professional issues

专业问题
  • 文章类型: Journal Article
    背景:名义组技术(NGT)广泛用于医疗保健研究,以促进决策和共识建立。传统的NGT需要面对面的互动,其局限性包括潜在的偏见,物流挑战和高成本。COVID-19大流行需要转向虚拟方法,这导致了虚拟名义组技术(vNGT)的发展。目的反思vNGT的使用,特别是在Ghader等人(2023)的背景下,了解其克服传统NGT局限性的有效性及其在大流行影响情景中的适用性。
    方法:本文回顾并讨论了有关NGT与其他共识建立方法相比的使用和有效性的文献,并研究了vNGT在克服传统NGT局限性方面的出现。作者还反思了他们在一项研究中使用vNGT,以确定阿联酋的心血管研究重点,并提供其实施细节。
    结论:vNGT弥合了传统NGT的局部性质与Delphi技术的全球范围之间的差距。它允许包括不同的参与者,节省成本,并提供时间效率。这项研究证明了vNGT的适应性,参与者参与创意产生,使用在线工具进行讨论和优先排序。然而,vNGT仍然存在挑战,包括某些人口统计数据的可访问性降低,跨时区的时间问题和技术困难。
    结论:vNGT成功集成了交互式,NGT的共识方面与Delphi的广泛影响。它在研究和决策中可能很有价值,尤其是在远程协作增加的时代。
    结论:vNGT可以通过实现更具包容性的医疗保健研究和政策制定显着影响,具有成本效益和及时的建立共识进程。然而,对可访问性和技术支持的考虑对于其更广泛的采用和有效性至关重要。
    BACKGROUND: Nominal group technique (NGT) is widely used in healthcare research to facilitate decision-making and consensus-building. Traditional NGT requires face-to-face interaction and its limitations include potential biases, logistical challenges and high costs. The COVID-19 pandemic necessitated a shift to virtual methods, which led to the development of virtual nominal group technique (vNGT). Aim To reflect on the use of vNGT, particularly in the context of Ghader et al (2023 ), to understand its effectiveness in overcoming the limitations of traditional NGT and on its applicability in pandemic-affected scenarios.
    METHODS: This paper reviews and discusses literature on the use and effectiveness of NGT compared to other consensus-building methods and examines the emergence of vNGT in overcoming the limitations of traditional NGT. The authors also reflect on their use of vNGT in a study to identify cardiovascular research priorities in the UAE and provide details of its implementation.
    CONCLUSIONS: vNGT bridges the gap between the localised nature of traditional NGT and the global reach of the Delphi technique. It allows for the inclusion of diverse participants, saves costs and offers time-efficiency. The study demonstrated vNGT\'s adaptability, with participants engaging in idea generation, discussion and prioritisation using online tools. However, challenges persist with vNGT, including reduced accessibility for certain demographics, timing issues across time zones and technical difficulties.
    CONCLUSIONS: vNGT successfully integrates the interactive, consensus-building aspects of NGT with the broad reach of Delphi. It can be valuable in research and decision-making, especially in an era of increased remote collaboration.
    CONCLUSIONS: vNGT can significantly impact healthcare research and policy formulation by enabling more inclusive, cost-effective and timely consensus-building processes. However, considerations for accessibility and technical support are crucial for its wider adoption and effectiveness.
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  • 文章类型: Journal Article
    护士经常经历多重挑战,并在其专业角色中面临众多要求,这可能会导致不利的影响,如压力,抑郁症,焦虑和倦怠。因此,重要的是确定可以支持他们的有效和可访问的策略。本文探讨了护士如何使用日记作为导航他们在实践中遇到的挑战的工具。它提供了一个一步一步的指南,为护士提供了一个可访问和有效的方法来记录,他们可以用它来支持他们的心理健康和自我护理。
    Nurses frequently experience multiple challenges and face numerous demands in their professional role, which may lead to adverse effects such as stress, depression, anxiety and burnout. Therefore, it is important to identify effective and accessible strategies that can support them. This article explores how nurses can use journalling as a tool for navigating the challenges they experience in their practice. It offers a step-by-step guide that provides nurses with an accessible and effective approach to journalling, which they can use to support their mental well-being and self-care.
