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Patient satisfaction is receiving greater attention due to the rise in pay-for-performance and public release of data from the Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS) (HHS, 2006). Incorporating this survey into reimbursement plans and quality monitoring systems has ensured that measuring and reporting patient satisfaction is important to value-based healthcare, including nurses' care delivery. Watson's Caring Theory (1979) was the lens through which registered nurses' reports were examined. Benner's landmark work (1984) was also used to examine levels of competence in novice and expert nurses. The purpose of this study was to determine whether, and to what degree, acute care novice and expert registered nurses reported how their caring behaviors, based on Watson's 10 carative factors (1979), impacted patient satisfaction. The unit of analysis included novice and expert nurses who practiced in a community hospital. A descriptive, correlational, mixed methods study was employed. This study concluded that novice and expert registered nurses reported their caring behaviors greatly impacted patient satisfaction. In addition, patient satisfaction was greatly impacted by novice nurses' task-oriented behaviors, reliance on past experiences, and instilled personal values, as well as expert nurses' emotional needs and clinical wisdom. Incongruence existed among study participants' reports that caring behaviors greatly impacted organizational patient satisfaction scores. Hospital-based nurse educators need to consider pedagogical and programmatic innovations inclusive of the nursing domains reported on the HCAHPS survey. Research is needed that focuses on bridging the incongruence between novice and expert registered nurses' reports of their impact on patient satisfaction and actual patient satisfaction scores.
This coherent presentation of clinical judgement, caring practices and collaborative practice provides ideas and images that readers can draw upon in their interactions with others and in their interpretation of what nurses do. It includes many clear, colorful examples and describes the five stages of skill acquisition, the nature of clinical judgement and experiential learning and the seven major domains of nursing practice. The narrative method captures content and contextual issues that are often missed by formal models of nursing knowledge. The book uncovers the knowledge embedded in clinical nursing practice and provides the Dreyfus model of skill acquisition applied to nursing, an interpretive approach to identifying and describing clinical knowledge, nursing functions, effective management, research and clinical practice, career development and education, plus practical applications. For nurses and healthcare professionals.
"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/
Competence is the creation of new rules, reasoning procedures, and the integration of skills, values, knowledge, and attitudes to specific, contextual practice situations (Benner, 2001; Benner, Tanner, & Chesla, 2009). Caring is the essence and central focus of the nurse’s role that is embedded in personal and cultural meanings and commitments that are both instrumental and expressive (Benner, 2001; Benner, Tanner, & Chesla, 2009; Hess, Dossey, Southard, Luck, Schaub, & Bark, 2013). The purpose of this study was to examine the relationship between competence and caring efficacy of practicing registered nurses (RN) while controlling for the impact of nurse education, nursing experience, specialty certification, and job role. Guided by Benner’s Novice to Expert Model, a cross-sectional non-experimental design used to describe nurses’ self-perceptions of competence and caring. The seven subscale, 73-item Nurse Competence Scale (NCS) and 30-item Caring Efficacy Scale (CES) were used to examine these perceptions in an online survey. A final convenience sample of 189 practicing, licensed registered nurses involved in direct patient care at least 50% of the time and recruited from four nursing organizations and a Veterans Affairs Medical Center, were used in data analysis. Descriptive statistics were used to describe the demographic data. Most participants were female with an average age of 47 and 18 years of experience. Most held undergraduate degrees, possessed a nursing specialty certification, and worked as staff nurses. Hierarchal multiple regression was used to examine the relationship between competence and caring efficacy. A moderate, positive relationship between nurse competence and caring efficacy was found. This relationship was not influenced by education, experience, specialty certification, or job role. Correlations were used to compare the frequency of use versus perceived competence on the subscales of the NCS. No relationships were noted between use and perceived competence on six of seven subscales. There was a small correlation in the help domain. These findings suggest that nurse competence and caring develop according to Benner’s Novice to Expert Framework and affirm that experience is not a linear process but a continuum of experiential learning opportunities and skills acquisition.
The Institute of Medicine study Crossing the Quality Chasm (2001) recommended that an interdisciplinary summit be held to further reform of health professions education in order to enhance quality and patient safety. Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across disciplines and occupations developed ideas about how to integrate a core set of competencies into health professions education. These core competencies include patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. This book recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, and leadership. Educators, administrators, and health professionals can use this book to help achieve an approach to education that better prepares clinicians to meet both the needs of patients and the requirements of a changing health care system.
