Clinical nursing research
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Clinical nursing research · Apr 2014
Randomized Controlled Trial Multicenter StudyBarriers and facilitators to implementing delirium rounds in a clinical trial across three diverse hospital settings.
Delirium occurs in more than half of hospitalized older adults with dementia, substantially worsening outcomes. The use of multiple strategies and a local opinion leader, unit champion, has cumulative and lasting effects compared with single-strategy interventions. The purpose of this article is to describe the early barriers and facilitators to rounding with unit champions in a cluster randomized clinical trial in Year 2 of a 5-year trial (5R01NR011042-02). ⋯ Qualitative data were thematically analyzed. On average, rounds lasted 25.54 min (SD = 13.18) and were conducted with the unit champion 64% of the time. This is one of the first studies to systematically address quantitative and qualitative barriers and facilitators to nurse-led delirium rounds, demonstrating the gradual adoption of an intervention in diverse clinical settings.
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Clinical nursing research · Feb 2012
Randomized Controlled TrialThe Nursing Home Falls Self-Efficacy Scale: development and testing.
We examined a brief measure of falls self-efficacy in nursing home residents participating in a pilot randomized controlled trial to study the effects of hip protectors on the prevention of fractures (N = 116, mean age 82 ± 8, 72% female). Internal consistency reliability was acceptable with Cronbach's alpha of .79. Factor analysis supported two factors representing self-efficacy expectations and outcome expectancy. ⋯ We found lower falls self-efficacy in participants who needed help with mobility, in people with lower executive function, and in participants who reported fear of falling. Scores were not associated with prospective falls or adherence with hip protector use. The findings of this study provide preliminary support for the reliability and validity of the scale for future research.
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Clinical nursing research · Feb 1999
Randomized Controlled Trial Clinical TrialTesting a model of the nursing assessment of infant pain.
The purpose of this study was to test whether elements of an infant pain assessment model interacted as postulated by the model. The elements are the infant's response to comfort measures and the principle of consolability. Four different scenarios for each of 16 videotaped infants were prepared. ⋯ Forty-eight volunteer pediatric nurses assessed infant pain of 16 scenarios, each depicting one of the 16 infants. Mean level of assessed pain was highest for the "high likelihood of pain and difficult to console" group, second highest for the "high likelihood of pain and easily consoled" group, third highest for the "low likelihood of pain and difficult to console" group and least for the "low likelihood of pain and easily consoled" group. Findings supported the infant pain assessment model.
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Clinical nursing research · Nov 1998
Randomized Controlled Trial Clinical TrialThe preparation of patients for cardiac surgery.
This study examines the impact of a preadmission telephone intervention on anxiety, knowledge, and readiness for discharge for patients attending a preadmission teaching program prior to cardiac surgery. The primary goal of the telephone intervention was to provide support by giving additional information about individual concerns. ⋯ The more anxious group rated their perceived knowledge level lower, despite the fact that both groups had similar scores in actual knowledge. Given the potential barrier that anxiety can pose for patient learning, nurses need to adapt their interventions to deal with the patients' feelings of anxiety that accompany cardiac surgery to make the learning process effective.
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Clinical nursing research · Feb 1992
Randomized Controlled Trial Clinical TrialPatient-controlled analgesia for older adults.
Use of patient-controlled analgesia (PCA) was compared with nurse-administered intermittent intramuscular (IM) injections of morphine in older adults during their postoperative recovery. Data analyses indicated that the PCA and IM groups did not differ in pain intensity, pain distress, and satisfaction. The PCA group had significantly less sleep disturbance from pain than the IM group. Neither group was considered to have acceptable pain management.