Science topic

Nursing Research and Evidence Based Practice - Science topic

Nursing Research and Evidence Based Practice are nursing, as an evidence based area of practice, has been developing since the time of Florence Nightingale to the present day, where many nurses now work as researchers based in universities as well as in the health care setting.
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I am seeing so many different titles for nurses in primary care practices who are doing care coordination - which is also defined in a number of different ways. I would love to get some feedback around what people think may be the differences.
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In my PhD, I identified 9 different professions delivering case management. The specific training of each brought an eclectic range of expertise and challenges to the role. However, in nursing poor role definitions and inconsistent use of titles have complicated understanding for the practitioner and the patient. In addition, there may be intra and inter-professional differences in explaining how case management should be delivered and by whom.
The academic and grey literature terms interchangeably including care management, case management, activity, approach and interventions - sometimes, this variation arises within the same article, adding more confusion. Sue Lukersmith’s work has been very helpful but the terminology used still differs within and across various professions adding further misunderstanding between different professional disciplines. EG social workers refer to "care " rather than case management.
Therefore, a sensible approach in defining a case management service should first clarify its purpose and the needs of the people it aims to serve. This will point toward the knowledge and skills needed for the conduct of the role. Have a look at my thesis on : https://eprints.soton.ac.uk/421176/1/Saltrese_A_Final_Thesis_2018_April.pdf
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Do any of the accrediting nursing organizations have codes of ethics, similar to those for physicians, that all of the nurses that they have accredited must follow? Thanks.
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In Canada, the Canadian Nurses Association published a document entitled Ethical Research Guidelines for Registered Nurses in 2002.
In Australia, three nursing organizations collaborated to develop the Code of Ethics for Nurses in Australia (2008).
Nurses in most countries have developed their own professional codes or follow the codes established by their governments.
The International Council of Nurses has developed the ICN Code of Ethics for Nurses, updated in 2006.
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Many times students critic their clinical marks because I don't have written standard for assessing their quality of activity. I built a special guideline for assessment their activities, but still I seeking for best standard for assessment.
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Clinical teaching to date should be oriented by Person Centered Medicine and the Person Centered Clinical Method. PBL and Evidence based medicine are obsolete and wrong models, because medical science is changed.
In the assessment of clinical skills in learning Person Centered Medicine, the method we use is correspondent to the Person Centered Medicine Clinical method  learning of its steps trough a questionnaire fulfilled by three clinical teachers after a simulation session, concerning the learning step and, at the end, of  the full procedure.
The problem is to prepare clinical teachers to teach Person centered Medicine and its epistemological basis which is founded on the paradigm shift of Medical Science , born in 1998, and that will be formalized in Milan on 13-14-15 October 2017 in the Congress:
" Medical science and health paradigm change"
Sign if you agree "la Charte Mondiale de la Santé-the World Health Charter"
Text and info on the Congress website
an on line-live course on Person Centered Clinical Method:
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my project considers collection and analysis of administrative quality and patient safety data from particular hospital to identify trends in quality and safety and to identify evidence of missed nursing care and its association with nurse staffing and skill mix. 
please any one has suggestions on the  data that should be collected for this purpose from the hospital and the way of analysing it.    
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Care left undone during nursing shifts: Associations with workload and perceived quality of care
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There is a wealth of research and information in relation to waste medication in primary care but appears to be limited when related to secondary care (hospitals). I am interested in how health professionals view medication waste and the impact this has upon health services. Additionally I wish to look at the root causes of medication waste within secondary care.
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Dear Karen Stone
Adequate knowledge about the health hazard of hospital waste, proper technique and methods of handling the waste, and practice of safety measures can go a long way toward the safe disposal of hazardous hospital waste and protect the community from various adverse effects of the hazardous waste. With this background, you must consider the levels of healthcare professions in you study and you must prepare appropriate questionnaire for each of them...
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I am a nurse,srinagarind university hospilal,khon kaen U,Thailand.I would like share with health and Wellness group.
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Hello Panor, I'm Fehim from Faculty of Health Science, Bandırma Onyedi Eylül University  Turkey(Türkiye). I'm an accident epidemiologist  of public health nursing.
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thank you very mich
Mary C R Wilson 
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I want to produce guidance for the children's community nursing team I work in around managing problematic gastrostomy sites.
Our team uses historic practice using different steroid and antibiotic cream to treat over granulation, infection and inflammation. 
Any suggestions on a suitable dressing that can be cut and used around a tube or button to help manage exudate and/or treat a granuloma?
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We use in Brazil Sodium Chloride 20% if in light bulb, soak a gauze and apply on the granuloma. There is a product in gel form, Hypergel of the Molnlycke which is a gel with 20% sodium, it may also be applied a thin layer on granuloma and cover with gauze.
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The responsibility of the nurse education towards theoretical education and clinical training. Is it the nurse education's responsibility to see that the student is also clinical competent in her work? and to what extent?
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The faculty member who teach theoretical class, has to be in touch with the clinical settings and keeps following up the students training. This is crucial to link theory with practice and to be realistic with the examples and students feedback.
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  1. am trying to conduct a primary research on the impact of social interaction/isolation on the increase rise in the development and advancement of dementia but I need supporting articles and suggestions on the best research methods and approach to utilize.
