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PubMed1988

Job analysis. National Certification Board: Perioperative Nursing, Inc, document.

The document is the critical element in developing an exam that reflects current perioperative nursing practice. The test specifications ensure that each phase of perioperative nursing practice is adequately measured at a proficient level of care. In addition to developing test specifications, the NCB:PNI has recommended that A Job Analysis could be used in the following situations. 1. Nurse managers could use the document in refining job descriptions, evaluating employee performance, creating clinical ladder criteria, and establishing standards of patient care. 2. Perioperative nurse educators could use it in developing self-directed learning contracts, designing curriculum for students or staff development. 3. Researchers could use the document in justifying the existence of registered nurses in the OR. 4. Perioperative nurses could use it for peer review and self-evaluation.

Certification↗

PubMed1997

The role and resources required for the introduction of generic ward assistants using GRASP systems workload methodology: a quantitative study.

Non-nursing workers have been advocated as a means of ameliorating high nursing utilizations, whether the cause be budgetary or the inability to recruit trained staff. The creation of a generic worker who would undertake domestic, catering and non-nursing activities has been seen as a way of improving the ward environment and releasing trained staff and health care assistants from non-nursing activities, GRASP systems workload methodology was used to develop a job description and a tool to quantify the resources needed to introduce such workers. A quantitative research study and activity analysis was carried out on two sample wards to validate the tool. The results were validated by a 'within study' audit process comparative analysis and an activity qualitative analysis using a Likert attitudinal scale. Empirical analysis of the study's findings and the financial consequences were predicted across the Trust.

Delphi Technique↗

PubMed2000

Providing after-hours on-call clinical coverage in academic health sciences centres: the Hospital for Sick Children experience.

An increasing number of admissions of patients requiring complex and acute care coupled with a decreasing number of pediatric postgraduate trainees has caused a shortage of house staff available to provide after-hours on-call coverage in the Department of Pediatrics at Toronto's Hospital for Sick Children. The Clinical Assistant program created to deal with this problem was short on staff, did not provide adequate continuity of care and was becoming increasingly unaffordable. The Clinical Departmental Fellowship program was created to address the problem of after-hours clinical coverage. The program is aimed at qualified pediatricians seeking additional clinical or research training in one of the subspecialty divisions in the Department of Pediatrics. We describe the hiring process, job description and evolution of the program since its inception in 1996. This program has been mutually advantageous for the individual fellows and their sponsoring divisions as well as the Department of Pediatrics and the Hospital for Sick Children. We recommend the introduction of similar programs to other academic medical departments facing staff shortages.

Academic Medical Centers↗

PubMed1993

Nurse manager performance appraisal: a collaborative approach.

The job description and performance appraisal criteria for the Clinical Nurse Manager (CNM) were revised to provide clarity of role responsibilities and promote collegiality. The new formats reflected much better the complexities and differences existing in the 15 distinct inpatient and ambulatory practice settings. Six categories were defined which summarized the CNM role and a qualitative tool was developed for performance evaluation.

Employee Performance Appraisal↗

PubMed1988

The development of a role charter for nursing unit administrators.

Issues of decentralization and changes in the structure of the traditional Head Nurse role were motivating factors for the proactive stance taken by the Medical-Surgical Head Nurse Group at The Wellesley Hospital. Increasing frustration with the conventional role and the need for a reflective performance appraisal tool provided further impetus for the development of a revised job description. The three departments of nursing each submitted their perception of the role. A task force was established whose mandate was to review and revise the three separate submissions and combine them into a composite document. This article describes the process from the initial motivating factors to the development of a cohesive Total Head Nurse Group and finally a 'Role Charter for Nursing Unit Administrators.'

Humans↗

PubMed1995

Learning in the clinical area: the Portsmouth Partnership experience.

This paper outlines a new, innovative method of obtaining a degree pertinent to one's job description. The Partnership Programme implemented from the University of Portsmouth had its first intake of students in October 1992. The course is primarily aimed for students in full-time employment. Following submission of a portfolio, students can obtain a degree in two years. Students undertake part-time university modules and learning projects at the workplace, the latter forming up to 60% of their total credits. Presently there are only two similar course frameworks in the United Kingdom.

