看護とケアのジャーナル

Background: Efficient collaboration and information exchange among care givers is essential during patient´s hospital period for the high quality and safety of patient care. Nursing documentation plays important part in effective collaboration and information exchange. One prerequisite for efficient and productive multidisciplinary collaboration is the nursing documentation when it is in appropriate format and easily accessible. In Finland, nursing documents are produced, stored and represented with a nursing documentation system (NDS), which is part of an electronic health record (EHR). The nursing model applied is based on a nursing process, a nationally defined nursing core data set and the Finnish Care Classification (FinCC). Research design and method: This study is a part of the research where we evaluated the feasibility and usability of the structured nursing documentation model and four widely used NDSs. One perspective in evaluation was the study of the usefulness of the nursing model and NDSs in multi-professional collaboration and information exchange. The materials were collected with thematic interviews with seven physicians and 20 nurses in spring 2010 in the clinical contexts of primary, specialized and private health care. Results: Nursing documentation model and NDSs supported poorly electronic multi-professional care and information exchange. Physicians found nursing documentations difficult to access and to understand. Information was documented as small, separate items and thus a comprehensive picture of the patient’s situation was not present. Collaborative care aspects were either not supported. The nursing model used could not be utilized by the physicians and NDSs did not take into account the needs of those physicians who require information on patient care provided by nurses. Conclusion: Experiences from our study could be used by other hospitals, care givers and countries for better design of nursing documentation. In the future, better utilization of information requires that the nursing documentation model and NDSs are designed to support not just documentation but also information exchange and multi-professional collaboration.

Violence in healthcare is a prominent global concern. To prevent violence it is necessary to have an organized plan of action against violence. It is vital to learn where violence originates and then to develop an organized interventional plan to prevent violence. This article analyzes the origins [causes and risk factors] of violence and delineates the process and development of an evidence based violence prevention plan designed to negate violence risk factors and prevent violence. Specific techniques are presented for prevention and de-escalation of aggression to prevent violence. Strategies are determined for development and implementation of effective violence prevention plan utilizing holistic evidence based interventions to prevent/reduce healthcare violence for a safe and therapeutic environment for everyone. Implications for practice are strategies for best practice in safety and violence prevention. Environmental, patient and caregiver interventions for prevention of aggression and violence in healthcare facilities is delineated as well as psychosocial management of aggressive behavior for safety in the healthcare environment. An effective violence prevention educational plan is presented for holistic applications for decreasing healthcare violence promoting mental health, wellness and recovery.

Development of a gestational sac in a cesarean scar of the lower uterine segment is a rare form of ectopic pregnancy. Cesarean scar pregnancy (CSP) is rising in frequency, as are cesarean section deliveries. CSP is a potentially life-threatening condition which, if not detected early and managed aggressively, can result in uterine rupture, massive hemorrhage and maternal death. The most common presentation of CSP is abdominal pain and vaginal bleeding. CSP is diagnosed using ultrasonography, magnetic resonance imaging, and endoscopic modalities. There is currently no standard treatment protocol in CSP. In this article, we aim to find the most appropriate methods of diagnosis and treatment modalities, with their implications in clinical practice for this condition.

Aim: To assess the impact of leadership training on nurse leaders’ perceptions of evidence-based leadership (EBL) and practice (EBP). Background: Nurse leaders are the key persons for promoting EBP. They have to use evidence skillfully both in practice and leadership. Methods: 47 nurse leaders participated in EBL training (2010 – 2011) for the “At Safe” project. Data were collected from 42 leaders before the training and 34 after. The questionnaires were developed as part of the project. The data were analyzed using frequency analysis. Results: Before the training most of the nurse leaders had the positive perceptions of using research knowledge to develop the practice and leadership. The training had helped nurse leaders to understand that decisions can be justified with research knowledge, which strengthened the leaders’ responsibility to develop EBP, EBL and their work unit. Most of the nurse leaders seldom brought research publications for their staff to read or discussed findings with them. Conclusions: Nurse leaders have a positive attitude to EBP and EBL but they need to more promote it to their staff and use it for their own leadership. The EBL courses might highlight the importance of using evidence in leadership, but changing their leadership style needs time and willingness. The nurse leaders should become aware of the importance of EBL and EBP. There is an urgent need for training and new innovations to support EBL.

