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Issue 43 - 13 Dec 2012

Harmless nursing chat or alienating attitudes? Six Scenarios explore some unsafe nursing views and ways to confront them.
A DVD and workshop guide. To order


Articles - Patient Privacy

1. Don't violate patient privacy regs for anyone
Patient Education Management (Aug 2010).
: Have you ever been put into the uncomfortable position of being asked for confidential health information about an employee by a senior leader or administrator? Be ready for this "sticky situation," as it may violate patient privacy regulations, says Patricia B. Strasser, PhD, RN, COHN-S/CM, FAAOHN, principal of Partners in BusinessHealth Solutions in Toledo, OH

2. Electronic Health Records and Patient Privacy - An Oxymoron?
By Kaplan, Arline. Psychiatric Times 29. 8 (Aug 2012): 1,7.
  More than 200 pages of sensitive notes about Julie became available to any physician within the Partners HealthCare System who treated her.2,3 Julie discovered this widespread distribution when she saw a new internist because of a stomach ailment. According to a fact sheet issued by the Office of the National Coordinator for Health Information Technology (ONC), ARRA provides resources to "help health care providers across the country use EHRs to increase quality, safety, and efficiency of health care; train thousands of people for careers in health information technology who will help health care providers implement EHRs; and assist states in creating health information exchanges for the secure and efficient exchange of patients' EHRs among health care providers

3. Patient Privacy: The Right to Know Versus the Need to Access
By Grzybowski, Darice M. Health Management Technology 26. 9 (Sep 2005): 54, 53.
Computerization of clinical information, while offering new opportunities to improve and streamline the healthcare delivery system, also presents new challenges for those whose job it is to protect the use and potential misuse of that information. There are, fundamentally, two schools of thought on ways to work toward creating a more secure yet usable clinical data trail on the information highway. Technology-based solutions focus primarily on the ability of specially designed hardware or software to limit access of information based on special biometric identifiers, smart cards or other means of control, including generation of specific prompted audit lists for "outside scope" access. Proponents of policy-based solutions have focused on developing model legislation that would define rights of access, data element definition, procedures for release and access, and monetary fines for abuse of confidentiality. The final solutions must be ones that balance a level of satisfaction and comfort with access to that of the privacy available within computerized records

4. Patients" privacy and satisfaction in the emergency department: A descriptive analytical study
By Nayeri, Nahid Dehghan; Aghajani, Mohammad. Nursing Ethics 17. 2 (Mar 2010): 167-77
Respecting privacy and patients’ satisfaction are amongst the main indicators of quality of care and one of the basic goals of health services. This study, carried out in 2007, aimed to investigate the extent to which patient privacy is observed and its correlation with patient satisfaction in three emergency departments of Tehran University of Medical Science, Iran. Questionnaire data were collected from a convenience sample of 360 patients admitted to emergency departments and analysed using SPSS software. The results indicated that,
according to 50.6% of the patients, the extent to which their privacy was respected was described as either ‘weak’ or ‘average’. Spearman’s coefficient indicated a significant correlation between respecting privacy and the patients’ satisfaction about the various aspects of privacy studied. Considering the levels of privacy observed together with the patients’ degree of satisfaction, it is imperative that clinical professionals address both aspects from conceptual and practical viewpoints.

5. Environmental Issues in Patient Care Management: Proxemics, Personal Space, and Territoriality
By McLaughlin, Celeste; Olson, Rhonda; White, Mary Joe, PhD, RN. Rehabilitation Nursing 33. 4 (Jul/Aug 2008): 143-7, 177
: Patient privacy issues play a significant role in healthcare policy. However, concern for patient privacy may not always carry over into patient care activities. An Association of Rehabilitation Nurses chapter research committee undertook a study to assess rehabilitation nurses' knowledge of proxemics, personal space, and territoriality and their application in rehabilitation nursing practice. The theoretical framework was Hall's 1966 theory of proxemics. A pretest-posttest design with a 1-hour educational intervention was used with a convenience sample of rehabilitation nurses (N = 43). The tests consisted of 12 multiple-choice questions and 1 open-ended question related to practice. Paired-samples t tests of pretest and posttest scores demonstrated improvement in posttest scores (p <.0005). Analyses of variance were conducted to determine whether there were any differences on the posttest scores when looking at education level, years of work experience, years of work experience in rehabilitation nursing, and certification. Higher education levels correlated with higher test scores (p < .005). Although findings are limited by sample size, results indicate that rehabilitation nurses are not familiar with the impact of proxemics. The nurses'application of these principles in the open-ended question indicates that a patient's personal space in a healthcare setting is determined by the nurse, not the patient. The implications that result from a call to action on these issues are discussed

