Nurses' knowledge and opinions about the nursing research process in The Netherlands

Nursing research is just gaining ground in The Netherlands, as it is in every European country. Therefore, this study had the purpose of discovering to what extent Dutch nurses in the clinical areas have acquired research-based knowledge since it was introduced into the country, in the 1970s. Questionnaires, which included provision for demographic data, were distributed to 110 nurses, comprising head nurses, recently qualified nurses and final-year student nurses. A 65% response was achieved and the findings revealed that nursing research as a concept was not new to the Dutch nurses. They claimed they had obtained their knowledge through nursing training, reading, conferences and other sources such as mass media. The head nurses were the most knowledgeable followed by the recently qualified nurses and then the student nurses. However, the respondents claimed that their knowledge was superficial. The need to extend nurses' knowledge through support and encouragement in relation to nursing research seminars and conferences is recommended.     

An assessment of two training interventions designed to increase the knowledge of obstetrical nurses and nurse-midwives about the maternal serum triple screen

The purpose of this study was to assess the effects of two brief training interventions designed to improve nurses' and nurse-midwives' knowledge about the maternal serum triple screen. The low intervention consisted of written information on the triple screen; the high intervention consisted of written information plus a one hour oral presentation. Knowledge was assessed at baseline, immediately following the oral presentation (high intervention only), and one month following the interventions. Forty-seven nurses, nurse-midwives and nursing assistants participated. Sixteen respondents (34 per cent) who routinely talk to patients about the triple screen obtained a score of less than 70 per cent on the knowledge questionnaire at baseline assessment. Respondents' knowledge about the maternal serum triple screen included areas that needed to be improved in order for them to be able to provide patients with accurate and complete information. Both interventions assessed in this study resulted in an increase in participants' knowledge about the maternal serum triple screen, however the high intervention was more effective. This study presents evidence that improvements in health care professionals' knowledge can be made with brief educational interventions.     

Clinical oncology nurses' perceptions of research

Within the realm of oncology nursing, research has been an integral part in its development as a specialty practice. Yet despite the growing volume of published nursing research studies, little is known about how nurses working in oncology care settings perceive research. Therefore, the purposes of this study were to examine clinical oncology nurses' perceptions of research and to determine factors influencing their perceptions. Two hundred and eighty-three registered nurses providing cancer care to patients in 40 health care agencies across northern Ontario participated in the survey. Data were collected using a questionnaire developed by Alcock and colleagues (1990) which addressed nurses' perceived value of research, their role, interest and experience in research as well as the research climate of the agency. The findings showed that respondents valued nursing research and perceived a research role for staff nurses. However, the respondents did not perceive strong administrative or collegial support for nurses' involvement in research activities. In addition, the study results indicated that the clinical oncology nurses' perceptions of research were influenced by educational preparation.     

Attitudes Toward Giving Smoking Cessation Advice Among Nursing Staff at a Long-Term Residential Care Facility.

The objective of this study was to provide a first assessment of (a) long-term care staffs' prevalence of and attitudes toward giving smoking cessation advice to residents and (b) predictors of advice giving. Results of a survey (N = 115) found that 54.8% of licensed nurses and 34.6% of nursing assistants reported ever advising. Advising was associated with job classification and believing that residents' problem lists should include smoking. Not advising was associated with believing advice is the physicians' responsibility. Staff somewhat endorsed risks of smoking and benefits of cessation for residents, smoking as a right and pleasure, and that some residents cannot make decisions about smoking. Staff moderately endorsed safety concerns: 36% wanted policy changes. Lack of institutional support and perceived residents' cessation disinterest were key barriers. The findings suggest that staff may be missing intervention opportunities and that institutional support of advising cessation may facilitate maintenance and improvement of nursing home residents' health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Licensure, use, and training of paramedical personnel to perform screening flexible sigmoidoscopy

BACKGROUND: The purpose of this study was to assess the state board of nursing guidelines about the performance of flexible sigmoidoscopy by nurses and to determine the current use and training of paramedical personnel in flexible sigmoidoscopy at gastroenterology fellowship programs in the United States. METHODS: Separate one-page questionnaires were sent to state boards of nursing and directors of endoscopy at gastroenterology fellowship programs in the United States. RESULTS: Twenty percent (10 of 50) of state boards of nursing explicitly approve the performance of sigmoidoscopy by registered nurses, and 50% (25 of 50) explicitly approve the practice by nurse practitioners. Forty-six percent (23 of 50) of state boards of nursing have no written policy but allow nurses to use a "decision making model" to determine whether the performance of sigmoidoscopy is allowed. Fifteen percent (24 of 164) of gastroenterology fellowship programs in the United States use paramedical personnel to perform flexible sigmoidoscopy. Sixty-three percent (15 of 24) of these programs started since 1995, and 67% (16 of 24) require that the paramedical personnel perform 50 or more supervised sigmoidoscopies during their training. Forty-five percent (5 of 11) of programs with physician assistants/nurse practitioners use these personnel to perform colonoscopy or endoscopy. CONCLUSIONS: Nurses are allowed to perform flexible sigmoidoscopy in most states based on current state board of nursing guidelines. The use of paramedical personnel to perform endoscopic procedures is increasing rapidly.     

