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Dissertations / Theses on the topic 'Surgical ward'
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Stone, Leanne Nicole, and S. F. Burton. "The impact of a ward pharmacist in a surgical ward of a private hospital in the Eastern Cape." Thesis, Nelson Mandela Metropolitan University, 2015. http://hdl.handle.net/10948/5916.
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Medication errors are becoming problematic in both hospital and outpatient settings worldwide. Inappropriate use of medication can cause harm to the patient and maintaining high levels of quality patient care is essential to protect all patients. Clinical pharmacy practice contributes to improved patient care by optimising medication therapy; and promoting health, wellness and disease prevention. The involvement of a pharmacist at a ward level has been shown to improve patient care; reduce mortality and morbidity rates; decrease healthcare costs; minimise medication errors; and improve outcomes of drug therapy. However, clinical pharmacy is a fairly new practice in South Africa and there are limited studies available. This study aimed to evaluate the perceived benefits of a ward-based pharmacist on the provision of pharmaceutical care to patients in a hospital setting and to consequently implement a ward-based pharmacy service. The objectives of the study were: (1) to assess, via a questionnaire, the perceptions and attitudes of medical practitioners and nurses to ward-based pharmacy prior to and after implementation of a ward-based pharmacy service, (2) to implement a ward-based pharmacy service in a selected hospital ward; (3) to document and analyse the nature of the work and activities that a ward pharmacist undertakes, and (4) to document and analyse the frequency and nature of ward pharmacist interventions. The study was conducted in a surgical ward of a private hospital in the Eastern Cape. The study design was an intervention study, using a mixed-methods design, with a convergent approach. A convenience sample of 106 patients was obtained over the eight week study period. Participation was voluntary and confidentiality was maintained at all times. Four data collection tools were used during the study and a pilot study was conducted to ensure their validity and reliability. The quantitative data was analysed statistically while the qualitative questions were analysed through coding the various responses. The results of the study showed that medical practitioners and nurses of a surgical ward had a positive attitude towards ward pharmacy both prior to and after the implementation of a ward pharmacy service. There were ward pharmacist interventions made in 50% (n=106) of the patients who participated in the study. A large percentage (57%; 50; n=87) of the ward pharmacist interventions were pharmacist-initiated interventions to optimise patient care while prescribing errors (51%; 19; n=37) were the most commonly occurring medication error. The majority of the medication items involved in the interventions (34%; 34; n=101) were related to the anti-microbial medication class. Overall, there was a 73% (36; n=49) acceptance rate of the ward pharmacist interventions that were made to both the medical practitioners and nurses. There were a number of factors that had a significant relationship with a ward pharmacist intervention being required which included: (1) number of medication items (p=0.001; Chi² test; p<0.0005 Student’s t-test), (2) length of hospital stay (p<0.0005; Chi² test), (3) presence of one or more chronic disease states (p=0.003; Chi² test) and (4) presence of one or more allergies (p=0.028; Chi² test). The ward pharmacist interventions were shown to be of clinical significance and to have a positive impact on the patients concerned. It can be concluded that the ward pharmacy service was beneficial to the patients, medical practitioners and nursing staff.
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Kreckler, Simon Michael. "Improving patient safety on a surgical ward using a quality improvement approach." Thesis, University of Cambridge, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.610295.
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MacLeod, Martha L. P. "Experience in everyday nursing practice : a study of 'experienced' surgical ward sisters." Thesis, University of Edinburgh, 1990. http://hdl.handle.net/1842/19083.
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Ödling, Gunvor. "Professional caregivers’ experiences of caring for women with breast cancer on a surgical ward." Doctoral thesis, Umeå universitet, Institutionen för omvårdnad, 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-371.
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The overall aim of the thesis was to describe caregivers’ experiences of caring for women with breast cancer on a surgical ward. The study was based on interviews with narrative parts and tape-recorded clinical supervision sessions. The interviews and clinical supervision sessions were transcribed verbatim, and analysed by content analysis. Nurses (n=10) described life for women with breast cancer as either having freedom or not having freedom, with both physical and existential suffering. Dying occurred either naturally in patients’ own home or unnaturally in hospital. The nurses felt that it is possible to alleviate suffering during dying through providing adequate pain relief but also, through listening, providing information and changing the caring atmosphere (I). Breast cancer as an illness was described from a dark point of view by caregivers (n=37). The descriptions focused on loss of breasts and control, progression of the illness and annihilation. The illness seemed, in the caregivers’ mind, to often end with a painful death. Caregivers who had the opportunity to follow the total care process described a lighter viewpoint (II). According to nurses (=31) the most important needs among women, their relatives and nurses themselves were the needs to talk and receive information. There was a discrepancy between what was described as important needs and the descriptions of how these needs were provided for. Nurses, whose own needs for support were sometimes unsatisfactorily met (III), seemed almost to be unaware of the needs among women and their relatives. In the clinical supervision sessions caregivers reflected on difficult care situations related to women’s, relatives’, and most often caregivers’ feelings (n=38). The care situations were described as evoking feelings of discomfort, powerlessness and reduced self-esteem. These feelings were described by caregivers as arising in connection with caring for especially women with advanced breast cancer in a changing organisation (IV). Caregivers’ descriptions of caring for women with breast cancer show a lot of negative experiences of powerlessness and frustration. They met women and their relatives who suffered in various ways and had considerable need for support. Caregivers often found themselves unable to meet these needs due to organisational obstacles e.g. lack of time and lack of knowledge about other caregivers’ responsibility in the care.
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Ödling, Gunvor. "Professional caregivers' experiences of caring for women with breast cancer on a surgical ward /." Umeå : Univ, 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-371.
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Pucher, Philip. "Structural and care process improvement of ward-based postoperative care to optimise surgical outcomes." Thesis, Imperial College London, 2014. http://hdl.handle.net/10044/1/24994.
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Much of the variation seen in surgical outcomes can be explained by differences in the quality of management of post-operative complications and ward-based care. The surgical ward round (WR) is critical to determining post-operative care and serves as the primary point of interaction between clinician and patient. Despite this, it is an area not subject to training or assessment at present. This thesis demonstrates the high degree of variability which exists in the conduct of WRs. It establishes the link between suboptimal patient assessment and increased risk of preventable post-operative complications. These place patients not only at risk of short-term deterioration, but result in reduced long-term survival as well. In order to quantify WR quality, a novel assessment tool has been developed and validated within a simulated environment. Ward simulation is a nascent branch of simulation which has been only preliminarily explored to date. A simulation environment was developed to take advantage of the known benefits of simulation such as controllability, reproducibility, and recordability, whilst maintaining a high level of fidelity and realism. An evidence-based curriculum for surgical WR training was designed and implemented in a simulation-based course. By focusing on structured generic processes of patient assessment and management, this resulted in significant improvement of trainee performance in routine WRs. To ensure standardised and optimum management of specific conditions, checklists have proven themselves to be of great value in a number of surgical and medical disciplines. Surgical complications are common, yet their management often suboptimal. As part of this thesis, evidence-based protocols for the management of the six most common complications were designed and validated. The implementation of these in a simulation-based randomised, controlled trial has resulted in greatly increased adherence to evidence-based standards of care, as well as improved communication and clinician performance. This thesis explores the variance currently present in surgical ward rounds, and the potentially grave consequences of this for patient outcomes. To date, WRs have been one of the last areas of surgical care still dependent on the Halstedian principle of experiential learning alone. The tools have now been developed with which to assess, improve, and standardise critical structures and care processes in the assessment and management of the post-operative surgical patient. Future implementation of these and integration into surgical curricula will benefit clinician training, patient care, and surgical outcomes alike.
