International journal of nursing studies
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Clinicians worldwide are being called upon to reconcile accountability for patient outcomes with the resources they consume. In the case of intensive care, contradictory pressures can arise in decisions about continuing treatment where benefit is diminishing. As concern grows about the cost effectiveness of treatment at end-of-life, nursing expertise and advocacy become significant factors in decision making. ⋯ If nurses are to be effective patient advocates at end-of-life, they will need to develop clear criteria within which nursing assessments of patient status can be framed, the specialized skills to manage the non-medical needs of dying people and the organizational and political skills to negotiate changing clinical practice and workplace relations.
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Increasingly, nurses in Western countries express positive attitudes to complementary and alternative medicine (CAM) but lack knowledge, access to education and organisational policy to guide practice. It is unclear whether nurses in developed Asian countries mirror or differ from this profile. ⋯ Taiwanese nurses need more formal education about CAM and require access to clear policies regarding the safe use of CAM in nursing practice.
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Nurses are able to prescribe independently from a list of nearly 250 prescription only medicines for a range of over 100 medical conditions or, from the whole British National Formulary as a supplementary prescriber. There is some evidence available on the prescribing practices of district nurses and health visitors and early independent extended prescribers. Little or no attention has focussed on supplementary nurse prescribing. ⋯ Independent extended/supplementary nurse prescribers work predominantly in primary care and do prescribe medicines. These nurses are highly qualified and have many years clinical experience. Supplementary prescribing is used by a minority of nurses. Implementing the Clinical Management Plan is a barrier preventing the use of this mode of prescribing. The continuing professional development needs of independent extended/supplementary nurse prescribers are frequently unmet. It will become increasingly important that these needs are met once nurses are able to prescribe the full range of medicines included in the British National Formulary, limited only by their area of competence.
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As demand for nurses and other health professionals continues to outstrip supply it is important to understand what motivates individuals to join a non-medical health profession. ⋯ Findings suggest that although a service orientation remains a key factor in choosing nursing, students also look for a career which matches their interests and attributes, as well as offering professional values and rewards. Nursing may be in danger of losing service orientated recruits to other non-medical health professions.
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To reduce risky adolescent sexual behavior, education programs must be tailored to specific cultures and stage of adolescence. ⋯ The TpB may be an effective theory to guide the development of theory-driven sexual abstinence interventions to reduce risky sexual behavior for Korean males, while the Theory of Reasoned Action may be an effective theory for Korean females.