Little is currently understood about the nature of nurses' knowledge in the context of wound management or the impact of limitations in evidence and education on clinical and educational outcomes.
...Aim
The purpose of this study was to gain a rich and detailed understanding of the origins and nature of knowledge in generalist and specialist nurses with a key role in the delivery of wound management.
Design
A qualitative reflexive thematic analysis was carried out on data gathered.
Method
Semi‐structured interviews with five wound management specialists and five wound management generalist nurses were carried out between July 2019 and May 2020. Chinn and Kramer's patterns of knowing (2015) was applied as a conceptual framework from which to explore nursing knowledge in the context of wound management.
Results
Seven main themes and 16 subthemes were generated: the bigger picture; the smaller picture; it all comes together at the bedside; show me the evidence; industry: a political football; do good not harm; the power isn't ours; and I'm not that creative…but.
Conclusion
The knowledge that nurses apply in wound management is multidimensional, contextual, and highly integrated; with components that are unique from nursing knowledge in the wider sense. Although the patterns of knowing in wound management are well integrated, they are not equally represented and the types of knowledge that nurses demonstrate is not consistently aligned with those that they value.
Impact
Significant distinctions were not found between wound management specialist and generalists, however specific traits were identified in the knowledge development of those working in a community role and industry represents a unique influencing factor in the context of wound management knowledge formation.
Nurse managers have a pivotal role in fostering unit climates supportive of implementing evidence-based practices (EBPs) in care delivery. EBP leadership behaviors and competencies of nurse managers ...and their impact on practice climates are widely overlooked in implementation science. The purpose of this study was to examine the contributions of nurse manager EBP leadership behaviors and nurse manager EBP competencies in explaining unit climates for EBP implementation in adult medical-surgical units.
A multi-site, multi-unit cross-sectional research design was used to recruit the sample of 24 nurse managers and 553 randomly selected staff nurses from 24 adult medical-surgical units from 7 acute care hospitals in the Northeast and Midwestern USA. Staff nurse perceptions of nurse manager EBP leadership behaviors and unit climates for EBP implementation were measured using the Implementation Leadership Scale and Implementation Climate Scale, respectively. EBP competencies of nurse managers were measured using the Nurse Manager EBP Competency Scale. Participants were emailed a link to an electronic questionnaire and asked to respond within 1 month. The contributions of nurse manager EBP leadership behaviors and competencies in explaining unit climates for EBP implementation were estimated using mixed-effects models controlling for nurse education and years of experience on current unit and accounting for the variability across hospitals and units. Significance level was set at α < .05.
Two hundred sixty-four staff nurses and 22 nurse managers were included in the final sample, representing 22 units in 7 hospitals. Nurse manager EBP leadership behaviors (p < .001) and EBP competency (p = .008) explained 52.4% of marginal variance in unit climate for EBP implementation. Leadership behaviors uniquely explained 45.2% variance. The variance accounted for by the random intercepts for hospitals and units (p < .001) and years of nursing experience in current unit (p < .05) were significant but level of nursing education was not.
Nurse managers are significantly related to unit climates for EBP implementation primarily through their leadership behaviors. Future implementation studies should consider the leadership of nurse managers in creating climates supportive of EBP implementation.
This is a time-tested, practical guide for nurses and other healthcare professionals who wish to transform their healthcare systems based on caring values and the promotion of intra- and ...inter-professional dialogue among stakeholders. It describes a theoretically grounded model created by nurses for transforming the culture of healthcare systems at all levels, and features tested strategies that facilitate accessibility, efficiency, effectiveness, and enhanced outcomes. At its most basic level, this model, the Dance of Caring Persons, expresses the fundamental beliefs and attitudes that each person in the healthcare system lives caring meaningfully in unique and valuable ways, and the contributions of each person to the whole of the enterprise have a significant place within it.
The book features successful examples of how various units of the healthcare system can apply specific strategies to their inter- and intra-professional work, and how to engage and sustain authentic dialogue among and between stakeholders. Chapters feature information from a great variety of health professionals that represent a broad range of participants in healthcare. Detailed information is presented in a variety of formats ranging from formal written responses to chapter contents to transcriptions of small group conversations relating to the topic at hand. The book reflects the interests of such major stakeholders as patients and families, nurses, physicians and other primary and adjunctive care providers, ancillary service providers, administrators and managers, and all other individuals involved in the many aspects of organisational models and delivery of health care and human resource functions and outcomes. Each chapter includes questions to consider and suggested resources to help with implementation of strategies. The text incorporates professional standards and essentials from the Joint Commission, ANCC, and AACN (DNP).
