472 research outputs found
Inviting patients to participate in their pressure injury care: The next step in prevention
No full textPreventing wound care issues such as pressure injuries (PI) is a healthcare safety priority (Australian Commission on Safety and Quality in Health Care, 2014). A major concern in Australia is that hospital-acquired pressure injury (HAPI) prevalence rates remain relatively unchanged over recent years, ranging between 9% and 18% (Mulligan, Scott and Prentice et al., 2011). PIs negatively impact on patients, nurses and healthcare organisations in terms of physical and emotional distress, increased workloads and economic burden, and reduced community confidence (Latimer, Chaboyer and Gillespie, 2014; Nguyen, Chaboyer and Whitty, 2015). Most clinicians agree that implementing international clinical practice guidelines (CPG) for pressure injury prevention (PIP) may help to reduce HAPI prevalence rates (Moore, Johansen and van Etten et al., 2015). However, many patients do not receive their planned PIP care (Vanderwee, Defloor and Beekman et al., 2011; Latimer, Gillespie and Chaboyer, 2015; Latimer, Chaboyer and Gillespie, 2016). Responding to this clinical practice gap requires innovation, with the area of patient participation warranting further consideration.No Full Tex
18Aug2019_abst_Japanese_18-1017_R4 – Supplemental material for The Dietary Patterns of Japanese Hemodialysis Patients: A Focused Ethnography
No full textSupplemental material, 18Aug2019_abst_Japanese_18-1017_R4 for The Dietary Patterns of Japanese Hemodialysis Patients: A Focused Ethnography by Michiyo Oka, Kaori Yoneda, Michiko Moriyama, Satsuki Takahashi, Claudia Bull and Wendy Chaboyer in Global Qualitative Nursing Research</p
Neurological Alterations and Management
No full textWritten by leading critical care nursing clinicians, Leanne Aitken, Andrea Marshall and Wendy Chaboyer, the 4th edition of Critical Care Nursing continues to encourage and challenge critical care nurses and students to develop world-class practice and ensure the delivery of the highest quality care.
The text addresses all aspects of critical care nursing and is divided into three sections: scope of practice, core components and specialty practice, providing the most recent research, data, procedures and guidelines from expert local and international critical care nursing academics and clinicians.
Alongside its strong focus on critical care nursing practice within Australia and New Zealand, the 4th edition brings a stronger emphasis on international practice and expertise to ensure students and clinicians have access to the most contemporary practice insights from around the world
Essential nursing care of the critically ill patient
No full textThis chapter is about essential nursing care. Because it is often referred to as basic nursing, nurses may not always perceive it as deserving of priority. Yet, how well patients are cared for has a direct effect on their sense of wellbeing and their recovery. ‘Interventional patient hygiene’ is a systematic, evidence-based approach to nursing actions designed to improve patient outcomes using a framework of hygiene, catheter care, skin care, mobility and oral care.1 This chapter focuses on the physical care, infection control, preventative therapies and transport of critically ill patients. The first two areas are closely linked: poor-quality physical care increases the risk of infection. The final areas are essential features of critical care nursing
Team communications in surgery - creating a culture of safety
No full textAs a key department within a healthcare organisation, the operating room is a hazardous environment, where the consequences of errors are high, despite the relatively low rates of occurrence. Team performance in surgery is increasingly being considered crucial for a culture of safety. The aim of this study was to describe team communication and the ways it fostered or threatened safety culture in surgery. Ethnography was used, and involved a 6-month fieldwork period of observation and 19 interviews with 24 informants from nursing, anaesthesia and surgery. Data were collected during 2009 in the operating rooms of a tertiary care facility in Queensland, Australia. Through analysis of the textual data, three themes that exemplified teamwork culture in surgery were generated: ‘‘building shared understandings through open communication’’; ‘‘managing contextual stressors in a hierarchical environment’’ and ‘‘intermittent membership influences team performance’’. In creating a safety culture in a healthcare organisation, a team’s optimal performance relies on the open discussion of teamwork and team expectation, and significantly depends on how the organisational culture promotes such discussions
The future of nutrition care in hospitals
No full textMalnutrition affects up to 50% of hospitalised patients (Ray et al., 2014; Barker et al., 2011) and has severe consequences for patients and the health care system. Malnutrition increases the risks of mortality (Lim et al., 2012) and complications like pressure injuries (Banks et al., 2010), infections (Schaible and Stefan, 2007) and falls (Vivanti et al., 2011) and is associated with increased length of stay, readmissions and higher hospital costs (Lim et al., 2012). Inadequate dietary intake is the major modifiable risk factor for malnutrition and the majority of patients fail to meet their nutritional needs in hospital (Thibault et al., 2011). Improving dietary intakes among hospitalised patients is difficult as the problem is complex and multifactorial. Patient related factors include poor appetite; nutrition impacting symptoms such as nausea or constipation; problems with self-feeding; chewing or swallowing problems; increased nutrition requirements; older age and individual preferences (Sanson et al., 2018; Vanderwee et al., 2010; Kubrak and Jensen, 2007). Hospital related factors encompass nutrition care practices, hospital foodservice and the mealtime environment (Kubrak and Jensen, 2007).Full Tex
Developing and testing a patient centered pressure ulcer prevention care bundle
Get PDFSession presented on Sunday, July 26, 2015:
