To see the other types of publications on this topic, follow the link: Intensive and critical care nursing.
Dissertations / Theses on the topic 'Intensive and critical care nursing'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 dissertations / theses for your research on the topic 'Intensive and critical care nursing.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse dissertations / theses on a wide variety of disciplines and organise your bibliography correctly.
1
Fisher, Joyce Ann. "Critical thinking in critical care nurses." Virtual Press, 1996. http://liblink.bsu.edu/uhtbin/catkey/1036181.
Full textAbstract:
Critical care nurses need finely honed critical thinking skills in order to be safe, competent, and skillful practitioners of their profession. If clinical nurses do not learn how to reason effectively, they may make inappropriate decisions about their patients' care, ultimately resulting in increased patient mortality (Fonteyn, 1991). In addition, increasing nurses' decision-making and autonomy has been shown to improve job satisfaction and retention (Prescott, 1986).There are many authors who write about the need for developing critical thinking skills among practicing professional nurses (Creighton, 1984; Jenkins, 1985; Levenstein, 1981, 1983, 1984). However, research assessing the impact of continued education and clinical experience on the development of critical thinking skills is sparse.The purpose of this exploratory study is to determine if there is a relationship between the level of critical thinking skills (as measured by the Watson-Glaser Critical Thinking Appraisal Tool, 1980) in critical care nurses and the length of nursing experience, amount of continuing education pursued annually, and the level of formal nursing education completed. The conceptual framework that provides the basis for this study is Patricia Benner's (1984) application of the Dreyfus Model of Skill Acquisition to clinical nursing practice.Participants (N = 61) were obtained on a voluntary basis from the population of critical care nurses working in the intensive Care Unit, Coronary Care Unit, Cardiac Catheterization Laboratory, or Emergency Care Center of a 600 bed midwestern acute care facility. Each participant in the study was asked to sign an informed consent agreeing to participate after receiving a written and oral explanation of the study. Confidentiality of the participants was maintained by substituting identification numbers for the subjects' names on the data collection instruments. The investigator supervised the administration of the critical thinking instrument and demographic questionnaire.The Pearson product-moment correlation coefficient and a two-tailed t-test for independent samples were used to determine if there were any significant relationships between the WGCTA score and the length of critical care experience, attendance of continuing education programs, or completion of additional formal education. This data analysis supported hypothesis one with the results revealing a significant positive correlation (r = .46, p = <.001) between the WGCTA scores and the length of critical care experience. In addition, a statistically significant but weak positive correlation was found between the WGCTA scores and the length of experience in CCU (r = .52, p = .001). No significant correlation existed between the WGCTA scores and length of experience in ECC, ICU, or CCL. Hypothesis two was supported with a significant difference (t = 3.58, df = 59, p = .001) found between the critical thinking ability of the two groups, with those who have completed an additional formal program of nursing education scoring higher. A significant but weak positive correlation (r = .30, p =.020) was found between the number of continuing education programs attended annually and the WGCTA scores. Multiple regression was performed with the total WGCTA score being the dependent variable and total critical care experience, completion of additional formal education, and attendance of continuing education programs being the independent variables. Only total critical care experience entered the equation (E = 16.03, p = <.001) explaining 21% of the variance.The information gained from this study will provide direction for the review of existing orientation, continuing education, and staff development programs provided at different levels of nursing experience and make suggestions for change to enhance critical thinking skill development.School of Nursing
2
Hendricks, Lucia Elizabeth. "Critical thinking : perspectives and experiences of critical care nurses." Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/71821.
Full textAbstract:
Thesis (MCurr)--Stellenbosch University, 2012.ENGLISH ABSTRACT: The increasingly complex role of the critical care nurse in an intensive care environment demands a much higher level of critical thinking and clinical judgment skill than ever before. Critical thinking in nursing practice may be defined as the cognitive ability to analyse, predict and transform knowledge, ensuring quality nursing care. To reason from a nurse’s perspective requires that we learn the content of nursing; this includes the concepts, ideas and theories of nursing. The aim and objectives of the study were to explore critical care nurses’ perspectives and experiences with regards to the concept of critical thinking, facets influencing the application of critical thinking skills in clinical practice and how these impact on the delivery of quality nursing care. A qualitative approach, using a case study design was utilised. A sample of six participants, who met the study inclusion criteria and consented to participate, were interviewed individually. Subsequently, five of these six participants took part in a focus group discussion to capture additional data to clarify and enrich the individual interview data. A field worker was present during the interviewing processes to note non-verbal data and later verify transcribed data. Feasibility of the proposed study was established by conducting a pretest which elicited relevant information. Ethical approval for the study was obtained from the Health Research Ethics Committee at the Faculty of Medicine and Health Sciences, Stellenbosch University. Permission and consent was obtained from the relevant hospital group to interview nurses working in the intensive care units. Qualitative content analysis, which focuses on the content or contextual meaning, was used to analyse interview data. Coding of the data through emergent themes and sub-themes was done by the researcher and supported through independent coding to verify and strengthen the analysis and interpretation of the researcher. . The results depicted how the participants personally understood the concept of critical thinking and the components influencing the application of critical thinking skill in clinical practice. The study of the participants’ perspective of the concept of critical thinking and portrayed how they experience analytical and independent thinking, competence and confidence, as well as knowledge, skill and expertise, to influence the quality of patient care. The data revealed several themes that facilitated critical thinking in critical care nurses. These themes were ‘team support’, ‘experience and exposure’ and ‘empowering the mind’. Emergent themes elaborating the limitations of critical thinking included ‘being stressed’, ‘professional boundaries’ and ‘being busy’. Several recommendations and suggestions for future research were offered.
AFRIKAANSE OPSOMMING: Die toenemende komplekse rol van die kritieke-sorgverpleegster in ’n intensiewe-sorg omgewing verg ’n veel hoër vlak van kritiese denke en ’n kliniese oordeelvaardigheid as ooit tevore. Kritiese denke in ’n verplegingspraktyk kan gedefinieer word as die kognitiewe vermoë om te kan analiseer, om vooruit situasies te kan bepaal en die vermoë om kennis te omskep sodat kwaliteit verpleegsorg verseker kan word. Om soos ’n verpleegster te kan dink, stipuleer dat die inhoud van verpleging geleer moet word wat konsepte, idees en teorieë daarvan insluit. Die doel en oogmerke van die studie is om die ervarings en perspektiewe van kritieke-sorgverpleegsters te ondersoek, met betrekking tot die konsep van kritiese denke, fasette wat die toepassing van kritiese denkvaardighede in ’n kliniese praktyk beïnvloed en die impak daarvan op die lewering van kwaliteit verpleegsorg. Die metodologie wat toegepas is, is ’n kwalitatiewe benadering deur middel van ’n gevalle-studie ontwerp. ’n Steekproefgrootte van ses deelnemers wat aan die inklusiewe kriteria voldoen het, is mee onderhoude individueel gevoer en daarna is met vyf van hierdie ses deelnemers in ’n fokusgroep onderhoude gevoer ten einde data op te neem wat andersins verlore kon geraak het. ’n Veldwerker was teenwoordig gedurende die proses van onderhoudvoering om die opgeneemde en getranskribeerde data te verifieer. Die data-insamelingsinstrument is in die vorm van ’n onderhoudsgids ontwikkel om die navorser gedurende die onderhoudvoering te help. ’n Loodsondersoek is uitgevoer om die haalbaarheid van die voorgestelde studie te ondersoek en is sodoende geskep om relevante inligting te onthul. Etiese goedkeuring vir die studie is verkry van die Gesondheidsnavorsing Etiese Komitee aan die Fakulteit van Geneeskunde en Gesondheidswetenskappe, Universiteit Stellenbosch. Goedkeuring en toestemming is van die hospitaalgroep aan wie die hospitaal behoort verkry, waar die studie onderneem is om sodoende onderhoude te kan voer met verpleegsters wat in die intensiewe-sorgeenhede werk. ’n Primêre, kwalitatiewe inhouds analise is gebruik om omderhoud data te analiseer wat fokus op die inhoud of kontekstuele betekenis daarvan. Kodering van die data deur die toepassing van die temas en sub-temas wat voorgekom het, is deur die navorser gedoen. Die data is onafhanklik gekodeer om die analise en interpretasie van die navorser te verifieer en te bekragtig ten einde die akkuraatheid en getrouheid in die formulering van die betekenis en interpretasie van gebeure met juiste weergawe daarvan, te verseker. Die resultate wat as hooftemas vanuit die individuele onderhoude voortgespruit het, asook die van die fokusgroep het die deelnemers se eie begrip van die konsep van kritiese denke en komponente wat die toepassing van kritiese denkvaardigheid in ’n kliniese praktyk beïnvloed, getoon. Die konsep van kritiese denke het die wyse waarop analitiese en onafhankilke denke, bevoegdheid en selfvertroue, asook kennis, vaardigheid en kundigheid die kwaliteit van pasiëntsorg beïnvloed, uitgebeeld. Die voortkomende data het daartoe aanleiding gegee dat die faktore wat die fasilitering en beperking van kritiese denke beïnvloed, bespreek kon word. Data rakende fasilitering het getoon hoedat die ondersteuning van die span, ervaring, blootstelling en die verruiming van die gees, kritieke-sorgverpleegsters positief kan beïnvloed om kritiese denke in hulle daaglikse verplegingsaktiwiteite effektief te kan toepas. Data wat verband hou met beperkings het getoon hoedat stres, professionele kwessies en besigwees kritieke-sorgverpleegsters negatief kan beïnvloed in die toepassing van kritiese denke gedurende daaglikse verplegingsaktiwiteite. Verskeie aanbevelings vir toekomstige navorsing is voorgestel.
3
Singleton, Alsy R. "Patient satisfaction with nursing care : a comparison analysis of critical care and medical units." Virtual Press, 1997. http://liblink.bsu.edu/uhtbin/catkey/1061875.
Full textAbstract:
Patient satisfaction is an outcome of care that represents the patient's judgment on the quality of care. An important aspect of quality affecting patient's judgment can be attributed to patients' expectations and experiences regarding nursing care according to type of unit. The purpose of this study was to examine differences between patients' perceptions of satisfaction with nursing care in critical care units and medical units in one Midwestern hospital.The conceptual framework was "A Framework of Expectation" developed by Oberst in 1984, which asserted that patients have expectations of hospitals and health care professionals regarding satisfaction and dissatisfaction with care. The instrument used to measure patient satisfaction was Risser's Patient Satisfaction Scale, with three dimensions of patient satisfaction: (a) Technical-Professional, (b) Interpersonal-Educational, (c) Interpersonal-Trusting. The convenience sample included 99 patients50 from critical care units and 49 from medical wards. Participation was voluntary. The study design was comparative descriptive and data was analyzed using a t-test.The demographic data showed that the majority of patients had five or more admission. About one-third of the patients were 45-55, 56-65, 66-75, respectively. Findings related to the research questions were that: (a) 84 percent of the respondents rated overall satisfaction in the satisfactory to excellent range, (b) results of a t-test showed significant differences in overall patient satisfaction with patients being more satisfied with care in critical care units. Significant differences were found in three subscales with critical care being more satisfied. No relationship was found between patient satisfaction and age/and/or type of unit.Conclusions were that in both medical and critical care units patients were more satisfied with Technical-Professional and Interpersonal-Trusting than with Interpersonal-Educational. Also noted was that patients in the units where nurse-to-patient ratio was higher participants perceived that nurses had more time, energy and ability to meet patient expectation. Implications call for analysis of nurse/patient ratio in relation to patient satisfaction and nurses in relation to patient education as well as patient's perceptions of getting their needs met.School of Nursing
4
Moon, Mikyung. "Relationship of nursing diagnoses, nursing outcomes, and nursing interventions for patient care in intensive care units." Diss., University of Iowa, 2011. https://ir.uiowa.edu/etd/3356.
