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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The attainment of evidence-based practice is at the fore of the international practice development agenda. It is therefore imperative that robust evaluation methodologies are available to scrutinise new approaches to service development. ⋯ The collaborative approach nurtured by the realistic evaluation framework was found particularly helpful and there was consensus that the evaluation had become integral to the intervention itself. There were a number of methodological challenges and a need to limit the depth of 'realistic unravelling'. However, as a formative approach, in the messy world of interdisciplinary practice development, realistic evaluation proved a worthy design.
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The majority of older persons in Lebanon live with their family, which provides the help and care required when their relative is functionally impaired. Knowing that taking care of an older impaired relative is considered a source of enrichment for the caregiver and an act of gratitude towards the older person in Lebanon. However, there are few formal resources to support these families. This study is informed by a theoretical framework of stress. ⋯ Many stressors proved associated with one or other of the health indicators under study and the resources emerged as significant factors related to caregiver's health.
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Canadians overwhelmingly support universal coverage for health services and seniors' entitlement to high standards of care in long-term care facilities (LTCFs). Government rhetoric reflects these values, but claims of fiscal prudence often means translation into policy and improved care is uneven. Ontario is moving towards standardized "quality of care" measures, but such measures often ignore residents' views and socio-psychological issues. ⋯ Seniors said little regarding the fabulous new facility, but discussed quality of care as a socio-psychological concept intimately connected to staff relations. Government and administrative inattention to issues of sufficient funding for staff, relationship needs and continuity of care for seniors threatened to undermine residents' experiences of meaning, as well as any potential benefits from facilities and program improvements.
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Family presence during CPR: a study of the experiences and opinions of Turkish critical care nurses.
The concern over family witnessed cardiopulmonary resuscitation has been a frequent topic of debate in many countries. ⋯ This study reveals that critical care nurses in Turkey are not familiar with the concept of family presence during cardiopulmonary resuscitation. In view of the increasing evidence from international studies about the value of family presence during cardiopulmonary resuscitation we recommend educational program about this issue and policy changes are required within the hospitals to enhance critical care in Turkey.