Journal of Nursing & Care

To ascertain the possible impact of Rogerian Science on nursing in Spain, a bibliographic study of journals publishing in Spanish has been carried out. The results indicate a scarcity of articles on Rogers’ model, which is in line with the present authors’ perception of a general lack of awareness and appreciation of the model within their own national (Spanish) nursing community. Bibliographic results on Rogerian literature published in other (non- English) European languages are also presented, for comparison with the result for Spanish. Nursing research in Spain is still in the process of development, the incorporation of nursing into the European Higher Education Programme has allowed improvements in academic training but there is a need to call to action for Spanish nurses to explore out of the Scientific Iberoamerican space (ECI).

To ascertain the possible impact of Rogerian Science on nursing in Spain, a bibliographic study of journals publishing in Spanish has been carried out. The results indicate a scarcity of articles on Rogers’ model, which is in line with the present authors’ perception of a general lack of awareness and appreciation of the model within their own national (Spanish) nursing community. Bibliographic results on Rogerian literature published in other (non- English) European languages are also presented, for comparison with the result for Spanish. Nursing research in Spain is still in the process of development, the incorporation of nursing into the European Higher Education Programme has allowed improvements in academic training but there is a need to call to action for Spanish nurses to explore out of the Scientific Iberoamerican space (ECI).

Diabetes is a disease in which premature development of conditions which increase blood coagulation are the leading cause of death. A reduction in the consequences of elevated glucose levels is the main focus of clinical treatment. It has been determined that the addition of glucose to anti-coagulated human blood, followed by incubation for 24 hours results in the generation of a hypercoagulable state, which is evaluated by reduction in whole blood clotting time. Incubation for 2 hours did not show the same change in clotting. Furthermore, the addition of glucono-delta-lactone, a low-toxicity food additive mitigated the hypercoagulable state which may, in part, be produced by tissue factor generated by up-regulated monocytes. This demonstration of in vitro glucose toxicity may broaden our clinical knowledge of the diabetic state. Also, glucono-delta-lactone warrants additional studies to confirm its anticoagulant properties.

Medication errors in intravenous drug administration can be defined as any mistakes in the preparation, dispensing and administration of these drugs. Medication errors can be classified based on the stage of intravenous therapy in which the error occurs (pre-preparation phase, preparation of medication by nurse, drug labelling, and drug administration). In intravenously administered medications, errors may have particularly serious consequences.

Medication errors are more likely to be recorded during the morning hours. Inappropriate speed of administration was found to be the most common type of error in intravenously administered drugs, with slow bolus injection being the route of administration associated with the most risk. Greater safety of the medication process can be achieved by eliminating risk factors and by using different strategies to detect errors. In addition to eliminating the most dangerous human risk factors (work overload of nurses, their fatigue, and general lack of personnel), the use of various supportive technologies, such as computerized prescription of drugs, barcode scanning, and the use of electronic infusion pumps, effectively decreases the risk of medication errors.

Exchange programs are an important educational activity for student nurses. Each year, eight student nurses from a Taiwan University are chosen to go to Brisbane, Australia for one month as part of an exchange program. At the nursing exchange program, they not only attended labs, tutorials, simulations, lectures, and workshops, but also visited hospitals and aged care facilities. An explorative and descriptive approach was used to examine the experiences of eight student nurses. Four categories emerged from the analysis: 1) “Help from friendly environment,” 2) “having eye-opening experiences,” 3) “feeling home sick,” and 4) “feeling culture shock.” Although several studies have found similar findings, no recent studies discussing the experiences of Asian students in exchange programs in Western countries were found. The findings provide potential insight into the Asian students’ experiences of exchange programs in Western countries. Nurse educators can consider these perspectives in planning educational exchange program in the future and inform future potential participants what to expect during the program.

Introduction: Transcultural nursing education is often neglected within nursing curricula and inclusion within curricula may be haphazard. Little is known about nursing students’ views on transcultural nursing education. There is a lack of research examining how nursing students are prepared in university and practice settings for nursing in a multicultural society.

Objective: To examine nursing students' preparation for and experience of cross-cultural encounters.

Method: Semi-structured interviews were undertaken with a purposive sample of 10 final year students from one university in Sweden: 5 participants were from a Swedish background and 5 from an immigrant background. Interviews explored participant’s experiences of preparation for and experience of nursing in a multi-cultural society. Interviews were audio recorded, transcribed and analysed using ‘framework’ approach.

