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1 – 10 of over 36000
Article
Publication date: 1 May 2007

Suzanne M. Rice, Andrew Van Slobbe and Danny Rathgeber

There is increasing evidence in the literature that patient outcome is strongly linked to the quality of nursing care. In practice, the process of measuring the quality of nursing…

1934

Abstract

Purpose

There is increasing evidence in the literature that patient outcome is strongly linked to the quality of nursing care. In practice, the process of measuring the quality of nursing care is complex and multifaceted as it is dependent not only on the skills and practices of the individual nurse, but also on the professional and organisational structure that is practised within. The expert panel concept was developed to address clinical standards and practice at The Royal Melbourne Hospital. The Nursing Expert Panel's purpose was to evaluate nursing practice, identify practice deficits, highlight areas of clinical innovation and excellence, and make recommendations where appropriate to improve patient outcome. The aim of this paper is to investigate this.

Design/methodology/approach

A pilot programme to evaluate eight clinical areas was developed and implemented. The key areas of evaluation included clinical care as well as the managerial and professional practices that support patient care. The Expert Panel, consisting of predominantly nursing staff, was recruited from within the organisation. During the evaluation, the panel collected qualitative and quantitative data using a variety of data collection tools. Data were then analysed and recommendations developed.

Findings

Five common themes of practice deficit were identified during the pilot period and the development of strategies for practice improvement is in progress.

Originality/value

Following successful implementation of the pilot phase, the Nursing Expert Panel process is now being implemented across the organisation. With ongoing evaluation and improvement of the Expert Panel Process, this quality initiative will become the foundation of nursing standards and practice evaluation at this organisation.

Details

Clinical Governance: An International Journal, vol. 12 no. 2
Type: Research Article
ISSN: 1477-7274

Keywords

Book part
Publication date: 20 October 2017

Basil P. Tucker and Matthew Leach

Purpose: The current study aims to cast light on the divide between academic research in management accounting and its applicability to practice by examining, from the standpoint…

Abstract

Purpose: The current study aims to cast light on the divide between academic research in management accounting and its applicability to practice by examining, from the standpoint of nursing, how this gap is perceived and what challenges may be involved in bridging it.

Design/Methodology/Approach: The current study compares the findings of Tucker and Parker (2014) with both quantitative as well as qualitative evidence from an international sample of nursing academics.

Findings: The findings of this study point to the differing tradition and historical development in framing and addressing the research–practice gap between management accounting and nursing contexts and the rationale for practice engagement as instrumental in explaining disciplinary differences in addressing the research–practice gap.

Research Implications Despite disciplinary differences, we suggest that a closer engagement of academic research in management accounting with practice “can work,” “will work,” and “is worth it.” Central to a closer relationship with practice, however, is the need for management accounting academics to follow their nursing counterparts and understand the incentives that exist in undertaking research of relevance.

Originality/value: The current study is one of the few that has sought to look to the experience of other disciplines in bridging the gap. Moreover, to our knowledge, it is the first study in management accounting to attempt this comparison. In so doing, our findings provide a platform for further considering how management accounting researchers, and management accounting as a discipline might, in the spirit of this study’s title, “Learn from the Experience of Others.”

Details

Advances in Management Accounting
Type: Book
ISBN: 978-1-78743-297-0

Keywords

Article
Publication date: 18 August 2014

Sarah Wall

The purpose of this paper is to report on ethnographic research that investigated how self-employed nurses perceive the contemporary healthcare field, what attributes they possess…

2700

Abstract

Purpose

The purpose of this paper is to report on ethnographic research that investigated how self-employed nurses perceive the contemporary healthcare field, what attributes they possess that facilitate their roles as change agents, what strategies they use to influence change, and what consequences they face for their actions, thus contributing to what is known about organizational change in institutionalized settings such as healthcare.

Design/methodology/approach

Focussed ethnography was used to explore self-employed nurses’ work experiences and elucidate the cultural elements of their social contexts, including customs, ideologies, beliefs, and knowledge and the ways that these impact upon the possibilities for change in the system.

