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Iranian Nurses’ Attitudes and Perception towards Patient Advocacy  [PDF]
Mohadeseh Motamed-Jahromi,Abbas Abbaszadeh,Fariba Borhani,Homa Zaher
ISRN Nursing , 2012, DOI: 10.5402/2012/645828
Abstract: Patient advocacy is an inherent component of professional nursing ethics; in other words, nurses' enough knowledge would be essential to gain a positive attitude towards nursing advocacy. Using a descriptive-analytic design, this study aimed to assess the correlation between nurses' perception and attitudes towards patient advocacy, amongst 385 nurses in Kerman, Iran; hence, a three-part questionnaire was applied: part I, a demographic data sheet, part II, attitude measuring instrument, and part III, perception measuring instrument in nursing advocacy. The results implied that fairly positive attitudes and perception were found amongst the participants, and nurses’ attitudes, in general, were positively correlated to their perception toward nursing advocacy. This means that with an improvement in perception, the attitude would also improve. In addition to our findings, it seems that these nurses needed more advocacy educational programs and support from responsible employers. 1. Introduction Patient advocacy is an intrinsic essence of professional nursing ethics. This ethical principle is vital to the nurse-patient relationship and reveals a thought of reverence towards patients as human beings [1] and towards patients’ rights [2, 3]. Indeed, patients’ needs or desires are recognized as a key impulsion for advocacy in nursing [4]. Therefore, it is defined as a crucial section of nurses’ attempts to encourage and protect health and interests of patients by supplying information and assisting clients in their decisions [5], cooperating to patients’ self-determination, autonomy, or empowerment [6], pleading the reason of client [7], defending the client from pointless worries [8], revealing information about misbehavior that imperils the welfare of others [9], and respecting patients values and beliefs, together with educating and interceding [6]. Curtin and Gadow stated that advocacy is the elemental foundation for nursing and exclusively illustrates the essence of nursing practice [10, 11]. Gadow alluded to advocacy as the “philosophical basis and aim of nursing.” Maybe the clearest definition of advocacy in nursing can be found in Gadow’s explanation. Advocacy not only safeguards but positively contributes to the exercise of self-determination [11, page 53]. Kohnke recommended that advocacy is a type of caring and kindness in nursing practice and that it is a learned skill that nurses would develop through different experiences, especially if advocacy is esteemed as worthwhile [5]. A great deal of the argument of patient advocacy is originated from the
A study of professional nurses’ perceptions of factors affecting the process of client education
Goudarzi Z,Khosravi Kh,Bahrani N,Vaskooii Kh
Hayat Journal of Faculty of Nursing & Midwifery , 2004,
Abstract: Introduction: Education of patients and helping them to be independent in process of self-care in both health and disease is one of the basic responsibilities of nurses. Methods and Materials: This descriptive-analytic research was done to study perceptions of 317 nurses working in hospitals of Tehran University of Medical Sciences of factors affecting the process of patient education. Data was gathered by means of a questionnaire containing 30 questions about facilitating factors and 17 about inhibiting factors. We used Likert score to measure questions. Data analysis performed by SPSS software. Statistical test were Chi square, t test, variance analysis and correlation of variance. Results: The highest percentage of nurses (52.1%) believed that enough attention is not being paid to facilitating factors such as considering patient education as priority in patient care, nurses being responsible for patient education, considering patient education as a criteria in nurses annual evaluation, importance of patient education for nurse administrators, having in-service education about patient teaching and having proper time, place and personnel for patient education. Majority of nurses (57.4%) believed factors such as shortage of nurses, lack of proper place, time and patient motivation for receiving education, nurses and nurse administrators’ inattention to patient education and negative attitude of doctors toward patient education by nurses are inhibiting factors in process of education. Statistical tests showed a meaningful relation between demographic variables such as sex, clinical background, shift work and position and facilitating factors. There was also a meaningful relation between variables like working in more than one shift, having clinical experience of patient education and being evaluated for patient education during study of nursing and inhibiting factors. Conclusion: This study shows low level of facilitating factors for patient education in hospitals of Tehran University of Medical Science. To improve patient education in these hospitals it is necessary to improve facilitating factors.
