Ethical dilemmas in nursing documentation

2021 ◽  
pp. 096973302110466
Author(s):  
Lone Jørgensen ◽  
Mette Geil Kollerup
Keyword(s):  
Oral Tradition ◽  
Ethical Dilemmas ◽  
Qualitative Content Analysis ◽  
Decision Makers ◽  
Nurse Leaders ◽  
University Hospital ◽  
Patient Harm ◽  
Hospital Data ◽  
Nursing Documentation ◽  
Fair Distribution

Background: Nursing documentation is an essential aspect of ethical nursing care. Lack of awareness of ethical dilemmas in nursing documentation may increase the risk of patient harm. Considering this, ethical dilemmas within nursing documentation need to be explored. Aim: To explore ethical dilemmas in nurses’ conversations about nursing documentation. Research design, participants and context: The study used a qualitative design. Participants were registered nurses from a Patient Hotel at a Danish University Hospital. Data were collected in three focus groups with a total of 12 participants. Data analysis consisted of qualitative content analysis inspired by Graneheim and Lundman. Ethical consideration: This study was conducted in accordance with the ethical principles of research and regulations in terms of confidentiality, anonymity and provision of informed consent. Findings: Ethical dilemmas were strongly present in nurses’ conversations about nursing documentation. These dilemmas were demonstrated in two themes: (1) a dilemma between respecting patients’ autonomy and not causing harm, which was visible in nurses’ navigation between written documentation and oral tradition, and (2) a dilemma concerning justice and fair distribution of goods, which was visible in nurses’ balancing between documenting deviations and proof of nursing practice. Discussion: Ethical dilemmas in nursing documentation regarding respecting patients’ autonomy and not causing harm accentuated discussions on professional responsibility and patient participation in clinical decisions. Dilemmas in justice and fair distribution of goods emphasised discussions on trust in relationships versus trust in electronic health records. Conclusion: Actual tendencies in the healthcare system may increase ethical dilemmas in nursing documentation. Sharing otherwise invisible and individual experiences of ethical dilemmas in nursing documentation among nurses, nurse leaders and decision-makers will enable addressing these in reflections and discussions as well as in considering adjustments of conditions for nursing documentation.

scholarly journals Exploring Factors Affecting the Emergency Specialists’ Decision-Making in Case of Emergencies in Patients

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Abbasali Ebrahimian ◽  
Seyed-Hossein Hashemi-Amrei ◽  
Mohammadreza Monesan
Keyword(s):  
Decision Making ◽  
Emergency Department ◽  
Qualitative Content Analysis ◽  
Decision Makers ◽  
Decision Making Process ◽  
Factors Affecting ◽  
Emergency Situations ◽  
The Core ◽  
Semistructured Interviews ◽  
Emergency Decision

Introduction. Appropriate decision-making is essential in emergency situations; however, little information is available on how emergency decision-makers decide on the emergency status of the patients shifted to the emergency department of the hospital. This study aimed at explaining the factors that influence the emergency specialists’ decision-making in case of emergency conditions in patients. Methods. This study was carried out with a qualitative content analysis approach. The participants were selected based on purposive sampling by the emergency specialists. The data were collected through semistructured interviews and were analyzed using the method proposed by Graneheim and Lundman. Results. The core theme of the study was “efforts to perceive the acute health threats of the patient.” This theme was derived from the main classes, including “the identification of the acute threats based on the patient’s condition” and “the identification of the acute threats based on peripheral conditions.” Conclusions. The conditions governing the decision-making process about patients in the emergency department differ from the conditions in other health-care departments at hospitals. Emergency specialists may have several approaches to decide about the patients’ emergency conditions. Therefore, notably, the emergency specialists’ working conditions and the others’ expectations from these specialists should be considered.

The use of bedside chest radiography at a university hospital. Data on a two-week period

2012 ◽  
Vol 81 (3) ◽  
pp. e260-e263 ◽  
Author(s):  
Alessandra Delnevo ◽  
Stefania Tritella ◽  
Luca Alessandro Carbonaro ◽  
Oxana Bobrechova ◽  
Giovanni Di Leo ◽  
...  
Keyword(s):  
Chest Radiography ◽  
University Hospital ◽  
Hospital Data

scholarly journals Violência contra a mulher: compreendendo a atuação interdisciplinar

