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The purpose of this article is to describe the concept of valuing through defining and developing the essential elements of the valuing process. The valuing process relates to structuring the meaning of individual health. This concept is related to a nursing theory put forth by both Rogers and Parse. In addition, implications of the valuing process in nursing for quality health care are given.
This article explores the importance of high quality communication between managers and staff for the effective management of change within the National Health Service (NHS). In particular, a methodology termed communication audit is outlined. Such audits enable managers to gather accurate information about communication practices within organizations and allows them to assess the nature, quantity and quality of internal communications. This, in turn, facilitates the identification and resolution of potential problems and helps to provide a clearly focused agenda for action and change. A case study is offered which illustrates how such an audit was applied to a Unit of Management within the NHS. The implications for managers throughout the organization are then considered.
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Central lines are commonly placed in pediatric oncology patients during their therapy. Advanced practice nurses (APNs) play an important role in the coordination and facilitation of line placements so that they may be inserted in an expeditious manner Collaboration between the Divisions of Oncology and Surgery is often key to attaining this goal. At the Children's Hospital of Philadelphia, the APNs in Oncology and Surgery have developed a collaborative approach to the placement of central lines in oncology patients. Many positive changes ensued between these divisions after collaboration occurred and a system for line placements was put into place. A well-defined process for central line placement is currently being utilized that meets the needs of the patients. Central lines are being placed in a timelier manner, procedures are coordinated, and treatment is started earlier, which has increased the satisfaction of patients, families, and health care providers. Finally, this collaboration led to an improved relationship and better communication between the Divisions of Oncology and Surgery.
Many wonder why there has been so little change in care quality despite substantial quality improvement efforts. Questioning why current approaches are not making true changes draws attention to the organization as a source of answers. The authors bring together the case study method and complexity science to suggest new ways to study health care organizations. The case study provides a method for studying systems. Complexity theory suggests that keys to understanding the system are contained in patterns of relationships and interactions among the system's agents. They propose some of the "objects" of study that are implicated by complexity theory and discuss how studying these using case methods might provide useful maps of the system. They offer complexity theory, partnered with case study method, as a place to begin the daunting task of studying a system as an integrated whole.
Research councils, agencies, and researchers recognize the benefits of team-based health research. However, researchers involved in large-scale team-based research projects face multiple challenges as they seek to identify epistemological and ontological common ground. Typically, these challenges occur between quantitative and qualitative researchers but can occur between qualitative researchers, particularly when the project involves multiple disciplinary perspectives. The authors use the convergent interviewing technique in their multidisciplinary research project to overcome these challenges. This technique assists them in developing common epistemological and ontological ground while enabling swift and detailed data collection and analysis. Although convergent interviewing is a relatively new method described primarily in marketing research, it compares and contrasts well with grounded theory and other techniques. The authors argue that this process provides a rigorous method to structure and refine research projects and requires researchers to identify and be accountable for developing a common epistemological and ontological position.
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The interdependencies of Pharmacy and Therapeutics Committee members in 222 teaching hospitals were studied by use of the social relations model. Cooperation, influence, frustration and enjoyment were studied among four-person subgroups chosen from the five roles recommended for hospitals by the American Society of Hospital Pharmacists: physician-chair, physician-nonchair, pharmacist, nurse and administrator. The results show that the elicitation and reception of cooperation, influence, frustration and enjoyment vary considerably by role (as manifest in actor and partner effects); small amounts of individual reciprocity (i.e. the association between actor and partner effects) were found for some measures of interdependence across roles, while small amounts of dyadic reciprocity (i.e. the association between reciprocal relationship effects) were found for many relationships. Significant group level (i.e. committee) effects were found as well.