A pilot study to determine the profile of recovery room nurses in Johannesburg hospitals
J Scribante, HC Perrie
Southern African Journal of Anaesthesia and Analgesia , 2011,
Abstract: Background: Apart from anecdotal evidence, very little is known of the recovery room nurses in South Africa. Method: An exploratory, prospective, descriptive pilot study was carried out in the recovery rooms of six Johannesburg hospitals, three academic and three private hospitals, one from each of the major private hospital groups. An appointment was scheduled and data were collected from either the theatre nursing manager, sister in charge of the recovery room or the nursing manager. The data collected reflected a brief profile of the selected recovery rooms and the demographic and education profile of nurses working there in August 2011. Results: Nurse:patient ratios were difficult to determine. Agency staff was used by one recovery room. The other recovery rooms used their permanent staff to work overtime. All the hospitals used anaesthetic nurses to double up when necessary. Only one of the recovery rooms had a supernumerary anaesthetist available during the day. A total of 49 nurses were working in the six recovery rooms during August 2011. The majority, 95.9% (n = 47), of the recovery room nurses were females and 4.1% (n = 2) were males. The average age of the recovery nurses was 44 years (25–63 years), with a median of 41 years. The experience of the recovery room nurses ranged from one month to 35 years with an average of 8.6 years. The majority of nurses, 57.1% (n = 28), were professional nurses, and 42.9% (n = 21) were enrolled nurses. Of the 28 professional nurses, 32.0% (n = 9) had no postgraduate training. The remaining 19 nurses had the following postgraduate qualifications: management and operating room technique 17.9% (n = 5), critical care 14.3% (n = 4), and education 10.7% (n = 3). The six-month anaesthetic nurse qualification, that is not an official South African Nursing Council-endorsed postgraduate qualification, was held by 35.7% (n = 10) of the professional nurses and 4.8% (n = 1) of the enrolled nurses. All the recovery rooms had an in-service education programme. Conclusion: There is a need to determine the profile of recovery room nurses in South Africa and to establish an appropriately trained and competent recovery room nursing workforce.
Thought Processes of Nurses in Nursing Assessment: Analysis of Nursing Problems and Patient Strengths, Patient Information  [PDF]
Kasumi Mikami, Ryoko Tsuchiya, Keiko Aizu, Yoshiko Nishizawa
Open Journal of Nursing (OJN) , 2014, DOI: 10.4236/ojn.2014.413106
Abstract: Aims: The purpose of this study was to clarify the thought processes of nurses in performing nursing assessment. Methods: The participants comprised 20 nurses working in a surgery ward. Patient information on a case, including presenting illness, vital signs, and other findings from admission until 09:00 on the day after surgery, was shown to the participants. After reading the case report, the nurses presented their assessments. Based on these assessments, nursing problems, patient strengths, and patient information were identified. Nursing problems and patient strengths were described by various words and sentences, and were classified according to similar content. Results: The number of nursing problems ranged from 1 to 8 and patient strengths from 0 to 6 for each nurse. The mean number of nursing problems was 4.7 ± 1.8, and the mean number of patient strengths was 2.2 ± 1.4. The main nursing problems were respiratory complications, postoperative wound pain, and anxiety, and the main patient strength was family cooperation. Patient information as evidence of respiratory complications included history of smoking, chest radiography results, postoperative vital signs, sputum color and properties. Patient information as evidence of postoperative wound pain included complaints of pain, epidural anesthesia, use of patient-controlled anesthesia and its effect. Patient information indicating family cooperation included family structure, preoperative visits by family, and presence of family while providing informed consent. Significant differences were seen in the number of nursing problems and patient strengths according to cognitive style. Conclusions: Postoperative complications were the nursing problems most commonly extracted by nurses. To clarify nursing problems and patient strengths, the nurses made assessments on the basis of information such as patient complaints, vital signs, and test results. However, extracted nursing problems and patient strengths were diverse, suggesting that nursing problems and patient strengths as determined by nurses differed between individual nurses.
Nurses Opinion on the Attributes of Polypharmacy in Patient Safety
John Lisha Jenny,Cheriathu Jenny,Sreedharan Jayadevan,Muttappallymyalil Jayakumary
Acta Medica Iranica , 2012,
Abstract: Nurses play a functional role in preventing drug related problems. They need to be aware of the dangers of polypharmacy while reviewing patient medications. We studied the nurses' opinion on the diverse effects of polypharmacy in the hospital setting. Nurses working in a tertiary care teaching hospital participated in this cross-sectional study, conducted over 3 months, by responding to a self-administered questionnaire. Chi-square test was used to analyze association between socio-demographic characteristics and items in the study. A value of P<0.05 was considered statistically significant. Increased drug interactions scored the highest (98.1%), followed by increased adverse drug effects (81.9%), and increase in financial burden (69.5%) among the negative effects of polypharmacy. 61% of the respondents felt that polypharmacy increased therapeutic effect in polypathology. No difference was observed in the opinion between male and female nurses or among varying nursing experience. Nurses with 5-10 years of experience opined increase in non-compliance to prescribed medication regimen and increase in financial burden also as negative attributes. Nurses pointed out both positive and negative implications of polypharmacy. Training programs such as continuing nursing education and workshops can be planned to translate this knowledge into practice in their routine nursing practice.
