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1
Rose, Pauline Mary-Therese. "Implementation and evaluation of a new model of nursing practice in radiation oncology." Thesis, Queensland University of Technology, 2010. https://eprints.qut.edu.au/37646/1/Pauline_Rose_Thesis.pdf.
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Patients undergoing radiation therapy for cancer face a series of challenges that require support from a multidisciplinary team which includes radiation oncology nurses. However, the specific contribution of nursing, and the models of care that best support the delivery of nursing interventions in the radiotherapy setting, is not well described.
In this case study, the Interaction Model of Client Health Behaviour and the associated principles of person-centred care were incorporated into a new model of care that was implemented in one radiation oncology setting in Brisbane, Australia. The new model of care was operationalised through a Primary Nursing/Collaborative Practice framework. To evaluate the impact of the new model for patients and health professionals, multiple sources of data were collected from patients and clinical staff prior to, during, and 18 months following introduction of the practice redesign. One cohort of patients and clinical staff completed surveys incorporating measures of key outcomes immediately prior to implementation of the model, while a second cohort of patients and clinical staff completed these same surveys 18 months following introduction of the model. In-depth interviews were also conducted with nursing, medical and allied health staff throughout the implementation phase to obtain a more comprehensive account of the processes and outcomes associated with implementing such a model.
From the patients’ perspectives, this study demonstrated that, although adverse effects of radiotherapy continue to affect patient well-being, patients continue to be satisfied with nursing care in this specialty, and that they generally reported high levels of functioning despite undergoing a curative course of radiotherapy. From the health professionals’ perspective, there was evidence of attitudinal change by nursing staff within the radiotherapy department which reflected a greater understanding and appreciation of a more person-centred approach to care. Importantly, this case study has also confirmed that a range of factors need to be considered when redesigning nursing practice in the radiotherapy setting, as the challenges associated with changing traditional practices, ensuring multidisciplinary approaches to care, and resourcing a new model were experienced.
The findings from this study suggest that the move from a relatively functional approach to a person-centred approach in the radiotherapy setting has contributed to some improvements in the provision of individualised and coordinated patient care. However, this study has also highlighted that primary nursing may be limited in its approach as a framework for patient care unless it is supported by a whole team approach, an appropriate supportive governance model, and sufficient resourcing. Introducing such a model thus requires effective education, preparation and ongoing support for the whole team.
The challenges of providing care in the context of complex interdisciplinary relationships have been highlighted by this study. Aspects of this study may assist in planning further nursing interventions for patients undergoing radiotherapy for cancer, and continue to enhance the contribution of the radiation oncology nurse to improved patient outcomes.
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Gies, Cheryl E. "Evaluating effectiveness of an inpatient nurse-directed smoking cessation program in a small community hospital :." Connect to full-text via OhioLINK ETD Center, 2004. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=mco1115124358.
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Thesis (M.S.)--Medical College of Ohio, 2004."In partial fulfillment of the requirements for the degree of Master of Science in Nursing." Major advisor: Debra Buchman. Includes abstract. Document formatted into pages: ix, 112 p. Title from title page of PDF document. Bibliography: pages 91-97.
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Nash, Robyn Elizabeth. "Collaboration in clinical education : development, implementation and evaluation of an innovative model of clinical education for undergraduate nursing students." Thesis, Queensland University of Technology, 2007. https://eprints.qut.edu.au/16493/1/Robyn_Nash_Thesis.pdf.
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Introduction
The purpose of this study was to enhance the prac experience of undergraduate nursing students and registered nursing staff. An innovative model of clinical education, the Clinical Education Unit (CEU) model was developed, implemented and evaluated.
Background to the study
Clinical education is a vital component of the undergraduate nursing curriculum. 'Real world' practice provides students with the opportunity to develop the knowledge, attitudes and skills needed to function effectively as a registered nurse. Despite the commitment of universities to produce competent graduates, there has continued debate regarding the preparedness of new graduates for practice as registered nurses. This has focussed continued attention on the adequacy of students' clinical education and, in particular, on the models used for clinical facilitation/supervision. There is little published evidence that clearly demonstrates the effectiveness of any of the current models of clinical education or that any particular model is better than any other in achieving quality outcomes (Wellard, Williams and Bethune 2000; Clare, White, Edwards and Van Loon 2002). Hence, as recommended in the recent National Review of Nurse Education (2002), ongoing evaluation of nursing curricula and teaching practice, including clinical education, is clearly warranted.
Methods
The study utilised action research methodology to examine the effects of the Clinical Education Unit (CEU) on the quality of clinical prac as experienced by undergraduate nursing students and registered nurses working with the students in wards where they were placed for their practicums. It was undertaken in two iterations or phases: Phase 1 - Development, implementation and initial evaluation of an innovative model of clinical education (the CEU model) and Phase 2 - Refinement and re-evaluation of the CEU model of clinical education. Using focus group discussions and survey questionnaires, qualitative and quantitative data were collected from undergraduate nursing students and clinical nursing staff in conjunction with each iteration of the study.
Results
Phase 1 results indicated that the CEU model was evaluated more positively by students and registered nurses than were the non-CEU models that were used for comparison. This result was demonstrated in the comments of students and registered nurses with regard to the respective models of clinical education and supported by their ratings of the quality of clinical experience through the QPE-Phase questionnaires. A similar trend was found in the results from Phase 2. The CEU-2 model was again evaluated more positively by students and registered nurses than were the non-CEU models that were used for comparison.
Conclusion
In summary, the results of this study indicate that the CEU model had a positive impact on the prac experience of students and registered nurses. In both phases of the study, students and registered nurses in wards where the CEU model was being used evaluated the prac experience more positively than did students and registered nurses in wards where non-CEU models were being used. Two key factors were found to be important in achieving this outcome: the collaborative nature of the CEU model and nursing staff ownership of students' clinical education. These factors provided an operating framework which enabled the development of positive learning environments in the wards where students were placed for prac. Equally important were arrangements for the supervision of students' practice which involved local clinical facilitation and the explicit inclusion of other nursing staff in the ward. Further, continued support from the university to allow the clinical facilitators to take a supernumary role when facilitating students, to provide staff development for clinical education and to support staff on a day-to-day basis during the prac was also important, if not essential. It is proposed that these factors, acting synergistically, promoted enhanced access to learning opportunities for students and improved learning outcomes for students and staff. The study makes an important contribution to nursing education by providing evidence that can inform future developments in the area of undergraduate clinical education. It has potential benefits for nursing education not only in the local context, but within the international arena as well.
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Nash, Robyn Elizabeth. "Collaboration in clinical education : development, implementation and evaluation of an innovative model of clinical education for undergraduate nursing students." Queensland University of Technology, 2007. http://eprints.qut.edu.au/16493/.
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Introduction The purpose of this study was to enhance the prac experience of undergraduate nursing students and registered nursing staff. An innovative model of clinical education, the Clinical Education Unit (CEU) model was developed, implemented and evaluated. Background to the study Clinical education is a vital component of the undergraduate nursing curriculum. 'Real world' practice provides students with the opportunity to develop the knowledge, attitudes and skills needed to function effectively as a registered nurse. Despite the commitment of universities to produce competent graduates, there has continued debate regarding the preparedness of new graduates for practice as registered nurses. This has focussed continued attention on the adequacy of students' clinical education and, in particular, on the models used for clinical facilitation/supervision. There is little published evidence that clearly demonstrates the effectiveness of any of the current models of clinical education or that any particular model is better than any other in achieving quality outcomes (Wellard, Williams and Bethune 2000; Clare, White, Edwards and Van Loon 2002). Hence, as recommended in the recent National Review of Nurse Education (2002), ongoing evaluation of nursing curricula and teaching practice, including clinical education, is clearly warranted. Methods The study utilised action research methodology to examine the effects of the Clinical Education Unit (CEU) on the quality of clinical prac as experienced by undergraduate nursing students and registered nurses working with the students in wards where they were placed for their practicums. It was undertaken in two iterations or phases: Phase 1 - Development, implementation and initial evaluation of an innovative model of clinical education (the CEU model) and Phase 2 - Refinement and re-evaluation of the CEU model of clinical education. Using focus group discussions and survey questionnaires, qualitative and quantitative data were collected from undergraduate nursing students and clinical nursing staff in conjunction with each iteration of the study. Results Phase 1 results indicated that the CEU model was evaluated more positively by students and registered nurses than were the non-CEU models that were used for comparison. This result was demonstrated in the comments of students and registered nurses with regard to the respective models of clinical education and supported by their ratings of the quality of clinical experience through the QPE-Phase questionnaires. A similar trend was found in the results from Phase 2. The CEU-2 model was again evaluated more positively by students and registered nurses than were the non-CEU models that were used for comparison. Conclusion In summary, the results of this study indicate that the CEU model had a positive impact on the prac experience of students and registered nurses. In both phases of the study, students and registered nurses in wards where the CEU model was being used evaluated the prac experience more positively than did students and registered nurses in wards where non-CEU models were being used. Two key factors were found to be important in achieving this outcome: the collaborative nature of the CEU model and nursing staff ownership of students' clinical education. These factors provided an operating framework which enabled the development of positive learning environments in the wards where students were placed for prac. Equally important were arrangements for the supervision of students' practice which involved local clinical facilitation and the explicit inclusion of other nursing staff in the ward. Further, continued support from the university to allow the clinical facilitators to take a supernumary role when facilitating students, to provide staff development for clinical education and to support staff on a day-to-day basis during the prac was also important, if not essential. It is proposed that these factors, acting synergistically, promoted enhanced access to learning opportunities for students and improved learning outcomes for students and staff. The study makes an important contribution to nursing education by providing evidence that can inform future developments in the area of undergraduate clinical education. It has potential benefits for nursing education not only in the local context, but within the international arena as well.
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Seago, Trena. "A DEBRIEFING TECHNIQUE IN HIGH-FIDELITY PATIENT SIMULATION AND COMPETENT DECISION-MAKING ABILITIES AMONG NURSING STUDENTS." UKnowledge, 2016. https://uknowledge.uky.edu/edc_etds/18.
