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Objective: Point-of-care tools (PoCTs) provide evidence-based information on patient care and procedures at the time of need. Registered nurses have unique practice needs, and many PoCTs are marketed to support their practice. However, there is little reported evidence in the literature about evaluating nursing-focused PoCTs., Case Presentation: The investigators developed a rubric containing evaluation criteria based on content, coverage of nursing topics, transparency of the evidence, user perception, and customization of PoCTs for supporting nursing practice. The investigators selected five PoCTs cited in the literature and of interest to local nursing leadership: ClinicalKey for Nursing, DynaMed, Lippincott's Advisor and Procedures, Nursing Reference Center Plus, and UpToDate. Application of the rubric found Lippincott had the highest coverage of diagnoses, while ClinicalKey for Nursing had strong content focused on interventions and outcomes. Nursing Reference Center Plus provided the most well-rounded coverage of nursing terminology and topics. DynaMed and UpToDate were more transparent with indicating conflict of interest, but both had lower coverage of nursing terminology, content, and care processes., Conclusion: None of the five PoCTs strongly met all of the evaluated criteria. The rubric developed for this study highlights each PoCT's strengths and weaknesses that can then be used to inform the decision-making process based on priorities and budget. The investigators recommend licensing a nursing PoCT and a PoCT like DynaMed or UpToDate to provide comprehensive, evidence-based, patient care coverage and to meet the diverse information needs of nurses., (Copyright © 2022 Annie Nickum, Emily Johnson-Barlow, Rebecca Raszewski, Ryan Rafferty.)

Aims and Objectives: To develop a theory that offered an evidence-based insight into the use of teleconsultation by nurses., Background: Teleconsultation is the use of video to facilitate real-time, remote interaction between healthcare practitioners and patients. Although its popularity is growing, there is little understanding of how teleconsultation impacts on the role of nurses., Design: The study adopted a constructivist grounded theory method, supplemented by the use of Straussian analytical approaches., Methods: Using selective and theoretical approaches, registered nurses with experience of using video in health care were sampled. Data were collected using semi-structured interviews exploring experiences, knowledge and feelings surrounding teleconsultation. Interviews were recorded, transcribed and subjected to three-stage, nonlinear manual analysis (open, axial and selective coding)., Results: Theoretical saturation occurred after 17 interviews. The core category identified from the data was 'nursing presence' Four subcategories of nursing presence were identified: operational, clinical, therapeutic and social. The degree to which presence could be achieved was dependent upon three influencing factors - enablers, constraints and compensation., Conclusions: Nurses provide different types of presence during teleconsultation, with the degree of presence dependent on specific characteristics of video-mediated communication. Where the use of video constrains the delivery of presence, nurses use a range of compensatory mechanisms to enhance patient care., Relevance to Clinical Practice: Teleconsultation provides an innovative approach to enhancing the delivery of health care. This study provides nurses with insight into the impact of teleconsultation on their professional role, and an understanding of how best to use video-mediated communication to support patient care., (© 2016 John Wiley & Sons Ltd.)

The present article discusses the role of nursing education in the advancement of the nursing profession in the context of the three facets of knowledge: generation, dissemination, and application. Nursing is an applied science and the application of knowledge in practice is the ultimate goal of the nursing profession. The reform of the healthcare delivery model requires that nurses acquire and utilize evidence-based clinical knowledge, critical thinking, effective communication, and team collaboration skills in order to ensure the quality of patient care and safety. Therefore, baccalaureate education has become the minimal requirement for pre-licensure nursing education. Schools of nursing are responsible to cultivate competent nurses to respond to the demands on the nursing workforce from the healthcare system. Attaining a master's education in nursing helps cultivate Advanced Practice Registered Nurses (APRNs) to further expand the roles and functions of the nursing profession in order to promote the quality of care in clinical practice. Nursing faculty and scholars of higher education institutions generate nursing knowledge and develop professional scholarship through research. Attaining a doctoral education in nursing cultivates faculties and scholars who will continually generate and disseminate nursing knowledge into the future.