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Pretorious, Georgina. "An assessment of the need for pharmaceutical care in a general surgical ward at Steve Biko Accademic Hospital in Gauteng Province." Thesis, University of Limpopo, 2012. http://hdl.handle.net/10386/1097.
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Thesis (MSc ( Med In Pharmacy)) -- University of Limpopo (MedunsaSummary Summary Summary The words “researcher” and “pharmacist” are used interchangeably. In the last two decades, the role of the pharmacist has been expanding beyond product orientated functions, such as procurement, stock control and dispensing, towards patient centered functions, in which the pharmacist assumes responsibility for treatment outcomes as part of the health care team. This research aimed to assess the need for the provision of pharmaceutical care from the pharmacist to the surgical wards of Steve Biko Academic Hospital. The objectives of the study were to determine the role of the pharmacist in the general surgical wards, to assist in the design of an antimicrobial ward protocol for the surgical wards, to record and assess antimicrobial patterns in the surgical wards, to describe and categorize the interventions performed by a pharmacist during the provision of pharmaceutical care, to identify factors which limited the provision of pharmaceutical care and provide recommendations for future undertakings, to calculate the cost implications of pharmaceutical care interventions made, to assess the time spent on interventions performed by a pharmacist during the provision of pharmaceutical care and to determine if the medical staff members in the surgical unit feel there is a need for the pharmacist providing pharmaceutical services to the wards. The study was conducted in the surgical wards of Steve Biko Academic Hospital. The study design was a cross-sectional operational study in which 62 patients were recruited over the eight week period. A pilot study was conducted to validate the data collection instruments. The data was analyzed with the assistance of a statistician using various statistical methods for the different variables in the study. ix Of the 62 study patients, 33 were female and 29 were male. The female-to-male ratio of the study patients was thus 1:0.88. The average age of the patient population, was 52.5 ± 17.2 years, with a range of 15 to 88 years. The mean duration of stay for the study patients was 8.9 days, with a range 1 to 111 days. A total of 120 diagnoses were made for the 62 study patients. Conditions diagnosed most frequently included conditions affecting the gastro-intestinal tract (38 patients), conditions affecting the cardiovascular system (28 patients), conditions affecting the endocrine system (14 patients) and infections (12 patients). The five medicines used most frequently in terms of numbers of patients and duration of therapy were paracetamol (53 patients, 277 patient-days), morphine/papaverine/codeine (41 patients, 155 patient-days), enoxaparin sodium (24 patients, 113 patient-days), co-amoxiclav (21 patients, 101 patient-days) and metoclopramide (22 patients, 90 patient-days). A total 188 interventions were made and documented during the study period and 153 (81.4%) interventions were accepted. The number of interventions suggested ranged from 0 to 10, with an average of three interventions per patient and a median of one intervention per patient. The most frequent interventions were made due to system error or non-compliance (29.3% of all interventions), on patient or nursing staffs’ knowledge of the medication (18.6%), untreated medical conditions (11.2%), therapeutic duplications (9.0%) and on prescribed doses and dosing frequency (5.9%). The total time spent providing pharmaceutical care services within the surgical wards over the study period was 32 days (227.9 hours) with an average time of 7.1 hours per day. Of the total time in the ward, 48% was spent on providing pharmaceutical care to the patients, 26% to record and access the total antibiotic usage in the ward, 9% on administration and 6% on meetings. Other functions comprising of 3% and less of the time was information to patients, x communication with doctors, educational sessions with nursing staff, communication with the pharmacy and stock control procedures. Questionnaires were completed by the doctors and nursing staff before and after the study period to determine if they felt there was a need for a pharmacist in the surgical ward. The doctors felt that there was a need for a pharmacist in the ward in terms of providing information and assisting in the rational use of medication. All of the nursing staff felt that there was a need for a pharmacist to visit the surgical ward and specifically to assist with the legal aspects of the prescriptions and with the education of the nursing staff. The pharmacist played an important role in the design of an antimicrobial ward protocol and in order to do so the pharmacist recorded and assessed the antimicrobial prescribing patterns of the surgical wards. In conclusion, the pharmacist present in the ward functioned as a gateway between the nursing staff and the doctors. The interventions that require the most attention was made due to system error and non-compliance. Important interventions were made on the patients’ and nursing staffs’ knowledge of the prescribed medication. The pharmacist played an important role in the education of nursing staff to discuss relevant topics and problems often encountered. Educational sessions with the patients involved giving them advice on home medication and the medication prescribed to them to take home. The amount of patients seen per week increased with time and the average time spent per patient consultation decreased with time. This is a clear indication that the researcher gained confidence and became more familiar with the pharmaceutical care process as the time passed. From the questionnaires completed by the doctors and nursing staff it was clear that they felt that there was a need for a pharmacist in the ward in terms of xi providing information, assisting in the rational use of medication, to assist with the legal aspects of the prescriptions and with the education of the nursing staff.
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Lupaszkoi, Hizden Thomas. "Creating a community of practice to prevent readmissions : An improvement work on shared learning between an intensive care unit and a surgical ward." Thesis, Hälsohögskolan, Högskolan i Jönköping, The Jönköping Academy for Improvement of Health and Welfare, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-30244.
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Background ICU readmissions within 72 hours after discharge from the intensive care unit (ICU) is a problem because this leads to higher mortality and longer hospital stays. This is a particular problem for the hospital studied for this thesis because there are only three fully equipped ICU beds available. Aim To prevent readmissions by introducing nursing rounds as a concept of “communities of practice” (CoP) and to identify supportive and prohibitive mechanisms in the improvement work and knowledge needed for further improvement work in similar settings. Methods Questionnaires, focus groups, Nelson’s improvement ramp, and qualitative content analysis. Results There were no readmissions from the participating ward after the nursing rounds started, but the reason for this is not clear. The staff experienced the nursing rounds as valuable and they reported greater feelings of confidence, increased exchange, and use of their own knowledge. Discussion The findings presented here support that hypothesis that CoP builds knowledge that can improve patient care. The information provided to the participants during the improvement project was identified as the most supportive mechanism for improvement work, and a lack of resources was seen as the most prohibitive mechanism.
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Andersson, Emilia, and Madelene Kjetselberg. "Anestesisjuksköterskors upplevelser av sin första tid på en operationsavdelning : En empirisk studie." Thesis, Högskolan i Gävle, Avdelningen för vårdvetenskap, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-33130.
