Pflege
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Pain treatment of surgical patients is still a deficient area, even if there are evidence-based possibilities of pain management. The aim of this study is to identify patients with a higher risk of severe postoperative pain at an early stage and improve nurses' pain management by identifying pain predictors whilst including them in analgesic treatment. In addition to the identification of predictors by a literature review, a cross-sectional study with 84 surgical patients of a convenience sample was undertaken to find possible predictors. ⋯ Correlation analysis was applied to verify the statistical significance of patient characteristics as well as surgical variables. Out of the 14 variables preoperative pain was found to increase the risk of postoperative pain. Comparison with other studies showed inconsistent results for pain predictors, and therefore nursing pain management based on pain predictors seems questionable.
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Advanced Nursing Practice seems to be an answer to the complex challenges of the health system. However, the quality of Advanced Nursing Practice is researched by comparison to medical care. ⋯ This vision has to be realised by means of autonomy and responsibility in nursing care. The competence to autonomous and responsible decision-making is based on an educational process, where the ability to perceive the situation of client as changeable is developed.
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Editorial Comparative Study
Evolution or revolution: can advanced practice nurses alter the future of health care?
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This article aims to provide an insight into the role as an Advanced Nurse Practitioner in Thoracic Surgery employed within the United Kingdom's National Health Service (NHS). Day-to-day duties were comprised of 7 Domains of Competence namely: management of patient's health status, nurse-patient relationship, teaching and coaching, professional role, managing and negotiating the health care delivery service, quality management, and cultural competence. These elements were enhanced further by becoming an independent and supplementary nurse prescriber, which helped to augment a seamless service delivery. The role formed an integral part in ensuring multi-disciplinary team cohesion and dynamics as well as the provision of continuity of care for both patients' and their families, across all health care settings.