BACKGROUND & AIMS: :Breast and cervical cancer are the most common causes of cancer mortality among women worldwide, but actually they are largely preventable diseases. There is limited data on breast and cervical cancer knowledge, screening practices and attitudes of nurses in Turkey. A self-administered questionnaire was used to investigate the knowledge and attitude of nurses on risk factors of the breast and cervical cancer as well as screening programmes such as breast self-examination (BSE), clinical breast examination, mammography (MMG) and papanicolaou (pap) smear test. In total, 125 out of 160 nurses participated in the study (overall response rate was 80.6%). The risk factors and symptoms of breast cancer was generally well known, except for early menarche (23.2%) and late menopause (28.8%). For cervical cancer, the correct risk factors mostly indicated by the nurses were early age at first sexual intercourse (56%), smoking (76%), multiple sexual partners (71.2%). As for screening methods, it was believed that BSE was a beneficial method to identify the early breast changes (84.8%) and MMG was able to detect the cancer without a palpable mass (57.6%). Little was known about the fact that women should begin cervical cancer screening approximately 3 years after the onset of sexual intercourse (23.2%) and if repeated pap smear test were normal, it could be done every 2-3 years. Most of the nurses considered that MMG decreases the mortality in breast cancer (65.6%) and also believed that pap smear test decreases the mortality in cervical cancer (75.2%). Despite high level of knowledge of breast cancer risk factors, symptoms and screening methods, inadequate knowledge of cervical cancer screening method were found among nurses.

背景与目标： 乳腺癌和宫颈癌是全世界女性中最常见的癌症死亡原因，但实际上，它们在很大程度上是可预防的疾病。在土耳其，关于乳腺癌和宫颈癌知识，筛查实践和护士态度的数据有限。使用自我管理的问卷调查护士对乳腺癌和宫颈癌危险因素的知识和态度，以及筛查计划，例如乳房自我检查（BSE），临床乳房检查，乳房X线摄影（MMG）和木瓜提取物（ pap）涂片测试。总共有160名护士中的125名参加了研究（总缓解率为80.6％）。乳腺癌的危险因素和症状是众所周知的，除了初潮初潮（23.2％）和绝经后期（28.8％）外。对于宫颈癌，主要由护士指出的正确危险因素是第一次性交时年龄较小（56％），吸烟（76％），多性伴侣（71.2％）。至于筛查方法，人们认为BSE是识别早期乳房变化的有益方法（84.8％），MMG能够在无明显肿块的情况下检测出癌症（57.6％）。对于女性应该在性交发作后约3年（23.2％）开始宫颈癌筛查这一事实鲜为人知，如果反复进行子宫颈抹片检查正常，则可以每2-3年进行一次。大多数护士认为MMG可降低乳腺癌的死亡率（65.6％），并且还认为巴氏涂片检查可降低宫颈癌的死亡率（75.2％）。尽管对乳腺癌危险因素，症状和筛查方法的了解很高，但在护士中仍发现宫颈癌筛查方法的知识不足。

BACKGROUND & AIMS: OBJECTIVE:To describe the changing role of school nurses in eight New Zealand (NZ) secondary schools from low socio-economic areas with high Pacific Island and Māori rolls. METHODS:An evaluation of a pilot addressing under-achievement in low-decile schools in Auckland, NZ (2002-05). Annual semi-structured school nurse interviews and analysis of routinely collected school health service data were undertaken. RESULTS:Two patterns of school nurse operation were identified: an embracing pattern, where nurses embraced the concept of providing school-based health services; and a Band-Aid pattern, where only the basics for student health care were provided by school nurses. CONCLUSIONS AND IMPLICATIONS:School nurses with an embracing pattern of practice provided more effective school-based health services. School health services are better served by nurses with structured postgraduate education that fosters the development of a nurse-practitioner role. Co-ordination of school nurses either at a regional or national level is required.

背景与目标： 目的：描述来自太平洋经济岛和毛利人卷高的低社会经济地区的八所新西兰中学的学校护士的角色变化。
方法：一项针对新西兰奥克兰低等学校成绩欠佳的飞行员的评估（2002-05年）。进行了年度半结构化学校护士访谈，并对定期收集的学校卫生服务数据进行了分析。
结果：确定了两种学校护士操作模式：一种拥抱模式，其中护士接受了提供基于学校的医疗服务的概念；和创可贴模式，其中学校护士仅提供学生医疗保健的基础知识。
结论与启示：实践型拥抱的学校护士提供了更有效的校本卫生服务。护士应接受结构化的研究生教育，从而更好地促进护士从业人员的角色发展，从而更好地为学校提供保健服务。需要在地区或国家范围内协调学校护士。