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Bakgrund: Anestesisjuksköterska är ett avancerat yrke som ställer höga krav på kompetens och självständighet. Forskning visar att nyexaminerade anestesisjuksköterskor upplever stress och otrygghet i sin nya profession. Syfte: Studiens syfte var att beskriva hur nyexaminerade anestesisjuksköterskor upplever sin första tid på en operationsavdelning. Metod: Deskriptiv design med kvalitativ ansats. Totalt tio anestesisjuksköterskor, från två medelstora och ett litet sjukhus i Mellansverige, inkluderades i studien. Studien har använt ett ändamålsenligt urval. Genom semi-strukturerade intervjuer med utgångspunkt från samlades data in. Data har analyserats med hjälp av en kvalitativ innehållsanalys. Huvudresultat: Ur anestesisjuksköterskornas beskrivningar framkom fyra huvudkategorier; den nya professionen, personlig utveckling, erfarenhet och organisatoriska faktorer och totalt tio subkategorier; att vara ny anestesisjuksköterska, att uppleva ansvar, att ha prestationskrav, känna tilltro till egen förmåga, att känna arbetsglädje, att utvecklas, brist på erfarenhet, erfarenhet skapar trygghet, brist på stöd från organisationen samt stöd från organisationen. Studien visar att anestesisjuksköterskorna upplevde sin första tid på en operationsavdelning som påfrestande men även som intressant och utvecklande. Nya arbetsuppgifter och stort ansvar upplevdes som betungande i början. Bristen på erfarenhet var stundtals påfrestande men stöd från kollegier bidrog till att majoriteten av anestesisjuksköterskorna upplevde trygghet. Då bristande stöd ökade deras upplevelse av otrygghet och ensamhet, framkom en önskan om mentorskap och mer handledning under anestesisjuksköterskornas första tid. Slutsats: Föreliggande studie beskriver nyexaminerade anestesisjuksköterskors upplevelse och resultatet visar att stress och en känsla av ensamhet präglade den första tiden. Bristande erfarenhet kunde vara påfrestande men med stöd från kollegier upplevde de en ökad trygghet. Resultatet visar att det fanns en önskan om mer stöd i form av mentorskap och handledning under anestesisjuksköterskornas första tid. Överlag ger studien en ökad förståelse för hur nyexaminerade anestesisjuksköterskor upplever sin första tid.Background: To be a Nurse Anesthetist is advanced and involves high demands for competence and independence. Research has shown that newly graduated nurse anesthetists experience stress and insecurity in their new profession. Aim: The study was aimed to describe how newly graduated nurse anesthetists experience their first time at a surgical ward. Method: Descriptive design with qualitative approach. A total of ten nurse anesthetists from two middle-sized and one small hospital in Sweden were included in the study. Purposive sampling has been used. The data were collected by semi-structured interviews with help from an interview guide. The data have been analyzed with a qualitative content analysis. Findings: The nurse anesthetist’s descriptions in the interviews were sorted in to four main categories and ten subcategories. The main categories were; The new profession, Personal development, Experience, and Organizational elements. The subcategories were: Newly graduated nurse anesthetist’s, To have responsibility, Performance anxiety, Belief in own ability, Job satisfaction, To progress, Lack of experience, Experience creates security, Lack of support from the organization and Support from the organization. The nurse anesthetists describe their first period at the surgical ward as demanding but also interesting and stimulating. New assignments and the large responsibility were described as burdensome at first. The lack of experience was at times hard to deal with but the support from the organization increased their feelings of security. In the study, nurse anesthetists’ wanted more support in the form of mentorship and coaching, as lack of support increased their feelings of insecurity and loneliness. Conclusion: The study describes how newly graduated nurse anesthetists’ experience feelings of stress and loneliness during their first period in a surgical ward. Lack of experience was demanding at first but with support from colleagues their feelings of security increased. The results show that newly graduated nurse anesthetists’ wanted more support in the form of mentorship and coaching. The study provides a deeper understanding of how newly graduated nurse anesthetists’ experience their first period in a surgical ward.
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Makoni, Axilia-Tanakasei. "An exploration of cultural issues affecting staff compliance with recommended infection prevention and control practices in a 'ring-fenced' acute hospital elective surgical ward." Thesis, University of Essex, 2018. http://repository.essex.ac.uk/21628/.
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Healthcare associated infection (HCAI) poses a serious threat to patients admitted into hospital as well as health care staff. Whilst recommendations for preventing HCAI exist, many research studies, primarily quantitative in nature, have reported serious concerns about the suboptimal infection prevention and control (IPC) practices adopted by healthcare workers (HCWs) within acute clinical settings. However, there remains a lack of understanding about why suboptimal practices persist. Although quantitative studies have identified poor staff compliance with the IPC recommended practices, attempts to tackle the problem have yielded limited success. It is suggested that a key reason for this is the failure to take into account the cultural context in which the non-compliant behaviours take place. This qualitative study, guided by ethnographic principles, uses a combination of focus groups and individual interviews with frontline staff and organisational leaders to explore cultural issues affecting staff compliance with recommended IPC practices in a ring-fenced acute hospital elective surgical ward (ESW). The study reveals that noncompliance with IPC policies and procedures in the ESW was legitimised and subsequently tolerated by both frontline and managerial staff, especially when the acute hospital was under stress. In particular, the ESW operational ring-fencing policy for protecting elective surgical patients from HCAI acquisition was repeatedly breached due to the conflicting pressures and competing demands of a busy hospital environment. The findings challenge the sustainability of the policy of ring-fencing the ESW as a discrete component of a busy acute hospital in order to protect elective surgical patients from HCAI in the context of the current healthcare system. It is highly likely that, as people live longer due to advances in medicine and technology, the demand for trauma and medical emergency beds will increase in the future, rendering the ring-fencing of any bed unsustainable in an acute hospital setting.
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Leopoldson, Carolina, and Madeleine Johansson. "Det ni vet ─ vet jag också det? : Patienters upplevelser av delaktighet vid akut inskrivning på kirurgisk vårdavdelning." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-296345.
