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1
Scullion, Jane. "The Nurse Practitioners’ Perspective on Inhaler Education in Asthma and Chronic Obstructive Pulmonary Disease." Canadian Respiratory Journal 2018 (August 5, 2018): 1–9. http://dx.doi.org/10.1155/2018/2525319.
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Asthma and chronic obstructive pulmonary disease (COPD) can be debilitating conditions adversely affecting a person’s quality of life. Effective treatments are available, but common errors in the use of inhalers compound the issue of disease control. The beliefs and concerns of a patient can also have an impact on treatment adherence, the consequences of which are diminished disease control and the occurrence of exacerbations. Once a treatment has been prescribed, it is often nurses who manage the patient long-term, and they may even be the main care provider. This puts nurses in a key position to monitor inhaler technique, communicate with the patient to improve adherence, and even suggest alternative treatments if the patient and therapy are incompatible. This review examines the central role that nurses play in disease management and emphasizes how effective inhaler education can make a difference to disease control. Good communication between the nurse and patient is vital if this is to be achieved. Recent updates to asthma and COPD guidelines are reviewed, and key resources available to help manage patients are highlighted. Finally, with regard to inhaler education, we reconsider the nursing keystones of “Know it,” “Show it,” “Teach it,” and “Review it.”
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Zhao, Yongmei, Min Liu, Zhihong Fan, Jinjing Li, Ling Shi, Yixin Zhang, Yuerui Gong, and Wei Yang. "Application of Audio Education in Respiratory Medicine Wards." Clinical Nursing Research 29, no. 6 (February 17, 2019): 392–97. http://dx.doi.org/10.1177/1054773819829622.
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Improving the efficiency of patient education can help improve patient’s satisfaction and alleviate the pressure of nurse shortage. This study aimed to develop and pilot an educational audio to improve the effectiveness of inpatient education. A primary literature review was conducted and educational materials were written and recorded by MP3. A pilot study was conducted in 713 adult patients in the department of respiratory medicine at a large urban Shanghai teaching hospital. Patients in the experimental group showed greater satisfaction with their health education. For the education to be effective during the admission, the asthma patients in the experimental group spent less time in face-to-face communication. The feedback rate for disease education among asthma patients in the experimental group was significantly higher. Wider applications of audio in patient education may be valuable to better adjust to nurse reduction and to improve nursing service quality.
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Henry, Heather. "Understanding personal asthma action plans." Practice Nursing 32, no. 3 (March 2, 2021): 96–100. http://dx.doi.org/10.12968/pnur.2021.32.3.96.
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Personal asthma action plans are an essential tool to keep people with asthma as well as possible. Heather Henry explains the role of the practice nurse in developing them Personal asthma action plans (PAAPs) are written plans that help people with asthma to self-care and keep themselves as well as possible. PAAPs are usually developed in partnership with the patient or carer in primary care. PAAPs aim to ensure that people with asthma know how to manage their asthma and when to seek help if their condition deteriorates. To manage their asthma adequately at home, patients will need regular education about what asthma is, an understanding of their triggers, how their medications work and managing their devices. The practice nurse can play a key role in developing the PAAP, monitoring asthma control, and subsequently modifying the PAAP if necessary to maintain control of the condition.
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Henry, Heather. "Understanding personal asthma action plans." Journal of Prescribing Practice 3, no. 9 (September 2, 2021): 370–74. http://dx.doi.org/10.12968/jprp.2021.3.9.370.
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Personal asthma action plans (PAAPs) are written plans that help people with asthma to self-care and keep themselves as well as possible. PAAPs are usually developed in partnership with the patient or carer in primary care. PAAPs aim to ensure that people with asthma know how to manage their asthma and when to seek help if their condition deteriorates. To manage their asthma adequately at home, patients will need regular education about what asthma is, an understanding of their triggers, how their medications work and managing their devices. The practice nurse can play a key role in developing the PAAP, monitoring asthma control, and subsequently modifying the PAAP if necessary to maintain control of the condition.
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Gresko, Susan, and Elizabeth Burgess Dowdell. "Perceptions of Pediatric Nurse Practitioners and How a Pulmonary Function Printout Influenced Practice." Nursing Research and Practice 2012 (2012): 1–7. http://dx.doi.org/10.1155/2012/794585.
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The rate of asthma in the pediatric population has risen over the last two decades and is now considered to be the most common serious chronic disease in children and adolescents as well as a serious public health concern. In one suburban, Pennsylvania nurse-managed clinic, a group of pediatric nurse practitioners (PNPs), noted an increase in the number of children with asthma and purchased a pulmonary function machine (Spirometer). The purpose of this paper is to discuss how the integration of a pulmonary function measurement printout influenced a small group of PNPs visit satisfaction, their delivery of nursing care, and the response of the families. As the incidence of asthma increases in the pediatric population, nurse practitioners and other healthcare professionals can take a leading role in patient teaching and provision of care by augmenting their practice with new technology combined with continued education for the client and family.
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Condren, Michelle, and James A. Boger. "Impact of a Pediatric Clinic-Based Multidisciplinary Asthma Education and Management Program." Journal of Pediatric Pharmacology and Therapeutics 10, no. 4 (October 1, 2005): 254–58. http://dx.doi.org/10.5863/1551-6776-10.4.254.
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OBJECTIVE The objective of this study was to determine if a multidisciplinary asthma education and management program within a general pediatric clinic impacts clinical outcomes of children with asthma. METHODS An asthma education and management clinic was started by a general pediatrician, a pharmacist, and a nurse. At a patient's initial clinic visit, data were collected summarizing hospitalizations, emergency department visits, and number of systemic corticosteroid courses for the previous year. The same data were collected at each subsequent visit. A retrospective review of this data was performed for patients who enrolled in the clinic between February 1999 and 2002 to compare outcomes between the year before enrollment in the clinic and the following year. Patients were included if they received follow-up for at least one year. RESULTS Fifty-seven patients with a mean age of 8.5 years qualified for data analysis. Forty-eight percent of the study population was classified as having moderate persistent asthma, and 11% of patients were severe persistent. Compared to the year prior to clinic enrollment, the number of hospitalizations per patient decreased by 82% (P < .001). Emergency department visits decreased by 81% (P < .001). The number of systemic corticosteroid courses decreased by 72% (P < 0.001). CONCLUSIONS Patient enrollment in a general pediatric clinic-based multidisciplinary asthma education and management program decreases hospitalizations, emergency department visits, and systemic corticosteroid exposure.