Background : Working in the intensive care unit can be traumatic for nursing personnel. Critical care nurses are faced with repeated exposure to death and dying as they are involved in caring for patients who are actively dying, have a terminal illness or face impending death. These nurses relate in different ways to the phenomena of death and dying within their nursing profession and their scope of practice. Critical care nurses often have a difficult time coping with the stress that comes with caring for those who are dying or relating to loved ones of those that are dying. Aim of the study : The aim of the study was to explore the critical care nurse’s experiences of death and dying. Methods : A qualitative, descriptive phenomenological research approach was used to guide the study. Approval to conduct the study was obtained from Durban University of Technology Faculty Research Committee, the eThekwini District Health Research Unit, and the Nursing Service Manager of the participating hospital. The study population comprised of nurses working in the Critical care unit of the participating hospital. Results : Findings of this study revealed that issues such as communication, multicultural diversity, education and coping mechanisms relating to caring for the critically ill and dying patient are essential in nursing education and practice. Conclusions : Critical care nurses need to have support networks in place, not only to assist in providing care, but also for their own emotional support and well-being.

Due to the uncertainties of job availabilities among rural communities, poverty stricken families find it hard to supply enough food to their family members. However, food insecurity has been defined by Weiser and Bangsberg as the limited or uncertain availability of nutritionally adequate, safe foods or the inability to acquire personally acceptable foods in socially acceptable ways. South African study by Mashau supported Mills and Bangsberg study by warning that hunger is the most extreme consequence of food insecurity. Tshililo also warned that immune system of a person with HIV and AIDS needs to be boosted with nutritious food. The broader concept encompassed problems with household food supply, quality of diet, feelings about the situation, and what effort was made to maintain household food supplies. The purpose of this study was to explore food insecurity among HI sero-positive patients in rural Vhembe district of Limpopo Province. A qualitative, exploratory, descriptive and contextual design was used. A non-probability, purposive sampling method was used to select family members who care for HI seropositive patients at home. In-depth interviews were conducted to 20 participants. Data were analyzed according to Tesch’s open-coding method. This study revealed that due to financial constrains; family socio-economic status is affected. Therefore patient’s conditions are deteriorated as well balanced diet cannot be maintained.

Objective: Changing the posture of patients is an integral part of nursing care. However, postural changes after cardiac surgery can have potential adverse effects on patients. To prevent these effects, an appropriate assessment of the patient’s condition is necessary. This study aimed to clarify the assessment by nurses to determine the timing to perform the first postural change in patients who have undergone cardiac surgery, with special reference to changes in blood pressure. Methods: A qualitative study using semistructured interviews was conducted among registered nurses working in an intensive care unit of a hospital. Results: Participants (n = 12) focused on four factors when interpreting a patient’s blood pressure: “rewarming,” “circulatory blood volume,” “cardiac output,” and “body movements.” Participants assessed their patients based on two criteria: the first emphasizing specific blood pressure values and the second focusing on stability of the blood pressure, representing static and dynamic parameters, respectively. Nurses made an appropriate assessment by careful consideration of these two criteria. Conclusion: The present results demonstrate that the assessment of blood pressure includes four factors. We propose that the assessment of dynamic changes in blood pressure are required in addition to the static status. This study may support nurse’s assessment for the first postural change in patients after cardiac surgery.

Among Korean-American women, breast cancer is the second leading cause of death. Although the incidence is lower than that of Caucasian women, Korean-American women are more likely to be diagnosed at more advanced stages of breast cancer. Among the suggested methods in breast-cancer prevention are early detection and routine screenings. The present study was conducted to explore the impact of breast-cancer educational workshops on breast-cancer knowledge and breast self-examination (BSE) practices among Korean-American women. Knowledge of breast cancer and health beliefs (perceived benefits, perceived barriers, and perceived self-efficacy) were examined before and after the educational workshop. The results indicated that educational workshops have a positive influence on breast-cancer knowledge, health beliefs, and the intent to practice BSE in the future

eHealth systems development to date have had little involvement from nurses. The Australian Government eHealth strategy was developed to implement a Personally Controlled Electronic Health Record as the foundation to an integrated and coordinated eHealth system for the 21st Century. A review of the PCEHR was released on the 19th May 2014 recommending a greater involvement of users in the governance of this major infrastructure project. Nurses will have a seat on the governing Board. There is an opportunity to provide nursing input into the design and development of the system. The Norwegian Nurses Organisation call for the inclusion of the International Classification of Nursing Practice into all eHealth systems.

Honor societies have been a valued tradition among academia dating back to 1776. Traditionally, honor societies have evolved as a means of recognizing academic excellence, leadership, service and scholarship. As a result, various disciplines including nursing have inducted students into respective honor societies over the past several hundred years. The proliferation of online education programs have raised issues related to the continuance of recognizing academic excellence in similar ways as traditional brick and mortar institutions. As a result, this article explored past, present and future trends for Honor Societies as educational programs and delivery formats continue to evolve.