The Journal of the New York State Nurses' Association
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J N Y State Nurses Assoc · Oct 2010
Implementing the Critical Care Pain Observation Tool using the Iowa Model.
Utilization of the Iowa Model of evidence-based practice (EBP) helps to facilitate change in nursing care. This was observed when an alteration in pain-rating assessment scales needed to be implemented at St. Joseph's Hospital Health Center in Syracuse, NY Research showed that the Critical Care Pain Observation Tool (CPOT) was psychometrically sound in assessing pain in the nonverbal (unconscious, unresponsive, and sedated) intensive care unit patient population. ⋯ Joseph's was undertaken using the Iowa Model of EBP. Application of the Iowa Model provided a systematic framework for changing nursing practice by incorporating critical thinking, clinical inquiry and judgment, multidisciplinary collaboration, and facilitation of learning. As evidenced by implementation of the CPOT, organizational implementation of EBP using the Iowa Model positively impacts change across an entire healthcare continuum through the improvement of patient care processes.
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A nursing research alliance is a group of individuals in a geographic area who come together to identify ways to promote evidence-based practice, collaborate on research projects, and raise awareness of nursing research in the healthcare community. Six alliances currently exist in New York State. These alliances are actively engaged as catalysts for the generation and use of best evidence as the basis for nursing practice. In this article the authors will provide information about how interested individuals can develop an alliance in their area.
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J N Y State Nurses Assoc · Dec 2008
Case ReportsCase study: an ethical dilemma involving a dying patient.
Nursing often deals with ethical dilemmas in the clinical arena. A case study demonstrates an ethical dilemma faced by healthcare providers who care for and treat Jehovah's Witnesses who are placed in a critical situation due to medical life-threatening situations. A 20-year-old, pregnant, Black Hispanic female presented to the Emergency Department (ED) in critical condition following a single-vehicle car accident. ⋯ Her refusal was based on a fear of blood transfusion due to her belief in Bible scripture. The ethical dilemma presented is whether to respect the patient's autonomy and compromise standards of care or ignore the patient's wishes in an attempt to save her life. This paper presents the clinical case, identifies the ethical dilemma, and discusses virtue ethical theory and principles that apply to this situation.
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Changes in the causes of death and advances in medical technology are leading nurses today to become more involved with end-of-life care than previously. Yet, terminally ill patients and their families have reported dissatisfaction with end-of-life care. ⋯ Attitudes about end of life affect nurses' ability to care for and communicate with patients and families facing these issues. For this reason, it is important to examine nurses' attitudes about end-of-life care, specifically hospice referral, to improve care to patients and families facing death.
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When caring for critically ill patients, critical care nurses work with technology every day. Technology and equipment malfunctions can have a profound effect on nurses' practice and self-image. ⋯ They questioned their competence and felt malfunctioning technology jeopardized their credibility and professional image. These findings are useful when structuring educational sessions on technology and in facilitating a supportive environment for critical care nurses when technology malfunctions.