Nursing -- Practice

With passage of the Patient Protection and Affordable Care Act (PPACA) and the
publication of the Institute of Medicine’s report on the future of nursing, nurses are slated to take on an expanded role in primary healthcare delivery in the near future. Nurse practitioners, in particular, will be instrumental in filling the gap in primary care
availability engendered by the increasing specialization of physician practice and
increased access to healthcare made possible by the provisions of the PPACA.
The need for this study was identified through gaps in the literature related to nurse practitioner practice; specifically, the paucity of quantitative research regarding
patients’ perspectives of core holistic nursing values in nurse practitioner care, and, since nursing care is by definition and tradition holistic in nature, this inquiry attempted to quantify the degree to which nurse practitioner care upholds and preserves core holistic nursing values.

Patients who are hospitalized and are without voice would like to participate in
their care. This requires clear communication. Speak for Myself™ (SFM) was developed
for use at the bedside so that communication may be facilitated between patient and nurse when the patient is voiceless. The objective of this study was to evaluate Speak for Myself™ at the bedside and to measure the outcomes. This was a mixed methods, one group pre-test-post-test, quasi-experimental study. Twenty adult patients in three
hospitals in South Florida agreed to use Speak for Myself™ during their acute care
hospital stay (M = 8.86 hours). This group of participants (n = 20) ranged from 45 to 91
years old (males = 14; females = 6). Of the participants, 15 (75%) self-identified as
European American, 2 (10%) self-identified as Hispanic, 2 (10%) self-identified as
African American, and 1 (5%) self-identified as Asian. Ten of the participants (50%)
were in respiratory failure. Two (10%) were receiving oxygenation measures related to
unspecified complications of their illnesses. Of the remaining eight participants (40%),
one each was receiving oxygenation measures due to atrial fibrillation, arteriosclerotic
heart disease, cardiogenic shock, endocarditis, neck abscess, renal failure, status post
seizure activity, and tongue metastasis.