Science topic

Clinical Nursing - Science topic

Explore the latest questions and answers in Clinical Nursing, and find Clinical Nursing experts.
Questions related to Clinical Nursing
  • asked a question related to Clinical Nursing
Question
7 answers
I have wondered why many scientists, nurses and medical doctors do not use clinical (nursing and medical) colour pictures to teach or share experiences with the community members in this modern era of "Seeing is believing!"
"AIDucation 20-10" is frankly the use of medical illustrations or colour pictures (Hospital library) for nurses and doctors; abused for the local village folks, schools, churches, mosques and workplaces to raise awareness.
Relevant answer
Answer
I believe that for a very long time scientific accuracy of the images was the main point. With the true colors, and lines. However today, with all changes in how we communicate science, this is slowly changing. In baby steps, people are using more visual tools to show certain scientific information. And the appearance of online software that allows the creation of scientific illustrations in a more visually appealing way has also been a huge influence.
I don't know if you're looking for a tool that does that, but I recommend you the online software named Mind the Graph. Check their website. Hope this helps!
  • asked a question related to Clinical Nursing
Question
19 answers
Several organizations do not recommend aspiration when administering vaccines because no data exist to justify the need for this practice. They argue that: 1) Aspiration is more painful for the patient, 2) IM injections are not given in areas where large vessels are present, so the inadvertent intravascular injection is improbable and 3) There is no reports of a vaccine being administered intravenously and causing harm in the absence of aspiration.
However, 1) there seems not to be more pain in the adult in relation with aspiration (Taddio et al. Procedural and Physical interventions for vaccines injections: systematic review of randomized controlled trials and quasi-randomized controlled trials. Clin J pain, 2015), 2) the inadvertent intravascular injection is relatively frequent with 40% of the nurses claiming blood aspiration, and this is not exclusive of dorso gluteal site –dorso gluteal (15%) vs deltoid (12%)— (Cristine M Thomas. Blood Aspiration During IM Injection. Clinical Nursing Research 2015) and 3) such reports justifying security do not involve many patients, not consider secondary effects in the long run and not consider a potential decrease in efficacy of the vaccines -- intravenous administration seems to produce a rapid antigen depletion-- (Sissons H. Aspirating during the intramuscular injection procedure: a systematic literature review. Journal of Clinical Nursing 2015).
Are we doing it right?
Relevant answer
Answer
Yes right
  • asked a question related to Clinical Nursing
Question
7 answers
I am drafting a plan on how to assess the capacity and learning needs of clinical nurses to do research. Thus, any suggestions about methods or tools which can help me answer this concern will be highly appreciated.
Relevant answer
Answer
Thanks for sharing your ideas
I found this article and it is helpful
I also got the approval for the EBP. Thanks Dr Younas...
  • asked a question related to Clinical Nursing
Question
18 answers
Since I'm interested in Conceptual Analysis, I've been searching for work making use of this "research method". What surprised me is that almost half of the papers I found are from the field/discipline of Nursing Studies/Research. Considering that arguably all scientific fields/disciplines (sociology, psychology, mathematics, engineering, linguistics, law, economics, physics, philosophy, medicine, etc.) could equally employ Conceptual Analysis, can anyone explain to me the special connection there seems to be between Nursing Studies/Research and Conceptual Analysis? Thank you!
Relevant answer
Answer
Etienne,
There will be a few reasons for this - such as a high proportion of nursing research that is what I call 'naval-gazing' research i.e. trying to make sense of 'abstract' things and 'what is the nature of things'. There may be multiple terms for these 'issues' and those terms are often used interchangeably/incorrectly. Concept analysis is designed to bring clarity to this prevelant issue in nursing. Of course, it isn't just unique to nursing though - which is why you will see it with other disciplines.
Another reason is that most of the seminal frameworks i.e. Morse, Rodgers, Walker and Avant, Hupcey etc were developed by nurses.
A further reason, and one that some might not like me saying, is that it can be deemed as 'easier' research compared to other methodologies and yet still publishable. The data for concept analysis is narrative data derived from the existing literature. It does not require sampling and setting techniques, the recruitment of participants, ethics approval - nor data collection in the physical clinical field.
  • asked a question related to Clinical Nursing
Question
5 answers
I’m a bit lost.
what type of systematic review should I do if I’m looking at studies that are gaving a cohort focused interviews or questionnaires to fill. I’m researching What are the barriers to clinical nurses conducting research?
all studies found are not qualitative. They are quantitative and assess the scale responses to questionnaires.
Relevant answer
Answer
For systematic review, you need some standardized criteria. Most of research are having both components like qualitative as well as quantitative. So we have to included the researches which are following some standardized tool for intervention, which can be one of the criteria for comparison.
  • asked a question related to Clinical Nursing
Question
33 answers
Nursing, originated from the word "caring" has struggled through the different eras and somehow adjusted to the criteria of profession but still lacks the autonomy ( in many countries) in their field of caring and more pronounced as helping hands for those who have authority in clinical practice. What can be the breakthrough for clinical nurses to gain actual autonomy? Is there any unrecognized scope for nurses to explore for their correct identity?
Relevant answer
Answer
Nursing is an autonomous profession, but it seems nurses are forgetting about their autonomy. If nurses strictly adhere to utilizing nursing theory and nursing care plan during their practice no body from any other profession can involve in their duties. Who is having the knowledge of these two body of knowledge apart from nurses.
Making clinically credible researches and utilizing the findings of those researches is another way nursing profession can excell mong all the healthcare professionals, since nurses interact with patients more than members of any other profession.
  • asked a question related to Clinical Nursing
Question
13 answers
There are behaviors/actions that clinical nurses perform in caring for specific patients that offer 'peace of mind'. I am not referring to preparedness but specifically those actions that offer peace of mind when caring for some patients.(For example, placing the code cart nearer to a specific patient's room, flushing that peripheral IV at the beginning of the shift, etc.) Any assistance on finding any literature on this or a similar concept (insurance?) would be appreciated. Thank you.
