Documentation demonstrates the unique contribution of nursing to the care of clients. This study investigated the relationships of Providers accountability of nursing documentations in the clinical settings. Judgmental and simple random sampling techniques were used to select documented nursing actions for 264 clients. One research question and four null hypotheses guided the study. The instrument used for data collection was checklist on Nursing documentation in the clinical setting. Descriptive statistics of frequency, means and standard deviation (SD) were used to summarize the variables. Pearson Product Moment correlation was used to answer the research question, while analyses of variance (ANOVA) was adopted in testing the null hypotheses at 0.05 level of significance. The result indicated that significant correlation existed between legal implications of nursing documentation and the core principles of nursing documentation. Significant differences were also observed among providers’ accountability of nursing documentations with regard to promotion of interdisciplinary communication, legal implications of documentation, impacts on quality assurance and nursing science.
Knowledge and Practice of Documentation among Nurses in Ahmadu Bello Universi...iosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care. Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice. The journal publishes original papers, reviews, special and general articles, case management etc.
The Effect of Protocol of Nursing Intervention on Quality of Care in Minor In...iosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care.
Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice
Knowledge and Practice of Documentation among Nurses in Ahmadu Bello Universi...iosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care. Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice. The journal publishes original papers, reviews, special and general articles, case management etc.
The Effect of Protocol of Nursing Intervention on Quality of Care in Minor In...iosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care.
Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice
HRSA Comprehensive Geriatric Education Grant Posternomadicnurse
This grant funds a Clinical Nurse Specialist position to work with current Gerontological CNS in providing education, mentoring / support, developing / measuring outcomes for knowledge, practice change and patient outcomes by:
Expanding NICHE training at Piedmont Hospital in Atlanta beyond Acute Care nurses to include Emergency Department nurses;
2) Introducing NICHE training at Piedmont Fayette, Piedmont Newnan and Piedmont Mountainside for Acute Care and Emergency Department nurses;
3) Introducing NICHE training for nursing staff at two of our Long-Term Care facility partners; and
4) Disseminating program materials and information to other healthcare entities throughout Georgia and the U.S. through local workshops and presentations at national healthcare conferences.
Introduction: The patient’s perception of quality of care is fundamental to utilization of health services. Health utilization would partly depend on clients’ perception of the quality of care.
Methods: A cross-sectional study involving health clients (18 to 70 years) who accessed health services in the Bantama submetro
in the Kumasi metropolis was conducted. A total of 400 clients were recruited from ten health facilities for the study.
Data was collected through interviewing using semi-structured questionnaires using SPSS and analyzed into descriptive and
inferential statistics with STATA 11.
Results: Majority of subscribers assessed healthcare with their National Health Insurance (NHI) cards. Eight percent (8%) had
never accessed healthcare with their NHIS cards. Respondents’ reasons included not falling sick and low quality of healthcare
under the NHIS. Respondents 216 (54%) indicated delays in seeing a doctor, getting laboratories done, and accessing health care as a whole. Seventy-four percent (74%) of the entire population attributed both NHIS and cash and carry systems as the
payment methods associated with delays in health facilities. Clients who viewed the overall the quality of health provision as good or very good were more likely to access healthcare with NHIS card as compared to those who rated the overall health provision as poor or very poor (OR=2.1; p<0.01).
Conclusion: Clients’ perceptions and experiences with quality of health provision influence their utilization of healthcare under the NHIS scheme. Increased enrolment in the scheme should be supported with provision of quality services to enhance clients’ satisfaction.
A study on patient satisfaction with special reference to government hospital...Tapasya123
In this study researchers analyse the satisfaction level of patients regard to facilities
available in government hospitals. A sample of 100 patients is taken from Pandit Brij
Sundar Shama Government General Hospital (GGH) at Bundi District in the state
of Rajasthan in India. Four dimensions of perceived quality were identified—Admission
Procedure, Diagnostic Services, Behaviour of the staff, Cleanliness. The developed
scale is used to evaluate perceived quality at a range of various types of facilities
for patients. Perceived quality at public facilities is only marginally favourable, leaving
much scope for improvement. Better staff and physician relations, interpersonal skills,
good diagnostic and cleanliness service can improve the level of satisfaction among
employees.
Keywords:
INTERGRATIVE REVIEW 14
Equipment and Product Safety
Introduction
Equipment, drugs, and medical supplies have significant impact on quality of patient care and they account for high proportion of health care costs. Hospitals should make informed choices about what to procure in order to meet priority health needs and avoid wasting the limited resources (Chu, Maine, & Trelles, 2015). Procurement is an important part of managing equipment and products, and stock control, effective storage, and maintenance are also significant factors in health services. Many firms have produced information about important drugs, however, there is less information available about essential equipment and medical supplies (Weinshel, et al., 2015). This results in procurement of items which are inappropriate because they are incompatible with existing equipment, technically unsuitable, and spare parts are unavailable. Despite this, there is little information available about these aspects of management of equipment and medical supplies.
According to “American Association of Critical-Care Nurses (AACN), there is convincing evidence that unhealthy surgery environment contributes significantly to ineffective care delivery, medical errors, and stress among nurses (Magill, O’Leary, Janelle, & Thompson, 2018). This integrative literature review was executed to find evidence between surgery operation environment and products on patient safety. This paper is intended to be resourceful in management and procurement of equipment and medical products at primary health care level. It includes guiding concepts for care and maintenance, selecting products and equipment, and safe disposal of medical waste.
Purpose of research
The integrative literature review aim at analyzing pieces of research which have been conducted on surgical environment and product and their effect on patient safety and outcome.
Background
Although there are various improvement ongoing, the prevalence of healthcare-associated infections (HAIs) remain a risk and cost within hospitals. Unsafe, inappropriate, and negligent surgical products and equipment affect one in ten patients, on average in the US. Despite the advancement in use of surgical techniques and ergonomic improvements in operating rooms, cases of surgical site infections (SSIs) are high and they cause patient mortality and morbidity. Necessarily, there is increased emphasis on prevention of these infections. The risk of error in operating environment is greater. Some of the environmental and products risks include risk of patient falling and risks of infections. In this light, nurses should promote use of evidence-based care to promote patient safety and improve the quality of care.
