LITERATUR REVIEW: EFEKTIVITAS MODIFIKASI DOKUMENTASI KEPERAWATAN (A Literature Review: Effectivities of Nursing documentation modification)

Introduction: Nursing documentation was a written and printed record that contained of patient health record development and was the duty and responsibility of the nurse. Incompleteness in nursing documentation was a frequent problem. This happened because poor of nurse knowledge about that, and the method used was still manual by writing. Computer Systems presented to help overcome this. Modifications with various model approaches were also necessary to improve the quality of nursing documentation. The purpose of this literature review was to examined modification method of nursing documentation to improve the quality of nursing documentation. Methods: This Literature review was done based on the issue, methodology, as well as the result equation obtained and the method used. A total of 6 articles used in this literature review were quantitative research, 3 of which were cross sectional studies. Results: In this literature review we found out that modification of nursing documentation with VIPS model can improve the quality of nursing documentation, as well as modification with computer system known as Electronic Health Record can improve the quality of nursing documentation. Discussion: Modification of nursing documentation is very important to make it easier for nurses to perform nursing documentation

Psychometric Properties of the Elderly Nursing Core

Abstract Aim: To assess the psychometric properties of the Elderly Nursing Core Set. Methods: Cross-sectional descriptive study; convenience sample composed of 427 individuals aged 65 years old or older. Results: Factor analysis of principal components allowed extracting 4 concepts, i.e., Self-Care, Learning and Mental Functions, Communication, and Relationship with Friends and Caregivers, which explained 82.25% of the total variance. Varimax rotation indicated a very good measure of sampling adequacy (KMO = 0.947), with Bartlett’s test of sphericity (X2(300) = 11131.28, p < 0.001) and an excellent Cronbach’s alpha value of 0.963. Conclusion: The Elderly Nursing Core Set exhibits excellent psychometric properties, i.e., consistency, reliability, and internal validity, for which reason it is recommended as a means of determining the nursing care needs of individuals aged 65 years old or older and assessing the outcomes of nursing interventions targeting that population

Psychometric Properties of the Elderly Nursing Core Set

Aim: To assess the psychometric properties of the Elderly Nursing Core Set. Methods: Cross-sectional descriptive study; convenience sample composed of 427 individuals aged 65 years old or older. Results: Factor analysis of principal components allowed extracting 4 concepts, i.e., Self-Care, Learning and Mental Functions, Communication, and Relationship with Friends and Caregivers, which explained 82.25% of the total variance. Varimax rotation indicated a very good measure of sampling adequacy (KMO = 0.947), with Bartlett’s test of sphericity (X2(300) = 11131.28, p < 0.001) and an excellent Cronbach’s alpha value of 0.963. Conclusion: The Elderly Nursing Core Set exhibits excellent psychometric properties, i.e., consistency, reliability, and internal validity, for which reason it is recommended as a means of determining the nursing care needs of individuals aged 65 years old or older and assessing the outcomes of nursing interventions targeting that population

The construction of a subset of ICNP® for patients with dementia: a Delphi consensus and a group interview study

BACKGROUND: The International Classification for Nursing Practice (ICNP&reg;) 2013 includes over 4000 concepts for global nursing diagnoses, outcomes and interventions and is a large and complex set of standardised nursing concepts and expressions. Nurses may use subsets from the ICNP as concepts and expressions for research, education and clinical practice. The objective of this study was to identify and validate concepts for an ICNP subset to guide observations and documentation of nursing care for patients with dementia. METHOD: The process model for developing ICNP subsets was followed, according to the guidelines adopted by the International Council of Nursing (ICN). To identify relevant and useful concepts for the subset, a modified form of the Delphi method was used. Six nurses working in healthcare services in three municipalities in Norway with postgraduate education in geriatric psychiatry and dementia care participated in two Delphi sessions. The participants reviewed and scored the concepts included in the suggested subset and had an opportunity to rewrite them and offer alternatives. To validate the subset after the Delphi study, a group interview was conducted with six other nurses with postgraduate education in geriatric psychiatry and dementia care. The group interview was recorded and transcribed, and summative content analysis was used. RESULTS: Suitable concepts for an ICNP subset to guide observations and documentation of nursing care for patients with dementia were identified. In total, 301 concepts were identified, including 77 nursing diagnoses, 78 outcomes and 146 nursing interventions. An increased focus on concepts to describe basic psychosocial needs such as identity, comfort, connection, inclusion and engagement was recommended by nurses in the validation process. CONCLUSIONS: Relevant and pre-formulated nursing diagnoses, goals and interventions were identified, which can be used to develop care plans and facilitate accuracy in the documentation of individuals with dementia. The participants believed that it may be difficult to find formulations for all steps of the nursing process. In particular, nursing diagnoses and psychosocial needs are often inadequately documented. The participants highlighted the need for the subset to contain essential information about psychosocial needs and communication

