Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Professional Autonomy”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 649 records · Page 36Linked to original sources
PubMedDate not supplied

Hospital nurses' perceptions of pharmacist prescribing.

The final report from the Crown review team was published in March 1999. It proposed that new groups of healthcare professionals should be permitted to prescribe medicines. Most of the recent progress has centred on the extension of community nurse prescribing. However, changes have also been proposed to prescribing practices within the hospital setting to include nurses, pharmacists, and other healthcare professionals. This study is an initial piece of work examining hospital nurses' perceptions of pharmacist prescribing to identify if there are issues that warrant further investigation. Postal questionnaires, seeking responses to statements describing pharmacists writing prescriptions for drug treatment, were sent to 200 nurses at five NHS teaching hospitals in Birmingham. Completed questionnaires were received from 115 nurses (a response rate of 57.5%). Fifty-four respondents added comments to the questionnaire, giving some insight into their responses to the statements on pharmacist prescription-writing and prescribing. These comments indicated five key issues that may warrant further investigation: (1) pharmacists' knowledge of the patient (2) doctors losing the opportunity to review drug treatment (3) potential communication problems (4) pharmacists' workload, and (5) legal and professional accountability.

Attitude of Health Personnel↗
PubMedDate not supplied

Differentiating between a consultant nurse and a clinical nurse specialist.

With the introduction of nurse consultants, and regulation of the use of the designation 'specialist nurse', experienced practitioners such as clinical nurse specialists have seen their position eroded. Nurse consultants are a new NHS-employment category, and are expected to be at the top rank of the profession both in status and in salary. However, this article argues that nurses at various levels have the same core functions, and that these do not differ for nurse consultants. Distinguishing between practitioners that might have the same job description could be better done by measuring outcomes. More care needs to be taken over the use of words such as 'expert', which is used differently in different contexts, and it is suggested that competencies be developed by which to measure the effects of expertise. Although nurse consultant appointments are often driven by various political directives and they are employed to meet local and national priorities, difficult issues need to be faced. First, if nurse consultant jobs are the top of the clinical career ladder, will clinical nurse specialists (CNSs) need to accept a lower rung on it? Further, perhaps the title CNS should become obsolete or be regulated? Can CNSs claim parity of pay using the 'Agenda for Change' framework?

Attitude of Health Personnel↗
PubMedDate not supplied

Nursing research: perspectives on critical thinking.

Critical thinking is an important component of professional practice. It is the hallmark of the competent nursing practitioner and yet there is no consensus on its definition, teaching or learning strategies of critical thinking skills in nursing students. Although critical thinking appears to be desirable at all levels of nursing practice, evidence to support its educational development in nurses appears to be limited. If educators are to prepare nurses to become leaders in their profession, the educational development of these essential skills in nurses needs to be addressed.

Assertiveness↗
PubMed2001

Discharge planning and social work practice.

Current health care practice discharge planning has emerged as a major professional function in hospital settings. To examine the tasks involved in discharge planning and how frequently they are being performed, 124 Alabama hospitals were contacted with a 72% rcsponse rate. Of the 178 surveys returned by discharge planners the core tasks were identified and ranked in terms of performance frequency. The results revealed that the tasks performed typically resembled that of generalist social workers. When specialization occurred, it was related to the populations served and not the specialized tasks or methods utilized. From this data recommendations are made for linking advanced generalist social work practice to discharge planning activities.

Alabama↗
PubMed1991

The Medicare assignment controversy: the construction of public-professional conflict.

The conflict between the elderly and organized medicine over "mandatory assignment" and "balance billing" is a significant public policy issue. Considerable ideological importance has been attached to this conflict by both sides, despite the relatively modest proportion of total revenue for physician services received through balance billing in payment for care of Medicare beneficiaries. The positions of these two coalitions are examined as well as the efforts of the Physician Payment Review Commission (PPRC) to craft a public policy response. Three alternative resolutions--those adopted by Congress in 1989 on the recommendation of the PPRC, the Canadian solution, and actions taken on a state level--are then contrasted. The concentrated impact on the elderly of balance billing practices is considered as a problem, especially for elderly of limited income and resources. Justification of the practice is typically provided by the profession on the ideological grounds of preservation of professional autonomy rather than economic gain, which also reflects the current relatively limited use of balance billing; a significant majority of all claims submitted in the United States are now assigned to physicians. A continuation of the gradualist strategy of the PPRC is endorsed as the most appropriate short-range solution to these problems, which diminish in significance with a more comprehensive national health financing scheme.

Aged↗
PubMed1990

Non-salary retention incentives for social workers in public mental health.

