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Biomedical subjects

A L Kitson

Publications and source records attributed to A L Kitson.

10 recordsLinked to original sources
PubMed2001

Does nursing education have a future?

This paper analyses the relationship between government and nurse education policy using the current changes in England as a case study. It argues that there are times when ideologies of governments and professions coalesce, signifying the most opportune times for advancement. It also illustrates times when policy shifts are made because nursing is perceived as relatively insignificant in the order of health policies and politics. It goes on to argue that nursing leaders need to be aware of the political and policy context in order to select the most effective methods of moving the agenda forward. Using UK reforms, particularly the English strategy document Making a Difference (Department of Health 1999d) as a case study, the paper analyses recent events in nurse education to illustrate the key points. The paper concludes by suggesting that the nursing profession must recognize promoters and barriers for change and commit itself to the transformation of nursing practice through the realization of a new educational agenda that embraces the principles of new democracy. Namely, these are equality, mutual responsibility, autonomy, negotiated decision-making, inclusivity, collaboration and celebrating diversity.

Clinical Competence↗
PubMed1997

Cardiac rehabilitation services in England and Wales: a national survey.

We sent a short postal questionnaire to 244 centres in England and Wales that admitted patients with cardiac conditions. In total, 199 (81%) of the centres claimed to provide a cardiac rehabilitation service. Of these, 25 were randomly selected as a representative sample and visited in order to obtain detailed information concerning the provision of services. Most (18 (72%)) of the centres had commenced their rehabilitation programme within the previous 5 years, usually at the instigation of interested staff. Patient entry to cardiac rehabilitation programmes was restricted; women (who represented only 15% of attenders), elderly people (excluded in 10 (40%) centres), and those with more complex problems, such as angina or heart failure, were under-represented. The central components of all programmes were education and exercise training but there was a wide range in the quantity and quality of service provision. Most (22 (88%)) programmes were hospital out-patient based, one (4%) was hospital in-patient based, one (4%) was community-based and one (4%) was home-based. The staffing and funding of programmes was variable, with 7 (28%) having no identified funding. There are wide variations in the resources currently available for the rehabilitation of patients with coronary heart disease. There is a need for clearer direction of these services, in particular to determine minimum service provision. Guidelines are necessary to give a framework for this relatively new and rapidly expanding service.

Aged↗
PubMed1997

Johns Hopkins address: does nursing have a future?

PURPOSE: To outline the importance of identifying where nursing is heading as a profession and explore the metaphors it uses to explain its role to society. Current images of nursing are confused. Nurses should articulate clearly why nursing should be retained as a social force for improving health and meeting the needs of vulnerable people. SCOPE: The historical development of nursing considering the metaphors used. CONCLUSIONS: Because of contemporary pressures on nursing, the metaphors used are inconsistent and require interpretation. Nurses should find new metaphors and resolve complex internal tensions. Unless nursing can articulate its primary function more cogently, it risks extinction.

History of Nursing↗
PubMed1996

Clinical guidelines: an introduction to their development and implementation.

There is a great deal of interest in the United Kingdom in clinical guidelines as a means of assisting practitioner and patient decision making about care options and in improving the quality of the care provided. Confusion remains, however, over what is meant by a clinical guideline and how it differs from and relates to protocols and standards. This paper was written under the auspices of the Royal College of Nursing Steering Group for the college's work on clinical guidelines, with the aim of clarifying some of the terminology used in the field and introducing ways in which clinical guidelines might be used by practitioners and patients to readers. At the moment just how effective the use of clinical guidelines can be on care is poorly established. What is known, however, is that crucial to their success are the strategies and methods used for their implementation. Such strategies and methods raise questions about how a sense of ownership can be engendered in those using the clinical guidelines and how they may be best operationalized. These questions are considered in this paper.

Clinical Protocols↗
PubMed1996

Cardiac rehabilitation in the United Kingdom: guidelines and audit standards. National Institute for Nursing, the British Cardiac Society and the Royal College of Physicians of London.

