Дисертації: "Surgical nursing"

1

Gefter, Aleksey. "EMERGENCY SURGICAL CONDITIONS FROM THE NURSING PERSPECTIVE." Thesis, Тернопіль, 2021. https://repository.tdmu.edu.ua//handle/123456789/17173.

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The aim of the study was to investigate the specific aspects of nursing process as applied to emergency surgery in patients with ballistic injuries and household trauma, to determine the risks faced by medical personnel when working with patients in dangerous neighborhoods, to identify nursing strategies in managing aggressive patients, and to define the need for surgical interventions in ballistic injuries and household trauma as part of a research study.

2

Abdou, Jeanne Anne. "Circadian rhythm disruption and post-surgical recovery." FIU Digital Commons, 1998. http://digitalcommons.fiu.edu/etd/1252.

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Circadian rhythms, patterns of each twenty-four hour period, are found in most bodily functions. The biological cycles of between 20 and 28 hours have a profound effect on an individual's mood, level of performance, and physical well being. Loss of synchrony of these biological rhythms occurs with hospitalization, surgery and anesthesia. The purpose of this comparative, correlational study was to determine the effects of circadian rhythm disruption in post-surgical recovery. Data were collected during the pre-operative and post-operative periods in the following indices: body temperature, blood pressure, heart rate, urine cortisol level and locomotor activity. The data were analyzed by cosinor analysis for evidence of circadian rhythmicity and disruptions throughout the six day study period which encompassed two days pre-operatively, two days post-operatively, and two days after hospital discharge. The sample consisted of five men and five women who served as their own pre-surgical control. The surgical procedures were varied. Findings showed evidence of circadian disruptions in all subjects post-operatively, lending support for the hypotheses.

3

Oliver, Mary Swarna Philomena. "An ethnogaphic [sic] interpretive approach to describing the clinical practice of registered nurses in the field of medical and surgical nursing practice /." St. Lucia, Qld, 2001. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe16446.pdf.

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4

Palmer, Josephine Chiara. "Factors associated with professional nursing practice in medical-surgical nurses." Thesis, The University of Arizona, 1990. http://hdl.handle.net/10150/277266.

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The purpose of this study was to identify and describe factors perceived to be important to nursing practice by registered nurses. The sample, 170 medical-surgical nurses, was 37% of the total in the primary study (N = 455). An exploratory/descriptive design was used to content analyze the qualitative data obtained from one open-ended question asked in the Differentiated Group Professional Practice in Nursing project. Results showed two concepts in the conceptual framework, Group Cohesion and Job Satisfaction, with regard to Pay and Physician/Nurse Relationships, were supported. Other categories generated included the importance of Administrative Support, both Nursing and Non-Nursing, Education, Adequate Staffing, Flexibility in Hours, and Role Recognition. Another set of responses were categorized as Conflicts - Dissatisfiers. Categories generated included Entry into Practice, Non-Nursing Functions and Changing Attitudes.

5

Kan, Bik-yu Ada. "Nurses' perceptions of communication the oncology and surgical context /." Click to view the E-thesis via HKUTO, 2004. http://sunzi.lib.hku.hk/hkuto/record/B31972925.

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6

Denzik, Bridget A. "Bedside Nurse Recognition of Delirium in the Medical-Surgical Setting." Thesis, Walden University, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10100216.

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Delirium in adults aged 65 and older is a common occurrence in the acute care setting and is often unrecognized by bedside nurses. Delirium can trigger a negative cascade of events resulting in an increase in morbidity and mortality, functional decline, longer length of stay, and high rates of post hospital institutionalization and has a significant socioeconomic impact. The purpose of this quality improvement project was to establish a solid foundation using scholarly literature to support the development of a delirium prevention, recognition, and treatment program in the medical-surgical acute care setting applying the program logic framework. The goal was accomplished by developing a structured program to enhance nurse education (phase 1) using a pretest/posttest design. Phase 2 will be implemented at a later date. The null hypothesis for the project was there is no difference between the pretest group knowledge of delirium scores and the posttest group scores following education. The results of the 36-paired pretests/posttests indicated a significant difference (p < 0.05) following the educational PowerPoint on delirium. Providing education and opportunities for bedside nurses to apply this new knowledge is an effective strategy to increase the identification of delirium, which can lead to improved patient outcomes, reduced socioeconomic burden associated with delirium, and increased positive social change. The economic impact of delirium is considerable with the average cost per day of delirium patients reaching nearly 3 times the cost of patients not having delirium. The elderly population is projected to continue to rise, which will have a profound impact on hospitals and health care as a whole.

7

Maneewat, Khomapak. "Nursing Care Practices and Workplace Relations in a Thai Surgical Ward: An Exploration of Clinical Decision-Making." Thesis, Griffith University, 2010. http://hdl.handle.net/10072/367549.

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This thesis offers a study of how a local ward culture underpins nursing actions of Thai surgical nurses in order to account for issues such as lack of sustainability, and failure to use research, including evidence-based nursing practice and the new multimodal model of care which has been officially adopted in the Thai hospital context. The study was conducted at a Thai surgical ward to illuminate and describe the culture of the Thai surgical nurse, including the ways in which the organizational culture influences or guides their thinking, decision-making, and actions in a patterned way. The knowledge about how the Thai surgical nurses allocate care, and make clinical decisions in the surgical ward in the context of social relations and staff culture is constructed through an ethnographic approach based on fieldwork at the non-private general surgical wards of one university hospital in Southern Thailand. A better understanding of the diversity of Thai surgical nursing practice is then enacted from a typical day in the life of the Thai surgical nurses, which consists of the realities, ritualised practices, relations, and integration both with within their group and with others. The study results represent the way that nursing organizational culture informs the practices, decision-making, and the predictions of the nurses’ possible response to change. The pre- and post-operative cares allocated by the nurses of the TSW are routinised, almost ritualised, and reflect fixed assumptions about the way cares ought to be delivered, including those reflecting the lack of commitment to implementing new multimodal models of care as well as research utilization and evidence-based practice. The study raises significant concerns about the status of professional nursing in Thailand in terms of professional autonomy and the status of the nurses within the Thai hospital context. Empowering professional nursing is therefore recommended as a first priority to change Thai nursing culture. The ritualised practices, task-oriented working system, and the dominance of the medical model in the Thai nursing culture further reflect the need to establish an evidence-based nursing culture to create professional identity and improve the quality of care.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
Nursing and Midwivery
Griffith Health
Full Text

8

Lee, Kyung Hae, of Western Sydney Nepean University, and Faculty of Nursing and Health Studies. "Do not resuscitate : bioethical and nursing perspectives." THESIS_FNHS_XXX_Lee_K.xml, 1995. http://handle.uws.edu.au:8081/1959.7/672.