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Bakgrund: År 2015 infördes Patientlagen (SFS 2014:821) som slår fast att hälso- och sjukvården ska ge patienterna möjlighet att bli delaktiga i sin vård. Studier visar att patientdelaktighet kan förbättra kvaliteten på vården och har en betydelsefull del i att uppnå en säker vård för patienterna. På kirurgisk vårdavdelning inkommer patienter dygnet runt och är beroende av sjuksköterskan för att göras delaktiga i sin vård. Syfte: Att beskriva hur patienter som skrivs in akut upplever delaktighet gällande information och planering i samband med inskrivning av sjuksköterska på kirurgisk vårdavdelning. Metod: Kvalitativ studie med semistrukturerade intervjuer (15 deltagare). Datan analyserades med latent kvalitativ innehållsanalys enligt Graneheim och Lundman (2004). Huvudresultat: Patienter upplevde att det var viktigt att få information om sin vård och planering vid inskrivning på kirurgisk vårdavdelning. Både positiva och negativa upplevelser vid inskrivningen framkom och orsaken till detta grundades i sjuksköterskans bemötande. Vårdrelationen var viktig för att känna sig trygg i en utsatt situation och var förutsättning för att uppleva delaktighet. Patienterna berättade att delaktighet vid inskrivningen var att bli lyssnad på och att få en individuellt anpassad information. Slutsats: Patientdelaktighet vid inskrivning på kirurgisk vårdavdelning förutsätter att sjuksköterskan bjuder in patienten till delaktighet samt ger information på ett individanpassat sätt. Delaktighet är viktigt för att minska fel i vården, bedriva en lagstadgad vård och för tryggheten hos patienterna. För att klara lagkraven på vården behöver både patienter och vårdpersonal utbildning inom ämnet för att skapa en gemensam syn på vad delaktighet i vården innebär.Background: In 2015 a new patient-law was launched in Sweden. It states that healthcare should give the patients possibility to participate in their own care. Studies have shown that patient participation can improve the quality of care and reduce adverse events in healthcare. In surgical wards patients are admitted every hour of the day and they are dependent on the registered nurse to get involved in their care. Aim: To describe how patients admitted from the emergency department experience their participation during the enrollment with the nurse in the surgical ward with a specific focus on information and planning of the care. Methods: A qualitative study based on semi-structured interviews (n=15 participants). Data was analysed with content analysis according to Granheim and Lundman (2004). Results: The study showed that during the enrollment at the surgical ward patients experienced information about the care and the plan as important. Both positive and negative experiences during the enrollment were shown in the result. The reason was based on the nurses caring or uncaring relationship with the patient. The nurse-patient relationship was important for the patient to feel safe in an exposed situation and was a prerequiesite for participation. Patients talked about participation at the enrollment and pointed out that being listened to and personalized information as the most important. Conclusion: Patient participation at enrollment at the surgical ward requires the nurse to invite the patient to take part and gives information in a personalized manner. Participation is important to reduce errors in care, carry on a statutory care and to the safety for patients. To manage the requirements of the patientlaw, both patients and staff needs education about the subject to create a mutual vision of what participation in care is.
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Hynninen, N. (Nina). "Ikääntyvä muistisairas potilas kirurgisella vuodeosastolla." Doctoral thesis, Oulun yliopisto, 2016. http://urn.fi/urn:isbn:9789526214559.
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Abstract The purpose of this study was to describe and explain the care of older people with dementia in surgical wards from the viewpoints of the patients and their close relatives, nursing staff and physicians. The study was conducted in two stages. The first stage of the study was conducted with a qualitative approach, collecting the data from older people with dementia (n=7), their close relatives (n=5), nursing staff (n=19) and physicians (n=9) using individual and group interviews. The data were analysed using inductive content analysis. The approach in the second stage was quantitative: data were collected with a questionnaire from the nursing staff (n=191). The data were analysed using descriptive statistics as well as explorative factor analysis. The nursing staff stated that responding to the physical, psychological and social needs of patients with dementia requires more effort and time than usual. The nursing staff pointed out that they did not have all the required know-how to provide good care for older people with dementia. The nursing staff with longer work experience indicated doing nothing more often than other nursing staff when encountering challenge behaviour of a patient with dementia. Concerns about well-being of a patient and feeling shame about patient’s behavioural symptoms were causing exhaustion among close relatives. Relatives expected some time for personal dialogue and support from the nursing staff. The patients experienced that they did not get enough information about their own care. The study provides new information that can be used to develop the care of older people with dementia in hospital environment. The results can be utilized in basic, further and updating education in the field of health careTiivistelmä Tutkimuksen tarkoituksena oli kuvata ja selittää ikääntyvän muistisairaan potilaan hoitotyötä kirurgisella vuodeosastolla muistisairaiden potilaiden, omaisten, hoitohenkilökunnan ja lääkäreiden näkökulmasta. Tutkimus toteutettiin kahdessa vaiheessa. Ensimmäisen vaiheen lähestymistapa oli kvalitatiivinen eli laadullinen, ja aineisto kerättiin kirurgisilla vuodeosastoilla olevilta muistisairailta potilailta (n=7), omaisilta (n=5), hoitohenkilökunnalta (n=19) ja lääkäreiltä (n=9) yksilö-, pari- ja ryhmähaastatteluina. Aineisto analysoitiin induktiivisella sisällön analyysilla. Tutkimuksen toisen vaiheen lähestymistapa oli kvantitatiivinen eli määrällinen, ja aineisto kerättiin kyselylomakkeella kirurgisilla vuodeosastoilla työskentelevältä hoitohenkilökunnalta (n=191). Aineisto analysoitiin käyttäen kuvailevan tilastotieteen menetelmiä sekä eksploratiivista faktorianalyysia. Ikääntyvän muistisairaan potilaan hoitotyössä korostui fyysiseen, psyykkiseen ja sosiaaliseen avuntarpeeseen vastaaminen, joka vaati keskimääräistä enemmän aika- ja henkilöstöresursseja. Hoitohenkilökunta toi esille, ettei heillä ollut tarvittavaa tieto-taitoa muistisairaiden potilaiden hoitamiseen. Hoitajat, joilla oli pitkä työkokemus reagoivat muistisairaan potilaan käytösoireisiin muita hoitajia välinpitämättömämmin. Huoli potilaan voinnista ja häpeän tunne potilaan käytösoireista aiheuttivat puolestaan omaisen uupumista. Omaiset kaipasivatkin henkilökunnalta keskusteluapua ja tukea. Potilaat taas kokivat, etteivät he saaneet tarpeeksi tietoa hoitoaan koskevista asioita. Tutkimuksella tuotetaan uutta tietoa, jonka avulla voidaan kehittää ikääntyvän muistisairaan potilaan hoitotyötä sairaalaympäristössä. Tuloksia voidaan hyödyntää terveydenhuoltoalan perus-, jatko- ja täydennyskoulutuksessa
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Lilljeqvist, Linda, and Erica Nordström. "Hur genomförs omvårdnaden i livets slutskede på en akutkirurgisk vårdavdelning? : En intervjustudie." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-324252.