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Mudd, Shawna S., and JoAnne Silbert-Flagg. "Implementing the Flipped Classroom to Enhance Nurse Practitioner Clinical Decision-Making in the Care of the Pediatric Asthma Patient." Nursing Education Perspectives 37, no. 6 (2016): 352–53. http://dx.doi.org/10.1097/01.nep.0000000000000083.
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Vlahadamis, Ann, Melanie Danilak, Krista M. Rawson, Karen M. King, and Edith Pituskin. "Group medical appointments: A novel approach in patient education for adjuvant endocrine therapy." Journal of Clinical Oncology 31, no. 26_suppl (September 10, 2013): 133. http://dx.doi.org/10.1200/jco.2013.31.26_suppl.133.
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133 Background: Group medical appointments (GMA) are currently practiced for a wide range of medical conditions such as diabetes, hypertension, asthma, and cardiovascular disease. Previously, postmenopausal estrogen receptor positive breast cancer patients (ERBCP) attended individual physician clinic appointments to learn about their options for adjuvant endocrine therapy. This resulted in variable education provided, lengthy medical oncologist (MO) clinic visits and significant wait-lists to attend clinic. Accordingly, we embarked on a pilot program to determine the feasibility and acceptability of GMA in this patient population. Methods: Since 2010, ERBCP requiring endocrine therapy were referred and scheduled in the biweekly GMA program. Education regarding choices, risks, benefits and side effects of endocrine therapy were provided by a nurse practitioner (NP) and/or pharmacist (RX). After questions were solicited from the group, individual ERBCP were provided with prescriptions and scheduled for guideline-based follow-up. Results: Approximately 900 ERBCP have attended GMA, with 100% of MOs referring eligible patients. Surveys indicate high levels of satisfaction with the information provided and the GMA format. Conclusions: GMA provided by NP and/or RX is feasible and acceptable to both ERBCP and MOs. Health system benefits include increased efficiency and reduced cost, with MO clinic reserved for complex patient needs. Patient benefits include timely access to care and high levels of reported satisfaction. Future work will examine the effects of GMA on patient compliance and medication reconciliation with endocrine therapy.
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Liu, Wei, Elizabeth Manias, and Marie Gerdtz. "Exploring power relations embedded in medication communication processes on general medical wards." Qualitative Research Journal 14, no. 2 (July 8, 2014): 161–78. http://dx.doi.org/10.1108/qrj-06-2013-0041.
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Purpose – The purpose of this paper is to examine power relations embedded in verbal and non-verbal medication communication processes that involve nurses, doctors, pharmacists and patients in two general medical wards of an acute care hospital. Design/methodology/approach – This paper reports on the findings of an ethnographic study investigating medication communication processes in hospital spatial environments. It was theoretically informed by the work of Norman Fairclough. Data collection methods comprising video-recordings and video reflexive focus groups were employed. Fairclough's critical discourse analytic framework guided data analysis. Findings – Four different forms of power relations between clinician-patient, nurse-doctor, clinician-organisation and multidisciplinary interactions were uncovered. Nurses asserted their professional autonomy when communicating with doctors about medications by offering specific advice on medical prescribing and challenging medication decisions. Video reflexivity enabled nurses to critically examine their contribution to medication decision-making processes. Clinicians of different disciplines openly contested the organisational structure of patient allocation during medical discussions about management options. Clinicians of different disciplines also engaged in medication communication interchangeably to accomplish patient discharge. Originality/value – An investigation of existing power relations embedded in medication communication processes within specific clinical contexts can lead to a better understanding of medication safety practices. Video reflexive focus groups are helpful in encouraging clinicians to reflect on their practice and consider ways in which it could be improved in how power relations are played out.
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Kramer, Hannah, and Rebecca Batt. "Anaphylaxis: how to recognise and manage in primary care." Practice Nursing 32, no. 6 (June 2, 2021): 232–36. http://dx.doi.org/10.12968/pnur.2021.32.6.232.
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Anaphylaxis is a life-threatening emergency. Hannah Kramer and Rebecca Batt explain how correct diagnosis, avoidance and patient education are fundamental in reducing risk Anaphylaxis is a serious systemic hypersensitivity reaction that is usually rapid in onset and can cause death. It is an immune-mediated reaction, which typically occurs when a person is exposed to a trigger, for example a food, drug, or insect sting. This article aims to assist with the recognition of symptoms and to guide management of anaphylaxis in primary care. Beyond the acute, the practice nurse can play a key role in helping patients to manage their allergies in the long-term, particularly for those who are most vulnerable. Patients should be supported in understanding how best to avoid their triggers, in managing their emergency medication, and in the importance of good asthma control.
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Anastasaki, Marilena, Maria Trigoni, Anna Pantouvaki, Marianna Trouli, Maria Mavrogianni, Niels Chavannes, Jillian Pooler, et al. "Establishing a pulmonary rehabilitation programme in primary care in Greece: A FRESH AIR implementation study." Chronic Respiratory Disease 16 (January 1, 2019): 147997311988293. http://dx.doi.org/10.1177/1479973119882939.
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Pulmonary rehabilitation (PR) is an evidence-based, low-cost, non-medical treatment approach for patients with chronic respiratory diseases. This study aimed to start and assess the feasibility, acceptability and impact of a PR programme on health and quality of life of respiratory patients, for the first time in primary care in Crete, Greece and, particularly, in a low-resource rural setting. This was an implementation study with before–after outcome evaluation and qualitative interviews with patients and stakeholders. In a rural primary healthcare centre, patients with chronic obstructive pulmonary disease (COPD) and/or asthma were recruited. The implementation strategy included adaptation of a PR programme previously developed in United Kingdom and Uganda and training of clinical staff in programme delivery. The intervention comprised of 6 weeks of exercise and education sessions, supervised by physiotherapists, nurse and general practitioner. Patient outcomes (Clinical COPD Questionnaire (CCQ), COPD Assessment Test (CAT), St. George’s Respiratory Questionnaire (SGRQ), Patient Health Questionnaire-9 (PHQ-9), Incremental Shuttle Walking Test (ISWT)) were analysed descriptively. Qualitative outcomes (feasibility, acceptability) were analysed using thematic content analysis. With minor adaptations to the original programme, 40 patients initiated (24 with COPD and 16 with asthma) and 31 completed PR (19 with COPD and 12 with asthma). Clinically important improvements in all outcomes were documented (mean differences (95% CIs) for CCQ: −0.53 (−0.81, −0.24), CAT: −5.93 (−8.27, −3.60), SGRQ: −23.00 (−29.42, −16.58), PHQ-9: −1.10 (−2.32, 0.12), ISWT: 87.39 (59.37, 115.40)). The direct PR benefits and the necessity of implementing similar initiatives in remote areas were highlighted. This study provided evidence about the multiple impacts of a PR programme, indicating that it could be both feasible and acceptable in low-resource, primary care settings.
