scholarly journals Interpersonal Communication among Critical Care Nurses: an Ethnographic Study

2020 ◽  
Vol 9 (1) ◽  
pp. 57-64
Author(s):  
Tayebeh Mahvar ◽  
Nooredin Mohammadi ◽  
Naima Seyedfatemi ◽  
AbouAli Vedadhir
Keyword(s):  
Critical Care ◽  
Interpersonal Communication ◽  
Critical Care Nurses ◽  
Ethnographic Study ◽  
Critical Conditions ◽  
Structured Interviews ◽  
Critical Care Units ◽  
Effective Care ◽  
High Level ◽  
Communication Culture

Introduction: Interpersonal communication in critical care units is one of the most important factors due to complicated and critical conditions of patients. Nurses’ confrontation with ethical distresses and conflict resolution techniques are often influenced by the culture governing these units. This study aimed to explore interpersonal communication culture among critical care nurses. Methods: A focused ethnographic approach was used to conduct study in Iran. The research method was based on the research evolutionary cycle model recommended by Spradley (1980). Data were collected over six months through purposeful sampling and semi structured interviews (n=18) and participation observation (n=43). The data were obtained over six months of observation and interview with participants. Data analysis was done by Spradley method and was interpreted to discover the meaning units from the obtained themes. MAXQDA10 was used to manage data. Results: Five major domains of observations and high-level consensus were extracted in this study, including grouping, work-life interaction, professionalism, organizational atmosphere and experience. Conclusion: Development of interpersonal communication culture is influenced by various factors. Besides, the working models and nurses’ use of workspace are indispensable components of effective communication at workplace. The findings of this study can be helpful in determining appropriate strategies and practices to resolve communication problems among nurses by specifying challenges, thereby leading to proper communication among nurses, promoting this communication and finally providing high quality and more effective care.

Embodied Spatial Practices and the Power to Care

2019 ◽  
pp. 360-377
Author(s):  
Elise Paradis ◽  
Warren Mark Liew ◽  
Myles Leslie
Keyword(s):  
Health Care ◽  
Critical Care ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Ethnographic Study ◽  
Spatial Practices ◽  
Critical Care Units ◽  
Interprofessional Care ◽  
The Social

Drawing on an ethnographic study of teamwork in critical care units (CCUs), this chapter applies Henri Lefebvre’s ([1974] 1991) theoretical insights to an analysis of clinicians’ and patients’ embodied spatial practices. Lefebvre’s triadic framework of conceived, lived, and perceived spaces draws attention to the role of bodies in the production and negotiation of power relations among nurses, physicians, and patients within the CCU. Three ethnographic vignettes—“The Fight,” “The Parade,” and “The Plan”—explore how embodied spatial practices underlie the complexities of health care delivery, making visible the hidden narratives of conformity and resistance that characterize interprofessional care hierarchies. The social orderings of bodies in space are consequential: seeing them is the first step in redressing them.

scholarly journals Assessing the caring behaviors of critical care nurses

2018 ◽  
Vol 8 (10) ◽  
pp. 77 ◽  
Author(s):  
Samah Anwar Shalaby ◽  
Nouf Fahad Janbi ◽  
Khairiah Khalid Mohammed ◽  
Kholud Mohammed Al-harthi
Keyword(s):  
Job Satisfaction ◽  
Critical Care ◽  
Educational Background ◽  
Critical Care Nurses ◽  
Affecting Factors ◽  
Caring Behaviors ◽  
Factors Affecting ◽  
Critical Care Units ◽  
Depth Analysis ◽  
The Impact

Objective: To assess the critical care nurses’ perception of their caring behaviors and factors affecting these behaviors.Methods: Participants of this descriptive correlational exploratory study included 277 critical care nurses selected conveniently from nurses worked in all critical care units in King Khalid Hospital, Jeddah. A self-reported questionnaire namely, “Critical Care Nurses Caring Behavior Perception” developed by the researchers after reviewing related literature was used to assess caring behaviors and their affecting factors as perceived by critical care nurses.Results: Seventy percent of the nurses aged between 31 to 50 years old and more than half of nurses had ICU experience ranged from 6 to 10 years, while two thirds of nurses had no previous training about caring behaviors. The study findings revealed that the majority of nurses had high scores of perceived caring behaviors, whereas the mean of their perception was 296.96 ± 18.32. There was a statistical significant positive relationship between nurses’ perception and their work circumstances, workload, job satisfaction, educational background and patient characteristics.Conclusions: It is important to consider critical units’ circumstances, nurses’ educational background, job satisfaction, as well as the nature of critically ill patients in order to promote nurses awareness and implementation of caring behaviors. Moreover, replication of the current study using qualitative approach for in-depth analysis of the impact of factors could affecting caring behaviors on nurses’ perception in various highly specialized critical care units.

