Zane Robinson Wolf

Responses and concerns of healthcare providers to medication errors.

This descriptive, correlational study examined the responses and concerns of healthcare professionals about making medication errors and estimated patient harm from such errors. A systematic random sample of nurses, pharmacists, and physicians (N = 402) completed a self-report survey about a medication error they judged to be serious. Respondents were guilty, nervous, and worried about the error. They feared for the safety of the patient, disciplinary action, and punishment. A few subjects indicated that they never reported the errors. The most frequent symptoms associated with errors were neurologically based. The injury suffered by patients was not severe overall according to the harm scales. Weak correlations were found for the harm scales and responses and concerns. The authors suggest a supportive environment for the provider following an error and continuous quality improvement efforts to eliminate system-based errors.

Substruction: Illustrating the connections from research question to analysis

This article examines the process of theoretical substruction as a heuristic device to assist graduate students and beginning investigators identify the conceptualization and operationalization phases of research proposals. As a thinking process, substruction enables investigators to delineate the foundational elements of studies. Creating the figure during substruction helps researchers increase their knowledge of the theoretical, empirical, or descriptive links between the conceptual and operational components of a study. Consequently, the researcher ascertains the fundamental pattern of the study. A qualitative and a quantitative example of substructed studies are included.

Nursing student medication errors involving tubing and catheters: A descriptive study

This retrospective case study examined reports (N=27) of medication errors made by nursing students involving tubing and catheter misconnections. Characteristics of misconnection errors included attributes of events recorded on MEDMARX error reports of the United States Pharmacopeia. Two near miss errors or Category B errors (medication error occurred, did not reach patient) were identified, with 21 Category C medication errors (occurred, with no resulting patient harm), and four Category D errors (need for increased patient monitoring, no patient harm) reported. Reported intravenous tubing errors were more frequent than other type of tubing errors and problems with clamps were present in 12 error reports. Registered nurses discovered most of the errors; some were implicated in the mistakes along with the students.

Communicating for the first time with delusional patients

BACKGROUND: Aggression and threats of violence are acknowledged elements of psychiatric settings. One of the most upsetting clinical experiences for nursing students is the psychiatric-mental health practicum in which students are expected to communicate therapeutically with hospitalized, delusional patients. OBJECTIVE: The purpose of this article is to describe the experiences of undergraduate baccalaureate nursing students as they communicate for the first time with delusional, hospitalized patients whom they perceived as frightening and to describe the meaning and essences of their experiences. It was assumed that students would find the delusional patients frightening. STUDY DESIGN: Colaizzi’s (1978) phenomenologic approach was used to investigate the student experience. Participants (N = 35) wrote about their experiences during week 12 of a senior year psychiatric-mental health nursing class. RESULTS: Students feared the unpredictable behavior of patients and wished to avoid interaction with them; the students also made the transition from fear of patients to empathy and concern for them. The findings indicated that students were reassured by staff proximity. CONCLUSIONS: Psychiatric nursing faculty should develop role-playing scenarios about caring for delusional patients and establish strong alliances with staff to increase the students’ sense of safety.

Paterson and Zderad’s Humanistic Nursing Theory: Concepts and Applications

This continuing education article analyzes Paterson and Zderad’s humanistic nursing theory. It examines its origins by exploring early publications and investigates the theory’s major concepts. The article determines the influence of humanistic nursing theory on the development of caring theories and its application to research, nursing education, and patient care situations. Humanistic nursing theory has been applied to nursing research, education, and clinical practice. Its utility for understanding and analyzing relational encounters in healthcare settings continues and is significant.

