On the scene: staff development at University Hospital, University of Washington. Self-evaluation of learning in the leadership program.
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The next five years will be critical. A hospital can 'make its market' with bold initiatives with its physicians,s or lose market share and referrals to a more proactive competitor. Take an active posture in hospital-physician relations. Here are five promising approaches to developing a strong, committed relationship between a hospital and its key physicians.
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The gap between preservice preparation of nurses for critical-care work and employers' expectations is a crucial factor in providing safe care in special-care units. In this study of senior nursing students from 32 Midwestern schools of nursing, it was found that about 75 per cent of the students had had some experience in critical care, with a mean of 46 hours of experience. Most students observed, did selected procedures, or helped a staff nurse. Only 3 per cent planned and carried out care for more than one patient at a time. Fifty-eight per cent considered themselves unprepared to work in areas of critical care and needed more practice and theoretical instruction. There was wide variation in adequacy of instruction in frequently-used assessment and management techniques.
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This chapter shows how concepts from organizational psychology can be used to design a comprehensive staff training model for a statewide mental health service system, and emphasizes the importance of competency identification in this model.
This article describes a collaborative effort between specialty areas at a large urban medical center to develop a comprehensive liver transplant educational program. The historical overview, needs assessment, and program planning are discussed. The implementation, planning, and evaluation phases are examined. The process presented here can serve as a framework for clinical educators confronted with major new initiatives.
Under new basic life support guidelines, stroke victims receive the same priority care as those having a heart attack. Revised advanced cardiac life support guidelines encompass changes to algorithms and policies.
Leadership, that amorphous concept so essential to nursing and so difficult to describe in its broadest context, can be learned if viewed as a set of behaviors that may be applied selectively to assist a group to move toward its goals. Given a supportive climate, a variety of approaches are effective, including one-to-one consultation, role modeling, goal orientation, and workshops on specific leadership behaviors.
Psychiatric inpatients often complain of problems with anxiety, but a computerised search of the nursing literature failed to find any publications detailing nurse-led, individual or group anxiety management work specifically aimed at psychiatric inpatient populations. In the UK, psychiatric inpatient populations are characterized by people with clinical diagnoses of schizophrenia and major affective and personality disorders. This is a very different population from that treated in the vast majority of published trials of cognitive and other approaches to anxiety management. A pilot study was conducted on four psychiatric acute admission wards to determine the practicality of treating a convenience sample of psychiatric inpatients with self-reported anxiety problems along broadly cognitive lines. Patients attended a course of three anxiety management groups (AMGs) run by nurses and were given homework and other exercises to complete. Patients reported significant reductions in anxiety after completion of the treatment. The AMGs were facilitated by staff nurses under the supervision of a clinical nurse specialist, and not by fully trained therapists as in most treatment studies relating to anxiety. Further studies, particularly randomized controlled trials, are needed to explore the efficacy and practicality of nurses delivering brief psychological interventions to psychiatric inpatients.