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Nursing faculty are utilizing high-fidelity patient simulation (HPS) with debriefing to help engage nursing students in making competent clinical decisions. This quasi-experimental study examined the use of HPS with debriefing and students’ ability to make nursing care decisions using standardized exams. The experimental group received debriefing after HPS and the control group did not receive debriefing after HPS. The pre- and post-test assessed participants’ ability to make clinical care decisions. The analysis of the pre-test and post-test HESI scores showed that there was no significant difference between the two groups.
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Koehn, Amy R. "To report or not report : a qualitative study of nurses' decisions in error reporting." Thesis, Indiana University, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3665927.
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This qualitative study was successful in utilization of grounded theory methodology to ascertain nurses' decision-making processes following their awareness of having made a medical error, as well as how and/or if they corrected and reported the error. Significant literature documents the existence of medical errors; however, this unique study interviewed thirty nurses from adult intensive care units seeking to discover through a detailed interview process their individual stories and experiences, which were then analyzed for common themes. Common themes led to the development of a theoretical model of thought processes regarding error reporting when nurses made an error. Within this theoretical model are multiple processes that outline a shared, time-orientated sequence of events nurses encounter before, during, and after an error. One common theme was the error occurred during a busy day when they had been doing something unfamiliar. Each nurse expressed personal anguish at the realization she had made an error, she sought to understand why the error happened and what corrective action was needed. Whether the error was reported on or told about depended on each unit's expectation and what needed to be done to protect the patient. If there was no perceived patient harm, errors were not reported. Even for reported errors, no one followed-up with the nurses in this study. Nurses were left on their own to reflect on what had happened and to consider what could be done to prevent error recurrence. The overall impact of the process of and the recovery from the error led to learning from the error that persisted throughout her nursing career. Findings from this study illuminate the unique viewpoint of licensed nurses' experiences with errors and have the potential to influence how the prevention of, notification about and resolution of errors are dealt with in the clinical setting. Further research is needed to answer multiple questions that will contribute to nursing knowledge about error reporting activities and the means to continue to improve error-reporting rates.
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Arsov, Svetoslav A. "Primary Care and Behavioral Health Services in a Federally Qualified Health Center." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6966.
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Between 2013 and 2016, 8.1% of U.S. adults 20 years and older suffered from depression, but only 29% of them sought help. This project addressed the low depression screening rate in a Federally Qualified Health Center (FQHC) that supported integrated care. The purpose of the project was to evaluate the integration of behavioral health into primary care in an FQHC through the rate of depression screenings. Two theoretical frameworks, the find-organize-clarify-understand-select/plan-do-study-act model and the Centers for Disease Control and Prevention's framework for program evaluation in public health were combined into a list of questions and data validity tests that were used to conduct the evaluation. This quality improvement (QI) project evaluated an existing QI initiative. Findings revealed that 75% of the patients seen, and not the initially reported 53%, received depression screenings, which indicated an improved outcome. Other findings were inadequate use of theoretical frameworks, poor data quality, and suboptimal effectiveness of QI team processes. The strategies and tools recommended in this project could be used by organizational leaders and QI teams to evaluate and improve QI initiatives. The project's contribution to awareness about depression through integrated care could increase patients' access to care, quality of life, and life expectancy, and positively impact social change.
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Ramsbotham, Joanne. "The development and evaluation of an innovative nursing practice model to improve undergraduate nursing students' competence in paediatric physical assessment." Thesis, Queensland University of Technology, 2009. https://eprints.qut.edu.au/31084/1/Joanne_Ramsbotham_Thesis.pdf.
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Introduction The purpose of this study was to develop, implement and evaluate the impact of an educational intervention, comprising an innovative model of clinical decisionmaking and educational delivery strategy for facilitating nursing students‘ learning and development of competence in paediatric physical assessment practices. Background of the study Nursing students have an undergraduate education that aims to produce graduates of a generalist nature who demonstrate entry level competence for providing nursing care in a variety of health settings. Consistent with population morbidity and health care roles, paediatric nursing concepts typically form a comparatively small part of undergraduate curricula and students‘ exposure to paediatric physical assessment concepts and principles are brief. However, the nursing shortage has changed traditional nursing employment patterns and new graduates form the majority of the recruitment pool for paediatric nursing speciality staff. Paediatric nursing is a popular career choice for graduates and anecdotal evidence suggests that nursing students who select a clinical placement in their final year intend to seek employment in paediatrics upon graduation. Although concepts of paediatric nursing are included within undergraduate curriculum, students‘ ability to develop the required habits of mind to practice in what is still regarded as a speciality area of practice is somewhat limited. One of the areas of practice where this particularly impacts is in paediatric nursing physical assessment. Physical assessment is a fundamental component of nursing practice and competence in this area of practice is central to nursing students‘ development of clinical capability for practice as a registered nurse. Timely recognition of physiologic deterioration of patients is a key outcome of nurses‘ competent use of physical assessment strategies, regardless of the practice context. In paediatric nursing contexts children‘s physical assessment practices must specifically accommodate the child‘s different physiological composition, function and pattern of clinical deterioration (Hockenberry & Barrera, 2007). Thus, to effectively manage physical assessment of patients within the paediatric practice setting nursing students need to integrate paediatric nursing theory into their practice. This requires significant information processing and it is in this process where students are frequently challenged. The provision of rules or models can guide practice and assist novice-level nurses to develop their capabilities (Benner, 1984; Benner, Hooper-Kyriakidis & Stannard, 1999). Nursing practice models are cognitive tools that represent simplified patterns of expert analysis employing concepts that suit the limited reasoning of the inexperienced, and can represent the =rules‘ referred to by Benner (1984). Without a practice model of physical assessment students are likely to be uncertain about how to proceed with data collection, the interpretation of paediatric clinical findings and the appraisal of findings. These circumstances can result in ad hoc and unreliable nursing physical assessment that forms a poor basis for nursing decisions. The educational intervention developed as part of this study sought to resolve this problem and support nursing students‘ development of competence in paediatric physical assessment. Methods This study utilised the Context Input Process Product (CIPP) Model by Stufflebeam (2004) as the theoretical framework that underpinned the research design and evaluation methodology. Each of the four elements in the CIPP model were utilised to guide discrete stages of this study. The Context element informed design of the clinical decision-making process, the Paediatric Nursing Physical Assessment model. The Input element was utilised in appraising relevant literature, identifying an appropriate instructional methodology to facilitate learning and educational intervention delivery to undergraduate nursing students, and development of program content (the CD-ROM kit). Study One employed the Process element and used expert panel approaches to review and refine instructional methods, identifying potential barriers to obtaining an effective evaluation outcome. The Product element guided design and implementation of Study Two, which was conducted in two phases. Phase One employed a quasiexperimental between-subjects methodology to evaluate the impact of the educational intervention on nursing students‘ clinical performance and selfappraisal of practices in paediatric physical assessment. Phase Two employed a thematic analysis and explored the experiences and perspectives of a sample subgroup of nursing students who used the PNPA CD-ROM kit as preparation for paediatric clinical placement. Results Results from the Process review in Study One indicated that the prototype CDROM kit containing the PNPA model met the predetermined benchmarks for face validity and the impact evaluation instrumentation had adequate content validity in comparison with predetermined benchmarks. In the first phase of Study Two the educational intervention did not result in statistically significant differences in measures of student performance or self-appraisal of practice. However, in Phase Two qualitative commentary from students, and from the expert panel who reviewed the prototype CD-ROM kit (Study One, Phase One), strongly endorsed the quality of the intervention and its potential for supporting learning. This raises questions regarding transfer of learning and it is likely that, within this study, several factors have influenced students‘ transfer of learning from the educational intervention to the clinical practice environment, where outcomes were measured. Conclusion In summary, the educational intervention employed in this study provides insights into the potential e-learning approaches offer for delivering authentic learning experiences to undergraduate nursing students. Findings in this study raise important questions regarding possible pedagogical influences on learning outcomes, issues within the transfer of theory to practice and factors that may have influenced findings within the context of this study. This study makes a unique contribution to nursing education, specifically with respect to progressing an understanding of the challenges faced in employing instructive methods to impact upon nursing students‘ development of competence. The important contribution transfer of learning processes make to students‘ transition into the professional practice context and to their development of competence within the context of speciality practice is also highlighted. This study contributes to a greater awareness of the complexity of translating theoretical learning at undergraduate level into clinical practice, particularly within speciality contexts.
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O'Neill, Eileen. "An evaluation of the Project 2000 model of nurse education." Thesis, Queen's University Belfast, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.287367.
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Ramakrishnan, Vijaya. "Use of Simulation for Tracheostomy Care, a Low Volume, High Risk Nursing Procedure." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/4981.
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Often, education regarding low volume and high-risk procedures, like tracheostomy, are ignored. Lack of experience, skills, and human resources can lead to decreases in confidence levels, diminished quality of care, and potentially an adverse event. The purpose of this DNP project was to prepare simulation-based education on the tracheostomy procedure and provide hands-on education to bedside nurses. The project answered the question: To what extent will a simulation-based teaching method adequately prepare staff nurses in a post-acute surgical unit to perform this high risk low volume procedure? The Johns Hopkins evidence-based model method was used to assist in translation of the practice change process. The International Nursing Association for Clinical Simulation and Learning standards were used to design simulation scenarios. Surgical acute care nurses (n = 35) including day and night shift nurses, new graduates, and experienced nurses participated. Groups of five to eight nurses participated in a two-hour simulation session at hospital simulation center. Pre- and post-surveys on confidence level data, and National League of Nursing evaluation tool data on educational practices and simulation designs were collected from all participants. Paired t-test statistics showed a significant increase in confidence level from pre to post education (p < .001). Because of the significant impact on patient care due to preventing complications and by improving nursing staff's level of confidence, the project may contribute to positive social change.
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McKenna, Hugh P. "The selection and evaluation of a nursing model for long-stay psychiatric patient care." Thesis, University of Ulster, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.335767.
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Williams, Marjory Dana. "Construction and Initial Evaluation of a Systems Model of Nursing Best Practice from a Complexity Science Perspective." Diss., The University of Arizona, 2006. http://hdl.handle.net/10150/195170.
