Search

Summary Engaging patients—defined broadly as individuals with lived experience of a given condition, family members, caregivers, and the organisations that represent them—as partners in research is a priority for policymakers, funders, and the public. Nonetheless, formal efforts to engage patients are absent from most studies, and models to support meaningful patient engagement in clinical anaesthesia research have not been previously described. Here, we review our experience in developing and implementing a multifaceted patient engagement strategy within the Regional Versus General Anesthesia for Promoting Independence After Hip Fracture (REGAIN) surgery trial, an ongoing randomised trial comparing spinal vs general anaesthesia for hip fracture surgery in 1600 older adults across 45 hospitals in the USA and Canada. This strategy engaged patients and their representatives at both the level of overall trial oversight and at the level of individual recruiting sites. Activities spanned a continuum ranging from events designed to elicit patients' input on key decisions to longitudinal collaborations that empowered patients to actively participate in decision-making related to trial design and management. Engagement activities were highly acceptable to participants and led to concrete changes in the design and conduct of the REGAIN trial. The REGAIN experience offers a model for future efforts to engage patients as partners in clinical anaesthesia research, and highlights potential opportunities for investigators to increase the relevance of anaesthesia studies by incorporating patient voices and perspectives into the research process.

Aiming to integrate the knowledge from Design, Business and Engineering, and achieve innovation in teaching and learning process of new product or service development, this paper presents the “OpenFab” experience, applied in the Engineering Fundamentals discipline, to the students entering the Engineering courses. The study observes the process of development of a preliminary engineering project using a Design methodology and applying the principles of Management, analyzing its effects and impacts as teaching strategies in the students’ learning. It was also observed the dimensions related to the technical-scientific competences and the possible and existing interdisciplinary knowledge, and other soft skills like teamwork, creativity and problem solving. The activity also aims to bring together the disciplines of Physics, Chemistry, Drawing, Calculus and Programming, addressing not only the technical resolution of a problem, but solutions in a wide range of social and environmental contexts through entrepreneurial actions. The Fab Lab was widely used by students to make models and prototypes, developing autonomy and integration through the provision of appropriate space, technical support and all the necessary resources for project development. Students were able to experience a practical application of theoretical subjects in real time, developing a new product or service.

The 1990s brought a new generation of scholars that reshaped the discipline of the history of nursing. These scholars, practitioners (nurses who saw history as a way to think about critical current problems) who realized the power formalized training in historical methods could bring to their research and scholarship, sought out interdisciplinary collaborations to bring broader standpoints to larger historical questions that the history of nursing could answer. This essay will examine works of this more recent group of scholars to chart the directions that the history of nursing in the United States has taken.

This study investigates what needs to be considered in our current health services to appropriately respond to abused Korean immigrant women. Using a community-based participatory approach, this qualitative interpretive description analyzed counseling documents and semi-structured interviews. Data analyses suggested that intimate partner violence (IPV) screening for ethnic minority women in health care settings can be improved by informing patients about the role of health care providers in addressing IPV, establishing rapport before IPV screening, assuring confidentiality is maintained, respecting Korean immigrant women's unique perspectives and response toward IPV, providing translation services, and collaborating with ethnic minority women's community organizations.

