Search results for: nursing administration

Authors: Claire Stafford, Charles Golden, Daniel Amen, Kristen Willeumier

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The aim of this study is to investigate the effect of the administration of the Conners Continuous Performance Test (CPT-3) on cerebral blood flow (CBF) in adults with ADHD. The data for this study was derived from a large SPECT database. Participants in the ADHD group (n=81, Mage=37.97) were similar to those in the healthy control group (n=8503, Mage=41.86). All participants were assessed for cerebral blood flow levels before and after CPT-3 administration. Both age and gender were considered covariates. Multiple 2-by-2 ANCOVAs with repeated measures were conducted with sphericity assumed. The main effects of CPT-3 administration on CBF levels were significant in the left and right side of the frontal and occipital, and right temporal lobe. The main effects of ADHD diagnosis were significant in all brain areas assessed. The interaction between CPT-3 administration and ADHD diagnosis was significant in the left and right side of the limbic system, basal ganglia, the frontal lobe, and occipital lobe. Post hoc tests with a Bonferroni adjustment revealed that CBF levels increased following CPT-3 administration but less so in the ADHD group. Individuals had higher levels of CBF following the administration of CPT-3. Due to a significant interaction, we can infer that ADHD diagnosis changes the effect of CPT-3 administration on CBF levels. This is consistent with our hypothesis considering that CPT-3 is a test of sustained attention, a common challenge for children with ADHD. The aforementioned interaction was not found to be significant in the parietal lobe. This may be due to the nature of CPT- 3 which does not require an integration of sensory information.

Keywords: SPECT, ADHD, conners continuous performance test, cerebral blood flow

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Authors: K. Rowan

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In this paper, the author will discuss how developing a specialized orientation has improved nursing satisfaction and decrease the incidence of incivility among staff. With the predicted shortages in nursing, we must provide an environment that reflects the needs of the current workforce while also focusing on the sustainability of nursing. Each generation has different qualities and methods in which he or she prefers to learn. The Baby Boomer has a desire to share their knowledge. They feel that the quality of undergraduate nursing education has declined. Millennials have grown up with 'helicopter parents' and expect the preceptor to behave in the same manner. This information must be shared with the Baby Boomer, as it is these staff members who are passing the torch of perioperative nursing. Currently, nurse fellows are trained with the Association of periOperative Nurse’s Periop 101 program, with a didactic and clinical observation program. There is no specialized perioperative preceptor program. In creation of a preceptor program, the concept of Novice to Expert, communication techniques, dealing with horizontal violence and generational gap education is reviewed with the preceptor. The fellows are taught communication and de-escalation skills, and generational gaps information. The groups are then brought together for introductions and teamwork exercises. At the program’s core is the knowledge of generational differences. The preceptor training has increased preceptor satisfaction, as well as the new nurse fellows. The creation of a specialized education program has significantly decreased incivility amongst our nurses, all while increasing nursing satisfaction and improving nursing retention. This model of program can translate to all nursing specialties and assist in overcoming the impending shortage.

Keywords: baby boomers, education, generational gap, millennials, nursing, perioperative

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Authors: Wadsana Sarakarn, Pimonpan Charoensri, Baliya Chaiyara

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Objectives: To study the outcomes of the developed nursing model to prevent early postpartum hemorrhage (PPH). Materials and Methods: The analytical study was conducted in Sunpasitthiprasong Hospital during October 1st, 2015, until May 31st, 2017. After review the prevalence, risk factors, and outcomes of postpartum hemorrhage of the parturient who gave birth in Sunpasitthiprasong Hospital, the nursing model was developed under research regulation of Kemmis&McTaggart using 4 steps of operating procedures: 1) analyzing problem situation and gathering 2) creating the plan 3) noticing and performing 4) reflecting the result of the operation. The nursing model consisted of the screening tools for risk factors associated with PPH, the clinical nursing practice guideline (CNPG), and the collecting bag for measuring postpartum blood loss. Primary outcome was early postpartum hemorrhage. Secondary outcomes were postpartum hysterectomy, maternal mortality, personnel’s practice, knowledge, and satisfaction of the nursing model. The data were analyzed by using content analysis for qualitative data and descriptive statistics for quantitative data. Results: Before using the nursing model, the prevalence of early postpartum hemorrhage was under estimated (2.97%). There were 5 cases of postpartum hysterectomy and 2 cases of maternal death due to postpartum hemorrhage. During the study period, there was 22.7% prevalence of postpartum hemorrhage among 220 pregnant women who were vaginally delivered at Sunpasitthiprasong Hospital. No maternal death or postpartum hysterectomy was reported after using the nursing model. Among 16 registered nurses at the delivery room who evaluated using of the nursing model, they reported the high level of practice, knowledge, and satisfaction Conclusion: The nursing model for the prevention of early PPH is effective to decrease early PPH and other serious complications.

Keywords: the development of a nursing model, prevention of postpartum hemorrhage, pregnant women, postpartum hemorrhage

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Authors: Narges Solaymani

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medical training of patients. Nursing is a very important profession in the societies of the world. Although in the past, all caregivers of the sick and disabled were called nurses, nowadays, a nurse is a person who has a university education in this field. There are nurses in bachelor's, master's, and doctoral degrees in nursing. New courses have been launched in the master's degree based on duty-oriented nurses. A nurse cannot have an independent treatment center but is a member of the treatment team in established treatment centers such as hospitals, clinics, or offices. Nurses can establish counseling centers and provide nursing services at home. According to the standards, the number of nurses should be three times the number of doctors or twice the number of hospital beds, or there should be three nurses for every thousand people. Also, international standards show that in the internal and surgical department, every 4 to 6 patients should have a nurse.