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Despite the acceptance of best practice as a standard for quality health care delivery, the exact nature of what constitutes best practice does not share universal definition or application. The purpose of this dissertation is to propose an integrative conceptual representation of nursing best practice from the philosophical perspective of complexity science.A five-step concept clarification approach was used to identify the concept, systematize observations and descriptions, develop an operational definition, construct a model, and formulate hypotheses. An expert panel explored preliminary validity of the definition and model.Purposive recruitment of clinicians and scholars was conducted for expert panel membership. The expert panel rated the strength of the model dimensions of adequacy, representative-ness, consistency, clarity, simplicity, generalness, accessibility, importance, and relevance, as well as interest in development and application. Narrative data from open-ended questions was incorporated into model refinement.Clinician properties and context properties emerged as two principle domains of interdependent influence. Key dynamic processes included critical thinking by which clinicians operationalize properties into practice choices, and informative reflection by which the organization monitors and improves performance through information flow and learning. All aspects of the conceptual model, with the exception of consistency of relationships, were ultimately rated as strengths by the expert panel. Relationships among constructs were identified as complex, diverse, and difficult to isolate. Expert perception was that clinician and context properties most likely equally influence nursing best practice, but that context properties may have greater influence than clinician properties over time.This model incorporates a full range of interdependence across clinician and context domains of influence. This model requires further operationalization of constructs prior to formal validity testing. The application of complexity science introduces challenges to research and measurement in the study of complex adaptive systems. The model presented in this dissertation provides a perspective from which a better understanding of health care system interdependencies may arise.
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Obioma, Chidiadi. "Improving the Quality of Nursing Documentation in Home Health Care Setting." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3500.
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Poor nursing documentation of patient care was identified in daily nurse visit notes in a health care setting. This problem affects effective communication of patient status with other clinicians, thereby jeopardizing clinical decision-making. The purpose of this evidence-based project was to determine the impact of a retraining program on the quality of documentation of patient care in nurses' notes in a home health agency in central Texas. A retrospective audit of quality of nursing documentation using the Nurse and Midwifery Content Audit Tool (NMCAT) was done. A pre- and posttest design was used. A convenience sample of de-identified nurses' notes (80 pre- and 80 post) was selected from active patient records in the agency (n = 160). Descriptive and inferential statistics from the project showed that there was improved quality for the 15 criteria representing quality nursing documentation. After the educational intervention, documentation of patient's status if changed or unchanged improved to 80%, and patient's response to treatment improved (57% to 85%), entries were written as incidents occurred improved (53% to 64%). The nurse refers to the patient by name improved (0% to 66%). These findings were an indication of practice change, validating the need for periodic audits of nurses' notes in the agency in order to demonstrate compliance with quality standards. Based on the project findings, a retraining program is recommended to improve structured nursing documentation in a home health agency. This project is likely to contribute to social change as it enhanced the information communicated to other health care providers, coordination of care, and patient outcomes.
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Duncan, Darcy N. "Educating to the Collaborative Care Model." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3560.
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The problem addressed in this project was the lack of experienced RNs needed in the acute care setting to deliver safe, quality patient care, while effectively managing resources and providing job satisfaction. The purpose of this project was to determine if an education module designed to educate charge and rover nurses on the Collaborative Care Model (CCM) would enhance staff nurses' abilities to provide safe, high quality care to patients, and improve staff nurse retention on one unit in an acute care setting. The theoretical frameworks utilized to guide the education module included: Lewin's theory of planned change, Benner's novice to expert model, and AACN's synergy model for patient care. The project question asked if an educative process designed around the CCM for charge nurses and rovers would result in improvement and sustainment of nursing quality indicators on the unit and improve staff nurse retention. The educational modules included two, four-hour education sessions with power point presentations and interactive assignments presented on two separate dates. Analysis of effectiveness was determined by comparing initial and post education nursing quality indicators (Hospital Consumer Assessment of Healthcare Providers & Systems Dashboard and the Human Resources Score Card) for the unit. Results showed that staff turnover was reduced from 41% to 35.9% and patients' perceptions of teamwork increased from 47.4% to 60.9% following the education modules. This project contributes to positive social change by providing education to promote quality care and staff nurse retention.
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Smuts, Nicolette. "The elaboration and empirical evaluation of a partial talent management competency model in the nursing profession." Thesis, Stellenbosch : Stellenbosch University, 2011. http://hdl.handle.net/10019.1/17786.
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Thesis (MComm)--Stellenbosch University, 2011.ENGLISH ABSTRACT: This study stems from an urgent need to understand which factors contribute to nurse practitioners’ intention to quit, and consequently what organisations can do to retain these practitioners. There is increased pressure on the healthcare sector, more specifically nursing, due to a severe shortage in this discipline. These shortages are not an isolated phenomenon, but influence the private as well as public sector worldwide, as well as in South Africa. A multitude of factors contribute to the fact that nursing is a scarce skill worldwide. Some factors are controllable, others not. By isolating the controllable factors, organisations and managers can be equipped to put action plans in place to decrease the impact of this crisis. Processes and action plans to enlarge the nursing pool, and also to retain the current workforce, can contribute to overcoming this challenge. There is proof that the implementation of a structured talent management programme can contribute to overcoming this challenge. Line managers and their competence regarding the management of personnel play a key role in such a talent management programme. This study has as its objective to re-evaluate an existing talent management competency model for line managers, and to propose additional variables that can influence organisational outcomes like job satisfaction, organisational commitment and turnover intention. By understanding which line manager competencies influence organisational outcomes, and the manner in which they influence these outcomes, line managers as well as organisations can be equipped to formulate processes and programmes that can contribute to the retention of a scarce skill, and importantly, also minimise the impact of a worldwide crisis. The results of the study indicated that the operationalisation of the talent management competencies failed. The originally proposed model consequently had to be reduced by deleting all talent management latent variables from the model. Poor model fit was obtained for the reduced model. Modifications were, however, made to the reduced model based on modification index suggestions derived from the data. The modified model showed good fit and support was obtained for all the paths in the modified model. Crossvalidation of the modified model was recommended.
AFRIKAANSE OPSOMMING: Hierdie studie spruit uit ‘n dringende behoefte om te verstaan watter faktore daartoe bydra dat verpleegkundiges die voorneme ontwikkel om ‘n organisasie te verlaat, en gevolglik wat organisasies kan doen om verpleegkundiges wel te behou. Toenemende druk word in die gesondheidsorgsektor ervaar, meer spesifiek op verpleging, weens ernstige tekorte in hierdie dissipline. Hierdie tekorte is nie ‘n geïsoleerde verskynsel nie, maar raak die privaatsektor sowel as die publieke sektor wêreldwyd, sowel as Suid-Afrika. ‘n Veelvoud van faktore dra daartoe by dat verpleegkunde ‘n skaars vaardigheid wêreldwyd is. Sekere faktore is beheerbaar, ander nie. Deur die beheerbare faktore te isoleer, kan organisasies en bestuurders aksieplanne in plek stel om die impak van hierdie krisis te verminder. Prosesse en aksieplanne om byvoorbeeld die verplegingpoel te vergroot, en ook om die huidige werksmag te behou, kan bydra tot die oorbrugging van hierdie uitdaging. Daar is bewyse dat die implementering van ‘n gestruktureerde talentbestuurprogram kan bydra om hierdie uitdaging te oorkom. ‘n Sleutelrol in so ‘n talentbestuurprogram, is die lynbestuurder en sy/haar bevoegdheid ten opsigte van die bestuur van personeel. Hierdie studie het ten doel om ‘n bestaande talentbestuurmodel vir lynbestuurders te her-evalueer en addisionele veranderlikes voor te stel wat organisasie-uitkomste soos werkstevredenheid, organisasie-verbondenheid en voorneme om te bedank beïnvloed. Deur te verstaan watter lynbestuurbevoegdhede organisasie-uitkomste beïnvloed en die wyse waarop hierdie bevoegdhede op hierdie uitkomste inwerk, kan lynbestuurders, sowel as organisasies, toegerus word om prosesse en programme te formuleer. Hierdie programme kan ‘n bydra lewer tot die behoud van ‘n skaars vaardigheid, en sodoende die impak van ‘n wêreldwye krisis minimaliseer. Die resultate van die studie het aangetoon dat die operasionalisering van die talentbestuurbevoegdhede onsuksesvol was. Die oorspronklik voorgestelde model moes gevolglik gereduseer word deur die talentbestuur-latente veranderlikes uit die model te verwyder. Swak modelpassing is vir die gereduseerde model bevind. Wysigings is egter aan die gereduseerde model aangebring gebaseer op modifikasie-indeksvoorstelle afgelei uit die data. Die gewysigde model het goeie passing getoon en steun is vir al die bane in die gewysigde model gevind. Kruisvalidasie van die gewysigde gereduseerde model is aanbeveel.
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Jackson, Molly. "Program Evaluation of an Outpatient Palliative Care Model." Case Western Reserve University Doctor of Nursing Practice / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=casednp1430830260.
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Whiteley, Sarah Jay. "The construction of an evaluation model for use in conjunction with continuing education courses in the nursing profession." Thesis, Queen Margaret University, 1989. https://eresearch.qmu.ac.uk/handle/20.500.12289/7394.
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Continuing education in Scotland underwent radical changes in the early 1980's, when the National Board for Nursing, Midwifery and Health Visiting for Scotland responded to the proposals of a working party report (Working Part 1981). They began re-designing their continuing education provision for qualified nurses, and in conjunction with this development, they commissioned two consecutive evaluations. One was to look at a course entitled 'The Experienced Charge Nurse Module', and the other was of a more complex modular development, entitled 'Professional Studies I and II'. This thesis uses the work that was carried out by the author in executing the two evaluations, to propose a new model of evaluation for use in conjunction with continuing education courses. The need for the model became apparent in the early stages of the research, after the relevant nursing, evaluation, and continuing education literature sources were considered. No existing models appeared to completely meet the demands of the complexities of adult, continuing education courses, although it was considered that the 'Illuminative Evaluation' model of Parlett and Hamilton (1972) was a good basis to work from. Through the initial evaluation of the Experienced Charge Nurse Module, certain methodologies - predominantly qualitative - were tested, and used in conjunction with progressive focusing (Parlett and Hamilton, 1972) and grounded theory techniques (Glaser and Strauss, 1967). This based the research strongly in the phenomenological field, and these techniques were pursued and strengthened through the second, much larger evaluation of Professional Studies I and II. The main development at this stage, was that of a monitoring exercise. This complemented the evaluative component, and when the two elements were combined, they formed the 'Structure-Process-Outcome' model of evaluation (based on the categories used in the quality assurance field (Donabedian, 1966). This is proposed as a flexible and comprehensive model which can be adapted for use at either the macro or micro level of evaluation.