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This report focuses on the use of Watson's theory of human caring for Do Not Resuscitate (DNR) patients in acute medical-surgical wards. It discusses the dilemmas facing DNR patients and their nurses and explores the solutions to these dilemmas offered by Watson's theory. Traditional nursing practice places the nurse in a difficult situation by focusing on physical health. The report discusses the philosophical assumptions underlying Watson's theory. These assumptions led Watson to focus on nursing holistically, and to emphasise an integrated approach to nursing, which promotes the comfort of the patient physically, spiritually and emotionally. Her focus is on the broader aspects of caring such as involving the care domain of nursing, instead of the narrower view of nursing which focuses on care for the 'cure' only. This appproach is particularly relevant to DNR situations because these situations involve patients for whom there is no physical cure. Watson's holistic approach to caring offers the nurses of DNR patients guidelines for their practice and meaning for their nursing actions. Because current DNR decisions are often made by medical officers but implemented by nurses, it is the nurse who may be legally liable for the patient's death. This can cause anxiety for the nurses involved. Another cause of anxiety can be the traditional focus in nursing on physical cure. In the care of DNR patients, no such cure is possible. This can leave the nurse feeling distressed and incompetent. DNR the patients, may lack of autonomy and suffer feelings of insecurity. It is in these areas that Watson's ten carative factors can offer support, for both patients and nurses.
Master of Nursing

9

McClelland, Beverley. "Critical factors that influence staff retention in an acute perioperative environment a thesis in partial fulfilment of the degree in Master of Health Science at Auckland University of Technology, April 2004." Full thesis. Abstract, 2004. http://puka2.aut.ac.nz/ait/theses/McClellandB.pdf.

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10

Maron, Margaret M. "The relationship of stress levels among a group of medical-surgical nurses vs. intensive care nurses /." Staten Island, N.Y. : [s.n.], 1990. http://library.wagner.edu/theses/nursing/1990/thesis_nur_1990_maron_relat.pdf.

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11

Fuentes, Rebecca. "Implementing a Self-Scheduling Model to Decrease Nurse Turnover in Medical-Surgical Nursing." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7541.

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Nurses may experience job stress and burnout due to the amount of hours worked and demanding schedules. At one hospital, nurse turnover rates were high in medical-surgical units. Surveys and interviews conducted by hospital administration found that the bedside nurses were dissatisfied with scheduling practices and that this dissatisfaction could lead to heightened turnover. The purpose of this project was to determine if the implementation of a self-scheduling model would decrease nurse turnover on a medical-surgical nursing unit. This quality improvement project focused on facilitating the empowerment of nurses through a self-scheduling model; it followed the quality improvement steps of the Deming approach of Plan-Do-Check-Act. During the pilot, turnover rates of the unit that implemented the self-scheduling model were reviewed 30 days pre- and 30 days post-implementation. The project results showed a decrease in turnover rates from 12.96% to 10.00% on the unit where the model was implemented. This project has a social impact by allowing nurses to participate in a self-scheduling model to have workâlife balance, because the work environment plays a significant role in encouraging engagement and decrease in turnover. Implementing this model in other units may result in decreased nurse turnover for the hospital.

12

Chard, Jennifer Clarissa 1963. "Professional nursing practice in medical-surgical and intensive care units: Baseline comparisons." Thesis, The University of Arizona, 1990. http://hdl.handle.net/10150/278593.

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This study had three purposes: (1) to examine the differences and similarities between intensive care and medical-surgical RNs' self-reports of professional nursing practice and job satisfaction. (2 & 3) to explore the influence of professional nursing practice on nurse satisfaction in intensive care RNs and medical-surgical RNs, respectively. A two-group, cross-sectional descriptive design with a sample of 340 RNs was utilized to perform a secondary analysis of baseline data from the Differentiated Group Professional Practice project. Self-reports of RNs evidenced significantly higher levels of autonomy and control over nursing practice among intensive care subjects as opposed to medical-surgical subjects. The concepts of organizational commitment, autonomy, control over nursing practice, and group cohesion had a positive influence on total job satisfaction for the medical-surgical subjects. The above concepts with the exception of autonomy had a positive influence on total job satisfaction for the intensive care subjects.

13

Kan, Bik-yu Ada, and 簡碧如. "Nurses' perceptions of communication: the oncology and surgical context." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2004. http://hub.hku.hk/bib/B31972925.

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14

Marine, Jeremey, and Jeremey Marine. "Self-Assessment of Medical-Surgical Nurses’ Behavioral Healthcare Competency." Diss., The University of Arizona, 2018. http://hdl.handle.net/10150/626668.

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Millions of people in the United States are living with a serious mental illness or substance abuse disorder. These individuals suffer from a high rate of medical co-morbidities. Because of this, patients hospitalized on medical-surgical units for medical reasons often are living with psychiatric/substance abuse co-morbidities, which are not addressed during their medical hospital admission. These patients can be perceived as difficult and even dangerous by nurses who have not received training or education in mental health care. The purpose of this project is to measure medical-surgical nurse’s perceptions of their abilities to recognize psychiatric/substance abuse symptoms and their perception of self-competency to provide appropriate interventions. This project utilized the Behavioral Health Care Competency (BHCC) instrument to measure hospital nurse perceptions of behavioral healthcare competency to determine if additional education and training are needed. The BHCC tool was administered to 19 nurses working on two medical-surgical units in Southern Arizona. Findings support the need for educational intervention, especially in the areas of psychotropic medication recommendation and intervention for patients experiencing hallucinations.

15

MacLeod, Martha L. P. "Experience in everyday nursing practice : a study of 'experienced' surgical ward sisters." Thesis, University of Edinburgh, 1990. http://hdl.handle.net/1842/19083.

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16

Ludwig, Frances. "Prophylaxis of enteral nutrition associated diarrhea with psyllium hydrophilic mucilloid, a bulk forming laxative in surgical icu patients /." Staten Island, N.Y. : [s.n.], 1987. http://library.wagner.edu/theses/nursing/1987/thesis_nur_1987_ludwi_proph.pdf.

