Hu li za zhi The journal of nursing
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Nursing education has evolved from the apprentice system into today's formal doctoral programs. However, has the elevated status of nursing education necessarily led to qualitative improvements? This paper focuses on the crisis and myths related to the nursing education paradigm, the evolution and ongoing reform of nursing education, as well as its future prospects.
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This case report concerns the nursing experience of applying back massage to a patient in an intensive care unit (ICU) from 10 May, 2005, in order to improve the patient's quality of sleep. In order to collect information about his quality of sleep of the patient, the author used observation, interview and a Richards-Campbell sleep questionnaire (RCSQ). It was observed that, before massage, the patient's sleep quality was poor, which wa why the protocol with back massage was proposed. ⋯ Applying back massage to an ICU patient may therefore be regarded as helpful improving the patient's sleep quality. It is hoped that this case report may serve as a positive reference for health care providers so that it may help patients to recover fully through rest and sleep. Since this report concerned only one patient, however, to understand the real outcome of how back massage could improve the quality of sleep of ICU patients, research is planned on the use of back massage protocol on a large number os such patients.
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This article describes an experience of providing nursing care to an eighty year-old patient with urinary tract infection (UTI). The author cared for this patient in the role of clinical geriatric nurse specialist from May 11 to 23 in 2005. Through comprehensive assessment, careful review of medical records, contact with family and nursing home healthcare workers, it was determined that the patient's cognition and physical function declines were due to delirium resulting from the last time the patient had been hospitalized in the intensive care unit (ICU). ⋯ No delirious event occurred during hospitalization and cognitive functions improved. From this experience, early assessment and intervention should be conducted for high-risk elderly patients in order to prevent delirious events and declines in cognitive and physical functions. The author hopes this case report will prove a useful reference to nurses charged with caring for elderly patients at risk for delirium.
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The process of being weaned from mechanical ventilation is a stressful transition for critically ill patients who are taken off ventilation assistance and regain spontaneous breathing. Degree of weaning success is being increasingly used as an outcome indicator in clinical practice and lay literature. ⋯ Following the concept analysis framework of Walker and Avant (1995), any such analysis that targets development of an operational definition of successful weaning should focus on two distinct sets of indicators, namely objective physiological and subjective psychological. Listing defining attributes and developing a model case will accurately reflect underlying relationships between weaning concepts.
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Hypoxia often occurs in the course of emergency treatment the monitoring systems alarm is not heard promptly by the nurses in attendance. In this study, nurses were monitored for the speed of their reactions to such alarms in 326 clinical instances. ⋯ For these reasons the hospital implemented briefings about alarms during morning meetings, a coordinated response mechanism, improvements in standards concerning the setting and inspection of alarms, the setting of limits on the frequency of patient's visits and the numbers of visitors, and the setting of a standard alarm volume level. As a result, the percentage of nurses responding to alarms within ten seconds increased to eighty percent, raising standards of nursing care, medical treatment and patient safety.