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Purpose: This study aimed to develop a nursing clinical judgment scale (NCJS) and verify its validity and reliability in assessing the clinical judgment of nurses., Methods: A preliminary instrument of the NCJS comprising 38 items was first developed from attributes and indicators derived from a literature review and an in-depth/focus interview with 12 clinical nurses. The preliminary tool was finalized after 7 experts conducted a content validity test based on a data from a preliminary survey of 30 hospital nurses in Korea. Data were collected from 443 ward, intensive care unit, emergency room nurses who voluntarily participated in the survey through offline and online for the verification of the construct validity and reliability of the scale., Results: The final scale comprised 23 items scored on a 5-point Likert scale. Six factors- integrated data analysis, evaluation and reflection on interventions, evidence on interventions, collaboration among health professionals, patient-centered nursing, and collaboration among nurse colleagues - accounted for 64.9% of the total variance. Confirmatory factor analysis supported the fit of the measurement model, comprising six factors (root mean square error of approximation = .07, standardized root mean square residual = .04, comparative fit index = .90). Cronbach's α for all the items was .92., Conclusion: The NCJS is a valid and reliable tool that fully reflects the characteristics of clinical practice, and it can be used effectively to evaluate the clinical judgment of Korean nurses. Future research should reflect the variables influencing clinical judgment and develop an action plan to improve it., Competing Interests: The authors declared no conflict of interest., (© 2023 Korean Society of Nursing Science.)

The tone of research has changed, says Janet Scammell , Associate Professor (Nursing), Bournemouth University, and it is important that nurses consider the extent of user involvement when undertaking or citing research.

This paper concerns the French Health Care System that revolutionized the rationale of the existing social protection. It emphasizes that, in this country, it is essential to train professionals integrated into a "know-how", and also prepared for the current and future changes in the nursing profession. A literature review was carried out based on the classification and analysis of the texts and documents researched, and we tried to understand the French Health and Nursing System. This allowed the construction of two thematic categories. The first one is the "Health Service" that addresses health training courses for prevention, while the second one deals with Nursing Education, which is a competency-based framework. The demography of nurses in France is also discussed, which highlights the increased number of nurses from 2010 to 2018.

Introduction: Bedside nursing handover may be an efficient way to achieve quality nursing outcomes, supporting the personalization of care. Recent literature attests to how bedside nursing handover is perceived by cardiac patents, but the experience of nurses participating in these handovers is largely unknown. The aim of this study is to explore nurses' experiences after the implementation of bedside nursing handover in an Italian cardiac surgical ward., Method: A qualitative descriptive research approach was used to respond to the study aim, and the data was collected using two focus groups., Results: The main themes that were identified revolved around improving nursing care, greater professionalism, effective relationships, consequences for the patient, and obstacles to change. Moreover, we found that nurses perceive bedside nursing handover to be effective in promoting patient-centred care. The nurses in our study also felt that any difficulties with the implementation of a bedside nursing handover protocol (e.g. confidentiality) should be addressed through continued nursing education., Conclusions: This study provides a valuable insight into nurses' perceptions of bedside nursing handover in a single cardiac surgery setting in Italy and is the first qualitative investigation from this perspective. Further research may help to elucidate the impact of bedside nursing handover on clinical and organisational outcomes.

Obtaining informed consent and ensuring patient autonomy are critical to implementing a patient-centered model of healthcare. Informed consent is a complex process of communication that includes three elements: disclosure, competence in making decisions, and voluntariness. However, individual patient factors, doctor-patient interaction, and cultural issues are known to influence the process of obtaining informed consent. Individual patient factors include the ability of patients to understand and determine their intent; doctor-patient interaction includes communication skills; and cultural issues include the expectations of patients with regard to family involvement in medical decision-making and in decision-making motives. After assessing the relevant influencing factors, healthcare providers typically provide patients with comprehensive information on the benefits and risks of treatment as well as related alternatives. Moreover, healthcare providers typically provide patients with audio/video, Internet, and written information with illustrations based on individual patient needs. In addition to the above, we suggest that healthcare providers proactively adopt the perspective of patients in order to better encourage patients to address questions, to engage with patients in more productive discussions, and to take the initiative to explain and clarify patients' questions in order to minimize anxiety. This approach will help ensure that patients are adequately informed and free from coercion so that they make appropriate healthcare-related decisions. However, even under this optimal situation, healthcare providers must emphasize the needs of their patients and respect their decisions.

