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‘Scraps’: hidden nursing information and its influence on the delivery of care What nurses commonly describe as ‘scraps’ are defined as the personalized recordings of information that is routinely made on any available piece of paper (hence scraps) or in small notebooks. The use of scraps is common in practice and has been noted in research from across the globe. Drawing on an empirical study it is argued that scraps are a unique combination of personal and professional knowledge that informs the delivery of care. The overall aim of the study was to discover how nurses define and communicate information about patients and the delivery of care to each other on an elderly care unit. The processes by which information was constructed and the organizational structure and interactions that influenced this were also identified. The research design was an ethnographic one that involved: observations of formal nursing end of shift reports (23 handovers) and informal interactions between nurses (146 hours); interviews (n + 34) with registered nurses, student nurses and nursing auxiliaries; and analysis of written records. Data were collected from five acute elderly care wards at a district general hospital in the south of England. A grounded theory analysis was undertaken which revealed that scraps may have a significant role in the communication of information and the delivery of care. Therefore a categorization of scraps within three main themes was undertaken. First, the analysis revealed the processes involved in the construction of scraps. Second, the content and role of scraps in influencing the delivery of care was exposed. Finally, the potentially confidential nature of scraps and consequent problems of storage and disposal was recognized. The findings are discussed in relation to a suggested model of the interrelationship between paperwork, scraps, handovers and the delivery of nursing care. It is concluded that scraps are significant... [ABSTRACT FROM AUTHOR]

This paper examines the research base for 'magnet hospitals'--hospitals that have a good reputation for recruitment and retention of registered nurses. It also assesses the extent to which the concept of the magnet hospital continues to have relevance to nursing in the United Kingdom (UK). The study reviews previous research, examines recent trends in nursing employment, and reports on case studies conducted as fieldwork research. The early research on magnet hospitals, conducted in the 1980s in the United States of America (USA), is reassessed in the light of subsequent cost containment driven changes in the USA nursing labour market and in the organization of USA hospitals. Many of these changes have impacted on nursing staff, with increases in workload, and with changes in skill mix, particularly as a result of increased use of care assistants. Similar developments have been happening in the UK. The paper examines the extent to which the concept of the magnet hospital can retain validity in this changing health care environment. Case studies in 14 USA magnet hospitals were conducted in 1997. The results highlight that, as a result of hospital reorganization and merger, some of these hospitals no longer exhibit core characteristics of 'magnetism', whilst others have retained these characteristics despite organizational change. The paper concludes by cautioning that the concept of the magnet hospital continues to have a relevance to the management of nursing resources, but that the research base, with some notable exceptions, continues to be weak and that there is a need for monitoring and a process of re- accreditation to maintain a 'live' register of magnet hospitals. [ABSTRACT FROM AUTHOR]

Reports of fear and psychological distress on the part of nurses when caring for AIDS patients have drawn attention to the real possibility that care for this very sick group of patients may be less than adequate. This paper reviews what is currently known about the attitudes of nurses and the care provided to HIV-infected individuals. The authors reveal the paucity of empirical data concerning quality of care and how the concept of stima might serve to aid our understanding. The need for more research documenting the quality of care provided to HIV-infected patients is discussed. [ABSTRACT FROM AUTHOR]

This article focuses on various developments related to nursing. The National League for Nursing has issued an official call for papers for its 1983 biennial convention, the first such call ever to be made by the League in connection with this national meeting. Deadline for abstracts is October 15, 1982, for presentations during the June 1983 convention. A Western Kentucky University junior has received the highest award in Kentucky which goes to a student nurse. Jeana Keating of 520 Cajjewood Drive in Louisville, Kentucky, has been chosen Ideal Nursing Student in Kentucky for 1982 by the Kentucky Association for Nursing Students at its meeting in Fort Mitchell, Kentucky.

This paper is based on an address delivered in Faneuil Hall, Boston, Massachusetts, USA, on 6 May 1975, as part of the American bicentennial celebrations. The history of nursing in America is traced over two centuries-from 1776, when nursing was nothing more than neighbourly assistance rendered by unprepared amateurs, to the present day, when nursing has reached a highly professional status. The influences of the revolutionary and civil wars and legislative and social changes on nursing and the training of nurses are recorded and discussed. The major contribution to the history of American nursing made by the American Nurses' Association is conceded. Its continued contributions to the extension and development of nursing as a profession, to the education of nurses, and to support for the principle that health care is a right, are all documented. The paper is a concise and well-referenced synopsis of the development of nursing in the USA during its first 200-year history, advancing from 'a most indefinite quantity' to 'the largest professional group among the health occupations'. [ABSTRACT FROM AUTHOR]

The article presents information about issues discussed at the conference held at the College of Nursing, University of Tennessee, Knoxville, Tennessee from July 4-8, 1982. A number of nursing faculty members from the University of Akron, Ohio, shared their experiences of a study to determine the perceived health care needs of the family. Their findings suggested that the consumers of health care services are beginning to change their conception of health and methods of obtaining and maintaining it.

