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PubMed2005

Family presence during pediatric resuscitation: an integrative review for evidence-based practice.

Many pediatric health care institutions lack guidelines to address the presence of family members during resuscitation activities. This integrative literature review was used to establish an evidence-based approach that would compliment our institution's philosophy of "family centered care." The evidence supports a partnering with the families: Hospital staff ask families whether they want to be present during life-saving interventions by health care professions. Families want to make the choice, and when they are present during resuscitation efforts, there is less litigation, anxiety, and second-guessing regarding the efforts and competence of the staff providing that care. No literature was found to support beliefs that family member presence is harmful to the family or the institution. A practice policy is provided that respects family choice and presence during life-saving measures in pediatric care facilities.

Attitude to Health↗
PubMed2001

The meaning of research utilization. A preliminary typology.

The preliminary findings of the meaning of research utilization as perceived by the bedside nurse provide some clues for promoting research utilization. Nurses must believe in the importance of nursing research to the profession, the individual clinician, and the patient. Nurse researchers should present their findings to the bedside nurse in a way that can be easily applied to the practice setting. Shaping a positive research mindset is important to the goal of a research-based practice. Infusing research findings throughout nursing courses, in addition to having a research course to learn basic critiquing skills, emphasizes the importance of nursing research to the individual student and encourages a seamless transition to clinical practice. The institutional setting wields a great deal of power when it comes to mandating practice changes. The institution must value research and embrace a continuing state of change by empowering the nursing staff to question the status quo. Research-focused university settings provide excellent opportunities to learn about the research process and share research findings. Policies and procedures should be updated regularly to reflect changes in the scientific base of nursing practice. Institutional support of research utilization fosters an environment that expects excellence in practice. Encouraging nurses to be more involved in nursing research activities and to value their role as data collectors has been shown to increase research awareness and utilization of findings. Nurses must believe they have the personal and professional power to change practice according to the evidence. This preliminary report has presented data that begin to describe what research utilization means to the bedside RN. The typology presented is grounded in the reality of the practicing nurse and provides important insights for those who wish to foster a research and evidence base for professional nursing practice. As further qualitative and quantitative information about the phenomenon of research utilization is collected, an integrated approach to concept clarification can occur.

Clinical Nursing Research↗
PubMed1998

Interinstitutional comparison of surgical biopsy diagnosis turnaround time: a College of American Pathologists Q-Probes study of 5384 surgical biopsies in 157 small hospitals.

OBJECTIVES: To study the turnaround time (TAT) for rendering diagnoses on routine biopsy specimens, to examine pathology practice variables that influence TAT, and to assess the level of surgeons' satisfaction with biopsy TAT. DESIGN: Over a 3-month period, voluntary participants in the College of American Pathologists Q-Probes laboratory quality improvement program prospectively collected TAT data on up to 20 biopsy specimens performed on elective surgical cases, completed questionnaires profiling their institution's practice characteristics, and had surgeons complete questionnaires indicating their satisfaction with biopsy report TAT. SETTING AND PARTICIPANTS: One hundred fifty-seven private and public small hospitals located in 43 American states (n = 153), Canada (n = 1), and Australia (n = 3). MAIN OUTCOME MEASURES: The routine surgical biopsy report TATs for 2 testing intervals, each commencing when surgeons acquired the biopsy specimens. One interval concluded when pathologists signed off the biopsy diagnoses, and the other concluded when surgeons received the hard-copy reports. RESULTS: Pathologists signed off 85.9% of 5384 biopsy diagnoses by the second working day, and surgeons received 88.3% of the hard-copy reports by the fourth working day. In 90% of hospitals participating in this study, pathologists signed off half their biopsy diagnoses between the second and third postcollection days, and 90% of surgeons received half their final hard-copy reports by the fourth postcollection day. Institutional practice variables associated with fewer sign-off and/or hard-copy receipt TATs exceeding the institutional 90th percentile performance benchmarks included yearly surgical caseloads greater than 2000 cases per full-time equivalent pathologist, provision of pathology support services on site, and accreditation of the hospital by the Joint Commission on Accreditation of Healthcare Organizations and of the laboratory by the College of American Pathologists. Most (96.4%) surgeons indicated that they were satisfied with hard-copy TATs and that they believed most (98.1%) of the hard-copy TATs had no effect on the lengths of their patients' hospital stays. CONCLUSIONS: Pathologists are capable of signing off most routine biopsy diagnoses within 2 working days and delivering the final hard-copy reports to surgeons within 4 working days (both intervals measured from the time that surgeons collect biopsy specimens). Most surgeons report they are satisfied with this level of performance.

