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PubMed2006

[Impact on the professional practices of French dermatologists of the 2001 consensus conference on the care of immunocompetent patients with cutaneous or mucous membrane herpes infection].

BACKGROUND: Our aim was to assess the impact of the 2001 French Consensus Conference on the professional practices of French dermatologists treating immunocompetent patients with mucocutaneous herpes simplex infection (ocular herpes excluded). This conference was preceded by a survey that revealed a lack of homogeneity in practices. METHODS: A questionnaire (similar to that of 2001) was submitted in 2003 to 205 dermatologists, half of whom had responded to the first survey. It contained 40 questions about diagnosis, prevention and treatment. The analysis compared the answers given in the 2001 survey with those of dermatologists either answering for the first time or answering again in 2003. RESULTS: In 2003, the response rate was of 96% (43% in 2001). Statistically significant changes were obtained for the following items: better knowledge of situations requiring a precise history of herpes infection, dramatic decrease in prescribing herpes serological tests, increase in prescribing serological tests for other sexually transmitted diseases in patients with genital herpes, better knowledge of prevention strategies, decreased intention of prescribing topical antiviral agents, increased intention of using oral antiviral agents in patients with recurrent genital or orofacial herpes and those with recurrent erythema multiforme. No statistically significant improvement was noted regarding: failure to prescribe any direct virology test to confirm herpes infection before prescribing long-term viral treatment, high use of "prophylactic" oral antivirals in patients with recurrence of UV-induced herpes. DISCUSSION: The fact that the telephone survey was conducted by a dermatologist rather than a service provider could account for the very high response rate observed. The utilization of a part of the sample of practitioners surveyed in 2001 lends credibility to the results. Our study nevertheless remains a survey of prescribing intentions rather than of actual practice. While the 2001 consensus conference on the practices of French dermatologists appears to have had a clear effect regarding numerous items, considerable progress is still required in certain diagnostic and therapeutic areas.

Consensus Statements as Topic↗
PubMedDate not supplied

Achieving a professional practice model. How primary nursing can help.

The authors of this article show how a change to primary nursing causes a series of predictable changes in hospital organizations and nursing departments. They conceptualize the series of changes as a continuum. Using their continuum as a framework, they analyze primary nursing at six acute care hospitals, noting how the changes in nursing practice affect seven key variables in the organization. Nursing leaders may wish to use the insights provided by the framework to push their organizations further toward the goal of more autonomy, power, and achieving a model of professional practice.

Authoritarianism↗
PubMed2005

The case for integrating grounded theory and participatory action research: empowering clients to inform professional practice.

Grounded theory and participatory action research methods are distinct approaches to qualitative inquiry. Although grounded theory has been conceptualized in constructivist terms, it has elements of positivist thinking with an image of neutral search for objective truth through rigorous data collection and analysis. Participatory action research is based on a critique of this image and calls for more inclusive research processes. It questions the possibility of objective social sciences and aspires to engage people actively in all stages of generating knowledge. The authors applied both approaches in a project designed to explore the experiences of female survivors of childhood sexual abuse with physical therapy and subsequently develop a handbook on sensitive practice for clinicians that takes into consideration the needs and perspectives of these clients. Building on this experience, they argue that the integration of grounded theory and participatory action research can empower clients to inform professional practice.

Child↗
PubMed2002

[Nursing practice in home care: social-demographic profile and professional practice].

OBJECTIVES: To characterise the Andalusian nurses providing home care (HC), to describe the activities developed, to define the components of nursing practice and to identify differences between the care of terminal cancer, of AIDS patients, of elderly people with dementia and of patients who had undergone more serious out-patient surgery. DESIGN: Cross-sectional descriptive study using a postal questionnaire. SETTING: Primary care centres in Andalusia. PARTICIPANTS: 348 PC nurses working in home care. Multi-stage sampling, proportional by provinces. MAIN MEASUREMENTS: Social-demographic and work characteristics, nursing activity in the home, type and frequency of activities performed in the care of each kind of patient and use of protocols. RESULTS: 61.14% reply rate. 65.5% were women, with mean age of 39.7 and averaging 10 years of PC experience. Mean number of patients attended was 10.5 per week, and mean time was 20.7 minutes. 90.1% had attended cancer patients, 16.7% AIDS patients, 83.3% elderly people with dementia, and 87.2% patients discharged early. In all cases the most commonly developed item was the technical one, followed by preventive/health promotion and psycho-social. Except in the case of evaluation of physiological needs, in all the other activities the frequency of the item was in function of the pathology of the patient (P<.05). Nursing practice in the home of terminal cancer patients and of elderly people with dementia only differs in the handling of emotional problems in both patient and carer, and in the preventive item (P<.05). 60% of the sample said they used no protocol in home care. CONCLUSIONS: The most common activities in care of home care patients are giving treatment, dressings, bandages, and monitoring of the vital constants, followed by assessment of physiological needs. Nursing practice does not seem to be fully conditioned by the pathology, but rather in function of groups of patients with similar needs and problems. Most Andalusian home-care nurses use no protocol in caring for these four classes of patient.

Acquired Immunodeficiency Syndrome↗