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Look at Yvonne Lu's work from Indiana University and also an intervention called Time Slips. I think these may be helpful
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I am looking for a instrument for data collection.
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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
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The two surveys that will be compared are: An All Employee survey and the Nursing  Work Index- Practice Environment Scale. Influences on nurse retention and intention to leave will be examined.
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it seems you are going to compare 2 different scales used in both survyes. If both of them measure the same concept, then you can find the total score for each and do correlation between them
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Does anyone have any information regarding a tool to measure attitudes and beliefs of clinical nurses regarding a specific clinical intervention?
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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
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I am a nursing doctoral student (DNP program). My project is about injuries among nurses and I need a tool to measure my interventions. Could you help?
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You may want to look at the work of Dr. Audrey Nelson on safe patient handling. She did much with the Veterans' Administration to reduce injuries to health care professionals when moving patients. Her research resulted in numerous articles and I incorporated her work in the chapter on Mobility and Immobility in Fundamentals of Nursing by Potter and Perry published by Elsevier.    I also agree with my previous colleague's posting. Do not use abbreviations. Clearly articulate your needs so others may understand your question
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Constant change in health environment impact nursing practice and education and creates gap. Change demands Graduate education to adapt and innovate to bridge the gap to maintain the balance between education and industry and promote quality health care.
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Grants, scholarships, tuition vouchers, and loan reimbursements, designed to lower the cost of a nursing education, have also tended to depress starting wages. This is because nursing graduates who receive subsidized education through these programs are willing to, or in some cases are required to, work for lower starting wages than they would without the subsidies.As a result all nursing graduates are lower, including for those who did not receive a subsidy for their education through the government programs.
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In ICU patients that are 65 years of age and older, what is the effect of patient teaching about Pennsylvania Order for Life Sustaining Treatment forms upon admission, in comparison to no teaching about POLST forms, on patient knowledge of end of life care?
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I'm sorry, I do not have information to assist with your question.
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Among Africans, Asians, Europeans,
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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.
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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....
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"Gesundheit und Pflege" is a study program in Germany in which pre-service teachers are trained to teach in Vocational Schools the Health and Health Care Science. One of the aims of my study is to find out whether evidence-based practice was implemented to the "Health and Health Care" teacher program in Germany. Can you recommend me any paper which explores and explains the program overall and its aims. German papers are also welcome. Thank you!
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Dear Nilüfer, 
attached you find an abstract about this research. Unfortunately this is only published as book: Pflegespezifische Kompetenzen im europäischen Bildungsraum. V & R GmbH.
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I mean not just ECG signal and its parameter, but also some added information about the person, e.g.: age, other diagnoses, hereditary diseases, gender? These information could serve for the datamining statistics. Does anyone know such kind of databases? The well known physionet database contains just the ECG signal and not the information about the patients.
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You can check the ptb-diagonistic ecg database available in Physionet.
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What evidence based research is there concerning the care of EVD's and nursing?
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You might try reviewing the guidelines for care established at the major neurosurgical care centers.  Also, the device manufacturer may be able to help.  Meanwhile, check out http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4450504/
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The plan is to look at the degree of association or relationship between graduate nurses' work experiences and the rate of retention and the implication for nursing education.
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Hi Irena,
would be useful to provide both a link and a title
Thanks
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How do we know/measure if nursing residencies really work to close the gap between education and practice?
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In a DNP project, I compared outcomes of new graduates in three sites, with only one having a nurse residency program. I used the Casey-Fink Graduate Nurse Experience Survey from the University of Colorado. It measure five subscales of stress, support, ability to organize and prioritize, communication and leadership, and professional satisfaction. The tool was developed in 1999 to measure newly licensed RN comfort with skills over time. Casey et al. have used the survey as part of the Nurse Residency Program developed in collaboration between UHC and AACN. The CFCNES has a Cronbach alpha of .89 and validity testing was done using an expert panel of educators. Pub med link to my article: http://www.ncbi.nlm.nih.gov/pubmed/24658039?otool=mnmcclib&myncbishare=mnmcclib (Harrison, D. & Ledbetter, C. (2014). Nurse Residency Programs - Outcome Comparisons to Best Practices. JNPD, 30(2), 76-82.)
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Particularly end of life care.
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THANK YOU KINDLY 
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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?
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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.  
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....writing a research paper for school....appreciate any input as well as articles to print as proof of my research.....
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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, 
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Long-term care facilities (LTCFs) may be defined as institutions, such as nursing homes and skilled nursing facilities that provide healthcare to people who are unable to manage independently in the community. Working In long term facility, were most of the patient are chronic and needs to attend their activities of daily living 24/7. The majority of residents in LTC require custodial care, which consists of assistance or give bathing, dressing, feeding, and mobility. Other residents may require a higher level of care called skilled nursing care, which includes treatments to management disease such as tube feedings, ostomy care, and rehabilitation services. This wide variation of resident needs serves as the basis for the multiple levels of nurses working in LTC. What is the staffing ratio to provide quality care in long term facilities?
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Dear Ruby 
I agree with the point of view that multi-dimensional interventions required to optimize the outcomes of care. Maintaining a healthy work environment and staffing adequacy required. skilled and trained employees required as well. 
I wish these papers might help (included references could help).
