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PubMed2004

A study of community guides: lessons for professionals practicing with and in communities.

A study of 35 nonprofessional helpers, identified as community "guides," focused on the contribution each made to helping marginalized individuals and families become a part of their communities. The lessons learned through these lay helpers can inform a postmodern social work practice that promotes the use of indigenous practice principles appropriate for work with and in culturally distinct communities. The practice wisdom of these guides demonstrates a need for professionals to reposition themselves in the associational life of a community, and to make their practice less visible. It is shown that an effective community-building practice that respects community solutions to individual and community problems requires permeable boundaries on the part of intervening professionals.

Community Participation↗
PubMedDate not supplied

Assessment of significant harm: improving professional practice.

Judging whether a child is suffering or is likely to suffer 'significant harm' has become a critical task for professionals working in the field of child health. Yet little guidance is available about what the phrase means in its entirety or how it should be applied in practice. This study set out to clarify the position by examining how the phrase was used in practice by a selected sample of experienced health and social work staff. The evidence collected suggests flaws in the general approach adopted by professionals to identification and assessment in child protection cases. The data indicate a heavy concentration of attention on the weaknesses of families being assessed rather than their strengths and on parents rather than children. Problems are identified in responding effectively to long-term, chronic abuse such as emotional abuse and neglect.

Child↗
PubMed1997

[Medical liability and unintentional offenses in professional practice].

Malpractice and negligence lawsuits against physician have significantly increased lately. Therefore, the legal and ethical setting of this problem in our country must be specified. There are multiple causes that lead to attribute the responsibility of a determinate damage to medical practice, but the most important is an inadequate medical-patient-family relationship. Lawsuits are transcendental for physicians and affect them in several ways. Several measures are proposed to reduce them. Considering the increasing importance of solidarity and shared compensations, the responsibility of institutions and other professionals, besides physicians, is analyzed.

Chile↗
PubMed1994

Concept clarification in professional practice--dignity.

Dignity is recognized as being important to maintain, but what is it, and is it the same for each person? The purpose of this study was to explore the meaning of dignity, to clarify the concept in order to benefit clients, and to forward knowledge in nursing. The concept analysis was carried out by examining personal definitions of dignity contributed by students of DipHE Nursing courses, a literature review, and discussion with other professionals. The concept analysis contains a review of definitions, postulates critical attributes, offers case examples, and suggests related cases and antecedents. It is not intended to be conclusive, but to provide a catalyst for further thought and exploration.

Aged↗
PubMed1993

Council on Certification Professional Practice Analysis.

The CCNA has completed a PPA and will begin implementing its recommendations with the December 1993 certification examination. The results of the PPA provide content validation for the CCNA certification examination. The certification examination is reflective of the knowledge and skill required for entry-level practice. Assessment of this knowledge is accomplished through the use of questions that are based on the areas represented in the content outline. Analysis of the PPA has resulted in changes in the examination content outline and percentages of questions in each area to reflect current entry-level nurse anesthesia practice. The new outline is based on the major domains of knowledge required for nurse anesthesia practice. These changes are justified by the consistency in the responses of the practitioners surveyed. There was overall agreement as to the knowledge and skills related to patient conditions, procedures, agents, techniques, and equipment that an entry-level CRNA must have to practice. Members of the CCNA and Examination Committee will use the revised outline to develop questions for the certification examination. The questions will be focused on the areas identified as requiring high levels of expertise and those that appeared higher in frequency. The PPA survey will be used as a basis for subsequent content validation studies. It will be revised to reflect new knowledge, technology, and techniques related to nurse anesthesia practice. The CCNA has demonstrated its commitment to the certification process through completion of the PPA and implementation of changes in the structure of the examination.

Certification↗
PubMedDate not supplied

Professional practice for the extended care environment: learning from one model and its implementation.

This article describes a model of professional nursing governance in an 800-bed long-term care facility and discusses the model's implications for nursing education. Seventy registered nurses, 330 ancillary staff, and 50 other health professionals provide care for about 100 residential, 350 intermediate, and 350 skilled nursing care patients in the facility. The governance model includes a registered nurse organization that determines all standards for nursing practice, policies governing practice, and nursing clinical programming. Each registered nurse has 24-hour, seven-days-a-week authority and accountability for a patient caseload. Average annual turnover of registered nurses is 5 per cent, and the average length of employment among the nurses is 7.5 years. Since the model was implemented, measures of patient welfare have increased. Experience with the governance model indicates that nursing education curricula need to increase students' (1) understanding of professional autonomy and accountability, (2) understanding of the role of nursing diagnoses and interventions to structure nursing knowledge, (3) skills of diagnostic and intervention reasoning, (4) consensus decision-making abilities, (5) knowledge of organizational structures and mechanisms for governance, and (6) mastery of technical intervention skills.