Results: Three themes were identified in the analysis: experiential learning through life experience, educational preparation for practice, and learning in clinical education. Students from an immigrant background emphasized the importance of their life experiences while ethnic Swedish students emphasized education in equipping them to meet patients from another culture than their own. In clinical settings students used their skills of self-awareness to reflect upon their response to cross-cultural encounters as well as critical reflection on practice. In clinical placements, students were inadequately prepared to deal with negative attitudes, racism and discrimination towards patients and in some instances towards themselves.

Conclusion: Although nursing students felt nursing education had equipped them with the necessary selfawareness, knowledge and skills to face cross-cultural encounters, nursing education had failed in preparing students to deal with negative attitudes, racism and discrimination. Nurse educators need to place greater emphasis on preparing students deal with difficult situations arising from racism and discrimination that they may experience in clinical practice. Students need to understand why racism and discrimination may occur and also how to respond and act appropriately.

This article examines the experiences of a student nurse early in training and how such experiences form the basis to understanding caring in nursing. Upon reflection of a seemingly routine event with a patient, the student nurse inspects the meaning of caring, patient-centered care, and holistic care, along with their barriers in the practice of nursing. To conclude, the student explores potential remedies to barriers in caring for both novice and experienced nurses.

Background: Significant efforts have been directed to understand medication errors causes in recent years because it contributes directly to patient morbidity and mortality. This study was conducted to determine the factors influencing the occurrence of medication administration errors, as perceived by nurses in emergency department (ED).

Aim: The current study aimed to assess emergency department nurses’ perceptions toward factors influencing the occurrence of medication administration errors.

Design: The study followed a cross-sectional descriptive design.

Setting: The present study was carried out at ED in teaching Main University Hospital in Alexandria governorate, Egypt.

Subjects: 84 nursing staff worked in the previous mentioned setting.

Tool: The data gathering tool was Medication Administration Errors (MAEs) Reporting Questionnaire which was developed by Wakefield in 1998 [1]. It contains 16 items regarding reasons why medication errors occur.

Results: This study suggested four categories for reasons of why MAEs occur in emergency department and the leading cause of medication errors was due to nurses- physicians' communication.

Conclusion: Medication errors are common in emergency department. A wide range of factors perceived as contributing factors of the occurrence of medication administration errors were identified such as nurses- physicians communication, medication packaging, pharmacy processes and nurse staffing. This information could be used to improve the medication system in emergency department in Egypt.

Recommendations: This study recommended for provision of safe work environment that encourage good physicians-nurses team work relationship, dissemination of safety guidelines in all hospital department specially nursing and pharmacy, on-going education and training on safe medication administration and supervision of newly hired nursing staff during medication administration process and provision of adequate staffing and fair scheduling for nursing staff working in a highly urgent care departments.

Background: Nurse Shift is a routine but essential operation in hospital management. Classically, paper records have been used in nurse shift but these procedures are time consuming and inefficient. For efficiency and quality nursing care, as well as patients' wellbeing, a computerized nurse shifting information system is essential.

Objective: This study aimed to estimate the performance of a computerized nurse shifting information system (CNSIS) designed to simplify the nurse shifting procedures.

Methods: Seventeen female nursing staffs were recruited into this study. Two thousand and one hundred sixty six nursing shift data related to 142 inpatients from one ward during the period of November 20, 2007 to January 4, 2008, were also used in the analysis. ANOVA was used in analysing the time consumed before and after CNSIS implementation.

Results: On application of CNSIS, time needed for shift (TNS) during 2nd (p<000), 3rd (p<000) and 4th week (p<000) had decreased significantly. Besides, only one incomplete intake and output event was reported.

Conclusions: The CNSIS appears to increase the efficiency of nursing administration. Implementation of CNSIS is promising and worth to be practically used in nursing administration.

Introduction: Needle Stick and Sharp Injuries (NSSIs) are the commonest rout by which blood borne infections such as HIV, HBV and HCV can transmit. Such infections serve as high occupational risks and threats to health professionals. The objective of this study was to assess the prevalence of Needle stick and sharp injuries and associated factors among nurses working in Jimma University Specialized Hospital, South West Ethiopia.

Methods: An institutional based cross sectional study design was employed among nurses with at least one year work experience in Jimma University Specialized Hospital from March 31 to April 04, 2014. A total of 173 study subjects were selected using simple random sampling technique from sampling frame using lottery method. Data was collected using pretested English version questionnaire through self-administered interview. To maintain the quality of data pretesting and supervision of data collection process was done. The collected data were checked for completeness, edited and entered into EpiData version 3.1 and exported to SPSS version 21.00 for analysis. To explain the study variables descriptive statistics was used. Association between dependent and independent variables was calculated using chi square test. P-value of less than 0.05 was considered as significant association.