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Kidd, Heather M. "The development, implementation and evaluation of a shared care model of nursing in a tertiary hospital using participatory action research and practice development." Thesis, Curtin University, 2012. http://hdl.handle.net/20.500.11937/2411.
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For the last decade there has been a growing body of international evidence demonstrating the adverse effects on patient care caused by the continued international shortage of registered nurses (RN). One solution being explored in hospitals in Australia is to change their staffing mix by recruiting more graduate RNs, enrolled nurses (EN) and introducing unregulated workers (nursing assistants) as a strategy to increase the nursing workforce. To assist with managing the varied skill mix, hospitals have investigated team nursing as an alternative to the established RN dependent patient allocation model of nursing delivery. There is no conclusive evidence that demonstrates the impact of one model of care as compared to another in terms of satisfaction, quality and cost of care.Major deficits exist in team based nursing research. These are largely due to the small scale of the studies; focus on its use in medical and surgical wards and limited evaluation measures for staff and patients’ satisfaction and patient outcomes. Consequently, these studies have not demonstrated team nursing as an effective model in supporting nurses deliver care nor as a model that ensures the provision of quality patient care. This study addresses these deficits and provides a strong evidence base for the use of team based nursing in tertiary hospitals to both support nursing staff and contribute to positive patient outcomes.The purpose of this study was to develop, implement and evaluate a team based model (subsequently coined Shared Care Model or SCM), that supported the different levels of skill mix in the provision of safe care for patients admitted to 21 nominated wards (571 beds) at the study hospital. The impact the SCM had on nurses’ workload, team approach to organisation and provision of nursing care, culture of support, nursing rounds, bedside and board handover were investigated. In addition, the impact the SCM had on patient satisfaction, patient complaints and adverse incidents was investigated.The philosophical base for this study was critical social theory and the methodology participatory action research (PAR), underpinned by principles and processes of emancipatory practice development (ePD). Data instruments included validated staff and patient satisfaction questionnaires and the study hospital’s clinical incident and complaint management’s electronic systems and databases.The major findings of the study were statistically significant increases in learning opportunities and more manageable workloads associated with a less experienced nurse working with a more experienced nurse. However, this did not have an overall statistically significant effect on improving the culture of support nor ensuring manageable workloads. Statistically significant reductions were found in the four major adverse events measured of medications, falls, injuries and behaviour. Patient satisfaction was statistically significantly improved in relation to discharge planning and there were significant reductions in complaints associated with the manner in which patient were treated by nurses. Despite maintaining high levels of patient satisfaction throughout the study period there were statistically significantly more complaints in relation to the quality of clinical care. These findings establish that combinations of RNs of different levels of experience when working together as a team either in pairs or with unregistered staff provides safe patient care for a diverse range of clinical specialities.
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Szelag, Daria Elizabeth. "Development and Evaluation of an Educational Tool on Infant Feeding for Childhood Obesity Prevention." Diss., The University of Arizona, 2015. http://hdl.handle.net/10150/593609.
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Introduction and Rationale: Childhood obesity is a public health epidemic in the United States. Prevention of childhood obesity is an important health concern, but there is a lack of prevention efforts focused on infancy (Birch, Anzman-Frasca, & Paul, 2012). Many health behaviors are learned in the very early childhood years (Dattilo et al., 2012), so infancy is an opportune time to begin obesity prevention efforts (Grote, Theurich, & Koletko, 2012; Paul et al., 2011). There are very few resources available to educate mothers and caregivers of infants on protective infant feeding practices to reduce obesity risk. Purpose and Objective: The purpose of this DNP project is to develop educational material about infant feeding practices as a significant modifiable risk factor for the development of childhood obesity. The educational material is directed towards pregnant women and caregivers of infants less than 12 months of age. The objective is to educate parents and caregivers about infant feeding practices and the importance of preventing excessive weight gain during the first year of life for the prevention of childhood obesity. Methods: The Information-Motivation-Behavior (IMB) Model of Health Behavior serves as a framework for the content of the educational material. The Toolkit for Making Written Material Clear and Effective serves as a guide for the design of the educational material. Results: A systematic assessment of the educational material was conducted using the Patient Education Materials Assessment Tool (PEMAT), a validated evaluation tool. The educational material was revised based on the PEMAT score. The PEMAT score was calculated for the revised handout and the handout is presented as an educational tool for the prevention of childhood obesity. Conclusions: This DNP Project demonstrated childhood obesity as a current significant health problem and identified infant feeding practices as a significant modifiable risk factor for the development of childhood obesity. Due to a lack of obesity prevention efforts focused on infancy, educational material was created using the IMB model of health behavior and the Toolkit for Making Written Material Clear and Effective. The final PEMAT evaluation yielded educational material that will likely have a positive health influence on the pediatric population.
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Silva, Marcos Barragan da. "Dimensões do Nursing Role Effectiveness Model no acompanhamento dos resultados de pacientes submetidos à artoplastia do quadril." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2017. http://hdl.handle.net/10183/163944.
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A avaliação de resultados voltada aos cuidados de saúde surge pela necessidade das profissões demonstrarem a sua efetividade nos resultados dos pacientes. Diversas abordagens têm sido utilizadas para identificar as relações entre as variáveis de Estrutura, Processo e Resultado na avaliação da qualidade do cuidado no contexto hospitalar. Pesquisadoras canadenses desenvolveram o Nursing Role Effectiveness Model (NREM), para auxiliar na identificação da contribuição da enfermagem aos cuidados de saúde. O NREM ainda não foi utilizado na perspectiva do Processo de Enfermagem Avançado, utilizando os Sistemas de Linguagem Padronizada NANDA-I, NIC e NOC para pacientes submetidos à Artroplastia do Quadril. Este estudo teve como objetivo analisar as relações entre as dimensões do Nursing Role Effectiveness Model no acompanhamento dos resultados de pacientes submetidos à Artroplastia do Quadril. Trata-se de um estudo longitudinal, aninhado a um desenho correlacional descritivo. Os dados foram coletados no Hospital de Clínicas de Porto Alegre. A população e amostra consistiram em pacientes submetidos à Artroplastia do Quadril, e enfermeiros assistenciais que prescreveram os cuidados a estes pacientes. No estudo longitudinal, os pacientes foram acompanhados por três a quatro dias consecutivos de pós-operatório, entre os meses de Março e Dezembro de 2016. Os enfermeiros foram entrevistados nos meses de Janeiro e Fevereiro de 2017. Os dados foram analisados estatisticamente. Os achados foram categorizados segundo as dimensões do NREM Estrutura, Processo e Resultado. Resultado: Foram incluídos 85 pacientes predominantemente do sexo feminino (58%), com média de idade de 64 (±13,5) anos. Na dimensão Estrutura, os pacientes foram diagnosticados, segundo a NANDA International (NANDA-I) com Dor Aguda (96%), Risco de Quedas (62%) e Mobilidade Física Prejudicada (54%), respectivamente. A maioria dos pacientes estava em repouso numa Cama Ortopédica (99%). Enfermeiros tinham uma idade média de 33 anos, Sendo a maioria (90%). Experiência com pacientes ortopédicos variou de um a seis anos. O nível de conhecimento na NANDA-I, NIC e NOC foi considerado de moderado a substancial. As intervenções de enfermagem, de acordo com a Nursing Interventions Classification (NIC) mais prescritas foram: Controle da DOR, Prevenção de QUEDAS e POSICIONAMENTO (Processo). Os Resultados da Nursing Outcomes Classification (NOC) (Posicionamento do corpo: autoiniciado, Mobilidade, Conhecimento: atividade prescrita e Nível de dor), tiveram mudanças significativas (P<0,001) durante o acompanhamento dos pacientes. As escalas apresentaram consistência interna (α>0,7). Conclui-se que as variáveis de Estrutura, Processo e Resultados, elencadas neste estudo, possuem relação; e de acordo com os efeitos que geram nos resultados alcançados no paciente, apresenta repercussões na qualidade do Processo de Enfermagem Avançado baseado nos Sistemas de Linguagem Padronizada NANDA-I, NIC e NOC para pacientes submetidos à Artroplastia do Quadril.The evaluation of health outcomes arises from the need for professions to demonstrate their effectiveness in patient outcomes. Several approaches have been used to identify the relationships between the Structure, Process and Outcomes variables in the quality care evaluation in the hospital. Canadian researchers to developed the Nursing Role Effectiveness Model (NREM) to identify the nursing contribution to health care. The NREM was not analyzed from the perspective of the Advanced Nursing Process, using the Standardized Language Systems NANDA-I, NIC and NOC for patients undergoing Hip Arthroplasty. This study aimed to analyze the relationships between the dimensions of the Nursing Role Effectiveness Model in the follow-up of the outcomes of patients undergoing for Hip Arthroplasty. It is a longitudinal study nested for descriptive correlative design. The data were collected at Hospital de Clínicas de Porto Alegre, Brazil. The population and sample consisted of patients undergoing to Hip Arthroplasty, and nurse assistants who prescribed care for these patients. In the longitudinal study patientes were followed for three to four postoperative day, on the March to December 2016. Nurses were interviewed in January and February 2017. Data were statistically analyzed. The findings were categorized according to the dimensions Structure, Process and Outcomes, from NREM. Results: Variables Structure, were included 85 patients predominantly female (58%), mean age 64 (± 13.5) years. The patients were diagnosed with Acute Pain (96%), Risk of Falls (62%) and Impaired Physical Mobility (54%), respectively. The majority of patients were resting in the Orthopedic Bed (99%). Nurses had a mean age of 33 years, being the majority (90%) female. Experience with orthopedic patients ranged from one to six years. Knowledge level in NANDA-I, NIC and NOC was considered moderate to substantial. The most prescribed NIC nursing interventions were: PAIN Control, FALL Prevention and POSITIONING, considered as Process variables. The Nursing outcomes NOC (Body Positioning: self-initiated, Mobility, Knowledge: prescribed activity and Pain Level) included in the Outcome dimension from NREM, had significant changes (P <0.001) during the follow-up. The scales showed internal consistency (α> 0.7). It is concluded that the Structure, Process and Outcomes variables are related and according to the effects it generates on the outcomes achieved, it has repercussions on the Advanced Nursing Process quality based on the Standardized Language Systems NANDA- I, NIC and NOC for patients submitted to Hip Arthroplasty.