BACKGROUND & AIMS: AIM:To explore nurses' understanding and interpretation of evidence-based practice (EBP). BACKGROUND:EBP has been welcomed into the nursing lexicon without a critical examination of its interpretation by practitioners. The literature suggests that there is a great deal of confusion and contradiction over the meaning and application of EBP. Although work has been conducted on how EBP might be implemented, the general issue of how nurses understand and use EBP is largely unexplored. This paper seeks to examine in depth the understandings of EBP, to enable managers, educationalists and policy makers to implement it more effectively. METHODS:All registered nurses, midwives and health visitors in one UK National Health Service (NHS) Trust were asked to complete a questionnaire in October 2006. RESULTS:Despite a disappointing response rate (8.9%, 218/2438), the survey revealed interesting tensions and contradictions in nurses' understanding of EBP. National and local guidelines, practitioners' own experience and patients' preferences were the main influences on nurses' practice. Published research had relatively little impact, particularly among nurses graded E, F and G and those who had not attended a study day on EBP. CONCLUSIONS:The hierarchies of evidence propounded in local and national guidelines are not adopted by practising nurses, who use other sources of evidence, such as reflection on their own experiences, when making clinical decisions. However, subsuming published evidence to clinical judgement does not contradict the original tenets of EBP. IMPLICATIONS FOR NURSING MANAGEMENT:Unless it is incorporated into national or local guidelines, research has relatively little impact on practice. To develop nursing practice and nursing knowledge, nurse leaders need to foster the synthesis of experiential knowledge and published research, in accordance with the founding principles of the EBP movement.

背景与目标： 目的：探讨护士对循证实践（EBP）的理解和解释。
背景：EBP在没有经过执业医师严格检查其解释的情况下，已被欢迎进入护理词典。文献表明，关于EBP的含义和应用存在大量的困惑和矛盾。尽管已经开展了有关如何实施EBP的工作，但是关于护士如何理解和使用EBP的一般性问题尚未得到充分探讨。本文旨在深入研究对EBP的理解，以使管理人员，教育家和政策制定者能够更有效地实施EBP。
方法：2006年10月，要求一个英国国家卫生服务（NHS）信托基金中的所有注册护士，助产士和健康访问者填写问卷。
结果：尽管回应率令人失望（8.9％，218/2438），但调查显示护士对EBP的理解存在有趣的紧张和矛盾。国家和地方的指导方针，从业者的经验以及患者的喜好是影响护士执业的主要因素。已发表的研究影响相对较小，特别是对E，F和G级护士以及未参加EBP学习日的护士。
结论：执业护士没有采用地方和国家指南中提出的证据层次，护士在制定临床决策时会使用其他证据来源，例如对自己的经历进行反思。但是，将公开的证据纳入临床判断并不与EBP的原始宗旨相抵触。
护理管理的含义：除非将其纳入国家或地方准则，否则研究对实践的影响相对较小。为了发展护理实践和护理知识，护士领导者需要根据EBP运动的创立原则，促进经验知识和已发表研究的综合。

BACKGROUND & AIMS: AIMS:The aim of the present study was to compare the levels of stress, depression, and intention to leave among clinical nurses employed in different medical units in relation to their demographic characteristics under the National Health Insurance (NHI) System in Taiwan. METHODS:Cross-sectional Spearman's correlation, one-way ANOVA with Scheffe post hoc analysis tests, and multiple regression analyses were conducted. Several self-report questionnaires, such as the Center for Epidemiological Studies Depression Scale, the Perceived Stress Scale and Intention to Leave Scale, were administered. A total of 314 research participants were surveyed, all of whom came from regional hospitals in Northern Taiwan. RESULTS:Marital status and working tenure were significant predictors to the levels of stress, depression, and intention to leave among nurses before taking the medical units into consideration. However, with adding medical units as predictors, the effect of marital status and working tenure were insignificant except for the stress model, indicating medical units were showing dominant effect over other variables. In particular, internal medical ward (IMW) nurses experienced a higher prevalence of depression than emergency room (ER) nurses and professional nursing practitioners. External medical ward (EMW) nurses also experienced greater depression than emergency room (ER) nurses. Both IMW and EMW nurses perceived significantly greater stress than ER and dialysis center. Moreover, IMW nurses also perceived greater stress than operating room (OR) nurses and showed stronger intention to leave than their counterparts in the outpatient service departments. CONCLUSIONS:The results indicated that significant differences existed among various medical units with regards to nurses' stress, depression, and intention to leave. Nurses working in internal and external medical wards, especially the inexperienced and married ones, experienced greater depression and stress, thereby developing stronger intention to leave their job.

