International journal of nursing studies
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Dementia is a global issue, with increasing prevalence rates impacting on health services internationally. People with dementia are frequently admitted to hospital, an environment that may not be suited to their needs. While many initiatives have been developed to improve their care in the acute setting, there is a lack of cohesive understanding of how staff experience and perceive the care they give to people with dementia in the acute setting. ⋯ This review has identified key issues in the care of people with dementia in the acute setting: improving pathways of care, creating suitable environments, addressing resources and staffing levels and placing emphasis on the education for staff caring for people with dementia. Recommendations are made for practice consideration, policy development and future research. Leadership is required to instil the values needed to care for this client group in an effective and personcentred way. Qualitative evidence synthesis can inform policy and in this case, recommends VIPS as a suitable framework for guiding decisions around care for people with dementia in acute settings.
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Improper placement of nasogastric tube used for feeding may lead to serious complications, including death of the patient. There are several different methods used to determine the appropriate length of nasogastric tube for optimal placement in adults. This integrative review of the literature was designed to identify the most accurate method to determine the internal length of nasogastric feeding tube in adults. ⋯ The nose-to-ear-to-xiphisternum and Hanson method should no longer be taught in nursing programs or used in practice by the nurse. The [gender-weight and nose-umbilicus-flat] method has been shown to be safer.
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All newborns are at risk of deterioration as a result of failing to make the transition to extra uterine life. Signs of deterioration can be subtle and easily missed. It has been postulated that the use of an Early Warning Tool may assist clinicians in recognising and responding to signs of deterioration earlier in neonates, thereby preventing a serious adverse event. ⋯ The Standard Observation Tool triggered an escalation of care more frequently than the Early Warning Tools, which may be as a result of behavioural data captured on the Standard Observation Tool and escalated, which could not be on the Early Warning Tools. Findings demonstrate that a single tool applied to all gestational age ranges may not be effective in identifying early deterioration or may over trigger an escalation of care. Further research is required into the sensitivity and specificity of Early Warning Tools in neonatal sub-populations.
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The meaning of dignity in health care has been primarily explored using interviews and surveys with various patient groups, as well as with health care practitioners. Philosophical analysis of dignity is largely avoided, as the existing philosophical literature is complex, multifaceted and of unclear relevance to health care settings. The aim of this paper is to develop a straightforward philosophical concept of dignity which is then applied to existing qualitative research. ⋯ Accordingly, health care practitioners respect a patient's dignity when they refrain from transgressing the patient's standards and values, or refrain from forcing the patient to transgress his or her standards and values. This concept is shown to explain and illuminate most of the key qualitative findings. It therefore provides a more coherent and synthesised concept of dignity in health care.
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Experienced pediatric nurses caring for increasingly sick and vulnerable children on medical and surgical units may be at particular risk for work-related stress. In view of their positive impact on quality of care, and the fact that they are particularly difficult to retain, it is imperative to understand the work-related stressors these nurses encounter in order to develop effective organizational interventions to minimize stressors and promote retention. ⋯ Experienced pediatric nurses felt powerless to provide quality care to an increasingly acute and vulnerable population. Dealing with multiple and diverse responsibilities, and limited resources and support, were important stressors. Nurse Managers and educators could mitigate stressors and improve retention of experienced pediatric nurses by offering targeted continuing education to those newly responsible for additional roles, and building supportive working environments that encourage collaboration and empower experienced nurses.