Digital Commons Network^™

Can Nursing Escape The Medical Model?, Rilda Brostrom Matthews

Biennial Convention (CONV)

ESCAPE-C is an acronym for an Assessment Tool for the first step of the Nursing Process. It is derived from concepts identified by major theorists and is used as a consistent framework for identifying patient needs. It incorporates the standard Nursing Process and is up to date with current Nursing Diagnoses. The needed concepts to be assessed are summarized in the ESCAPE-C acronym. Nurses need to assess needs of the persons or groups in response to their Environment, Self (Psycho, Social, Cultural and Spiritual needs), Comfort, ADL's [further delineated to MEETS: Move-Eat-Eliminate-Toilet-Sleep], Physical assessment and assessment of Educational needs. They …

Handwashing: What Is Staff Using?, Denise P. Cedeno

Biennial Convention (CONV)

Handwashing is a simple process to decrease nosocomial infections in the hospital and all staff are expected to comply with hand-washing guidelines. I hypothesized that if staff is provided with what they prefer to use to wash their hands, compliance will increase. Having several alternatives to use, also will increase compliance. Regardless of what is provided, heightening staff awareness of the importance of this simple procedure is vital. I surveyed 31 hospital staff, 5 males and 26 females, including registered nurses, patient care assistants, rehabilitation therapists, respiratory therapists, physicians, unit secretaries, Environmental Services staff, and nursing students by asking three …

Primary Solutions For Maximizing And Expanding The Role Of The Primary Care Nurse In Ontario, Registered Nurses' Association Of Ontario, Primary Care Nurse Task Force Registered Nurses' Association Of Ontario

General Submissions: Nursing as Profession

This report is a blueprint to maximize and expand the role of primary care nurses, paving the path for other health professionals in Ontario. To benefit the public, we call on government and its agencies, professional associations, trade unions, regulatory bodies, educators, clinicians and employers to embrace and promptly implement the recommendations in this report.

Woman Abuse: Screening, Identification And Initial Response, Registered Nurses' Association Of Ontario

General Submissions: Community and Population-based Materials

The overall purpose of this guideline is to facilitate routine universal screening for woman abuse by nurses in all practice settings. The intended outcome is increased opportunity for disclosure, which will promote health, well-being, and safety for women. Using evidence-based approaches and recommendations, this guideline offers nurses a repertoire of strategies that can be adapted to various practice environments.

Essential Skills For Evidence-Based Practice: Appraising Evidence For Therapy Questions, Jeanne T. Grace

Individual Articles

Evidence to support the effectiveness of therapies commonly compares the outcomes between a group of individuals who received the therapy and a group of individuals who did not. Nurses must be able to determine how well the study design supports claims that the therapy caused the difference in group outcome (validity). When findings are valid, nurses must also consider whether those findings apply to the patient population of interest (generalizability) and, if so, how the findings can be applied to practice.

Promoting Safety: Alternative Approaches To The Use Of Restraints, Registered Nurses' Association Of Ontario

General Submissions: Community and Population-based Materials

This guideline provides evidence-based recommendations for Registered Nurses (RNs) and Registered Practical Nurses (RPNs) related to the care of individuals who are at risk for behaviours that may result in harm to self/others and lead to the possible use of restraints (physical, chemical, environmental). Unless otherwise indicated in the guideline, the discussion focus is on physical restraint.

Facilitating Client Centred Learning, Registered Nurses' Association Of Ontario

General Submissions: Community and Population-based Materials

The aim of this guideline is to provide evidence-based recommendations for Registered Nurses, Registered Practical Nurses and other health-care providers to facilitate client centred learning that promotes and enables clients to take action for their health.

Hiv Risk Reduction Behaviors In Adolescent Females; The Influence Of Mastery And Self-Esteem, Ellen R. Long-Middleton

General Submissions: Presentations (Oral and Poster)

Purpose. The purpose of the study was to test the moderator effect of mastery on the relationship between self-esteem and HIV risk reduction behaviors.

