RESUMEN
BACKGROUND:: A key aspect to the provision of palliative care is maintaining the dignity of the individual being cared for. Nurses working in the community setting need knowledge and skills to meet the needs of individuals who need palliative care and their families. Dignity Care Intervention Ireland is a community-based pilot project designed to implement a dignity care intervention for individuals with a life-limiting condition living in their own home. As part of the overall intervention, an education programme was developed for nurses working in the community. METHOD:: Completion of a locally-designed questionnaire pre- and post-education. RESULTS:: Nurses working in the community setting welcomed and highly valued the Dignity Care Intervention Ireland education programme. There was an overall improvement in the understanding of palliative care for both groups and improved understanding of the principles of palliative care, with self-evaluated competence to apply these principles in daily clinical practice. CONCLUSION:: The importance of education about palliative care to support the delivery of dignity-preserving care cannot be underestimated. Ensuring nurses have the requisite knowledge will enhance future practice development and subsequently improve care for patients with life-limiting conditions and their families.
Asunto(s)
Enfermería en Salud Comunitaria/educación , Enfermería de Cuidados Paliativos al Final de la Vida/educación , Personal de Enfermería en Hospital/educación , Personal de Enfermería en Hospital/psicología , Personeidad , Derecho a Morir , Adulto , Actitud del Personal de Salud , Curriculum , Educación Continua en Enfermería/organización & administración , Femenino , Humanos , Irlanda , Masculino , Persona de Mediana Edad , Proyectos PilotoRESUMEN
AIMS AND OBJECTIVES: To evaluate a dignity care intervention provided by community nurses seeking to address dignity concerns for people with advanced and life-limiting conditions. BACKGROUND: Evidence would suggest that dying people fear a loss of dignity and a central focus of palliative care is to assist people to die with dignity. Whilst community nurses have a key role to play in the delivery of palliative care, specific interventions for dignity are lacking. DESIGN: A mixed methods study using online survey and focus group interviews and thematic analysis to examine data. METHODS: Twenty four community nurses implemented the dignity care intervention for people with advanced and life-limiting conditions were recruited from four pilot sites across Ireland. Four focus group interviews and on line survey were conducted between March-June 2015. RESULTS: The community nurses found the dignity care intervention useful. It helped the nurses to provide holistic end-of-life care and assisted in the overall assessment of palliative care patients, identifying areas that might not otherwise have been noted. Whilst it was a useful tool for communication, they noted that it stimulated some emotionally sensitive conversations for which they felt unprepared. CONCLUSIONS: Implementing the dignity care intervention in practice was challenging. However, the dignity care intervention facilitated holistic assessment and identified patient dignity-related concerns that may not have been otherwise identified. Further support is required to overcome barriers and enable dignity-conserving care. RELEVANCE TO CLINICAL PRACTICE: Ensuring dignity is a key aspect of palliative and end-of-life care; however, community nurses may not feel equipped to address this aspect of care. Implementing a dignity care intervention can assist in identifying patient dignity-related concerns and provision of holistic care. Community nurses need more training to assist in difficult conversations relating to dignity and end-of-life care.