背景与目标： 目的：本研究的目的是比较台湾国民健康保险（NHI）体制下不同医疗单位聘用的临床护士的压力，抑郁和离职意愿与他们的人口统计学特征之间的关系。
方法：采用横断面Spearman相关性，单因素方差分析与Scheffe事后分析检验，并进行多元回归分析。管理了一些自我报告调查表，例如流行病学研究中心抑郁量表，知觉压力量表和离职意向量表。总共对314名研究参与者进行了调查，他们全部来自台湾北部的地区医院。
结果：在考虑医疗单位之前，婚姻状况和工作任期是护士压力，抑郁和离职意愿的重要预测指标。但是，通过增加医疗单位作为预测指标，除压力模型外，婚姻状况和工作任期的影响均不显着，这表明医疗单位比其他变量表现出主导作用。特别是，内科病房（IMW）护士比急诊室（ER）护士和专业护理从业人员患抑郁症的几率更高。外部医疗病房（EMW）护士也比急诊室（ER）护士经历了更大的抑郁症。 IMW和EMW护士都比ER和透析中心感觉到更大的压力。此外，IMW护士比手术室（OR）护士承受的压力更大，并且比门诊部门的护士表现出更大的离职意愿。
结论：结果表明，各个医疗单位之间在护士的压力，抑郁和离职意向方面存在显着差异。在内部和外部医疗病房中工作的护士，尤其是经验不足和已婚的护士，承受更大的压力和压力，因此更倾向于离开工作岗位。

BACKGROUND & AIMS: AIM:This article is a report of a study of occupational burnout among nurses in China. BACKGROUND:Burnout is described as feelings of emotional exhaustion, depersonalization and reduced personal accomplishment. It is well-known that burnout is a major problem for many professions. Nurses are considered to be particularly susceptible to this. Measuring burnout among nurses is important because their well-being has implications for stability in the healthcare workforce and for the quality of care provided. METHOD:The sample consisted of 495 nurses from three provincial hospitals in China. The Maslach Burnout Inventory -- General Survey (MBI-GS) was used to measure burnout, and the Occupational Stress Inventory -- Revised edition was used to measure two dimensions of occupational adjustment (occupational stress and coping resources). After statistical testing for validity and reliability of the MBI-GS with nurses in China, participants' scores were evaluated and analysed. RESULTS:Scores for burnout of surgical and medical nurses were statistically significantly higher than those of other nurses (P < 0.05). Lower educational status was associated with lower professional efficacy, and younger nurses reported higher levels of burnout. The most significant predictors of emotional exhaustion were role overload, responsibility, role insufficiency and self-care (P < 0.05). The most significant predictors of cynicism were role insufficiency, role boundary, responsibility and self-care (P < 0.05). The most significant predictors of professional efficacy were role insufficiency, social support and rational/cognitive coping (P < 0.05). CONCLUSION:It is important to reduce occupational stress in nurses and to strengthen their coping resources to prevent burnout. This could be achieved with job redesign, modification of shiftwork systems, and by offering occupational health education.

背景与目标： 目的：本文是对中国护士职业倦怠的一项研究报告。
背景：倦怠被描述为情绪疲惫，人格解体和个人成就感降低的感觉。众所周知，倦怠是许多专业的主要问题。护士被认为特别容易受到这种影响。衡量护士的倦怠很重要，因为他们的健康状况会影响医疗保健队伍的稳定性以及所提供护理的质量。
方法：该样本由来自中国三所省级医院的495名护士组成。使用Maslach倦怠量表-一般调查（MBI-GS）来衡量倦怠，使用职业压力量表-修订版来衡量职业调整的两个维度（职业压力和应对资源）。在对中国护士进行MBI-GS有效性和可靠性的统计测试后，对参与者的分数进行了评估和分析。
结果：外科和医疗护士的倦怠分数在统计学上均显着高于其他护士（P <0.05）。较低的学历与较低的专业效能有关，年轻的护士报告的倦怠水平较高。情绪衰竭的最重要预测指标是角色超负荷，责任感，角色不足和自我护理（P <0.05）。犬儒主义的最重要预测因素是角色不足，角色边界，责任感和自我照顾（P <0.05）。职业效能最重要的预测指标是角色不足，社会支持和理性/认知应对（P <0.05）。
结论：重要的是减少护士的职业压力，并加强他们的应对资源，以防止职业倦怠。这可以通过重新设计工作，修改轮班系统以及提供职业健康教育来实现。

