Dissertations / Theses on the topic 'Approaches to nursing'
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Hurst, Keith. "Approaches to problem solving in nursing practice." Thesis, Sheffield Hallam University, 1990. http://shura.shu.ac.uk/20727/.
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One of the requirements for high quality individualised nursing care is that nurses must recognise and attempt to solve patients' health problems. It is generally agreed that this needs a problem-solving approach. It was decided to investigate the perceptions and understanding of problem solving in nursing using a model derived from the general literature. This model, from an analysis of 55 studies, consists of 5 phases which happen to be similar to the 4 or 5 stages in discussions of the nursing process. Insight into nurses' perceptions of problem solving was obtained by presenting 120 nurses, in individual interviews, with 7 specially constructed and validated vignettes of clinical problem solving. Deliberately, only one of the vignettes was complete, containing all 5 elements of the derived model. The remaining vignettes had one or more of the elements missing. The nurses were encouraged to comment on each vignette and the protocols were analysed in detail. Analysis revealed that the phase model was generally understood by all types of informants, but a number failed to detect the missing phases in some vignettes, in particular, problem identification, planning and evaluation. On the other hand, problem assessment and implementation almost always attracted comment. There did not appear to be a relationship between informants' nursing experience and the recognition or non-recognition of phases. Another finding was that informants were not always systematic in their analysis of the vignettes; that is, some did not begin their analysis with problem identification and conclude with evaluation. Overall, the findings lend support to a stages model as a theoretical basis for problem solving in nursing. The theoretical basis of problem solving in nursing is also discussed in relation to problem solving in allied professional disciplines. Finally, the implications of the study for nursing education and practice are explained and recommendations made for further study.
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Joshua, Beverly. "Nursing students' approaches to learning and clinical decision-making." Thesis, London South Bank University, 2017. http://researchopen.lsbu.ac.uk/1840/.
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The present and categorical correspondence between how students approach their learning and the way such approaches impact on the acquisition and augmentation of clinical decision-making skills is neither well understood, nor yet clearly established, in nurse education research. To address this gap, this study investigated the approaches to learning and the clinical decision-making of adult nursing students in their final year of training on two separate campuses of a central London university. Approaches to Learning Theory, promulgated by Martin and Sӓljö in 1976, and subsequently expanded and updated by Entwistle and colleagues, provided a theoretical lens and explanatory framework for this study. Acknowledging that the Approaches to Learning Theory adopts a hierarchy of three domains of approach, surface, strategic, and deep, it is argued that students’ clinical decisionmaking should be improved by changing their predominant approach to learning from the surface or strategic to the deep approach. To test this hypothesis, a research intervention was implemented for a purposive sample of participants who adopted either the surface or strategic approach to learning. Consistent with the underpinning principles of the deep approach to learning, the intervention focused on enhancing engagement with learning, problem-solving, and critical thinking skills. A second survey of approaches to learning and clinical decision-making was administered after the intervention, and semi-structured interviews were conducted to further corroborate the statistical findings. Instruments for data collection comprised the Approaches to Study Skills Inventory for Students, known as the ASSIST (Tait et al, 1998), Jenkins’ (1985) Clinical Decision-making Nursing Scale (CDMNS), and a short demographic questionnaire designed by the researcher. This research found that by altering the learning approach, consequent on the researchintervention, the adoption of the deep approach to learning enhanced clinical decision-making. Post-intervention findings revealed a strong positive correlation between the deep approach and clinical decision-making. Participants’ disposition for the surface approach also decreased significantly. Male participants indicated an affinity for the deep approach in comparison to female students who predominantly adopted the strategic approach. The study concluded that by cultivating students’ deeper engagement, underpinned by the intention to seek meaning and understand their learning, clinical decision-making was improved.
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Chan, Yung-kwan Albert, and 陳容坤. "Hong Kong nursing students' learning approaches: why and how do hospital-based general nursing students learn?" Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1994. http://hub.hku.hk/bib/B31957055.
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Chan, Yung-kwan Albert. "Hong Kong nursing students' learning approaches : why and how do hospital-based general nursing students learn? /." [Hong Kong] : University of Hong Kong, 1994. http://sunzi.lib.hku.hk/hkuto/record.jsp?B1383289X.
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Forbes, Helen. "Clinical teachers’ experiences of nursing and teaching." University of Sydney, 2007. http://hdl.handle.net/2123/2060.
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Doctor of Philosophy (PhD)Abstract Clinical teachers’ experiences of nursing and teaching Clinical nurse teachers’ experiences of nursing and teaching undergraduate nursing students on clinical placement are explored in this thesis because of concerns about the quality of nursing students’ learning outcomes. The aim was to identify variation in clinical teachers’ conceptions of nursing and their conceptions of, and approaches to teaching undergraduate nursing students. The study was significant because clinical teachers’ conceptions of nursing and approaches to clinical teaching have not been researched previously. Underpinning the study was a phenomenographic perspective on learning and teaching. This perspective views learning and teaching in terms of how they were experienced. Experience of nursing and clinical teaching, for example, can be understood in terms of related ‘what’ and ‘how’ aspects. The ‘what’ aspect concerns how nursing and clinical teaching were understood. The ‘how’ aspect is concerned the ways nursing and clinical teaching were approached. Experience of nursing and clinical teaching were described and analysed in terms of the separate ‘what’ and ‘how’ aspects and are understood in terms of the relationship between each of the aspects. Data from semi-structured interviews with twenty clinical teachers were analysed using phenomenographic research techniques (Marton & Booth, 1997) in order to identify variation in how nursing and clinical teaching were experienced. To extend the description, the research also sought to identify the empirical relationships between each of the aspects investigated. Key aspects of variation in clinical teacher experiences of nursing and clinical teaching and associated relationships have been identified. The results suggest that clinical teachers who adopted a student-centred approach to teaching conceived of nursing and clinical teaching in complex ways. The phenomenographic approach provides for an experiential and holistic account of clinical teaching: a perspective absent in nursing education research literature. The research findings extend knowledge that will assist with preparation and support of clinical teachers.
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Peterson, Wendy E. DiCenso Alba. "Adolescent mothers' satisfaction with postpartum nursing care : quantitative and qualitative approaches /." [Hamilton, Ont.] : McMaster University, 2004.
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Njeru, Jackson Ngigi. "Nursing Approaches for Use and Sustainability of Barcode Medication Administration Technology." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4541.
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Approximately 43.4% of medication errors occur at the time of administration despite the use of bar code medication administration (BCMA) System. This trend has prompted a national effort to mitigate this problem in the United States. Implementing BCMA in health care settings is one of those efforts. Studies focusing on the approaches employed by nurses when using this system are scant. The purpose of this qualitative case study was to investigate strategies nurses and their leaders use to ensure BCMA is implemented, maximized, and sustained. The technology acceptance model was used to guide the study. The 2 research questions addressed nurses' perceptions regarding the use and optimization of BCMA, and approaches of clinical nurses and their leaders to ensure that BCMA technology is properly used, optimized, and sustained in acute care units. Data collection included semistructured interviews with 8 participants. Thematic data analysis generated themes including ease of use, reduce errors, time saving, old technology, overreliance on technology, paper backups, and hope for future development. Common barriers to system effectiveness were system errors and inadequate training; intragroup and self-monitoring were important strategies to sustain use of the system. Study results may be used by health care leadership to reduce medication errors by adopting easy to use technology, change policies regarding training of BCMA end users in hospitals, increase the culture of patient safety among nurses, and prompt technology redesign within health care settings that meets the national patient safety goals.
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Chiu, Herng-Chia. "The Linkage Between Hospitals and Nursing Homes: Alternative Approaches to Minimizing Transaction Costs." VCU Scholars Compass, 1995. https://scholarscompass.vcu.edu/etd/4410.
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Finding more efficient ways to organize and deliver medical care is a major policy and management concern in the United States. High levels of expenditures for administrative and coordinating functions are attributed to the fact that health care systems are not "seamless" and that excessive transaction or friction costs are incurred in the exchanges between providers and purchasers and among providers. Renewed interest in vertical integration as a means to addressed these problems is being explored in the empirical literature, but rigorous theory-based investigations are rare. This study is a theory-based exploration of how hospitals address the "make-or-buy" decision of acquiring nursing home services for patients requiring post-acute stay placement.
The purpose of the study is to investigate under what circumstances hospitals chose to undertake formal arrangements to acquire nursing home services for patients to be discharged, rather than simply arranging for each discharge in the "spot market." In some instances this may be long-term contracting or leasing of beds, while in other instances it may mean the hospital acquires or develops its own skill nursing facility--a form of vertical integration. The study adopts Oliver Williamson's transaction cost economics theory as the theoretical basis for the study. This framework argues that the most efficient mode of transacting is determined by analyzing three dimensions of the transaction: uncertainty, frequency, and asset specificity (supplier identity). At higher levels of each of these dimensions, organizations are more likely to observe that "markets fail" and that formal arrangements between buyers and sellers are preferable, with vertical integration representing the "make" versus "buy" option.
The study uses data from the American Hospital Association Survey and other sources to identify if and how hospitals have made formal arrangements for nursing home services. It tests ten hypotheses derived from the theory that focus on the three dimensions of transactions and interactions among them. The methodology uses several analytical approaches to establish the validity of the measures of the dimensions, and then tests the hypotheses using multivariate logistic regression to contrast various modes of transaction. The importance of transaction uncertainty and specificity are strongly supported in the findings, while transaction frequency is weakly correlated to higher degrees of integration. The results are consistent with both the theoretical arguments advanced by transaction cost economics and with prior research, which is only available from non-health care applications.