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17

Opadotun, Olukemi. "Infection control practices for the prevention of surgical site infections in the operating room." Thesis, Nelson Mandela Metropolitan University, 2014. http://hdl.handle.net/10948/d1017195.

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Infections are a major cause of morbidity and mortality during the post-operative phase of patients’ recovery. Wound infections are the second most commonly encountered type of nosocomial infection. Because wound infections can be introduced by not applying infection control measures and sterile technique principles in the operating room, the implementation of infection control principles is an imperative. The aim of this study was to explore and describe infection control practices related to the prevention of Surgical site infections in the operating rooms in a public health care sector in the Nelson Mandela Bay Municipality. The findings were compared with practices, as indicated in an evidence-based guideline. The research design was quantitative, explorative, descriptive, comparative-descriptive and contextual in nature. The research sample consisted of all the professional nurses, in the operating room. The data were collected by means of a self-administered questionnaire. Descriptive statistics was used to present the data in the form of tables and graphs. Based on the analysis of the data, some recommendations were made for the implementation of infection control practices, in order to prevent Surgical site infections in the operating room.

18

Mori, Candace Lynn. "Understanding the Experience of Osteoporosis Risk in Bariatric Surgical Patients." Kent State University / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=kent1573669680874186.

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19

Stidham, Cova Teresa. "Depression Screening for Bariatric Surgical Patients." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6866.

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Obesity in the United States has increased to epidemic numbers over the last decade. Practitioners need to reverse the trend. To address the problem of depression in obesity, a practice guideline from a bariatric clinic for under-served populations was proposed to an expert panel. The Spell Out on First Use (PHQ-9) screening is a valid and reliable self-screening tool to assist the practitioner in determining the level of depression if any. The PHQ-9 has nine questions. No formal screening existed at the bariatric clinic, and the practice guideline (with algorithm and revised workflow) was proposed for use at the clinic. The expert panel consisted of the medical director, a surgeon, a psychiatrist, and a nurse practitioner at the clinic. The expert panel reviewed the materials and made one recommendation: to implement the PHQ-9 upon intake when the patient is being admitted to the program, and the panel recommends administering PHQ-9 prior to assessment by practitioners All panel members were in agreement about full implementation of the practice guideline, provided that an educational program on the revised workflow in the clinic was first presented. The expert panel also reviewed and approved the algorithm and the treatment pathways identified for patients to use in the practice after the results of the PHQ-9 are compiled. It is expected that use of the depression screening tool and recommended guidelines in the bariatric clinic will result in more effective treatment for the patients and thus better outcomes-a significant positive social change.

20

McNamee, Mary Josephine McCarthy John R. "Essential student clinical behaviors for satisfactory completion of initial medical-surgical nursing experiences as perceived by baccalaureate nursing faculty." Normal, Ill. Illinois State University, 1988. http://wwwlib.umi.com/cr/ilstu/fullcit?p8907677.

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Thesis (Ph. D.)--Illinois State University, 1988.
Title from title page screen, viewed September 23, 2005. Dissertation Committee: John R. McCarthy (chair), Ronald S. Halinksi, Mary Ann Lynn, Rodney P. Riegle, David L. Tucker. Includes bibliographical references (leaves 153-166) and abstract. Also available in print.

21

Yale, Ninon. "Postcesarean pain : characteristics and relationship with surgical anesthesia." Thesis, McGill University, 1992. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=61298.

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This study was designed to characterize postcesarean pain and examine its relationship with surgical anesthesia. Pain intensity was measured using a 0 to 10 numerical rating scale. The Short-Form McGill Pain Questionnaire was used to measure quality. The most common pain types reported were movement-associated and constant incisional pain (100% of subjects), gas pain (88.1%), and uterine contraction pain (83.3%). Each pain type differed in its intensity, duration and quality. Movement-associated incisional pain was the most intense and long-lasting pain type reported. On postoperative days 2 to 4, mothers who received complete epidural anesthesia during surgery reported less intense movement-associated incisional pain than those who received general or incomplete epidural anesthesia. However, statistical significance was not often obtained. These findings demonstrate the uniqueness of each pain type composing the postcesarean pain experience. The clinical data also support the hypothesis that epidural anesthesia diminishes the sustained hyperexcitability of the central nervous system caused by surgery.

22

Samuels, Sherry K. "Non-surgical methods and nursing roles in the management of low back pain." Honors in the Major Thesis, University of Central Florida, 2000. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/399.

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This item is only available in print in the UCF Libraries. If this is your Honors Thesis, you can help us make it available online for use by researchers around the world by following the instructions on the distribution consent form at http://library.ucf.edu/Systems/DigitalInitiatives/DigitalCollections/InternetDistributionConsentAgreementForm.pdf You may also contact the project coordinator, Kerri Bottorff, at kerri.bottorff@ucf.edu for more information.
Bachelors
Health and Public Affairs
Nursing

23

Wong, Sze Wing Julia. "The effects of concept mapping in student nurses' learning of medical-surgical nursing." Thesis, University of Liverpool, 2018. http://livrepository.liverpool.ac.uk/3027950/.

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Many student nurses are weak in studying medical-surgical nursing because high-order and critical thinking skills are required to understand and incorporate prior knowledge with new knowledge, and they are expected to formulate a holistic nursing care plan. Concept mapping (CM) was adapted in one medical-surgical nursing course in a higher private education institute in Hong Kong to enhance their learning. This study aimed to explore the effect of CM on student nurses' learning experience and examine the difference in academic performance of students who learned this subject by using CM and those who did not. Difference in academic performance based on five sensory modalities using Fleming's visual, aural, read/write, kinaesthetic, and multimodal (VARK) model was also explored. Lastly, a substantive theory was developed by using the grounded theory approach together with qualitative and quantitative results. The quantitative results showed that the pass rate of CM and non-CM groups was 100% and 77.59%, respectively. The difference of marks between the CM group (M=77.90 and SD=8.09) and non-CM group (M=57.56 and SD=10.16) was statistically significant (p=0.000) with a large effect (Cohen's d=2.21). However, no significant difference was observed in students with different sensory modalities, thereby suggesting that students with different sensory modalities benefit from CM use. In addition, 26 student nurses were interviewed during focus group discussion. Students from all sensory modality groups perceived CM as an effective tool to determine the relationships between nursing problems and nursing interventions in a systematic and well-organized manner via categorization. This form of presentation provides them a clear and overall picture in a short period, thereby enhancing their understanding, memorization, and retention of topic. However, some shortcomings of CM were also identified such as extensiveness, time-consuming, more confusing and too simple nature. Therefore, after the new and prior knowledge was bridged, students used their own perceived effective method to re-organize the knowledge to enhance their memory to prepare for the written examination. Both quantitative and qualitative results revealed that using CM seems able to improve the students' academic performance, and students gained a good understanding of relationships between concepts in medical-surgical nursing, particularly for students who are new in the subject. A substantive theory was finally developed which explains the relationships between teaching with an animated structural diagram and students' learning, and thus, the change of students' behaviour for attaining a better grade in the written examination.