Results: Out of the total 173 study subjects, 170 were included in the final analysis and giving a response rate of 98.3%. Majority of the study subjects 95 (55.88%) were female nurses. This study indicate that nurses’ sex, monthly salary, marital status, work experience, working Unit/department/, training on IP and patent safety, presence of contaminated needle and sharps materials in the working area, job satisfaction, level of job stress on nurse respondents, use of personal protective and gloves during the practice work by needles/sharps and recapping of needles after use had significant association with the occurrence of sharp and needle stick injury in nurses. In general this study revealed that no single factor accounted for the occurrence of NSSIs.

Conclusion and recommendation: This study demonstrated a relatively high prevalence of NSSIs among nurses of JUSTH. The high prevalence of NSSIs highlights the need for developing effective preventing strategies. Training of nurses should be emphasized and essential in preventing high NSSIs risks in the hospital.

Title: Evaluating the integrating of life and social sciences teaching to first-year nursing students.

Objectives: To evaluate an integrated teaching and learning approach to first-year nursing students, combining the life, social sciences and public health with a more integrated and clinical focused approach to teaching delivery

Background: Historically within the School of Nursing and Midwifery the life sciences and social sciences had been taught as separate modules with separate teaching teams. This had reflected in a somewhat dis-integrated approach to student learning and understanding without clear clinical focus on application. With focus upon student learning the teaching teams engaged with a stepped, incremental and progressive movement towards developing and delivering a more integrated structure of learning, combining the life sciences, social sciences and public health teaching and learning within the one extended first-year module. The focus was particularly on integrated understanding and clinical relevance. This paper discusses both the approach to developing the integrated model of teaching and the evaluation of that teaching.

Results: The module combining life, social science and Public health teaching was positively evaluated by the students. Evaluations are compared and contrasted from 2 nursing student groups of admissions. • integrated learning • clinical relevance • combining life and social science teaching

Introduction: Patient Experience is stressed more in the context of patient safety and patient-centered care. It is a crucial component in quality evaluation of healthcare. In Japan, Patient Experience Survey (PES) has been conducted at the national level in three-year intervals since 1996. We overviewed general satisfaction of patients in time- series and examined the factors associated with.

Methods: Open source data of PES from 1996 to 2011 were used to find time-series change in general patient satisfaction. For cross-sectional analysis, we examined the factors influencing patient satisfaction by using original PES data of 2005. Cronbach’s alpha was calculated for examining reliability of seven questions about patient satisfaction. Logistic regression analysis adjusted for age and sex was used for examining the associations with patient satisfaction and other factors.

Results: Overall rates of showing general satisfaction (extremely satisfied and satisfied) were gradually increased from 53.7% to 64.7% among inpatients, but less increase among outpatients from 48.1% to 50.4%. Seven questions on patient satisfaction in the questionnaire for both inpatients and outpatients, high reliability were confirmed with Cronbach’s alphas 0.895 and 0.863, respectively. The highest average score was found in satisfaction with care provided by nurse. Patients’ general satisfaction was highly related with satisfaction in good communication with physician (Pearson’s correlation coefficient; r=0.650, p<0.01). Among outpatients, satisfaction with the cost which patients paid on the day they visited had smaller correlation coefficients compared with other satisfaction variables (r=0.255-0.294). Respecting autonomy (patients decision was respected on treatment) had positive association with patient satisfaction (β=0.152, SE=0.031, p<0.001) and uncertainty of patient safety had negative association with patient satisfaction (β=-1.512, SE=0.052, p<0.001).

Figure 1: Percentages for levels of general satisfaction in PES 2005. The number of valid answers were collected as following: inpatients: n=132,932 (1996), n=113,980(1999), n=73,370(2002), n=112,719(2005), n=42,239(2008), n=51,632(2011), outpatients: n=214,432(1996), n=191,987(1999), n=115,907(2002), n=172,809(2005), n=100,946(2008), n=98,988(2011).

Conclusion: General satisfaction among patients has been stable or slightly improved over 15 years. Good communication with physician, respecting autonomy and patient safety should be recognized again to improve patient satisfaction.

Objective: Care coordination is a core competency for primary care nurses and an essential element of the Patient Centered Medical Home (PCMH) model. Implementing care coordination in primary care is challenging and requires changes in roles, staffing, and culture. Clinical Microsystems are frontline teams of healthcare staff that, when engaged in quality improvement, can make important contributions towards practice redesign. We used a Microsystem team to develop an effective model to integrate nurse care coordinators into a busy primary care center.

Methods: A Clinical Microsystem team, supported by an improvement coach, met weekly for one year to develop and test a new nurse staffing model in a large Federally Qualified Health Center. Intervention uptake and impact on workflow was tracked by direct observation of nurses and by measuring volume of nursing visits and virtual contacts. Nurses in a non-participating site with similar characteristics served as a comparison group.