Humans↗
PubMedDate not supplied

Nursing: concepts of professional practice.

As we approach the twenty-first century, nursing is preparing itself to meet the expected health care needs of the population. In this paper, which was recently presented to the Royal College of Nursing National Conference at Hartlepool, Maureen Lahiff sets out her vision of the future.

Clinical Competence↗
PubMed2002

Law and professional practice. Accountability and implications.

The role of the operating theatre nurse has expanded greatly in recent years and mistakes or errors are inevitably made. The majority of mistakes are usually easily corrected or go unnoticed, but those that aren't can produce substantial implications for the patient and the practitioner.

Clinical Competence↗
PubMedDate not supplied

Professional practice of pediatric nurse practitioners: implications for education and training of PNPs.

INTRODUCTION: The purpose of this study was to describe the characteristics of employment, the characteristics of children served, and the role functions of recent graduates of pediatric nurse practitioner (PNP) programs and to compare these characteristics across programs. METHOD: A 60-item multiple-choice survey tool was sent to graduates from 1996-1998 of 6 universities across the United States. RESULTS: A total of 137 surveys were received for a return rate of 52%. Less than half of the respondents (44%) indicated that they were employed in a primary care practice. Seventy percent indicated they "often" or "sometimes" provided care to children with acute/critical conditions, and 77% reported caring for children with chronic conditions. Role functions of case management, staff development, consultation, administration, and implementation of research were performed "often" or "sometimes" by more than 50% of respondents. Findings were fairly consistent in 5 out of 6 programs surveyed. DISCUSSION: Graduates of PNP programs are increasingly called on to provide care to children with complex health care needs in non-primary care settings. Role functions beyond the traditional areas required for pediatric primary care are now common practice. Educational programs should address these dynamic changes by assessing the adequacy of their curricula and clinical residencies in preparing graduates.

Case Management↗
PubMed1978

[Variations in the use of microscopic instruments for the examination of urinary calculi in routine professional practice and in research].

Generalising considerations concerning the problem of the analysis of urinary calculi as well as a longer testing within own examination prove modern microscopic methods and devices to be a scientific and practical instrumentarium for the examination of urinary calculi which has a good future. Expensive special microscopes may above all remained reserved for research examinations on urinary calculi, if simple laboratory microscopes for routine analyses of urinary calculi are supplemented by cheap additional constructing elements.

Germany, East↗
PubMed1994

Understanding microbiological concepts and computerized surveillance: enhancing professional practice.

This article describes a research study that explored whether registered professional nurses, when exposed to an experimental educational intervention that consisted of a simulated patient environment with staged microbiological concepts relating to reservoirs of infection and BOSS surveillance data reports, retain the concepts of microbiology and can apply these concepts in clinical practice. The design of this research project was quasi-experimental with triangulation of a qualitative dimension as all experimental group participants were interviewed at the completion of this study. Implications concerning nursing curricula and inservice education programs in health care facilities are discussed.

Analysis of Variance↗
PubMed1989

[The internist--responsibilities, professional practice and self concept. An introduction].

An analysis of claim and reality causes doubt about the fact whether the internal medicine as a basic clinical subject may at present fully meet its commission. The working group "ethics" of the GDR Society of Internal Medicine has worked out a material concerning the questions of the tasks, the activity and the self-appreciation of the internal specialists and puts it under discussion.

Ethics, Medical↗
PubMed2002

Examining the standardized application of rape kits: an exploratory study of post-sexual assault professional practices.

In this exploratory study we examine the practices surrounding with respect to standardization the administration and processing of the Sexual Assault Evidence Kit (SAEK). Despite the presumed scientific objectivity of this protocol, our survey of sexual assault nurses, physicians, police, and forensic scientists found that discretionary practices pervaded the evidentiary process. We argue that there must be greater awareness of the shaping of medicolegal evidence. Given the diverse characteristics of sexual assaults and of the health care needs of sexually assaulted women, we also suggest that it may be unreasonable to apply a single standard model of a rape kit.

Female↗