看護とケアのジャーナル

Through acculturation and socialization, caring involves both gendered and socially diverse patterns of understanding and behaving in the world. As a result, the implications for care are embedded in the personal and social values and experiences associated with gender, power, and politics. The general ethos of this paper will explore a feminist care ethic that emerged from the work of Carol Gilligan. This standpoint offers particular peripheral advantages as a feminist theorists’ critique of caring includes the critical examination of relationships from the position of people who have systematically been excluded from power. Although this perspective is theoretically challenging, it offer insights to the significance of caring for the other, the self and the community

Problem: Traumatic Brain Injury (TBI) results in a combination of physical, cognitive, and behavioral impairments with an estimated 2 million Americans sustaining TBI every year. The overall aim of this program was to implement evidence-based practice protocols for clinical management of traumatic brain injury patients. The routine integration of the following Evidence-Based Practice protocols: pulse oximetry and blood pressure monitoring every two hours, toileting and limited distance ambulation (10 to 25 feet) every two hours during the patients wakeful state, baseline Orientation-Log assessment (O-Log) on admission then on a daily basis, physical therapy and speech/cognitive therapy evaluations within 24 to 48 hours of admission were implemented to improve the functional and cognitive outcomes, and reduce bedside patient sitters in the acute care setting.

Data source: This was an exploratory pilot program that implemented EBP protocols for the clinical management of TBI patients. An analysis of trends (pre-EBP of 58 TBI patients vs. post-EBP of 50 TBI patients) was utilized to evaluate whether the change in practice made a significant difference in improving patient’s outcome.

Conclusion: The EBP protocols decreased sitter sessions by 80% and enabled TBI patients to achieve states of functional and cognitive well-being with a structured approach to clinical management. The finding for sitter session usage showed a reduction from 30 sessions 3 months before program implementation to 6 sessions during program implementation, with a continued sitter session reduction of 0 sessions for 6 months post program implementation. The results of this program established a structured and sustainable approach to the clinical management of TBI patients. Through the strategic cycle of patient assessment, ambulation, toileting and hemodynamic status evaluation, patients became less apt to develop confused and agitated states, which supported a safer patient environment and reduced the need for sitter sessions.

Implications for Practice: Results indicate that the EBP protocol created a structured approach to clinical patient management for the nursing staff. The continuous repetition of patient interventions supported by the protocols in concert with staff education on TBI and its consequences, created skill development in the nursing staff for assessing and managing altered states in this patient population.

Background: Stress can come in many forms and NICU is an environment where there may be many types of stress such as nursing a critically ill baby, increased workload, taking on other roles, coping with the death and dealing with parents. Purpose: To explore and describe staff nurses’ (SN) positive experiences while working in a Neonatal Intensive Care Unit (NICU) in one of Malaysia Method: A qualitative interpretative approach using a convenience sample of four staff nurses; described using pseudonyms, from NICU in one Malaysian hospital participated in an interview conducted in English, followed by answering a semi-structured questionnaire in Malay. Responses were translated into English prior to thematic analysis using the method of Braun and Clarke [1]. Results: Two major themes emerged, learning opportunities; describes the new knowledge and skills staff nurses had developed, and feelings of satisfaction; describes sources contributing to staff nurses’ satisfaction while working in NICU. Conclusions: The findings revealed that staff nurses’ positive experiences of gaining knowledge, developing new skills, opportunity to further study in post-basic courses and being appointed as a team leader upon their achievements.

This article reports how nursing staff, nurse managers, faculty, and graduate students from a regional children’s hospital and a research-intensive public university came together to solve a clinical challenge. The challenge was addressed when these practice and academic professionals collaborated and used nursing theory to educate staff nurses and plan a research project. The most significant results from this partnership have been the deep, reciprocal co-mentoring relationships that have formed among participants and the impressive results they have produced. Not finding a fitting description in the literature for the co-mentoring relationships formed through this partnership, the co-mentees formulated their own definition: a trusting, collaborative, and reciprocal teaching/learning relationship among interprofessional colleagues working together with shared power to produce quantifiable results that mutually benefit those involved. Outcomes from this ongoing endeavor include: transforming healthcare through the realistic use of nursing theory, research, and education at the bedside; enhancing nursing education, theory, and research in academia; increased nursing scholarship and professional growth; advancing institutional goals; and strengthening the discipline of nursing.

There is an aging population not only in Portugal but also worldwide. The nursing homes provide its users services adjusted to their needs. Therefore, these institutions should have specialized human resources in health care, such as Nurses. However in Portugal have a low presence of these professionals in nursing homes.

Objective: To identify a sensitive nursing care set of quality indicators in nursing homes.

Methodology: Using the method of a PICOD question, it was made a search in EBSCO (CINAHL Plus with Full Text, MEDLINE with Full Text, British Nursing Index), resulting in hundred and thirty eight articles in total. There were searched scientific articles published in full text (28-01-2009), between 1998/01/01 and 2008/12/31.

Results: From hundred and thirty eight articles we selected twelve and of this identified fourteen quality care indicators: resources to the emergency room; number of days of hospitalization; total days of hospitalization in advanced recovery units; number of medical procedures; sensory function; presence of urinary catheters; loss of function and activities of daily living; controlled use of drugs; use of nine or more different drugs; nutrition; control of infection; pressure ulcers prevalence; pain control; prevalence of falls.

Conclusion: The nursing provide an important contribution in improving quality in the nursing homes. The results seems to show that the introduction of these professionals has direct impact in reducing of the use of health services (emergency and hospital days), reducing the falls, better pain management, in prevalence of the number of pressure ulcers and increased functionality. This set of results has obtained from an international research and so, gives the opportunity to various nursing homes or students in very countries monitoring these indicators, to explore them with the aim to verify its applicability and adapt them to the local needs.