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Fok, Sin Mai. "Self-care in patients undergoing renal replacement therapy : a critical evaluation of the application of Orem's self-care model of nursing." Thesis, Glasgow Caledonian University, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.341696.
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Arendse, Carmen. "An evaluation of the effectiveness of a clinic-based HIV/AIDS counselling course on trainee functioning at work sites." Thesis, University of the Western Cape, 2002. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_1267_1365590967.
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The Western Cape AIDS Training, Information and Counselling Centre (ATICC) primarily focuses on the development and provision of information and different types of training programmes on HIV/AID/STIs. The Director of the Health Service of the Cape Metropolitan Council was invited by ATICC to select seven health educators and nurses who were involved in health education and counselling in their local clinics to complete a six-month training course. The objective of this study was to evaluate the effectiveness of the ATICC training course on the counselling practice of trainees at their clinics.
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Patterson, Susan Mary. "An evaluation of an adapted United States model of pharmaceutical care to improve psychoactive prescribing for nursing home residents in Northern Ireland." Thesis, Queen's University Belfast, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.492516.
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Introduction: This study adapted and tested the implementation of a holistic United States (US) pharmaceutical care model in nursing homes in Northern Ireland (NI). Methods: A qualitative study involving healthcare professionals and resident advocates was conducted to inform the adaptation of the US model to suit the NI primary care environment. The adapted model was tested in a cluster randomised controlled trial (cRCT) conducted in nursing homes over 12 months. The primary outcomes were the change in the number of residents prescribed inappropriate psychoactive (anxiolytic, hypnotic or anti-psychotic) medicines and the number of falls. An economic evaluation was carried out to calculate the change in direct healthcare resource usage over time. Economic modelling, including multidimensional work sampling, was performed to estimate the costs of service provision. Results: From the qualitative study findings, the main adaptations required in the UK related to pharmacists' access to medical records, prescribers and nursing home residents. In the cRCT, 11 matched pairs of nursing homes and 334 residents participated. Overall 51% residents (n=171) were taking an inappropriate psychoactive mcdication (0.74/ rcsident). At baseline thcrc was no difference in the proportion taking inappropriate psychoactive medications in the intervention (92/173, 53%) and control groups (79/161, 49%). At 12 months there was a significant rcduetion (p<0.001) in the proportion taking inappropriate psychoactive medications in the intervention group (25/128,20%) compared to controls (62/124, 50%), corresponding to an odds ratio (95% confidence intervals) of 0.26 (0.14, 0.49), aiter adjustment for clustering within homes. No differences were observed at 12 months between the number of residents with one or more falls or the falls rate. Healthcare costs remained unchanged over time. Economic modelling estimated a service provision cost of £80.25 per resident/annum. Healthcare professionals thought that pharmaceutical care should forn1 part of the normal range ofprimary care serVices. Conclusion: These findings highlight that pharmaceutical care significantly improves the quality of psychoactive prescribing in UK nursing homes.
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Cilliers, Liezel. "Evaluating the knowledge, attitudes and beliefs about the prevention and self-treatment principles for low back pain among nursing staff in Cecilia Makiwane Hospital, East London Hospital Comple." Thesis, University of the Western Cape, 2007. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_8881_1227608404.
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Nursing is a high-risk profession for the development of musculoskeletal problems and low back pain (LBP) in particular. Currently there is limited information available for the prevalence of LBP among the South African nursing population and no evidence on knowledge, attitudes and beliefs about the prevention and self-treatment principles for LBP among this group. The aim of this study was to evaluate the knowledge, attitudes and beliefs about the prevention and self-treatment principles for LBP among nursing staff in Cecilia Makiwane Hospital, East London Hospital Complex. The study found that the majority of the participants experienced LBP on a regular basis.
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Trinidad, David Ralph. "A Formative Program Evaluation of the Crucial Conversations™ Program." Diss., The University of Arizona, 2013. http://hdl.handle.net/10150/311588.
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VitalSmarts® Crucial Conversations™ general program theory might be a possible countermeasure addressing organizational culture and communication factors affecting quality and safety. This practice inquiry reports: a VitalSmarts® Crucial Conversations™ general program logic model, a major medical center's Crucial Conversations™ historical implementation program logic model, a clinical exemplar central line associated blood stream infection program logic model; and, findings that describe the fidelity of the major medical center's Crucial Conversations™ historical implementation and clinical exemplar central line associated blood stream infection program logic model to the VitalSmarts® Crucial Conversations™ general program logic model. The results demonstrated there was no fidelity between the major medical center's Crucial Conversations™ program logic model and the VitalSmarts® Crucial Conversations™ general program logic model. The clinical exemplar CLABSI program logic model and VitalSmarts® Crucial Conversations™ general program logic model fidelity differed in intended outcomes. The results might suggest that program adaptability along with program fidelity are factors that influence program strength, and these factors must be uniquely balanced within organizational dynamics to realize intended outcomes. The formative evaluation and program logic model might be a feasible methodology and applicable tool for exploring quality and safety within complex adaptive systems, such as organizational culture, where constraints possibly could exclude more rigorous scientific methodologies until factors are more understood.
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Holmstrom, Ashley Nicole. "Improving the Care of Patients with Urinary Catheters Through a Quality Improvement." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5723.
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Catheter-associated urinary tract infections (CAUTI) significantly increases patient morbidity and mortality, length of stay, and organizational cost. In the 2 years prior to project implementation, the incidence of CAUTI increased by 15% in the local acute care, inpatient facility that served as the project site. Nursing leaders at the project site linked the increase in CAUTIs to a nursing knowledge deficit related to CAUTI prevention principles. The clinical question focused on the impact of CAUTI prevention staff training on the incidence of CAUTI, length of stay, and cost to the local acute care organization. After a review and critical appraisal of the literature, using Lewin's theory of planned change and the Iowa Model of Evidence-Based Practice Change, an evidence-based, CAUTI-prevention training program was piloted as a quality improvement initiative. The project purpose was to evaluate that initiative by tracking the incidence of CAUTI for 90 days postintervention. A 1-sample t-test of the mean incidence with a 95% confidence interval revealed no statistically significant (p = .732) decrease in the incidence of CAUTI. Similar initiatives with fewer than 12 months of evaluation data have failed to demonstrate statistically significant findings; therefore, additional data are needed to adequately assess the impact of the project. Recommendations include extending the pilot project and additional training of unlicensed nursing personnel. Proper evaluation of the project may provide support for the implementation of CAUTI-prevention training programs, promoting social change by reducing the rate of infection, improving patient outcomes, and demonstrating financial stewardship of the local acute-care organization.
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Wiles, Brenda L. "Using The National Early Warning Score As A Set Of Deliberate Cues To Detect Patient Deterioration And Enhance Clinical Judgment In Simulation." Case Western Reserve University Doctor of Nursing Practice / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=casednp1458074763.
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Reimer, Nila B. "Things that matter to residents in nursing homes and the nursing care implications." Thesis, 2014. http://hdl.handle.net/1805/6054.
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Indiana University-Purdue University Indianapolis (IUPUI)A move toward care of residents in nursing homes where they are respected and heard is finally emerging. Common strategies used in nursing homes to improve quality of care for residents are integration of person-centered care and assessing care using satisfaction surveys. Although approaches of integrating person-centered care and satisfaction surveys have been valuable in improving nursing home quality, strategies of care that include things that matter from residents’ perspectives while living in nursing homes need investigation. The purpose of this qualitative descriptive study was to describe things that residents age 65 and older state matter to them while living in the long-term care sections of nursing homes. A qualitative mode of inquiry using purposeful sampling led to a natural unfolding of data that revealed things that mattered to residents. Content analysis was used to reduce the data in a manner that kept the data close to the context yet moved the data toward new ideas about including things that mattered to residents in nursing care. The findings revealed residents’ positive and negative experiences and addressed the question: How can nurses manage residents’ positive and negative aspects of care in nursing homes? This study substantiated the importance of developing nursing care strategies derived from residents’ descriptions of care. Finding ways to promote nurses’ investment in attitudes about a person-centered care philosophy is essential for successful person-centered care implementation. Enhancing nurses’ knowledge, skills, and attitudes with an investment in person centeredness will be more likely to put nurses in a position to role-model care that is person-centered from residents’ perspectives.
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Craven, Marianne. "Processes used by nursing faculty when working with underperforming students in the clinical area: a theoretical model derived from grounded theory." 2015. http://hdl.handle.net/1805/7345.
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Indiana University-Purdue University Indianapolis (IUPUI)Clinical nursing faculty members often work with students who underperform in the clinical area. Underperforming students are those who exhibit deficits in nursing knowledge, the application of nursing knowledge, psychomotor skills, motivation, and/or interpersonal skills. The outcomes of faculty work with underperforming students have implications for patient safety and the nursing workforce, yet little is known about how faculty work with underperforming students. The purpose of this project was to develop a theoretical framework that describes how clinical faculty work with underperforming students in the clinical area. Twenty-eight nursing faculty who had worked with underperforming nursing students during clinical rotations were interviewed and invited to tell stories about working with these students. Their narratives were analyzed using constant comparison analysis, and a theoretical framework was developed. The framework included three stages that unfolded as faculty worked with underperforming students over time. The first stage, Being Present, was the process by which faculty came to know students were underperforming. They did this by noticing red flags, taking extra time with students, working side-by-side with students, and connecting with students "where they were at." The second stage, Setting a New Course, was the process by which faculty attempted to provide remedial experiences to improve the performance of those students determined to be underperforming. The participants did this by beginning a new course of instruction for the students, bringing in new people to help the students, and creating new learning experiences for them. This process could result in students turning it [their performance] around, making it through [the clinical rotation], or not making it. The final stage, Being Objective, was the process by which participants made negative progression decisions. They did this by relying on objective indices, documenting problematic student behaviors, and obtaining validation for their decisions.
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Naude, Marita. "A model for transformational leadership by nursing unit managers." Thesis, 2014. http://hdl.handle.net/10210/11673.