This paper summarises a multidisciplinary workshop convened to prepare clinical guidelines and audit standards in cardiac rehabilitation in the United Kingdom. The workshop developed a three element model of the rehabilitation process and identified needs relating to medical and psychosocial care and the potential contributions of exercise, education, secondary prevention, and vocational advice. Draft clinical standards are proposed as a basis for locally developed guidelines and further research.

Cost-Benefit Analysis↗
PubMed1989

The role of the professional organisation in setting standards for nursing.

This paper explores a number of ways in which a professional nursing organisation may be involved in setting standards and evaluating practice. Aspects of this role will be discribed using two approaches: the paper starts off by tracing the developments in standard setting in a number of key professional nursing organisations and goes on to describe in detail how one organisation has approached the task. The paper concludes by highlighting a number of factors that need careful consideration by groups who might wish to develop similar projects.

Australia↗
PubMed1987

A comparative analysis of lay-caring and professional (nursing) caring relationships.

Acceptable definitions of the terms care and nursing have yet to be reached. Some may feel that lack of agreement on the meaning of these concepts is a rather esoteric or academic point: the argument put forward in this paper is that until a clearer perception of the concepts of care and nursing is arrived at, the profession will be limited in its ability to develop its expertise or to set standards related to the quality of care. The paper outlines the extent to which these concepts have been explored and details the developments and some of the limitations of present modes of thought. An alternative perspective is offered, based on a comparative analysis of the professional (nursing care) and lay-caring relationships. By this means, a set of characteristics similar in both relationships, has been identified. Quality of care in the professional caring relationship is thought to relate to the extent to which aspects of caring activities implicit in the lay-caring relationship are carried into the professional nurse-patient relationship and made explicit. The ability of the nurse to do this emerges as one aspect of her therapeutic nursing function.

Aged↗
PubMed1987

Raising standards of clinical practice--the fundamental issue of effective nursing practice.

The proposition put forward in this paper is that standards of nursing practice can only be assured if the profession is able to find ways of responding to the intuitions and gut reactions of its practitioners. Rather than deny them, nurses have to know how to test and thus legitimize them. Such a validation process demands more clinically based nursing research projects and the proliferation of arrangements such as clinical nursing practice units. It is further argued that by linking the intuitive and rational aspects of nursing in this way the profession is in a better position not only to fulfil its societal obligations but also to build up its own knowledge and skills.

Clinical Competence↗
PubMed1986

Indicators of quality in nursing care--an alternative approach.

Indicators of quality of nursing care were developed from a conceptual framework for geriatric nursing based on the twin concepts of care and having a positive attitude to the health and welfare of old people. These primary concepts were further developed using structural aids, in particular the theoretical guidelines for practice disciplines propounded by Dickoff et al. From this, a measure, called the Therapeutic Nursing Function (TNF) Indicator, was devised which attempted to identify those ward sisters who provided more patient-centred or therapeutic nursing care from ward sisters who gave routine-centred or non-therapeutic nursing care. The TNF Indicator, based on the conceptual framework, comprised a list of statements to which ward sisters responded. The scaling system divided responses into more--or fewer--therapeutic nursing responses. A stratified random sample of 25 ward sisters was used in the study and from this the characteristics of ward sisters in the upper and lower range of the scale were compared. Distinct variations were noted between groups in relation to demographic information, perception of geriatric nursing, use of nursing information, management approach and the ward sisters' concept of rehabilitation. A further instrument, the Therapeutic Nursing Function Matrix, attempted to measure the quality of care patients were receiving on geriatric wards. Nurse-patient interaction on a ward where the ward sister had a high TNF Indicator score was compared to a ward where the ward sister had a low score. The results showed that quality of care seemed to be related more to the orientation and perception of the ward sister than to any number of extraneous variables such as medical and paramedical input, ward facilities and ancillary staff support.

Activities of Daily Living↗