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Usuários frequentes de um serviço de urgência : perfil e motivos de busca por atendimento; Frequent users of an emergency service: profile and reasons to seek care; Pacientes frecuentes de un servicio de urgencias: perfil y motivos de búsqueda de atención

Acosta, Aline Marques
Fonte: Universidade Federal do Rio Grande do Sul Publicador: Universidade Federal do Rio Grande do Sul
Tipo: Dissertação Formato: application/pdf
Português
Relevância na Pesquisa
38.91364%
O estudo teve como objetivo geral analisar a utilização frequente por usuários adultos do serviço de urgência de um hospital universitário. Trata-se de uma pesquisa de métodos mistos do tipo explanatório sequencial. Foi realizada uma etapa de caráter quantitativo para descrever as características demográficas e clínicas dos usuários frequentes do serviço de urgência e identificar as características da utilização de serviço de urgência por usuários frequentes. A seguir, foi realizada uma etapa qualitativa, com o propósito de explorar os motivos da utilização frequente do serviço de urgência. Os dados quantitativos foram coletados por meio de registros dos prontuários eletrônicos dos pacientes, a partir de uma amostra de 385 usuários frequentes do Serviço de Emergência de um hospital universitário da região sul do Brasil. Os dados qualitativos foram obtidos por meio de entrevistas semiestruturadas por telefone com 18 usuários frequentes, selecionados por uma amostra intencional. Os dados da etapa quantitativa foram analisados no Programa Statistical Package for the Social Science (SPSS), pela utilização de técnicas de estatística descritiva e inferencial, com nível de significância de 5% (p<0,05). Para o tratamento dos resultados qualitativos...

Characteristics of effective clinical and theory instructors as perceived by LPN to RN versus generic students in an associate degree nursing program

Whitehead, Diane K
Fonte: FIU Digital Commons Publicador: FIU Digital Commons
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
59.84741%
The purpose of this study was to compare the characteristics of effective clinical and theory instructors as perceived by LPN/RN versus generic students in an associate degree nursing program.^ Data were collected from 508 students during the 1996-7 academic year from three NLN accredited associate degree nursing programs. The researcher developed instrument consisted of three parts: (a) Whitehead Characteristics of Effective Clinical Instructor Rating Scale, (b) Whitehead Characteristics of Effective Theory Instructor Rating Scale, and (c) Demographic Data Sheet. The items were listed under five major categories identified in the review of the literature: (a) interpersonal relationships, (b) personality traits, (c) teaching practices, (d) knowledge and experience, and (e) evaluation procedures. The instrument was administered to LPN/RN students in their first semester and to generic students in the third semester of an associate degree nursing program.^ Data was analyzed using a one factor mutivariate analysis of variance (MANOVA). Further t tests were carried out to explore for possible differences between type of student and by group. Crosstabulations of the demographic data were analyzed.^ There were no significant differences found between the LPN/RN versus generic students on their perceptions of either effective theory or effective clinical instructor characteristics. There were significant differences between groups on several of the individual items. There was no significant interaction between group and ethnicity or group and age on the five major categories for either of the two instruments. There was a significant main effect of ethnicity on several of the individual items.^ The differences between the means and standard deviations on both instruments were small...

Factors that motivate RNs to return to school for the BSN and to remain in school to complete the degree

Corbett, Shirley Ann
Fonte: FIU Digital Commons Publicador: FIU Digital Commons
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
100.87506%
This exploratory descriptive study examined the factors that influence Registered Nurses (RNs) to return to school to pursue a Baccalaureate of Science in Nursing degree (BSN) and the factors that contribute to the decision to remain in school to complete the degree. Students (N = 226) enrolled in RN-BSN programs in three different universities in southeast Florida participated in the study by completing researcher developed questionnaires. The study group included 140 students who were newly enrolled in an RN-BSN program and 86 students who were preparing to graduate from an RN-BSN program. The instruments used in this study were two researcher developed questionnaires, the Corbett Nursing Educational Motivational Inventory - Form A (CNEMI-A), administered to the newly enrolled students, and the Corbett Nursing Educational Motivational Inventory - Form B (CNEMI-B), administered to the graduating students. The questionnaires included researcher-developed items in addition to items derived from a modified form of the Educational Participation Scale used by other researchers. Demographic data were also collected. Findings indicated that changes in health care, career goals, personal satisfaction, and flexible curriculum patterns are the major reasons why RNs return to school for the BSN. Less significant factors were social support...