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
2. Nurse Level of Education, Quality of Care and Patient Safety in the Medical and Surgical Wards in Malaysian Private Hospitals: A Cross-sectional Study
Warm regards, 
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In the public health, the focus is more and more on the empowerment of the patient. What is the influence of the identity of a nurse in the youth care on the empowerment of a patient?
What different identities are there? How do I find out what the identity of a nurse is?
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Thank you for the clarification Dean. A bio-medically driven use of informational power (see 6 bases of power-over) to coerce individual behaviour change is not empowerment, even under the constraints of a nursing context. The end does not justify the means either because this is contrary to an empowerment approach that aims to build capacity, confidence, autonomy etc, Information exchange alone is insufficient and in fact could be disempowering. This is really about professional honesty and a willingness to accept that as practitioner we are not experts and may even not be able to help others to empower themselves within a work setting. 
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What strategies have institutions used to successfully implement a research program from "the ground up"?
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One thing that has been done for a while in my neck of the woods is the Research Challenge. It is a small grant $5000, that is specifically for nursing and allied health to conduct a research study.  It is a team's grant. Potential teams submit first a letter of intent, they are then matched with a research mentor that is committed to help the team, and the teams must attend a series of compulsory and optional workshops on literature search, grant proposal development, ethics etc. before submitting the final proposal. I believe this year there is funds to support 18 teams at our facility. It is quite amazing what past recipients have accomplished with these small grants. they have turned into ongoing research, larger projects, masters thesis, and organization wide QI projects. Here is the website for this current year's competition. Feel free to contact the team at VCHRI for more information. I have found them to be incredibly supportive.
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I am interested in the effect of computer based teaching program among staff nurses regarding evidence based practice.
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 Dear Dr. Ruby ,
I think this article may be useful:
Worldviews Evid Based Nurs. 2008;5(2):75-84. doi: 10.1111/j.1741-6787.2008.00123.x.
Effectiveness of a computer-based educational program on nurses' knowledge, attitude, and skill level related to evidence-based practice.
Hart P1, Eaton L, Buckner M, Morrow BN, Barrett DT, Fraser DD, Hooks D, Sharrer RL.
Regards,
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The HTA unit of the Quebec city university hospital is currently working on a hospital-base HTA review aiming to evaluate the efficacy and safety of anticipated surgical tray opening in OR facility.
In your operating room facility, are surgical trays opened before patient entry? If so, could you tell me more about your experience with this procedure?
Would you be interested to fill a short survey about this practice?
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once the operating room has been turned over and cleaned by the surgical patient service team and anesthesia techs, then the surgical team opens the trays to make sure that the necessary equipment is available for the surgical procedure.
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Little is known about the consultation nurse's role and the cares in HIV patients. There are big differences between high and low income countries. I´m trying to copile information about it. I haven't been able to find any guideline for the nurse in the most important databases. Should nurse iniciate and monitor ART? Or just monitor? 
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Attached implications of my study:
Nurses, who represent 65% of human resources in the Bolivian health system structure, must actively participate in the design of culturally adapted prevention programmes and health education interventions. In this regard, governmental health authorities, NGOs and international organisations should be actively engaged and aware of our study’s results, particularly highlighting the importance of local agents to promote their capacitation as well as the empowerment of indigenous populations. Nursing could develop programmes and interventions based on the transcultural care theory, preserving healthy cultural practices, negotiating the adaptation of others and remodelling those which support risk behaviours. Without an in-depth knowledge of this population’s cultural framework, any attempt at an intervention runs the risk of being done in vain.
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Hi all,
I'm working my way through the evidence base on decision making theory in clinical reasoning. There's obviously a myriad of models. Is anyone familiar with where current thinking lies? I'm particularly interested in making decisions using medical imaging.
Any thoughts or recommend articles would be appreciated.
Mark
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Hi Rabin,
Thanks for your really detailed response I've been doing some reading around dual process theory (Pat Croskerry has written a couple of nice articles), but haven't come across the naturalistic model, so I'll look that up thanks.
I'm working up an observational study investigating how clinical staff review images and make clinical/patient management decisions in the oncology setting.
I'll check out those references thanks and would appreciate any other thoughts you have.
Good luck with the publication
Best wishes
Mark
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Do you think Practical Guideline is a typical member of Evidence-based medicine (EBM) and if so, where to put it in the hierarchy of evidence?
It may be at Level I: Evidence-based clinical practice guidelines based on systematic review of RCTs [1], how about other cases?
1. Melnyk BM, Fineout-Overholt E (2005) Evidence-based practice in nursing & healthcare: a guide to best practice.
Thank you.
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I do not think that practice guidelines are the best level of EBM. Practice guidelines are interpretations of EBM filtered by Experts and reflect the perspectives of those Experts. Because practice guidelines are subjective, they are like an a priori knowledge built on some a posteriori knowledge. Statistically, both are questionable. Physicians should take in account their personal perspectives to built their a priori knowledge in order to face own clinical problems in each part of the word. 