Keywords: Nurse, Intensive Care, CPR, Bandage

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Authors: Dina Safrina

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This paper aims to discuss the suitability of tax administration in Indonesia based on Islamic Shari'a by looking at Abu Yusuf's idea of taxation. This research is a qualitative research and using data collection method by library research, that is by studying, deepening and citing theories or concepts from a number of literature. The purpose of this paper is to find out whether taxation in Indonesia is consistent with the thinking of Islamic economists, namely Abu Yusuf's idea which became known by economists as the canons of taxation. The ability to pay, lax time giving for taxpayers and the centralization of decision-making in the tax administration are some of the principles it emphasizes. In taxation he recommends the use of the Muqassamah (Proportional Tax) system rather than the Mixed (Fixed Tax) system. In this case, the determination of tax rates in Indonesia there are using fixed tax system, proportional tax, progressive tax and regressive tax. Abu Yusuf opposed the existence of Qabalah institution (the guarantor of tax payments to the state) at the time and suggested a tax administration centered and paid directly to the state. This is in accordance with those already applied in Indonesia where tax collection is done centrally. The tax system in Indonesia using self assessment system, which is the authority and responsibility given by the government to the taxpayer to calculate, pay and report the tax itself becomes the gap for taxpayers to commit fraud. Prerequisites that must be met for the success of this system is with the tax consciousness, tax honesty, tax mindedness, and tax discipline.

Keywords: Abu Yusuf, Indonesia, tax, tax administration

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Authors: Wong Ka Fai

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Introduction: Many students are worried before an examination; that is a common picture worldwide. Health problems from stress before examination were insomnia, tiredness, isolation, stomach upset, and anxiety. Nursing students experienced high stress from the examination. Guided imagery is a healing process of applying imagination to help the body heal, survive, or live well. It can bring about significant physiological and biochemical changes, which can trigger the recovery process. A study of nursing students improving their anxiety before examination with guided imagery was proposed. Aim: The aim of this study was to explore the outcome of guided imagery on nursing students’ anxiety before examination in Hong Kong. Method: The qualitative study method was used. 16 first-year students studying nursing programme were invited to practice guided imagery to improve their anxiety before the examination period. One week before the examination, the semi-structured interviews with these students were carried out by the researcher. Result: From the content analysis of interview data, these nursing students showed considerable similarities in their anxiety perception. Nursing students’ perceived improved anxiety was evidenced by a reduction of stressful feelings, improved physical health, satisfaction with daily activities, and enhanced skills for solving problems and upcoming situations. Conclusion: This study indicated that guided imagery can be used as an alternative measure to improve students’ anxiety and psychological problems.

Keywords: nursing students, perception, anxiety, guided imagery

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Authors: Tulasi Acharya

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The paper is a qualitative analysis of status of women and women in politics and administration in Nepal Himalaya. The paper reviews data of women in civil service and in administrative levels. Looking at the Nepali politics and administration from the social constructivist perspective, the paper highlights some social and cultural issues that have othered women as “second sex.” As the country is heading towards modernity, gender friendly approaches are being instituted. Although the data reflects on the progress on women’s status and on women’s political and administrative participation, the data is not enough to predict the democratic gender practices in political and administrative levels. The political and administrative culture of Nepal Himalaya should be changed by promoting gender practices and deconstructing gender images in administrative culture through representative bureaucracy and by introducing democratic policies.

Keywords: politics, policy, administration, culture, women, Nepal, democracy

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Authors: Evangelia Kotrotsiou, Mairy Gouva, Theodosios Paralikas, Maria Fiaka, Styliani Kotrotsiou, Maria Malliarou

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The purpose of this research is to investigate the way nurses perceive the care provided in comparison to the way patients perceive it, taking into account existing literature. As far as the sample of research is concerned, it has come from the population of nurses working in the General Hospital of Thessaloniki, St. Paul and the patients of its surgical clinic. In the present study, the sample consists of 100 nurses and 88 patients. The questionnaire used was the Caring Nurse-Patient Interactions Scale: 23-Item Version, created by Cossette et al. (2006). In the case of both patients and nurses, a high score was observed in relational care in the case of the frequency of nursing care in daily practice, as well as the satisfaction of providing nursing care. Overall, patients rated higher clinical care in the case of the frequency of nursing care in daily practice, as well as the satisfaction of the clinical care they were given. On the other hand, nurses rated higher comfort care in the case of the frequency of nursing care in everyday practice, as well as relational care in the area of the importance of nursing care in everyday practice.

Keywords: nursing care, patient needs, patient satisfaction, care giving

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Authors: Pascal Gliesche, Kathrin Seibert, Christian Kowalski, Dominik Domhoff, Max Pfingsthorn, Karin Wolf-Ostermann, Andreas Hein

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Robotic assistance in nursing care is an increasingly important area of research and development. Facing a shortage of labor and an increasing number of people in need of care, the German Nursing Care Innovation Center (Pflegeinnovationszentrum, PIZ) aims to address these challenges from the side of technology. Little is known about nurses experiences with existing robotic assistance systems. Especially nurses perspectives on starting points for the development of robotic solutions, that target recurring burdensome tasks in everyday nursing care, are of interest. This paper presents findings focusing on robotics resulting from an explanatory mixed-methods study on nurses experiences with and their expectations for innovative technologies in nursing care in stationary and ambulant care facilities and hospitals in Germany. Based on the findings, eight scenarios for robotic assistance are identified based on the real needs of practitioners. An initial system addressing a single use-case is described to show perspectives for the use of robots in nursing care.

