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[PMID]:26484461
[Au] Autor:Armstrong E; de Waard MC; de Grooth HJ; Heymans MW; Reis Miranda D; Girbes AR; Spijkstra JJ
[Ad] Endereço:From the *Department of Intensive Care, VU University Medical Centre, Amsterdam, The Netherlands; †Department of Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, The Netherlands; and ‡Department of Intensive Care, University Hospital Groningen, Groningen, The Netherlands.
[Ti] Título:Using Nursing Activities Score to Assess Nursing Workload on a Medium Care Unit.
[So] Source:Anesth Analg;121(5):1274-80, 2015 Nov.
[Is] ISSN:1526-7598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The medium care unit (MCU) or "stepdown" unit is an increasingly important, but understudied care environment. With an aging population and more patients with complex multiple diseases, many patients often require a higher level of inpatient care even when full intensive care is not indicated. However, the nurse-to-patient ratio required on a MCU is neither well defined nor clear whether this ratio should be adjusted per shift. The Nursing Activities Score (NAS) is an effective instrument for measuring nursing workload in the intensive care unit (ICU) but has not been used in an MCU. The aim of this study was to measure the nursing workload per 8-hour shift on an MCU using the NAS and compare it with the NAS from an ICU in the same hospital. We also compared the NAS between groups of patients with different admission sources. METHODS: The NAS was prospectively measured per patient per shift for 2 months in a 9-bed tertiary referral university hospital MCU and during a similar period in an ICU in the same hospital. RESULTS: The mean NAS per patient did not differ between day (7:30 AM to 4:00 PM) and evening (3:00 PM to 11:30 PM) shifts, but the NAS was significantly lower during the night shift (11:00 PM to 8:00 AM) than during the day (P < 0.0001) and evening (P < 0.0001) shifts. The mean NASs in the ICU for day and night shifts were significantly lower than the scores in the MCU (P = 0.0056 and P < 0.0001, respectively), but NAS during the evening shift did not differ between the ICU and the MCU. The mean NAS for patients admitted to the MCU from the accident and emergency department was significantly higher than for those admitted from the ICU (P = 0.002), recovery (P = 0.002), and general ward (P < 0.0001). Patients on the MCU had a NAS comparable with that of ICU patients. CONCLUSIONS: In our university hospital, NAS was higher during the day and evening hours and lower at night. We also found that patients from accident and emergency had a higher NAS than those admitted to the MCU from other locations. NAS in the MCU was not lower than the NAS in the ICU. Because of its ability to discriminate between day and evening workloads and between patients from different sources, the NAS may assist MCU managers in assessing staffing needs.
[Mh] Termos MeSH primário: Unidades de Terapia Intensiva/tendências
Papel do Profissional de Enfermagem
Cuidados de Enfermagem/tendências
Unidades de Autocuidado/tendências
Carga de Trabalho
[Mh] Termos MeSH secundário: Adulto
Idoso
Estudos de Coortes
Feminino
Hospitais Universitários/tendências
Seres Humanos
Tempo de Internação/tendências
Masculino
Meia-Idade
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1602
[Cu] Atualização por classe:151021
[Lr] Data última revisão:
151021
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:151021
[St] Status:MEDLINE
[do] DOI:10.1213/ANE.0000000000000968


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[PMID]:20509490
[Au] Autor:Benevent P
[Ad] Endereço:Unité d'autodialyse, Bois-Colombes. autodialyse@gmail.com
[Ti] Título:[Self hemodialysis center, individualized patient care].
[Ti] Título:Le centre d'autodialyse, une prise en charge individualisée des patients..
[So] Source:Soins;(745):37, 2010 May.
[Is] ISSN:0038-0814
[Cp] País de publicação:France
[La] Idioma:fre
[Mh] Termos MeSH primário: Instituições de Assistência Ambulatorial/organização & administração
Planejamento de Assistência ao Paciente/organização & administração
Diálise Renal/métodos
Autocuidado/métodos
Unidades de Autocuidado/organização & administração
[Mh] Termos MeSH secundário: França
Seres Humanos
Papel do Profissional de Enfermagem
Educação de Pacientes como Assunto
Diálise Renal/enfermagem
Diálise Renal/psicologia
Autocuidado/psicologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1007
[Cu] Atualização por classe:100531
[Lr] Data última revisão:
100531
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:100601
[St] Status:MEDLINE