Full textAbstract:
The purpose of the study was to identify NANDA - I diagnoses, NOC outcomes, and NIC interventions used in nursing care plans for ICU patient care and determine the factors which influenced the change of the NOC outcome scores. This study was a retrospective and descriptive study using clinical data extracted from the electronic patient records of a large acute care hospital in the Midwest. Frequency analysis, one-way ANOVA analysis, and multinomial logistic regression analysis were used to analyze the data. A total of 578 ICU patient records between March 25, 2010 and May 31, 2010 were used for the analysis. Eighty - one NANDA - I diagnoses, 79 NOC outcomes, and 90 NIC interventions were identified in the nursing care plans. Acute Pain - Pain Level - Pain Management was the most frequently used NNN linkage. The examined differences in each ICU provide knowledge about care plan sets that may be useful. When the NIC interventions and NOC outcomes used in the actual ICU nursing care plans were compared with core interventions and outcomes for critical care nursing suggested by experts, the core lists could be expanded. Several factors contributing to the change in the five common NOC outcome scores were identified: the number of NANDA - I diagnoses, ICU length of stay, gender, and ICU type.
The results of this study provided valuable information for the knowledge development in ICU patient care. This study also demonstrated the usefulness of NANDA - I, NOC, and NIC used in nursing care plans of the EHR. The study shows that the use of these three terminologies encourages interoperability, and reuse of the data for quality improvement or effectiveness studies.
5
Ferrel, Cynthia Lynn. "The experience of critical care nurses in initiating hospice care." abstract and full text PDF (free order & download UNR users only), 2008. http://0-gateway.proquest.com.innopac.library.unr.edu/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:1453534.
Full text
6
Kaddoura, Mahmoud. "New graduate nurses' perception of critical thinking development in critical care nursing training programs /." Access online resource, 2009. http://scholar.simmons.edu/bitstream/handle/10090/9655/Mahmoud%20Dissertation%207%20%20JULY.pdf?sequence=1.
Full text
7
Currey, Judy A., and mikewood@deakin edu au. "Critical care nurses' haemodynamic decision making." Deakin University. School of Nursing, 2003. http://tux.lib.deakin.edu.au./adt-VDU/public/adt-VDU20050728.094123.
Full textAbstract:
For cardiac surgical patients, the immediate 2-hour recovery period is distinguished by potentially life-threatening haemodynamic instability. To ensure optimum patient outcomes, nurses of varying levels of experience must make rapid and accurate decisions in response to episodes of haemodynamic instability. Decision complexity, nurses characteristics, and environmental characteristics, have each been found to influence nurses' decision making in some form. However, the effect of the interplay between these influences on decision outcomes has not been investigated. The aim of the research reported in this thesis was to explore variability in critical care nurses' haemodynamic decision making as a function of interplay between haemodynamic decision complexity, nurses' experience, and specific environmental characteristics by applying a naturalistic decision making design.
Thirty-eight nurses were observed recovering patients in the immediate 2-hour period after cardiac surgery. A follow-up semi-structured interview was conducted. A naturalistic decision making approach was used. An organising framework for the goals of therapy related to maintaining haemodynamic stability after cardiac surgery was developed to assist the observation and analysis of practice. The three goals of therapy were the optimisation of cardiovascular performance, the promotion of haemostasia, and the reestablishment of normothermia. The research was conducted in two phases. Phase One explored issues related to observation as method, and identified emergent themes. Phase Two incorporated findings of Phase 1, investigating the variability in nurses' haemodynamic decision making in relation to the three goals of therapy.
The findings showed that patients had a high acuity after cardiac surgery and suffered numerous episodes of haemodynamic instability during the immediate 2-hour recovery period. The quality of nurses' decision making in relation to the three goals of therapy was influenced by the experience of the nurse and social interactions with colleagues. Experienced nurses demonstrated decision making that reflected the ability to recognise subtle changes in haemodynamic cues, integrate complex combinations of cues, and respond rapidly to instability. The quality of inexperienced nurses' decision making varied according to the level and form of decision support as well as the
complexity of the task. When assistance was provided by nursing colleagues during the reception and recovery of patients, the characteristics of team decision making were observed. Team decision making in this context was categorised as either integrated or non integrated. Team decision making influenced nurses' emotions and actions and decision making practices. Findings revealed nurses' experience affected interactions with other team members and their perceptions of assuming responsibility for complex patients.
Interplay between decision complexity, nurses' experience, and the environment in which decisions were made influenced the quality of nurses' decision making and created an environment of team decision making, which, in turn, influenced nurses' emotional responses and practice outcomes. The observed variability in haemodynamic decision making has implications for nurse education, nursing practice, and system processes regarding patient allocation and clinical supervision.
8
LeBlanc, Allana E. "The Experience of Intensive Care Nurses Caring for Patients with Delirium." Thesis, Université d'Ottawa / University of Ottawa, 2016. http://hdl.handle.net/10393/34266.
Full textAbstract:
The purpose of this research was to seek a deep understanding of the lived experience of intensive care nurses caring for patients with delirium.
Delirium affects a large proportion of adult patients in the intensive care unit (ICU). Delirium has been linked to increased morbidity and mortality, longer intensive care and hospital length of stay, long-term cognitive impairments, short-term and long-term psychological distress, and increased hospital and health system costs. Critical care nurses play central roles in preventing, identifying, and treating ICU patients with delirium.
Semi-structured interviews were conducted with eight intensive care nurses working in an ICU in a tertiary level, university-affiliated hospital in Ontario, Canada. The researcher analyzed the interviews using an interpretive phenomenological approach as described by van Manen (1990).
The essence of the experience of critical care nurses caring for ICU patients with delirium was revealed to be finding a way to help them come through it. Six main themes emerged: It's Exhausting; Making a Picture of the Patient's Mental Status; Keeping Patients Safe: It's a Really Big Job; Everyone Is Unique; Riding It Out With Families; and Taking Every Experience With You. The findings describe how intensive care nurses find a way to help patients and their families through this complex and often distressing experience. This study has contributed to the understanding of the lived experience of ICU nurses caring for patients with delirium.
9
Vanderspank, Brandi. "The Social Construction of Intensive Care Nursing, 1960-2002: Canadian Historical Perspectives." Thèse, Université d'Ottawa / University of Ottawa, 2014. http://hdl.handle.net/10393/30922.
Full textAbstract:
Intensive care units (ICUs) emerged across Canada during the early 1960s, significantly contributing to the image of Western hospitals as places of scientific advancement that predominated over much of the twentieth century. ICUs rapidly became both a resource intensive and expensive type of care as the number and size of units increased to accommodate diverse patient populations and treatment options. Nurses enabled the formation and growth of ICUs through their constant presence and skilled care. There has been limited research, however, regarding the historical development of Canadian ICUs, the relationships between nurses and other personnel in such units, how they developed an identity as ICU nurses, or how ICU nursing became a specialty practice.
Situated within the broader histories of hospitals, healthcare, and nursing, this study uses a social history approach to examine nurses’ experiences within Canadian ICUs between 1960 and 2002. Berger and Luckmann’s Social Construction of Reality provided a lens for analysis and interpretation of oral histories, photographs, professional literature of the time period under study, and both archival and organizational records. This thesis argues that ICU nurses’ relationships with one another, in the context of a technologically complex environment, socially constructed their knowledge and skill acquisition, their socialization as ICU nurses, and the development of a specialized body of knowledge that ultimately led to formal recognition of ICU nursing as a specialty in Canada.
10
Patton, Lauren Ashley. "Education and Standardized Discussion Guides to EnhanceNurses' Spiritual Care Practices in the Medical Intensive Care Unit." Case Western Reserve University Doctor of Nursing Practice / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=casednp1519836081431734.
Full text
11
Perry, Mary Barbara. "Critical care nurses' perceptions of their experience with nursing quality assurance." Thesis, University of British Columbia, 1990. http://hdl.handle.net/2429/28795.
Full textAbstract:
The purpose of this study was to describe critical care nurses' perceptions of their experiences with nursing quality assurance activities. Using an exploratory, descriptive design, data were collected in a survey, utilizing a self-administered questionnaire. A convenience sample of critical care nurses, who are members of the Canadian Association of Critical Care Nurses, was used. The results showed that these particular nurses knew what comprised the components of a nursing quality assurance program, however, their participation in these activities was low. In addition, the majority identified that the primary purpose of nursing quality assurance activities was to meet the accreditation requirements of the hospital. Finally, the results also identified that all of this particular group of nurses felt that nursing quality assurance activities involved them, and the majority felt that these activities were part of their professional responsibilities.Applied Science, Faculty of
Nursing, School of
Graduate
12
Forozeiya, Dana. "Critical Care Nurses’ Experiences of Coping with Moral Distress." Thesis, Université d'Ottawa / University of Ottawa, 2017. http://hdl.handle.net/10393/35894.
Full textAbstract:
Over the last three decades, there has been a growing body of literature that has described moral distress as a prominent issue that negatively affects critical care nurses. However, little focus has been given to how nurses cope and continue on in their practice despite the hardship that moral distress can cause. This study sought to reveal nurses’ strategies of coping with moral distress to allow for a better understanding of this aspect of critical care nurses’ experiences. This study adopted a qualitative design that used Thorne’s (2008) approach to interpretative description. Face-to-face, semi-structured interviews were conducted with seven critical care nurses employed within two ICUs of a tertiary care academic hospital. Interviews were analyzed using Aronson’s (1995) approach to thematic analysis. The experience of coping with moral distress had an overarching theme of being “like grass in the wind.” Four major themes were identified: Going Against What I Think is Best, Moral Distress- It’s Just Inherent in Our Job, It Just Felt Awful, and Dealing with It.
13
Dunsdon, Jeananne. "Professional nurses experiences of a team nursing care framework in critical care units in a private healthcare group." Thesis, Nelson Mandela Metropolitan University, 2011. http://hdl.handle.net/10948/1444.
Full textAbstract:
A critical care unit is a dynamic and highly technological environment. Professional nurses who have been working in the critical care unit for a period of time are passionate about the environment in which they work. They find their on duty time challenging and stimulating. The critical care environment is slowly changing. Due to the fact that there are fewer professional nurses with an additional qualification in critical care available to work in the critical care units. The utilisation of an increasing number of agency nurses leads to an increase in sub-standard nursing care as well as dissatisfied doctors and patients. The shortage of critical care staff has resulted in the need to find an alternative human resources framework and still provide cost effective, safe quality patient care. This leads to the design and implementation of a team nursing care framework for critical care. The research objectives for this study were: - To explore and describe the experiences of professional nurses with regard to a team nursing care framework in private critical care units. - Develop guidelines to optimize the team nursing care framework in critical care units in a private hospital group. The research is based on a qualitative, explorative, descriptive and contextual research design. The study is based on a phenomenological approach to inquiry. Eleven in-depth semi structured face-to-face phenomenological interviews were utilized as the main means of collecting data. A purposive, criterion based, sampling method was used. Specific inclusion criteria were met and consent was obtained from the participants and from the management of the private clinic where the research was conducted. Two central themes were identified:- Theme One: The professional nurses experienced the team nursing care framework in the critical care unit as a burden. Six sub-themes were identified. - Theme Two: Professional nurses made recommendations for improvement of the team nursing care framework in the critical care unit. By describing the lived experiences of the professional nurses in the critical care units, based on research interviews, the researcher painted a clear picture of the team nursing care framework in the critical care unit. Guidelines were developed based on the identified themes. The broad guidelines are aimed at ensuring that the nurses are competent to care for critical care patients prior to them commencing work in the critical care unit. The researcher concludes this study by making recommendations for Nursing practice, education and research.