A study of state and trait anxiety and perceived causes of anxiety identified by licensed practical nurses returning to an associate degree nursing program

Weiss, Sally Ann
Fonte: FIU Digital Commons Publicador: FIU Digital Commons
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
100.72463%
The purpose of this study was to identify the state and trait anxiety and the perceived causes of anxiety in licensed practical nurses (LPNs) returning to an associate degree nursing program in order to become registered nurses (RNs). The subjects for this study were 98 students enrolled in a transitional LPN/RN associate degree nursing program in two community colleges in the state of Florida. The State-Trait Anxiety Inventory (STAI) developed by Spielberger (1983), was used as the measuring instrument for this study.^ In addition, a Q-sort technique was used to obtain information from the subjects regarding perceived causes of anxiety. Anxiety causes for the Q-sort cards used in the study were developed from the themes identified by a sample of LPN/RN students in a pilot study. The state and trait anxiety levels were obtained using the STAI for college students scoring key and scales. Descriptive statistics were used to determine the state and trait anxiety of the students. Correlational statistics were used to determine if relationships existed between the state and trait anxiety levels and perceived causes of anxiety identified by LPN students returning to an associate degree nursing program.^ The analysis of the Q-sort was performed by computing the means...

An evaluation of an intervention strategy for retention and determination of predictors of success for high -risk students in an associate degree nursing program

Woolley, Gale Robin
Fonte: FIU Digital Commons Publicador: FIU Digital Commons
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
110.334375%
The purpose of this study was twofold: (1) to evaluate the effect of a specific instructional Intervention, a Nursing Theory Laboratory, on increasing the retention of high risk students in the associate degree nursing program at Miami-Dade Community College in Miami, Florida; and (2) to identify predictors of success of high risk nursing students in this associate degree nursing program.^ Data were collected from the 195 nursing students enrolled in Nursing Fundamentals during the 1985-1987 academic years, and identified as high risk students. Control and experimental groups were selected based on enrollment in the Nursing Theory Laboratory.^ Results were determined by analyzing several cross-tabulations of selected variables and yielding chi square values, t-tests, and two discriminant analyses. There was no significant relationship between age or ethnic background and enrollment in the Nursing Theory Laboratory. There was no significant relationship between enrollment in the Nursing Theory Laboratory and success in Nursing 1 (Nursing Fundamentals). There was a significant relationship between enrollment in the Nursing Theory Laboratory and success in Nursing 3 (Medical-Surgical Nursing). Writing assessment test scores in two entrance tests and high risk categories...

Factors surgical team members perceive influence choices of wearing or not wearing personal protective equipment during operative /invasive procedures

Cuming, Richard G
Fonte: FIU Digital Commons Publicador: FIU Digital Commons
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
100.24135%
Exposure to certain bloodborne pathogens can prematurely end a person’s life. Healthcare workers (HCWs), especially those who are members of surgical teams, are at increased risk of exposure to these pathogens. The proper use of personal protective equipment (PPE) during operative/invasive procedures reduces that risk. Despite this, some HCWs fail to consistently use PPE as required by federal regulation, accrediting agencies, hospital policy, and professional association standards. The purpose of this mixed methods survey study was to (a) examine factors surgical team members perceive influence choices of wearing or not wearing PPE during operative/invasive procedures and (b) determine what would influence consistent use of PPE by surgical team members.^ Using an ex post facto, non-experimental design, the memberships of five professional associations whose members comprise surgical teams were invited to complete a mixed methods survey study. The primary research question for the study was: What differences (perceptual and demographic) exist between surgical team members that influence their choices of wearing or not wearing PPE during operative/invasive procedures?^ Four principal differences were found between surgical team members. Functional (i.e....