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  • 文章类型: Journal Article
    这篇“Howto”文章解释了如何使用反思行动和反思模型来反思临床实践,以帮助确保护士从经历或事件中获得全面的学习,从而增强其专业发展和患者护理。•反思是护理实践的重要组成部分,具有广泛的目的,包括,例如,自我探究经验以找到意义,获得洞察力和迅速行动,识别对护理情况的情绪反应,探索更广泛的问题,比如医疗文化。•Reflection-on-actioninvolvesaretrospectivecriticalexperimationofanexperienceorincidenttoidentifylearningpointsandmaybeengagedinalone,和另一个人,例如在临床监督期间,或在小组活动中。•有一系列反射模型可用于构造反射,其主要组成部分通常包括对事件的描述,反思其学习的意义和认同。反思活动:“如何\”文章可以帮助更新您的实践,并确保它仍然是基于证据。将本文应用于您的实践。反思并撰写简短的说明:•本文如何在使用反思技术时改善您的练习。•您如何使用这些信息来教育护生或您的同事反思临床实践的适当方法。
    UNASSIGNED: This \'How to\' article explains how to reflect on clinical practice using reflection-on-action and a reflective model to help ensure the nurse gains comprehensive learning from an experience or incident to enhance their professional development and patient care. • Reflection is a vital element of nursing practice and has a wide-ranging purpose including, for example, self-inquiry into experiences to find meaning, gain insight and prompt action, recognition of emotional responses to care situations and exploring wider issues, such as healthcare culture. • Reflection-on-action involves a retrospective critical exploration of an experience or incident to identify learning points and may be engaged in alone, with one other person, for example during clinical supervision, or in a group activity. • There are a range of reflective models that can be used to structure a reflection, the main components of which generally include a description of the event, reflection on its meaning and identification of learning. REFLECTIVE ACTIVITY: \'How to\' articles can help to update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: • How this article might improve your practice when using reflective techniques. • How you could use this information to educate nursing students or your colleagues on the appropriate methods for reflecting on clinical practice.
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  • 文章类型: Journal Article
    欺凌行为在健康和社会护理组织中已经存在多年。尽管研究人员已经研究了欺凌对护士和护理学生的影响,人们很少关注直接或间接对护士领导和经理造成的欺凌行为。本文为领导或管理角色的护士提供了简明实用的指导,以指导如何识别和管理针对自己的欺凌行为。•护理中的公开或秘密欺凌可能发生在组织的各个层面。•欺凌对实践产生负面影响,团队合作,员工士气和病人护理。•识别欺凌是解决不可接受行为的第一步。•承认你可能被欺负,并寻求支持来管理欺凌是一个有效的护士领导的标志。反思活动:“如何\”文章可以帮助更新您的实践,并确保它仍然是基于证据。将本文应用于您的实践。反思并写一篇简短的说明:•这篇文章在管理作为护士领导者被欺负时如何改善您的实践。•您如何使用此信息来教育您的同龄人如何管理被欺负作为护士领导者。
    UNASSIGNED: Bullying has existed in health and social care organisations for many years. Although researchers have examined the effects of bullying on nurses and nursing students, there has been too little focus on bullying behaviours inflicted directly or indirectly on nurse leaders and managers. This article provides concise and practical guidance for nurses in leadership or management roles on how to identify and manage bullying behaviours directed at themselves. • Overt or covert bullying in nursing can happen at every level of the organisation. • Bullying negatively affects practice, teamwork, staff morale and patient care. • Identifying bullying is the first step in addressing unacceptable behaviours. • Admitting that you may be being bullied and seeking support to manage bullying is a hallmark of an effective nurse leader. REFLECTIVE ACTIVITY: \'How to\' articles can help to update your practice and ensure it remains evidence-based. Apply this article to your practice. Reflect on and write a short account of: • How this article might improve your practice when managing being bullied as a nurse leader. • How you could use this information to educate your peers about managing being bullied as a nurse leader.
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  • 文章类型: Journal Article
    与家庭虐待相关的非致命勒死的受害者/幸存者(作者在整篇文章中使用了这个术语,但承认个人可能会使用各种术语来描述他们的经历)面临进一步严重伤害或死亡的风险,但往往不透露攻击。此外,一些体征和症状不是立即明显或明显。护士有专业责任通过启动保障和保护程序来应对对任何类型的家庭虐待的怀疑和/或披露,并且必须提供有效的护理。本文讨论了家庭虐待中的非致命勒死,包括出现的体征和症状以及披露的障碍,并描述了护士的角色。作者包括一个虚构的案例研究,以证明护士遇到非致命勒死的受害者/幸存者时可能会经历的情况类型。
    Victims/survivors (the authors use this term throughout the article but acknowledge that individuals may use various terms to describe their experiences) of non-fatal strangulation associated with domestic abuse are at risk of further serious harm or death, but often do not disclose the assault. In addition, some of the signs and symptoms are not immediately apparent or obvious. Nurses have a professional responsibility to respond to suspicions about and/or disclosure of any type of domestic abuse by initiating safeguarding and protection procedures and must provide effective care. This article discusses non-fatal strangulation in domestic abuse, including the presenting signs and symptoms and barriers to disclosure, and describes the role of the nurse. The authors include a fictional case study to demonstrate the type of situation nurses may experience when they encounter a victim/survivor of non-fatal strangulation.