BACKGROUND & AIMS: Objective:this study explores the process of the development of an intention to leave bedside nursing. Method:the process was studied from the perspective of 21 nurses using the grounded theory method. Data were collected using semi-structured interviews and the constant comparative method of Corbin and Strauss was used for data analysis. Results:according to the participants, the two main categories, "social image of nursing", and "culture and structure of the bedside", were the contextual factors that influence why nurses are leaving bedside care provision. Disappointment with a perceived lack of progress or improvement in the clinical experience formed primary psychosocial concerns for the participants. Competence and a process of self-control were steps taken by the participants. These, associated with interventional conditions produced the outcomes of the loss of professional commitment and desire to leave bedside nursing. "Failure to integrate personal expectations with organizational expectations: in search of escape" was the central category of the study that linked the categories together. Conclusion:the findings of this study provide useful information about the needs of nurses for overcoming the intention to leave bedside care. The identification of this process can help in recognizing emerging problems and providing solutions for them. Objetivo:este estudo explora o processo de desenvolvimento da intenção de deixar a enfermagem de cabeceira. Método:o processo foi estudado desde a perspectiva de 21 enfermeiras utilizando o método da Grounded Theory (Teoria Fundamentada). Os dados foram coletados utilizando entrevistas semi-estruturadas e o método comparativo constante de Corbin e Strauss se utilizou para analisar os dados. Resultados:segundo os participantes, duas categorias principais, "imagem social da enfermagem" e "cultura e estrutura de cabeceira", foram os fatores contextuais que influenciam as razões para que as enfermeiras estejam deixando o cuidado de cabeceira. A decepção com a percepção de falta de progresso ou melhora na experiência clínica cria preocupações psicossociais primárias para as participantes. A competência e o processo de autocontrole são passos dados pelas participantes. Isso associado a condições de intervenção foram os resultados da perda do compromisso profissional que as leva a deixar o cuidado de cabeceira. "O fracasso em integrar expectativas pessoais e expectativas da organização: em busca de uma saída" foi a categoria central do estudo que uniu as categorias. Conclusão:os achados deste estudo proporcionam informação útil sobre as necessidades das enfermeiras para superar as intenções de deixar o cuidado de cabeceira. A identificação deste processo pode ajudar a reconhecer os problemas emergentes e oferecer soluções para resolvê-los. Objetivo:este estudio explora el proceso de desarrollo de la intención de dejar la enfermería de cuidado de cabecera. Método:el proceso fue estudiado desde la perspectiva de 21 enfermeras utilizando el método de la Grounded Theory (Teoría Fundamentada). Los datos se recogieron utilizando entrevistas semiestructuradas; para analizar los datos se utilizó el método comparativo constante de Corbin y Strauss. Resultados:según los participantes dos categorías principales ("imagen social de la enfermería" y "cultura y estructura del cuidado de cabecera ") fueron los factores contextuales que influenciaron las razones para que las enfermeras deseasen dejar el cuidado de cabecera. La decepción con una percepción de falta de progreso o mejora en la experiencia clínica causó preocupaciones psicosociales primarias en las participantes. La competencia y el proceso de autocontrol fueron considerados por las participantes, y esto asociado a las condiciones de intervención resultaron en la pérdida del compromiso profesional que las lleva a dejar el cuidado de cabecera. La categoría central del estudio que unió las categorías encontradas fue: "Fracaso para integrar las expectativas personales con expectativas de la organización: en busca de una salida". Conclusión:los hallazgos de este estudio proporcionan información útil sobre las necesidades de las enfermeras para superar las intenciones de abandonar el cuidado de cabecera. La identificación de este proceso puede ayudar a reconocer los problemas emergentes y ofrecer soluciones para resolverlos.