The study makes an important, and perhaps unique, contribution to empirically operationalizing and testing a transaction cost economics-based interpretation of the decision to vertically integrate in health care. It also provides useful insight into the need for vertical integration to be selectively adopted as it may not be the most efficient mode of organization in all "make or buy" decision opportunities.
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Brown, Ann-Marie. "A Comparison of Two Gastric Feeding Approaches in Mechanically Ventilated Pediatric Patients." University of Akron / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=akron1403533434.
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Giger, Joyce Newman. "Conceptual and theoretical approaches to patient care : associated versus baccalaureate degree prepared nurse." Virtual Press, 1986. http://liblink.bsu.edu/uhtbin/catkey/468245.
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The purpose of the study was to determine if there is a relationship between types of entry-level preparatory nursing programs in which a nurse receives basic nursing education and conceptual and theoretical approaches to patient care. A secondary purpose of the study was to determine if there is a relationship between entry-level basic preparatory nursing education and nursing leadership, the ability to make nursing diagnosis, and implementation, as well as evaluation of the nursing process. Three nursing practice categories were identified and included: professional, all-nurse, and technical.Useable data collected by short-essay questionnaire from 343 out of 344 sample subjects were computed to determine the relationship, if any, between basic preparatory nursing education and conceptual and theoretical approaches to patient care. Decisions about three Null Hypotheses were made at the 0.05 level of significance utilizing analysis of covariance and the 0.01 level of significance utilizing Chi-Square analysis.FINDINGS1. For Hypothesis I, the main effect for degree work when covaried with Verbal Scholastic Aptitude Test Scores, Quantitative Scholastic Aptitude Test Scores, time, and age indicated a significance of 0.000 for all item associations in the professional, all-nurse, and technical categories utilizing analysis of covariance, and 0.0000 utilizing Chi-Square analysis.2. For Hypotheses II and III, the main effect for degree work when covaried with the aforementioned variables indicated a significance of 0.000 utilizing analysis of covariance, and 0.0000 utilizing Chi-Square analysis.Conclusions1. Graduates of Baccalaureate degree programs do vary in conceptual and theoretical approach to nursing care in specific nursing care situations.2. There is a significant relationship between the level of basic educational preparation and the degree and proficiency of leadership demonstrated by a nurse in specific nursing care situations, particularly, when uncontrolled variables have been controlled.3. There is a significant relationship between educational preparation and degree of proficiency to which the nurse makes nursing diagnosis, executes, and implements the nursing process, and evaluates the effects of nursing interventions.
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Al, Junaibi Suad Moosa Noor. "A case study of the Omani Ministry of Health's approaches to nursing education and its cultural congruency." Thesis, University of Nottingham, 2016. http://eprints.nottingham.ac.uk/38401/.
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Culture is a complex concept, but it is central to the task of curriculum design and development. The Ministry of Health (MoH) in the Sultanate of Oman plays a major role in healthcare education because it is the main employer and producer of healthcare professionals in the country. The MoH claims that its educational programmes are designed to meet the healthcare needs of the country at international standards, with ample consideration to the culture. As nursing is the major profession that the MoH invests in, produces, and employs, the purpose of this study is to explore the MoH’s approaches to designing, developing, and implementing the current basic (general) nursing curricula and its cultural congruency in the context of Oman. A qualitative case study design is used to answer the research questions. Educational policy documents, semi-structured qualitative individual interviews and focus groups have been used to collect data from the MoH’s nursing education decision makers, educators, students and service users (public) over a period of six months. Data was analysed using RichieRitchie and Spencer’s five-stage analytical framework to identify the themes from the data collected from the documents and the interviews. A purposeful sampling was used to select study participants from the MoH nursing education decision makers, educators, students and service users. Findings of the study reveal that the MoH’s current approach to nursing curriculum fails short of what Denis Lawton considers a culturally competent curriculum. The study proposes a framework, adapted from Lawton’s cultural analysis model, aimed at developing culturally congruent nursing education in Oman.
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Pleasance, Paul L. "Approaches to learning adopted by students undertaking a Diploma of Higher Education in Nursing programme." Thesis, University of Leicester, 1999. http://hdl.handle.net/2381/30941.
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Nursing education has undergone radical change during the last decade. All nursing programmes are now based in Institutions of Higher Education. While many aspects of the implications of these changes have been investigated, little research has been published concerning the approaches to learning adopted by student nurses. The Approaches and Study Skills Inventory for Students (ASSIST) is a tool designed to investigate preferences for different approaches to learning. It was administered to 296 students undertaking the Diploma of Higher Education in Nursing programme of De Montfort University, Leicester. The responses provided by the students were analysed using the constructs of the original authors (deep, surface and strategic approaches). The data was then subjected to factor analysis. There was found to be a high level of consistency between the original constructs and the factors extracted, and it was thus concluded that the inventory was probably a valid tool for use with the sample population. The approaches to learning favoured by various subgroups of the population were examined. Thus comparison could be drawn between male and female students, between younger and more mature students, between students with different previous academic qualifications, and between students undertaking different nursing branch programmes. It was found that deep approaches to learning were most favoured overall, and that there was no change in approach as the students progressed through the course. Older students showed an increased preference for deep approaches when compared to younger students, and male students showed similar preference when compared to female students. It was also found that students undertaking the adult nursing branch programme were more likely than other students to favour surface approaches to learning. Some of the implications for nursing education are discussed.
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Morrell-Scott, Nicola. "A phenomenological insight into the motivations, approaches, and knowledge of final year pre-registration nursing students." Thesis, Lancaster University, 2017. http://eprints.lancs.ac.uk/89462/.
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This thesis illuminates final year student nurses’ perceptions of their nurse education, and contributes both to the nursing and Higher Education (HE) literature. This thesis highlights both the approaches and motivations to learning student nurses take, the implications of this for wider public protection, and the role of the nurse. A qualitative phenomenological insider research study is undertaken, utilising a sample size of eighteen final year student nurses as the data source, undertaking semi-structured interviews from a United Kingdom (UK) Higher Education Institution (HEI). Data analysis is undertaken by using Interpretative Phenomenological Analysis (IPA). I argue that based upon the assumptions that student nurses make, in terms of their perceptions of what is and is not important from the curriculum, this changes approaches and motivations to learn. Subsequently, this causes gaps in the students’ knowledge. The perception of the role of the nurse is also found to be somewhat misjudged, and the holistic role of the nurse has been diminished. The theory practice gap is perceived by student nurses to not exist, yet whilst underpinning theoretical knowledge is limited there is a level of confidence. Furthermore, student nurses demonstrate a blissful ignorance towards the importance of knowledge for professional practice. Future practice as registrants may be affected, alongside the holistic role of the nurse being lost. Subsequent implications may be that patient care is adversely affected due to the approaches and motivations to learning that student nurses take.
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Curry, Tamika. "Adopting Innovative Approaches to Care: Facilitators & Barriers of School Nursing Practice in an Urban School District." Diss., Temple University Libraries, 2019. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/551882.
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Urban EducationPh.D.
As new approaches to practice become available for school nurses, urban school districts must address the need to provide facilitators for the dissemination and adoption of new evidenced based practice models. With instructional capacity, curriculum challenges, and school climate at the center of the decision making of educational leaders, the needs of school health become neglected. As new innovations become available, school nurses working in urban school districts often rely on individual continuing education to access new ideas due to barriers that exist in urban schools with limited funding and resources. This dissertation research had two primary aims: (1) expand current research regarding specific barriers and facilitators to practice, and (2) to better understand the school nurses’ adoption of the Framework for the 21st Century School Practicing Nurse in an urban school district. This framework addresses the specific needs of the school nurse working in an evolving educational health setting. Using a descriptive and inferential quantitative design with a convenience sample of school nurses in the School District of Philadelphia (SDP), participants completed an online survey designed to examine awareness, agreement, and alignment with the framework, as well as barriers and facilitators of adoption. The results revealed differences in level of awareness of the framework across various demographic groups within the SDP. After presenting the framework to participants, school nurses agreed with the importance of fully aligning practice. Further, there were variations in level of importance regarding specific practice components of the framework. Participants identified facilitators and barriers that impacted their ability to fully align school nursing practice with the framework.
Temple University--Theses
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Harrison, Nigel. "An exploration of stakeholder perceptions of academic dishonesty and approaches used to promote academic integrity in nursing students." Thesis, University of Manchester, 2013. https://www.research.manchester.ac.uk/portal/en/theses/an-exploration-of-stakeholder-perceptions-of-academic-dishonesty-and-approaches-used-to-promote-academic-integrity-in-nursing-students(3ba434dc-cc35-4c23-a2b1-c4a1a5c082fe).html.