Self-reported characteristics of women and men with intimate body piercingsAim. The purpose of this paper is to report the findings of a study exploring factors associated with female and male intimate body piercing, with particular emphasis on health issues. Background. Nipple and genital piercings (intimate piercings) have become common types of body art. Scant medical and nursing literature is available, leading to little understanding of these body modifications by health care providers. Method. A convenience sample of intimately pierced individuals (63 women and 83 men) from 29 states in the United States of America was surveyed via an author-developed questionnaire. Questions focused on demographic characteristics, decision factors and health problems related to intimate piercings. Self-reported characteristics were compared between female and male participants, and participants were compared demographically to United States general population. Results. Participants reported wearing nipple piercings (43%), genital piercings (25%) and both types (32%). Respondents were significantly younger, less ethnically diverse, better educated, less likely to be married, more often homosexual or bisexual and they initiated sexual activity at a younger age than the US population. Deliberate, individual decisions for procurement of the intimate piercings were made. Average purchase consideration was at age 25 (nipple) and 27 (genital); average age to obtain the piercing was 27 (nipple) and 28 (genital) years. Purposes for obtaining the piercings included uniqueness, self-expression and sexual expression. Most participants still liked their piercing (73-90%). Health concerns related to intimate piercings were described by both those with nipple piercings (66%) and with genital piercings (52%) and included site sensitivity, skin irritation, infection and change in urinary flow (male genital). Few STDs (3%) were reported and no HIV or hepatitis. Usually non-medical advice was sought for problems - often from the body piercer. Conclusions. Understanding client rationale is not a necessary prerequisite for providing quality patient care; however, awareness of purposes and decision-making in intimate piercing can help nurses to be sensitive to client needs and plan appropriate health education. [ABSTRACT FROM AUTHOR]

Bioethics is a multi-dimensional discipline. The traditional aspect being medical ethics, a branch of Western philosophy which, since the time of Hippocrates, has sought to formulate rules of proper conduct for physicians. Ethics and informed consent are interrelated issues. Consent is the central issue on which hangs most of the ethical problems in human experimentation. The informed consent of the human patient is the ultimate protection from the hazards of research and therapy in medicine, the basic premise of ills being that every human being has the right to determine what shall be done to his own body. The patient must have full prognosis, complications, sequelae, discomforts, costs, inconveniences, risks and expectations. Medically and ethically what should the patient be told? There appears to be no obvious format, but the patient should be told enough to allow him to make a rational decision. This paper contains an analysis of the reactions of just a few American nurses to this dilemma. The nurse who attempts to use only her scientific training to determine ethical conduct is in a quandary because seldom is there empirical evidence available to support her decision, no matter what it is. [ABSTRACT FROM AUTHOR]

Contributions of nursing research to nursing practice in the USA are increasing rapidly in four major areas: (1) the science of practice; (2) the artistry of practice; (3) the structures needed for optimal delivery of care; and (4) the methodologies needed for measurement and evaluation. Illustrative studies are described in each area, concluding with a plea for implementation of research findings. The authors presented this paper at the Open Forum, National League for Nursing Convention, 21 May 1975, New Orleans, Louisiana, USA, and it was first published In Journal of Nursing Administration (1976) March-April. [ABSTRACT FROM AUTHOR]

The author focuses on the quality of nursing care and discusses the major problems inherent in control of the quality of nursing care. The concept of quality is analysed and the approaches of health care professionals to the concept are discussed. An overview of the American contribution to the relevant research is presented together with ongoing developments in Europe. [ABSTRACT FROM AUTHOR]

Reports global developments related to medical care as of February 1996. Assessment on the health of women in midlife by the National Institute of Nursing Research in Bethesda, Maryland; Launch of the Nursing Practice Conference in Adelaide, South Australia; Details on the pilot scheme for academic libraries in Great Britain.

Presents news related to medical care as of September 1, 1993. Details of the second international interdisciplinary Qualitative Health Research Conference held in Hershey, Pennsylvania; Restriction to clinical teaching registration in Great Britain; Introduction of a massage therapy by the Institute of Advanced Nursing Education at the Royal College of Nursing in London, England.