Relevant answer
Answer
interesting.
  • asked a question related to Clinical Nursing
Question
11 answers
Nursing students are asked to site two sources for the above question, in regards to a Study done by means of a small group questionnaire, which correlates the importance of parenting behaviors, to parental stress. The common sense thinking indicates small group studies are not that applicable in the Clinical setting. But there is scant information to be found to argue otherwise.
Thank you.
Relevant answer
Answer
I think studies based on small samples, although not generalizable, give valuable insights as to rarer situations a nurse will occasionally encounter. Without these studies, the nurse will only know what to do the majority of the time but will lack knowledge regarding the exceptional cases.
  • asked a question related to Clinical Nursing
Question
4 answers
The practice of nursing in ICU varies from country to country, even within them. This is why some tasks are delegated to technical staff which probably affects the scores of the Nursing Activities Score.
Relevant answer
Answer
Dear Fortunatti
Fernandes etal. 2010 mentioned that, In an ICU, nurses note daily whether critical patients will require prolonged assistance regarding the performance of routine procedures both upon admission and during their stay because organ instability can occur at any time over the course of the patients' stays in these units.
Panunto 2012 stated that Nursing workload consists of the time spent by nursing staff to perform the activities for which they are responsible, whether directly or indirectly related to patient care. These activities can change depending on the patient's degree of dependency, the complexity of the disease, the characteristics of the institution, work processes, the physical layout and the nature of the professional team.
  • asked a question related to Clinical Nursing
Question
5 answers
Palliative care
Relevant answer
Answer
Fran-
I am the chair of an ad-hoc working group in Western Massachusetts, Nursing Education Palliative Care Interest Group (NEPIG). We meet monthly (including via the online platform ZOOM which is free for attendees to use) to discuss and plan for integration of palliative content into undergraduate nursing programs as well our communities generally. Which professions/education programs are you seeking literature about?
Best,
Olga
  • asked a question related to Clinical Nursing
Question
2 answers
Outcomes of clinical teaching include knowledge, skills, and attitudes that are acquired through clinical teaching and learning. Current nursing education program accreditation criteria focus on evidence that meaningful outcomes of learning have been produced. The effectiveness of clinical teaching can be judged on the extent to which it produces intended learning outcomes
Relevant answer
Answer
I agree also a great question. How can clinical nurse educators prove their worth? 
I think that Charlene Chu is suggesting the measuring work performance (in all of its dimensions) to determine an increase. This would be measuring changed behaviour and this confounds a few issues. What leads to changed behaviour? Knowledge and motivation. 
For example if a nurse educator delivered an education on how to perform a skill, but the nurses did not value the skill because there was insufficient perceived benefit, then the change in behaviour (measured through performance) is unlikely to be significant.
However, if you simply measured the nurses confidence and self-efficacy in their acquisition of the knowledge learned, then a separate translational study can be conducted as follow up. 
  • asked a question related to Clinical Nursing
Question
5 answers
In modeling time to event data using a proportional hazards regression approach for repeated events, in which some patients have multiple events, the situation is often conditional since a patient can only have a subsequent event if they had a previous event. For example, a cardiac patient having one or more arrhythmias after heart surgery or a metastatic breast cancer patient having multiple recurrences or progressions of their disease after chemotherapy treatment. Are there useful ways of estimating the hazard ratio with reliable standard errors in these kind of recurrent event processes? It would seem that the correlation between the events within each patient or subject should be accounted for in the model.
Relevant answer
Answer
Dear Dr Zurakowski,
One of the most applied approaches in multiple failure-time framework are extensions of the Cox's regression model (all of them are proportional hazards models). According with Kelly and Lim (2000), there have been proposed several extensions which seek to address to the most varies particularities of each case study. For reccurent event analysis, I recommend to you apply the Prentice, Williams and Peterson (PWP) model or the Andersen and Gill (AG) model. The PWP model is suggested to be applies when the risk of occurrence of the following events is affected by the previous ones and the AG model is applies when the events reveals that they have the same risks of occurence. Read the following paper of Amorin and Cai (2015) to easily understand the implementation of this two models: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4339761/
Further information can be found on my researchgate profile: https://www.researchgate.net/profile/Ivo_Sousa-Ferreira
Best regards,
Ivo Sousa-Ferreira.
  • asked a question related to Clinical Nursing
Question
3 answers
Good morning: I am preparing my doctoral thesis on competencies and their evaluation of nursing students, I have found bibliography of studies that have been done with the French version of the Nursing Clinical Competency Questionnaire (CNCQ-22), where it can be found This questionnaire ... Greetings and thank you Clinical Nursing Competency Questionnaire (CNCQ-22).
Relevant answer
Answer
“…una enfermera debe ser una persona preparada, que esté apta para atender y  mas que todo ser una persona humana que pueda tratar a las personas” Discurso de un paciente hospitalizado en un "Hospital de Infectología ...", en un estudio sobre "cuidado seguro".
  • asked a question related to Clinical Nursing
Question
2 answers
Buenos días: Estoy preparando mi tesis doctoral sobre las competencias y su evaluación de los estudiantes de enfermería, he encontrado bibliografía de los estudios que se han hecho con la versión francesa de la enfermería Competencia Clínica Cuestionario (CNCQ-22), donde se puede encontrar este cuestionario ...
saludos y gracias
Cuestionario de Competencia de Enfermería Clínica (CNCQ-22). Available from: https://www.researchgate.net/post/Clinical_Nursing_Competence_Questionnaire_CNCQ-22 [accessed Jul 20, 2017].
Relevant answer
Answer
Muchisimas gracias Juan..lo busco
  • asked a question related to Clinical Nursing
Question
9 answers
We are searching for relevant research studies that produced a validated pre/post course surveys to assess the perception and knowledge of the attendants of a course about Evidence Based Medicine. 