Patient safety is an important element in health care. Within the principles of WHO, patient safety is the reduction of risk of harm or injury associated with health care. Hospitals are focused in creating healthy and safe ...
Medical Record Audit in Clinical Nursing Units in Tertiary Hospitaliosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care. Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice. The journal publishes original papers, reviews, special and general articles, case management etc.
HRSA Comprehensive Geriatric Education Grant Posternomadicnurse
This grant funds a Clinical Nurse Specialist position to work with current Gerontological CNS in providing education, mentoring / support, developing / measuring outcomes for knowledge, practice change and patient outcomes by:
Expanding NICHE training at Piedmont Hospital in Atlanta beyond Acute Care nurses to include Emergency Department nurses;
2) Introducing NICHE training at Piedmont Fayette, Piedmont Newnan and Piedmont Mountainside for Acute Care and Emergency Department nurses;
3) Introducing NICHE training for nursing staff at two of our Long-Term Care facility partners; and
4) Disseminating program materials and information to other healthcare entities throughout Georgia and the U.S. through local workshops and presentations at national healthcare conferences.
Introduction: The patient’s perception of quality of care is fundamental to utilization of health services. Health utilization would partly depend on clients’ perception of the quality of care.
Methods: A cross-sectional study involving health clients (18 to 70 years) who accessed health services in the Bantama submetro
in the Kumasi metropolis was conducted. A total of 400 clients were recruited from ten health facilities for the study.
Data was collected through interviewing using semi-structured questionnaires using SPSS and analyzed into descriptive and
inferential statistics with STATA 11.
Results: Majority of subscribers assessed healthcare with their National Health Insurance (NHI) cards. Eight percent (8%) had
never accessed healthcare with their NHIS cards. Respondents’ reasons included not falling sick and low quality of healthcare
under the NHIS. Respondents 216 (54%) indicated delays in seeing a doctor, getting laboratories done, and accessing health care as a whole. Seventy-four percent (74%) of the entire population attributed both NHIS and cash and carry systems as the
payment methods associated with delays in health facilities. Clients who viewed the overall the quality of health provision as good or very good were more likely to access healthcare with NHIS card as compared to those who rated the overall health provision as poor or very poor (OR=2.1; p<0.01).
Conclusion: Clients’ perceptions and experiences with quality of health provision influence their utilization of healthcare under the NHIS scheme. Increased enrolment in the scheme should be supported with provision of quality services to enhance clients’ satisfaction.
A study on patient satisfaction with special reference to government hospital...Tapasya123
In this study researchers analyse the satisfaction level of patients regard to facilities
available in government hospitals. A sample of 100 patients is taken from Pandit Brij
Sundar Shama Government General Hospital (GGH) at Bundi District in the state
of Rajasthan in India. Four dimensions of perceived quality were identified—Admission
Procedure, Diagnostic Services, Behaviour of the staff, Cleanliness. The developed
scale is used to evaluate perceived quality at a range of various types of facilities
for patients. Perceived quality at public facilities is only marginally favourable, leaving
much scope for improvement. Better staff and physician relations, interpersonal skills,
good diagnostic and cleanliness service can improve the level of satisfaction among
employees.
Keywords:
INTERGRATIVE REVIEW 14
Equipment and Product Safety
Introduction
Equipment, drugs, and medical supplies have significant impact on quality of patient care and they account for high proportion of health care costs. Hospitals should make informed choices about what to procure in order to meet priority health needs and avoid wasting the limited resources (Chu, Maine, & Trelles, 2015). Procurement is an important part of managing equipment and products, and stock control, effective storage, and maintenance are also significant factors in health services. Many firms have produced information about important drugs, however, there is less information available about essential equipment and medical supplies (Weinshel, et al., 2015). This results in procurement of items which are inappropriate because they are incompatible with existing equipment, technically unsuitable, and spare parts are unavailable. Despite this, there is little information available about these aspects of management of equipment and medical supplies.
According to “American Association of Critical-Care Nurses (AACN), there is convincing evidence that unhealthy surgery environment contributes significantly to ineffective care delivery, medical errors, and stress among nurses (Magill, O’Leary, Janelle, & Thompson, 2018). This integrative literature review was executed to find evidence between surgery operation environment and products on patient safety. This paper is intended to be resourceful in management and procurement of equipment and medical products at primary health care level. It includes guiding concepts for care and maintenance, selecting products and equipment, and safe disposal of medical waste.
Purpose of research
The integrative literature review aim at analyzing pieces of research which have been conducted on surgical environment and product and their effect on patient safety and outcome.
Background
Although there are various improvement ongoing, the prevalence of healthcare-associated infections (HAIs) remain a risk and cost within hospitals. Unsafe, inappropriate, and negligent surgical products and equipment affect one in ten patients, on average in the US. Despite the advancement in use of surgical techniques and ergonomic improvements in operating rooms, cases of surgical site infections (SSIs) are high and they cause patient mortality and morbidity. Necessarily, there is increased emphasis on prevention of these infections. The risk of error in operating environment is greater. Some of the environmental and products risks include risk of patient falling and risks of infections. In this light, nurses should promote use of evidence-based care to promote patient safety and improve the quality of care.
Patient safety is an important element in health care. Within the principles of WHO, patient safety is the reduction of risk of harm or injury associated with health care. Hospitals are focused in creating healthy and safe ...
Medical Record Audit in Clinical Nursing Units in Tertiary Hospitaliosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care. Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice. The journal publishes original papers, reviews, special and general articles, case management etc.
