Дисертації з теми "Nursing not elsewhere classified"

 This thesis used a homogeneous sample of 116 professional nurses to empirically test the theoretical proposition that transactional coping and emotional intelligence are different constructs. Using that same sample, the research also empirically tested the theory that professional nurses' emotional work response behaviours require emotional intelligent ability (McQueen 2004; Molter 2001). Other research questions were related to testing relationships between emotional work, emotional intelligence, coping and the outcome variables of job satisfaction and health and well-being.  

A major problem that nurses face at the start of each shift is the amount of information they receive in relation to the patients allocated to their care. The patient may have been in the ward for many days and the nurse has abundant previous information about them. The patient may be a newly admitted and the only information nurses have is their name and that of the consultant. Not only is information needed at the start of the shift, but there are also ongoing needs throughout the shift. Therefore there is a constant process of giving and gathering information.
A qualitative approach using interviews and participant observation was chosen as the most appropriate form of investigation. Ten nurses were interviewed, then observed both at handover and for some hours afterwards. The collected data were analysed using a grounded theory approach. Because of data and time constraints only an initial conceptual framework could be developed and presented in this work.
It was found that nurses both actively seek and are passively given information, which they use for providing patient care. A continuum was found ranging from low to high for both the nurses' knowledge of the patient and the patient's condition, as well as the nurses' clinical knowledge and experience, that has an affect on these activities. This gathering of information can be likened to nurses "learning" about the patient much as one 'learns' the meaning of a picture. Initially one passively absorbs the scene but then the person looks more closely to fill in the details raised by questions they may have.
The process of gathering information needed for patient care is a complex intertwining of many factors relating both to the nurse and the situation. This has implications in the way information is communicated at each nursing change of shift if ongoing care is to be continued appropriately. 

The primary aim of this cross-sectional research project was to evaluate critical care nurses' knowledge of the care and use of central venous lines. A secondary purpose was to determine if their knowledge was related to sociodemographic characteristics.

A true -or -false and multiple-choice questionnaire was developed by the researcher, subjected to review by a panel of experts and pilot -tested. It was examined for reliability, item difficulty and discrimination in order to improve the validity of the instrument prior to the research study. Sociodemographic questions were included to examine the influence of variables such as critical care nursing experience, educational background, job position and location of practice on the nurses' knowledge of the care and use of central venous lines. T -tests and analysis of

variance were used to test hypotheses related to differences in mean scores among sociodemographic subgroups and a predetermined score that indicated sufficient knowledge of the participants in the study.

The final 30 -item questionnaire was mailed to six hundred members of the Australian College of Critical Care Nurses. A total of 250 nurses (42%) completed the questionnaire. The mean knowledge score of all the participants was 23.4 or 78% items correct, with a standard deviation of 3.41. The range of correct scores was 14 to 30. Significantly low mean scores were found in all subgroups except for nurses in managerial or educational positions, nurses working in a large rural area and nurses with a Master's degree or higher level of education. Nurses who completed a hospital -based critical care program had significantly higher scores than those who did not. There was a significant difference in scores according to the years of critical care experience with increasing scores as the years of experience increased.

The results suggest that critical care nurses have a general knowledge deficit of central venous lines. Educational programs, hospital -based critical care programs and the use of preceptors are methods that can be used to improve the knowledge base of nurses working in critical care areas. This study may be replicated on a larger scale to improve the validity and reliability of the questionnaire and to validate its findings.

 In health care the concept of risk has evolved on a medical and epidemiological platform (Hennekens & Buring 1987; Heyman 1998; Jacobs 2000) but despite use in nursing as early as Nightingale (1952) it has not been developed theoretically from a nursing perspective (Spiers 2000). At a time when contemporary health policy, managers and clinical practitioners are increasingly focusing on 'at risk' and `vulnerable' groups in society (Queensland Health 1993; Baum 1998) the terms risk and vulnerability continue to  be recognised as nebulous (Appleton 1994), and conceptualised differently in epidemiological, clinical and individual terms (Spiers 2000; Jacobs 2000). Acknowledging these differences and clarifying these concepts has relevance for nursing practice and research (Rose & Killien 1983), in particular the development of common understandings has the potential to develop nursing knowledge, direct nursing research and ultimately develop the practice of nursing (Norris 1982; Kim 1999; Jacobs 2000). 