14
Mallory, Caitlin Brook. "Critical Care Nurses' Experiences of Family Behaviors as Obstacles in End-of-Life Care." BYU ScholarsArchive, 2017. https://scholarsarchive.byu.edu/etd/6903.
Full textAbstract:
Background: Critical care nurses (CCNs) frequently provide end-of-life care for critically ill patients. CCNs may face many obstacles while trying to provide quality EOL care. Some research focusing on obstacles CCNs face while trying to provide quality EOL care has been published; however, research focusing on family behavior obstacles is limited. Research focusing on family behavior as an EOL care obstacle may provide additional insight and improvement in care. Objective: What are the predominant themes noted when CCNs share their experiences of common obstacles, relating to families in providing EOL care? Methods: A random geographically dispersed sample of 2,000 members of the American Association of Critical-Care Nurses was surveyed. Responses from a qualitative question on the questionnaire were analyzed. Results: Sixty-seven EOL obstacle experiences surrounding issues with families' behavior were analyzed for this study. Experiences were categorized into 8 themes. Top three common obstacle experiences included families in denial, families going against patient wishes and advance directives, and families directing care which negatively impacted patients. Conclusions: In overcoming EOL obstacles, it may be beneficial to have proactive family meetings to align treatment goals and to involve palliative care earlier in the ICU stay.
15
Vandergoot, Ann. "From ward nurse to proficient critical care nurse a narrative inquiry study : a dissertation [thesis] presented in partial fulfillment of the degree of Master of Health Science, 2005." Full thesis. Abstract, 2005.
Find full textAbstract:
Thesis (MHSc--Health Science) -- Auckland University of Technology, 2005.Appendices not included in e-thesis. Also held in print (65 leaves, 30 cm.) in Akoranga Theses Collection. (T 610.730690993 VAN)
16
Prentiss, Andrea S. "Hearing the Child's Voice: Their Lived Experience in the Pediatric Intensive Care Unit." FIU Digital Commons, 2014. http://digitalcommons.fiu.edu/etd/1633.
Full textAbstract:
Background: More than 200,000 children are admitted annually to Pediatric Intensive Care Units (PICUs) in the US. Research has shown young children can provide insight into their hospitalization experiences; child reports rather than parental reports are critical to understanding the child’s experience. Information relating to children’s perceptions while still in the PICU is scarce.
Aims: The purpose of this qualitative study was to investigate school age children’s and adolescents’ perceptions of PICU while in the PICU; changes in perceptions after transfer to the General Care Unit (GCU); differences in perceptions of school age children/adolescents and those with more invasive procedures.
Methods: Interviews were conducted in PICU within 24-48 hours of admission and 24-48 hours after transfer to GCU. Data on demographics, clinical care and number/types of procedures were obtained.
Results: Participants were 7 school age children, 13 adolescents; 10 Hispanic; 13 males. Five overarching themes: Coping Strategies, Environmental Factors, Stressors, Procedures/Medications, and Information. Children emphasized the importance of peer support and visitation; adolescents relied strongly on social media and texting. Parent visits sometimes were more stressful than peer visits. Video games, TV, visitors, and eating were diversional activities. In the PICU, they wanted windows to see outside and interesting things to see on the ceiling above them. Children expressed anticipatory fear of shots and procedures, frustration with lab work, and overwhelming PICU equipment. Number of child responses was higher in PICU (927) than GCU (593); the largest difference was in Environmental Factors. Variations between school age children and adolescents were primarily in Coping Strategies, especially in social support. Number of GCU procedures were the same (8 children) or greater (2 children) than PICU procedures.
Discussion: Admission to PICU is a very stressful event. Perceptions from children while still in PICU found information not previously found in the literature. Longitudinal studies to identify children’s perceptions regarding PICU hospitalization and post-discharge outcomes are needed.
17
Willmore, Elizabeth Elouise. "Physician Behaviors, Nursing, and Other Obstacles in End-of-Life Care: Additional Critical Care Nurse Perceptions." BYU ScholarsArchive, 2020. https://scholarsarchive.byu.edu/etd/9061.
Full textAbstract:
Background: Critical Care Nurses (CCNs) frequently provide end of life (EOL) care in intensive care units (ICUs). Barriers to EOL care in ICUs exist and have been previously published, but qualitative reports from CCNs themselves remain scarce. Qualitative data exploring barriers faced during ICU EOL care may increase awareness of obstacles and help remove them. Objective: Excluding family experiences, what are the major themes recounted by CCNs when asked to share common obstacles experienced in providing ICU EOL care? Methods: Members of the American Association of Critical-Care Nurses were randomly surveyed and responses to a single qualitative question were used. Results: There were 104 participants who provided 146 responses reflecting EOL obstacles which were divided into 11 themes; 6 physician- related obstacles and 5 nursing-and-other related obstacles. Top three EOL ICU barrier themes were inadequate physician communication, physicians giving false hope and nursing-related obstacles. Conclusion: Poor physician communication is the main obstacle noted by CCNs during ICU EOL care followed by physicians giving false hope. Heavy patient workloads were also a major barrier in CCNs providing EOL care.
18
BARTZ, CLAUDIA CAROL. "NURSE-PATIENT COMMUNICATION DURING CRITICAL ILLNESS EVENTS." Diss., The University of Arizona, 1986. http://hdl.handle.net/10150/183833.
Full textAbstract:
The purpose of this study was to explore and describe nurse-patient communication during critical illness events. The theoretical structure of the study was drawn from communication, sociolinguistic, and nursing theory. Data were collected in a 374-bed private hospital in the Southwest. The sample consisted of six registered nurses and nine patients experiencing cardiac surgery. Nine observed and audiotaped nurse-patient interactions, and fourteen audiotaped partcipant interviews provided the data base for analysis. Content analysis was used to organize the data. Findings were presented in terms of language, paralanguage, and nonverbal expression, and in terms of content, process, and product of nurse-patient communication. Participants used biomedical-technical language and casual-everyday language during the interactions. Nurses talked about what patients would experience while patients talked about themselves as a way of establishing their credibility within the biomedical setting. Nurses viewed nurse-patient communication as variable depending on the patients' needs and responses. Patients viewed nurse-patient communication as straightforward, not requiring adjustment for the needs of the participants. Products of communication for patients involved increased knowledge, reassurance, and increased confidence. Products of communication for nurses involved relieving the patients' anxieties, considering the patients' remembering, and increasing the nursing staff's knowledge about the patient while helping the patient to know the goals of the nursing staff. The introduction and closure segments of the six nurse-patient interactions for preoperative preparation of the patient were analyzed. Nurses began the introductions by assuming that the patients needed relief from anxiety but the patients demonstrated politeness more than anxiety. Nurses used strategies of questioning, starting the physical assessment, topic persistence, and self-monitoring to control the closure segments. Patients used narratives and humor as control strategies. The study findings suggest conceptual areas relevant to nurse-patient communication which may ground theoretical model development for nurse-patient communication. Nurses in clinical settings can compare their patient communication experiences with the findings of the study in order to increase their understanding of expression, form, and function of nurse-patient communication.
19
Marshall, Andrea Pauline. "Information use in clinical practice a case study of critical care nurses' enteral feeding decisions /." Connect to full text, 2008. http://hdl.handle.net/2123/3658.
Full textAbstract:
Thesis (Ph. D.)--University of Sydney, 2008.Title from title screen (viewed 11 February 2009). Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the Faculty of Nursing And Midwifery. Includes bibliographical references. Also available in print form.
20
Lamoreaux, Nicole. "Critical Care Nurses' Perceptions of End-of-Life Care: Comparative 17-year Data." BYU ScholarsArchive, 2016. https://scholarsarchive.byu.edu/etd/6382.
Full textAbstract:
BACKGROUND: Nurses working in intensive care units (ICUs) frequently care for patients and their families at the end-of-life (EOL). Providing high quality EOL care is important for both patients and families, yet ICU nurses face many obstacles that hinder EOL care. Researchers have identified various ICU nurse-perceived obstacles, but no studies have been found addressing the progress that has been made over the last 17 years.OBJECTIVE: To determine the most common and current obstacles in EOL care as perceived by ICU nurses and then to evaluate whether or not meaningful changes have occurred since data were first gathered in 1998.METHODS: A quantitative-qualitative mixed methods design was used. A random, geographically dispersed sample of 2,000 members of the American Association of Critical-Care Nurses was surveyed.RESULTS: Five obstacle items increased in mean score and rank as compared to 1999 data including: (1) family not understanding what the phrase "life-saving measures" really means; (2) providing life-saving measures at families' requests despite patient's advance directive listing no such care; (3) family not accepting patient's poor prognosis; (4) family members fighting about use of life support; and, (5) not enough time to provide EOL care because the nurse is consumed with life-saving measures attempting to save the patient's life. Five obstacle items decreased in mean score and rank compared to 1999 data including (1) physicians differing in opinion about care of the patient; (2) family and friends who continually call the nurse rather than calling the designated family member; (3) physicians who are evasive and avoid families; (4) nurses having to deal with angry families; and, (5) nurses not knowing their patient's wishes regarding continuing with tests and treatments.CONCLUSIONS: Obstacles in EOL care, as perceived by critical care nurses, still exist. Family-related obstacles have increased over time and may not be easily overcome as each family, dealing with a dying family member in an ICU, likely has never experienced a similar situation. Based on the current top five obstacles, recommendations for possible areas of focus may include (1) improved nursing assessment regarding the health literacy of families followed with directed, appropriate, and specific EOL information, (2) improved care coordination between physicians and other health care providers to facilitate sharing care plans, (3) advanced directives that are followed as written by patients, (4) designated family contact communicating with family and friends regarding patient information, and, finally, (5) earlier, transparent discussions of patient prognoses as disease processes advance and patient conditions deteriorate.
21
Cody, John Shawn. "Family Experiences with ICU Bedside Rounds: A Qualitative Descriptive Study: A Dissertation." eScholarship@UMMS, 2015. https://escholarship.umassmed.edu/gsn_diss/35.
Full textAbstract:
The hospitalization of a family member in an intensive care unit can be a very stressful time for the family. Family bedside rounds is one way for the care team to inform family members, answer questions, and involve them in care decisions. Few studies have examined the experiences of family members with ICU bedside rounds.
A qualitative descriptive study, undergirded by the Family Management Style Framework developed by Knafl and Deatrick (1990, 2003) and Knafl, Deatrick, and Havill (2012), was done at an academic medical center examining families who both participated and did not participate in the family bedside rounds. The majority of families who participated (80%) found the process helpful. One overarching theme emerged from the data of participating families: Making a Connection: Comfort and Confidence. Two major factors influenced how that connection was made: consistency and preparing families for the future. Three types of consistency were identified: consistency with information being shared, consistency about when rounds were being held, and
consistency with being informed of delays. The second major contributing factor was preparing families for the future. When a connection was present, families felt comfortable with the situation. When any of the factors were missing, families described feelings of anger, frustration, and fear. Family members who did not participate described feelings of disappointment and frustration about not having participated.