Keywords: robotics and automation, engineering management, engineering in medicine and biology, medical services, public health-care

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Authors: Esmaeil Sarikhani

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Objectives: Considering the importance of introducing new methods of improving self-compassion and compassion to the others in nursing students, this study intends to evaluate the effect of self-compassion training on nursing students. Methods: This is a field trial study in which 52 nursing interns from Isfahan University of Medical Sciences were selected using convenience sampling method and divided in two experimental and control groups. The sampling was done during two phases: before and after the intervention. The intervention consisted of eight sessions over eight weeks of self-compassion training. The data were collected using the self-compassion standard questionnaire with 26 questions before and after the intervention. Data were then analyzed by the SPSS18 software and independent and paired T-tests, and also Chi-square and Mann-Whitney tests. Results: The results obtained from the independent t-test showed that the mean score of self-compassion and its components in the experimental group was significantly increased compared to the control group (p < 0.001). Comparing the groups, the mean overall score difference of self-compassion and its components had also a statistically significant change after the intervention (p < 0.001). Conclusion: Self-compassion training program, leads to improving nursing students' self-compassion. As it seems, this method can be used as an important training course in order to improve compassion of nursing students to themselves and the others.

Keywords: self-compassion, student, nursing students, field trial

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Authors: Rungnapa Chantra

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As health care rapidly changes, the nursing profession is also evolving to improve quality of care while maintaining competency in their practice. The purpose of this study was to investigate the factors of disaster nurse competencies and investigate the predictable variables in disaster nurse competencies in Suratthani Province, Thailand. The sample consisted of 305 nurses who were recruited by simple random sampling. The development questionnaires from ICN Framework and research contains Pre/Mitigation, Preparedness, Response and Recovery/Rehabilitation Competencies (α=0.87). The data were analyzed using Principle Components Extraction and Orthogonal Rotation with Varimax Method. The findings were as follows; four significant factors of disaster nurse competencies in Suratthani Province, Thailand were identified. These factors were described by 62 variables that accounted for 50.01% of the total variance. The results of this study could be for agencies that are responsible for the development of nursing competencies and should be aware of the development of knowledge and skills in disaster management.

Keywords: disaster nursing competency of nurses, nursing informatics, health science, medical

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Authors: Elucir Gir, Laelson Rochelle Milanês Sousa, Renata Karina Reis, Soraia Assad Nasbine Rabeh, Mayra Gonçalves Menegueti, Ana Cristina de Oliveira e Silva, Sheila Araújo Teles

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Context and significance: Nursing team professionals faced challenges in combating the COVID-19 pandemic around the world. They were subjected to exhausting workloads and prolonged use of Personal Protective Equipment. Using N95 masks for long periods of time can cause skin changes. In this context, health professionals who worked on the front lines of fighting the pandemic were more exposed to possible physical and psychological changes. Objective: The aim of the study was to analyze the factors associated with skin lesions resulting from the use of N95 masks among nursing team professionals. Method: The study was carried out in all regions of Brazil from October to December 2020, with professionals from the nursing team who worked in health care during the COVID-19 pandemic. Participants were recruited via social media, and information was collected electronically and stored on the Survey Monkey platform. Descriptive statistics were used to characterize the sample, association tests (Chi-square), with a statistical significance level of p < 0.05. Factors associated with skin lesions resulting from the use of an N95 mask were determined by Binary Logistic Regression, with a significance level of 5% (α = 0.05). Results: 8,405 nursing professionals participated in the study, 5,492 nurses (65.3%), 2,747 nursing technicians (32.7%), and 7,084 females (84.3%). Female nursing team professionals were 1.4 times more likely to develop skin lesions due to the use of N95 masks when compared to males (OR 1.4 [CI95% 1.22 – 1.59] p < 0.001). The following protective factors were identified: nursing technician (ORA 0.608 [CI95% 0.43 – 0.86] p = 0.005) and not having provided assistance in field hospitals for COVID-19 (0.73 [CI95% 0.65-0.81] p<0.000). Conclusion: It was concluded that female nursing team professionals were more likely to have skin changes related to the use of N95 masks. The need for intervention studies is emphasized in order to explore measures to prevent these types of injuries. Descritores: Nursing professionals; COVID-19; SARS-CoV-2; Brazil.

Keywords: nursing professionals, COVID-19, SARS-CoV-2, Brazil

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Authors: Jean Ross

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Rural nursing is not an identified professional identity in the UK, unlike the USA, Canada, and Australia which recognizes rural nursing as a specialty scope of practice. In New Zealand rural nursing is an underrepresented aspect of nursing practice, is misunderstood and does not fit easily within the wider nursing profession and policies governing practice. This study situated within the New Zealand context adds to the international studies’ aligned with rural nursing practice. The study addresses a gap in the literature by striving to identify and strengthen the awareness of and increase rural nurses’ understanding and articulation of their changing and adapting identity and furthermore an opportunity to appreciate their contribution to the delivery of rural health care. In addition, this study adds to the growing global rural nursing knowledge and theoretical base. This research is a continuation of the author’s academic involvement and ongoing relationships with the rural nursing sector, national policy analysts and health care planners since the 1990s. These relationships have led to awareness, that despite rural nurses’ efforts to explain the particular nuances which make up their practice, there has been little recognition by profession to establish rural nursing as a specialty. The research explored why nurses’ who practiced in the rural Otago region of New Zealand, between the 1990s and early 2000s moved away from the traditional identity as a district, practice or public health nurse and looked towards a more appropriate identity which reflected their emerging practice. This qualitative research situated within the interpretive paradigm embeds this retrospective study within the discipline of nursing and engages with the concepts of place and governmentality. National key informant and Otago regional rural nurse interviews generated data and were analyzed using thematic analysis. Stemming from the analyses, an analytical diagrammatic matrix was developed demonstrating rural nursing as a ‘place–based practice’ governed both from within and beyond location presenting how the nurse aligns the self in the rural community as a meaningful provider of health care. Promoting this matrix may encourage a focal discussion point within the international spectrum of nursing and likewise between rural and non-rural nurses which it is hoped will generate further debate in relation to the different nuances aligned with rural nursing practice. Further, insights from this paper may capture key aspects and issues related to identity formation in respect to rural nurses, from the UK, New Zealand, Canada, USA, and Australia.

