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Developing leadership capacity for guideline use: a pilot cluster randomized control trial.

https://arctichealth.org/en/permalink/ahliterature123925
Source
Worldviews Evid Based Nurs. 2013 Feb;10(1):51-65
Publication Type
Article
Date
Feb-2013
Author
Wendy A Gifford
Barbara L Davies
Ian D Graham
Ann Tourangeau
A Kirsten Woodend
Nancy Lefebre
Author Affiliation
School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada. wgifford@uottawa.ca
Source
Worldviews Evid Based Nurs. 2013 Feb;10(1):51-65
Date
Feb-2013
Language
English
Publication Type
Article
Keywords
Diabetic Foot - therapy
Feasibility Studies
Home Nursing - education - methods - standards
Humans
Leadership
Nursing Process - organization & administration
Ontario
Pilot Projects
Practice Guidelines as Topic
Qualitative Research
Abstract
The importance of leadership to influence nurses' use of clinical guidelines has been well documented. However, little is known about how to develop and evaluate leadership interventions for guideline use.
The purpose of this study was to pilot a leadership intervention designed to influence nurses' use of guideline recommendations when caring for patients with diabetic foot ulcers in home care nursing. This paper reports on the feasibility of implementing the study protocol, the trial findings related to nursing process outcomes, and leadership behaviors.
A mixed methods pilot study was conducted with a post-only cluster randomized controlled trial and descriptive qualitative interviews. Four units were randomized to control or experimental groups. Clinical and management leadership teams participated in a 12-week leadership intervention (workshop, teleconferences). Participants received summarized chart audit data, identified goals for change, and created a team leadership action. Criteria to assess feasibility of the protocol included: design, intervention, measures, and data collection procedures. For the trial, chart audits compared differences in nursing process outcomes.
8-item nursing assessments score. Secondary outcome: 5-item score of nursing care based on goals for change identified by intervention participants. Qualitative interviews described leadership behaviors that influenced guideline use.
Conducting this pilot showed some aspects of the study protocol were feasible, while others require further development. Trial findings observed no significant difference in the primary outcome. A significant increase was observed in the 5-item score chosen by intervention participants (p = 0.02). In the experimental group more relations-oriented leadership behaviors, audit and feedback and reminders were described as leadership strategies.
Findings suggest that a leadership intervention has the potential to influence nurses' use of guideline recommendations, but further work is required to refine the intervention and outcome measures. A taxonomy of leadership behaviors is proposed to inform future research.
PubMed ID
22647197 View in PubMed
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The Development Process of eHealth Strategy for Nurses in Finland.

https://arctichealth.org/en/permalink/ahliterature281930
Source
Stud Health Technol Inform. 2016;225:203-7
Publication Type
Article
Date
2016
Author
Outi Ahonen
Pirkko Kouri
Ulla-Mari Kinnunen
Kristiina Junttila
Pia Liljamo
Dinah Arifulla
Kaija Saranto
Source
Stud Health Technol Inform. 2016;225:203-7
Date
2016
Language
English
Publication Type
Article
Keywords
Finland
Health Policy
Medical Informatics - organization & administration
Models, Educational
Nurse's Role
Nursing Informatics - organization & administration
Nursing Process - organization & administration
Telemedicine - organization & administration
Abstract
Growing use of information and communication technology (ICT) demands have caused a need for nursing to strengthen the knowledge, skills and competences related to ICT in health (eHealth) and define its versatile roles. The Finnish Nurses Association (FNA) named a group of eHealth experts from various professional fields that are closely connected to nursing e.g. nursing practice, higher education, nursing research and administration. The main purpose was to describe nurses' contribution to the national strategy concerning eHealth development and implementation in health and social care. The group searched for answers, discussed strategic issues, wrote drafts, and sent texts for open commentary circles. The chosen themes of the eHealth strategies deal with the role of the client, nursing practice, ethical aspects education and eHealth competences, nursing leadership, knowledge management and research and development. The article describes the strategic work and the structure of eHealth strategy of nurses in Finland.
PubMed ID
27332191 View in PubMed
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Documentation of pain management with TT- 2000+ in May 2008 viewed from clinical nursing practice.