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An increased number of investigations for academic dishonesty with nursing students was a catalyst for this research. The aim was to explore stakeholder perceptions of academic dishonesty and approaches used to promote academic integrity. Literature reviewed was largely anecdotal, focusing on accounts of incidents and concern over nurses’ fitness to practise, recognising a need to enhance understanding and strategic solutions. A single case study design was utilised, capturing views of expert witnesses, including nursing students, academic staff, practice mentors and administrative and support staff, using individual interviews and nominal groups. Documentary evidence of incidence occurring between 2004 and 2010 were also analysed. An integrated definition of Academic and Practice Misconduct specific to nursing was developed and a range of contributing factors influencing students identified. Incidence within the school was found to have gradually reduced, where collusion and plagiarism was found to be the most common types occurring; highest at academic level five and in essays. Almost half of academic staff had reported an alleged incident. A hierarchy of Academic and Practice Misconduct emerged, indicating a range of severity and degrees of deliberateness. A self-assessment tool has been developed to enable students to measure their level of risk of Academic and Practice Misconduct. Five themes emerged from thematic analysis of data on approaches used to promote academic integrity: devising strategies, policies and procedures; educating stakeholders; implementing holistic preventative processes and deterrents; detecting and managing alleged incidents; and on-going monitoring and enhancement. This was synthesised into a collaborative cycle with four phases for use by stakeholders, listing activities undertaken at course, school and university level and in practice settings. A self-assessment tool has been developed for academic staff to measure their level of involvement in promoting Academic and Practice Integrity. The concepts of risk and person centred approaches are utilised as theoretical frameworks to underpin the research findings. The study is presented as an integration of research, education and practice.
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Bentz, Philipp [Verfasser], Albert [Akademischer Betreuer] Brühl, Adrian [Akademischer Betreuer] Dusa, Albert [Gutachter] Brühl, and Adrian [Gutachter] Dusa. "Complexity in Nursing Homes. Neo-configurational approaches and Qualitative Comparative Analysis as method in nursing science to determine the influence of organizational factors in the complex adaptive system "nursing home" / Philipp Bentz ; Gutachter: Albert Brühl, Adrian Dusa ; Albert Brühl, Adrian Dusa." Vallendar : Philosophisch-Theologische Hochschule Vallendar, 2021. http://d-nb.info/1238517102/34.
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Baptiste, Lennise JC. "Process use across evaluation approaches: An application of Q methodology in program evaluation." Kent State University / OhioLINK, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=kent1271093193.
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Coward, Melaine. "An enquiry into nurse educators' beliefs, understandings and approaches to teaching the concepts of reflection to adult student nurses in UK Higher Education Institutes." Thesis, Kingston University, 2017. http://eprints.kingston.ac.uk/37908/.
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The approaches taken in teaching reflection to adult student nurses varies across the UK despite national curriculum outcomes from the professional statutory and regulatory body, The Nursing and Midwifery Council (NMC). This study highlights pertinent aspects of the various approaches to teaching, the inclusion of theory and the roles of the student, mentor and nurse lecturers in the utilisation of reflection to develop professional knowledge from experiences. Ethical approval was gained to conduct the study, utilising a case study approach, including nurse lecturers and curriculum documentation from a range of NMC accredited Higher Education Institutes across the UK. Semi structured interviews were conducted face to face with all participants in their home sites. Curriculum documentation used with students such as lecture notes, slides, module and programme handbooks and practice assessment documents were also collated in order to understand and analyse the approaches taken to teaching reflection. These two main data sources (interviews and curriculum documents) were also complemented by the use of field notes and a researcher journal in order to gain deeper understanding of the detail during data collection. A thematic analysis of the interview data and curriculum documents was undertaken to highlight and explore patterns and assist in the emergence of a theme and subthemes. Following in depth data analysis, the findings of this study detail an overarching theme of safe and caring practices, alongside three subthemes: II Personal and Professional Dimensions of Reflection Dimensions of Reflection in Nurse Education Articulation of Practice Although the publication of the Francis Inquiry (2013) was unanticipated at the inception of this research, it has shown to be a very important factor in analysing the data. The issue of patient safety that arose during data collection and became evident during analysis align closely to the publication of this significant report. The findings from this study are timely as the review of standards for nurse education and mentoring are underway. The findings from this study will also contribute to strengthening the student nurse role in assuring the best standards of care in the practice setting are achieved in order to improve patient safety through thoughtful approaches.
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Huang, Mei-hui. "Factors influencing self-directed learning readiness amongst Taiwanese nursing students." Queensland University of Technology, 2008. http://eprints.qut.edu.au/20709/.
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Rapid scientific and technological advances in health care mean that nurses need to keep learning and engage in professional education so that they can continue to provide safe and quality care. Education programs which prepare nurses for practice as a registered nurse have a vital role to play in ensuring that graduates are self-directed in responding to the need for ongoing learning throughout their professional career. In many countries, improving students’ readiness for self-directed learning has thus gained increasing recognition as being an important goal of nursing education programs. This level of interest in developing self-directedness in learning is evident in many policy documents and research in Taiwan. The aim of this study was to investigate factors influencing self-directed learning readiness amongst Taiwanese nursing students. A conceptual framework adopted from Biggs’s ‘3P model of teaching and learning’ was constructed to guide this study’s investigation. This study employed a two-staged mixed-method design to obtain a better understanding of Taiwanese students’ experience of SDL in undergraduate nursing programs. Stage one of the present study was a qualitative approach using semi-structured interview to explore students’ experiences with learning activities which they perceived to be self-directed in their undergraduate programs. Eight students were interviewed. Findings from this stage reveal that participants perceived a shift in teaching and learning styles between their previous nursing programs and the university. The more frequent use of student-directed learning activities, in which students were encouraged to be active and to take responsibility for their learning tasks, was one of the changes in teaching and learning approaches perceived by participants. Participants further suggested a number of factors that influenced the outcomes of these learning activities, including teacher-student interaction, facilitation process and learning resources. Stage two of this study used a quantitative approach consisting of two phases: instrument pilot testing and a cross-sectional survey. In the first phase, the instruments were translated into Chinese through a rigorous translation process and tested with a convenience sample of nursing students in Taiwan. Results indicated the translated instruments were reliable and stable. The second phase, a cross-sectional survey, was conducted to examine the conceptual framework of this study. A total of 369 undergraduate nursing students completed the questionnaire. Results of data analysis provides support for the conceptual framework proposed for this study, suggesting that students’ achievement goals and their perceptions of the learning environment significantly influence their adoption of learning approaches and the development of SDL readiness. Based on the results, this study provides practical implications that nurse educators may adopt to enhance students’ SDL readiness. This study also provides theoretical implications and recommendations for future research. It is envisaged that these recommendations may help future researchers focus their research design and further understandings of how to help students develop their ability to become self-directed learners.
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Souza, Allison Marlene. "Introducing the Health Coach Method of Motivational Interviewing to Medical Assistants to Improve the Patient Care Approach." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3414.
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The emerging health care culture of accountability for patient outcomes compounds problems for already overwhelmed clinicians struggling to fit everything entailed in complicated office visits into 15-minute appointments. Unprocessed frustrations tempt clinicians to use ineffective and outdated methods for trying to get their patients to comply or adhere to their care plans, undermining effective health care management. The intention of this project was to evaluate whether educating medical assistants in the health coaching method of motivational interviewing can improve the patient care approach while simultaneously assisting clinicians struggling with insufficient time. Several individual scheduling conflicts limited the target population into two primary care medical assistants and two auxiliary primary care office staff who voluntarily chose to learn the new approach. Guided by the adult learning theory, an educational lecture project was designed to capture the spirit of motivational interviewing through basic descriptions and strategies that will assist learners to focus on person-centered conversation skills, helping to balance both the needs of the patient and clinician. Following the education, participants filled out an anonymous post-lecture evaluation questionnaire to provide immediate feedback about learner understanding. Responses indicated the project met its stated objectives, and results showed the versatility of the motivational interviewing method which can be learned and effectively applied by health care workers from a wide range of professional backgrounds. Motivational interviewing is an innovative approach that utilizes therapeutic communication to promote behavior changes that lead to improved health of our communities and country.
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Kavanagh, McBride Louise. "An investigation to evaluate and understand nursing and midwifery students' reflective thinking levels, approaches to learning and epistemological beliefs over an internship programme in an Irish context." Thesis, Ulster University, 2015. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.669226.
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Salvage, Eva. "Vårdenhetschefers och sektionsledares uppfattningar om operationssjuksköterskans perioperativa omvårdnadsarbete samt införande av denna arbetsmetod." Thesis, Högskolan i Gävle, Avdelningen för hälso- och vårdvetenskap, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-11588.
