Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing
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Nurses in all clinical settings encounter ethical issues that frequently lead to moral distress. This critical incident study explored nurses' descriptions of ethically difficult situations to identify priorities, action responses, and regrets. ⋯ Ever-expanding treatment options raise ethical issues and challenge nurses to be effective patient advocates. Evidence-based nursing interventions that promptly identify and address moral conflict will benefit patients, their families, and the entire healthcare team by mitigating potential moral distress and disengagement.
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To determine the impact of nurse work environment and staffing on nurse outcomes, including job satisfaction and burnout, and on quality of nursing care. ⋯ Nurses should work with management and policymakers to achieve safe staffing levels and good work environments in hospitals throughout the world.
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Development of the Professional Practice Environment Assessment Scale (PPEAS) was based on the assumptions that a positive professional practice environment is more than and different from the absence of negative, abusive, or disrespectful behaviors by physicians; a positive professional practice environment improves patient outcomes as well as nurse and physician satisfaction; and a positive professional practice environment is characterized by mutual respect, understanding of roles, collaborative decision making, effective communication, and beliefs in the importance of nurse-physician relationships on patient outcomes. The PPEAS is intended as both a research tool and a method of assessing and monitoring changes in an organization's professional practice environment as it relates specifically to the impact the nurse and physician relationship has on the professional practice environment. The purpose of this study was to examine the psychometric properties of the PPEAS and determine if it was a valid and reliable instrument for assessing the positive attributes of the professional practice environment. ⋯ The professional practice environment has been implicated as a variable that impacts patient outcomes. The absence of negative physician behaviors is an inadequate measure for assessing the positive attributes of the professional practice environment. Instruments for assessing the professional practice environment typically looked at the presence of negative physician behaviors or examined a single aspect of the nurse-physician relationship. This article provides a theoretical framework that can be used to guide both practice and research. The PPEAS was developed within a theoretical framework that can be adapted to a variety of settings, cultures, and countries. The PPEAS is a valid and reliable instrument that can be used to assess the professional practice environment in a variety of settings.
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The aims of this study were to investigate variables related to cultural caregiving motives (obligation and reciprocity) and to analyze the relationship between these cultural caregiving motives and subjective burden in informal caregivers of disabled older people. ⋯ Balanced reciprocity is useful for early prevention and early intervention of subjective burden and must be included in nursing care plans for caregivers. Cultural factors support the comprehension of the caregiving process.
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Comparative Study
Comparison of hospital admission medication lists with primary care physician and outpatient pharmacy lists.
Medication reconciliation is a process to reduce errors and harm associated with loss of medication information as the patient enters and moves through the healthcare system. This study examines medication list accuracy upon hospital admission. ⋯ Medication reconciliation upon inpatient admission remains a high-volume and high-acuity problem. We found that not only hospital medication lists, but source lists, including those maintained by the patient, the PCP, and the OP, are vastly inaccurate.