Looking forward to receiving your suggestions
Relevant answer
Answer
Dear Omar
There is a systematic review entitled  'Effectiveness of Teaching Evidence-Based Medicine to Undergraduate Medical Students - A BEME Systematic Review' which included 27 trials. Therefore, it may useful to look at this review and going through all included studies which may provide you a lot of information and the reliability about the surveys that have been used in these studies.
Please check the following link or download the attached document: https://www.ncbi.nlm.nih.gov/pubmed/25401408
Good Luck
  • asked a question related to Clinical Nursing
Question
7 answers
i am currently conducting a research with regards to challenges that confront degree nursing students in Ghanaian universities. 
Relevant answer
Answer
If there have not been any previous studies of the challenges of nursing students in Ghanaian schools, you might want to start with a qualitative study.  A Phenomenological approach would work nicely asking about their experiences. Benner based a lot of her work on the Dreyfus Model of skill acquisition.  Both would fit a quantitative approach for your study.
Good luck
  • asked a question related to Clinical Nursing
Question
5 answers
 Role of ultrasound in teaching Living Anatomy To First Year MBBS students.
Relevant answer
Answer
Sonography  has a definite role in teaching and understanding of Anatomy. It helps Ist year MBBS students to observe and under stand many facts related to Anatomy. For example by taking a section of Liver,  we demonstrate them branches of portal vein and  three hepatic veins  in living. Demonstration of these structures and measurement of their internal diameter is not possible during dissection.  The Morrison's pouch --hepatorenal pouch & collection of fluid in it  can be better demonstrated by ultrasound. In regional anatomy and dissection we can not see the  internal diameters of blood vessels (aorta) and ducts (CBD) which are possible with the help of utrasound. utrasuond teaching really gives eary clinical exposure to our future clinician's and helps them to understand Anatomy in a better way. It is not a substitute to dissection but can be used  as a tool for better  understanding of Anatomy.  I believe that three hours teaching is adequate for IST Year MBBS students.Our Department has established a sonographic Lab in 2011  for this purpose and we have included  ultrasound teaching in undergraduate and post graduate curriculum.
  • asked a question related to Clinical Nursing
Question
5 answers
Am trying to find out the existing systems with regard to this.
please assist
Relevant answer
Answer
Hi, Jeanette,
The only thing I could find was the Nurses Professional Values Scale (Journal of Nursing Measurement, 17(3), 221-231. Hope this helps some.
  • asked a question related to Clinical Nursing
Question
3 answers
Is this role fit for purpose?
thoughts on accountability and delegation of duties.
Relevant answer
Answer
I have experience of working with assistant practitioners (AP) in Endoscopy and clinical research settings. At my new Trust I have met assistant practitioners in working with the surgical team doing all the pre-op checks. So I think accountability and delegation depends on and in area of practice.
They were all competent and in clinical research: AP were given own projects (assessed and deemed appropriate), later on 2 went on to Med School, one to  train as a Physio and another as a nurse. In endoscopy APs could undertake pre-assessment, discharge, perform cannulation and venipuncture etc. They had done level 4 NVQs, trained and assessed in these roles.
So role might have to fit the purpose you require, you need a clear job description and requirements, get the right candidates, inform or educate all other staff in clinical area what the role is about for acceptance, knowledge and understanding of role. This will make it easier for delegation of roles, knowing the boundaries and expectations from all involved. They will need clear training pathway and with this you are ensuring they are adequately trained to work in role and you can facilitate supervision, appraisal and other methods of evaluation focused on this. Additionally, you will need opportunities mapped out about how role can be further developed and adequate remuneration to make it attractive. With regards to accountability, they are not covered by NMC code of professional conduct, but the professional who has delegated is. Therefore as long as they are working within the scope of role they should be covered. This is speculation as I don't know if it applies to APs...., but maybe in case of misconduct they could be judged against someone in similar role or as per Trust or department guidelines. Hope this helps.
  • asked a question related to Clinical Nursing
Question
4 answers
I am searching for a survey that assesses clinical nurses use of unit/institutional quality metrics on nursing practice/engagement. For example - nurses understanding of "your unit's quality metrics", "use of quality data to inform your nursing practice"?
There seems to be very little research on clinical nurses' use of quality data.   
Relevant answer
Answer
Thank you!
  • asked a question related to Clinical Nursing
Question
5 answers
I need specific information including personal interviews, statistical outcomes research, narrow patient populations to describe how nursing care influences patient perceptions and improves patient outcomes throughout the diagnosis and treatment process.
Relevant answer
Answer
We are currently doing research on women with breast cancer using the VR technique to reduce pain and anxiety and enhance the quality of life. Once the resutls are formulated and paper get accepted for publication, I will send a copy to you.
  • asked a question related to Clinical Nursing
Question
3 answers
We are thinking of using a translation of The Safety Attidutes Questionnaire by Sexton et al. 2006.
Relevant answer
Answer
Thank you for your feedback.
@Nashwan: Yes, compliance and confounders are important. We are thinking of the following confounders: organizational Problems, interpersonal conflicts, team climate, job satisfaction, compliance, participation, and social desirability. However, we won't be able to measure all of these factors with larger constructs.
@Rodrigues: We are planning to use the German SAQ. However, we are not satisfied with this instrument. We think that the SAQ is not a sensitive instrument for measuring effects by SBAR communication in a pre-post-survey. Many items are not suitable or too general. For example, there are only items for handoff communication (shift change), but we will integrate SBAR in postsurgical communication.