Nurses’ Care Approach (NCAp): Connecting Differences to Islamic Believer Patients in the Arab World  [PDF]
Jefferson Garcia Guerrero
Open Journal of Nursing (OJN) , 2019, DOI: 10.4236/ojn.2019.93022
Abstract: Background: Nursing care approaches may vary from one patient to another. In the nursing profession, nurses are imbibed with the attributes of multicultural care competencies that would empower the nurses to be adaptive and mindful of how they provide and go with their carative nursing managements. This would entail that the non-Muslim nurses must be aware and be sensitive enough in their approaches and communicative exchanges with their Muslim patients. Objective: The study aims to identify the care approaches given by non-Muslim nurses working in the Arab world and how they elicit and provide a universal approach in caring Muslim patients. Methods: The study utilized a mixed methodology, specifically the explanatory sequential design, which involved a descriptive-comparative quantitative research design and eidetic qualitative research design. Results: Based on the result with the highest mean 3.63%, the respondents strongly agree that the non-Muslim nurse is aware of her own culture, 3.60% strongly agree that the non-Muslim Nurse does not discriminate the decisions of the patients regardless of gender, race, culture or belief and 3.58% still strongly agree that the non-Muslim nurse encourages patients to communicate as need arises. Here are three themes emerged from the study: understanding and respect of cultures, caring across borders, and caring calmness. In connecting the differences, non-Muslim nurses must be aware of their own culture, must not discriminate the decisions of the patients regardless of gender, race, culture or belief and must encourages patients to communicate as need arises. Conclusion: Knowing and understanding the scope of nursing practice with a high regard of respect to patients without discrimination will promote and provide holistic, safe and high-quality nursing care.
Patient Advocacy and the Affordable Care Act: The Growing Need for Nurses to Be Culturally Aware  [PDF]
Edward D. Ronnebaum, Carol Schmer
Open Journal of Nursing (OJN) , 2015, DOI: 10.4236/ojn.2015.53028
Abstract: The nurse-patient relationship is centered on patient advocacy. Patient advocacy is essential in providing individualized care and improving health outcomes. With the recent implementation of the Affordable Care Act, the patient advocacy concept requires further exploration. Published literature involving patient advocacy’s history, uses, definition, past analyses and nursing perceptions were examined. Outcomes of this literature review lead to further examining patient advocacy and how it is applied to culturally diverse patient populations, patient advocacy in nursing curricula and related research. Overall study results indicate that patient advocacy is associated with enhanced health encounters that include nurses presenting patients with understandable healthcare options and supporting patients with their healthcare preference. Although, this review identified positive outcomes of patient advocacy, nursing research must be directed toward creating a patient advocacy definition and measuring advocacy from a patient’s perspective. There is also a need for nursing leaders to consider placing a higher emphasis on cultural awareness research and education due to an increased rate of culturally diverse patients now seeking care through the Affordable Care Act.
Perceptions of Nurses on Patient Outcomes Related to Nursing Shortage and Retention Strategies at a Public Hospital in the Coastal Region of Tanzania  [PDF]
Bonventura Mtega, Lwijisyo Kibona, Khairunnisa Dhamani, Pammla Petrucka
Open Journal of Nursing (OJN) , 2017, DOI: 10.4236/ojn.2017.79076
Abstract: Background: There is little disagreement that the shortage of nurses affects patients’ outcomes globally. However, within the low and middle income country setting, there is minimal known about the perceptions of nurses on nursing shortages impact the health outcomes of their patients and what recruitment and retention strategies might be appropriate to address some of these challenges. This study explored the perceptions of nurses on the health outcomes of patient related to shortage of registered nurses and the strategies to retain nurses at a public hospital in Tanzania. Method: This qualitative descriptive study used semi-structured in-depth interviews with a select group of nurses in a large public hospital. Findings: Through an iterative coding process, a series of categories were derived which yielded three major themes—factors contributing to nursing shortage; compromised quality of care; and recruitment and retention strategies. Conclusion: A shortage of nurses affects the health outcomes of patients as it potentially hinders timely accomplishment of the optimal nursing. Efforts need to be proactive in recognizing the reasons for nursing shortages which are rooted in individual, institutional (agency), and organizational (systemic) issues. Within the LMIC context, such as where this study was conducted, it became apparent that the nurses wanted acknowledgement and opportunities to work collaboratively towards the resolution of workload issues for the benefit of the patients.