https://arctichealth.org/en/permalink/ahliterature149747
Source
Stud Health Technol Inform. 2009;146:503-5
Publication Type
Article
Date
2009
Author
Sara Asteljoki
Jukka Kesänen
Helena Pykälämäki
Sini-Vuokko Korpela
Liisa Montin
Author Affiliation
Orton Orthopaedic Hospital, Orton Foundation, Helsinki, Finland. sara.asteljoki@orton.fi
Source
Stud Health Technol Inform. 2009;146:503-5
Date
2009
Language
English
Publication Type
Article
Keywords
Finland
Humans
Medical Records Systems, Computerized
Nursing Process - organization & administration
Pain Management
Pain Measurement - nursing
Abstract
Electronic Patient Record (EPR) TT- 2000+ was implemented in Hospital Orton in January 2008. The software TT 2000+ was implemented in 2005. TT- 2000+ enables structured and specifically defined documentation in clinical nursing practice.
To describe the use of pain management documentation into TT- 2000+ and how the results can be implemented into clinical nursing practice. Can the results be used in development of clinical nursing practice? How does the evaluation of pain reflect into the number of documentation?
The data were obtained from documentations made in May 2008 from patient groups that had undergone total hip arthroplasty and total knee arthroplasty.
The number of total hip arthroplasty patients was 60 and total knee arthroplasty patients 51. The total number of pain documentations with the group of THA's was 992 and with TKA's 913.
Due to the circumstances in May 2008, the numbers of documentation into the TT- 2000+ are inadequate. Therefore, the documentation needs further research within a longer period of time. Undefined and unified way of maintaining and recording should be considered in processing information in clinical practice.
PubMed ID
19592894 View in PubMed
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A formative evaluation to develop a school health nursing early intervention model for adolescent substance use.

https://arctichealth.org/en/permalink/ahliterature163948
Source
Public Health Nurs. 2007 May-Jun;24(3):256-64
Publication Type
Article
Author
Marjatta Pirskanen
Eila Laukkanen
Anna-Maija Pietilä
Author Affiliation
Department of Nursing Science, University of Kuopio, Finland, and Kuopio Social and Health Care Centre, Kuopio, Finland. marjatta.pirskanen@kuopio.fi
Source
Public Health Nurs. 2007 May-Jun;24(3):256-64
Language
English
Publication Type
Article
Keywords
Adolescent
Adolescent Health Services - organization & administration
Attitude of Health Personnel
Cooperative Behavior
Early Diagnosis
Finland
Focus Groups
Humans
Mass Screening - organization & administration
Models, Nursing
Needs Assessment
Nurse's Role - psychology
Nurse-Patient Relations
Nursing Assessment - organization & administration
Nursing Evaluation Research
Nursing Methodology Research
Nursing Process - organization & administration
Nursing Staff - organization & administration - psychology
Qualitative Research
Questionnaires - standards
School Nursing - organization & administration
Substance-Related Disorders - diagnosis - prevention & control - psychology
Abstract
To improve an early intervention (EI) triggered by the Adolescents' Substance Use Measurement (ADSUME) as a method to prevent substance abuse among adolescents. We assessed how ADSUME and EI work in practice and how EI could be improved.
School health nurses (n=10) tested ADSUME and EI on 14- to 18-year-old adolescents (n=228). Six months later, these nurses and their professional partners were invited to assess EI in focus group interviews.
Four focus group interviews involving a total of 24 nurses and partners were implemented. Interview data were analyzed with qualitative content analysis.
ADSUME concretized assessment, activated profound dialogue, and proved to be an important part of EI. It was important to assess the adolescent's resources in addition to the ADSUME score. EI worked well in confidential dialogues after the adolescent and the PHN reached a consensus on the level of concern about the adolescent's substance use. The recommended EI enabled individual brief intervention in all four stages of substance use, from abstinence or experimental use to hazardous use.
EI was improved practically, and the contents of the intervention were reformulated. It is important to integrate EI with the preventive efforts of the school.
PubMed ID
17456127 View in PubMed
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Implementation of a nursing professional practice model.

https://arctichealth.org/en/permalink/ahliterature158030
Source
Healthc Manage Forum. 2007;20(3):24-9
Publication Type
Article
Date
2007
Author
Esther Leclerc
Mélanie Lavoie-Tremblay
Author Affiliation
Centre Hospitalier de l'Université de Montréal.
Source
Healthc Manage Forum. 2007;20(3):24-9
Date
2007
Language
English
French
Publication Type
Article
Keywords
Academic Medical Centers
Canada
Diffusion of Innovation
Efficiency, Organizational - standards
Humans
Multi-Institutional Systems
Nursing Process - organization & administration
Questionnaires
PubMed ID
18372886 View in PubMed
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[Improved nursing homes: out with routines--in with individualized care].

