurses intend to over comply the use of personal protective equipment. No association was found between the nurses&rsquo / knowledge and compliance regarding standard precautions. It is therefore important that every nurse should be educated about the basic principles of standard precautions and also the policies and protocols of infection control in order to prevent each nurse from getting infected. Training needs to be implemented starting in the wards through the unit manager to improve all the nurses&rsquo / knowledge and practice.</p>