Nursing curriculum: Changing students' knowledge and biases towards older adults

Parchment, Yvonne Diana
Fonte: FIU Digital Commons Publicador: FIU Digital Commons
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
60.059233%
Caring for the older adult is a topic debated and discussed at all levels of today's society. Nurses are expected to educate patients and family members about their medications and care following hospitalization or contact with the health care system. The majority of these patients are elderly. The purpose of the study was to determine if a course on aging would affect the knowledge and biases of nursing students in a Baccalaureate nursing program at a Southeast Florida University. Nursing students (N = 52) were surveyed at the beginning of the semester using Palmore's Facts on Aging Quiz that is structured to determine the knowledge and biases of individuals towards the older adult. Students were surveyed before and after the nursing course that had a didactic and clinical component in the hospital setting. Analysis of the data by Chi square and repeated measure ANOVA supported the hypothesis that a course segment on aging would affect the knowledge level of the nursing students and result in changes of their biases toward the older adult. ^

The impact of selected factors in nurses' attitudes toward bedside computers

Jaques, Eugenia Denise
Fonte: FIU Digital Commons Publicador: FIU Digital Commons
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
89.71582%
The purpose of this study was to determine the impact of selected factors on nurses' attitudes toward bedside computers. Bedside computer systems, also referred to as point-of-care systems, are clinical information systems that allow documentation of patient care and retrieval of data at the patient's bedside, or in close proximity to where care is delivered. The adoption of bedside computer systems appears to be increasing among U.S. institutions. As healthcare institutions undertake automation projects, they face many challenges associated with implementing large-scale change. ^ The study explored four factors and their relationship to nurses' attitudes toward bedside computers. A pre-bedside implementation survey of 184 staff nurses did not demonstrate a relationship between previous computer experience and nurses' attitudes toward bedside computers (p > .05). The data did not indicate a relationship between nurses' formal education and their attitude toward bedside computers (p > .05). The data did support a relationship between nurses' previous computer experience and their comfort in the use of bedside computers (p < .0005). Using a quasi-experimental control group design, attitudes of nurses were studied over an 18 month period. The Pre versus Post Survey data indicated that nurses who used bedside computers...

Predictors of first semester attrition and their relation to retention of generic associate degree nursing students

Jackson, Donna Katherine
Fonte: FIU Digital Commons Publicador: FIU Digital Commons
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
69.251924%
In community college nursing programs the high rate of attrition was a major concern to faculty and administrators. Since first semester attrition could lead to permanent loss of students and low retention in nursing programs, it was important to identify at-risk students early and develop proactive approaches to assist them to be successful. The goal of nursing programs was to graduate students who were eligible to take the national council licensing examination (RN). This was especially important during a time of critical shortage in the nursing workforce. ^ This study took place at a large, multi-campus community college, and used Tinto's (1975) Student Integration Model of persistence as the framework. A correlational study was conducted to determine whether the independent variables, past academic achievement, English proficiency, achievement tendency, weekly hours of employment and financial resources, could discriminate between the two grade groups, pass and not pass. Establishing the relationship between the selected variables and successful course completion might be used to reduce attrition and improve retention. Three research instruments were used to collect data. A Demographic Information form developed by the researcher was used to obtain academic data...

The theory of margin as a predictor of success on the National Council Licensure Examination for Registered Nurses

Sutton, Douglas Hoyt
Fonte: FIU Digital Commons Publicador: FIU Digital Commons
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
90.49985%
The National Council Licensure Examination for Registered Nurses (NCLEX-RN) is the examination that all graduates of nursing education programs must pass to attain the title of registered nurse. Currently the NCLEX-RN passing rate is at an all-time low (81%) for first-time test takers (NCSBN, 2004); amidst a nationwide shortage of registered nurses (Glabman, 2001). Because of the critical need to supply greater numbers of professional nurses, and the potential accreditation ramifications that low NCLEX-RN passing rates can have on schools of nursing and graduates, this research study tests the effectiveness of a predictor model. This model is based upon the theoretical framework of McClusky's (1959) theory of margin (ToM), with the hope that students found to be at-risk for NCLEX-RN failure can be identified and remediated prior to taking the actual licensure examination. To date no theory based predictor model has been identified that predicts success on the NCLEX-RN. ^ The model was tested using prerequisite course grades, nursing course grades and scores on standardized examinations for the 2003 associate degree nursing graduates at a urban community college (N = 235). Success was determined through the reporting of pass on the NCLEX-RN examination by the Florida Board of Nursing. Point biserial correlations tested model assumptions regarding variable relationships...