Differences in Perceptions of Patient Safety Culture between Charge and Noncharge Nurses: Implications for Effectiveness Outcomes Research  [PDF]
Deleise Wilson,Richard W. Redman,AkkeNeel Talsma,Michelle Aebersold
Nursing Research and Practice , 2012, DOI: 10.1155/2012/847626
Abstract: The implementation of evidence-based practice guidelines can be influenced by nurses’ perceptions of the organizational safety culture. Shift-by-shift management of each nursing unit is designated to a subset of staff nurses (charge nurses), whom are often recruited as champions for change. The findings indicate that compared to charge nurses, noncharge nurses were more positive about overall perceptions of safety ( ) and teamwork ( ). Among charge nurses, significant differences were observed based on the number of years’ experience in charge: perception of teamwork within units [ , ]; overall perceptions of safety, [ , ]; safety grade for work area [ , ]; number of events reported within the last month [ , ]. These findings provide important insights to organizational contextual factors that may impact effectiveness outcomes research in the future. 1. Introduction With the increasing emphasis in the efficient delivery of healthcare, healthcare organizations are investing in effectiveness outcomes research to improve patient outcomes. However, the uptake and implementation of evidence-based clinical practice guidelines are influenced by contextual factors such as leadership support and use of change champions [1–3] and personnel perceptions of patient safety [4]. Within acute care settings, nurses’ perceptions of patient safety cultures and attitudes towards new practice guidelines are very critical for predicting the use of research evidence and new guidelines [5, 6]. What is known about nurses’ perceptions of patient safety culture has been reviewed in comparison with interdisciplinary team members [7–9] and across ranks such as staff nurses versus nurse managers [10]. Yet, staff nurses are not a homogenous group. In most acute care settings for each nursing unit, the management of each shift is designated to a nurse who then leads other staff nurses on that shift. The shift-by-shift leaders may be known as charge nurses, or assistant nurse managers [11, 12] and are often used as champions for change [13, 14]. Since nurses are very pivotal to the implementation of safety guidelines, it is critical to have a deeper understanding of how these two groups of nurses, charge and noncharge nurses, perceive patient safety cultures. The purpose of this paper was to compare the perceptions of nursing units’ safety culture between charge nurses and staff nurses. For this study, the charge nurse is defined as a frontline nursing unit leader who makes shift-by-shift decisions about staffing, personnel and unexpected events that impact patient care [15]. In
Challenges and facilitators for patient and public involvement in England; focus groups with senior nurses  [PDF]
Markella Boudioni, Susan McLaren
Open Journal of Nursing (OJN) , 2013, DOI: 10.4236/ojn.2013.37064
Abstract: The concepts of patient and public involvement (PPI) have been recognized and linked with quality in health services internationally and in Europe. In England, for more than a decade, NHS policies have increasingly quoted patient-centred services. Limited evidence exists about the implementation of PPI policies and strategies within organisations; three studies only have explored health professionals’ perceptions of PPI. Although nurses’ positive support for patient and public involvement has been noted, comparatively little is known about senior nurses’ experiences of embedding PPI. A national consultation utilising three focus groups aimed to explore senior nurses’ perceptions of challenges and facilitators for PPI implementation. Four Strategic Health Authorities (SHAs) and eleven Primary Care Trusts (PCTs) in England, with fifteen senior nurses with leadership roles and direct PPI experience, participated. Nurses’ perceptions on patient and public involvement, challenges and facilitators for its implementation were discussed. Focus groups were digitally recorded and transcribed verbatim; anonymised transcripts were validated by participants and analysed with thematic analysis. Limited resources, patient representation and recruitment, complexities of implementing PPI and national policy changes were challenging. Commissioning limitations, lack of feedback on patient experience, limited staff awareness, negative attitudes, management of patients and public expectations constituted further challenges. Nursing role characteristics and informal involvement activities, PPI policy and cultural change, commissioning PPI competencies, related service frameworks, providing feedback on patient experiences to staff and recognition of involvement benefits were recognised as facilitators. Findings provided new insights into senior nurses’ experiences and evidence that progress towards meaningful, effective PPI remains slow. However, recognition of existing nursing role characteristics and potential delivery problems created by expanded nursing roles, informal PPI practice and internal organisational sharing of patient feedback may bring an “emerging productive partnership” with nurses enabling and contributing to effective PPI.
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