The Effects of Structured Health Policy Education on Connecticut Registered Nurses\u27 Clinical Documentation

Registered Nurses use clinical documentation to describe care planning processes, measure quality outcomes, support reimbursement, and defend litigation. The Connecticut Department of Health, guided by federal Conditions of Participation, defines state-level healthcare policy to include required care planning processes. Nurses are educated in care planning process standards, however no policy-required competency verification processes in academia or employers exists. Guided by the advocacy coalition framework, the purpose of this quasi-experimental study was to determine if the quality of nurse coalition actors’ clinical documentation, a relatively stable parameter, would increase after attending policy-centered structured education. Data were extracted from 272 electronic medical records (136 pre - 136 post attendance) and mean quality scores were computed using the Müller-Staub Q-DIO scale from 17 nurse coalition actors. A two group dependent t test was used to examine quality score differences and linear regression was used to isolate process education subsections that significantly predicted post mean score improvements. Findings indicate a statistically significant difference between pre and post education quality scores (p \u3c .001) and improvement drivers of the post-education quality scores were identified in the subscales of ‘diagnosis as a process’ (p \u3c .001) and ‘interventions’ (p \u3c .001). Implications for positive social change include recommendations to state-level policy makers to mandate confirmation of graduating nurses’ documentation quality and to install continuing education requirements as a condition of bi-annual license renewal; each area acting to reduce non-compliant clinical documentation in light of federal Conditions of Participation rules