A qualitative analysis of the lived experience of nursing staff developers in the process of changing to a new educational model

Dombro, Marcia Winters
Fonte: FIU Digital Commons Publicador: FIU Digital Commons
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
100.56523%
The purpose of this study was to document and critically analyze the lived experience of selected nursing staff developers in the process of moving toward a new model for hospital nursing education. Eleven respondents were drawn from a nation-wide population of about two hundred individuals involved in nursing staff development. These subjects were responsible for the implementation of the Performance Based Development System (PBDS) in their institutions.^ A purposive, criterion-based sampling technique was used with respondents being selected according to size of hospital, primary responsibility for orchestration of the change, influence over budgetary factors and managerial responsibility for PBDS. Data were gathered by the researcher through both in-person and telephone interviews. A semi-structured interview guide, designed by the researcher was used, and respondents were encouraged to amplify on their recollections as desired. Audiotapes were transcribed and resulting computer files were analyzed using the program "Martin". Answers to interview questions were compiled and reported across cases. The data was then reviewed a second time and interpreted for emerging themes and patterns.^ Two types of verification were used in the study. Internal verification was done through interview transcript review and feedback by respondents. External verification was done through review and feedback on data analysis by readers who were experienced in management of staff development departments.^ All respondents were female...

Effects of two intervention strategies on the behavior of nurses and nurse students related to advance directives

Thayer, Ann Tibbs
Fonte: FIU Digital Commons Publicador: FIU Digital Commons
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
100.17404%
Advance directives are one mechanism for preserving the rights of individuals to exercise some control over their health care when serious illness may prevent them from direct participation. Nurses, as the health care providers with the closest and most sustained contact with critically ill and dying patients, are positioned to assist patients to plan for future health care needs. Although a majority of nurses favor the concept of advance directives for their patients and for themselves, they have not played a significant role in facilitating advance health care planning with their patients nor implemented advance health care planning for themselves.^ Research has also shown that differing forms of education and counseling increase the completion rates for advance directives in selected populations, mostly the elderly and seriously ill. Not yet developed are effective educational strategies to assist nurses and nurse students to make optimal contributions in assisting their clients' plans for future health care decision-making. This study sought to determine whether specific learning strategies (a) increased the involvement of nurses and nurse students in facilitating advance care planning with patients and (b) increased the percentage of the nurses' and nurse students' own personal advance care planning activities.^ The study compared two learning interventions and two populations...

Employee perceptions of workplace empowerment in relation to self -reported intent to stay on the job

Nedd, Nicole
Fonte: FIU Digital Commons Publicador: FIU Digital Commons
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
89.99199%
As the nursing profession faces a shortage of nurses, workplace initiatives focused on retaining employees are critical to the United States healthcare industry (Sochalski, 2002). The purpose of this research was to determine whether self-reported intent to stay on the job was related to perceptions of workplace empowerment using Kanter's (1977) theory of organizational empowerment as a framework. ^ The sample consisted of 206 Florida registered nurses. Four self-report scales and a demographic questionnaire were administered by mail. The Conditions for Work Effectiveness Questionnaire (CWEQ; Chandler, 1987), Job Activity Scale (JAS; Laschinger, Kutzscher, & Sabiston, 1993), Organizational Relationships Scale (ORS; Laschinger, Sabiston, & Kutzscher, 1993) and an intent to stay instrument (Kim, Price, Mueller & Watson, 1996) were used to measure perceived access to empowerment structures, perceived formal power, perceived informal power, and intent to stay, respectively. The data were analyzed using descriptive statistics, correlational analysis, and hierarchical regression. ^ Twenty-eight percent of the variance of intent to stay was explained by perceived access to empowerment structures, perceived formal power, and perceived informal power when holding age...

