ABSTRACT
PURPOSE/AIMS: To explore nurses' perceptions of clinical nurse specialist practice as implemented in a highly specialized university hospital in Spain. DESIGN: A descriptive qualitative study was carried out in 3 inpatient wards, with a clinical nurse specialist within the team, at a high specialized university hospital in Spain. METHOD: Semistructured interviews were conducted by purposive sampling with 17 selected nurses with at least 2 years of professional experience who voluntarily agreed to participate and signed the informed consent form. Analysis of the qualitative data was conducted according to Burnard's method of content analysis. The Consolidated Criteria for Reporting Qualitative Research checklist was used. RESULTS: Four main categories emerged from the analysis of the data: "qualities of the role-holder," "role competencies in practice," "integration with the team," and "impact of the role" on nursing, the patient, and the organization. CONCLUSIONS: The findings of this study have interesting implications for the development and implementation of clinical nurse specialist practice in healthcare organizations. They also provide evidence of the benefit of implementing clinical nurse specialist practice for improving the quality of care, patient outcomes, and healthcare efficiency.
Subject(s)
Nurse Clinicians , Humans , Spain , Qualitative Research , Delivery of Health Care , HospitalsABSTRACT
FUNDAMENTO: Las Unidades de Cuidados Intensivos (UCI) acogen pacientes que con frecuencia presentan dolor. La correcta valoración del mismo y su tratamiento óptimo son imprescindibles para una atención de calidad; la enfermera, por su cercanía con el paciente, está en una posición única para lograrlo. Por tanto, el objetivo de este estudio es conocer el nivel de conocimientos de las enfermeras y las actitudes que manifiestan hacia el manejo del dolor en su práctica diaria, así como relacionarlo con sus datos sociodemográficos. MÉTODO: Estudio descriptivo, transversal, observacional en la UCI de un hospital universitario de nivel terciario. Se estudió el conocimiento y las actitudes en relación al dolor de las enfermeras, a través del cuestionario Knowledge and Attitudes Survey Regarding Pain traducido al español. RESULTADOS: Todas las enfermeras (n = 37) que trabajaban en la UCI cumplimentaron el cuestionario con una puntuación media de 5,87 sobre 10 (DE: 0,98; rango: 7,89-3,68). La puntuación del cuestionario no se relacionó con la edad, los años de experiencia profesional, los años trabajados en UCI, la formación especializada y la formación en dolor. En cambio, las enfermeras con formación de máster obtuvieron puntuaciones medias significativamente más altas en el cuestionario (6,97; DE: 0,75 vs 5,73; DE: 0,92; p = 0,018). CONCLUSIONES: Las enfermeras de la UCI poseen conocimientos y actitudes insuficientes en relación al dolor. La formación de máster mejora los resultados obtenidos en el cuestionario sobre conocimientos y actitudes en relación al dolor
BACKGROUND: Intensive Care Units (ICU) usually treat patients with pain. Being close to patients makes nurses key professionals for guaranteeing an optimal assessment and treatment of pain, which are crucial to ensure quality care. Therefore this study aims to describe the knowledge and attitudes of ICU nurses about pain management in their clinical practice, and its relationship with socio-demographic data. METHODS: Cross-sectional study carried out in a third level university teaching hospital ICU. The Knowledge and Attitudes Survey Regarding Pain (KARSP) translated into Spanish was used to obtain information about the knowledge and attitudes towards pain of nurses. RESULTS: All nurses (n = 37) working at the ICU answered the questionnaire. The mean score of the questionnaire was 5.87 over 10 (SD: 0.98, range: 7.89-3.68). There was not a statistically significant relationship among the questionnaire score and age, professional experience, time worked at the ICU, specialized training or pain training. However, nurses with a master's degree obtained significantly higher mean scores in the questionnaire (6.97; DE: 0.75 vs. 5.73; DE: 0.92; p = 0.018). CONCLUSIONS: ICU nurses show insufficient knowledge and attitudes towards pain. Having a master's degree improves the results obtained in the questionnaire about knowledge and attitudes towards pain
Subject(s)
Humans , Male , Female , Young Adult , Adult , Middle Aged , Critical Care/organization & administration , Critical Care Nursing/methods , Nursing Care/methods , Pain Management/nursing , Health Knowledge, Attitudes, Practice , Intensive Care Units/organization & administration , Nurse's Role , Professional Competence/statistics & numerical data , Cross-Sectional StudiesABSTRACT
BACKGROUND: Clinical narratives may be used as a means to improve the acquisition of clinical competences. Even though there are studies that recognize the potential value of clinical narratives to promote nursing professional development, there is no evidence that shows their value as a tool to improve nurses' competences to provide person-centred nursing care. PURPOSE: To evaluate the preliminary efficacy of narratives for the development of three nursing professional competences -respect, intentional presence and knowing the person- for providing person-centred care. METHOD: Using a pre-post quasi-experimental design, a pilot study with a total of 34 nurses enrolled in a training course of nursing specialization was conducted between September 2016 and June 2017. All the nurses received a multi-component intervention based on the Critical Reflective Inquiry model. The strategies of this programme consisted of writing three narratives, attending two masterclasses, participating in a discussion group, and participating in a face-to-face interview. The NarratUN Evaluation tool was used to assess the outcomes. Changes among nurses were analysed using the Wilcoxon signed Rank test. RESULTS: The difference in the means between the pre- and post-intervention scores were statistically significant for respect [0.59 (95% CI 0.23-0.95; p = 0.001)], intentional presence [0.75 (95% CI 0.32-1.17; p < 0.0001)] and knowing the person [0.62 (95% CI 0.25-0.99; p = 0.001)]. The difference in the mean score for use of the narrative and reflection also increased significantly [0.65 (95% CI 0.32-0.98, p < 0.001)]. CONCLUSIONS: The use of narratives combined with other reflective strategies (masterclass sessions and discussion groups) proved to be effective for the development of professional competences of nurses.