As healthcare providers, what we say to families matters. They need to be included in decision-making with honest, consistent, easy-to-understand information.
22
Adams, Bernardene Lucreshia. "The experiences of registered nurses' of their work environment in a critical care unit." Thesis, Nelson Mandela Metropolitan University, 2009. http://hdl.handle.net/10948/1057.
Full textAbstract:
Critical care nursing is a vital and significant part of health care provision to critically ill patients. It is a specialty area of nursing that requires registered nurses who are highly motivated, knowledgeable and skilled to provide optimal care to critically ill patients. These patients are nursed in a complex environment consisting of specialised equipment (such as ventilators, defibrillators, intravenous pumps, and cardiac monitors) that is not found in any other field of nursing. Collegial support and an adequate registered nurse: patient ratio is vital in critical care units in order to provide optimal quality care to critically ill patients. However, an understaffed work environment, the demands of critical care nursing and other work-related problems, such as conflict with physicians, inadequate remuneration packages and an increased workload can cause serious distress and dissatisfaction amongst registered nurses in this specific environment (Carayon & Gürses, 2005:287). The objectives of this study therefore are to explore and describe the experiences of registered nurses of their work environment in a critical care unit and to make recommendations that will assist registered nurses working in a critical care unit. A qualitative, explorative, descriptive and contextual research design will be utilised. Data will be collected by means of semi-structured interviews and analysed according to the framework provided by Tesch (in Cresswell, 2003:192). Purposive sampling will be used to select a sample of registered nurses working in a critical care environment. Guba’s model (in Krefting, 1991) will be utilised to verify data and to ensure trustworthiness of the study. Ethical considerations will be adhered to throughout the study. Once data has been analysed, recommendations will be made that will assist registered nurses working in a critical care unit.
23
Emmons, Margaret M. "Exploring the Enteral Feeding Practices Used by Critical Care Nurses: A Dissertation." eScholarship@UMMS, 2014. https://escholarship.umassmed.edu/gsn_diss/34.
Full textAbstract:
Mechanically ventilated critically ill patients treated in the intensive care unit (ICU) require enteral feedings to maintain adequate nutrition during critical illness. Delivery of adequate enteral nutrition is also critical to the recovery of critically ill patients. Enteral nutrition has been shown to decrease length of time on the ventilator, decrease length of stay and ICU and decrease mortality. Despite all the evidence regarding the benefits of enteral nutrition, critically ill patients continue to receive less than their prescribed calories and protein. Nurses are in a unique position to influence the delivery of enteral nutrition. Nursing practices that contribute to underfeeding must be identified and corrected to ensure adequate delivery of nutrients is achieved. The purpose of the study was to describe the professional practice of critical care nurses regarding enteral feeding in mechanically ventilated critically ill patients. Several barriers were identified by the participants in the study that contributed to underfeeding including inconsistent practice regarding gastric residual volume, holding feeds when changing patient position and lack of a standardized protocol for enteral feeding. Also identified in the study was the idea that nurses do not see enteral feeding as a life-saving intervention. It is not the “sexy part” of what ICU nurses do. Enteral feeding guidelines need to be developed to include those interventions that are important to nursing practice in order to increase enteral feeding times and improve patient outcomes.
24
Holbrook, Susan. "Burnout in the critical care setting : level of expertise and social support." Virtual Press, 1991. http://liblink.bsu.edu/uhtbin/catkey/834612.
Full textAbstract:
The purpose of this study was to examine burnout in the critical care nurse. One hundred-eighty eight nurses employed at Community Hospitals of Indiana were surveyed to determine the relationship between burnout, level of expertise and social support systems. Frequency and intensity of burnout was measured by the Maslach Burnout Inventory. Social support systems were measured by the Norbeck Social Support Questionnaire. Level of expertise was determined by question 1 of the demographic questionnaire length of time employed as a critical care nurse.Findings of this study revealed no significant differences in level of expertise related to intensity and frequency of burnout (F= .232). Results of ANOVA indicated the sampled nurses experienced a low to average degree of burnout for both frequency and intensity of burnout. Similarly using Pearson correlate there was no relationship between level of support systems and frequency also concluded that level of support systems did not and intensity of burnout (novice, p= -.23; competent, p= .11; expert, p= .07). Conclusions of this study indicated level of expertise was not a factor in determining intensity and frequency of burnout.It was burnout need to be readily available for all nurses in influence intensity and frequency of burnout in the novice, competent or expert critical care nurse.Implications indicate that preventative measures for critical care settings. Other implications were that nursing support systems may not be an effective strategy for burnout prevention and resources may need to focus on other strategies.School of Nursing
25
Whitney, Stuart Luhn. "THE RELATIONSHIP BETWEEN SOCIAL SUPPORT AND ROLE STRAIN AND PREVENTATIVE HEALTH BEHAVIORS IN CRITICAL CARE NURSES." Thesis, The University of Arizona, 1987. http://hdl.handle.net/10150/276557.
Full textAbstract:
The purpose of the research was to describe the relationships between social support and role strain and preventative health behaviors. The sample consisted of 62 critical care nurses employed in three southwest acute care facilities. Subjects completed instruments measuring social support, role strain, and four preventative health care behaviors. Pearson correlations revealed significant positive relationships between social support and personal/household roles women perform and ways women handle stress. Additional significant negative relationships existed between marital/relationship roles women perform and leisure physical activities, a subset of preventative health behaviors. The parental roles, obligations, and responsibilities women perform were also significantly related with leisure physical activities. Conclusions drawn indicate that the critical care nurses did not perceive themselves susceptible to cardiovascular disease and therefore did not participate in preventative health care activities, regardless of perceived helpful social support and an absence of role strain.
26
Campbell, Nancy, and University of Lethbridge School of Health Sciences. "Transitions in death : the lived experience of critical care nurses." Thesis, Lethbridge, Alta. : University of Lethbridge, School of Health Sciences, 2008, 2008. http://hdl.handle.net/10133/653.
Full textAbstract:
Critical care nurses often face the ordeal of witnessing a patient's death in a tense and stressful environment. Anecdotal stories shared among nurses reveal that unusual experiences often occur at the time of or after a patient's death. This hermeneutic phenomenological study explored the meaning of these experiences for critical care nurses. Using Parse's research method, in-depth interviews were conducted with six critical care nurses who described their experiences at the time of a patient's death as well as during the post-death period. These experiences brought a sense of peace and comfort to each individual as well as reinforced their individual belief patterns about life after death. A distinctive sense of nursing knowing at the time of death was also identified. The findings of this study indicate that the experiences of the phenomenon of death by critical care nurses have a significant impact on each individual and that further research and understanding of this impact is needed.ix, 113 leaves ; 29 cm.
27
Anthonie, Ramona F. G. "The experiences of critical nurses regarding staffing management in critical care units in private hospitals of the Cape Metropole." Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/71776.
Full textAbstract:
Thesis (MCurr)--Stellenbosch University, 2012.ENGLISH ABSTRACT: Nurse managers are responsible to staff different hospital units and departments with sufficient, trained and experienced personnel. Most critical care units in the private healthcare in South Africa are staffed below maximum workload levels and additional staff is supplemented when needed. Current staffing management strategies comprises the application of the patient acuity score, the utilisation of contracted agency staff and ward staff who assist occasionally in the critical care unit (CCU). The aim of the study was to explore the experiences of critical care nurses regarding staffing management within critical care units in private health care institutions in the Western Cape. The following objectives were set to: - explore the experiences of CCNs regarding staffing management strategies such as o the patient acuity score o the employment of ad hoc agency staff and o the utilization of ward staff A descriptive design with a qualitative approach was applied. A sample size of n=15 was drawn from a total population of N=377, using purposive sampling technique. A pilot-test was also completed. The trustworthiness of this study was assured with the use of Lincoln and Guba’s criteria of credibility, transferability, dependability and confirmability. All ethical principles were met. The findings of the study demonstrated that nurses perceive the workload in critical care units as heavy. The utilisation of the acuity score does not really assist in relieving the workload as managers tend not to consider the staffing requirements as predicted by the acuity score due to budget constraints. The enrolled nurses who assist occasionally in the critical care unit require supervision as well as ongoing development to ensure safe and quality patient care. Yet agency nurses were perceived as either extraordinary good or incompetent.
AFRIKAANSE OPSOMMING: Verpleegbestuurders het die verantwoordelik om verskillende hospitaaleenhede en departemente met voldoende opgeleide en ervare personeel te voorsien. Die meeste kritieke sorgeenhede in Suid-Afrika word met minder as dan die maksimum werkladingsvlak beman en addisionele personeel word aangevul wanneer nodig. Huidige personeelbestuurstrategieë behels die toepassing van die pasiënt akuïteit telling, die gebruik van ingekontrakteerde agentskap-personeel en saalpersoneel wat per geleentheid in die kritiekesorgeenheid help. Die doel van die studie was om die ervaringe van kritieke-sorgverpleegsters ten opsigte van personeel bestuur binne die kritiekesorgeenhede in die privaat gesondheidsorginstellings in die Weskaap, te ondersoek. Die volgende doelwitte is gestel: - Om die ervaringe van kritieke-sorgverpleegsters aangaande personeelbestuur-strategieë te ondersoek, soos: o die pasiënt akuïteit telling o die gebruik van agentskapverpleegpersoneel en o die gebruik van saal personeel, te ondersoek ’n Beskrywende kwalitatiewe studie is toegepas. ’n Steekproef van n=15 is uit ’n totale populasie van N=377 getrek deur die doelgerigte steekproeftegniek te gebruik. ’n Loodstoetsing van die semi-gestruktureerde vraelys is ook gedoen. Die betroubaarheid van hierdie studie was verseker deur van Lincoln en Guba se kriteria vir geloofwaardigheid, oordraagbaarheid, betroubaarheid en bevestigbaarheid gebruik te maak. Daar is aan alle etiese vereistes voldoen. Die bevindings van die studie toon dat die verpleegpersoneel die werklading in die kritiekesorgeenheid as veeleisend ervaar. Die aanwending van die pasiënt akuïteit-telling dra nie werklik by tot verligting van die werklading nie, aangesien bestuurders weens begrotingsbeperkings neig om nie die personeelbenodigdhede soos deur die akuïteit-telling voorspel in ag neem nie. Die ingeskrewe verpleegsters wat per geleentheid in die kritieke-sorgeenheid hulp verleen, benodig toesig asook volgehoue ontwikkeling ten einde veilige en kwaliteit pasiëntsorg te verseker. Die agentskapverpleegpersoneel is egter as baie bekwaam of onbevoeg beskou.
28
Mahmoodi, Mahnaz. "Patient perceptions of caring behaviors of nurses in a critical care setting unit." Virtual Press, 1998. http://liblink.bsu.edu/uhtbin/catkey/1117108.