Keywords: matrix, place, nursing, rural

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Authors: Hyunsik Park

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Objective: To provide information of charged nursing care facility for helping to establish geriatric health care policy, and to figure out which factors would be the main determinants for the choice of it. Method: 46 males and 53 females, and the same number of their caregivers admitted into the charged nursing care facility were recruited for intensive interview including personal information, disease information, and economic, familial, marital and emotional statuses. This is a cross-sectional study and we analyzed the data qualitatively. Results: Patients had 3.2 diseases and a hospitalization for 2.3 years on average. They were consists of 46 singles (46.9%), 8 unmarried (8.2%), 5 divorced (5.1%) and 32 married (32.7%). More than two third (70.1%) were supported by their eldest son or daughter. Mostly, the family caregivers decided to admit into the facilities by the doctor’s recommendation (68.4%). When they made a choice for a facility, most of them (42.9%) considered environmental and sanitary conditions. According to their expectation for management in nursing care facility, most caregivers (59.2%) wanted simple-staying for the duration, but most patients (61.3%) expected to be home after taking comprehensive rehabilitation. Three-quarter of the caregivers would agree to use nursing care facilities in the future, if they would be the same situation. Conclusion: Life style and environment are rapidly changing. In the near future, we need lots of the charged nursing care facilities for the old, thus this study can be the good reference for the preparing upcoming aged and super-aged society.

Keywords: nursing care facility, aged society, qualitative analysis, health

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Authors: Hsin-Yi Huang

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This study mainly discussed the disease-induced and surgery-induced physical, psychological, and spiritual issues faced by a patient who suffered from emphysema and respiratory failure and had underwent a right-lung transplantation surgery. Nursing care was provided from May 21 to May 29. Based on the observations, interviews, physical examinations, and evaluations that were carried out using Roy’s adaptation model, the following nursing issues were identified: risk of infection, lack of knowledge, and anxiety. Active care was provided and a good nursing relationship with the patient and the patient’s family was established. The four strategies of Bandura’s self-efficacy theory (self-transcendence, vicarious experience, verbal persuasion, and biofeedback) were employed. Instructions for the appropriate rehabilitation exercises were given, immunosuppressant concentration was monitored, and special measures were taken to prevent infection. The patient was encouraged to express feelings and was provided with sufficient information to alleviate anxiety. With assistance from nursing personnel and the medical team, the patient was successfully discharged from the hospital and thereafter embarked on the path of postoperative recovery. The patient learned about the importance of home self-care and regular follow-up outpatient visits, and patient management was implemented for discharge preparation services. This nursing case study may serve as a reference to nurses managing similar cases in future.

Keywords: anxiety, lung transplantation, Roy's adaptation model, self-efficacy theory

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Authors: Maria Rodriguez-Gazquez, Sara Chaparro-Hernandez, Jose Rafael Gonzalez-Lopez

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Introduction: Nurses are models in healthy behaviors for their patients. This is why it is important for these professionals to not only have a good knowledge of healthy behaviors but also practice. Today’s nursing students will be tomorrow’s professionals and to fulfill their role in caring they not only need knowledge, they also must maintain behaviors which enable them to improve and protect both the health of others and their own. This is why the university is a unique environment of opportunities to foster the maximum potential of health. To care for others we first have to take care of ourselves. It is important for these behaviors in Nursing students to be evaluated during the years of their university education in order to design timely interventions which improve the health behaviors of the future professionals. Aim: The objective of this study was to evaluate the lifestyles of first year nursing students of two Universities. Methodology: Cross-sectional study. In 2014, 140 first year Nursing students of two Universities Seville –US- (Spain -Europe, n=37) and Antioquia –UA- (Colombia -South America, n=93) self-reported the FANTASTIC Lifestyle checklist. Results: Findings reveal that (I) UA students doubled the percentage of dangerous or bad lifestyles with respect to the US students, (II) the lifestyles are not appropriate in 1 of 3 of nursing students in both Universities, (II) there are statistically significant differences for family support items (higher in US), positive thinkers (higher in UA), the use of safety belts and alcohol consumption before driving (higher in US). Discussion: The nursing students are mostly young people who are at a stage in which some of the most important behaviors for adult life can still be molded. It is necessary to develop educational interventions in their Nursing curricula to strengthen healthy behaviours during training. Nursing Schools not only have the duty to train professionals, but to also be agents that foster the health, welfare and quality of those who study and work there. It must encourage knowledge and skills oriented to healthy lifestyles.