Objectives: To understand requests for nursing Clinical Decision Support (CDS) interventions at a large integrated health system undergoing vendor-based EHR implementation. In addition, to establish a process to guide both short-term implementation and long-term strategic goals to meet nursing CDS needs., Materials and Methods: We conducted an environmental scan to understand current state of nursing CDS over three months. The environmental scan consisted of a literature review and an analysis of CDS requests received from across our health system. We identified existing high priority CDS and paper-based tools used in nursing practice at our health system that guide decision-making., Results: A total of 46 nursing CDS requests were received. Fifty-six percent (n=26) were specific to a clinical specialty; 22 percent (n=10) were focused on facilitating clinical consults in the inpatient setting. "Risk Assessments/Risk Reduction/Promotion of Healthy Habits" (n=23) was the most requested High Priority Category received for nursing CDS. A continuum of types of nursing CDS needs emerged using the Data-Information-Knowledge-Wisdom Conceptual Framework: 1) facilitating data capture, 2) meeting information needs, 3) guiding knowledge-based decision making, and 4) exposing analytics for wisdom-based clinical interpretation by the nurse., Conclusion: Identifying and prioritizing paper-based tools that can be modified into electronic CDS is a challenge. CDS strategy is an evolving process that relies on close collaboration and engagement with clinical sites for short-term implementation and should be incorporated into a long-term strategic plan that can be optimized and achieved overtime. The Data-Information-Knowledge-Wisdom Conceptual Framework in conjunction with the High Priority Categories established may be a useful tool to guide a strategic approach for meeting short-term nursing CDS needs and aligning with the organizational strategic plan.

The last four years have seen the development of supports toward research in nursing and other healthcare professionals' research, along with the fact that, nursing education has become part of university programs. Professional and scientific landscapes are changing and the opening perspectives let glimpse a growing professionalization of nurses' activities but also, raise the question of the nursing science construction in France. By considering interdisciplinary work, as an approach for complex situations of care, by specifying the purpose of the production of nursing scientific knowledge in order to meet the population needs of healthcare, by explaining the purpose of nursing research and theoretical elements that allow its construction, the following article offers an epistemological reflection on the evolution of the profession and on the construction of a nursing scientific discipline in France.

Japanese nurses are now being required to use research in clinical practice. As a result, they increasingly need to read nursing research literature written in English. Online machine translation is a convenient tool that may address any existing language barrier. The quality of machine translation has been evaluated using various methods; however, its reliability for nursing literature is unknown. In this study, existing methods for evaluating online machine translation quality were examined for structural accuracy and intelligibility of translations of nursing literature, and the usability of machine translations is discussed. In total, 297 English sentences from nursing study abstracts were evaluated for accuracy and intelligibility; 75 word items were identified as specific terms. Interrater reliability of the evaluation method was measured using two raters. The results showed the strong reliability of the existing evaluation method. Also, a possibly usable online machine translation system being offered in Japan was identified. Specific terms seemed to influence the extent of the intelligibility of the translations. Future studies need to include more samples of the nursing population to examine general perceptions of the usability of online machine translation systems for reading English nursing literature among the Japanese nursing population.

The advent of the electronic health record and numerous mobile, wireless tools with the capacity to capture, store, and transmit prodigious amounts of data, both using and creating evidence-based content and analytics for clinical decision support, requires that all care providers rethink approaches to care delivery. The nursing profession is called to acutely appreciate and support the vision of documentation systems that provide optimal decision support at the point of care, represent nursing knowledge, and are also capable of capturing care delivery outcomes that can be used to inform future care and improve the health of the public.

Most nurses are very familiar with the need for evidence-based practice, yet far fewer actually participate in the research that is a vital underpinning to evidence-based practice. This article explains the specialty of clinical research nursing and offers suggestions for getting involved., (© 2012 AWHONN.)

As nursing leaders retire and leave the profession, who will take their place? The question is not just about the number of nurses who will take on leadership roles; it is about the preparation required to be successful. Formal succession planning is a crucial part of strategy to ensure that nursing leadership positions, at all levels, are filled with qualified candidates.

The director of the Magnet Recognition Program provides a comprehensive look at the Magnet model component new knowledge, innovation, and improvements. This article examines Magnet organizations' responsibility to advance evidence-based practice, improve quality, and develop new models of care. It includes exemplars of innovative contributions from Magnet organizations around the country.

