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At least 577 records · Page 32Linked to original sources
PubMed1992

Incidence of cancer in Norwegian workers potentially exposed to electromagnetic fields.

The risk of cancer was investigated in a cohort of 37,945 male Norwegian electrical workers for whom information on job description was collected from 1960 census data and linked to the 1970 census data. The standardized incidence ratio was calculated for all cancer sites in the overall cohort by comparison with national incidence rates for economically active men at the 1960 census. The standardized incidence ratios for cancers of the breast, pleura (mesothelioma), larynx, and bladder and for soft tissue sarcoma were elevated, while those for non-Hodgkins and Hodgkins lymphoma were lower. The standardized incidence ratio for leukemia for electrical workers with 10 or more economically active years was 1.41. The standardized incidence ratio for brain tumors in this subgroup of electrical workers was 1.14. These results from a large, national, population-based study at the Cancer Registry of Norway give support to previous findings of a possible association between electrical work and the risk of leukemia.

Adult↗
PubMedDate not supplied

The benefits of patient education.

In this article, the role of the nurse in patient education is described, as well as the benefits of patient education, such as improved quality of care, improved patient satisfaction, increased compliance, improved staff satisfaction, and effective use of resources. Strategies for effective patient teaching also are presented.

Educational Status↗
PubMed1997

Congenital malformation and maternal occupational exposure to glycol ethers. Occupational Exposure and Congenital Malformations Working Group.

Glycol ethers are found in a wide range of domestic and industrial products, many of which are used in women's work environments. Motivated by concern about their potential reproductive toxicity, we have evaluated the risk of congenital malformations related to glycol ether exposure during pregnancy as part of a multicenter case-control study, conducted in six regions in Europe. The study comprised 984 cases of major congenital malformations and 1,134 controls matched for place and date of birth. Interviews of the mothers provided information about occupation during pregnancy, sociodemographic variables, and other potential risk factors (medical history, tobacco, alcohol, drugs). A chemist specializing in glycol ethers evaluated exposure during pregnancy, using the job description given by the mother, without knowledge of case or control status. We classified malformations into 22 subgroups. The overall odds ratio (OR) of congenital malformation associated with glycol ether exposure was 1.44 [95% confidence interval (CI) = 1.10-1.90], after adjustment for several potential confounders. The association with exposure to glycol ethers appeared particularly strong in three subgroups: neural tube defects (OR = 1.94; 95% CI = 1.16-3.24), multiple anomalies (OR = 2.00; 95% CI = 1.24-3.23), and cleft lip (OR = 2.03; 95% CI = 1.11-3.73). In this last subgroup, risk, especially of an isolated defect, tended to increase with level of exposure.

Abnormalities, Drug-Induced↗
PubMed2001

Maintaining quality care during a nursing shortage using licensed practical nurses in acute care.

Implications of an aging registered nurse workforce, coupled with an inadequate supply of new nurses, presented a unique challenge for the nurse executive in an acute care hospital. This article presents one possible solution: reintroduction of licensed practical nurses to the patient care setting. It describes a pilot project initiated to answer the following question: Is there a change in quality of patient care or staff satisfaction when the nursing care delivery system adds a licensed practical nurse to the registered nurse and patient care assistant care pairs? It also describes the driving forces behind this practice change and presents focus group discussions, the implementation process, and conclusions and recommendations.

Acute Disease↗
PubMed1996

Evaluation of the VA's Pilot Program in Institutional Reorganization Toward Primary and Ambulatory Care: Part II, A study of organizational stresses and dynamics.

BACKGROUND: Many academically affiliated hospitals are moving from an inpatient, subspecialty orientation in their patient care and educational programs toward a greater emphasis on ambulatory and primary care. Few studies have focused on the organizational, staffing, and management issues involved in implementing these changes. METHOD: The authors carried out a qualitative evaluation of the process of change in an academic Department of Veterans Affairs hospital during implementation of a major ambulatory primary care program. They interviewed four top managers individually and 59 top and middle managers, house officers, and patients in focus groups in the spring of 1992, nine months after implementation of the key components of the program. Four raters independently evaluated written transcripts of focus-group sessions and identified themes. RESULTS: The main problems identified were difficulty with administrative integration between inpatient and outpatient services; need for training, retraining, and orientation; tensions due to changes in roles and organizational culture; and inefficiency due to the need for frequent negotiations in daily work life. These four problems reflected tensions associated with new demands imposed by matrix management, changing job descriptions, policies and procedures, and changing patterns of communication and record keeping. CONCLUSION: During the process of implementation of a primary care focus throughout a medical center, extra demands upon staff are inevitable and should be anticipated and planned for. Twelve key factors for successful organizational change are discussed.

