Relevant bibliographies by topics / Nursing Care – methods

Academic literature on the topic 'Nursing Care – methods'

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Published: 26 July 2024

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Journal articles on the topic "Nursing Care – methods"

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Parreira, Pedro, Paulo Santos-Costa, Manoel Neri, António Marques, Paulo Queirós, and Anabela Salgueiro-Oliveira. "Work Methods for Nursing Care Delivery." International Journal of Environmental Research and Public Health 18, no. 4 (February 21, 2021): 2088. http://dx.doi.org/10.3390/ijerph18042088.

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This article analyzes the work methods based on care design, identification of needs, care organization, planning, delivery, evaluation, continuity, safety, and complexity of care, and discharge preparation. It describes the diagnosis of the situation, goal setting, strategy selection, implementation, and outcome evaluation that contribute to adopting a given work conception and/or method for nursing care delivery. Later, the concepts underlying the several methods—management theories and theoretical nursing concepts—are presented, with reference to relevant authors. The process of analysis and selection of the method is explained, highlighting the importance of diagnosis of the situation, goal setting, strategy selection, implementation, and outcome evaluation. The importance of various elements is highlighted, such as structural aspects, nature of care, target population, resources, and philosophy of the institution, which may condition the adoption of a method. The importance of care conceptualization is also underlined. The work methods are presented with a description of the key characteristics, advantages, and disadvantages of the task-oriented method (functional nursing) and patient-centered methods: individual, team nursing, and primary nursing. A critical and comparative analysis of the methods is then performed, alluding to the combination of person-centered methods.
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Milecka, Dorota, Henryka Homętowska, and Stanisław Manulik. "The rationing of nursing care phenomenon in the light of scientific reports – definitions, system solutions, assessment methods – PART I." Journal of Education, Health and Sport 13, no. 4 (March 1, 2023): 281–91. http://dx.doi.org/10.12775/jehs.2023.13.04.033.

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Rationing of nursing care is a widespread and growing phenomenon whose causes are multifaceted and whose consequences are serious. Nursing rationing is defined as withholding or failing to perform necessary nursing tasks due to insufficient time, staffing, and/or inadequate skills. Nursing rationing is also defined as omission, delay, or failure to complete, which qualifies as an error of omission. Unfinished nursing care has many negative consequences for patients, nurses, and organizations. The presented series of three papers aims to show many important aspects related to care rationing. This first part of the series of rationing of nursing care phenomenon will address definitions and concepts of rationing of nursing care, rationing of nursing care in the context of health care rationing, rationing of care versus omission of care or medical error, methods for assessing the rationing and the quality of nursing care, and main reasons for rationing of nursing care.
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Jasińska, Joanna. "Patient Safety in Nursing Care." Journal of Clinical Peadiatrics and Care 1, no. 1 (March 13, 2023): 01–03. http://dx.doi.org/10.58489/2836-8630/005.

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Background. Patient safetyis an undeniable important aspectin the context of improvingthe quality of the entire health system. Improving patient’s safety should be comprehensive and includetwo dimensions of safety – technical and functional. One source of information aboutthe level of patient’s safety are medical staff, but there is a gap here, which is no central system that would collect, analyze and draw conclusions from a sufficiently large number of problems reported by stakeholders. Objectives. The aim of this study was to evaluate the patient’s safety on the basis of the declaration of nurses. Material and Methods. The study involved 160 professionally active nurses. The study was performed by the authors questionnaire based on the questionnaire “Hospital Survey on Patient Safety Culture” developed by the Agency for Healthcare Research and Quality. The selection of the sample was based on the availability of respondents. The study was performed in January 2021. More than ¾ of respondents indicated the hospital as a placeof employment. Results. Nearly 40% of respondents said that their boss rarely and very rarely takes into account the suggestions of employees for the improvement of patient’s safety. Over 40% of respondents said that their workplace is often and very often trying to do too many tasks and too fast. Conclusions. It is necessary to create a culture of safety by improving communication between doctors and nurses or line managerand nurses. There is a need for greater involvement of line manager in solving problems reported by nurses in terms of providing safe care to patients (Piel. Zdr. Publ.2021, 5, 1, 33–39).
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Nuela Masaquiza, Catalina Fernanda, Adriana del Rocío Lascano Sánchez, Anderson José Sangacha Yugsi, Cinthya Anabel Ortiz Martinez, Diana Nathalie Navarrete Tinajero, and Gissel Katherine Carvajal Chango. "Nursing care management in primary health care." Sapienza: International Journal of Interdisciplinary Studies 5, no. 1 (January 24, 2024): e24004. http://dx.doi.org/10.51798/sijis.v5i1.722.

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Background: Nursing management in PHC is essential to achieve quality care and patient satisfaction. Objective: Analyze the management of nursing care in Primary Health Care. Methods: Qualitative and descriptive approach, semi-structured interviews were carried out with a group of male and female nurses who work at the PHC level. The interviews focused on exploring their perceptions and experiences in relation to nursing management. The data obtained were analyzed using content analysis to identify emerging themes and patterns. Results: They revealed several interesting perspectives on nursing management in the context of PHC, solid cognitive and attitudinal competencies to face the challenges of work, and highlighted the need to practice compassion as an integral part of nursing care in this environment. Conclusions: It is vitally important to strengthen and support nursing staff in the management of primary health care, emphasizing the need to promote training and professional development in these areas to improve the quality of care and outcomes. health in the Primary Health Care.
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Verkaik, Renate, Paulien van Antwerpen-Hoogenraad, Anke de Veer, Anneke Francke, and Judith Huis in het Veld. "Self-management-support in dementia care: A mixed methods study among nursing staff." Dementia 16, no. 8 (February 22, 2016): 1032–44. http://dx.doi.org/10.1177/1471301216632416.

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Background Self-management in patients and family caregivers confronted with dementia is not self-evident. Self-management skills may be limited because of the progressive cognitive decline of the patient and because family caregivers are often also very aged. Self-management support by nursing staff is therefore of paramount importance. Objectives To gain insight into how nursing staff perceive their self-management support tasks, and how they put them into practice. Research questions are: ‘What are the opinions and experiences of Dutch nursing staff working in home care or residential elderly care regarding self-management support for people with dementia and their family caregivers?' and ‘Do nursing staff feel sufficiently trained and skilled for self-management support?’. Methods A mixed methods approach was used, combining cross-sectional quantitative survey data from 206 Dutch nursing professionals with qualitative interviews among 12 nursing staff working in home care or residential elderly care in The Netherlands. Results Nursing staff working in home care experienced self-management support of people with dementia as a part of their job and as an attractive task. They consider ‘helping people with dementia to maintain control over their lives by involving them in decisions in daily care’ the essence of self-management support. Nursing staff saw family caregivers as their main partners in providing self-management support to the patient. They were less aware that family caregivers themselves might also need self-management support. Nursing staff often felt insufficiently trained to give adequate self-management support. RN’s and CNA’s did not differ in their opinions, experiences and training needs. Conclusions Nursing staff in home care do consider self-management support an important and attractive task in dementia care. Their skills for providing self-management support to patients with dementia and family caregivers need improvement. Recommendations Nursing staff need sufficient training to enable the proper provision of self-management support for people with dementia. More attention should also be given to the support of self-management for family caregivers.
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Pereira, Jessika Lopes Figueiredo, Cecília Danielle Bezerra Oliveira, and Inacia Sátiro Xavier De França. "Systematization of nursing care in intensive care unit." Journal of Nursing Education and Practice 8, no. 1 (September 26, 2017): 114. http://dx.doi.org/10.5430/jnep.v8n1p114.