Aims:  This article reports on findings from a qualitative study which explored the influence of a Masters in Nursing on the professional lives of British and German nurses and its role in further professionalizing nursing., Background: A collaborative Masters programme was delivered in the United Kingdom and Germany. This provided an opportunity to study the influence of the programme on the professionalization of nursing in different country contexts. Continuing education is thought to contribute to furthering professionalization. Evidence to support this in the field of nursing is limited., Methods: An interpretive research design was used and data were collected via semi-structured interviews with ten German nurses and nine British nurses. Data were collected in the United Kingdom and Germany from August 2006 to February 2007. Interviews were recorded and transcribed, and data were analysed using a template approach with further immersion and crystalization of the data., Findings: Nurses' personal and professional confidence improved; research-based evidence was used to underpin changes made to practice; new roles and careers emerged; multi-professional working was enhanced; and nurses rediscovered nursing and championed the profession., Conclusion: A diagram is presented based on the findings. Masters education is at the centre as the catalyst with four interconnecting circles, which depict elements that contribute to professionalization. The diagram highlights overlap and interplay between nurses' increased personal confidence, improved cognitive functioning, evidence-based practice development and enhanced professionalism. Findings support the theory that this Masters in Nursing programme enhanced practice and further professionalization of nursing in both countries., (© 2011 Blackwell Publishing Ltd.)

The objective was to identify the profile of production and analyze perceptions, feelings and confrontations on the process of death and dying in the practice evidenced in nursing scientific production in the period 1994 to 2009. There was a qualitative, descriptive research, developed through a systematic literature review with metasynthesis from the meta-ethnographic method. Ten studies met the inclusion criteria, this set was subjected to quality assessment checklist with Critical Appraisal Skills Programme. Subjects perceive this process as a transition, separation and finitude. This is permeated with feelings of frustration and powerlessness and the most effective interventions to this issue is the development of coping strategies that vary with the reality of each individual.

Aim: Using a neo-Foucauldian approach, a critique of texts explicitly dealing with the definitional work for practice development (PD) was undertaken., Background: PD has been taken up by many organizations as a way of focusing on nurses' practices to benefit patients and the organization., Evaluation: Literature pertaining to the PD phenomenon was examined and the present study explores those texts accomplishing definitional work. The discourse corpus collected together articles in nursing journals, book chapters and textbooks. The corpus was analysed using the discourse analysis method., Key Issues: PD uses and manipulates its location in a network of managerialism, evidence-based nursing, safety and quality discourses in healthcare to verify (and confirm) its definition and its position as central to progress in nursing practice., Conclusion: We argue that while PD is portrayed as 'emancipatory' and transforming, nurses bear the responsibility for the system and its failures in a web of intricate power relations., Implications for Nursing Management: The present study offers a review of the PD ideology in nursing where a critical perspective has yet to be found. Nursing managers should understand that PD is not a panacea for improving patient care., (© 2011 Blackwell Publishing Ltd.)

Clinicians are interested in options for delivering community-based wound care. Studies have largely focused on nurse clinics as an alternative to people receiving wound care at home. A prospective, two-arm, cohort study of individuals who requested and received their preference for community-based leg ulcer care delivered in either their home or in a nurse-led clinic was conducted to explore the relationship between choice of care location and health outcomes. Provision of care was similar-ie, care was guided by an evidence-informed protocol and a trained nursing team. Individual and system level outcomes were compared between the groups, including 3-month healing rates, 1-year ulcer recurrence rate, time free of ulcers, health-related quality of life (HRQL), satisfaction with care, and resource use. Following the baseline assessment, data were collected every 3 months until healing occurred plus a 1-year follow-up to monitor recurrence. Of the 104 participants (average age 67.5 years), 56 chose home and 48 chose clinic-based care. More than half (55%) of the participants were men, 53.8% had an ulcer <5 cm(2) and <6 months' duration, 84% were English-speaking, and 51.9% had a previous episode of ulceration. No significant sociodemographic, HRQL, or clinical characteristic differences were found between groups at baseline. A trend toward improved healing for those choosing clinic care was observed (3-month healing rates at home were 48.1% versus clinic care 66.7%, P = 0.07) but neither healing outcome nor other variables, including resource utilization, were significantly different and post-hoc analysis revealed only 48% power to detect a difference in healing. The results confirm previous research indicating that the organization rather than the location of care is most important; however, observed differences in healing rates pose an important question for future inquiry regarding the potential impact of choice and whether the quality of care is standardized and delivered by the same team. The concept of providing individuals/families with the choice of care location warrants further research.

Nurses are the single largest component of North Carolina's health workforce, and nursing jobs are an essential driver of the state's economic recovery. We propose 5 recommendations for creating a nursing workforce system that, if implemented, would position the state to meet the future health care needs of North Carolinians.