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Godden, D. J., A. Robertson, N. Currie, J. S. Legge, J. A. R. Friend, and J. G. Douglas. "Domiciliary Nebuliser Therapy — A Valuable Option in Chronic Asthma and Chronic Obstructive Pulmonary Disease?" Scottish Medical Journal 43, no. 2 (April 1998): 48–51. http://dx.doi.org/10.1177/003693309804300207.
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Domiciliary nebulisers are in widespread use for patients who have severe chronic airways disease, both asthma and chronic obstructive pulmonary disease (COPD). We report a study of the use of domiciliary nebulisers designed to assess practical problems and the value of such therapy in preventing hospital admissions. A total of 405 patients underwent a structured interview at home and their case records were reviewed. Technical performance of the nebuliser compressors was assessed The mean (SD) age of those interviewed was 64.5 (12) years. 185 patients had a physician diagnosis of asthma, and 208 had COPD. 87% patients used their nebuliser at least once daily. Side effects, reported by 54%, were related to frequency of use and commoner in younger patients. 29 subjects (7%) died within 2 years of receiving their nebuliser. Among the survivors, the 2 year periods before and after supply of the nebuliser were compared The percentage of patients requiring hospital admission for exacerbations of lung disease fell from 56% to 46% (p<0.01) but the number and duration of admissions was unchanged Those whose admission duration increased had more severely impaired spirometry when the nebuliser was supplied and had lower activity scores and higher breathlessness scores at the time of interview indicating more severe disease. Approximately half of the compressors were malfunctioning and patients' understanding of the principles of nebuliser treatment was poor. The provision of domiciliary nebuliser can influence hospital admission inpatients with obstructive airways disease. There is also a need for improved patient education and for technical support which may require the development of a nurse-run nebuliser service.
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Gregersen, A. G., M. T. Hansen, S. E. A. Brynhildsen, V. A. Grøndahl, and A. C. Leonardsen. "Students’ Perspectives on Learning Practical Nursing Skills: A Focus Group Study in Norway." Nursing Research and Practice 2021 (April 9, 2021): 1–9. http://dx.doi.org/10.1155/2021/8870394.
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Practical nursing skills are complex and involve technical, theoretical, and practical aspects, caring perspectives adjusted to both patient and circumstances, as well as ethical and moral considerations. Patients’ length of stay in hospitals is decreasing, and more advanced patient treatment is conducted in primary healthcare settings. Hence, education and nursing skills need adjustment in line with the rapidly evolving field of practice. Studies emphasize a need to uncover whether the technical aspect of nursing skills, in general, is challenging in students’ learning. The aim of this study was to explore students’ perspectives on practical nursing skills and how they can best learn these. Three focus group interviews were conducted with registered nurse students and intellectual disability nurse students in their last semester (n = 11). Conventional, inductive content analysis in line with recommendations from Hsieh and Shannon was used to analyze the data. Two main categories with subcategories were identified: (1) the content of practical skills, with subcategories (a) human-to-human relations, (b) organizational competence, and (c) technical mastering and (2) building competence, with subcategories (a) need for supervision, (b) planning the learning situations, and (c) relevance for practice. Students experienced that practical skills did not only include technical aspects but also the ability to establish a relationship to the patient and to organize their working day. Supervising was assumed as essential both when training in the simulation center and in clinical placement, as well as planning of the training, respectively. Students experienced that some skills learned in the university college were less relevant in clinical practice and that certain skills were difficult to perform in practice due to the type of clinical placement. Hence, there is a need to review the approach to and content of practical nursing skills’ learning in healthcare undergraduate programs, to prepare students for clinical practice, and to ensure that they build the competence needed in healthcare services.
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Brofidi, Kalliopi, Konstantinos Vlasiadis, and Anastas Philalithis. "Assessment of the nursing practice environment in Greek Hospitals: a cross-sectional study." Journal of Research in Nursing 23, no. 6 (August 12, 2018): 535–45. http://dx.doi.org/10.1177/1744987118788705.
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Background The organisational characteristics of the nursing practice environment play a crucial role in nurses’ job satisfaction, job retention, quality-of-care service provision and patient outcomes. The widely used Practice Environment Scale of the Nursing Work Index assesses the favourability of these traits, showing the grade of magnetism of these factors in the workplace. Aims and methods This study aims to assess the nurse working environment at five public hospitals in Greece, and to compare these data with those of Magnet and non-Magnet hospitals. The Practice Environment Scale of the Nursing Work Index was completed by 532 nurses. Results Findings have shown that all five hospitals were assessed by nurses as unfavourable working environments. Four of five subscales were identified as unfavourable by the participants and only Collegial Nurse-Physician Relations were evaluated as a positive organisational trait. The mean scores in all five subscales of favourability were significantly lower than the corresponding scores of non-Magnet hospitals in the US. Conclusions The present study shows the favourability grade of Greek hospitals. When compared with Magnet and non-Magnet hospitals in the US, Greek hospitals were perceived as more unfavourable than non-Magnet hospitals. Action to improve the current situation must be taken by hospital management, supporting nurse involvement, continuous education, changing human resources management and adopting evaluation procedures.
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Gessling, Aliya, Mary Rank, Deborah Larson, Ann Soloway, Jessica Langston, and Quy Tran. "COVID-19 and advance care planning: A unique opportunity." Journal of Clinical Oncology 39, no. 28_suppl (October 1, 2021): 32. http://dx.doi.org/10.1200/jco.2020.39.28_suppl.32.
