看護とケアのジャーナル

Objective: Humanitarian medical and/or surgical missions have become common over the past 50 years. Little is known, however, about the quality of these missions, especially when a patient becomes unstable and requires resuscitation. We would like to present the “mock code” Operation Smile uses to ensure the best quality of care should a medical or surgical emergency arise during a mission. Operation Smile, a worldwide children’s medical charity, provides surgery for children with correctable facial deformities in 51 countries. The mock code was initially implemented as an educational tool to enhance skills and team dynamics. It has become a useful practice for preparing a team of medical professionals to respond to an unexpected medical or surgical emergency. A mock code is performed at each mission prior to the start of the surgical week. The mission team consists of 35-60 members, including medical professionals from many different countries and diverse backgrounds. Team members have varying levels of expertise, and thus a mock code is vital to give good resuscitative care. The volume of cases, the variety of professional backgrounds, the unfamiliar equipment and protocols, the language and cultural barriers, and the fact that these individuals have not previously worked together makes it essential to develop an emergency-preparedness plan. Emergencies involving pediatric patients generate a great deal of anxiety for the child, for the parents, and for the medical and nursing staff involved. Running an emergency code is always a challenge, especially when the patient is a child. Conclusion: The use of this tool allows us to build a special alliance between medical and nursing staff prior to an emergency. The mock code empowers nurses and doctors to feel more prepared to respond to pediatric emergencies and improve the quality of resuscitative care, should the need arise.

Objective: Oral mucositis (OM) is a common side effect of allogeneic stem cell transplantation and can lead to infections with increased morbidity, mortality, higher costs and an impact on the quality of patients’ lives. We conducted a study on the stem cell transplantation ward of a Swiss university hospital which treats oral mucositis with state-of-the-art measures.

Method and participants: In a randomized controlled, non-blinded trial involving 72 patients with allogeneic stem cell transplantation, we investigated the effectiveness of the oral rinse Caphosol® versus filtered water, in terms of duration of OM (primary endpoint), manifestation of OM and occurrence of pain, dry mouth, swallowing problems and changes in perception of taste (secondary endpoints).

Results: Results show Caphosol® had no effect on the duration of OM, with no difference in pain, dryness of mouth, swallowing problems and changes in perception of taste between the two groups. Predictors which seem to be associated with longer duration of OM are myeloablative conditioning and female gender. The number of oral rinses per day and in total show no significant correlation to duration of OM.

Conclusion: Consequently, in the setting of allogeneic stem cell transplantation in a patient group with a high risk for severe OM, oral rinsing with Caphosol® is not more effective than filtered water.

We want more than we have realistically possibilities to do. Caregivers are aware about how they have to act in the daily work in patient settings. Still we have to stat that we don´t can guarantee ethically good care of patients.

Aim: Aim of the study is to describe and explain the relationship between the ethos of caring and nursing intensity, based on a theory model developed by a hermeneutic approach.

Method: The study is a theoretically study with a hermeneutic approach and a hypothetic-deductive design. Materials are results from four sub-studies published between 2009 and 2013.

Findings: The model includes for corn stones and sex interoperations patters witch keep the corn stones together in a process of moving.

Conclusion: The theoretical model explained in this paper has opportunities to guide the caregivers in their daily work for providing ethically good care to older people.

Background: Current studies mainly emphasized the spiritual needs and care of cancer and hospice patients; few deal with the other critically ill patients.

Aim: This study aimed to describe the spiritual needs and care of ICU patients from nurses’ perspectives.

Design: This is a qualitative study.

Method: The semi-structured guided interviewing on ICU nurses in a medical center of southern Taiwan was approved by the IRB at the research department of the hospital and data collection was carried out from January to June 2012. The investigator repeatedly read the transcribed text, and found statements relevant to the themes in the transcriptions to form significant statements as the basis of data analysis. To ensure the rigor of this study, the investigator adopted the approach of trustworthiness of qualitative research proposed by Lincoln and Guba.

Results: For the assessment of patients’ spiritual needs, the patients were divided into two groups: conscious and unconscious groups. The spiritual needs of the former were assessed by the clinical observation and judgment, while the latter were assessed through family interpretation. In addition, there are six themes in general spiritual care: care skills, interaction promotion, religious belief, cultural care, wish fulfilment, alleviation of grief and terminal care. Spiritual care of the conscious and unconscious patients were also included.

Conclusion: Spiritual needs and care from ICU nurses’ perspective were different from the patients; however, both of views were focused on the general spiritual care, while ICU nurses divided spiritual care into the conscious and unconscious patients. Relevance to clinical practice: The authors suggested that a complete guideline of spiritual care for critically ill patients integrating with the cultural care and interdisciplinary cooperation could be developed on the basis of the results of this study in the future, which could provide more empirical data as the nursing reference.