背景与目标： 目的：本研究探讨了打算离开床边护理的过程。
方法：采用扎根理论方法，从21名护士的角度研究了这一过程。使用半结构化访谈收集数据，并使用Corbin和Strauss的恒定比较方法进行数据分析。
结果：根据参与者的意见，两个主要类别是“护理的社会形象”和“床边的文化和结构”，这是影响为什么护士离开床边护理服务的背景因素。对临床经验缺乏认识或缺乏进展的失望情绪构成了参与者的主要社会心理顾虑。能力和自我控制的过程是参与者采取的步骤。这些与介入状况相关的结果导致丧失了专业承诺和渴望离开床边护理的后果。 “未能将个人期望与组织期望整合：寻求逃避”是将各个类别联系在一起的研究的中心类别。
结论：这项研究的发现为护士克服床边护理的需求提供了有用的信息。识别此过程可以帮助您识别新出现的问题并为其提供解决方案。
对象：在企业中发展的过程，以及在企业中发展的过程。
方法：对基础理论进行21世纪的透视。（Teoria Fundamentada）。科罗拉多州立大学分校的校徽和科宾大学和斯特劳斯分校的半合校课程。
结果：参加者，基本原则，“企业形象”和“企业文化”，以及“因人而异”，如“应有尽有”。参加竞赛的演说者和从业者所经历的成就的逐渐变迁。参加自动竞赛的竞争者。 Isso associado acondiçõesdeconvençãoforam os resultados da perda do compromisso profissionalque as leva a deixar o cuidado de cabeceira。类别中的中部类别为“类别中的预期合集”。
结论：作为必要的必要性，作为对dexar o cuidado de cabeceira的需求。一个确定性的加工过程中，由于解决了紧急解决方案而出现的问题，这是一个重新思考的问题。
对象：从工作室到电影院的探索，从电影院到电影院的演出。
方法论：扎根理论的实用理论21（TeoríaFundamentada）。 Los datos se recogieron utilizando entrevistas semiestructuradas; Para analyzar los datos seutilizóelmétodocomparativo constante de Corbin y Strauss。
结果：主体参与人（“enfermería社会影像”和“ cacucera y estructura de cuidado”）上下文关系因人而异。参加者在体验性进步方面的成就得到了极大的认可。参与者参加自动控制的能力和过程控制权之间的纠纷，以及在任何情况下都必须遵守的自动控制权。在中央美术学院就读的主题是：“对人的期望的整体构架：在商业上的期望”。
结论：失去了一切，失去了一切，失去了一切。紧急情况处理过程中出现的紧急情况，由解决方案产生。

BACKGROUND & AIMS: :The end of the twentieth century and the beginning of the twenty-first century are marked by technology revolution and strategic changes in organizations. Strategies such as the e-learning, has been used for training human resources. This study aimed to compare the knowledge acquired among groups of nurses who used e-learning and those who undergone a traditional classroom training. The true-experimental design was used followed by a quantitative analysis. This study was performed at the Hospital and Maternity São Luiz. The study population was composed by 60 nurses, randomly assigned to two groups, named A and B. Group A received the traditional classroom training and group B received the computer-assisted training. In the data collection, participants filled in a questionnaire before and after the training to evaluate their knowledge and to characterize the population. Results showed there was an equal acquisition of knowledge in both groups; confirming the efficacy of both methods.

背景与目标： ：二十世纪末和二十一世纪初是技术革命和组织战略变革的标志。电子学习等策略已用于培训人力资源。这项研究旨在比较使用在线学习的护士和接受过传统课堂培训的护士之间获得的知识。使用真实实验设计，然后进行定量分析。这项研究是在圣路易斯医院和孕妇医院进行的。研究人群由60名护士组成，随机分为两组，分别为A和B。A组接受了传统的课堂培训，B组接受了计算机辅助培训。在数据收集中，参与者在培训前后填写了问卷，以评估他们的知识并表征人群。结果表明，两组的知识获取量均相等。确认两种方法的功效。

BACKGROUND & AIMS: :While the nephrology nursing shortage persists despite the continued growth of the population of individuals with Stage 5 chronic kidney disease, there is a paucity of empirical data regarding nephrology nurses' perceptions of their work environments. Moreover, there are no studies that have examined the relationship of work environment attributes to patient and nurse outcomes in dialysis settings. The purpose of this study was to examine the relationships between staff nurses' perceptions of dialysis work environments, nurses' intentions to leave their current jobs, nurse turnover, patient satisfaction, and patient hospitalization rates. A descriptive, correlational design was used. Nurse level and facility level data were obtained. The sample for nurse-level data consisted of 199 registered nurses in staff nurse roles in 56 dialysis facilities of a national dialysis company. The sample for facility-level analysis consisted of 46 dialysis facilities, and nurse-level data were aggregated for facility-level analysis. The Practice Environment Scale-Nursing Work Index (PES-NWI) was used to measure nurses' perceptions of the dialysis work environment. Nurses' intention to leave their jobs and facility-level turnover rates were the nurse outcomes examined in this study. Facility-level patient satisfaction and hospitalization rates were the patient outcomes examined. Correlation coefficients were computed to measure the relationships between study variables, and independent t-tests were performed to examine subgroup differences in work environment perceptions. Overall, nurses rated the work environment somewhat favorably. Nurses who expressed intention to leave their jobs rated the work environment more negatively compared to nurses who intended to stay. Significant correlations were found between nurses' perceptions of the dialysis work environment, nurses' intention to leave their jobs, nurse turnover rates, and patient hospitalizations. Study findings suggest that nurses' perceptions of the dialysis work environment are important for nurse and patient outcomes in dialysis settings. Further research is needed to explore the predictive ability of the work environment for nurse and patient outcomes in hemodialysis units.

