Canadian Jensens Nursing Health Assessment: A Best Practice Approach

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Some of the causes for a CVA include atrial fibrillation and hypertension; hence the nurse would palpate a heat beat and blood pressure, etcetera. Online presentation sign-up will occur on the first week. Students will be assigned by the professor. The professor will post a sample on-line presentation on cerebral vascular accident. This is a guideline and does not depict the exact way that you need to present this. It can be done in, Word or One document format.

The student will post their assignment in SafeAssign for plagiarism check in Week 5.

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The assignment is to cover the following areas: The pathophysiology of selected disease process. This part of the assignment should be very thorough. It should include the pathophysiology, those at risk and why, signs and symptoms. This information should be applied to the rest of the assignment. Symptoms- Eight critical characteristics.

The specific interviewing questions of selected disease process The specific things that the nurse would inspect for with regards to the selected disease process, the anticipated observations, and explanation of these observations The specific things that the nurse would palpate for with regards to the selected disease process, the anticipated observations, and explanation of these observations The specific things that the nurse would auscultate for with regards to the selected disease process, the anticipated observations, and explanation of these observations Your best source for information is the Jarvis-Physical and Health Assessment.

Please be sure to provide proper APA citing for any videos, content or pictures used in the presentation, as well as a reference list for resources used. There should be at least two references with one being Jarvis- Physical and Health Assessment. Documentation The student will document the findings on assessment of a colleague obtained during lab.

Documentation includes subjective and objective data, free of grammar and spelling error and proper use of medical terminology. Practical Testing Students must demonstrate a head to toe physical assessment. Re-testing will take place in person during supplemental exam week. The student will perform a head to toe examination on a peer in the lab in person. Practical exams will be held during weeks 12 and Each student will be assigned a date and time to come to the lab with a partner.

Each student will have 30 minutes to perform the head-to-toe assessment on their client. Each student will have one opportunity to look at the rubric or cue cards prior to the end of the 30 minutes. The evaluation process may include, but is not limited to, tests, exams, assignments or presentations. Any absences or missed submissions due to medical or other reasons must be supported by medical or other appropriate documentation within one 1 week of the due date.

Failure to produce documentation within the timeframe will result in a grade of zero in the missed evaluation. The faculty and program area must be notified immediately in the event of a missed evaluation. Upon acceptance of the documentation, the weighting of the missed deliverable will normally be applied to the final exam. Failure to meet the above will result in a grade of "F".

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Since this is a professional credit subject, marking standards reinforce professional practice by demanding that all written work must demonstrate the following characteristics for clarity and conciseness: Students are required to submit assignments through Safe Assign. Safe Assign compares submitted assignments against existing sources to identify areas of overlap.

You can only submit your assignment once through Safe Assign. It was distributed to all nurses from the five pediatric care units who participated in the intervention, just after its completion. As recommendations on the use of needles were limited to vulnerable groups, such as neonates and children, the intervention only concerned these five units.

The postintervention questionnaire included two sections. The first section presented questions about the psychosocial determinants identified during the first phase of the study six questions measuring attitude and three questions measuring PBC. Nurse intention to follow recommendations regarding the use of filter needles was assessed by a single item. The second section of the questionnaire assessed participants' satisfaction with the intervention based on six questions developed specifically for this study.

All questions were assessed on a 7-point Likert scale. See Supplementary File 1 in Supplementary Material available online at http: Finally, the assistant head nurses of the various units were questioned about the use of filter needles one month after the intervention to learn if there were changes observed since the intervention. We conducted t -tests and Wilcoxon rank tests on all items and constructs to detect differences before and after the intervention.

To test the theoretical model, we used a logistic regression in order to learn if attitude and PBC constructs had a significant influence on intention. We dichotomized the intention by classifying it in two categories: Nurse satisfaction with the intervention was analyzed by conducting a descriptive analysis of the six items measuring it in the questionnaire.

All statistical analyses were done using SAS 9. Ethical approval was requested from the ethical committee of the university health centre. The committee concluded that approval was not necessary because the project was part of a quality improvement initiative. This study still adhered to the usual ethical considerations of informed consent, voluntary participation, and confidentiality. For the preintervention survey, questionnaires were completed and returned on a possibility of nurses working on the five pediatric units.

Twelve questionnaires were excluded, resulting in questionnaires included, for an effective response rate of For the postintervention questionnaire, of the nurses who received the intervention completed the questionnaire, for an effective response rate of Table 2 presents participants' characteristics for the two questionnaires. Since the theoretical constructs did not follow a normal distribution, the Wilcoxon rank test was deemed more appropriate than the t -test. However, both tests indicated that all variables were significantly higher after the intervention, as shown in Table 3.