Education, Nursing, Continuing↗

PubMed2004

What do consultant occupational physicians do in the National Health Service? An audit.

AIM: To assess the range of activities undertaken by National Health Service (NHS) consultant occupational physicians, and quantify the proportion of time spent on these so that appropriate guidance and a model job description may be developed by the Association of NHS Occupational Physicians (ANHOPS). METHODS: A questionnaire was developed and sent to all full time consultant occupational health physicians (as recorded on the ANHOPS database). RESULTS: Sixty-five questionnaires were sent out, of which 38 were returned (59%). Only 31(48%) of replies matched the entry criteria of being full-time NHS consultants returning fully completed questionnaires. An average of 18 h face-to-face clinical work (range = 0-36 h) over five sessions (range = 0-9 sessions) was found. Remaining time was predominantly spent on clinical administrative work although some consultants took on a variety of other managerial activities. CONCLUSIONS: Responding full-time NHS consultant OHPs found it difficult to quantify and categorize their workloads, particularly for non-clinical work. Their responsibilities vary widely. Of use for job planning purposes is the average commitment of clinical sessions (five).

Humans↗

PubMed1999

Evaluating the performance of academic medical education administrators.

Educators have devoted little attention to formal evaluation of educational administrative personnel. The authors surveyed the educational administrators working in McMaster University's Department of Medicine residency program and found they felt they were receiving little useful feedback. The authors also surveyed the colleagues, residents, and administrative staff with whom the administrators worked and found they felt they had inadequate input into the administrators' evaluation. In response to these results, a measurement instrument was developed based on existing job descriptions and feedback was obtained on administrators' performance from relevant individuals. After three yearly evaluations, administrators and evaluators acknowledged much broader input into evaluation but saw little evaluation-related improvement in performance. Of the administrators, 85% felt the process should continue as did 91% of the evaluators. An evaluation process may not alter perceived performance when it is already good but there may be other benefits to rigorous evaluation.

Attitude of Health Personnel↗

PubMed1999

Occupational asthma.

The seriousness of asthma in the general population has been recognized by increased prevalence, morbidity, and mortality rates in the past 20 years. The effects of occupational asthma on health and productivity in the workplace have been so deleterious that the Occupational Safety and Health Administration targeted 1995 as a crisis year for effective remediation. Several risk factors have been identified, but all asthma is multifactorial. Inhaled chemical, physical, and microbiological agents in the form of dust, fumes, gases, and vapors may cause workplace asthma, which is mediated through pharmacologic, immunologic, or irritant mechanisms. Because of the complexity of these mechanisms after exposure to the offending agents, the clinical manifestations may be classed as immediate, delayed, or dual responses. Evaluating causation and relationship to work requires a thorough history (including detailed job description), physical examination, and definitive studies to determine the presence of bronchospasm, bronchial hyperreactivity, atopy, work-relatedness, and presence of specific sensitization. Goals of treatment for occupational asthma are to maintain pulmonary function as close to normal as possible, to maintain a normal lifestyle, and to prevent exacerbation. In occupational asthma, particularly, the patient (or the inciting cause, if known) should be removed from the offending environment as soon as possible. Specific treatment depends upon the specific offending agent, and antiasthma therapy may be needed following the guidelines of the National Heart, Lung, and Blood Institute.

Asthma↗

PubMed1996

[Nurses' representations of the managerial function, what professional commitment does this mean?].