The Perception of Emergency Medical Staff on the Use of Electronic Patient Cl...ijtsrd
Background The electronic recording of patient information in ambulance services has provided healthcare professionals with the ability to send patient data to their GP or other relevant services electronically. It is critical to comprehend how paramedics view and adjust to electronic platforms as technology continues to advance. Objective To identify the facilitators and barriers EMS staff encounter when using e PCR. To explore the overall perception of EMS staff towards the utilization of e PCR in EMS settings. Method Four databases were searched including PubMed, Scopus, Medline and Science Direct. Result All 11 publications were evaluated for qualitative data and the publication was found to be of fair or good quality. Studies investigating the perception of staff found mixed perceptions. The search generated a total of 1365 potential articles. After the initial screening process, 229 duplicate records were removed Out of the remaining 1136 papers, 1079 were excluded as they did not meet the selection criteria the title, abstract, and keywords. Of the remaining 57 papers, a full text screening eliminated 46 for the study design quantitative studies n=22 , no perception of staff documented n=19 and no full text available n=5 . Thus, 11 papers that met the inclusion criteria were selected for final analysis. The risk of bias was quantified using CASP. A qualitative synthesis was conducted and three major themes emerged Facilitators, Barriers and overall perception of staff. Conclusion This systematic review found that EMS staff hold complex and diverse views on e PCR systems. While several facilitators and barriers impact e PCR adoption, it has been found that e PCR has the potential to enhance documentation, communication, data driven decision making and finally the ability to improve overall patient care quality. To ensure successful adoption, addressing technical issues, data security and training requirements and organisational barriers is important. Reshma Joe | Jomin George "The Perception of Emergency Medical Staff on the Use of Electronic Patient Clinical Records Systems in Emergency Medical Service: A Systematic Review" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-8 | Issue-1 , February 2024, URL: https://www.ijtsrd.com/papers/ijtsrd62365.pdf Paper Url: https://www.ijtsrd.com/medicine/other/62365/the-perception-of-emergency-medical-staff-on-the-use-of-electronic-patient-clinical-records-systems-in-emergency-medical-service-a-systematic-review/reshma-joe
ABSTRACT Handover, or the communication of patient information be.docxransayo
ABSTRACT: Handover, or the communication of patient information between clinicians, is a fundamental component of health care. Psychiatric settings are dynamic environments relying on timely and accurate communication to plan care and manage risk. Crisis assessment and treatment teams are the primary interface between community and mental health services in many Australian and international health services, facilitating access to assessment, treatment, and admission to hospital. No previous research has investigated the handover between crisis assessment and treatment teams and inpatient psychiatric units, despite the importance of handover to care planning. The aim of the present study was to identify the nature and types of information transferred during these handovers, and to explore how these guides initial care planning. An observational, exploratory study design was used. A 20-item handover observation tool was used to observe 19 occasions of handover. A prospective audit was undertaken on clinical documentation arising from the admission. Clinical information, including psychiatric history and mental state, were handed over consistently; however, information about consumer preferences was reported less consistently. The present study identified a lack of attention to consumer preferences at handover, despite the current focus on recovery-oriented models for mental health care, and the centrality of respecting consumer preferences within the recovery paradigm.
INTRODUCTION Handover is the transfer of verbal and written communication of patient information between members of the health-care team. It is integral to the practice of all healthcare clinicians (Millar & Sands 2012). The Australian Commission for Safety and Quality in Health Care (ACSQHC 2011) recognizes the importance of handover in the continuum of health care, and acknowledges that information transferred between clinicians during the handover can directly affect the quality of care delivered to patients. Poor-quality handover practice has been linked to a number of unfavourable patient outcomes, including increased hospital stays, consumer dissatisfaction, delays in treatment, and other adverse clinical outcomes (Hill & Nyce 2010; Manser & Foster 2011; Siemsen et al. 2012; World Health Organization Collaborating Centre for Patient Safety
Solution
s (WHOCCPSS) 2007). In the present study, we report on the findings of a study that investigated handover between the crisis assessment and treatment team (CATT) and the inpatient psychiatric unit (IPU).
There is little in the published literature that reports on handover practices in acute psychiatric settings, and no previous research that has specifically investigated handover between the CATT and the IPU. The lack of studies in this area is concerning, given that in Australia and internationally, CATT service models are in wide use to facilitate community access to psychiatric assessment and care for people who are experien.
(
Critical Appraisal Tools Worksheet
Template
)
Evaluation Table
Use this document to complete the evaluation table requirement of the Module 4 Assessment,Evidence-Based Project, Part 4A: Critical Appraisal of Research
Full citation of selected article
Article #1
Article #2
Article #3
Article #4
Ashcroft, D., Lewis, P., Tully, M., Farragher, T., Taylor, D., & Wass, V., Williams, S. D., & Dornan, T. (2015). Prevalence, Nature, Severity and Risk Factors for Prescribing Errors in Hospital Inpatients: Prospective Study in 20 UK Hospitals. Drug Safety, 38(9), 833-843. DOI: 10.1007/s40264-015-0320-x
Carayon, P., Wetterneck, T., Cartmill, R., Blosky, M., Brown, R., & Kim, R., Kukreja, S., Johnson, M., Paris, B., Wood, K. E., & Walker, J. (2014). Characterising the complexity of medication safety using a human factors approach: an observational study in two intensive care units. BMJ Quality & Safety, 23(1), 56-65. DOI: 10.1136/bmjqs-2013-001828
Hines, S., Kynoch, K., & Khalil, H. (2018). Effectiveness of interventions to prevent medication errors. JBI Database Of Systematic Reviews And Implementation Reports, 16(2), 291-296. DOI: 10.11124/jbisrir-2017-003481
Khalil, H., Chambers, H., Sheikh, A., Bell, B., & Avery, A. (2017). Professional, structural and organisational interventions in primary care for reducing medication errors. Cochrane Database System Review, 10 (CD003942). DOI: 10.1002/14651858.CD003942.pub3.
Conceptual Framework
Describe the theoretical basis for the study
The study deduced the reasoning that doctors during their first year of post-graduate training are prone to making disproportionate errors in their prescription.