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32 Background: Advance Care Planning (ACP) is a process to document patient preferences for future health care. Conversations between healthcare providers, patients, and loved-ones are required to reflect a patient’s values, goals, and ultimately their choices for life-sustaining treatments (LST). The COVID-19 pandemic has highlighted the critical importance of these discussions and the need for improved patient engagement. Methods: As COVID-19 infections surged, the VA Northern California Health Care System (VA NCHCS) Hospice and Palliative Care Section (HPCS) partnered with Patient Aligned Care Teams to expand urgent outreach to high-risk patients needing LST documentation. High risk was defined as age > 80, COPD or asthma diagnosis, or Care Assessment Need Score > 80 (CAN Score models risk of hospitalization or death within 1 year). An experienced HPCS Nurse Practitioner (NP) contacted these identified patients to 1.) provide COVID-19 education, 2.) conduct a high-quality goals of care conversation, and 3.) complete LST documentation and other ACP needs. A representative cohort was then followed up to evaluate concordance of treatment with their documented preferences. Results: Between March 2020 and September 2020, 910 patients were identified as high risk. Of these patients, 294 agreed to participate in the telehealth visit and complete LST documentation. Importantly, 108 (37%) patients chose DNR and other LST limitations. In addition, 142 (48%) patients created POLST documentation and 128 (43%) completed Advance Directives. Over 70% of patients who were hospitalized in the VA received care concordant with the newly documented LST preferences. A follow up survey of 29 participants found the outreach impactful and their preferences documented correctly. Conclusions: Prior studies have demonstrated success at educating primary providers to conduct ACP discussions, but given the limitations imposed by COVID-19 restrictions, this novel and highly cost-effective process of coupling a highly trained HPCS NP with a primary care team to perform ACP was piloted with success. After only a single ACP discussion, patients were able to formalize their limits to treatment and subsequent care aligned with these preferences. Patients also found this focused ACP discussion meaningful. This pathway will be integrated within the VA NCHCS as a long-term approach to continued ACP outreach.
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Semenoh, Olena, and Olena Kravchenko. "PROFESSIONAL ETHICS IN LINGUA-CULTURAL DIMENSIONS: AMERICAN EXPERIENCE." Aesthetics and Ethics of Pedagogical Action, no. 16 (September 9, 2017): 70–83. http://dx.doi.org/10.33989/2226-4051.2017.16.175981.
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The article outlines the concepts "nurse", "professional ethics of nurses." The professional ethics of nurses has been defined as a component of medical ethics which studies moral consciousness, moral and ethical aspects of professional activity, moral principles and values that regulate the moral relationship between s nurse and s patient, the patient's family, other members of the medical community and community. The analysis of foreign and Ukrainian experience of formation of nurses’ professional ethics gives grounds to characterize the quality as a set of interrelated cognitive, praxeological, communicative components; their presence allows to interact productively with the professional and social environment on the basis of professionally important ethical knowledge, skills, professional important qualities that are aimed at the effective organization of the medical-preventive process and the solution of professional tasks. The content of the professional ethics of a future nurse consists of ethical categories and professionally important ethical qualities such as: professional duty, responsibility, dignity, conscience, honor, respect, mercy, empathy, tolerance.The peculiarities of educational programs of future licensed younger nurses training (LPN) in the United States aimed at the formation of professional ethics have been outlined. A review of the linguistic- cultural aspect of the formation of nurses’ professional ethics at American higher education institutions has been conducted. The experience of classes on "Nursing Ethics", "Foreign Language" at Cherkasy Medical Academy has been presented; they are aimed at understanding the world of the profession, the culture of communication in medical community, ethical behavior, moral relations, prevention of conflict situations, and provision of psychological support.
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Jović, Duška, Darija Knežević, and Nataša Egeljić-Mihailović. "Problems of graduate nurses in everyday practice / Problemi diplomiranih medicinskih sestara u svakodnevnoj praksi." SESTRINSKI ŽURNAL 2, no. 2 (October 21, 2015): 5. http://dx.doi.org/10.7251/sez0215005j.
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The importance of nurses in the Republic of Serbian is still not sufficiently recognized, and it can be said that the role of nurses in the region and in our country, undervalued. The health care system of the Republika Srpska is still no systematization which would define the role of nurses with different levels of education. This leads to animosity between graduate nurses and other health care team members, and the greatest damage suffered by patients.The aim of this study is to assess the objective, everyday work problems graduate nurses in the Republika Srpska and their comparison with similar or the same problems faced by nurses at work in other countries. Used the method of literature review in the international databases in the period from 21.12.2014 to 31.12.2014.The main problems that nurses face in their daily work are: relationship nurse-patient ratio of nurses to patients, communication between nurses and doctors, the relationship between nurses. The comparative analysis shows that all of these problems in a negative way more pronounced in the Republika Srpska healthcare than anywhere else in the world. Although our nurses have sufficient knowledge, skills and tenacity to overcome these problems, but they are not set as leaders of teams of health care as in the world, but are systematically pushed aside. The result of such relations is that a large number of graduate nurses each year go into the European Union countries where their diploma appreciates and have economic values.
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Mararash, H. "Medical and social factors and quality of life in patients with arterial hypertension: the role of the nurse." Bukovinian Medical Herald 24, no. 4 (96) (November 26, 2020): 48–57. http://dx.doi.org/10.24061/2413-0737.xxiv.4.96.2020.102.
