Academic Nursing Center Primary Care Quality Improvement Using an Electronic Health Record and a Practice-Based Research Network

Practice-based research networks (PBRN) seek to improve healthcare through the use of research, quality improvement, and collaborative learning. When used by nontraditional models of care such as the nurse managed healthcare center (NMHC), PBRNs can be incorporated into successful quality improvement (QI) programs. UT Health Services is a NMHC utilizing a PBRN as one component of a comprehensive QI program in an effort to deliver high quality healthcare.

Observation of the Clinical Effects of Detailoriented Nursing in Health Checkups at a Health Management Center

Objective:To observe the clinical effects of detail-oriented nursing in health checkups at a health management center.Methods:A total of 240 individuals undergoing health checkups at the hospital’s health management center from June 2023 to June 2024 were enrolled and randomly divided into two groups according to a random number table method.The control group received routine nursing care,while the observation group received detail-oriented nursing care,with 120 cases in each group.Differences in checkup quality and nursing risk incidence were compared.Results:The form submission rate,project completion rate,and one-time checkup completion rate in the observation group were higher than those in the control group,while the checkup time was shorter(P<0.05).The incidence of nursing risks such as item loss,falls,and patient-nurse disputes was lower in the observation group compared to the control group(P<0.05).Conclusion:Applying detail-oriented nursing in health checkups at a health management center can effectively improve checkup quality and reduce the occurrence of nursing risks.

Application Research on Community Nursing Practice Teaching Combined with Diabetes Health Management

Objective Discuss and reform community nursing practice teaching mode, and improve effects of community nursing teaching. Method Students are grouped into experimental group and control group randomly. Students in the experimental group manage individualized health of diabetes patients in the observation group, and students in the control group conduct group health education and management for diabetes patients, no individualized health management. Results Students in the two groups compare cognition about this course and community nursing before teaching, no remarkable difference (all P values are ? 0.05), and compare diabetes knowledge and living behaviors of the old in the two groups, no remarkable difference (all P values are ? 0.05). After teaching, students in the two groups compare recognition of this course and community nursing as well as test performance, and there are remarkable differences (all P values are ? 0.05). And comparison of diabetes knowledge and living behaviors of the old in the two groups shows remarkable differences (all P values are ? 0.05). The implementation of individualized health management mode in community nursing practice teaching can improve students' professional knowledge and competence, and help diabetes patients to form good behaviors and life styles. The combination of community nursing practice teaching and individualized health management for diabetes patients can improve students' professional knowledge and competence, and help diabetes patients to control illness state and improve their physical conditions.

Community Health Management and Nursing Strategies for Elderly Hypertension

Objective:To explore the therapeutic effects of community health management and nursing strategies for elderly hypertensive patients.Methods:A total of 64 elderly hypertensive patients who were treated in our hospital from March 2020 to March 2021 were selected.The control group took conventional care and guidance.The research group carried out community health management and nursing strategy guidance on the basis of the control group.Then compare the blood pressure levels of the two groups of patients before and after nursing and the patients’satisfaction with nursing.Results:Through comparison,it can be seen that the diastolic and systolic blood pressure levels of the study group and the control group are not significantly different before nursing.After nursing,the diastolic blood pressure of the patients in the study group was 81.22.1 mmHg and the systolic blood pressure was 126.58.7 mmHg.The diastolic blood pressure of the control group was 90.55.4 mmHg and the systolic blood pressure was 136.412.9 mmHg.There are obvious differences in the comparison of the two sets of data.By comparing the two groups of patients’satisfactions with nursing care,it can be seen that among the 32 patients in the study group:31 were very satisfied and basically satisfied,with a satisfaction rate of 96.87%.Among the 32 patients in the control group,28 were very satisfied and basically satisfied,with a satisfaction rate of 87.5%.The data of the two groups of patients are clearly comparable.Conclusion:Through community health management and nursing strategies,the satisfaction and treatment effect of elderly hypertensive patients can be improved,thereby contributing to the recovery of patients.

Prevention from a community perspective facilitating and constraining factors perceived by nurses in local community health centers in the course of prevention and health promotion

The purpose of this paper is to explore the stimulating factors and the obstacles experienced by nurses in community health centres in their work with prevention and health promotion. We conducted the qualitative research design consisting of fifteen nurses in five community health centres in Ghent. There was also a focus group and participant observation. All participants experienced stimulating factors as well as obstacles in their work with preventive interventions. The most strongly facilitators were the Electronic Medical File and the multidisciplinary approach. The obstacles mentioned by the nurses were the communication problems and the financial problems. This study may have an important impact on nursing practice and nursing prevention. Further research is needed on nurses working in community health centres and the way they approach their patients in the course of preventive actions.