Full textAbstract:
Caring is a universal need of all humans and is central to the practice of nursing (Watson, 1979). Considerable research has been conducted in the study of caring behavior and caring. However, there has been little nursing research which focuses on the meaning of care as perceived by the patient. The purpose of this study was to further determine the patient's perceptions of caring behaviors of nurses by using Watson's (1979) theory of carative nursing.Watson's theory identified ten carative factors which served as the basis for the caring behavior's assessment instrument's (CBA) seven subscales. The instrument was administered to a convenience sample of 100 adults, 59% female, 40% male over 21 years of age hospitalized during 1997-1998 on the progressive care unit of a large Midwest hospital.Data were analyzed using descriptive and correlational statistics as well as MANOVA. The Cronbach's alpha reliability coefficient for each subscale ranged from 0.88 to 0.98. Principle components factor analysis revealed seven factors which accounted for 71% of the variance in the data and provided support for construct validity of the instrument.Finding showed that critical care patients perceived caring behaviors of nurses in a critical care setting as having much importance on all seven subscales of the CBA. Overall, they perceived technical professional, helping/ trusting subscale and teaching/learning subscale as having much importance. There were no significant differences found on behaviors based on age, sex, education, length of hospital stay and number of hospital admissions.There were no significant differences between those who were married and not married. Married patients perceived as less caring behavior on humanism helping/trusting and teaching subscales.A major conclusion was that patients in the critical care setting overall perceived all behaviors of nurses in a critical care setting as identified in the CBA's seven subscales of the instrument as having the most importance. The behaviors identified as having the most important were technical-professional including giving shots and taking care of equipment (monitor).School of Nursing
29
Van, Belkum Corrien. "A process of quality improvement for outcomes-based critical care nursing education." Thesis, Stellenbosch : Stellenbosch University, 2001. http://hdl.handle.net/10019.1/52125.
Full textAbstract:
Dissertation (PhD) -- University of Stellenbosch, 2001.ENGLISH ABSTRACT: A thoughtfully planned learning program provides a blueprint for critical care nursing and gives direction to theory and clinical practice. The design of a learning program for critical care nursing that is adaptive, learner focussed and integrated, helps nurses acquire the necessary competencies (knowledge, technical skills and attitudes/values) needed for critical thinking. It also enables critical care nurses to grow professionally and to develop expertise in critical care nursing. Outcomes-based education has become the "new buzz word" in South Africa, and a paradigm shift from content-based to outcomes-based education has become essential. Institutions are concerned with efficient and effective approaches to critical care nursing delivery. The institution (nursing department) proves its worth by anticipating patient care needs and planning its learning program cognizant of the need to correlate activities with the institution's (nursing department) mission and outcomes. Planning that meets the learning needs of the critical care nursing learners not only provides the ability to meet job expectations, but also experiences for professional growth and satisfaction. In an age of nursing shortage, a well planned, integrated and outcomes orientated critical care learning program is essential. The outcome of the research was identified as a process of quality improvement for outcomes-based critical care nursing education, which included validated standards to facilitate quality critical care nursing education. This was researched by utilising an adapted Laing and Nish Model for Quality Assurance (1981) as the research strategy. Seven (7) steps were identified, namely: Step one included the identification and clarification of values; step two determined criteria, established standards for outcome, structure and process; step three ratified criteria and validated standards; step four identified and analysed factors influencing the results; step five selected appropriate actions to maintain or improve critical care nursing education; step six implemented the selected actions and in step seven, assessment (testing) was done. In steps two and three of the quality improvement process the Muller's (1996) Three Phase Model for Standard Development was implemented. Seven (7) standards were identified and formulated, namely: Standard one - Quality improvement; Standard two - Standard formulation; Standard three - Philosophy; Standard four - Legislative framework; Standard five - Curriculum development (learning program development); Standard six - Outcomes-based education; and Standard seven - Critical care nursing education. During the process of validation of the standards, standards five and six were combined and became Standard five - Outcomes-based learning program development. In step three the Delphi technique as part of the second phase of Muller's model (1996), was utilised to gain expert opinions / validation of standards. Operationalisation and assessment of the validated standards as part of a process of quality improvement for outcomes-based critical care education were done in a higher education institution. The results of this pilot study that was done supported the central theoretical assumption, namely that outcomes-based critical care nursing facilitates quality critical care nursing. The uniqueness of the research lies in the fact that in outcomes-based critical care nursing education there is no formal process of quality improvement for outcomes-based critical care nursing education. In this research, standards were developed and presented as part of a process of quality improvement for outcomes-based critical care nursing education. These standards should guide the developer of an outcomes-based critical care nursing education program during the development of the learning program (meso curriculum) and could be utilised to judge the quality of the current learning programs' quality. Five of the six standards are generic and could be utilised with minor adjustments in any higher education learning program.
AFRIKAANSE OPSOMMING: 'n Weldeurdagte leerprogram dien as 'n bloudruk vir kritiekesorg-verpleging, en rig beide die teorie en die kliniese praktyk. Die ontwerp van 'n leerprogram vir kritiekesorg-verpleging wat ge"integreerd,leerder-gefokus en aanpasbaar is, help verpleegkundiges om die nodige vaardighede (kennis, tegniese vaardighede en houdings/waardes) vir kritiese denke te ontwikkel. Dit stel kritiekesorg verpleegkundiges ook in staat om professioneel te groei en om kundigheid in kritiekesorg-verpleging te ontwikkel. Uitkoms-gebaseerde onderrig is die "nuwe wagwoord" in Suid-Afrika en het 'n paradigmaskuif van inhoud-gebaseerde- na uitkoms-gebaseerde onderrig genoodsaak. Instellings is begaan oor doeltreffende en effektiewe benaderings vir die lewering van kritiekesorg verpleging. Die verrnoe van 'n instelling (departement verpleging) om pasientsorq-behoeftes te voorspel en om die kritiekesorg leerprogram se aktiwiteite in ooreenstemming met die instelling (departement verpleging) se missie en verwagte uitkomstes te beplan, bewys die waarde van die instelling (departement verpleging). 8eplanning wat aan die leerbehoeftes van die kritiekesorg-Ieerders voldoen, bevredig nie aileen hul werksverwagtinge nie, maar het ook professionele groei en genoegdoening tot gevolg. In Goed-beplande, ge"integreerde en uitkoms-georienteerde kritiekesorg leerprogram is essensieel in 'n tyd waar verpleegtekorte aan die orde van die dag is. Ten einde gehalte-verpleegonderrig te fasiliteer, is die uitkoms van die navorsing as 'n proses van gehalteverbetering vir uitkoms-gebaseerde kritiekesorgverpleegonderrig, wat gevalideerde standaarde insluit, ge"identifiseer. 'n Aangepaste Laing en Nish Model vir Gehalteversekering (1981) is as navorsingstrategie vir hierdie navorsing gebruik. Sewe (7) stappe is ge"identifiseer, naamlik: Stap een sluit die identifisering en verduideliking van waardes in; stap twee bepaal kriteria en skep standaarde vir uitkoms, struktuur en proses; stap drie bekragtig en valideer die standaarde; stap vier identifiseer en ontleed faktore wat die resultate belnvloed; stap vyf selekteer toepaslike aksies om kritiekesorg-verpleegonderrig te handhaaf of te verbeter; stap ses implementeer die geselekteerde aksies en in stap sewe is assessering (toetsing) gedoen. Muller (1996) se Drie Fase Model vir Standaardontwikkeling is in stappe twee en drie van die gehalteverbeteringsproses ge"implementeer. Sewe (7) standaarde is ge"identifiseer en geformuleer, naamlik: Standaard een - Gehalteverbetering; Standaard twee - Standaardformulering; Standaard drie - Filosofie; Standaard vier - Wetlike raamwerk; Standaard vyf - Kurrikulumontwikkeling (Ieerprogramontwikkeling); Standaard ses - Uitkoms-gebaseerde onderrig; en Standaard sewe - Kritiekesorg-verpleegonderrig. Tydens die valideringsproses van die standaarde, is standaarde vyf en ses gekombineer as Standaard vyf - Uitkomsgebasseerde leerprogramontwikkeling. Gedurende stap drie is die Delphitegniek tydens die tweede fase van Muller (1996) se model gebruik om deskundige opinies te verkry I die standaarde te valideer. Operasionalisering en assessering van die gevalideerde standaarde as deel van In sisteem van gehalteverbetering vir uitkoms-gebaseerde onderring is in 'n hoeronderwysinstelling gedoen. Die resultate van hierdie toetsstudie het die sentrale teoretiese aanname, naamlik dat uitkoms-gebaseerde kritiekesorg-verpleging gehalte kritiekesorg-verpleging fasiliteer, ondersteun. Die uniekheid van hierdie navorsing is gelee in die feit dat daar in uitkomsgebaseerde kritiekesorg-verpleegonderrig, geen formele proses van gehalteverbetering vir uitkoms-gebaseerde kritiekesorg-verpleegonderrig is nie. In hierdie navorsing is standaarde ontwikkel en aangebied as deel van In sisteem van gehalteverbetering vir uitkoms-gebaseerde kritiekesorg-verpleegonderrig. Hierdie standaarde kan tydens die ontwikkeling van die leerprogram (mesokurrikulum), die ontwikkelaar van In uitkoms-gebaseerde kritiekesorgverpleegondderigprogram begelei, en kan gebruik word om die gehalte van huidige leerprogramme te beoordeel. Vyf van die ses standaarde is generies en kan, met minimale veranderinge in enige hoer onderwys leerprogram gebruik word.
30
Baning, Karla M. "Outcomes of a Comprehensive Patient and Family-Centered Program in an Adult Intensive Care Unit." Diss., The University of Arizona, 2012. http://hdl.handle.net/10150/228151.
Full textAbstract:
Background: Intensive care unit (ICU) admission is often life threatening, and may cause severe anxiety within the family system. Anxiety can impair decision-making ability. A majority of ICU patients cannot direct their own treatment; therefore, family members are often required to make major decisions under stressful conditions. Patient and family-centered care (PCFF) has been shown to reduce anxiety, improve decision-making, and improve outcomes for patients and their families. However, no published study has examined outcomes of a comprehensive PFCC program in the ICU. Purpose: The study purposes were to evaluate a comprehensive program to improve PFCC within an adult ICU, and to determine the usefulness of specific PFCC interventions. Methods: An exploratory comparative design was used. Data from ICU patients' family members and ICU nurses, before and after implementation of a PFCC program, were compared using the 30-item combined Critical Care Family Needs Inventory/Needs Met Inventory (CCFNI/NMI). Convenience samples of 49 adult family members of patients admitted to the ICU for at least 36 hours and 85 nurses employed in the ICU full-time for at least six months were recruited from an adult ICU in a 337-bed tertiary care hospital in the southwestern region of the United States. The program was conducted in 3 stages: baseline assessment, program development and implementation, and evaluation. Results: After the PFCC implementation statistically significant differences between nurses' and family members' responses were reported for18 items on the CCFNI and 20 items on the NMI. Five of the10 items family members ranked highest at baseline remained in the top 10 after PFCC implementation, and 3 needs ranked lowest at baseline moved up to the top 10. Conclusions: The results show that the nurses' education was likely the most efficacious program intervention. There may be a hierarchy of needs specific to ICU patients' family members, similar to those described by Maslow. Further study is needed to determine the effectiveness of the CCFNI/NIM in measuring outcomes before and after a PFCC intervention.
31
Mahon, Paula R. "From the inside out : a critical ethnographic look at paediatric intensive care nursing and the determinants of nurse retention." Thesis, University of Bath, 2011. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.555745.