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Introduktion: Den perioperativa omvårdnaden där operationssjuksköterskan ingår innefattar faserna före, under och efter operation och kan ses som ett arbetssätt. Perioperativ omvårdnad har utarbetats under 1990-talet. Arbetssättet har inte efterlevts i någon stor grad trots positiva effekter för patienter och personal. Operationssjuksköterskans arbete är fortfarande övervägande traditionellt, med fokus på tiden då patienten är sövd och opereras. Vårdenhetschefers och sektionsledares uppfattningar om den perioperativa omvårdnaden har betydelse för hur arbetet bedrivs på operationsavdelningar. Syfte: Att beskriva vårdenhetschefers och sektionsledares uppfattningar om operationssjuksköterskans perioperativa omvårdnadsarbete samt om införandet av perioperativ omvårdnad. Metod:Datainsamling skedde genom öppna intervjuer med fyra vårdenhetschefer och fyra sektionsledare inom operationssjukvården på två länssjukhus och två universitetssjukhus i Sverige. Insamlad data har analyserats kvalitativt med manifest innehållsanalys. Huvudresultat: Perioperativ omvårdnad som arbetssätt hade enligt vårdenhetschefer och sektionsledare inom operationssjukvård ett värde genom att förnya operationssjuksköterskans arbetssätt vilket anses förbättra patientens omvårdnad. För att införa perioperativ omvårdnad krävdes att olika behov tillgodoses, som tydliggörande av patientnyttan, stöd som skapar rätt förutsättningar, samt att det behövs motivation hos operationssjuksköterskor. Slutsats: Perioperativt omvårdnadsarbete är, trots dess värde, inte möjligt att genomföra utan långtgående förändringar i synsätt och organisation.Introduction: Perioperative care in which the operating room nurse takes part includes the phases before, during and after operation and can be seen as a way of working in parallel with the care process. This approach has however not been applied to any great extent in pratice despite several studies having shown the positive effects for both patients and staff. The common view of the operating room nurse’s role is still a traditional one with the focus on the time when the patient is anaesthetized and during the actual surgery. Unit managers and section leaders perceptions of perioperative care are important since it affects how the approach is applied in practice. Aim: To describe the unit managers and section leaders perceptions of the operating nurse’s perioperative care work together with how the process is applied in practice. Method: Data were collected by semi-structured interviews with four unit managers and four section leaders within the operating room unit of two provincial hospitals and two university hospitals in Sweden. Data have been analysed with a qualitative content analysis. Main results: Perioperative care as an approach has, according to the unit managers and section leaders in the operating room unit, a value as it revitalises the operating room nurse’s method of working which in turn is thought to improve patient care. It is maintained that in order to introduce perioperative care certain requirements need to be fulfilled, such as clarification of the benefit to patients, support in order to create the right conditions, as well as the need for motivated operating room nurses. Conclusion: Perioperative nursing care is, despite its value, not possible to implement without farreaching changes to how operating room nursing is approached as well as organisational changes.
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Mesquita, Simone Karine da Costa. "Abordagens pedag?gicas na forma??o de enfermeiros : compreens?o de docentes de enfermagem." Universidade Federal do Rio Grande do Norte, 2012. http://repositorio.ufrn.br:8080/jspui/handle/123456789/14754.
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Previous issue date: 2012-04-20Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior
In the new world order is notorious changes in social, ethical, economical and political aspects in the society, which reach incisively higher education, requiring a number of modifications and a new vision in nursing education, in order to meet the demands of the Unique Health System. Thus, the Higher Education Institutes (HEI) and teachers are invited to face new challenges and reflect on their practices, using pedagogical approaches and innovative methodologies to meet the requirements of a globalized society. This study has as an objective to analyze the perspective of teachers in what concern the pedagogical approaches used in nursing education and to identify pedagogical approaches utilized by teachers in nursing education. This is a field research of exploratory kind, descriptive, of quantitative approach. The search was conducted at the Department of Nursing of the Federal University of Rio Grande do Norte UFRN, based in the city of Natal. The population consisted of forty-six teachers. From this population was selected a sample of twenty teachers. Data collection occurred from August to September 2011, through the utilization of the technique of interview and questionnaire. The obtained data were analyzed in two moments. In the first moment, was carried out the quantitative analysis that refers to the obtained data through the interview technique, methodological procedures were submitted to the content analysis proposed by Bardin. On the second moment, concerning the quantitative analysis of the questionnaires applied to the teachers and of the identification data, which were digitized and transferred to a spreadsheet electronic of Microsoft Excel XP, tabulated and organized into tables, containing their relative and absolute frequencies. It is worth mentioning that were respected the aspects of the CNS Resolution 196/96. With regard to the characteristics of research participants, 20% were male; with a degree of titration of 55% doctorates; regarding time of service there was a greater representation from 15 to 45 years, with 45%. The results showed that 90% of teachers who participated in the research have an appropriate understanding of non-critical pedagogical approaches, only 10% had an inadequate understanding. However, 70% of teachers, despite having an adequate understanding, reported difficulties when attempting to implement these pedagogies. Most teachers, with representability of 80% consider the non-critical pedagogies relevant in nursing education, as well as critical pedagogies, being represented by 95% of teachers. It was concluded that both critical and non-critical pedagogies are in teachers practice of undergraduate nursing education. It feels like a moment of transition, since the presence of new ways of teaching as a part of this educational context, with educational models that give value to scientific, ethical and personal aspects in the educational process. The research contains limitations, however highlights the contribution of new possibilities for action, reflection on the context of performance, maximizing the pedagogical skills necessary to conduct teaching process, in line with the new educational paradigm of higher education
No mundo hodierno s?o not?rias as mudan?as nos aspectos social, ?tico, econ?mico e pol?tico na sociedade, as quais atingem de modo incisivo, o ensino superior, exigindo uma s?rie de modifica??es e uma nova vis?o na forma??o de enfermeiros, a fim de atender as demandas do Sistema ?nico de Sa?de. Diante disso, as institui??es formadoras e os docentes s?o convidados a enfrentar os novos desafios e refletir sobre suas pr?ticas, a fim de favorecer uma maior flexibilidade e capacidade de articula??o, utilizando abordagens pedag?gicas e metodologias inovadoras, para fazer frente ?s exig?ncias de uma sociedade globalizada. O presente estudo tem como objetivo analisar a perspectiva do docente no que concernem as abordagens pedag?gicas utilizadas na forma??o de enfermeiros e identificar as abordagens pedag?gicas empregadas por docentes na forma??o de enfermeiros. Trata-se de uma pesquisa de campo do tipo explorat?ria, de abordagem quantitativa. A pesquisa foi realizada no Departamento de Enfermagem da Universidade Federal do Rio Grande do Norte UFRN, sediada na cidade de Natal, no estado do Rio Grande do Norte. A popula??o foi composta por cinquenta e tr?s docentes. Desta popula??o, foi selecionada uma amostra de vinte docentes que atuam na referida Institui??o. A coleta de dados ocorreu no per?odo de agosto a setembro de 2011, atrav?s da t?cnica de entrevista semi-estruturada e da utiliza??o de um question?rio. Os dados obtidos ser?o analisados individualmente, em dois momentos: No primeiro momento, a an?lise quantitativa referente aos dados obtidos por meio da t?cnica de entrevista, os quais foram submetidos aos procedimentos metodol?gicos da an?lise de conte?do proposta por Bardin. No segundo momento, an?lise quantitativa dos dados quantitativos coletados resultantes dos question?rios aplicados aos docentes e dos dados de identifica??o dos participantes, os quais foram transferidos para uma planilha eletr?nica do Microsoft Excel XP, com tabula??o e organiza??o em tabelas dos dados, contendo suas frequ?ncias relativas e absolutas. Vale salientar, que foram respeitados os aspectos presentes na Resolu??o CNS 196/96, a qual refere os aspectos ?ticos e legais da pesquisa envolvendo seres humanos. Os resultados mostram que 90% dos docentes participantes da pesquisa apresentam uma compreens?o adequada das abordagens pedag?gicas n?o cr?ticas, apenas 10% tinham um entendimento inadequado. Com rela??o ?s pedagogias cr?ticas, 80% dos participantes da pesquisa referiram uma compreens?o adequada. Por?m, 70% dos docentes, apesar de terem uma compreens?o adequada, relataram dificuldades durante a tentativa de implementa??o destas pedagogias. A maioria dos docentes, como representabilidade de 80%, consideram as pedagogias n?o cr?ticas relevantes na forma??o do enfermeiro, como tamb?m as pedagogias cr?ticas, sendo representada por 95% dos docentes. Com rela??o ?s caracter?sticas dos participantes da pesquisa, 20% eram representantes do sexo masculino; com grau de titula??o de 55% com doutorado; referente ao tempo de servi?o houve uma maior representatividade entre 15 a 45 anos, com 45%. Contudo, com vista a identificar as abordagens pedag?gicas que norteiam suas pr?ticas docentes na forma??o de enfermeiros da UFRN, revelou que tanto as pedagogias cr?ticas, quanto e as pedagogias n?o cr?ticas est?o presentes na pr?tica de docentes da gradua??o em enfermagem. Isso reflete um momento de transi??o, visto que a presen?a das novas formas de ensinar j? faz parte deste contexto educativo. Por fim, cabe ressaltar, a import?ncia compreender sobre modelos educacionais que valorizam os aspectos cient?ficos, ?ticos, pessoais no processo educativo. A pesquisa tem a pretens?o de proporcionar aos docentes a contribui??o de novas possibilidades de a??o no sentido de refletir sobre o contexto de atua??o, com compet?ncias pedag?gicas necess?rias para conduzir o processo de ensino, em conson?ncia com o novo paradigma pedag?gico do ensino superior
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Weeks, Keith William. "Setting a foundation for the development of medication dosage calculation problem solving skills among novice nursing students : the role of constructivist learning approaches and a computer based 'Authentic World' learning environment." Thesis, University of South Wales, 2001. https://pure.southwales.ac.uk/en/studentthesis/setting-a-foundation-for-the-development-of-medication-dosage-calculation-problem-solving-skills-among-novice-nursing-students(5003cde5-921c-46f1-a70d-04370fbb13ce).html.
