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"Nursing Assessment Methods"
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Children and young people's nursing at a glance
Children and Young People's Nursing at a Glance, is the perfect companion for study and revision for pre-registration children's nursing students from the publishers of the market-leading at a Glance series. Divided into seven sections it explores assessment and screening, working with families, the newborn infant, the developing child, child health policy, nursing the sick child and young person and chronic and life-limiting conditions. This comprehensive book is an invaluable resource for pre-registration nursing students as well as newly qualified nurses wanting to consolidate and expand their knowledge of children and young people's nursing. Breaks down complex aspects of child health care in an accessible and un-intimidating way The perfect revision and consolidation textbook Linked closely with the NMC standards for pre-registration nursing education, and the essential skills clusters framework Highly visual colour presentation, with approximately 130 illustrations Includes boxes, summary boxes, key points and recommendations for practice to improve the learning experience Supported by a companion website featuring over 500 interactive multiple choice questions (www.ataglanceseries.com/nursing/children) Available in a range of digital formats - perfect for 'on the go' study and revision.
eBook
Adjusting Early Warning Score by clinical assessment: a study protocol for a Danish cluster-randomised, multicentre study of an Individual Early Warning Score (I-EWS)
IntroductionTrack and trigger systems (TTSs) based on vital signs are implemented in hospitals worldwide to identify patients with clinical deterioration. TTSs may provide prognostic information but do not actively include clinical assessment, and their impact on severe adverse events remain uncertain. The demand for prospective, multicentre studies to demonstrate the effectiveness of TTSs has grown the last decade. Individual Early Warning Score (I-EWS) is a newly developed TTS with an aggregated score based on vital signs that can be adjusted according to the clinical assessment of the patient. The objective is to compare I-EWS with the existing National Early Warning Score (NEWS) algorithm regarding clinical outcomes and use of resources.Method and analysisIn a prospective, multicentre, cluster-randomised, crossover, non-inferiority study. Eight hospitals are randomised to use either NEWS in combination with the Capital Region of Denmark NEWS Override System (CROS) or implement I-EWS for 6.5 months, followed by a crossover. Based on their clinical assessment, the nursing staff can adjust the aggregated score with a maximum of −4 or +6 points. We expect to include 150 000 unique patients. The primary endpoint is all-cause mortality at 30 days. Coprimary endpoint is the average number of times per day a patient is NEWS/I-EWS-scored, and secondary outcomes are all-cause mortality at 48 hours and at 7 days as well as length of stay.Ethics and disseminationThe study was presented for the Regional Ethics committee who decided that no formal approval was needed according to Danish law (J.no. 1701733). The I-EWS study is a large prospective, randomised multicentre study that investigates the effect of integrating a clinical assessment performed by the nursing staff in a TTS, in a head-to-head comparison with the internationally used NEWS with the opportunity to use CROS.Trial registration number NCT03690128.
Journal Article
Improving Nursing Confidence and Consistency in Assessment of Opioid Withdrawal: Efficacy of Simulation and Debriefing
The purpose of the current study was to determine if the amount of confidence in completing the Clinical Opiate Withdrawal Scale (COWS) varied among participants and whether consistency in scoring outcomes to patients occurred with COWS assessment among groups assigned to simulation and debriefing conditions. Sixty nursing staff were randomized into three groups: (a) scenario; (b) scenario and simulation; and (c) scenario, simulation, and debriefing. Staff were administered a questionnaire to assess their confidence before (i.e., pretreatment) and after (i.e., posttreatment) the simulation exercise and at 30-day follow up. The COWS assessment tool was completed by nursing staff during treatment and follow-up sessions. Significant improvements in confidence were found in all three treatment conditions. Highest consistency in scoring outcomes of the COWS to patients was found with the scenario, simulation, and debriefing condition. All participants reported having increased confidence completing the COWS. The amount of confidence among groups was not significant. Although nursing confidence did not differ among groups, increased scoring outcome reliability was found in groups using simulation and debriefing. [ Journal of Psychosocial Nursing and Mental Health Services, 56 (10), 27–35.]
