The challenge to transfer the health care of Aboriginal peoples of Canada from non-Aboriginal to predominantly Aboriginal health professionals, requires preliminary innovative approaches in ...post-secondary education. Described in this paper, is the background, development and progress to date of the Integrated Nursing Access Program (INAP) for Aboriginal students, and its phenomenological approach to curriculum design. Traditional indigenous knowledge and methodologies are embedded in process learning and university-level program activities. Learning in this INAP Bachelor of Nursing program occurs over three years, during which time students complete high school requirements together with some first year nursing courses. The program is followed by three additional years of exclusive baccalaureate level nursing education. To date, students have successfully completed the first half of this program.
Objectives: The purpose of this study is to identify the differences between the integrated nursing care service and non integrated nursing care service through electronic nursing documentation. ...Methods: We retrospectively reviewed the electronic nursing documentation of 102 patients who were admitted to G general hospital for analyzing the frequency of nursing statements between the month of January 2016 and the month of January 2017 using random sampling. The data were analyzed using percentage, mean, standard deviation, chi-square test and independent t-test with the SPSS Win 20.0 Program. Results: The frequency of use for the nursing statements was investigated: there was a significant difference in nursing record on pain assessment (p<0.001), nurse rounding, fall prevention (p=0.001), rounding for voiding, oral medication counseling, skin assessment, oral care, cold pack apply, bath, shampoo, face wash and teeth brushing, meal assistance, hot pack apply and tube feeding (p<0.001) between the integrated nursing care service and non integrated nursing care service. There was no significant difference in the frequency of nursing diagnosis. Conclusions: Results confirm that the nurse`s job had changed in the integrated nursing care service for example the direct patient care related in daily living assistance. Based on these results, the additional efforts to increase the records of patient education, counseling and emotional assessment are needed in order to improving the effective integrated nursing care service through job analysis.
Using a mixed method approach, the workload activity of health visitors, practice nurses and district nurses was measured through time diaries; and teamwork was measured using the Primary Care ...Teamwork Questionnaire, in conjunction with semi-structured interviews exploring the views of key stakeholders and the nurses themselves. The main themes arising are implementation of change, shifting role boundaries, communication and teamwork. Findings indicate that this type of organisational change is concerned predominantly with structure, professional and organisation issues, rather than patient care. In the teams studied, the opportunity of integration led to a pragmatic coalition that encouraged its members to plan, execute and manage change by themselves, according to a vague definition rather than a patient focused agenda. (Original abstract - amended)
An integrated adolescent curriculum on health and development (ADH) was implemented in a pre-service nursing programme in a university.
This study examined the efficacy of an ADH curricular framework ...in improving the competency variables of student nurses in delivering ADH services.
The design of the study was quasi-experimental with the systematically designed ADH training curriculum as an intervention. Pre- and post-tests incorporating an experimental group and a control group for a sample of 101 student nurses were used.
Reports from 50 student nurses in the experimental group indicated that there was a significant increase from the pre-test to the post-test phase in the total score for the variables in the ADH Competency Checklist (
Z
=
−
5.71,
p
<
0.001) and its four subscales: the professional development subscale (
Z
=
−
5.37,
p
<
0.001), the psychosocial and physical well-being subscale (
Z
=
−
5.66,
p
<
0.001), the health behaviours and lifestyles subscale (
Z
=
−
5.07,
p
<
0.001), and the identity and reproductive health subscale (
Z
=
−
4.86,
p
<
0.001). Significant changes were detected in the ADH competency variables for the control group in the post-test phase.
The findings reveal that the systematic integration of ADH in the nursing curriculum had the positive impact of increasing the competency of student nurses for the examined variables.
The Health Service Reform Programme in Ireland will be the biggest change ever seen in the health service. This programme will be dependent on information structures that provide appropriate and ...timely information. The Nursing Informatics Project Team in the Mater Misericordiae University Hospital, Dublin is in the process of implementing an Integrated Nursing Information System, which will facilitate participation in the new reforms.
Changing structures and organisations in primary care raise questions about the role and fit of traditional nursing disciplines. This paper discusses recent findings from an evaluation of integrated ...nursing teams. The study design used a mixed method approach measuring workload activity of health visitors, practice nurses and district nurses, through time diaries; and teamwork using the Primary Care Teamwork Questionnaire, in conjunction with semi-structured interviews exploring the views of key stakeholders and the nurses themselves. The main themes arising from the interviews are discussed, taking account of the findings from the assessment of workload and teamwork questionnaire. The key themes addressed are implementation of change, shifting role boundaries, communication and teamwork. The findings indicate that this type of organisational change is concerned predominately with structure, professional and organisational issues rather than patient care. In the teams studied the opportunity of integration led to a pragmatic coalition that encouraged its members to plan, execute and manage change by themselves, according to a vague definition rather than a patient focused agenda. In order to ensure a quality nursing service and avoid old historical rivalries this needs to be addressed as nursing teams are reconfigured in primary care groups.