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The paper examines the role of medical and social factors, general well-being, and quality of life in patients with hypertension. The role of the nurse of the therapeutic department in the preventive training of patients is emphasized to form a healthy lifestyle and reduce the pathogenic impact of negative social factors.Objective – substantiation of the main measures for prevention of hypertension and improvement of quality of life by studying medico-social and social factors of patients' quality of life with arterial hypertension by nurses.Material and methods. The survey (by questionnaire) involved 120 patients with arterial hypertension consulted at the Municipal Institution "Polyclinic №1" in Chernivtsi, including: men – 43.3%, women – 56.7% aged from 23 to 79 years. With the help of the questionnaires, medical and social, sociological factors of influence, general well-being and quality of life were studied. The research was conducted according to all ethical rules, in particular, in compliance with the principles of voluntariness, confidentiality, research integrity. The results of the study were processed by conventional statistical methods using computer packages STATISTICA 10 and presented by the appropriate number of observations, percentages, and the exact value of p.Results. I and II degree AH prevailed among the examined individuals, and burdened heredity was found in 62.5% (75 people). Insufficient amount of vegetables and fruits, fish in the diet and salt intake of more than 5 g per day (60%) was found. The vast majority of respondents had a secondary special, less of respondents – higher education. Social status survey: 71.62% were employed, most worked full time. According to the survey, 22.09% of people noted excellent working conditions, 38.37% – good, satisfactory – 25.58%, and 13.96% poor working conditions. It was found that the percentage of patients (60.47%), among whom there are excellent and good sanitary and working conditions, exceeds the percentage of respondents with satisfactory and poor working conditions (39.53%). The majority of respondents (53.49%) indicated satisfactory and poor psychological working conditions, which slightly exceeded the number of employees with excellent and good working conditions (46.51%). The advantage of assessing excellent and good material and technical working conditions over excellent and good psychological conditions (60.47% vs. 46.51%) was revealed. The financial condition of the majority of respondents was assessed as average (42.5%). The level of QOL fluctuated from very high to extremely low. Factors that led to a decrease in the level of QOL are the following: the indicator of "health" (1.44), "social status" (1.48), "job satisfaction" (1.59), "social activity" (1.62). Social factors such as financial difficulties, additional work to increase income were reported as negative during the last 6 months by every second patient; deterioration of mutual understanding, deterioration of relations: husband / wife, children, parents, friends, the threat of unemployment for relatives – every third respondent.Conclusions 1. 120 Patients with hypertension have a burdened heredity (62,5%), insufficient consumption of the recommended amount of vegetables and fruits (25,83%), fish in the diet (12,5%), and excessive salt consumption (60%); the predominance of people is with secondary special education and workers (71,62%) with excellent and good sanitation and satisfactory and poor psychological working conditions (39,53%), with an average financial situation (42,5%) and fluctuations in the level of QOL from very high to extremely low. 2. Hypertension worsens the QOL of patients, which is manifested by a decrease in both physical and psychological states. 3. The ability of patients to adequately perceive their disease and form attitudes toward treatment and prevention depends on the level of education. 4. Social support, training and diagnosis of hypertension are significant predictors of commitment to prevention and treatment. 5. Education of patients with hypertension on the principles of a healthy lifestyle by nurses, assistance in reducing the pathogenic impact of negative social factors, the constant promotion of medical knowledge will contribute to the formation of a responsible attitude to maintaining their own health, prevent complications, improve the QOL and social adaptation.
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Manwani, Deepa, Veronica Carullo, Michael Rinke, Steven Choi, and Catherine Driscoll. "Reducing Health Care Utilization in Sickle Cell Disease Patients By Implementation of an Individualized, Multimodal Care Plan during Hospital Admission and at Inpatient to Outpatient Discharge." Blood 124, no. 21 (December 6, 2014): 444. http://dx.doi.org/10.1182/blood.v124.21.444.444.
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Abstract Background: SickleCell Disease (SCD) is a chronic illness characterized by vaso-occlusive complications leading to unpredictable episodes of pain, cumulative organ damage and high health care utilization rates. National estimates of total hospital costs for sickle cell related hospitalizations are approximately $488 billion (Steiner 2006). 30 day readmission rates are used as a quality metric for a variety of chronic diseases: 33% of patients with SCD are readmitted within 30 days, compared to 3.4% for asthma, 12% for pneumonia, 16% for heart failure and 20% for diabetes (Brousseau 2010, Berry 2011). Multiple factors contribute to this high utilization rate and not all are modifiable. Increasing age and psychosocial comorbidities are associated with a greater length of stay (LOS). 18-30 year old patients, public insurance and admissions for pain crisis are associated with a higher 30 day readmission rate. Lack of outpatient follow up with a trained hematologist following hospital admission has been demonstrated to increase SCD readmission rates (Leschke 2012). Debaun et al have noted that written discharge management guidelines alone had low utilization rates, however when intensive ongoing patient and provider education by a nurse educator was also included, the 30 day readmission rate decreased from 28 to 11% (Frei-Jones 2009). Hydroxyurea responders have been shown to have a reduced LOS. Hypothesis: Implementation of an individualized, multimodal care plan during inpatient stay and at inpatient to outpatient discharge will reduce acute care utilization. It is likely that the implementation of the comprehensive care plan at this key transition point will be more effective due to (1) greater psychological readiness in the patient/ family to accept escalation of care soon after an acute event (2) decreased instances of “missed opportunities” in the event that the patient does not follow up with a provider with sickle cell specific expertise and (3) improvement in communication amongst inpatient providers, outpatient providers with specific hematology expertise and the multi-disciplinary team. Methods: A SCD quality improvement effort was initiated at The Children’s Hospital at Montefiore (CHAM) in July 2012 with the specific goals of reducing the 30 day readmission rates and length of stay (LOS). Secondary endpoints included admission rates, ED return rates and cost savings. Our efforts were directed at consistent and comprehensive implementation of best-practice guidelines, improved pain management strategies, a multimodal approach to patient care, andutilization of the hospital admission as an opportunity to design a comprehensive care plan. Representatives from the inpatient team, the primary hematologists, nursing, social work, psychology and pain management met weekly to create the care plan. A pre–post design was utilized, comparing data 3.5 years before to 1 year after the initiation of the transition intervention. Results: A significant reduction rate in LOS by 10% and 30 day readmission rate by 37%, with even greater gains in the 18-21 year age group was noted. This was not accompanied by an increase in ED visits (3 and 7 days) and in fact there was a significant reduction in the 3 day ED return rate in older patients. We also saw an overall reduction in the SCD inpatient admission rate by 22% and increase in hydroxyurea use. Table 1: Outcomes from the ongoing SCD Quality Improvement project Number of admissions 3 Day ED Return (%) 7 Day ED Return (%) 30 Day Readmission Rate % LOS (days) < 18 years National Average 17 4.21 Before 556 3.3 0.95 18.1 4.1 After 140 3.4 1.01 14.7 4.0 p-value 0.9 0.8 0.059 0.6 ≥ 18 years National Average 41.1 6.8 Before 1685 11.5 0.9 41.4 6.6 After 592 5 2.1 18.6 5.4 p-value 0.02 0.2 <0.0001 0.04 All Ages Before 2241 5 0.94 24 4.7 After 732 3 1.23 15 4.2 p-value 0.8 0.52 <0.001 0.018 * “Before” and “After” represent data prior to and after the implementation of the ongoing QI initiatives respectively Conclusion: We demonstrate the feasibility of reducing acute care utilization in SCD patients, with the implementation of an individualized, multimodal, comprehensive care plan during hospital admission and at discharge. Disclosures No relevant conflicts of interest to declare.