2017 ◽  
Vol 11 (12) ◽  
pp. 5245
Author(s):  
Maria Cíntia Gomes ◽  
Margaret Olinda de Souza Carvalho e Lira ◽  
Michelle Christini Araújo Vieira ◽  
Sued Sheila Sarmento ◽  
Israel De Lima Florentino
Keyword(s):  
Violence Against Women ◽  
Practical Knowledge ◽  
Structured Interview ◽  
Physical Structure ◽  
University Hospital ◽  
Hospital Data ◽  
Categorical Analysis ◽  
Emergency Team ◽  
Analysis Technique ◽  
Violencia Domestica

RESUMOObjetivo: compreender as estratégias de atuação interdisciplinar em situações de violência contra a mulher. Método: estudo qualitativo, descritivo, com nove profissionais da equipe de emergência de um hospital universitário. Os dados foram coletados a partir de entrevista semiestruturada e interpretados pela técnica de Análise de Conteúdo, na modalidade Análise Categorial. Resultados: do total de participantes, sete referem saber identificar sinais suspeitos de violência à mulher, mas descrevem limitações e inseguranças que interferem no desempenho satisfatório durante o atendimento atribuídas ao pouco conhecimento teórico sobre a temática, à superlotação e a deficiências na segurança externa e na estrutura física do local de trabalho. Conclusão: a insuficiência de conhecimento teórico e prático e as deficiências nas condições de trabalho foram limitações que afetaram a atuação da equipe de emergência no atendimento à mulher em situação de violência. Os resultados contribuirão para reflexões de equipes interprofissionais sobre a atuação e cuidado à mulher agredida em emergências hospitalares. Descritores: Violência contra a Mulher; Violência Doméstica; Violência Sexual; Emergências; Assistência Hospitalar. ABSTRACTObjective: to understand the strategies of interdisciplinary action in situations of violence against women. Method: qualitative, descriptive study with nine professionals from the emergency team of a university hospital. Data were collected from a semi-structured interview and interpreted by the Content Analysis technique, in the Categorical Analysis modality. Results: seven of the participants reported knowing how to identify suspicious signs of violence against women, but they describe limitations and insecurities that interfere with the satisfactory performance during the service attributed to the lack of theoretical knowledge about the subject, overcrowding and deficiencies in external security and physical structure of the workplace. Conclusion: the lack of theoretical and practical knowledge and the deficiencies in working conditions were limitations that affected the emergency team's role in providing care to women in situations of violence. The results will contribute to reflections of interprofessional teams on the performance and care of women attacked in hospital emergencies. Descriptors: Violence Against Women; Domestic Violence; Sexual Violence; Emergencies; Hospital Care.RESUMENObjetivo: comprender las estrategias de actuación interdisciplinaria en situaciones de violencia contra la mujer. Método: estudio cualitativo, descriptivo, con nueve profesionales del equipo de emergencia de un hospital universitario. Los datos fueron recolectados a partir de entrevista semiestructurada y interpretados por la técnica de Análisis de Contenido, en la modalidad Análisis Categorial. Resultados: del total de participantes, siete se refieren saber identificar signos sospechosos de violencia a la mujer, pero describen limitaciones e inseguridades que interfieren en el desempeño satisfactorio durante la atención, atribuidas al poco conocimiento teórico sobre la temática, el hacinamiento y las deficiencias en la seguridad externa y en la estructura física del lugar de trabajo. Conclusión: la insuficiencia de conocimiento teórico y práctico y las deficiencias en las condiciones de trabajo fueron limitaciones que afectaron la actuación del equipo de emergencia en la atención a la mujer en situación de violencia. Los resultados contribuirán a reflexiones de equipos inter profesionales sobre la actuación y cuidado a la mujer agredida en emergencias hospitalarias. Descriptores: Violencia contra la Mujer; Violencia Doméstica; Violencia Sexual; Urgencias Médicas; Atención Hospitalaria.

scholarly journals Position of lips and tongue in rest in newborns with and without ankyloglossia

CoDAS ◽  
2021 ◽  
Vol 33 (6) ◽  
Author(s):  
Silvia Márcia Andrade Campanha ◽  
Roberta Lopes de Castro Martinelli ◽  
Durval Batista Palhares
Keyword(s):  
Visual Inspection ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Sectional Study ◽  
Hospital Data ◽  
Chi Square ◽  
Cross Sectional ◽  
Significance Level ◽  
Significant Difference ◽  
Chi Square Test

