Effect of Joint Commission International Accreditation on the Nursing Work Environment in a Tertiary Medical Center.

How might a tertiary hospital's nursing staff respond to the huge improvement effort required for external accreditation if they are encouraged to lead the change process themselves? This article reports the results of a concurrent evaluation of the nursing work climate at ward level, before and after accreditation by the Joint Commission International. Physician-nurse relations improved; the involvement of social workers, dieticians, and physiotherapists increased; support services responded more quickly to requests; and management-line staff relations became closer.

Computerization and its contribution to care quality improvement: the nurses' perspective.

Background: Despite the widely held belief that the computerization of hospital medical systems contributes to improved patient care management, especially in the context of ordering medications and record keeping, extensive study of the attitudes of medical staff to computerization has found them to be negative. The views of nursing staff have been barely studied and so are unclear. The study reported here investigated the association between nurses' current computer use and skills, the extent of their involvement in quality control and improvement activities on the ward and their perception of the contribution of computerization to improving nursing care.

Moral distress and structural empowerment among a national sample of Israeli intensive care nurses.

Aim: The aim of this study was to determine levels of structural empowerment, moral distress, and the association between them among intensive care nurses.

Background: Structural empowerment is the ability to access sources of power. Moral distress is the painful feelings experienced when a person knows the right thing to do but cannot do so due to external constraints.

ICU nurses' oral-care practices and the current best evidence.

Purpose: The purpose of this study was to describe the oral-care practices of ICU nurses, to compare those practices with current evidence-based practice, and to determine if the use of evidence-based practice was associated with personal demographic or professional characteristics.

Design: A national survey of oral-care practices of ICU nurses was conducted using a convenience sample of 218 practicing ICU nurses in 2004-05. The survey instrument included questions about demographic and professional characteristics and a checklist of oral-care practices.