Nursing model of care

The current study uses an ecological model of biopsychosocial vulnerability to guide the description of risk and protective factors for the mental health of gender minority (i.e., transgender and gender non-conforming) adolescents at the individual, family, community, and societal levels. Minority stress is the vulnerability of youth who are lesbian, gay, bisexual, and transgender (LGBT) to adverse mental health outcomes due to stigma. In addition, unlike cisgender (non-transgender) LGB individuals, gender minorities may experience internal stress related to gender dysphoria...

The purpose of this paper is to discuss the influence of applying Orem's self-care framework practice methodology on the content and comprehensiveness of a case study about a woman who denied having self-care deficits. The discussion begins with presentation of the case as it might have been found in a classroom or health professions journal and contrasts this with application of Orem's self-care framework practice methodology to illustrate how much more comprehensive the content of the case study is and how well it highlights the role of the primary care nurse practitioner in complex geriatric care...

The authors of this article integrate two historically parallel yet disparate fields of nursing, caring science theory and nursing quantum leadership science. Through a nursing, discipline-specific unitary paradigm lens, intersecting principles of caring science and quantum leadership science are uncovered. The result is a model for unitary, discipline-specific, nursing healthcare leadership: Quantum Caring Healthcare Leadership. Ontological congruence is uncovered among the philosophical-ethical-theoretical principles of caring science and the unifying disciplinary structural concepts from quantum leadership...

BACKGROUND: Aging is associated with an increased risk of accidental falls. Falls in older people have been widely studied in nursing homes and in the elderly with poor functionality, but there have been few investigations into functionally independent community-dwelling older adults. OBJECTIVE: To determine the predictive factors for falls in functionally independent community-dwelling older adults. METHODS: A cohort trial-nested case-control study was carried out...

QUESTIONS: What is the economic value of a physiotherapy career relative to other healthcare professions? Is the graduate debt reported for physiotherapy manageable according to recommended salary-weighted debt service ratio benchmarks? DESIGN: Net present value (NPV) is an economic modelling approach that compares costs and benefits of an investment such as healthcare education. An economic analysis using the NPV approach was conducted and reported in US dollars for the Doctor of Physical Therapy degree...

BACKGROUND: DNR decisions are frequently made in oncology and hematology care and physicians and nurses may face related ethical dilemmas. Ethics is considered a basic competence in health care and can be understood as a capacity to handle a task that involves an ethical dilemma in an adequate, ethically responsible manner. One model of ethical competence for healthcare staff includes three main aspects: being, doing and knowing, suggesting that ethical competence requires abilities of character, action and knowledge...

OBJECTIVES: ERAS protocols were developed for colorectal surgery to hasten post-op recovery. Variations of the protocol are being adopted for gynecologic procedures despite limited population and procedure-specific outcome data. Our objective was to evaluate if implementation of an ERAS pathway would facilitate reduced length of admission in an urogynecology population. MATERIALS AND METHODS: In this retrospective analysis of patients undergoing pelvic floor reconstructive surgery by 7 female pelvic medicine and reconstructive surgeons we compared same day discharge, length of admission and post-op complications before and after implementation of an ERAS pathway at a tertiary-care hospital...

INTRODUCTION: Antipsychotic use in nursing homes varies widely across the United States; inadequate staffing, skill mix, and geropsychiatric training impede sustained improvement. AIM: This study identified risk factors of antipsychotic use in long-stay residents lacking qualifying or potentially qualifying diagnoses. METHOD: This secondary analysis used 2015 Minimum Data Set and cost report data from 458 Missouri nursing homes. The full sample (N=29,679) was split into two subsamples: residents with (N=15,114) and without (N=14,565) a dementia diagnosis...

Background: Healthcare professionals' empathic behaviour is an important component of quality health care. Patients' reports suggest that empathy is often lacking. Specific factors that may facilitate or inhibit empathetic behaviour have not been extensively examined. In Qatar, empathy may be affected by a completely multicultural, multilinguistic setting where healthcare professionals and patients interact. Aim: The purpose of this integrative literature review is to provide the latest evidence on factors that influence the demonstration of empathetic behaviour of nurses and physicians toward patients and to draw general conclusions that increase understanding...

The aim of this meta-analysis of studies of workers in the health and social care sector was to examine the relationship between interprofessional work and employee outcomes of job stress, autonomy, burnout, engagement, job satisfaction, turnover intention, and perceived service quality, and to examine the influence of different moderators on those relationships. A systematic literature search of the PsycInfo, Embase, Medline, and the Cumulative Index to Nursing and Allied Health Literature databases was conducted to identify relevant articles...