背景与目标： ：尽管尽管患有5期慢性肾脏病的人数持续增长，但肾科护理人员短缺仍然存在，但是关于肾科护士对其工作环境的看法的经验数据很少。此外，尚无研究检查透析环境中工作环境属性与患者和护士结局之间的关系。这项研究的目的是检验护士对透析工作环境的看法，护士离职的意图，护士离职率，患者满意度和患者住院率之间的关系。使用了描述性的相关设计。获得了护士级别和设施级别的数据。护士级数据的样本由199家在一家国家透析公司的透析设施中担任护士职位的注册护士组成。用于设施级分析的样本由46个透析设施组成，并且汇总了护士级数据以进行设施级分析。实践环境量表-护理工作指数（PES-NWI）用于衡量护士对透析工作环境的看法。护士离开工作的意图和机构级别的离职率是本研究中检查的护士结局。设施水平的患者满意度和住院率是检查的患者结局。计算相关系数以衡量研究变量之间的关系，并进行独立的t检验以检验工作环境感知中的亚组差异。总体而言，护士对工作环境的评价较高。与打算留下来的护士相比，打算离开工作的护士对工作环境的评价更为负面。在护士对透析工作环境的看法，护士离开工作的意愿，护士离职率和患者住院之间，发现了显着的相关性。研究结果表明，护士对透析工作环境的理解对于透析环境中的护士和患者结局非常重要。需要进一步的研究来探索工作环境对血液透析部门护士和患者结果的预测能力。

BACKGROUND & AIMS: OBJECTIVES:To test an educational intervention designed to improve lactation knowledge, attitudes, and beliefs of NICU nurses and to improve their intentions to provide mothers with lactation support. DESIGN:Quasi-experimental, time-series pretest/posttest. SETTING:NICU of a Midwestern, free-standing, tertiary-care children's hospital. PARTICIPANTS:Convenience sample of 64 NICU nurses and 2 separate convenience samples of mothers of infants hospitalized in the NICU (n=19 and 13, respectively). METHODS:Nurses were measured on study outcomes at multiple time points, beginning with 2 weeks before and ending at 3 months after attendance to a 4-hour educational program. Mothers were sampled before and 3 months after the intervention. MAIN OUTCOME MEASURE(S):Nurses' lactation knowledge, attitudes, beliefs, and intentions to support lactation and mothers' perceptions of lactation support in the NICU. RESULTS:Findings suggest that this educational intervention was effective for improving NICU nurses' lactation knowledge and attitudes, and that these improvements were maintained over time. Further, the supportive atmosphere for lactation in this NICU significantly improved following the implementation of the educational intervention for nurses. CONCLUSION:Intermittent, short educational programs which include practical how-to's and motivational encouragement for staff may provide the empowerment nurses need in order to be supportive of lactation.

背景与目标： 目的：测试旨在提高NICU护士的哺乳知识，态度和信念并改善其为母亲提供哺乳支持的意图的教育干预措施。
设计：准实验性，时间序列的前测/后测。
地点：中西部独立式三级儿童医院的NICU。
参与者：64位新生儿重症监护病房护士的便利性样本和在新生儿重症监护病房住院的婴儿母亲的2个单独的便利性样本（分别为n = 19和13）。
方法：从多个时间点（从参加4小时教育计划的前2周开始到结束3个月后）对学习结局进行测量。在干预前和干预后三个月对母亲进行了采样。
主要观察指标：护士对哺乳的知识，态度，信念和意图，以及母亲对新生儿重症监护病房的哺乳支持的看法。
结果：研究结果表明，这种教育干预措施可有效改善重症监护病房护士的哺乳知识和态度，并且随着时间的流逝，这些改善措施得以保持。此外，在实施护士教育干预后，该新生儿重症监护室（NICU）的哺乳支持气氛得到了显着改善。
结论：间歇性，短期的教育计划包括实用的操作方法和对员工的激励性鼓励，可以为护士提供支持哺乳所需的能力。

BACKGROUND & AIMS: BACKGROUND:Screening, brief intervention, and referral to treatment (SBIRT) for substance use has an impact on morbidity and mortality and health care cost. LOCAL PROBLEM:Nurses in ambulatory care settings may lack knowledge about evidence-based substance use SBIRT. METHODS:A comparison of pre- and postintervention data was performed to determine whether knowledge improved and to identify facilitators and barriers to SBIRT implementation. INTERVENTIONS:Nurses completed an online self-paced program focusing on alcohol and drug use screening, motivational interviewing used in a brief intervention, and referral to specialty treatment. RESULTS:Postintervention knowledge scores increased (P < .001). Facilitator and barrier themes included time, education, resources, receptivity, and interprofessional collaboration. CONCLUSIONS:The implementation of the SBIRT online program was feasible for nurses to complete during work hours and resulted in increased SBIRT-related knowledge.