This paper examines the community nursing contribution to primary care by reporting on a qualitative evaluation study of the introduction of integrated nursing teams by an NHS community trust in one ...location in the United Kingdom. A pluralistic evaluation approach ( Smith & Cantley 1985) was used to identify the various criteria by which the different stakeholders involved in the initiative judged the integrated nursing teams to be successful. Six teams at various stages of development were included in the study, together with other groups who had a vested interest in the performance of the teams. Data were collected by means of in‐depth individual interviews with team coordinators, team facilitators, senior trust managers, GPs and practice managers; and focus group interviews with team members. The criteria for success identified by the various stakeholders provided a framework through which the overall success of the initiative was judged. Five meanings of success were identified, namely: team working; effective communication; an orientation towards the general practice; changes in working practices; and responsiveness to change. Key findings relating to each of the criteria are presented and consideration given to the implications arising for the development of Primary Care Groups (PCGs). The paper concludes that, paradoxically, by stepping aside from the traditional hierarchy inherent in the primary health care team (PHCT), integrated nursing teams may provide community nurses with the opportunity to make a more active contribution to the future development of primary care.
The "Health Management Plan"(HMP) for caring diabetic patient was begun by the National Health Insurance (NHI) in Taiwan in order to maximize the effectiveness of limited medical resources. This ...study describes the clinical experience of the nurse-directed diabetic HMP program and analyzes factors associated with the outcome. One hundred and thirty-six patients, all of whom had participated in the diabetic HMP program at least 5 times, were enrolled in the study. The effect of the HMP was evaluated by comparing hemoglobin A1C status before and after %) maintained their hemoglobin A1C status over the course of HMP participation. Diabetic patients with regular exercise habits showed a 2.8-fold increased chance of outcome improvement compared with those who did not exercise regularly. The chance of outcome improvement in patients with complications was found to be one-third that of patients who had no complications (Odds ratio: 0.3, 95% CI: 0.1-1.0). This study found that specially trained nurses, following agreed upon protocols and algorithms and collaborating with medical team members, can effectively concentrate on providing comprehensive and effective diabetes care.
Im nachfolgenden Beitrag wird eines der international derzeit viel diskutierten Managementkonzepte -- das in Großbritannien favorisierte care management -- aufgegriffen und in seiner Bedeutung für ...die Optimierung der bundesdeutschen ambulanten Pflege diskutiert. Nach einer skizzenartigen Darlegung wesentlicher Konzeptelemente werden vier zentrale sich in der ambulanten Versorgung und Pflege stellende Aufgabenkomplexe für care management erörtert: Herstellung einer bedarfs- und bedürfnisgerechten Pflege, Sicherung von Versorgungsintegration und -kontinuität speziell bei chronischer Krankheit, Unterstützung pflegender Angehöriger, Gesundheitsförderung als Aufgabe der Pflege. Gezeigt wird dabei, daß care management ein Instrument ist, um die bestehenden Versorgungsdefizite in der ambulanten Pflege aufzugreifen und innovativen Lösungen zuführen zu können und damit die derzeit international mit großer Verspätung begonnene Professionalisierung der bundesdeutschen Pflege zu befördern. The following article treats one of the management concepts now undergoing extensive international debate -- the care management favored in Great Britain -- and discusses its importance in respect to the optimization of outpatient care in the Federal Republic of Germany. After a presentation of the key elements comprising the concept, four central task complexes relating to care management are discussed: establishing demand- and need-oriented nursing, assuring the integration and continuity of care, especially when chronic diseases are involved, helping family members to provide nursing care and promoting health as one of the nursing profession's tasks. It is shown that care management is a tool that can be used to tackle deficits in outpatient nursing care and find innovative solutions to them, thereby promoting the nascent professionalization of nursing in Germany, a trend that is long overdue in international terms.PUBLICATION ABSTRACT
This paper describes the introduction of an "Integrated Nursing Study" course in Oita University of Nursing and Health Sciences. This course aims at integrating organically basic education and ...technical education of nursing. It is also intended that the skills required for nursing practice will be improved. The goal of this subject is to master the nursing skills necessary to provide appropriate assessment and proper nursing care, according to more theoretical, technical and practical knowledge, in the ordinary situations of medical and public health services, which nurses are likely to encounter. The course is set in the second semester of the senior-year curriculum. This period seems the most effective for fourth year students to take the course because they can make integrated judgments about nursing care after studying for over three years at the university. It is also expected that the nursing students can concentrate on the subject autonomously before the busy period of obtaining employment and of preparation for the national examination for a nursing license. The course is conducted in group work. Practices and roll-playing activities are made based on case studies of medical/nursing services. It is assumed that the course takers have had pseudo-clinical experiences by performing the highly specialized tasks which are close to real situations in medical/nursing places. It is also believed that the students have not only acquired knowledge of practical cases of medical/nursing services, but also realized the importance of the nursing attitudes required to pursue things profoundly on the basis of clinical evidence.