Nursing Students’ Experience with Information Literacy Skill

This study examined the searching skills and extent of usage of electronic databases by Nursing, Midwifery and Public Health Nursing students in the University of Health and Allied Science (UHAS). The focus was on forty (40) level 300 students drawn from a universe of two hundred and forty six (246) of the School of Public Health (SPH). The study used quantitative method approach and the survey instruments were questionnaire, interview and observation. The data collected were analyzed and classified into the following themes: usefulness, extent of use, determinants of use of e-databases, searching skills, and main drawbacks of learning information literacy skills (ILS). Although all the respondents strongly agreed that e-databases are indispensable for academic and professional practice, findings revealed that majority of them have low quality of searching skills and that accounts for the sparse use of the e-databases. This positive association is proven by Pearson’s chi square test (0.000). The study also established that students’ attitude, academic loads and methodology of teaching were the challenges hindering the acquisition of ILS of students. As a consequence, the study recommends that Academic librarians should intensify their education on e-databases, the development of research guides and encourages stronger collaboration with faculty members in the teaching of ILS so that student nurses would be more adept in searching for information to enhanced scholarship and professional practice.

The nurses’ voice of working in a newly established community based 24-hour support center for people with psychiatric disabilities

This study explores the perceptions of a small group of nurses working at a newly established 24-hour community-based service enter (SC) for users with psychiatric disability using a qualitative approach. Since the mental health reform in Sweden in 1995 where the communities (in Sweden called municipalities) were given the responsibility to establish service and support to people with severe psychiatric disabilities, they have struggled in finding suitable forms of these kinds of areas. In 2010, this led to the creation and development of a new center aiming to provide services and support based on the expressed needs of people with physchiatric disability in a community located in southern Sweden. During 2011, a total of three group interviews were performed to capture the employed nurses’ perceptions of this newly established SC. The interview texts were analyzed by way of qualitative content analysis. A first reading of the interview texts revealed that the nurses’ perceptions of the service center were unwaveringly positive but that their beliefs about who the specific target group were differed. The main finding was summarized by the theme: Making a difference—on an individual, professional, and organizational level. The sub themes were: 24-hour availability, unclear assignment, and preventing mental illness. The findings indicate a need for a community round-the-clock service center in this Swedish community and a more clear definition of the target group.

Challenges faced by community health nurses to achieve universal health coverage in Myanmar:A mixed methods study

Objective:This study aimed to identify the challenges of community health nurses(CHNs)in delivering effective community health care to achieve universal health coverage(UHC)in Myanmar.Methods:A total of 30 CHNs from township health centers in the northeastern,southern,and western parts of Myanmar were purposefully recruited for quantitative and qualitative interviews.Quantitative data were processed using Microsoft Excel software,and qualitative data were analyzed using thematic analysis.This study is registered with researchregistry6201.Results:Around the country,30 CHNs uncovered their hardships in implementing primary health care to achieve UHC.Over 90%of the participants agreed to the problem of inadequate health infrastructure,while half of them felt unmotivated when they encountered role conflicts among various cadres of healthcare providers and poor opportunities for career promotion.Major problems arose from the lack of standard professional education at the entry point to community settings because most CHNs did not achieve specialized training in providing public health services.Complications are incapable of evaluating health services for policy-making and the inability to conduct health research to develop evidencebased practices.Insecure work and living conditions,unsupportive community relationships,and undereducation in professional practices were supportive major themes explored by CHNs to achieve a deeper understanding of the barriers to UHC.Not only the health system itself but also the population and other geographical factors have contributed to many challenges to CHNs.Conclusion:Myanmar’s CHNs face many challenges in achieving UHC.These challenges are not confined to the health sector.Some situations,such as geographical barriers and transportation problems,remain persistent challenges for healthcare providers.This study highlights the fact that current health systems should be strengthened by qualified healthcare providers and sufficient infrastructure.Meanwhile,public empowerment plays a critical role in promoting health development.

