1,720,960 research outputs found
Consensus on nurse-sensitive indicators for adult intensive care units in South Africa
Get PDFDissertation (MCur (Health Sciences))--University of Pretoria, 2022.Background: Nurse-sensitive indicators (NSI) are tools specifically related to nursing care that can be used to measure nurses’ contribution to patients’ outcomes. NSI are important for demonstrating and evaluating quality of nursing care to ensure that patients receive efficient, effective, and safe care. In South Africa, where critical care faces challenges of resource scarcity and increased demand for Intensive Care Unit (ICU) services, there is a need to implement the use of nurse-sensitive indicators to monitor the quality of care critically ill patients receive. However, there are no published sets of nurse-sensitive indicators for adult ICUs in the country.
Objective: The study aimed to develop and reach consensus on nurse-sensitive indicators for adult ICUs in South Africa.
Methods: The study used a scoping literature review and two rounds of eDelphi technique among registered nurse specialists in critical care.
Results: Thirty-four nurse-sensitive indicators were identified from 29 studies in the scoping review. In the first eDelphi round, a panel of 32 ICU nursing experts reduced the 34 indicators to 29 and added 3 others to obtain a set of 32 indicators which were grouped into 12 categories of systems or areas of use. These were then presented to a second panel of ICU experts in the second eDelphi round. All the 32 indicators obtained agreement of at least 85% in the second eDelphi round and were finalized for possible implementation in ICU in South Africa. The 12 categories included the respiratory, cardiovascular, neurological, gastrointestinal, integumentary, and urinary tract systems. Others were infection control, patient safety, nursing processes, workload, training and experience, and institution related.
Conclusion: The study established consensus on a set of 32 nurse-sensitive indicators grouped into 12 categories suitable for use in adult ICUs in South Africa. However, there is need to establish validity, reliability, and burden of data collection by conducting pilot studies in actual ICU settings.Nursing ScienceMCur (Health Sciences)Unrestricte
Moral distress of critical care nurses when initiating do-not-resuscitate orders for critical ill patients in a specific government hospital
Get PDFDissertation (MA (Nursing Science))--University of Pretoria, 2023.Introduction: Patients who are critically ill or seriously injured are routinely admitted to critical
care units. If the patient’s condition deteriorates beyond a certain point, the medical
practitioner may prescribe or decide on a do-not-resuscitate (DNR) order that must be
executed by the professional nurse. Professional nurses may experience moral distress that
manifests in poor teamwork, depression, and absenteeism.
Aim: To explore and describe factors contributing to moral distress of critical care nurse
executing do-not-resuscitate orders.
Design: The explorative descriptive qualitative design was selected to answer the research
questions posed.
Methods: Critical care nurses of a selected public hospital in Gauteng province were selected
through purposive sampling to participated in the study.
Participants: The shift leader assisted with selection of participants who met the eligibility
criteria. The mean age of the participants was 36 years and most of them had more than five
years’ critical care nursing experience.
Finding: The findings were classified under three main topics which are moral distress;
communication and psychological impact of DNR orders.
Conclusion: Clearly defined national guidelines or legal framework are required to regulate
DNR processes. The study further demonstrated the need for unit based ethical platforms and
debriefing sessions for the critical care nurses.
Key Words: Critical Care Nurse, Critical Care Unit, Do-not-resuscitate order, Moral distress.Nursing ScienceMA (Nursing Science)Unrestricte
Factors contributing to normalization of deviance among perioperative nurses
Get PDFDissertation (MNur (Nursing Science))--University of Pretoria, 2023.Introduction
Patient safety in the operating room remains a global concern and perioperative adverse events continue to occur at unacceptable rates. Unidentified factors in a specific operating room cause perioperative nurses to deviate from standard operational procedures. Gradual and steady disconnection from written procedures occur. With repetition and the absence of immediate effect on the patient’s safety, these deviations become acceptable and normalized. If minor deviations are tolerated, it becomes the modus operandi. Normalization of deviance in the operating room is a reality and unsafe practice jeopardizes patient safety and adverse events occur. It was considered important to identify the contributing factors in the particular hospital.
Aim
This study aimed to explore and describe the factors that contribute to normalization of deviances among perioperative nurses in a private hospital in South Africa.
Research Design
Qualitative contextual, and descriptive study.
Methodology
Self-reported narrative guides were distributed to the total population of twenty perioperative nurses and nineteen shared their perceptions of contributing factors to normalization of deviance. Data were analysed using thematic analysis.
Findings
Three themes and twelve sub-themes were formulated. These themes and sub- themes explored and described the factors contributing to normalization of deviances in the operating room of a specific private hospital. The themes were related to governance, workplace culture and individual factors.
