Improving the quality of communication during handover in a Paediatric Emergency Department: a qualitative pilot study.

INTRODUCTION: There is a dearth of literature that specifically addresses the handover reporting process among healthcare staff working in children's Emergency Department (ED). Widespread gaps in service provision, such as gaps in communication in handover reports to ambulance staff have been noted in the general literature on the topic. There are also improvements observed in handover when a structured mnemonic was encouraged. Structured reports improve communication, safety and may reduce medication errors. Thus, the improvement of handover reporting in children's ED has important implications for children's healthcare practice. However, little is known about communication processes during handover reports in Italian children's ED or its consequences for errors or risks. METHODS: A qualitative description methodology was used. Semi-structured interviews were used to collect data from five children's ED nurses. Thematic content analysis was used to identify common themes. RESULTS: Emergent themes were: interpersonal influences on handover; structural issues; and local contextual factors. CONCLUSIONS: The findings of this pilot study prompted the need for a standardized tool that improves communication during handover. As such, standardizing the communication process during handover could be effectively resolved by using a mnemonic tool adapted for handover in a paediatric emergency department.

Resilience: synthesis of concept analyses and contribution to nursing classifications.

AIM: To synthetize elements of research on concept analyses of resilience; and to propose a definition of resilience to NANDA International (NANDA-I) and International Classification for Nursing Practice (ICNP(®) ). BACKGROUND: Nursing classifications represent nursing knowledge that is clinically relevant and in continuous development. INTRODUCTION: Nursing is considered holistic and there is always the need to consider human responses to health and life processes. Continuously there are new and emerging concepts concerning humans and health that should be considered within the organization and delivery of health care as resilience. METHODS: In March 2015, the authors performed a synthesis of the findings of research concept analysis research derived from a systematic literature search of electronic databases (PsycINFO, CINAHL and PubMed). Search terms used in the title were: 'resilience' AND 'analysis' AND 'concept'. Papers written in Portuguese or English were included. FINDINGS: A total of 27 papers were identified and eight papers were included. Of these, seven papers used Walker & Avant's () model and one used Rodger's () model. Resilience emerged as a fundamental concept across the lifespan that is closely related to health and well-being. DISCUSSION: Resilience is a phenomenon of interest for nurses. Similar attributes, antecedents, consequents and definitions were synthesized into a new proposal of a definition of resilience. While some diagnoses related to resilience are classified in NANDA-I, the concept is not included in ICNP(®) . CONCLUSION AND IMPLICATIONS FOR NURSING AND HEALTH POLICY: The inclusion of the concept into ICNP(®) and the update in NANDA-I is a contribution for nursing knowledge through education and for clinical practice, as this could promote the effectiveness of interventions in several contexts.

The challenge of contemporary nurse education programmes. Perceived stressors of nursing students: mental health and related lifestyle issues.

This study aimed to identify the lifestyle behaviours of nursing students. The research tool was a 146-item questionnaire based upon the College Lifestyle and Attitudinal National survey. Most students considered their mental health as either good or very good. Those in the final year were more likely to rate their mental health poorly. Many experienced programme-related stressors including examinations and assignments and studies in general. More than one-third also reported stressors related to relationships with clinical staff and clinical assessment of competence. There is a concern that the added demands of modern nursing programmes place the student under considerably more pressure, because of competing demands. While many students talk to their peers or family, many do not and prefer rather to go it alone, with some choosing to escape through alcohol or drugs. The support and encouragement of healthy coping mechanisms among nursing students is paramount to ensure a healthy nursing workforce for the future. Nursing students support the mental and physical health of others, and therefore in many ways ought to a role model. Nurturing and supporting their mental health is crucial to the future of profession.

A critical review of appropriate conceptual models for use by coronary care nurses.