Full textAbstract:
The aim of this study is to examine key features within the cultural context in a Canadian Paediatric Intensive Care Unit (PICU) environment as experienced by nurses, and to identify what these influences are and how they shape nurses’ intentions to remain at critically ill children’s bed-sides for the duration of their careers. This is a qualitative study which follows a critical ethnographic approach. Over 20 hours of observation and face-to-face semi-structured interviews were conducted. Approximately one third of the nursing population at the research site PICU were interviewed (N=31). Participants describe a complex process of becoming an expert PICU nurse that involved several stages. By the time participants became experts in this PICU they believed they had significantly narrowed the power imbalance that exists between nursing and medicine. This study illuminates the role both formal and informal education plays in breaking the power barrier for nurses in the PICU. This level of expertise and mutual respect between professions aids in retaining nurses in the PICU. The lack of autonomy and/or respect shown to nurses by administrators appears to be one of the major stressors in nurses’ working lives and can lead to attrition from the PICU. Family Centred Care (FCC) is practiced in paediatrics and certainly accentuated in the PICU as there is usually only one patient assigned per nurse, who thus afforded the time to provide comprehensive care to both the child and the family. This is considered one of the satisfiers for nurses in the PICU and tends to encourage retention of nurses in the PICU. However, FCC was found to be an inadequate term to truly encompass the type of holistic care provided by nurses in the PICU.
32
Bell, Janet. "An investigation into the scope of practice of a registered critical care nurse in a private hospital." Thesis, Stellenbosch : University of Stellenbosch, 2011. http://hdl.handle.net/10019.1/16595.
Full textAbstract:
Thesis (MCur)--University of Stellenbosch, 2005.ENGLISH ABSTRACT: The critical care nurse works in an environment where patient need often shifts the parameters within which she or he practices. It is expected of a skilled critical care nurse to be able to make independent decisions and take action regarding patient care based on her or his knowledge and skills without discounting the parameters of her or his scope of practice. Practice experience has indicated that the critical care nurse is often uncertain about whether her or his clinical activities are protected by the regulations provided by the Nursing Council. This is more specifically true in the private hospital industry where medical advice or assistance is not always easily available. This situation led to the following research question: Do the available professional and legal guidelines provide an appropriate foundation to guide the practice of the registered critical care nurse in the private hospital sector critical care environment? A non-experimental descriptive study with a qualitative orientation was conducted in 19 private hospitals in the Western Cape. Through nonprobability, random sampling, 71 registered critical care nurses were included in the study. A questionnaire was designed and validated to collect the data. Quantitative data was analysed through Excel® while qualitative data was analysed thematically. It was found that the legal and professional guidelines in place at present do provide a foundation for the clinical activities of critical care nursing in the private hospital sector. It is suggested that it is rather the critical care nurses’ interpretation of the Scope of Practice (No.R.2598 of 30/11/1984 as amended) that limits their practice as opposed to the wording of the regulations. It is recommended that critical care nurses must determine nursing care parameters based on patient need, using the regulations as a foundation for critical, analytical and reflective practice rather than as a set of rules to be followed. Key words: Scope of practice, critical care practice, ICU nursing care, private hospital nursing practice.
AFRIKAANSE OPSOMMING: Die kritiekesorgverpleegkundige werk in ‘n omgewing waar pasiëntebehoeftes gereeld die parameters waarin sy of hy praktiseer, verskuif. Dit word van ’n bekwame kritiekesorgverpleegkundige verwag dat sy of hy onafhanklike besluite en aksies met betrekking tot pasiëntesorg, gebaseer op haar of sy kennis en vaardighede, sal neem sonder om die parameters van haar of sy bestek van praktyk te oorskry. Praktykondervinding het getoon dat die kritiekesorgverpleegkundige dikwels onseker is oor watter van haar of sy optredes deur die Regulasies, soos deur die Raad op Verpleging gespesifiseer word, beskerm word. Dit is nog meer spesifiek van toepassing in die privaathospitaal-industrie waar geneeskundige advies en bystand nie altyd maklik beskikbaar is nie. Die situasie het tot die volgende navorsingsvraag aanleiding gegee: Voorsien die beskikbare professionele en wetlike riglyne ’n geskikte grondslag om die praktyk van ’n geregistreerde kritiekesorgverpleegkundige in die privaatsektor- kritiekesorgomgewing te rig? ’n Nie-eksperimentele, beskrywende studie met ’n kwalitatiewe oriëntasie is in 19 hospitale in die Wes-Kaap onderneem. Deur nie-waarskynlikheids-, toevallige steekproefneming is 71 geregistreerde kritiekesorgverpleegkundiges in die studie ingesluit. ’n Vraelys is ontwerp en gevalideer om inligting in te samel. Kwantitatiewe data is deur middel van Excel ontleed terwyl kwalitatiewe data tematies ontleed is. Daar is gevind dat die wetlike en professionele riglyne wat tans beskikbaar is, ‘n grondslag bied vir die kliniese aktiwiteite van kritiekesorgverpleegkundiges in die privaathospitaal.. Dit word voorgestel dat dit die kritiekesorgverpleegkundige se interpretasie van die Bestek van Praktyk (No.R.2598 of 30/11/1984 soos aangepas) is wat hulle praktyk beperk, eerder as die bewoording van die regulasie self.
33
Altman, Marian. "A Biobehavioral Approach to Examining Moral Distress in Critical Care Nurses." VCU Scholars Compass, 2017. https://scholarscompass.vcu.edu/etd/5148.
Full textAbstract:
Moral distress is a complex and challenging problem that may cause negative biopsycohosical and professional outcomes for critical care nurses. The purpose of this work was to explore the relationship between the ethical climate of the work environment and moral distress as experienced by critical care nurses; and to explore relationships among mediators of stress (nurse characteristics e.g. education (BSN, nonBSN), years certified as a critical care nurse, and tolerance of ambiguity) and their relationship with perceived stress, moral distress, health status and salivary alpha amylase. A descriptive correlational cross-sectional design was used for this pilot study of 100 critical care nurses working in adult intensive care units in one large academic medical center. Data were analyzed using descriptive statistics to characterize the sample and the model variables. Regression analysis using a stepwise regression model building technique was used to determine predictors of the study outcomes (moral distress, health status, and salivary alpha amylase). The findings demonstrate that the ethical characteristics of the work environment and perceived stress were predictive of moral distress, psychological/emotional outcomes and stress symptoms. Other variables thought to mediate these relationships were not significant. Future research is needed to find ways to prevent moral distress from occurring and to support nurses dealing with moral distress.
34
Bezerra, Rosana Mendes. "O SIGNIFICADO DE CUIDAR NA UNIDADE DE TERAPIA INTENSIVA PEDIÁTRICA." Pontifícia Universidade Católica de Goiás, 2012. http://localhost:8080/tede/handle/tede/2984.
Full textAbstract:
Made available in DSpace on 2016-08-10T10:54:25Z (GMT). No. of bitstreams: 1
ROSANA MENDES BEZERRA.pdf: 1117027 bytes, checksum: 2bd3a56545030c4fe5b18a990314fbe8 (MD5)
Previous issue date: 2012-12-05The Pediatric Intensive Therapy Unit of is characterized as highly technological environment with specialized professionals. It is permeated by feelings of loss, anguish and at the same hopes on the expectation of stability and recovery of a child. The nursing team sets a team that plans, implements and develops the process of caring basead on healthpublic policies. To assure a critical pediatric patient and its family a humanized, integrated and systematic care with quality in its entirety is a matter to be questioned along with the understanding of nursing about the meaning of child caring into a critical unit. Therefore, it was chosen to develop a qualitative case study in which the target was to comprehend the meaning of taking care at the PITU from the nursing components perspective team. Six nursing assistants, six nursing technician and two nurses participated. The data collection happened from December of 2010 to August of 2011 through semi structured interviews and participant observation held on a private place inside its own health institution. Through the study and interpretation of data, it is noted that the attributed feelings from the participants in the meaning of caring in the Pediatric Intensive Therapy Units is associated with the dimensions techniques of humanization, the pressure and the love for caring. The participants mentioned that caring is composed by assistance activities concerning the eating, the hygienization, the medication, the elimination and the ventilator support. It was also added that characteristics of humanization emerges strongly in the sense of giving warmth, affection and to dialogue. They shower love for what they do, and the fulfillment to work with critical children and families, in addition to personal accomplishment, recalling the existence of the old nursing. Team work and the concern of taking care of who also takes, was identified as well, just like therecognition fo the family by the care carried out. To take care like a creator of tension was referred as harmful for health development actions. They are represented by the overwork, by the absence of hiring for a position, human resources and insufficient materials, impossibility of helping a family, specially a mother during the process of hospitalization beside suffering from seeing the affliction of ones and the nurse s frustration for not seeing the pediatrical patient and their family through the systematized assistance. Results show that tensions are overcame by the satisfaction of caring in a critical pediatric atmosphere, but also leaves the nursing team in its working limits. The need of managers to suit an actual policy assistance model for health should be accomplished when a nursing service fragmentation doesn t provide the care guided in its integrality, in humanization and the sysmatization of the nursing assistance.
A Unidade de Terapia Intensiva Pediátrica é caracterizada como ambiente altamente tecnológico e com profissionais especializados. É permeada por sentimentos de perda, angústia e ao mesmo tempo esperança na expectativa da estabilização e recuperação da criança. A equipe de enfermagem configura um grupo que planeja, implementa e desenvolve o processo de cuidar embasado nas políticas públicas de saúde. Garantir ao cliente crítico pediátrico e sua família o cuidado humanizado, integralizado, sistematizado e com qualidade em sua totalidade é hoje um ponto a ser questionado juntamente a compreensão da enfermagem sobre o significado de cuidar de criança em unidade crítica. Neste sentido, optouse por desenvolver um estudo de caso qualitativo com o objetivo de compreender o significado de cuidar na UTIP na perspectiva dos componentes da equipe de enfermagem Participaram seis auxiliares de enfermagem, seis técnicas de enfermagem e 2 enfermeiras. A coleta de dados ocorreu de dezembro de 2010 a agosto de 2011 por meio de entrevista semiestruturada e observação participante, em local privativo, dentro da própria instituição de saúde. Através da análise e interpretação dos dados, ficou constatado que os sentidos atribuídos pelas participantes ao significado do cuidar em unidade de terapia intensiva pediátrica está relacionada as dimensões técnicas, de humanização, das tensões e do gostar para cuidar. Os participantes mencionaram que o cuidar é composto por atividades assistenciais relacionadas a alimentação, higienização, medicação, eliminações, suporte ventilatório. Acrescentaram ainda que as características de humanização estão fortemente presente no sentido de dar carinho, dar aconchego e dialogar. Apontaram gostar do que fazem, sentir muita satisfação para trabalhar com criança crítica e com sua família além da realização pessoal, lembrando o sacerdócio existente na enfermagem antiga. O trabalho em equipe, a alteridade e a preocupação de cuidar de quem cuida também foram identificados bem como o reconhecimento da família pelo cuidado desenvolvido. Cuidar como gerador de tensões foram citadas como prejudiciais ao desenvolvimento das ações de saúde. Estão representadas pela sobrecarga de trabalho, desvio de contratação de função, recursos humanos e materiais insuficientes, impossibilidade de acolher a família, principalmente a mãe durante todo o processo de hospitalização além de sofrer ao ver o sofrimento do outro e a frustração do enfermeiro por não assistir o cliente pediátrico e sua família através da assistência sistematizada. Os resultados apontam que as tensões são superadas pela satisfação em cuidar neste ambiente crítico pediátrico, mas que deixa a equipe de enfermagem em seu limite laboral. A necessidade dos gestores adequarem o modelo de assistencial vigente as políticas de saúde deve ser realizado uma vez que a fragmentação do serviço de enfermagem não proporciona o cuidado pautado na integralidade, na humanização e na sistematização da assistência de enfermagem.
