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PubMedDate not supplied

Decision making in professional practice.

There is a large body of work relating to the nursing process but comparatively little on decision making. Two main views exist, namely the rationalist and the phenomenological perspectives. It can be argued that the rationalist perspective is a quantitative approach whereas the phenomenological perspective offers a more holistic view. Intuitive judgment presents problems as it is only used by experts and is difficult to teach. In professional practice the decision-making process and the nursing process work together.

Clinical Competence↗
PubMed2003

The Attending Nurse Caring Model: integrating theory, evidence and advanced caring-healing therapeutics for transforming professional practice.

This paper presents a proposed model: The Attending Nursing Caring Model (ANCM) as an exemplar for advancing and transforming nursing practice within a reflective, theoretical and evidence-based context. Watson's theory of human caring is used as a guide for integrating theory, evidence and advanced therapeutics in the area of children's pain. The ANCM is offered as a programme for renewing the profession and its professional practices of caring-healing arts and science, during an era of decline, shortages, and crises in care, safety, and hospital and health reform. The ANCM elevates contemporary nursing's caring values, relationships, therapeutics and responsibilities to a higher/deeper order of caring science and professionalism, intersecting with other professions, while sustaining the finest of its heritage and traditions of healing.

Child↗
PubMed2005

[Patient-related factors and professional practices associated with postoperative pain].

BACKGROUND: Unrelieved postoperative pain is reported despite of widely defined standards for postoperative pain management. The objective of this study was to identify the relationship between patient characteristics, medical practices and outcomes (severe post-operative pain and patient satisfaction). METHODS: Using a cross-sectional observational study in 18 departments of adult surgery from 5 hospitals, medical records were audited according to a set of explicit criteria (patient characteristics and professional practices). Postoperative pain severity was measured with a 0 to 10 visual numerical scale and patient satisfaction using a six-level verbal rating scale (from very satisfied to very unsatisfied). The surgical procedures were classified into three levels of expected severe pain frequency (high, median, low). The relation between severity of pain, satisfaction on one hand, and process and patient characteristics on the other, was studied with chi(2)-test and logistic regression. RESULTS: 625 patients were included. 41.8% suffered from postoperative pain and 81.6% were satisfied. Pain measurement before leaving the postoperative anesthesia care unit (p<0.02) and protocols for analgesia in painful surgery (p<0.05) were associated with a lower frequency of pain. Three patient characteristics were associated with a higher frequency of severe postoperative pain: painful surgical procedure (p<0.001), mental pain (p<0.005), and preoperative pain (p<0.0001). The lack of administration of analgesia was a major explicative factor: 64% of patients with severe postoperative pain, did not receive all analgesics ordered. Patient satisfaction was higher when the patient was requested to notify pain (p<0.05) before surgery and lower after painful surgical procedures (p<0.05). CONCLUSION: There are two ways to improve pain management: first the quality of the analgesic prescription particularly for painful surgical procedures and secondly the administration of the prescribed analgesia.

Analgesics↗
PubMedDate not supplied

[Assessment of appropriateness and verification of interventions in the professional practice of the occupational physician].

Evaluation of Occupational Health Practice is both an intriguing research field and an essential tool to assure the quality of intervention. The objectives of this paper are: (i) to define the principles of evaluation and the role of quality assurance of intervention, (ii) to define the principles of audit of professional practice, (iii) to outline the role of research in evaluating and improving intervention and other practice.

Humans↗
PubMed1995

Assessing the outcomes of professional practice redesign. Impact on staff nurse perceptions.

There are many reports in the literature of management innovations to redesign nursing roles and care delivery systems in response to the dramatic changes taking place in the healthcare environment. Few of these innovations have been evaluated systematically in terms of the dynamics and effects of change at the work group level. The authors present results of a longitudinal study evaluating the work group outcomes of a professional practice model implemented in an academic medical center. The strategy of integrating ongoing data collection and feedback into a process of continuous change also are presented.

Academic Medical Centers↗
PubMed2005

Adverse factors and the mental health of older people: implications for social policy and professional practice.

Defining 'older people' as a homogenous group is problematic; it can lead to stereotypical and stigmatizing perceptions of what old age is, attracting consequent negative attitudes to later life. Nevertheless, evidence suggests that some in the older age bracket are subject to particular stressors and physical changes that can adversely affect their mental health. This paper will consider challenges to mental health in older age groups and particularly the phenomenon of dementia. The role and influence of diagnosis, social policy and professional practice will also be addressed and suggestions will be made as to how people could improve their responses to either the predisposition to or the actual occurrence of mental distress in later life. In addition, it is argued that person-centredness is important as the caring/cultural medium through which provisions and policies are mediated: that obtaining appropriate balances between corporate and individual contributions and interventions must constitute the context wherein future developments lie.

Adaptation, Psychological↗
PubMed2006

General practice: professional preparation for a pandemic.

General practice will play a key role in both prevention and management of an influenza pandemic. Australian pandemic plans acknowledge a role for general practice, but there are few published data addressing the issues that general practitioners and their practices will face in dealing with such a crisis. The outcome will revolve around preparation in three key areas: Definition of the role of general practice within a broad primary care pandemic response, and adequate preparation within general practices so they can play that role well. Planning exercises and forums must include GPs, and rehearsals must include practical experience for general practices and their staff. Local Divisions of General Practice and GP practices can advocate for this, can define their role, and can prepare by using pandemic preparedness checklists; Definition and enactment of communication strategies to facilitate transfer of useful clinical and administrative data from practices and rapid dissemination of information into the community via general practice; Resource provision, which should be centrally funded but locally distributed, with personal protective equipment, vaccines and antivirals readily available for distribution. Resources must include support for human resource management to ensure appropriate health care professionals reach areas of workforce demand. Administrative, clinical and financial resources must be available to train GPs and practices in pandemic awareness and response.

Attitude of Health Personnel↗
PubMed1994

[The Royal Court of the Protomedicato in the Kingdom of Chile: control of professional practice during the 2nd half of the 18th century].

The present article in an approximation to the study of one of the functions commended to the Royal Court of the examining board of physicians in the Spaniard colonies in the 18th century: the control of medical sciences practice. The study is restricted to the "Kingdom of Chile", temporally framed to the second half of the eighteenth century and performed fundamentally with the sources existent in the National Archive and in the National Medicine Museum of Chile. In the first place, a sketch of the existent situation before 1750 was performed, followed by a detailed analysis of the way in which this control was accomplished in the second half of the eighteenth century, the commissioned subjects, the obtained results and the causes for these results. After all these analyses, the ineffectiveness of this control became evident, allowing the proliferation of witch doctors and quacks. This was due, in part to the court in charge of the supervision and in part to the authorities and the own attributes of the kingdom.

Chile↗
PubMed1986

Adding a partner or associate to your professional practice.

Written partnership agreements, employment contracts and related documents may seem to complicate what appears to be a straightforward arrangement, and can make a close relationship somewhat more impersonal. The decision to add a partner, however, is fundamentally a professional and business consideration, and raises many economic and practical issues that either aren't initially apparent or which may only become relevant after the passage of time. In addition, the tax laws may cause two seemingly similar approaches to have significantly different results. It is worth the time and effort to think through your objectives and the price you are willing to pay to realize them, and to recognize that your new associate will have some legitimate concerns that need to be addressed. A well thought-out written arrangement will provide both of you with a degree of certainty and the comfort of knowing that you and your associate have the same understanding of your common venture.

Optometry↗