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Considered as a logical next step from healthy house, have hospitals been catalysts in the development of modern medicine? Or have they, as many architectural and medical historians had assumed, simply been passive reflections of medical innovation? (Adams, 2008)
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Buildings are never neutral: they define relationships and organise our lives. In numerous ways hospitals reflect the categories of society, by showing age and gender differentiation, for example, and by articulating wards in accordance with specialisms and diseases. Miasma theory which designated 'bad air' as a cause of disease resulted in great emphasis on cross-ventilation, because it was only in the 1870s that Pasteur established the existence of microbes, and before that what one could smell was self-evidently dangerous. However, in modern hospitals air-conditioning has taken over, and whole buildings are planned for ease of servicing, to the detriment of way-finding. Until the mid 19th century the chapel had a hierarchically dominant role because God was still in the picture and many people died. Today most people die in hospital but we don't acknowledge it because is it supposed to be a healing place. In the 19th century operating theatres were just that, with lots of dirty people in ranks of seats looking on, now it is one of the most tightly defined enclaves of modern life with stringent barriers and ritual cleansing. In the 1920s tuberculosis was a major killer and without antibiotics was difficult to cure, but UV light in sunlight killed the bacillus, so patients were exposed to the open air in buildings like Aalto's Paimio, and this idea was reflected in many other buildings of the period, such as open-air schools. For a good history of the building type see Thompson and Goldin 1975, and on miasma theory and birth Ann-Marie Adams. There will be a chapter in hospitals in my forthcoming book Architecture and Ritual.
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Colour is believed to be a fundamental element of environmental design, especially in healthcare spaces as it is linked to psychological, physiological, and social reactions of human beings, as well as aesthetic and technical aspects of human-made environments. Choosing a color palette for a specific setting may depend on several factors including geographical location, characteristics of potential users (dominant culture, age, etc.), type of activities that may be performed in this particular environment in specific wards/hospitals in hospitals according to each function (paediatric wards/ cancer hospitals etc) , the nature and character of the light sources, and the size and shape of the space (Ruth et al., 2004).
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We see the world around us through colors. Whenever there is light there is color, and therefore we see the surfaces that (in)form visual space perception. More than 85% or 90% of all information that arrives to our brain from the exterior comes from the sense of sight. So, light and color are, together, the main keys for our communication with the world, and the way the world communicate with us. 
I do not agree with some color palettes that are being used, leading to the 70´s and 80's approach of having a color for each floor, etc. Color should respond to functional an aesthetic issues, promoting at same time comfort for the patients and adequate professional care. If we have the same concerns in two or more floors we should address them in the same way. A waiting area should be designed in a balanced harmony between hot and cold colors, nor having to be blue just because you are in the "blue" floor!
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About Forensic Nurses around the world
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Dear Rafael,
J Psychiatr Ment Health Nurs. 2001 Feb;8(1):25-32.
Something special: forensic psychiatric nursing.
Martin T
Abstract
In this paper the claims that forensic psychiatric nursing has achieved the status of a specialist area of nursing are refuted. An examination of the literature demonstrates that specialist knowledge and skills have not been documented. It is suggested that three requirements are necessary if forensic psychiatric nurses wish to achieve specialty status. Forensic nurses have to consolidate their role in the containment and care of patients, they have to return to the nurse-patient relationship as the foundation of psychiatric nursing practice, then, within that relationship, nurses must expand their practice to include dealing with offence issues.
In agreement with the last point nurses need extended education dealing with aggression. violence and offence issues as well as spiritual issues. According to my research on mental nursing competence males were more able to deal with aggressive but also more willing to deal with spirirtual issues than female forensic nurses.
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Instruction designs integrating simulation and problem-based learning to improve nursing student critical thinking, clinical reasoning, and psychomotor skills.
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I think the following article has a good answer for this question:
Aqel A., Ahmad M. (2014). High Fidelity Simulator effects on CPR Knowledge and Skills Acquisition and Retention. Worldviews on Evidence-Based Nursing, 11(6), 394-400. DOI:10.1111/wvn.12063
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Ad-hoc testing is a random testing of an application without proper test plan. It's carried out at the end of the project when all the test cases are executed. The method is testing done without any specific procedure. This type of testing will be done when there is insufficient time.
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from its name, adhoc, it can be done when the participants are available. The researcher is ready. and the expected outcome from the research is decided
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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.
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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
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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
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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. 
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I am a PhD student. I plan on doing my dissertation on spirituality. Specifically, how do nurses define spirituality? I would appreciate any suggestions for updated peer review articles as well as the best way to do a literature review. Thanks!
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Hello Pattie,
I have used the work of Harold G. Koenig. His basic book is entitled Handbook of Religion and Health. He defines spirituality as, "...the personal quest for understanding answers to ultimate questions about life, about meaning, and about relationship to the sacred or transcendent, which may or may not lead to or arise from the development of religious rituals and the formation of community."  I hope this helps. When providing spiritual care, nurses must pause to reflect on their own definitions of spirituality, as well as their values and beliefs.  Presence and listening are of importance.
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health literacy?
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Hi Charlotte,
thanks for your comments. As you know, three dimensions or levels of health literacy were identified: functional (where is icluded the numeracy capability you pointed about), interactive and critical. 
In my opinion, it is necessary to take into account these dimensios in the design of assesment tools and interventions. In our mobile application, we ask the user, after use, to perform what they learned. For example, accesing and request a medical appointment. At the same time, the app returns information, thus having objective data of user empowerment. 
Written information, especially if autoinformed, has its drawbacks and limations.
Greetings.