Aims and objectives In this critical literature review, we examine evidence-based interventions that target sexual behaviours of 18- to 25-year-old emerging adult women. Background Nurses and clinicians implement theory-driven research programmes for young women with increased risk of HIV/AIDS and sexually transmitted infections. Strategies to decrease transmission of HIV and sexually transmitted infections are rigorously evaluated and promoted by public health agencies such as the United States Centers for Disease Control and Prevention. While many interventions demonstrate episodic reductions in sexual risk behaviours and infection transmission, there is little evidence they build sustainable skills and behaviours. Programmes may not attend to contextual and affective influences on sexual behaviour change. Design Discursive paper. Methods We conducted a conceptually based literature review and critical analysis of the Centers for Disease Control and Prevention's best-evidence and good-evidence HIV behavioural interventions. In this review, we examined three contextual and affective influences on the sexual health of emerging adult women: (1) developmental age, (2) reproduction and pregnancy desires and (3) sexual security or emotional responses accompanying relationship experiences. Results Our analyses revealed intervention programmes paid little attention to ways age, desires for pregnancy or emotional factors influence sexual decisions. Some programmes included 18- to 25-year-olds, but they made up small percentages of the sample and did not attend to unique emerging adult experiences. Second, primary focus on infection prevention overshadowed participant desires for pregnancy. Third, few interventions considered emotional mechanisms derived from relationship experiences involved in sexual decision-making. Conclusions Growing evidence demonstrates sexual health interventions may be more effective if augmented to attend to contextual and affective influences on relationship risks and decision-making. Modifying currently accepted strategies may enhance sustainability of sexual health-promoting behaviours. Relevance to clinical practice This study provides nurses and public health educators with recommendations for broadening the content of sexual health promotion intervention programming.

In light of recent recommendations from the American Association of Colleges of Nursing's Baccalaureate Essentials , the Institute of Medicine's Future of Nursing , and the Carnegie Foundation's Educating Nurses , many schools of nursing are actively redesigning their undergraduate curriculums. Although the process of curricular change is a complicated one, it is also one that can generate faculty excitement, growth, and engagement. This article describes the process used to bring together the entire faculty and other stakeholders in a unique way to create a new undergraduate nursing curriculum that looks to the future and taps university and faculty strengths. The trajectory of the process and important points within that trajectory are discussed. Key products of the process, which served as articulating steps in building the final product, are also considered and how the framework translates into course work. Faculty engagement at each step resulted in a curriculum owned and endorsed by all constituents, a curriculum that breaks down the "silos" that exist not only among courses and clinical experiences but also between the undergraduate educational experience and the more complicated and contingent one of clinical practice.

I examine the history of the East Harlem Nursing and Health Service in New York City from its beginnings as a demonstration project in 1922 to its closing in 1941. I explore the less tangible goals, needs, and ambitions of the many different constituents that paid for, delivered, and received health care services. I place these goals, needs, and ambitions as critically important drivers of ultimate success or failure. The East Harlem Nursing and Health Service gained international fame among public health leaders for its innovative and independent nursing practice and teaching. However, it ultimately failed because its commitment was to a particular disciplinary mission that did not meet the needs of the constituent communities it served. From 1928 to 1941, the service focused more on the educational advancement of public health nursing and less on addressing the real health care needs of those in East Harlem.

This paper presents the analysis, design and implementation of a Learning Object Repository for Mobile Devices, it is remarkable the use of free software tools is presented. The use of mobile devices has taken a great preponderance in business, personal life and education. One example is the increasing educational applications designed to support learning in different educational use. The use of mobile device has taken a great preponderance in business, personal life and education. One example is the increasing use of educational applications designed to support learning in different educational levels. However, it is necessary to have a repository that is able to adapt to learning objects that have the characteristics to be visible from a mobile device. This paper presents a first approach to the study of elements for the design of a Learning Object Repository for Mobile is done experimentally. It proposes a methodology to perform such design and the first results allow to observe the functionality of a repository of this type. This design of repository is aimed at an Institution of Higher Education.

