KilbrewRecuperation and NursingCare is a purpose-built premises. Residents are accommodated in single and twin bedrooms, each with en-suite shower, toilet and wash basin facilities. A variety of communal rooms are provided for residents' use, including sitting, dining and recreational facilities. The centre is located close to Ashbourne town on a large mature site, at the end of a short avenue in from the road. Together with gardens surrounding the centre, there are also two enclosed, themed gardens within the centre premises. The centre provides accommodation for a maximum of 74 male and female residents, over 18 years of age. Residents are admitted on a long-term residential, respite and convalescence care basis. The service provides care to residents with conditions that affect their physical and psychological function. Each resident's dependency needs are regularly assessed to ensure their care needs are met. The provider employs a staff team consisting of registered nurses, care assistants, maintenance, housekeeping and catering staff.
While there were systems in place to ensure residents' nutritional needs were met, and that they did not experience poor hydration, details of fluid and food intake records required improvement to ensure accurate information regarding quantities consumed was documented. This finding is actioned in Outcome 11. A policy was in place to guide practice and clinical assessment in relation to monitoring and recording of weights, nutritional intake and risk of malnutrition. Residents' food preferences were ascertained on admission and residents were facilitated to provide feedback on the menu options and choices provided to inform improvements. Staff spoken with were knowledgeable regarding the need to monitor residents at nutritional risk. Residents were screened for nutritional risk on admission and reviewed regularly thereafter. Residents' weights were monitored and checked routinely on a monthly basis or more frequently when indicated. Referrals were appropriately made by staff or residents' GPs in response to assessment of need or a change in a resident's condition. Nutritional care plans were in place that detailed residents' individual food preferences and dietary needs. Care plans outlined the recommendations made by the dietitian and speech and language therapist where
guidance to staff and was complete with a quick glance easy to read guide for staff. The inspectors saw in resident's files, who had been identified as a falls risk, assessments and care plans in place. The inspectors saw in the rooms of those residents at risk of falls control measures such as call bells, appropriate lighting, clutter free floor, low low beds, sensor mats and bed rails where required. Where bed rails were in use the resident’s general practitioner had been involved and consent from the resident, where permissible, had been received. Documentation regarding their usage was also present in the restraint register. Where residents required assistance of two care staff, due to their mobility, the inspectors found there was sufficient space in their bedrooms for this assistance. The bathrooms they availed of were equipped with appropriate facilities and space for two staff. The inspectors were assured that falls management was appropriate to the individual needs of residents.
Where necessary the inspector saw that referrals had been made to the dietician and plans of care put in place such as an increase in protein to promote tissue granulation. Tissue Viability Nurses were also sourced when required which for the most part were sourced through the general practitioner. The general practitioner also reviewed
person in charge was a qualified nurse with postgraduate qualification in healthcare management and gerontology. Her post at the centre was full-time and she was assisted by an assistant director of nursing in addition to a team of nurses, healthcare assistants and ancillary staff members. She facilitated the inspection well and demonstrated her knowledge of the Regulations and the Standards in addition to her responsibilities in implementing these throughout the day for example good care planning and record management.
Universal Screening Tool' (MUST), details of the assessment procedure including a template of the tool was not included in this advisory document Residents were screened for nutritional risk using the MUST assessment process on admission and reviewed regularly thereafter. Residents' weights were checked routinely on a monthly basis and more frequently where residents experienced unintentional weight loss. Nutritional assessment and care plans were in place that outlined the recommendations of dietician and speech and language therapists where appropriate. Systems were in place for recording and monitoring residents' nutritional and fluid intake where required. Inspectors saw that residents had a choice of hot meals for lunch and tea. While there were arrangements in place for communication between nursing and catering staff to support residents with special dietary requirements, some improvement was needed to ensure copies of the original recommendation sheets were consistently provided to the chef. Inspectors found that residents on weight-reducing, diabetic and fortified diets, and residents who required modified consistency diets and thickened fluids, received the correct diets. Although staff supported residents requiring assistance, not all residents received assistance in a timely manner in one dining room and were observed to be waiting for assistance with their meal and with leaving the dining room. This finding is discussed in outcome 5.