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Independent study is primarily self-directed with the student supported by a tripartite team of academic and clinical staff. The student negotiates a learning contract which identifies what it is they intend to learn about and the evidence they will provide that demonstrates this learning has taken place. The module is thus flexible in enabling students to pursue areas of individual interest, facilitating the development of advanced practice by allowing students the opportunity to engage with issues at the cutting edge of practice.
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In my practice I provide hypothetical case Study with study guide
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Working on a 2 month pilot study with immediate recognition to show strengthening and empowerment of job satisfaction of the professional nurse. Hoping to publish this in the future.
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Just got through reading on emotional fatigue and burnout in ED nurses.  One of the major items discussed was the failure of management to acknowledge or provide positive feedback as a major source of stress (Riahi, S. 2011).  Further more, when the stress signals started to be displayed, the stress only increased when management was insensitive to the stress displayed (Riahi S, 2011).  
Reference
Riahi, S. (2011). Role stress amongst nurses at the workplace: Concept analysis. Journal of Nursing Management, 19, 721-731. http://dx.doi.org/10.1111/j.1365-2834.2011.01235.x
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Nursing educators have to incorporate evidence based practice into their courses/ curriculums and use these strategies to support their teaching methods.
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We have recently implemented an on-line portfolio in the midwifery trainning programme , and we are having good feed-back from midwifery students and mentors. This dynamic tool is intended to support theoretical teaching during clinical training period. As a dynamic tool, it allows to continuously incorporate  emerging evidence into teaching. The main goal of this tool is to support mentors task and students clinical trainning process trough a continuous feed-back while "learning by doing"
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I'm a nursing science student at the PMU in Salzburg/Austria. At the moment I'm writing at my bachelor thesis.
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Dear Lisa
I spent a year following the stories of frail older people in hospital waiting for a bed in a nursing home. I visited them during this time and collected stories full of humour, resilience and despair. These people were 'bed blockers' and we still have this in the UK
 
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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.
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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. 
 
 
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I am trying to write an essay on the autolytic debridement of slough using such dressings
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hi kevin
i just came across a few article on capillary dressing hope it helps you.
VACUTEX™ capillary action dressing: a multicentre, randomized trial
Linda Russell, Michelle Deeth, Helen M Jones, Tim Reynolds
British Journal of Nursing, Vol. 10, Iss. Sup2, 08 Jun 2001, pp S66 - S70
Importance of moisture balance at the wound-dressing interface (107kb)
S.M. Bishop, M. Walker, A.A. Rogers, W.Y.J. Chen
Journal of Wound Care, Vol. 12, Iss. 4, 02 Apr 2003, pp 125 - 128
A Randomized Crossover Investigation of Pain at Dressing Change Comparing 2 Foam Dressings
Woo, Kevin Y. RN, MSc, PhD, GNC(C), FAPWCA; Coutts, Patricia M. RN, IIWCC; Price, Patricia BA(Hons), PhD, CHPsychol, AFBPsS, FIHE; Harding, Keith MB, ChB, MRCGP, FRCS; Sibbald, R. Gary MD, FRCPC(Med Derm), MEd, MACP, FAAD, FAPWCA
Evaluation of a wound dressing using different research methods (98kb)
Tim Reynolds, Linda Russell
British Journal of Nursing, Vol. 13, Iss. Sup2, 10 Jun 2004, pp S21 - S24
Drawtex: a unique dressing that can be tailor-made to fit wounds (143kb)
Linda Russell, Amanda Evans
British Journal of Nursing, Vol. 8, Iss. 15, 12 Aug 1999, pp 1022 - 1026
Article: Debridement of necrotic tissue and eschar using a capillary dressing and semi-permeable film dressing.
Jackie Lisle British journal of community nursing 10/2002;
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Assisting in a research study at place of employment.
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We are using TAP blocks more and more for pediatric surgical cases and this has included neonatal surgery up to and including adolescents. TAP blocks last about 4 hours whereas a caudal block as used in infants/toddlers will last much longer (approx. 8 hours)
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I would like to do research related to techniques to help higher education students (especially nursing students) successfully manage test anxiety. I have seen too many students either fail nursing courses or fail NCLEX who have this issue. Often these students are very capable clinically, they simply have test taking issues.
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I completed my doctoral research and published it in the Alternative and Complementary Therapies Journal in April 2014. My study used diffused essential lemon oil during an exam with nursing students and it significantly reduced their cognitive test anxiety scores post intervention. Please let me know if you'd like additional information on my work. Thank you!
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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.
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Dear Jennifer, thanks for your wonderful contribution and indeed it is a good way to go.
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Intermittent pneumatic compression devices role in DVT prophylaxis is an area that needs to be discovered still more deeply. The design of these machines, pressure exerted on legs and the optimal time to be used still need to be researched.
All are an important confounding factors that need to be addressed by randomized control trials before concluding : Did it work, or not?
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We use IPC in all our patients who undergo pneumonectomy for five days postoperatively, combined with enoxoparin for six weeks. The rationale is to prevent (mostly fatal) embolic events in the unique remaining lung. This procedure is now in place for six years and we had no such events in this timeframe. (it is of course an event that is rare, but before we used ICP, major embolic events were seen in about 1% of pneumonectomy patients; we do 40+ pneumonectomies a year, so calculating the odds it seems an improvement).