Current nursing practice of point-of-care laboratory diagnostic testing in critical care units

1995 ◽  
Vol 4 (6) ◽  
pp. 429-434 ◽  
Author(s):  
Lamb LSJr ◽  
RS Parrish ◽  
SF Goran ◽  
MH Biel
Keyword(s):  
Critical Care ◽  
Patient Care ◽  
Laboratory Testing ◽  
Point Of Care ◽  
Diagnostic Testing ◽  
Critical Care Nurses ◽  
Point Of Care Testing ◽  
Critical Care Units ◽  
In Vitro Diagnostic

BACKGROUND: The development of user-friendly laboratory analyzers, combined with the need for rapid assessment of critically ill patients, has led to the performance of in vitro diagnostic testing at the point of care by personnel without formal laboratory training. OBJECTIVES: To determine the range of laboratory testing performed by critical care nurses and their attitudes toward this role. METHODS: A survey of critical care nursing consultants was conducted, using a modified Likert scale, to assess objective measures of point-of-care testing practice in critical care units and to determine nurses' attitudes toward the practice of point-of-care testing. Statistical analysis was performed to determine significant trends in responses. RESULTS: Of the units responding to the survey, 35% used critical care nurses exclusively to perform point-of-care testing, 32.5% used laboratory technicians and critical care nurses, and 25% used other personnel. Of critical care nurses performing laboratory testing, 95.5% performed blood glucose analysis; 18.7%, arterial blood gas analysis; 4.5%, electrolyte analysis; 4.5%, hematology profiles; and 22.7%, other testing. Most agreed that stat tests were not reported promptly, thereby necessitating bedside testing. Respondents indicated that they would prefer that laboratory personnel operate in vitro diagnostic equipment and that requirements for critical care nurses to perform laboratory testing detracted from other patient care duties. CONCLUSIONS: Most nurses who perform point-of-care testing responded that it was necessary and helpful in patient management. However, they would prefer, because of their other patient care responsibilities, that laboratory personnel take this responsibility.

scholarly journals The challenges of using physical restraint in intensive care units in Iran: A qualitative study

2020 ◽  
pp. 175114371989278
Author(s):  
Zahra Salehi ◽  
Soodabeh Joolaee ◽  
Fatemeh Hajibabaee ◽  
Tahereh Najafi Ghezeljeh
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Qualitative Study ◽  
Intensive Care Units ◽  
Physical Restraint ◽  
Critical Care Nurses ◽  
Structured Interviews ◽  
Standard Equipment ◽  
Restraint Use ◽  
Ensure Patient Safety

Background Physical restraint is widely used in intensive care units to ensure patient safety, manage agitated patients, and prevent the removal of medical equipment connected to them. However, physical restraint use is a major healthcare challenge worldwide. Aim This study aimed to explore nurses' experiences of the challenges of physical restraint use in intensive care units. Methods This qualitative study was conducted in 2018–2019. Twenty critical care nurses were purposively recruited from the intensive care units of four hospitals in Tehran, Iran. Data were collected via in-depth semi-structured interviews, concurrently analyzed via Graneheim and Lundman's conventional content analysis approach, and managed via MAXQDA software (v. 10.0). Findings Three main themes were identified (i) organizational barriers to effective physical restraint use (lack of quality educations for nurses about physical restraint use, lack of standard guidelines for physical restraint use, lack of standard physical restraint equipment), (ii) ignoring patients' wholeness (their health and rights), and (iii) distress over physical restraint use (emotional and mental distress, moral conflict, and inability to find an appropriate alternative for physical restraint). Conclusion Critical care nurses face different organizational, ethical, and emotional challenges in using physical restraint. Healthcare managers and authorities can reduce these challenges by developing standard evidence-based guidelines, equipping hospital wards with standard equipment, implementing in-service educational programs, supervising nurses' practice, and empowering them for finding and using alternatives to physical restraint. Nurses can also reduce these challenges through careful patient assessment, using appropriate alternatives to physical restraint, and consulting with their expert colleagues.