https://arctichealth.org/en/permalink/ahliterature237362
Source
Sykepleien. 1986 Feb 21;73(4):4-9, 34
Publication Type
Article
Date
Feb-21-1986

Newly graduated nurses' use of knowledge sources in clinical decision-making: an ethnographic study.

https://arctichealth.org/en/permalink/ahliterature282073
Source
J Clin Nurs. 2017 May;26(9-10):1313-1327
Publication Type
Article
Date
May-2017
Author
Siri Lygum Voldbjerg
Mette Grønkjaer
Rick Wiechula
Erik Elgaard Sørensen
Source
J Clin Nurs. 2017 May;26(9-10):1313-1327
Date
May-2017
Language
English
Publication Type
Article
Keywords
Anthropology, Cultural
Clinical Competence
Clinical Decision-Making
Denmark
Health Knowledge, Attitudes, Practice
Humans
Nursing Assessment - organization & administration
Nursing Process - organization & administration
Nursing Staff, Hospital - organization & administration
Surveys and Questionnaires
Abstract
To explore which knowledge sources newly graduated nurses' use in clinical decision-making and why and how they are used.
In spite of an increased educational focus on skills and competencies within evidence-based practice, newly graduated nurses' ability to use components within evidence-based practice with a conscious and reflective use of research evidence has been described as being poor. To understand why, it is relevant to explore which other knowledge sources are used. This may shed light on why research evidence is sparsely used and ultimately inform approaches to strengthen the knowledgebase used in clinical decision-making.
Ethnographic study using participant-observation and individual semistructured interviews of nine Danish newly graduated nurses in medical and surgical hospital settings.
Newly graduates use of knowledge sources was described within three main structures: 'other', 'oneself' and 'gut feeling'. Educational preparation, transition into clinical practice and the culture of the setting influenced the knowledge sources used. The sources ranged from overt easily articulated knowledge sources to covert sources that were difficult to articulate. The limited articulation of certain sources inhibited the critical reflection on the reasoning behind decisions. Reflection is a prerequisite for an evidence-based practice where decisions should be transparent in order to consider if other evidentiary sources could be used.
Although there is a complexity and variety to knowledge sources used, there is an imbalance with the experienced nurse playing a key role, functioning both as predominant source and a role model as to which sources are valued and used in clinical decision-making. If newly graduates are to be supported in an articulate and reflective use of a variety of sources, they have to be allocated to experienced nurses who model a reflective, articulate and balanced use of knowledge sources.
PubMed ID
27805748 View in PubMed
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Nurses' reasoning process during care planning taking pressure ulcer prevention as an example. A think-aloud study.

https://arctichealth.org/en/permalink/ahliterature168590
Source
Int J Nurs Stud. 2007 Sep;44(7):1109-19
Publication Type
Article
Date
Sep-2007
Author
Kajsa Helena Funkesson
Els-Marie Anbäcken
Anna-Christina Ek
Author Affiliation
Department of Social and Welfare Studies, Linköping University, Sweden. kajsa.funkesson@isv.liu.se
Source
Int J Nurs Stud. 2007 Sep;44(7):1109-19
Date
Sep-2007
Language
English
Publication Type
Article
Keywords
Aged
Attitude of Health Personnel
Clinical Competence
Decision Making
Female
Health Knowledge, Attitudes, Practice
Humans
Nurse's Role - psychology
Nurse-Patient Relations
Nursing Assessment
Nursing Homes
Nursing Methodology Research
Nursing Process - organization & administration
Nursing Staff, Hospital - organization & administration - psychology
Patient Care Planning - organization & administration
Pressure Ulcer - nursing - prevention & control
Problem Solving
Professional Autonomy
Qualitative Research
Skin Care - nursing
Sweden
Thinking
Time Factors
Abstract
Nurses' clinical reasoning is of great importance for the delivery of safe and efficient care. Pressure ulcer prevention allows a variety of aspects within nursing to be viewed.
The aim of this study was to describe both the process and the content of nurses' reasoning during care planning at different nursing homes, using pressure ulcer prevention as an example.
A qualitative research design was chosen.
Seven different nursing homes within one community were included.
Eleven registered nurses were interviewed.
The methods used were think-aloud technique, protocol analysis and qualitative content analysis. Client simulation illustrating transition was used. The case used for care planning was in three parts covering the transition from hospital until 3 weeks in the nursing home.
Most nurses in this study conducted direct and indirect reasoning in a wide range of areas in connection with pressure ulcer prevention. The reasoning focused different parts of the nursing process depending on part of the case. Complex assertations as well as strategies aiming to reduce cognitive strain were rare. Nurses involved in direct nursing care held a broader reasoning than consultant nurses. Both explanations and actions based on older ideas and traditions occurred.
Reasoning concerning pressure ulcer prevention while care planning was dominated by routine thinking. Knowing the person over a period of time made a more complex reasoning possible. The nurses' experience, knowledge together with how close to the elderly the nurses work seem to be important factors that affect the content of reasoning.
PubMed ID
16806220 View in PubMed
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Nursing Telehealth, Caring from a Distance.