Safety during medication is a significant issue in healthcare more so in intensive care units (ICUs). Therefore, the complexity of the medication management process is reflected on the convolution of evaluating medication errors and adverse drug events in ICUs.
This study seeks to assess the effectiveness of interventions developed to avert medication error during administration of medication, medication-related death, and medication-related harms among acute care patients.
During primary care, there are adverse events associated with medication and they represent a significant cause of hospital admission and mortality and these events could be as a result of patient going through adverse drug reactions or medication errors and the latter is preventable.
Design/Method Describe the design and how the study
was carried out
The study used pharmacists as their subjects across 20 health facilities over 7 selected days and the data was collected based on the number of checked medication orders, details of the prescribing errors, and the prescriber’s grade.
As part of the study’s methodology, the research has assessed the effect of electronic medical record on the safety and quality across ICUs by having cross-sectional study which has reported on the medication safety before EHR was used in two ICU facilities ...
Towards EHR Interoperability in Tanzania Hospitals : Issues, Challenges and O...IJCSEA Journal
This study aimed at identifying the issue, challenges and opportunities from the health consumers in Tanzania towards interoperability of electronic health records. Reaching that level of seamless data sharing among Hospitals needs the cooperation of all stakeholders especially the health consumer whose data are the ones to be shared. Without their acceptance that means there is nothing to share. Recognizing that we conducted a study in Tanzania to identify the challenges, issues and opportunities towards health information exchange through interoperable EHRs. The study was conducted in three major cities of Tanzania to identify the security, privacy and confidentiality issues of information sharing together with related challenges to data sharing. This was in order to come up with a clear picture of how to implement some EHRs that will be trusted by health consumers. The participants (n=240) were surveyed on computer usage, EHRs knowledge, demographics, security and privacy issues. A total of 200 surveys were completed and returned (83.3% response rate). Among them 67.5% were women, 62.6% had not heard of EHRs, 73% were highly concerned about the privacy and security of their information. 75% believed that introduction of various security mechanisms will make EHRs more secure and thus better. We conducted a number of chi-square tests (p<0.05) and we realized that there was a strong relationship among the variable of age, computer use, EHRs knowledge and the concerns for privacy and security. The study also showed that there was just a small difference of 8.5% between those people who think EHRs are safer than paper records and those who think otherwise. The general observation of the study was that in order to make EHRs successful in our Hospitals then the issue of security, and health consumer involvement were they two key towards the road of successful EHRs in our hospitals practices and that will make consumers more willing to allow their records to be shared among different health organizations. So besides the issues identified, this study helped us to identify the key requirements which will be implemented in our proposed framework
Evidence based nursing practice is one of most important for perfect and accurate in terms of saving a life.this presentation covers almost all aspect of EBD
This study aimed at identifying the issue, challenges and opportunities from the health consumers in
Tanzania towards interoperability of electronic health records. Reaching that level of seamless data
sharing among Hospitals needs the cooperation of all stakeholders especially the health consumer whose
data are the ones to be shared. Without their acceptance that means there is nothing to share. Recognizing
that we conducted a study in Tanzania to identify the challenges, issues and opportunities towards health
information exchange through interoperable EHRs. The study was conducted in three major cities of
Tanzania to identify the security, privacy and confidentiality issues of information sharing together with
related challenges to data sharing. This was in order to come up with a clear picture of how to implement
some EHRs that will be trusted by health consumers. The participants (n=240) were surveyed on computer
usage, EHRs knowledge, demographics, security and privacy issues. A total of 200 surveys were completed
and returned (83.3% response rate). Among them 67.5% were women, 62.6% had not heard of EHRs, 73%
were highly concerned about the privacy and security of their information. 75% believed that introduction
of various security mechanisms will make EHRs more secure and thus better. We conducted a number of
chi-square tests (p<0.05) and we realized that there was a strong relationship among the variable of age,
computer use, EHRs knowledge and the concerns for privacy and security.The study also showed that there
was just a small difference of 8.5% between those people who think EHRs are safer than paper records and
those who think otherwise. The general observation of the study was that in order to make EHRs successful
in our Hospitals then the issue of security, and health consumer involvement were they two key towards the
road of successful EHRs in our hospitals practices and that will make consumers more willing to allow
their records to be shared among different health organizations. So besides the issues identified, this study
helped us to identify the key requirements which will be implemented in our proposed framework.
Determine the Patients' Satisfaction Concerning In-hospital Information Progr...iosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care.
Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice
Nephrology Nursing Journal September-October 2014 Vol. 41, No. 5 447
Patient Safety and Patient Safety
Culture: Foundations of Excellent
Health Care Delivery
Primum non nocere. First do no harm.
Patient safety forms the founda-tion of healthcare delivery justas biological, physiological,and safety needs form the
foundation of Maslow’s hierarchy
(Maslow, 1954). Little else can be
accomplished if the patient does not
feel safe or is, in fact, not safe. But the
healthcare system is extremely com-
plex, and ensuring patient safety
requires the ongoing, focused efforts
of every member of the healthcare
team.
Patient safety moved to the fore-
front in health care with the release in
1999 of the Institute of Medicine (IOM)
landmark report, To Err is Human:
Building a Safer Health System, which
estimated that annually in the United
States, up to one million people were
injured and 98,000 died as a result of
medical errors (IOM, 2000). The re -
port caught the attention of the media,
and there were headlines across the
nation about the safety (or lack of safe-
ty) for patients in healthcare organiza-
tions. In 2013, James updated the esti-
mate of patient harms associated with
Beth Ulrich
Tamara Kear
Continuing Nursing
Education
Beth Ulrich, EdD, RN, FACHE, FAAN, is
Editor, the Nephrology Nursing Journal, and a
Professor, the University of Texas Health Science
Center at Houston School of Nursing. She is a Past
President of ANNA and a member of ANNA’s
Sand Dollar Chapter. She may be contacted direct-
ly via email at [email protected]
Tamara Kear, PhD, RN, CNS, CNN, is an
Assistant Professor of Nursing, Villanova
University, Villanova, PA, and a Nephrology
Nurse, Liberty Dialysis. She is on the Editorial
Board for the Nephrology Nursing Journal,
serves as the ANNA Research Committee chairper-
son, and is a member of ANNA’s Keystone Chapter.