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[PMID]:17042335
[Au] Autor:Guy K
[Ad] Endereço:Calderdale and Huddersfield NHS Foundation Trust.
[Ti] Título:'Medicines management is not just a pharmacy issue'.
[So] Source:Nurs Times;102(40):12, 2006 Oct 3-9.
[Is] ISSN:0954-7762
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Autoadministração/métodos
Unidades de Autocuidado/organização & administração
Medicina Estatal/organização & administração
[Mh] Termos MeSH secundário: Seres Humanos
Sistemas de Medicação no Hospital/organização & administração
Papel do Profissional de Enfermagem
Reino Unido
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:0611
[Cu] Atualização por classe:161124
[Lr] Data última revisão:
161124
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:061018
[St] Status:MEDLINE


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[PMID]:16879540
[Au] Autor:Grantham G; McMillan V; Dunn SV; Gassner LA; Woodcock P
[Ad] Endereço:Convalescent Unit, Flinders Medical Centre, Bedford Park, SA, Australia.
[Ti] Título:Patient self-medication--a change in hospital practice.
[So] Source:J Clin Nurs;15(8):962-70, 2006 Aug.
[Is] ISSN:0962-1067
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS AND OBJECTIVES: The purpose of this study was to evaluate the effectiveness of a self-medication programme (SMP) for inpatients of the Nursing Convalescent Unit, a 26-bed unit with medical and surgical patients. BACKGROUND: Self-medication is an important part of self-management of chronic illness. Self-medication is a way of allowing patients to give themselves their medications in hospital after receiving education instead of the usual practice of medications administered by a Registered Nurse (RN). DESIGN: The pilot study was undertaken over a six-month period to examine the relationship between a programme of self-medication and patient knowledge and adherence to medication regimens, number of medication errors, efficiency in relation to the number of nursing hours associated with the SMP, patient and nursing satisfaction. METHODS: A total of 220 patients participated in the study. The SMP included three levels of patient self-administration of medications: level one, medications administered by a RN; level two, self-medication directly supervised by a RN and level three, self-medication indirectly supervised by a RN. Outcome measures included staff and patient satisfaction, number of medication errors, time taken by nurses to undertake activities related to the SMP and the number of patients who achieved levels two and three. RESULTS: Study findings showed that 45% of patients remained on level one, 26% achieved level two and 29% achieved level three. There were no patient initiated medication errors during the study period. Efficiencies were identified in staff workload associated with patient discharge procedures. Overall, nurses perceived that the SMP increased their knowledge of medications and contributed to effective patient education. CONCLUSIONS: In selected patients, the SMP was an effective aid for improving adherence to medication regimens. Collaboration between nurses, medical staff, pharmacists, patients and carers is integral to the success of in hospital SMP.
[Mh] Termos MeSH primário: Atitude do Pessoal de Saúde
Recursos Humanos de Enfermagem no Hospital/psicologia
Satisfação do Paciente
Autoadministração
Unidades de Autocuidado/organização & administração
[Mh] Termos MeSH secundário: Idoso
Austrália
Convalescença
Feminino
Conhecimentos, Atitudes e Prática em Saúde
Hospitais de Ensino
Seres Humanos
Masculino
Erros de Medicação/estatística & dados numéricos
Pesquisa em Avaliação de Enfermagem
Pesquisa Metodológica em Enfermagem
Recursos Humanos de Enfermagem no Hospital/educação
Inovação Organizacional
Educação de Pacientes como Assunto/organização & administração
Projetos Piloto
Desenvolvimento de Programas
Avaliação de Programas e Projetos de Saúde
Autoadministração/enfermagem
Autoadministração/psicologia
Inquéritos e Questionários
Gestão da Qualidade Total/organização & administração
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:0609
[Cu] Atualização por classe:160803
[Lr] Data última revisão:
160803
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:060802
[St] Status:MEDLINE