The Intermediary Roles of Public Health Nurses (PHNs) in Utilizing Communication Robots (CRs) in Community Health Care Practice

Robot technology is expected to reduce the burden of medical professionals, a concern in the super-aged society. The aim of this article is to determine the intermediary roles of Public Health Nurses (PHNs) in using Communication Robots (CRs) in Community Health care. It is necessary to consider who will manage, and how to draw lines of responsibility when a problem occurs when using robots in the future. Regarding the mediator or intermediary role of PHNs in the use of CRs, PHNs are expected to be cognizant of varieties of robots for use with persons of diverse ages and health levels, as well as of robot performances. As one of the community healthcare workers who service the elderly living in the community, the role of PHNs as mediators or intermediaries is to pay attention to ethical and moral issues while working with CRs to manage the health of the community. Lack of understanding of the intermediary role might create possible ethico-moral issues in the future. Therefore, it is critical for PHNs to understand their role as intermediaries. In doing so, it is expected that older people at home will be able to live peaceful lives, as well as be physically and mentally healthy.

Environmental health in public health community practice: An integrative review of the literature

It is understood that the performance of Public Health Nursing is indispensable for the development of sustainable health communities, with regard to sub-standard living conditions in environments that include physical, chemical and biological factors influencing these conditions. This work is in an integrative review which aims to characterize how Environmental Health appears in scientific Public Health Nursing production, for the development of community health. Out of 442 articles, 30 met the search criteria. The publications covered contamination and exposure to environmental risks;strengthening of community groups for environmental health and workforce development of public health nursing for community practice in environmental health. The results summarized in the present study support the growing trend of interest in Environmental Health as knowledge which is essential to Public Health Nursing practice in the community.

Role of community health nurse in the prevention of elderly dehydration:A mini-review

As dehydration is related to negative health outcomes in the elderly,including an increased risk of disability and death,prevention may help improve health,functional status,and quality of life.Dehydration diagnosis can be challenging in the elderly as the traditional physical indications of dehydration may be absent or ambiguous.Numerous etiologies place the elderly at an increased risk.The role of the community health nurse(CHN)derives from the responsibilities attached to her,and the Betty Neuman’s Systems Model of health care with three levels of protection is usually applied to the CHN.In this mini-review,we try to integrate the Betty Neuman’s Systems Model with the results of identified articles.This study includes a literature search of reputable international databases such as SpringerLink,PubMed,Embase,and Wanfang,particularly for the period 2005 to the present.Ten articles that met the qualifying criteria were included in this study.The findings of this study draw a picture of the role of CHN in preventing dehydration across the three levels of prevention as mentioned by Betty Neuman.

Assessment of Knowledge and Practices of Community Health Nurses on Data Quality in the Ho Municipality of Ghana

Background: High data quality provides correct and up-to-date information which is critical to ensure, not only for the maintenance of health care at an optimal level, but also for the provision of high-quality clinical care, continuing health care, clinical and health service research, and planning and management of health systems. For the attainment of achievable improvements in the health sector, good data is core. Aim/Objective: To assess the level of knowledge and practices of Community Health Nurses on data quality in the Ho municipality, Ghana. Methods: A descriptive cross-sectional study was employed for the study, using a standard Likert scale questionnaire. A census was used to collect 77 Community Health Nurses’ information. The statistical software, Epi-Data 3.1 was used to enter the data and exported to STATA 12.0 for the analyses. Chi-square and logistic analyses were performed to establish associations between categorical variables and a p-value of less than 0.05 at 95% significance interval was considered statistically significant. Results: Out of the 77 Community Health Nurses studied, 49 (63.64%) had good knowledge on data accuracy, 51 (66.23%) out of the 77 Community Health Nurses studied had poor knowledge on data completeness, and 64 (83.12%) had poor knowledge on data timeliness out of the 77 studied. Also, 16 (20.78%) and 33 (42.86%) of the 77 Community Health Nurses responded there was no designated staff for data quality review and no feedback from the health directorate respectively. Out of the 16 health facilities studied for data quality practices, half (8, 50.00%) had missing values on copies of their previous months’ report forms. More so, 10 (62.50%) had no reminders (monthly data submission itineraries) at the facility level. Conclusion: Overall, the general level of knowledge of Community Health Nurses on data quality was poor and their practices for improving data quality at the facility level were woefully inadequate. Therefore, Community Health Nurses need to be given on-job training and proper education on data quality and its dimensions. Also, the health directorate should intensify its continuous supportive supervisory visits at all facilities and feedback should be given to the Community Health Nurses on the data submitted.