35
Ananian, Lillian Virginia. "Relationship Based Care: Exploring the Manifestations of Health as Expanding Consciousness within a Patient and Family Centered Medical Intensive Care Unit." Thesis, Boston College, 2014. http://hdl.handle.net/2345/bc-ir:103534.
Full textAbstract:
Thesis advisor: Dorothy JonesA family's unique way of being, formulated through social, economic, environmental and political factors, becomes fractured during a loved one's critical illness. Family members experience burdensome physical and emotional symptoms as they transition through the marked uncertainty endemic to high acuity illness. For some, this burden results in long term psychiatric disturbances. Assessment tools and interventions have been proposed for family members experiencing a loved one's critical illness. However, ongoing suffering suggests inherent limitations within these reductionist approaches. The need for a more encompassing disciplinary perspective is suggested. Margaret Newman's (1986, 1994, 2008) theory of Health as Expanding Consciousness (HEC) and its praxis research method was employed to explore relationship based care among intensive care unit (ICU) family members and registered nurses. HEC retains person/environmental integrity through unfolding of unitary knowledge via exploration of meaning. Additionally, its holistic perspective aligns philosophically with the belief in nursing science as the study of caring in the human health experience, endorsing both the mutuality of the nurse/client relationship and pattern recognition's capacity to inspire transformational growth. The study was performed in an eighteen bed medical ICU in the northeast region of the United States. This unit's design includes an integrated critical/palliative care model. Exploration of the study's two research questions was accomplished using the practice and research components of HEC within a sample of eight family members and six registered nurses. Results demonstrated family members' capacity to achieve consciousness expansion within the context of a loved one's critical illness. Registered nurses revealed their ability to steadfastly partner with both patients and families. Repetitive elements distinguished as thematic commonalities were recognized among both family member and registered nurse participants. Additionally, thematic integration between family members and registered nurses was appreciated. HEC was found to offer unique insights into caring relationships between ICU family members and registered nurses
Thesis (PhD) — Boston College, 2014
Submitted to: Boston College. Connell School of Nursing
Discipline: Nursing
36
McKnight, Michelynn. "An Observational Investigation of On-Duty Critical Care Nurses' Information Behavior in a Nonteaching Community Hospital." Thesis, University of North Texas, 2004. https://digital.library.unt.edu/ark:/67531/metadc4498/.
Full textAbstract:
Critical care nurses work in an environment rich in informative interactions. Although there have been post hoc self-report survey studies of nurses' information seeking, there have been no observational studies of the patterns and content of their on-duty information behavior. This study used participant observation and in-context interviews to describe 50 hours of the observable information behavior of a representative sample of critical care nurses in a 20-bed critical care hospital unit. The researcher used open, in vivo, and axial coding to develop a grounded theory model of their consistent pattern of multimedia interactions. The resulting Nurse's Patient-Chart Cycle describes nurses' activities during the shift as centering on a regular alternation with the patient and the patient's chart (various record systems), clearly bounded with nursing "report" interactions at the beginning and the end of the shift. The nurses' demeanor markedly changed between interactions with the chart and interactions with the patient. Other informative interactions were observed with other health care workers and the patient's family, friends and visitors. The nurses' information seeking was centered on the patient. They mostly sought information from people, the patient record and other digital systems. They acted on or passed on most of the information they found. Some information they recorded for their personal use during the shift. The researcher observed the nurses using mostly patient specific information, but they also used some social and logistic information. They occasionally sought knowledge based information. Barriers to information acquisition included illegible handwriting, difficult navigation of online systems, equipment failure, unavailable people, social protocols and mistakes caused by multi-tasking people working with multiple complex systems. No formal use was observed of standardized nursing diagnoses, nursing interventions, or nursing outcomes taxonomies. While the nurses expressed respect for evidence-based practice, there clearly was no time or opportunity for reading research literature (either on paper or online) while on duty. All participants expressed frustration with the amount of redundant data entry required of them. The results of this study have significant implications for the design of clinical information systems and library services for working critical care nurses.
37
Shubane, Nancy. "Black critical care nurses' perceptions of organ donation and organ transplantation." Pretoria : [s.n.], 2009. http://upetd.up.ac.za/thesis/available/etd-10262009-185326/.
Full text
38
Seal, Mitchell J. "Mastery learning and the essentials of critical care orientation : a heuristic participant evaluation." Scholarly Commons, 2007. https://scholarlycommons.pacific.edu/uop_etds/658.
Full textAbstract:
This study employed a heuristic -participant evaluation of the instruction of the web-based Essentials of Critical Care Orientation (ECCO) program using two research questions: (1) How well does the ECCO adhere to Bloom's theory of mastery learning and instruction; and (2) What effect, if any, does this have on the participant RN? Evaluation findings demonstrated that the ECCO is 66 hours of expository instruction with little to no meaningful feedback, correction, or enrichment activity, is not well aligned, and has significant design flaws related to objectives and transfer of instruction and to the processes of instruction. This results in the participant RN being left to his own devices to achieve mastery. Heuristic findings demonstrated the effect on the participant RN - feelings of frustration, resentment, fear, lack of confidence, and apprehension which in sum outweigh feelings of accomplishment and yield a compulsion to leave critical care practice. Discussion includes implications of findings and results, recommendations for the ECCO program improvement, and concludes with suggestions for future research.
39
Place, Bernard. "Constructing the critically ill body : an investigation into the design and development of a clinical data-logging computer to be used by nurses working on a paediatric intensive care unit." Thesis, London South Bank University, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.245125.
Full text
40
Archer, Elize. "Using simulation for achieving competency in the practical procedures of a Critical care nursing programme." Thesis, Stellenbosch : Stellenbosch University, 2008. http://hdl.handle.net/10019.1/2028.
Full textAbstract:
Thesis (MPhil (Curriculum Studies))--Stellenbosch University, 2008.Background to the study: The Critical Care nursing programme at the Faculty of Health Sciences (Stellenbosch University) is a one-year programme. The practical component consists of practical procedures and case presentations. Students have limited time available in the clinical areas to reach competency in the practical skills. Students tend to use the majority of the clinical teaching time available to reach competency in these practical procedures, rather than discussing the patient and learning the skills to integrate and understand the patient’s condition and treatment, which they can acquire by doing case presentations. The end result of this misuse of clinical contact time is that some of the students, by the end of their programme, still have difficulty to integrate a patient’s diagnosis and treatment regime, although they have managed to complete the expected practical procedures. Summary of the work: A case study design was used. I wanted to investigate whether one could make use of simulation and the Clinical Skills Centre (CSC) to complete the majority of the practical procedures so that more time would be available in the clinical areas for the students to do case presentations. The study focuses on describing how the tutors and students involved experienced the use of simulation, as well as how it impacted on the available teaching time in the clinical areas. Conclusions and recommendations: Some of the most important issues that were highlighted in the study and needs to be mentioned are the following: · The students highly valued supervision by a Critical Care tutor when practising their skills in the CSC. · Students indicated that they valued the opportunity to practise some of the more risky procedures in simulation, because it presents no risk to patients. · Case presentations seem important to be added to the CSC’s practical sessions in order to attempt making the practical simulated scenarios even more realistic. · The teaching at the bedside in the clinical areas used to be done somewhat ad hoc. With the teaching in the CSC now being much more structured, this necessitates the teaching at the bedside to be revisited and to be structured to a certain extent. Summary of the results: The information obtained from the Critical Care tutors and the students indicated that these two groups were largely in agreement that simulation seems to be valuable and can effectively be used in a Critical Care nursing programme.
41
Ryder-Lewis, Michelle. "Reliability study of the sedation-agitation scale in an intensive care unit : a thesis submitted in partial fulfilment to the Victoria University of Wellington in fulfilment of the requirements for the degree of Master of Arts (Applied) Nursing /." ResearchArchive@Victoria e-Thesis, 2004. http://hdl.handle.net/10063/59.
Full text
42
Bjurlefält, Peter. "Erfarenhet av debriefing inom akutsjukvården." Thesis, Högskolan i Gävle, Avdelningen för vårdvetenskap, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-30487.
Full textAbstract:
Samfattning Bakgrund: I vår vardag världen över drabbas människor oavsett kön och ålder av olyckor, dödsfall och andra traumatiska händelser. Vissa yrken medför en större risk att utsättas för traumatiska händelser. Exempel på dessa är ambulans, räddningspersonal, polis och vårdpersonal inom främst akutsjukvård. Dessa händelser kan ibland bli personen övermäktigt. Ett sätt att motverka bl.a. utbrändhet och posttraumatiskt stressymptom (PTSD) hos vårdpersonalen är att genomföra debriefingsamtal. Detta genomförs med den vårdpersonal som varit delaktig i en traumatisk händelse. Syfte: Syftet med denna studie var att beskriva erfarenheten av debriefing hos vårdpersonal inom akutsjukvården i samband med traumatiska händelser i sin yrkesutövning. Metod: Litteraturstudie som totalt innehåller 10 vetenskapliga artiklar varav fem är kvalitativa och fem är kvantitativa. Resultat: Studieresultatet påvisar att debriefing uppfattas som ett positiv redskap när det gäller avlastning efter en traumatisk händelse för vårdpersonalen inom akutsjukvården. De främsta faktorerna som lyfts i studien är tid och plats för debriefing, debriefingens inverkan på kommunikationen mellan vårdpersonalen, val av debriefingledare och behovet av väl utformade riktlinjer för debriefingen. Slutsats: I föreliggande studie påvisas att debriefing bör betraktas som ett effektivt verktyg att motverka psykisk ohälsa hos vårdpersonalen och att debriefing även förstärker kommunikationen mellan de olika professionella yrkesgrupperna inom akutsjukvården. Studien visar även att det är viktigt med väl utformade riktlinjer för att debriefingens syfte skall uppnås.Abstract Background: In our everyday lives worldwide, people are affected regardless of gender and age by accidents, deaths and other traumatic events. Some professions involve a greater risk of being exposed to traumatic events. Examples of these are ambulance, emergency personnel, police and health care personnel, primarily in emergency care. These events can sometimes become overpowering. One way to counteract burnout and post-traumatic stress symptom (PTSD) in healthcare professionals is to carry out debriefing talks. This is done with the healthcare staff who has participated in a traumatic event. Aim: The purpose of this study was to describe the experience of debriefing in healthcare professionals in emergency care in connection with traumatic events in their professional practice. Method: Literature study that contains a total of 10 scientific articles, five of which are qualitative and five are quantitative. Results: The study results show that debriefing is perceived as a positive tool when it comes to unloading after a traumatic event for the healthcare staff in emergency care. The main factors raised in the study are time and place for debriefing, debriefing impact on the communication between the healthcare staff, the choice of debriefing leader and the need for well-designed guidelines for debriefing. Conclusion: The present study demonstrates that debriefing should be regarded as an effective tool for counteracting mental illness in the healthcare staff and that debriefing also reinforces communication between the various professional occupational groups in emergency care. The study also shows that well-designed guidelines are important for achieving the purpose of the debriefing.
43
Brown, Andrew Scott. "Differences in attitudes towards risk in the use of medical devices by doctors and nurses in an acute care setting : organisational, professional and personal dimensions." Thesis, Swansea University, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.678287.