Findings

These self-employed nurses reflected on the shortcomings in the healthcare system and took entrepreneurial risks that would allow them to practice nursing according to their professional values. They used a number of strategies to influence change such as capitalizing on opportunities, preparing themselves for innovative work, managing and expanding the scope of nursing practice, and building new ideas on foundational nursing knowledge and experience. They had high job satisfaction and a strong sense of contribution but they faced significant resistance because of their non-traditional approach to nursing practice.

Originality/value

Despite dramatic restructuring in the Canadian healthcare system, the system remains physician-centered and hospital-based. Nursing ' s professional potential has been largely untapped in any change efforts. Self-employed nurses have positioned themselves to deliver care based on nursing values and to promote alternative conceptions of health and healthcare. This study offers a rare exploration of this unique form of nursing practice and its potential to influence health system reform.

Details

Journal of Health Organization and Management, vol. 28 no. 4
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 11 December 2008

Julia Halpin, Patricia Wain and Peter Nolan

This paper reports on a study undertaken in one mental health NHS foundation trust in the UK, which sought to examine to what extent advanced practice nursing could contribute to…

158

Abstract

This paper reports on a study undertaken in one mental health NHS foundation trust in the UK, which sought to examine to what extent advanced practice nursing could contribute to advancing new ways of working in the future. The literature on advanced nursing in the UK is critically discussed and where availability permits, reference is made to international literature. The findings of a survey of nurses with a Masters degree or acting at advanced level are reported and discussed. Though the data reported here are largely confirmed by similar studies, nevertheless the insights provided should alert organisations to the complexity of introducing new roles during a time of radical change in the health care system. Despite the efforts of a highly motivated trust, respondents identified barriers and obstacles that were of such significance that some were forced to rethink their readiness to embrace the role. It is hoped that the recommendations derived from this study may assist other organisations at a similar stage of implementing advanced nursing practice roles.

Details

The Journal of Mental Health Training, Education and Practice, vol. 3 no. 4
Type: Research Article
ISSN: 1755-6228

Keywords

Article
Publication date: 1 August 2003

Christine Smith

This paper presents a research study that demonstrates the inadequacy of the traditional biomedical approach to caring for older people and shows the benefits of using a more…

Abstract

This paper presents a research study that demonstrates the inadequacy of the traditional biomedical approach to caring for older people and shows the benefits of using a more holistic, bio‐psychosocial approach. An ethnographic inductive approach was taken. Non‐participant observation was performed on complete episodes of nursing practice, followed by semi‐structured interviews to explore and ratify theories in use. Phase one of the data analysis used qualitative inductive analysis to generate main categories and themes. Phase two was a process of factor isolation, which identified factors of practice theories in use. The themes identified were: nursing therapeutics; preventative nursing; communication; nurse‐patient relationships; collaborative nursing; nursing assessment; decision making; and management of patient care. Further analysis identified that important theoretical factors included: encouraging; responding; comforting; explaining; maintaining ability; judgement in action; and collaborating. This knowledge is embedded in the practice theories of practitioners but it is only by exploring and critiquing these that we can hope to understand the complex nature of nursing practice as it relates to the care of older people.

Book part
Publication date: 9 May 2023

Robert Weech-Maldonado, Akbar Ghiasi, Justin Lord, Ganisher Davlyatov, Larry Hearld, Ferhat Devrim Zengul and Kent Rondeau

Nursing homes experience high nursing staff turnover. Nursing staff in nursing homes is comprised of gray and blue collar workers that include registered nurses (RNs), licensed…

