International journal of nursing studies
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Multicenter Study Controlled Clinical Trial
The impact of nurse-directed protocolised-weaning from mechanical ventilation on nursing practice: a quasi-experimental study.
Internationally, nurse-directed protocolised-weaning has been evaluated by measuring its impact on patient outcomes. The impact on nurses' views and perceptions has been largely ignored. ⋯ We conclude that nurse-directed protocolised-weaning had no effect on nurses' views and perceptions due to the high level of satisfaction which encouraged nurses' participation in weaning throughout. Control group changes are attributed to a 'reactive effect' from being study participants. Weaning protocols provide a uniform method of weaning practice and are particularly beneficial in providing safe guidance for junior staff.
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Despite growing evidence in the US, little evidence has been available to evaluate whether internationally, hospitals in which nurses care for fewer patients have better outcomes in terms of patient survival and nurse retention. ⋯ Nurse staffing levels in NHS hospitals appear to have the same impact on patient outcomes and factors influencing nurse retention as have been found in the USA.
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Comparative Study
Registered nurses' education and their views on competence development in municipal elderly care in Sweden: a questionnaire survey.
Recent changes of municipal elderly care in Sweden have resulted in that persons 65 years and older, previously nursed in hospital facilities, are now being cared for in the municipality. This change has had a significant impact on the work situation of registered nurses (RNs) and calls for appropriate educational preparation to enable RNs to undertake their new roles effectively. ⋯ An important future prospect is to develop the competence of RNs in elderly care. In order to ensure high quality and security in elderly care, it is also essential to increase the number of RNs with specialist competence.
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Critical care units' CCUs environment has been regarded as a leading stressor because of the complex nature of patient's health problems that require an extensive use of very sophisticated technology. Multiple and complex care predominates in CCUs have been described by patients to be stressful and emotionally demanding. ⋯ The findings suggest that single and older patients with low income and low education experience more difficulties than their counterparts. Nurses must utilize more effective communication techniques and interventions to relieve patients' pain, and provide an atmosphere in which rest is possible, with less light, noise, and the fewest possible interruptions. Although the results of this study indicate the need to provide the best possible physical care, it is equally important to give adequate attention to patients' and families' psychological aspects.