6. The Influence of Nurses' Attitudes, Subjective Norms and Perceived Behavioral Control on Maintaining Patients' Privacy in a Hospital Setting
By Tabak, Nili; Ozon, Meirave. Nursing Ethics 11. 4 (Jul 2004): 366-77
: The research reported in this article examined the influence of nurses’ attitudes, subjective norms and perceived behavioral control on maintaining patients’ privacy during
hospitalization. The data were gathered from 109 nurses in six internal medicine wards at an Israeli hospital. The research was based on the theories of reasoned action and planned behavior. A positive and significant correlation was shown between nurses’ attitude to promoting and maintaining patient privacy and their planned behavior, while perceived behavioral control was the best variable for predicting the nurses’ behavior. Better educated nurses believed that they had fewer resources and anticipated more obstacles in acting to promote and maintain patient privacy. This research adds a new dimension to what is already known about nurses’ attitudes to maintaining patients’ privacy, nurses’
planned behavior and their actual behavior. The practical implications of the findings are the identification of factors that influence the attitudes and behavior of nursing staff, which, in turn, will enable allocation of resources for solving difficulties and removing obstacles. The results will allow the formulation of educational programs to guide staff and also the application of policies based on both patient and nursing staff needs.

Articles - Nursing Economic$. Sep/Oct2012

7. Editorial. Nurse Staffing: Using Evidence to Create a Pathway To Excellence
By Nickitas, Donna M. Nursing Economic$. Sep/Oct2012, Vol. 30 Issue 5: p245-245
An introduction is presented in which the editor discusses various reports within the issue on topics including investigation of the nursing staff and its impact on patient safety, care and quality and innovations to understand the challenges of nursing staff..

8. Guest Editorial. Forging the Future of Staffing Based on Evidence: Second Edition.
By Douglas, Kathy S.; Kerfoot, Karlene M. Nursing Economic$. Sep/Oct2012, Vol. 30 Issue 5: p246-246
An introduction is presented in which the editor discusses various reports within the issue on topics including nurse staffing and impatient mortality, safe staffing and evidence-based practice..

9. ANA Principles: The Framework For Nurse Staffing to Positively Impact Outcomes
By Weston, Marla J.; Brewer, Katherine C.; Peterson, Cheryl A. Nursing Economic$. Sep/Oct2012, Vol. 30 Issue 5: p247-252
The article discusses the revised 2nd edition of American Nurses Association's (ANA's) principles for nurse staffing, which explains the factors to be taken into account in order to reach quality care and patient safety. Several changes made to the principles include a definition of appropriate nurse staffing, and addition of elements related to practice environment such as overtime, length of shift, self-care, and work-life balance. The 6 sections of the new framework are also discussed..

10. CNE SERIES. The Nursing Workforce: A Comparison of Three National Surveys
By Auerbach, David I.; Staiger, Douglas O.; Muench, Ulrike; Buerhaus, Peter I. Nursing Economic$. Sep/Oct2012, Vol. 30 Issue 5: p253-261
The article notes that the termination of the National Sample Survey of Registered Nurses (NSSRN) ended a key source of information on nurses. Yet, it provided an opportunity to address some biases concerning the use of licensing data to compile lists of RNs to construct a sampling frame. A comparison of the NSSRN with existing alternatives for nursing workforce data from two U.S. Census Bureau surveys, the Current Population Survey (CPS) and the American Communities Survey (ACS) is presented..

11. Staffing Based on Evidence: Can Health Information Technology Make it Possible?
By Harper, Ellen M. Nursing Economic$. Sep/Oct2012, Vol. 30 Issue 5: p262-281
The article discusses a pilot study assessing the Clinical Demand Index (CDI) model for predicting nurse intensity, using 4 data sets including data abstracted from electronic health records (EHRs), study unit's admissions, discharges, and transfers (ADT) events and data of staff nurses. The results suggest that the CDI Model and health IT can play an important role in demonstrating that clinical data from the EHR can be abstracted real time whereas data related to ADT were inconclusive.

