Recherche en soins infirmiers最新文献

Introduction: Errors in reasoning are the main causes of poor decision-making in clinical practice. To remedy this, many studies highlight the importance of supervising clinical reasoning during medical internships.Although decision-making is an ongoing process at all key moments of the perioperative period, there are no studies on the supervision of clinical reasoning during student nurse anesthetist internships.The objective of this study was to identify the characteristics of the supervision of clinical reasoning by anesthesia professionals with student nurse anesthetists.

Methodology: A multicenter qualitative study was carried out using observations and individual interviews with five nurse anesthetists and five students.

Results: Three themes are identified : the characteristics of the learner’s and supervisor’s posture ; the teaching methods used ; and the specificities of clinical reasoning.

Analysis: The nurse anesthetists question clinical reasoning only when they detect difficulties in the student. However, no traceability is carried out. Students spontaneously verbalize their clinical reasoning when unexpected events occur.

Discussion: The results will be used as a basis for a new tool for tracing learning during internships.

Health generally represents what nurses should strive for in their practice. However, due to their general nature, the definitions of health are problematic for designing a health-oriented nursing practice. Rather than attempting to design it through a conceptual definition of what health is, some authors from the human sciences suggest using models that allow for a concrete commitment to health. Although this avenue is little explored in nursing, it is suggested that these practice-oriented health models would make it possible to design actionable mechanisms that generate health through practices, like nursing. The objective of this article is, through existing practice-oriented health models, to propose actionable mechanisms of health-oriented nursing practice. By invoking two models, from the writings of the philosopher Nordenfelt, as well as the sociologist Venkatapuram, two illustrations are proposed, both of which allow us to propose different actionable mechanisms. Anchored in the values that support a health-oriented practice, as well as in a descriptive component, this reflection highlights the potential of such models to concretely pursue a health-oriented nursing practice. These proposals appear to be promising for the participation of nursing science in the transdisciplinary understanding of health.

Background: Delirium prevention in the ICU should focus on a non-pharmacological approach. However, these recommendations are not always applied by care providers.

Objective: To select knowledge translation strategies to facilitate the implementation of non-pharmacological best practices to prevent delirium in the ICU.

Method: A consensus study was conducted. Barriers and facilitators to the implementation of nonpharmacological methods, and knowledge translation strategies, were identified in two nominal groups. A context assessment was also carried out. Nine professionals and one patient-partner participated.

Results: The barriers and facilitators on which consensus was reached were most frequently related to environmental context and resources, intention, and knowledge. The areas of organizational context with the highest levels of agreement were interpersonal relations, culture and leadership. Consequently, knowledge translation strategies were selected to facilitate practices, as well as to modify the environment and improve knowledge.

Conclusion: A structured method was used during this study to guide the selection of knowledge translation strategies. The application of these strategies could potentially improve clinical practice in intensive care.

Critical discourse analysis is a methodological approach that allows for the questioning of structures that relegate certain ideas and certain people to the margins. In health sciences, this approach, with its origins in the field of critical linguistics, is useful for highlighting the many societal processes that privilege certain conceptions of health and health care while labelling other perspectives as « alternative” or “fringe”. However, critical discourse analysis is still underused in nursing science despite its emancipatory potential. We attribute this reluctance, among other things, to its theoretical anchoring, to its linguistic origin, and to the vagueness and variability of its analysis methods. The objective of this article is therefore to better understand how critical discourse analysis can be used in the discipline of nursing to shed light on the power dynamics and social inequalities that persist. Different examples of studies carried out using critical discourse analysis are also presented to concretely illustrate how this approach can be used in nursing sciences.

Background: Involving family caregivers in direct care in the intensive care unit is increasingly recognized as part of best care practices. However, little is known about the factors that foster this involvement.

Objective: The aim of this study was to identify the factors in the literature that promote or limit the involvement of family caregivers in direct care in adult intensive care units.

Method: A rapid literature review was conducted in MEDLINE and CINAHL for English-and French-language articles published between 2010 and 2021.