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Objective: This study analysed the problems encountered by novice nursing students during the process of learning medication dosage calculation skills via didactic transmission methods and 'word problems'. Subsequently constructivist approaches were applied to the design and development of a computer-based 'Authentic World' learning environment. The relationship between exposure to these two teaching methods and the learning of dosage calculation skills, was evaluated in both college- and clinical-based environments. Participants and Setting : 44 novice nursing students following a pre-registration HE Diploma in Nursing Studies programme, within a large UK school of nursing. Design : During the college based phase of the investigation, two groups of 22 participants were exposed to a 'cross-over' experimental approach, involving: a) tuition via transmission and 'Authentic World' methods, followed by a written dosage calculation assessment. b) cross-over to the alternative treatment, followed by a written dosage calculation assessment. During the clinical-based phase of the investigation, a nine participant sub-sample were assessed during dosage calculation situations within child, adult and mental health care settings. A thematic analysis of post-assessment interviews was performed to identify participants' perceptions of the efficacy of the teaching strategies in assisting to bridge the theory-practice divide. Findings : Evaluations of participants' performance during written assessments revealed three error types: conceptual, arithmetical operation and computation errors. Findings indicated that exposure to the 'Authentic World' environment, assisted participants to develop accurate schema for understanding dosage problems and eliminated all conceptual errors. Development of schema for arithmetical operation and computation skills took a more protracted period of time. On completion of the college-based phase 80% of participants scored 100% on the written assessment, and performance on the written assessments proved to be predictive of dosage calculation performance in clinical practice. Conclusions: These results suggest that exposure to constructivist approaches assist novice nursing students to both develop requisite schema and understanding of medication dosage problems, and to bridge the theory-practice divide in this area of practice. Development of schema for arithmetical operation and computation methods requires a more protracted time period for assimilation and accommodation to occur. Implications for practice : The predictive nature of this education process assists learners scoring 100% on written assessments to enter clinical practice as advanced beginners in this domain; and enables early mobilisation of college support mechanisms to assist learners who manifest arithmetical operation and computation errors, to develop accurate schema for these skills.
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Prosser, Rina Marie. "Laying the Foundation for New Approaches in Evidence-Based Sex Education Curriculum Programs: A Family Life Policy Change." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/1208.
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The teen pregnancy rate in Henry County, Tennessee has increased over the years. The purpose of this project was to develop an evidence-based family life education policy for possible adoption by the board of education to address the persistent high teen pregnancy rate for girls aged 15-17 in the county. This present study resulted in a revised policy that was based on a comprehensive policy termed Abstinence-Centered Plus Contraception. An 18-member collaborative, organizational, and community project team, made up of community leaders, nurses, counselors, teachers, and students, assisted in the development and adoption of the policy, practice guidelines, and the development of implementation and evaluation plans for the newly adopted policy. The theoretical framework was based on the social, cognitive, and behavior change theories. The program logic model served as a framework to monitor its progress. Existing peer-reviewed literature, including research studies, state and national teen pregnancy prevention projects and curriculum, and publicly available statistics, were gathered and reviewed by the project team as background to be used for developing and changing policy at the institutional level. Project monitoring involved tracking processes surrounding policy and practice guideline development and adoption, as well as implementation and evaluation plan development for the adopted policy and whether these processes progressed as the empirically-derived teen pregnancy prevention projects should when changing sex education policy at the organizational level. This project resulted in policy adoption and developing a policy implementation and evaluation plan to be disseminated within a county school system that could decrease teen pregnancy rates and demonstrate positive outcomes.
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Alshammari, Muna A. B. J. M. "The role of nurses in diabetes care and the impact of the different approaches of nurses' role on patients percieved quality of nursing care : two case studies from the UK and Kuwait." Thesis, University of Nottingham, 2018. http://eprints.nottingham.ac.uk/49796/.
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Type 2 diabetes (T2D) is considered as a global major health problem, which requires healthcare systems to find solutions to meet the needs of the great numbers of people with T2D. One key to these solutions is nurses who undertake the provision of diabetes care. Nursing care in T2D varies across countries as a result of differences in healthcare systems, the way in which they are organised and other factors relating to nursing practice. The UK and Kuwait are two countries which have high incidences of T2D but differing health care delivery models, which has raised the need to understand the different roles of nurses in providing T2D care in these two countries’ healthcare systems. Key aims of this research were: (1) to investigate the actual roles undertaken by nurses in T2D care; (2) to investigate the extent to which these different roles affect perceived quality of nursing care; (3) to investigate the guidelines of diabetes care in the UK and Kuwait; and (4) to evaluate if nurses are delivering care based on these guidelines. This study investigated two cases in the UK and Kuwait regarding nursing roles in T2D care and how they affect the perceived quality of nursing care. In order to understand the phenomenon, a multiple case study design was employed involving multiple sources of information including documents review, non-participant observations, and semi-structured interviews with nurses and their patients with T2D. The diabetes clinic sites for this study were Nottingham University Hospitals (NUH) Trust in the UK and the Ministry of Health (MoH) hospitals in Kuwait. A thematic approach was utilised as a framework for the within-case and cross-case analyses. The findings of the study showed that nurses are motivated and competent to provide optimum care to achieve patient satisfaction, which is a significant sign of quality of nursing care. The nurse-led system in the UK and the physician-led system in Kuwait indicate different approaches in T2D care. In the UK, the nurse’s part in T2D care has been extended and advanced, making the role comparable to a physician's role. For instance, the status of 'nurse consultant' and 'nurse prescriber', allows the nurse to coordinate and lead diabetes care. In Kuwait, nurses contribute significantly to T2D diabetes care; however, their role is not officially recognised as they are not titled ‘diabetes nurse’ despite the fact they follow physician-established guidelines. Findings from this research further showed that the role of a diabetes nurse in Kuwait lacks clarity, as evidenced by the lack of any published statements specifying their roles according to their specialisation, experience and qualifications. This absence of what nurses are supposed to be doing or a lack of a statement relating to the guideline-informed role of nurses has therefore resulted in an undervaluation and lack of support for this role in Kuwait. The results of this study enhanced understanding of the roles nurses play within T2D care in both the UK and Kuwait. The information gathered also provides better understanding about nurses’ guideline-informed roles and their actual roles in T2D care and therefore that data determines how the differences in the roles of nurses might impact on patients' perceived quality of nursing care.
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Carson, Anna, and Tove Grimgarn. "Depression hos äldre : Vårdpersonals beskrivning och förståelse - en litteraturöversikt." Thesis, Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-5966.
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Bakgrund: Depression är vanligt förekommande hos äldre och kan få betydande konsekvenser för äldres hälsa. Depression hos äldre skiljer sig i flera hänseenden från depression i yngre åldrar. Skillnaderna framkommer bland annat i symtombild, orsaker, och riskfaktorer för depression. Hos äldre patienter är somatisk samsjuklighet vanligt förekommande vilket kan försvåra sjukdomsförloppet samt upptäckt och behandling av depression. Syfte: Syftet med litteraturöversikten var att beskriva förhållningssätt till depression hos äldre bland sjukvårdspersonal inom somatisk vård. Metod: En litteraturöversikt utfördes, baserad på tio vetenskapliga artiklar, nio kvalitativa och en av mixad metod. Innehållet analyserades och organiserades i kategorier. Databaser som användes var CINAHL complete, PubMed och PsycINFO. Resultat: Tre kategorier med underkategorier utformades. I vårdpersonals förståelse av depression hos äldre framkom tre underkategorier; Bakomliggande orsaker och riskfaktorer, Hinder för att upptäcka och bedöma depression samt Kunskap och utbildning. Kategorin Attityder till depression är indelad i två underkategorier, Stigma hos äldre samt Depression som en normal del av åldrande. I Kategorin Vårdpersonals förutsättningar att hantera depression hos äldre framkom två underkategorier; Vårdpersonals roller och funktioner samt Tidsramar inom vården. Diskussion: Litteraturöversiktens resultat diskuteras utifrån tidigare studier samt översiktens teoretiska utgångspunkt tidvattenmodellen. För att visa på relevansen och betydelsen av vårdpersonals förhållningssätt kring äldre med depression diskuteras resultatet även ur ett patientperspektiv.Background: Depression is common in old age and can have a significant impact on older patients’ health. Depression among the elderly differs in several aspects from depression in younger patients. The differences occur in the appearance of symptoms, causes, and risk factors for depression. Somatic comorbidity is common among older patients which can worsen the course of depression and obstruct identification and treatment. Aim: The aim of the review was to describe approaches to depression in the elderly among health care personnel in somatic care. Method: A literature review was conducted based on ten scientific articles, nine qualitative and one mixed method. The content was analyzed and organized in categories. Databases used were: CINAHL complete, PubMed and PsycINFO. Results: Three categories with subcategories were constructed. In Health personnel's understanding of depression three subcategories emerged; Underlying causes and risk factors, Obstacles to identify and screen for depression, and Knowledge and training. The category Attitudes towards depression is divided in two subcategories; Stigma in old age and Depression as a normal part of ageing. In the category Health personnel’s conditions to manage depression in older patients, two subcategories emerged; Roles and functions of health personnel and Timeframes in healthcare. Discussion: The results of the literature review are discussed from the perspective of previous studies as well as the theoretical framework of the review, the tidal model. To indicate the relevance and significance of health personnel’s approaches to depression in old age the results are also discussed from a patient perspective.
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Pimenta, Flaviana Regina. "Profissionais de enfermagem vítimas de acidentes com material biológico de um hospital de ensino do interior paulista: atendimento e seguimento clínico especializado." Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/83/83131/tde-31102011-101146/.