ABSTRACT Purpose Verify the position of lips and tongue at rest in newborns with and without ankyloglossia. Methods Cross-sectional study, carried out with 130 newborns in University Hospital. Data collection was performed by the researcher and speech-language pathologists from the Hospital. Information on gestational age, sex, weight, height and days of life was collected. The position of the lips and tongue at rest was evaluated through visual inspection with the newborns asleep. After the newborns were awakened, Neonatal Screening of the validated Protocol for the evaluation of the lingual frenulum for infants was performed to detect the alteration of the lingual frenulum. The data obtained were described and submitted to statistical analysis using the Chi-Square test to verify the association between the position of the lips with the tongue and to compare the position of the lips and tongue with and without ankyloglossia. The Mann-Whitney test was used to verify the behavior of the variables the differed between newborns with and without ankyloglossia. The significance level of 5% was adopted. Results When comparing the data, a significant difference was found between: weight and height with and without ankyloglossia; position of lips and tongue. An association between the position of the tongue and lips with and without ankyloglossia was also found. Conclusion Newborns without alteration of the lingual frenulum have a tendency to remain with their lips closed and their tongue elevated during rest and newborns with ankyloglossia have a tendency to keep their lips parted and their tongue low during rest.

scholarly journals Nursing Students and Nurses’ Recommendations Aiming at Improving the Development of the Humanistic Caring Competency

2021 ◽  
pp. 084456212110489
Author(s):  
Dimitri Létourneau ◽  
Johanne Goudreau ◽  
Chantal Cara
Keyword(s):  
Nursing Education ◽  
Nursing Students ◽  
Methodological Approach ◽  
University Hospital ◽  
Hospital Data ◽  
Interpretive Phenomenology ◽  
Pedagogical Strategies ◽  
Individual Interviews ◽  
Progressive Development ◽  
Regulatory Bodies

Background Most nursing education programs prepare their students to embody humanism and caring as it is expected by several regulatory bodies. Ensuring this embodiment in students and nurses remains a challenge because there is a lack of evidence about its progressive development through education and practice. Purpose This manuscript provides a description of nursing students’ and nurses’ recommendations that can foster the development of humanistic caring. Methods Interpretive phenomenology was selected as the study's methodological approach. Participants (n = 26) were recruited from a French-Canadian university and an affiliated university hospital. Data was collected through individual interviews. Data analysis consisted of an adaptation of Benner’s (1994) phenomenological principles that resulted in a five-stage interpretative process. Results The following five themes emerged from the phenomenological analysis of participants’ recommendations: 1) pedagogical strategies, 2) educators’ approach, 3) considerations in teaching humanistic caring, 4) work overload, and 5) volunteerism and externship. Conclusion The findings suggest the existence of a challenge when using mannikins in high-fidelity simulations with the intention of developing humanistic caring. The findings also reaffirm the importance of giving concrete and realistic exemplars of humanistic caring to students in order to prevent them from making “communication” synonymous to “humanization of care”.

scholarly journals Adesão à identificação correta do paciente pelo uso da pulseira

2018 ◽  
Vol 12 (10) ◽  
pp. 2621
Author(s):  
Tamyris Garcia De Assis ◽  
Luana Ferreira De Almeida ◽  
Luciana Guimarães Assad ◽  
Ronilson Gonçalves Rocha ◽  
Cíntia Silva Fassarella ◽  
...  
Keyword(s):  
Patient Safety ◽  
Descriptive Statistics ◽  
University Hospital ◽  
Patient Identification ◽  
Hospital Data ◽  
Health Team ◽  
Systems Quality ◽  
Quantitative Descriptive ◽  
And Training

