International journal of nursing studies
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Multicenter Study
Medication communication between nurses and patients during nursing handovers on medical wards: a critical ethnographic study.
Communication is central to safe medication management. Handover is a routine communication forum where nurses provide details about how patients' medications are managed. Previous studies have investigated handover processes as general communication forums without specific focus on medication information exchange. The effects of social, environmental and organisational contexts on handover communication and medication safety have not been explored. ⋯ Nurse coordinators need to relinquish organisational control of the handover practice and appreciate the contribution of bedside nurses to patient information exchange. Bedside nurses need to be provided with opportunities to raise questions during the group handover. Designated meeting spaces need to be provided to reduce interruptions to the group handover process.
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Multicenter Study Comparative Study
Quality of life of residents with dementia in traditional versus small-scale long-term care settings: a quasi-experimental study.
The number of people living with dementia worldwide is increasing, resulting in a need for more residential care. In response to criticism of the traditional medical approach to residential dementia care, many large nursing homes are transforming their traditional care facilities into more home-like small-scale living facilities. ⋯ Both small-scale and traditional settings appear to have beneficial effects on different domains of quality of life of residents with dementia. Future research should focus more on the quality and content of the care provided, than on the effects of the scale and design of the environment in long-term care settings.
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Delirium is a serious and frequent psycho-organic disorder in critically ill patients. Reported incidence rates vary to a large extent and there is a paucity of data concerning delirium incidence rates for the different subgroups of intensive care unit (ICU) patients and their short-term health consequences. ⋯ The delirium incidence in a mixed ICU population is high and differs importantly between ICU admission diagnoses and the subtypes of delirium. Patients with delirium had a significantly higher incidence of short-term health problems, independent from their severity of illness and this was most pronounced in the mixed subtype of delirium. Delirium is significantly associated with worse short-term outcome.
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In many countries, acute care nurse practitioners contribute to patient care through an expanded scope of practice that includes nursing and medical activities. There have been calls across nations to establish better understanding of how nurse practitioners enact their roles in healthcare teams. The 2006 introduction of cardiology nurse practitioners in Quebec, Canada provides an opportunity to examine this process more closely. ⋯ The practitioners' scope of practice changed in response to pressures inside and outside healthcare teams or a lack of healthcare system structures. The study findings appear to be applicable to nurse practitioners working in other specialties, and in other countries. Future research needs to examine how the pace of work affects the nurse practitioners' ability to provide care.
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Estimates of incidents (adverse events) occurring during inpatient hospital stays suggest patient safety demands attention. Improving the safety of health care systems requires understanding incidents and their causes. Labour and delivery nurses can contribute to understanding incidents and incident reporting because they actively identify and report incidents in practice. ⋯ Team work in Canadian labour and delivery practice settings influences determinations of what constitutes incidents and how they are managed. The complexity of incidents that occur in perinatal practice contexts suggests new approaches would be valuable for incident reporting.