While workers' reasons for leaving jobs are myriad, little is known of what might induce workers to remain in jobs. The literature reports that money, alone, is not sufficiently persuasive as an incentive. This study of social workers in the public mental health system in Colorado reveals the incentive value of a set of non-salary retention measures. The findings of the study show that measures which furthered professional enrichment, contribution to the profession, and the exercise of professional autonomy are rated most highly. Cross-tabulations with some demographic variables reveal significant findings. Recommendations for implementing the findings are presented.

Colorado↗
PubMedDate not supplied

Third party reimbursement for pharmacist services: why has it been so difficult to obtain and is it really the answer for pharmacy?

OBJECTIVES: To describe three models of how health insurance coverage can develop for health care goods and services and apply them to pharmacist services. Also, to raise readers' awareness of the costs/tradeoffs involved in receiving third party reimbursements of insurance coverage from a health provider perspective. DATA SOURCES: Insurance theory and literature. SUMMARY: The three models for developing health insurance coverage are the risk-pooling model, the demand model, and the cost containment model. The risk-pooling model does not apply to coverage for pharmacist services because the cost of such services is not catastrophic and unpredictable. Applying both the demand model and the cost containment model to developing coverage for pharmacist services presents some challenges, but the demand model has been used more successfully to obtain insurance coverage for other health care goods and services. Potential costs and tradeoffs to the health care provider associated with insurance coverage are higher administrative costs, lower reimbursement rates, and loss of professional autonomy. CONCLUSION: If pharmacists want to increase third party coverage for their services, the best approach may be to increase patient demand for insurance coverage by promoting and charging for pharmacist services. However, pharmacists should seriously consider whether the benefits of such coverage for their services outweigh the costs.

Cost-Benefit Analysis↗
PubMed2006

Realising the developmental potential of Clinical Governance.

To be effective, Clinical Governance should reach all levels of a healthcare organisation. It requires structures and processes that integrate financial control, service performance, and clinical quality in ways that will engage clinicians and generate service improvements. The Clinical Governance arrangements of many Trusts, however, present several flaws. In particular, the "silos" organisational structure of Clinical Governance is based on generic issues such as risk management, clinical audit, clinical effectiveness and staff development, and it tends to treat clinical work as an undifferentiated aggregate. An alternative model focused on clinical pathways and on a balance between professional autonomy and accountability (responsible autonomy) should be promoted to make Clinical Governance work.

Clinical Medicine↗
PubMed1985

Creative productivity in women analysts.

A pilot study of female analyst creative productivity finds that women authors are well represented in numbers in two leading analytic journals, The Journal of The American Academy of Psychoanalysis and Journal of the American Psychoanalytic Association, for 1980-81. However, women analyst members of the journals' parent organizations are very poorly represented compared with male analyst members. This has led to an exploration of factors affecting female analyst productivity, encompassing a broad sweep from the sociological to the personal, dynamic level. Differential opportunities for women analysts may be inherent in the educational processes. There is evidence for an "accumulation of disadvantage" for women in the field of psychiatry, as well as the impression of gender bias and feelings of stigmatization in psychoanalysis. The question of whether academic research career paths for women are adequately encouraged is raised. Mentorship patterns are also discussed. Whether gender bias affects journal publications and the nature of psychoanalytic thinking is questioned. Women's lessened productivity is sometimes ascribed to practical aspects of feminine role. This myth is debunked for women in science, where married women with children are equally productive. The author suggests that women analysts, however, may be a select group and may be more subject to role conformity pressures. Feminine role conflicts and their effects are discussed. Dynamic issues related to creative productivity are explored in two major areas. The author suggests that female preoedipal object relations may play a part in females devaluing of their own creative efforts in a competitive arena. The oedipal situation is also discussed, especially with regard to very high-achieving women. It is suggested that though competition with the maternal-nurturant rival may be worked through, often there is incomplete resolution of the surpassing and separation from the protective, loving, but dominant oedipal father, thus limiting true professional autonomy.

Clinical Competence↗
PubMedDate not supplied

[Patterns in nursing supervision at hospitals in Feira de Santana-Ba].

This is an exploratory descriptive study about Nurse Supervision Pattern (NSP) performed in Feira de Santana-Bahia-Brazil, in 1994, which aims at describing supervision pattern and identifying interference factors. A questionnaire and descriptive statistics have been used. Supervision pattern proved that the kind of hospital is a factor that interferes on NSP. Based on literature, percentual exam of results and author's professional experience, it asserted that sex, academic graduation, earnings, health politics, planning and technical administrative structure are conditional factors for NSP, as well as lack of professional autonomy, interference of political parties, deficiency of material and human resources, low salaries, unsuitable environment and unsatisfactory interpersonal relationships mentioned by the subjects.

Brazil↗