BACKGROUND AND PURPOSE: Communication about risk factors for diabetes between nurse practitioners and college students may not be occurring as the prevalence of Type 2 diabetes increases. The purpose of this secondary analysis was to evaluate if college students are being told of their risk for diabetes based on known risk factors of weight, sleep, and depressive symptoms. METHODS: Descriptive, cross-sectional study was completed using National Health and Nutrition Examination Survey 2011-2012...

PURPOSE OF REVIEW: The present review describes our research experiences and efforts in advancing the field of infection prevention and control in nursing facilities including postacute and long-term care settings. RECENT FINDINGS: There are over two million infections in postacute and long-term care settings each year in the United States and $4 billion in associated costs. To define a target group most amenable to infection prevention and control interventions, we sought to quantify the relation between indwelling device use and microbial colonization in nursing facility patients...

OBJECTIVES: To evaluate the impact of low-friction (LF) bedding on graft loss in an acute burn care setting, and to examine the feasibility and costs of using LF bedding compared with standard care. DESIGN: Proof of concept before and after study with feasibility of delivering the intervention. SETTING: Three burns services within two UK hospital trusts. PARTICIPANTS: Inclusion criteria were patients older than 4 weeks, who received a skin graft after burn injury and were admitted overnight...

BACKGROUND: Recently, a bundled payment model was implemented in the United States to improve quality and reduce costs. While hospitals may be rewarded for lowering costs, they may be financially exposed by high cost complications, the so-called bundle busters. We aimed at determining the incidence, etiology, and costs of postacute complications after total joint arthroplasty (TJA). METHODS: A retrospective study was conducted using a prospectively collected database of patients who underwent primary total hip arthroplasty (THA) or total knee arthroplasty (TKA) from January 2015 to April 2016...

BACKGROUND: A first step to offer community-dwelling older persons proactive care is to identify those at risk of functional decline within a year. This study investigates the predictive value of registered information, questionnaire and GP-opinion on functional decline. METHODS: In this cohort study, embedded within the ISCOPE-trial, participants (≥75 years) completed the ISCOPE-screening questionnaire on four health domains. GPs gave their opinion on vulnerability of participants...

BACKGROUND: Poor nutrition and age per see add to the development of sarcopenia, i.e. loss of muscle mass and strength, which contributes to increased risk of impaired activities of daily living (ADL) and reduced independence. Protein deficiency plays an important role in the development of sarcopenia. In order to increase the muscle mass protein intake should be combined with physical exercise. A daily physical activity, the sit-to-stand exercise, has been proven to decrease older persons' dependence in ADL...

BACKGROUND: Elderly patients are vulnerable to adverse drug reactions (ADRs). Drug-related readmissions (DRRs) can be a major consequence of ADR. Therefore, this study aimed to investigate the effects of a ward-based, comprehensive pharmaceutical care service on the occurrence of DRRs as the endpoint in dependent-living elderly patients. METHODS: A randomized, controlled trial was performed at a German University Hospital. Patients fulfilling the following criteria were eligible: admission to a cooperating ward, existing drug therapy at admission, 65 years of age and older, home-care or nursing home residents in ambulatory care, and a minimum hospital stay of three days...

BACKGROUND: Enhanced recovery after surgery programs may improve recovery and reduce duration of hospital stay after joint replacement surgery. However, uptake is incomplete, and the relative importance of program components is unknown. This before-and-after quality improvement study was designed to determine whether adding 'non-surgical' components, to pre-existing 'surgical' components, in an Australian private healthcare setting, would improve patient recovery after total hip replacement...

Providing nursing students with appropriate clinical practice during their undergraduate programme is critical to ensuring that graduates meet the competency requirements to gain registration as a nurse. In response to the predicted nursing workforce shortage, universities have been significantly increasing the enrolment of undergraduate nurses into Bachelor of Nursing courses. This has placed a demand on the availability of clinical placements and often universities struggle to find appropriate places. In this study, a Bachelor of Nursing course incorporated an Integrated Clinical Learning Model (ICLM) for the first time during a mental health placement...

BACKGROUND: Nurse practitioners (NPs) are helping to bridge the gap not only in primary care but also in specialty practice. In an outpatient, neurosurgical spinal clinic in the midwest, patient volume exceeded provider availability, and to rectify this problem, a proposal for an NP triage system and an NP-led spinal clinic was presented. PURPOSE: The aim of this project was to use NPs to facilitate patient triage in an outpatient neurosurgical practice to expedite patients' access to care and ultimately improve patient satisfaction, outcomes, and healthcare expenditure...