Current healthcare changes make it a requirement for hospital and primary healthcare nurses to collaborate when working with adults to continue to meet the needs of patients. The findings of this study can be used to improve collaboration in practice and to devise research to improve collaboration between hospital and primary healthcare nurses.
Around 10% of hospital patients acquire a healthcare-associated infection and it has been estimated that around one-third of these could be prevented. This article discusses the causal link between hand hygiene and infection and the reasons why healthcare workers (HCW) fail to comply with hand-hygiene policies. The action of hand hygiene is discussed in terms of the removal of transient micro-organisms and the agents used. Reasons for non-compliance and some measures for achieving compliance, such as education and patient empowerment, are discussed alongside the difficulties that these present. In order to move forward, it is suggested that the problem has to be managed through cultural change, making it easier for HCWs to comply by improving hand-cleansing facilities and materials and providing feedback to personnel on local infection rates so that high-priority areas can be targeted. This may be facilitated by locally based action research.
The cost of infections in central venous catheters (CVCs) is high both to the NHS and to the patients and their carers. This article discusses reduction of infection in patients with CVCs. Adding to the debate on how to do this, three interlinked factors are discussed: (1) the virulence of the invading micro-organisms, (2) the environment for microbial growth, and (3) the host defence mechanisms. The article encourages healthcare workers to use interprofessional groups to write, update frequently, and discuss protocols designed to reduce infections. The discussion and updating of the protocols, based on local experience, monitoring actions and infection rates within the interprofessional group, will assist in the reduction of infection.
Aim: To identify the process of involvement in rehabilitation and produce a substantive theory of involvement based on data from a grounded theory study.Method: Qualitative data were collected longitudinally from 4 older people and 15 health care staff during the older people's stay in a rehabilitation unit in the UK and after discharge.Data were collected as recorded interviews with the older person in rehabilitation, interviews with their practitioners and routine conversations between the participants and staff.
Conclusion:This study describes the components of involvement and how they interact within Therapeutic Relationships. Further research is now needed to demonstrate the transferability of this substantive theory in other settings and with other client groups.
This paper describes the relationship between the professional nursing and managerial imperatives in health care and explains some of the ways the managerial culture affects the working environment of professional nurses. It goes on to highlight some of the professional developments of the last 17 years and describes how these could augment the difference in imperatives. Finally it suggests ways in which the nursing profession might develop to maintain its unique contribution to health care, whilst embracing the managerial domain. This is necessary to ensure that professional nursing is nurtured and not overwhelmed by workloads and empirical assessments of nursing outputs.
This paper describes the relationship between the professional nursing and managerial imperatives in health care and explains some of the ways the managerial culture affects the working environment of professional nurses. It goes on to highlight some of the professional developments of the last 17 years and describes how these could augment the difference in imperatives. Finally it suggests ways in which the nursing profession might develop to maintain its unique contribution to health care, whilst embracing the managerial domain. This is necessary to ensure that professional nursing is nurtured and not overwhelmed by workloads and empirical assessments of nursing outputs.
Infection is a major cause of morbidity in haemodialysis patients, of which between 25% and 50% of infections are related to vascular access, most commonly central venous catheters (CVCs) (Kessler et al, 1993). The morbidity associated with CVC infection provides a focus for research investigation, as there is limited knowledge available in relation to physiological and psychological parameters that may increase the probability of haemodialysis patients acquiring a CVC-related infection. This study explores these issues and discusses various factors that influence infection. It then describes how organisms which live on and inside our bodies can become parasitic, thus causing an infection. The precautions taken by healthcare professionals to reduce colonization and infection are enumerated, and the value of considering patients' physiological and psychological parameters alongside the more traditional extrinsic infection control approaches is discussed.
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