Since the 1960s, the perspectives of social history have invigorated the study of nursing’s own past. Its emphasis on social structures, processes, and the experiences of (admittedly unfortunately designated) “ordinary” men, women and children opened a vast terrain of scholarship we have yet to completely mine. The charge was to “tell history from below” – to make relatively invisible individuals into influential actors; to make kinship networks into powerful forces; and to make the threads of everyday life – threads woven from new concepts like race, class, and gender – into a rich tapestry of meaning. Descriptive quantification led the assault. Historians assembled hard numbers from wills, church rolls and census data. They put these numbers through statistical measures and explored what the results meant about the lives of those who rarely left documentary evidence. Sam Bass Warner (1987) used such processes to bring to life the lives of Philadelphia’s urban poor. Christopher Maggs (1983) brought them to nurses with his analysis of the records of nine British hospitals. More qualitative approaches to social history, however, quickly dominated the field. Historians turned to the stories of less heralded groups of men and women who left documentary data in their association records, letters, reports, and diaries. The history of nursing thrived with this approach, with groundbreaking work by such scholars as Susan Reverby (1987) and Darlene Clark Hine (1989) in the United States and Celia Davis (1995) and Anne Marie Rafferty (1996) in Britain. Certainly, this kind of research remains critically important. But new challenges and opportunities now present themselves. Even as scholars acknowledge the power of international research projects to ask and answer new kinds of questions, significant intellectual and methodological barriers remain. One the other hand, new kinds of digital media and resources from around the globe flood our computer screens but their potential to provide answers to questions historians might pose remains largely untapped. This paper returns to social history’s quantitative roots in examining the possibilities of one such digital data source: the Integrated Public Use Microdata Series (IPUMS). IPUMS, based in the Minnesota Population Center, standardizes and digitalizes broad spans of United States census data collected every ten years since 1850. IPUMS digitalized data enable new kinds of questions to be posed or different kinds of answers to be retrieved about patterns of social and economic change. We used IPUMS to ask a simple question about which there is inconsistent, conflicting, and sometimes absent data: who chose to do the work of nursing in the United States between 1900 and 1950? IPUMS answers revealed not only numbers but also a much more nuanced picture of the intersection of issues gender, race, and marital status among nurses then previously acknowledged. IPUMS has recently begun a similar standardization of international census data; and similar census data also exist in other countries around the globe. We present this work, then, as the beginning steps of an international project that looks at who assumes professional responsibility for the sick, and how these choices might vary by time, place, and social context.

This work posits how medical history might be conceptualized if nurses and nursing history was used as the analytical lens. Nursing is seen not as a separate part or subsection of medical history, but rather one that is deeply embedded in the relationships and social order of clinical practice. Nursing is an analytical category in and of itself. By approaching nursing as such a category, we enlarge "new notions of historical significance" to encompass personal, political, public, and private activities that constitute medical experiences.

This article explores the interconnected personal and professional lives of all seventeen graduates of the Latter-day Saints Nurses Training School class of 1919 over almost six decades of their lives. It places the experiences of these women at the nexus of ideas about women, work, family, and religion, and considers work that took place not just within hospitals and health care agencies but also within families, and families' particular patterns of wage work and unremunerated housework, care work, and that on farms or small businesses. These graduates actually moved rather easily and intermittently back and forth between domestic and market economies; their paid nursing work was integrated into, rather than separate from, their work as wives and mothers. Their life stories show how these women actively embraced the gendered meaning of nursing for how it privileged both their professional work and their commitment to Mormon traditions.

The medical model of clinical practice has long presented rather awkward challenges to the discipline of nursing. This study explores this challenge within nursing practice more deeply by examining two moments in the history of nursing practice: that before and that after the late 19th century professionalizing of the discipline. The first historical case study looks to the experiences of lay men and women staff caring for insane patients at the Friends Asylum in early 19th-century Philadelphia. This case study explores the workings of particular clinical encounters in day-to-day clinical practice. The second historical case study looks to the organizational efforts of pediatric nurse practitioners in the 1970s. This case study, set during a time when the heuristic value of themedical model was already well-established, explores the tensions exerted by organized medicine and by organized nursing on the practicing nurse, and the efforts of both organizations to cloak their concerns surrounding professional legitimacy and control in the rhetoric of patient care and safety. These two seemingly disparate case studies suggest that the medical model has historically worked as an effective framework to contain the turmoil and turbulence that inevitably comes with the realities of both clinical practice and more organizationally focused disciplinary strategies. This study argues that the medical model has been an effective tool for thinking about all kinds and models of care for the sick. Nurses appropriated the model to free them to do what they did best both before and after the development of modern models of practice. Hence, this study re-conceptualizes the medical model as both a source of power in nursing, and as a multidisciplinary, multidimensional organizational model of clinical and organizational practice.

