Telephone triage and consultation is increasingly being used to counsel patients about the appropriate level and timing of care. Nurses are becoming the most frequently used health care professionals providing this care. Although roles vary, consensus is emerging about role definition, scope of practice, and use of protocols. Professional associations and state boards of nursing are examining critical issues related to licensure and standards of practice. Nurses who practice telephone triage and consultation indicate that it is an exciting and demanding specialty with unique issues related to quality, documentation, amount of experience necessary, information resources, and supportive technology. The issues reported by practicing nurses are not necessarily those reported in the literature (e.g., liability, licensure, and practice standards). Developing or modifying current standards of practice needs immediate attention from professional nursing groups, as does the issue of licensure. Nursing educators need to be aware of this emerging role and prepare their students to function competently in this area. Finally, researchers have a rich and varied field of study around this new practice field and its impact on patient care and outcomes.

Adult↗

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Actual burn nutrition care practices. A national survey (Part I).

Explore the source record for details and available documents.

Burn Units↗

PubMedDate not supplied

Actual burn nutrition care practices. A national survey (Part II).

Explore the source record for details and available documents.

Adult↗

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Familial aggregation studies with matched proband sampling.

A method is proposed for the analysis of clustered, continuous data arising from matched familial aggregation studies. The problem is suggested by a study designed to estimate the familial aggregation of obstructive sleep apnea (OSA). The study design uses 'proband' sampling, in which individuals identified at sleep clinics as having a high degree of OSA ('cases') are matched to neighborhood 'controls', individuals with normal levels of OSA. The resulting data are used to develop estimates of familial correlations for indices of hypopnea/apnea derived from the sleep monitoring of individual family members. The properties of conditional multivariate normal distributions and random-effects models are used to accommodate proband sampling and matching effects. Examples and simulations are used to demonstrate the importance of applying the proposed procedures.

Adolescent↗

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ERASMUS cultural exchanges in Europe.

This article addresses the history and aims of the European Community's (EC) ERASMUS cultural exchange scheme for nursing students in higher education. It also examines the process of setting up an ERASMUS network, drawing on personal experience gained over the last 3 years, in order to help those who may be contemplating ERASMUS cultural exchanges for students and staff.

Curriculum↗

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Further understanding of, and a new treatment for, "Irukandji" (Carukia barnesi) stings.

A brief analysis is presented of the large recorded numbers of swimmers who have been stung by the "Irukandji" (Carukia barnesi) jellyfish during the 1985-1986 summer season in north Queensland, and the results are discussed. Many of the victims may suffer from symptoms of overstimulation of the sympathetic system, and hypertension is shown to be another complication of this syndrome. This hypertension seems to respond well to intravenously-administered phentolamine, an alpha-adrenergic receptor blocking drug. Phentolamine also reduces the excessive shaking and sweating that appears to be part of the "Irukandji syndrome". Diazepam relieves the anxiety which is part of the syndrome, but antihistamine agents and hydrocortisone seem to have no beneficial effect.

Adult↗

PubMedDate not supplied

The balanced scorecard: a potent tool for energizing and focusing healthcare organization management.

The current environment for healthcare organizations contains many forces demanding unprecedented levels of change. These forces include changing demographics, increased customer expectations, increased competition, and intensified governmental pressure. Meeting these challenges will require healthcare organizations to undergo fundamental changes and to continuously seek new ways to create future value. This article provides explanation of a potent new management tool-the balanced scorecard-that can be used by healthcare organizations to meet these challenges. The article also presents the opinions of many high-level healthcare administrators that the balanced scorecard can be highly beneficial to healthcare organizations. It also summarizes these administrators' suggestions regarding the goals and measures that can make up an effective scorecard for a hospital as a whole, as well as for a specific subunit of a hospital. Interestingly, while no published report of balanced scorecard implementations in healthcare organizations exists, a number of administrators stated that they had fully implemented systems similar to the scorecard. These actions can be considered support for the scorecard's potential usefulness; at the same time, they suggest that some sharing of experiences will likely be available in the future. As all administrators are well aware, moving from concept to practice is often difficult. While the article includes some suggestions for scorecard development and implementation, each organization must engage in the full range of activities, from defining its mission to the selection of goals and strategies, and develop its own unique scorecard to assist progress toward the selected goals. As a starting point, Table 3 provides a timeline of some general events that may be common to all organizations during this process.

Benchmarking↗