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Peña-Pita, Amalia Priscila, and Beatriz Pérez-Giraldo. "Aplicación de la teoría de Peplau en pacientes con diabetes hospitalizados." Revista Ciencia y Cuidado 13, no. 2 (December 30, 2016): 42. http://dx.doi.org/10.22463/17949831.762.
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Objetivo: aplicar la teoría de las relaciones interpersonales de H. Peplau en la atención a pacientes con diabetes mellitus tipo 2, para mostrar su importancia en la práctica clínica hospitalaria y en la prevención de las complicaciones de las personas con esta enfermedad en el hogar. Materiales y Métodos: la experiencia clínica desarrollada se organizó mediante una adaptación de la metodología del marco lógico. La muestra estuvo conformada por cinco pacientes hospitalizados con diabetes mellitus tipo 2. Se tuvo en cuenta variables como la relación profesional de enfermería paciente, nivel de conocimiento y capacidad de cuidado. Las técnicas de recolección de información fueron la entrevista semiestructurada, el taller (intervención educativa) y la lista de chequeo. Resultados: la aplicación de la teoría de H. Peplau permitió un acercamiento con los pacientes. A partir de éste, se logró un proceso de educación y seguimiento en el cual la mayoría reconoció la importancia de las prácticas preventivas para el manejo de su condición clínica. Conclusiones: mediante el fortalecimiento de las relaciones interpersonales, orientado por la teoría de H Peplau, la (el) enfermera (o) y el paciente identifican las necesidades de cuidado con el fin de atenderlas y generar conductas preventivas para evitar complicaciones por la enfermedad. De esta forma, tanto los pacientes como el profesional de enfermería logran tener un mayor nivel de autonomía. PALABRAS CLAVE: educación en enfermería, diabetes mellitus tipo 2, relaciones interpersonales, teoría de enfermería.Application of the Peplau theory in hospitalized diabetic patients ABSTRACTObjective: apply the H.Pelau theory of interpersonal relations in the care of patients with diabetes mellitus type 2, to show its importance in the hospital clinical practice and in the prevention of complications on individuals with this disease at home. Materials and Methods: the clinical experience developed was organized through an adaptation of the logical framework methodology. The sample was composed of five hospitalized patients with diabetes mellitus type 2. Variables as the nurse-patient professional relationship, level of knowledge and care ability were taken into consideration. The collection techniques were: semi-structured interview, workshop (educational intervention) and check list. Results: the application of the H. Pelau theory allowed an approach with the patients. From this start point, a process of education and monitoring was achieved, wherein most recognized the importance of the preventive practices for the handling of their clinical condition. Conclusions: through the strengthening of interpersonal relations, oriented by the H. Pelau theory, the nurse or patient identify the care necessities in order to assist and generate conducts to prevent disease complications from the disease. Therefore, patients and nursing professionals are able to have a higher autonomy level. KEYWORDS: education, nursing, diabetes mellitus type 2, interpersonal relations, nursing theory.Aplicação da teoria de Peplau em pacientes com diabetes hospitalizados RESUMOObjetivo: aplicar a teoria das relações interpessoais de H. Peplau no atendimento a pacientes com diabetes mellitus tipo 2, para mostrar sua importância na prática clínica do hospital e na prevenção das complicações das pessoas com esta doença no lar. Materiais e Métodos: a experiência clínica desenvolvida se organizou através de uma adaptação da metodologia do marco lógico. A amostra esteve conformada por cinco pacientes hospitalizados com diabetes mellitus tipo 2. Teve-se em conta variáveis como a relação professional de enfermagem - paciente, nível de conhecimento e capacidade de cuidado. As técnicas de recolecção de informação foram: uma entrevista semiestruturada, um workshop (intervenção educativa) e uma lista de verificação. Resultados: a aplicação da teoria de H. Peplau permitiu uma aproximação com os pacientes. A partir disto, foi alcançado um processo de educação e acompanhamento, em que a maioria reconheceu a importância das práticas preventivas para o manejo de sua condição clínica. Conclusões: através do fortalecimento das relações interpessoais orientado pela teoria de H Peplau, a (o) enfermeira (o) e o paciente identificam as necessidades de cuidado com o fim de atendê-las e gerar condutas preventivas para evitar complicações pela enfermidade. Desta forma, ambos os pacientes e os professionais de enfermagem podem alcançar maior nível de autonomia. PALAVRAS-CHAVE: educação em enfermagem, diabetes mellitus tipo 2, relações interpessoais, teoria de enfermagem.
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Brandão-Neto, Waldemar, Andrea Rosane Sousa Silva, Estela Maria Leite Meirelles Monteiro, Clara Maria Silvestre Monteiro Freitas, Inacia Sátiro Xavier França, and Carla Campos Muniz Medeiros. "Education in health as a tool of nursing care: integrative literature review." Revista de Enfermagem UFPE on line 5, no. 6 (July 10, 2011): 1541. http://dx.doi.org/10.5205/reuol.1262-12560-1-le.0506201130.
