The influence of clinical relapses and steroid therapy on the development of Gd-enhancing lesions: a longitudinal MRI study in relapsing-remitting multiple sclerosis patients

A two-round Delphi study was performed in Pediatric Nursing at a large midwestern teaching hospital. The purpose of the study was to identify research priorities for the Pediatric Research committee for future projects. The initial survey was sent to all pediatric nursing staff. Sixty-two staff (19%) responded to the first round. Forty-five separate research topics/themes of interest were identified. The second round survey was sent to the 62 staff who responded to Round 1. Forty-eight staff (76%) responded. Participants were given a list of the 45 topics identified in Round 1, and asked to identify their top five priorities. Results were analyzed by unit and by Division. The identified priorities for the Division are described here.     

Study of the relation between transformational leadership of the head nurse and supplementary efforts of nursing personnel

The present study proposes to show that the ethos of the Head Nursing staff is related to the practice of transformational leadership, and to additional efforts displayed by the treatment staff. Using a sampling of 57 nurses, it was established that transformational leadership presented a positive influence on additional efforts which were superior to that produced by transactional leadership. Contrary to transactional leadership, transformational leadership was shown to exert a positive effect on the ethos of the leader who in turn, had a positive influence on the extra care supplied by the nursing staff.     

Nursing education planning: a Delphi study

The purpose of this study was to assess the Delphi technique as a viable method for forecasting future events in nursing education by determining the degree of accuracy of previously predicted events and identifying the circumstances that delayed or accelerated occurrence of the predicted events. Data were collected by three rounds of questionnaires distributed to 33 administrative heads of all nursing education programs in a southeastern state. The use of simple statistics concluded the Delphi technique was a valid instrument in nursing education planning: 22 of 26 events occurred as predicted, resulting in an 84.6% accuracy rate; 24 of 25 events which had not occurred remained viable, resulting in a 96% accuracy rate; 98.1% of the original events had either occurred or were still viable to occur.     

Peripheral blood manifestations of T(H)2 lymphocyte activation in stable atopic asthma and during exercise-induced bronchospasm

This study set out to develop the nursing care of breast cancer patients at the Central University Hospital in Turku, Finland, using the methods of action research and to evaluate the results of the development effort from the point of view of both patients and nursing staff. A theoretical model of the care of cancer patients was constructed on the basis of existing knowledge of how people react in stress and crisis situations or at different stages of a difficult illness. A specific care programme for breast cancer patients was also planned for the hospital's oncology and surgical units. Data were collected using questionnaires. Results indicated that our theoretical model of the care of cancer patients worked reasonably well. They also clearly highlighted the areas in which there is room for further improvement. Patients' experiences of the nursing staff were generally positive and the majority of the nursing staff also regarded the development project as a success.     

A study of the educational and research priorities of registered nurses in rural Australia

This study set out to identify the educational and research priorities of registered nurses practising in rural and remote areas of Australia. It included two groups of participants, one which identified as rural and another which identified as remote. The findings for the rural cohort in the study are presented in this article. Research participants represented a national sample. The Delphi method was used to obtain the most reliable consensus of the nurse participants. In the final phase of the study, 13 high priorities were identified. Study findings highlight perceived needs for clinical nursing research and continuing education for nurses practising in rural Australia.     

Nurses helping nurses. Development of internal specialists in long-term care

The prevalence of psychiatric disorders and behavioral disturbances among nursing home residents, combined with observed deficits in geriatric mental health/illness expertise among LTC staff, supports the need for creative approaches to improve the knowledge, understanding, and management of such problems among LTC providers. The train-the-trainer model described in this article proved to be a viable method to providing geriatric mental health consultation and training that targets both improved quality of life for residents and quality of work life for the staff in charge of residents' care. More collaborative efforts among nursing specialists, subspecialists, and generalists are needed to empower those who work in LTC to utilize strengths and abilities inherent to their positions. Nursing homes nurses, who are all too familiar with the problems and challenges of their patient population, may act not only as mental health trainers but also as resource persons, role models, liaisons with geropsychiatric specialists, and leaders in the application of geropsychiatric care principles to residents within their facility, thus promoting improved resident and staff care alike.     

The Research Nurse Intern program. A model for research dissemination and utilization

The Research Nurse Intern program at the University of Nebraska Medical Center is designed to support the development of research-based nursing practice and to foster the professional development of staff nurses. The activities of the 2-year program are based on a model that blends research dissemination and utilization with the change process. The authors' purpose is to describe a staff nurse-focused program and its successes in accomplishing these two standards of clinical nursing practice.     