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Introdução: a transmissão ocupacional do HIV, HBV e HCV aos profissionais da área da saúde é um fato concreto. Objetivos: avaliar a conduta dos profissionais de enfermagem vítimas de acidentes com material biológico de um hospital de ensino do interior paulista em relação ao atendimento e seguimento clínico especializado. Material e método: trata-se de um estudo de corte transversal aprovado pelos Comitês de Ética em Pesquisa do referido hospital e da Escola de Enfermagem de Ribeirão Preto da Universidade de São Paulo. A população do estudo foi composta por 1.215 profissionais de enfermagem, que foram entrevistados no período de 01 de junho de 2010 a 30 de maio de 2011. Resultados: dos 1.215 profissionais da equipe de enfermagem entrevistados, 636 (52,3%) sofreram pelo menos um acidente com material biológico ao longo de sua experiência profissional, 454 (71,4%) procuraram pelo atendimento especializado no Ambulatório de Acidente Ocupacional ao Profissional da Saúde (AOPS) e 26 (5,7%) interromperam o seguimento clínico antes do período recomendado e os motivos mais frequentemente relatados foram atendimento demorado (26,9%), sorologia do paciente fonte negativa (23,1%) e (15,4%) esquecimento. 168 (37,0%) profissionais acidentados tiveram indicação de antirretrovirais, sendo que 109 (64,9%) tiveram efeitos adversos e 52 (31,0%) abandonaram a terapêutica. Apresentar efeitos adversos foi o motivo mais frequentemente relatado para interrupção dos antirretrovirais (94,3%). Ressalta-se que 182 profissionais acidentados não procuraram atendimento no AOPS e a maioria 115 (63,2%) relatou não tê-lo procurado, pois acreditavam que o acidente era de baixo risco. Conclusão: identificar os motivos que levam os profissionais a não procurar atendimento, bem como completar a terapêutica e o seguimento clínico pode contribuir para a proposição de estratégias capazes de aumentar a adesão dos profissionais às medidas profiláticas após exposição ocupacional a material biológico, e consequentemente minimizar o risco de soroconversão ao HIV e HBV e identificar precocemente a soroconversão para o HCV, uma vez que não existe, até o momento, quimioprofilaxia para minimizar o risco de soroconversão para este vírus.Introduction: occupational transmission of HIV, HBV and HCV to health professionals is a concrete fact. Objectives: to evaluate the conduct of nursing professionals from a teaching hospital in the interior of the state of São Paulo, Brazil, who were victims of accidents with biological material in relation to the care and specialized clinical follow-up. Material and method: it is a cross-sectional study which was approved by the Research Ethics Committees of the studied Hospital and of the Ribeirão Preto College of Nursing, University of São Paulo. The study population consisted of 1,215 nursing professionals, who were interviewed in the period from June, 1st 2010 to May, 30rd 2011. Results: of the 1,215 nursing professionals interviewed, 636 (52.3%) have experienced at least one accident with biological material throughout their professional experience, 454 (71.4%) sought specialized care at the Outpatient Clinic for Occupational Accident among Health Care Workers (AOPS) and 26 (5.7%) discontinued the clinical follow-up before the recommended period, and the reasons most frequently reported were delayed care (26.9%), patients with negative serology (23.1%) and forgetfulness (15.4%). 168 injured professionals (37.0%) had an indication for antiretroviral therapy, being that 109 (64.9%) of them had adverse effects and 52 (31.0%) abandoned therapy. Having adverse effects was the most frequently reported reason for discontinuation of antiretrovirals (94.3%). It is highlighted that 182 injured professionals did not seek care at the AOPS and the majority, i.e. 115 (63.2%) professionals, reported not seeking it, because they believed that the accident was at low risk. Conclusion: identifying the reasons why professionals do not seek care and not complete the treatment and the clinical follow-up may contribute to the proposition of strategies to increase professionals\' adherence to the prophylaxis measures after occupational exposure to biological material, and therefore minimize the risk of seroconversion to HIV and HBV, and identify early HCV seroconversion, since there is not, so far, chemoprophylaxis to minimize the risk of seroconversion to this virus.
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Negrinho, Nádia Bruna da Silva. "Condutas referidas pelos profissionais de enfermagem após exposição percutânea ocupacional com material biológico potencialmente contaminado." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/22/22132/tde-17012017-154325/.
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Introdução: Os profissionais de enfermagem são os que mantêm os maiores índices de acidentes com material biológico. A importância da adoção de medidas preventivas é fundamental para garantir a proteção dos mesmos e reduzir os acidentes de trabalho. Após a ocorrência de um acidente ocupacional com material biológico, medidas pós-exposições devem ser instituídas para reduzir o risco de soroconversão. Objetivo: Analisar as condutas referidas pelos profissionais de enfermagem após a ocorrência de exposição ocupacional percutânea com material biológico potencialmente contaminado. Material e Método: Trata-se de estudo do tipo transversal, realizado em um hospital de alta complexidade, localizado no interior do Estado de São Paulo, Brasil. O projeto foi aprovado pelo Comitê de Ética em Pesquisa da instituição e da Escola de Enfermagem de Ribeirão Preto da Universidade de São Paulo. A amostra do estudo foi composta por profissionais de enfermagem. Os dados foram coletados por meio de entrevistas individuais no próprio local de trabalho, no período entre março e novembro de 2015. Resultado: Foram entrevistados 226 profissionais; desses, 39 (17,3%) afirmaram ter sofrido exposição ocupacional a material biológico na instituição, sendo que a maioria 24 (61,5%) envolveu contato por via percutânea. Em relação às condutas referidas pelos profissionais de enfermagem após exposição ocupacional com material biológico potencialmente contaminado, a maior parte dos participantes: interromperam imediatamente a atividade que estavam fazendo (87,5%), lavaram a área atingida abundantemente com água e sabão (100,0%), realizaram o comunicado imediato ao enfermeiro supervisor sobre o acidente (95,8%), preencheram o formulário para investigação de acidentes e foram encaminhados para o atendimento especializado (95,8%). Os profissionais mencionaram a emissão da Comunicação de Acidente de Trabalho pelo Serviço de Engenharia de Segurança e Medicina do Trabalho em 100,0% dos casos de acidentes com material biológico. Conclusão: O presente estudo permitiu identificar as condutas referidas pelos profissionais de enfermagem após exposição ocupacional com material biológico potencialmente contaminado. Destaca-se que a maioria interrompeu a atividade desenvolvida no momento do acidente, realizou cuidados na área atingida, procurou imediatamente pelo enfermeiro supervisor, atendimento clínico especializado e notificou o acidenteIntroduction: Nursing professionals have the highest rates of accidents with biological material. The importance of adopting preventive measures is fundamental to ensure their protection and reduce work accidents. After the occurrence of an occupational accident with biological material, post-exposure measures must be followed to reduce the risk of seroconversion. Objective: To analyze the approaches mentioned by nursing professionals after the occurrence of a percutaneous occupational accident with potentially contaminated biological material. Material and Method: A cross-sectional study was conducted in a high-complexity hospital in the interior of the state of São Paulo, Brazil. The research project was approved by the Research Ethics Committee of the institution and the Ribeirão Preto College of Nursing, at the University of São Paulo. The study sample was made up of nursing professionals. Data were collected by means of individual interviews at the participants\' workplace, between March and November 2015. Result: A total of 226 professionals were interviewed; of these, 39 (17.3%) stated they had suffered occupational exposure to biological material at the institution, of whom 24 (61.5%) involved percutaneous contact. Regarding the therapeutic approaches mentioned by the nursing professionals after the occupational exposure to potentially contaminated biological material, most participants interrupted the activity they were doing immediately (87.5%), washed the affected area abundantly with water and soap (100,0%), immediately reported the accident to the supervisor nurse (95.8%), filled in a form for investigation of accidents and were referred to specialized care (95.8%). It is noteworthy that the professionals mentioned the issuance of the Work Accident Notification to the Work Medicine and Safety Engineering Service in 100,0% of the cases of accidents with biological material. Conclusion: The present study allowed to identify the approaches mentioned by nursing professionals after occupational exposure to potentially contaminated biological material. It is noteworthy that most professionals interrupted the activity they were developing at the time of the accident, cared for the affected area, sought the supervisor nurse immediately, as well as specialized clinical care, and notified the accident
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Clarke, Janice. "Nursing and spirituality : a theological approach." Thesis, Cardiff University, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.445257.
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Skinner, Elise. "Ethics of Finitude: Nursing and the Palliative Approach." Thesis, Université d'Ottawa / University of Ottawa, 2018. http://hdl.handle.net/10393/37290.
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Purpose: Within the contemporary socio-political context of palliative care and an aging demography, there is a called-for shift to an upstream provision of palliative care in the form of a palliative approach to care as well as to frame access to palliative care within a health equity perspective. In the literature, there is a paucity of nurses’ experiences in the provision of palliative care within psychiatric settings. Moreover, little is known of the process by which nurses engage in a palliative approach to care for patients experiencing multiple marginalities, including institutionalization, mental health, and advanced age. This research explored how nurses in forensic and geriatric psychiatry engage with aging patients and mortal considerations to discern how ethical dimensions of care, aligned within the palliative approach, are enacted. An ethical lens by which to apprehend dimensions of human finitude, reflective of central elements of the palliative approach and public health palliative care, was proposed to help to delineate a process of recognition through which values can be identified in the care of patients. The purpose of this thesis was to explore the phenomenon by which nurses engaged with mortality as both an antecedent to adopting a palliative approach and as a phenomenon that captures nurses’ continued engagement with patients within this approach.