Aims. The aims of this study were to: 1) examine the relationships among mastery, self-esteem and HIV risk reduction behaviors in a culturally-diverse group of adolescent females, and 2) determine if differences exist in relationships among mastery, self-esteem and HIV risk reduction behaviors among three cultural groups. Framework. AIDS is a leading cause of death in adolescent and young adult populations. Heterosexual transmission of HIV is the fastest growing mode of infection among women, and minority …

Hemolysis Of Blood Specimens: Increasing Time In The Emergency Department, Sherry Young, Julie Hiles

General Submissions: Presentations (Oral and Poster)

Purpose: The nurses in a rural Emergency Department (ED) noted an increased incidence of hemolysis of blood specimens after adopting the practice of nurses obtaining blood specimens via a newly established intravenous site (IV), increasing throughput time in the ED. The purpose of this study was to determine if there was a significant difference in the proportion of hemolysis of blood specimens obtained from a newly inserted IV using a 20g Advant IV safety catheter and blood specimens obtained from a 21g-23g straight needle venipuncture. Design: Non-experimental descriptive quantitative retrospective design was selected to compare hemolysis of blood drawn via …

Rapid Intraosseous Vascular Access While Wearing Personal Protective Equipment, Stephen W. Borron, Diana F. Montez, Patti Haas, Thomas Philbeck, Juan C. Arias

General Submissions: Presentations (Oral and Poster)

Purpose: The ability to obtain rapid vascular access for fluid or medication administration is standard of care when working in emergency conditions. Hazardous material incidents require more sophisticated levels of personal protective equipment (PPE) that can interfere with fine motor skills needed for intravenous line placement. This study included participants representing a variety of clinical professions who could potentially face that challenge. Participants were tested for their ability to place intraosseous (IO) lines for quick antidote administration wearing various levels of PPE.

Design: This was an experimental study utilizing live anesthetized goats. Setting: The study was conducted in the lab …

Infant Feeding Decision: What New Mothers Have Told Us, Margaret-Rose Agostino

Biennial Convention (CONV)

Objective: To explore the infant feeding decision of new mothers and elicit their perspective regarding breastfeeding.

Design: Descriptive exploratory.

Setting: Postpartum units at seven birthing hospitals, including two tertiary perinatal centers in New Jersey and thirteen participant home telephone interviews.

Participants: 394 new mothers prior to hospital discharge; 13 interviewees including a total of eight African-American women, five who were non-WIC eligible and a total of five White women, three who were non-WIC eligible.

Main Outcome Measures: Central Jersey New Mother Survey, semi structured home telephone interviews.

Results: Knowledge regarding the health benefits of breastfeeding by the mother both during …

Telephone Support For First-Time Breastfeeding Mothers: Building A Foundation For Healthier Tomorrows, Margaret-Rose Agostino

International Nursing Research Congress (INRC)

Objective: To assess the effect of post-discharge telephone breastfeeding support on reducing the risk of early weaning from mother's stated goal.

Literature Review: Data Sources: Cochrane Pregnancy and Childbirth Group trials register; PubMed; Med Line; CINAHL; Proquest; Ovid; Academic Search Premier: Health Source: Nursing/Academic Edition; Library, Information Science & Technology Abstracts; PsychARTICLES; PsychINFO. Search terms: breastfeeding, lactation, support, duration, cessation, weaning, and telephone support. Restricted to English, full text, published January 1997-December 2008. Study Selection: 78 articles met the inclusion criteria: peer review, journal articles, human subject, clinical trial, meta-analysis, practice guideline, and review.

Data extraction: Quality review conducted utilizing …

Information Literacy: A Prerequisite To Evidence-Based Nursing, Kimberly Dawn Belcik

International Nursing Research Congress (INRC)

Purpose: Information literacy is an ambiguous term that many professionals in various fields, including nursing, have attempted to define. It is emphasized as a skill nurses should have yet it has not been conceptualized within nursing. The purpose of this paper is to analyze the concept of information literacy. This analysis emphasizes information literacy in the context of nursing as a prerequisite to evidence-based nursing practice.

Methods: The method used to analyze the concept is the Walker and Avant method. All steps of the Walker and Avant method are used with the exemption of the invented and illegitimate cases in …

Differences In Mastery And Self-Esteem In Culturally Diverse Adolescent Females, Ellen R. Long-Middleton

International Nursing Research Congress (INRC)

Purpose: Mastery, a global sense of control over one's life, and self-esteem, the value placed on oneself, are psychological characteristics associated with numerous health-enhancing behaviors. Developing interventions to fortify and enhance an individual's sense of mastery and self-esteem may serve to promote health-enhancing behaviors. Yet, differences in mastery and self-esteem among individuals of diverse cultures are not well understood, nor are the ways in which mastery and self-esteem impact health-enhancing behaviors. This is particularly so in adolescent females. Hence, the purpose of this investigation was to determine if differences existed in mastery and self-esteem levels in diverse cultural groups of …

Hiv Risk Reduction Behaviors In Adolescent Females: The Influence Of Mastery And Self-Esteem, Ellen R. Long-Middleton