With nurses and unlicensed supportive personnel composing the greatest percentage of the workforce at any hospital, it is not surprising nursing leadership plays an increasing role in the attainment of financial goals. The nursing leadership team at one academic medical center reduced costs by more than $10 million over 4 years while outperforming national benchmarks on nurse-sensitive quality indicators. The most critical success factor in attaining exceptional financial performance is a personal and collective accountability to achieving outcomes. Whether it is financial improvement, advancing patient safety, or ensuring a highly engaged workforce, success will not be attained without thoughtful, focused leadership. The accountability model ensures there is a culture built around financial performance where nurses and leaders think and act, on a daily basis, in a manner necessary to understand opportunities, find answers, and overcome obstacles. While structures, processes, and tools may serve as the means to achieve a target, it is leadership's responsibility to set the right goal and motivate others.

The Institute of Medicine asserts that evidence-based practice can become a reality because the tools to find the best evidence are available. However, teaching the naïve sophomore how to use these tools while ensuring that this first search experience is successful from both the student and the instructor standpoint is complex. The authors describe an assignment that ensures students will master the steps needed to locate quality evidence.

This is the seventh article in a nine-part series describing the Principles of Nursing Practice developed by the Royal College of Nursing (RCN) in collaboration with patient and service organisations, the Department of Health, the Nursing and Midwifery Council, nurses and other healthcare professionals. The article discusses Principle F, the application of skills and knowledge to person-centred nursing care.

We are interested in the kind of knowledge that is particularly relevant to caring practice and the way in which qualitative research findings can serve such knowledge. As phenomenological researchers we have been engaged with the question of how findings from such research can be re-presented and expressed more aesthetically. Such a movement towards a more aesthetic phenomenology may serve the communicative concern to express phenomena relevant to caring practice in ways that appeal to the 'head, hand and heart'. The paper first offers some thoughts about the complex kind of knowledge relevant to caring that is not only technical or propositional, but actionable and aesthetically moving as well. We call this kind of knowledge 'embodied relational understanding'. Further, the paper outlines the development of one way of serving a more aesthetic phenomenology whereby research findings can be faithfully and evocatively translated into more empathically impactful expressions. We call this process 'embodied interpretation'. It is guided by an epistemological framework grounded in the philosophies of Gadamer and Gendlin. We finally illustrate the process with reference to the experience of living after Stroke, and consider the value of this translational process for nursing education and practice., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

Morbidity and mortality conferences have been used to educate healthcare providers, to critique staff performance, and to improve patient outcomes since the early 1900s. Historically well documented in physician-focused journals, the use of morbidity and mortality conferences is less predominant in the nursing literature. This article highlights one hospital's experience with planning, implementing, and evaluating a nursing morbidity and mortality conference and identifies implications for use in professional nursing development.

Objectives: To assess Southern European intensive care unit nurses' knowledge about evidence-based guidelines for the prevention of ventilator-associated pneumonia and to compare these findings with a pan-European perspective., Design: A sub-analysis from an observational study performed using a 9-questions, multiple-choice questionnaire performed during the period October 2006 - March 2007., Setting: Six Southern European countries, selected from 22 participant European countries., Participants: Volunteer nurses from intensive care units., Results: 3329 questionnaires were obtained, 1182 of them belonging to Southern European countries with a 75.8% response rate. Global average score was 45.1%, being it significantly better in the South of Europe (46.6%, P<.001). A linear multiple regression analysis showed that years of working experience (per class of increase) (B=0.154 ± (SD) 0.045) (95% CI (0.066-0.242))(p=0.001) and working in a smaller intensive care unit (B=-0.210 ± (SD) 0.059)((95% CI) -0.326-0.094)(P<.001) was independently associated with better test scores., Conclusions: Southern European critical care nurses' knowledge about ventilator-associated pneumonia prevention is poor, but significantly better than in the pan-European countries., (Copyright © 2010 Elsevier España, S.L. y SEMICYUC. All rights reserved.)

Background: The Nursing and Midwifery Content Audit Tool (NMCAT) was developed to monitor the quality of nursing documentation., Methods: A health care record audit was conducted on 200 records. Using a time-sampling approach, recent nursing documentation was examined. Inter-rater reliability was determined at 85% agreement between two raters., Results: The NMCAT criteria relating to the recording of the patients' health status, use of objective information and logical presentation were met to a high level. The patients' response to treatment or nursing interventions including medications requires attention. The recording of events immediately after they have occurred was limited. The structure of the sentences and language used, restricted the readability of the documentation. The widespread use of local abbreviations, often connected together to form the text, was problematic., Conclusions: The present study provides new audit solutions based on time-sampling approaches and focused evidence-based criteria. The use of language support software and writing coaches to improve the presentation of nursing documentation is recommended., Implications for Nursing Management: The NMCAT is a time-efficient tool available to managers for monitoring the quality of nursing documentation, either at a unit level or across health facilities to demonstrate compliance with quality standards., (© 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.)