THE SUBJECT OF THIS RESEARCH: "What idea nurses have about the managerial function; from a professional point of view what commitments does this function entail?" is connected with: The fact that at a legislative level there is no reglementation of the managerial function. From a legal point of view, the nature of the commitments in connection with this function is not accurate enough as there is no law explaining exactly what does the job of charge nurse consist in. Therefore, the opinions the whole medical profession have about the managerial function are various. On the other hand, taking into consideration what charge nurses think about their own function can help to explain the behaviour as, usually the ideas determine the practice (cf. ABRIC 1994). The methodology used was based on a scientific procedure and first of all I had to break with my prejudices and wrong opinions which only give you the illusion that you can understand the matters. Readings and exploratory talks helped me in that way and so I could formulate the problem. I worked within this theoretical context and I practically tested the facts by means of semi-directed interviews. The result of the analysis invalidated the hypothesis put forward at the beginning. As regards to the idea nurses have about the managerial function, the difference expressed is more regarding the connection between the nurses values and those ones of the charge nurses, rather than regarding the adequacy between the function and the place of the charge nurse. This is somewhere the notion of project according to ARDOI-NO (1984) in which it is necessary to define the aim of the project first and to establish the means used for the realization after. To formulate the problem only--in our research: the job description--is not enough. It must be developped. So, this procedure enable me, first, to consider the problems differently and to study complicated situations in which we can feel uncertain. The question is at the same time to anticipate and to accept to discover something different. Therefore, there is no model explaining how to understand the complexity of a problem. The charge nurse who is, on one hand, responsible of a conformity must accept to discover, on the other hand, something new: it is one of the paradox of this function.

Attitude of Health Personnel↗

PubMed1996

Evaluation of the neonatal nurse practitioner role: the next frontier.

The neonatal nurse practitioner (NNP) role at Dartmouth Hitchcock Medical Center in Lebanon, New Hampshire, has been in place since 1989. As part of the professional growth and development of this NNP group, the necessity for a useful evaluation instrument emerged. This instrument needed to be congruent with the job description, practice philosophy, and strong commitment to peer review. The literature search and institutional survey failed to uncover an acceptable option, so an evaluation instrument was developed, tested, and refined. This instrument captures the diverse scope of NNP practice and incorporates a continuum of novice to expert competencies based on the work of Patricia Benner. This evaluation mechanism has had a profound effect on our group, encouraging the development of a shared vision of the NNP role and stimulating professional growth.

Clinical Competence↗

PubMedDate not supplied

The BMET (biomedical equipment technician) career.

This feature article provides an overview of Biomedical Equipment Technician (BMET) careers. Job descriptions and career paths are given for BMET Is, IIs, IIIs, Equipment Specialists and Supervisors, including actual examples of career paths taken by BMETs "in the field." The usual educational requirements for each career are discussed, as well as internship programs such as the one at University Hospital in Stony Brook, New York. The Wentworth Center for Clinical Engineering (Boston) is given as an example of a collaborative BMET educational venture involving hospitals, industry, and students. BMET certification is discussed as a professional option. Finally, BMET careers in industry, shared services and government are described.

Allied Health Occupations↗

PubMed1999

Anaesthesia clinical directors in the United Kingdom: organisation, objectives and support needs.

A postal survey of all 269 acute hospital trusts identified in the United Kingdom was carried out to study the work of Clinical Directors of anaesthesia. Initial responses from 163 Clinical Directors and 129 completed questionnaires were analysed. Four main areas of concern revealed by the survey were contracts and objectives, funding of managerial sessions, access to information and perceived need for support. Most Clinical Directors had no job description and most had no formal written objectives, despite a substantial body of advice that these should be provided. There was generally substantial underfunding of managerial hours compared with those actually worked and approximately 20% of Clinical Directors surveyed had no funding for managerial duties. Clinical Directors' ratings of the information available to assist their decision making were also a cause of concern. Clinical Directors perceived that they need better networking, more training particularly on human resource management and improved management information.

Adult↗

PubMed1996

Guidelines for developing a nurse practitioner practice.

Nurse practitioners must take an active role in defining and establishing their practices. In many cases, medical and administrative staffs develop the NP job description. As a result, many NPs are finding themselves in unsatisfactory, often task-oriented roles. This problem is largely due to NPs' inexperience in establishing practices and a lack of documentation of current practices. When developing the NP practice within the National Cancer Institute-Medicine Branch, it was apparent that the nursing literature offered no information on how to establish an NP practice. This article presents guidelines for developing an NP practice and is based on information obtained during the developmental stages of the nurse practitioner practice at the National Cancer Institute-Medicine Branch.

Forms and Records Control↗

PubMed1995

[Trends and traditions in Scandinavian general medicine].