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Objective: To evaluate the systematization of nursing care in intensive care unit (ICU).Methods: This is an integrative review of the literature carried out through the VHL, SCIELO and LILACS databases with articles published between 2009 and 2014.Results: Five articles were selected, where it was possible to observe that the lack of applicability of the systematization of nursing assistance in the ICU is more reality found, however, when held, this process provided a registry organized and directed the data and execution and evaluation of the nursing care.Conclusions: The instruments need to be fairly discussed and proposed nursing professionals to become empowered.
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Ventura-Silva, J. M., M. M. Martins, L. L. Trindade, A. C. Faria, S. C. Barros, R. M. Melo, I. J. Oliveira, S. F. Castro, and O. M. Ribeiro. "Nurses’ Work Methods Assessment Scale: A Construct Validation." Nursing Forum 2023 (September 11, 2023): 1–7. http://dx.doi.org/10.1155/2023/8884183.

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Background. A nursing work method is the base for the organization and implementation of nursing care to patients based on nurses’ skills. Nurses’ work methods are consensually organized into two groups: task-oriented work methods (functional method) and client-centered work methods (teamwork method, individual work method, and work method per reference nurse). As for the impact of the work method on clients, we highlight the interference in the quality of care provided and, regarding nurses, the impact on workload and job satisfaction. Therefore, the existence of tools that allow identifying the organizational methodologies of nursing care is relevant. Aim. The aim of the study is to test the validity and reliability of the nurses work methods assessment scale (NWMAS). Methods. The methodological study followed the recommendations of the EQUATOR network. The NWMAS was previously developed as a self-completion questionnaire. To determine construct validity, exploratory and confirmatory factor analyses were performed. Results. 325 participants were enrolled in this study. In exploratory factor analysis, the 25 items comprising NWMAS were distributed in five dimensions, contemplating the work methods. Cronbach’s alpha of the total scale was 0.846. The confirmatory factor analysis revealed a good fit. Conclusion. The NWMAS is a valid and reliable tool. Implications for Nursing Practice. The NWMAS identifies the work methods adopted by nurses in hospital settings, is a valuable tool for nursing management, and contributes to the definition of strategies that promote the quality of nursing care and the safety of patients.
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Suwardianto, Heru, and Vitaria Wahyu Astuti. "Competency In Critical Care Nursing With Approach Methods Journal Sharing of Critical Care (JSCC) In Nursing Profession Students." STRADA Jurnal Ilmiah Kesehatan 9, no. 2 (November 1, 2020): 686–93. http://dx.doi.org/10.30994/sjik.v9i2.361.

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The results showed that most respondents had good critical nursing competency scores including primary assessment: airway assessment (53.8%); breathing assessment (56.4%); Circulation assessment (61.5%); Disability assessment (56.4%); and Exposure assessment (59%), professionalism (56.4%), critical nursing care competencies (79.5%), Clinical reasoning process (71.8%), Patient safety (61.5%) and critical care exam score (46.2%). The result of statistical test with Pearson test obtained that the primary assessment: airway assessment (ρ = 0.038); circulation assessment (ρ = 0.029); Exposure assessment (ρ = 0.023), competence of critical nursing care (ρ = 0.049), clinical reasoning process (ρ = 0.028) and patient safety (ρ = 0.001) have a significant relationship to the critical care exam score. The implementation of learning methods for journal sharing of critical care has a positive impact on competencies and results in good student competencies.
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Ren, Xueqiong, Jianing Jin, Yaer Chen, and Jing Jin. "Research on the Effect of Nursing Methods for Gestational Diabetes Mellitus Based on Comprehensive Nursing Intervention." Computational and Mathematical Methods in Medicine 2022 (July 14, 2022): 1–10. http://dx.doi.org/10.1155/2022/2396658.

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In order to explore the effective way of gestational diabetes care, this paper applies comprehensive nursing to gestational diabetes care. In terms of nursing intervention for pregnant women with gestational diabetes mellitus, combining the phased changes of pregnant women’s physiological and psychological needs during pregnancy, this paper comprehensively implements health education, diet intervention, exercise intervention, pregnancy monitoring, psychological intervention, infection prevention, and perinatal monitoring and other nursing interventions in a selective and focused manner. This makes the intervention measures at each stage focused, intersecting, interpenetrating, and continuing to play a role, which can effectively improve the implementation effect of the intervention measures and better promote the effective improvement of pregnancy outcomes. In addition, this paper studies the effect of gestational diabetes care based on comprehensive nursing intervention through a controlled trial, and the study verifies that comprehensive nursing has a good effect in gestational diabetes care.
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Czwikla, Jonas, Maike Schulz, Franziska Heinze, Thomas Kalwitzki, Daniel Gand, Annika Schmidt, Chrysanthi Tsiasioti, et al. "Needs-based provision of medical care to nursing home residents: protocol for a mixed-methods study." BMJ Open 9, no. 8 (August 2019): e025614. http://dx.doi.org/10.1136/bmjopen-2018-025614.

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IntroductionNursing home residents typically have greater needs for medical care than community-dwelling elderly. However, restricted cognitive abilities and limited mobility may impede their access to general practitioners and medical specialists. The provision of medical care in nursing homes may therefore be inappropriate in some areas of medical care. The purpose of this mixed-methods study is to systematically assess, evaluate and explain met and unmet medical care needs in German nursing homes and to develop solutions where medical care is found to be inappropriate.Methods and analysisFirst, statutory health insurance claims data are analysed to identify differences in the utilisation of medical care between nursing home residents and community-dwelling elderly with and without need for long-term care. Second, the health status and medical care of 500 nursing home residents are assessed and evaluated to quantify met and unmet medical care needs. Third, qualitative expert interviews and case conferences and, fourth, quantitative analyses of linked data are used to provide structural, case-specific and generalisable explanations of inappropriate medical care among nursing home residents. Fifth, a modified Delphi study is employed to develop pilot projects aiming to improve medical care in nursing homes.Ethics and disseminationThis study was approved by the Ethics Committee of the University of Bremen on 23 November 2017. Research findings are disseminated through presentations at national and international conferences and publications in peer-reviewed scientific journals.Trial registration numberDRKS00012383.
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Dissertations / Theses on the topic "Nursing Care – methods"

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Lyons, Maureen A. "Pre-conception care : current practice and methods of provision." Thesis, Aston University, 1988. http://publications.aston.ac.uk/15142/.

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This thesis examines the present provisions for pre-conception care and the views of the providers of services. Pre-conception care is seen by some clinicians and health educators as a means of making any necessary changes in life style, corrections to imbalances in the nutritional status of the prospective mother (and father) and the assessment of any medical problems, thus maximizing the likelihood of the normal development of the baby. Pre-conception care may be described as a service to bridge the gap between the family planning clinic and the first ante-natal booking appointment. There were three separate foci for the empirical research - the Foresight organisation (a charity which has pioneered pre-conception care in Britain); the pre-conception care clinic at the West London Hospital, Hammersmith; and the West Midlands Regional Health Authority. The six main sources of data were: twenty five clinicians operating Foresight pre-conception clinics, couples attending pre-conception clinics, committee members of the Foresight organisation, staff of the West London Hospital pre-conception clinic, Hammersmith, District Health Education Officers working in the West Midlands Regional Health Authority and the members of the Ante-Natal Care Action Group, a sub-group of the Regional Health Advisory Group on Health Promotion and Preventive Medicine. A range of research methods were adopted. These were as follows: questionnaires and report forms used in co-operation with the Foresight clinicians, interviews, participant observation discussions and informal meetings and, finally, literature and official documentation. The research findings illustrated that pre-conception care services provided at the predominantly private Foresight clinics were of a rather `ad hoc' nature. The type of provision varied considerably and clearly reflected the views held by its providers. The protocol which had been developed to assist in the standardization of results was not followed by the clinicians. The pre-conception service provided at the West London Hospital shared some similarities in its approach with the Foresight provision; a major difference was that it did not advocate the use of routine hair trace metal analysis. Interviews with District Health Education Officers and with members of the Ante Natal Care Action Group revealed a tentative and cautious approach to pre-conception care generally and to the Foresight approach in particular. The thesis concludes with a consideration of the future of pre-conception care and the prospects for the establishment of a comprehensive pre-conception care service.
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Eberwine, Julia K. "Methods Used to Assess Critical Care Nurses’ Ability to Detect the Deteriorating Patient and the Perceived Effectiveness of Those Methods." University of Cincinnati / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1459438932.