Nurses’ Perceptions of Patient Safety in Community Mental Health Settings: A Qualitative Study

Mental health care has moved from hospital settings to community mental health settings, and there is a need to explore the perceptions of patient safety among registered nurses working in this field. Patient safety is to include everyone and to be the goal in all aspects of health care. The aim of the study was to explore registered nurses’ perceptions of patient safety in community mental health settings for people with serious mental illness. The study was qualitative and descriptive in nature and interviews were carried out during spring 2012, with seven registered nurses working in community mental health settings for people with serious mental illness in five municipalities in the middle of Sweden. The sampling was purposive and data were analysed using qualitative content analysis. The findings showed that the registered nurses understood patient safety as providing support to people with serious mental illness in regaining and maintaining health through good treatment and respecting self-determination and avoiding coercion. The terms of daily living in small community mental health settings within the a large community health care organization, communication, sufficient knowledge of psychiatric disabilities among people in the residents’ network, and national laws and regulations, all had implications for patient safety. The registered nurses perceived patient safety as involving a wide range of issues that in other areas of care are more often discussed in terms of quality of care. Determining the boundaries of patient safety in community mental health settings for people with serious mental illness can be a first step in establishing workable routines that ensure safe patient care.

Challenges for Nurses in Providing Patient-Centered Care in Rural Primary Health Care Clinics in Nigeria

Globally, patient-centered care has become the focus of the healthcare system. It is imperative to note that during a global pandemic crisis, patient-centered care principles seek to empower partnering approaches in Primary Health Care (PHC), and have recently gained prominence in nursing practice and applied nursing research. However, nurses are faced with challenges in achieving the desired results in the PHC system. Thus, the study aimed to explore the factors that influence PCC utilization in the PHC facilities in Nigeria. A qualitative exploratory-descriptive design was used for this study. Data collection was conducted with the nurses from PHC facilities through individual interviews. Data saturation was achieved with 35 participants from 30 PHC facilities in Osun State, Nigeria, using a purposive sampling technique. All interviews were audio-recorded, later transcribed verbatim, and analyzed using the thematic analysis approach. NVivo 12 software was used for data management. The results from this study were categorized into two factors: Organizational factors and individual factors. Six themes that emerged from the study include inadequate management support, insufficient opportunities for further training, work overload and time constraints, health personnel readiness to use PCC, dearth enthusiasm for change, and poor nurses’ Accountability. The study shows that nurses encountered diverse challenges in providing patient-centered care. To improve the quality of healthcare delivery in the PHC facilities, there is a need to reinforce adequate management support, education, continued training, and the internal motivation of nurses to achieve transformative health outcomes in the community.

Factors Influencing Patient-Centered Care in the Primary Health Care Settings: The Impact of the Pandemic Crisis and Nurses’ Experience

Patient-centered care has over the past decades, been recognized worldwide as an important component of the health system giving a wider dimension to high-quality healthcare and service delivery. The impact on healthcare and services to the patient is the nurses’ ability to create a friendly rapport with the patients. Yet, the majority in the rural Primary Health Care facilities are still facing many challenges in demonstrating patient-centeredness services to the community. Thus, the objective of this study is to explore and describe the factors influencing patient-centered care provision and nurses’ experience in Primary Health Care facilities. An exploratory qualitative approach with purposive sampling was used to gather data. Individual interviews with 35 nurses were conducted using a semi-structure interview guide question in the Primary Health Care settings in Nigeria. Each of the interviews with the nurses lasted for 25 minutes to one hour. All interviews were audio-taped, and transcribed verbatim using Microsoft Word. The transcripts were read and re-read, coded using NVivo version 12 software to organize the relevant information and categorized them into themes and sub-themes. Thematic analysis guided this study. The findings revealed three themes and sub-themes. The impact of environmental factors with two subthemes—suitable working environment and coordinated care;resources—shortage of staff and inadequate resources as sub-themes, and lastly, cultural sensitivity and religious influence—communication. Poor implementation of PCC strategies in most of the PHC facilities could lead to poor patient care and a lack of job satisfaction among nurses. This study identified that nurses have both negative and positive experience in providing patient-centered care health services. Providing patient-centered care in the Primary Health Care setting promotes the goal of achieving universal health coverage in Nigeria if the government would prioritize nurses’ pay, employ more staff, provide a conducive working environment, and opportunities for further training programs for nurses to enable and empower them with the necessary knowledge and skills. This, in turn, will translate into a range of outcomes that are socially valued, such as health responsiveness, health coverage and fairness.

