A survey of pain assessment and management practices among critical care nurses

1994 ◽  
Vol 3 (2) ◽  
pp. 123-128 ◽  
Author(s):  
MC Gujol
Keyword(s):  
Critical Care ◽  
Pain Assessment ◽  
Management Practices ◽  
Critical Care Nurses ◽  
Opioid Use ◽  
Convenience Sample ◽  
Policy Makers ◽  
Survey Results ◽  
Medication Decisions ◽  
The Relationship

BACKGROUND: Postoperative pain is one of the major obstacles in the prevention of complications during patient recovery. Pain and its management have gained great interest among researchers, clinicians and policy-makers. PURPOSES: To explore the relationship between two variables in pain assessment (length of time after surgery and ventilator status) and medication decisions made by critical care nurses, and to identify nurses' concerns about opioid use. METHODS: A convenience sample of 71 critical care nurses participated in the survey. RESULTS: Certain patient conditions such as length of time after surgery and ventilator status affected nurses' assessment and management of pain. Nurses' knowledge about pain assessment and management may affect patient care and outcomes.

Critical Care Nurses' Pain Assessment and Management Practices: A Survey in Canada

2012 ◽  
Vol 21 (4) ◽  
pp. 251-259 ◽  
Author(s):  
L. Rose ◽  
O. Smith ◽  
C. Gelinas ◽  
L. Haslam ◽  
C. Dale ◽  
...  
Keyword(s):  
Critical Care ◽  
Pain Assessment ◽  
Management Practices ◽  
Critical Care Nurses

Nurses’ Accuracy in Estimating Backrest Elevation

2002 ◽  
Vol 11 (1) ◽  
pp. 34-37 ◽  
Author(s):  
Amy Dillon ◽  
Cindy L. Munro ◽  
Mary Jo Grap
Keyword(s):  
Critical Care ◽  
Basic Education ◽  
Critical Care Nurses ◽  
Care Practice ◽  
Demographic Information ◽  
Convenience Sample ◽  
Control And Prevention ◽  
Random Number Table ◽  
The Difference ◽  
The Relationship

• Background Positioning patients is a key component of nursing care and can affect their morbidity and mortality. The Centers for Disease Control and Prevention recommend that patients receiving mechanical ventilation have the head of the bed elevated 30°to 45°to prevent nosocomial pneumonia. However, use of higher backrest positions for critically ill patients is not common nursing practice. Backrest elevation may be affected by the accuracy of nurses’ estimates of patients’ positions. • Objectives To determine the difference between nurses’ estimates of bed angles and measured bed angles and to describe the relationship between nurses’ characteristics and the accuracy of their estimates. • Methods A convenience sample of 67 nurses attending the 1999 American Association of Critical-Care Nurses National Teaching Institute and Critical Care Exposition in New Orleans, La. Each subject provided demographic information and estimated 3 bed angles. The angles were preselected by using a random number table. Summary statistics were used and were categorized according to the demographic information provided by participants. Estimated angles were correlated with measured angles, and accuracies in estimating angles were correlated with demographic characteristics. • Results Nurses were accurate in estimating bed angles (correlation, 0.8488). Demographic information, including sex, age, years of practice, years of critical care practice, basic education, highest educational level, and present position had no relationship to accuracy. • Conclusions Nurses are able to estimate backrest elevation accurately. Other explanations are needed to understand why recommendations for backrest elevation are not used in practice.

Maternal Buprenorphine Dose at Delivery and Its Relationship to Neonatal Outcomes

2015 ◽  
Vol 22 (3) ◽  
pp. 127-130 ◽  
Author(s):  
Alane B. O'Connor ◽  
Liam O'Brien ◽  
William A. Alto
Keyword(s):  
Healthcare Providers ◽  
Adverse Outcomes ◽  
Neonatal Outcomes ◽  
Opioid Use ◽  
Dose Response Relationship ◽  
Infant Outcomes ◽  
Nas Score ◽  
Medication Decisions ◽  
The Relationship ◽  
Illicit Opioid Use

Background/Aims: To determine whether there is a dose-response relationship between maternal dose of buprenorphine at delivery and neonatal outcomes. Methods: This retrospective cohort study of 155 maternal-infant dyads exposed to buprenorphine during pregnancy examines the relationship between maternal dose of buprenorphine at delivery and gestational age, birthweight, method of delivery, Apgar scores at 1 and 5 min, duration of infant hospital stay, peak neonatal abstinence syndrome (NAS) score, duration of NAS and incidence of pharmacologic treatment of NAS. Results: Analyses failed to support any relationship between maternal dose of buprenorphine at delivery and any of the 9 clinical outcomes (all p values >0.093). Conclusions: This study failed to provide any evidence to support limiting or reducing maternal dose of buprenorphine during pregnancy in order to reduce possible adverse outcomes to the infant. Findings suggest that healthcare providers can focus medication decisions on maternal opioid cravings to reduce the risk of relapse to illicit opioid use rather than out of concern for adverse infant outcomes.