A pressure injury (PI), also known as a pressure ulcer, is an area of localized damage to the skin and underlying tissue caused by pressure or shear and/or a combination of these (DeFloor et al., 2005). PI incidence rates are an indicator of quality of nursing care, thus PI Prevention (PIP) is an international priority. Yet, implementation of PIP strategies remains suboptimal in many settings. A care bundle is a structured group of interventions, based on research evidence and/or clinical practice guidelines (CPG), which have been shown to improve patient outcomes. They improve processes of care and encourage CPG compliance. In relation to PI, a US group developed an 8-item PIP care bundle that included skin care, tuRNg, and nutritional assessment, directed at nursing staff and although their annual PI prevalence data showed trends towards improvements in PI prevalence (Baldelli & Paciella, 2008). To date, care bundles have focused on guiding clinicians in their practice, yet the literature on patient participation suggests involvement of patients and their families working alongside clinicians could be a major driver in the use of care bundles (Coulter, 2006). Our team developed a patient centred PIP care bundle (PIPCB) to be used by patients, in partnership with nurses. A care bundle is an example of a complex healthcare intervention. This care bundle was based on the literature on patient participation in care, care bundles and current PIP CPGs. The training resources included a 5-minute DVD, a brochure and a poster. Modifications to the content of the PIPCB were based on feedback from health professionals and consumers (Gillespie, Chaboyer et al., 2014). Our pilot trial investigated the feasibility of the PIPCB. Over half of the 102 medical and surgical patients approached, were willing to participate in the pilot. Interviews with 11 patients and 20 nurses showed the PIPCB was well received, informative and could likely be integrated into current clinical practice (Chaboyer & Gillespie, 2014). With funding awarded by the Australian National Health and Medical Research Council, a cluster randomised trial (c-RT) was undertaken in 8 hospitals in 3 states in Australia. The research team was comprised of 8 nurses, a statistician and a health economist. To be eligible for the study, hospitals had to be metropolitan referral hospitals that cater to diverse patient adult populations and case mix groups, offering acute medical and surgical and rehabilitative services. They had to have 200 or more beds. All adult patients who had restricted mobility from wards except day-surgery, critical care, mental health, and dialysis units were eligible to participate. The primary outcome of for the trial was the development of a new PI, with secondary outcomes PI stage, hospital length of stay, and patient participation in care (self report 7-item patient participation scale adapted to PIP). The PIPCB was delivered by dedicated intervention research assistants (RAs) to both the patient and nurses (patient and cluster level) and was comprised of three main messages; 1) keep moving, 2) eat a healthy diet and 3) look after your skin. Patients reached the study endpoint if they developed a PI, if they were discharged, after study day 28, if they died or if they were transferred to another hospital or to the ICU and were mechanically ventilated. An economic sub-study was undertaken to identify the cost effectiveness of the PIPCB. In total, 1,600 patients with restricted mobility were recruited (200/site) with the sub-study recruiting 320 patients (40/site). Separate recruiters, outcome assessors and intervention research assistants were employed in addition to dedicated RAs for the health economic sub-study. This presentation will provide an overview of the program of research that led to this large, multi-site c-RT as well as the findings to date. It will also briefly introduce the process evaluation, that was undertaken alongside this c-RT to better understand and explain who the PIPCB worked for and under what conditions
Researching continuity of care: Can quality of life outcomes be linked to nursing care?
No full textResearch that informs nursing interventions across the care continuum is vital, especially with shortened hospital stays. Measuring Quality of Life (QOL) and Health Related Quality of Life (HRQOL) helps identify health status improvements, but fails to provide insight into the effectiveness of nursing interventions aimed at continuity of care. Four research examples illustrate the need for complementary, qualitative studies of what patients and their families think, feel, need and want. These indicate a need to reconceptualise the research agenda in terms of the complexity and settings of nursing practice, and the need for informational as well as statistical significance. Read More: http://pubs.e-contentmanagement.com/doi/abs/10.5172/conu.16.1-2.51Griffith Health, School of Nursing and MidwiferyFull Tex
Missed nursing care: An overview of reviews
No full textMissed nursing care is care that is delayed, partially completed, or not completed at all. The aim of this overview of reviews was to identify the nursing care that is missed, the factors that influence missed nursing care and the outcomes from it. To be included, reviews had to use the systematic review process and focus on hospital care. Databases were searched from inception until August sixth, 2020. One author screened the papers and extracted data on included reviews and a second checked this. Two authors independently assessed the quality of the reviews. Seven reviews were included in this overview. Categories of care missed included: (a) communication and information sharing; (b) self-management, autonomy, and education including care planning, discharge planning and decision; (c) fundamental physical care; and (d) emotional and psychological care including spiritual support. Factors associated with missed care were related to staffing levels and/or labor resources skill mix, material resources not being available, patient acuity and teamwork/communication. Outcomes of missed nursing care included: less/poorer quality of patient care, patient satisfaction, and nurses' job satisfaction, increased patient adverse events, and the organizational outcomes of increasing hospital length of stay and hospital readmission. In-depth qualitative and mixed methods research is needed to better understand how nurses prioritize care and why care is missed. Longitudinal and experimental research is required to better clarify if these relationships between missed care and negative patient outcomes are likely cause and effect.Full Tex
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