This study was motivated by the need to understand and account for a Child Health Nurses' (CHNs') concept of risk within contemporary child health practice so as to develop the knowledge base of child health nursing in relation to risk and to encourage reflection by child health nurse practitioners. Additionally this knowledge could lead to common meanings and shared understandings among CHNs, and ultimately improved practice. For the purposes of this study risk will be recognised as a term having both quantitative and qualitative dimensions with epidemiological, clinical and individual attributes which, when linked to nursing assessment directs the planning and implementation of preventive health practices.  

This dissertation has used an historical approach to investigate nursing at the Rockhampton Hospital between 1930 and 1950. It has focussed on the work practices of those nurses who carried out the majority of the work, the trainee nurses. The work practices examined include those related to infection control, treatments and interventions, monitoring activities and ward management issues such as hierarchical structure and communication.

This dissertation has placed nursing history at the centrepoint of three related disciplinary fields - medical, labour and women's history. This has allowed some of the origins of the rituals, traditions and culture of nursing to be identified. In particular the image of nurses as the doctor's handmaiden has been examined. This dissertation has revealed that while a large proportion of nursing activities were regulated by doctors, nurses controlled a significant amount of their work. This dissertation has, therefore, supported and challenged the foundations of the handmaiden image.

A focus group study was conducted to provide a base of knowledge related to the facilitators and inhibitors of appropriately trained nurses carrying the pager that notifies of the need for a medical emergency team (MET) response. The study site was in regional Queensland and seventeen Registered Nurses participated in the study. The concepts found in data progressively contributed to the development of four major themes: motivators to do the training, applying theory to practice, the MET experience and prioritising the pager. The data uncovered some information that has not previously been reported in the literature. Other findings offer support for evidence that already exists.

Nursing is one of the most important professions in the United States but it has historically endured high levels of shortage and turnover (Apker, Propp, & Ford, 2009; Fox & Abrahamson, 2009). A nurse’s organizational climate and culture have been shown to impact a number of job outcomes including intention to leave the organization (Aiken & Patrician, 2000), and therefore is of interest to both scholars and practitioners alike. One way to understand the context in which nurses work is through organizational identification because people make sense of their own identities in part through the organizations to which they belong (Kuhn & Nelson, 2002). However, because individuals have various identities which can reinforce but at times conflict with each other (Scott et al., 1999) and the strength of these identities can dictate outcomes such as performance (Trybou, Gemmel, Pauwels, Henninck, & Clays, 2013), it is necessary to explore how nurses connect to different identities and social collectives (e.g., team, organization, and occupation/profession) within their work. Further, these connections with the multiplicities of identifications may help explain the decisions that guide nurses’ career trajectories as well as how the perceived identity of a nurse guides individuals to choose a career in nursing. This project seeks to understand how nurses talk about their jobs and how communicating with other nurses influences their career trajectory and decision to stay in or leave their organization or the nursing profession altogether.

This project draws upon both social identity theory and self-categorization theory to help explain how nurses communicate and situate themselves among others in their workplaces. Social identity theory and self-categorization theory are suited for this study’s social constructionist approach and the topic of this research because they explain how the strength and multiplicities of identification within an organization are constructed and shaped by communication with others. Data collection methods for this study consist of in-depth interviews with nurses of specific licensures, posts collected online from a nurse discussion forum, and a questionnaire of nurse forum participants. This study applies a mixed methods approach consisting of qualitative and quantitative analyses. In doing so, this project contributes in several ways including extending our understanding of (1) the connections between the multiplicities of identification; (2) how nurses construct meaning in their jobs to guide career decisions; (3) the nature of nurses’ interactions in online spaces; (4) nurse career decisions; and (5) nurses’ perceptions of the nursing profession before entering the profession.