  • asked a question related to Clinical Nursing
Question
7 answers
I am doing my doctorate on research evaluating Tactical Emergency Casualty Care training for law enforcement officers? The study evaluates the training of law enforcement officers and their ability to stabilize victims of (mass) violence in a prehospital situation. Two questions: If anyone has worked on a similar study I would love to hear from you, and 2. What kind of statistics would I use to evaluate this study as I am writing up my proposal. It is a retrospective, descriptive study with the hypothesis : How has Tactical Emergency Casualty Care training prepared law enforcement officers with the operational tools necessary to provide on-scene medical care to successfully stabilize patients of (mass) violence. I do have about 40 7-question questionnaires as my data. 4 questions are choose the best response and the last three questions are yes or no questions with an open ended answer . Thanks for any help you can provide.
Relevant answer
Answer
Hi Heidie,
Your four closed ended questions could have scores added (3 for best fit, 0 for worst fit). Your open ended questions sound like hybrids...any chance you could email me the blank questionnaire?
Rich
  • asked a question related to Clinical Nursing
Question
10 answers
looking at the types of infractions doctors and nurses get discipline/reprimand for and at the consequences for infractions
I am trying to get state-by-state information on doctors, nurses, and physician assistants about disciplinary actions. I have found related information, but despite help from the FSMB and from a state Board of Nursing, have not found what I'm looking for: 5 or more years of information on specific infraction (such as failure to keep records, fraud, mis-prescribing etc) along with the specific consequences (that is, more than "must meet certain terms and conditions"). Any ideas on how to get that?
Relevant answer
Answer
Agency for Healthcare Research and Quality   www.ahrq.gov
Institute of Medicine www.iom.edu
Institute for Healthcare Improvement www.ihi.org
Institute for Safe Medication Practices www.ismp.org
National Institutes of Health www.nih.gov
these might be areas to gain more data
  • asked a question related to Clinical Nursing
Question
19 answers
Cultural differences, disabilities and language barrier
Relevant answer
Answer
There are definitely instances where misunderstanding of culture or the existence of a language barrier can affect patient care. They can also lead to misdiagnosis and improper treatment. That is why it is so very important that we teach nursing students - and all other health care professionals - to recognize and appreciate individual differences. We must learn to value - and understand - the differences among us.
Cultural competence and sensitivity must be included in the nursing curriculum and modeled by instructors, in both the classroom and clinical setting. Health professionals should be taught how to work with interpreters, etc.
Communication is essential to providing good care.
  • asked a question related to Clinical Nursing
Question
5 answers
I am looking for any transport (pre-hospital, ems, transport program) research involving utilizing an acuity assessment tool to aid in determining patient stability and augmenting decision making for level of care placement (floor vs icu).
Relevant answer
Answer
Neonatology has created the TRIPS score. Originally by Shoo Lee in Canada.
Here is a recent article by Jeffrey Gould using CA data. 
  • asked a question related to Clinical Nursing
Question
7 answers
we have a project on assessing attitude and moral values among nurses of the current generation.
need some questionnaire
Relevant answer
Answer
Have a really good think about  what you mean by values, moral distress is not the same thing, it is a consequence of value dissonance.
Good luck
  • asked a question related to Clinical Nursing
Question
10 answers
This question has come up in our Surgical Services Department to have these processes in place for trauma patients who emergently come to the Operating Room.  Any assistance in locating data specific to this would be greatly appreciated!
Relevant answer
Answer
  • asked a question related to Clinical Nursing
Question
4 answers
I need to use this tool for a study in my country but will like to know how to get the permission to use it.
Relevant answer
Answer
Hi. It is Mikko Saarikoski who has the English Version of the questionnaire. The paper by Henriksen, Normann and Skaalvik is based on a Norwegian Version of the scale.
Best regards, Mari Wolff Skaalvik
  • asked a question related to Clinical Nursing
Question
2 answers
I am a master degree student in clinical nursing, working on a systematic review for my final exam. Advise and thoughts from experts in the field are an important part of my search strategy.
In additon, I will really appreciate your suggestions on any primary research on this topic. Thank you!
Relevant answer
Answer
Thank you so much!
  • asked a question related to Clinical Nursing
Question
3 answers
I am current work on Job Demand, Task Complexity, Burnout and Coping Strategies Among Clinical Nurses?
Relevant answer
Answer
Glad to have been of assistance!
Very best wishes with your work on these important topics,
Mary
  • asked a question related to Clinical Nursing
Question
3 answers
I am looking for a instrument for data collection.
Relevant answer
Answer
Researcher can prepare a  questionnaire on care of the premature neonatal infants by following recommended books and it can be used as a self administering questionnaire .for research. prepared questionnaire  can be validated by experts in the field before implementing or collecting data- Its my point of view
  • asked a question related to Clinical Nursing
Question
4 answers
Does anyone have any information regarding a tool to measure attitudes and beliefs of clinical nurses regarding a specific clinical intervention?
Relevant answer
Answer
agree with Peter on the fact that attitude and belief scales are content oriented.
The content or the situation or intervention  (specify the attitude or belief towards which) you intend to measure. As the scale varies from situation to situation.
As it wont be appropriate to use one scale to all..as a matter of fact it would be irrelevant.
In case you are looking for a sample to formulate or understand the structure of an attitude or belief scale, you may find may of them by google search.
regards
Rathish
  • asked a question related to Clinical Nursing
Question
3 answers
In italy there is a "albo profetional."
Relevant answer
Answer
Not in the UK, as far as I know.
  • asked a question related to Clinical Nursing
Question
11 answers
People with morbid obesity are admitted to hospitals and practice centers for a broad array of conditions, such as broken bones, pregnancy, or skin rashes`. Given the brief treatment episodes that are the norm for primary presenting complaint, what are the training/ educational needs for health care professionals when they come across this type of patient? I believe this is a special population.at risk for inadequate treatment plans and psychological harm from stigmatizing attitudes.