This historical case study looks at two foundation-funded health demonstration projects in New York City from 1920 to 1935. It specifically examines the disciplinary interests, the work, and the aspirations of nurses and social workers as they tried to provide coordinated and cost-effective care to the individuals and families with whom they worked. It attends to the processes—not just the outcomes—involved in the coming together and moving apart of the different organizations, disciplinary interests, knowledge domains, and spheres of public and private responsibilities involved in caring for those in need. It locates the problems of coordination within disciplinary tensions as nurses and social worker—working within a web of gender, class, race, and power—sought to advance their own disciplinary interests even as they searched for better ways to care for the families in their charge.

The disciplinary focus of available overviews of the history of nursing research neglects how such analyses might illuminate the broader questions of what factors in the world of research in general and nursing research in particular frame the intellectual processes of disciplined curiosity, reasoned inquiry, and painstaking experimentation. Because it is precisely these broader questions that are of increasingly vital concern to the history both of nursing and of knowledge development, suggested here are ways in which the history of research in nursing might be positioned as a case study of the interplay between the social and the scientific in the generation of new data, new knowledge, and new considerations. To this end, interconnected examples of social context and gender are used to show how recasting nurses as critical actors in and interpreters of the world of science and research may well prove to be the historian's intellectual contribution to the profession's drive for sustained legitimation and authority.

Historians of nursing can inform and provide perspective and context to the discipline and to policy makers. This article provides several examples of the interplay of history and health policy debates across time and place. From issues of the nursing workforce to discussions about the skill level needed to safely care for patients and the issues of practice boundaries, history provides evidence for shaping our understanding of and engagement with health policy. History offers a way to understand the present and think about the future. It illustrates a critical perspective for both action and advocacy.

This study analyzes the expectations that incoming students and faculty bring to accelerated pre-licensure education programs for second-degree students. Although research supports the congruence of expectations between students and faculty as essential to learning, anecdotal evidence and single case reports suggest there may be important discrepancies in expectations of second-degree students and their faculty. Data are intended to support curriculum review, refinement, and innovation in these programs.

BACKGROUND Nurses have always had an interest in the relationships among families, clinicians, and healthcare institutions. This case study of the Friends Asylum for the Insane in early 19th century Philadelphia examines the historical roots of these relationships. METHODS Data sources are archival documents about the male founders of the Friends Asylum, its constituent families, and the committees responsible for the creation and the maintenance of the institution. RESULTS Families seeking a temporary respite from day-to-day turmoil created The Friends Asylum in Philadelphia. The Friends Asylum allowed them to continue to explore the processes that ultimately gained them an enduring identity as members of the newly emerging middle-class. DISCUSSION These data suggest that the Asylum served individuals limited in their capacity for the self-control needed for a new kind of middle-class identity and those families vulnerable to the demands made by the roots of this new identity. For individuals, it provided a place that replicated the intimate domestic ideal. And for families, it allowed the sharing of care-taking responsibilities with kin who wanted the insane out of the home, but not out of the family. CONCLUSION In the early 19th century, families presented clinicians not just with dilemmas, but with solutions that carried substantial cultural weight. This study suggests that theoretical innovations in healthcare might draw from the transformations in normative rules about domestic, work, and social roles. It suggests that nurses remain aware of the possibility that it may not be nurses who empower patients; it may be patients who empower nurses.

Why turn to the past when attempting to build nursing's future? To make good decisions in planning nursing's future in the context of our complex health care system, nurses must know the history of the actions being considered, the identities and points of view of the major players, and all the stakes that are at risk. These are the lessons of history. - from the Introduction. This book presents nursing history in the context of problems and issues that persist to this day. Issues, such as professional autonomy, working conditions, relationships with other health professionals, appropriate knowledge for education and licensure, gender, class, and race are traced through the stories told in this volume. Each chapter provides a piece of the puzzle that is nursing. The editors, all noted nurse historians and educators, have carefully made selections from the best that has been published in the nursing and health care literature.