24

Smith, Heather. "Educating Medical--Surgical Nurses to Improve Nursing Knowledge and Understanding of Health Literacy." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6674.

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Low health literacy levels put patients at greater risk for poorer compliance and access to care, which leads to worse patient outcomes. Nurses must understand health literacy to improve health literacy for their medical surgical patient population. It is necessary for a formal education program on this topic. The purpose of this project was to increase medical surgical nurses' awareness and knowledge of the importance of health literacy and to introduce the REALM-SF tool to assess a patient's literacy level, allowing a nurse to better individualize the education provided to the patient. Lewin's change management theory was key in the development of this project with attention to his three stages of change acceptance. The practice focus question was, "Will medical-surgical nurses show an improvement in their knowledge of health literacy when comparing measurement of knowledge pre education and immediately post education?" The HL-SF12 for registered nurses tool was used to collect data for this project as a pre- and post-implementation knowledge assessment. Thirty-one medical surgical nurses participated in this education session. The results of this analysis show that there is a significant gap in medical-surgical nurses' knowledge of health literacy. However, all participates showed a significant increase in their scores from pretest to posttest after the educational module, which signifies that this education program was successful. Assessing health literacy is a major step towards improving the delivery of patient education by nurses and assists the patients in the management of their medical problems. All of this leads to positive social change by making sure that the education provided by the nurses is understood and received well by the patients and their families.

25

Gregory, Sabrina. "Managing Acute Pain in Postoperative Surgical Patients." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/3030.

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Every year, millions of Americans suffer from either chronic or acute pain that results in tremendous healthcare cost, rehabilitation, and loss of work productivity. Pain is an unpleasant sensation associated with sensory and emotional experiences that can cause potential or actual tissue damage. One plausible solution to managing pain is the use of nonpharmacological modalities such as guided imagery. The purpose of this project was to determine if there was a difference in pain scores following pharmacological interventions and the use of guided imagery among postoperative same day surgical patients. Guided imagery is a nonpharmacological modality that uses pictures, music, and imaginary scenes to help heal the body in addition to using relaxation techniques and mental images for the management of pain. This project included the translation of evidence into practice using guided imagery on a 25-bed same day surgery unit (N = 34 patients), guided by Kolcaba's comfort theory. The findings of this project included using guided imagery for same day surgery patients who rated their pain greater than 4 on the traditional pain scale of one to ten, with one equaling no pain and ten equaling worst pain. The results of the evaluation showed a significant decrease in pain scores between premedication to postmedication (p < 0.001), premedication and postguided imagery (p < 0.001), and postmedication and postguided imaginary (p < 0.001). Guided imagery has been demonstrated to be efficient and cost effective methods to reducing pain. This project indicated that use of nonpharmacological and pharmacological interventions working together could be more effective for pain management in same day surgical patients.

26

Little, Charlene Knight. "Decreasing Surgical Site Infections in Vascular Surgery Patients." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2412.

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Postoperative surgical site infections are common complications in the operating room. Infections prolong hospital stays, heighten costs, and increase morbidity and mortality. The purpose of this evidence-based quality improvement project was to develop policy, program, and practice guidelines to prevent surgical site infections in vascular surgery patients. Rosswurm and Larrabee's change model was used to develop materials using the best evidence for the recommended practice changes. The Plan, Do, Check, Act model was selected to guide quality improvement. The project goal was to decrease the surgical site infection rate to below the national average. Products of the project include policy, protocol, and practice guidelines developed based on recommended practices of the Association of periOperative Registered Nurses and current peer-reviewed literature. An interdisciplinary project team of institutional stakeholders was used to insure context-relevant operationalization of the evidence in practice. The team was assembled, led in a review of relevant literature, and convened regularly until project products were finished. Three scholars with expertise in the content area were then identified by the project team and asked to validate the content of developed products. Products were revised according to expert feedback. Implementation and evaluation plans were developed by the project team to provide the institution with all necessary process details to carry out the practice change. The evaluation plan advises using a retrospective chart review to compare rates of infection between patients receiving chlorhexidine skin preparation with showers and preoperative chlorhexidine cloths alone. A positive outcome could contribute to positive social change by decreasing preventable infections.

27

Walker, Annette Clare, of Western Sydney Nepean University, and Faculty of Nursing and Health Studies. "Nurse and patient work: comfort and the medical-surgical patient." THESIS_FNHS_XXX_Walker_ A.xml, 1996. http://handle.uws.edu.au:8081/1959.7/286.

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This grounded theory study investigates the experiences and perceptions of comfort and discomfort of hospital patients admitted for medical-surgical conditions, with a focus on the post-accute stage of hospitalisation. In-depth post-discharge interviews were conducted with seventeen English speaking adults who had been admitted to nine Australian hospitals. A substantive theory of finding comfort and of managing discomfort was generated. Processes of self-talk (anticipating, interpreting, accepting, making allowances and maintaining perspective) and self-care (self-help and seeking help, which involved accommodating to the level and type of help available through deferring, avoiding, persisting or desisting) were used to find comfort and to manage discomfort. The study has implications for nursign practice, management, research and education. Existing practice in the areas of assessment, communication, individualised care planning and the management of discomfort need to be strengthened if nursing care is to make a difference for this category of patient. The study revealed that integrated caring by nurses perceived by informants as 'experts', contributed most to the experience of finding comfort and managing discomfort in this group of informants
Doctor of Philosophy (PhD)

28

Lucas, Valentina. "Perceived Stress and Surgical Wound Cytokine Patterns." VCU Scholars Compass, 2012. http://scholarscompass.vcu.edu/etd/2937.