Australia↗
PubMed1986

The National Institute of Mental Health epidemiologic study: implications for family practice.

The National Institute of Mental Health has begun a five-site epidemiologic study of the prevalence and incidence of common psychiatric illnesses. Preliminary results reveal a high prevalence of substance abuse disorders in men and a high prevalence of affective and anxiety disorders in women. Evaluation of health care provider utilization shows that women and elderly patients with mental health problems are more likely to visit primary care providers only for mental health problems. The results have important implications for the research and curriculum of family practice.

Adult↗
PubMed1996

Consensus radiation protection practices for academic research institutions.

Under the auspices of the Howard Hughes Medical Institute, a set of consensus guidelines for Radiation Protection Practices has been developed for biomedical research using radioactive materials. The purposes of the guidelines are (1) to promote good radiation protection practices consistent with the needs of biomedical research, the ALARA principle, and regulatory requirements; (2) to establish common goals and consistent practices within radiation safety programs; and (3) to build a meaningful partnership between radiation safety professionals and the biomedical research community. These practices are intended to enhance radiation protection and the efficiency of the research staff. The consensus guidelines will lessen the variability in radiation safety practices that is evident among many academic research institutions and will encourage better acceptance and regulatory compliance by users of radioactive materials in biomedical research.

Academies and Institutes↗
PubMedDate not supplied

Institutional ethnography: explicating the social organization of professional health practices intending client empowerment.

Institutional enthnography uses traditional ethnographic procedures grounded in an analytic approach for explicating the social organization of knowledge. I illustrate the theory and method by describing my experience and analysis-to-date in a study of the social organization of knowledge in mental health, day program occupational therapy in Atlantic Canada. I emphasize the research standpoint within everyday experience. From this point, the researcher explicates (through description) how (micro) social relations, i.e. everyday actions, speech and documentation, are embedded in the (macro) practices of "institutions" such as mental health services. I summarize data management procedures including use of ETHNOGRAPH. Analysis-to-date is showing how the organization of mental health day programs both constrains and creates potential for occupational therapists enabling client empowerment.

Canada↗
PubMed2004

An investigation of dentists' knowledge, attitudes and practices towards HIV+ and patients with other blood-borne viruses in South Cheshire, UK.

This paper derives from research conducted in the North West of England which was funded by the South Cheshire Health Authority. The research was funded because anecdotal evidence within a charity HIV/ AIDS organisation in the region suggested that some HIV positive individuals had been experiencing difficulties accessing NHS dental care. Following previous studies, this paper therefore examines dentists' knowledge, attitudes and practices in order to assess which factors may be influential in affecting dentists' willingness to treat patients with HIV/AIDS and other blood-borne viruses. The study population consisted of all 330 dentists working within the South Cheshire region whose addresses were obtained from the Local Health Authority. A response rate of 46% was obtained and the results were analysed using basic descriptive statistics and the chi-squared (chi(2)) test. The results of this study suggest that age and type of dental practice are significant factors associated with treatment practices, attitudes and sense of ethical responsibility amongst dentists in the South Cheshire region. Consistent with previous studies, this could be interpreted as due to the impact of educational programmes. Further qualitative research is recommended in order to address these issues in more depth.

