The workload of nursing: A concept analysis using walker and avant approach

Background and aims: To predict the nursing workforce needed to care for patients in hospital wards, the workload of nursing care should be specified. In this regards, clarifying the concept of "nurse workload" can expand professional contributions of nurses in the health care system. The aim of this study was to assess the multiple dimensions of nursing workload, define its characteristics and functions in nursing, and ultimately provide a conceptual definition of nursing workload. Methods: Walker and Avant (2011) eight-step method of concept analyze was used for clarifying the concept of "nurse workload". Using “nursing” and “workload” keywords, electronic databases including Pubmed, SCOPUS, CINAHL, OVID, Persian Scientific Information Database (SID), Iranian Research Institute for Science and Technology (IranDOC) and MAGIRAN publication database were searched without time limit based on the inclusion criteria, and 8 studies included into review. Results: The nursing workload was defined and the five dimensions of this concept were determined. Workload dimensions were the amount of time, knowledge, skills and behavior (nursing competence); nursing intensity (direct patient care); physical activity; mental and emotional processes; and the ability of nurses to change the treatment plan during their shift. Nursing workload includes direct and indirect activities that nurses do on behalf of the patient. Workload was defined as the need for nursing care or nursing skilled to meet the caring needs of patients. Conclusion: Nursing workload is amount of time and care that a nurse performs (directly or indirectly) to patients, work setting, and professional development. Therefore, the whole time of nursing that nurses need to perform in both of nursing and non-nursing activities should be considered in the nursing workload measurement. By understanding the nursing workload, nurse managers can take appropriate action to improve nurses working conditions. In addition, the fair distribution of the nurse's workload will maximize their productivity

Ethical challenges in nursing

Background and aims: The conflict between values transforms a situation or problem into an ethical challenge. Due to high workload, nurses are frequently confronted with the ethical challenges and despite having different specialities, they are incapable of confronting ethical challenges. The aim of this study was to investigate ethical challenges in nursing profession. Methods: This is a review article that was done in 2016, data were collected by searching through online databases such as Scopus,web of science, PubMed, Iran medex, iranpsycho Magiran and SID with the keywords challenge, ethics, nursing with no time limit. 27 articles were included in the present study. Results: The results of the study were categorized into three categories: Ethics fundamental (autonomy, avoidance of Damage, Usefulness, equality), moral decision making (moral uncertainty, Moral distress, ethical tension), and ethical challenges (professional, communication and educational challenges). Conclusion: Sensitivity to ethical issues and challenges in the professional practice of nursing practice is vital and must be entered in training,clinincal and nursing research

A concept analysis of Nursing responsibility

زمینه و هدف: مسئولیت در پرستاری ابعاد گسترده ای داشته و در واقع تضمین کننده شاخص های سلامت و بهبود کیفیت خدمات پرستاری است. بررسی متون پرستاری نشان می دهد در ارتباط با تبیین مفهوم مسئولیت در پرستاری آراء بسیار متفاوتی مطرح شده است. هدف از این بررسی تحلیل مفهوم مسئولیت به روش واکر اوانت (2005) می باشد. روش بررسی: جستجوی متون و با استفاده از واژه کلیدی مسئولیت در پرستاری در پایگاه های اطلاعاتی , Iranmedex, SID Medline Scopus, proquest, ovidSP, انجام شد. مقالات معتبر داخلی و خارجی و کتاب های لاتین و فارسی زبان مرتبط با مفهوم مسئولیت در پرستاری که بین سالهای 2000 تا 2013 منتشر شده بودند بررسی شدند. پس از اعمال طرح جستجو 18 مقاله و5 کتاب که با موضوع مرتبط و در دسترس بودند، انتخاب شده و به روش واکر اوانت تحلیل و با کمک این منابع، واژه های مرتبط مشخص شدند . یافته ها: تحلیل مفهوم نشان داد مفهوم مسئولیت در پرستاری با واژه هایی چون دقت ، پاسخگویی و تعهد هم ردیف است، مسئولیت با واژه های وقت گذرانی و بی تفاوتی در تضاد بوده و این دو مفهوم با وجود مسئولیت حرفه ای همگرایی نخواهد داشت. مسئولیت در پرستاری فرآیندی پیچیده است که با مفاهیم پاسخگویی، تعهد، نوعدوستی و وجدان کاری مشخص می شود. نتیجه گیری : زمانی که رعایت اخلاق حرفه ای در پرســتاران با چاشــنی معنابخشی و احساس معنویت در کار، تجلی و نمود پیدا کند، تأثیر قابل ملاحظه ای بر مسؤولیت پذیری پرستاران خواهد داشت. پرستار مسئولیت پذیر در واقع فردی پاسخگو در برابر مراقبت است و هدف وی رضایت دریافت کنندگان خدمات پرستاری است. به عبارتی کار داوطلبانه و توجه به برابری درعرضه خدمات، احترام به خواسته ها و شخصیت افراد و سعی در ایجاد اعتماد مددجویان به عنوان ارزش های مسئولیت پرستاری است