Asunto(s)
Enfermería en Salud Comunitaria/métodos , Relaciones Enfermero-Paciente , Cuidados Paliativos/psicología , Personeidad , Cuidado Terminal/psicología , Adulto , Anciano , Femenino , Grupos Focales , Humanos , Irlanda , Masculino , Persona de Mediana Edad , Investigación Cualitativa , Encuestas y Cuestionarios , Adulto JovenRESUMEN
BACKGROUND: Nurse staffing interventions have been introduced across countries in recent years in response to changing patient requirements, developments in patient care, and shortages of qualified nursing staff. These include changes in skill mix, grade mix or qualification mix, staffing levels, nursing shifts or nurses' work patterns. Nurse staffing has been closely linked to patient outcomes, organisational outcomes such as costs, and staff-related outcomes. OBJECTIVES: Our aim was to explore the effect of hospital nurse staffing models on patient and staff-related outcomes. SEARCH STRATEGY: We searched the following databases from inception through to May 2009: Cochrane/EPOC resources (DARE, CENTRAL, the EPOC Specialised Register), PubMed, EMBASE, CINAHL Plus, CAB Health, Virginia Henderson International Nursing Library, the Joanna Briggs Institute database, the British Library, international theses databases, as well as generic search engines. SELECTION CRITERIA: Randomised control trials, controlled clinical trials, controlled before and after studies and interrupted time series analyses of interventions relating to hospital nurse staffing models. Participants were patients and nursing staff working in hospital settings. We included any objective measure of patient or staff-related outcome. DATA COLLECTION AND ANALYSIS: Seven reviewers working in pairs independently extracted data from each potentially relevant study and assessed risk of bias. MAIN RESULTS: We identified 6,202 studies that were potentially relevant to our review. Following detailed examination of each study, we included 15 studies in the review. Despite the number of studies conducted on this topic, the quality of evidence overall was very limited. We found no evidence that the addition of specialist nurses to nursing staff reduces patient death rates, attendance at the emergency department, or readmission rates, but it is likely to result in shorter patient hospital stays, and reductions in pressure ulcers. The evidence in relation to the impact of replacing Registered Nurses with unqualified nursing assistants on patient outcomes is very limited. However, it is suggested that specialist support staff, such as dietary assistants, may have an important impact on patient outcomes. Self-scheduling and primary nursing may reduce staff turnover. The introduction of team midwifery (versus standard care) may reduce medical procedures in labour and result in a shorter length of stay without compromising maternal or perinatal safety. We found no eligible studies of educational interventions, grade mix interventions, or staffing levels and therefore we are unable to draw conclusions in relation to these interventions. AUTHORS' CONCLUSIONS: The findings suggest interventions relating to hospital nurse staffing models may improve some patient outcomes, particularly the addition of specialist nursing and specialist support roles to the nursing workforce. Interventions relating to hospital nurse staffing models may also improve staff-related outcomes, particularly the introduction of primary nursing and self-scheduling. However, these findings should be treated with extreme caution due to the limited evidence available from the research conducted to date.
Asunto(s)
Modelos de Enfermería , Personal de Enfermería en Hospital/organización & administración , Admisión y Programación de Personal/organización & administración , Ensayos Clínicos como Asunto , Humanos , Partería/organización & administración , Evaluación de Resultado en la Atención de Salud , Especialidades de Enfermería/organización & administraciónRESUMEN
In 2005, the Healthcare Information Management Systems Society (HIMSS) Nursing Informatics Community developed a survey to measure the impact of health information technology (HIT), the I-HIT Scale, on the role of nurses and interdisciplinary communication in hospital settings. In 2007, nursing informatics colleagues from Australia, England, Finland, Ireland, New Zealand, Scotland and the United States formed a research collaborative to validate the I-HIT across countries. All teams have completed construct and face validation in their countries. Five out of six teams have initiated reliability testing by practicing nurses. This paper reports the international collaborative's validation of the I-HIT Scale completed to date.
Asunto(s)
Encuestas de Atención de la Salud/normas , Sistemas de Información en Hospital , Cooperación Internacional , Rol de la Enfermera , Proceso de Enfermería , Humanos , Comunicación InterdisciplinariaRESUMEN
This paper discusses oncology nursing students' views of an objective structured clinical examination (OSCE). The OSCE has been used as a form of assessment in medical education since the 1970s. It has subsequently been used by nursing faculties as one of a number of approaches to assessment of clinical skills. As a form of assessment it has been lauded as being more objective than traditional clinical examinations. The information in this study was collected through annual evaluations since 1998, when the OSCE was first employed to assess the students on a post-graduate oncology nursing programme. The sample comprised 185 students, and the principle areas addressed were students' perceptions regarding their degree of preparation for the examination, the overall efficacy and relevance of the OSCE in testing clinical skills and their views on stress and anxiety associated with this form of assessment. The results indicate that while students acknowledge the OSCE was stressful, they felt they were well prepared and appreciated the efficacy and relevance of this assessment method.