For the use: the first three days the IPC is running 24/24, when the patient is fully mobilized the IPC is only used during the night. Most patients complain, not of discomfort wearing them, but from the noise the pumps make.
This is of course a totally different population from stroke patients, but we feel it works
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I am looking for recent data on the prevalence of wheelchair use in the general population, this is a difficult one to quantify I know as wheelchair use may be transient or permanent. In addition I am seeking data on prevalence of pressure ulcers in this group. What I have found is mainly related to specific populations such as persons with spinal injuries but not wheelchair users in general.
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Also, refer to research by Amit Gefen from Israel. He studies the seated population.
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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.
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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.
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The quantitative analysis is basically descriptive in nature of a database which has been built from patient records having a specific illness.
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In your specific case, "existing patient records" randomization is not a real issue. Make sure that in your work you describe, with detail, how you gained access to the data. Another key issue is how you formulate the problem, make sure that yours is clearly stated.
Randomization would be central if you were studying health people. as I understand you are studying a diseased population.
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I am looking for existing guidelines on the management of bariatric patients in a hospital setting (not in terms of weight loss surgery, but everyday management of the larger patient). We are looking at formalising a guidelines and hope to learn from other services - while there are some available through online searches, it would be great to review a wider range.
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I oversee the end-of-life and postmortem practice of a trauma hospital in a high-risk, inner city community of Los Angeles. We devote particular attention to the needs of our over-sized patients and the unique challenges they bring to their famlies when they die. As most of my families have little if any resources to provide a traditional funeral, much less the added funerary expenses involved with larger persons, we developed a protocol for maintaining their dignity, preservation, and privacy that mirrors the care of patients with a lesser habitus (we call our expired patients 'patients' after they die,because they are stil in our care). We have a cooling protocol if they are unabe to be placed in traditional morgue drawer the first 24-30 hours after death; we have contracted with a local mortuary with a room refrigeration system to hold them after that window, especially if the family needs a bit more time. We do not charge the families for this service.
Families appreciate having referrals to mortuaries who offer emotional support and reduced rates, knowing cremation is often their only option. It took time and patience to put it all in place -i.e. shaping the use of language and behavior, artfully crafting step-by-step instructions, and partnering with the funeral homes. The driving force behind the practice is love and acceptance - of the living and the dying, of the small and the not-so-small. If you have any questions, jet me an e-mail.
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Several theories within the nursing discipline refer to the emotional dimension of careging and research is growing in this field. Do you think that practice follows research in this area? Are we adequately trained to use emotion management as a therapeutic instrument?
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In my opinion the nursing education is not simply to raise awareness of rules and procedures, but to help learning how to get in touch with the cognitive and emotional processes present in places of care and that are started by caring of the patient.
We teachers should think of a training of health professionals that recognized the ethical and epistemological roots of nursing, putting at the center of caring enhancement of human relationship between nurse and patient.
The evolution of scientific knowledge takes place within different contexts of practice in relation to life stories, so nursing student has the need to deepen the emotional dimension of the experience of fragility and pain.
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My team and I are looking at alarm fatigue and alarm safety within our organization. We are able to find a lot of literature about the problem, but none specific to pediatrics.
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Anicia, we have some basic data from a study we did at one of our customer sites with some alarm data from a PedsICU. I am happy to share it with you. paul.mcgurgan@excel-medical.com
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Aspects of research (evidence) and practice knowledge are needed to achieve a high level of competence and it is not desirable to draw a strict line between the two types of knowledge.
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Evidenced based knowledge (EBK) is generated from scientific research while practice-based is knowledge (PBK) gained over time by means of practice (i.e. like apprenticeship).
If you notice, most apprentice know what they do but they do not understand the science or scientific rationale behind what they do. EBK makes a person to understand the science behind the practice. In this way (i.e. with EBK one is open to thinking outside the box, and can also apply the science to other situations.
Scientific reasoning affects practice. It makes practice flexible but PBK makes practice rigid as the technician cannot figure out another way of doing things other than what he has learnt through practice.
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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?
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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.
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I am searching for samples of questionnaires as I would like to find out from the patients related factors in order to improve our nursing intervention to minimize the prevalence rate of fluid overload to improve patients quality of life. Could someone guide me through this?
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I don't know any questionnaires about this topic, however I suggest to check pulse oximetry to avoid fluid overload in haemodialysis patients. Indeed fluid overload is life threatening only if it impairs pulmonary gas exchange and hence decreases pulse oximetry. On the contrary leg edema is not life threatening and does not impair gas exchange.
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I want to to examine nurses' perceptions about the value and applicability of the Braden Scale as an evidence-based practice assessment tool for determining nursing interventions.
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At our facility, we use the Braden scale daily on every patient. A score of 9 or below gets an automatic consult to the wound care nurse who assesses the pt for treatment and preventative measures. Prevention is the key. It is a good tool for identifying at risk patients.
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I am developing a study on affectivity in childcare hospitalized unaccompanied. This study aims to explore and understand the determinants and specificities of affection in caring for hospitalized children unaccompanied. Currently, this aspect is of ulmost importance given the socio-economic context that Portuguese has deteriorated, and that has led to an increase of hospitalized children unaccompanied by people affectively significant. It is crucial to explore the human-affective relationship in nursing practice in pediatric settings.