An exploration of the value of specialist neurosurgical nurses

The differences in the knowledge and skills of 75 nurses working in a variety of practice settings were examined using a case study vignette of a neurosurgical patient developed by researchers. The case study tested nursing care throughout a patient's hospital experience, including admission, presurgery, postsurgery and discharge preparation. The findings showed that nurses who had specialised in neurosurgery scored markedly higher, in all aspects of practice knowledge, than expert nurses in other specialties and general nurses. Patients undergoing neurosurgery are safer if they have nurses who are experienced, skilled and knowledgeable to care for them.     

"Codependency". A disease or the root of nursing excellence?

A hermeneutic phenomenological study was conducted to explore how eight professionally competent nurses experienced and evaluated the relation between their childhood adaptation to dysfunctional families and their nursing careers. From the participants' discussion of this topic, the following themes emerged: escaping difficulties by becoming a nurse, coping roles guide nursing career, sensitivity to the untold, transforming dysfunctional responses, and wounded healers. The study did not support the view that children of alcoholics seek careers in nursing to meet their codependent needs for self-esteem, control, or belonging. Instead, its findings indicate that some children of alcoholics become competent nurses by finding positive application for the coping skills they learn in their families. This indicates that, when working with individuals from dysfunctional families, nurses could support them to create new avenues for their coping skills instead of trying to "exterminate" them because of their "codependent" nature.     

Retention of advanced cardiopulmonary resuscitation knowledge by intensive care trained nurses

The teaching and reinforcing of advanced cardiopulmonary resuscitation (ACPR) is an important part of the role of an intensive care nurse manager. This study highlights the need for a structured training programme, as well as regular updates in ACPR. Current research shows poor retention of CPR skills amongst nursing staff. A small study was undertaken amongst intensive care trained nurses at The Middlesex Hospital intensive care unit (ICU). 18 nurses took part in the study, and were each interviewed with regard to their knowledge of ACPR in December 1990. The period of time since last trained in ACPR ranged from 2 months-4 years. Those who had been recently updated in ACPR (up to 4 months prior to interview) scored higher than those who were updated more than 2 years ago. The results showed that most nurses interviewed were only able to answer correctly half the questions asked. These results indicate that the nurses in the study generally demonstrated a severe lack of knowledge of ACPR. This indicates the need for a structured training package in ACPR, followed by frequent reinforcement of ACPR knowledge and skills for nurses practising in an ICU environment.     

Nurses who work in general medical practices: a Victorian survey

A questionnaire survey of 452 general medical practices in Victoria attracted responses from 277 practices, many of which did not employ nurses. The 93 respondents from 85 practices who were nurses reported that they enjoyed flexible working hours and stable employment. While their main reason for working in GPs' rooms was convenience, the most important aspect of their work was interaction with patients and fellow workers. Sixtyseven percent of nurses thought continuing education in specific skills was necessary for their work, 43% thought a post-registration qualification in community health nursing would be desirable and 47% thought a special interest group of nurses working in medical practices would be useful.     

Decision-making models of Finnish nurses and public health nurses

This study described nursing decision-making models and variables related to these models. For this purpose a 56-item Likert-type questionnaire was constructed according to the Dreyfus model of skill acquisition as applied to nursing by Benner and information processing theory. The target group consisted of 100 registered nurses working in inpatient clinics and 100 public health nurses working in preventive health care. The decision-making variables explored were nurses' experience, education and knowledge as well as the nature of the nursing task and context. The results revealed four different types of decision-making: (a) unquestioning/questioning decision-making, (b) creative-diversive decision-making, (c) patient/nurse-oriented decision-making, and (d) rule- and situation-based decision-making. The most important factors related to decision-making were experience and the nature of the nursing task and context.     

Testicular histopathology in congenital lipoid adrenal hyperplasia: a light and electron microscopic study

During the 1980s, interest was shown in North America as to how Intensive Care Nurses use their work time, in response to a shortage of trained nurses. These studies were developed to investigate the amount of nursing time that could be saved by computerised recording systems. Similar pressures are now present in the United Kingdom, but there are no published work load studies of Intensive Care Nurses. This study used a five category tool to examine the work load of nurses in a cardiothoracic ICU. The methodology was designed so that comparison could be made with the earlier American studies. The 36 nurses studied spent 41% of their time in direct nursing care, 22% in patient assessment, 19% in clerical duties, 11% in time outside the unit and 7% in non-nursing duties. These findings were compared with the North American studies. Similarities were found which give some support to the reliability and validity of the tool.     