Thank you
Relevant answer
Answer
The care of the morbidly obese patient is embedded in my critical care course for BSN students. I treat it like any other risk factor for each disease process that we cover in my critical care course.  For example, when discussing myocardial infarction/cardiac arrest/cardiogenic shock, I talk about the increased risk to obese patients (increased demand on an impaired pump and decreased peripheral circulation).  I include discussion about why many patients in these higher risk groups are unable to maintain a cardiac diet and exercise regimen.  (Dependence upon others for meals, limited financial resources, physical debilitation, fear/anxiety/depression, etc.).  Therefore, the importance of setting realistic goals for each patient and involving caregivers is included.  I also discuss the use of specialty beds and lifts in maintaining skin integrity, mobility, and decreasing the risk of infection.  I discuss the need to match the physical ability of the nurse to perform CPR to the size of the patient he or she is attempting to compress.  (At 120 lbs., I often found it difficult to provide adequate compressions to obese patients, despite correct technique. I didn't have the strength or mass to be effective.  I make sure the students understand that asking for help with compressions provides better patient outcomes; it's about the patient not your pride).
  • asked a question related to Clinical Nursing
Question
7 answers
I am working on my DNP and am trying to identify a tool that will allow me to measure nurse leader communication competence. As part of a project to increase engagement, I will provide managers with a recognition toolkit to aid them in providing meaningful performance feedback and recognition. I would like to do a pre/post survey to determine if they are more confident in their communication with staff.
Relevant answer
Answer
I know of the communication assessment tool for therapeutic communication (2009) which has domains.
they include: domain 1-professional practice
domain 2-critical thinking and analysis
domain 3-provision and coordination of care
domain 4-collaborative and therapeutic practice
each domains is rated on scale 0-2 with their descriptions, at the end of the assessment the score is totalled and compared with the performance level.
performance level includes: ESTABLISHED COMPETENT, BEGINING COMPETENT AND NOT YET COMPETENT.
I hope this gives a helping clue while you research more on it.
best regards....
  • asked a question related to Clinical Nursing
Question
1 answer
Could this be a new paradigm for patient safety that has many applications? Where have you seen ongoing processes in hospitals where people stop to take stock of what they are doing?
Relevant answer
Answer
This sounds akin to critical thinking / critical awareness and the reflection so necessary to achieve.  Perhaps the closest to a new paradigm would be the debriefing process and after action reporting used in the military.  They are not used in the hospital but adding five minutes for debrief to the end of shift report could be incredibly healing to the team and milieu - especially for quality improvement.
  • asked a question related to Clinical Nursing
Question
3 answers
I need a tool to review and validate the amount of evidence present in current evaluation forms used around the country versus the amount of soft data collection that is used to evaluate employees.
Relevant answer
Answer
Taleo is a comprehensive software system that tracks goals and reviews at the employee level on up to the management level. It is used for self review and management/employee review process. At our company, it is used globally at all the plant locations I believe. Depending upon how far you want to take the review process, it can be used as a tool to help develop the employee's future goals as well. You don't specify how many employees or how large your company is. This program is more for larger companies, however, I'm sure there are scaled down versions out there that do similar tasks.  Good luck.
  • asked a question related to Clinical Nursing
Question
1 answer
ONLY nurse clinicians?
Relevant answer
Answer
Dear colleague, the implementation of CVC as any setting involved decision/policy making and the availability of patients monitoring equipments and other related resources. 
  • asked a question related to Clinical Nursing
Question
1 answer
If there are any references you can provide, that would be appreciated.
Relevant answer
Answer
Hourly and again if there is a status change. I can look around for a source. Hth!
  • asked a question related to Clinical Nursing
Question
1 answer
How have you managed the transition? Has you experience matched your expectations?
Relevant answer
Answer
After educating the nurses you can led them to practice with the patients under your supervision if they become good you can assess the effect of your educational intervention on the patients outcomes thanks
  • asked a question related to Clinical Nursing
Question
3 answers
 I am researching nursing attitude in caring for dying. I have used the DAP-R, frommelt attitude towards caring for the dying scale. however I will really like to test for the nursing caring attributes against attitude towards death and dying, can some recommend a scale for me to use?I will really for the against nursing caring attributes.
Relevant answer
Answer
You could look at Joanne Duffy's Caring Assessment Tool. 
  • asked a question related to Clinical Nursing
Question
13 answers
Failure to rescue is shorthand for failure to rescue (i.e., prevent a clinically important deterioration, such as death or permanent disability) from a complication of an underlying illness (e.g., cardiac arrest in a patient with acute myocardial infarction) or a complication of medical care. Failure to rescue rates used for both research purposes and as quality indicators are typically derived from hospital administrative databases. However, it is not clear how identify it, so what are the best indicators to measure it?
Relevant answer
Answer
I also think that retrospective analysis is the only option. Is it accurate to limit failure to rescue to cardiac arrest? Perhaps one of the early warning system frameworks (EWS; http://www.ihi.org/resources/Pages/ImprovementStories/EarlyWarningSystemsScorecardsThatSaveLives.aspx) could be used to expand the conceptualization of "failure to rescue" . It seems that failure to respond, or a delay in response, at any point when the evidence (i.e., vital signs, O2 sat) suggests an intervention could be on a continuum of failure to rescue.  
  • asked a question related to Clinical Nursing
Question
2 answers
....writing a research paper for school....appreciate any input as well as articles to print as proof of my research.....
Relevant answer
Answer
Maintaining a healthy work environment and staffing adequacy required to reduce the burnout among nurses.  
I wish this paper might help (included references of prof Linda Aiken).
1. The Impact of Patient to Nurse Ratio on Quality of Care and Patient Safety in the Medical and Surgical Wards in Malaysian Private Hospitals: A Cross-sectional Study
The attached file one paper I wish this will help as well. 
Warm regards, 
  • asked a question related to Clinical Nursing
Question
7 answers
OSCE in nursing students.
Relevant answer
Answer
Dear Dr. Biju,
I send you an article. I hope it is useful .