- NEW! Next Generation NCLEX® (NGN) examination-style case studies at the end of each section familiarize you to the way that content will be tested in the new NGN exam. - NEW! Leadership roles/competencies and evidence-based practice examples are included from across the care continuum: ambulatory care, long-term care, and community-based care. - NEW! Content on management in a culturally diverse healthcare environment relates to both hospital staff and patients. - NEW! Additional Evidence-Based Practice boxes relate to "innovation" topics in leadership and management. - NEW! Updated organization reflects the Magnet Recognition (2019) and Pathways to Excellence (2016) standards, allowing you to learn the skills and competencies that magnet status hospitals require when hiring nurses.
Praise for Educating Nurses "This book represents a call to arms, a call for nursing educators and programs to step up in our preparation of nurses. This book will incite controversy, wonderful debate, and dialogue among nurses and others. It is a must-read for every nurse educator and for every nurse that yearns for nursing to acknowledge and reach for the real difference that nursing can make in safety and quality in health care." —Beverly Malone, chief executive officer, National League for Nursing "This book describes specific steps that will enable a new system to improve both nursing formation and patient care. It provides a timely and essential element to health care reform." —David C. Leach, former executive director, Accreditation Council for Graduate Medical Education "The ideas about caregiving developed here make a profoundly philosophical and intellectually innovative contribution to medicine as well as all healing professions, and to anyone concerned with ethics. This groundbreaking work is both paradigm-shifting and delightful to read." —Jodi Halpern, author, From Detached Concern to Empathy: Humanizing Medical Practice "This book is a landmark work in professional education! It is a must-read for all practicing and aspiring nurse educators, administrators, policy makers, and, yes, nursing students." —Christine A. Tanner, senior editor, Journal of Nursing Education "This work has profound implications for nurse executives and frontline managers." —Eloise Balasco Cathcart, coordinator, Graduate Program in Nursing Administration, New York University
Emergency and Trauma Care is written for Australian emergency care providers including paramedics, emergency nurses, pre-hospital care providers, nurse practitioners, general practice nurses and allied health practitioners including occupational therapists and physiotherapists who are caring for trauma patients.This book follows the patient journey from pre-hospital to definitive care. Using a body systems approach, each chapter provides comprehensive coverage of all aspects of adult and paediatric emergencies. Implications for clinical practice is supported by chapters of professional practice, clinical skills, research, evidence-based practice, and legal, ethical and cultural issues. Clinical assessment, physiology, management and rationale for intervention of common and not so common emergency presentations are provided, with each chapter providing clear and relevant examples for both Paramedics and Nurses.Emergency and Trauma Care brings together a team of highly respected clinical practitioners and academics to deliver the most up-to-date text dealing with the practical procedures and evidence experienced by emergency and trauma care providers every day. - Chapter 2 Pre-hospital care overview in Australia and NZ - Chapter 10 Scene assessment, management and rescue - Chapter 11 Pre-Hospital Clinical Reasoning, Triage and Communication - Pre-hospital and emergency nursing considerations included in all relevant chapters - Chapter 5 Cultural Considerations in Emergency Care addresses cultural diversity, beliefs and values and focuses on Aboriginal and Torres Strait Islander health and Maori health - Chapter 19 Resuscitation includes advanced life support, airway management and incorporates the 2010 Australian Resuscitation Council guidelines - Chapter 37 People with disabilities provides assessment, examination and communication strategies for working with clients with intellectual and physical disabilities - Section 5 focuses on examination and communication strategies for working with unique population groups, including the elderly, disabled, obstetric and paediatric patients - Section 6 details major trauma assessment and management, blast injury, and trauma to specific body regions - Essentials outline the main points addressed in each chapter - Practice tips assist with communication skills, procedures and assessment - Case studies supported by questions throughout - Summaries and Key points, review questions, web links and references provide for consolidation and further research. - Evolve resources include Power point slides, 30 additional Case studies, image bank, web links - Three paramedic specific chapters (including scene assessment and management)
This follow up title to the award winning Relationship-Based Care: A Model for Transforming Practice shows readers how Relationship-Based Care transforms the culture of care delivery. Written as a field guide, this book will inspire those who are working on the critical relationships that deliver superior care. The Relationship-Based Care Field Guide gives readers a sense of what It’s like to be part of an organization that never stops evolving. Long after Relationship-Based Care is alive and thriving in your organization, it will continue to grow and change. It is an essential resource, no matter where you are on your RBC journey!
This text is an invaluable resource for nurse researchers, scholars, and health care professionals committed to effective, quality nursing care as evidenced by nursing-sensitive outcomes measurement. The authors provide a comprehensive review of literature specific to outcomes measurement for self-care, symptom control, pain, adverse occurrences, and patient satisfaction.