Use of an accident and emergency department by hospital staff

OBJECTIVE: To assess the number of attendances by hospital staff at an accident and emergency (A&E) department, and reasons for their attendance. METHODS: A&E attendances by hospital staff were studied for a 12 month period. Comparison was made with attendances by non-hospital staff in full or part time employment. Differences between the observed and expected numbers of attendances were analysed using chi 2 analysis. RESULTS: 560 staff attendances were recorded out of 78,103 total attendances. There was an observed excess number of attendances by nursing staff for work related incidents when compared to the control group (P = 0.01). However, there were fewer attendances by nursing staff for non-work related incidents (P = 0.01). Staff other than doctors and nurses attended the A&E department more frequently than the control group for non-work related incidents (P = 0.01), but their attendance for incidents occurring at work were the same as the control group (P = NS). CONCLUSIONS: The increased use of A&E resources by staff other than doctors and nurses may be inappropriate and further research into their reasons for attendance is warranted.     

Isotopic ventriculography in healthy young volunteers. Their response to different types of stress

BACKGROUND AND OBJECTIVES: This study determined the perceived characteristics of family practice residency training programs that produce a high percentage of graduates who provide maternity care. METHODS: We surveyed a Delphi panel of 28 family practice maternity care experts. RESULTS: Consensus was reached after the third survey. The characteristics of the family medicine faculty and teaching service were rated as most important. Other essential characteristics were an adequate obstetrical training volume; mutual respect between obstetric and family medicine faculty and residents; support for family practice maternity care from obstetricians, administration, and nursing staff; and family physicians being accepted in the community as maternity care providers. CONCLUSIONS: Family practice residency programs that produce a high percentage of graduates who provide maternity care have a unique, family practice maternity care-friendly environment. Residency programs wishing to increase the percentage of their graduates who provide maternity care should ensure that their faculty support family practice maternity care, are competent in maternity care, and model maternity care in their own practices. They should strive to ensure an adequate volume of obstetrical cases for resident education and work toward educating patients and local obstetricians, nursing staff, and hospital administration regarding family practice maternity care.     

Competency validation for cross-training in surgical services

Cross-training is a cost-effective means of maximizing the potential of staff members and available resources. The responsibility to provide quality patient care should not be compromised by cross-training efforts. Surgical services department staff members at Deaconess-Nashoba Hospital, Ayer, Mass, developed a competency validation project for nurses involved in the cross-training program. They accomplished this by implementing current nursing standards and practices and promoting continuity of patient care through the preoperative, intraoperative, and postoperative phases. Perioperative nurses and health care facilities have the responsibility to provide safe, effective, and efficient care to all patients. By assessing competencies for perioperative nurses, staff members can enhance their commitment to caring for their profession and their communities.     

National quality of care activities in Germany

The burn nursing Delphi study identified pain management as the most important area of burn nursing research. The question, "What is the best method to measure the pain of the patient with burns?" ranked in the top 10% of the nursing research priorities and is the research question of this study. The most commonly used pain assessment tools were determined in a 1994 survey of burn centers. Of those that responded, 67% used the Visual Analog Scale and 43% used an adjective scale. Forty patients were enrolled in this prospective, multicenter study. Visual analog and color scales were used during a 3-day cycle and word and faces scales were used during another 3-day cycle. Pain levels were assessed twice each day, once during a quiet time and then again immediately after a painful activity. At the end of each 3-day cycle the patient was asked which tool he or she preferred. At the completion of the study period the patient was asked to select the overall most preferred tool for pain assessment. Although this study indicates that patients prefer the faces and color scales to the most commonly used visual analog and adjective scales, further research is needed to determine the potential impact of preferred tools on pain intervention. The results may also lead burn centers to re-evaluate current selection of pain assessment tools.     

Orbital aspergillosis. A fatal masquerader

The limited contribution of nursing research and the utilisation of research findings in the field of bone marrow transplantation (BMT) in Europe have been identified as issues needing further attention. Reasons behind these issues include the lack of nursing training in research techniques, problems with funding nursing research, staff shortages and language barriers. An overall research strategy for nurses has been suggested as well as academic research support for those nurses who do not feel confident carrying out research projects. A small scale study in four European BMT centres identified that the main nursing research priorities included isolation techniques, psychosocial and quality of life issues, staff issues, central line catheter care and mouth care/management of oral mucositis. The same study also showed that only 20% of the BMT units regularly use research and research findings in their day-to-day nursing practice.     

Staff–patient relationships in nursing homes: Sources of conflict and rehabilitation potential.