Regards,
  • asked a question related to Clinical Nursing
Question
4 answers
It has seemed to me in my consulting practice that when staff nurses participate in reviewing their actual daily routines against best practices that they can then see that a shared mental model of actual "scheduled" processes in the day makes sense. They learn they must offer initial direction and ongoing checkpoints to NAPs (as would be suggested by state nurse practice acts) and also review team progress/success and offer feedback prior to the end of the shift (best teamwork routines).Interaction at eye level at the patient's bedside about patient/family goals becomes a norm.  The new shared mental model ("A Day in the Life of an Expert") becomes part of a group teamwork identity.  
At the present I note that some of the basic professional leadership practices are missing at the bedside:  leadership in helping patients identify and engage in shared goals, lack of delegation and supervision of assistive personnel). Wouldn't the predominant method staff RNs use for processing (Conservator) support creating a clearly defined structure of best practices? Using a structure that incorporates expert practices  and "routine" steps could potentially ensure better care and would fit thinking patterns.  
Perhaps I am taking this study several steps too far?
Thank you! 
Relevant answer
Answer
thank  you so much Nadeshiko for your perspective on this as a student!
Ruth
  • asked a question related to Clinical Nursing
Question
12 answers
1. What is the legal basis for nurses in the field of prevention and health promotion? Are there specific laws to professional?
2. How does it look with the budgeting of preventive and health-promoting measures? How are they paid? For example, in Germany, only about 3% of the budget is used for this.
3. Are the aspects of prevention and health promotion are already represented in the curriculum in training of nurses?
Relevant answer
Answer
Dear Rebekka,
according to your first question: law to professional of nurse says about the powers and duties and offcourse nurse have a knowleage to be active  in the field of prevention and health promotion. Taking part and creating this kind of actions depends rather from job place and employer.
Law on medicinal entities requires them to promote health and health education (and this is acctualy answer on your question). This task mainly for nurses. The problem is the lack of time for these tasks. Nurses in the first dealing with the patient, then filling out multiple documents, and to promote the health- very often it is neglected due to lack of time. Much depends on the willingness of the nurses themselves. Certainly health education should be their responsibility. Thats why we should build empowerment of nurses, witch is not popular i Poland.
The third question: yes, ofcourse. On Medical University of Warsaw, on Health Scinences Division.,  where nurses are educated, both at the first and second degree study level is the subject of health promotion. We teach there, among others, about the role of prevention, health education methods, health determinants, and how to develop and implement health promotion programs according to WHO's Health Promoting Hospitals.
  • asked a question related to Clinical Nursing
Question
5 answers
Most nursing concepts are relatively abstract. As a result the multiple dimensions and characteristics included in their meaning must be specified carefully and with precision. Therefore, how to reach "mature" concepts for operationalization in nursing research?
Relevant answer
Answer
Thank you Dr. Griffiths for your vision. Definitely I agree with you regarding "not to consider or claim nursing specific concepts" for conducting research in nursing. I was also talking about concepts in psychosocial fields (as most of the concepts used in nursing research are mainly borrowed from other disciplines), however, even major concepts are still debatable in its definition such as Health, coping, stress. Consequently, the operational definition will not be highly valid! 
  • asked a question related to Clinical Nursing
Question
18 answers
I work on Inpatient Acute Rehab in a large urban hospital, and we do get telephone report from acute units when receiving/admitting a patient, but communication needs to be improved.  Suggestions to make that happen?
Relevant answer
Answer
SBAR is a tool originated from the US Navy and was adapted for use in healthcare for preparation for transfer of a patient to a different hospital setting, hopefully to get the specialized care they need.  Transfer of accountability (TOA) from nurse to nurse requires a slightly different approach.  Valera is correct in stating that "a formal protocol/policy in place that is followed consistently on every unit regarding what information needs to be communicated to the receiving RN".  Using the nursing Kardex, RN's should be able to report on the patient name, age, diagnosis, any allergies, previous hospital admissions and medical history, and of course a pertinent head-to-toe body systems assessment. Tests results, outstanding remaining issues, and family updates/concerns are reported lastly.  A well documented nursing Kardex is an invaluable tool.
  • asked a question related to Clinical Nursing
Question
10 answers
The tool should help to assess nursing skills, not only the nursing student's ability to perform a task, but also the quality of nursing care.
Relevant answer
Answer
Hi Bindu,
i used before 2 books which are helpful
if you are interested communicate with me in this email and I will send the 2 books to you by the end next week
  • asked a question related to Clinical Nursing
Question
23 answers
Self-efficacy refers to the extent of an individual’s belief in his or her abilities. Because self-efficacy is based on feelings of self-confidence and control, it is a good predictor of motivation and behavior. This is particularly ingesting in nursing field, there are different questionnaire used to measure self efficacy, is there someone confident with some of the availed tools?
Relevant answer
Answer
HI Rosario, as Edwin points out, self-efficacy is task specific, which people often confuse and why the general self-efficacy scale is questionable. I am not sure what specific task you are looking for in nursing, but I have developed an Evidence-Based Practice Self-Efficacy Scale, that measures one's confidence in how to approach and and implement EBP. We have published preliminary validity and reliability of the scale and have further supporting data not yet published. If interested, let me know and I will gladly get you a copy at no cost. We have a request form online at the University of Iowa Hospitals & Clinics, Hundreds of providers across the country and in several other countries have requested to use the scale. 
  • asked a question related to Clinical Nursing
Question
7 answers
What is the best methodology for debriefing in clinical simulations?
Use some background?
Relevant answer
Answer
First, congratulations for your desire to implement debriefing after simulation.  It is the most crucial portion of the simulation.  As students engage in simulation, particularly those in which they are subject to some degree of stress, you may see their working memory rapidly degrade.  Two excellent background articles on this can be found here:
Toni Schmader, Michael Johns, Chad Forbes. An Integrated Process Model of Stereotype Threat Effects on Performance, Psychological Review (2008), Vol. 115, No. 2, 336–356
Joels, M., et.al. Learning under stress: how does it work?, Trends in cognitive sciences (2006), vol.10, no. 4, 152-8.