Gaps in research focusing on work related stress, burnout, job satisfaction and general health of nurses is evident within developing contexts like South Africa. This study identified the ...relationship between work related stress, burnout, job satisfaction and general health of nurses. A total of 1200 nurses from four hospitals were invited to participate in this cross-sectional study (75% response rate). Participants completed five questionnaires and multiple linear regression analysis was used to determine significant relationships between variables. Staff issues are best associated with burnout as well as job satisfaction. Burnout explained the highest amount of variance in mental health of nurses. These are known to compromise productivity and performance, as well as affect the quality of patient care. Issues, such as security risks in the workplace, affect job satisfaction and health of nurses. Although this is more salient to developing contexts it is important in developing strategies and intervention programs towards improving nurse and patient related outcomes.
Nursing Council chief executive Catherine Byrne says in the proposal document that the new competencies reflected the council's commitment to Te Tiriti о Waitangi and the role of nurses in improving ...health equity for Maori. Professional responsibility; management of nursing care; interpersonal relationships; interprofessional health care and quality improvement. The proposed new EN pou/domains are: * Те Tiriti о Waitangi * Cultural safety * Knowledge-informed practice * Professional accountability and responsibility * Partnership and collaboration Details for both can be found here: (https://www.nursingcouncil.org.nz/NCNZ/News-section/news-item/2023/12/Consultationon-competencies-for-Enrollecl-and-Registered-Nurses.aspx) NZNO members have expressed concern too many new competencies would add to their workload - already burdened by continuing competence requirements such as professional development and recognition programmes (PDRPs).
The purpose of this qualitative study was to explore registered nurses' lived experiences of peer-to-peer incivility in the workplace. An aim of this study was to understand the participants' ...experiences of peer-to-peer incivility in the workplace, its effect on patient safety and nursing job satisfaction and retention. Descriptive phenomenology was used to understand the nurse's lived experience who has encountered peer-to-peer incivility in the workplace. Semi-structured interviews were conducted with participants with audiotapes transcribed and analyzed for common themes that represented the participants' experiences with peer-to-peer incivility. Through the process of phenomenological reduction, the researcher suspended beliefs, biases, and preconceived notions about the investigational phenomenon. Based on the findings of this study, suggestions are offered for further research and required actions to elevate the work atmosphere of the nurse from uncivil to a healthy and professional workplace. There was no hierarchy of themes. All themes and subthemes were equally important. Two themes and five subthemes emerged from the participants' verbal descriptions. The participants revealed how their workplaces were highly competitive and that one had to fend for oneself in order to survive. Many of the participants verbalized that they did not feel supported by their peers. Participants chose words such as war, enemy, brutal and rival to describe their workplace. Experiences of competing and fighting with one another were shared and therefore, being in a war-zone, became apparent. Participants described how incivility in their workplace prevented them from being able to provide adequate care to their patients. Additionally, the participants revealed emotional, physical, and social consequences that directly or indirectly had an impact on them. Feelings of rejection, disrespect, not treated with dignity, and treated unjustly feeling demoralized and humiliated were common themes shared from the participants' experiences with peer-to-peer incivility in their workplace. The study findings have substantial implications for nursing education, nursing practice, nursing research, and nursing science. This investigation provides novel information about experiences with uncivil peers and relates the experience to being in a war-zone. Some participants shared their perceptions of the impact on safe patient care, retention of nurses, and medical costs. Finally, this study suggests what it is like to be a nurse who has experienced peer-to-peer incivility and how that experience has affected their decision to remain in their nursing position.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Oncology Nursing Practice At Brigham and Women's Hospital the newly licensed nurse (NLN) receives a 12-week orientation in the oncology service. To prepare for independent practice, orientees are ...matched with a preceptor for 10 weeks of dayshift and 2 weeks of night shift. Over the past few years, there has been an increased turnover of bedside nurses. The 2020 turnover rate for RNs increased by 2.8%. When filtered to NLNs within their first year of practice the 2020 turnover rate was 23.9% (Aull & Nobles, 2022). Units continue to regularly orient multiple NLNs, with the majority assigned to night shifts. The night shift workflow promotes development of crucial skills like time management and organization. The ability to orient with less interruptions can help NLNs build confidence in their nursing abilities. However, they must also navigate challenges, including disrupted sleep patterns, limited access to resources, and less experienced staff. Night shift NLNs need to adjust to a different routine and cluster care. Ongoing dialogue between preceptor and orientee is important to ensure a robust orientation. The preceptor will continue to evaluate the NLN's skill set and the bidirectional discussion can help build confidence and independence, as the NLN progresses towards independent practice.It is beneficial to personalize each orientation experience while still ensuring consistency in education. Everyone has a different learning style and receives information differently; this is something a preceptor can observe and discuss with the orientee. A concept to always reinforce is the ability to obtain information, assistance, and support from your institution and coworkers. There is often limited experience available on night shift, so it is not enough to rely on the charge nurse or coworkers to know the answer to everything. After completing the didactic education component, it is essential to have nurses practice their skills hands on. The concept of experiential learning engages nurses in experiences that allow them to practice and apply new knowledge while also receiving feedback in a controlled supportive environment (Ward, 2022). Sometimes there is fear of asking too many questions and feeling like a burden to other nurses, doctors, as well as support staff. Throughout orientation these nurses should feel supported and encouraged to feel confident in their assessments, successfully obtain information and ask questions as needed to not only help themselves but to better serve their patients.