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Stokes, Yehudis. "Exploring Nurses' Knowledge and Experiences Related to Trauma-Informed Care." Thesis, Université d'Ottawa / University of Ottawa, 2016. http://hdl.handle.net/10393/35223.

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Background: Recognition of the significance of psychological trauma and its impact on individuals, families, communities, and society at large has greatly expanded over the past 20 years, calling for the need to develop both trauma-sensitive and trauma–responsive services. Nurses, as direct care providers who work within a holistic perspective, are positioned to play an integral role in the advancement of ‘trauma-informed care’ within healthcare services. Objectives: The specific objectives of this thesis were: a) to describe the use of social media (Facebook and LinkedIn) in the recruitment of Registered Nurses for an online survey, and b) to explore and describe the understandings and experiences related to trauma and trauma-informed care among nurses that scored the highest on this scale. Method: This was a two-phase study design using mixed methods. Phase One consisted of an online quantitative self-report survey. Participants were recruited via social media with the aim of examining nurses’ attitudes related to trauma-informed care. Phase Two consisted of a qualitative study exploring nurses’ knowledge and experiences related to trauma-informed care. The studies were conducted using a sequential approach; that is, the target sample for Phase Two (qualitative study) was identified based on the results of the survey (Phase One). Findings: From the first phase of this research, I proposed that social media, and specifically Facebook and LinkedIn, offer suitable platforms for recruiting a diverse sample of Registered Nurses to complete an online survey. Associated advantages and challenges as well as specific differences between Facebook and LinkedIn as recruitment platforms should be considered when incorporating these strategies. Four main categories emerged from the second phase of the research: “(Not)Knowing Trauma-Informed Care”, “Conceptualizing Trauma and Trauma- Informed Care”, “Nursing Care in the Context of Trauma”, and “Dynamics of the Nurse-Patient Relationship in the Face of Trauma”. These findings highlight important considerations for trauma including, the complex dynamics of trauma that affect care, the importance of both knowing trauma as a concept, but also knowing how to act in response to trauma knowledge, the need to facilitate trauma-informed care beyond mental healthcare, and the parallels between nursing and trauma-informed care. Conclusion: This Master’s thesis has explored the use of a novel survey recruitment strategy as well as emphasized the need for nurses and organizations to incorporate trauma-informed principles in the services they provide, and in their cultures as a whole. This research reinforces that the discipline of nursing is aptly situated to apply tenets of trauma-informed care and that we must further the progression of trauma-informed care in practice, policy, education, and research.
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Cowey, Eileen Stewart. "Using an end-of-life care pathway in acute stroke : a mixed methods study of decision-making and care experiences." Thesis, University of Glasgow, 2016. http://theses.gla.ac.uk/7653/.

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Background: The evidence base on end-of-life care in acute stroke is limited, particularly with regard to recognising dying and related decision-making. There is also limited evidence to support the use of end-of-life care pathways (standardised care plans) for patients who are dying after stroke. Aim: This study aimed to explore the clinical decision-making involved in placing patients on an end-of-life care pathway, evaluate predictors of care pathway use, and investigate the role of families in decision-making. The study also aimed to examine experiences of end-of-life care pathway use for stroke patients, their relatives and the multi-disciplinary health care team. Methods: A mixed methods design was adopted. Data were collected in four Scottish acute stroke units. Case-notes were identified prospectively from 100 consecutive stroke deaths and reviewed. Multivariate analysis was performed on case-note data. Semi-structured interviews were conducted with 17 relatives of stroke decedents and 23 healthcare professionals, using a modified grounded theory approach to collect and analyse data. The VOICES survey tool was also administered to the bereaved relatives and data were analysed using descriptive statistics and thematic analysis of free-text responses. Results: Relatives often played an important role in influencing aspects of end-of-life care, including decisions to use an end-of-life care pathway. Some relatives experienced enduring distress with their perceived responsibility for care decisions. Relatives felt unprepared for and were distressed by prolonged dying processes, which were often associated with severe dysphagia. Pro-active information-giving by staff was reported as supportive by relatives. Healthcare professionals generally avoided discussing place of care with families. Decisions to use an end-of-life care pathway were not predicted by patients’ demographic characteristics; decisions were generally made in consultation with families and the extended health care team, and were made within regular working hours. Conclusion: Distressing stroke-related issues were more prominent in participants’ accounts than concerns with the end-of-life care pathway used. Relatives sometimes perceived themselves as responsible for important clinical decisions. Witnessing prolonged dying processes was difficult for healthcare professionals and families, particularly in relation to the management of persistent major swallowing difficulties.
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Ehrlich, Carolyn Elsie. "Implementing Care Coordination in General practice: Embedding New Methods." Thesis, Griffith University, 2011. http://hdl.handle.net/10072/366389.

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In Australia, the health care system is complex, constantly changing and comprised of multiple layers. Within this complex system, service fragmentation, care segmentation, and confusion about access to and provision of health care services, is likely to be the usual experience of both consumers and providers of health care. Chronic condition care coordination is frequently touted as one solution to these problems, but its implementation has been less successful. Given that access to the health care system most frequently originates in general practice, implementation within this context is particularly important. However, implementing chronic condition care coordination within general practice is not likely to be simple because a complete reorientation of general practice will be required, from an acute care focus towards the ongoing management of chronic conditions. Nurses (RNs) who work in general practice provide an opportunity for achieving this type of reorientation, but the sustainability of any changes will be dependent on the way in which practices become routinely embedded in the work of general practice. This research examines the implementation of RN-provided chronic condition care coordination in general practice. According to Normalization Process Theory (NPT) (May & Finch, 2009), the extent to which any new practice or innovation becomes embedded in usual practice is dependent on the extent to which its components are workable within the context and are capable of being integrated into existing ways of operating. Thus, the most appropriate theoretical framework to apply to the interpretation of this research is NPT.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Human Services and Social Work
Griffith Health
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Rotich, Everlyne Chepkemoi. "Development of Woman-Centred Midwife-led Model of Care through Participatory Methods for the Uasin Gishu County Hospital, Kenya." Doctoral thesis, Faculty of Health Sciences, 2021. http://hdl.handle.net/11427/33002.