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Normal wound healing is a complex process that occurs in overlapping phases and depends upon interactions of the patient, environment and a large number of cells, growth factors, cytokines, chemokines, and other biochemical mediators. Psychological stress has been shown to adversely affect the normal wound healing process through its impact on cellular immunity. Cellular immunity impacts wound healing through the production and regulation of many of the above biochemical mediators of wound healing. The purpose of this pilot study was to examine the relationships among pre- and post-operative psychological stress experienced by women who were undergoing either immediate or delayed breast reconstruction following mastectomy for breast cancer and influence of that stress on wound healing, specifically the biochemical mediators of wound healing in the local wound environment. An integration of Lazarus and Folkman’s cognitive appraisal model of stress and coping and the psychoneuroimmunology model proposed by McCain, Gray, Walter and Robins (2005) served as the theoretical framework for the research. A descriptive non-experimental design was used, with samples collected over time to describe biochemical patterns in surgical wounds of women undergoing autologous breast reconstruction. Biochemical data were collected preoperatively, as well as at 24, 48, 72 and 96 hours postoperatively. Psychological stress instruments were administered pre-operatively and 48 hours post-operatively. Although subjects overall displayed low levels of psychological stress, meaningful wound fluid biochemical mediator patterns were detected. This study adds to our knowledge concerning wound fluid chemical mediators present in the local wound environment over time.

29

Strayer, Robert Michael. "Variables Predicting Success in an Advanced Medical-Surgical Nursing Course and the NCLEX-RN for Pre-Licensure Baccalaureate Nursing Students." Diss., Temple University Libraries, 2010. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/103572.

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Educational Psychology
Ph.D.
The purpose of this descriptive, ex post facto study was to examine possible relationships between demographic, pre-programmatic, and programmatic factors with success in a final Advanced Medical-Surgical nursing course and the National Council Licensure Examination for Registered Nurses, as well as their predictive abilities. Data were obtained from the academic records of 209 full-time and part-time nursing program graduates who completed an upper-division baccalaureate nursing degree at a mid-Atlantic private urban university. Descriptive and inferential analyses were utilized to discover possible relationships between the two dependent variables and the various independent variables in groupings suggested by Carroll's (1963) model of School Learning. Two models were derived to predict success in the nursing program as evidenced by successful completion of the final Advanced Medical-Surgical nursing course and passing the NCLEX-RN on the first attempt. The first model identified age at entrance to the nursing program and repeating a science course as the two factors that explained approximately 49% of the variance in the Advanced Medical-Surgical course performance. The second model was able to predict 97.2% correctly those graduates who would be successful on the NCLEX-RN, and only identify 43.8% of those candidates likely to fail. The overall classification ability by the model was 89%. Implications for nursing educators are that more attention needs to be given to admission policies/procedures, and that students entering nursing programs require routine standardized evaluation, identification and remediation of nursing content gaps in order to be successful throughout their nursing studies and ultimately on the NCLEX-RN.
Temple University--Theses

30

Tortorella, Genova Toni. "Evaluating Medical-Surgical Nurses' Knowledge and Attitudes Regarding Pain| A Descriptive Comparative Analysis." Thesis, The William Paterson University of New Jersey, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3617158.

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Background: Pain is part of the human experience. The management of pain is a problem of significant magnitude in the United States. Nurses are on the forefront of this issue with the capacity to assess and respond to patients needs. Nurses' knowledge and attitudes towards pain can predict the nurses' ability to adequately meet patient's pain reduction needs.

Objective: The aim of this DNP project was to replicate a 1996 study comparing outcomes of the attitudes and knowledge regarding pain survey of a convenience sample of medical-surgical nurses in 2013 with nurses from 1996 to determine if attitudes towards pain have changed.

Method: Cross-sectional, descriptive, comparative design. The Nurses' Knowledge and Attitudes Survey Regarding Pain (NKASRP) and a demographic survey were utilized to assess the nurses' knowledge level and attitudes toward pain and pain management.

Sample: A convenience sample of nurses (n=58) from nine in-patient, medical-surgical units at a large multi-facility health care system volunteered to participate.

Results: No significant differences were found between the attitudes on pain from the 1996 and 2013 respondents. The mean score on the NKASRP was 67%. No significant correlations were identified between any demographic variable and nurses' scores.

Conclusion: Despite increased educational preparation since 1996, the mean score on the NKASRP remained well below what is considered average knowledge. Nursing academics and hospital orientations need to evaluate nurses' attitudes and knowledge and provide the education that can help nurses provide adequate pain management to patients.

31

Mitchell, Lucy. "Development of a behavioural rating system for scrub nurses' non-technical skills." Thesis, University of Aberdeen, 2011. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=167786.

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In the first study, a literature review and semi-structured interviews with experienced scrub nurses (n=25) and consultant surgeons (n=9), identified ‘communication’, ‘teamwork’, ‘situation awareness’ and ‘coping with stress’ skills as important skills for scrub practitioners. The second study used focus groups (n=4 groups) of experienced scrub nurses (total n=16 participants) to sort and label the extracted non-technical skill data, from study 1, into skill categories and underlying elements. The focus groups also generated ‘behavioural markers’ describing good and poor performance of those elements. This preliminary taxonomy contained eight categories with 28 underlying elements. An expert panel, comprising two psychologists and a subject matter expert used an iterative process, with reference to the system design guidelines, to refine the taxonomy. The resulting prototype was called the Scrub Practitioners’ List of Intraoperative Non-Technical Skills (SPLINTS) system which had three skill categories – ‘Situation awareness’; ‘Communication and teamwork’; ‘Task management’, each of which had three underlying elements. The third study tested the psychometric properties of the prototype SPLINTS system. Scrub practitioners (n=34) attended a single-day evaluation session where they received training (5 hours) and practice (1 hour) using the SPLINTS system before rating the scrub practitioner’s behaviour seen in standardized surgical video scenarios (n=7) (1 hour). Within-group agreement was acceptable (r_wg >.7) for the three skill categories and for six of the nine elements. Future work will assess the usability of SPLINTS system in the operating theatre environment. This project has provided scrub practitioners with a structured method for training and assessing an important aspect of performance, which could help to reduce adverse events in the operating theatre.

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Nelson, Julia Ellen 1959. "differences in learning style preferences, environmental press perceptions, and job satisfaction between surgical intensive care and general surgical unit nurses." Thesis, The University of Arizona, 1991. http://hdl.handle.net/10150/558149.

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33

Loew, Justin Thomas. "Educating Medical-Surgical/Staff Nurses to Improve Nursing Knowledge of Patient Education, Focusing on Health Literacy." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/1904.

