Journal of clinical nursing
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The aim of this paper was to review the current literature clinical decision-making models and the educational application of models to clinical practice. This was achieved by exploring the function and related research of the three available models of clinical decision making: information-processing model, the intuitive-humanist model and the clinical decision-making model. ⋯ It is proposed that clinical decision making improves as the nurse gains experience of nursing patients within a specific speciality and with experience, nurses gain a sense of saliency in relation to decision making. Experienced nurses may use all three forms of clinical decision making both independently and concurrently to solve nursing-related problems. It is suggested that O'Neill's clinical decision-making model could be tested by educators and experienced nurses to assess the efficacy of this hybrid approach to decision making.
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The review examines from international research: the extent to which practitioners comply with infection control precautions; the pertinent issues that are considered influential in compliance; what strategies have been evaluated to instigate positive behaviour changes amongst practitioners and the effect of these interventions. ⋯ Compliance to infection control precautions is internationally suboptimal. The evidence confirms that compliance to specific aspects of standard/UPs varies, and practitioners are selective in their application of recommended practice. Compliance does improve following a structured intervention; however, research fails to indicate for how long the intervention affects practitioner compliance, or whether compliance after a period of time returns to the norm. Several reasons for non-compliance are discussed, and recommendations for future research are suggested. Relevance to clinical practice. Suboptimal compliance has significant implications for staff safety, patient protection and the care environment. Infection control teams and researchers need to consider the reasons for non-compliance and provide a supportive environment that is conducive to the routine, long-term application of standard precautions.
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To describe the development of an integrated career and competency framework for diabetes nursing. ⋯ The description of the process of developing of the integrated career and competency framework should help other groups going through the same process. Relevance to clinical practice. In addition to helping groups identify a formula for the development of a competency framework, the framework itself is designed to provide a basis for educational programmes, personal career development and a tool for managers managing career progression within diabetes nursing.
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The aim of this investigation was to enhance the understanding of the concept of caring. ⋯ The findings explicate a cohesive process of caring. They provide insight into the human attributes and clinical milieu that are necessary for caring to emerge. They also offer clarity regarding the therapeutic benefits of caring.
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Review
A review of the efficacy of dexamethasone in the prevention of postoperative nausea and vomiting.
To consider the efficacy of dexamethasone in preventing postoperative nausea and vomiting following general anaesthesia and a range of surgical procedures, compared with a placebo of sodium chloride (normal saline). To inform nurses' pharmacological knowledge of the effects of this medication during peri-operative care. ⋯ Nurses in the peri-operative arena can administer this medication, when ordered, with the knowledge based on research evidence as to why it has been included in preoperative protocols. However, dexamethasone has been noted in postanaesthesia recovery care units as a clinical pathway option for the management of postoperative nausea and vomiting and no retrieved articles discuss this option.