The majority of the samples were within young age group and male, most of them graduated from institute of nursing, the majority of them were in low experience in CCU, the majority of the nurses have not participated in training regarding nursingcare in CCU, and small numbers of the nurses had trained only once. There was a significant relationship between the quality of care and age, gender, duration of experience in nursing and in CCU. A very highly significant relationship was found with levels of education of nurses, participation and time in training regarding nursingcare in CCU.It is recommended to increase the number of nurses with high
High-quality nursingcare is a type of patient- centered scientific nursing protocol that empha- sizes the professional care methods, enhances fundamental nursingcare, and implements pri- mary nursing comprehensively . Transitional nursingcare refers to a series of nursing activi- ties that, conforming to evidence-based medi- cine principles, aids the patients and their fam- ily to improve their self-nursing ability, thereby enabling continuous nursingcare for patients in different situations. High-quality nursingcare and transitional nursingcare have been report- ed to yield promising outcomes for COPD [9-11]. Few studies have focused on the combined application of these two strategies in the recov- ery of COPD patients.
strategies, more than half of the students’ demonstrated negative caring behavior. There was also no significant difference in students’ caring behavior before and after completion of the learning program. However, according to the 10 carative factors, the transpersonal teaching-learning factor, provision of supportive, protective, and/or corrective mental, physical, sociocultural, and spiritual environment, and existential-phenome- nological spiritual forces significantly improved. It can be concluded that the effectiveness of a variety of learning strategies in improving nursing students’ caring behavior could greatly be affected by the role performance of tutors/facilitators or lecturers. Hence, the tutors may need a quality enhancement program (scientific meeting, training of trainer [ToT], and regular performance evaluation). It is recommended incorporating a holistic humanistic approach in implementing learning strategies throughout the course of undergraduate study to enable students strengthen their caring behavior.
In addition to the task nursing, patient assignment, team nursing and primary nursing a number of institution specific nursing practice/care delivery models had come into being. In August 1 988 the Robert Wood 10hnson Foundation and The Pew Charitable Trust challenged American nurse leaders and their executive colleagues to take a risk, to shift their paradigms, and use their imaginations to create a vision for the future. The SHNP (Strengthening Hospital Nursing Program) was developed in response to the challenge (Flarey, 1 995). Older models of care delivery were redeveloped and new models uniquely designed around an individual organisation ' s mission and philosophy were created. Since then models have proliferated and nurses have sought to find the most effective and efficient nursingcare delivery system. To illustrate this, just prior to the interviews for this study the USA journal Nursing Management published articles on five community health models; the Carondelet model community nursing (Ethridge, 1 997); the University of Rochester school based health centre (Walker, & Chiverton, 1 997) ; the Vanderbuilt University community health models (Spitzer, 1 997) ; the community nursing centre model, developed at the University of Wisconsin-Milwauke (Lundeen, 1 997) and the Community Nursing Organisation(CNO) model at the Carle Clinic (Shraeder & Britt, 1 997).
Drawdown and recuperation pattern of wells are much dependent on the aquifer parameters. Analysis of drawdown and recuperation pattern of wells is necessary for the determination of various aquifer parameters. The levels at which water stands in a well before pumping is called static water level. When a well is being pumped, the water level in the well lowers. In general case initial contribution of water from the well mostly comes from the well storage. It is only after sometime that the aquifer starts contributing to pumpage. The time gap between the onset of pumping and the beginning of an appreciable flow of water from the aquifer to the well depends mainly on the transmissivity of the aquifer. The linear relationship between drawdown and time implies that the water is pumped mostly from storage. Thus time drawdown curves were initially linear, but later with the beginning of the contribution from the aquifer; they gradually become non-linear.