Persónumiðaða matstækið Hermes: Þróun og notkun í endurhæfingarhjúkrun

Bakgrunnur: Persónumiðuð nálgun og þátttaka sjúklinga eru grundvallarviðmið í endurhæfingarhjúkrun. Í samræmi við þessi viðmið er mælt með að hjúkrunarfræðilegt heilsufarsmat sé persónumiðað en í slíku mati taka sjúklingar þátt í að meta heilsu sína og væntingar sínar til endurhæfingarinnar. Samt sem áður hefur persónumiðað matstæki í endurhæfingarhjúkrun ekki verið fyrir hendi. Markmið: Meginmarkmið doktorsritgerðarinnar er að lýsa: i) heimspekilegum og fræðilegum hugmyndum og aðferðum sem nýttar voru við þróun persónumiðaðs matstækis í endurhæfingarhjúkrun sem nefnt var Hermes, og ii) innleiðingu og notkun matstækisins í endurhæfingarhjúkrun. Aðferðir: Ritgerðin samanstendur af þremur sjálfstæðum eigindlegum rannsóknum. Í rannsókn I voru 60 eldri eigindlegar rannsóknir samþættar. Í gegnum samþættinguna var gerð gagnrýnin hugtakagreining á persónumiðaðri þátttöku sjúklinga í heilbrigðisþjónustu en rammagreining (e. framework analysis) var notuð við gagnagreininguna. Rannsókn II var þátttökurannsókn (e. action research) en gegnum hana var matstækið, Hermes, þróað með hjúkrunarfræðingum og innleitt í endurhæfingu með endurteknum ígrundandi hringferlum. Með rannsókninni var kannað hvernig hægt er að þróa matstæki, byggt á fræðilegum og fyrirbærafræðilegum grunni, sem stuðlar að persónumiðaðri þátttöku í heilsufarsmati í endurhæfingarhjúkrun. Þátttendur voru ráðgjafi og 12 hjúkrunarfræðingar í endurhæfingu. Gögnum var safnað með rýnihópa- og einstaklingsviðtölum og endurskoðun á skráningu á Hermes. Gagnagreining var unnin með aðleiðandi innihaldsgreiningu (e. deductive content analysis). Rannsókn III var sértæk vettvangsrannsókn (e. focused ethnography) þar sem kannað var hvernig notkun Hermes getur mögulega stuðlað að persónumiðaðri þátttöku fólks með langvinna verki í heilsufarsmati í endurhæfingu. Þátttakendur voru 14 sjúklingar með langvinna verki í endurhæfingu og fimm hjúkrunarfræðingar þeirra. Gögnum var safnað með þátttökuathugun og hálf-stöðluðum viðtölum og voru gögnin greind með þemagreiningu. Niðurstöður: Meginniðurstöður rannsóknanna voru þær að Hermes stuðlaði að persónumiðaðri þátttöku sjúklinga í heilsufarsmati í endurhæfingarhjúkrun ásamt því að fyrirbærafræðileg nálgun birtist í matinu. Rannsókn I sýndi að persónumiðuð þátttaka sjúklinga í heilbrigðisþjónustu er byggð á reynslu sjúklinga, gildum, væntingum og þörfum, og grundvallast á virðingu og jafnræði. Þessi hugtakarammi um persónumiðaða þátttöku sem rannsókn II byggðist á birtist í þremur samþættum stigum. Þau voru: Stig mannlegra tengsla; stig úrvinnslu upplýsinga; og framkvæmdastigið. Í rannsókn II var heilsufarsmatstækið Hermes þróað í gegnum ígrundandi ferli í samstarfi við hjúkrunarfræðinga í endurhæfingu og í framhaldinu var það innleitt í endurhæfinguna. Matstækið var byggt á fræðilegum og fyrirbærafræðilegum grunni. Meginkostur matstækisins var að það stuðlaði að persónumiðaðri þátttöku sjúklinga í heilsufarsmati og sjónarhorn þeirra kom sterkt fram í matinu. Þetta gerði það að verkum að hjúkrunarfræðingar skildu betur ástand og aðstæður sjúklinga. Þá gaf Hermes viðtalinu ramma, stuðlaði að samræðu um heilsufarsvanda og auðveldaði mat á árangri af endurhæfingunni. Einnig samræmdist notkun Hermes ýmsum þáttum í hinum fyrirbærafræðilega bakgrunni. Í rannsókn III kom í ljós gagnsemi Hermes sem matsaðferðar við að meta áhrif langvinnra verkja á sjúklinga. Niðurstöður sýndu hvernig notkun Hermes stuðlaði að styðjandi tengslum og samræðu milli sjúklinga og hjúkrunarfræðinga sem var opin og með túlkandi ívafi. Með þessu móti myndaðist skilningur á veikindunum og aðstæðum sjúklinga sem gat verið hjálplegur við að koma til móts við heilsufarsleg áhyggjuefni. Í heildina stuðlaði Hermes að persónumiðari þátttöku sjúklinga með langvinna verki í heilsufarsmati og nýtingu fyrirbærafræðilegrar heimspeki við heilsufarsmat í hjúkrun. Ályktanir: Þróun og notkun Hermes stuðlaði að persónumiðaðri þátttöku sjúklinga í endurhæfingu. Því er matstækið talið nýtilegt í endurhæfingarhjúkrun. Einnig er mögulegt að matstækið sé gagnlegt á öðrum sviðum heilbrigðisþjónustu. Mikilvægt er að styrkja fræðilegan grunn matstækisins með frekari rannsóknum.Background: Person-centredness and patient participation are central ideals in nursing rehabilitation practices. In line with those ideals, a person-centred nursing