In Scotland a national audit project has been undertaken to devise evidence-based guidelines for the clinical management of patients with tuberous sclerosis (TS), a dominantly inherited multisystem disorder. In order to facilitate the audit and use of these guidelines a 'Care Pathway' was devised to form the patient records. We describe the process of guideline development for TS and our TS Care Pathway.

Evidence-Based Medicine↗

PubMedDate not supplied

Is there another nursing shortage? What the data tell us.

New York State has a very large nursing population. We examined several sources of wage, employment, and other data and determined the presence of a moderate nursing shortage in New York State.

Data Interpretation, Statistical↗

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Active learning strategies to teach case management.

Changes in healthcare delivery require a new understanding of the concepts of case management in managed care. The authors describe the construction and evaluation of a learning module that encourages active engagement and skill development. Students develop an understanding of how to plan for care of populations in an effort to meet managed care demands. This approach to teaching case management can be effective in an educational setting and possibly in clinical settings as well.

Case Management↗

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Guidelines for evaluating tools for clinical decision making.

Managed care is designed to reduce healthcare costs by controlling use of services and by improving quality outcomes. Preparation of nurses to practice in a health management environment mandates clear understanding of this new environment Nursing educators should focus on the spectrum of health services and enhance the nurses'ability to assess patients independently, implement health plans, and be responsible for outcomes. Nurses must understand how clinical decision-making tools facilitate planning care to maximize use of resources. The authors describe the construction and evaluation of a learning strategy that involves the use of guidelines to evaluate clinical decision-making tools. Two examples are presented: evaluating clinical pathways in a case management project and evaluating algorithm (practice guideline) outcome data from a prenatal population case study from a local health maintenance organization.

Algorithms↗

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BRCA1 gene testing for breast and ovarian cancer in one family.

Most breast cancer is multifactorial in origin, but dominantly inherited genes are implicated in the development of approximately 5-10% of breast cancer as a whole. The identification of the BRCA1 gene, thought to account for 2% of all breast cancer and be present in almost all families affected by breast and ovarian cancer, makes testing for susceptibility to breast and ovarian cancer possible for the few families in which researchers have identified a gene mutation. Genetic counselling, by medically qualified geneticists, is available for people with rare genetic conditions caused by gene mutations. In this article, the authors describe their first experience of BRCA1 gene testing in 23 family members. They identify a unique role within a new specialty, cancer genetics, for specialist nurse practitioners in genetic testing and counselling.

Adolescent↗

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Alcohol and the brain.

Explore the source record for details and available documents.

Alcoholism↗

PubMedDate not supplied

No alternative.

Explore the source record for details and available documents.

Complementary Therapies↗