Administrative Personnel↗
PubMed2001

Roadmap to physical medicine and rehabilitation: answers to medical students' questions about the field.

Medical specialty training has undergone dramatic changes in the last 5 yr. This article was prepared by the Undergraduate Education Committee of the Association of Academic Physiatrists in an attempt to help guide medical students who are considering a career in physical medicine and rehabilitation. This report is an update of two previous articles addressing medical students' questions to assist them in making educated decisions about residency training and medical practice.

Career Choice↗
PubMed1990

The clinical nurse specialist role in the Army Medical Department.

Although clinical nurse specialists (CNSs) have been in the Army Medical Department for more than 10 years, there are no reports in the literature regarding role implementation for them. In this study, a survey of all practicing CNSs in the Army Medical Department (AMEDD) and their supervisors was conducted with the purpose of defining their perceived role and the value placed on it by their supervisors. The results showed that the study population (n = 52) has implemented the role with all components (practice, education, consultation, administration, and research) considered important by them. Further, 85% of the CNSs report positive job satisfaction, and 67% believe they have reached role maturation. Their supervisors were equally or more positive about the importance of the role, and all (n = 26) felt it must be maintained despite budget constraints and nursing shortages. Findings were that CNSs experience role satisfaction, have achieved role maturation, and are valued by their supervisors within the AMEDD.

Adult↗
PubMed1991

Measuring success: CNS performance appraisal.

With the current focus on quality outcomes and economic issues related to health care, clinical nurse specialists (CNSs) must effectively document their unique contributions that enhance the realization of organizational missions. This paper examines an outcome-oriented performance appraisal tool designed to quantify CNS services. Eleven performance criteria with performance behaviors were negotiated by CNSs and their respective supervisors based on job descriptions and organizational goals. A quantitative scoring system was then developed based on specific performance behaviors. This method of objective outcome based evaluation has not only substantiated the CNS's value but also has enhanced collaboration between CNSs and administrators.

Consultants↗
PubMed2002

Using your clinical expertise in nursing education.

Due to the expected retirement of large numbers of nursing faculty in the next few years, clinical nurse specialists may find themselves being recruited for faculty positions in schools of nursing. There are several points to consider when deciding if a full- or part-time academic position is right for you, including the school's philosophy and the job description. If you do decide to become a faculty member, you will also need to consider such issues as classroom teaching, clinical teaching, working with students, and accreditation of nursing schools. Academic nursing is a rewarding career and is an opportunity for clinical nurse specialists to use their expert clinical knowledge as well as apply their client and staff education skills to a different population in a different environment.

Career Choice↗
PubMed2000

The research nurse role in a clinic-based oncology research setting.

Public demand and government support for evaluating new cancer drugs and methods in a more timely manner have significantly affected clinical research programs. To meet these demands, it is critical to have research personnel with an appropriate skill mix to ensure that clinical trials are conducted safely and effectively, while scientific integrity is maintained. This article describes the development and integration of the research nurse role within an oncology research program in a large outpatient oncology clinic. Methods for evaluating the research nurse role included literature review, analysis of job descriptions, and dialogue with research staff, oncology staff, and a clinical nurse specialist. A Review of the Nurse Practice Act of Wisconsin and the Oncology Nursing Society standards provided license and practice standards. Similarities and differences between the roles of the research nurse and the chemotherapy nurse are analyzed. Complementary roles and functions are identified, and areas of role overlap are defined. This report expands the limited current literature regarding this subject. The findings provide the reader with a framework for evaluating the roles of registered nurse personnel in a clinical setting. Although each institution has unique characteristics or research needs, the method used to address the reported program is transferable.

Clinical Nursing Research↗
PubMedDate not supplied

Retaining medical directors in community health centers. The importance of administrative relationships.

Physician retention has become a critical issue for maintaining the success of today's health care organizations. With many external factors--increasing malpractice premiums, lower reimbursement rates, and managed care controls--driving physicians out of the practice, it is imperative to understand how the internal functions of the organization can help maintain satisfaction in the workplace and prevent physicians from leaving (Reece, 2000; Taylor, 2002). This is especially important in Community and Migrant Health Centers (C/MHCs), federally supported health clinics providing care to low-income and uninsured patients in medically underserved communities and neighborhoods. In this study, we examine the medical directors' roles and responsibilities, their relationships with the C/MHC administrators, and whether these impact satisfaction and, ultimately retention in the centers.

Attitude of Health Personnel↗