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  • 文章类型: Journal Article
    护理行业承受着越来越大的压力,许多护理人员发现保持标准并提供安全,有效和高效的护理,满足患者的需求。护士的工作满意度是基于支持的感觉,包括对实践的担忧-无论是他们自己的还是他们的同事的。本文讨论了护士管理者如何支持员工挑战次优实践,承认自己的错误,并通过培养心理安全的氛围从这些错误中吸取教训。这包括采用关系型领导模式;培养开放式沟通;明确角色和期望;确保绩效管理的透明度和公平性;与员工进行支持性的“艰难对话”;在调查问题时表现出客观性;并促进“公正文化”。
    The nursing profession is under growing pressure and many nursing staff find it increasingly challenging to maintain standards and provide safe, effective and efficient care that meets the needs of patients. Nurses\' job satisfaction is predicated on feeling supported, including when there are concerns about practice - whether their own or that of their colleagues. This article discusses how nurse managers can support staff to challenge suboptimal practice, admit their own errors and learn from these by fostering a climate of psychological safety. This includes adopting a relational model of leadership; cultivating open communication; providing clarity on roles and expectations; ensuring transparency and fairness in performance management; having supportive \'tough conversations\' with staff; demonstrating objectivity when investigating concerns; and promoting a \'just culture\'.
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  • 文章类型: Journal Article
    死亡和死亡的现实是生活的核心方面,经常被悲伤的感觉包围,恐惧和不确定性。护士在照顾接近生命尽头的人及其家人方面发挥着至关重要的作用,同时铭记当前卫生和社会护理服务的需求和挑战。在这篇文章中,作者认为,作为生活的一部分,对死亡的现实更加开放可能有助于护士更加适应那些垂死的人的个人需求。这篇文章强调了通过同情的镜头来解决每个人的症状和关注的重要性,恐惧和痛苦。虽然重点是照顾接近生命尽头的人,作者断言,护士可以从他们关心的人那里学到很多关于生命的美丽和死亡的自然性。
    The reality of death and dying is a central facet of life, often surrounded by feelings of sadness, fear and uncertainty. Nurses have an essential role in caring for people who are approaching the end of life and their families, while being mindful of the current demands and challenges in health and social care services. In this article, the author suggests that being more open to the reality of death as part of life may assist nurses in being more attuned to the personal needs of those who are dying. The article emphasises the importance of considering each person\'s symptoms and concerns through the lens of compassion to address pain, fear and distress. While the focus is on caring for people who are approaching the end of life, the author asserts that there is much that nurses can learn from those they care for about the beauty of life and the naturalness of death.
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  • 文章类型: Journal Article
    背景:国际研究表明,各个急诊科(ED)的分诊护士决策实践和培训经验差异很大。然而,在英国似乎没有发表类似的研究。了解因素,例如人口统计,培训和决策可以提供在英国ED工作的分诊护士的照片,确定改进实践并为进一步研究提供信息所需的干预措施。
    目标:为了探索人口统计学,在英国ED中评估患者分诊时视力的注册护士的培训经验和决策实践。
    方法:这项研究使用了在线,描述性,描述性横断面调查设计。
    结果:来自英国各地的51名分诊护士对调查做出了回应。大多数(61)已经取得了学士学位作为他们的最高资格,3有研究生学历。受访者自排位赛以来的中位数为七年,在他们目前的ED工作了六年,在分诊工作了五年,并使用了一系列的头衔来描述他们的角色。低人员配备和繁忙的ED环境增加了受访者的压力水平,这影响了经验不足的护士对分诊决策能力的信心。更有经验的受访者依靠他们的知识和技能来应对压力。并非所有受访者都接受过分诊培训,对于那些有,不同ED的训练类型和频率各不相同。总的来说,受访者对金额满意度较低,他们接受的培训的质量和内容。
    结论:需要在ED中更安全的人员配置水平和更多的员工福利支持。制定国家标准,纳入定义的知识和技能,并设定进修培训的时间段,需要加强ED的分诊实践。
    BACKGROUND: International research suggests that triage nurses\' decision-making practices and training experiences vary significantly across emergency departments (EDs). However, there does not appear to be similar research published in the UK. Understanding factors, such as demographics, training and decision-making could provide a picture of triage nurses working in UK EDs, identify the interventions required to improve practice and inform further research.
    OBJECTIVE: To explore the demographics, training experiences and decision-making practices of registered nurses who assess patient acuity at triage in UK EDs.
    METHODS: The study used an online, descriptive, cross-sectional survey design.