Objectives: There were three objectives to the project: 1) explore nurses’ engagement with mortality within an ethics of finitude; 2) identify enablers and barriers, and related historical and socio-political discourses, to engagement of nurses with their patients within an ethics of finitude, and; 3) articulate and deepen understanding of the palliative approach, including ethical dimensions and considerations. The research was an analytical elaboration of a qualitative study at the University of Ottawa that examined the palliative approach to nursing care in forensic and geriatric psychiatry at a mental health facility in eastern Ontario.
Methods: Situated within a constructivist epistemic stance, the analytical framework elaborated for this analysis drew from both interpretive description (ID) and interpretive phenomenological analysis (IPA). Utilizing convenience sampling, eight Registered Nurses (7 women and 1 man) working in forensic or geriatric psychiatry completed interviews.
Findings: Engagement of nurses within an ethics of finitude was revealed to surface through a process of recognition (recognition of mortality, recognition of the increased vulnerability of patients, and recognition of a corresponding increased responsibility for vulnerable patients) and through the affirmation of values including human connection, dignity, comfort, family, familiarity, and personhood. Barriers and enablers to this engagement emerged related to the care environment, the psychiatric nurse and patient construction, and factors related to family. The implications of the related discourses in the articulation of the palliative approach emerged in relation to health system considerations and to the language of the palliative approach.
Conclusion: The process of recognition explored through the proposed ethical lens and revealed in the findings delineated values that underpin the palliative approach by offering an alternate conceptualization to their identification and enactment. Insights from this project underscore preliminary insights on a process to identify care practices aligned within the palliative approach as well as possibilities for critical questioning related to interconnected axes of an ethics of finitude in both the care of individual patients and in the enactment of health policy.
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Russell, Anthony Charles. "A workshop intervention approach to nursing stress management." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1996. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp04/MQ33447.pdf.
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Siegel, Elena Ohanian. "An ethnographic approach to understanding the nurse's role as supervisor of nursing assistants in nursing homes /." Thesis, Connect to this title online; UW restricted, 2006. http://hdl.handle.net/1773/7203.
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Woodhead, Jonele Maree. "Comparison of radial and femoral approaches for coronary angiography with or without percutaneous coronary intervention in relation to vascular access site complications : a thesis submitted to the Victoria University of Wellington in partial fulfilment of the requirements for the degree of Master of Nursing (Clinical) /." Researcharchive @Victoria, 2008. http://hdl.handle.net/10063/880.
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Gregg, Julie E. "Competency-based education, an effective approach to nursing orientation." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/MQ57436.pdf.
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Goodchild-Brown, Beatrix. "Carinus Nursing College : an historical study of nursing education and management using the general systems approach, 1947-1987." Master's thesis, University of Cape Town, 1992. http://hdl.handle.net/11427/26620.
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The purpose of this dissertation is to research aspects of the historical development of Nursing Education and Nursing Management at the Carinus Nursing College from 1949 to 1987; to determine and explain how the College has adapted and coped with historical change and to determine whether proposals for the future can be made. Research has been done by applying the general systems theory and by using the standard methods of historical analysis. Data has been collected by means of oral history, literature search and documentation. The variables isolated are the College as a system; the government or influential super systems; resources such as financial, personnel and students and material inputs; and throughput or processing the work in the output, which leads to the professional nurse. The models used are Bucheles' organizational system, Sharma's flow chart pattern, Mintzberg's parts of organizational systems, and power flows and as shown in Emery, Feibleman and Friends relations and rules of interaction in systems thinking. Parsons' "imperatives of maintenance of a system" as well as Alvin Toffler's "second and third wave phenomena as responses to change" were two further models that were used. By using Robert Buchele's model, the work is divided into four parts: - i) the College as a system ii) the super systems iii) the resources iv) the throughput or processing. A further design that emerged was that two eras could be distinguished, within which three historical phases: - Early, Middle and Late are developed.
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Idczak, Sue Easter. "Nursing Students' Experiences of Being and Presence: A Hermeneutic Approach." Toledo, Ohio : University of Toledo, 2005. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=toledo1115122643.
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Dissertation (Ph.D.)--University of Toledo, 2005.Typescript. "Submitted as partial fulfillment of the requirements for the Doctor of Philosophy Degree in Higher Education." "A dissertation entitled"--at head of title. Title from title page of PDF document. Bibliography: p. 163-174.
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Andersson, Johanna, and Ellinor Hallberg. "Medical Information Systems & the Nursing Profession : a Sociotechnical Approach." Thesis, Uppsala universitet, Företagsekonomiska institutionen, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-354050.
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Due to the digitalization era and challenges faced by the healthcare sector, Medical Information Systems are now being extensively used at hospitals. The implementation of the systems is a complex task which entails a need for careful considerations from a managerial view, since the main purpose with implementing the systems is for managerial control. One of the things management should consider is the professional aspect. The nursing profession is a highly specific one, and this could implicate special considerations. The aim of this master’s thesis is to take on a sociotechnical approach towards the implementation of Medical Information Systems and investigate how the nursing profession is affecting the implementation process, and what it may implicate for hospital management. To answer the research question a qualitative approach has been chosen. The empirical data has been gathered through semi-structured interviews with nurses from the case organization. The result implies that the nursing profession have a substantial impact on the implementation process. Instead of embracing the instructions and support offered by management, the nurses develop their own way of working within the system.
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Gillrell, Charlotte. "Scientific approach in clinical placement in nursing education -Phenomenographic study." Thesis, Malmö högskola, Fakulteten för hälsa och samhälle (HS), 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-25194.
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Gillrell, C. Vetenskapligt förhållningssätt i verksamhetsförlagd-sjuksköterskeutbildning. Fenomenografisk studie. Examensarbete i omvårdnad 15 högskolepoäng. Malmö högskola: Fakulteten för hälsa och samhälle, Institutionen för Vårdvetenskap, 2015.Det är en utmaning för sjuksköterskestudenten att identifiera omvårdnadsbehov hos en patient. Aktuell studie har fokuserat på vad den handledande sjuksköterskan uppfattar vara centralt i ett vetenskapligt förhållningssätt i omvårdnadsarbetet och hur fenomenet förmedlas till sjuksköterskestudenter. Resultatet visade variation i syftet med ett vetenskapligt förhållningssätt. En del handledare uppfattade att syftet med fenomenet var att identifiera omvårdnadsbehov, andra menade att syftet var att utföra omvårdnad flexibelt utifrån faktakunskap och vad som var det bästa för patienten. Starkast stöd för målet med ett vetenskapligt förhållningssätt i omvårdnadsarbetet var att ge den bästa och säkraste vården för specifik patient. Fenomenet vetenskapligt förhållningssätt kunde förmedlas om den verksamhetsförlagda utbildningen gavs tid, utrymme och hade strukturerade läraktiviteter samt reflektion i handling, och på handling.Gillrell, C. Scientific approach in clinical placement in nursing education. A phenomenographic study. Degree project in Care Science 15 credits. Malmö University: Faculty of health and society, Department of Care Science, 2015.It is a challenge for nursing students to identify the care needs of a patient. Current study has focused what the supervising nurse perceived to be the center of a scientific approach in nursing and how the phenomenon was communicated to the nursing students. The results showed variation in the purpose of a scientific approach. Some supervisors perceived that the purpose of the phenomenon was to identify care needs, others meant that the aim was to carry out nursing flexible based on factual knowledge and what was best for the patient. The strongest support for the goal of a scientific approach in nursing work was to provide the best and safest care for a specific patient. The phenomenon of scientific approach could be communicated, in the clinical placement, if given the time and space, and if the student had structured learning activities and reflection in action, and on action.
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Mahoney, Glenna. "Competency Assessment in Sexual Assault Nursing Practice| An Evidence-Based Approach." Thesis, Carlow University, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=3595809.
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The purpose of this project was to develop and test a pilot competency assessment tool for sexual assault nurses. The content for the competency assessment was based on available evidence, primarily targeting current standards of sexual assault nurse examiner (SANE) practice. Descriptive statistics from a regional crime lab allowed the researcher to identify areas for improvement in the evidence-collection technique. This information was then used to develop the content of the competency assessment. A team of experts helped inform the development of an online competency assessment using a web-based platform. The competency assessment was tested on a small sample of sexual-assault nurse examiners. The instrument demonstrated a reasonable level of consistency and reliability (KR20 was 0.66) for an initial assessment. The aim of developing and testing an online instrument to serve as a baseline for establishing a valid and reliable competency assessment for sexual assault nurse examiners was achieved.
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Sinfield, Melissa. "Respectful relationships : an approach to ethical decision-making for gerontic nursing /." View thesis, 2001. http://library.uws.edu.au/adt-NUWS/public/adt-NUWS20030924.140531/index.html.
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Lewis, Tom. "The hermeneutic nature of process in nursing : a grounded theory approach." Thesis, London South Bank University, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.265279.
