scholarly journals Professional nurses' understanding of clinical judgement: A contextual inquiry

2016 ◽  
Vol 21 ◽  
pp. 280-293 ◽  
Author(s):  
Anna C. Van Graan ◽  
Martha J.S. Williams ◽  
Magdalena P. Koen
Keyword(s):  
Health Care ◽  
Nursing Care ◽  
Cognitive Skills ◽  
Relevant Literature ◽  
Clinical Judgement ◽  
Clinical Environment ◽  
Health Care Environment ◽  
Public And Private ◽  
Health Care Clinics ◽  
Professional Nurses

Higher cognitive skills are essential competencies for nurses joining the technologically and increasingly complex health care environment to provide safe and effective nursing care. Educators and clinical facilitators have recognised that newly qualified nurses do not meet the expectations for entry level clinical judgement and are held accountable for finding adequate learning experiences as preparation for such practice demands. An explorative and descriptive qualitative design was followed in this study to reach an understanding of clinical judgement in the clinical nursing environment from the perspective of professional nurses. Eleven professional nurses (n = 11) working at primary health care clinics, public and private hospitals participated voluntarily. Data was collected by means of the “World Cafe” method, incorporating a combination of techniques such as interviewing, discussions, drawings, narratives and reflection. The focus was on professional nurses' knowledge of the meaning of clinical judgement and factors influencing the development of clinical judgement in the clinical environment. Qualitative thematic content analysis principles were applied during data analysis. The findings were integrated with the relevant literature to culminate in conclusions that should add to the knowledge base of clinical judgement as an essential skill for improving autonomous and accountable nursing care.

scholarly journals Comparing and Contrasting Patient and Health Care Professional Views on Spiritual Care: Implications for Practice

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 116s-116s
Author(s):  
M. Fitch
Keyword(s):  
Health Care ◽  
Spiritual Care ◽  
Advanced Disease ◽  
Clinical Environment ◽  
Health Care Environment ◽  
Missed Opportunities ◽  
Spiritual Distress ◽  
Health Care Practitioners ◽  
Simple Question ◽  
The Individual

Background: Providing spiritual care has been identified as important in cancer care, especially for those individuals who are living with advanced disease. However, the busy nature of the current health care environment has created challenges for health care practitioners to identify spiritual distress and engage in appropriate interventions. Aim: This project was undertaken to deepen our understanding of spiritual care and the realities of identifying spiritual distress in a busy clinical environment. We sought to identify if there was a simple question that would be useful in screening for spiritual distress when used by the frontline provider. Methods: Patients with advanced disease (N=16) and health care practitioners (N=21) who care for them were interviewed in depth using an open-ended approach. Verbatim transcripts were analyzed separately for each group and themes identified. Subsequently, the perspectives from each group were compared, and common as well as discordance perspectives were identified. Results: Common views included spirituality as unique to the individual; spiritual distress as isolation, loneliness, and a sense of disconnection; spiritual care as listening, being with, and engendering a sense of connectedness; and identifying spiritual distress as needing a conversation rather than a single question. Contrasting views were seen in the difficulty health care practitioners had in describing spirituality, giving examples of spiritual distress and spiritual care from their own practices, and seeing a role for themselves in providing spiritual care. Patients, on the other hand, easily described these concepts and offered eloquent examples of their experiences related to spirituality and receiving spiritual care. Conclusion: Health care practitioners in this study struggled in describing spirituality and identifying roles for themselves in providing spiritual care. Patients considered spiritual care as important to their experience of living with advanced disease and expected it would be provided by their practitioners. The variation in perspectives could contribute to “missed opportunities” to support individuals and provide meaningful spiritual care.

scholarly journals Perceptions of strategies to facilitate caring for patients in primary health care clinics

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Tintswalo V. Nesengani ◽  
Charlene Downing ◽  
Marie Poggenpoel ◽  
Chris Stein
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Nurse Managers ◽  
Active Listening ◽  
Constructive Feedback ◽  
Health Care Clinics ◽  
Primary Health ◽  
Contextual Design ◽  
Asking Questions ◽  
Professional Nurses