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[PMID]:16112674
[Au] Autor:Moser A; van der Bruggen H; Widdershoven G
[Ad] Endereço:Faculty of Health Sciences, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands. a.moser@student.unimaas.nl
[Ti] Título:Competency in shaping one's life: autonomy of people with type 2 diabetes mellitus in a nurse-led, shared-care setting; a qualitative study.
[So] Source:Int J Nurs Stud;43(4):417-27, 2006 May.
[Is] ISSN:0020-7489
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: In the Netherlands diabetes specialist nurses play an important role in specialized, long-term care for the chronically ill. One of the goals of nurse-led, shared care is to encourage chronically ill people to participate actively in selecting the organisation and interventions of care. This paper reports the findings of a study to determine which concepts of autonomy people with type 2 diabetes use in a nurse-led, shared-care setting. OBJECTIVES: The aim of this article was to portray how people with type 2 diabetes mellitus who are being cared for by diabetes specialist nurses in a shared-care unit view autonomy. DESIGN AND SETTING: This qualitative study used in-depth interviews and was carried out in a nurse-led, shared-care unit in the Netherlands. PARTICIPANTS: The study population consisted of 15 people who were enrolled for at least 1 year at the nurse-led, shared-care unit and who lived independently at home. METHOD: Data were analysed with a grounded-theory-like method. RESULT: The core category, 'competency in shaping one's life', described how people with diabetes exercise their autonomy. Seven categories that emerged were considered dimensions of autonomy. The dimensions were: identification, self-management, welcomed paternalism, self-determination, shared decision-making, planned surveillance, and responsive relationship. CONCLUSION: Autonomy is a multi-dimensional, dynamic and complex construct. Further research is needed to investigate which decision-making processes patients with type 2 diabetes use in a nurse-led, shared-care setting.
[Mh] Termos MeSH primário: Comportamento Cooperativo
Diabetes Mellitus Tipo 2/prevenção & controle
Relações Enfermeiro-Paciente
Participação do Paciente/psicologia
Autonomia Pessoal
Autocuidado/psicologia
[Mh] Termos MeSH secundário: Assistência ao Convalescente/organização & administração
Idoso
Tomada de Decisões
Diabetes Mellitus Tipo 2/psicologia
Feminino
Hospitais Universitários
Seres Humanos
Masculino
Meia-Idade
Modelos de Enfermagem
Modelos Psicológicos
Países Baixos
Enfermeiras Clínicas/organização & administração
Enfermeiras Clínicas/psicologia
Papel do Profissional de Enfermagem/psicologia
Pesquisa Metodológica em Enfermagem
Participação do Paciente/métodos
Pesquisa Qualitativa
Autocuidado/métodos
Autoeficácia
Unidades de Autocuidado/organização & administração
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:0606
[Cu] Atualização por classe:151119
[Lr] Data última revisão:
151119
[Sb] Subgrupo de revista:IM; N
[Da] Data de entrada para processamento:050823
[St] Status:MEDLINE


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[PMID]:16044863
[Au] Autor:Deegan C; Watson A; Nestor G; Conlon C; Connaughton F
[Ad] Endereço:St James's Hospital, Dublin.
[Ti] Título:Managing change initiatives in clinical areas.
[So] Source:Nurs Manag (Harrow);12(4):24-9, 2005 Jul.
[Is] ISSN:1354-5760
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Autoadministração/métodos
Autoadministração/enfermagem
Unidades de Autocuidado/organização & administração
[Mh] Termos MeSH secundário: Idoso/psicologia
Comunicação
Avaliação Geriátrica
Pesquisa sobre Serviços de Saúde
Hospitais de Ensino
Seres Humanos
Irlanda
Participação nas Decisões
Determinação de Necessidades de Cuidados de Saúde
Papel do Profissional de Enfermagem
Avaliação em Enfermagem
Pesquisa em Avaliação de Enfermagem
Cultura Organizacional
Inovação Organizacional
Avaliação de Processos e Resultados (Cuidados de Saúde)/organização & administração
Cooperação do Paciente/psicologia
Desenvolvimento de Programas
Avaliação de Programas e Projetos de Saúde
Garantia da Qualidade dos Cuidados de Saúde/organização & administração
Centros de Reabilitação/organização & administração
Autoadministração/psicologia
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:0509
[Cu] Atualização por classe:050727
[Lr] Data última revisão:
050727
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:050728
[St] Status:MEDLINE