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Plus this article to relate.
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I am undertaking such a review currently
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Alex:
There are several such reviews, including three Cochrane joint systematic reviews (SR) and meta-analyses [1,2,3], another joint SR/MA [4], two additional SRs [5,6], and three additional meta-analyses [7,8,9].
Note that there are over a dozen more non-systematic literature or narrative reviews that you may also find useful to consult; although not strictly systematic, nonetheless they are solid and comprehensive literature reviews on general and special issues relating to PDPH.
Good luck on your own research.
SR/MA on PDPH (Post-dural Puncture Headaches):
1. Arevalo-Rodriguez I, Ciapponi A, Munoz L, Roqué i Figuls M, Bonfill Cosp X. Posture and fluids for preventing post-dural puncture headache. Cochrane Database Syst Rev 2013; 7:CD009199.
2. Basurto Ona X, Uriona Tuma SM, Martínez García L, Solà I, Bonfill Cosp X. Drug therapy for preventing post-dural puncture headache. Cochrane Database Syst Rev 2013; 2:CD001792.
3. Boonmak P, Boonmak S. Epidural blood patching for preventing and treating post-dural puncture headache. Cochrane Database Syst Rev 2010; (1):CD001791.
4. Bradbury CL, Singh SI, Badder SR, Wakely LJ, Jones PM. Prevention of post-dural puncture headache in parturients: a systematic review and meta-analysis. Acta Anaesthesiol Scand 2013; 57(4):417-30.
5. Apfel CC, Saxena A, Cakmakkaya OS, Gaiser R, George E, Radke O. Prevention of postdural puncture headache after accidental dural puncture: a quantitative systematic review. Br J Anaesth 2010; 105(3):255-63.
6. Wu CL, Rowlingson AJ, Cohen SR, et al. Gender and post-dural puncture headache. Anesthesiology 2006; 105(3):613-8.
7. Richman JM, Joe EM, Cohen SR, et al. Bevel direction and postdural puncture headache: a meta-analysis. Neurologist 2006; 12(4):224-8.
8. Choi PT, Galinski SE, Takeuchi L, Lucas S, Tamayo C, Jadad AR. PDPH is a common complication of neuraxial blockade in parturients: a meta-analysis of obstetrical studies. Can J Anaesth 2003; 50(5):460-9.
9. Choi PT, Galinski SE, Lucas S, Takeuchi L, Jadad AR. Examining the evidence in anesthesia literature: a survey and evaluation of obstetrical postdural puncture headache reports. Can J Anaesth 2002; 49(1):49-56.
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would like to have an example on using the concept maping method in teaching pediatric nursing for the BS program.
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Concept mapping is the graphic illustration of concepts and relationship of concepts in a topic. It is an inductive teaching-learning process. Attached is sample concept map of topics in pediatric nursing
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Dear colleagues, can anyone help me with any information on factors influencing nursing students in clinical setting.
Thank you. Jane Kennly
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Interrelatedness of learning objectives, related learning experience, clinical practice environment, and evaluation tool; required competence of the nursing students; and teaching competence and nursing skills of the clinical instructor influence nursing students in clinical setting
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Is the nursing process a good implementation to provide holistic care?
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I agree with Chika Ugochukwu recommending the use of Nursing process to provide individualized holistic care. In addition, nursing care should be holistic regardless of the method of nursing care. The body, mind and spirit are intertwined and inseparable.
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I am looking for the connections between EI and empathy.
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I believe that being empathetic is one of the indicators of being emotionally intelligent. Empathy requires that one understands the needs of others, as if they were his/hers. Putting oneself in the place of others is an art. Moreover, feeling of others without getting too much involved to the degree that one cannot be of value in helping others is not an easy task. In short, emotional EI is using ones emotions in a constructive manner and relate to people in the most appropriate way.
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Doing a research paper.
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Benner & Wrubel actually responded to Edwards' article, please see Benner, P., & Wrubel, J. (2001). Response to: Edwards S.D. (2001) Benner and Wrubel on caring in nursing. Journal of Advanced Nursing 33(2), 16-171. Journal of Advanced Nursing, 33(2), 172-4.
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Characteristics of the Nursing leadership influence growth and development of the nursing profession.
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Talking about autonomy of nurses is an old as well as ever new topic. In my opinion autonomy is not given but instead it is gained. Proving to hospital managers and other health care personnel that you are competent and are doing your job in the best possible way is important to gain confidence and independence. In addition nurse managers and leaders either facilitate or inhibit the autonomy of nurses. Being assertive and defending the nurses' rights and empowering nurses are important to gain autonomy.
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Misconceptions of traumatic brain injuries are common for both patients and families dealing with these conditions. Values about pain and antidepressant medications may create potential conflict between the health care provider who orders these, the nurse who attempts to administer these medications, and the family who does not value pain and antidepressant medications for alleviating the pain and sense of loss caused by a traumatic brain injury. How can healthcare providers better anticipate the education and collaborative needs of patients and families concerning mild traumatic brain injuries and care plans? And, how does a practitioner best open the dialogue of mental health and misconceptions of mental health?