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ABSTRACTObjective: to know the Brazilian scientific productions on the actions of education in health as a tool of the care provided by nurses, published from 2000 to 2010. Methodology: this is an integrative review study that used the descriptors health education and, nursing care, whose search was carried out in the databases LILACS and BDENF. Eleven publications were selected, those which met the inclusion criteria and answered the guiding question: what is the scientific knowledge produced nationally and the strategies used with regard to the actions of health education within the nursing care? Results: through the critical reading and the synthesis of publications it was possible to show the studies valued, besides the technical assistance attention, spaces of listening and socialization with effective strategies which provide the educational process with a dialogic and participative mode. Conclusion: in the relation of nurses with the care subjects, it is essential to overcome postures of accommodation and the (re)construction of acting scenes capable of renewing the attitudes in health, in a tune where the care-educate brings together science, ethics, art, aesthetics, politics, and culture. Descriptors: education in health; education in nursing; nursing care; nurse-patient relations; health promotion.RESUMOObjetivo: conhecer as produções científicas nacionais que abordaram as ações de educação em saúde como ferramenta do cuidado realizado pelo enfermeiro, publicadas no período de 2000 a 2010. Metodologia: trata-se de um estudo de revisão integrativa que utilizou os descritores educação em saúde e cuidado de enfermagem, com busca realizada nas bases de dados LILACS e BDENF. Foram selecionadas onze publicações que atenderam os critérios de inclusão e responderam a questão norteadora: qual é o conhecimento científico produzido nacionalmente e as estratégias utilizadas em relação às ações de educação em saúde no âmbito do cuidado de enfermagem? Resultados: por meio da leitura crítica e síntese das publicações foi possível evidenciar que os estudos valorizaram, além da atenção assistencial técnica, espaços de escuta e socialização com o estabelecimento de estratégias que efetivam o processo educativo de modo dialógico e participativo. Conclusão: na relação dos enfermeiros com os sujeitos do cuidado, torna-se essencial a superação de posturas de acomodação e a (re)construção de cenários de atuação capazes de renovar o agir em saúde, numa sintonia em que o cuidar-educar faz convergir ciência, ética, arte, estética, política e cultura. Descritores: educação em saúde; educação em enfermagem; cuidados de enfermagem; relações enfermeiro-paciente; promoção da saúde.RESUMENObjetivo: conocer las producciones científicas nacionales que abordaron las acciones de educación en salud comoherramienta de atención de enfermería, publicadas entre 2000 y 2010. Metodología: se trata de un estudio de revisión integrativa que utilizó los descriptores educación en salud y cuidado de enfermería, con búsqueda en las bases de datos LILACS y BDENF. Se seleccionaron once publicaciones que cumplían con los criterios de inclusión y que respondieron a la pregunta clave: ¿cuál es el conocimiento científico producido a nivel nacional y las estrategias utilizadas en relación a las acciones de educación en salud en el cuidado de enfermería? Resultados: por medio de la lectura crítica y síntesis de las publicaciones, fue posible evidenciar que los estudios valoran, además de la atención asistencial técnica, espacios de escucha y socialización con el establecimiento de estrategias para realizar el proceso educativo de manera dialógica y participativa. Conclusión: en la relación de los enfermeros con los sujetos del cuidado, tórnase esencial la superación de posturas de pereza y la (re)construcción de senarios de acción capaces de renovar las actitudes en salud, en una sintonía en la cual el cuidar-educar hace convergir ciencia, ética, arte, estética, política y cultura. Descriptores: educación en salud; educación en enfermería; cuidados de enfermería; relaciones enfermero-paciente; promoción de la salud.
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Ozoh, Obianuju B., Yeside Akinbolagbe, Abiodun Tekobo, Sandra K. Dede, Michelle G. Dania, and Olufunke Adeyeye. "The feasibility and effect of a nurse-led, patient-centered asthma education program in a Nigerian context." Journal of Asthma, July 19, 2021, 1–10. http://dx.doi.org/10.1080/02770903.2021.1942040.
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Norderud Lærum, Birger, Gunilla Telg, and Georgios Stratelis. "Need of education for dry powder inhaler storage and retention – a patient-reported survey." Multidisciplinary Respiratory Medicine 11 (June 8, 2016). http://dx.doi.org/10.4081/mrm.2016.314.
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Background: Dry powder inhalers (DPIs) are the most commonly used devices in asthma treatment in the Nordic countries. As new DPIs become available, patients are likely to be exposed to more than one type of device, with variable optimal handling. The aim was to examine real life storage and retention of multidose DPIs in patients with asthma. Methods: This patient-reported survey on real life storage and retention of DPIs included asthma patients using multidose DPIs. Basic patient characteristics, information on inhaler use and storage, check of expiry date, and concurrent inhaler use was examined using an on line questionnaire. Results: A total of 738 patients were included with a median age of 41 years, out of which 83 % were women. Sixty-three per cent reported storage conditions pre-defined as risk locations for their maintenance inhaler and 38 % of the responding patients had more than one maintenance inhaler in use at the same time. Two thirds of the study population checked inhaler expiry date less than monthly or not at all. Use after expiry date was frequently reported. Two thirds of the patients had not received information on DPI storage, either from their doctor and/or nurse or at the pharmacy. Conclusions: This patient reported survey indicates that two thirds of the patients store their inhaler devices in suboptimal conditions, and only a minority had received instruction regarding inhaler handling. Non awareness of inhalers’ expiry dates and use of more than one maintenance inhaler simultaneously was common. As inhaler mishandling may impact device functionality, improved communication and patient education is needed.
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Souza, Jhuliano Ramos Silva de, Andreia Barbosa Cristina Costa, and Sueli de Carvalho Vilela. "Interpersonal relations between nursing-patient in the perspective of current violence." Revista de Pesquisa Cuidado é Fundamental Online, June 1, 2020, 648–53. http://dx.doi.org/10.9789/2175-5361.rpcfo.v12.9103.
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Objective: to reflect on the importance of the interpersonal relationship between nurse-patient in the perspective of current violence. Methods: this is a descriptive-reflective study. The databases used were: Latin American and Caribbean Health Sciences Literature, National Library of Medicine, SCOPUS, Web Of Science and Cumulative Index to Nursing and Allied Health Literature, in the languages: English, Spanish and Portuguese, of the last ten years. Results: three categories emerged: 1) Violence suffered by nursing professionals in the workplace; 2) Education as a tool to minimize workplace violence and 3) Nursing care for vulnerable people exposed to violence. Conclusion: interpersonal relationships can prevent acts of violence from being carried out in the workplace, and the institution itself and the management sectors can train the entire team, using continuing education as an effective tool for this issue.