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Background: The concept woman-centred care is gaining currency in maternity care and is increasingly being used to guide provision of quality care. The midwifery philosophy supports woman-centred care and is associated with positive pregnancy and birth outcomes. Development of a woman-centred midwife-led model of care requires involvement of the users (women), service providers (midwives), and health administrators to ensure representativeness of the model. Purpose: The purpose of this study was to explore, through participatory methods, the views of women midwives and health service managers on current maternity care, and describe desired maternity care and develop a woman-centred maternity care model for Uasin Gishu County, Kenya. Methodology: Appreciative Inquiry 4-D cycle was used in the study. The Human Scale Development framework guided the study. Thirty two midwives, 85 women attending maternity and well-baby services at the facility, and four facility and three county health service managers participated in the study. Focus group discussions and interviews were carried out from May 2015 to April 2016 using the four phases of the Appreciative Inquiry cycle. Phase one “discovered” what best maternity care looks like, phase two “dreamt” what best maternity care would look like, phase three “designed” the model, and phase four “destiny” was used for development of implementation strategies. Data was analysed using thematic analysis augmented by thematic networks analysis and NVIVO 11 software. Ethical approval was obtained from the University of Cape Town and the Moi University and Moi Teaching and Referral Hospital Research Ethics Committees. Individual's participation was voluntary, informed consent was obtained and confidentiality maintained. There was no compensation for participation.
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Preshaw, Deborah Hazel Louise. "Ethical issues experienced by healthcare workers providing palliative care in nursing homes : a mixed methods study." Thesis, Queen's University Belfast, 2017. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.728393.

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Background: Ethical issues experienced by healthcare providers can be associated with detrimental outcomes, however, little is known about the nature of these issues within palliative care provision in nursing homes. Aim: To provide a comprehensive understanding of care providers’ experiences of ethical issues during palliative care provision in nursing homes in the United Kingdom. Methods: A two phase, exploratory, sequential, mixed methods design was utilised. Semi-structured interviews with 13 Registered Nurses and ten Healthcare Assistants were used to explore ethical issues during palliative care provision. An instrument was developed measuring the frequency and level of distress associated with these ethical issues and utilised in a cross-sectional survey with 69 RNs and 129 HCAs. Results: Three themes grouped experiences of ethical issues. Issues in practice were found when conflicts arose between what felt right and the duty of care. Within this theme, making decisions in the residents’ best interests to prevent them from coming to harm (Mean = 2.68; SD= 1.24) was most frequently reported. Relational issues focused on conflicts within interpersonal relationships. Caring for residents who were only accepting small amounts or refusing food/fluids (Mean = 2.71; SD= 1.19) occurred most frequently. Organisational issues resulted from the structure and quality of services. Poor staff communication (Mean = 2.48; SD= 1.39); and lack of time (Mean = 2.36; SD= 1.44) resulted in the highest distress scores. No significant differences were identified between RNs and HCAs in the frequency (t= -.85, d.f. =196, p=.40), or level of distress (t= -.24, d.f. =176, p=.81) associated with ethical issues. Conclusions: Ethical issues within the UK nursing homes focus on acting within the duty of care, interpersonal relationships, and coping with a routinized organisational structure. Improved communication between healthcare professionals, residents, and families, and palliative care training may improve the palliative care experience.
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Himes, Alisha N. "An Historical Analysis of the Perception of Pain & Pain Management Methods from 1800-1945." Walsh University / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=walsh1587571133744558.

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Zeitz, Kathryn. "Post-operative observations, ritualised or vital in the detection of post-operative complications." Title page, contents and abstract only, 2003. http://web4.library.adelaide.edu.au/theses/09PH/09phz483.pdf.

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Copy of author's previously published work inserted. Includes bibliographical references (leaves 273-283). Aims to identify if the current practice of post-operative vital sign collection detects complications in the first 24 hours after the patient has returned to the general ward setting using a combination of methods within a triangulated approach to data collection.
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Mallo, Ryan Seth. "Dying to Be a Man| A Mixed Methods Study Implementing Men's Health Promotion and the Psychology of Masculinity in Graduate Primary Care Curriculum." Thesis, Northwest Nazarene University, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10933610.

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The health outcomes of men are significantly worse, when compared to their female counterpart, for the top 15 leading causes of death nationwide. At this time, men are not actively engaged in the healthcare system and didactic and clinical education does not adequately prepare providers to care for men or understand the psychology of masculinity. As of 2016 there were no primary care programs or medical schools that incorporated a specific course in men’s health promotion or the psychology of masculinity within their curriculum. This research study implemented one curricular module on the content of men’s health promotion and the psychology of masculinity. The researcher sought to understand what aspects of men’s primary healthcare and masculinity were taught within Primary Care Providers (PCP) didactic and clinical studies, what PCPs state was lacking from their curriculum, and how that translates to their ability to practice clinically. The research took place at six separate universities throughout the United States. Using a five-point Likert scaled survey, quantitative data was collected from students in six universities after they participated in a single module on men’s health promotion and masculinity. One month after students at the six universities went through the intervention, a second quantitative, five-point Likert Scale survey was collected that sought to determine what information from the module was applicable in their clinical education and settings after going through the intervention. The researcher then conducted six, qualitative, semi-structured, open-ended interviews with students who responded favorably to such an interview in quantitative evaluations through Qualtrics. Data analysis was completed through Wilcoxon Signed Rank Testing. Cohen’s d effect size was utilized to understand the significance of effect size within the data. Students in primary care agree that lack of timely healthcare, on behalf of men, is a stressor on the healthcare system and 100% of students agree they would welcome more content in their didactic education on men’s health promotion and the psychology of masculinity. Similarly, 94.5% of respondent’s state there is a need for primary care students to learn how to engage men in primary preventive care with 77% of respondents requesting more gender specific training. Students that went through the educational endeavor found value in the content delivered with 83.4% of participants stating they planned to make changes in their practice as a result of going through the educational module. Quantitative findings revealed that less than 20% of those surveyed are consistently utilizing evidence based interventions noted in literature to recruit and retain men into primary preventive care. Qualitative interviews noted that participants found themselves unconsciously unaware of their limitations in caring for men in the primary care setting, but fully aware that diverse and holistic care improves patient outcomes. Qualitative respondents also expressed a desire to grow professionally and a willingness to engage in pioneering practices that would equip them to deliver excellence in care.

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Books on the topic "Nursing Care – methods"

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Lippincott Williams & Wilkins., ed. Critical care nursing. Philadelphia: Lippincott Williams & Wilkins, 2007.

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Elaine, Mohn-Brown, and Eby Linda, eds. Medical-surgical nursing care. 3rd ed. Upper Saddle River, N.J: Pearson Prentice Hall, 2011.

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Towle, Mary Ann. Maternal-newborn nursing care. Upper Saddle River, N.J: Pearson/Prentice Hall, 2009.

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Crawford, Doreen, and Michaela Dixon. Paediatric intensive care nursing. Chichester, West Sussex: Wiley-Blackwell, 2012.

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L, London Marcia, ed. Maternal & child nursing care. 3rd ed. Upper Saddle River, N.J: Pearson Education, 2011.

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L, Weaver Aurora, ed. Critical care nursing demystified. New York: McGraw Hill Medical, 2011.

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M, Ashworth Pat, and Clarke Cilla, eds. Cardiovascular intensive care nursing. Edinburgh: Churchill Livingstone, 1992.

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G, Gossman William, ed. Critical care nursing review. 2nd ed. New York: McGraw-Hill, Medical Pub. Division, 2006.

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Lantz, John Martin. Nursing care of the elderly. 4th ed. South Easton, MA: Western Schools Press, 1998.

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Jaffe, Marie S. Nursing procedures for home care. Albany, NY: Delmar Publishers, 1993.

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Book chapters on the topic "Nursing Care – methods"

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Kielo-Viljamaa, Emilia. "Competence Assessment Instruments and Methods in Wound Care." In Wound Care Education in Nursing: A European Perspective, 101–6. Cham: Springer International Publishing, 2024. http://dx.doi.org/10.1007/978-3-031-53230-6_11.

