1,720,972 research outputs found
Nursing Leadership Perceptions of Clinical Pathways After Transitioning to an Electronic Health Record in the Acute Care Setting
No full textBackground: Both clinical pathways (CPs) and electronic health records (EHRs) increase the quality and efficiency of health care; however, no known studies have examined the integration of CPs into the EHR during an organizational EHR launch.
Aim: To understand how nursing leadership perceives the nursing practice changes that accompanied the transition from paper to EHR-based CPs.
Methods: A case study design was utilized, focusing on CPs utilized by one acute care unit within a tertiary care organization.
Findings: Transfer of paper CPs into an EHR not built for the Canadian health care context proved to be difficult. In the integration process, a single paper document became spread throughout the EHR. EHR-based CPs are not as clear, and represent a larger documentation burden, than their paper counterparts.
Conclusion: Nursing agency has been greatly affected by the change in format of CPs. Further exploration of nursing agency regarding CPs is warranted
New Graduate Nurses' Transition in Critical Care: A Systematic Review of Qualitative Evidence
No full textBackground: The nursing shortage has been heightened by the COVID-19 pandemic. To mitigate shortages, we must rely on a steady influx of new graduate nurses. A considerable preparation-practice gap is affecting transition to practice. The transition experience to critical care is further amplified, as these environments involve specialized training and knowledge. Objective: To describe the transition of new graduate nurses into critical care nursing practice Design: Qualitative evidence synthesis Setting(s): Critical care settings: intensive care units and emergency departments. Participants: New graduate nurses with at least 2 years’ experience beginning their career in critical care Methods: We searched Ovid MEDLINE® ALL, including EPub, Ahead of Print and In-Process; Other Non-Indexed Citations, Embase Classic + Embase, PsycINFO, CINAHL and Education Source on EBSCO and the Nursing and Allied Health and ERIC databases on ProQuest. Results: Twelve studies met inclusion criteria. Seventy-eight findings were extracted and grouped into six synthesized themes: (i) Barriers and Facilitators to Communication in Critical Care; (ii) Struggling with Uncertainty during Difficult Situations; (iii) Support and Its Impact on Acceptance and Attaining Desirable Nursing Qualities in Critical Care; (iv) Knowledge Develops with Time and Exposure to Complex Clinical Situations; (v) Being a Student in Critical Care; and (vi) Novel Perspectives Related to COVID-19. Conclusions: This qualitative evidence synthesis affirms that NGN transition is a complex phenomenon in critical care. Offering support, guidance and ensuring access to resources during transition to professional practice could improve new graduate nurse retention, as well as improving confidence and competence in the workplace
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
Punctuated Entropy in the ICU During COVID-19:Team Nursing and Burnout
No full textBackground: The novel demands on hospital capacity arising from the COVID-19 pandemic revealed already-existing systemic weaknesses. Intensive care units experienced a sustained surge capacity and were forced to introduce modified standards of care and practices. Purpose: In this article we use punctuated entropy as a conceptual lens to reveal the impact of the COVID-19 pandemic on Ontario hospitals by drawing attention to the cumulative impact of repeated disaster events on their capacity to recover. Methods: This qualitative instrumental case study took place at a Medical-Surgical Intensive Care Unit in a university-affiliated teaching community hospital in a large urban center in Ontario, Canada. Twelve healthcare professionals from the ICU participated in in-depth semi-structured interviews. Results: In-depth interviews with healthcare providers revealed an already-vulnerable system and the disproportionate impact of COVID-19 on the nursing workforce, compounding pre- burnout and compassion injury. Conclusion: The structure of intensive care and the dynamics of collaborative practices within ICUs are subject to continual reconfiguration, potentially leading to punctuated entropy – a permanent state of a lack of capacity to recover. Disaster recovery planning in healthcare services delivery should not be focussed simply on navigating the ‘temporary’ effects of a single event, but rather on how the event interacts with the already existing ‘pathological’ state of the healthcare system. In this way solutions to longitudinal systemic problems in ICU healthcare delivery can be anticipated and plans for mitigation can be put in place.</p
ICU clinicians’ experiences of terminal weaning and extubation
Get PDFContext: Aside from spontaneous death, a majority of ICU deaths occur after a decision to either withhold or withdraw life-sustaining measures, including withdrawal of ventilatory support. While terminal weaning or terminal extubation are both used, the lack of evidence on the superiority of one method over the other can create challenges for ICU clinicians. There is a need to explore clinicians’ experiences related to terminal weaning/extubation to understand their decision-making processes as well as the context and mechanisms that guide this process.Objectives: This study aimed to explore ICU clinicians’ experiences of Terminal Weaning of Mechanical Ventilation (TWMV) in order to better understand the process, and clinicians’ feelings about the process.Methods: This study used an exploratory descriptive qualitative design. Data were collected via semi-structured, face-to-face interviews with 20 ICU clinicians. An inductive, data driven thematic analysis approach was used for data analysis.Results: Analysis of the data resulted in four themes: Fine-tuning the Process of TWMV; Focusing on the Family; Ensuring Patient-Centered Care; and Impact on Healthcare Clinicians and Support Needs.Conclusions: The identified themes provide insight into the complexity of the withdrawal of mechanical ventilation within the context of end-of-life care in the ICU. The themes highlight the need for clear communication of a TWMV plan between clinicians to avoid conflict during the process, ensuring medication is in place for potential distressing symptoms, incorporating patient and family wishes in planning, supporting the family during the process, and training and support for clinicians
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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