加拿大多伦多Sunnybrook Health Sciences Centre NICU护理对我国的借鉴

通过介绍Sunnybrook Health Sciences Centre NICU的护理管理和工作制度、医院感染预防、病房布局、护理业务培训和对早产儿发育的护理等内容,为我国NICU护理工作开展提供借鉴。提出我国应该加强根据国内外的最新护理进展情况规范NICU护士专科知识教材和培训方法;合理布局NICU,以改善病房环境和预防医院感染;合理安排治疗和护理时间,尽量减少对早产儿的干扰,促进其发育;鼓励父母参与患儿的护理。

Nurse Mentor Training Program to Improve Quality of Maternal and Newborn Care at Primary Health Centres: Process Evaluation

Quality of maternal and newborn care could be improved if health care providers’ knowledge and competencies as well as system level constraints are addressed. However, due to several barriers staff nurses who form the frontline of health care workforce have limited access to enhancing their clinical knowledge and competencies. To address this gap, a new cadre of nurse mentors (NMs) for the public health system were trained by specialists from a teaching hospital in a special 5-week training course. This included 54 hours of theory and 110 hours of practical in clinical obstetric and newborn care, apart from mentoring, quality improvement and health systems issues. The nurse mentors were assigned to support staff nurses in the primary health care centres (PHCs) in eight northern Karnataka districts. Each NM covered 6-8 PHCs monthly for 2 - 3 days and thus a total of 385 PHCs were reached. They received support in the field through supportive supervision visits done by the specialists who had trained them, as well as by refresher training and clinical postings to the district hospitals. This paper presents impact of the training program on change in immediate and long term knowledge and competency scores of nurse mentors. Their baseline knowledge scores changed from 44.3 ± 12.7 to 72.1 ± 13.8 immediately after the training in obstetric and from 18.2 ± 19.1 to 66.4 ± 14.9 in newborn (p p p > 0.05). Skills score soon after training increased from 62.2 ± 13.2 to 69.6 ± 12.5 in obstetric after a 1 year period and from 52.6 ± 9.3;63.5 ± 14.4 in newborn (p < 0.001) content areas respectively. These findings have implications for those interested in improving quality of maternal and child care through nurse-dependent health delivery systems.

The lived experience of a 24-hour support center for persons with psychiatric disabilities: Making me feel almost like an ordinary person

This study illuminates nine psychiatric disabled persons’ lived experience of a newly established community-based service center open around the clock. This new 24-hour support center (SC) was established in 2011 in a Swedish community to better match and facilitate the disabled persons’ needs. In order to illuminate the disabled person’s experiences individual interview was performed. A phenomenological-hermeneutical method inspired by Paul Ricoeur was used to interpret the texts. After a naive reading, a structural analysis revealed two themes: 1), becoming aware of myself as a person, and 2) having a lifeline and belongingness. The comprehensive understanding was interpreted as meaning “Making me feel almost like an ordinary person”, which incorporated the person’s past with their present together with a direction for the future and hope for a more fulfilling life.

基于岗位分析与工时测定的医院健康体检(管理)中心护士人力资源配置研究

目的:构建医院健康体检(管理)中心护士人力资源配置方法,为完善健康体检(管理)中心的规范化管理提供指导。方法:通过文献回顾,利用岗位分析和工时测定相结合的方法,梳理北京市某三甲综合医院体检中心主要8项护士岗位工作。其中不以流程作业方式运行的岗位包括护士长岗位、体检服务台、市场外联岗位;以流程作业方式运行的静脉采血、心电图等岗位,采用工时测定法计算该院健康体检中心2023年11月至2024年1月各岗位完成每次检查所需工时,并推算所需护士数。结果:结合岗位分析与工时测定,测算该院体检中心护士人力合理配置应为20人。结论:根据研究结果,该体检中心调整护士配置人数,有效提高了体检工作质量与人员工作效率,为其他医院健康体检(管理)中心护士人力资源合理配置提供了有益的借鉴,对推动健康体检规范化管理具有重要意义。

社区护士肺康复知信行及培训需求现状调查研究

目的:了解社区护士的肺康复知信行现状及相关培训需求。方法:2024年5月至6月,通过便利抽样法对广州市、东莞市社区卫生服务中心的310名护士进行线上调查,对调查对象的一般资料、肺康复知信行问卷和肺康复知识培训需求问卷结果进行分析。结果:310名调查对象肺康复知信行问卷标准分为(68.51±0.78)分,知识维度标准分为(57.99±0.94)分,态度维度标准分为(78.01±0.97)分,行为维度标准分为(75.12±1.00)分。最高学历和是否参加过肺康复相关知识培训是调查对象肺康复知信行的影响因素。大部分调查对象认可肺康复培训的必要性(96.13%),并且有肺康复培训的需求(90.65%)。结论:社区护士肺康复知信行总体水平处于中等水平,知识储备不足,需加强相关知识培训,提升肺康复质量。