assessment is advocated: namely, assessment through which patients participate in assessing their health and their preferences for rehabilitation. Yet a person-centred assessment tool for such patient participation has hitherto been lacking in rehabilitation nursing. Overall aim of the thesis: To describe: i) the philosophical and theoretical background and methods used in the development of a person-centred health assessment, named Hermes, for use in nursing rehabilitation, and ii) the integration and use of the tool in rehabilitation. Methods: This thesis consists of three interdependent conceptual and qualitative studies. Study I constitutes an integrative review of 60 qualitative studies through which an ideal (person-centred) participation in health care is critically analysed via framework analysis. Study II is an action research study, depicting the process through which 12 nurses in rehabilitation and a consultant participated in developing the tool. It explores how a theoretically based assessment tool, underpinned by phenomenology, can be developed for enhancing a person-centred approach to the participation of patients in nursing assessment and care planning in rehabilitation. Data were collected by focus-group and individual interviews and observation of the documentation on the tool. Data were analysed through framework analysis. Study III is a focused ethnographical study. It explores the feasibility of using the assessment tool Hermes, developed in Study II, to enable a person-centred approach to the participation of patients with chronic pain in their health assessment at admission in rehabilitation nursing. Participants were 14 patients with chronic pain and their five nurses. Data were collected by participant observation and semi-structured interviews, and analysed through thematic analysis. Results: The main results of the studies were that Hermes facilitated a person-centred approach to health assessment in nursing rehabilitation and that the philosophy of phenomenology was satisfactorily operationalised in such assessment practice. Study I illustrated that person-centred participation in health care is based on patients’ experiences, values, preferences and needs, in which respect and equality were central. This concept which informed Study II manifested itself through three intertwined phases: the human connection phase, the phase of information processing and the action phase. In Study II, the trajectory through which the assessment tool Hermes was developed, in collaboration with nurses in rehabilitation and subsequently adopted into practice, emerged. During this process, its theoretical and phenomenological grounding was fine-tuned. The main advantage of the adoption of the tool into practice was that it enhanched the participation of patients in health assessment and their perspectives became salient in the assessment. This in turn promoted nurses’ understanding of the patients’ situations. Furthermore, Hermes was helpful in structuring the assess interview, discussing health issues of concern and in the evaluating progress. In addition, through the use of the tool, several aspects of its phenomenological grounding were supported. In Study III, the benefits of using Hermes as a method to assess the impact of chronic pain on patients were revealed. The findings demonstrated how the application of Hermes allowed for the development of a supportive connection and dialogue between nurses and patients that was open and interpretive. This generated an understanding of the illness situation and discussions about ways to adjust to health issues of concern. In summary, Hermes facilitated person-centred participation of patients with chronic pain in their health assessment and operationalised a phenomenological philosophy in nursing assessment in rehabilitation. Conclusions: Through the development and use of Hermes, the ideal of person-centred participation in rehabilitation nursing was facilitated. Thus, the tool is regarded as feasible for general use in nursing rehabilitation. Moreover, it could have potential relevance for other health-care settings. Further studies are needed, however, for evaluating its use in alternative settings.Rannsóknarsjóður Háskólans á Akureyri Rannsóknarsjóður Háskóla Íslands Rannsóknarsjóður Ingibjargar R. Magnúsdóttur B-hluti vísindasjóðs Félags Íslenskra hjúkrunarfræðing