Statements of Disclosure: Please refer to page
457.
Note: Additional statements of disclosure and
instructions for CNE evaluation can be found on
page 457.
This offering for 1.4 contact hours is provided by the American Nephrology Nurses’
Association (ANNA).
American Nephrology Nurses’ Association is accredited as a provider of continuing nursing
education by the American Nurses Credentialing Center Commission on Accreditation.
ANNA is a provider approved by the California Board of Registered Nursing, provider number
CEP 00910.
This CNE article meets the Nephrology Nursing Certification Commission’s (NNCC’s) continu-
ing nursing education requirements for certification and recertification.
Copyright 2014 American Nephrology Nurses’ Association
Ulrich, B., & Kear, T. (2014). Patient safety and patient safety culture: Foundations of ex -
cellent health care delivery. Nephrology Nursing Journal, 41(5), 447-456, 505.
In 1999, patient safety moved to the forefront of health care based upon astonishing sta-
tistics and a landmark report released by the Institute of Medicine (IOM). This report,
To Err.
Similar to Relationships of Providers’ Accountability of Nursing Documentations in the Clinical Setting (20)
Immunizing Image Classifiers Against Localized Adversary Attacksgerogepatton
This paper addresses the vulnerability of deep learning models, particularly convolutional neural networks
(CNN)s, to adversarial attacks and presents a proactive training technique designed to counter them. We
introduce a novel volumization algorithm, which transforms 2D images into 3D volumetric representations.
When combined with 3D convolution and deep curriculum learning optimization (CLO), itsignificantly improves
the immunity of models against localized universal attacks by up to 40%. We evaluate our proposed approach
using contemporary CNN architectures and the modified Canadian Institute for Advanced Research (CIFAR-10
and CIFAR-100) and ImageNet Large Scale Visual Recognition Challenge (ILSVRC12) datasets, showcasing
accuracy improvements over previous techniques. The results indicate that the combination of the volumetric
input and curriculum learning holds significant promise for mitigating adversarial attacks without necessitating
adversary training.
Saudi Arabia stands as a titan in the global energy landscape, renowned for its abundant oil and gas resources. It's the largest exporter of petroleum and holds some of the world's most significant reserves. Let's delve into the top 10 oil and gas projects shaping Saudi Arabia's energy future in 2024.
Automobile Management System Project Report.pdfKamal Acharya
The proposed project is developed to manage the automobile in the automobile dealer company. The main module in this project is login, automobile management, customer management, sales, complaints and reports. The first module is the login. The automobile showroom owner should login to the project for usage. The username and password are verified and if it is correct, next form opens. If the username and password are not correct, it shows the error message.
When a customer search for a automobile, if the automobile is available, they will be taken to a page that shows the details of the automobile including automobile name, automobile ID, quantity, price etc. “Automobile Management System” is useful for maintaining automobiles, customers effectively and hence helps for establishing good relation between customer and automobile organization. It contains various customized modules for effectively maintaining automobiles and stock information accurately and safely.
When the automobile is sold to the customer, stock will be reduced automatically. When a new purchase is made, stock will be increased automatically. While selecting automobiles for sale, the proposed software will automatically check for total number of available stock of that particular item, if the total stock of that particular item is less than 5, software will notify the user to purchase the particular item.
Also when the user tries to sale items which are not in stock, the system will prompt the user that the stock is not enough. Customers of this system can search for a automobile; can purchase a automobile easily by selecting fast. On the other hand the stock of automobiles can be maintained perfectly by the automobile shop manager overcoming the drawbacks of existing system.
Quality defects in TMT Bars, Possible causes and Potential Solutions.PrashantGoswami42
Maintaining high-quality standards in the production of TMT bars is crucial for ensuring structural integrity in construction. Addressing common defects through careful monitoring, standardized processes, and advanced technology can significantly improve the quality of TMT bars. Continuous training and adherence to quality control measures will also play a pivotal role in minimizing these defects.
COLLEGE BUS MANAGEMENT SYSTEM PROJECT REPORT.pdfKamal Acharya
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Industrial Training at Shahjalal Fertilizer Company Limited (SFCL)MdTanvirMahtab2
This presentation is about the working procedure of Shahjalal Fertilizer Company Limited (SFCL). A Govt. owned Company of Bangladesh Chemical Industries Corporation under Ministry of Industries.
Vaccine management system project report documentation..pdfKamal Acharya
The Division of Vaccine and Immunization is facing increasing difficulty monitoring vaccines and other commodities distribution once they have been distributed from the national stores. With the introduction of new vaccines, more challenges have been anticipated with this additions posing serious threat to the already over strained vaccine supply chain system in Kenya.
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Author: Robbie Edward Sayers
Collaborators and co editors: Charlie Sims and Connor Healey.
(C) 2024 Robbie E. Sayers
Relationships of Providers’ Accountability of Nursing Documentations in the Clinical Setting
1. International Journal of Environment, Agriculture and Biotechnology (IJEAB) Vol-2, Issue-3, May-Jun- 2017
http://dx.doi.org/10.22161/ijeab/2.3.44 ISSN: 2456-1878
www.ijeab.com Page | 1362
Relationships of Providers’ Accountability of
Nursing Documentations in the Clinical Setting
Chiejina E.N (Ph.D)
Department of Nursing Science, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Nnewi Campus
Nigeria.
Abstract— Documentation demonstrates the unique
contribution of nursing to the care of clients. This study
investigated the relationships of Providers accountability of
nursing documentations in the clinical settings. Judgmental
and simple random sampling techniques were used to select
documented nursing actions for 264 clients. One research
question and four null hypotheses guided the study. The
instrument used for data collection was checklist on
Nursing documentation in the clinical setting. Descriptive
statistics of frequency, means and standard deviation (SD)
were used to summarize the variables. Pearson Product
Moment correlation was used to answer the research
question, while analyses of variance (ANOVA) was adopted
in testing the null hypotheses at 0.05 level of significance.