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[PMID]:14603547
[Au] Autor:Schmit-Pokorny K; Franco T; Frappier B; Vyhlidal RC
[Ad] Endereço:kschmit@unmc.edu
[Ti] Título:The Cooperative Care model: an innovative approach to deliver blood and marrow stem cell transplant care.
[So] Source:Clin J Oncol Nurs;7(5):509-14, 556, 2003 Sep-Oct.
[Is] ISSN:1092-1095
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Competition among healthcare institutions, the need to improve outcomes, and the desire to decrease costs have motivated blood and marrow stem cell transplant centers to develop innovative care models. In an effort to meet these challenges, a major midwestern medical center adapted the transplant process to the outpatient setting. This transition created greater educational and care demands for patients and families. To address these demands and provide improved accommodations and amenities for patients and families, the center adopted an innovative model of care, Cooperative Care, for transplant recipients. Cooperative Care embraces patients and families as key members of the healthcare team. A family member serves as a primary caregiver for the patient during the acute inpatient phase of the transplant. Care becomes more personal and individualized, cost is reduced, the rate of rehospitalization potentially is decreased, and patients ultimately become more confident and competent in caring for themselves. The healthcare team shifted its care philosophy to incorporate a care partner, increase patient control and independence, and create greater emphasis on education. Outcomes, including patient satisfaction, have demonstrated success and motivated expansion of this model to other patient populations.
[Mh] Termos MeSH primário: Cuidadores/educação
Cuidadores/psicologia
Comportamento Cooperativo
Família/psicologia
Transplante de Células-Tronco Hematopoéticas/psicologia
Modelos de Enfermagem
Participação do Paciente/psicologia
[Mh] Termos MeSH secundário: Centros Médicos Acadêmicos
Assistência Ambulatorial/organização & administração
Currículo
Pesquisa sobre Serviços de Saúde
Transplante de Células-Tronco Hematopoéticas/enfermagem
Seres Humanos
Decoração de Interiores e Mobiliário
Nebraska
Avaliação em Enfermagem
Avaliação de Resultados (Cuidados de Saúde)
Alta do Paciente
Educação de Pacientes como Assunto
Satisfação do Paciente
Filosofia em Enfermagem
Avaliação de Programas e Projetos de Saúde
Unidades de Autocuidado/organização & administração
Materiais de Ensino
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:0312
[Cu] Atualização por classe:071115
[Lr] Data última revisão:
071115
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:031108
[St] Status:MEDLINE


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[PMID]:14601218
[Au] Autor:Guy K; Gibbons C
[Ad] Endereço:Calderdale and Huddersfield NHS Trust.
[Ti] Título:Doing it by yourself.
[So] Source:Nurs Manag (Harrow);10(6):19-23, 2003 Oct.
[Is] ISSN:1354-5760
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:The DoH (1999) describes how it 'needs leaders who are motivated, self aware, socially skilled and able to work together with others across professional and organisational boundaries'. Self-medication incorporates all professional groups and divisions within Calderdale and Huddersfield NHS Trust; we work in partnership with the pharmacy departments. The main purpose of any organisation in the health and social sector is to ensure that a high quality service is delivered to service users (Martin 2001), so self-medication is now being given the attention it deserves. Assessment will be integral to every service user's stay and will continue throughout their stay, including transfer from secondary to primary care. It is expected that following its introduction, quality will improve; patients will receive their medication on time and it is anticipated that discharge delays will reduce. We acknowledge however that this will be difficult to demonstrate, as often medical conditions are cited as reasons for admission, not non-compliance with medication regimes. We see ourselves as being competent in the roles of change agents and our styles have changed throughout the process. We have worked together as equals and focused on one outcome. It will call on all our professional and educational skills to mould staff so that they are ready to embrace the change. Perhaps the lesson that has been learned so far is that, despite meticulous planning, the actions of others for whom we are not responsible can seriously disrupt the plan. The opportunity to manage change through experiential learning, reflection and the transfer of knowledge has been challenging while enhancing our personal growth and self-awareness. The project has been extended until March 2004 because of the merger and the associated increased workload. Becoming a project manager, leader and change agent has proved to be an exciting, interesting and challenging experience, although at times we felt isolated. The project has now entered a phase that involves intense staff training and phase one of introduction.
[Mh] Termos MeSH primário: Enfermeiras Administradoras/organização & administração
Autoadministração/métodos
Unidades de Autocuidado/organização & administração
[Mh] Termos MeSH secundário: Inglaterra
Hospitais de Distrito
Hospitais Gerais
Seres Humanos
Liderança
Enfermeiras Administradoras/psicologia
Recursos Humanos de Enfermagem no Hospital/educação
Recursos Humanos de Enfermagem no Hospital/organização & administração
Recursos Humanos de Enfermagem no Hospital/psicologia
Inovação Organizacional
Autoadministração/enfermagem
Medicina Estatal/organização & administração
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:0312
[Cu] Atualização por classe:041117
[Lr] Data última revisão:
041117
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:031107
[St] Status:MEDLINE