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D.Cur. (Professional Nursing Science)It was very dear that dramatic transformation is needed in the new South Africa to accommodate the transformation demanded by the Reconstruction and Development Programme, the National Health System, and other political, economic, social, technological and staff management changes. It was also evident that transformational leadership was needed in nursing in general and in nursing management in particular. This is a qualitative, contextual, exploratory, descriptive and theory-generating study, with the overall aim of exploring and describing a model for transformational Ieadershlp by nursing unit managers to facilitate individual and nursing unit transformation. To accomplish this aim, specific objectives were formulated. Firstly, a conceptual framework and model were explored and described by means of analysis, synthesis, derivation and deductive reasoning. The model was described within the meta theoretical assumptions of the Nursing for the Whole Person Theory (ORU 1990; RAU 1992). The theoretical assumptions were derived from till' Nursing for the Whole Person Theory whereas the methodological assumptions were based on the Nursing Research model of Botes (1995). This Nursing Research model proposed functional reasoning approach. During the exploration and description of the model, connect identification and classification were handled according Lo the survey list of Dickoff, james and Wiedenbach (1968). Thereafter, an education programme was explored and described by deriving the theoretical content on transformational leadership from the conceptual framework and LIl(' model. TIll' principles of adult education (Knowles 1984, Gravett 1991) and the constructivistic learning theory (Klopper 1994 (a» were utilised for the didactical development of the education programme. This education programme was then implemented in a nursing service. Through purposive sampling, four nursing unils in the same nursing service were selected and the model implemented for a period of 12-14 weeks. The cases Ludy method was utilised.
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Sampaio, Francisco Miguel Correia. "Development and evaluation of a psychotherapeutic intervention model in nursing." Doctoral thesis, 2018. https://hdl.handle.net/10216/111039.
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Sampaio, Francisco Miguel Correia. "Development and evaluation of a psychotherapeutic intervention model in nursing." Tese, 2018. https://hdl.handle.net/10216/111039.
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CHANG, YU-SHUN, and 張宇舜. "Use Kano Model in Service Quality Evaluation of Postpartum Nursing Care Center." Thesis, 2016. http://ndltd.ncl.edu.tw/handle/10041380302731751034.
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碩士中華大學
科技管理學系
104
Chinese people believe that maternal confinement is very important, as the family structure change and the trend of the times, post-natal care homes because they should be born. However, in the case of fertility down year by year, month of the opening of the center was competing, therefore, want to survive this popular piece on the battlefield, to maintain market advantage and industrial competitiveness, how to meet a wide range of maternity services demand and improve service quality will be the subject of each post-natal care home are most concerned about. In this study, post-natal nursing home quality of service to the questionnaire SERVQUAL scale based architecture, reference model design Kano questionnaire and asked entry to the characteristics of post-natal care homes and defined by experts to be modified from. In this study, purposive sampling and snowball sampling method questionnaires, total issued 130 questionnaires, access to the object mostly women, through literature review Construction study architecture, application Kano model, view, post-natal care homes provide quality of service attribute to paragraph, and proposed order to improve service quality and follow-up research proposals to the item. The results found that 23 question the quality of service to be key: "One-dimensional quality." Subtotal 13 title, accounting for 56.52%. "Must-be course quality '9 meter title, accounting for 39.13%. "Indifferent quality." Subtotal 1 problem, accounting for 4.35%, "Attractive quality" and " Reverse quality " None. The women of different background variables to categorize entries studies have shown a higher military and government circles and the business community for the quality of service requirements. From the study was incremental index of satisfaction, "care of" facets representing the highest title 3, post-natal care homes should actively provide this facet services, to improve customer satisfaction. This study was based on results sorted out postpartum women nursing home service delivery model recommendations, post-natal care industry expectations in providing quality of service can be more in line with consumer demand, improve customer satisfaction, service quality, thereby enhancing business performance.
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Van, Dyk Ellie Catharina. "A model for trust in the nursing education environment." Thesis, 2016. http://hdl.handle.net/10500/22634.
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Trust is an important concept in nursing. Nursing is frequently described as a profession which is built on trusting relationships; hence, to produce competent professional nurses the building of trust and trusting relationships in nursing education is of utmost importance. The purpose of the study was to understand trust and trusting relationships between and among educators and students in the teaching and learning environment.
A qualitative approach with a grounded theory design was used to discover the value of trust and trusting relationships and to develop a model for trust in the nursing education environment. All the nursing education institutions offering the R425 nursing programme in the selected province were included. Two nursing education institutions offered the R425 nursing programme in this province, a university and one public multi-campus nursing education institution with three campuses. The target population consisted of educators and students complying with the sampling criteria. Sampling of educators and students was purposive and convenient. The sample size consisted of fourteen students was purposive and convenient. The sample size consisted of fourteen educators and sixty students. In-depth face-to-face interviews were conducted with educators and fourteen focus group interviews were conducted with students.
The three stages of Charmaz (2014) were used for the analysis of data, namely initial, focused and theoretical coding until data saturation was evident. Data collection and analysis and the literature review were done concurrently. Three role players were identified to be important in trust in nursing education. The role players are the educator, student and professional nurse. In the study two sets of data, namely the educators’ views and students’ views on trust in nursing education were synthesised. Four themes emerged, namely: namely professional relations, expectations of the role players in nursing education, creating a conducive teaching and learning environment and, finally, outcomes of trust or lack of trust. Ensuing from the findings of the current study, a model for trust in nursing education was developed – an important contribution to the body of knowledge of nursing education.
The study throws light on self-trust, trusting relationships among role players, and trust in the teaching and learning environment. Awareness of trust and trusting relationships among the role players results in positive learning experiences, increased self-trust, self-confidence, motivation and better performance in nursing education. Recommendations made have a bearing on developing self-trust and trusting relationships among role players, the implementation of the model for trust in nursing education, and future studies in trust in nursing educationHealth Studies
D. Litt. et Phil. (Health Studies)
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Lin, Fu-Mei, and 林富美. "The Preliminary Study of Applying Balanced Scorecard Model in Evaluating Hospital Nursing Home." Thesis, 2004. http://ndltd.ncl.edu.tw/handle/32855774409466640624.
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碩士臺北醫學大學
護理學研究所
93
As the population is aging rapidly, and the family structure and disease patterns are changing, the healthcare need has been shifted from acute care to long-term care in Taiwan. Hence, in the highly competitive environment of nursing homes, quality, cost-effectiveness, and customer satisfaction should be the goals that long-term care institutions strive for. Balanced scorecard is a strategic management tool to transform strategies into practice, which focuses on customer perspective, financial perspective, internal process perspective, and employee’s learning and growth perspective, to effectively implement strategies so as to meet organization’s missions. The purposes of this study are to establish strategic objectives and performance indicators to facilitate nursing home’s successful operation to improve the performance of nursing home. The study was designed to be an interventional study, after applying balanced scorecard to nursing home operation strategy, to compare the differences of performance before and after implementing balanced scorecard. The study sample is selected by convenient sampling. The study subjects were selected from some hospital nursing home in Taipei, consisting of employees, residents and their relatives. Data collection was done from January to October in 2004. Balanced scorecard strategy was implemented in the nursing home for this study from March to July in 2004. We used descriptive statistics, pair-t test, independent-t test, and nonparametric Wilcoxon test for data analysis to compare the differences of each performance indicator after implementing balanced scorecard. The results of this study are as the following: 1.Customer perspectives: the satisfaction score of residents’ relatives for the nursing home had improved after implementing balanced scorecard, and the difference is statistically significant (p< .05). 2.Financial perspectives: the cost per bed per month was decreased after implementing balanced scorecard. 3.Internal process perspective: (1)Nosocomial infection rate, pressure sore point prevalence, and the rate of unexpected transfers\discharges to acute inpatient care increased after implementing balanced scorecard causing lack of man power in that period. (2)The missed billing of medical supplies rate decreased after implementing balanced scorecard. 4.Learning and growth perspective: (1)Employees’ satisfaction had improved after implementing balanced scorecard, and the difference is statistically significant (p< .05). The highest score is on “harmonious interaction with residents and their relatives” whereas the lowest score is on “current workload”. (2)The personnel turnover rate decreased from 57.1% in 2004 to 32.1% in 2003. (3)The nursing care techniques accuracy improved after implementing balanced scorecard, and the difference is statistically significant (p< .05). The research results indicate that implementing balanced scorecard in nursing home will lead to performance improvement although some quality indicators slack off due to the unexpected shortage of manpower in this study. Hopefully, this study would be helpful for not only hospital nursing homes, but also other types of nursing home, long-term care institutions and healthcare organizations. Key words : Balanced Scorecard, Nursing Home.
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Fulton, Barbara Jean. "Evaluation of the effectiveness of the Neuman Systems Model as a theoretical framework for baccalaureate nursing programs." 1992. https://scholarworks.umass.edu/dissertations/AAI9305991.
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This study shows the relationship of a theoretically based nursing curriculum and the integration of the specific conceptual model by students as a technique for thinking and/or delivering care. A descriptive correlational design was used to evaluate the integration of the Neuman Systems Model into a baccalaureate nursing program and measures the degree of student integrated learning. This summative evaluation identifies baseline data on ten baccalaureate nursing programs and the degree of model integration into the philosophy of the program, course objectives, course syllabi, classroom and clinical areas, and teaching-learning activities such as student papers and nursing care plans. Ten baccalaureate nursing programs and 94 senior nursing students from the eastern and midwestern United States participated in the study. Schools were selected because of model use. All participant programs claimed the use of the Neuman Systems Model as the theoretical framework of the nursing program. National League for Nursing Self-Study reports were reviewed and scored as to degree of integration on the Neuman Systems Model Integration Grid. Results of this study confirm a positive relationship between an integrated nursing curriculum and integrated student learning. A direct correlation between program score of levels of model integration and student scores from written papers and nursing care plans was observed.
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Khanyile, Thembisile. "Development and testing of a model for implementation of recognition of prior learning." Thesis, 2001. http://hdl.handle.net/10413/5437.
