Clinical nursing research
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Bedside nurses care for patients with pain every day but the task is often challenging. A previous qualitative study that investigated nurses' experiences as they treated patients with pain suggested that nurses may suffer from moral distress if they are unsuccessful in providing adequate pain relief. ⋯ Many participants indicated a need for interprofessional pain management education. Further investigation is needed to clarify the impact of moral distress on nurses managing hospitalized patients' pain.
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Clinical nursing research · Aug 2015
A Balancing Act: Experiences of Nurses and Physicians When Making End-of-Life Decisions in Intensive Care Units.
The purpose of this qualitative, descriptive study was to describe end-of-life decision-making experiences as understood by critical care nurses and physicians in intensive care units (ICUs). A purposive sample of seven nurses and four physicians from a large teaching hospital were interviewed. Grounded theory analysis revealed the core category of "end-of-life decision making as a balancing act." Three interacting subthemes were identified: emotional responsiveness, professional roles and responsibilities, and intentional communication and collaboration. ⋯ When balance was achieved during end-of-life decision making, nurses and physicians described positive end-of-life experiences. The consequence of an imbalance during an end-of-life decision-making experience was moral distress. Practice recommendations include development of support interventions for nurses and physicians involved in end-of-life decision making and further research to test interventions aimed at improving communication and collaboration.
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Clinical nursing research · Feb 2015
Automatic delirium prediction system and nursing-sensitive outcomes in the medical intensive care unit.
In Korea, delirium risk screening has not been routinely implemented in intensive care units (ICUs). The purpose of this study was to implement an Automatic Prediction of Delirium in Intensive Care Units (APREDEL-ICU) system to investigate its impact on nursing-sensitive outcomes and to assess nurse satisfaction with the system. A pre-post research design was used. ⋯ However, the nurses reported that their knowledge regarding delirium care increased after the system was introduced. The proposed system was successfully implemented without increasing the burden of nurses in their assessment of delirium risk. Long-term use of APREDEL-ICU could enhance preventive care and consequently result in positive patient outcomes.
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Clinical nursing research · Dec 2014
Efficiently assessing patient health literacy: the BHLS instrument.
Although health literacy limitations are common among patient populations, no efficient yet comprehensive health literacy assessment tool is available to nurses for use in busy health care settings. This study presents beginning evidence for the validity and reliability of a new health literacy assessment tool, the Brief Health Literacy Screen (BHLS). One hundred patients attending four primary care clinics completed the BHLS and the Test of Functional Health Literacy in Adults (TOFHLA) short form and answered questions about the health literacy tools. ⋯ Comparative discrimination findings were significant at BHLS cut point of 18 and S-TOFHLA cut point less than 23. Patients rated the BHLS significantly less difficult to complete than the S-TOFHLA. Results of preliminary testing indicate the BHLS is a potentially efficient, effective, and patient-friendly screening tool for health literacy.
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Clinical nursing research · Oct 2014
Accuracy of inhaler use in patients with chronic obstructive pulmonary disease.
Inaccurate use of medication inhalers can reduce effectiveness, patient adherence, and disease stability. Therefore, the accurate use of inhalers in patients with chronic obstructive pulmonary disease (COPD) is crucial. This cross-sectional study evaluated 196 Korean patients with COPD for step-by-step accuracy of inhaler use with four different types of inhalers (metered-dose inhaler [MDI], Turbuhaler, Diskus, and HandiHaler); differences in accuracy levels by sociodemographic or clinical characteristics were evaluated. ⋯ The proportion of patients with completely accurate inhaler use was low, ranging from 21.9% (Turbuhaler) to 46.2% (MDI). Errors with all types of inhalers were most commonly seen in the "breathing out" steps, before and after medication inhalation. Personalized nursing educational programs, correcting errors individually for each patient, could dramatically increase the accuracy of inhaler use and the effectiveness of the inhaled medications in patients with COPD.