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Background: The purpose of end-of-life care is to relieve suffering and optimize quality of life. Important tasks for healthcare professionals are symptom alleviation and facilitate well-being. It is common for patients, who are treated palliative, to die within the surgical wards. The environment can be stressful and it is not always optimal for these patients to be cared for there. Aim: The aim was to describe how end-of-life care was delivered for patients in surgical wards, according to the nurses, with specific focus on the fundamentals of care. Method: Semi-structured interviews with 12 registered nurses in two surgical wards. The interviews were analysed using a qualitative content analysis. Result: The analysis resulted in three categories: The nursing needs of patients at the end-of-life, The organization's negative impact on patient care and Adapted care based on the patient and relative’s needs. The results showed that organizational factors such as lack of time and resources, but also lack of knowledge among the healthcare professionals, could lead to difficulties to fulfill both the physical and psychosocial needs of the patient. When a person-centered care was used the needs of the patients were easier to fulfill and the nursing care functioned in a better way. Conclusion: Person-centered care is an important part of end-of-life care. The healthcare professionals at surgical wards care for this patient-group in a dedicated way, and nursing around them usually operate well, except when there is a lack of time and more acute situations must be prioritized. There is a need to increase the knowledge of palliative care among the healthcare professionals.Bakgrund: Palliativ vård i livets slutskede ska lindra lidande och främja livskvaliteten. Viktiga uppgifter för sjukvårdspersonalen som vårdar patienter i livets slutskede är att ge symtomlindring och underlätta välbefinnandet. Det är vanligt att patienter som vårdas palliativt i livets slutskede avlider inom slutenvården och på kirurgiska vårdavdelningar. På dessa avdelningar kan miljön vara stressig och det är inte alltid optimalt att denna patientgrupp vårdas där. Syfte: Att beskriva hur sjuksköterskor ansåg att omvårdnaden genomfördes för patienten som vårdats i livets slutskede på en akutkirurgisk vårdavdelning, med specifikt fokus på de fundamentala delarna av vården. Metod: Semistrukturerade intervjuer med 12 sjuksköterskor från två kirurgiska vårdavdelningar. Data analyserades med kvalitativ innehållsanalys. Resultat: Analysen resulterade i tre kategorier: Omvårdnadsbehoven hos patienten i livets slutskede, Organisationens negativa inverkan på patientens omvårdnad och Anpassad vård utifrån patienten och dennes anhöriga. Resultatet visade att organisatoriska faktorer som tids- och resursbrist, men även kunskapsbrist hos sjukvårdspersonalen, gjorde att patienternas fysiska och psykosociala omvårdnadsbehov inte alltid blev tillgodosedda. När vården var personcentrerad och patienterna delaktiga ansåg sjuksköterskorna att omvårdnaden genomfördes på ett bättre sätt. Slutsats: En personcentrerad vård är viktigt för både patienter, som befinner sig i livets slutskede, och deras anhöriga. Sjukvårdspersonalen på akutkirurgiska vårdavdelningar är engagerade i denna patientgrupp och omvårdnaden kring dem fungerar oftast bra. Det händer dock att tiden inte räcker till för patientgruppens komplexa omvårdnadsbehov och andra akuta situationer prioriteras ibland före. Det finns ett behov av att öka kunskapen om palliativ vård hos personalen som vårdar dessa patienter.
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Anderson, Oliver. "Designing Out Medical Error (DOME) in surgical wards." Thesis, Imperial College London, 2015. http://hdl.handle.net/10044/1/55113.
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Background One in ten hospital patients are unintentionally harmed by their healthcare management. Healthcare professionals are often blamed for making mistakes that could be prevented if all the factors influencing human performance were addressed by designing the system to be safer. Hypothesis This thesis is part of the Designing Out Medical Error (DOME) project, which tested the hypothesis that a multidisciplinary team of designers, clinicians, psychologists and business analysts working collaboratively could design interventions to improve patient safety in surgical wards. Methods & Results We used a combination of observational techniques including Healthcare Failure Mode and Effects Analysis to proactively assess risk in surgical wards. We focused on five high-risk processes: hand hygiene, isolation of healthcare-associated infection, vital signs monitoring, handover communication and medication delivery. Patients and healthcare professionals were involved at every stage and helped co-design a suite of concepts to address risk in these processes. We progressed two prototypes: the Respiratory Rate Recorder and the CareCentre® (a bedside work table containing equipment including alcohol hand-rub) to simulated and clinical trials. The trials demonstrated that the accuracy of manual respiratory rate measurement and the adherence of healthcare workers to hand hygiene guidelines was significantly improved respectively, thus supporting the hypothesis. Conclusion Multidisciplinary collaborations that engage with the teams, processes and equipment of the healthcare system can co-design safer interventions. Better design can influence behaviour and improve the performance of healthcare professionals. The DOME project demonstrates a successful method for others to follow.
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Rodgers, Sheila E. "Research utilisation by nurses in general medical and surgical wards." Thesis, University of Edinburgh, 2000. http://hdl.handle.net/1842/22600.
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There has been extensive speculation about the lack of research utilisation in nursing but little attempt to quantify this phenomenon outside of North America. The current demands for evidence-based practice necessitate research utilisation as one element of that process. The study reported in this thesis aimed to investigate the extent to which nurses utilise research and further, to identify factors that promote and those that hinder research utilisation. The study was limited to nurses working in general medical and surgical wards. The study comprised a survey on the extent of research utilisation and potential influencing factors, and follow up interviews to explore the effect of identified influencing factors on research utilisation. Seventy three percent (680/936) of the nurses returned questionnaires to measure the level of utilisation of 14 research-based practices and assess the presence of potential influencing factors. The total mean research utilisation score for all nurses across all 14 nursing practices suggests that on average, nurses had heard of, believed in and were beginning to use the practices. Several factors were significantly associated with research utilisation including completion of higher education, studying research, reading research-based journals, surgical rather than medical nursing, the organisational culture and management style, the promotion of accountable practice, a clear strategy for research at nursing management level, hospital size and nursing skill mix. These were further explored in the interviews. The discussion of the findings focuses on those that illuminate the influence of both the individual and the organisation on research utilisation and also consider the interaction between individual practitioners and the organisation.
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Lamond, Dawn W. "Information processing and handover : an investigation." Thesis, University of Surrey, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.241801.
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King, Roslyn Anne Lindy. "Levels of expertise in nurses working in surgical wards and intensive care units : a qualitative study." Thesis, King's College London (University of London), 1998. https://kclpure.kcl.ac.uk/portal/en/theses/levels-of-expertise-in-nurses-working-in-surgical-wards-and-intensive-care-units--a-qualitative-study(d1915802-e2fd-48f1-9686-ac3e6716ae2e).html.
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Bowman, Michael P. "An exploration of the role of the nurse in acute medical and surgical and longstay (geriatric) wards." Thesis, University of Newcastle Upon Tyne, 1990. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.293970.
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Johnston, Maximilian Joseph. "Exploring and improving the escalation of care process for deteriorating patients on surgical wards in UK hospitals." Thesis, Imperial College London, 2015. http://hdl.handle.net/10044/1/38452.
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Despite impressive progress in technical skills, the rate of adverse events in surgery remains unfavourably high. The variation seen in surgical outcomes may be dependent on the quality of ward-based surgical care provided to post-operative patients with complications, specifically, the recognition, communication and response to patient deterioration. This process can be termed escalation of care and is an under-explored area of surgical research. This thesis demonstrates the impact of delays in the escalation of care process on patient outcome. The facilitators of, and barriers to, escalation of care are then identified and described in the context of the UK surgical department. In order to prioritise areas within the escalation of care process amenable to intervention, a systematic risk assessment was conducted revealing suboptimal communication technology and a lack of human factors education as key failures. To ensure that communication technology intervention was conducted based on evidence, several exploratory studies describe the current methods of communication in surgery and explore areas of innovation and intervention. Following this, a human factors intervention bundle was implemented within a busy surgical department, which successfully improved supervision, escalation of care and safety culture. This thesis describes, for the first time, escalation of care in surgery and outlines important strategies for intervention in this safety-critical process. To date, ward-based care has been one of the most under-researched areas in surgery, despite its clear importance. The tools to improve escalation of care in surgery have been described and initial attempts at implementation have demonstrated great promise. Future use of these strategies should benefit surgeons and other clinical staff of all grades and ultimately, the surgical patient.