Background: Caring in nursing helps patients feel better, whilst the absence of caring will affect patients psychologically, emotionally and physically.Aim: The aim of this article was to explore and describe primary health care (PHC) professional nurses’ and PHC nurse managers’ perceptions of the developed strategies to facilitate effective caring for patients in PHC clinics.Setting: This study was conducted in two PHC clinics in Ekurhuleni, an area east of the Gauteng province, South Africa.Methods: The study used a qualitative, exploratory, descriptive and contextual design. In-depth individual phenomenological interviews were conducted with eight purposively selected PHC professional nurses working in PHC clinics and two PHC nurse managers supervising PHC clinics in Ekurhuleni. Giorgi’s coding method was used to analyse the data.Results: Three themes were identified from the results of the exploration and description of PHC professional nurses’ and PHC nurse managers’ perceptions of the developed strategies. The use of active listening skills, showing interest in what is being said, asking questions and providing constructive feedback that focuses on the issue were the most effective strategies in improving effective communication between PHC nurse managers and PHC professional nurses. The PHC professional nurses were encouraged to put patients’ interests first whilst adhering to the ethical principles of nursing.Conclusion: Although caring is considered as the core of nursing practice, PHC professional nurses and PHC nurse managers perceive that rendering effective caring for patients needs to be reinforced through the use of strategies that will enable change and improve clinical practice in PHC clinics.

scholarly journals Antiretroviral Therapy in Public and Private Routine Health Care Clinics in Cameroon: Lessons from the Douala Antiretroviral (DARVIR) Initiative

2005 ◽  
Vol 41 (1) ◽  
pp. 108-111 ◽  
Author(s):  
C. Laurent ◽  
H. Meilo ◽  
J.-B. Guiard-Schmid ◽  
Y. Mapoure ◽  
J.-M. Noel ◽  
...  
Keyword(s):  
Health Care ◽  
Antiretroviral Therapy ◽  
Public And Private ◽  
Health Care Clinics

scholarly journals Strategies to facilitate effective caring for patients in primary health care clinics

Curationis ◽  
2021 ◽  
Vol 44 (1) ◽  
Author(s):  
Tinswalo Nesengani ◽  
Charlene Downing ◽  
Marie Poggenpoel ◽  
Chris Stein
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Conceptual Framework ◽  
Care Provider ◽  
Phase 1 ◽  
Phase 2 ◽  
Care Clinic ◽  
Health Care Clinics ◽  
Primary Health ◽  
Professional Nurses

Background: Caring is described as the innermost core of nursing which occurs in a relationship between the patient and the care provider. Although caring in nursing is associated with maintaining and strengthening of the patient’s sense of dignity and being a person, there seems to be a gap between caring theories in nursing, healthcare policies and caring for patients by professional nurses in primary health care clinics. Developing strategies that will facilitate effective caring for patients by professional nurses in primary health care clinics within an ethical and mindful manner became an area of focus in this study.Objectives: To develop strategies to facilitate effective caring for patients by professional nurses in primary health care clinics in South Africa.Method: Strategies were developed based on the conceptual framework developed in Phase 2, which was derived from synthesis of the results of Phase 1 of the previously conducted study and supported by literature. The conceptual framework reflects the survey list of Dickoff, James and Wiedenbach’s practice theory.Results: Three strategies were developed: 1) facilitating maintaining of the empowering experiences; 2) facilitating addressing the disempowering experiences by professional nurses, and 3) facilitating addressing of the disempowering primary health care clinic systems.Conclusion: The developed strategies, being the proposed actions, procedures and behaviours, could facilitate effective caring for patients by professional nurses in primary health care clinics.

Examining healthcare systems: a market analysis for Kenya

2019 ◽  
Vol 43 (1/2) ◽  
pp. 2-20
Author(s):  
Elise Catherine Davis ◽  
Terri Menser ◽  
Alondra Cerda Juarez ◽  
Lesley E. Tomaszewski ◽  
Bita A. Kash
Keyword(s):  
Health Care ◽  
Literature Review ◽  
Health Care Services ◽  
Relevant Literature ◽  
Health Care Environment ◽  
Content Type ◽  
Governmental Agencies ◽  
Care Services ◽  
Narrow Scope ◽  
Subject Areas

