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1.
Am J Crit Care ; 17(2): 101-11; quiz 112, 2008 Mar.
Article in English | MEDLINE | ID: mdl-18310646

ABSTRACT

BACKGROUND: Debate continues among nurses about the advantages and disadvantages of family presence during resuscitation. Knowledge development about such family presence is constrained by the lack of reliable and valid instruments to measure key variables. OBJECTIVES: To test 2 instruments used to measure nurses' perceptions of family presence during resuscitation, to explore demographic variables and perceptions of nurses' self-confidence and the risks and benefits related to such family presence in a broad sample of nurses from multiple hospital units, and to examine differences in perceptions of nurses who have and who have not invited family presence. METHODS: Nurses (n = 375) completed the Family Presence Risk-Benefit Scale and the Family Presence Self-confidence Scale. RESULTS: Nurses' perceptions of benefits, risks, and self-confidence were significantly and strongly interrelated. Nurses who invited family presence during resuscitation were significantly more self-confident in managing it and perceived more benefits and fewer risks (P < .001). Perceptions of more benefits and fewer risks were related to membership in professional organizations, professional certification, and working in an emergency department (P < .001). Data supported initial reliability and construct validity for the 2 scales. CONCLUSIONS: Nurses' perceptions of the risks and benefits of family presence during resuscitation vary widely and are associated with how often the nurses invite family presence. After further testing, the 2 new scales may be suitable for measuring interventional outcomes, serve as self-assessment tools, and add to conceptual knowledge about family presence.


Subject(s)
Attitude of Health Personnel , Family , Professional-Family Relations , Resuscitation/nursing , Visitors to Patients , Adolescent , Adult , Female , Humans , Indiana , Male , Middle Aged , Nursing Staff, Hospital/psychology , Self Concept
2.
Crit Care Nurs Clin North Am ; 18(4): 469-79, ix, 2006 Dec.
Article in English | MEDLINE | ID: mdl-17118301

ABSTRACT

The Institute of Medicine identifies quality health care as care that is safe, time, effective, efficient, equitable, and patient centered. In the ICU, where patients who have complex, high-acuity are at increased risk of complications, morbidity, and mortality, promoting quality-focused case is especially important. This article describes several performance-improvement initiatives that were developed and implemented a Midwestern community hospital during a 4-year period. The initiatives to reduce catheter-associated blood stream infections, to identify early sepsis, and to promote evidence-based care.


Subject(s)
Critical Care/organization & administration , Infection Control/organization & administration , Outcome and Process Assessment, Health Care/organization & administration , Quality Assurance, Health Care/organization & administration , Total Quality Management/organization & administration , Benchmarking/organization & administration , Catheterization, Central Venous/adverse effects , Catheterization, Peripheral/adverse effects , Evidence-Based Medicine , Health Services Needs and Demand , Hospitals, Community , Humans , Midwestern United States , Nurse's Role , Nursing Evaluation Research , Nursing Records , Nursing Staff, Hospital/education , Nursing Staff, Hospital/organization & administration , Nursing Staff, Hospital/psychology , Personnel Turnover , Pneumonia, Ventilator-Associated/prevention & control , Practice Guidelines as Topic , Program Development , Program Evaluation , Sepsis/diagnosis , Sepsis/etiology , Sepsis/prevention & control
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