The column presents a scholarly dialogue about nursing's role in interprofessional education, practice, and collaboration. Susan Hassmiller, PhD, RN, FAAN, is the Robert Wood Johnson Foundation (RWJF) senior adviser for nursing. In this role, she shapes and leads the foundation's strategies to address nurse and nurse faculty shortages and ensures that RWJF's commitments in nursing have a broad and lasting national impact. In partnership with AARP, Hassmiller directs the foundation's Future of Nursing: Campaign for Action. This effort, active in 50 states plus the District of Columbia, strives to implement the recommendations of the Institute of Medicine's 2011 report, The Future of Nursing: Leading Change, Advancing Health, for which Hassmiller served as the study director.

Health professionals have to work together to ensure quality patient care.There are many studies exploring interprofessional education and practice. However, interprofessional knowledge is related to teamwork and organizational context. Some frameworks include "patient-centered" concepts to highlight the contribution of the patient but descriptions of the patient's contribution to the interprofessional practice are limited. Nursing professionals develop extensive expertise as a patient-centered professional practice and their experience can inspire new collaborative approaches.This article aims to summarize the state of knowledge regarding interprofessional practice and patient-centered nursing expertise.We also highlight the contribution of nursing in developing this approach and the ways in which nursing contributes to the development of interprofessional knowledge that is consistent with its values.

Aim: To identify the common, core elements of patient-centred care in the health policy, medical and nursing literature., Background: Healthcare reform is being driven by the rhetoric around patient-centred care yet no common definition exists and few integrated reviews undertaken., Design: Narrative review and synthesis., Data Sources: Key seminal texts and papers from patient organizations, policy documents, and medical and nursing studies which looked at patient-centred care in the acute care setting. Search sources included Medline, CINHAL, SCOPUS, and primary policy documents and texts covering the period from 1990-March 2010., Review Methods: A narrative review and synthesis was undertaken including empirical, descriptive, and discursive papers. Initially, generic search terms were used to capture relevant literature; the selection process was narrowed to seminal texts (Stage 1 of the review) and papers from three key areas (in Stage 2)., Results: In total, 60 papers were included in the review and synthesis. Seven were from health policy, 22 from medicine, and 31 from nursing literature. Few common definitions were found across the literature. Three core themes, however, were identified: patient participation and involvement, the relationship between the patient and the healthcare professional, and the context where care is delivered., Conclusion: Three core themes describing patient-centred care have emerged from the health policy, medical, and nursing literature. This may indicate a common conceptual source. Different professional groups tend to focus on or emphasize different elements within the themes. This may affect the success of implementing patient-centred care in practice., (© 2012 Blackwell Publishing Ltd.)

The advent of the electronic health record and numerous mobile, wireless tools with the capacity to capture, store, and transmit prodigious amounts of data, both using and creating evidence-based content and analytics for clinical decision support, requires that all care providers rethink approaches to care delivery. The nursing profession is called to acutely appreciate and support the vision of documentation systems that provide optimal decision support at the point of care, represent nursing knowledge, and are also capable of capturing care delivery outcomes that can be used to inform future care and improve the health of the public.

This article is the second in a series of four on the role of information and its management across health and social care. It describes the role of data in delivering nursing care and the importance of structured nursing content in electronic records to support modern services. The article gives examples of information systems that enable nurses to access data for clinical decision making, looks at the knowledge needs of future service users, and reflects on the support and training nurses need to operate in integrated health and care services.

Nursing theories have long existed to guide nursing practice but, in reality, can be challenging to achieve. In this paper the application of Parse's theory on Human Becoming is seen through a nurse's experience with an oncology patient and her family. Her reflection highlights how the concepts and paradoxes of the theory can meet practice. An attitude of true presence enables the nurse to provide quality patient-centred care. Over a period of a year the focus evolves from the perspective of the patient's illness to that of life outside the illness. During that transition, new light is shed on the situation whereby the ultimate meaning changes and transformation occurs for the nurse, the patient and her family.