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A primary problem faced by a majority of medical-surgical nurses is a lack of knowledge and skills necessary to improve health literacy among patients. This inadequacy among medical-surgical nurses is often linked to insufficient training on how to identify and interact with patients with lower health literacy. Improvement of patient health literacy can be realized through proper training, education, and a better application of communication strategies. The aim of this project was to improve current medical-surgical nurses' practice guidelines via the use of educational programs. The project developed pilot protocols and policies in order to improve its practical applications. The project was achieved in 6 steps: (a) assembling an interdisciplinary team, (b) reviewing literature and evidence, (c) developing policy and practice guidelines, (d) content validation, (e) creating an implementation and (f) evaluation plan. The team delivered the new policy and guidelines and observed the medical surgical nurses. During the month-long review, nurses who applied guidelines that they had been equipped with were deemed competent. Conversely, nurses who did not show competency were given on-the-spot education and were observed to make sure that they learned the necessary guidelines and practices. These instances were recorded and collected for review. The interdisciplinary team's positive evaluation of the project indicated a potential positive social impact for the 59% of elderly population in need of this specialized care as well as the estimated 36% of American adults who have limited health literacy. Equipping medical-surgical nurses with strategies for effective communication and health literacy when working with either population could help to minimize the readmission rates of patients, and overall number of Emergency Room visitations due to low health literacy.

34

Denzik, Bridget Ann. "Bedside Nurse Recognition of Delirium in the Medical-Surgical Setting." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2206.

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Delirium in adults aged 65 and older is a common occurrence in the acute care setting and is often unrecognized by bedside nurses. Delirium can trigger a negative cascade of events resulting in an increase in morbidity and mortality, functional decline, longer length of stay, and high rates of post hospital institutionalization and has a significant socioeconomic impact. The purpose of this quality improvement project was to establish a solid foundation using scholarly literature to support the development of a delirium prevention, recognition, and treatment program in the medical-surgical acute care setting applying the program logic framework. The goal was accomplished by developing a structured program to enhance nurse education (phase 1) using a pretest/posttest design. Phase 2 will be implemented at a later date. The null hypothesis for the project was there is no difference between the pretest group knowledge of delirium scores and the posttest group scores following education. The results of the 36-paired pretests/posttests indicated a significant difference (p < 0.05) following the educational PowerPoint on delirium. Providing education and opportunities for bedside nurses to apply this new knowledge is an effective strategy to increase the identification of delirium, which can lead to improved patient outcomes, reduced socioeconomic burden associated with delirium, and increased positive social change. The economic impact of delirium is considerable with the average cost per day of delirium patients reaching nearly 3 times the cost of patients not having delirium. The elderly population is projected to continue to rise, which will have a profound impact on hospitals and health care as a whole.

35

Driskill, Karen. "An Educational Program to Reduce Surgical Site Infection in Vascular Patients." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6891.

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Surgical site infections (SSIs) are a leading cause of morbidity and mortality in the United States. Researchers have demonstrated the impact that SSIs have on the healthcare system and the need to improve patient outcomes. The purpose of this project was to develop an educational program for the 8-member nursing staff of an outpatient vascular surgical office to help reduce the occurrence of SSI rates for patients seen pre and postoperatively after a noted increase in SSI rates at this clinical setting. Guided by the Fitzpatrick model, a group of 6 health care providers comprising 3 surgeons and 3 nurse practitioners served as content experts to conduct formative evaluation during development of the educational program. Members of the surgical office nursing staff completed a questionnaire; results were analyzed using descriptive analysis. Findings indicated that 100% of nursing staff had no on-site work training on basic signs and symptoms of infection and infection control; 100% of staff were not confident in assessment of the surgical site and addressing patient issues; and at least 50% reported that they lacked knowledge of proper wound care including bathing, dressing changes, and expected symptoms for healing and/or complications postoperatively. Educational materials were designed to address these gaps. This project might benefit the surgical center nursing staff by providing education to help reduce surgical site infection in vascular patients, and bring about positive social change by improving quality of life and patient outcomes for the vascular surgery patient through a reduction in the occurrence of SSIs.

36

Masterson, Lisa M. "Implementing a Glycemic Management Protocol with Surgical Patients." Mount St. Joseph University Dept. of Nursing / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=msjdn1619806592278265.

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37

Jacobs, Lisa. "Peripheral IV Insertion Competence and Confidence in Medical/Surgical Nurses." Mount St. Joseph University Dept. of Nursing / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=msjdn1588803002744564.

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38

Dacey, Ashley Ann, and Ashley Ann Dacey. "Music as a Therapeutic Nursing Intervention and Cardiac Surgical Inpatients' Experience: A Quality Improvement Project." Diss., The University of Arizona, 2017. http://hdl.handle.net/10150/625636.

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Enduring cardiac surgery can result in physical pain and feelings of anxiety during the recovery period. Although pharmaceutical interventions exist to help alleviate these symptoms, complimentary therapies are seldom encountered in hospital settings. Listening to calming music has been shown to improve the patient experience and can be a safe adjunct to standard pharmaceutical management of pain and anxiety. The aim of this project was to implement music as a nursing intervention for open-heart patients and to evaluate both nurse attitudes and trends in use and patient experiences of pain, anxiety, and satisfaction. A descriptive, quality improvement project following the Plan-Do-Study-Act format for healthcare improvement was conducted on a cardiac telemetry unit at a suburban hospital in Arizona. Thirty percent of staff nurses provided feedback. The majority of participating nurses had a bachelor’s degree (58%) and less than 10 years of nursing experience (79%). Of the participating nurses, 79% recommended the intervention, with two fully providing the intervention to the patient when requested. Patient surveys were completed by 13% of potential patient participants, though only two surveys were suitable for analysis. Patients (n=2) reported improvements in satisfaction levels and would recommend the intervention for others. One reported an improvement in pain and the other patient reported an improvement in anxiety. Overall, music was viewed favorably by nurses and patients as a complementary therapy, but because of the short study period and limited nurse and patient feedback, more quality improvement projects are needed to determine its direct effects on patients. Engaging and recruiting frontline staff in the design of the project and enlisting more financial support from the organization would be advised.

39

Lewis, Robin A. "The effect of virtual clinical gaming simulations on student learning outcomes in medical-surgical nursing educaiton courses." [Huntington, WV : Marshall University Libraries], 2009. http://www.marshall.edu/etd/descript.asp?ref=943.