Needs of Patients’ Family Members in an Intensive Care Unit With Continuous Visitation

2016 ◽  
Vol 25 (2) ◽  
pp. 118-125 ◽  
Author(s):  
Mini Jacob ◽  
Cynthia Horton ◽  
Sharon Rance-Ashley ◽  
Tera Field ◽  
Robbie Patterson ◽  
...  
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Rank Order ◽  
Family Members ◽  
Continuous Family ◽  
Convenience Sample ◽  
Critical Care Units ◽  
Level Of Satisfaction ◽  
National Organizations ◽  
High Level

BackgroundAlthough many critical care experts and national organizations support open visitation in intensive care units (ICUs), most ICU visiting policies do not allow unrestricted presence of patients’ family members.ObjectiveTo describe how well the needs of family members were met in an adult neuroscience ICU with a continuous visitation policy and an adjoining private suite for patients’ family members.MethodsAn exploratory, descriptive study design was used to identify the effects of continuous family visitation in the neuroscience ICU on patients’ family members and their needs and experiences during their time in the unit. A convenience sample of consenting family members completed a survey of family need items 72 hours after the patient was admitted to the unit.ResultsThe most important needs identified by the 45 family members surveyed were items relating to information about the patient, visiting the patient, being given hope, talking with a doctor each day, and being assured that the best care is being given to the patient. Least important items were related to physical comforts for the family members. The vast majority of family members rated their needs as being met for all of the items in the survey and reported a high level of satisfaction with care.ConclusionIn a neuroscience ICU with an open visitation policy and a private suite for patients’ family members, family members rated their needs as being met at a high level, unlike in prior studies in units with limitations on family visitation. The rank order of the importance of each need in the survey was similar to rankings in prior studies in a variety of critical care units.

scholarly journals Improving the nursing informatics competency of critical care nurses: results of an interventional study

2020 ◽  
Author(s):  
Somayeh Jouparinejad ◽  
Golnaz Foroughameri ◽  
Reza Khajouei ◽  
Jamileh Farokhzadian
Keyword(s):  
Critical Care ◽  
Training Program ◽  
Nursing Practice ◽  
Intervention Group ◽  
Educational Programs ◽  
Critical Care Nurses ◽  
Nursing Informatics ◽  
Interventional Study ◽  
Critical Care Units ◽  
The Impact

Abstract Background Along with growth and development of health information technology (HIT), nursing informatics (NI) is becoming a fundamental part of all domains of nursing practice especially in critical care settings. Nurses at different levels of the nursing continuum are expected to equip with NI competency for providing patient-centered evidence-based care. Therefore, improvement of the nurses’ NI competency through educational programs is important and necessary for effective using of HIT. This study aimed to evaluate the impact of a training program on NI competency of critical care nurses. Methods In this interventional study, 60 nurses working in critical care units at hospitals affiliated with a large University of Medical Sciences in the southeast of Iran were randomly and equally assigned to the control and intervention groups. NI competency was trained to the intervention group in a three-day workshop. Data were collected using demographic questionnaire and Nursing Informatics Competency Assessment Tool (NICAT) before and one month after the intervention. Results In the pretest stage, both intervention and control groups were at the “competent” level in terms of the NI competency, and no significant difference was observed between them ( p =0.65). However, in the posttest, the NI competency and its dimensions significantly increased in the intervention group with a large effect size compared with the control group ( p = 0.001). This difference showed that the intervention group achieved the “proficient” level in posttest stage. Conclusions The improved scores of NI competency and its dimensions after using the training program implied the effectiveness of this method in enhancing the NI competency of nurses working in the critical care units. The higher efficiency of the training program can be determined by its application in diverse domains of nursing practice. The project is a fundamental for improving nurses’ NI competency through continuous educational programs in Iran, other cultures and contexts.

scholarly journals Burnout, Moral Distress, and Job Turnover in Critical Care Nurses

2018 ◽  
Vol 3 (3) ◽  
pp. 108 ◽  
Author(s):  
Brooke A. Whittaker ◽  
Deborah R. Gillum ◽  
Judith M. Kelly
Keyword(s):  
Critical Care ◽  
Quality Of Care ◽  
Moral Distress ◽  
Nurse Retention ◽  
Critical Care Nurses ◽  
Ethnographic Study ◽  
Job Turnover ◽  
Nurse Turnover ◽  
Excessive Stress

Nurse turnover, shortages, and lack of nurse retention have all been linked to stress among nurses. This ethnographic study explored if burnout and moral distress, often a result of excessive stress, led to job turnover among critical care nurses in northern Indiana and southern Michigan. It also explored the factors that may cause burnout and moral distress in the identified population. Although burnout and moral distress have been studied in various professions and locales over the years, research specific to critical care nurses has been limited in the northern Indiana, southern Michigan area. In this study, 100% of the nurses felt that burnout and moral distress led to turnover. These same nurses attributed burnout and moral distress to affecting the quality of care given to patients. The guiding framework for this study’s design was Corley’s theory of moral distress.

scholarly journals Improving the informatics competency of critical care nurses: results of an interventional study in the southeast of Iran