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Qureshi, Irtiza. "Health and social care inequalities in relation to ethnicity; British South Asian men and nursing careers." In Health and Social Care Research Methods in Context, 155–73. London: Routledge, 2021. http://dx.doi.org/10.4324/9781003157724-11.

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Phillips, Jane, and Patricia M. Davidson. "Action Research as a Mixed Methods Design: a Palliative Approach in Residential Aged Care." In Mixed Methods Research for Nursing and the Health Sciences, 195–216. Oxford, UK: Wiley-Blackwell, 2009. http://dx.doi.org/10.1002/9781444316490.ch11.

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Eeltink, Corien, Sarah Jayne Liptrott, and Jacqui Stringer. "Nursing Research and Audit in the Transplant Setting." In The European Blood and Marrow Transplantation Textbook for Nurses, 321–31. Cham: Springer International Publishing, 2023. http://dx.doi.org/10.1007/978-3-031-23394-4_16.

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AbstractNursing research is a systematic inquiry that uses disciplined methods to answer questions or solve problems in order to expand the knowledge base within a given field. There are various issues to address in order to complete a successful study. The aim of this chapter is to provide the reader with an overview of the key topics for consideration and give guidance as to where to go for further information. Providing best care to patients undergoing HSCT is the moral and ethical duty of all nurses. As a consequence, awareness of, and involvement in, research as the vehicle to ensuring best practice is also our moral duty.
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McCulloch, Jock, and Pavla Miller. "Technologies, Care and Repatriations: 1926–1966." In Mining Gold and Manufacturing Ignorance, 345–69. Singapore: Springer Nature Singapore, 2023. http://dx.doi.org/10.1007/978-981-19-8327-6_13.

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AbstractUntil 1950, there was no effective chemotherapy for tuberculosis. Treatment consisted of an enhanced diet, isolation, and skilled nursing—methods which were expensive and not greatly effective. The centrepiece of the mines’ management of tuberculosis was repatriation of sick miners, without notification of local authorities, isolation of those with infective disease, or education of those around them on how to avoid infection. This approach enhanced the mines’ profitability but confounded every principle of public health. In the 1950s, the development of mass miniature radiography and the discovery of new drugs for the treatment of tuberculosis radically changed the available technologies of care. In discussing international standards of compensation for occupational lung disease, ILO held that the worker’s history of dust exposure, a clinical examination and radiographic findings had to be considered. The Chamber of Mines used mass miniature radiography for a different purpose: those with dusted lungs were identified at entry medicals and then repatriated without compensation. Where chemotherapy was provided to sick miners, the treatment rarely lasted more than a month; as a result, most patients developed drug resistant tuberculosis. Today, South Africa and its labour-sending regions have one of the world’s highest rates of multi-drug-resistant TB.
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"Models for delivering nursing care." In Oxford Handbook of Adult Nursing, edited by George Castledine and Ann Close, 13–26. Oxford University Press, 2009. http://dx.doi.org/10.1093/med/9780199231355.003.0002.

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Key concepts of nursing care 14 Delivering clinical nursing care 16 Accountability 18 Methods of nursing care delivery 20 Team approaches to care 22 Hospital–community links 24 Rehabilitation nursing 25 These are the concepts that are the basis of nursing care models. Models are conceptual mental constructs of the essential factors in nursing care from which nursing methods are developed....
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Vrbnjak, Dominika, Dušica Pahor, and Majda Pajnkihar. "4 The relationship between perceptions of caring relationships, person-centred climate, and medication administration in nursing: a mixed-methods study." In Innovative Nursing Care, 45–60. De Gruyter, 2023. http://dx.doi.org/10.1515/9783110786088-004.

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"Knowledge of Nursing Students Towards Tele-nursing Care: A Cross-Sectional Study." In NEW METHODS IN SCIENTIFIC RESEARC. ALL SCIENCES ACADEMY, 2023. http://dx.doi.org/10.59287/nmsr.1246.

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Robinson, Terry, and Jane Scullion. "Palliative care." In Oxford Handbook of Respiratory Nursing, 507–14. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198831815.003.0023.

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Although there are respiratory diseases that are acute and respond well to treatments, many end in what could be viewed as an essentially palliative or terminal phase. Many respiratory disease processes are essentially chronic in nature and some patients should be considered palliative from diagnosis. There is increasing evidence that patients with end-stage lung disease experience declining heath, anxiety, depression, fatigue, coping difficulties, and somatic preoccupation, and if this is unrecognized then there is a potential for basic needs to remain unmet. This chapter describes the management of breathlessness, chest clearance, and relaxation during the palliative phase of care, methods for managing anxiety, depression, and pain, and the nurse’s role in care during end-of-life care.
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Ringdahl, Deborah, Natalie Pool, and Mary Koithan. "Integrative Nursing Practice." In Integrative Nursing, edited by Mary Jo Kreitzer and Mary Koithan, 167–84. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190851040.003.0013.

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The principles of integrative nursing provide a framework to guide the practice of nursing in a way that aligns our beliefs and values with actions and therapeutic strategies. When conceptualized from an integrative approach to care, nurses support the person’s innate capacity to heal by providing care based on symptom severity, physiologic response, the patient’s condition, patient/family needs and preferences, and available resources. This chapter describes whole-person/whole-systems assessment that focuses on health and wellbeing, clinical decision-making, and methods to apply the full range of therapeutic interventions to weave together a way of being-knowing-doing that honors nursing’s traditions and prepares them to lead integrative healthcare delivery models.
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Conference papers on the topic "Nursing Care – methods"

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Koh, Myung Suk, Young Suk Lim, and Mihyang Cha. "Investigation of Contraceptive Methods for Family Planning of a district, Uganda." In Health Care and Nursing 2015. Science & Engineering Research Support soCiety, 2015. http://dx.doi.org/10.14257/astl.2015.88.39.

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Rachmania, Diana, Widyasih Sunaringtyas, and Dhina Widayati. "INSTRUMENT DEVELOPMENT OF MANPOWER (M1) NURSING MANAGEMENT BASED ON PROFESSIONAL NURSING CARE METHODS AND JCI ACCREDITATION." In THE 4th INTERNATIONAL NURSING CONFERENCE “LIFE CYCLE APPROACH FOR SUCCESSFUL AGING”. Universitas Muhammadiyah Jember, 2019. http://dx.doi.org/10.32528/inc.v0i0.2697.

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Iwata, H., S. Tsumoto, and S. Hirano. "Maintenance of nursing care plan using similarity-based data mining methods." In 2013 ICME International Conference on Complex Medical Engineering (CME 2013). IEEE, 2013. http://dx.doi.org/10.1109/iccme.2013.6548219.

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Serigatti, Giulia, Marcele Pescuma Capeletti Padula, and Camila Waters. "Nursing care for patients diagnosed with epilepsy: bibliographic research." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.304.

