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Advanced Practice Nurses' Knowledge of Sexually Transmitted Infection and Established Counseling GuidelinesJackson, Naundria Jarlego, Jackson, Naundria Jarlego January 2016 (has links)
Background: Sexually transmitted infection (STI) rates represent a significant health disparity among young adult African American women. A major factor contributing to this issue is inconsistent condom use. This is especially a challenge for the state of Georgia, which has a high incidence of STI among the southern states. STI prevention counseling delivery through primary care providers is the primary recommendation from the Centers for Disease Control and Prevention and U.S. Preventive Services Taskforce. However, knowledge, attitudes, and practices of STI prevention counseling by advanced practice registered nurses (APRN) who care for young adult African American women are unknown in Georgia.Purpose: This doctor of nursing practice project investigated knowledge, attitudes, and practices of STI prevention by Georgia APRNs caring for young adult African American women on an outpatient basis and determined congruency of their counseling with primary prevention guide-lines. Methods: The design was descriptive cross-sectional. An online survey using Qualtrics software was distributed via professional listservs and postal mail to eligible Georgia APRNs currently in practice. Participants' knowledge of STI, STI prevention, and current practice guidelines and recommendations were assessed using knowledge questionnaires including true/false and multiple choice questions. Participants' attitudes regarding STI prevention counseling with young African American women and current APRN behaviors, in relation to current practice guidelines, were measured using Likert-type scales. Outcomes: The final sample size included 22 participants. Forty initiated the survey, ten did not meet eligibility criteria, six ended the survey during eligibility screening, and two ended the survey after completing less than seven percent of it. In general, participants were knowledgeable of STI and the majority of participants were knowledgeable of the CDC and USPSTF guidelines. The majority of participants felt comfortable discussing sexual practices with patients and providing feedback and advice on reducing STI risk behavior. However, the majority of participants did not believe that their current practice setting actively supported their delivery of STI prevention counseling. Overall, participants' practices were more congruent with the CDC guidelines compared to the USPSTF guidelines. This was reflected in knowledge and practice behaviors, specifically assessing for STI, providing feedback on risk behavior, and advising on behavior change with STI-infected patients and those at risk for STI. Fewer chose the USPSTF as their established practice guideline. This was revealed in practice behaviors pertaining to 'high-risk' counseling, as few tended to set goals for STI risk behavior change, document behavior goals, refer to STI resources, or follow up with referrals made to other STI risk reduction programs. Practice implications: Although overall APRN knowledge of STI was high, there were some knowledge deficits relating to appropriate barrier methods for viral-based STI and high-risk sexual behaviors associated with HBV. There was also a lack of knowledge and practice behaviors of the USPSTF STI prevention counseling guidelines. Therefore, future studies and interventions should aim to educate APRNs about these knowledge and practice insufficiencies.
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Lärande av praktiska färdigheter inom sjuksköterskeprofessionen : studier av lärande i olika arenorEwertsson, Mona January 2017 (has links)
A central part of the nursing profession is the performance of practical skills. In order to provide adequate care, maintain patient-safety, and feel comfortable in the profession, registered nurses (RNs) need to be equipped with requisite skills. Overall aim: To explore and describe how learning and development of practical skills occurs during the preparatory phases and within the nursing profession. Method: Qualitative (I, III, IV) and quantitative methods (II) were used. Data were collected through individual interviews (I, IV), questionnaires (II) and participant observations, including informal talks (III, IV). Results: Both students and new RNs expressed a need to learn and develop practical skills (I, II, III, IV). Less than half of the new RNs had access to a clinical skill laboratory (CSL), where they could learn and practice practical skills (II). The students described that learning at a CSL had been meaning for their clinical practice. They also expressed a great need for continuing learning in real patient situations (I, III, IV). During clinical practice, preceptors and students took different approaches which affected student’s learning processesö (I, III, IV). There was a tension between learning at a CSL and learning in clinical practice sites because students perceived differences in the performance of skills. Students described that they understood that performance of skills could be done in different ways without injuring patients. However, the data also showed deviations in performances that could jeopardize patientsafety. In these situations, student’s behavior differed (I, IV). One third of new RNs deviated from evidence based guidelines when they performed practical skills which they were unfamiliar with (II). Both students and new RNs reported that reflection in connection with the performance of practical skills was not common (I, II III, IV). Conclusions: Cooperation between university CSLs and clinical settings must be intensified in order to enhance the understanding of learning processes regarding practical skills. A consensus regarding academic approaches should be reached. Universities need to support preceptors in educational issues where the importance of reflection is clarified and exemplified. Increasing patient-safety requires that new RNs receive opportunities for training in artificial environments, and that a culture that reinforces the use of guidelines and a reflective stance is cultivated.