The result indicated that significant correlation existed
between legal implications of nursing documentation and
the core principles of nursing documentation. Significant
differences were also observed among providers’
accountability of nursing documentations with regard to
promotion of interdisciplinary communication, legal
implications of documentation, impacts on quality
assurance and nursing science.
Keywords— Relationships, Care Providers,
Accountability, Nursing documentations, Clinical Setting.
I. INTRODUCTION
Tools are needed to support the continuous and efficient
shared understanding of a patient’s care history that
simultaneously aids sound intra and inter-disciplinary
communication and decision-making about the patient’s
future care (Joint Commission on the Accreditation of
Healthcare Organisations, 2005). Such tools are vital to
ensure that continuity, safety and quality of care endure
across the multiple handovers made by the many clinicians
involved in patient care. Generally, tools are implements
held in the hands, which in the healthcare setting refer to
documentation. Potter and Perry (2010) describe
documentation as anything written or electronically
generated that describes the status of a client or the care or
services given to that client. Nursing documentation refers
to written or electronically generated client information
obtained through the nursing process (ARNNL, 2010).
Nursing documentation is a vital component of safe, ethical
and effective nursing practice regardless of the context of
practice or whether the documentation is paper based or
electronic, it is an integral part of nursing practice and
professional patient care rather than something that takes
away from patient care, and it is not optional.
According to Potter and Perry (2010), nursing
documentation must provide an accurate and honest account
of what and when events occurred, as well as identify who
provided the care. The documentation should be factual,
accurate, complete, current (timely), organized and
compliant with standards (Professional and Institutional).
Potter and Perry (2010) further stated that these core
principles of nursing documentation apply to every type of
documentation in every practice setting.
Documentation in nursing covers a wide variety of issues,
topics and systems (Yocum, 2002; Huffman, 2004, Lindsay
et al 2005; Johnson et al 2006). Such areas of coverage
include all aspects of nursing process, plan of care,
admission, transfer, transport, discharge information, client
education, risk taking behaviours, incident reports,
medication administration, verbal orders, telephone orders,
collaboration with other health care professionals, date and
time of any event as well as signature and designation of the
recorder.
The primary purpose of documentation is to facilitate
information flow that supports the continuity, quality and
safety of care. Potter and Perry (2010) pointed out that data
from documentation allow for communications and
continuity of care, quality improvement/ assurance and risk
management, establish professional accountability, make
provision for legal coverage, funding and resource
management, and also expand the science of nursing. Potter
and Perry (2010) also explained that clear, complete and
accurate health records serve many purposes for the clients,
families, registered nurses and other health care providers.
2. International Journal of Environment, Agriculture and Biotechnology (IJEAB) Vol-2, Issue-3, May-Jun- 2017
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DeLauna and Ladner (2002) further affirmed that
documentation is the professional responsibility of all health
care practitioners, and that it provides written evidence of
the practitioner’s accountability to the client, the institution,
the profession and the society.
Literature has revealed that the tensions surrounding
nursing documentation include the amount of time spent in
documenting, the number of errors in the records, the need
for legal accountability, the desire to make nursing work
visible, and the necessity of making nursing notes
understandable to the other disciplines (Spraque and
Trapanier 1999; Castledine, 1998; Dimond, 2005; Pearson,
2003). This study therefore intends to examine the
relationships of Providers accountability of nursing
documentations in the clinical settings.
Research Question.
To what extent does the legal implications of nursing
documentation relate with the core principles of the
documentation?.
Hypotheses.
Promotion of interdisciplinary communication does not
significantly differ in the nursing actions documented by
the Primary, Secondary and third party providers.
There is no significant difference in the legal
implications of the nursing documentations by the
primary, secondary and third party providers.
Quality assurance of documented nursing actions does
not significantly differ among the primary, secondary
and third party providers of the documentation.
The impact of the documented nursing actions on
Nursing Science does not significantly differ among the
primary, secondary and third party providers of the
documentation.
II. MATERIALS AND METHODS
Design and Sampling.
The study was a retrospective research design. Judgmental
sampling technique was adopted in selecting one Teaching
Hospital and one specialist Hospital (tertiary Health
Institutions) in Anambra State of Nigeria. Simple random
sampling was used to select two General Hospitals
(Secondary Health Institutions) and two comprehensive
Health Centres (Primary Health Institutions) out of the 24
General Hospitals and 10 comprehensive Health Centres in
Anambra State. This was to give all the primary and
secondary health institutions equal chance of being selected
for the study (Nworgu, 1991).
Nursing documentations on Clients were obtained from
three units (medical, surgical and maternity units) of each of
the selected health institutions. Other units (e.g. Emergency
unit, Out-patient Department, and other special units) were
excluded in the study. Documented nursing actions for 96
clients were obtained from the selected tertiary health
institutions, 72 were obtained from the secondary health
institutions and 96 from the primary health institutions. On
the whole nursing documentation for 264 clients were used
for the study. Ethical approval were obtained from the six
institutions used for the study. Informed consent was also
obtained from the clients whose records were used.
Confidentiality was ensured by not including the names of
the health institutions in the data collection. Alphabetical
codes were used to represent the selected health institutions
while numerical codes were used for the patients whose
records were obtained for the study. Generally, records of
nursing documentation done from July – September 2015
were used for the study.
Instrument.