背景与目标： 背景：筛查，短暂干预和转介治疗（SBIRT）以使用药物会影响发病率，死亡率和医疗保健成本。
本地问题：非卧床护理环境中的护士可能缺乏基于证据的药物使用SBIRT的知识。
方法：比较干预前和干预后的数据，以确定知识是否有所改善，并确定实施SBIRT的促进因素和障碍。
干预措施：护士完成了一个在线自定进度的计划，重点是酒精和药物使用筛查，简短干预中使用的动机访谈以及转诊至专科治疗。
结果：干预后知识得分增加（P <.001）。促进者和障碍的主题包括时间，教育，资源，接受能力和专业间的合作。
结论：实施SBIRT在线计划对于护士在工作时间内完成工作是可行的，并增加了与SBIRT相关的知识。

BACKGROUND & AIMS: :Health care systems are changing at an unprecedented rate, but few are making the changes in a system affecting nearly 200,000 staff in over 1,100 different sites of service delivery originating from 171 medical centers nationwide, as is the Veterans Health Administration. The issues of change, quality of care, morale and opportunities involved in being a nurse today in a system undergoing this magnitude of change is presented within the framework of the quality of care initiatives that have been launched by VA. The new organization design of VA, emphasizing local decision-making, a description of the multiple quality programs recently introduced and integrative strategies that have been used by the Nursing Strategic Healthcare Group, the VA corporate level policy and nursing programs information center for the country, to support the change process are discussed.

背景与目标： ：医疗保健系统正在以前所未有的速度变化，但很少有系统在变化，这种变化影响了来自171个医疗中心的1,200多个服务站点中近200,000名员工，而退伍军人健康管理局也是如此。在弗吉尼亚州发起的护理质量计划的框架内，提出了在当今经历如此巨大变化的系统中，成为一名护士所涉及的变革，护理质量，士气和机会等问题。弗吉尼亚州的新组织设计，着重于地方决策，描述了最近引入的多项质量计划以及护理战略医疗保健集团，该州弗吉尼亚州公司级政策和护理计划信息中心所采用的综合策略，支持变更过程的讨论。

BACKGROUND & AIMS: BACKGROUND:It is important to clarify nurses' perceptions of conditions for patient education in daily work as research findings are ambiguous. There is a gap between societal regulations on nurses' competence in accomplishment/achievement of patient education and research findings. AIM:The aim was to describe nurses' perceptions of conditions for patient education, focusing on aspects of competence. The aim was also to describe differences in conditions for nurses working in primary, municipal and hospital care. METHODS:The study is a cross-sectional survey and is part of a project about nurses' patient-education. A randomized selection of nurses (842) received a questionnaire comprising 47 items concerning factual experience and attitudes to patient education and 13 background items. Questionnaires were returned by 83% of participants. Descriptive statistics, non-parametric tests and content analysis for open-ended items were used. RESULTS:Nurses' perceptions of conditions for patient education differ between health-care settings. Primary care nurses are at an advantage in following research in patient education, perception of their own competence (prioritizing and knowing their mandate in patient teaching), pedagogical education and post graduate specializations. CONCLUSIONS:Nurses' patient education must be more visualized and appropriate conditions created at each workplace. In this change process, managers' support is considered vital.

背景与目标： 背景：由于研究结果含糊不清，因此必须弄清护士对患者在日常工作中所受教育条件的看法。关于护士在完成/实现患者教育和研究结果方面的能力的社会法规之间存在差距。
目的：旨在描述护士对患者教育条件的看法，重点放在能力方面。目的还在于描述初级，市政和医院护理工作护士的条件差异。
方法：这项研究是一项横断面调查，是有关护士患者教育项目的一部分。随机选择的护士（842）收到了一份调查表，包括47项与事实经验和对患者教育的态度有关的调查表，以及13项背景调查表。 83％的参与者返回了问卷。使用了开放性项目的描述性统计，非参数测试和内容分析。
结果：在医疗机构之间，护士对患者教育条件的看法有所不同。初级保健护士在以下方面具有优势：在患者教育方面的研究，对自身能力的感知（优先考虑和了解患者在教学中的职责），教育学教育和研究生专业。
结论：护士的患者教育必须更加形象化，并在每个工作场所创造适当的条件。在这种变革过程中，经理的支持被认为是至关重要的。