While the signing of the Patient Protection and Affordable Care Act was a historical event marking the beginning of health care reform in the United States, it signaled the start of a golden age for ambulatory care nursing. Ambulatory care RNs are well-positioned to fully participate in health care reform initiatives. RNs are well-positioned to lead, facilitate, and/or participate in all patient care medical homes' and accountable care organizations' quality and safety initiatives through enhanced use of major ambulatory care RN role dimensions such as advocacy, telehealth, patient education, care coordination and transitional care, and community outreach. RNs are also well-positioned to provide patient-centered care, coordinate care, and manage transitions across ambulatory care settings. For the golden age of ambulatory care nursing to become a reality, initiatives surrounding competencies, education modules, and leadership must be addressed immediately.

This is the seventh article in a nine-part series describing the Principles of Nursing Practice developed by the Royal College of Nursing (RCN) in collaboration with patient and service organisations, the Department of Health, the Nursing and Midwifery Council, nurses and other healthcare professionals. The article discusses Principle F, the application of skills and knowledge to person-centred nursing care.

This is the fifth article in a nine-part series describing the Principles of Nursing Practice developed by the Royal College of Nursing (RCN) in collaboration with patient and service organisations, the Department of Health, the Nursing and Midwifery Council, nurses and other healthcare professionals. This article discusses Principle D, the provision of person-centred care.

Person-centredness as a concept is becoming more prominent and increasingly central within some research literature, approaches to practice and as a guiding principle within some health and social care policy. Despite the increasing body of literature into person-centred nursing (PCN), there continues to be a 'siloed' approach to its study, with few studies integrating perspectives from across nursing specialties. The purpose of this paper is to present the results of a study undertaken to explore if the secondary analysis of findings from four different and unrelated research studies (that did not have the main aim of researching person-centredness) could inform our understanding of person-centred nursing. A qualitative meta-synthesis was undertaken of the data derived from the four unrelated research studies undertaken with different client groups with long-term health conditions. A hermeneutic and interpretative approach was used to guide the analysis of data and framed within a particular person-centred nursing framework. Findings suggest 'professional competence' (where competence is understood more broadly than technical competence) and knowing 'self' are important prerequisites for person-centred nursing. Characteristics of the care environment were also found to be critical. Despite the existence of expressed person-centred values, care processes largely remained routinised, ritualistic and affording few opportunities for the formation of meaningful relationships. Person-centred nursing needs to be understood in a broader context than the immediate nurse-patient/family relationship. The person-centred nursing framework has utility in helping to understand the dynamics of the components of person-centredness and overcoming the siloed nature of many current perspectives., (© 2010 The Authors. Journal compilation © 2010 Nordic College of Caring Science.)

Any organization on the journey to nursing excellence might initiate its search for a professional practice framework by exploring the many nursing-specific theories, frameworks, and conceptual models that are readily available in the literature. Although adopting an "off the shelf" professional practice framework for nursing may sound easier for a nursing organization than creating its own framework, achieving a good fit into an existing culture is more difficult when adopting rather than creating a practice framework. ven though creating a customized framework requires a considerable amount of upfront time, dedication, and a willingness to make some mistakes along the way, in the end a customized framework ensures cultural alignment. SThis framework describes the foundational structures and guiding principles, the key processes that influence how work is conducted, and the outcomes desired as the result of the work. Identifying evaluative methods for determining progress on identified strategic intents was crucial in bridging the gap between theory and outcomes. This model continues to provide flexibility and adaptability to meet needs in a constantly changing health care environment and difficult economic times.