Attached one article you may find helpful in this regard.
Next, when you debrief, it is important to have some idea of a)what learning objective were you simulating (what did you want them to know), b) how did you measure how well they knew it, c) did the student know how they would be measured (was there a formal rubric showing what was expected for demonstrations of competence)?
Good conversations are open, and usually begin with something like "How did things go?" or  "How do you think you did?"  I find students to be their own harshest critics most of the time.  If you have video capabilities so much the better.  If you would like to discuss this more, please email...
All the best,
Rich
  • asked a question related to Clinical Nursing
Question
4 answers
For my research of the operationalization of attitude of our students, I am looking for as many literature, which deals with this subject.
Relevant answer
Answer
It's related to their college instruction
I proposed: clinical round, group discussion with senior, really story, and other techniques that are in education sciences
  • asked a question related to Clinical Nursing
Question
5 answers
The use of clinical simulation in nursing education is increasing rapidly. There are a variety of methods, uses, and forms, but the major objective is to provide a safe, nonthreatening environment for students to learn clinical skills, critical thinking and decision making, and collaboration
Relevant answer
Answer
Even in clinical situation/clinical simulation one (the clinical instructor )needs to consider the level of knowledge that has to be assessed or taught. Therefore bloom's taxonomy is still appliable. The scenario has to be formulated in such a way that reflects or conforms to the objectives to the outcome.
This is also in line with the learner's level of education. 
  • asked a question related to Clinical Nursing
Question
3 answers
Although nurse educators usually have the intended outcomes in mind when they design clinical learning activities, those activities may produce positive or negative unintended outcomes as well.
Relevant answer
Answer
Confidence in competency to practice has always been a primary concern of students and clinical instructors. The introduction of simulation labs with new technology is reducing this, improving confidence and competence to practice in clinical settings. This technology is likely to grow, See; https://www.ncsbn.org/09_SimulationStudy_Vol40_web_with_cover.pdf
  • asked a question related to Clinical Nursing
Question
4 answers
NICE (2014) - Domestic violence and abuse: how health services, social care and the organisations they work with can respond effectively (Link attached for full guidance) 
Questions directed at - All Nurses, GP's, All Psychiatric Professionals and Healthcare Support Workers. 
  • Did you know about the guidelines prior to reading this question?
  • Have the guidelines increased your interest in domestic violence?
  • Do you agree with the guidance?
  • Do you feel that you have sufficient training to deal with domestic violence?
  • Would you like further training about domestic violence?
  • Do you feel the issues surrounding domestic violence should be left to specialist services?
  • Have the guidelines prompted a change in the way your local trust deals with domestic violence? 
Thank you in advance for your input. 
Relevant answer
Answer
I suspect the lack of response is due in part to this forum not being one used by nurses, doctors etc. unless they are engaged in research.  Here is an option to consider: Amazon Mechanical Turk https://www.mturk.com/mturk/welcome  It is pretty inexpensive to create a survey to help you get this type of information.  
  • asked a question related to Clinical Nursing
Question
3 answers
When considering the rapid growth of computer, Web-based, and other instructional technologies it is difficult to identify the types of self directed learning activities for clinical teaching.
Relevant answer
Answer
What are the types of self directed learning activities available for clinical teaching? When considering the rapid growth of computer, Web-based, and other instructional technologies it is difficult to identify the types of self directed learning activities for clinical teaching.
In my experience we provide learning plan used by students as guide in self directed learning. The learning plan consist of:
1. Learning Objectives
2. Learning Contents and references
3. Self Evaluation in the form of paper pencil test and return demonstration depending on the learning objectives.
4. Pre-test and Post test
  • asked a question related to Clinical Nursing
Question
3 answers
What is the nursing care of spinal cord injured patient in the scene of the accident, in the emergency-intensive care unit and in the long-term rehabilitation? I would like related references or books about spinal cord injury nursing/neurological nursing/neuroscience nursing...thank you in advance!
Relevant answer
Answer
Should not move unnecessarily, Careful position in transferring the patient, prevent further damage, There are aides to assist with the moving of the
spine-injured patient. Then take him for surgery.
  • asked a question related to Clinical Nursing
Question
4 answers
I currently work in an Electrophysiology Lab where we routinely Foley patients requiring left sided heart procedures that necissitate the use of heparin.  I am constructing a paper and developing best practice guidelines and looking for research, with minimal results. Any ideas on such historical research are appreciated.
Relevant answer
Answer
Yes, Lubricating the urethra (preferentially by gentle injection via a 10 cc syringe) can reduce traumatic effect of catheterization in male, lidocaine gell %2 also helps to painless insertion provided that it be left at least 5 min before  catheterzation. this lubrlcating process is not limited the "male" gender and should be applied for females also. 
 
 
  • asked a question related to Clinical Nursing
Question
4 answers
I know HCAPS and Press Ganey don't
Relevant answer
Answer
I'm not aware of a specific tool for patient satisfaction with bedside reporting. You could look at the Patient Satisfaction Questionnaire (PSQ-III) - http://www.rand.org/health/surveys_tools/psq.html.
It looks simple (Likert-scoring system) and considers multiple components of a patient's perspective of the healthcare system, but it may be a bit lengthy. AS THE QUESTIONS HAVE ALREADY BEEN TESTED for validity, you can extract the questions that apply more specifically to your objectives (bedside reporting) after checking for any variations in inter-rater reliability of the modified tool. However, the extra 2-3 minutes may be negligible compared to what the information could reveal about attitudes toward healthcare providers. I hope the information helps. Good luck!
  • asked a question related to Clinical Nursing
Question
3 answers
Studies estimate that 44% to 85% of nurses are victims of LV; up to 93% of nurses report witnessing lateral violence in the workplace (Christie & Jones, 2014).