Biennial Convention (CONV)

AIDS is a leading cause of death in adolescent and young adult populations. Heterosexual transmission of HIV is the fastest growing mode of infection among women, and minority populations are affected disproportionately. It is important to identify and assess psychological determinants of HIV risk reduction behaviors, in order that health care interventions may be tailored to maximize a client's preventive efforts. Hence, the concepts of mastery and self-esteem were investigated in relationship to HIV risk reduction behaviors in a culturally diverse group of adolescent females. Mastery is a global sense of control over one's life, and self-esteem is the value …

Keeping Women And Their Infants Together During The Recovery Phase Following Cesarean Section, Leeann Clegg, Jaclyn Madsen, Julia Snethen

Biennial Convention (CONV)

[Invited Poster or Paper Session] (Please contact the primary investigator for more information about this study.)

Promoting Continence Using Prompted Voided, Registered Nurses' Association Of Ontario

General Submissions: Community and Population-based Materials

Best practice guidelines are systematically developed statements to assist decision-making by healthcare practitioners and clients about appropriate healthcare. The purpose of this guideline is to provide information on implementing a treatment program of prompted voiding for older adults with urinary incontinence. The goals of prompted voiding are to:

• Reduce the frequency and severity of urinary incontinence episodes
• Prevent the complications associated with urinary incontinence
• Improve quality of life

Prevention Of Falls And Fall Injuries In The Older Adult, Registered Nurses' Association Of Ontario

General Submissions: Community and Population-based Materials

The purpose of this guideline is to increase all nurses' confidence, knowledge, skills and abilities in the identification of adults within health care facilities at risk of falling and to define interventions for the prevention of falling. It does not include interventions for prevention of falls and fall injuries in older adults living in community settings. The guideline has relevance to areas of clinical practice including acute care and long-term care, and will assist nurses to apply the best available research evidence to clinical decisions, and to promote the responsible use of health care resources. Specifically, Prevention of Falls and …

End Of Life Care During The Last Days And Hours, Registered Nurses' Association Of Ontario

General Submissions: Community and Population-based Materials

The purpose of this best practice guideline is to provide evidence-based recommendations for Registered Nurses and Registered Practical Nurses on best nursing practices for end-of-life care during the last days and hours of life. The guideline does not replace consultation with palliative care specialists, who can support nurses to provide quality end-of-life care. The guideline is intended to be a resource to nurses who may not be experts in this practice area. It is acknowledged that individual competencies vary between nurses and across categories of nursing professionals. The inclusion of recommendations on clinical, education, organization and policy topics makes this …

Prevention Of Constipation In The Older Adult Population, Registered Nurses' Association Of Ontario

General Submissions: Community and Population-based Materials

The purpose of this guideline is to reduce the frequency and severity of constipation among older adults through the use of adequate hydration and dietary fibre, regular consistent toileting and physical activity. Achieving and maintaining a pattern of normal bowel elimination will prevent constipation, decrease the use of laxatives, and improve the quality of life for older adults. There is no agreed upon definition of constipation in the clinical and research communities (Koch, Voderholzer, Klauser & MullerLissner,1997). Some authors maintain that defining constipation on the basis of symptoms is misguided (Probert, Emmett & Heaton, 1995).

Risk Assessment And Prevention Of Pressure Ulcers, Registered Nurses' Association Of Ontario

General Submissions: Community and Population-based Materials

This best practice guideline assists nurses who work in diverse practice settings to identify adults who are at risk of pressure ulcers. This guideline further provides direction to nurses in defining early interventions for pressure ulcer prevention, and to manage Stage I pressure ulcers.

Essential Skills For Evidence-Based Practice: Understanding And Using Systematic Reviews, Jeanne T. Grace

Individual Articles

Systematic reviews are comprehensive reviews of quantitative research literature conducted according to explicit guidelines established in advance. The strengths of systematic reviews as sources of evidence for practice are the exhaustive nature of the literature search, the objective criteria for determining which research will be included, and the methods used to synthesize the findings from each study into comprehensive conclusions. Guidelines for appraising systematic reviews focus on these strengths and whether the results of the systematic review can be applied to practice.