Recent decades have witnessed radical changes both in the workload and in the job description of general practitioners (GPs) in the Nordic countries, and the trend continues. Owing to social changes, particularly the deterioration in health care economy, the GPs will in the future be required to deal with increasing numbers of patients as well as increasingly severe categories of diseases, previously treated at hospital departments and clinics. This will entail increased demands in terms both of the further education of GPs and of the equipment available to them. It will also entail improved and extended cooperation between GPs and consultants, both in matters of overall policy and in the management of individual cases.

Education, Medical, Continuing↗

PubMedDate not supplied

Tuberculosis surveillance of community hospital employees. A recommended strategy.

OBJECTIVE AND METHODS: To suggest a cost-effective strategy with a high degree of surveillance for the transmission of tuberculosis infection to employees in community hospitals. We performed a cost-benefit analysis of tuberculin skin testing over a 4-year period. The setting was a community hospital in Bronx, NY. The subjects consisted of employees of the hospital who were categorized into high-risk employees defined as individuals who worked daily in patient care and low-risk employees defined as those not directly involved in patient care. All cases of tuberculin skin test conversion among employees were reviewed over a 4-year period. The departments involved, total number of employees, chest radiographic findings, and prophylaxis instituted were noted. RESULTS: The number of employees who were screened over the past 4 years consisted of 897 in 1990, 857 in 1991, 1357 in 1992, and 1316 in 1993. The mean annual conversion rate was 1%, 1.5%, 1.7%, and 1.4% for the 4 years, respectively. Skin test conversions according to job description revealed that of the total number of conversions 42% were from the nursing staff, 6.2% among the physicians and residents, and 52% among the ancillary staff. There was no difference in conversion between medical and nonmedical services such as the gynecology and surgical floors. CONCLUSION: Since tuberculin conversion rates of high-risk employees and those exposed to infectious tuberculosis cases have been low, we suggested a comprehensive strategy of 6-month tuberculin testing for high-risk employees and yearly testing for low-risk employees and eliminating boosting and repeated testing at 12 weeks in those exposed to infectious cases of tuberculosis.

Adult↗

PubMed2001

A qualitative study of the organizational consequences of telemedicine.

The organizational consequences of telemedicine have frequently been mentioned in the telemedicine community, but there are few empirical studies. A study was therefore carried out of what happens in organizations when telemedicine is implemented. Qualitative interviews were undertaken with 30 persons working in teledermatology, telepsychiatry, a telepathology frozen-section service and tele-otolaryngology. Almost all respondents reported numerous organizational changes, some important. Changes in work processes were the most common. Examples of the organizational consequences of telemedicine were organizational restructuring, new organizational units, changed mechanisms for internal coordination, different flows of patients through the health-care system, improved coordination of care, new job descriptions, relocation of the place of work, employment of personnel living far away from the workplace, effects on employees not directly involved in telemedicine, sharing of experiences, minor staffing changes, clinical teamwork independent of co-location, administrative meetings arranged by telemedicine, merger of organizations independent of location, less travel by staff (and patients), a possible beneficial effect on the quality of care, and limited opposition to the adoption of the technology. Telemedicine may be important in the future organization of the disciplines studied and in health-care generally. The infrastructure of electronic networks may play an important role for organizations as the volume of telemedicine activity increases and economies of scale are realized.

Health Facility Administration↗

PubMedDate not supplied

Use of a nurse extender role in the rehabilitation setting.

In an effort to meet the increasing demand for bedside caregivers, nurse extender programs have proliferated over the past 2 years throughout the country. Standards for their job descriptions, however, are as varied as the number of programs. At Braintree Hospital, a great deal of time and effort has been spent to develop a program that is managed and supervised by registered nurses and that supports the appropriate delegation of tasks that do not require the skill of a professional nurse. Merker and Burkhart (1990) supported the use of a nurse extender to enhance the delivery of patient care and suggested that nursing administrators need to assess the current environment, define a strategy for the use of nurse extenders, and then implement that strategy. They also noted that because all healthcare facilities differ, it is important that each facility design its own program to meet its individual needs.

Clinical Competence↗