A 9-year longitudinal study of reported oral problems and dental and periodontal status in 70- and 79-year-old city cohorts in northern Sweden

BACKGROUND: From 1991 to 1994, a special projects grant to teach nurses cancer prevention/screening theory and clinical skills was developed, implemented, and evaluated. Approximately 60 nurses in Colorado rural settings attended five two-day training sessions over a 20-month period. Attitudes, constructive or destructive, regarding specific behaviors lead to intentions to perform those behaviors and have an important impact on cancer-related nursing practice. METHODS: Two cancer-related attitude scales, Cancer Prevention/Early Detection Attitude Inventory and Fanslow Cancer Attitudes Scale, were administered prior to the first training session, following the final session, and at six-month follow-up. Data reflecting program impact on nursing practice were obtained from follow-up self-assessment of confidence in implementing new knowledge and skills. RESULTS: Significant differences in pre- and post-training attitude scores and fairly high-level confidence ratings suggest that these nurses will continue to use their cancer prevention and detection skills in practice. CONCLUSION: Documentation of practice activities to date has been impressive.     

Serotonin receptors and the acute attack of migraine

The concept of nursing expertise has been the focus of considerable debate since the early 1980s, yet an agreed definition of the concept and the precise criteria by which it can be evaluated remains elusive. This paper will describe an exploratory study into A & E nurses' constructs of the nature of nursing expertise. Seven first level Accident and Emergency (A & E) nurses were interviewed using Kelly's Repertory Grid Technique. Each was asked to provide examples of nurses with whom they are working or have worked, to match eight given examples designed to represent varying levels of clinical expertise. The informants were asked to consider in what way two of their chosen examples were alike and differed from a third in their clinical practice. A total of 55 bi-polar constructs emerged which were clustered under four main headings. These suggested that A & E nurses perceived expert practice to be characterized by a high level of empirical knowledge, supportive team building, assertive clinical leadership and patient-focused involvement.     

Experimental teleradiology. Novel telematics services using image processing, hypermedia and remote cooperation to improve image-based medical decision making

Various reports draw attention to the deficiency of services available for critically ill children. In December 1993 the British Paediatric Association published a report by a multidisciplinary working party on intensive care. The Minister of Health has apparently promised to act on the recommendations the working party made. In fact, purchasers are being encouraged to act and ask questions about the provision of paediatric intensive care--but no extra funding is available to provide it. However, this will all take time and until more resources are available children are still being cared for on adult intensive care units by nurses who may not be experienced in caring for sick children. One of the main areas of concern nurses have when caring for children is the physiological differences between an adult and a child. This paper is designed to assist in identifying the differences and consequent nursing implications. In an attempt to prioritize the nursing care a systems/modified model has been used over 2 papers. The review of the systems demonstrates the differences between adults and children and, where possible, highlights the nursing care and medical treatment a child requires. All aspects of care have been included as well as the psychological problems (see Part 2 which will be published in the next issue) encountered by the family of a critically ill child. Where possible easy reference tables have been included and the author hopes to introduce the package into the existing orientation programme for established staff and staff new to the unit in the hopes of decreasing the stress when a child is admitted. Paediatric resuscitation has not been covered intentionally, as the information on the physiological differences seemed to grow like 'Jack's beanstalk'. Therefore, a flow chart for basic and advanced life support is included as an appendix in Part I. It is hoped this will stimulate readers' interest for more in-depth study.     

Positioning of stroke patients: evaluation of a teaching intervention with nurses

BACKGROUND AND PURPOSE: There is agreement, although little evidence, that consistently positioning stroke patients in allegedly reflex-inhibiting positions is therapeutic and will enhance functional recovery. The nursing staff, therefore, needs to know and implement these postures and understand their potential underlying value. We examined nurses' knowledge of and practice in positioning stroke patients before and after a formal teaching intervention. METHODS: In a quasi-experimental study, 38 stroke patients and 59 nursing staff members (44 trained nurses and 15 healthcare assistants) from 6 wards were studied. The wards were randomly allocated to experimental or control status. Patients were assessed on entry into the study by use of a range of measures to establish group equivalence. Nineteen aspects of their position were documented at intervals throughout their stay with a previously developed observational tool. One thousand sets of observations of patient position were made. Using 2 questionnaires, the nurses' knowledge of the terminology used to denote posture and of issues relating to the moving and positioning of stroke patients was assessed before, immediately after, and 3 months after a package of formal teaching was implemented on the experimental wards. Nurse knowledge and patient position were used as the main outcome measures. RESULTS: Immediately after teaching, nurses in the experimental group scored significantly higher than those in the control group on the terminology questionnaire (P < 0.05) and the moving and positioning questionnaire (P < 0.001). Three months later, the experimental group scored higher on the latter questionnaire only (P < 0.005). The positioning of patients in the experimental group was improved overall after the teaching (P < 0.0005), and improvements to specific parts of the body were noted. CONCLUSIONS: It was possible to effect a degree of change in the nurses' knowledge of and practice in the positioning of stroke patients. However, the quality of patient positioning remained variable. More effective ways of improving positioning need to be developed. Only then can the effects of recommended positioning be evaluated.     