Purpose This paper aims to present a literature review of the health workforce, hospital and clinic systems, infrastructure, primary care, regulatory climate, the pharmaceutical industry and community health behavior of the Kenyan health-care system with the purpose of providing a thorough background on the health-care environment in Kenya. Design/methodology/approach A systematic literature review was conducted using Pub Med, searching for “Kenya” in the title of articles published from January 1, 2015 to February 24, 2016; this provided a broad overview of the type of research being conducted in Kenya. Other data provided by governmental agencies and non-governmental agencies was also reviewed to describe the current state of population health in Kenya. Findings An initial review of 615 Pubmed articles included 455 relevant articles. A complete review of these studies was conducted, resulting in a final sample of 389 articles. These articles were categorized into three main subject areas with 14 secondary subject areas (Figure 1). Research limitations/implications The narrow scope of the search parameters set for the systematic review was a necessary limitation to focus on the most relevant literature. The findings of this study provide a thorough background on health care in Kenya to researchers and practitioners. Originality/value This compilation of data specific to Kenya provides a detailed summary of both the country’s health-care services and health status, focusing on potential means of realizing increased quality and length of life.

scholarly journals Clinical judgement within the South African clinical nursing environment: A concept analysis

2016 ◽  
Vol 21 ◽  
pp. 33-45 ◽  
Author(s):  
Anna C. Van Graan ◽  
Martha J.S. Williams ◽  
Magdalena P. Koen
Keyword(s):  
South African ◽  
Nursing Care ◽  
Concept Analysis ◽  
Data Sources ◽  
Clinical Judgement ◽  
The South ◽  
Health Care Environment ◽  
Treatment Protocols ◽  
Clinical Nursing ◽  
Definition Of

Reform in the South African healthcare and educational system were characterized by the ideals that the country needs to produce independent, critical thinkers. Nurses need to cope with diversity in a more creative way, defining their role in a complex, uncertain, rapidly changing health care environment. Quality clinical judgement is therefore imperative as an identified characteristic of newly qualified professional nurses. The objective of this study was to explore and describe clinical judgement through various data sources and review of literature to clarify the meaning and promote a common understanding through formulating the characteristics and developing a connotative (theoretical) definition of the concept. An explorative, descriptive qualitative design was used to discover the complexity and meaning of the phenomenon. Multiple data sources and search strategies were used, for the time frame 1982—2013. A concept analysis was used to arrive at a theoretical definition of the concept of ‘clinical judgement’ as a complex cognitive skill to evaluate patient needs, adaption of current treatment protocols as well as new treatment strategies, prevention of adverse side effects through being proactive rather than reactive within the clinical nursing environment. The findings emphasized clinical judgement as skill within the clinical nursing environment, thereby improving autonomous and accountable nursing care. These findings will assist nurse leaders and clinical nurse educators in developing a teaching-learning strategy to promote clinical judgement in undergraduate nursing students, thereby contributing to the quality of nursing care.

Improving Communication Skills in Health Care

2013 ◽  
Vol 20 (3) ◽  
pp. 109-117
Author(s):  
Lynda Katz Wilner ◽  
Marjorie Feinstein-Whittaker
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Communication Skills ◽  
Health Care Professionals ◽  
Skills Training ◽  
International Medical Graduate ◽  
Medical Graduate ◽  
Health Care Environment ◽  
Medical Interpreters ◽  
Accent Modification

Hospital reimbursements are linked to patient satisfaction surveys, which are directly related to interpersonal communication between provider and patient. In today’s health care environment, interactions are challenged by diversity — Limited English proficient (LEP) patients, medical interpreters, International Medical Graduate (IMG) physicians, nurses, and support staff. Accent modification training for health care professionals can improve patient satisfaction and reduce adverse events. Surveys were conducted with medical interpreters and trainers of medical interpreting programs to determine the existence and support for communication skills training, particularly accent modification, for interpreters and non-native English speaking medical professionals. Results of preliminary surveys suggest the need for these comprehensive services. 60.8% believed a heavy accent, poor diction, or a different dialect contributed to medical errors or miscommunication by a moderate to significant degree. Communication programs should also include cultural competency training to optimize patient care outcomes. Examples of strategies for training are included.

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