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[PMID]:12802837
[Au] Autor:Jensen L
[Ad] Endereço:Faculty of Nursing, University of Alberta, 3rd Floor, Clinical Sciences Building, Edmonton, Alberta T6G 2G3. louise.jensen@ualberta.ca
[Ti] Título:Self-administered cardiac medication program evaluation.
[So] Source:Can J Cardiovasc Nurs;13(2):35-44, 2003.
[Is] ISSN:0843-6096
[Cp] País de publicação:Canada
[La] Idioma:eng
[Ab] Resumo:For patients to manage their medication regimens at home, adequate preparation is required prior to hospital discharge. Self-administered medication programs are a strategy for improving medication knowledge and regimen adherence. The purpose of this study was to evaluate the effectiveness of a self-administered cardiac medication program on patients knowledge of and adherence to their medication regimen. Patient and nurse satisfaction with the self-administered medication program were assessed. A comparison group, repeated measures design was used in which patients received nurse-administered medications (n = 172) or self-administered medications (n = 178). Data were collected at admission, discharge, and 2, 6, and 16 weeks post-discharge. Outcome variables were medication knowledge, medication adherence, and program satisfaction. Patients in the self-administered medication group had significantly higher medication knowledge scores over time compared to those in the nurse-administered medication group. There was no statistically significant difference between groups on medication adherence. The self-administered medication group reported significantly higher levels of satisfaction and had significantly fewer medication errors and medication-related problems compared to the nurse-administered medication group.
[Mh] Termos MeSH primário: Cardiopatias/tratamento farmacológico
Autoadministração/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Atitude do Pessoal de Saúde
Avaliação Educacional
Conhecimentos, Atitudes e Prática em Saúde
Cardiopatias/psicologia
Seres Humanos
Erros de Medicação/prevenção & controle
Erros de Medicação/estatística & dados numéricos
Meia-Idade
Pesquisa em Avaliação de Enfermagem
Recursos Humanos de Enfermagem no Hospital/psicologia
Cooperação do Paciente/psicologia
Educação de Pacientes como Assunto
Avaliação de Programas e Projetos de Saúde
Autoadministração/enfermagem
Autoadministração/psicologia
Unidades de Autocuidado
[Pt] Tipo de publicação:CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; JOURNAL ARTICLE; MULTICENTER STUDY; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:0307
[Cu] Atualização por classe:071115
[Lr] Data última revisão:
071115
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:030614
[St] Status:MEDLINE


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[PMID]:11924617
[Au] Autor:Walker A
[Ad] Endereço:School of Nursing and Community Health, University of Western Sydney.
[Ti] Título:Trajectory, transition and vulnerability in adult medical-surgical patients: a framework for understanding in-hospital convalescence.
[So] Source:Contemp Nurse;11(2-3):206-16, 2001 Dec.
[Is] ISSN:1037-6178
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Relatively recent changes in health care have seen shorter hospital stays and a considerable increase in day-only admissions, anticipated to involve 60% of all patients admitted for surgery and/or investigations within the next couple of years. Surprisingly little is known about the experiences of the approximately 40% of patients who will begin to convalesce in hospital following illness, trauma or surgery. Findings from a qualitative study, briefly reported here, identified a sense of vulnerability in transition as a significant discomfort. By examining assumptions underlying the care of patients recovering in hospital, the nexus between system-determined care trajectories transition, and patient vulnerability can be identified and problems suitably addressed.
[Mh] Termos MeSH primário: Continuidade da Assistência ao Paciente
Hospitalização
Procedimentos Cirúrgicos Operatórios/enfermagem
[Mh] Termos MeSH secundário: Austrália
Convalescença/psicologia
Seres Humanos
Cuidados Pós-Operatórios
Unidades de Autocuidado
Procedimentos Cirúrgicos Operatórios/psicologia
Procedimentos Cirúrgicos Operatórios/reabilitação
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:0208
[Cu] Atualização por classe:120302
[Lr] Data última revisão:
120302
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:020402
[St] Status:MEDLINE



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