Purpose: Traditionally, nursing care has focused primarily on patients' problems and to solve these problems on behalf of the patient. However, with the growing focus in health care on patient-centered care, self-management of illness, and patient empowerment, the problem-oriented approach to nursing care is no longer sufficient. Assessing and strengthening patients' health assets has evolved into a complementary approach to problem-focused care, helping patients achieve and maintain their health and wellness. This requires a clear definition of the concept of health assets and a better understanding of their role in overall health and wellness. The purpose of this paper was to examine the concept of health assets, including its attributes, associated concepts, and application in a health care context., Methods: We systematically reviewed 60 journal articles and Web documents dated from 1966 through March 2007. Data were then analyzed using Rodger's evolutionary method of concept analysis., Results: The health assets concept has not been widely used in health care. However, use has increased during recent years within multiple disciplines, including psychology, psychiatry, nursing, medicine, social sciences, and public health. This concept analysis identified core attributes of health assets to be potentials in the individuals' possession. The core attributes embraces relational, motivational, protective, and volitional strengths, which are internal; and support, expectations of others, and physical and environmental elements, which are external. The antecedents of health assets are genes, values, beliefs, and life experiences. Health assets mobilize an individual to engage in deliberation, decision making, and change. Consequences of health assets are positive health behaviors that can lead to mastery, self-actualization, and improved health outcomes. We propose both a definition of health assets and a descriptive model of its components and relationships., Conclusion: Focusing nursing care on a person's health assets, as a complement to the traditional approach of addressing a person's health problems, may contribute to improved health behavior and outcomes. Health assets should, therefore, receive greater attention in nursing practice, education, and research., (Copyright 2009 Elsevier Ltd. All rights reserved.)

Reflection about a doctorate's thesis. It was carried through an abstraction of the described theory by specialist authors in thematic, a transposition for the practical of competency management in nursing. The essential competency shows attributes of knowledge, ability and attitude - called CHA, to add value to the organization of health with focus in the customer. It is essential to awake in all the team, the responsibility and real concern with the patient, family and visitors. The professional constitutes oneself as the inspired leader of its group. The management competency of the nurse can give change to the development of the human resources and promote the enchantment in the attendance of the customers, making the difference in the health organizations.

Aim: The present study aimed to evaluate psychometric properties of the English language Person-centred Climate Questionnaire--staff version (PCQ-S)., Background: Person-centred care emphasizes the individual's perspective in the care process. However, the concept is subject to some debate and few measurement tools exist., Methods: During 2 months in 2007, the Swedish PCQ-S was translated to English and distributed to a sample of Australian hospital staff (n = 52). Psychometric evaluation using statistical estimates of validity and reliability were performed., Results: The 14-item questionnaire showed high reliability as Cronbach's alpha was satisfactory for the total scale (0.89), and for the four subscales: 0.87, 0.79, 0.82 and 0.69. Test-retest reliability were evaluated in a subsample of 40 staff and resulted in P-values >0.05 between mean scores of the PCQ-S at test and retest, r-values between 0.6 and 0.9, and a two-way mixed effects model, single measures intra-class correlations of 0.75 with a confidence interval of 0.58-0.86. Validity of the scale needs further evaluation., Conclusions and Implications for Nursing Management: The English PCQ-S makes possible studies of associations between person-centredness and different organizational systems, environments, staff characteristics and health and managerial styles. However, scale validity needs further evaluation.

Aims: This paper reports findings from a large-scale quasi-experimental study that used a measure of caring as a means of evaluating person-centred nursing and aims to illustrate the synergy between the concepts of caring and person-centredness., Background: Evidence would suggest that effective person-centred nursing requires the formation of therapeutic relationships between professionals, patients and others significant to them in their lives and that these relationships are built on mutual trust, understanding and a sharing of collective knowledge. This correlates with the conceptualization of caring that is underpinned by humanistic nursing theories., Design: A pretest post-test design was used in this study to evaluate the effect of person-centred nursing on a range of outcomes, one of which was nurses' and patients' perception of caring., Methods: The Person-Centred Nursing Index was the main data collection tool. The Caring Dimension Inventory and Nursing Dimensions Inventory, were component parts of the Person-Centred Nursing Index and were used to measure nurses' and patients' perceptions of caring. The Person-Centred Nursing Index was administered at five points in time over a two-year intervention period., Results: Nurses had a clear idea of what constituted caring in nursing, identifying statements that were reflective of person-centredness, which was consistent over time. This was in contrast to patients, whose perceptions were more variable, highlighting incongruencies that have important implications for developing person-centred practice., Conclusion: The findings confirm the Caring Dimension Inventory/Nursing Dimensions Inventory as an instrument that can be used as an indicator of person-centred practice. Furthermore, the findings highlight the potential of such instruments to generate data on aspects of nursing practice that are traditionally hard to measure., Relevance to Clinical Practice: The findings would suggest that nurses need to be aware of patients' perceptions of caring and use this to influence changes in practice, where the prime goal is to promote person-centredness.