BACKGROUND & AIMS: :Oncology nurses encounter increasingly complex ethical challenges in clinical practice. This ethnographic study explored 30 oncology nurses' descriptions of ethical situations and 12 key informants' perspectives on factors that influence the development of ethically difficult situations. Nurses described the goals of preventing patient suffering and injury, being honest with patients, and contributing meaningfully to patient improvement and stated goals. Nurses experienced six primary challenges in meeting their goals: being the eyes and arms of patient suffering, experiencing the precariousness of competing obligations, navigating the intricacies of hope and honesty, managing the urgency caused by waiting, straining to find time, and weighing risks of speaking up in hierarchal structures. Nurse actions included addressing concerns, creating other avenues, murmuring to one another, staying silent, and looking away. Several factors influenced nurses' responses to ethical challenges. Results imply a contextual model of moral action that reveals a need for altering practice environments in addition to improving nurses' ethics skills. Nurses are very aware of their moral responsibilities in ethically difficult situations and need work environments conducive to interprofessional collaboration and open dialogue.

背景与目标： ：肿瘤科护士在临床实践中面临越来越复杂的伦理挑战。这项人种学研究探讨了30位肿瘤科护士对道德状况的描述，以及12位主要信息提供者对影响道德困难状况发展的因素的观点。护士描述了预防患者遭受痛苦和伤害，对患者诚实并为患者改善做出有意义的贡献的目标，并阐明了目标。护士在实现其目标方面遇到了六个主要挑战：成为患者痛苦的眼睛和手臂，经历竞争义务的pre可危，克服希望和诚实的错综复杂，管理因等待而造成的紧迫性，费力地寻找时间，以及权衡风险在层级结构中发言。护士的行动包括解决疑虑，开辟其他渠道，互相抱怨，保持沉默以及将目光移开。几个因素影响了护士对道德挑战的反应。结果暗示道德行动的情境模型表明，除了提高护士的道德技能外，还需要改变实践环境。护士非常意识到自己在道德困难的情况下应承担的道德责任，因此需要有利于专业间合作和公开对话的工作环境。

BACKGROUND & AIMS: :As nurses move into more nontraditional, expanded roles, they sometimes lack a social and professional support group within the work setting. Feeling isolated and lacking support, several clinical nurse specialists (CNSs) at a large county institution began the Specialty Nursing Council. The Specialty Nursing Council provides a means of networking and support for nurses in specialty roles in a three institution health care campus. Monthly meetings are conducted to bring members together and for continuing education programs. The keys to success in forming this type of council are: 1) a dedicated group that plans, organizes, and distributes informational material; 2) common goals and objectives; 3) direct benefits to members.

背景与目标： ：随着护士担任非传统的，扩展的角色，他们有时在工作环境中缺乏社会和专业支持小组。感到孤立无援且缺乏支持，一家大型县级机构的几名临床护士专家（CNS）成立了专业护理委员会。专业护理委员会为三机构医疗保健园区中担任专业角色的护士提供了一种联网和支持的手段。每月举行一次会议，以使成员聚集在一起并参加继续教育计划。成立这种类型的理事会的成功关键在于：1）一个专门小组，负责计划，组织和分发信息材料； 2）共同的目标； 3）直接给会员带来的好处。

BACKGROUND & AIMS: :Little is known about the current training and barriers in resuscitation skills among practicing ward nurses. A convenience sample of 459 ward nurses, recruited from 11 academic teaching hospitals in Korea, were surveyed to assess current training and barriers to optimal resuscitation performance on the wards. The Perceived Barriers scale was developed, refined, and its psychometric properties were assessed. Approximately 36% of nurses had received simulation-based resuscitation skills training. Exploratory factor analysis identified four barriers accounting for 58.4% of the variance: insufficient training (37.7%), lack of competence (9.8%), lack of self-confidence (5.9%), and workload and tension (5.1%). Strategic planning and resuscitation skills training should be incorporated into staff development programs to reduce barriers to optimal resuscitation performance and cope with work demands for ward nurses.

背景与目标： ：关于执业病房护士当前对复苏技能的培训和障碍知之甚少。从韩国11家学术教学医院招募的459名病房护士的便利样本进行了调查，以评估病房当前的培训和最佳复苏性能的障碍。感知障碍量表得到了发展，完善，并评估了其心理测量特性。大约36％的护士接受了基于模拟的复苏技能培训。探索性因素分析确定了四个障碍，占差异的58.4％：培训不足（37.7％），缺乏能力（9.8％），缺乏自信（5.9％），工作量和紧张程度（5.1％）。应将战略规划和复苏技术培训纳入员工发展计划中，以减少实现最佳复苏绩效的障碍并应对病房护士的工作需求。