RESUMO Objetivo: analisar a adesão à identificação do paciente por pulseira pela equipe de saúde e pelos pacientes. Método: trata-se de estudo quantitativo, descritivo e documental. Constituiu-se a amostra por 137 pacientes internados em uma unidade cardiointensiva de um hospital universitário. Coletaram-se os dados, mediante o preenchimento de um formulário estruturado, em seguida, organizados e analisados utilizando-se a estatística descritiva simples. Resultados: observou-se a presença da pulseira de identificação em 100% dos pacientes. Destes, 26% apresentavam não conformidades. Ansalisou-se, a partir dos relatos dos pacientes, que 61% dos profissionais não utilizaram a pulseira para identificá-los no momento dos procedimentos e 90% dos pacientes não foram orientados quanto ao motivo e importância da utilização da pulseira. Conclusão: observou-se de forma unânime a identificação dos pacientes, no entanto, necessita-se, na prática, de maior sensibilização e treinamento da equipe multiprofissional para a adequação conforme se preconiza na Meta 1 de Segurança do Paciente. Descritores: Segurança do Paciente; Sistemas de Identificação de Pacientes; Qualidade da Assistência à Saúde; Gestão de Risco; Hospitalização; Hospitais Universitários.ABSTRACT Objective: to analyze the adherence to the identification of the patient by hospital wristband by the health team and by the patients. Method: this is a quantitative, descriptive and documentary study. The sample consisted of 137 patients hospitalized in a cardio-intensive unit of a university hospital. Data was collected by completing a structured form, then organized and analyzed using simple descriptive statistics. Results: the presence of the identification wristband was observed in 100% of the patients. Of these, 26% had nonconformities. From the patients' reports, 61% of the professionals did not use the wristband to identify them at the time of the procedures and 90% of the patients were not guided as to the reason and importance of the use of the wristband. Conclusion: the identification of patients was unanimously observed, however, it is necessary, in practice, to increase awareness and training of the multi-professional team for the adequacy as recommended in Goal 1 of Patient Safety. Descriptors: Patient Safety; Patient Identification Systems; Quality of Health Care; Risk Management; Hospitalization; Hospitals, University.RESUMENObjetivo: analizar la adhesión a la identificación del paciente por pulsera por el equipo de salud y por los pacientes. Método: se trata de un estudio cuantitativo, descriptivo y documental. Se constituyó la muestra por 137 pacientes internados en una unidad cardiointensiva de un hospital universitario. Se recogen los datos, mediante el llenado de un formulario estructurado, a continuación, organizado y analizado utilizando la estadística descriptiva simple. Resultados: se observó la presencia de la pulsera de identificación en el 100% de los pacientes. De ellos, el 26% presentaba no conformidades. Se analizó, a partir de los relatos de los pacientes, que el 61% de los profesionales no utilizaron la pulsera para identificarlos en el momento de los procedimientos y el 90% de los pacientes no fueron orientados en cuanto al motivo e importancia del uso de la pulsera. Conclusión: se observó de forma unánime la identificación de los pacientes, sin embargo, se necesita, en la práctica, de mayor sensibilización y entrenamiento del equipo multiprofesional para la adecuación conforme se preconiza en la Meta 1 de Seguridad del Paciente. Descriptores: Seguridad del Paciente; Sistemas de Identificación de Pacientes; Calidad de la Atención de Salud; Gestión de Riesgos; Hospitalización; Hospitales Universitarios.

scholarly journals A Nursing Intelligence System to Support Secondary Use of Nursing Routine Data

2015 ◽  
Vol 06 (02) ◽  
pp. 418-428 ◽  
Author(s):  
F. Rauchegger ◽  
E. Ammenwerth ◽  
W.O. Hackl
Keyword(s):  
Nursing Care ◽  
Routine Data ◽  
Routine Care ◽  
University Hospital ◽  
Quality Analysis ◽  
Data Sets ◽  
Nursing Documentation ◽  
Intelligence System ◽  
Secondary Use ◽  
Spiral Model

SummaryBackground: Nursing care is facing exponential growth of information from nursing documentation. This amount of electronically available data collected routinely opens up new opportunities for secondary use.Objectives: To present a case study of a nursing intelligence system for reusing routinely collected nursing documentation data for multiple purposes, including quality management of nursing care.Methods: The SPIRIT framework for systematically planning the reuse of clinical routine data was leveraged to design a nursing intelligence system which then was implemented using open source tools in a large university hospital group following the spiral model of software engineering.Results: The nursing intelligence system is in routine use now and updated regularly, and includes over 40 million data sets. It allows the outcome and quality analysis of data related to the nursing process.Conclusions: Following a systematic approach for planning and designing a solution for reusing routine care data appeared to be successful. The resulting nursing intelligence system is useful in practice now, but remains malleable for future changes.Citation: Hackl WO, Rauchegger F, Ammenwerth E A Nursing Intelligence System to Support Secondary Use of Nursing Routine Data. Appl Clin Inform 2015; 6: 418–428http://dx.doi.org/10.4338/ACI-2015-04-RA-0037

scholarly journals Adjacent Primary Care May Reduce Less Urgent Pediatric Emergency Department Visits

2020 ◽  
Vol 11 ◽  
pp. 215013272092627
Author(s):  
Julia Ellbrant ◽  
Jonas Åkeson ◽  
Helena Sletten ◽  
Jenny Eckner ◽  
Pia Karlsland Åkeson
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Patient Characteristics ◽  
Pediatric Emergency ◽  
Emergency Department Visits ◽  
University Hospital ◽  
Pediatric Emergency Department ◽  
Hospital Data ◽  
Cross Sectional ◽  
Ed Visits