Keywords: cross-sectional studies, life style, nursing students, questionnaires

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Authors: Rabeab Khunpukdee, Aranya Sukchoui, Nonluk Somgit, Chitima Bunnaul

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Endotracheal displacement is a major risk of life threatening among critically ill patients. Standard nursing protocol is needed to minimize this risk and to improve clinical outcomes. To evaluate the effectiveness of the endothacheal care nursing guideline. The incidence rates of endochacheal displacement, oxygen deficiency after extubation, re-intubation, and nurse’s satisfaction on the utilization of the endotracheal care nursing guideline. An evidence-based nursing practice framework was used to develop the endotracheal care nursing guideline. The guideline valid content was review by a 3 panel of experts. The index of item objective (IOC) of the guideline was 0.93. The guideline was implemented in 130 patients (guideline group) and 19 registered nurses at a medicine ward, Had Yai hospital, Thailand. Patient’s outcomes were evaluated by comparison with those 155 patients who received the routine nursing care (routine care group). Descriptive statistics, frequency, percentage, mean, standard deviation and Mann Whitney U-test was analyzed using the computer program. All significantly and better outcomes were found in the guideline group compared to the routine care group. The guideline group has less incidence rates of endotracheal displacement (1.54 % vs 9.03 %, p < 0.05), and none of the guideline group had oxygen deficiency after extubation (0 % vs 83.33%) compared to the routine care group. All of the 2 patients in the guideline group, compared to 6 of 14 patients in the routine care group were re-intubation. The overall rate of re-intubation in the total group (n = 130 vs 155) was seen less in the guideline group than the routine care group (1.54 % vs 3.87). Overall, nurses satisfaction was at high-level (89.50%) on the utilization of the guideline.

Keywords: endotracheal care, nursing guideline, re-intubation, satisfaction

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Authors: Kamolrat Turner, Boontuan Wattanakul

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Critical thinking and creativity are prerequisite skills for working professionals in the 21^st century. A survey conducted in 2014 at the Boromarajonani College of Nursing, Chon Buri, Thailand, revealed that these skills within students across all academic years was at a low to moderate level. An action research study was conducted to develop the EREC IF Model, a framework which includes the concepts of experience, reflection, engagement, culture and language, ICT, and flexibility and fun, to guide pedagogic activities for 75 sophomores of the undergraduate nursing science program at the college. The model was applied to all professional nursing courses. Prior to implementation, workshops were held to prepare lecturers and students. Both lecturers and students initially expressed their discomfort and pointed to the difficulties with the model. However, later they felt more comfortable, and by the end of the project they expressed their understanding and appreciation of the model. A survey conducted four and eight months after implementation found that the critical thinking and creativity skills of the sophomores were significantly higher than those recorded in the pretest. It could be concluded that the EREC IF model is efficient for fostering critical thinking and creativity skills in the undergraduate nursing science program. This model should be used for other levels of students.

Keywords: critical thinking, creativity, undergraduate nursing students, EREC IF model

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Authors: Hacer Erdöl, Merve Aydın, Hacer Kobya Bulut, Kıymet Yeşilçiçek Çalık

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Like all occupations, nursing is significantly influenced by the society which it serves and it also affects it. Social structure affects attitudes of nurses, nursing practice, society's attitudes towards nursing and those who have chosen nursing as a profession. People who choose nursing schools take the views of the society’s they live in on nursing to nursing school. Until the 1960s, many nursing schools had not accepted men as students and women had received nursing education and profession had been carried out by women. In our country, in 2007 an amendment to article eight of Nursing Law was passed and with these changes men also began to be able to choose the nursing as a profession. In Turkish, nurse means 'sister'. Hence, in this study to determine the problems that male nursing students likely encounter at the clinic, non-clinical environment and in their private life regarding the title of nurse, among qualitative research methods phenomenological research design was used. Using purpose sampling method, a total of 18 voluntary male students-13 in third grade and 5 in fourth grade at nursing school- were taken to the study. Data were collected through interviews and by the ethical principles much attention was paid to ensure the confidentiality and to protect participants’ identity. During the interviews lasting 30-40 minutes on average, nine pre-configured standard questions were asked and when necessary free questions were also used in order to ensure the clarity of the responses. With pre- configured standard questions, the reasons why students chose the profession, the problems they had in clinical and non-clinical environment and the potential problems they might encounter in their private lives regarding the title of nurse were questioned. Content analysis was performed on data collected and three main themes were obtained. According to the findings of the evaluation of data, it was found that almost all the students preferred the profession due to possible work opportunities, there were students who did not bother nurse title as well as the ones who did bother and as the most important problem they might encounter in their private lives was to feel worried if their kids had to answer "What does your father" question as "my dad is a nurse" and being ridiculed afterwards. The results of this study show that studies should be done to change the social judgment stemmed from the recognition of nursing as a female profession and take advantage of media through creating public spotlight to accomplish this.

Keywords: choice of profession, the title of the profession, title problems, nursing

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Authors: Dercan Gencbas, Hatice Bebis, Sue Moorhead