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
The OCN (Oncology Certified Nurse) certification is a nationally recognized standard of excellence and is also an emblem of advanced competency at this tional Institute-designated Comprehensive ...Cancer Center. This institution supports, encourages, and financially recognizes this achievement; they offer a formal two-day ONCC Curriculum Review. Many nurses have expressed concern that they are unable to commit to these full day reviews given the current staffing needs. In March 2022, less than 50 percent of nurses in the outpatient cancer center reported OCN certification and alternatives to improve this rate were investigated. The nurse driven Professional Practice Council (PPC), representing approximately 100 outpatient cancer center nurses, was charged with a goal of increasing the number of outpatient OCN nurses by 10 percent by June 2023. An online survey was conducted to gauge interest, identify barriers, and raise awareness. The most significant barrier identified was insufficient time to prepare for the exam, and a majority of survey participants expressed interest in a mentoring program. The PPC partnered with the Clinical Education Specialist to develop a mentoring opportunity by providing a series of short monthly review sessions titled "OCN Test Prep" in which a relevant oncology nursing topic is reviewed by the PPC members. The early morning, 45-minute program, offered both in person and online, includes practice test questions and pre and post test surveys. Presenters provide test taking tips and share personal experiences regarding the exam process. Nursing CEUs are awarded. OCN Test Prep sessions, starting May 2022, have had consistent participation of 10-15 nurses with demonstrated improved proficiency per post test questionnaire results. The mentors have enhanced their presentation skills. Prep session attendees have provided feedback that the review sessions are informative and inspiring. The group sessions have also fostered a sense of community, exemplified by the participants motivating each other to plan their testing dates. This institution celebrates OCN achievement each year in May, at which time the council measures the percent of outpatient nurses who have obtained OCN. This innovative PPC OCN Test Prep provides a less formal, concise format which facilitates participation, enhances test preparation, and motivates test registration. If the 10 percent increase in OCN attainment outcome is achieved, this effort would be sustained and could be scaled for other nurses employed by this Comprehensive Cancer Center.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Professional Development Nurse Residency programs offer newly graduated nurses an opportunity to become more familiar with the institution and what resources are available. Being able to share ...experiences and/or questions is vital to this nursing population. Aside, from having colleagues from all parts of the institution to exchange ideas/thoughts with, there are monthly experiences/programs to further assist in the development of the new nurse. Our institution started with a pilot nurse resident program (1997-2001) with good success based upon feedback. As of 2002 our institution officially began the Vizient/ AACN Nurse Residency Program™ for inpatient nurses. However, with care migrating from inpatient to outpatient it was determined that a nurse residency program should be available to anyone who starts their nursing career at an ambulatory site. While discussing and researching the possibility of implementing an ambulatory nurse resident program, it became evident that very few institutions have an ambulatory nurse resident program. The purpose was to develop an ambulatory nurse resident program in the oncology setting. Caring for an oncology patient can be very demanding, and a new graduate nurses' knowledge in relation to the patient population is minimal. In preparation of hiring our first new graduate nurse multiple discussions occurred with various stakeholders to determine what an adequate orientation would be. As oncology is specialized we determined orientation would be a combination of inpatient and outpatient. There was a strong consensus that having the nurse spend a month inpatient on our hematology/BMT unit would be of great benefit, especially in increasing comfort levels through patient interactions. Disease-specific didactic classes were developed, recorded, and uploaded to our virtual learning platform for ease of access 24/7. Each week of orientation, not including inpatient time, the nurse resident completes disease-specific classes. The following week the focus of patient care is on those with the disease just learnt. A specific preceptor was determined to ensure continuity of teaching style and learning. Weekly check-ins were arranged to discuss any challenges faced, and to answer any questions. Weekly check-ins proved beneficial to the nurse and to leadership. During one check-in it was determined that a pause in new education needs to occur for increased synthesis between content and care. Constructive feedback from our nurse resident, preceptor, and the inpatient preceptor will assist in determining how our next nurse resident receives orientation.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
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