Analisis Kepatuhan Perawat pada Standar Asuhan Keperawatan di Unit Rawat Inap Kelas III RSU PKU Muhammadiyah Bantul YOGYAKARTA Tahun 2010

Background: A hospital is an organization of health professionals through an organized and permanent medical facilities conducting medical services, continuous nursing care, diagnosis and treatment of illnesses suffered by patients. Nurses require documentation standards as guidance and direction in maintenance recording / documentation of activities and instructions for making patterns / recording formats appropriate, evidence recording and reporting on the status of the client and used as a communication tools that is accurate and complete. Nurses are not only required to improve the quality of nursing care, but also claimed to be properly documented. Nurses often do not obey and do the routine without regard to their legality aspect, although many factors are influence documentation. This study aims to determine compliance with standards of nursing care nurse at PKU Muhammadiyah Hospital in Bantul. Methods: This was a qualitative descriptive research with a view to charging documents compliance with nursing standards of nursing care PKU Muhammadiyah Hospital in Bantul. This research was conducted with a view of nursing care standards document in May 2010. Implementation process that includes data collection, data processing, and presentation of comprehensive data and information accurately, timely, and trustworthy in the hospitalization. Results: he results seen from the documentation of nursing care standards shows that the nurses in the inpatient unit class PKU Muhammadiyah Hospital in Bantul III comply with the standards of nursing care that is 100% obedient to categorize nurses in assessment, diagnosis and planning, while 94.7% of nurses in the implementation of compliance and categorize 89.5% nurses in the evaluation categorize obedient. Conclusion: Compliance with the standards of nursing care nurse in the Inpatient Unit RSU PKU Muhammadiyah class III Bantul, has been running quite well because the nurse dutifully on the charging document nursing care standards

An evaluation of nursing documentation as it relates to pro re nata (prn) medication administration : a research report presented in partial fulfilment of the requirements for the degree of Master of Nursing in Mental Health at Massey University

Aims of the project: l. To investigate if documentation related to pro re nata (Latin, prn) medication administration by mental health nurses, in a particular Forensic Psychiatry Clinic, in a metropolitan city in New Zealand, complies with the requirements of the National Mental Health Sector Standards (Ministry of Health, 1997), the specific District Health Board's policies, the local policies of the Forensic Psychiatry Clinic, the Code of Conduct for Nurses and Midwives (Nursing Council of New Zealand, 1999) and follows the nursing process. 2. To investigate whether there are any variations in the documentation practices between nursing shifts. Methods: A retrospective file audit was conducted at a forensic psychiatry clinic in a city in New Zealand. Non-random sampling was used. Data was collected from all admissions in 2002 that had prn medication administered during the first four weeks. A document questionnaire was designed to capture the required data to answer the research questions Results: From the sample of 27 files data was collected from up to 170 nursing entries. This was primarily a descriptive and exploratory study. None of the nursing entries met all the requirements of the National Mental Health Sector Standards (Ministry of Health, 1997), company policies, local area policies and/or the Code of Conduct for Nurses and Midwives (Nursing Council of New Zealand, 1999) in relation to nursing documentation. Nearly 47% of the prn medication administered had no documentation, apart from that in the medication-recording chart, to indicate it had been given. Approximately 85% of prn administrations had no evidence of an assessment prior to administration. Where it was documented that a client had requested medication. nearly 82% had no evidence of assessment. A large number of prn medications were administered from prescriptions that did not meet legal or policy requirements. Evidence of planning was lacking in the documentation with nearly 98% of the notes not indicating the rationale for a choice of route of administration where this was permitted on the prescription. No nursing entry offered a rationale for the choice of dose where this was allowed. The name of the medication, dose, route and/or time administered was frequently missing. Of the prn administrations considered for an outcome, nearly 60% had no documented outcome. Little difference was found in the nursing documentation between the shifts. However it was noted that for day and aftenoon shift, the earlier in the shift the medication was administered the less likely there was to be any mention of the medication being administered. Conclusion: The findings established extremely poor documentation practices. The lack of evidence of patient assessment, prior to administration of the medication in the documentation, raises the issue of whether this is being done prior to prn medication administration or simply not being documented. The documentation left questions about decision making in the planning of administration. The large number of medication administrations lacking a documented outcome raises uncertainty about nurses' knowledge of evaluating care, or even whether they are actually evaluating the care given. As a result of these findings, it is recommended that further research in this area be undertaken in New Zealand

Developing and Testing the Standard of Practice and Evaluation of Critical-Care-Nursing Tool (SPECT) for Critical Care Nursing Practice.

BACKGROUND: Nurses working in critical care often undertake specialty education. There are no uniform practice outcomes for critical care programs, and consumer input to practice standards has been lacking. METHODS: A structured multiphase project was undertaken to develop practice standards and an assessment tool informed by critical care nursing stakeholders as well as patients and families-the Standards of Practice and Evaluation of Critical-Care-Nursing Tool (SPECT). RESULTS: Testing of the SPECT revealed adequate content validity index (CVI), domain CVI (range, 0.772 to 0.887), and statement CVI (range, 0.66 to 1.00). Reliability was adequate in terms of internal consistency (Cronbach's α > 0.864) and test-retest Spearman rank correlation (range, 0.772 to 0.887); intra-rater kappa agreement was significant for 102 of 104 statements with moderate agreement for 94.2% of statements. CONCLUSION: The SPECT appears to have clinical feasibility, preliminary validity and reliability, and provides a clear definition for the expected practice level for graduates of a critical care education program

