International journal of nursing studies
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Multicenter Study
Nurse-led central venous catheter insertion-procedural characteristics and outcomes of three intensive care based catheter placement services.
Nurse-led central venous catheter placement is an emerging clinical role internationally. Procedural characteristics and clinical outcomes is an important consideration in appraisal of such advanced nursing roles. ⋯ This study has demonstrated safe patient outcomes with nurse led CVC insertion as compared with published data. Nurses who are formally trained and credentialed to insert CVCs can improve organisational efficiencies. This study adds to emerging data that developing clinical roles that focus on skills, procedural volume and competency can be a viable option in health care facilities.
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Multicenter Study
Determinants of medication underuse and medication overuse in patients with chronic non-malignant pain: a multicenter study.
In chronic non-malignant pain, medication is often used as an important cornerstone of the treatment. Medication non-adherence is a frequent problem in chronic conditions. In patients with chronic non-malignant pain, medication non-adherence ranges between 8% and 53%. Two types of non-adherence can be identified: underuse and overuse of pain medication. ⋯ Patients underusing or overusing their medication do have a different risk profile. The set of determinants of non-adherence, proposed by WHO, is suitable to study determinants of underuse, but the framework is less suitable to study determinants of medication overuse.
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Multicenter Study
Frequencies of falls in Swiss hospitals: concordance between nurses' estimates and fall incident reports.
Patient falls are frequent incidents in hospitals, and various measurement methods are described in the literature to assess in-patient fall rates. However, the literature includes no validation of nurses' estimates of fall frequencies, which are the preferred assessment method in multi-centre surveys. ⋯ Nurses' long-term estimates of patient incidents are concordant with continuously and systematically assessed data, and offer valid data where other measurement methods are unavailable.
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Multicenter Study
The views and preferences of resuscitated and non-resuscitated patients towards family witnessed resuscitation: a qualitative study.
A number of international studies have explored the views of family members and healthcare professionals on the concept of family witnessed resuscitation (FWR). In contrast the perspective and preferences of patients have been under-researched, particularly in relation to those who have survived resuscitation. ⋯ The study provides a unique understanding of patient preferences of FWR and some of their views begin to contest arguments in the literature. Patients' perspectives suggest both relatives and they themselves benefit in different ways. Although participants recognised that family members had emotional, informational and proximity needs, these had to be balanced with allowing the resuscitation team to manage the clinical emergency and make decisions. It is also evident that not all patients wish their families to be present. Healthcare professionals should therefore strive to identify the wishes of patients and relatives in respect to FWR and facilitate the presence of loved ones as appropriate. Further research into the area is still required.
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Multicenter Study Controlled Clinical Trial
The effects of integrated care on quality of work in nursing homes: a quasi-experiment.
In nursing homes there is a gradual move from traditional care to integrated care. Integrated care means a demand-oriented, small-scale, co-operated and coordinated provision of services by different caregivers. This integration has direct effect on the work of these separate disciplines. With the introduction of integrated care the quality of work of these caregivers should be assured or even be improved. ⋯ The intervention on the psycho-somatic wards was unsuccessful. Although the introduction of integrated care on the somatic wards was successful, the effects on quality of work were limited. Next to quantitative research, more qualitative in-depth research is needed to examine models of integrated care and their effects on the work of caregivers within health care organisations, with special attention for specific characteristics of different types of nursing home care (somatic vs. psycho-geriatric).