The instrument used for data collection in the study was
checklist titled Checklist on Nursing Documentation in the
clinical setting (CNDCS). Section A of the instrument
provided general information of the health institution (eg
level of health institution, clinical specialty, form of
documentation, client’s clinical diagnosis, documentation of
accountability, section B of the instrument was made up of
eight sub-sections designed to measure documented nursing
actions (eg admissions, transfers, discharges, plan of care,
client education, medication, incident reports, vital signs,
etc), extent of ensuring core principles in the documentation
(eg whether factual, accurate, complete, timely, organized
and compliant with standards), ensuring promotion of
interdisciplinary communication (eg name(s) of the people
involved in the collaboration, date and time of the contact,
information provided to or by healthcare provider,
responses from healthcare provider, etc), timeliness of the
documentation (eg how timely, chronological and
frequency), preciseness of the documentation (eg
objectivity, unbiased, legibility, clear and concise, etc),
Legal implication (eg use of authorized abbreviations,
informed consent, advanced directive, etc), impact on
quality assurance/ improvement (eg facilitates quality
improvement initiative, facilitates risk management, and
used to evaluate appropriateness of care), and impact on the
science of nursing (eg provides data for nursing/health
research, used to assess nursing intervention and client
outcomes, etc). The instrument was designed in a 4 – point
3. International Journal of Environment, Agriculture and Biotechnology (IJEAB) Vol-2, Issue-3, May-Jun- 2017
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scale ranging from 1 to 4 with poor/many omissions having
I point, 2 points for fair/incomplete with few omissions, 3
points for good/almost complete, and 4points for very
good/complete.
The instrument was subjected to reliability test by collecting
data from nursing documentations for 15 patients from three
levels of health institutions (primary, secondary and
tertiary) in another State of Nigeria that was not used for the
study. The instrument test/ retest reliability was 0.65.
Data Analysis.
Standard descriptive statistics of frequency, means and
standard deviation were used to summarize the variables.
Mean score, standard deviation and Pearson Product
moment correlation (r) were used to answer the research
question while Analysis of variance (ANOVA) was adopted
in testing the null hypotheses at 0.01 and 0.05 levels of
significance respectively. SPSS version 21 was used in the
data analysis.
III. RESULT
Table.1: General Information of the Health Institutions used for the study
Variable Frequency Percentage
Level of Health Institution:
Primary
Secondary
Tertiary
96
72
96
36.4
27.3
36.4
Clinical Specialty:
Medical unit
Surgical unit
Maternity unit
97
63
104
36.7
23.9
39.4
Form of Documentation:
Written documentation
Electronic documentation
262
2
99.2
0.8
Client Diagnoses:
Obstetric condition
Medical condition
Surgical condition
Sepsis/Infection
105
93
61
5
39.8
35.2
23.1
1.9
Demonstration of Accountability:
Primary provider
Secondary provider
Third party provider
247
15
2
93.6
5.7
0.8
Total N = 264
Table 1 shows the general information of the health
institutions used for the study. Primary Health Centre
constituted 36.4% of the Health institutions, 27.3%
constituted secondary level while tertiary level constituted
36.4%. The clinical specialties of the health institutions that
were used for the study were medical unit 36.7%, surgical
unit 23.9% and maternity unit which formed 39.4%. Out of
the forms of nursing documentations, 99.2% was written
documentation while electronic documentation formed
0.8%; 39.8% was obstetric conditions, medical conditions
35.2%, surgical conditions 23.1% while documented
infective conditions constituted 1.9%. For demonstration of
accountability in the documented nursing actions, 93.6%
was done by primary providers, 5.7% by secondary
providers, while third party providers accounted for 0.8% of
the documentations. Total number of each variable was 264.
Table.2:Descriptive Statistics of the Measured Variables
Variable N Minimum Maximum Mean SD
Nursing Action Documentation 264 23.00 76.00 54.6402 9.86811
Core principles of Documentation 264 11.00 24.00 19.2462 2.38101
Promotion of interdisciplinary
communication
264 9.00 36.00 30.8485 5.61433
4. International Journal of Environment, Agriculture and Biotechnology (IJEAB) Vol-2, Issue-3, May-Jun- 2017
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Timeliness of Documentation 264 6.00 12.00 9.5568 1.32703
Preciseness of Documentation 264 18.00 40.00 31.9470 3.30299
Legal implication 264 11.00 24.00 19.6439 2.47153
Impact on Quality Assurance 264 4.00 12.00 9.6250 1.63129
Impact on Nursing Science 264 4.00 16.00 13.7462 2.43860
Valid N (Listwise) 264
Table 2 shows the descriptive statistics of the measured
variables. Out of the 264 documented nursing actions, the
mean was 54.6402 and the standard deviation (SD) was
9.86811. Mean for the core principles of the documentation
19.2462 with SD of 2.38101. For promotion of
interdisciplinary communication, the mean was 30.8485
with SD of 5.61433. Timeliness of documentation had a
mean of 9.5568 with SD of 1.32703. Mean for preciseness
of the documentation was 31.9470 with SD of 3.30299. For
legal implications, the mean was 19.6439 with SD of
2.47153. Impact of the documentation on quality assurance
had a mean of 9.6250 with SD of 1.63129, while impact on
Nursing Science had a mean of 13.7462 with SD of
2.43860.
Table.3: Relationship between Legal implications of nursing action documentation and the core principles of documentation.
Variables N X SD r Critical
value
Level of
significance
Legal implication of
documentation
264 19.6439 2.47153 **
0.543
0.000 0.01
Core principles of
documentation
264 19.2462 2.38101
**Correlation was significant at 0.01 level (2 – tailed).
In table 3, the correlation value (r) for the relation between legal implications of documentation and the core principles was
0.543, and it was significant at 0.01 level.
Table.4: ANOVA showing comparison of the nursing action documentations by the Primary, Secondary and third party providers
for promotion of interdisciplinary communication, legal implications, impacts on quality assurance and nursing science.