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Background: Characterized as a seizure crisis, the transient occurrence of signs and/or symptoms resulting from brain electrical impulses, in an unorganized, excessive and repeated manner. It’s the responsibility of the health team, including nursing, to provide information to the population about the disease. Objective: Identify, through scientific articles, nursing care for patients diagnosed with epilepsy. Design and setting: Bibliographic and descriptive research on nursing care for patients diagnosed with epilepsy, a search for scientific articles was carried out in Latin American and Caribbean Health Sciences and Nursing Database, which are part of the Virtual Health Library Methods: Articles available, online, in Portuguese, Spanish and English, published from January 2008 to December 2018. Results: Five articles were analyzed, which identified the nursing care provided to patients diagnosed with epilepsy. The articles were categorized as: “training of nurses on epilepsy care” in four articles that describe the development and implantation of a plan to take care of epilepsy by nurses, the care for patients with specialist nurse in epilepsy and training of nurses to be specialist nurses; and “education and training of parents of children diagnosed with epilepsy” in an article that describes a tool development by nurses to help parents and family to take care of a child with epilepsy. Conclusions: The nurse with the health team is very important in the participation of explanatory processes of individual and family adaptation, as they can identify the limitations that must be worked on and they assist in the development of solutions.
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Halbwachs, Helena Kristina. "MANAGING THE QUALITY OF NURSING AND SOCIAL CARE IN SENECURA GROUP HOMES FOR THE OLDER ADULTS." In 14. kongres zdravstvene in babiške nege Slovenije,11. in 12. maj 2023, Kongresni center Brdo, Brdo pri Kranju. Zbornica zdravstvene in babiške nege Slovenije - Zveza strokovnih društev medicinskih sester, babic in zdravstvenih tehnikov Slovenije, 2023. http://dx.doi.org/10.14528/asae9754.15.

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Effective quality management is a key element in ensuring the safety of residents and the high quality of nursing and social care services in long-term care facilities. It requires a systematic and holistic approach, as quality management consists of many interdependent and interrelated elements. This paper presents case strudy - the quality management of nursing and social care in the SeneCura group of nursing homes. Quality management is carried out with support of the parent headquarters, by professional quality managers closely liaising with the management of the nursing homes. Comprehensive quality management consists of risk management, monitoring feedback, surveying residents and staff, monitoring training activities, monitoring a wide range of quality indicators, providing guidelines, standards and policies, and monitoring compliance and adherence to these documents through internal controls and other methods. An important activity of the central quality function and of the management as a whole is to create and maintain a culture of safety, where there is no fear of reprisals for failures Unfortunately, it is not possible to compare the indicators and the effectiveness of quality management in long-term care in the Slovenian context, as there is no consensus at the moment to make the data comparable and transparent. This makes the exchange of experience and good practice all the more important
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Wahyuni, Sri, Tutik Rahayu, and Apriliani Yulianti Wuriningsih. "Spiritual Endorphine Stimulation as Methods to Increase Fetal Well Being on Pregnant Woman with Early Premature Rupture of Membranes." In The 9th International Nursing Conference: Nurses at The Forefront Transforming Care, Science and Research. SCITEPRESS - Science and Technology Publications, 2018. http://dx.doi.org/10.5220/0008331306990702.

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Silva, Sâmela Maria de Oliveira, Manuelle de Araujo Holanda, Julia Maria Pacheco Lins Magalhães, Thaísa Mirella da Silva, and Suzana Maria de Oliveira Costa Meneses. "Relevance of the nursing consultation in the care of the cancer patient in chemotherapeutic treatment - experience report." In II INTERNATIONAL SEVEN MULTIDISCIPLINARY CONGRESS. Seven Congress, 2023. http://dx.doi.org/10.56238/homeinternationalanais-096.

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Abstract The National Cancer Institute (INCA) has released updated data on the cancer landscape in Brazil, with an estimated incidence of 625,000 new cases of cancer (450,000, excluding cases of non-melanoma skin cancer) for each year of the triennium 2020-2022. Because of these facts, we found the need for a nursing practice that not only provided technical assistance, located in the outpatient setting, but that this care was extended to the home, through the care of the patient himself, or family members and caregivers. According to Pinheiros (1999), the nurse, in the performance of her role as an educator, aims to promote, maintain and restore health, in the teaching of skills and attitudes, as well as in the modification of inappropriate or unacceptable methods by society. Therefore, this educational activity can be provided by nurses through nursing consultation, which aims to provide specialized and individualized care to the client, through a contextualized and participatory approach. Thus emphasizing the relevance of the nursing consultation for establishing a bond with the patient, family member, and/or caregiver; guiding them regarding self-care, clarifying what chemotherapy is, and handling the side effects of antineoplastic treatment, thus favoring the increase in treatment and treatment success.
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Lorber, Mateja, and Mojca Dobnik. "Izgorelost zaposlenih v zdravstveni negi med drugim valom COVID-19." In Society’s Challenges for Organizational Opportunities: Conference Proceedings. University of Maribor Press, 2022. http://dx.doi.org/10.18690/um.fov.3.2022.37.

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Introduction: A pandemic of COVID-19, a major public problem with a high number of infections and deaths, can lead to many psychological issues in healthcare professionals. The study aimed to examine burnout among employees in nursing employees in caring for COVID-19 patients. Methods: A descriptive cross-sectional study was used. The sample included employees in nursing from four hospitals, where they take care of COVID-19 patients. Results: Burnout is at the upper-moderate level, but high emotional exhaustion in 64% of employees in nursing. 88% of employees in nursing were deployed to another clinical area, and 65% felt under stress because of their job. There were significant differences in emotional exhaustion according to the level of education (p=0.015) and employees who were deployed to another department or not (p=0.008). Conclusions: Employees in nursing experienced a high level of emotional exhaustion. Psychological support is essential to preserving employees’ health and well-being, mainly when emotional exhaustion and occupational stress levels are high.
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Santos, Deborah Ferreira, Marcele Pescuma Capeletti Padula, and Camila Waters. "Nursing diagnoses of patients with Ischemic Stroke: a bibliographic search." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.706.

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Introduction: Stroke causes cell injury and neurological damage that induce paralysis of a particular brain zone from which it has been left without proper circulation owing to thrombus, embolus or hemorrhage. Objective: Identify, through scientific articles, the nursing diagnoses of Stroke patients. Methods: Bibliographic and descriptive research held at Virtual Health Library, using the specific descriptors: Stroke and Brain Ischemia that were crossed with the general descriptor: Nursing Diagnosis, written in Portuguese and published from 2008 to 2018. Results: Eight articles were selected between 2008 and 2018 we found two publications in the following years: 2010, 2012, 2013 and 2015. The first publication was in 2010 and the last one in 2015, there is no evidence of research on nursing diagnoses in patients with stroke in the last four years. All studies were performed cross-sectionally, with data collected in the state of Ceará and with a sample ranging from 24 to 156 patients. The Nursing Diagnoses cited by the articles were: urinary incontinence; risk for aspiration; impaired verbal communication; intolerance and risk for activity intolerance; risk for disuse syndrome; risk for falls; fatigue; impaired physical mobility, impaired bed mobility, impaired wheelchair mobility; impaired transfer ability; impaired walking; sedentary lifestyle. Conclusion: Stroke results in disabilities that compromise the quality of life. The importance of preventing risk factors for stroke is clear, as well as the need for quick and effective care, emphasizing the individually, systematic and qualifies nursing care in order to decrease stroke sequels and guarantee quality of life.
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Barreto, Everton Rodrigo, Rosana Maria Faria Vador, and Thalita Martins Ferraz Meneses. "Nurse performance in viral oncolytic therapy." In III SEVEN INTERNATIONAL MULTIDISCIPLINARY CONGRESS. Seven Congress, 2023. http://dx.doi.org/10.56238/seveniiimulti2023-084.