2020 ◽  
Author(s):  
Somayeh Jouparinejad ◽  
Golnaz Foroughameri ◽  
Reza Khajouei ◽  
Jamileh Farokhzadian
Keyword(s):  
Critical Care ◽  
Training Program ◽  
Intervention Group ◽  
Critical Care Nurses ◽  
Nursing Informatics ◽  
Management Skills ◽  
Control Groups ◽  
Interventional Study ◽  
Critical Care Units ◽  
And Control

Abstract BackgroundNursing informatics (NI) along with growth and development of health information technology (HIT) is becoming a fundamental part of all domains of nursing practice especially in critical care settings. Nurses are expected to equip with NI competency for providing patient-centered evidence-based care. Therefore, it is important and necessary to improve nurses’ NI competency through educational programs for effective using of HIT. This study aimed to evaluate the impact of a training program on NI competency of critical care nurses.MethodsThis interventional study was conducted in 2019. Stratified sampling technique was used to select 60 nurses working in critical care units of three hospitals affiliated with a large University of Medical Sciences in the southeast of Iran. These nurses were assigned randomly and equally to the control and intervention groups. NI competency was trained to the intervention group in a three-day workshop. Data were collected using demographic questionnaire and the adapted Nursing Informatics Competency Assessment Tool (NICAT) before and one month after the intervention. Rahman in the US (2015) developed and validated the original NICAT to assess self-reported NI competency of nurses with 30 items and three dimensions (Computer literacy, Informatics literacy Information management skills). The NICAT is scored on a five-point Likert scale and the overall score ranges from 30 to150. Two medical informatics specialists and eight nursing faculty members approved the validity of the adapted version of NICAT and its reliability was confirmed by Cronbach’s alpha (95%). Results: All 60 participants completed the educational program and returned the completed questionnaire. Majority of participants in the intervention and control groups were female (83.30%), married nurses (70.90%, 73.30%) aged 30-40 years (51.6%, 35.5%). In the pretest stage, both intervention and control groups were competent in terms of the NI competency and its dimensions, and no significant difference was observed between them (p=0.65). However, in the posttest, the NI competency and its dimensions in the intervention group significantly increased with a large effect size compared with the control group (p = 0.001). This difference showed that the intervention group was proficient in the posttest stage. The highest mean difference in the intervention group was associated with the informatics literacy dimension and the lowest mean difference was associated with the informatics management skills dimension.Conclusions: The improved scores of NI competency and its dimensions after using the training program implied the effectiveness of this method in enhancing the NI competency of nurses working in the critical care units. The application of the training program in diverse domains of nursing practice shows its high efficiency. The project is fundamental for improving nurses’ NI competency through continuous educational programs in Iran, other cultures and contexts.

scholarly journals Culture of Interpersonal Communication in ICU Nurses: An Ethnographic Study

2021 ◽  
Author(s):  
Tayebeh Mahvar ◽  
Behzad Hemmatpour ◽  
Hamidreza Saiediborojeni ◽  
Hamideh Mashalchi ◽  
Masoud Fallahi ◽  
...  
Keyword(s):  
Interpersonal Communication ◽  
Interpersonal Relationships ◽  
Work Experience ◽  
Moral Distress ◽  
Management Strategies ◽  
Individual Characteristics ◽  
Ethnographic Study ◽  
Structured Interviews ◽  
Top Down ◽  
The Individual

Introduction: Interpersonal Nurses Communication (IPC) in Intensive Care Unit (ICU) is known to be important due to the critical situation of patients and the nurses’ experience with moral distress. Nurses interpersonal relationships and ways of resolving conflicts are influenced by the culture of this sector. Aim: To specify the culture of IPC among nurses in ICU. Materials and Methods: This was a qualitative multi-site ethnographic study conducted from May 2017 to September 2019 at Kermanshah University of Medical Sciences. Data were collected through participatory observation and formal and informal semi-structured interviews. The study environment included four ICUs in two hospitals. Data were obtained from an uninterrupted observation for five months, intermittent observation for six months, 15 formal interviews and 31 informal interviews. The process stems from the research evolutionary cycle model and Spradley’s Steps. In order to discover the meaning of the patterns from the obtained themes, the findings were interpreted after analysis. In this study, Spradley method was used to analyse the data. Results: In this study, 66.7% of the nurses were female, the mean age was 38.66±9.1 years, and mean work experience was 14.43±8.4 years. The three main themes of the high-level code consensus emerged as follows: Grouping which included the formation of groups, cooperation and competition between groups, and demarcation and characteristics of groups. The governing organisational relationships include managerial strategies and nature of the wards. And the individual characteristics that included top-down look, work discipline and experience. Conclusion: The IPC among the ICU nurses is a dynamic and inevitable process and influenced by factors such as nurses’ membership in the groups established in the ICU, nurses’ cooperation, management strategies, physical and emotional nature of critical care units, work experience and former communications, discipline, and features such as a top-down attitude.

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