https://arctichealth.org/en/permalink/ahliterature281931
Source
Stud Health Technol Inform. 2016;225:188-92
Publication Type
Article
Date
2016
Author
Lars Botin
Christian Nøhr
Source
Stud Health Technol Inform. 2016;225:188-92
Date
2016
Language
English
Publication Type
Article
Keywords
Denmark
Electronic Health Records - organization & administration
Models, organizational
Nursing Care - standards
Nursing Informatics - organization & administration
Nursing Process - organization & administration
Nursing Records
Organizational Objectives
Tasmania
Telemedicine - organization & administration
Abstract
Tele-technology in the health care system is prognosed to be able to produce better health, better care at lower cost (Triple aim). This paper will discuss the validity of this prognosis, which in many ways is considered as some sort of diagnosis of the conditions concerning triple aim in relation to Tele-technology. Tele-technology in the health care system covers three different types of technological settings: telecare, telehealth and telemedicine. This paper will disclose the different meanings of telecare, telehealth and telemedicine and discusses how nursing informatics can accomplish and gain from this disclosure. Theoretically and methodologically the paper is based on post-phenomenological readings and reflections, where use, practice, users, participants, values and knowledge systems are addressed on an equal level in order to understand technology and how we act appropriately through and with technology.
PubMed ID
27332188 View in PubMed
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RN and RPN decision making across settings.

https://arctichealth.org/en/permalink/ahliterature177849
Source
Can J Nurs Leadersh. 2000 Nov-Dec;13(4):11-8
Publication Type
Article
Author
J. Royle
A. DiCenso
A. Baumann
B. Boblin-Cummings
J. Blythe
C. Mallette
Author Affiliation
School of Nursing, McMaster University, Hamilton, ON.
Source
Can J Nurs Leadersh. 2000 Nov-Dec;13(4):11-8
Language
English
Publication Type
Article
Keywords
Adult
Attitude of Health Personnel
Benchmarking
Clinical Competence - standards
Decision Making
Factor Analysis, Statistical
Female
Health Facility Environment - organization & administration
Health Knowledge, Attitudes, Practice
Humans
Male
Nurse's Role
Nursing Administration Research
Nursing Methodology Research
Nursing Process - organization & administration
Nursing Staff - organization & administration - psychology
Nursing, Practical - organization & administration
Ontario
Organizational Culture
Organizational Policy
Professional Autonomy
Questionnaires
Self Efficacy
Abstract
Nursing decision making was a focus of the Province-Wide Nursing Project (PWNP), a 3-year project to promote best nursing practice. In much of the growing literature on nursing decision making, it is assumed that there are differences in the way RNs and RPNs make decisions. However, there is little scientific evidence to support this assumption. The RN and RPN decision making across settings questionnaire was completed by nurses employed in the 23 agencies of the 4 Participating Complexes taking part in the project. The survey questions were subjected to factor analysis and reduced to five factors. Results revealed measurable differences between the way that RNs and RPNs made decisions. Both RNs and RPNs reported making decisions frequently and experiencing little difficulty in making them. However, there were statistically significant differences in the frequency with which RNs and RPNs perceived they made decisions and the difficulty they found in making them. To plan effective health care, it is important to take account of the strengths of different health care workers. There is a need for further research to investigate the reasons behind the differences revealed in these findings.
PubMed ID
15495385 View in PubMed
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12 records – page 1 of 2.