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Introduction: Viral oncolytic therapy (VOT) is an emerging approach in cancer treatment, which is based on the selective replication of a viral vector inside cancer cells, triggering the death of tumor cells by lysis and the spread of new viral particles to the remaining adjacent malignant cells. However, special care is needed from nurses to manage immune-mediated side effects and provide support and education to patients and their families during treatment. Objectives: To survey the nurse's performance in the face of VOT; propose a model of Systematization of Nursing Care (SNC) with the main nursing diagnoses related to VOT. Methods: This is a qualitative literature review, using as a primary source of research the databases - CAPES, PubMed, Scielo, BVS. Composing a sample of 39 articles relevant to the formulation of this article. Results: Although there is a significant scientific production on nursing care in the oncological context, there are still few studies that specifically address the SNC related to TOV and immunotherapies. In view of this and considering and need to fill this gap, an SNC model is proposed, considering the oncologic patient in the face of a holistic view. Regarding the adverse reactions associated with therapy, it is of paramount importance, and the implementation of SNC as a structured care process can contribute significantly to the excellence of care for cancer patients undergoing this innovative therapy, with the main nursing diagnoses related to OVT Conclusion: The integration of scientific knowledge, clinical skills and a humanized approach strengthens the role of nurses as a fundamental part of the multidisciplinary team in the treatment of cancer through OVT.
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Reports on the topic "Nursing Care – methods"

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Lees-Deutsch, Liz, Rosie Kneafsey, Amanda Rodrigues Amorim Adegboye, Natasha Bayes, Shea Palmer, Aiden Chauntry, and Mariam Khan. National Evaluation of the Professional Nurse Advocate Programme in England: SUSTAIN – Supervision, Support, Advocacy for Improvement in Nursing, Mixed Methods study. Coventry University, June 2023. http://dx.doi.org/10.18552/rihw/2023/0001.

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The Professional Nurse Advocate (PNA) programme is a clinical and professional leadership programme delivered by Higher Education Institutions (HEI) which equips nurses with the skills to deliver restorative clinical supervision to colleagues in England. The programme has been gradually rolled out across England during 2021/22 with the aim of ensuring there will be PNAs in place to support colleagues in the following specialties: Critical care, Mental Health (Adult Acute & Children and Young Peoples inpatient settings) Community, Learning Disabilities (Adult), Children and Young People, Safeguarding, Health & Criminal Justice settings (HCJ), and International Nurses. In February 2022, NHSE sought an evaluation of the PNA programme. A research team from Coventry University was commissioned to undertake this work. This Executive Summary Report sets out the methods, activities, findings, and recommendations as requested by commissioners.
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James-Scott, Alisha, Rachel Savoy, Donna Lynch-Smith, and tracy McClinton. Impact of Central Line Bundle Care on Reduction of Central Line Associated-Infections: A Scoping Review. University of Tennessee Health Science Center, November 2021. http://dx.doi.org/10.21007/con.dnp.2021.0014.

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Purpose/Background Central venous catheters (CVC) are typical for critically ill patients in the intensive care unit (ICU). Due to the invasiveness of this procedure, there is a high risk for central line-associated bloodstream infection (CLABSI). These infections have been known to increase mortality and morbidity, medical costs, and reduce hospital reimbursements. Evidenced-based interventions were grouped to assemble a central line bundle to decrease the number of CLABSIs and improve patient outcomes. This scoping review will evaluate the literature and examine the association between reduced CLABSI rates and central line bundle care implementation or current use. Methods A literature review was completed of nine critically appraised articles from the years 2010-2021. The association of the use of central line bundles and CLABSI rates was examined. These relationships were investigated to determine if the adherence to a central line bundle directly reduced the number of CLABSI rates in critically ill adult patients. A summary evaluation table was composed to determine the associations related to the implementation or current central line bundle care use. Results Of the study sample (N=9), all but one demonstrated a significant decrease in CLABSI rates when a central line bundle was in place. A trend towards reducing CLABSI was noted in the remaining article, a randomized controlled study, but the results were not significantly different. In all the other studies, a meta-analysis, randomized controlled trial, control trial, cohort or case-control studies, and quality improvement project, there was a significant improvement in CLABSI rates when utilizing a central line bundle. The extensive use of different levels of evidence provided an excellent synopsis that implementing a central line bundle care would directly affect decreasing CLABSI rates. Implications for Nursing Practice Results provided in this scoping review afforded the authors a diverse level of evidence that using a central line bundle has a direct outcome on reducing CLABSI rates. This practice can be implemented within the hospital setting as suggested by the literature review to prevent or reduce CLABSI rates. Implementing a standard central line bundle care hospital-wide helps avoid this hospital-acquired infection.
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McCarthy, Sean T., Aneesa Motala, Emily Lawson, and Paul G. Shekelle. Prevention in Adults of Transmission of Infection With Multidrug-Resistant Organisms. Rapid Review. Agency for Healthcare Research and Quality (AHRQ), April 2024. http://dx.doi.org/10.23970/ahrqepc_mhs4mdro.

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Objectives. This rapid review summarizes literature for patient safety practices intended to prevent and control the transmission of multidrug-resistant organisms (MDROs). Methods. We followed rapid review processes of the Agency for Healthcare Research and Quality Evidence-based Practice Center Program. We searched PubMed to identify eligible systematic reviews from 2011 to May 2023 and primary studies published from 2011 to May 2023, supplemented by targeted gray literature searches. We included literature that addressed patient safety practices intending to prevent or control transmission of MDROs which were implemented in hospitals and nursing homes and that included clinical outcomes of infection or colonization with MDROs as well as unintended consequences such as mental health effects and noninfectious adverse healthcare-associated outcomes. The protocol for the review has been registered in PROSPERO (CRD42023444973). Findings. Our search retrieved 714 citations, of which 42 articles were eligible for review. Systematic reviews, which were primarily of observational studies, included a wide variety of infection prevention and control (IPC) practices, including universal gloving, contact isolation precautions, adverse effects of patient isolation, patient and/or staff cohorting, room decontamination, patient decolonization, IPC practices specifically in nursing homes, features of organizational culture to facilitate implementation of IPC practices and the role of dedicated IPC staff. While systematic reviews were of good or fair quality, strength of evidence for the conclusions was always low or very low, due to reliance on observational studies. Decolonization strategies showed some benefit in certain populations, such as nursing home patients and patients discharging from acute care hospitalization. Universal gloving showed a small benefit in the intensive care unit. Contact isolation targeting patients colonized or infected with MDROs showed mixed effects in the literature and may be associated with mental health and noninfectious (e.g., falls and pressure ulcers) adverse effects when compared with standard precautions, though based on before/after studies in which such precautions were ceased. There was no significant evidence of benefit for patient cohorting (except possibly in outbreak settings), automated room decontamination or cleaning feedback protocols, and IPC practices in long-term settings. Infection rates may be improved when IPC practices are implemented in the context of certain logistical and staffing characteristics including a supportive organizational culture, though again strength of evidence was low. Dedicated infection prevention staff likely improve compliance with other patient safety practices, though there is little evidence of their downstream impact on rates of infection. Conclusions. Selected infection prevention and control interventions had mixed evidence for reducing healthcare-associated infection and colonization by multidrug resistant organisms. Where these practices did show benefit, they often had evidence that applied only to certain subpopulations (such as intensive care unit patients), though overall strength of evidence was low.
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Schnabel, Filipina, and Danielle Aldridge. Effectiveness of EHR-Depression Screening Among Adult Diabetics in an Urban Primary Care Clinic. University of Tennessee Health Science Center, April 2021. http://dx.doi.org/10.21007/con.dnp.2021.0003.