BACKGROUND: There is little evidence of the extent of conceptual model use within cardiovascular nursing. Concern exists within nursing that nursing theory and conceptual model use within practice is less than optimal. It is further suggested that there is little evidence of nursing theory occupying its true position as the central tenet of nursing practice and cardiovascular nurses have been challenged to reconsider this aspect of practice. AIM: The aim of this review is to explore the effectiveness of conceptual models used within cardiovascular nursing to further explore their potential benefit. METHODS: Using key terms, a search was conducted using electronic databases CINAHL and PUBMED; yielding seven papers that fulfilled selection criteria. FINDINGS: Few papers related to research studies in the area. However, of those identified significant examination and testing of concepts emerged within the studies. Rather than merely using concepts as an organizing framework or a component of the study, theories alluded to were scrutinized and consistently applied. Although studies identified mostly referred to specific testing and examination of aspects of conceptual models, the notion of self-care and support for clients emerges as a strong theme within the review. The relationship between nurse and client seemed to be pivotal in any noted improvements. CONCLUSIONS: The findings have limited application to practice. In the absence of large-scale longitudinal studies, only selected aspects of conceptual models or theory were scrutinized. Further research is required in this area to identify conceptual models of nursing that are most appropriate for cardiovascular nursing care.

Critical practice in nursing care: analysis, action and reflexivity.

This article examines critical practice and its underlying principles: analysis, action and reflexivity. Critical analysis involves the examination of knowledge that underpins practice. Critical action requires nurses to assess their skills and identify potential gaps in need of professional development. Critical reflexivity is personal analysis that involves challenging personal beliefs and assumptions to improve professional and personal practice. Incorporating these aspects into nursing can benefit nursing practice.

How to conduct an effective literature search.

The ability to describe and analyse published literature on a topic and develop discussion and argument is central to evidence-based patient care. A literature review is an assessment procedure that is commonly applied in nursing settings. Effective literature searching is a crucial stage in the process of writing a literature review, the significance of which is often overlooked. Although many current textbooks refer to the subject, information is often of insufficient depth to guide an effective search. This article outlines important considerations in the search strategy and recommends practical advice for students to ensure best use of their valuable time. It is suggested that a systematic, organised search of the literature, that uses available resources effectively, is more likely to produce quality work.

The use of touch to enhance nursing care of older person in long-term mental health care facilities.

The self-care deficits experienced by older clients in long-term mental health settings, because of cognitive impairment, are likely to impact upon the clients' higher-order needs. The practice of nursing the elderly involves a lot of personal contact, during the delivery of fundamental physical care. While physiological and safety needs are crucial to clients in long-term settings, higher-order needs need also to be addressed. From the clients' perspective nurse's use of touch provides comfort, warmth and security, although there is a dearth of empirical evidence of these benefits. This paper explores the nurse's use of touch, the impact of touch and the experiences of touch on the older person in long-term settings. Because of the dearth of research in the use of touch with elderly clients in long-term care mental health facilities, a review of the literature was performed on the topic. This revealed that touch by nurses is frequently associated with routine tasks within nursing, and is less likely to be a caring touch intervention. Recommendations include further research on the topic and caution with widespread adoption of caring touch as an intervention.

Absenteeism among nursing students - fact or fiction?

This study explores absenteeism patterns and trends among a group of third-year student nurses. A questionnaire was used to elicit information about absence behaviour from 110 students at two hospital sites. Retrospective analysis of attendance records of 70 of these students, covering a period of 123 weeks, was also performed to determine absenteeism trends. The findings of the study reveal that 1567 days were lost because of absenteeism during this period on 1027 episodes. This represents a time lost index, which is the amount of days lost expressed as a percentage of total days available, of 4% among the group. Most absenteeism episodes lasted 3 days or less, with 73% of episodes lasting only 1 day. Absenteeism commencing either on Mondays or Fridays accounted for more than half of the absenteeism episodes in the group. Voluntary absence was a reported feature of this group, which occurred more frequently from lectures than wards. The main reasons cited for absence from both lectures and ward duties were personal and social commitments and stress. Students' views on nursing as a career and responses to factors that may cause stress were examined and revealed an association with reported absence behaviour.