scholarly journals Identity, diversity and diversity management

2016 ◽  
Vol 35 (1) ◽  
pp. 48-64 ◽  
Author(s):  
Lotte Holck ◽  
Sara Louise Muhr ◽  
Florence Villesèche
Keyword(s):  
Design Methodology ◽  
Management Practices ◽  
Diversity Management ◽  
Future Research ◽  
Policy Makers ◽  
Content Type ◽  
Hr Managers ◽  
The Relationship ◽  
Practical Implications ◽  
Diversity Research

Purpose – The purpose of this paper is to examine the relationship between the identity and diversity literatures and discuss how a better understanding of the theoretical connections between the two informs both diversity research and diversity management practices. Design/methodology/approach – Literature review followed by a discussion of the theoretical and practical consequences of connecting the identity and diversity literatures. Findings – The authors inform future research in three ways. First, by showing how definitions of identity influence diversity theorizing in specific ways. Second, the authors explore how such definitions entail distinct foci regarding how diversity should be analyzed and interventions actioned. Third, the authors discuss how theoretical coherence between definitions of identity and diversity perspectives – as well as knowledge about a perspective’s advantages and limitations – is crucial for successful diversity management research and practice. Research limitations/implications – The authors argue for a better understanding of differences, overlaps and limits of different identity perspectives, and for a stronger engagement with practice. Practical implications – The work can encourage policy makers, diversity and HR managers to question their own practices and assumptions leading to more theoretical informed diversity management practices. Originality/value – The theoretical connections between identity and diversity literature have so far not been reviewed systematically. The work foregrounds how important it is for diversity scholars to consider identity underpinnings of diversity research to help further develop the field within and beyond the three streams the authors discuss.

Forest communities: New frameworks for assessing sustainability

1999 ◽  
Vol 75 (5) ◽  
pp. 747-754 ◽  
Author(s):  
Solange Nadeau ◽  
Bruce Shindler ◽  
Christina Kakoyannis
Keyword(s):  
Management Practices ◽  
Well Being ◽  
The United States ◽  
Community Capacity ◽  
Forest Community ◽  
Forest Communities ◽  
Community Stability ◽  
Policy Makers ◽  
Community Resiliency ◽  
The Relationship

In both Canada and the United States, there has been a growing interest in the sustainability of forests and forest communities. Policy makers and scientists have attempted to understand how forest management practices can enhance or harm the future of such communities. Although many studies have historically used economic indicators as measures of community stability, more recently researchers have demonstrated that the relationship between communities and forests goes far beyond simple economic dependency. Thus, recent frameworks for assessing forest communities have also addressed the need for broader social and institutional components. In this article, we briefly review three of these recent concepts — community capacity, community well-being and community resiliency — and examine what each of these terms has to contribute to the assessment of forest communities. Key words: forest community, community stability, community capacity, community well-being, community resilience

Consequences of clinical situations that cause critical care nurses to experience moral distress

2012 ◽  
Vol 19 (4) ◽  
pp. 479-487 ◽  
Author(s):  
Debra L Wiegand ◽  
Marjorie Funk
Keyword(s):  
Critical Care ◽  
End Of Life ◽  
Thematic Analysis ◽  
Moral Distress ◽  
Medical Center ◽  
Critical Care Nurses ◽  
Negative Consequences ◽  
Convenience Sample ◽  
Methodological Rigor ◽  
Descriptive Approach

Little is known about the consequences of moral distress. The purpose of this study was to identify clinical situations that caused nurses to experience moral distress, to understand the consequences of those situations, and to determine whether nurses would change their practice based on their experiences. The investigation used a descriptive approach. Open-ended surveys were distributed to a convenience sample of 204 critical care nurses employed at a university medical center. The analysis of participants’ responses used an inductive approach and a thematic analysis. Each line of the data was reviewed and coded, and the codes were collapsed into themes. Methodological rigor was established. Forty-nine nurses responded to the survey. The majority of nurses had experienced moral distress, and the majority of situations that caused nurses to experience moral distress were related to end of life. The nurses described negative consequences for themselves, patients, and families.