PURPOSE: Increasing healthcare professionals' knowledge about organ and tissue donation; the national mandates regarding referral compliance; and the effect on donors, donor families, and transplant recipients is a challenging task. Physicians not routinely involved in organ donation or transplantation are some of the most difficult professionals for organ procurement organizations to access. A course for medical students was developed to initiate the transfer of information, comfort, and familiarity with the organ and tissue donation process. METHODS: Discussions with a local medical school revealed that little organized education on organ and tissue donation existed. An elective course was developed consisting of 2-hour lectures, once a week for 6 weeks. Topics included an overview of tissue and organ donation, history and significance of the current crisis, determination of brain death and its role in organ donation, tissue donation, pretransplant and posttransplant processes, ethical issues, and the donor family and recipient experience. RESULTS: A thorough course proposal was presented to the medical school's Chairman of Surgery and Chairman of Transplantation. The proposal was approved for first- and second-year medical students. CONCLUSION: Offering medical students a unique and comprehensive course may attract curious students who could become future champions for donation. This type of educational approach may significantly influence future interactions between physicians and organ procurement organizations. If more organ procurement organizations implement this type of program, the medical students' knowledge of donation will not only affect and benefit the local organ procurement organization's service area but other procurement organizations throughout the country as well.
OBJECTIVE: To familiarize the reader with the sequence of events in a hospital-based cardiopulmonary resuscitation. DATA SOURCES: The American Heart Association's Textbook of Advanced Cardiac Life Support and the Standards and Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiac Care. DATA EXTRACTION: The roles and responsibilities of members of the cardiopulmonary code team are discussed. DATA SYNTHESIS: A typical code sequence is described, with emphasis on drug therapy. CONCLUSIONS: This information will provide a better understanding of the cardiopulmonary resuscitation team response and, in particular, the role of the pharmacist as an integral team member.
The laboratory component of a first-semester general chemistry course for science majors is described. The laboratory involves a semester-long project undertaken in a small-group format. Students are asked to examine whether plants grown in soil contaminated with lead take up more lead than those grown in uncontaminated soil. They are also asked to examine whether the acidity of the rainwater affects the amount of lead taken up by the plants. Groups are then given considerable independence in the design and implementation of the experiment. Once the seeds are planted, which takes about 4 wk into the term, several shorter experiments are integrated in before it is time to harvest and analyze the plants. The use of a project and small working groups allows for the development of a broader range of learning outcomes than occurs in a "traditional" general chemistry laboratory. The nature of these outcomes and some of the student responses to the laboratory experience are described. This particular project also works well at demonstrating the connections among chemistry, biology, geology, and environmental studies.
This excerpt, chapter 12 from the book Nursing Management: Principles and Practice, edited by Mary Magee Gullatte, RN, MN, ANP, AOCN, FAAMA, is part of a series of clinically relevant reprints that appear periodically in the Clinical Journal of Oncology Nursing.
Two child observation and assessment centres run by a Social Services Department have quickly filled up with older children who stay indefinitely. Many of these children have physical as well as emotional problems and have been admitted as family emergencies in an unplanned way. The paper discusses how, if at all, the psychiatrist called in for advice by social workers can help. This is thought to be a widespread problem.
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With respect to the ethical debate about the treatment of animals in biomedical and behavioral research, Harry F. Harlow represents a paradox. On the one hand, his work on monkey cognition and social development fostered a view of the animals as having rich subjective lives filled with intention and emotion. On the other, he has been criticized for the conduct of research that seemed to ignore the ethical implications of his own discoveries. The basis of this contradiction is discussed and propositions for current research practice are presented.
Describes the implementation of a collaborative preventive intervention project (Healthy Schools) designed to reduce levels of bullying and related antisocial behaviors in children attending two urban middle schools serving primarily African American students. These schools have high rates of juvenile violence, as reflected by suspensions and expulsions for behavioral problems. Using a quasi-experimental design, empirically based drug and violence prevention programs, Bullying Prevention and Project ALERT, are being implemented at each middle school. In addition, an intensive evidence-based intervention, multisystemic therapy, is being used to target students at high risk of expulsion and court referral. Hence, the proposed project integrates both universal approaches to prevention and a model that focuses on indicated cases. Targeted outcomes, by which the effectiveness of this comprehensive school-based program will be measured, are reduced youth violence, reduced drug use, and improved psychosocial functioning of participating youth.