Decreasing Duration of Mechanical Restraint Episodes by Increasing Registered Nurse Assessment and Surveillance in an Acute Psychiatric Hospital

Background Application of mechanical restraints is a high-risk emergency measure that requires psychiatric intensive care in order to assure patient safety and expedite release at the earliest opportunity. While current regulations require that trained staff continuously observe restrained individuals, assessment by a registered nurse is required only once an hour. This project builds on research that demonstrated a regulatory change requiring more frequent registered nurse assessments led to decreased duration of mechanical restraint episodes in an acute psychiatric hospital. Purpose The purpose of this project was to implement and evaluate a practice change that required increased frequency of registered nurse assessment and surveillance during mechanical restraint episodes. Methods The nursing department standard requirement for frequency of face-to-face registered nurse assessment and surveillance of patients during episodes of mechanical restraint was increased on pilot units from once every thirty minutes to continuous assessment and surveillance throughout the duration of the restraint application. Quantitative data was collected on hours of duration of restraint episodes on four pilot units for three months before and three months after the intervention and mean duration of episodes was compared before and after the practice change. Results Mean duration of episodes on pilot units decreased 44% in the three months post intervention: 15% on adult units and 70% on the adolescent unit. Conclusion and Recommendation Increasing the frequency of registered nurse assessment and surveillance during mechanical restraint has been shown to decrease duration of restraint episodes. Nurses are encouraged to change practice standards for mechanical restraint, which is a high-risk emergency measure, to provide continuous psychiatric intensive care by a registered nurse. Keywords: mechanical restraint, physical restraint, psychiatric patient

A protocol for advanced psychometric assessment of surveys

Background and Purpose. In this paper, we present a protocol for advanced psychometric assessments of surveys based on the Standards for Educational and Psychological Testing. We use the Alberta Context Tool (ACT) as an exemplar survey to which this protocol can be applied. Methods. Data mapping, acceptability, reliability, and validity are addressed. Acceptability is assessed with missing data frequencies and the time required to complete the survey. Reliability is assessed with internal consistency coefficients and information functions. A unitary approach to validity consisting of accumulating evidence based on instrument content, response processes, internal structure, and relations to other variables is taken. We also address assessing performance of survey data when aggregated to higher levels (e.g., nursing unit). Discussion. In this paper we present a protocol for advanced psychometric assessment of survey data using the Alberta Context Tool (ACT) as an exemplar survey; application of the protocol to the ACT survey is underway. Psychometric assessment of any survey is essential to obtaining reliable and valid research findings. This protocol can be adapted for use with any nursing survey.<br /

Roles and responsibilities of the student nurse mentor: an update.

Facilitating the learning of student nurses in the workplace is an integral role of the registered nurse. This article aims to provide an overview of the role and responsibilities of the mentor in supporting pre-registration nursing students in clinical practice. The professional obligations for the mentor to meet the Nursing and Midwifery Council (NMC) standards (NMC, 2008a) will be explored, including the ongoing requirements to keep up to date in mentoring practices. Some of the challenges within the role will be identified, including the importance of recognizing and supporting the failing student. Recent changes to the preparation requirements for sign-off mentors will be discussed. The article concludes by presenting the potential benefits to both the individual and the practice placement provider

A comprehensive educational approach to improving NCLEX‐RN pass rates

Background Nurse educators strive to find the best educational methods to prepare students in their attempt to pass the National Council Licensure Examination for Registered Nurses (NCLEX‐RN). The purpose of this study is to describe the implementation of an online coaching program with Appreciative Advising and Emotional Intelligence education as combined educational strategies to improve student learning outcomes. Methods The study was conducted at a university in the Midwestern United States. The sample consisted of students in four graduating classes (2013, n = 15; 2014, n = 19; 2015, n = 18; and 2016, n = 17), who had followed supplemented program preparation in a prelicensure program. Electronic surveys were disseminated to determine satisfaction with student program supports through analysis of the mean overall average scoring of seven‐point Likert scale rates. NCLEX‐RN actual pass rates were reviewed to examine the quality of online coaching toward student preparation via a t test to compare the mean NCLEX‐RN pass rates before and after implementation. Results The students reported satisfaction with the additions of Appreciative Advising and Emotional Intelligence. NCLEX‐RN pass rates showed significant improvements with the combined program support additions. Conclusion The findings suggest that nursing schools that include student program support with an online coaching program can result in positive trends related to NCLEX‐RN pass rates

Evaluation of the Specialist Community Public Health Nursing Peripatetic Assessment Model

The Health Visitor Implementation Plan 2011-15: a call to action, called for an additional 4200 health visitors to be trained by 2015. To accommodate larger numbers of students, specialist community public health nursing (SCPHN) programmes across the UK have undergone significant transformation in terms of practice supervision. Somerset Partnership NHS Trust introduced a peripatetic assessment model involving practice teachers and practice mentors. This differed from traditional one-to-one approaches of supervision to one-to-three. Practice teachers mostly supervised students through close collaboration with mentors who worked directly with students on a daily basis. Using a mixed methods approach, the evaluation aimed to assess the effectiveness of the new model from the perspective of SCPHN students, mentors, practice teachers (PTs) and managers. Data was collected through an anonymous online survey and individual interviews or focus groups. Overall, participants were positive about the peripatetic model’s impact on student learning and practice experience, in addition to the general up-skilling of the wider health visiting workforce and possible implications of continuation into the future. Any concerns raised focused on adequate preparation and support for mentors and the need for clear communication and role differentiation between practice teachers and mentors