12. Nurse Practitioner Workforce: A Substantial Supply of Primary Care Providers
By Poghosyan, Lusine; Lucero, Robert; Rauch, Lindsay; Berkowitz, Bobbie. Nursing Economic$. Sep/Oct2012, Vol. 30 Issue 5: p268-294
The article states that with the Patient Protection and Affordable Care Act and through practice, policy, and research recommendations for nurse practitioners (NP) in primary care, the demand for care can be met on a larger scale. It highlights the need for consistent practice regulations across states, payments based on services to be provided, and better work environments to optimally use the NP workforce..

Journal - Table of Contents

13. From Nursing Times, 27 November - 3 December 2012, Vol 108 no 48
Editor's view
Recognise the value of all roles in nursing
13B. Inability to swallow tablets is common and cause for concern' [We naturally chew food before swallowing, but tablets and capsules require a complicated, conscious mechanism to over-ride the need to chew and the gag reflex, designed to eject foodstuffs that are not adequately chewed.]
13C. Preparing patients to undergo surgery [Good pre-operative care, helping patients to feel less anxious and making sure their individual needs are met, means they have a better experience and faster recovery]
13D. Managing obesity in adults [Obesity poses a serious risk to health. This review gives an introduction to, and taster of, our newly launched Nursing Times Learning unit on obesity management in adults]
13E. I may have the best medical care but was badly let down emotionally [Lyn Holmes, aged 45, has breast cancer. Despite the best medical care, she describes how she felt let down by a lack of emotional support during her diagnosis and treatment].
13F. Effect of music on mealtime disruptions


14. 8th National Immunisation Workshop and Conference
he conference will present recent research from areas of disease control, global approaches to immunisation, post marketing surveillance, immunisation communication using social media, adult vaccination and specialised programmes and future vaccines
Date: 10th   to  12th September 2013
Venue: Auckland, New Zealand
More information:

News - National

15. Fat tax could improve health: study
ODT - Wed, 12 Dec 2012

Taxing fizzy drinks and fatty foods and subsidising fruit and vegetables could have significant health benefits, a new study has shown. Researchers from the Universities of Otago and Auckland examined the relationship between food pricing, consumption and non-communicable diseases like cardiovascular disease and diabetes in their study, published in PLOS magazine

16. Warning over 'excessive' Brussels sprouts at Christmas
TVNZ - Lifestyle News

Brussels sprouts may not be everyone's cup of tea, but doctors say they definitely should not be on some plates at Christmas.
The controversial vegetable is a traditional festive staple in countries including the United Kingdom

17. A Marlborough doctor plans to open a medical centre in Renwick early next year.
Marborough Express - 5 Dec 2012

Doctor Buzz Burrell said yesterday the centre would provide for people in Renwick and the surrounding rural communities, particularly people who were immobile and vulnerable.
"I've heard a lot of people who live in Renwick say they are worried about getting to the doctor's as they get older and it would be lovely to be meet their needs. I'm guessing there's a community of about 2000 people in Renwick, and I'm amazed it's survived this long without a medical centre.

18. Privacy versus patient health under spotlight
Timaru Herald - 6 Oct 2012

Pressure is mounting for mental health workers to change the way they deal with the privacy concerns of suicidal patients, in the face of concern the issue is contributing to New Zealand's suicide problem. Julia Hollingsworth investigates. Robert* hadn't wanted to tell anyone he was there. He was scared, unwell, wanting to die and felt he had run out of options. He planned to go to the hospital, talk to someone and leave again - as he puts it now - a little better equipped to deal with the world

News - International

19. Prank callers not to blame, say mental health experts
The Age - December 8, 2012

MENTAL health experts hold grave concerns for the radio presenters at the centre of the royal prank call controversy, urging the public not to blame them for the suspected suicide of the nurse who took the call. Mel Greig and Michael Christian from Sydney's 2Day FM had to close their Twitter accounts on Saturday after angry social media users accused them of having "blood on their hands". But leading psychiatrist and former Australian of the Year Patrick McGorry called for calm, saying suicide was a complex issue that was unlikely to be caused by one individual factor

20. Foundations that give cancer patients confidence to face the day
The Age - 13 Dec 2012

It is vital to treat the person as well as the illness, writes Lu Sun
As if being seriously ill were not punishing enough, the physical changes that cancer treatments bring about can also take away a patient's self-confidence. One charity, however, is in its third decade of helping Australians feel better through looking good

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