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Lesaca RN MN, Leonora Tilda. "Graduate Tracer Study of the Faculty of Nursing University of Tripoli, Libya: An Evidenced-Based Information for Curriculum Update and its Implications in Quality Assurance." International Journal of Current Science Research and Review 04, no. 09 (September 6, 2021). http://dx.doi.org/10.47191/ijcsrr/v4-i9-05.
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The Faculty of Nursing ensures the quality of education it provides is suitable to the health needs to meet the demands and challenges of health care in the country. Deemed to produce future nursing leaders and educators, the faculty has undertaken its first graduate tracer study. Graduate tracer studies obtain both intrinsic and extrinsic results and benefits. Intrinsic results can be used to point at areas for improvement in study programs and service delivery at universities. The study, based on the Commission on Higher Education-adapted survey questionnaire filled in by the Bachelor of Science in Nursing graduates batch 2011-2017. With descriptive-normative research design and snowball sampling technique, smoothed the way for 126 respondents out of 189 graduates. Data showed a predominance of females over males, single over married, mostly within 2528 years of age. Majority were employed as full time in a government health facility, as well as with satisfaction in their work as a nurse ascribable to monetary remuneration. The job placement rate of the graduates is 65%, filling in the shortage of nurses in Libya. The competency-based curriculum is consistent, aligned and relevant to the nursing job requirements in Libya. Accorded well to the World Health Organization’s patient safety curriculum, ‘Safe and Quality Nursing Care’ competency appraised as the most used in their area of nurse work. Followed by ‘communication’, ‘human relations’, ‘research’, ‘problem solving’, and ‘leadership’. ‘Critical thinking’ however deemed as least used competency in the care of patients. The study recommends regular graduates tracking, further curriculum development and policy on educational achievement as one of the criteria for remuneration. Furthermore, researches on topics related to extent of knowledge and application of the learned competencies in nursing education, employability and the employers’ preferences on employability of the graduates, job satisfaction and its factors among graduates and competencies used by nurse-employed and non-nurse employed nursing graduates. Lastly, an assessment of the faculty’s program and learning is essential for teaching innovations’ upgrade and development not to disregard strategies to improve critical thinking abilities and use among nurses in their area of practice. This is to achieve the end goal of this present study, to entrench quality assurance within the faculty from the evidenced-information in distinction to the voice of its graduates.
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Suyitno, Adi, Titin Andri Wihastuti, and Lilik Supriati. "ANALISIS FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN PELAKSANAAN KOMUNIKASI TERAPEUTIK PERAWAT DI IPCU RSJ Dr. RADJIMAN WEDIODININGRAT LAWANG." Jurnal Kesehatan Mesencephalon 3, no. 2 (November 14, 2017). http://dx.doi.org/10.36053/mesencephalon.v3i2.51.
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Abstract :The nurse is the primary healthcare provider in the hospital and has an important role in the health service for the patient. Patients who come to the Intensive Psychiatric Care Unit (IPCU) generally exhibit various symptoms of behavioral problems, such as violent behavior, other injurious tendencies, agitation, and attempted suicide, requires the nurse to make a strict 24-hour observation.The aims of this research was to analyze various factors that have associated with implementation of therapeutic communication in IPCU RSJ Dr.Radjiman WediodiningratLawang. This research was an analytic observational research with cross sectional approach. Population in this research is all of IPCU nurses (Camar, Perkutut and mawar ward) 43 respondent.The number of samples is 40 respondents. To know the description of each variable used univariate analysis, to know the relationship between variables used Spearman test when the data is normally distributed and spearman and to know the most dominant factor in affecting implementation of therapeutic communication is used multivariate test of linear regression. The result of bivariate test shows p value as follows: nurse knowledge level (p = 0,004), nurse perception (p = 0,123), nurse emotional intelligence (p = 0,015), nurse age (p = 0,227), Nurse education (p = 0,351), if this value has been lower than 0,05 then this variabel has significan relations with dependen variabel. The results of multivariate test has shown that knowledge level has becae a most influence factors that affect the implementation of therapeutic communication. There was a significant correlation between nurse emotional intelegence and levels of knowledge with implementation of therapeutic communication in IPCU RSJ Dr. Radjiman Wediodiningrat LawangKeyword : knowledge, perception, emotional intelligence, age, education, implementation of therapeutic communicationAbstrak : Perawat merupakan tenaga kesehatan utama di rumah sakit dan memiliki peranan penting dalam pelayanan kesehatan kepada pasien. Pasien yang datang di Intensive Psychiatric Care Unit (IPCU) umumnya menunjukkan berbagai gejala masalah perilaku, seperti perilaku kekerasan, kecenderungan mencederai orang lain, agitasi, dan percobaan bunuh diri sehingga menuntut perawat untuk melakukan observasi ketat selama 24 jam. Melakukan analisis faktor internal yang berhubungan dengan pelaksanaan komunikasi terapeutik perawat di IPCU RSJ Dr. Radjiman Wediodiningrat Lawang. Penelitian ini observasion alanalitik dengan pendekatan cross sectional. Populasi dalam penelitian ini adalah semua perawat IPCU (Ruang Camar, Perkutut dan Mawar) yang berjumlah 43 orang dengan jumlah sampel 40 orang. Untuk mengetahui hubungan antar variabel digunakan uji spearman dan untuk mengetahui faktor yang paling dominan dengan pelaksanaan komunikasi terapeutik digunakan uji multivariate regresi linier. Hasil uji bivariat menunjukkan p value sebagai berikut : tingkat pengetahuan perawat (p=0,004), persepsi perawat (p=0,123), kecerdasan emosi perawat (p=0,015), usiaperawat (p=0,227), pendidikan perawat (p=0,351), dimana hubungan dikatakan bermakna apabila p<0,05. analisis multivariat dengan regresi linier diperoleh hasil bahwa tingkat pengetahuan merupakan faktor yang paling dominan dengan nilai p (0,004) dengan nilai r = 0,300 yang artinya variable ini memiliki keeratan hubungan yang sedang. Terdapat hubungan yang bermakna antara pengetahuan dan kecerdasan emosi perawat dengan pelaksanaan komunikasi terapeutik pada perawat di IPCU RSJ Dr. Radjiman Wediodiningrat Lawang. Kata Kunci : pengetahuan, persepsi, kecerdasan emosi, usia, pendidikan perawat, pelaksanaan komunikasi terapeutik