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Research Productivity of Doctorally Prepared NursesFarren, Elizabeth Anne 08 1900 (has links)
The purpose of this study is to determine the possible relationship between post-doctoral research productivity of doctorally prepared nurses and instructional experiences of doctoral study, conditions of employment and other factors that may be related to research productivity. The design of the study is causal comparative.
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Telephone Nursing : Stakeholder views and understandings from a paediatric and a gender perspective / Omvårdnad per telefon : Intressenters syn och förståelsefrån ett pediatrik- och ett genusperspektivKaminsky, Elenor January 2013 (has links)
‘First line healthcare’ is offered via telephone in many Western countries. The overall aim of this thesis is to describe Telephone Nursing (TN) from three viewpoints: telenurses, parents calling for their children, and operation managers. Four empirical studies were conducted. Telenurses described their work in five different ways: ‘Assess, refer and give advice to the caller’, ‘Support the caller’, ‘Strengthen the caller’, ‘Teach the caller’ and ‘Facilitate the caller’s learning’, which all constitute a TN ‘work map’. Authentic paediatric calls between parents and telenurses revealed that 73% of callers were mothers and children were aged between 5 days and 14.5 years. The top three contact reasons were ear and skin problems, and fever, with a median call length of 4.4 minutes. More than half of the calls resulted in referrals and 48% received self-care advice. The likelihood of fathers being given referrals as a result of their call was almost twice as high as that for mothers, while mothers were almost twice as likely to receive self-care advice as fathers. Parents described their degree of worry and trust that influenced their decisions whether to contact SHD or not. Their calls were carefully prepared, and the parent calling often depended on family routine. Parents reported to follow recommendations. Most relied upon their own intuition if further worried, but some indicated they would never seek healthcare unless it was recommended. Operation managers described four main goals of TN work: ‘create feelings of trust’, ‘achieve patient safety’, ‘assess, refer and give advice’, and ‘teach the caller’. Equitable healthcare was regarded as important, whereas health promotion was not considered as part of the goals. Conclusion: The studied TN viewpoints present concordance and discrepancies. Paediatric health calls appear mostly to be a woman-to-woman activity. Telenurses’ increased gender competence might increase TN safety. For that matter, telenurses’ collaboration with parents and making parents aware of holding the ultimate responsibility for their child’s condition is important. Goals of TN work and their relationship with healthcare obligations such as equitable healthcare and health promotion need further clarification. The viewpoints described in this thesis may contribute to the development of TN.
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Improving Retention Strategies for Experienced NursesHollis, Kimberly M. 01 January 2019 (has links)
Experienced nurses depart the workforce in significant numbers; therefore, it is critical to understand how those departures affect patient care and safety. The focus of this systematic review included appraisal of recent research to provide an understanding of strategies used in acute care settings to retain experienced nurses. Guided by Benner's model of skill acquisition, the purpose of this systematic review was to identify factors that influence the decision of nurses with experience to leave or remain working in acute care work settings. The 19 articles selected for this review were limited to those pertaining to experienced registered nurses who have worked in the acute care setting for 2 years and longer. The review excluded articles pertaining to registered nurses with fewer than 2 years of experience, who were considered at the novice or proficient level of nursing. The results of this literature review showed that management conflicts, lack of support, work environments, work schedules, and disproportionate staffing levels were among the factors leading to morale distress and burnout in experienced nurses. These findings have the potential to contribute to positive social change by guiding administrative efforts to retain experienced nurses and improve mentoring of newer nurses and, ultimately, improve patient outcomes.
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The extent to which registered nurses in the ACT state that they use physical assessment skills as a basis for nursing practiceJames, Jennifer Ann, n/a January 1988 (has links)
The purpose of this research was to discover the extent
to which practising registered nurses in the ACT
undertake physical assessment. It was also organized to
discover the perceived reasons why, in appropriate
instances, it was not undertaken and the extent to which
certain variables may have influenced its practice or
non-practice. It was directed also at discovering the
extent to which the practising registered nurse would be
prepared to undertake workshops on the subject, so that,
if appropriate, a core of registered nurses could be
provided to act as the role-models and to create the
necessary learning environment in the ACT hospitals and
agencies where most of the Canberra College's graduates
would find employment.