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In the nursing process, many of the nursing classification systems were created to be used in international. From these, NANDA-I, Nursing Outcomes Classification (NOC) and Nursing Interventions Classification (NIC). In this direction, the main objective of this study is to establish a model for caregivers in hospitals and communities in Turkey and to ensure that nursing outputs are assessed by NOC-based measures. There are many scales to measure Urinary Incontinence (UI), which is very common in children, in old age, vaginal birth, NOC scales are ideal for use in the nursing process for comprehensive and holistic assessment, with surveys available. For this reason, the purpose of this study is to evaluate the validity of the NOC outputs and indicators used for UI NANDA-I. This research is a methodological study. In addition to the validity of scale indicators in the study, how much they will contribute to recovery after the nursing intervention was assessed by experts. Scope validations have been applied and calculated according to Fehring 1987 work model. According to this, nursing inclusion criteria and scores were determined. For example, if experts have at least four years of clinical experience, their score was 4 points or have at least one year of the nursing classification system, their score was 1 point. The experts were a publication experience about nursing classification, their score was 1 point, or have a doctoral degree in nursing, their score was 2 points. If the expert has a master degree, their score was 1 point. Total of 55 experts rated Fehring as a “senior degree” with a score of 90 according to the expert scoring. The nursing interventions to be applied were asked to what extent these indicators would contribute to recovery. For coverage validity tailored to Fehring's model, each NOC and NOC indicator from specialists was asked to score between 1-5. Score for the significance of indicators was from 1=no precaution to 5=very important. After the expert opinion, these weighted scores obtained for each NOC and NOC indicator were classified as 0.8 critical, 0.8 > 0.5 complements, > 0.5 are excluded. In the NANDA-I / NOC / NIC system (guideline), 5 NOCs proposed for nursing diagnoses for UI were proposed. These outputs are; Urinary Continence, Urinary Elimination, Tissue Integrity, Self CareToileting, Medication Response. After the scales are translated into Turkish, the weighted average of the scores obtained from specialists for the coverage of all 5 NOCs and the contribution of nursing initiatives exceeded 0.8. After the opinions of the experts, 79 of the 82 indicators were calculated as critical, 3 of the indicators were calculated as supplemental. Because of 0.5 > was not obtained, no substance was removed. All NOC outputs were identified as valid and usable scales in Turkey. In this study, five NOC outcomes were verified for the evaluation of the output of individuals who have received nursing knowledge of UI and variant types. Nurses in Turkey can benefit from the outputs of the NOC scale to perform the care of the elderly incontinence.

Keywords: nursing outcomes, content validity, nursing diagnosis, urinary incontinence

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Authors: Katerine Moraes dos Satons, Gisele Massante Peixoto Tracera, Regina Célia Gollner Zeitoune

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To analyze the psychosocial risks related to the organization of nursing work in outpatient clinics of university hospitals. Cross-sectional epidemiological study developed in 11 outpatient units linked to the three public universities of the city of Rio de Janeiro, Brazil. Participants were 388 nursing professionals who worked in patient care at the time of the research. Data were collected from July to December 2018, using a self-applicable instrument. A questionnaire was used for sociodemographic, occupational and health characterization, and the Work Organization Scale. The bivariate analyses were performed using the odds ratio (OR), with a confidence interval of 95%, significance level of 5%. The organization of nursing work received an assessment of medium psychosocial risk by the professionals participating in the research, demanding interventions in the short and medium term. There was no association between sociodemographic, occupational and health characteristics and the organization of outpatient work. Interventional measures should be performed in the psychosocial risk factors presented in this research, with a view to improving the work environment, so that the importance of maintaining satisfactory material conditions is considered, as well as the adequate quantity of human resources. In addition, it aims to expand the spaces of nursing participation in decision- making, strengthening its autonomy as a profession.

Keywords: occupational risks, nursing, nursing team, worker’s health, psychosocial risks

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Authors: Şenay Pehli̇van, Gülümser Kublay

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Female inmates placed in a Correctional Institution (CI) have more physical health problems than other women and their male counterparts. Thus, they require more health care services in the CI and nursing services in particular. CI nurses also have the opportunity to teach behaviors which will protect and improve their health to these women who are difficult to reach in the community. The aim of this study was to evaluate effect of nursing services provided in a CI on the physical health levels and health behaviors of female inmates. The study has a quasi-experimental design. The study was done in Female Closed CI in Ankara, Turkey. The study was conducted on 30 female inmates. Before the implementation of nursing interventions in the initial phase of the study, female inmates were evaluated in terms of physical health problems and health behavior using forms, a physical examination, medical history, health files (file containing medical information related to prisons) and the Omaha System (OS). Findings obtained from evaluations were grouped and symptoms-findings were expressed with OS diagnosis codes. Knowledge, behavior and status scores of prisoners in relation to health problems were determined. After the implementation of the nursing interventions, female inmates were evaluated in terms of physical health problems and health behavior using OS. The research data were collected using the Female Evaluation Form developed by the researcher and the OS. It was found that knowledge, behavior and status scores of prisoners significantly increased after the implementation of nursing interventions (p < 0.05).

Keywords: prison nursing, health promotion and protecting, nursi̇ng servi̇ces, omaha system

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Authors: J. Magerman, P. Martin

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Nursing students' clinical abilities is highly dependent on the quality of the clinical experience obtained while placed in the clinical environment. The clinical environment has amongst other, key role players which include the clinical supervisor. The primary role of the clinical supervisor is to guide nursing students to become the best practice nursing professionals. However, globally literature alludes to the failure of educating institutions to deliver competent nursing professionals to meet the needs of patients and deliver quality patient care. At the participating university, this may be due to various factors such as large student numbers and social and environmental challenges experienced by clinical supervisors. The aim of this study was to explore and describe the lived experiences of clinical supervisors who supervise nursing students at a higher education institution. The study employed a qualitative research approach utilizing a descriptive phenomenological design. Purposive sampling was used to select participants, who supervised first and second year nursing studnets at the higher education institution under study. TH esample comprised of eight clinical supervisors who supervise first and secon year nursing studnets at teh institution under study. Data was collected by means of in-depht interviews. Data was analysed using Collaizzi's seven steps method of qualitative analysis. Five major themes identified , focussed on the experiences regarding time a sa constraint to job productivity, the impact of teh organisational culture on the fluidity of support, interpersonal relationships a sa dynamic communication process, impact on the self, and limited resources. Trustworthiness of the data was ensured by means of applying Guba's model of truth value, applicability, consistency and neutrality. Reflexivity was also used by the researcher to further enhance trustworthiness.