Relevant answer
Answer
Not until the playing field is equal among nurses: Consistent educational backgrounds. In every profession, power generates resentment of some sort. Its particularly severe among nurses and has been traditionally.
  • asked a question related to Clinical Nursing
Question
6 answers
Nurses in developing world work under unsatisfactory conditions that threaten their physical, mental and social wellbeing. With the gross shortage of nurses and the invitation of retired nurses to continue working, there is a need to understand the response of the nurses and indications for further studies especially in Africa and developing world.
Relevant answer
Answer
Dear Jennifer, thanks for your wonderful contribution and indeed it is a good way to go.
  • asked a question related to Clinical Nursing
Question
3 answers
Clinical Skills Assessment (CSA) is a performance based examination
Relevant answer
Answer
perhaps a more intriguing question would be - how are nursing performing clinical skills assessments after they graduate... I know what we teach our BN students and yet when I am on the floor, often I will see/hear qualified nurses missing basic cues.
So is it because they dont understand what they are learning when an undergraduate or do they loose assessment skills due to increasing work demands?
  • asked a question related to Clinical Nursing
Question
42 answers
Some colleagues claim that inserting a central venous catheter without ultrasound help is a vicium artis. Still, most of my colleagues and I mostly use anatomical landmarks. If several such attempts fail or we have a history of prior fail attempts, we use the ultrasound.
Relevant answer
Answer
So I pose the question..
Without US, how can you determine;
1) the vessels patency
2) the vessels pathway
3) respiratory variation/haemodynamic stability of the vessels
If you had a thrombosed R)IJ, then you would not know until you had already tried the procedure i.e punctured the vessel (on possibly more than 1 attempt, and had a likely failed guidewire feed).
US would allow the clinician to determine the vessels 'state of health' before even commencing the procedure, therefore reducing the risk of possible inadvertent thrombus dislodgement.
  • asked a question related to Clinical Nursing
Question
10 answers
A concept map is a graphic or pictorial arrangement of key concepts related to a patient’s care. By developing a concept map, students can visualize how signs and symptoms, problems, interventions, medications, and other aspects of a patient’s care relate to one another.
Relevant answer
Answer
My experience with students is they need to be prompted to ensure they cover all aspects of their area of study. Placing the patient as the core focus, then asking the student to use prompts such (For example):
Physical - What is the condition, clinical signs, symptoms etc
Psychological - How does the condition impact on self concept
Social - How does the condition impact on the patient/family social interactions
Cultural - Do the cultural beliefs of the patient have an impact on any of the other prompts and how may clinical decisions be impacted by these beliefs
Professional - What potential clinical interventions could be made? What frames the decision making process? Are there any legal or ethical issues that need to be taken into account?
This approach seems to stop the student over focusing on one aspect and prompts a greater realization of the holistic impacts of the decision making process.
  • asked a question related to Clinical Nursing
Question
17 answers
Main foci so far have been literature on resilience, death anxiety, and terror management theory. I'm planning a critical ethnography in acute care setting.
Relevant answer
Answer
Try to narrow the search words and look for articles such as:
Diagnosing Suffering: A Perspective and Recognizing Suffering both by Eric J. Cassell, MD
The treatment of suffering when patients request elective death.
Cherny, Nathan I.; Coyle, Nessa; Foley, Kathleen M.
Journal of Palliative Care, Vol 10(2), 1994, 71-79.
Barriers to psychological care of the dying.
P Maguire
  • asked a question related to Clinical Nursing
Question
7 answers
From long years of experience in nursing education I have always felt that formative evaluation ends up as some sort of judgement about the student's performance. Hence students must be exposed adequately to the clinical environment and the educator should have opportunities to teach, observe and provide feedback. There are instances when we are required to provide formative evaluations every 2 clinical days. Is this good practice? Will this benefit students?
Relevant answer
Answer
In my experience as faculty and dean in the college of nursing the prescribed number of hours and days allotted for related clinical experience as prescribed in the curriculum are adequate to meet the desired learning outcomes. We have competency appraisal course with 12 units (6 hours/week in 36 weeks). The competency appraisal course is offered in fourth year level of BS Nursing. On going clinical competence appraisal is being done during the entire semester.
Strategic curriculum planning is a good suggestion to address clinical formative evaluation and other related matters.
  • asked a question related to Clinical Nursing
Question
2 answers
I'm studying the way male nursers live their experiences in clinical practice, and I'm focusing in the masculinity approach to understand the way that masculinity affects the nurse relationship with patients (users), other nurses, and other health professionals. So I want to know which sources are available to understand the masculinity approach.
Relevant answer
Answer
It is an interesting question related to gender issues in nursing practice. You already mentioned that your study focuses on how masculinity affects the nurse relationship with patients (users), other nurses, and health professionals. The impact of masculinity on roles and functions of nurses depends on the culture where nursing practice occurs. In other words the variations in roles and functions of the male nurses and relationships with other nurses and health professionals depends on the culture where nursing practice is carried out. There are lots of literature and studies related to your study. Good luck!
  • asked a question related to Clinical Nursing
Question
5 answers
I was thinking of a way to measure enzyme levels in serum, or other fluids for diagnostic purposes, especially in third world countries. Enzyme activities like lipases, liver enzymes, and other enzyme activities could be measured, possibly with a hand held device and would be cheap and easy enough to sell over the counter.
Relevant answer
Answer
From my personal experience with lipases, I 've found that an easy technique is to quantify activity using p-nitrophenyl palmitate as substtrate, measuring the paranitrophenol that is being released using a spectrophotmeter.
In general you would need the substrate, which you can easily find in the 'usual' industries, paranitropenol for standard curves to correlate the performance with something, a protocol to extract the lipases (usually detergents and sonication), and a spectrophotometer.
I don't know if it sounds too complicated, however it takes about 5-6 hours for the whole procedure, and the results are convenient.
I hope this helps.