Low-frequency and rare exome chip variants associate with fasting ?glucose and type 2 diabetes susceptibility

Wessel, Jennifer; Chu, Audrey Y.; Willems, Sara M.; Wang, Shuai; Yaghootkar, Hanieh; Brody, Jennifer A.; Dauriz, Marco; Hivert, Marie-France; Raghavan, Sridharan; Lipovich, Leonard; Hidalgo, Bertha; Fox, Keolu; Huffman, Jennifer E.; An, Ping; Lu, Yingchan
Fonte: Nature Publishing Group Publicador: Nature Publishing Group
Tipo: Article; published version
Português
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39.647114%
This paper was originally published in Nature Communications (Wessel J, Chu AY, Willems SM, Wang S, et al. Nature Communications 2015, 6, 5897 doi:10.1038/ncomms6897).; Fasting ?glucose and ?insulin are intermediate traits for type 2 diabetes. Here we explore the role of coding variation on these traits by analysis of variants on the HumanExome BeadChip in 60,564 non-diabetic individuals and in 16,491 T2D cases and 81,877 controls. We identify a novel association of a low-frequency nonsynonymous SNV in ?GLP1R (A316T; rs10305492; MAF=1.4%) with lower FG (?=?0.09?0.01?mmol?l^?1, P=3.4 ? 10^?12), T2D risk (OR[95%CI]=0.86[0.76?0.96], P=0.010), early ?insulin secretion (?=?0.07?0.035?pmol_insulin mmol_glucose^?1, P=0.048), but higher 2-h ?glucose (?=0.16?0.05?mmol?l^?1, P=4.3 ? 10^?4). We identify a gene-based association with FG at ?G6PC2 (pSKAT=6.8 ? 10^?6) driven by four rare protein-coding SNVs (H177Y, Y207S, R283X and S324P). We identify rs651007 (MAF=20%) in the first intron of ?ABO at the putative promoter of an antisense lncRNA, associating with higher FG (?=0.02?0.004?mmol?l^?1, P=1.3 ? 10^?8). Our approach identifies novel coding variant associations and extends the allelic spectrum of variation underlying diabetes-related quantitative traits and T2D susceptibility.; CHARGE: Funding support for ?Building on GWAS for NHLBI-diseases: the U.S. CHARGE consortium? was provided by the NIH through the American Recovery and Reinvestment Act of 2009 (ARRA) (5RC2HL102419). Sequence data for ?Building on GWAS for NHLBI-diseases: the U.S. CHARGE consortium? was provided by Eric Boerwinkle on behalf of the Atherosclerosis Risk in Communities (ARIC) Study...

NURSING IN THE PREVENTION OF INFECTION CATHETER CENTRAL: systematic literature review.

Zuzarte, Jannyne dos Santos; Cruz, Isabel CF da; Fluminense Federal University
Fonte: Universidade Federal Fluminense Publicador: Universidade Federal Fluminense
Tipo: Peer-reviewed Article; Literature Review Formato: text/html
Publicado em 31/01/2013 Português
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41.06836%
INTRODUCTION: The adult client in a situation of high complexity in use of central venous catheterization (CVC) is totally dependent on intensive care. In this context Is that the nurse must be alert to use all senses to Their Develop a holistic look and systematically observe the intent to Promote the best and safest care to humans. In this sense the Evidence-Based Practice (EBP) proposes that the problems that arise in clinical care practice, are organized using the PICO strategy, which is an acronym for Patient, Intervention, Comparison and "Outcomes" (outcome). These four components are the key elements of the research question and the construction of clinical question for bibliographic search of evidence. Thus, considering that the customer adult / senior high in complexity with the use of central venous catheterization (CVC) has risk of catheter-related infection, emerged the following clinical question: In adult client of high complexity, where the effectiveness of dressing with antiseptic chlorhexidine in preventing the potential for infection of central venous catheterization? BACKGROUND: The interest in studying this subject appeared in Evidence-Based Practice in Career Training Specialist (TPE), while postgraduate Nursing. Noting that the dressings in central venous catheter were not made with 2% chlorhexidine...