Journal Article
Assessment : a 2-in-1 reference for nurses
This unique 2-in-1 reference presents vital information on history taking, physical examination, and interpretation of findings in two practical, helpful ways on every page. The wide inner column contains detailed narrative text; the narrow outer column contains brief bulleted summaries of the same information. This format enables nurses to quickly scan the bulleted points and jump to more detail as needed without turning the page. In addition to full assessment guidance for every body system, this essential reference covers mental health assessment and nutritional assessment. Two 8-page full-color inserts bring to life assessment techniques and landmarks. Icons highlight specific techniques; lifespan, gender, and racial differences in findings; and abnormal findings.
eBook
Initial management of acute medical patients : a guide for nurses and healthcare practitioners
INITIAL MANAGEMENT OF ACUTE MEDICAL PATIENTS INITIAL MANAGEMENT OF ACUTE MEDICAL PATIENTS A GUIDE FOR NURSES AND HEALTHCARE PRACTITIONERS Second Edition Initial Management of Acute Medical Patients is a clinically focused, practical and contemporary guide for assessing and managing patients with acute medical conditions.
eBook
Development and Psychometric Evaluation of the Self-Efficacy for Appropriate Medication Use Scale (SEAMS) in Low-Literacy Patients With Chronic Disease
Medication nonadherence remains a significant obstacle to achieving improved health outcomes in patients with chronic disease. Self-efficacy, the confidence in one's ability to perform a given task such as taking one's medications, is an important determinant of medication adherence, indicating the need for reliable and valid tools for measuring this construct. This study sought to develop a self-efficacy scale for medication adherence in chronic disease management that can be used in patients with a broad range of literacy skills. The Self-efficacy for Appropriate Medication Use (SEAMS) was developed by a multidisciplinary team with expertise in medication adherence and health literacy. Its psychometric properties were evaluated among 436 patients with coronary heart disease and other comorbid conditions. Reliability was evaluated by measuring internal consistency and test-retest reliability. Principal component factor analysis was performed to evaluate the validity of the SEAMS. Reliability and validity analyses were also performed separately among patients with low and higher literacy levels. The final 13-item scale had good internal consistency reliability (Cronbach's α = 0.89). A two-factor solution was found, explaining 52.3% of the scale's variance. The scale performed similarly across literacy levels. The SEAMS is a reliable and valid instrument that may provide a valuable assessment of medication self-efficacy in chronic disease management, and appears appropriate for use in patients with low literacy skills.
Journal Article
Clinical assessment and monitoring in children
Assessment and monitoring are fundamental aspects of the care of the acutely ill child, especially in high dependency areas and critical care units. Clinical Assessment and Monitoring in Children is a practical, introductory guide which provides detailed information on assessment and monitoring techniques, including physical assessment, physiological monitoring and an appraisal of additional assessment tools to enable practitioners to develop effective skills. The book adopts a physical systems approach, discusses assessment strategies and tools (starting with the least invasive and moving to the more complex) and examines how to analyse and apply the information to provide ongoing care. Each chapter explores physical assessment and examination whilst maintaining the focus on the child and the family. Clinical Assessment and Monitoring in Children assumes no prior knowledge, and provides the knowledge and skills needed to underpin decision-making and provide effective evidence-based care. This is an invaluable resource for all health care practitioners involved in caring for children. Key Features: • Explores assessment and monitoring of children from 0 – 16 years • Draws upon National Service Frameworks and clinical practice guidelines • Adopts a system by system approach • Provides knowledge and skills needed to underpin decision-making and provide effective evidence-based care • Includes hints on trouble-shooting and gaining the child and family’s co-operation • Includes case studies and suggested further reading
eBook
Profile and predictors of global distress: Can the DT guide nursing practice in prostate cancer?
This study examines the ability of the distress thermometer to accurately identify patients with higher symptoms, unmet needs and psychological morbidity.
Baseline data collected as part of a randomized controlled trial evaluating a nurse-led supportive care intervention for men with prostate cancer commencing radiotherapy at a specialist cancer hospital in Melbourne, Australia. Measures assessed global distress (DT), anxious and depressive symptomatology (HADS), prostate-cancer specific quality of life (EPIC-26), unmet supportive care needs (SCNS-SF34R) and cancer treatment-related concerns (CATS). Following descriptive and correlational analysis, hierarchical multiple regression was employed to examine the contribution of variable sets to explaining variance in DT scores.
Less than 20% of men reported DT scores of 4 or higher, indicating overall low distress. The DT accurately identified almost all men reporting HADS score indicative of anxious or depressive symptomatology, suggesting it accurately identifies psychological morbidity. Importantly, the DT identified a further group of distressed men, not identified by HADS, whose distress related to unmet needs and prostate cancer-specific issues, indicating the DT is superior in identifying other forms of distress. While the hierarchical multiple regression confirmed anxious and depressive symptomatology as the best predictor of distress score, many other scales are also good predictors of DT scores, supporting the argument that distress is multi-determined.
Nurses can be confident that the DT accurately identifies patients with psychological morbidity and importantly identifies other patients with distress who may require intervention. A distress score of 4 or higher identified participants with higher physical symptomatology, higher unmet needs, more concerns about treatment and poorer quality of life. The low prevalence of distress reaching cut off scores suggests nurses would not be overwhelmed by the outcomes of screening and could use the score to prioritise the patients who need greater attention at entry to radiotherapy services.
Journal Article