Socio-economic and gender determinants of immunisation coverage in the federal capital territory, Nigeria

Abstracts in English and ZuluImmunisation is a cost-effective public health intervention that contributes to the attainment of the Sustainable Development Goals (SDGs). About 40% of children under the age of five years die from vaccine-preventable diseases in Nigeria. Routine immunisation has been quite low in Nigeria, where national coverage is estimated to be 33%, according to a 2016–2017 survey. This empirical research was aimed at determining the key socio-economic and gender determinants of immunisation in the Federal Capital Territory (FCT), identifying gaps and proffering solutions. Mixed methods of data collection and analysis were used. Data were gathered from several secondary sources and from 11 key informants using semi-structured interviews and 501 household and 26 health-facility surveys using questionnaires mounted on Open Data Kit. Lot quality assurance sampling and probability to population size methodology were used to size the samples and identify survey locations. Odds ratio analysis and logistic regression analysis were conducted to gauge the statistical association between the determinants and the coverage of immunisation. The main finding that was reached on the basis of the documents reviewed and the feedback received from the key informants was that they were gender blind at worst and gender neural at best. Most of the current strategies give little attention to socio-economic and gender barriers. Over 40 immunisation variables were identified. The analysis, particularly using the 2x2 odds ratio, yielded mixed results. The majority of the variables exhibited a close statistical association as far as immunisation indices were concerned. These variables included urban residency, married couples, literacy, birth at a health facility, antenatal care experience, vaccination card possession, immunisation knowledge, child health information, non-farming earnings, socio-economic status and tolerance of spouse beating. On the other hand, variables that were found to have no statistical significance included sex, marital status, marriage type, age, religion, tetanus toxoid (TT) vaccination and adequacy of income. Immunisation and gender are intertwined, particularly because of mothers’ biological and social attachment to their children. At the same time, conducting vaccination avails the opportunity to access almost all households. Moreover, it is important to recognise that socio-economic and gender determinants are not totally in control of one ministry. Single agenda interventions will not produce the desired result. A paradigm shift and the concerted effort of various sectors and partners are required. Therefore, the Nigerian government should galvanise the relevant stakeholders to bring gender and socio-economic variables into the mainstream throughout the immunisation ecosystem and to implement integrated development initiatives by prioritising vulnerable communities.Ugonyo yindlela engcono yokungenela kwezempilo yabantu engathela esivivaneni ekufinyeleleni izinhloso zentuthuko eqhubekela phambili ezaziwa ngelokuthi yi- Sustainable Development Goals (SDGs). Cishe izingane ezifinyelela ku 40% ezingaphansi kweminyaka emihlanu zibulawa yizifo ezivimbelekayo ngomgcabo emitholampilo eNigeria. Ukugonya njalo kusezingeni eliphansi eNigeria, laphokhona ukwengamela kuzwelonke kulinganiselwa ku 33%, ngokuya kocwaningo olwenziwe phakathi kuka 2016-2017. Ucwaningo lokuthola ubufakazi lwalunenhloso yokubona imithelela yezesimo sabantu nomnotho (socio-economic) kanye nobulili ngokugonya kwi-Federal Capital Territory (FCT) ukubona amagebe kanye nokutholakala kwezixazululo. Amamethodi axubene okuqokelela ulwazi kanye nohlaziyo kwasetshenziswa. Ulwazi lwaqokelelwa ngokufunda imithombo yemibhalo (secondary sources) kanye nakubantu ababalulekile abanolwazi (key informants) abangu 11 ngokusebenzisa ama-semi-structured interview kanye nemizi engu 501 kanye namasurvey amafasilithi ezempilo angu 26 ngokusebenzisa uhla lwemibuzo yamaquestionnaire ebifakelwe kwi-Open Data Kit. Kwasetshenziswa nemethodi ye-Lot quality assurance sampling ne-probability, ngemethodoloji yobuningi babantu, ukwenza usayizi wamasampuli kanye nokubona izindawo okumele kwenziwe kuzo ama-survey. Kwenziwa nohlaziyo lwe-Odds ratio analysis kanye ne-logisic regression analysis ukubona ukuhambelana kwamastatistiki phakathi kwezinto eziwumthelela kanye nokunaba kongamelo lokwenziwa kogonyo. Okukhulu okutholakele ngokulandela amadokhumende okufundwe kuwo, kanye nezimpendulo ezivela kulabo abanolwazi ababalulekile (key informants) kube wukuthi bekungaboneleli ubulili (gender blind) kanti futhi bekungachemile ngokulandela ubulili (gender neutral) ngezinga elibi nangokungcono kakhulu. Amasu amaningi amanje awanakekeli kakhulu izihibe ezimayelana nabantu nezomnotho kanye nezobulili. Kwaphawulwa cishe izinto ezehlukene zama-variable ezingu 40 mayelana nogonyo. Uhlaziyo, ikakhulukazi ngokusebenzisa i 2x2 odds ratio, lwaveza imiphumela exubene. Ezinto zama-variable ehlukene eziningi zikhombise ukuhlobana phakathi kwamastatistiki mayelana namaindices ogonyo. Lama variable, abandakanye ukuhlala emadolobheni, abantu abashadile, ikhono lokubhala nokufunda, ukuzalwa kwezingane kumafasilithi ezempilo, izipiliyoni zonakekelo lwengane ngaphambi kokuzalwa, ukuba nekhadi lomgcabo ix wasemitholampilo, ulwazi ngogonyo, ulwazi ngempilo yengane, ukuthola imali ngemisebenzi engeyona eyokulima, isimo sabantu mayelana nezomnotho, kanye nokuqinisela ukuhlukunyezwa ngokushaywa kwabesimame. Kanti ngakolunye uhlangothi, ama-variable atholakale engenakho ukubaluleka ngokwamastatistiki, abandakanya ubulili, isimo ngokomendo, inhlobo yomendo, iminyaka yobudala, inkolo, umgcabo we-tetanus toxoid (TT), kanye nokwenela kwengeniso lemali. Ugonyo kanye nobulili kuyangenelana nokuhambelana, ikakhulukazi ngenxa yokusondelana komama kanye nezingane zabo. Ngaso leso sikhathi, ukwenziwa kogonyo kuhlinzeka ngethuba lokufinyelela cishe kuwo yonke imizi eminingi. Nangaphezu kwalokho, kubalulekile ukwamukela ukuthi isimo sabantu mayelana nezomnotho kanye nobulili kuyizinto ezinomthelela, azinalo ulawulo oluphelele kumnyango kangqongqoshe owodwa. Ungenelo ngento eyodwa ngeke kwaveza imiphumela efiswayo. Ukugudluka ngokomqondo (paradigm shift), kanye nemizamo eqhubekela phambili yemikhakha ehlukene kanye nabasebenzisani kuyadingeka. Ngakho-ke uhulumeni waseNigeria, kumele agqugquzele ababambiqhaza abafanele ukuhlanganisa nokufaka emkhakheni ofanele izinto ezimayelana nabantu nomnotho kanye nobulili, kuyo yonke inqubo yokusebenzisana kwemikhakha okumele isebenzisane nehlangene ukusebenza ngokulandela inqubo yentuthuko ehlangane ngokubonelela imiphakathi ekwizimo ezibucayiDevelopment StudiesD. Phil. (Development Studies