Creation of a Caring Protocol: Activities and Dissemination Strategies in Caring Research and Instruments

Few acute care healthcare agencies have tested the effect of a caring-focused program on the satisfaction of hospitalized, adult patients. Caring interventions need to be tested to document the effectiveness of nurse caring on a healthcare outcome, patient satisfaction. This study identified critical elements in interventional studies on nurse caring by determining patterns and caring activities in interventions (programs, protocols, or standards) to develop a caring protocol for a National Cancer Institute Comprehensive Cancer Center (NCICCC). Research, other published articles on caring programs, and instruments were analyzed for patterns and elements indicative of caring behaviors or activities representing nurse caring that could contribute to a caring intervention. Intervention dissemination strategies were also analyzed for incorporation into the programs implementation in a nursing department of the NCICCC. Content analysis techniques identified patterns and activities in caring interventions and ...

Nursing center-Health Intervention Program in Philadelphia: Program evaluation and outcomes

BACKGROUND The La Salle Neighborhood Nursing Center provided the Health Intervention Program (HIP) for vulnerable children with special needs, and families in Philadelphia challenged by chronic physical, developmental, behavioral, and emotional conditions and low incomes. AIMS We evaluated the effectiveness of HIP for a 5-year period and the consistency of quarterly and annual reports as a quality improvement initiative. METHODS Using program evaluation, secondary analysis design, the effect of a city-wide, family support home visiting program was assessed. Consistency of documentation of program outcomes on annual reports was described. Data were obtained from reports, framed by program objectives submitted via the ETO® database to the Department of Public Health. Components of the HIP consisted of case management, supportive services, information, and referrals provided by a multidisciplinary healthcare team. RESULTS Family services, program outcomes, referrals, community meetings, and themes demonstrated program complexity and effectiveness. Reports showed inconsistent documentation on 19 outcomes for program objectives. CONCLUSIONS Children with special needs and their families shared challenges and barriers to their health. The institution staff should create a table to report outcomes on program objectives to evaluate trends across funding years and establish interrater reliability on quarterly and annual reports.

The Moral Construct of Caring in Nursing as Communicative Action: Foundational Elements and Applications

Abstract This continuing education article analyzes Sumners theory, the moral construct of caring in nursing as communicative action. The dissemination of the theory includes the development of an instrument, its application to nursing administration, and its promise for use in patient care situations. It serves as a framework for nurses providing direct care to patients to reexamine the nurse–patient relationship.

Strategies to Implement the Standard of Care/Caring Protocol in an Acute Care Oncology Hospital Setting: A Focus Group Study

Abstract The investigation examined intervention strategies used by registered nurse caring crusaders during implementation of a nursing departments standard of care/caring protocol in a cancer hospital. The aim was to obtain increased understanding of how caring crusaders and investigators accomplished intervention fidelity during a program evaluation pilot study. An after program focus group design was implemented. Major themes consisted of context; accepting the idea of the protocol and resisting the education session in preparation for the caring protocol rollout; launching the caring protocol; getting on board with the protocol; maintaining the protocol throughout the timeline; persistence of caring crusaders; and competing standards. Additional major themes were: unanticipated project outcome; desiring recognition for performance; caring protocol: caring construct and caring activities as hidden nursing work; importance of nurse managers to the caring protocol; and reaching out to other employees a...

Women's experience of abuse in a healthcare setting reveals preceding loss of power struggles, with sensitivity and dependency making them vulnerable to staff domination

Commentary on: Bruggemann AJ, Swahnberg K. What contributes to abuse in health care? A grounded theory of female patients’ stories. Int J Nurs Stud 2013;50:404–12[OpenUrl][1][CrossRef][2][PubMed][3] The purpose of this study was to describe patients’ reports of contributors to their experiences of abuse in healthcare. The investigators hoped to gain more knowledge of the occurrence and prevention of abuse in healthcare and … [1]: {openurl}?query=rft.jtitle%253DInt%2BJ%2BNurs%2BStud%26rft.volume%253D50%26rft.spage%253D404%26rft_id%253Dinfo%253Adoi%252F10.1016%252Fj.ijnurstu.2012.10.003%26rft_id%253Dinfo%253Apmid%252F23122025%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.1016/j.ijnurstu.2012.10.003&link_type=DOI [3]: /lookup/external-ref?access_num=23122025&link_type=MED&atom=%2Febnurs%2F17%2F3%2F97.atom