Challenges and Barriers to Providing Care to Older Adult Patients in the Intensive Care Unit: A Qualitative Research

BACKGROUND: Enhancing the quality of care for elderly patients needs an understanding of the challenges and obstacles experienced by the intensive care unit (ICU) staff in providing care. AIM: To explore the most challenging issues experienced by ICU staff, in particular, nurses, in the care of elderly patients in the general adult ICU. DESIGN: A qualitative research design was employed. The Standards for Reporting Qualitative Research (SRQR) were followed. METHODS: Based on theoretical sampling, we carried out 34 in-depth semi-structured interviews from two medical adult ICUs. Data analysis was carried out using qualitative conventional content analysis. RESULTS: Data analysis led to the identification of three interrelated categories and 12 subcategories. Three main categories were factors related to nurses’ attitude in elderly care, factors related to the system of care, and factors related to the models of patient care delivery. These categories came under the main theme of "Inappropriate and unfair system for elderly care". CONCLUSION: The findings of this study increase scholarly understanding of challenges and barriers to providing care to elderly patients in the general adult ICU. We found that the provision of care to elderly patients is inappropriate and unfair. Various obstacles must be overcome to improve the care of these patients. For example, negative attitudes toward elder care, inappropriate environments, lack of resources, lack of knowledge and skills, a specialized model of care delivery, respect for humanity, care without considering patient age, and separating professional conflicts from patient care. These findings may be used by ICU’s caregivers and managers to improve the quality of care. IMPLICATIONS FOR PRACTICE: Various obstacles were documented that need to be overcome by hospital administrators, nursing managers, clinical nurses, nursing educators, nursing researchers to improve the care of elderly patients admitted to ICU

The Methodological Accuracy in Interventional Medical Education Articles Published in Approved Iranian Journals from 2005 to 2013

Background & Objective: Evaluation of methodological research reports increases the trust by the readers and users from application of results. This paper aimed to verify the accuracy of methodology in medical education interventional articles published in approved domestic journals. Methods: This cross-sectional study was used with a broad literature review in medical education interventional articles published in approved domestic journals by a review of medical journals archives and search databases. Thirty articles archived and its methodological accuracy was evaluated by special forms. The reliability of the study was confirmed with internal consistency and its validity has been confirmed in previous studies. Results: Over 90% of the suitability of the design was appropriate. Inclusive and exclusive criteria of subjects were found only in 26.8% of the cases. Blindness in 70% of the cases was observed. The reliability and validity of the instrument were not found in 66.7% of the cases. Fallow up length was not determined in 70%, and informed consent was not obtained in 80% of the subjects. Conclusion: There was inaccuracy in cases such as the instruments reliability and validity, sample selection, blindness, groups matching, etc. Journal writers are recommended to pay more attention to accuracy of research methodology in publishing medical education interventional articles. Keywords Medical education Methodology accuracy Iranian approved scientific journa

The position of "Variation" clause in the legal order of construction contracts With emphasis on sample contracts of Iran, FIDIC and England

ABSTRACTThe variation clause is one of the common conditions in domestic and international construction contracts. Given the executive realities of construction and industrial projects, the application of this clause seems appropriate and sometimes necessary. The subject of this clause is change in the works. Changes depending on how the clause is written, including removal, increase or decrease, replacement, change of sequence and method of construction, and any changes to what the contractor has undertaken in the initial contract. Work is also a permanent and temporary work that is required to build and complete the project and is included in the contract documents such as Service description, employer requirements and technical specifications. Variation clause is the positive condition under which the contractor undertakes to execute a unilateral change order issued by the employer without the need for another agreement. It is very important to examine the variation clause in terms of limitations due to the subject and time domain as well as the legal effects of its implementation or violation. But before that, a detailed study of the legal meaning and nature of the mentioned clause and identification of its position in the legal order of constuction contract is necessary. The present article deals with the latter

Inductive and Deductive: Ambiguous Labels in Qualitative Content Analysis

The propounded dualism in Content Analysis as quantitative and qualitative approaches is widely supported and justified in nursing literature. Nevertheless, another sort of dualism is proposed for Qualitative Content Analysis, suggesting the adoption of inductive and/or deductive approaches in the process of qualitative data analysis. These approaches have been referred and labelled as inductive or conventional ; and deductive or directed content analysis in the literature. Authors argue that these labels could be fallacious, and may lead to ambiguity; as in effect, both approaches are employed with different dominancy during the process of any Qualitative Content Analysis. Thus, authors suggest more expressive, comprehensive, yet simple labels for this method of qualitative data analysis