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40

麥寶晶 and Po-ching Mak. "Evidence-based guidelines for deep vein thrombosis prophylaxis in a surgical intensive care unit." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193031.

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Deep vein thrombosis (DVT) and pulmonary embolism (PE) are together known as venous thrombo-embolism (VTE), one of the most common complications after surgery and trauma injury. In the case of critically ill patients, it is also a significant medical and financial burden, associated with high mortality and morbidity. In recent years, much evidence has come to light showing that DVT prophylaxis can effectively reduce DVT, and it has been incorporated into various evidenced-based guidelines (Geerts et al., 2008; Nicolaides et al., 2006). The objectives of this study are to examine, through a comprehensive literature review of published studies, the effectiveness of various means of DVT prophylaxis aimed at reducing DVT, and to develop an evidence-based guideline for the use of DVT prophylaxis in surgical intensive care unit (ICU) settings. Keywords related to DVT prophylaxis were used in conducting the search in electronic bibliographic databases like MEDLlNE, CINAHL, PubMed and the Cochrane Library. A total of 110 articles were identified, and seven studies fulfilled the inclusion criteria of the study. Data from the seven studies have been extracted to form tables of evidence; the qualities of the studies were then rated, and the levels of evidence assigned according to SIGN 50: A guideline developer’s handbook (Network, Harbour & Forsyth, 2011). Three studies attained a higher level of evidence with strong methodological design and demonstrated a statistically significant reduction in the incidence of DVT. The implementation potential of DVT prophylaxis was examined in terms of target setting, target audience, transferability of findings, feasibility and cost-benefit ratio. And it was found that the development of evidence-based guidelines for DVT prophylaxis was feasible, cost-beneficial and transferable in current settings. The findings of the seven reviewed studies have been translated into an evidence-based DVT prophylaxis guideline. The main focuses of the guideline are the choice of prophylaxis used with surgical ICU patients and the strategies for improving adherence and prophylaxis monitoring. Combined pharmacological and mechanical DVT prophylaxis is recommended for ICU patients who are at high risk of DVT. For patients with active bleeding or high risk of bleeding, mechanical prophylaxis like intermittent pneumatic compressor (IPC) or gradual compression stocking (GCS) should be used first, followed by a review for pharmacological prophylaxis when the risk of bleeding has decreased. In addition, routine assessment of thrombosis and bleeding risk for high-risk ICU patients and regular checking of fitting and functioning of the DVT prophylaxis are recommended. An implementation plan consisting of communication, pilot and evaluation plan was developed. A 12-month programme including communication with stakeholders, marketing of the innovation, training of frontline staff, a five-week pilot study and implementation of the guideline followed by evaluation will be carried out. In the evaluation, programme effectiveness was assessed in terms of patient outcome (e.g. incidence of DVT), process outcomes (e.g. level of knowledge related to DVT, compliance with the guideline and level of staff satisfaction) and system outcome (e.g. financial cost reduction).
published_or_final_version
Nursing Studies
Master
Master of Nursing

41

Howard, Valerie Michele. "A comparison of educational strategies for the acquisitions of medical-surgical nursing knowledge and critical thinking skills." Connect to resource online, 2007. http://etd.library.pitt.edu/ETD/available/etd-04182007-205440.

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42

McGarvey, Helen Elizabeth. "The operating department : investigating the role of the nurse." Thesis, University of Ulster, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.326331.

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43

Hilton, George Leslie. "SENSORY REGRESSION TIME FROM SUBARACHNOID BLOCK WITH HYPERBARIC 0.75% BUPIVACAINE IN THE OBESE PATIENT." VCU Scholars Compass, 1989. http://scholarscompass.vcu.edu/etd/5067.

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The purpose of this study was to determine if obese patients have a different sensory regression time from subarachnoid block than non-obese patients using hyperbaric 0.75% bupivacaine. A quasi-experimental design was used. Twenty patients were separated into two groups; one group was classified as obese, and the other group was classified as non-obese. The data consisting of age, height, weight, sex, and surgical procedure were recorded preoperatively. All the patients received hyperbaric 0.75% bupivacaine via subarachnoid puncture. The levels of spinal anesthesia were recorded at the highest level achieved. The injection time was also recorded. When the surgery was completed, the patient was transferred to the recovery room and levels of sensory blockade were checked by pin-prick with an 18-gauge needle every 10 minutes until complete recovery from the spinal anesthesia had been achieved. The hypothesis, there will be no difference in sensory regression time from SAB with hyperbaric 0.75% bupivacaine between obese and non-obese patients, failed to be rejected. No statistically significant difference, using linear regression analysis, was found in mean regression time between groups (obese versus non-obese).

44

Hudalla, Christa Choate. "The Effect of Tourniquet Application On Systemic Coagulation." VCU Scholars Compass, 1992. http://scholarscompass.vcu.edu/etd/5073.

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Seven orthopedic surgery patients requiring the use of a tourniquet were studied. The hypothesis stated that tourniquet application does not affect coagulation. A total of 5 blood samples were drawn perioperatively (preoperative, 5 minutes after induction of anesthesia, 30 minutes after tourniquet inflation, 2 - 5 minutes after tourniquet deflation, and 30 minutes after tourniquet deflation. For each sample, TEG parameters (R, R + k, MA and α) were measured. The value for each TEG parameter was compared by analysis of variance (ANOVA), then the samples were contrasted and examined by repeated measures ANOVA. None of the TEG parameters showed a statistically significant difference in the blood samples before, during or after tourniquet application. The hypothesis could not be rejected at the α = .05 level of significance. A t test was used to examine the effect of anesthesia on coagulation. The TEG parameters indicated a significant relationship between the TEG values R and R + k, and a near significant relationship between TEG values MA and a and the administration of anesthesia. It was concluded that tourniquet use does not effect coagulation when applied 2 hours or less. However, anesthesia had a significant effect on TEG parameters R and R + k. The clinical significance of this effect was questionable since the type of anesthesia varied in some patients, and none of the patients in the study demonstrated symptoms of coagulopathy.

45

Stevens, Gwynneth Roberta. "An exploration of the role of the registered nurse in enhancing and developing the nursing skills of undergraduate nursing students in a surgical setting." Master's thesis, University of Cape Town, 2014. http://hdl.handle.net/11427/13789.