Since the first undergraduate course in nursing was
introduced in the tertiary sector, nurse academics have
placed significant emphasis on the teaching of the
nursing process. It is within the first phase of this
process, the assessment phase, that the physical
assessment of the patient/client is conducted.
Discussions with practising registered nurses and
observations, led to some uncertainty as to the extent
to which physical assessment was actually being used. A
review of the literature showed that no investigation of
the matter had been reported in the Australian
literature. It was, therefore, proposed to make good
this deficiency and to resolve any uncertainty about the
extent of use of physical assessment in the ACT.
This study was restricted to registered nurses in the
ACT where all beginning nurses are educated at the CCAE
with a curriculum which includes a comprehensive study
of physical assessment. Even so, it is recognized that
such studies will only reach a beginning level of
competency. In order to ensure that the graduates of
these courses extend their competency in physical
assessment they need to be able to use these skills in
every day nursing practice.
This research, therefore, was conducted using a
questionnaire which incorporated questions about the use
of 36 physical assessment skills. The survey, on a onetime
participation basis, was conducted for all
registered nurses rostered on a fortnightly period in
April 1987. A 66.7% response rate was achieved.
The responses were analyzed and the findings, results
and recommendations are included in the appropriate
sections of this thesis.
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Sjuksköterskors strategier för att hantera arbetsrelaterad stress : En litteraturstudie / Strategies used by registered nurses to manage work related stress : A literature studyLindberg, Ragnhild, Ölvebo, Mikaela January 2015 (has links)
Bakgrund: Yrkesrelaterad stress har ökat markant under de senaste tio åren. Vårdyrken anses vara bland de arbeten som är mest tyngda av stress. Långvarig stress kan ge individen fysiska såväl som psykiska problem och kan leda till utbrändhet. För att kunna fastställa en god och säker vård krävs stressförebyggande åtgärder, eftersom kraven på sjuksköterskor höjs allt mer. Syfte: Syftet med litteraturstudien var att beskriva sjuksköterskors strategier för att hantera arbetsrelaterad stress. Metod: Litteraturstudie inkluderande nio kvalitativa studier varav en studie som även bestod av kvantitativa resultat, men endast de kvalitativa resultaten behandlades i denna litteraturstudie. Artiklarna analyserades med inspiration av kvalitativ innehållsanalys. Resultat: Två huvudkategorier identifierades; ”Stressreducering på arbetsplatsen” och ”Stressreducering utanför arbetet”. Den första huvudkategorin utgjordes av underkategorierna ”Kollegialt stöd”, ”Prioriteringar”, ”Att påverka sin egen arbetstid”, ”Att distansera sig”, ”Att stärka sig själv” samt ”Tro och andlighet”. Den andra huvudkategorin bestod av underkategorierna ”Att lämna arbetat bakom sig”, ”Fritidsaktiviteter”, ”Sömn” samt ”Tobak och alkohol”. Slutsats: Sjuksköterskor kan ta till flertalet strategier för att reducera stress kortsiktigt. Däremot krävs organisatoriska förändringar på högre nivå för att på lång sikt reducera arbetsstressen hos sjuksköterskor. / Background: Work related stress has increased greatly during the past decade. Healthcare workers are considered having among the most stressful working conditions. Long term stress may cause physical as well as psychological harm on the individual, which may lead to burnout. In order to be able to secure a good and safe healthcare for the patients, it is essential to find long term stress reducing solutions. This is especially important in today’s healthcare, since the demands on the registered nurse are getting even higher. Aim: The aim of this literature study is to describe the strategies used by registered nurses for manage work related stress. Methods: This literature study included nine qualitative articles, of which one also consisted of quantitative results. However, only qualitative results were included in this literature study. All nine articles were analysed with inspiration from qualitative content analysis. Results: Two main categories were identified; ”Stress Reduction at the Workplace” and ”Stress Reduction Outside of the Workplace”. The main category first mentioned consisted of the subcategories “Collegial Support”, “Priorities”, “Influencing One’s Own Working Hours”, “To Distance Oneself”, “To Strengthen Oneself” as well as “Belief and Spirituality”. The second main category consisted of the subcategories “To Leave Work Behind”, “Spare Time Activities”, “Sleep” and also “Tobacco and Alcohol”. Conclusion: Registered nurses may use several strategies in order to reduce stress momentarily. However, organisational changes on a higher level are needed to reduce work related stress in the long term among registered nurses.