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The Minister of Education's public statement In August 1999, that South African citizens should mobilize and build an education and training system for the 21'st century . among other things emphasized the application of procedures for recognition of prior learning as part of the restructuring process. On the other hand the resolution taken by the South African nursing Council at the beginning of 2000. that enrolled nurses should be upgraded through the process of recognition of prior learning further increased the urgency for nursing education institutions to develop and implement RPL policies In South Africa, Recognition of Prior learning (RPL)is seen as an appropriate approach to offer equity and redress of past imbalances in the education and training system. The purpose of the study was to develop and test an appropriate model that could be used for Recognition of Prior Learning for nurses. To test the model, it was implemented in a form of pilot projects by three institutions. It was important for the model development to identify and involve all the stakeholders of the nursing education system. An appropriate design for the study was a multiphase decision oriented evaluation research . Stuffelbeam's Context. Input, Process and Product evaluation model was used to guide the research process. The first phase was the development of the model which involved the Context evaluation. During the context evaluation phase, the Education Committee of the South African Nursing Council and the evaluative researcher developed the guidelines for the RPL process. These were refined by the stakeholders during the regional workshops. The results of this phase was the RPL guidelines. The second phase was the Input and the Process evaluations. Each institution had to make planning decisions for Implementation. The result was RPL policies for each institution Thereafter. the three institutions Implemented the RPL guidelines to specific target groups of nurses that were identified for the purpose of the pilot project. Data collection instruments varied according to the phase of the model development. Checklists were used to measure the extent to which each Institution had followed the RPL guidelines Dunng the Product (evaluation) phase. candidates' scores were compared with those of other candidates who accessed the specific programs through the traditional entry routes. According to the results all RPL candidates were successful In the programs they aimed at accessing DUring the testing phase after access, the RPL candidates compared favourably with other the other candidates who accessed the programs through traditional routes . The result indicate that the self- directed approach used during RPL helped the candidates in the actual programs. A process onented and competency- focused model was developed through an inclusive process. Nursing education Institutions and policy makers can use the model to structure and evaluate RPL implementation in nursing education institutions in South Africa.Thesis (Ph.D.)-University of Natal, Durban, 2001.
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Su, Chen-Fang, and 蘇臻芳. "The Study for Evaluation of Skill Mix of Nursing Model ─ An Example on a Regional Hospital in Middle-Taiwan." Thesis, 2008. http://ndltd.ncl.edu.tw/handle/06016531608682637771.
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碩士亞洲大學
健康管理研究所
96
In order to look after Skill Mix of Nursing Model implementation result, does take the result monitor tools embrace the degree of satisfaction and quality indicators after the manpower structural changed. The object of study for a region hospital join a pilot project of Skill Mix of Nursing Model, to look after the patients’ folks , the service person, the nursing staffs and doctors. By structural formula degree of satisfaction questionnaire and focus group understanding demand and supplier's subjective view, and reference implementation period related quality indicators.In the findings, the patients’ folks and the nursing staffs measure variable around the degree of satisfaction do not have the difference; Regardless of the supplier or the demand looks after positive attitude towards Skill Mix of Nursing Model. In focus group , The medical quality is the subject which the participant most pays great attention, Lightens the folks’ economic burden is approved by the most being interviewed personnel. The medical quality indicators, besides tumbles being injured rate, other all demonstrated that patients join a pilot project, indicators’ data is higher than has not participated, because the influence indicators' factor are many, could not by this result express that the participant looks after the quality to be bad.Suggested in view of the findings, (1) policy suggestion: Should carry out and cause between continually the hospital the uniformization, and drafts the coordinated sets of measures, avoids abusing into the circumvention manpower cost the method; (2) The source of funds: The consideration source of funds, suggested that pays own expenses and the health insurance part subsidy by the patient;(3) implementing agency should have urges during specialized and the auxiliary manpower the cooperation and the education mechanism; (4) patient classifies internationally not consistent standard, suggested that picks the medical care personnel specialized judgment and the patient bears under ability, does compares the classification for the choice different attendance manpower is the consideration; (5) study in the future: In view of the different hospital between the comparison, increases the case number, causes the statistical result to be more objective; If the patient is clear for consciousness, communication unobstructive, may aim at the patient to understand its degree of satisfaction.
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Chung, Yueh-Chin, and 鍾月琴. "Evaluating the Faculty’s Motivations and the Effectiveness of Faculty Development Programs in Nursing Colleges with Kirkpatrick’s Model." Thesis, 2014. http://ndltd.ncl.edu.tw/handle/nj2mp6.
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博士中山醫學大學
醫學研究所
102
Objective: The objective of this study is to evaluate the faculty’s learning motivations and the effectiveness of faculty development programs in nursing colleges with kirkpatrick’s model. The results can serve as a policy-making reference for nursing education and for improving and planning of faculty training programs in nursing schools. Methods and Materials: In applying a quantitative-based, supplemented by qualitative research research design, we conducted a cross-sectional questionnaire survey on 281 faculty members in 13 different Universities of Science and Technology, obtaining a response rate of 50%. Quantitative research methods included focus group and 7 individual qualitative interviews to collect information. Thirty nursing faculty members were involved in objective structured clinical examination (OSCE) interventions program of Kirkpatrick''s evaluation. After data collection, valid samples were processed and analyzed using descriptive statistics, the Pearson correlation and ANOVA with SPSS17.0. Results: The results we obtained are described as follows: (a) The learning motivation of the majority of faculty attending training activities involved the pursuit of knowledge and individual interests, meeting the requirements of the job, and self-improvement, in contrast to simply making new friends or developing social relationships. (b) Faculty stated that they acquired the most knowledge from the fields of new curricular design and nursing-ethics teaching, and from trends in nursing education development, whereas expressed enthusiasm for courses in nursing humanities. Faculty stated that they learned more from problem-based learning (PBL), small group tutoring skills, bedside teaching skills, the cloud platform for learning, and feedback skills than from other teaching strategies. Activities related to research and thesis writing skills were considered beneficial to their personal development. The faculty expressed high interest in participating in the courses of OSCE; in addition, faculty also gave greater support on programs related to counseling skills, nursing administration, and motivational theory and practice, and personal career.Very high proportion (98.6％)of faculty was willing to participate in the programs in the furure, and most of them preferred a half-day and 1-day activities with formats of workshop, learning communities and growth camps. (c) Effectiveness of the faculty training programs was evaluated with Kirkpatrick model : “response level,” “learning level,” “behavior level,” and “result level.” We investigated with a survey for all participants, and almost all faculty rascribed to intrinsic motivation rather than oxternal factors, and a significantly positive correlation was demonstrated between impacts and the 4 effectiveness levels on all (r = 0.66). Effectiveness of training pogram was determined to be significantly higher in administration levels than in that of teaching faculty. The needs of programs were different for faculty among various disciplines and teaching experiences. (d) Faculty who participated in OSCE activities expressed agreement that the learning experiences brought the scope of clinical applicability and a higher confidence on clinical teaching, and was beneficial to their professional growth. Conclusions: Faculty participating in the faculty training programs from different regions of Taiwan’s Nursing Colleges expressed an affirmative positive attitude and believed that the effectiveness of the programs were beneficial to their teaching and learning for nursing faculty. Our investigation demonstrated that facutlty development programs are beneficial to enhance the quality of nursing education to all institutions. A substantial majority (98.6%) of faculty is willing to participate in the future faculty development programs. Recommendations: (a) Rewarding system is beneficial to to enhance faculty to participate in the training/learning programs or activities. Critical thinking and multiple interactive teaching modes and learning communities can be promoted to strengthen to meet different training requirements. self-directed and life-long learning. (b) To develop a mechanism to encourage faculty to participate in learning/training programs, which are lined up with the missions and objectives of each individual institution and international and accreditation standards. (c) The institution should respect faculty who has higher intrinsic motivation and will have high effectiveness through the training/learning programs. (d) Our research supported that the Kirkpatrick 4-level evaluation model is useful as a tool to investigate the effectiveness of the programs or activities to enhance faculty development in nursing collegs.
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Brooker, Dawn J. R., Rosemary J. Woolley, and David Lee. "Enriching opportunities for people living with dementia in nursing homes: An evaluation of a multi-level activity based model of care." 2007. http://hdl.handle.net/10454/3783.
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NoThis paper reports on the evaluation of the Enriched Opportunities Programme in improving well-being, diversity of activity, health, and staff practice in for people with dementia. Participants were 127 residents with a diagnosis of dementia or enduring mental health problems in three specialist nursing homes in the UK. A repeated measures within-subjects design was employed, collecting quantitative and qualitative data at three points over a twelve-month period in each facility with follow-up 7 to 14 months later. Two-way ANOVAs revealed a statistically significant increase in levels of observed well-being and in diversity of activity following the intervention. There was a statistically significant increase in the number of positive staff interventions but no change in the number of negative staff interventions overall. There was a significant reduction in levels of depression. No significant changes in anxiety, health status, hospitalisations, or psychotropic medication usage were observed. The Enriched Opportunities Programme demonstrated a positive impact on the lives of people with dementia in nursing homes already offering a relatively good standard of care, in a short period of time. The refined programme requires further evaluation to establish its portability.
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Klodnicka, Kouri Kristyna. "Development and evaluation of a nursing psycho-educational program focused on communication for family caregivers in early Alzheimer's disease." Thèse, 2008. http://hdl.handle.net/1866/6666.
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Li, Yu-Lin, and 李宥林. "Applying the Taiwanese Electronic Health Record Systems Success Evaluation Model to Explore the Efficiency of Mobile Nursing Station Based on Nurses’ Perspectives." Thesis, 2012. http://ndltd.ncl.edu.tw/handle/36101183340755614966.