Reports on the issues and forthcoming events featured in the July 22, 2001 issue of the `Journal of Advanced Nursing.' Support of African governments for the Framework Convention on Tobacco Control; Commendation given by the American Nurses Association for the recommendation of the Institute of Medicine for a broad overhaul of the nation's health care delivery system; Eradication of the ebola outbreak in Uganda.

Examines the application of the proportional overlap kappa statistic to assess the level of agreement between raters of interview data in Great Britain. Impact of the growth in health services research on interview studies; Analysis of agreement values; Focus on the lack of qualitative data on parental perceptions.

There has been extensive speculation about the lack of research utilization in nursing but little attempt to quantify this phenomenon outside of North America. The current demands for evidence-based practice necessitate research utilization as one element of the process. As part of a larger project, this study aimed to describe the extent of research utilization by registered nurses in general medical and surgical wards in the Scottish Health Service. A postal survey was conducted for nurses to self-report their level of utilization of 14 research-based practices. The 14 practices represented examples of direct, indirect and methodological utilization of research. A research utilization score was constructed for each of the 14 practices and a total mean score constructed for all 14 practices. A random two-stage stratified sampling resulted in a total sample of 936 nurses from 25 hospitals. A 73% response rate was achieved. The total mean research utilization score for all nurses across all 14 nursing practices suggests that on average, nurses had heard, believed in and were beginning to use the practices. The sampling technique over-represents nurses in large hospitals and charge nurses, hence a weighting calculation on all scores was completed. There was little difference in weighted and unweighted scores. Scores on individual practices ranged from 60% (405/680) of nurses never having heard of a practice to 85% (574/680) always using a practice. This approach provides a valid and reliable method of assessing the extent of nursing research utilization. In several of the practices, nurses are making significant attempts at research-based practice. The level of research utilization compares favourably with research completed in North America and provides a baseline for United Kingdom and other country studies. [ABSTRACT FROM AUTHOR]

It is unacceptable for health care professionals to acquiesce quietly to inconsistencies in the quality of health care received by patients. In the United Kingdom, the introduction of clinical governance has formalized the expectation that professionals' practice will meet recognized standards of care consistently. It is being stated that all available evidence is being used to identify national standards of excellence. This will inform professionals not only of expected outcomes but of also the structures and processes that need to be in place to support the attainment of such outcomes. Clinical practice benchmarking is one continuous quality improvement approach, which is being used by paediatric units in 27 National Health Service Trusts in the north-west of England to promote the utilization of available evidence in to practice. The evidence base for benchmarks of best practice is considered continuously using a hierarchy of evidence. This clarifies the different evidence available, upon which benchmarks or standards of excellence can be based, but reinforces the kudos awarded quantitative research evidence within health care. Once benchmarks have been agreed, benchmarking activity supports practitioners in a continuous cycle of comparison and sharing that is aimed at ensuring that children and their families receive evidence-based care, wherever they are admitted in the north-west of England. [ABSTRACT FROM AUTHOR]

The purpose of this study was to describe the clinical practice of clinical nurse specialists (CNSs). Data were collected from three recorded case studies and interviews from a theoretical sample of 17 masters-prepared CNSs who had functioned in the CNS role for a minimum of 1 year. Using the constant comparative method, transcribed interviews were line-coded and clustered to form groups of data that could be labelled as constructs. Caring was validated as the basic psychological process. Scientific caring included investigating and teaching; humanistic caring included creating the new, showing the way, working with others, and taking care of the environment. It was found that CNSs took care of the caretakers as well as the patients and their families. [ABSTRACT FROM AUTHOR]

The developments leading to the present American health care organization are traced. It is clear that hospitals have dominated at the expense of primary health care programmes. Health care costs have soared dramatically. There are particular problems inherent in a system shared between federal and state governments and a private health care industry. Attempts to provide a fully (or partially) tax-funded health service in the USA have been bedevilled by a number of factors. These include opposition from labour unions, politicians, vested-interest groups and, in particular, the American Medical Association. As part of its opposition, the AMA politicized itself in 1950. But, in the political literature, American nurses are not portrayed as being very politically active. Reasons for this are explored. The introduction of Medicare and Medicaid programmes is discussed and the legal, social and political implications. Recent attempts in the USA to control costs are assessed and new trends and new problems identified. [ABSTRACT FROM AUTHOR]

The article presents information on various developments in the field of nursing. The American Association of Neuroscience Nurses (AANN) invites interested nurses and other health professionals to submit abstracts for review and potential presentation at the AANN annual meeting. Three nurses have been successful this year in the RCN-3M Awards for Accident & Emergency Nursing, and a total of £1500 is being given by 3M Health Care. The money will fund the nurses towards achieving the projects they each put forward as entries to the scheme.