Variable Providers/
Accountability
N X SD Source Sum of
squares
df Mean
squares
F-cal F-crit
(sig)
Promotionof
Interdisciplinary
communication
Primary
Provider
247 30.9595 5.47559 Between
Groups
240.611 2 120.305 3.901 0.021
Secondary provider 15 30.4667 5.55321
Third party provider 2 20.0000 15.55635 Within
Groups
8049.328 261 30.840
Total 264 30.8485 5.61433 8289.939 263
Legal
Implicationof
documentation
Primary
Provider
247 19.6316 2.44074 Between
Groups
53.323 2 26.662 4.480 0.012
Secondary provider 15 20.4667 2.38647
Third party provider 2 15.0000 2.82843 Within
Groups
1553.207 261 5.951
Total 264 19.6439 2.47153 1606.530 263
Impacton
Quality
Assurance
Primary
Provider
247 9.6032 1.57614 Between
Groups
3.824 2 1.912 0.717 0.489
Secondary provider 15 10.0667 2.18654
Third party provider 2 9.0000 4.24264 Within 696.051 261 2.667
5. International Journal of Environment, Agriculture and Biotechnology (IJEAB) Vol-2, Issue-3, May-Jun- 2017
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Groups
Total 264 9.6250 1.63129 699.875 263
NB: Probability: 0.05 level of significance.
Table 4 shows that with regard to providers accountability
of nursing action documentation, the calculated F-ratio for
promotion of interdisciplinary communication was 3.901;
for legal implications of documentation, impacts on Quality
assurance and nursing science, the F-ratios were 4.480,
0.717 and 2.415 respectively. These results were more than
the critical values. Therefore the null hypotheses are
rejected. Scheffe Post-Hoc (Akuezuilo and Agu, 2004) test
of multiple comparison of mean was used to determine the
order of significant differences across the Primary,
Secondary and third party providers of accountability.
Table.5: Scheffe Post-Hoc test of multiple comparison of the means of promotion of interdisciplinary communication and the
legal implications of nursing action documentation across the primary, secondary and third party providers.
Dependent
variable
(1) providers of
Documentation
(J) Providers of
Documentation
Mean Difference
(1 – J)
Standard
Error
Sig (F –
Crit)
Promotionof
interdisciplinary
communication
Primary Provider Secondary Provider
Third party provider
0.49285
10.95951*
1.47678
3.94272
0.739
0.006
Secondary provider Primary provider
Third party provider
-0.49285
10.46667*
1.47678
4.18045
0.739
0.013
Third party provider Primary provider
Secondary provider
-10.95951*
-10.46667*
3.94272
4.18045
0.006
0.013
LegalImplicationsof
documentation
Primary provider Secondary provider
Third party provider
-0.83509
4.63158*
0.64871
1.73193
0.199
0.008
Secondary provider Primary provider
Third party provider
0.83509
5.46667*
0.64871
1.83636
0.199
0.003
Third party provider Primary provider
Secondary provider
-4.63158*
-5.46667*
1.73193
1.83636
0.008
0.003
Key: *The mean difference was significant at 0.05 level
Table 5 shows that for promotion of interdisciplinary
communication, the mean difference of 10.95951 between
primary, secondary and third party providers was in favour
of the primary providers; also the mean difference of
10.46667 between secondary and third party providers was
in favour of secondary provider. For legal implications of
documentation, the mean difference of 4.63158 between
primary and third party providers was in favour of primary
providers, while the mean difference of 5.46667 between
secondary and third party providers was in favour of
secondary providers.
IV. DISCUSSION
Findings from the study indicate significant correlation
(r=0.543) between legal implications and core principles of
nursing documentation (table 3). Failure to document
Impacton
nursingscience
Primary
Provider
247 13.7692 2.37522 Between
Groups
28.417 2 14.208 2.415 0.091
Secondary provider 15 13.8667 2.32584
Third party provider 2 10.0000 8.48528 Within
Groups
1535.579 261 5.883
Total 264 13.7462 2.43860 1556.996 263
6. International Journal of Environment, Agriculture and Biotechnology (IJEAB) Vol-2, Issue-3, May-Jun- 2017
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appropriately is a key factor in clinical mishaps and a
pivotal issue in many malpractice cases (Springhouse,
1995) because the client’s medical record is a legal
document, and in the case of a lawsuit the record serves as
the description of exactly what happened to a client. Lyer
and Camp (1999) noted that in 80% to 85% of malpractice
lawsuits involving client care, the medical record is the
determining factor in providing proof of significant events.
DeLaune and Ladner (2002) pointed out that legal issues of
documentation require legible and neat writing, proper use
of spelling and grammer, use of authorized abbreviations as
well as factual and time-sequenced descriptive notations.
These features are elements of effective documentation
which invariably constitute the characteristics of the core
principles of nursing documentation (Porter and Perry,
2010).
The study revealed significant differences in the providers’
accountability of nursing documentation with regard to
promotion of interdisciplinary communication, legal
implications of documentation, impacts on quality
assurance and nursing science (tables 4 and 5). According
to Kozier et al (2004), each health care organization has
policies about recording and reporting client data, and each
nurse is accountable for practicing according to these
standards. Agencies also indicate which nursing
assessments and interventions that can be recorded by
registered nurses (RNs) and which interventions that can be
charted by unlicensed personnel (Kozier et al 2004). The
role of the nurse varies with the needs of the client, the
nurse’s credential, and the types of employment setting
(Kozier et al, 2004). CRNNS (2012) indicate that legislation
and standards of practice of a profession require nurses to
document the care they provide demonstrating
accountability for their actions and decisions. First hand
knowledge means that the professional who is doing the
recording is the same individual who provided the care. The
RN who has the primary assignment is expected to
document the assessment, interventions and clients response
noting as necessary the role of other care providers. Third
party recordings include documentations by non-
professionals such as auxiliary staff, designated recorders,
client/ family and students (SRNA, 2011). Certainly,
proficiency should not be expected from these unlicensed
personnel, hence the significant difference observed in this
study about the documentations of the primary, secondary
and third party providers. CRNNS (2012) pointed out that
quality documentation is an integral part of professional RN
practice; it reflects the application of nursing knowledge,
skills and judgment, the clients’ perspective and
interdisciplinary communication.
V. CONCLUSION
This study indicates that significant correlation exists
between the legal implications of nursing documentation
and the core principles of the documentation. It also
revealed that quality nursing documentation requires
accountability of the professional RN.
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