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碩士美和科技大學
健康照護研究所
100
Background and Research Purpose The aim of this research is to recognize end-users’ opinion of using mobile nursing station by adopting the structure of Taiwanese success electronic health record systems model. Therefore, there are four research purposes: (1) exploring nurses’ opinion of using mobile nursing stations based on the knowledge of evidence-based management; (2) exploring nurses’ opinion about what are the important elements of success mobile nursing stations for evaluating end-users’ opinion of using such technology; (3) exploring which demographic variables will affect end-users’ opinion of using such technology; (4) exploring whether there are significantly differences opinion among nurses using such technology between two hospitals within the chain of a health care system. Material and Methods By adopting the idea of the structure of Taiwanese success electronic health record systems model and the cross-sectional research design to establish research hypotheses. It focuses on those who need to use the mobile nursing stations in daily work were recruited as study samples between two hospitals within the chain of a health care system. For this research, data were collected since November 2011 to January 2012. According to the opinion of “Quantitative research method”, both descriptive statistics and inferential statistics (exploratory factor analysis, reliability test, T test, one-way ANOVA with post-hoc analysis, and path analysis) were performed to conduct research hypothesis. Results It sent 930 questionnaires to research samples and 719 valid questionnaires were used for data analysis (returned rate 91.48%). For the results of one-way ANOVA with post-hoc analysis, it found that the elements of User Satisfaction and Organizational Net Benefits will be affected by the variable of Position; the elements of Service Quality and Organizational Net Benefits will be affected by the variable of Education; the elements of Medical Data Quality, User Satisfaction and Organizational Net Benefits will be affected by the variable of Years of Service; the elements of Organizational Behaviours, System Quality, and User Use will be affected by the variable of Use of Time. In addition, results of path analysis also identified that nurses in different hospitals have significantly different opinions of using mobile nursing stations. For the results of path analysis within whole nurses and nurses of hospital A, 15 of 19 hypothesis were accepted, and there are: (1) the element of System Quality, Medical Data Quality, Services Quality, and Safety Quality will be affected by the element of Organizational Behaviours; (2) the element of User Use and User Satisfaction will be affected by the element of System Quality; (3) the element of User Use will be affected by the element of Medical Data Quality; (4) the element of User Satisfaction will be affected by the element of Medical Data Quality; (5) the element of User Satisfaction will be affected by the element of Services Quality; (6) the element of User Use and User Satisfaction will be affected by the element of Safety Quality; (7) the element of User Use will be affected by the element of User Satisfaction; (8) the element of Organizational Net Behaviours will be affected by the element of User Use; (9) the element of Organizational Net Behaviours will be affected by the element of User Use and User Satisfaction. For the results of path analysis within nurses of hospital B, 13 of 19 hypothesis were accepted, and there are: (1) the element of System Quality, Medical Data Quality, Services Quality, and Safety Quality will be affected by the element of Organizational Behaviours; (2) the element of User Use will be affected by the element of System Quality; (3) the element of User Satisfaction will be affected by the element of Medical Data Quality; (4) the element of User Satisfaction will be affected by the element of Services Quality; (5) the element of User Use will be affected by the element of Safety Quality; (6) the element of User Satisfaction will be affected by the element of Safety Quality; (7) the element of User Use will be affected by the element of User Satisfaction; (8) the element of Organizational Net Behaviours will be affected by the element of User Use and User Satisfaction. Conclusion and Suggestions Results of research indicate that the current mobile nursing station is a success information system within the hospitals of health care system. In addition, the eight evaluation elements of this research are not only provide a complete evaluation model for evaluating mobile nursing station, but also establishing a useful evaluation questionnaire to evaluation end-users’ opinion of using such technology. In addition, Position, Education, Years of Services, and Use of Time are the most important demographic variables which will affect nurses’ opinion of using mobile nursing station. Finally, all users of mobile nursing station are holding a positive viewpoint for such information technology and system although there are existing a significantly differences nurses opinions of using mobile nursing stations in different hospitals. It suggests adopting both quantitative and qualitative research method for further research to provide a complete view and value of evaluating end-users’ opinion of using mobile nursing station.
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Chang, Ho-Mei, and 張和美. "Evaluating Effectiveness of Swaddling on Physiological Indicators among Preterm-Infants During Suction Period- on the Application of Levine’s Conservation Model of Nursing." Thesis, 2006. http://ndltd.ncl.edu.tw/handle/70287476946340466010.
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碩士中國醫藥大學
護理學系碩士班
94
Background: Suctioning was a necessary procedure to ventilated preterm infants. Yet it was negative impacts on physiological indicators, which would deplete the energy of preterm infants and affect their growth and development. Purpose: to investigate the effectiveness of swaddling (experimental groups) on indicators of heart rate, respiratory rate, O2 saturation, blood pressure and energy expenditure of preterm-infants while suctioning compared to non-swaddling(cmparison groups). Method: This was quasi-experimental, cross-over, and repeated measurement design. Seventeen subjects whose birth weights were under 2000gm and ventilated preterm-infants were tested in a medical center. Randomized sequencing, there were 10 for swaddling first then nonswaddling, and 7 for nonswaddling first then swaddling. Used SPSS for Window 12.0 and SAS (9.1)/GEE to analyzed these data. Results: Preterm infants’ mean heart rates were more stable 9.18 beats/min while swaddling compared to non-swaddling before and after suctioning, and showed significant statistic difference (Z=-2.91, P=0.004). However, after control the times’ interaction, there were no difference between swaddling and non-swaddling in variations on heart rate. The other physiological indicators such as respiratory rate, O2 saturation and blood pressure were no group difference, and had no group and time interaction during suction stimulating to preterm-infants. Conclusion: The hypothesis of preterm infant with swaddling could stabilize their physiological indicators while suctioning period was not proved. So, it was difficult to stablize the physiological indicators by non-pharmacological intervention during the suctioning process. But the energy was conserved because the HR > 140 beats/min in experimental groups during the suction period was less than the cmparison groups. Implication: Although swaddling could not stablize the physiological indicators in preterm infants during the suctioning process, their energy was conserved. The swaddling intervention was suggested to apply in the sution process for the preterms.
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Davhana-Maselesele, Mashudu. "Problems in integrating theory with practice in selected clinical nursing situations." Diss., 2000. http://hdl.handle.net/10500/17944.
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Text in EnglishThe current changes in health care systems challenges knowledgeable, mature and independent practitioners to be able to integrate theoretical content with practice. The study aims to investigate the problems of integrating theory with practice in selected clinical nursing situations. The study focused on the rendering of family planning services to clients which is a component of Community Nursing Science. The findings of the study reveal that there is a need for an integrated holistic curriculum which will address the needs of the community. It was concluded that a problem-based and community-based curriculum, safe and patient-friendly clinical environments, intersectoral collaboration between college and hospital management and student involvement in all processes of teaching and learning will improve the integration of theory and practice. There also appears to be a need for tutors to be more involved in clinical teaching, accompaniment and the continuous evaluation of students.
Health Studies
M.A. (Nursing Science)
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Jeal, Bethany. "Welcome Home: Impact and Effectiveness of the Dr. Peter Centre's Harm Reduction Model for Those Living With HIV/AIDS and who Use Illicit Drugs : Part of the Mixed Method Study Titled: A Mixed Method Evaluation of the Impact of the Dr. Peter Centre on Health Care Access and Outcomes for Persons Living with HIV/AIDS." Thesis, 2015. http://hdl.handle.net/1828/7048.
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The Dr. Peter Centre (DPC), an HIV care facility, provides integrated health care services incorporating harm reduction strategies as part of service provision. These services include a “Harm Reduction Room” for those members who inject drugs, to do so in a supervised environment. In this thesis, I explore the perspectives of DPC members on the harm reduction approach as part of a larger study titled A mixed Method Evaluation of the Impact of the Dr. Peter Centre on Health Care Access and Outcomes for Persons Living with HIV/AIDS who use Illicit Drugs. Thirty DPC members were recruited as part of the qualitative portion of the larger mixed-method study. One-on-one in depth interviews were conducted with each participant and audio-recorded and then transcribed verbatim. Participant narratives reflected positive experiences with nurses and other staff, and with the harm reduction philosophy at the DPC. Narratives from both participants who inject drugs and participants who do not inject drugs indicated support for the harm reduction room because of the safety it provides. Safety was related to reducing the direct harmful effects of injection drugs such as infection and overdose, and also to the refuge from the street and freedom from stigma of drug use that the DPC provides. Participant accounts expressed a sense of acceptance and belonging as a part of the community at the DPC highlighting the role of DPC in shifting drug use patterns. This thesis emphasizes that the harm reduction philosophy and the provision of harm reduction services at the DPC contributes to the overall health and well being of participants.Graduate
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Dlamini, Thabile A. "Evaluating the health education for clients with diabetes mellitus by nurses in a hospital in Swaziland." Diss., 2018. http://hdl.handle.net/10500/25588.
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The purpose of the study was to evaluate the health education for clients diagnosed with diabetes mellitus by nurses working in the diabetes clinic of the specific hospital. The quantitative descriptive cross sectional design used two questionnaires to collect data from all 20 nurses working in the diabetes clinic and from a convenient sample of 132 clients diagnosed with diabetes mellitus, making use of the health services at the diabetes clinic of the hospital. Data was analysed by a computer program, statistical package for social science (SPSS). Measures were taken to ensure acceptable ethical practice, validity and reliability of the study. Findings revealed the absence of official documents to guide the health education and other factors, such as not knowing the learning needs of the clients, not utilising teaching methods optimally. Recommendations address the development of standard procedures, lesson plans, recording of health education sessions and education skills development for the nurses.Health Studies
M. A. (Nursing Science)
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Chaibva, Cynthia Nombulelo. "Factors influencing adolescents' utilisation of antenatal care services in Bulawayo, Zimbabwe." Thesis, 2007. http://hdl.handle.net/10500/1975.
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Adolescent pregnancies are high risks obstetric occurrences. Antenatal care (ANC) provides opportunities to recognise and treat obstetric complications, enhancing the pregnancy outcomes for mothers and babies. This study investigated factors influencing pregnant adolescents' utilisation of ANC services in Bulawayo, using the Health Belief Model's major tenets.
A quantitative descriptive design was used in four phases: 80 adolescents' ANC records were audited; structured interviews were conducted with 200 adolescents attending ANC and with 80 adolescents who had delivered their babies without attending ANC; and 52 midwives completed questionnaires portraying their perceptions on adolescents' utilisation of ANC services in Bulawayo.
Documentation of ANC services provided to adolescents did not meet the expected standards. Poor or non utilisation of ANC services was influenced by socio demographic factors, individual perceptions of adolescents about antenatal care, perceived benefits of and perceived barriers to the utilisation of ANC. Most pregnant adolescents could not access these services because they could not pay the ANC and/or delivery fees charged at government clinics/hospitals. Midwives required more training in providing and recording adequate ANC services. Free ANC and delivery services could enhance adolescents' pregnancy outcomes in Zimbabawe. An information brochure on the importance of ANC attendance for adolescents has been compiled, based on the research results (see Annexure J).Health Studies
D.Litt. et Phil. (Health Studies)