The two tests produced the same results. A logistic regression model was used in order to learn whether the constructs targeted in the intervention attitude and PBC had a significant influence on intention. In the final regression model, only PBC remained as a predictor of intention, with an odds ratio of 3. The final logistic regression model explained The area under the ROC curve, which represents a measure of the correctness of the classification that would result from the regression model, was 0.

The satisfaction questionnaire was developed in-house and comprised five specific items regarding the intervention and a global satisfaction item. We also computed the Cronbach alpha and performed a confirmatory factor analysis in order to verify the internal consistency of the items related to satisfaction from the postintervention questionnaire. The vast majority of nurses were highly satisfied with the intervention. Indeed, more than 95 percent of nurses responded 6 agree or 7 totally agree to the six questions related to satisfaction in the questionnaire see Table 4 for details.

In addition, the follow-up with the assistant head nurses of the various units allowed us to gather additional comments regarding the effects of the intervention. In most cases, the assistant head nurses did not notice issues concerning the use of filter needles in their respective units, except in one unit that had problems obtaining needles during the first week.

They also gathered comments from nurses who said they could not use standard needles anymore knowing what they could potentially inject into their patients. The assistant head nurses believed that the intervention convinced nurses to use filter needles with arguments based on research evidence.

This study aimed to increase nurse intention to adhere to recommendations for clinical practice related to the use of filter needles, based on research evidence. Using the Intervention Mapping framework, a theory-based intervention was developed, implemented, and evaluated in five pediatric units of a large university medical centre in Quebec Canada in order to achieve this goal.

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Nurse intention was already high in the preintervention questionnaire mean of 6. This finding is important because, despite a high baseline value, it shows that the intervention could still improve nurse intention to follow clinical guideline recommendations. The same holds for the two theoretical constructs from the TPB that were targeted by the intervention.

Both direct determinants of intention, that is, attitude and perceived behavioral control, significantly improved following the intervention. Moreover, all items measuring the beliefs associated with these constructs were significantly higher after the intervention. Of particular interest is the fact that the specific behavioral beliefs that were targeted by the intervention, namely, reason and enjoyment, showed a significant increase of 0.

The control belief that was targeted by the intervention, ease of use, also showed an increase of 0. PBC was the only construct that predicted nurse intention to follow recommendations related to the use of filter needles in their practice after the intervention, while attitude was not significant any longer. This could be due to the high intention scores among respondents, which left very limited variance to be explained. As PBC was the stronger determinant of intention prior to the intervention, this construct remained the only predictor in the postintervention regression.

This finding supports the fact that showing nurses how easy using filter needles can be increases the chances to improve their adherence to recommendations related to their use. Many studies have reported PBC as a prominent predictor of healthcare professional intention to follow clinical recommendations. Among them, the Kortteisto et al. It is worth noting that the vast majority of nurses seemed very satisfied with the intervention.

As we were not aware of any tools available in French to assess nurse satisfaction with a behavior change intervention, we developed our own tool. We hope that this simple six-item questionnaire can be used for evaluating participants' satisfaction with other similar interventions. Although it was not possible to assess nurse behavior in this study due to resource constraints, we did an informal follow-up with the assistant chief nurses of all five units that received the intervention.

Apart from a problem regarding the availability of filter needles in one unit during the week following the intervention, all assistant chief nurses said that nurses were very keen to follow recommendations regarding the use of filter needles in parenteral injections. Nurses mentioned that they had no choice but to use filter needles because they were now aware, based on scientific evidence, of the potential harms to patients associated with the injection of glass particles.

There are several limitations to consider in this study. First, care units that participated in this study come from a single multisite university medical centre in the province of Quebec Canada. Although the results may be different in other settings and may consequently be difficult to generalize, we believe that it is possible to follow the approach for targeting similar behaviors in other settings of care since the study applies the Intervention Mapping framework [ 31 ], a structured approach to theory-based interventions.

Canadian Jensen's Nursing Health Assessment a Best Practice Approach.

Second, it was impossible for us to match the answers of participants from the first phase of the study to those of the second phase because the questionnaires were entirely anonymous. This limited the possibility of applying more robust analyses to test the differences before and after the intervention. We had to consider the two samples as independent although they should have been treated as nonindependent. Third, we used a single group before-after design to assess the intervention's effects on nurse intention.