Adult↗
PubMed1992

Hospital and office practices of radiology groups.

To obtain information on the characteristics and practices of radiology groups in the United States, the American College of Radiology conducted a group practice survey in 1989; this report presents the main survey findings about the office and hospital practices of such groups. A questionnaire and one follow-up were mailed to all 2,591 radiology groups in the United States. Responses were weighted to reflect all groups. Hospital practices averaged 0.7 diagnostic radiologic procedures (including outpatient procedures) per patient day, with little variation by hospital type. Magnetic resonance (MR) imaging and angioplasty procedures were concentrated in teaching hospitals, but this was not true of other sophisticated procedures such as computed tomography and nuclear medicine. Offices averaged 15,000 diagnostic examinations annually, with less variation than expected according to group size. In both hospitals and offices, more than 90% of technologists were registered. Outsiders (most often, referring physicians and hospitals) had a financial interest in half of all offices. MR imaging and mammography grew faster than any other examinations, but only 44% of hospital practices accepted nonreferred patients for mammography.

Ambulatory Care↗
PubMed1994

Operational characteristics of radiology groups in the United States in 1992.

PURPOSE: To determine the operational characteristics of radiology groups in the United States in 1992. MATERIALS AND METHODS: The American College of Radiology surveyed a stratified random sample of 695 radiology groups, including academic departments, units in multispecialty groups, and staff of government facilities. After intensive follow-up, a 69% response rate was achieved for in-scope groups. The responses were weighted to show what findings would have been if all radiology groups in the country had responded. RESULTS: Thirteen percent of groups practiced in a university or teaching hospital; 59%, in a nonprofit hospital; and 18%, in a proprietary hospital; 42% routinely read images obtained by other practices; and 15% were involved with mobile vans. Radiologists in diagnostic-only practices averaged 11,100 procedures per year per full-time equivalent. However, the average was about one-third lower in office-only practices and primarily academic practices. Most groups had no female radiologists. CONCLUSION: Workload data show a great deal of variability and means should not be taken as standards.

Female↗
PubMed1998

Profiles of the Endocrine Clinic: the Mayo Clinic.

It is evident that clinical endocrinology, as a discipline, is entering a particularly exciting period in its evolution. Knowledge gained from basic and clinical research is being translated at the bedside for the benefit of our patients. The emergence of new drugs and novel treatment strategies has equipped clinical endocrinologists with the tools to more successfully combat many old enemies, such as diabetes and osteoporosis. Realization of full benefit from these exciting new tools requires a practice model in which the clinical endocrinologist's role is preeminent and is coordinated and integrated with those of practitioners drawn from other disciplines. The Mayo Division of Endocrinology, Metabolism, and Nutrition provides one such model of highly integrated care. We believe that as the pace of knowledge regarding basic mechanisms of disease and their treatment quickens, such integrated divisions will prove well suited to deliver the highest quality care to people with endocrine disorders.

Academic Medical Centers↗
PubMedDate not supplied

Academic group practice: facing its greatest challenge ever.

Academic practices are facing serious financial challenges, particularly in regard to declining margins. By responding appropriately, writes Kenneth Wilczek, academic practices can benefit from the future--and that benefit may be significant.

Academic Medical Centers↗
PubMedDate not supplied

Competitive marketing strategies. A challenge for academic practices.

A special challenge has been presented to academic medical practices by the new healthcare environment. While increased competition for patients and resources affects all medical groups, it is the academic practices who are responsible for training the physicians of tomorrow. Not only must they sharpen their students' awareness of the new environment and teach them to incorporate effective management strategies into their practices, but they must set an example in effective management as well. The basic concepts of competitive marketing strategy, along with helpful exhibits, are presented here, and strategies for effectively maximizing position are discussed from the viewpoints of product mix, process market, and financing.

Academic Medical Centers↗