    RESULTS: A total of 51 triage nurses from across the UK responded to the survey. Most (61) had achieved a bachelor\'s degree as their highest qualification, while 3 had postgraduate qualifications. Respondents had a median of seven years since qualifying, six years working in their current ED and five years working in triage and used a range of titles to describe their role. Low staffing and busy ED environments increased respondents\' stress levels, which affected confidence in triage decision-making abilities among less experienced nurses. More experienced respondents coped with their stress by relying on their knowledge and skills. Not all respondents had received triage training, and for those that had, the training varied in type and frequency across EDs. Overall, respondents had low satisfaction with the amount, quality and content of the training they had received.
    CONCLUSIONS: There is a need for safer staffing levels in EDs and greater support for staff welfare. The development of national standards, incorporating defined knowledge and skills and set time periods for refresher training, is required to enhance triage practice in EDs.
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  • 文章类型: Journal Article
    自我意识是有效领导的重要组成部分。具有自我意识的领导者对自己的优势和局限性表现出理解,以及管理自己和团队成员情绪的能力。提高自我意识和对自己和他人的理解可以在增加信心和加强沟通方面有好处。此外,护士领导和管理者需要自我意识来识别他们的优点和缺点,导航复杂性,培养积极的关系,培养持续改进的文化。这篇文章定义了自我意识,讨论了其对护士领导的重要性,并确定了护士可以用来发展自我意识的各种工具和方法。
    Self-awareness is a crucial component of effective leadership. Leaders who are self-aware exhibit an understanding of their strengths and limitations, as well as an ability to manage their emotions and those of their team members. Heightened self-awareness and understanding of oneself and others can have benefits in terms of increasing confidence and enhancing communication. Moreover, nurse leaders and managers need self-awareness to identify their strengths and weaknesses, navigate complexities, foster positive relationships and cultivate a culture of continuous improvement. This article defines self-awareness, discusses its importance for nurse leadership and identifies various tools and methods that nurses can use to develop their self-awareness.
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  • 文章类型: Journal Article
    目标:关于健康差异和教育不平等的根本原因的讨论往往忽视了将种族主义确定为主要因素。研究人员必须从系统的角度来确定种族主义和其他形式的系统性压迫对健康的影响。目前尚不清楚这种观点在物理治疗研究文献中的存在程度。我们进行了范围审查,以量化和描述与多样性有关的物理治疗研究的数量,股本,以及专门审查种族和/或族裔以及提及种族主义或反种族主义的包容性。
    方法:对PubMed和Scopus数据库进行了系统搜索,以查找1997年至2021年之间发表的文章。对文章进行了筛选,以确保它们完全或主要集中在物理治疗和使用多样性上,股本,和包含在个人身份因素背景下的术语。相关文章共158篇。每个都标记有文章类型和个人身份因素重点。
    结果:纳入的大部分文章本质上是描述性/观察性的。收录的文章探讨了各种个人身份因素,种族和种族是最常见的焦点,其次是文化,残疾,和社会经济地位。一小部分文章明确讨论了种族主义或反种族主义。
    结论:这些发现强调了在物理治疗研究中需要更多地关注种族主义,这是健康差异和教育不平等的根本原因。解决这一差距对于促进多样性至关重要,股本,并最终为边缘化人群实现最佳健康成果。
    结论:包括考虑种族主义和其他形式的系统压迫的动机,设计,和对物理治疗研究的解释将有助于更多地了解不平等的根源,提高我们发展有效的能力,多层次干预。
    OBJECTIVE: Discussions of the root causes of health disparities and educational inequities often neglect to identify racism as a primary factor. Researchers must take a systems perspective in order to identify the effects of racism and other forms of systemic oppression on health. It is unclear to what extent this perspective exists in the physical therapy research literature. We conducted a scoping review to quantify and describe the volume of research in physical therapy pertaining to diversity, equity, and inclusion that specifically examines race and/or ethnicity and references racism or antiracism.
    METHODS: A systematic search of PubMed and Scopus databases for articles published between 1997 and 2021 was conducted. Articles were screened to ensure they were focused exclusively or primarily on physical therapy and used diversity, equity, and inclusion terms in the context of personal identity factors. This resulted in 158 relevant articles. Each was tagged with an article type and personal identity factor focus.
    RESULTS: A majority of the included articles were descriptive/observational in nature. The included articles explored various personal identity factors, with race and ethnicity being the most common focus followed by culture, disability, and socioeconomic status. A small proportion of articles explicitly discussed racism or antiracism.
    CONCLUSIONS: These findings highlight the need in physical therapy research for greater attention to racism as a fundamental cause of health disparities and educational inequities. Addressing this gap is crucial for promoting diversity, equity, and inclusion within the field and ultimately achieving optimal health outcomes for marginalized populations.
    CONCLUSIONS: Including consideration of racism and other forms of systemic oppression in the motivation, design, and interpretation of research in physical therapy will help to make more visible the root causes of inequity and improve our ability to develop effective, multi-level interventions.
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