Relationship between moral distress and ethical climate with job satisfaction in nurses

2017 ◽  
Vol 26 (2) ◽  
pp. 346-356 ◽  
Author(s):  
Sharareh Asgari ◽  
Vida Shafipour ◽  
Zohreh Taraghi ◽  
Jamshid Yazdani-Charati
Keyword(s):  
Job Satisfaction ◽  
Critical Care ◽  
Social Security ◽  
Ethical Climate ◽  
Moral Distress ◽  
Correlation Study ◽  
Critical Care Nurses ◽  
Quality Of Work Life ◽  
Distress Scale ◽  
The Relationship

Background: Moral distress and ethical climate are important issues in the workplace that appear to affect people’s quality of work life. Objectives: This study was conducted to determine the relationship of moral distress and ethical climate to job satisfaction in critical care nurses. Materials and methods: This descriptive-correlation study was conducted on 142 critical care nurses, selected from five social security hospitals in north Iran through census sampling. Data were collected using a demographic questionnaire, the Moral Distress Scale–Revised, the Olson’s Hospital Ethical Climate Survey, and the Brayfield and Rothe Job Satisfaction index. Ethical considerations: The research project was approved by the Ethics Committee of Mazandaran University of Medical Sciences and the Medical Deputy of the Social Security Organization. Findings: The mean scores obtained by the critical care nurses for moral distress, ethical climate, and job satisfaction were 87.02 ± 44.56, 3.51 ± 0.53, and 62.64 ± 9.39, respectively. Although no significant relationships were observed between moral distress and job satisfaction, the relationship between ethical climate and job satisfaction was statistically significant (p < 0.05). Conclusion: Identifying ethical stressors in the workplace and giving proper feedback to the authorities to eliminate these factors and improve the ethical climate in these workplaces can help enhance job satisfaction in nurses and lead to higher quality care.

Pain Management in the Critically Ill: What Do We Know and How Can We Improve?

1994 ◽  
Vol 5 (2) ◽  
pp. 159-168 ◽  
Author(s):  
Michele A. Alpen ◽  
Marita G. Titler
Keyword(s):  
Critical Care ◽  
Quality Improvement ◽  
Pain Management ◽  
Critically Ill ◽  
Pain Assessment ◽  
Pain Control ◽  
Critical Care Nurses ◽  
Critical Care Units ◽  
Knowledge And Attitudes ◽  
Nurses Knowledge

Pain management in the critically ill is a challenge and a problem of great concern for critical care nurses. The authors review research on pain in the areas of pain assessment, nurses’ knowledge and attitudes, pharmacologic interventions, and nonpharmacologic interventions for the management of pain. Although the research base is not completely developed in the critically ill population, implications for practice are provided, based upon the findings in populations akin to the critically ill. Strategies are outlined for achieving improved pain control in critical care units through education, adoption of standards on pain management, and quality improvement activities

The relationship between ethical conflict and nurses’ personal and organisational characteristics

2018 ◽  
Vol 26 (7-8) ◽  
pp. 2427-2437 ◽  
Author(s):  
Zahra Saberi ◽  
Mohsen Shahriari ◽  
Ahmad Reza Yazdannik
Keyword(s):  
Critical Care ◽  
Ethics Education ◽  
Organizational Factors ◽  
Educational Status ◽  
Clinical Situation ◽  
Critical Care Nurses ◽  
Ethical Conflict ◽  
Stressful Environment ◽  
Wide Range ◽  
The Relationship

Introduction: Critical care nurses work in a complex and stressful environment with diverse norms, values, interactions, and relationships. Therefore, they inevitably experience some levels of ethical conflict. Aim: The aim of this study is to analyze the relationship of ethical conflict with personal and organizational characteristics among critical care nurses. Methods: This descriptive-correlational study was conducted in 2017 on a random sample of 216 critical care nurses. Participants were recruited through stratified random sampling. Data collection tools were a demographic and professional characteristics questionnaire, the Ethical Conflict in Nursing Questionnaire-Critical Care Version, and the Organizational and Managerial Factors Questionnaire. The data were analyzed using the SPSS software (v. 22.0). Ethical considerations: All participants were informed about the study’s aim and were assured that participation in and withdrawal from the study would be voluntary. Findings: The mean score of exposure to ethical conflict was 201.91 ± 80.38. The highest-scored conflict-inducing clinical situation was “working with professionally incompetent nurses or nurse assistants.” Married nurses, nurses with official employment, nurses with master’s degree, and nurses with the history of attending ethics education programs had significantly higher exposure to ethical conflict than the other nurses (p < 0.05). The significant predictors of exposure to ethical conflict were marital status, educational status, reward system, organizational culture, manager’s conduct, and organizational structure and regulations (p < 0.05). These predictors accounted for 37.2% of the total variance of exposure to ethical conflict. Conclusion: Critical care nurses experience moderate levels of exposure to ethical conflict. A wide range of personal and organizational factors can contribute to such exposure, the most significant of which is the professional incompetence of nursing colleagues, nurse assistants, and physicians. Therefore, many improvements at personal and organizational levels are needed to reduce critical care nurses’ exposure to ethical conflict.

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