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This thesis is an enquiry into the nature of process in nursing. The study was initiated by the experience of the researcher as a nurse attempting to utilise the Nursing Process in clinical practice. From the outset however, the focus of the study shifted from the utility of the Nursing Process to the nature of process in nursing. The data were collected by in depth, unstructured interviews with twenty staff nurses from general medical and surgical wards in five district general hospitals in the South of England. The interviews were transcribed, and analysed following grounded theory methods. The analysis produced a number of categories related to nursing practice and the context in which it occurs. The major finding of the study is represented as the core category and is labelled Nursing carea s clinicalh ermeneuticIsn. identifying this category the researcher considers nursing to be essentially a process of interpretation of clinical situations, that is to say that process in nursing is essentially hermeneutic in nature. Other categories were identified relating to the strategies used by nurses and the context of nursing practice. These were labelled as; latching over,T hinking about,B eingt here,D oing to,f orand with, Letting go, Climate of Constantc hangeL, andscapeo f predictabilitya nd Landscapeo f perfect expectation. These categories were linked to each other and to the core category forming an illumination of the core category. The categories of SufferingC' omfortinga nd Healing were identified as providing the impetus for nursing care. The categories have been linked together in a statement of substantive theory which describes nursing care as clinical hermeneutics in the following way: A process, which is the resultant of a complex, dynamic interplay between knowing, thinking, feeling, doing and context, in which the nurse seeks to prevent and relieve suffering, to promote comfort and facilitate healing. This interpretative process is achieved by helping the patient to understand the illness process, by reducing the alienating effects of illness and by facilitating a return to a taken-for-granted state of wholeness of mind and body. It is achieved through the nursing strategies of watching over, thinking about, being there, doing to, for and with and lettinggo and shaped by the context in which it occurs. In using grounded theory to achieve this theoretical stance, the thesis makes and seeks to justify four important claims about nursing. These are firstly, that nursing is more than simply a collection of tasks, but rather is a process of interpretation involving certain kinds of tasks. Secondly that apparently simple (or indeed complex) tasks involved in nursing are themselves an integral part of the process of interpretation. Thirdly that as a hermeneutic process, nursing may claim to have a philosophical basis. And finally that as a hermeneutic process, nursing is supported by and requires many forms of knowing, none of which are privileged but all of which are legitimate.
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Smith, Kelly M. "Broadening the Lens: A Systems Approach to Nursing Home Quality Improvement." Scholar Commons, 2018. https://scholarcommons.usf.edu/etd/7365.
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The National Quality Award Program, sponsored by the American Healthcare Association National Center for Assisted Living, was implemented to cultivate continuous quality improvement in nursing homes and assisted living facilities. Based upon the Baldridge Criteria for Performance Excellence, the program utilizes a systems-based or Big “Q” approach to quality and requires applicants to examine seven categories of their organizational environment including: 1) leadership, 2) strategy, 3) customers, 4) measurement, analysis, and knowledge management, 5) workforce, 6) operations, and 7) results. The subsequent dissertation examines whether award status is associated with better performance on publicly reported quality measures and financial performance within the nursing home setting. Findings suggest implementation of Baldridge principles may promote improved quality; however, further research is warranted to fully understand the relationship.
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Sather, Linda Strube. "Patient focused care : the path to empowered self-management a grounded theory approach /." Access Digital Full Text version, 1992. http://pocketknowledge.tc.columbia.edu/home.php/bybib/11063890.
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Thesis (Ed.D.)--Teachers College, Columbia University, 1992.Typescript; issued also on microfilm. Sponsor: Elizabeth Maloney. Dissertation Committee: Jane Monroe, . Includes bibliographical references (leaves 85-90).
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Chien, Li-Yu. "Reculturing curriculum within a nursing context in Taiwan : an action research approach." Queensland University of Technology, 2007. http://eprints.qut.edu.au/16469/.
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The focus of this study is on curriculum change within a nursing institute in Taiwan where there is a growing demand for reform to nurse education in order to produce more competent practitioners. I conceptualised a framework to guide the transformation process in ways that were empowering, sustainable and generative. I argued that curriculum change also involves the beliefs, customs, attitudes or expectations of those who participate in the process: essentially it is a reculturing process. My conceptual framework included notions such as student-centredness, reculturing, collaborative practices and reflections, personal growth, and professional development. A plan of action was developed based on the notions contained in the conceptual framework and carried out within an Action Research methodology. Action Research provided the mechanism by which the collaborators explored and understood their conceptions of teaching and learning and then planned and implemented action to change the current situation, and evaluate and reflect on the transformations. Strategies such as personal practical theorising, focus group, critical debate, and collaborative reflection were used to bring about the curriculum change. The significance of this study lies in its practical contribution to all aspects of curriculum making including innovation, planning, implementation and ongoing review. Although information generated from this study is not generalisable, lessons learned from it may be utilised by other educational institutes with similar issues and similar contexts.
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Allen, Susan. "Creating an integrated nursing team within primary healthcare : an action enquiry approach." Thesis, University of Leicester, 2005. http://hdl.handle.net/2381/27841.
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This thesis is based on a journey towards developing team working within a primary healthcare setting which enabled the NHS agenda for primary care service delivery to keep pace with the government modernisation agenda. (Department of Health, 1997). Initially the focus was on the development of an integrated nursing team which enabled all disciplines of nurses to work towards a patient focussed healthcare service, but it soon became evident that all staff involved in delivering the primary healthcare service were essential to the process and developments of the enquiry if the objective was to be achieved. An action enquiry approach based on collaborative and participative action research (Carr and Kemmis, 1986; Lincoln and Guba, 1989; Cayer, 1997) was discussed and was the prime method of enabling changes to occur in the healthcare practice. This is represented by the interrelated four main cycles of enquiry that have emerged from the data, and discussed in this thesis. Key to the success of the developments was an understanding of team working and leadership as it applied within a healthcare setting and also the underlying dynamics, which are evident when different professional groups from different traditions and knowledge base work together. (Schon, 1983) This was explored within the context of a systems approach to organisational development and through reflective dialogue along the principles advocated for creating a learning organisation. (Senge, 1990) This thesis will demonstrate how confidence developed in myself and the practitioners, especially those from marginalised groups, and how the wider healthcare system made an impact on the developments within the practice. The area of leadership will be discussed from multiple perspectives and recognition that as a concept all stakeholders had a poor understanding of leadership. The key finding from this study identifies the need for a holistic approach to manage and sustain change, and indeed everyday productive working relationships. This especially identifies the importance of giving attention to the preparation of future healthcare workers, the appropriateness of organisational structures in which services are delivered and support structures available to those in team leadership positions.
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McCance, Tanya Violet. "An exploration of the experience of caring in nursing : a hermeneutic approach." Thesis, University of Ulster, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.310111.
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Ramnarine-Singh, Susan. "Integration of Technology into a Nursing Curriculum Using a Mixed Method Approach." ScholarWorks, 2014. https://scholarworks.waldenu.edu/dissertations/508.
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In 2011, the Institute of Medicine and 2010 Affordable Care Act addressed the need to use technology in nursing programs. The purpose of this study was to understand faculty perceptions of technology use and integration into the nursing curriculum at a college located in Texas. Lewin’s change theory acted as the theoretical framework to explore organizational dynamics involved in effective strategies. The guiding research questions explored faculty perceptions of technology use, types of technology used, and correlation to teaching experience using a convergent mixed-method approach. Thirty faculty members completed the Teacher’s Intention to Use Technology survey and 15 faculty members participated in interview sessions. Faculty with fewer years of experience were compared to faculty with more years of experience and differed on ease of use (p = .010), embracing technology (p = .011), enjoying technology (p = .026), available assistance (p = .020), classroom preparation (p = .043), and ease of learning (p = .047). The qualitative data analysis used an open coding scheme and resulted in themes indicating the need for training, especially for faculty with less experience. Record review indicated scattered use of technological tools. A professional development workshop promoting teaching strategies using technology to help achieve learning outcomes, an online orientation to available technology, and a hands-on interactive workshop was created. Implications for positive social change include improving faculty members’ knowledge and application of technology in order to positively affect and enhance teaching/learning strategies, student learning environment, and ultimately the lives of patients they serve.
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Smith, Yvonne M. "USING A QUALITATIVE APPROACH TO EXPLORE NURSING FACULTY PERCEPTIONS OF TEACHING ONLINE." Kent State University / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=kent1410960146.
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Bradshaw, Trevor. "Canadian Forces Military Nursing Officers And Moral Distress: A Grounded Theory Approach." Thesis, University of Ottawa (Canada), 2010. http://hdl.handle.net/10393/28839.
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Background: Deployed military nurses frequently experience moral dilemmas in their delivery of care, putting them at risk to suffer moral distress.
Purpose: The purpose of this study was to understand the experience of deployed Canadian Forces nurses and moral distress.
Methods: A grounded theory approach provided the framework for the study's design and data analysis. Semi-structured interviews were conducted with ten nurses previously deployed on combat or humanitarian missions.
Findings: A new Moral Distress Model was developed reflecting four contributing factors to the development of moral distress: patient care delivery, chain-of-command, lack of moral preparation and training, and lack of professionalism. The central category -- "unique environment" -- suggests that moral distress is a two-part process: moral deliberation, and moral impact, influenced by the unique environment.
Conclusion: Moral distress was a prominent phenomenon affecting deployed CF nurses. Pre-deployment training and on-going educational and supportive strategies are suggested to mitigate the significant impact of moral distress.
Keywords: ethics, morals, nurses, military nurses, military personnel, decision making