Aims and Objectives: This paper uses the findings of two studies to explore the nature of nurses practice when working with vulnerable and marginalised populations, particularly with regard to the attributes of holism and individualised care. A secondary analysis of the findings of two separate studies was undertaken, one on the elderly with delirium and the other with indigenous Maori women., Background: Often considered vulnerable and marginalised, elderly and indigenous experiences of health services are often fraught with their health needs not always identified or addressed. Nursing claims that holism and individualised care are pivotal attributes underpinning nursing practice. However, the secondary analysis of two research studies highlight how vulnerable and marginalised populations accessing health and nursing services experience needs that are neither acknowledged nor integrated into intervention and treatment plans., Design: A secondary analysis of one study with the elderly with delirium used a critical gerontological methodology informed by postmodernism and Foucaults understanding of discourse. The other study with indigenous Maori women utilised Glaserian grounded theory informed by a Maori-centred methodology., Methods: The research on the elderly with delirium analysed 20 data sources, including interviews with older persons who had experienced delirium, members of their families and health professionals. The research with 38 indigenous Maori women aged between 24 and 65 years, inductively analysed interview data using constant comparative analysis, theoretical sampling and saturation of the core categories to generate a substantive grounded theory., Results: The findings of each study showed that a problem focussed approach to health care is offered to patients that does not incorporate individual health experiences. In addition, the social context integral to peoples lives outside of the health care environment is ignored and as such the very foundations of nursing practice, that of holism, is merely a rhetorical construct., Conclusions: Vulnerable and marginalised patients experience care that neglects their perceived health needs and the realities of their life circumstances., Relevance to Clinical Practice: Individualised care that extends beyond the presenting issue is vital, but raises challenges when working with those population groups considered vulnerable and marginalised to improve outcomes of their health experience.

The aim of this study was to clarify the relationship of nursing autonomy and other factors related to attitudes toward caring for dying patients. A cross-sectional survey of nurses was conducted in November 2003 using a self-administered questionnaire. We collected demographic data from 178 (75%) participants and used the Frommelt Attitude Toward Care of the Dying scale, Form B, Japanese version (FATCOD-Form B-J), the Pankratz Nursing Questionnaire (PNQ), and the Death Attitude Inventory (DAI). FATCOD-Form B-J measures nurse's attitude toward caring for dying patients. It includes two subscales: positive attitude toward caring for the dying patient and perception of patient- and family-centered care. The PNQ measures nursing autonomy of individual nurses and has three subscales: nursing autonomy and advocacy, patients' rights, and rejection of traditional role limitations. The DAI measures attitudes toward death in context of Japanese cultural characteristics. It includes seven subscales: afterlife beliefs, death anxiety, death relief, death avoidance, life purpose, death concern, and supernatural beliefs. We investigated the factors associated with the FATCOD-Form B-J. Support of a mentor regarding end-of-life issues (beta = .19, P = .001), death avoidance domain of the DAI (beta = -.14, P = 0.03), life purpose domain of the DAI (beta = .23, P = .001), and rejection of traditional role limitations domain of the PNQ (beta = .51, P = .001) were selected as significant independent variables by multivariate analysis to evaluate nurses' positive attitudes toward caring for dying patients. Death anxiety domain of the DAI (beta = -.17, P = .02), patients' rights domain of the PNQ (beta =.46, P = .001), and rejection of traditional role limitations domain of the PNQ (beta = .34, P = .001) were selected as significant independent variables by multivariate analysis to evaluate the nurses' perception of patient-and family-centered care. In conclusion, nursing autonomy plays an important role in the attitudes of Japanese nurses who care for dying patients. Educational and administrative efforts to strengthen nursing autonomy are necessary.

Although clinical governance is prominent in modern health care, it is often perceived as an abstract concept. This article explains the key components of clinical governance and relates these to nursing practice. The author emphasises that clinical governance should be viewed as an opportunity to improve care delivery.