expanding the offerings in health for the population of drug users (Passos, Souza, 2011). The adoption of the DR perspective presupposes openness to dialogue, reflection, questioning and continuous evaluation of interventions. Approaches based on DR imply considering the vulnerability of people and collectives (Brasil, 2013). In this way, care in the context of drug consumption shows the need to know the different profiles that surround the issue. Thus, the importance of listening to the teachers of the nursing and medical courses about their understanding of public policies in the mental health area related to drug use is justified, observing the weaknesses and potentialities for the construction of strategies that prevention and coping with drug use. In this context, the need to carry out the study with the following guiding question was observed: how teachers of undergraduate courses in Nursing and Medicine perceive the care related to the consumption of crack, alcohol and other drugs, in the context of social and health public policies?
Despite the use of increasing numbers of antihypertensive agents in care home residents, there has been no improvement in the control of their blood pressure. These vulnerable people are therefore being exposed to an increased risk of side effects without the intended bene ﬁ t. This increase in the number of agents may well re ﬂ ect the growing problem of polypharmacy, which has been extensively documented and discussed over the past few years. 30 These ﬁ ndings justify further study of the treatment of hypertension in care homes in countries outside the United States. They also justify reexamination of whether the bene ﬁ t of treatment exceeds the harm in some diagnostic groups resident in care homes, such as those with dementia in whom the risk of side effects may be particularly high. The ﬁ ndings also remind clinicians to take particular care to weigh potential bene ﬁ ts and harms in prescribing for hypertension in care home residents, given that increasing treatment does not necessarily lead to better blood pressure control.
There have also been reviews focused on research challenges in LTC settings. A number of studies summa- rized ethical challenges [12–14], while others discussed the difficulties of studying a particular condition in LTC, such as falls, delirium and incontinence [15–17]. Ruck- deschel et al. targeted issues on gaining LTC staff sup- port , while Reed et al. discussed the issue of research governance in LTC . An article by Maas et al. in 2002 was a more extensive review, covering various challenges of nursing research in LTC, but it was not a systematic review and did not use a comprehensive lit- erature search strategy . We searched the PROSPERO website to check for existing systematic review protocols on this topic and found none . The purpose of this study was to provide an updated and comprehensive sys- tematic review of the challenges of conducting research in LTC facilities as reported in empirical research stud- ies. By organizing these challenges into themes, we hope to provide investigators with a framework for anticipat- ing and dealing with these challenges in order to facili- tate research in LTC.
Benefits in cash are provided by the state or local municipalities, benefits in kind are provided by the local municipalities. Social welfare services are organised by municipalities, because they are best acquainted with local life. The local government can provide services itself or purchase the services from private or public sector organisations. The care service provider can thus be an establishment or organisation of any ownership form, but the service it provides must meet established requirements. From the point of view of increasing service efficiency, it is advisable that local governments co-operate to supply certain services together. As there are over 200 municipalities in Estonia, many local governments are relatively small. Accordingly, it is not financially possible or even feasible for them to offer all the services in each municipality alone.
Based on the results of the research by Wicaksana (2016), the performance of field nurses is inseparable from the indicators of the nursing services quality and patient satisfaction which lead to quality nursingcare services based on the performance of professional nurses. Nurses' performance on nursing services in hospital requires strong commitment of nurses to hospital organizations. The nurse's commitment to the organization is a work attitude that is defined as a situation in which a nursing staff takes sides with the organization and its goals and intends to maintain membership in that organization.According to Zurnali (2010), organizational commitment is a strong and close feeling of someone towards the goals and values of an organization in relation to their role in the effort to achieve those goals and values. Organizational commitment of a nurse as a state of psychology that characterizes the relationship of nurses with the organization or its implications that influence whether nurses will remain in the organization or not is identified in three components: affective commitment, continuance commitment and normative commitment (Zurnali, 2010).