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Background Diabetes mellitus (DM) and depression are important comorbid conditions that can lead to more serious health outcomes. The American Diabetes Association (ADA) supports routine screening for depression as part of standard diabetes management. The PHQ2 and PHQ9 questionnaires are good diagnostic screening tools used for major depressive disorders in Type 2 diabetes mellitus (DM2). This quality improvement study aims to compare the rate of depression screening, treatment, and referral to behavioral health in adult patients with DM2 pre and post-integration of depression screening tools into the electronic health record (EHR). Methods We conducted a retrospective chart review on patients aged 18 years and above with a diagnosis of DM2 and no initial diagnosis of depression or other mental illnesses. Chart reviews included those from 2018 or prior for before integration data and 2020 to present for after integration. Sixty subjects were randomly selected from a pool of 33,695 patients in the clinic with DM2 from the year 2013-2021. Thirty of the patients were prior to the integration of depression screening tools PHQ2 and PHQ9 into the EHR, while the other half were post-integration. The study population ranged from 18-83 years old. Results All subjects (100%) were screened using PHQ2 before integration and after integration. Twenty percent of patients screened had a positive PHQ2 among subjects before integration, while 10% had a positive PHQ2 after integration. Twenty percent of patients were screened with a PHQ9 pre-integration which accounted for 100% of those subjects with a positive PHQ2. However, of the 10% of patients with a positive PHQ2 post-integration, only 6.7 % of subjects were screened, which means not all patients with a positive PHQ2 were adequately screened post-integration. Interestingly, 10% of patients were treated with antidepressants before integration, while none were treated with medications in the post-integration group. There were no referrals made to the behavior team in either group. Conclusion There is no difference between the prevalence of depression screening before or after integration of depression screening tools in the EHR. The study noted that there is a decrease in the treatment using antidepressants after integration. However, other undetermined conditions could have influenced this. Furthermore, not all patients with positive PHQ2 in the after-integration group were screened with PHQ9. The authors are unsure if the integration of the depression screens influenced this change. In both groups, there is no difference between referrals to the behavior team. Implications to Nursing Practice This quality improvement study shows that providers are good at screening their DM2 patients for depression whether the screening tools were incorporated in the EHR or not. However, future studies regarding providers, support staff, and patient convenience relating to accessibility and availability of the tool should be made. Additional issues to consider are documentation reliability, hours of work to scan documents in the chart, risk of documentation getting lost, and the use of paper that requires shredding to comply with privacy.
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Newman-Toker, David E., Susan M. Peterson, Shervin Badihian, Ahmed Hassoon, Najlla Nassery, Donna Parizadeh, Lisa M. Wilson, et al. Diagnostic Errors in the Emergency Department: A Systematic Review. Agency for Healthcare Research and Quality (AHRQ), December 2022. http://dx.doi.org/10.23970/ahrqepccer258.

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Objectives. Diagnostic errors are a known patient safety concern across all clinical settings, including the emergency department (ED). We conducted a systematic review to determine the most frequent diseases and clinical presentations associated with diagnostic errors (and resulting harms) in the ED, measure error and harm frequency, as well as assess causal factors. Methods. We searched PubMed®, Cumulative Index to Nursing and Allied Health Literature (CINAHL®), and Embase® from January 2000 through September 2021. We included research studies and targeted grey literature reporting diagnostic errors or misdiagnosis-related harms in EDs in the United States or other developed countries with ED care deemed comparable by a technical expert panel. We applied standard definitions for diagnostic errors, misdiagnosis-related harms (adverse events), and serious harms (permanent disability or death). Preventability was determined by original study authors or differences in harms across groups. Two reviewers independently screened search results for eligibility; serially extracted data regarding common diseases, error/harm rates, and causes/risk factors; and independently assessed risk of bias of included studies. We synthesized results for each question and extrapolated U.S. estimates. We present 95 percent confidence intervals (CIs) or plausible range (PR) bounds, as appropriate. Results. We identified 19,127 citations and included 279 studies. The top 15 clinical conditions associated with serious misdiagnosis-related harms (accounting for 68% [95% CI 66 to 71] of serious harms) were (1) stroke, (2) myocardial infarction, (3) aortic aneurysm and dissection, (4) spinal cord compression and injury, (5) venous thromboembolism, (6/7 – tie) meningitis and encephalitis, (6/7 – tie) sepsis, (8) lung cancer, (9) traumatic brain injury and traumatic intracranial hemorrhage, (10) arterial thromboembolism, (11) spinal and intracranial abscess, (12) cardiac arrhythmia, (13) pneumonia, (14) gastrointestinal perforation and rupture, and (15) intestinal obstruction. Average disease-specific error rates ranged from 1.5 percent (myocardial infarction) to 56 percent (spinal abscess), with additional variation by clinical presentation (e.g., missed stroke average 17%, but 4% for weakness and 40% for dizziness/vertigo). There was also wide, superimposed variation by hospital (e.g., missed myocardial infarction 0% to 29% across hospitals within a single study). An estimated 5.7 percent (95% CI 4.4 to 7.1) of all ED visits had at least one diagnostic error. Estimated preventable adverse event rates were as follows: any harm severity (2.0%, 95% CI 1.0 to 3.6), any serious harms (0.3%, PR 0.1 to 0.7), and deaths (0.2%, PR 0.1 to 0.4). While most disease-specific error rates derived from mainly U.S.-based studies, overall error and harm rates were derived from three prospective studies conducted outside the United States (in Canada, Spain, and Switzerland, with combined n=1,758). If overall rates are generalizable to all U.S. ED visits (130 million, 95% CI 116 to 144), this would translate to 7.4 million (PR 5.1 to 10.2) ED diagnostic errors annually; 2.6 million (PR 1.1 to 5.2) diagnostic adverse events with preventable harms; and 371,000 (PR 142,000 to 909,000) serious misdiagnosis-related harms, including more than 100,000 permanent, high-severity disabilities and 250,000 deaths. Although errors were often multifactorial, 89 percent (95% CI 88 to 90) of diagnostic error malpractice claims involved failures of clinical decision-making or judgment, regardless of the underlying disease present. Key process failures were errors in diagnostic assessment, test ordering, and test interpretation. Most often these were attributed to inadequate knowledge, skills, or reasoning, particularly in “atypical” or otherwise subtle case presentations. Limitations included use of malpractice claims and incident reports for distribution of diseases leading to serious harms, reliance on a small number of non-U.S. studies for overall (disease-agnostic) diagnostic error and harm rates, and methodologic variability across studies in measuring disease-specific rates, determining preventability, and assessing causal factors. Conclusions. Although estimated ED error rates are low (and comparable to those found in other clinical settings), the number of patients potentially impacted is large. Not all diagnostic errors or harms are preventable, but wide variability in diagnostic error rates across diseases, symptoms, and hospitals suggests improvement is possible. With 130 million U.S. ED visits, estimated rates for diagnostic error (5.7%), misdiagnosis-related harms (2.0%), and serious misdiagnosis-related harms (0.3%) could translate to more than 7 million errors, 2.5 million harms, and 350,000 patients suffering potentially preventable permanent disability or death. Over two-thirds of serious harms are attributable to just 15 diseases and linked to cognitive errors, particularly in cases with “atypical” manifestations. Scalable solutions to enhance bedside diagnostic processes are needed, and these should target the most commonly misdiagnosed clinical presentations of key diseases causing serious harms. New studies should confirm overall rates are representative of current U.S.-based ED practice and focus on identified evidence gaps (errors among common diseases with lower-severity harms, pediatric ED errors and harms, dynamic systems factors such as overcrowding, and false positives). Policy changes to consider based on this review include: (1) standardizing measurement and research results reporting to maximize comparability of measures of diagnostic error and misdiagnosis-related harms; (2) creating a National Diagnostic Performance Dashboard to track performance; and (3) using multiple policy levers (e.g., research funding, public accountability, payment reforms) to facilitate the rapid development and deployment of solutions to address this critically important patient safety concern.
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