Keywords: clinical supervision, clinical supervisors, nursing students, clinical placements

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Authors: Kamolrat Turner, Chularat Howharn

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Critical thinking and creativity are desirable competency for contemporary nurses although there are growing concerns supporting a disturbing paucity in its achievement. Nursing colleges in Thailand have developed teaching strategies and curricula that nurture critical thinking and creativity dispositions according academic levels. Objectives: This descriptive study identified critical thinking and creativity dispositions of Thai nursing students according academic levels. Methods: A cross-sectional questionnaire survey was conducted among 515 nursing students for four academic levels. All are studying at Boromarajonani College of Nursing Chon Buri, Thailand. Descriptive and univariate general linear model analysis were applied. Results: The scores on critical thinking disposition gradually increased as academic level is rising from the junior year throughout the senior year, but its scores are neutral. Scores on creativity skill is neutral and constant thorough the four academic years. The fourth grade students had slightly higher scores on creativity when compared to others. A significant relationship between critical thinking and creativity was also found. Conclusions: The scores on critical thinking disposition gradually improved which greatly increased in the senior year. However, creativity has neutrally progressed. The findings suggest the importance of targeting the development of curriculum and teaching strategies for all grades of nursing students to increase their critical thinking and creativity skills.

Keywords: critical thinking, creativity, undergraduate nursing students, competency

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Authors: U.-B. Schaer, M. Wehr, R. Hodler

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Background: Most nursing students require more training time for necessary nursing skills than defined by nursing schools curriculum to acquire basic nursing skills. Given skills training lessons are too brief to enable effective student learning, meaning in-depth skills practice and repetition various learning steps. This increases stress levels and the pressure to succeed for a nursing student with slower learning capabilities. Another possible consequence is that nursing students are less prepared in the required skills for future clinical practice. Intervention: The Bern College of Higher Education of Nursing, Switzerland, started the independent peer practice learning program in 2012. A concept was developed which defines specific aims and content as well as student’s rights and obligations. Students enlist beforehand and order the required materials. They organize themselves and train in small groups in allocated training location in the area of Learning Training and Transfer (LTT). During the peer practice, skills and knowledge can be repeatedly trained and reflected in the peer groups without the presence of a tutor. All invasive skills are practiced only on teaching dummies. This allows students to use all their potential. The students may access learning materials as literature and their own student notes. This allows nursing students to practice their skills and to deepen their knowledge on corresponding with their own learning rate. Results: Peer group discussions during the independent peer practice learning support the students in gaining certainty and confidence in their knowledge and skills. This may improve patient safety in future daily care practice. Descriptive statics show that the number of students who take advantage of the independent peer practice learning increased continuously (2012-2018). It has to be mentioned that in 2012, solely students of the first semester attended the independent peer practice learning program, while in 2018 over one-third of the participating students were in their fifth semester and final study year. It is clearly visible that the demand for independent peer practice learning is increasing. This has to be considered in the development of future teaching curricula.

Keywords: learning program, nursing students, peer learning, skill training

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Authors: Monica Ginn

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Providing recovery-oriented practice in forensic settings is often a contentious issue. This paper focuses on recovery with how it is influenced by the forensic population and how it is impacted by forensic nurses’ attitudes and practices. Understanding the culture of forensic nursing and how forensic nurses experience and perceive recovery for forensic patients provided insights into how forensic nurses use recovery-oriented practices to enhance nursing care in secure settings and facilitate successful reintegration back into community care and society. Interviews were completed with nurses who work with the Not Criminally Responsible patient population in an inpatient setting to discuss and explore how they use recovery-oriented practice in their practice in spite of their role in assessing and managing risk.

Keywords: forensic nursing culture, not criminally responsible, offender recovery, recovery-oriented practice, secure recovery

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Authors: Mette Kjerholt, Thora Grothe Thomsen, Connie Bøttcher Berthelsen, Bibi Hølge Hazelton

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Academic nursing is a relatively new phenomenon in Denmark. Leadership and management training in nursing does not prepare Danish nurse leaders to become leaders for nurses with academic background, and some leaders may feel estranged with including this kind of nursing staff in clinical settings. Currently there is a debate regarding what academic nurses can contribute with in clinical practice, and some managers express concern regarding whether this will lead to less focus on clinical practice and more focus on theoretical issues that may not seem so relevant in a busy everyday clinical setting. The paper will present the experiences of integrating three advanced nurse practitioners with Ph.D. degrees (ANP) in three different clinical departments at a regional hospital in Denmark with no prior experiences with such profiles among its staff.

Keywords: leadership, advanced nurse practitioners, clinical practice, academic nursing

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Authors: Mansoureh Karimollahi, Mehriar Adrmohammadi, Mohsen Mohammadi

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Introduction: Patient satisfaction with nursing care is considered as an important indicator of the quality and effectiveness of the health care system, and improving the quality of care is not possible without paying attention to the opinions and expectations of patients. Considering that the scales for assessing satisfaction with nursing care in our country are not comprehensive and measure very few areas, therefore, in this study, psychometrically, the Persian version of the Newcastle Nursing Care Satisfaction Scale was used in patients hospitalized in the wards. Internal medicine and general surgery were discussed. Methods: This cross-sectional study was conducted on 200 patients admitted to the surgery and internal departments of hospitals affiliated to Ardabil University of Medical Sciences. The Newcastle nursing care satisfaction scale was used for the first time in Iran in comparison with the good nursing care scale from the patients' point of view to evaluate the criterion validity. The Newcastle nursing care satisfaction scale was used after translation, validity, and reliability. Results: The level of satisfaction of patients and the experience of patients with nursing care was at a favorable level, respectively, with an average of 111.8 ± 14.2 and 69.07 ± 14.8. Total CVI was estimated at 0.96 for the experience section, 0.95 for the satisfaction section, and 0.96 for the whole scale. The index (CVR) was also 0.95 for the experience section, 0.95 for the satisfaction section, and 0.95 for the whole scale. Criterion validity was also estimated using 0.725 correlation. The validity of the construct was also confirmed using the goodness of fit index (X2=1932/05, p=0.013, KMO=0.913). Convergent validity was estimated at 0.99 in the experience subscale and 0.98 in the satisfaction subscale. . The overall reliability in the experience subscale and satisfaction subscale was 94%, 92%, and 98%, respectively, which indicated the acceptable reliability of the questionnaire. Conclusion: The Persian version of the Newcastle nursing care satisfaction scale as a comprehensive tool that can be easily completed by patients and is easy to interpret, has good validity and reliability and can be used in patient care centers, in departments Surgery, and internal medicine are recommended.