 This research will investigate job design, workplace interaction and job satisfaction among the various classification of nurses employed at the Rankin Park Unit, John Hunter Hospital. This topic was chosen as the researcher believes and supported by Yoder & Heneman (1975) that the level of staff job satisfaction is reflected in the quality of care that is given to clients, and that improved career pathways and job design directly impact on staff morale and ultimately staff satisfaction. The research into job design, workplace interaction and job satisfaction among nursing staff within the Rankin Park Unit was carried out over a one year period. The instruments of survey, Job Characteristics Inventory (J.C.I.) andL Satisfaction Survey (J.S.S.), were administered to a sample of 181 nurses from the institution. This quota was representative of the various classifications of nurses within the Rankin Park Unit, including; Professional (Registered Nurses, R.N.), Technical (Enrolled Nurses, E.N.), and Service (Assistant In Nursing, A.I.N.) members. Definitions of these titles are located in Appendix A (Definitions of terms and Abbreviations). The responses were analysed and presented in thesis form, to both Central Queensland University and the Hunter Area Health Service. The responses to the instruments of survey and analysis of results give significant insight into areas of possible improvement in job design and job delineation for nurses, thereby flowing on to improved job satisfaction and improved productivity. The information stemming from this research will assist nursing staff at all levels, in association with Institutional Management to map career paths for nurses employed within the Hunter Area Health Service.  

 The aim of this qualitative research project is to develop insight into and an interpretation of, the lived experiences of preceptors in clinical preceptorship programs for undergraduate nursing students. A framework based on hermeneutic phenomenology has been selected as the methodology to facilitate this research process. In depth interview technique is used for data generation from four selected preceptors from the same health care agency. Information shared by these preceptors is analysed within the hermeneutic framework. Evolving theme generation is documented and discussed with a view to enhanced insight into the phenomenon. Nurse educators, nurse managers, preceptors and students may use findings from this study to stimulate satisfying preceptorship experiences in an environment of collaborative nursing education. Other benefits relate to enhanced preceptor, preparation professional leadership programs that will engender positive professional attitudes and improved abilities of preceptors.  

Like most things in today's world, health technology has undergone many changes over the past few decades. Medical and technological advances have changed many health practices. The subject of this study is perioperative personnels' knowledge and understanding of radiation in the perioperative environment. The concern of this study is whether perioperative personnel who are exposed to radiation during their daily work routines are adapting their work practices in line with this changing technology, specifically regarding radiation in the Operating Suite.

A focus group study was undertaken to determine the knowledge and understanding of radiation exposure and safety held by perioperative personnel during their daily work routines within the Operating Suite. The personnel studied came from diverse backgrounds with varying education levels and experiences. They consisted of preoperative nurses, theatre assistants, surgeons and anaesthetists. A total of 23 personnel from the population of 82 participated in four homogeneous focus groups.

The discussions were tape-recorded and copies of the transcripts and preliminary analysis were returned to participants for correction, comment and verification. Following the processes of data collection and ongoing data analysis five intra and inter related categories were identified. These were the dangers of radiation exposure; the lack of knowledge and education on radiation exposure and safety; the radiation environment; protective devices and apparel; and, the radiographer's role and responsibilities. The study identified self -determined deficits in the knowledge and understanding of radiation exposure and safe radiation practices by the participants.

The results demonstrate that, at this point in time, safe radiation practices by perioperative personnel are not optimised within this environment. The recommendations - education on radiation exposure and safety, the appropriate quantity and quality of protective apparel, attention given to signage and warning systems, the roles and responsibilities of radiographers identified and enacted upon; and, future research involving the monitoring of perioperative personnel to determine whether safe exposure levels were not exceeded - could indeed provide a safer perioperative environment.

It has also been recommended that policies and procedures and an education package covering the use of radiation within the perioperative environment are required