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The knowledge that critical care nurses have of evidence-based practice in their practiceMiller, Des Franco Abiattor 29 January 2014 (has links)
The purpose of this study was to explore and describe the knowledge that a cohort of
40 intensive care unit nurses had of evidence-based practice. It was assumed that they
lacked the knowledge to locate, evaluate understand and apply research findings.
Quantitative, non-experimental descriptive research was conducted to explore their
knowledge and to formulate recommendations for promoting it. Data collection involved
administering a structured questionnaire administered to the cohort in an intensive care
unit. The findings revealed that, although they were familiar with the basic concept of
evidence-based practice, they were reluctant and lacked the skills to adopt it in their
practice. It is recommended that they be trained and empowered to develop research
expertise from within their own ranks. Finally it is recommended that nursing
management should play a more proactive role in identifying cost-effective strategies in
overcoming barriers to finding, promoting and integrating evidence-based practice / Health Studies / M.A. (Health Studies)
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Challenges identified by experienced IMCI-1-trained registered nurses in implementing the integrated management of childhood illnesses (IMCI) strategy in Gaborone, BotswanaMupara, Lucia Mungapeyi 12 February 2014 (has links)
The study was a descriptive quantitative survey which endeavoured to identify
challenges experienced by IMCI trained registered nurses in implementing the
guidelines and procedures of the strategy when tending children under 5 years in
Gaborone health district. The study also solicited for recommendations on how to
address the identified challenges. The research population comprised of all the IMCI-1
trained registered nurses and systematic sampling was employed to randomly select
study participants. Data were collected using a questionnaire and was analysed using
Excel Advanced software package. Study findings identified challenges related to
political support, cost of IMCI training, training coverage, health systems and features of
the IMCI strategy. Recommendations for improving use of the strategy included
garnering for more political support, adopting short duration training courses, scaling up
both pre-service and in-service training as well as addressing the challenges related to
health systems and the unique features of the strategy / Health Studies / M.A. (Public Health)
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Registered nurse-led emergency department triage : organisation, allocation of acuity ratings and triage decision makingGöransson, Katarina January 2006 (has links)
Successful triage is the basis for sound emergency department (ED) care, whereas unsuccessful triage could result in adverse outcomes. ED triage is a rather unexplored area in the Swedish health care system. This thesis contributes to our understanding of this complex nursing task. The main focus of this study has been on the organisation, performance, and decision making in Swedish ED triage. Specific aims were to describe the Swedish ED triage context, describe and compare registered nurses’ (RNs) allocation of acuity ratings, use of thinking strategies and the way they structure the ED triage process. In this descriptive, comparative, and correlative research project quantitative and qualitative data were collected using telephone interviews, patient scenarios and think aloud method. Both convenience and purposeful sampling were used when identifying the participating 69 nurse managers and 423 RNs from various types of hospital-based EDs throughout the country. The results showed national variation, both in the way triage was organised and in the way it was conducted. From an organisational perspective, the variation emerged in several areas: the use of various triageurs, designated triage nurses, and triage scales. Variation was also noted in the accuracy and concordance of allocated acuity ratings. Statistical methods provided limited explanations for these variations, suggesting that RNs’ clinical experience might have some affect on the RNs’ triage accuracy. The project identified several thinking strategies used by the RNs, indicating that the RNs, amongst other things, searched for additional information, generated hypotheses about the fictitious patients and provided explanations for the interventions chosen. The RNs formed relationships between their interventions and the fictitious patients’ symptoms. The RNs structured the triage process in several ways, beginning the process by searching for information, generating hypotheses, or allocating acuity ratings. Comparison of RNs’ use of thinking strategies and the structure of the triage process based on triage accuracy revealed only slight differences. The findings in this dissertation indicate that the way a patient is triaged, and by whom, depends upon the particular organisation of the ED. Moreover, the large variation in RNs triage accuracy and the inter-rater agreement and concordance of the allocated acuity ratings suggest that the acuity rating allocated to a patient may vary considerably, depending on who does the allocation. That neither clinical experience nor the RNs’ decision-making processes alone can explain the variations in the RNs triage accuracy indicates that accuracy might be influenced by individual and contextual factors. Future studies investigating triage accuracy are recommended to be carried out in natural settings. In conclusion, Swedish ED triage is permeated by diversity, both in its organisation and in its performance. The reasons for these variations are not well understood.
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