Previous research has shown that obtaining health information-including where to locate a doctor and seek appropriate treatment-is a major challenge for Chinese and other Asian immigrants to adapt to the US. Although social media could provide Chinese immigrants with health information and other benefits, the new technology’s value is still uncertain for potential users. This pilot study utilizes a qualitative research design to better understand the ambivalent attitudes of Chinese immigrants towards social media. We found that Chinese immigrants still perceived social media as having a number of shortcomings. Yet, if used properly, social media could be very useful for these immigrants to seek and share health information with their peers. Based on interview results, we identified several opportunities for developing social media tools, and directions for further research.

Objective: The transmission of hospital-acquired infections most commonly occurs by means of healthcare workers coming into contact with contaminated surfaces or patients during routine care and the lack of or poor implementation of hygiene procedures. We present this study to assess the efficacy of a new environmental infection control system, managed by a nurse in charge of infection control, in terms of safety, clinical outcome and hospital/healthcare costs.

Methods: The following is an observational retrospective study performed at University Hospital of Catania; containing data on HAI infections from years 2013 and 2014, before and after a new disinfection procedure was introduced. The procedure used a no-touch technology for the indoor environment, using micronebulized hydrogen peroxide and silver cations. Cases of infections concerned adult inpatients with hospitalization time being greater than three days. The efficacy of the procedure was evaluated by comparing the decrease in number of infections, related deaths, and changes in antimicrobial load, whereas economic impact of the new procedure was assessed by a cost-effectiveness analysis. User satisfaction and environmental safety issue were also addressed.

Results: A total of 489 patients were hospitalized in the ICU between January 1, 2013 and December 31, 2014. The introduction of the procedure coincided with a significant decrease overall in infection-related deaths, as well as hospital days (16.95 ± 20.46 (mean ± SD) to 11.55 ± 10.03 (mean ± SD: p value <0.05). Bacterial load in samples from CVC and from broncho-alveolar lavage decreased, as well. The incremental cost-effective ratio resulted in € 807.80 to be added for each infection-related death avoided.

Conclusion: We demonstrated that HyperDRYMist technology with hydrogen peroxide and silver cations is effective, safe and cost-effective without evidence of safety risk. Biodecontamination performed by motivated and experienced nurses could be useful in reducing microbial load and nosocomial infections. The system can contribute to improving the ICU patient's final outcome.

Aim: The objective was to analyze the content of Nursing Professional Practice Law and compare it to the content of papers addressing professional identity published in Revista Brasileira de Enfermagem.

Methods: Bibliographic and documental searches were conducted using qualitative analysis grounded on Eliot Freidson’s Sociology of Professions. The corpus consisted of texts published between 1983 and 2012, and Brazilian Legal Documents.

Results: The thematic category "Contradictions of the nursing profession" emerged. A weakness of the professional project was identified, which is based on the fragmentation of work. This reductionist approach legitimizes the maintenance of nursing divided into professional and non-professional workers, restricting the practice of nurses.

Conclusion: The complexity of care requires social responsibility to construct a professional project that provides scientific, ethical, philosophical and political foundations to workers to support their practice.

The purpose of this paper was to describe and clarify the construct of resilience in effort to identify its importance and usefulness to nursing. A synthesis of the relevant literature defining and clarifying the concept of resilience, its attributes, antecedents and consequences are presented. The definitions of the concept of resilience through the years have been relatively similar in their inclusion of the elements of positive adaptation or coping in the face of severe stress or adversity. However, the terms that have been used to describe this phenomenon differ and include invulnerability, hardiness, and stress resistance. The concept of resilience is one that can be used by nurses when caring for people who are facing physical, psychosocial and cultural adversities within their environment. It is unclear whether resilience is an outcome of an intervention, or a moderator or mediator to coping behaviors. What becomes clear is that more nursing research needs to be done to examine the role of resilience in health promotion, acute care, and chronic illness.

Background: Asthma affects 235 million people worldwide. In developed countries, 1 in 12 people suffer from asthma. In Ireland this statistic is higher with 1 in 10 individuals suffering from asthma. Nurses are at the forefront in the battle against the effects of asthma on patients. This review aims to examine the critical role of health promotion interventions by nurses in the management of asthma.

Method: This literature review, in conjunction with a presentation slide deck, looks to:

1. Identify asthma triggers as an important source of knowledge for nurses when treating asthma.
2. Explore techniques that improve patient education and self-management of asthma.
3. Highlight the importance of Health promotion in relation to asthma.

Results: From this review it was determined that health promotion in asthma must be an educational initiative where it’s amalgamated into nursing practice and becomes on integral part of a nurse’s toolkit.

Conclusion: A simple education leaflet detailing what was presented in the enclosed slides was designed following this review to support patient education for the effective self-management of adults with asthma. Further study should be conduct on the long term benefits of this leaflet.