A three-stage process is being undertaken to investigate the fundamentals of care. Stage One (reported here) involves the use of a met a-narrative review methodology to undertake a thematic analysis, categorization and synthesis of selected contents extracted from seminal texts relating to nursing practice. Stage Two will involve a search for evidence to inform the fundamentals of care and a refinement of the review method. Stage Three will extend the reviews of the elements defined as fundamentals of care. This introductory paper covers the following aspects: the conceptual basis upon which nursing care is delivered; how the fundamentals of care have been defined in the literature and in practice; an argument that physiological aspects of care, self-care elements and aspects of the environment of care are central to the conceptual refinement of the term fundamentals of care; and that efforts to systematize such information will enhance overall care delivery through improvements in patient safety and quality initiatives in health systems.

Any organization on the journey to nursing excellence might initiate its search for a professional practice framework by exploring the many nursing-specific theories, frameworks, and conceptual models that are readily available in the literature. Although adopting an "off the shelf" professional practice framework for nursing may sound easier for a nursing organization than creating its own framework, achieving a good fit into an existing culture is more difficult when adopting rather than creating a practice framework. ven though creating a customized framework requires a considerable amount of upfront time, dedication, and a willingness to make some mistakes along the way, in the end a customized framework ensures cultural alignment. SThis framework describes the foundational structures and guiding principles, the key processes that influence how work is conducted, and the outcomes desired as the result of the work. Identifying evaluative methods for determining progress on identified strategic intents was crucial in bridging the gap between theory and outcomes. This model continues to provide flexibility and adaptability to meet needs in a constantly changing health care environment and difficult economic times.

Unlabelled: Hand hygiene is critical to the safety of patients in hospitals today., Objective: Engaging staff, physicians, patients, and visitors in hand hygiene is important to create a safe environment. The author discusses the development and implementation of an evidence-based practice guideline for improving hand hygiene and application of that guideline in an academic medical center setting., Method: Establishment of a multidisciplinary team committed to improving organizational performance, development of a practice guideline, organizational assessment, and the implementation of a multimodal intervention plan are all keys to success., Conclusion: Organizational culture can be changed utilizing an evidence-based, organization-specific approach to hand hygiene.

The randomised controlled trial (RCT) is at the heart of the evidence-based medicine movement and by implication should also be central to evidence-based nursing. One objection to RCTs in nursing science is that nursing is too complex an activity to be subjected to a carefully controlled experimental paradigm. We suggest that this argument is false and use examples from complex interventions research in nursing and experimental laboratory methods to demonstrate that RCTs can bring much needed clarity to the search for nursing knowledge.

Although evidence-based practice (EBP) has been demonstrated to provide the highest quality of care to patients and their families, its use in nursing has not yet been widespread. Using a case-method approach, a pilot study was conducted to explore the implementation of EBP to determine the best practice for clinical issues identified in professional nurses' practice settings. In addition, the investigator sought to determine available evidence, identify barriers described by nurses, and gain an understanding of nurses' perceptions regarding the use of EBP in clinical practice. Findings revealed that with mentoring and support, the formulation of PICO questions (addressing population, intervention, comparison, and outcome), retrieval of evidence, interpretation of statistics, and implementation of EBP were identified by nurses as challenging, stimulating activities that dramatically enhance nursing practice.

Pressure injuries, also known as pressure ulcers or 'bed sores', are caused by prolonged pressure on the skin and underlying tissues and are common in healthcare settings. They result from a variety of factors including pressure, moisture and friction, with a higher risk among older adults, post‑surgical patients and those with limited mobility or long‑term conditions. These injuries can extend hospital stays and significantly impact patient recovery and mortality risk. Prevention includes regular repositioning, the use of pressure‑relieving devices, skin care and nutritional support. The National Institute for Health and Care Excellence provides guidelines to mitigate these risks through systematic risk assessments and targeted interventions. Early detection and specialist care by a multidisciplinary team are crucial to improving patient outcomes. Consistent pplication of prevention strategies are needed to reduce incidence, improve patient care and alleviate the economic burden of thesex injuries on the NHS. [ABSTRACT FROM AUTHOR]