Results: 25 articles were selected (n=20 primary studies, n=5 literature syntheses). The results show a diversity of factors that influence the involvement of relatives in direct intensive care units. These factors can be grouped into four categories : relational, informal, clinical, and political.

Conclusion: This review identifies the organizational, clinical and human issues relating to the involvement of family caregivers in direct care in order to propose recommendations to facilitate the implementation of this approach in the intensive care units.

Introduction: Strokes represent a major public health issue in which nurses are involved, both in care and in research. The literature reveals a description of their activities in treating the disease and the altered functions in which it results, as well as in managing the experience of the sufferer. The aim of this work was to describe the knowledge upon which nurses draw when caring for patients in the acute phase of stroke.

Methods: This exploratory qualitative descriptive multicentric survey was carried out via non-directive interviews with nurses working in neurovascular units. Thematic qualitative analysis was used to describe their activities and to highlight the knowledge and skills used.

Results: The results show that the nurses express themselves with ease when discussing their medical knowledge, and with more difficulty concerning knowledge from the human, social, and nursing sciences. However, they often combine this knowledge in a nursing perspective.

Discussion: This work opens up prospects with regard to supporting the nursing knowledge already leveraged and developing the nursing knowledge (concepts and theory of care) relevant to the particular context of strokes. The results also encourage a reflective analysis of nurses’ experience.

This article explores the relevance of the psycho-corporal mediation that interventions based on social aesthetics allow when working with the homeless, particularly regarding the specific nature of their identities and bodies. Based on an ethnographic survey conducted in an experimental shelter for extremely marginalized people (named the “Integration Village”), we detail the health, body, and identity issues related to this type of care. The scientific literature and the social aestheticians we interviewed also indicate that the bodily and psychological dimensions of this type of treatment are closely intertwined. After specifying the modalities for the implementation of social aesthetics sessions in the Village, we focus on the perceptions and expectations of homeless patients toward this potential care approach. Finally, we observe the effects of a social aesthetics-based approach on homeless individuals in order to test the hypothesis that socio-aesthetic care is beneficial to them (at different levels and in different ways), both in terms of their relationship with their bodies and their self-esteem.

Context: Family caregivers play an essential role in the continuity of care for patients with mental health problems. However, the lack of consideration for their role and difficulties in their collaboration with health professionals impact their involvement.

Objective: The purpose of this study is to identify the issues underlying the family-professional partnership.

Method: A qualitative and exploratory study is used to collect data from providers of support services, family caregivers of patients with psychiatric disorders, and mental health professionals. Semi-structured interviews and focus groups conducted from October 2017 to August 2018 were analyzed to determine key issues surrounding this partnership.

Results: A total of thirty-two family caregivers, nine healthcare professionals, and eleven providers participated in the study. The central concerns related to the partnership are information, continuity of care, and the relationship between patients, family members, and professionals. The relational dimension appears to be an important element for all three groups of participants, who nevertheless point out difficulties with regard to their positioning in this tripartite relationship.

Discussion/conclusion: In the context of the current healthcare system, the concept of partnership creates obstacles to family caregivers being able to contribute their expertise while feeling recognized by the other actors.

Introduction: In France, advanced practice for psychiatric and mental health nurses has been developing since 2019. The acquisition of clinical skills by advanced practice nursing students requires monitoring and evaluation. This article outlines the process for creating an internship logbook.

Objective: To develop and verify a tool for assessing the skills of advanced practice nursing students specializing in psychiatry and mental health during the internship stage.

Method: The Delphi method described by Hasson was used, with the aim of obtaining a consensus of over 80% of the experts consulted.

Results: A panel of ten experts, all internship tutors at partner healthcare establishments of Aix Marseille University, was consulted twice. The internship logbook was composed of 68 items.

Discussion: This tool is the product of a multidisciplinary process including nurses and psychiatric nurses. It can be adapted to a variety of learning environments and helps tutors track the acquisition of clinical skills during the internships, both through external and self-assessment.

Conclusion: A new Delphi consultation will foster uptake of this tool. Advanced practice nurses in psychiatry and mental health will be included in the group of experts.