In Iran, due to lack of nurses, lack of time, fatigue, the managers’ interest in routine physical care, and the lack of emphasis on holistic care in nursing education, nurses may not have the necessary knowledge and skills for hol- istic care. For this reason, the patients are dissatisfied . Peyrovi et al. (2013) reported that care for Iranian patients is focused on more physical aspects of care, while nurses are required to pay attention to other di- mensions of care to provide comprehensive care . It is very important and essential to study holistic nursingcare for all aspects of human existential dimensions such as body, mind and soul, and the relationship between the viewpoint of patients as care recipients on holistic care and overall satisfaction with nursingcare has not been studied in Iran. Therefore, the current study aimed to determine the relationship between overall patient satisfaction“ and “holistic nursingcare in hospitals of southeastern Iran.
And it is from this idea that the nursing accompanies the development of the technologies, being able to realize them in the work process, just like the education technologies that they help in the process of teaching and learning, what it is of great importance in the education in health, besides it is possible to observe the importance of the technologies assistance what have as objective to mediate it to take care given by the professional to a user in the primary, secondary or tertiary attention (AFIO et al, 2014). And with that the technologies assistance (TA) make possible the construction of a scientific- technical knowledge that results from investigations, applications of theories and of the daily experience, constituting a set of systematized, processual and instrumental actions for installment of a presence qualified a human being in all his dimensions and have as supporting objective, maintaining and promoting the process of the life of the persons in situations of health and disease (NIETSCHE et al.,2005). In this way, the technologies have great importance in the daily life of work of the nurse, since they provide scientific character to the care, making possible to adapt and to plan the presence, developing scientific knowledge that provoke improvements in the service and produce products that they will influence in practice of taking care (RITTER et al., 2015). In this context the objective of the study was of building a technology assistencial for the applicability of the SAE in the APS, in the program of the prenatal one, which subsequently it will be validated for the implementation.
, responsibility and the role of caring for the other (Santos, 2014). The accumulation of new knowledge observed during the care practice favored the development of nursing theories, providing a scientific character for the nursing practice. The formulation of theoretical postulates was the solution found to compile all nursing knowledge, in order to promote a service based not only on the biological dimension of the human being, but also on the understanding of the man as a social being (Silva et al., 2015). Currently, the NCS establishes into an object of concern for nurses in the most varied spheres of action, in the teaching, research or assistance context. There is an increasing effort and involvement of professionals to perform the NCS in many health institutions, but the constant modifications required for its implementation demonstrate advances and setbacks, with results that change according to the local organization (Benedet et al., 2016). While seeking its solidification as a care science, the nursing still seeks the organization of its professional precepts. In this context, the NCS appears as a solid theoretical structure that aims to professionalize the assistance to the client through working instruments that support in decision-making for the application of scientific, holistic and constant care (Salvador et al., 2017). The objective of this study is to investigate nurses’ knowledge about the theorization and the applicability of the NCS and the NP in the Intensive Care Unit (ICU).
stone surgery. The possible reasons were that full preoperative preparation made patients in the best condition to receivesurgery; nursesad- equately prepared the items toensure smooth operation; meticulous psychological care, and effective health guidance let the patients coop- erate with medical staffs better; the primary nurses closely observed the changes of the patients’ condition, strengthened the drainage tube nursing, prevented the complications, and treated complications once they appeared; th- ese measures together ensured the success of kidney stone surgery and promoted patient recovery, which was similar to the findings of previous findings [1, 35]. It was said that provid- ing positive psychological care, eliminating patients’ concerns, helping patients establish the confidence for surgery, closely observingthe condition after operation, giving symptomatic nursing, and strengthening the drainage tube nursing could effectively reduce the incidence of infection, shorten the hospital stays, as well as promote the patient recovery early . This study is a single center study, and there are some limitations in sample selection. Therefore, in the future research, multi-center researches need tobe carried out with more representative samples.