Tom Andrews

Mobile technology and its use in clinical nursing education: a literature review

Nursing students face a variety of challenges to learning in clinical practice, from the theory-practice gap, to a lack of clinical supervision and the ad hoc nature of learning in clinical environments. Mobile technology is proposed as one way to address these challenges. This article comprehensively summarizes and critically reviews the available literature on mobile technology used in undergraduate clinical nursing education. It identifies the lack of clear definitions and theory in the current body of evidence; the variety of mobile devices and applications used; the benefits of mobile platforms in nursing education; and the complexity of sociotechnical factors, such as the cost, usability, portability, and quality of mobile tools, that affect their use in undergraduate clinical nursing education. Implications for nursing education and practice are outlined, and recommendations for future research are discussed.

A review of oral preventative strategies to reduce ventilator-associated pneumonia

AIM This article evaluates the evidence for and efficacy of the use of mechanical hygiene and chlorhexidine in the prevention of ventilator-associated pneumonia (VAP). SEARCH STRATEGIES INCLUSION CRITERIA primary research articles; randomized controlled trials; systematic reviews. EXCLUSION CRITERIA quasi-experimental trials; opinion articles. Search Engines: PubMed; CINAHL; and EBSCO. BACKGROUND VAP is the commonest infection found in critically ill patients who are mechanically ventilated. It is associated with increased mortality, increased length of stay in intensive care and increased costs. RELEVANCE TO CLINICAL PRACTICE VAP is a health care-associated infection consistent with the presence of an endotracheal tube and mechanical ventilation for greater than 48 h. Efforts aimed at reducing infection rates include oral decontamination and mechanical hygiene to control the bacteria responsible, since there is an association between changes in bacteria found in the oropharynx and its development. Tooth brushing and the use of an oral antiseptic such as chlorhexidine gluconate are increasingly recommended in ventilator care bundles. CONCLUSION While there have been a number of studies conducted evaluating the efficacy of both approaches, there is limited evidence to support their use. The frequency of oral decontamination and mechanical hygiene interventions have not been established and chlorhexidine 2% seems to be more effective compared to weaker concentrations, but data is mainly confined to patients following cardiothoracic surgery.

Awareness of dying revisited.

G ROUNDED THEORIES are powerful tools that nurses can use to improve nursing care quality.1 Specially trained researchers derive grounded theories from observations and conceptualizations of real-world happenings. Because of this real-world orientation, grounded theories are particularly appropriate for nursing research. Grounded theories can offer clear understandings of predictable processes and patterns of behavior. When nurses better understand patterns that negatively affect patients, they can work toward altering them to improve the quality of patient care. In a 2007 article titled “How Grounded Theory Can Improve Nursing Care Quality,” we demonstrated how grounded theories can help nurses understand that certain patterns always seem to emerge, that particular people respond in predictable ways, and that actions produce predictable results.1 We offered 2 distinct grounded theories, Visualizing Deteriorating Conditions2 and Moral Reck-

How grounded theory can improve nursing care quality.

This article presents an overview of the grounded theory research method and demonstrates how nurses can employ specific grounded theories to improve patient care quality. Because grounded theory is derived from real-world experience, it is a particularly appropriate method for nursing research. An overview of the method and language of grounded theory provides a background for nurses as they read grounded theories and apply newly acquired understandings to predictable processes and patterns of behavior. This article presents 2 exemplar grounded theories with suggestions as to how nurses can apply these and other grounded theories to improve the provision of quality nursing care.

Protecting family interests: an interview study with foreign-born parents struggling on in childhood cancer care

Swedens population is gradually changing to become more multiethnic and diverse and that applies also for recipients of health care, including childhood cancer care. A holistic view on the sick child in the context of its family has always been a cornerstone in childhood cancer care in Sweden. The purpose of this study was to gain knowledge about the experiences and main concern of foreign-born parents in the context of paediatric cancer care. Interviews were performed with eleven foreign-born parents and data were analysed using a classic grounded theory approach. Foreign-born parents often feel in a position of powerless dependence, but family interests are protected in their approaches to interaction with healthcare staff, through cooperation, contesting, and reluctant resigning. Healthcare staff need to listen to foreign-born parents and deal with their concerns seriously to prevent powerless-dependence and work for trustful cooperation in the common fight against childhood cancer.

What factors influence arterial blood gas sampling patterns

STUDY OBJECTIVE To investigate if patterns of arterial blood gas (ABG) sampling were influenced by values of fractional inspiratory oxygen (FiO2), partial pressure of carbon dioxide (PCO2), partial pressure of oxygen (PO2) and oxygen saturation (%SaO2). SETTING An intensive care unit (ICU) in a university teaching hospital located in the North of England, UK. DESIGN A retrospective, descriptive, correlation study based on patient records. PARTICIPANTS All patients admitted to the ICU for 24 hours or greater and who had an arterial line in situ. MEASUREMENTS AND RESULTS The study included the records of 65 patients consecutively admitted to the ICU. Patients in this study had more blood gases taken than reported elsewhere in the literature. While consistent correlation was found between values of FiO2, PCO2, PO2 and %SaO(2), values of PO2 were the most consistent. CONCLUSIONS Values of PO2 are associated with frequency of ABG sampling and to a lesser extent on FiO2. Nurses in this study opted to track changes in oxygenation using ABGs despite continuous monitoring of %SaO2.

Playing the game: How young people moderate influences in accommodating asthma in their lives

This article presents moderating influences, one of the sub-core categories from the theory of accommodating interruptions. This theory emerged in the context of young people who have asthma, explaining how they develop behaviours in their everyday lives (Hughes 2014; Hughes et al., 2017). The aim of this research was to develop a theory on the behaviours of young people who have asthma, in relation to the impact of asthma on the lives and the issues affecting them. This research was undertaken using a classic grounded theory approach. Data were collected through in-depth interviews, participant diaries and clinic consultations with young people aged 11–16 years who had asthma for over one year. Moderating influence accounts for how social influences and social culture affect what young people who have asthma wish to achieve and how they want to be perceived by others. Young people moderate influences by their features or attributes in order to meet their own needs.

Implementing mobile information technology in clinical nursing education: how, why, when, where and what happened? Some answers from a review of the literature

Background Clinical practice presents a variety of challenges for nursing students which can impact their learning and application of knowledge and skills. Their inexperience coupled with the lack of supervision and ad hoc nature of learning in clinical environments can reduce their hands-on skills and negatively impact patient care. New methods are needed to help nursing students and educators address the theory-practice gap [1]. Information and communication technologies (ICT) such as mobile devices are being proposed as one way to support nursing students in clinical practice as they provide instant access to evidence based information at the point of care [2]. Despite the advantages it offers implementing mobile technology in clinical nursing education has proved challenging. The literature review aims to investigate how, why, when and where hand-held devices have been utilised in clinical nursing education and what factors facilitated or hindered their use.