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  • ISSN: 2379-9501
    Volume 3 Issue 1
    Research Article
    Kirsi Coco*, Kerttu Tossavainen, Juha E Jaaskelainen and Hannele Turunen
    This study has investigated Finnish nurses' evaluations of the guidance provided for traumatic brain injury patients' family members in relation to the symptoms and consequences of TBI. The data was collected during 2010 from neurosurgical nursing staff of five Finnish University Hospitals (N = 172). The response rate was 67 % (n = 415).
    The surveyed nurses responded that they regularly provide guidance for TBI patients' family members in line with their responsibilities. However, only about one third of respondents reported that they regularly advice family members about symptoms caused by rise in intracranial pressure. Nursing staff with less than three years of work experience generally responded that they only seldom provide guidance for family members about the consequences of TBI.
    It is hoped that the study's findings will be applied in the planning of specialized courses, in-service training and orientation provided for neurosurgical nursing staff.
    Samia M. Teleb Osman and Hala Mohamed Mohamed Bayoumy*
    Introduction: Chemotherapy induced neutropenia (CIN), is a significant problem among cancer patients receiving chemotherapy. CIN is causing serious complications in approximately 80% of patients. There is a pressing need to design evidence based nursing protocols to provide safe and effective care for patients with neutropenia.
    Methods: The aim of present study has three – folds. First was the assessment of nurses' knowledge and practices for management of CIN patients; the second was the development of an evidence-based nursing intervention protocol according to most recent strong evidences of neutropenia management and the nurses' educational needs; and finally applying the developed protocol and thereafter evaluating its impact on nurses, as well as patients' knowledge and practice. A Quasi- experimental research design was utilized in this study. A convenient sample of 30 oncology nurses, as well as thirty patients was recruited from Oncology Department of Assiut University Hospital. Tools: data collection instruments included; nurses CIN knowledge test; neutropenia guideline observation checklist for evaluating nurses' practice compliance with designed protocols; patients' CIN test; and checklist to assess patient's' practices related to oral care and hand washing.
    Results: Mean scores for nurses' and patients' post protocol knowledge as well as practice level were significantly higher than the pre protocol scores. A positive significant correlation between total knowledge and practice scores was observed.
    Conclusion: Designing and implementing evidence based nursing intervention protocol is important for improvement of nurses' knowledge and practice and enhancement of patients' outcomes. Providing patients and their families with the necessary knowledge and practice through implementation of educational programs is a must to equip them with the necessary skills for prevention and management of problems related to alteration in protective mechanisms.
    Jenny Tohotoa*
    Fall prevention in Western Australian hospitals is monitored with a monthly generic falls assessment/management tool. Whilst this practice is suitable for bed ridden patients, it fails to capture the falls risk for older adult mental health patients who are predominantly ambulant and frequently confused. This paper describes the development of a specific mental health falls risk management tool (MHFRMT) for use in older adult mental health units. The development of this tool evolved from formative focus group research which successfully identified relevant predictors of risks for falls in this population. Corresponding management strategies were then developed for each criterion to the assessed levels of risk. Fall prevention management strategies included referral to physiotherapists for gait and balance testing, referral to occupational therapists for functional ability status and to podiatry for foot care.
    The new tool was initially piloted across three older adult mental health units in Western Australia with staff feedback resulting in some formatting revisions. The tool was then piloted at a fourth older adult mental unit with no further revisions required. The result was a new tool encompassing a weekly assessment rather monthly like the current generic falls form. Staff feedback was mainly about the format of the new tool rather than the content, suggesting that future studies need to focus on investigating the reliability and validity of the MHFRMT. Finally, although some staff were not happy with the increased work load associated with a weekly assessment, the weekly reporting highlighted two key issues in this patient group over three weeks: (1) fluctuating cognition and (2) mental state and behaviour changes. Additionally, the medication alert system identified the number of medications that increase falls risk and also indicated the risk alert level associated with each medication.
    Carlo Turci*, Rosaria Alvaro, Maria Grazia Proietti, Ausilia Pulimeno, Alessandro Stievano and Gennaro Rocco
    Introduction: The satisfaction for the organizational health in nurses is fundamental to provide safe and high quality care. Between 2009 and 2011, the research team conducted a survey to measure organizational health and its level of satisfaction in nurses working in various health centres in Rome and its metropolitan area, including intensive care units and accident & emergency departments.
    Materials and methods: In this study it was used a validated tool developed in 2010, the Nursing Organizational Health Questionnaire. The statistic analysis of the data was performed by means of the SPSS 19.0 package.
    Results: Dimensions of organizational health calculated in relation to the mean cut-off value of 2.6 showed a poor job environment comfort, high levels of stress and a scarce openness to innovation. Regarding the satisfaction for the organizational health, 28% of the nurses were fully satisfied, 35% were unsatisfied and 37% showed reasonable levels of satisfaction. Stronger associations with dissatisfaction were observed for the following domains: job environment comfort, organizational context, safety and accident prevention and openness to innovation.
    Discussion: Healthcare organizations involved in this study ought to intervene on various intrinsic factors linked to the job (job environment comfort, organizational context, openness to innovation and safety and accident prevention) to improve the satisfaction for nurses' organizational health.
    Conclusions: The quality of life and wellbeing of health professionals and of the organizations are linked to the capacity to provide high quality care to patients, especially in areas that have a very stressful impact, such as the intensive care units and the accident and emergency fields. Therefore, the organizational features become instrumental to achieving high quality care outcomes and should be the target of interventions in the healthcare centres included in the study.
    Annette Mwansa Nkowane*, Jane Khayesi, Prakin Suchaxaya, Margaret Loma Phiri, Silvina Malvárez and Onyema Ajuebor
    This study examined the existing education and scope of practice for community health nursing (CHN) and identified factors enhancing the practice. A cross-sectional study among government nursing leaders, regulatory bodies, nursing training institutions, nursing associations and community health nurses (CHNs) was conducted in 13 countries facing human resources for health crisis. Only 12 countries are reported in this paper due to insufficient data in one participating country. Surveyed countries had functional frameworks for nursing workforce education, management regulation and service delivery. Seventy percent of CHNs had formal post-basic training. Majority performed diverse roles at health facilities of which 40% performed tasks they were not trained for. Only 15% had received inter-professional education. Surveyed countries had incentives including retention packages. Although CHNs can contribute to universal health coverage, the enhancement of their skills in order to effectively make this contribution requires commitment from policy-makers and leaders in the form of investing in the development of the profession]
    Clinical Study
    Shahina Sabza Ali Pirani*
    Abstract: When nursing practice is guided by a theoretical framework, it serves as an organizing model for a body of knowledge. This paper described a clinical scenario which was analyzed through Florence Nightingale's Environmental theory. Nightingale defined 13 canons of environment and she gave a detailed description of each aspect. Her major canons include: ventilation, light, noise, cleanliness of rooms/walls, bed and bedding, personal cleanliness, and taking food. According to Nightingale, if nurses modify patients environment according to her canons of environment, she can help patient to restore his usual health or bring patient in recovery. This was also reflected in the clinical scenario. Hence, Nightingale provided a basis for providing holistic care to the patients and it is still applicable today. From the scenario, it is recommended that, at community level, people should be given awareness regarding basic environmental hygiene through media and Lady Health Visitors.' At hospital level, if checklist regarding environmental factors is attached in patient's bedside folder then it will compel nurses for its implementation and hence will result in positive effects on patient's condition.
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