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Hi Laura,
This is an area that can create a lot of angst for clinicians in understanding what the family and patient require in providing support, education and promoting well-being of the patient, but also recognizing what stage of grief and loss cycle the family may be experiencing. The ability to roll with resistance and change is an important analogy as mental and general healthcare clinicians, we want to provide patient and family centered care while trying to maintain a family systems perspective. Often as we know this takes a multidisciplinary and consistent approach to assist the family and patient in understanding the path to recovery and the available treatment and therapy options.
I hope these articles may be of some help:
What evidence and guidelines exists on how best to resolve conflict through education and patient/family collaboration in plan of care for recovery?
Clinical practice guidelines for support of the family in the patient-centered intensive care unit: American College of Critical Care Medicine Task Force 2004–2005
Collaborative Communication in Pediatric Palliative Care: A Foundation for Problem-Solving and Decision-Making. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2151773/
Implementing Team Approaches in Primary and Tertiary Care Settings: Applications from the Rehabilitation Context.
Given et al (2001). Family Support in Advanced Cancer http://onlinelibrary.wiley.com/doi/10.3322/canjclin.51.4.213/pdf
Consumer-oriented interventions for evidence-based
prescribing and medicines use: an overview of systematic
reviews (Review)
Sorry about the long entry, but hope this is some help.
James
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Patient and family communication is fundamental to nursing practice, but are there specific interventions or training, evaluated in telling family members the patient is dying, or likely to die very soon?
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Dear Myfanwy,
in my opinion it could be useful to "train" nurses in order to care about "bad-news communicating"; everyday we see doctors that maybe are not so empathyc or have not enough time to explain, answer etc. with family members of a patient.
Although this kind of work has always been linked with the figure of the doctor, I really think that a nurse can do this job and can do it better, because the point is that a nurse has the competence to speak clearly and professionally but has also a "strict relation" with the patient, so a nurse can be more empathyc with families.
In my University, both medicine and nursering courses have lessons about this, although I think it's more something you "have inside" and you understand when you practice in hospital.
Best regards
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Have you heard of situations where there are self (or relative-managed) homes that would cater for people who need care? In other words, there seems to be very few alternatives to nursing homes. There is also the case that there are people who may need to receive more than home care and may wish to share homes with others, but not within an institutional setting.
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Hi Alex,
In the USA, New York State has something called comfort care homes. They are terrific alternative for many people who may not have the resources to die in their own home but prefer a home like setting. The homes are non-profit and rely heavily on volunteers and philanthropic support. Patients are eligible if they have an estimated prognosis of 3 months or less.
Sally
Here is the link and description.
"The Homes for the Dying (Comfort Care Homes) all work on the same model—caring for two people at a time with the help of volunteers and nurses, providing care at no cost to patient or family. A Hospice nursing agency supports the care with nursing, social work, chaplain, and aide visits. Each Home for the Dying acts independently, choosing from the list of referred patients based on their own assessment of who has the greatest need of their help. When a home is interested in offering a bed to someone, the nurse manager of the house will come out to interview the person, bringing pictures of the house to help the person understand what the house might be like. Declining the offer of a bed does not mean that in the future a bed might not be available—-usually when the next bed becomes available; the person would be given another chance to go there."
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I'm looking at information and recommendations to parents. Evidence/research vs custom/old wives tales/folk law.
Guidelines/leaflets/policies you refer to or recommend would be helpful please.
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I have found an article regarding Sid research by Fleming P J and colleagues. Details below.
Arch Dis Child 1999;81:112-116 doi:10.1136/adc.81.2.112
Pacifier use and sudden infant death syndrome: results from the CESDI/SUDI case control study
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Exparel is a medication used in surgery. It is the liposomal version of bupivacaine. The company did 3 "pivotal" trials for its approval (www.fda.gov). 2 of these were against placebo and 1 was against bupivacaine. Exparel did better than placebo, but not better than bupivacaine. The exparel versus bupivacaine study was never published. The 2 placebo trials are heavily marketed.
Exparel is $300 versus $2 for bupivacaine.
I have put together an article with above details as well as other information that shows similar outcomes with exparel and bupivacaine and just submitted to pharmacy journal. However, seems like I should do more.
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There are times in which an expensive version of a drug is effective for an individual while the less expensive one is not. I would urge caution in drawing any conclusions based on one study that is only available from the FDA. That is not to say you should not publish, only use caution.
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Situation: SLP's are often completed, turned in to staff development, and placed on the back burner until such a time that the critical piece of information is needed for patient care. Do we use a buddy system for skill check off? Do our educators check them off? How do we assure our patients that they are receiving the best care?
Researching: Adult Learning Theory, Education Learning Theory, Staff Education, etc.
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As the Clinical Nurse Educator for my facility, it's my job to check off skills and knowledge. However, I have found that not everyone learns best by simply completing packages. Some learn visually, by doing or by listening. I find the best method is a combination of all types of learning, so everyone gets benefit from the particular skill/knowledge. I have also found that, apart from the mandatory training that staff have to do each year, very few are motivated to do additional study, despite the many free opportunities available to them in this form (free, online self-directed learning). This is most likely due to the large amount of mandatory training that must be completed and staff have little time/inclination to do anything 'they don't have to do'.
The learning packages are reviewed usually yearly to 2-yearly to ensure best practice and goes through an onerous process to be approved. I regularly approach staff to see 'how they're going' and if they need help with anything and I have othe