Abstract

Nursing homes experience high nursing staff turnover. Nursing staff in nursing homes is comprised of gray and blue collar workers that include registered nurses (RNs), licensed practical nurses (LPNs), and certified nurse assistants (CNAs). The relationship between human resource management (HRM)practices, organizational culture, and nursing staff turnover is examined in underresourced (high Medicaid) nursing homes. Survey data from 348 nursing home administrators (NHAs) of USA high Medicaid (85% or higher) facilities were merged with secondary data sources for 2017–2018. The dependent variables (nursing staff turnover rates) consisted of the percentages of RNs, LPNs, and CNAs that had voluntarily quit the organization during the past year. The independent variables were: (1) HRM practices (employee-centered and high involvement practices); and (2) organizational culture: clan, market, hierarchical, and non-dominant. Organizational and market variables were controlled for. Data were modeled using Poisson log-linear regression, and propensity score weights were used to adjust for potential survey non-response bias. Results show high involvement HRM practices and having a clan culture are associated with lower RN, LPN, and CNA staffing turnover. Study findings suggest that organizational culture and HRM practices may be instrumental in reducing nursing turnover in underresourced nursing homes.

Details

Management and Organizational Studies on Blue- and Gray-collar Workers: Diversity of Collars
Type: Book
ISBN: 978-1-80455-754-9

Keywords

Article
Publication date: 1 October 2000

Elisabeth Davenport

The difficulties of basing healthcare on literary warrant have been explained in different ways: busy practitioners have no time to read extensively, physical access is difficult…

466

Abstract

The difficulties of basing healthcare on literary warrant have been explained in different ways: busy practitioners have no time to read extensively, physical access is difficult, and adequate surrogates for texts like indexes, abstracts, systematic reviews are partial in their coverage. The author suggests that a deeper problem of domain conflict must be addressed. This paper reviews problems identified in previous research on evidence‐based nursing practice, which indicates that there are conflicts between medical and nursing domains. EBM (evidence‐based medicine, or “text”) poses challenges for nurses (proponents of “caritas”). An additional surrogate for the medical corpus, the clinical guideline, is discussed. When based on inclusive consultation, this may prove to be a hospitable epistemological bridge for groups whose domains are in conflict. Drawing on “social studies of science” literature, the author explores the provenance and status of the clinical guideline as a “translation artefact” or bridging mechanism, and presents a “snapshot” case study of the Scottish Intercollegiate Guidelines Network in 1998. She suggests that the clinical guideline is a powerful documentary genre, which links several strands of information science: information retrieval, literary warrant and the politics of classification.

Details

Journal of Documentation, vol. 56 no. 5
Type: Research Article
ISSN: 0022-0418

Keywords

Article
Publication date: 21 July 2010

Pamela Inglis

The forensic nursing role is complex, creates tensions within itself and is underpinned by core values, knowledge, skills and personal attributes; often referred to as ‘good…

Abstract

The forensic nursing role is complex, creates tensions within itself and is underpinned by core values, knowledge, skills and personal attributes; often referred to as ‘good nurse’ characteristics (Smith & Godfrey, 2002). Forensic nurses perform unique, multifaceted roles; they are viewed by patients as ‘a source of treatment, comfort and advice’, but also as ‘part of the system that deprives them of their liberty’ (United Kingdom Central Council for Nursing, Midwifery and Health Visiting & University of Central Lancashire (UKCC & UCLAN), 1999: 42). This is problematic both for nurses and patients. Although appearing as opposites, security and therapeutic characteristics of nurses can and do co‐exist in forensic nursing (Peternelji‐Taylor & Johnson, 1996). Through critical analysis of dialogue from interviews and focus groups, this paper depicts forensic practice with people with a learning disability through a study that explores apparent ‘truths’ about such people detained in forensic settings (here referred to as ‘the men’) and the staff who work with them. Beliefs about nursing characteristics were exposed through discourses present in dialogue between the men and the staff. General research questions included: (1) What are the discourses related to learning disability and forensic practice? (2) What ideologies underpin and justify forensic practice? (3) What in particular are the positive discourses? Related discussion is primarily concerned with the way that staff and men share relationships and with characteristics of the nursing staff. Findings generally suggest that the staff may be viewed as prison wardens, leading to relationships of mistrust. Paradoxically, there are also positive discourses identifying warm and therapeutic relationships and good nurse characteristics of the staff. This may have practice implications, such as enabling staff to hear positive views expressed by the men and begin to develop metrics of ‘good’ forensic nurse characteristics that may positively affect treatment.