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Underwood, Janet E. "Just a bunch of grapes? : liminality and the experiences of adult visitors to NHS acute medical and surgical wards in England." Thesis, University of Huddersfield, 2016. http://eprints.hud.ac.uk/id/eprint/32051/.
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In this thesis, I argue that the practice of visiting patients on the more general acute medical and surgical wards in National Health Service hospitals in England has been underresearched and is frequently overlooked by policy. This is despite the large number of written complaints received annually about NHS acute hospital care services in England. The thesis commences with an extensive examination of the contextual influences on hospital visitors’ experiences and expectations. This is followed by a detailed account of the qualitative research, using semi-structured interviews, with participants who had been hospital visitors. Visiting experiences were described as a journey through the patient’s admission, hospital stay and discharge or death. This journey was identified as a time of liminality (van Gennep 1960) with the visitors’ everyday routines and structures suspended and transitions to be made. Liminality and its core features identified by Turner (1974) therefore provided a theoretical framework through which to explore the data. The analysis resulted in the identification of extensions to the understandings of liminality when applied to the hospital-visiting scenario. In turn, the use of liminality, as central to the theoretical framework, provided richer interpretations of hospital visitors’ experiences and so adds to the knowledge about the practice of hospital visiting. Evidence is therefore provided to support future policy, training and professional education improvements and to suggest measures to improve hospital visiting experiences. These improvements, especially in terms of hospital hospitality, effective communication and improved discharge management, could increase hospital visitors’ satisfaction and reduce the costs to the NHS incurred by responding to the high volume of written complaints.
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May, Carl R. "'Getting to know them' : an exploratory study of nurses' relationships and work with terminally ill patients in acute medical and surgical wards." Thesis, University of Edinburgh, 1991. http://hdl.handle.net/1842/19115.
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In this study the ways in which a group of experienced staff nurses defined, understood and accounted for their social relationships with terminally ill patients are explored. Two major bodies of social theory - an actor-oriented micro-sociological perspective, grounded in the work of Alfred Schutz and Peter L. Berger; and a macro-perspective derived from the work of Michel Foucault - are drawn on to argue: (1) That social relationships between nurses and patients are rendered problematic by the ways in which nurses defined them as encompassing an interest in the patient as a 'whole' individual. Attention is drawn to the ways in which this individuation is achieved through the production, collation and distribution of knowledge about the patient as a 'public' social actor, and as a 'private' subject. (2) That the problematic status of this social relationship is resolved through its definition as a site of particular forms of work. Here the patient is designated as more than a sick body; beyond material practices directed at palliating the effects of organic disorder, the patient is the focus of attention directed at penetrating and inspecting the sphere of the private subject. (3) That work directed at the patient's subjectivity offers not only a potent mode of surveillance to reveal psychosocial 'needs' and 'problems'. This work also permits work to adjust the patient's subjective view of social reality and so to integrate him or her into an ideal trajectory that leads to an unproblematic death.
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Warren, Sara. "Understanding the significance of the social determinants of health on the outcome of complicated surgical neonates at Red Cross War Memorial Children's Hospital." Master's thesis, University of Cape Town, 2012. http://hdl.handle.net/11427/10761.
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Includes bibliographical references.The United Nations Millennium Declaration conference held in September of 2000, set key Millennium Development Goals. Millennium Development Goal 4 requires a reduction in the mortality rate of children under the age of five years by two-thirds by the year 2015, from a baseline in 1990. In South Africa, it has been recognised that without a substantial reduction in neonatal deaths, MDG-4 will not be met. This study will focus on the social determinants of health which play a key role in neonatal outcome in South Africa. It will evaluate the effects of these social determinants of health (Primary caregiver's education level, Primary caregiver's age, and Living Standards Measure) on the outcome of neonates admitted to, and operated on, in the general surgery unit of Red Cross War Memorial Children's Hospital (RCWMCH), within the Western Cape, South Africa. This study is based on the hypothesis that there is an association between Neonatal outcome, and a selection of social variables, namely: primary caregiver's level of education, primary caregiver' age, and LSM. The protocol (Part A) describes the sampling methodology that was used during the intervention. This will be followed by a literature review (Part B), Article (Part C), and Appendix (Part D).
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Stevens, Ashley Marie. "American Society, Stereotypical Roles, and Asian Characters in M*A*S*H." Bowling Green State University / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=bgsu1459520345.
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Ping, Chang Jia, and 張嘉蘋. "The critical care competence analysis of general medical and surgical ward nurses in medical centers." Thesis, 2006. http://ndltd.ncl.edu.tw/handle/53411994833850048429.
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碩士長榮大學
醫學研究所碩士班護理組
94
Because of the insufficient beds of the intensive care unit of medical centers. More patients with critical illness admitted to the general ward. Thus nurses are subjected to a stressful situation due to the lack of experiences in taking care of patients with critical illness. Therefore, this study aimed to (1) categorize clinical situations of critically ill patients in the general ward and (2) explore required critical care competence of nurses working in the general ward. The Modified Delphi technique with 3-round survey by questionnaires was used. Subjects recruited from 11 medical centers were 37 expert nurses who have five years working experience in medical surgical wards and critical care units. After 3-round questionnaires, 25 critically ill situations of patients with 92.8% consensus among experts were identified. Furthermore, 4 classified clinical competences with 363 items required by the nurses of the general wards were determined. Among these 363 items, 240 and 120 items are needed by nurse ladder II and III status applicants of general surgical medical wards respectively. Only 3 items lack consensus among the experts. Results of this study provide information for nurses’ in-service training regarding to critical care in general ward and for nurse administrators to establish and evaluate job descriptions of nurses in the general ward.
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Chen, Mei-Hua, and 陳美華. "Using Data Envelopment Analysis Method to Measure the Efficiency Difference of Medical and Surgical Ward." Thesis, 2009. http://ndltd.ncl.edu.tw/handle/z93mfh.