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Registered nurses in clinical settings, through years of training combined with experience, become empowered with valuable knowledge and skills. The majority of these registered nurses are employed in public hospitals, caring for patients from culturally diverse backgrounds who face economic, psycho-social, and, in particular, physical challenges. Such conditions often provide a rich environment to undergraduate nurses for experiential learning. The experienced registered nurses, working in this rich environment, are well positioned to fulfil a crucial role in transferring, developing and enhancing skills for educating undergraduate nursing students. Their role in the development of undergraduate nursing students in the clinical environment should never be underestimated or under-utilised. The clinical environment should be considered as the most important resource for developing the confidence and competencies of undergraduate nurses. It is within this background that this research study was undertaken. The aim of this research study was to contribute to the teaching and learning roles and functions of registered nurses working in the surgical wards at the study setting in terms of teaching undergraduate nursing students. The researcher intends to make certain recommendations for the improvement of teaching and learning for undergraduate nursing students in the clinical context. In addition to exploring the feelings and perceptions of registered nurses regarding their teaching role, the minor dissertation seeks to explore some of the misconceptions and challenges relating to the nature, extent and responsibilities of this teaching role. I therefore set out to answer the following research question: â€œHow do registered nurses at a Western Cape academic hospital perceive their teaching and learning role as clinical teachers?â€

46

Forren, Jan Odom. "POST DISCHARGE NAUSEA AND VOMITING IN AMBULATORY SURGICAL PATIENTS: INCIDENCE AND MANAGEMENT STRATEGIES." Lexington, Ky. : [University of Kentucky Libraries], 2009. http://hdl.handle.net/10225/1141.

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Thesis (Ph. D.)--University of Kentucky, 2009.
Title from document title page (viewed on May 12, 2010). Document formatted into pages; contains: vii, 166 p. : ill. Includes abstract and vita. Includes bibliographical references (p. 141-157).

47

Bull, Rosalind Margaret. "Theatre wear must be worn beyond this point : a hermeneutic ethnographic exploration of operating room nursing." Title page, table of contents and abstract only, 2002. http://web4.library.adelaide.edu.au/theses/09PH/09phb9355.pdf.

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48

Naour, Michelle G., and Michelle G. Naour. "Transition of Care: The Evaluation of Hand-off Communication Between Emergency Department and Medical/Surgical Nursing Units." Diss., The University of Arizona, 2018. http://hdl.handle.net/10150/626622.

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Hand-off communication from the emergency department (ED) to inpatient nurses is an important process for transfer of safe and quality patient care from one department to another. Annually, there are130.4 million ED visits with 12.2 million of those visits resulting in hospital admission, providing ample opportunities for poor communication (Rui, Kang, & Albert, 2013). Miscommunications during patient hand-off are estimated to contribute to 80% of adverse events (The Joint Commission, 2012). This theory-driven, quality improvement project sought to evaluate the hand-off communication process between nurses from the ED and nurses in the inpatient Medical/Surgical units using human factors System Engineering Initiative for Patient Safety (SEIPS) approach, originally created by Pasqual Carayon in 2006. An online survey was created using an adapted SEIPS Model evaluating the interactive concepts of person, tools and technologies, tasks, organization, and environment and their impact on staff and patient outcomes. The survey was distributed to both the ED and Medical/Surgical nurses to gain their perspective on the interdepartmental hand-off communication process and how it impacts the staff and patient outcomes. There as an included option for the bedside nurses to provide recommendations on how to improve the hand-off communication process. Data was collected, anonymously, through an online database and descriptive statistics were used to analyze the results. The quality improvement project found that majority of nurses prefer verbal hand-off communication with a structured standard format of delivery in conjunction with the electronic health record. The project found that nurses perceive that the nurse-to-patient ratio and surrounding tasks impact the effectiveness and quality of hand-off communication. The most common suggested hand-off communication improvements were to not allow hand-off communication or transfer of the patient from the ED to the Medical/Surgical unit during peak times, such as shift change, and to follow up on tools and technology compliance. Overall, the person, the tools and technologies, the tasks, and the environment are contributing to ineffective hand-off, while the organization has adequately provided the resources the staff needs to perform an effective hand-off communication. All of which were concluded to have an impact on the staff and patient outcomes.

49

Law, Wei-bong, and 羅緯邦. "The development of a clinical guideline on risk assessment and relatedpreventive measures of thromboembolism for adult surgical patients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B46582381.

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50

Gosse, C. Suzanne. "Critical thinking skills : a comparative analysis of experienced operating room and medical-surgical registered nurses." Virtual Press, 1995. http://liblink.bsu.edu/uhtbin/catkey/958783.

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Critical thinking skills have emerged as a vital tool for the professional nurse confronting an explosion of technology and compressed plans of treatment. The purpose of this research was to compare the critical thinking skills of experienced registered nurses from two practice settings: the operating room and general medical-surgical floors. Critical thinking was defined as a "composite of attitudes, knowledge, and skills" (Watson-Glaser, 1980, p. 1).The research of Benner (1984) provided the foundation for this research. Benner documented the development of knowledge and skill in nursing practice. Nurses at the proficient and expert stages of development were the focus of this research.A non-random, convenience sample containing fifty one nurses was drawn from two Midwestern hospitals. Demographic data was gathered to further describe the sample. Participation in the study was voluntary and anonymity of subjects was assured.The Watson-Glaser Critical Thinking Appraisal (WGCTA) (1980) was the instrument utilized to measure the critical thinking skills of the experienced nurses. This tool has established validity and reliability and is considered a benchmark for measuring critical thinking ability.Analysis of the WGCTA (1980), results revealed a mean of 54.29, SD 9.66 for the total group of experienced registered nurses (N=5 1). For the operating room nurses (n=28) a mean of 52.71 with a SD of 9.41 was obtained. Among the medical-surgical nurses (n=23), the mean score was 56.21 with a SD of 9.81. T-test and MANOVA analysis was carried out. No significant statistical differences were found between the means in either the total scores of the WGCTA or on the five sub-tests for the two groups. The data submitted for analysis reflected a very experienced group (51 % with > 15 years nursing experience) and predominate Associate and Diploma preparation (61 %). Norming information available for the WGCTA indicated the scores obtained in this research were comparable to much larger samples drawn from nursing students and police officers.A conclusion of this research is that critical thinking, as measured by the WGCTA (1980), develops uniformly across diverse practice areas. An examination of the usefulness of the WGCTA to accurately measure the process of critical thinking in experienced nurses is recommended. More research into the important issues of critical thinking and experienced nursing practice is recommended.
School of Nursing

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