Details

Journal of Learning Disabilities and Offending Behaviour, vol. 1 no. 2
Type: Research Article
ISSN: 2042-0927

Keywords

Article
Publication date: 19 July 2019

Janet Richardson, Daniel Clarke, Jane Grose and Paul Warwick

The purpose of this paper is to assess the contribution of scenario-based learning aimed at raising awareness of sustainability in health-care practitioners. The Lancet Countdown…

1271

Abstract

Purpose

The purpose of this paper is to assess the contribution of scenario-based learning aimed at raising awareness of sustainability in health-care practitioners. The Lancet Countdown on Climate Change calls for urgent action on health and climate change; this requires appropriate knowledge, skills and competencies that can be gained through undergraduate education. The International Council of Nurses calls for leadership in nursing for sustainability; however, climate change and health are given little attention in nursing and health-care curricula.

Design/methodology/approach

A cohort of nursing and midwifery students was introduced to sustainability and climate change in the context of health care through scenario-based learning sessions in each of their three years of undergraduate education. Questionnaires were used to collect data on participant’s attitudes toward sustainability and climate change, how useful the educational sessions were and the extent to which their clinical practice had changed.

Findings

Significant differences were found between scores in Years 1 and 2 suggesting greater awareness of the importance of sustainability in nursing education and practice. Comparison of Years 2 and 3 scores found participants more likely to apply sustainability principles in clinical practice and challenge unsustainable practices in the work environment.

Research limitations/implications

Further research is required to explore sustainability practice in postgraduate nurses/midwives. However, this study supports the need for sustainability education to be embedded within health-care professional degrees through applied and participatory pedagogical approaches.

Originality/value

To the best of the authors’ knowledge, this is the first study to evaluate sustainability education and its impact on nursing attitudes towards practice.

Details

International Journal of Sustainability in Higher Education, vol. 20 no. 4
Type: Research Article
ISSN: 1467-6370

Keywords

Article
Publication date: 13 July 2015

Philippa Rasmussen

The purpose of this paper is to explore the applicability of the process of identifying a conceptual framework of practice to areas of nursing without a current clearly identified…

Abstract

Purpose

The purpose of this paper is to explore the applicability of the process of identifying a conceptual framework of practice to areas of nursing without a current clearly identified scope of practice. Worldwide, nursing is a diverse profession with many recognised sub-specialties, some of which are under threat. Nurses with specialised knowledge, experience and education are needed to provide specific care in nursing sub-specialties. However, some of these characteristics are implicit and not clear to the wider nursing community. This paper presents an overview of research to identify the parameters of practice for a sub-specialty of nursing.

Design/methodology/approach

The methodology was interpretive enquiry as it allowed for the interpretation of multiple realities which resulted in a rich description of the work of a sub-specialty. The research used document analysis, focus group interviews and individual interviews as the methods of collecting data. Documents were analysed using iterative and thematic analysis The focus group and individual interview data were analysed using an adaptation of a six-phase thematic analysis process.

Findings

This paper presents the findings of the entire analysis and the resultant holistic conceptual framework for the work of the child and adolescent mental health nurse in the inpatient unit. The findings have contributed new knowledge to mental health nursing, specifically child and adolescent mental health nursing making the parameters of practice more explicit. Research is currently being undertaken in Australia to further develop the framework for other sub-specialties of nursing such as community health and orthopaedics. These sub-specialties have been identified as potentially at risk.

Originality/value

This paper discussed the applicability of a broader use of a qualitative research methodology used to identify scope of practice in child and adolescent mental health nursing, for other nursing specialties.

Details

The Journal of Mental Health Training, Education and Practice, vol. 10 no. 3
Type: Research Article
ISSN: 1755-6228

Keywords

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