Conclusion
The contributing factors to normalization of deviance among perioperative nurses in this particular hospital were described. Normalization of deviance, or the routine violation of safety practices, in the operating room of a private hospital was a concern since a gradual increase of adverse events were observed. The contributing factors were unknown and were explored and described in this study as being related to governance, workplace culture and individual factors. As a result, strategic planning according to these factors could be planned to decreased error and adverse events in the surgical environment; a supportive and transparent relationship between management and staff members could be established and potential system weaknesses could be identified and addressed to benefit patients, perioperative staff, and the organisation.
Keywords
adverse events, normalization of deviance, patient safety, perioperative nurseNursing ScienceMaster (Nursing Science)UnrestrictedFaculty of Health SciencesSDG-03:Good heatlh and well-bein
Transition support needs of the Novice clinical nurse educators at a public nursing college in Gauteng : A case study
No full textDissertation (MSc (Nursing Science))--University of Pretoria, 2022.ABSTRACT
Introduction
Experienced professional nurses with an additional qualification in nursing education, leave the clinical practice to join the academic environment in the college to become nursing educators. It is important that the thinking process of the novice clinical nurse educator is nurtured to boost self-confidence. If these novice clinical nurse educators are not supported during their transition period it is likely to reduce student satisfaction and outcomes. Due to these consequences, there is a need to conduct the study to explore the nature of transition support needed by the novice clinical nurse educators to enhance the quality of clinical education.
Aim
The aim of this study is to explore and describe the transition support needs of novice clinical nurse educators and to recommend guidelines for the support of novice clinical nurse educators during the transition period from being a professional nurse in practice to a clinical nurse educator at a nursing college.
Research Design
A holistic single case study design was appropriate for this study as it allows a phenomenon to be examined in a great deal of depth.
Methodology
The study was conducted in a public nursing college in Gauteng province. The population was novice clinical nurse educators, experienced nurse educators and heads of departments. Purposive sampling method was used to select the study participants. Semi structured interviews were used telephonically, and a semi structured questionnaire were used. All interviews were recorded with the participants’ consent. Content analysis was used to analyse the transcribed interviews and semi-structured questionnaires. Research was conducted ethically, and trustworthiness was ensured. Findings were grounded in current literature and disseminated to stakeholders pertinent to the research.
Findings
The following main themes emerged: 1) Professional socialization 2) Mentorship 3) Structured orientation program and 4) Supportive work environment
Conclusion
The findings and recommendations should assist the nursing colleges to compile structured intensified programmes for the orientation of novice clinical nurse educators. The transition support policy should include the appointment of dedicated mentors, evaluation, and monitoring processes for the progress of the transition.
Key words: Clinical education, Expert, Novice, Nurse Educator, Professional nurse, TransitionNursing ScienceMCur (Nursing Science)Unrestricte
Consensus on nursing guidelines to manage patients admitted to intensive care units with an open abdomen : e-Delphi method
Get PDFDissertation (MNurs (Clinical)--University of Pretoria, 2024.Aim(s): To obtain a consensus on the use of nursing guidelines for managing patients with open abdomens admitted to intensive care units.
Background: Critically ill patients who present with an open abdomen in the intensive care unit pose multiple challenges, especially for nurses, who play a pivotal role in the management of these patients. Updated evidence-based guidelines should be developed for nurses to alleviate nursing challenges when managing these patients.
Design: A modified e-Delphi consensus design
Methods: An expert panel, including nurses, surgeons, and intensivists with expertise in managing patients with open abdomens in intensive care units, was invited to participate. The data were collected using the Qualtrics survey platform. The expert panel was asked to rate the importance of each guideline statement as well as the importance and practicality of each nursing intervention using a 4-point Likert scale. Experts were allowed to suggest changes to refine the guidelines and interventions.
Results: Thirty-one experts participated in Round 1, 22 participated in Round 2, and 18 participated in Round 3. Most of the experts were nurses (71%). The experts were informed of five nursing statements and their interventions. A consensus >80% was obtained on the content of the nursing statements and their interventions, but refined changes were made to the guideline statements and their interventions, which were presented to the experts in rounds two and three. A consensus >90% was obtained after Round 3.
Conclusion: The panel of experts was able to reach a consensus on the nursing guidelines in Round 3, concluding that the 2020 guidelines have been updated. In the future, nursing guidelines should be introduced in practice and in training and a nursing protocol should be developed.
Reporting method: The study adhered to the relevant EQUATOR reporting guidelines: Guidance on Conducting and Reporting Delphi Studies (CREDES) checklist.Nursing ScienceMNurs (Clinical)UnrestrictedFaculty of Health Science
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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