Keywords: psychometrics, Newcastle nursing care satisfaction scale, nursing care satisfaction, general surgery department

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Authors: Ahmed Bux Jamali

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The purpose of this study is to examine and evaluate the overall counterterrorism cooperation during Obama Administration towards Pakistan. It aims and focuses on the performances and measures taken by United States of America during President Obama in office in order to eradicate terrorism from Pakistan. Being a grave national security threat, terrorism played a disastrous role in the domestic peace and stability of both countries. For the sake of curbing this menace in South Asia in general and Pakistan in particular, the role of Obama Administration is viable and results-oriented despite major ups and downs in Pakistan U.S Relations during that period of time. Obama administration formulated policies when he comes to office in 2009 by looking at the already efforts done by Bush Administration to counterterrorism from Pakistan. Obama’s foreign policy was revolving around defense and diplomacy when it comes to dealing with Pakistan. The concept of smart power was indeed a core principle of Obama’s administration to gain the strategic objectives in Pakistan. Obama’s strategies in terms of providing military aid packages and various assistance programs, working on institutional building and strengthening the economy helped Pakistan in strengthening the military capabilities to go for militant operation in the safe havens area in the tribal areas of Pakistan. It further helped building institutional mechanism in the governmental policies to counter terrorism and militancy. The training of combat forces, artillery, and equipment provided by US proved fatal for the militant terrorist organizations seeking hideouts in the tribal areas of Pakistan. Resultantly, many top leaders of al Qaeda and many affiliated militant groups were captured and given to US as well. Despite many ups and downs in the bilateral relations on various domestic and international issues, both countries didn’t compromise the elimination of terrorist phenomena from Pakistan which was indeed a great success of the Obama administration’s counterterrorism and counterinsurgency strategies in the long run.

Keywords: counterterrorism cooperation, national security strategy, Obama administration, Pakistan-US relations

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Authors: Fatma Refaat Ahmed, PhD, RN. Assistant Professor, Department of Nursing, College of Health Sciences, University of Sharjah, UAE. ([email protected]). Sally Mohamed Farghaly, Nursing Administration Department, Faculty of Nursing, Alexandria University, Alexandria, Egypt. ([email protected])

Abstract:

Context: Intensive care unit (ICU) nurses often face pressure and constraints in their work, leading to the rationing of care when demands exceed available time and resources. Observations suggest that ICU nurses are frequently distracted from their core nursing roles by non-core tasks. This study aims to provide evidence on ICU nurses' multitasking activities and explore the association between nurses' personal and clinical characteristics and their time allocation. Research Aim: The aim of this study is to quantify the time spent by ICU nurses on multitasking activities and investigate the relationship between their personal and clinical characteristics and time allocation. Methodology: A self-observation form utilizing the "Diary" recording method was used to record the number of tasks performed by ICU nurses and the time allocated to each task category. Nurses also reported on the distractions encountered during their nursing activities. A convenience sample of 60 ICU nurses participated in the study, with each nurse observed for one nursing shift (6 hours), amounting to a total of 360 hours. The study was conducted in two ICUs within a university teaching hospital in Alexandria, Egypt. Findings: The results showed that ICU nurses completed 2,730 direct patient-related tasks and 1,037 indirect tasks during the 360-hour observation period. Nurses spent an average of 33.65 minutes on ventilator care-related tasks, 14.88 minutes on tube care-related tasks, and 10.77 minutes on inpatient care-related tasks. Additionally, nurses spent an average of 17.70 minutes on indirect care tasks per hour. The study identified correlations between nursing time and nurses' personal and clinical characteristics. Theoretical Importance: This study contributes to the existing research on ICU nurses' multitasking activities and their relationship with personal and clinical characteristics. The findings shed light on the significant time spent by ICU nurses on direct care for mechanically ventilated patients and the distractions that require attention from ICU managers. Data Collection: Data were collected using self-observation forms completed by participating ICU nurses. The forms recorded the number of tasks performed, the time allocated to each task category, and any distractions encountered during nursing activities. Analysis Procedures: The collected data were analyzed to quantify the time spent on different tasks by ICU nurses. Correlations were also examined between nursing time and nurses' personal and clinical characteristics. Question Addressed: This study addressed the question of how ICU nurses allocate their time across multitasking activities and whether there is an association between nurses' personal and clinical characteristics and time allocation. Conclusion: The findings of this study emphasize the need for a lean evaluation of ICU nurses' activities to identify and address potential gaps in patient care and distractions. Implementing lean techniques can improve efficiency, safety, clinical outcomes, and satisfaction for both patients and nurses, ultimately enhancing the quality of care and organizational performance in the ICU setting.

Keywords: motion study, ICU nurse, lean, nursing time, multitasking activities

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