Background Debate continues among nurses about the advantages and disadvantages of family presence during resuscitation. Knowledge development about such family presence is constrained by the lack of reliable and valid instruments to measure key variables. Objectives To test 2 instruments used to measure nurses’ perceptions of family presence during resuscitation, to explore demographic variables and perceptions of nurses’ self-confidence and the risks and benefits related to such family presence in a broad sample of nurses from multiple hospital units, and to examine differences in perceptions of nurses who have and who have not invited family presence. Methods Nurses (n = 375) completed the Family Presence Risk-Benefit Scale and the Family Presence Self-confidence Scale. Results Nurses’ perceptions of benefits, risks, and self-confidence were significantly and strongly interrelated. Nurses who invited family presence during resuscitation were significantly more self-confident in managing it and perceived more benefits and fewer risks (P < .001). Perceptions of more benefits and fewer risks were related to membership in professional organizations, professional certification, and working in an emergency department (P < .001). Data supported initial reliability and construct validity for the 2 scales. Conclusions Nurses’ perceptions of the risks and benefits of family presence during resuscitation vary widely and are associated with how often the nurses invite family presence. After further testing, the 2 new scales may be suitable for measuring interventional outcomes, serve as self-assessment tools, and add to conceptual knowledge about family presence.
Background Prevention of falls during hospitalization depends in part on the behaviors of alert patients to prevent falls. Research on acutely ill patients’ intentions to behave in ways that help prevent falls and on the patients’ perceptions related to falls is limited. Objective To explore hospitalized adults’ perceptions related to risk for falling, fear of falling, expectations of outcomes of falling, and intention to engage in behaviors to prevent falls. Methods Adult, alert, acutely ill inpatients (N = 158) at risk for falling completed a survey consisting of 4 scales and 3 single items. Nurses’ assessments and patients’ perceptions of the risk for falling were compared. Results Decreased intentions to engage in behaviors to prevent falls were correlated with patients’ increased confidence in their ability to perform high-risk behaviors without help and without falling (P < .001), decreased fear of falling (P < .001), and decreased perceived likelihood of adverse outcomes if they did fall (P < .001). Although nurses’ assessments indicated a risk for falls, 55.1% of the patients did not perceive a high likelihood of falling while hospitalized. Whereas 75% of patients intended to ask for help before getting out of bed, 48% were confident that they could get out of bed without help and without falling. Conclusions Although assessments may indicate a risk for falling, acutely ill inpatients may not perceive they are likely to fall. Patients’ intentions to engage in behaviors to prevent falls vary with the patients’ fall-related perceptions of confidence, outcomes, and fear related to falling.
Aims and objectives To explore the similarities and differences in factors that influence nurses' and physicians' decision‐making related to family presence during resuscitation. Background Despite the growing acceptance of family presence during resuscitation worldwide, healthcare professionals continue to debate the risks and benefits of family presence. As many hospitals lack a policy to guide family presence during resuscitation, decisions are negotiated by resuscitation teams, families and patients in crisis situations. Research has not clarified the factors that influence the decision‐making processes of nurses and physicians related to inviting family presence. This is the first study to elicit written data from healthcare professionals to explicate factors in decision‐making about family presence. Design Qualitative exploratory‐descriptive. Methods Convenience samples of registered nurses (n = 325) and acute care physicians (n = 193) from a Midwestern hospital in the United States of America handwrote responses to open‐ended questions about family presence. Through thematic analysis, decision‐making factors for physicians and nurses were identified and compared. Results Physicians and nurses evaluated three similar factors and four differing factors when deciding to invite family presence during resuscitation. Furthermore, nurses and physicians weighted the factors differently. Physicians weighted most heavily the family's potential to disrupt life‐saving efforts and compromise patient care and then the family's knowledge about resuscitations. Nurses heavily weighted the potential for the family to be traumatised, the potential for the family to disrupt the resuscitation, and possible family benefit. Conclusions Nurses and physicians considered both similar and different factors when deciding to invite family presence. Physicians focused on the patient primarily, while nurses focused on the patient, family and resuscitation team. Relevance to clinical practice Knowledge of factors that influence the decision‐making of interprofessional colleagues can improve collaboration and communication in crisis events of family presence during resuscitation.
Schools of nursing are positioned to increase cultural awareness for students and potentially change practice. Dimensions of culturally focused field experiences were investigated to determine the relevancy of the dimensions of the Matrix for Personal and Professional Growth Through a Transcultural Immersion Experience. A questionnaire was developed and administered to two samples of nursing students following participation in an immersion experience. Results provided evidence of validation for major dimensions of the matrix, including situational predetermining factors, modifying factors, transitional factors, and outcomes of the matrix. The model for transcultural nursing immersion experiences was conceptualized, and propositions were generated.
Critical thinking is an essential skill for nurses who practice in complex health care systems. This study explored nursing faculty members' perceptions of teaching critical thinking to baccalaureate student nurses in clinical settings. Six clinical faculty members were interviewed using an ethnographic approach. Findings focus on two domain analyses that describe the nature of critical thinking and strategies to effectively teach it. Faculty members conceptualized critical thinking as “putting it all together” through information seeking, reflecting, assigning meaning, problem solving, predicting, planning, and applying information. Faculty members perceived that they teach critical thinking through a number of approaches that include asking questions, reviewing written products, conducting clinical conferences, and evaluating student journals. The findings of this study have implications for faculty who seek a clearer definition of critical thinking in nursing and a rich description of strategies to teach this skill.
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