The use of a more robust experimental design such as the randomized controlled trial or controlled before-after study was not possible due to limited resources and constraints related to this real-life intervention. In fact, only the five pediatric units in which the intervention was conducted were targeted by the decision to recommend the use of filter needles in parenteral injections in this university medical centre, limiting the possibility of having a control group.

Clinical recommendation adoption and adherence among healthcare professionals is a continuous challenge. This study, based on the Intervention Mapping framework and the theory of planned behavior, allowed for the development, implementation, and evaluation of a theory-based intervention among pediatric care nurses in order to improve their intention to follow clinical recommendations regarding their use of filter needles. Based on the results, we believe that the intervention did improve the intention of these nurses to use filter needles according to recommendations in their practice.

In light of this study, theory-based interventions may be a potential solution to improve adherence of healthcare professionals to clinical recommendations. The authors would like to thank David Simonyan for the statistical analysis of the data. The authors also thank all those who participated in the study. The funder has no role in study design, data collection and analysis, decision to publish, or preparation of the paper. National Center for Biotechnology Information , U. Journal List Nurs Res Pract v. Published online Jul Author information Article notes Copyright and License information Disclaimer.

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. This article has been cited by other articles in PMC. Abstract The manipulation of glass ampoules involves risk of particle contamination of parenteral medication, and the use of filter needles has often been recommended in order to reduce the number of particles in these solutions. Introduction Due to the properties of glass, glass ampoules are often used in the process of parenteral administration of medication.

Open in a separate window. Methods The Intervention Mapping IM framework was used to guide all the steps related to this intervention. Intervention Mapping IM is a framework elaborated by Bartholomew et al. Preliminary Steps The two first steps of the IM framework were achieved through a collaborative project between the university hospital nursing directorate and a research team. Intervention The third step of the IM framework consisted in the identification of strategies based on behavioral change theories. Table 1 Details of the simulation strategy. Step theoretical construct targeted Details Parameters examples 1 Presentation of scientific evidence knowledge Present scientific evidence on the negative effects of glass ampoules for patients, information on research, and recommendations about the use of filter needles.

For modeling [ 28 ]: One uses a filter needle; the other uses a standard needle. For reinforcement [ 28 ]: For persuasion [ 29 ]: Find solutions, if possible. Offer follow-up if there is an impasse or obstacle that was not resolved. Evaluation of the Intervention The sixth step of IM is the program evaluation. Postintervention Questionnaire The postintervention questionnaire was developed based on results from the first phase of the study and pretested by four nurses who were not from the intervention units. Statistical Analyses We conducted t -tests and Wilcoxon rank tests on all items and constructs to detect differences before and after the intervention.

Ethical Considerations Ethical approval was requested from the ethical committee of the university health centre.

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Participants For the preintervention survey, questionnaires were completed and returned on a possibility of nurses working on the five pediatric units. Table 2 Characteristics of the participants, before and after intervention. TPB Constructs before and after the Intervention Since the theoretical constructs did not follow a normal distribution, the Wilcoxon rank test was deemed more appropriate than the t -test. Table 3 Differences between pre- and postintervention scores on survey items 1.

Satisfaction and Comments on the Intervention The satisfaction questionnaire was developed in-house and comprised five specific items regarding the intervention and a global satisfaction item. Table 4 Nurse satisfaction with the intervention. Discussion This study aimed to increase nurse intention to adhere to recommendations for clinical practice related to the use of filter needles, based on research evidence.

Limitations There are several limitations to consider in this study.

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Conclusion Clinical recommendation adoption and adherence among healthcare professionals is a continuous challenge. Supplementary Material Postintervention questionnaire translated from French. Click here to view. Acknowledgments The authors would like to thank David Simonyan for the statistical analysis of the data. Conflict of Interests The authors declare that they have no conflict of interests. Revista Brasileira de Anestesiologia. Preston ST, Hegadoren K. Glass contamination in parenterally administered medication.

Journal of Advanced Nursing. Glass particle contamination of parenteral preparations of intravenous drugs in anaesthetic practice. Southern African Journal of Anaesthesia and Analgesia. Are special filter needles required when drawing up medication from a glass ampule? Are there hidden risks to patients, ie, sharp glass particles, if a filter needle is not used?

Woody G, Davis BA. Increasing nurse competence in peripheral intravenous therapy. Journal of Infusion Nursing. Particle size distribution of propofol injection from ampules and vials: International Journal of Pharmaceutical Compounding. Hazards of parenteral treatment: Archives of Disease in Childhood.

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