Discusses research indicating that staff–patient interactions often function to encourage dependency among nursing home residents. Hypotheses are developed as to why staff members tend to elicit dependency; these include the operation of culturally and cognitively based stereotypes about the aged, adherence to the medical model, institutional constraints on nursing homes, and burnout. Additional evidence shows that continued dependency and passivity are detrimental to the health of patients and that interventions aimed at decreasing dependency reduce the likelihood of disease and death. Methods of instructing staff members in specific skills for encouraging independent and active engagement by residents are suggested. Possible changes in institutional policies within nursing homes, such as rewarding staff according to residents' outcomes and implementing tactics to prevent burnout among staff members, are also discussed. (54 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A multiregional study of nurses' beliefs and attitudes about work safety and patient assault

OBJECTIVE: The study attempted to increase understanding of nursing staff members' beliefs and concerns about work safety and patient assault. METHODS: A study conducted at a university-affiliated psychiatric facility in California in the late 1980s was replicated in five other psychiatric settings. Data were collected using the Attitudes Toward Patient Physical Assault Questionnaire, containing 31 statements designed to elicit nurses' beliefs about safety concerns, staff performance, and legal issues related to assaults. RESULTS: A total of 557 nursing staff members at the six sites responded to the questionnaire; 84 percent were female. The majority (76 percent) had been physically assaulted at least once, but 71 percent reported feeling safe in their work environment most of the time. Compared with female staff members, males tended to believe that assaults were to be expected, that assaulted staff have personality traits that make them vulnerable to assault, and that legal action against assaultive patients might jeopardize their jobs. Recently hired staff were more confident that their facilities did not admit unmanageable patients and that the environment was adequate to prevent assaults. Staff who had been assaulted more frequently tended to believe that assaults were to be expected. CONCLUSIONS: The study highlights a nationwide concern among nursing staff about safety. Ensuring a safe working environment requires better training, more adequate staffing, and a security plan to protect staff, patients, and others.     

Do nurses have the information resources and skills for research utilization?

While access to information resources and the skills to use them do not ensure that nurses will use nursing research in their practice, they are important facilitators. Mailed questionnaires to assess existing information resources, the information management skills of nurses, and what additional resources and training are required were returned by 67 of the 71 vice-presidents or directors of nursing in hospitals in two regions of Ontario. The two regions have similar information resources, nursing staff with research expertise, and opportunities for training in research and information management but there is variation among hospitals. Most vice-presidents agreed that nurses need better information resources and skills to access and evaluate professional literature. The rapidly developing field of information technology, including the Internet, provides potential for sharing resources and expertise. Nursing administrators can minimize barriers and help staff nurses recognize that information management skills enhance professional development and improve patient care.     

Spirituality and the treatment of the dually diagnosed: an investigation of patient and staff attitudes

Spirituality is a neglected area of study and research in the treatment of addictions. The role of spirituality in the treatment of the dually diagnosed has received particularly scant attention. One hundred and one patients on an in-patient dual-diagnosis unit, as well as the 31 members of the nursing staff who treat them were surveyed. Patients and staff were questioned about their spiritual beliefs and what was the role of spirituality in the patients' recovery from addiction. Staff were questioned about their own spirituality and what they think the patients' level of spirituality is. In addition the staff were asked what they think the patients' view of spiritually is. Results indicate that the patients and staff are equally spiritually oriented. The patients view spirituality as essential to their recovery and value spiritual programming in their treatment more than some concrete items. The nursing staff underestimated both the patients' level of spirituality and this importance placed on spiritual issues. The authors suggest that more attention should be given by staff to spirituality in the treatment of this population.     

Evaluation of a multidrug chemotherapy protocol (ACOPA II) in dogs with lymphoma

The introduction of market forces into health care delivery systems has had a number of important influences on the roles nurses perform. There have been increasing efforts to find alternative and more cost-effective ways of delivering care. One facet of this situation has been the examination of the roles and responsibilities of registered nurses (RNs) with the view of exploring different ways of using professional skills and determining if RN services are always required. One result of this has been the increased use of unlicensed personnel. The substitution of professional nursing staff by unlicensed personnel has become a major concern for practitioner, manager and client alike. This paper reviews some of the concepts of economic substitution as well as the assumptions advanced for the use of unlicensed personnel in clinical areas as a substitute for nursing services. While there has been increased use of unlicensed staff, the evaluation of clinical outcomes has been poor. This paper reviews primarily the hospital-based evidence about the impact of using unlicensed personnel in practice, and suggests there are methodological problems with the research published to date. Findings suggest that substitute service providers generally 'do no harm'. By contrast, evidence is presented indicating the major contributions nurses make to client care when adopting advanced practice roles (acting as a substitute for other professionals).