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碩士中臺科技大學
醫護管理研究所
97
With the rapid change in the social environment and the implementation of global budgets limits of National Health Insurance (NHI) , this research surveys management efficiency of medical and surgical ward in order to provides the guidelines of the whole development in the hospital and the evaluation of management efficiency of the clinical nursing divisions. The objectives of this research include three approaches as follows: (1) to evaluate the total efficiency, pure technical efficiency, and scale efficiency of medical and surgical ward; (2) to find out the input and output evaluation items that are sensitive to relative efficiency evaluation, and (3) to find out the influence on medical and surgical ward when input and output measuring items are changed.Our research is a traversal progress that adopts regression data analysis for data choice and studies on the 11 units of medical and surgical wards and 33 Decision Making Units (DMU) for the medical center in the middle of Taiwan. Our resource data come from the regression data of the medical and surgical ward in the medical center, and then we get 3 input variables and 9 output variables from data collection of references and the investigation of Delphi technique. In the management evaluation, we address the Data Envelopment Analysis (DEA) method to achieve the evaluation of 11 units of medical and surgical wards. The method divides into two models: multiple input items and multiple output items (CCR model) and dynamic scale reward relationship between input and output items (BCC model). Based on these two models, we address our research in the efficient values analysis, reference combination analysis, differential variables analysis and sensitivity analysis.The experimental results show that (1) the efficiency value analysis: there are 29 Decision Making Units (DMUs) in the total efficiency and 28 DMUs in the pure technical efficiency and scale efficiency, respectively, (2) the reference combination analysis: there are 11 DMUs referred in the total efficiency and 11 DMUs referred in the pure technical efficiency, (3) the differential variables analysis: the average technical efficiency value is 0.996 and there are 29 DMUs to reach the relative efficiency, and (4) the sensitivity analysis: the number of departments and the occupational rates change mostly and all of relative efficiency values are greater than 1 in the number of patients when we delete an input variable. In the meanwhile,the restraint and infection rate change mostly in the total efficiency when we delete an output variable.Therefore, using the DEA-oriented CCR model to realize the relative efficiency of medical and surgical wards in 2004 to 2006 is a good way to help the nursing chiefs achieve the best total efficiency of the ward allocation and provides suggestions to refine the non-efficiency units in the goal values and scale.
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Wang, Wen-Pei, and 王文佩. "The effectiveness of the aromatherapy body massage on anxiety and sleep quality in general medical surgical ward nurses." Thesis, 2014. http://ndltd.ncl.edu.tw/handle/24582078519258983001.
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碩士高雄醫學大學
護理學研究所
102
Anxiety and the poor sleep quality are common problems among nurses. This study was to investigate the effects of the aromatherapy body massage on the anxiety reduction and the sleep quality improvement among nurses. The experimental longitudinal study was conducted and staff nurses working in medical surgical wards were recruited from one regional teaching hospital in southern Taiwan. Twenty-five subjects, who were randomly assigned to the experimental group received aromatherapy, while twenty-five subjects in the control group only listened to the music. The “Beck Anxiety Inventory” and the “Pittsburgh Sleep Quality Index” were used for the data collection. The collected were analyzed by descriptive ststistic, The paired t-test, ANCOVA, repeat measure ANOVA, and Pearson product- moment correlation. The result showed that these nurses with an average age of 30.64（±4.19）years have 8.22（±4.38）years of working experience. Overall, all the subjects experienced mild（42％） or moderate（30％） anxiety and all reported poor sleep quality. After receiving the aromatherapy body massage, there was a statistical significance（p＜.001）improvement on the anxiety and the sleep quality between the nurses in the experimental group and those in the control group. It is concluded that aromatherapy body massage could relieve the anxiety and improve the sleep quality of nurses. It is recommended that the aromatherapy body massage can be applied to resolve the anxiety and sleeping problems of nurses. It can enhance the quality of life of nurses to deliver high- quality patient care .
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Lue, Ya-Meei, and 陸雅美. "The Relationship Between Work Stress and Intention to Quit for New Nursing Staffs of General Medical and Surgical Ward Nurses in Medical Center." Thesis, 2006. http://ndltd.ncl.edu.tw/handle/27016701598424503071.
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碩士長榮大學
醫學研究所
94
Nursing work is a career with challenge. Because of different emergency situations, patients with variant diseases, and requests from the family of patients, nurses are facing a lot of pressure on their works. These pressures may affect their health, further, decrease the quality of nursing care and lower the satisfaction about their jobs. The purpose of this study was to study the relationship between the work stress and intention to quit for new nursing staff of general medical and surgical ward in medical center. A total of 187 participants were recruited from three public medical centers located at northern, southern and central of Taiwan through a purposed sampling procedure. And data were collected throught structive questionnaire. The data is analyzed with SPSS Window 12.0 edition. The results of the study showed : 1. The new nursing staffs who worked in the general medical and surgical ward had medium scores of working stress and medium to low scores of intention to quit. 2. Work stresses were significant different in terms of participants’ educational levels, working years, and salary levels. 3. There are no significant relationships were found between personal data and intention to quit. 4. Work stress had significant positive relationship with intention to quit. The result of the study suggests that for helping the new nursing staff to facing and solving the work stress, a clinic supervising system and supporting groups should be implemented in the medical center. Meantime, in order to enforce the capacity against the stress, stress relief methods should be included in pre-training course for new nursing staff.
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Chang, Yu-Fang, and 張玉芳. "Study of Attitudes toward Physician–Nurse Collaboration in Medical-Surgical Wards From Physicians’ and Nurses’ Perspective." Thesis, 2012. http://ndltd.ncl.edu.tw/handle/43771650930816507596.