The exposure to verbal abuse of student nurses gaining placement experience

Clinical placement experience has a key role to play in the socialisation and preparation of future members of the nursing profession. Aggression experienced by healthcare workers is currently receiving considerable attention and student nurses have been identified as a group vulnerable to experiencing workplace abuse (Little 1999). The primary aim of the study is to gain a greater understanding of the nature, severity, frequency and sources of verbal abuse experienced by student nurses in health care settings in the south east of England, using as a definition, “the use of inappropriate words… causing distress” (Department of Health 2003). A convenience sample of 156 third year student nurses of all four branches of one preregistration nursing programme in the south east of England was studied with questionnaires distributed retrospectively; 11 4 student nurses returned the questionnaires equating to a response rate of 73%. Results 46% of respondents reported experiencing verbal abuse, 39% had witnessed other students experiencing verbal abuse and 61% reported that they were aware of other students experiencing verbal abuse. Students reported experiencing threats to kill, racial abuse, sexually orientated verbal abuse and bullying while gaining placement experience. Student nurses are a high risk group for experiencing verbal abuse whilst gaining placement experience.In the literature, mental health and learningdisability settings are viewed as high risk areasfor experiencing aggression (Beech and Leather 2003); this study suggests that student nurses experience verbal abuse in a variety of settings and verbal abuse may be more prevalent on general medical and surgical wards than previously expected