Results: The Microsystem team developed and implemented a new nurse care coordination model for their site. The intervention emphasized patient self-management, independent nursing visits, and hospital and emergency room transition support. The nurse care coordinator in this new role managed 335 patients over a nine-month study period. The nurse in this new role spent 276 minutes over two days of observation engaged in direct care coordination work while two nurses at the comparison site spent only 94 minutes and 149 minutes, respectively, over the same time period.

Conclusion: Engaging front line staff is an effective way for organizations to make changes in delivery systems, improve quality and spread innovations. In this study, a Microsystem team developed a model to provide key components of care coordination to support PCMH practice redesign at a large community health center.

Objective: The purpose of this study was to determine the characteristics of Parental Perceptions of Toddlers and Preschoolers Feeding Assessment Index (PPTPFAI) scores of parents with preterm children through comparisons with full-term children; to identify factors associated with PPTPFAI for preterm children; and to obtain recommendations for nursing care aimed at supporting parents who feed preterm children.

Methods: We conducted a cross-sectional study of parents of pre- and full-term toddlers and preschoolers using an anonymous self-administered questionnaire and an interview. We performed descriptive statistical analysis using the Spearman rank correlation coefficient and Mann-Whitney U test. We set the PPTPFAI as the dependent variable and performed a stepwise multiple regression analysis.

Results: Comparisons of the PPTPFAI total score or the individual sub factor scores between the 76 preterm children and 76 full-term children revealed no significant difference. We found no significant correlation between gestational age at birth, physique at birth, or duration of hospitalization directly after birth and PPTPFAI total score or individual sub factor scores in parents of preterm children. The main factors influencing the PPTPFAI score were the child’s reaction score, child’s age, and Parenting Stress Index-Short Form score.

Conclusion: For parents to feel that they are supporting their preterm children’s eating on their own initiative, it is important to focus nursing care on the perceptions of parents of their preterm children’s reactions as well as parenting stress.

Background: Women who have a mental illness are no less likely to plan for motherhood than any other group in the community. On the contrary, many women with mental illnesses are fully functioning members of society, juggling employment, career, study, family and parenting in conjunction with the ‘normal’ stressors of life. However this is not the case for all. Their burden of illness places extra strain and stress on their lifestyle and family dynamics, often being exacerbated during pregnancy and following the birth. Although some of these effects may be ameliorated using different treatment modalities, they are frequently offered in a disconnected fashion. The introduction of an integrated, holistic approach, as the primary model of care, can successfully incorporate aspects of assessment, prevention and management, thereby strengthening maternal mental health in pregnancy and encouraging healthy mother and infant outcomes.

Purpose: This paper will highlight and discuss special issues for pregnant women with mental illnesses, to increase clinical awareness, encourage risk assessment and promote management planning, by using an integrated model of care in support of women during pregnancy and in early motherhood.

Conclusion: Pregnancy places extraordinary stress on every conceivable aspect of a woman’s life, including the exponential changes to her own body, intimate relationships, family groupings, career development and lifestyle adjustments. There is true, ongoing, holistic change to the extent that mental health can be compromised. Knowledge of such changes and the opportunity to encourage healthy outcomes must, therefore, be fully supported with an integrated approach by clinicians, consumers and carers.

Objective: This study aimed to establish appropriate health education in Thailand to compare the health education of Thailand and Japan.

Method: Participants in Salaya, Thailand, totalled of 24 people aged 69.1 ± 6.6 years, whereas participants in Minowa, Japan totalled 46 people aged 62.7 ± 4.7 years. Implementing the health program lasted 6 months in Salaya and 10 months in Minowa. We measured the energy expenditure using a pedometer and implementing Go/No-Go task for the brain function test and physical fitness tests in the before and after this period.

Results: The results of Salaya showed the average walking steps were 4,012. As for Minowa, the average walking steps were 8,644. In Minowa, the Go/No-Go task number of error responses significantly decreased after the program, although Salaya was not significantly different. As for Salaya, the results for grip strength and sit ups significantly decreased after the program, whereas 6-minute walk significantly improved. In Minowa, the results of the handgrip strength, sit ups, sit-and-reach flexibility, 10-meter obstacle walk, and the 6-minute walk significantly improved after the program. The handgrip strength and sit ups of Minowa showed a significant difference from those of Salaya.

Conclusion: By doing the 90-minute strength and weight training once a week in Minowa the participants may have encouraged one another to a superior number of walking steps, and better rest results on the Go/No-Go task and the physical fitness tests compared with those of Salaya