Aims: Pediatric emergency department (ED) overcrowding is a challenge. This study was designed to evaluate if a hospital-integrated primary care unit (HPCU) reduces less urgent visits at a pediatric ED. Methods: This retrospective cross-sectional study was carried out at a university hospital in Sweden, where the HPCU, open outside office hours, had been integrated next to the ED. Children seeking ED care during 4-week high- and low-load study periods before (2012) and after (2015) implementation of the HPCU were included. Information on patient characteristics, ED management, and length of ED stay was obtained from hospital data registers. Results: In total, 3216 and 3074 ED patient visits were recorded in 2012 and 2015, respectively. During opening hours of the HPCU, the proportions of pediatric ED visits (28% lower; P < .001), visits in the lowest triage group (36% lower; P < .001), patients presenting with fever ( P = .001) or ear pain ( P < .001), and nonadmitted ED patients ( P = .033), were significantly lower in 2015 than in 2012, whereas the proportion of infants ≤3 months was higher in 2015 ( P < .001). Conclusions: By enabling adjacent management of less urgent pediatric patients at adequate lower levels of medical care, implementation of a HPCU outside office hours may contribute to fewer and more appropriate pediatric ED visits.

Development of Hospital Data Warehouse for Cost Analysis of DPC Based on Medical Costs

2007 ◽  
Vol 46 (06) ◽  
pp. 679-685 ◽  
Author(s):  
I. Kumamoto ◽  
Y. Uto ◽  
F. Muranaga
Keyword(s):  
Cost Analysis ◽  
Data Warehouse ◽  
Evaluation System ◽  
Malignant Tumors ◽  
Intrahepatic Bile Duct ◽  
Medical Costs ◽  
University Hospital ◽  
Medical Procedure ◽  
Hospital Data ◽  
Medical Expenses

Summary Objectives : To develop a data warehouse system for cost analysis, based on the categories of the diagnosis procedure combination (DPC) system, in which medical costs were estimated by DPC category and factors influencing the balance between costs and fees. Methods : We developed a data warehouse system for cost analysis using data from the hospital central data warehouse system. The balance data of patients who were discharged from Kagoshima University Hospital from April 2003 to March 2005 were determined in terms of medical procedure, cost per day and patient admission in order to conduct a drill-down analysis. To evaluate this system, we analyzed cash flow by DPC category of patients who were categorized as having malignanttumors andwhose DPC category was reevaluated in 2004. Results : The percentages of medical expenses were highest in patients with acute leukemia, non-Hodgkin's lymphoma, and particularly in patients with malignant tumors of the liver and intrahepatic bile duct. Imaging tests degraded the percentages of medical expenses in Kagoshima University Hospital. Conclusions : These results suggested that cost analysis by patient is important for hospital administration in the inclusive evaluation system using a case-mix index such as DPC.

scholarly journals People living with AIDS: Association between nursing diagnoses and sociodemographic/clinical characteristics

2018 ◽  
Vol 71 (5) ◽  
pp. 2535-2542 ◽  
Author(s):  
Richardson Augusto Rosendo da Silva ◽  
Romanniny Hévillyn Silva Costa ◽  
Laísi Catharina da Silva Barbalho Braz ◽  
Indira de Araújo Lucena ◽  
Kalyane da Silva Ferreira ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Illicit Drugs ◽  
Family Income ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Clinical Aspects ◽  
Access To Health Services ◽  
Hospital Data ◽  
Cross Sectional ◽  
Nursing Diagnoses

ABSTRACT Objective: To analyze the association between nursing diagnoses and sociodemographic and clinical characteristics in people living with AIDS. Method: Cross-sectional study with 100 people living with AIDS in a University Hospital. Data collection took place between January and July 2015, using an interview script and physical examination. The association occurred through Pearson's Chi-Square Test and Fisher's Exact Test. Results: The most prevalent nursing diagnoses were: ineffective protection, poor knowledge, lack of adherence and sexual dysfunction. Significant associations were observed among nursing diagnoses with the following sociodemographic and clinical characteristics: marital status, place of residence, level of schooling, family income, modes of transmission of acquired immunodeficiency virus, current opportunistic infection, abandonment of treatment, difficulty of access to health services and use of alcohol and illicit drugs. Conclusion: The diagnoses presented significant associations with sociodemographic and clinical aspects.

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