Value Conflicts In Evidence-Based Practice, Jeanne T. Grace

Individual Articles

Ethical dilemmas about care arise when the persons involved in care decisions have conflicting values. Evidence-based practice clarifies the nature of some ethical concerns about care because it sets three explicit values for clinical decision-making: effectiveness of care, efficiency of care, and incorporation of patient values. Defining effectiveness involves establishing relative values for outcomes and determining whose values must be considered. Defining efficiency involves establishing relative values for resources used and determining whose resources must be included. Incorporation of patient values involves balancing those values against the values of other members of society or the strength of the evidence supporting …

Essential Skills For Evidence-Based Practice: Statistics For Therapy Questions, Jeanne T. Grace

Individual Articles

Evidence to support the effectiveness of therapies commonly compares the outcomes between a group of individuals who received the therapy and a group of individuals who did not. Nurses must be able to interpret the statistics used to report these comparisons to determine not only whether there is a “real” (i.e. statistically significant) difference between the outcomes of the groups, but also whether that difference is large enough and precise enough to be clinically meaningful. The statistics involved depend on whether the outcome is expressed as a categorical (e.g. yes/no) or a continuous (e.g. pounds, length of stay) measure. When …

Strategies To Support Self-Management In Chronic Conditions: Collaboration With Clients, Registered Nurses' Association Of Ontario

General Submissions: Community and Population-based Materials

The purpose of this guideline is to provide evidence-based recommendations for Registered Nurses and Registered Practical Nurses in self-management support. These recommendations identify strategies and interventions that enhance an individual's ability to manage their chronic health condition. It is intended for nurses who work in a variety of practice settings across the continuum of care. It is acknowledged that the practitioner's knowledge, skills, attitudes, critical analysis and decision making vary and are enhanced over time by experience and education. It is acknowledged that effective health care depends on a coordinated interprofessional approach incorporating ongoing communication between health professionals and clients/families.

Nursing Care Of Dyspnea: The 6th Vital Sign In Individuals With Chronic Obstructive Pulmonary Disease (Copd), Registered Nurses' Association Of Ontario

General Submissions: Community and Population-based Materials

This guideline, Nursing Care of Dyspnea: The 6th Vital Sign in Individuals with COPD, will address the nursing assessment and management of stable, unstable and acute dyspnea associated with COPD. The guideline focuses its recommendations on four areas: (1) Practice Recommendations directed at the nurse; (2) Educational Recommendations directed at the competencies required for practice; (3) Organization and Policy Recommendations directed at practice settings and the environment in order to facilitate nurses' practice and (4) Evaluation and monitoring indicators

Caregiving Strategies For Older Adults With Delirium, Dementia And Depression, Registered Nurses' Association Of Ontario

General Submissions: Community and Population-based Materials

This guideline has been developed to address the question of how best to care for older adults (65 years or older) with delirium, dementia and/or depression. It is the intent of this document to recommend care strategies to assist Registered Nurses (RNs) and Registered Practical Nurses (RPNs) who are working in diverse settings in acute, long-term, and community care.

Enhancing Healthy Adolescent Development, Registered Nurses' Association Of Ontario

General Submissions: Community and Population-based Materials

The nursing profession has long been considered a leader in the area of health promotion and disease prevention. The goal of this document is to assist nurses working with youth in a variety of practice settings, i.e. schools, public health units, community health centres, adolescent clinics, hospitals, and in family practice. Recommendations are inclusive of adolescent development across diverse contexts (e.g. cultural, socioeconomic, structural, political). This guideline is intended for nurses who are not necessarily experts in the above-mentioned practice areas, and who work in a variety of practice settings across the continuum of care. It is acknowledged that individual …

Screening For Delirium, Dementia And Depression In Older Adults, Registered Nurses' Association Of Ontario

General Submissions: Community and Population-based Materials

This guideline has been developed to improve the screening assessment of older adult clients for delirium, dementia and depression. This guideline does not include recommendations for the management of these conditions in day-to-day nursing practice.

Best practice guidelines are systematically developed statements to assist nurses and clients in decision making about appropriate healthcare (Field & Lohr, 1990). This guideline focuses on: (1) Practice recommendations: directed at the nurse to guide practice regarding assessment and screening for delirium, dementia and depression in older adults; (2) Education recommendations: directed at educational institutions and organizations in which nurses work to support its implementation; …

Essential Skills For Evidence-Based Practice: Evidence Access Tools, Jeanne T. Grace

Individual Articles

In an efficient search for evidence to address clinical questions, clinicians consult trustworthy collections of critically evaluated evidence when those resources exist. The “5S” hierarchy organizes these resources in terms of their usability in clinical practice and suggests which sources to consult first. When relevant evidence cannot be found in one of the more developed resources, the clinician’s ability to conduct an effective and efficient search of the health care literature to locate evidence is a crucial skill for evidence-based practice. Two features of literature database search engines are particularly helpful: subject headings and clinical queries. Subject headings are specific …