Background Although strong evidence indicates that the presence of a patient's family during resuscitation has a positive effect on the family, the practice is still controversial and is not consistently implemented. Objectives To explore nurses' experience with resuscitation, perceptions of the benefits and risks of having a patient's family members present, and self-confidence in having family presence at their workplace. Differences in demographic characteristics and relationships between nurses' perceptions of self-confidence and perceived risks and benefits of family presence were evaluated. Methods The study was descriptive, with a cross-sectional survey design. A convenience sample of 154 nurses working in inpatient and outpatient units at an urban hospital were surveyed. The 63-item survey included 2 previously validated scales, demographic questions, and opinion questions. Results Nurses' self-confidence and perceived benefit of family presence were significantly related (r = 0.54; P < .001). Self-confidence was significantly greater in nurses who had completed training in Advanced Cardiac Life Support, had experienced 10 or more resuscitation events, were specialty certified, or were members of nurses' professional organizations. Barriers to family presence included fear of interference by the patient's family, lack of space, lack of support for the family members, fear of trauma to family members, and performance anxiety. Conclusions Changing the practice of family presence will require strengthening current policy, identifying a team member to attend to the patient's family during resuscitation, and requiring nurses to complete education on evidence that supports family presence and changes in clinical practice. (American Journal of Critical Care. 2014;23:e88-e96)
A large healthcare system was challenged to develop a nursing professional practice model that would apply to and be understood by nurses at all levels and across all entities of the organization. A team was convened, composed of direct care nurses, educators, clinical nurse specialists, Magnet program directors, managers, and directors, representing 5 hospitals, the organization institute for nursing, and system support services. The group drafted a model describing nursing across the organization. The draft model was vetted in nursing governance councils across the entity. The model includes a theoretical framework; a mission, vision, and values; elements of professional practice; internal accountabilities; and nursing outcomes. Nurses learned about the model through Web-based and face-to-face training, through participation in a professional practice model blog and group discussions.
Healthcare practice is increasingly focused on delivering care that is based on published research evidence. Staff development nurses can institute journal clubs to teach nursing staff critical appraisal of research articles and ways to translate research findings into clinical practice. Unfortunately, attending meetings regularly is often a challenge for nurses, and relatively few have the knowledge and expertise to adequately critique research articles. One way to bridge the limitations of accessibility and limited research expertise of journal club members is to establish a virtual journal club. This article describes one hospital's experience with developing a virtual journal club.
Meeting the Magnet Recognition Program® requirements for integrating research into practice can be daunting, particularly for nonacademic hospitals. The authors describe 1 healthcare system's approach to advancing nursing research in 5 hospitals through collaboration with a local university school of nursing and development of an infrastructure to support, empower, and mentor clinical nurses in the conduct of research. Outcomes include completed research, presentations, publications, practice change, and professional development.
Advancing evidence-based practice in hospitals can be a challenge. To address this issue, a virtual journal club (VJC) was developed using available intranet technology. Research manuscripts are posted along with professional critiques and discussion questions. Comments from nurse VJC participants are reviewed by the hospital's nursing research council and analyzed for practice implications. Recommendations for practice change derived from the analysis are forwarded to the appropriate decision-making body for consideration. This process closes the loop ensuring that the VJC not only exposes the nursing staff to scientific evidence to support changing their practice but also may lead to institutional policy changes that are based on best practice evidence in the literature. The authors discuss the VJC and the outcomes of an evaluation project.
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