Full text
44
Soh, Kim Lam. "Knowledge about nosocomial pneumonia prevention among critical care nurses in New Zealand a thesis presented in partial fulfillment of the requirement for the degree of Master of Health Science, Auckland University of Technology, September 2003 /." Full thesis. Abstract, 2003. http://puka2.aut.ac.nz/ait/theses/SohK.pdf.
Full textAbstract:
Thesis (MHSc--Health Science) -- Auckland University of Technology, 2003.Appendix B not included in e-thesis. Also held in print (128 leaves, 30 cm.) in Akoranga Theses Collection. (T 610.7361 SOH)
45
Almerud, Sofia. "Vigilance & Invisibility : Care in technologically intense environments." Doctoral thesis, Växjö : Växjö University Press, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:vxu:diva-1506.
Full text
46
Jarden, Rebecca Jane. "Gastric residual volumes in the adult intensive care patient : a systematic review : a thesis submitted to the Victoria University of Wellington in fulfilment of the requirements for the degree of Master of Nursing (Clinical) /." ResearchArchive@Victoria e-Thesis, 2009. http://hdl.handle.net/10063/1188.
Full text
47
Helmersson, Anna, and Mandana Rostampour. "Empowerment hos intensivvårdspatienten - hur svårt kan det vara? : En systematisk litteraturstudie." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-352319.
Full textAbstract:
Bakgrund: Patienter som drabbas av svår sjukdom och vårdas på intensivvårdsavdelning upplever känslor av total förlust av kontroll, förstärkt av oförmågan att kommunicera. Att få kunskap, kontroll och inflytande över sin vård leder till mindre smärtlindring och kortare vårdtid. Patientcentrering i vården brister dock, vilket kan leda till ökade kostnader för såväl samhället som patienter. Syfte: Att identifiera och beskriva hinder mot empowerment till patienter inom intensivvård samt vilka möjligheter som finns för att överbrygga dessa hinder. Metod: En systematisk litteraturstudie analyserad i två steg med meta-syntes enligt Evans samt meta-aggregation, inspirerad av Joanna Briggs’ Institute. Resultat: Både hinder och lösningar för empowerment till intensivvårdspatienten finns på flera plan. Sjukdomen gör att patienten förlorar förmåga till empowerment, vårdmiljön känns skrämmande, vårdpersonal upplevs vara avvisande och brister i arbetsmiljön leder till sämre möjlighet till delaktighet. Specialistsjuksköterskan inom intensivvård behöver ge patienten indirekt delaktighet, förklara vårdmiljön, skapa en ömsesidig relation och uppmuntra delaktighet. Ett stödjande ledarskap och goda arbetsvillkor är andra nödvändiga förutsättningar för detta. Slutsats: Genom en ökad medvetenhet om de hinder som finns för empowerment till intensivvårdspatienten kan specialistsjuksköterskor och arbetsgivare aktivt arbeta för att komma över hindren och istället stärka patientens möjligheter att bli en del av vårdteamet.Background: To become critically ill and be cared for at an ICU involves feelings of total loss of control, reinforced by the inability to communicate. Gaining knowledge, control and influence over the nursing care results in reduced need for pain relief and shorter stay in hospital. Patient centered care is however lacking. This might incur a higher cost for society, as well as the patient in the form of suffering.Aim: To identify and describe barriers to patient empowerment in critical care and what means there are to overcome these barriers. Method: Systematic literature review, analysed in two steps with meta synthesis according to Evans and meta aggregation, inspired by the Joanna Briggs’ Institute. Results: Barriers as well as possibilities for patient empowerment in ICU were found on various levels. Being critically ill disables the patient from feeling or receiving empowerment, the nursing environment is frightening, staff is perceived as dismissive and working conditions impede patient participation. The specialist nurse in intensive care needs to give the patient indirect participation, explain the nursing environment, create a mutual relationship and encourage participation. Good working conditions and a supportive workplace leadership are also required. Conclusion: By being aware of what the barriers to patient empowerment in the ICU are, specialist nurses and employers can actively engage in the work to overcome them, as well as engaging in the support of the patient to become part of the care team.
48
Cairns, Paula L. "Prevention of Post Intensive Care Syndrome-Family with Sensation Awareness Focused Training Intervention: A Randomized Controlled Trial Pilot Study." Scholar Commons, 2018. https://scholarcommons.usf.edu/etd/7606.
Full textAbstract:
Post Intensive Care Syndrome-Family (PICS-F) refers to acute and chronic psychological effects of critical illness on family members of patients in intensive care units (ICU). Evidence about the increase and persistence of PICS-F warrants the need for prevention interventions. This study evaluated the feasibility of providing Sensation Awareness Focused Training (SĀF-T) during the ICU stay for spouses of mechanically ventilated patients. Methods: A randomized controlled trial of SĀF-T versus a control group was conducted (n=10) to assess safety, acceptability, feasibility, and effect size of the intervention on PICS-F symptoms. Symptoms assessed as outcome measures included stress, anxiety, depression, posttraumatic stress disorder, and sleep efficiency. Those randomly assigned to SĀF-T received one session daily over 3-days in the ICU. Repeated measures (day 1, day 3, day 30, and day 90) of PICS-F symptoms in both groups were analyzed. Results: Mean age was 58 ± 12 years; 70% were female. Feasibility success criteria were met in weekly recruitment (8 ± 3.5), enrollment rate (67%), SĀF-T acceptability (100% of doses received, no adverse events) with significantly lower post SĀF-T stress levels (p<.05) compared to pre SĀF-T stress levels, ActiWatch acceptability rate (90% agreed to wear, no adverse events) with no significant difference in sleep efficiency between groups (p>.05), and repeated measures completion rate (>90%). Conclusions: This study provided guidance for modifications to protocol outcome measures and evidence of a large effect size, which will inform a larger clinical trial to assess the effectiveness of the SĀF-T intervention in reducing PICS-F.
49
O'Hara, Sullivan Susan. "Macrocognition in the Health Care Built Environment (m-HCBE): A Focused Ethnographic Study of 'Neighborhoods' in a Pediatric Intensive Care Unit: A Dissertation." eScholarship@UMMS, 2016. https://escholarship.umassmed.edu/gsn_diss/46.
Full textAbstract:
Objectives: The objectives of this research were to describe the interactions (formal and informal) in which macrocognitive functions occur and their location on a pediatric intensive care unit (PICU); describe challenges and facilitators of macrocognition using three constructs of space syntax (openness, connectivity, and visibility); and analyze the health care built environment (HCBE) using those constructs to explicate influences on macrocognition.
Background: In high reliability, complex industries, macrocognition is an approach to develop new knowledge among interprofessional team members. Although macrocognitive functions have been analyzed in multiple health care settings, the effect of the HCBE on those functions has not been directly studied. The theoretical framework, “Macrocognition in the Health Care Built Environment” (m-HCBE) addresses this relationship.
Methods: A focused ethnographic study was conducted, including observation and focus groups. Architectural drawing files used to create distance matrices and isovist field view analyses were compared to panoramic photographs and ethnographic data.
Results: Neighborhoods comprised of corner configurations with maximized visibility enhanced team interactions as well as observation of patients, offering the greatest opportunity for informal situated macrocognitive interactions (SMIs).
Conclusions: Results from this study support the intricate link between macrocognitive interactions and space syntax constructs within the HCBE. These findings help to advance the m-HCBE theory for improving physical space by designing new spaces or refining existing spaces, or for adapting IPT practices to maximize formal and informal SMI opportunities; this lays the groundwork for future research to improve safety and quality for patient and family care.
50
Favretto, Débora Oliveira. "Aspiração endotraqueal em pacientes críticos adultos intubados sob ventilação mecânica: revisão sistemática." Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/22/22132/tde-31102011-082522/.
Full textAbstract:
Este estudo trata-se de uma revisão sistemática da literatura e tem como referencial teórico a prática baseada em evidência. Buscou-se identificar e analisar na literatura evidências oriundas de ensaios clínicos controlados e randomizados sobre os cuidados relacionados à aspiração de secreções endotraqueais em pacientes adultos, em estado crítico, intubados e sob ventilação mecânica. Os passos metodológicos desta revisão foram guiados pelas recomendações da Colaboração Cochrane. A busca foi realizada nas bases de dados PUBMED, EMBASE, CENTRAL, CINAHL e LILACS. Das 631 referências encontradas, 17 estudos foram selecionados após a análise dos títulos e resumos. Foi realizada a extração dos dados e análise do risco de viés por dois revisores, para cada estudo selecionado. Os 17 estudos foram publicados no período de 1987 à 2009. Ao todo, foram investigados 2.890 pacientes adultos, intubados e sob ventilação mecânica. Foram encontradas evidências quanto a seis categorias de intervenções relacionadas à aspiração endotraqueal: aspiração endotraqueal baseada em pesquisa x aspiração endotraqueal usual, em um estudo; aspiração endotraqueal de rotina x aspiração endotraqueal minimamente invasiva, em dois estudos; aspiração endotraqueal de sistema aberto x aspiração endotraqueal de sistema fechado, em oito estudos; troca do sistema fechado em 24 horas x 48 horas, em dois estudos; troca diária do sistema fechado x troca não rotineira, em um estudo; e instilação de soro fisiológico x não instilação de soro fisiológico, em três estudos. As intervenções foram realizadas analisando desfechos referentes a alterações hemodinâmicas, alterações dos gases sanguíneos, colonização microbiana e infecção nosocomial, e outros desfechos. Foram encontradas evidências relevantes quanto à prática da aspiração endotraqueal, entretanto, as limitações metodológicas e riscos de viés encontrados nos estudos selecionados reduzem a confiabilidade de tais evidências, demonstrando a necessidade de estudos futuros. Também, foi observada a necessidade da realização de ECCRs que contemplem os demais passos da aspiração endotraqueal e desfechos.This systematic review of literature used the evidence-based practice as the theoretical framework. This study aimed to identify and analyze in the literature the evidence of randomized controlled trials on care related to the endotracheal secretions suctioning in critically ill adult patients who were intubated and undergoing mechanical ventilation. The methodological steps were guided by the recommendations of the Cochrane Collaboration. The search was conducted in the PUBMED, EMBASE, CENTRAL, CINAHL and LILACS databases. Of the 631 found references, 17 studies were selected after the analysis of titles and abstracts. The data extraction and the analysis of the risk of bias by two reviewers for each selected study were performed. The 17 studies were published in the period from 1987 to 2009. In the total, 2,890 adult patients who were intubated and undergoing mechanical ventilation were investigated. Evidences for six categories of interventions related to endotracheal suction were found: research-based endotracheal suction x usual endotracheal suction, in one study; routine endotracheal suction x minimally invasive endotracheal suction, in two studies; open endotracheal suction system x closed endotracheal suction system, in eight studies; change of closed system in 24 hours x 48 hours, in two studies; daily change of closed system x non-routine change, in one study; and instillation of saline x non-instillation of saline, in three studies. The interventions were performed through the analysis of outcomes related to hemodynamic alterations, blood gas alterations, microbial colonization and nosocomial infection, and other outcomes. Relevant evidences related to the practice of endotracheal suction were found; however, methodological limitations and risks of bias found in selected studies reduce the reliability of such evidences, demonstrating the need for further studies. Also, the need for the realization of ECCRs that address the remaining steps of endotracheal suction and outcomes were observed.