A profile of European ICU nursing

OBJECTIVE: To evaluate major similarities and major differences between Western European countries in intensive care unit (ICU) nurse staffing, education, training, responsibilities, and initiative. DESIGN: A questionnaire was sent to Western European doctor members of the European Society of Intensive Care Medicine, to be passed on to the nurse-in-charge of their ICU. RESULTS: 156 completed questionnaires were analyzed: 49% were from university hospitals, 26% from university-affiliated hospitals, and 25% from community hospitals; 42% of the hospitals had more than 700 beds, 67% of the ICUs had between 6 and 12 beds, and 54% were mixed medical-surgical units. Among British units, 79% had more than three full-time nursing equivalents (FTE) per ICU bed, while in Sweden 75% of units had less than two FTE/ICU bed. University hospitals had more nursing staff per bed than community hospitals. As regards training, 33% of nurses followed a training course before starting work on the ICU and 64% after starting on the unit, and 85% had easy access to continuing education, particularly in the university hospitals. In an emergency, more than 70% of nurses regularly initiated oxygen administration, mask ventilation, or cardiac massage. In Sweden 100% of nurses and in Switzerland 91% of nurses regularly inserted peripheral intravenous catheters, but only 7% of German nurses did. No German nurses and only 12% of British nurses regularly performed arterial puncture, but in Sweden 75% of nurses regularly did. CONCLUSION: Even though the number of participants were limited, our questionnaire revealed variations in nurse staffing patterns among European countries and in their systems of training and education. Nurse autonomy also varies widely between countries.     

Discharge planning for new mothers. At home everything is different

In the hope of discovering a user friendly resource applicable to the Clinical practice of all nurses, staff at Vancouver General Hospital experiment with the use of nursing protocols. Last year nurses on the neurological unit proposed that effective management of seizure patients could be further facilitated when expected standards of care were properly developed, implemented, utilized and evaluated in the form of a nursing protocol. A two phase study was conducted attempting to compare those patients admitted to the unit one year prior to the use of the protocol, with those admitted for one year following its implementation. The results of this study will be presented in relation to the effectiveness of the protocol on patient outcomes. As well, the unit nurses' response to working with the protocol will be reviewed.     

Nursing homes as a setting for psychological practice: Public policy perspectives.

Recent federal legislation has provided renewed interest in improving the quality of nursing home care. The lack of both funding and personnel are significant barriers that may keep psychology's disciplinary expertise from being fully used in nursing homes. Nursing homes may be forced to undertake mandated activities (e.g., preadmission screening, nurses aides' training, and evaluation) without psychologists' expertise, relying either on medical practitioners with little knowledge of mental health interventions or on minimally qualified, entry-level mental health workers. Advocates for improved nursing home care must see the links among basic disciplinary skills, interdisciplinary collaboration, and improved care for mentally impaired elderly individuals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The basic principles of the synapses federated healthcare record server

The NIGHTINGALE Project (NIGHTINGALE Project: HC1109 DGXIII Contract and Technical Annex, European Commission, December 1995) which started on the 1st of January, 1996, after the approval of the European Commission, has a 36 month duration. It is essential in planning and implementing a strategy in training the nursing profession in using and applying healthcare information systems. NIGHTINGALE contributes towards the appropriate use of the developed telematics infrastructure across Europe by educating and training nurses in a harmonious way across Europe in the upcoming field of nursing informatics. NIGHTINGALE develops courseware material based on the curriculum development process using multimedia technologies. Computer based training software packages in nursing informatics will be the basis of the training material and the corresponding courses. CD-ROM based training and reference material will also be provided in the courses whereas the traditional booklets, teaching material and textbooks can also play an adequate role in training. NIGHTINGALE will disseminate all information and courseware material freely to all interested parties through the publications of the proceedings of the conferences, through the establishment of the world wide web (WWW) server in nursing informatics for Europe (http://www.dn.uoa.gr/nightingale), which will become a depository of nursing information knowledge across Europe as well as a dissemination node of nursing informatics throughout the European members states for the benefit and welfare of the European citizen.