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碩士慈濟大學
護理學系碩士班
100
Physicians and nurses tend to differ in their cognition of clinical practices and target care responsibilities based on their perceptions of values, increasing the likelihood of conflicts due to an intense working environment. To prevent conflicts from occurring, positive physician-nurse collaboration should be encouraged. Additionally, the attitudes of the health care providers are an influencing factor. The aim of the study was explore the attitudes of physicians and nurses toward physician-nurse collaboration, and whether they were different among hospitals or among medical-surgical divisions. The cross-sectional and correlational study was conducted by using the Jefferson Scale of Attitudes Toward Physician Nurse Collaboration, the scale was modified after performing repeated translations and expert panel, this study clustered randomly selected physicians and nurses from the medical-surgical ward six hospitals (including 1 medical center, 3 regional and 2 district hospitals) were asked to participate in the study. We distributed 600 questionnaires and recovered 518 completed responses, for an effective response rate of 86.3%. Data were encoded using SPSS12.0 for Windows to conduct statistical analysis. Descriptive statistics, independent sample t-test, one-way analysis of variance (ANOVA), Spearman rank correlation analysis were used to analyze the data. Overall, physicians and nurses showed a significantly high willingness to collaborate, achieving an average score of 52.84 ± 5.06. However, nurses were more willing to collaborate compared to physicians. Among the four dimensions of the Jefferson Scale, “shared responsibility” and “physician’s authority” reached a level of significance (p < .05), with physicians scoring higher than nurses for “shared responsibility”. This indicates that the physicians recognized the value of adopting a physician-nurse collaborative approach to resolve patient problems and share patient care responsibilities. Conversely, nurses scored higher for “physician’s authority” compared to the physicians, indicating that the nurses hoped to collaborate with physicians on all medical and health care related matters. Physicians’ and nurses’ attitudes toward collaboration were not found significant differences among different level hospitals. However, physicians from the medical division scored higher for “physician’s authority” compared to the surgeons, with a significance level of p < .05. Analysis using independent t-tests and one-way ANOVA revealed that participants’ personal attributes, including phsyicain-nurse category, gender, age, years of experience, educational level, service division, and nursing title were associated with their attitudes toward physician-nurse collaboration, reaching a p < .05 level of significance. By contrast, level of hospital and physician title was not associated with attitudes toward physician-nurse collaboration. Females scored higher than males for “physician’s authority”, specifically, female physicians scored higher than male physicians did. Although respondents who were younger and newly employed scored comparatively lower for “shared responsibility”, “professional and cooperative education” and “nurse’s autonomy”, they scored the highest for “physician’s authority”. Regarding education level, respondents with a master’s degree or above obtained a comparatively higher score for “shared responsibility”, who completed junior college of respondents, the lowest score for “shared responsibility”, while had the highest score for “physician’s authority”. Nurses who held senior positions showed a significantly higher willingness to collaborate; specifically, nurses who held management positions demonstrated the most positive attitude toward physician-nurse collaboration. In recent years, Taiwan’s hospital accreditation system merged medical teams with nursing teams to form health care teams dedicated to the provision of integrated patient-orientated services, providing quality health care services to the public through the collaborative efforts of health care providers. The results of the study enhance health care providers’ understanding of the importance of cooperation when establishing good collaborative relationships, improving work satisfaction and providing patients with quality healthcare services. In addition, the results also showed that nurturing professionalism at various education levels is associated with health care providers’ evaluation and attitudes toward physician-nurse collaboration. The results of the study can provide a suggestion for experts promoting a 12-year national education system to abolish the nursing education in five-year junior college system and support efforts to raise the content of basic nursing education in Taiwan to degree level. Furthermore, we recommend schools and hospitals reinforce the concepts of nurse-physician collaboration through educational training courses to enhance understanding and encourage communication, promoting a positive collaborative relationship.
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Lai, Zi-Yi, and 賴姿伊. "The Study on Design of Modular-Based Nursing Shift Report Curriculum and Instruction in Medical-Surgical Wards." Thesis, 2010. http://ndltd.ncl.edu.tw/handle/02890964062134440225.
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碩士國立台北護理學院
醫護教育研究所
98
ABSTRACT The purpose of nursing shift report task is to protect patient safety and continuity of care, essential to effective communication. Ability to practice nursing shift report is one of the necessary practice competency, but the literature still lacks the competency-based curriculum and instruction. Therefore, this study based on the theory of effective communication, the study aims to: (a) Construction and standardization of surgical ward nursing shift change process, (b) design competency of nursing shift repots modular curriculum and teaching materials. To achieve this two studies, the research literature review, clinical interviews and focus group interviews to collect information on three methods, after three stages, 11 steps. Findings of the study include: (a) complete the standardization of the "nursing shift reports," the implementation process, (b) confirm that "nursing shift reports," the implementation process must possess the competency, (c) competency to complete four modules to practice nursing shift reports curriculum ( nursing shift reports task prior knowledge, nursing shift reports process, nursing shift reports situational awareness and determine decision-making, nursing shift reports issues including patient safety), (d) medical and surgical nursing shift reports modular curriculum of study manual. Based on the results and literature review, and make two conclusions ：(a) the nursing shift reports is based on the theory of communication, but also to achieve effective communication requires nursing shift reports the conditions of prior knowledge on the nursing shift report situational understanding and decision-making process competency to determine the nursing shift repors the message for accuracy and completeness.Nursing shift reports can therefore use the correct record of the shift reports and there is a single,as well as effective communication skills,effective time management,and facilitate continuity of care. (B) nursing shift reports by the full competency of modular curriculum , strengthening communication skills between nurses and learn way of doing things with the attitude, the shift reports to correct, to establish the organizational culture of patient safety. Finally, this study offers new pre-clinical training institution or school training competency of nursing students practice nursing shift reports reference.
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Wu, Ming-Chuan, and 吳明娟. "A Study of Training Needs Assessment for New Nurses Employed in the Surgical Wards in General Hospitals." Thesis, 2008. http://ndltd.ncl.edu.tw/handle/63116251215374046755.
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碩士國立台北護理學院
醫護教育研究所
96
This study adopted a secondary analysis method to explore nursing practices situation handling confidence and nurse’s practicing competencies mastery and its related factors for new nurses who had worked in surgical wards for one year . The training needs of new nurses in surgical wards were also examined. The convenience sample included nurses who had worked for one year or less at hospitals Department of Health. Data were obtained from structural questionnaires. Out of 143 questionnaires issued (103 for nursing personnel and forty for ward supervisors)127 copies were collected (ninety-two from new nurses and thirty-five from ward supervisors, a validity rate of 88.81%. The two measurement tools in the study were the Nursing Practicing Situation Handling Confidence Scale (fifty items in four sub-scales) and the Nursing Practice Competencies Mastery Scale (eighty-six items in four sub-scales ). Content validity was examined by five surgical nursing experts. Two scales of four categories for Cronbach α between .946~.985 and .947~.985 revealed high internal consistency. Descriptive statistical analysis was performed using SPSS 15.0 for Windows, Pearson r, t test, one-way ANOVA and multiple regression. The data analysis revealed the following six conclusions : (1) The averages of four categories of nursing practice situation handling confidence (0~10) were 6.59(±1.38), 6.56 (±1.53), 6.65 (±1.48) and 7.00 (±1.75). The averages for four categories of nursing practice competency mastery (1~4) were 3.10 (±0.57), 3.24 (±0.56), 3.15(±0.60) and 3.00(±0.54). (2) In nursing practice, situation handling confidence and nursing practice competency mastery of three groups of nurses who had worked less than one year (3 months, 3-6 months and 6-12 months), the group who had worked for 6-12 months had better performance than the other two groups. (3) Nursing practice situation handling confidence and nursing practice competencies mastery were positively related; the former explained 18.9% of deviation in the latter. (4) Individual factors (number of months of experience, nursing practice competencies mastery) and organizational factors (support from peers, patients and their families) explained 44.3% of the deviation in confidence of nurses in handling nursing practice situations. Working months was an important influential factor in nursing care self-confidence. (5) Training needs (1 highest to 5 lowest) of new nurses increased with the number of working months. Twenty-one priority items were noted in three of the four categories, two for nurses who had worked for 3 months, thirteen for new nurses who had worked 3-6 months and six for new nurses who had worked for 6-12 months. In order of nursing practice competence mastery of the four categories, self-assessment values of new nurses who had worked for less than 3 months were higher than the expected values of nurses in charge of wards (no training needs available); eighty-six items in nursing practice competency mastery of new nurses who had worked for 3-6 months and 6-12 months is below 3. This study explores the importance, prevalence and the expected abilities of four categories of care scenarios and practice ability items. Results of this study provide a valuable reference for incorporation in future nursing school curricula and clinical planning when designing courses for employment, orientation training and continuing education courses.