Overall, I believe that the most senior trust nurses must establish how many elderly patients receive the kind of care I have described. While new ways of working and new developments in practice are important, we must not forget the essential elements of care in our wish to be innovative. In 2005, it takes courage to be a leader in the NHS. But even greater courage will be required by my mother and her family if she is ever admitted to hospital again. Because an ever increasing number of elderly people need care, all those responsible for this vulnerable client group, including policy makers, need to consider carefully how such care can be improved.

This study, conducted at one University College in Norway, describes nursing students' perceptions of nursing as a theoretical subject and as a function. A descriptive/explorative design was selected. Thirty students from the first year and 30 students from the third year wrote down their perceptions in response to four open-ended questions. Fifteen students from each year (n = 30) were interviewed. A qualitative content analysis was performed. According to the results, the content of the subject of nursing encompasses various fields of knowledge; therefore, the subject of nursing is unclear. The findings indicate that the third-year students either did not gain new insights on the subject or were still unable to verbalize such insights, contrary to the expectations expressed in the curriculum. Regarding the functions of nursing, the first-year students believed there is considerable report writing, which affected their nursing care, but the third-year students believed nurses are obliged to lead and plan nursing care. The students' perceptions of the content of the subject of nursing related only in part to professional functions, both at the beginning and end of their nursing education.

The effectiveness of the SANE program is borne out by the following testimonies: "The emotional support required by these victims is best rendered by a SANE. This frees the ED nurse to care for other patients, while sexual assault victims receive a high level of care," says Nancy Donel, RN manager at St. Thomas Hospital ED. "The DOVE program benefits not only the emergency physician, but the EMS system as well. It gives us a resource and a specifically identified program with well-trained, qualified providers. Through their training and knowledge, SANEs not only help victims, but also increase the number of legal convictions that take assailants off the streets. This improves the health and safety of the communities in which we live and serve," says Michael Mackan, MD, of the Summa Health System.

This paper argues for a broadening of the way evidence is developed and used in health-care. It contends that the current political and policy imperatives and the evidence-based practice movement are in direct tension with the other major ideological movements that promote patient-centred healthcare services. Nursing is affected by this tension because it is more naturally focused on relationships with clients to achieve health outcomes. The unresolved and mounting tension could be alleviated by embracing a broader definition of what counts as evidence and by focusing more on patient-centred healthcare methodologies and acknowledging the interdependency of distinct ways of generating new knowledge. A number of case studies are used to illustrate how research focusing on patient perspectives and nurses' response to patient experiences can improve the evidence base for nursing.

The purpose of this article is to describe how evidence-based methods were used to create a strategic plan for recruitment and retention of nursing staff. Collecting data on the nursing workforce, thorough review and critique of the literature, and linking the literature to strategic goals and imperatives were accomplished. The success of the strategic plan requires much more than an evidence-based approach, however. Indeed, success is largely dependent on a radical change in culture. The long view is to create a patient-centered culture where spiritual values are integrated with knowledge and skill, resulting in competent caring for patients and families. That vision requires the recruiting and retention of competent and caring nurses. To retain rather than recruit nurses, the organizational culture must become a good place within which to work. Espousing spiritual values is not enough. Current employees and newcomers must recognize these values in the behaviors of staff, managers, and leaders. Beyond evidence-based methods, values integration is critical. In the end, it is the values-based behaviors of people rather than the evidence or the strategic plan that should allow this system to effectively confront and manage the continuing nursing shortage.

On 24 September 1997 Western Sydney Area Health Service and the University of Western Sydney, Nepean (Australia) launched a network of nine Clinical Development Units (Nursing). The approach taken towards the development of CDU(N)s in western Sydney differs substantially from those taken elsewhere in terms of preparation for CDU(N) leadership and the role of CDU(N) criteria in the designation ('accreditation') process. The rationale underpinning the western Sydney approach, together with details of a leadership preparation programme, are discussed.

The main target of the present essay is to carry out a reflexion on the adoption of the functional method in nursing work, as well as on the criticism to this method. A secondary aim will be to show how the nursing team has been "using" this method in their daily work routine in the search for a more humanized nursing care.