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At least 685 records · Page 38Linked to original sources
PubMed2003

Cross-infection prevention, basic hygiene practices and education within nursing and health care in Latvia: a Swedish-Latvian practice development project.

The primary aim of this practice development project was to explore the level of knowledge of nursing and medical staff at the Infection Clinic at Liepaja regarding the spread of infectious diseases. Arrangements were also made for some of the Latvian health care staff to visit the Infection Clinic in Gothenburg to increase their knowledge about basic hygiene and to enable them to study the research in this area. Later we were able to formulate this new knowledge into written guidelines. The theoretical education started with questions regarding staffs expertise in preventing the spread of infections. Areas covered were handwashing, hand disinfection, use of disposable gloves and protective clothing. This revealed a need for development of both theoretical and practical knowledge in this area. However, hygiene practices improved after the theoretical education and the visits to the Infection Clinic in Gothenburg. On our return visit to Liepaja dispensers of liquid soap together with hand disinfectants were evident at every wash basin on the unit. Disposable gloves were also routinely used for the dressing of wounds and invasive procedures. Furthermore, disposable coats and masks were used when caring for highly infectious patients. The key cultural differences were the lack of nursing documentation and the relative absence of a dialogue directly between the nurse and the patient.

Clinical Competence↗
PubMed1998

A shared community-based practice: an alternative model for WOC nursing practice.

In the past, as the populations in many communities have grown, WOC nurses have been hired for each of the major health care facilities located in that community. However health care restructuring has caused many local hospitals to reevaluate their use of specialty practice nurses, including ET/WOC specialists. In response to this trend, a shared community practice model was established that has allowed each agency to make use of ET nursing service on an "as needed" basis, while maintaining daily accessibility to this important resource person. This article describes the evolution and growth of this practice model during the past two decades of intense reform in health care delivery.

Community Health Services↗
PubMed1992

A practical gloving and handwashing regimen for dental practice.

The debate concerning the re-use of gloves in dental practice continues, despite the fact that recent guidelines on cross-infection control recommend that a new pair of gloves should be used for each patient. Whichever policy for glove use is adopted, it is important to take the maximum possible precautions in hand care. This paper presents a practical regimen for hand/glove washing which is simple, quick and effective. The importance of establishing a hand-care regimen in dental practice is emphasised.

Cross Infection↗
PubMedDate not supplied

Improved practical skills of midwives practicing in the Eastern Cape Province of the Republic of South Africa through the study of a self-education manual.

OBJECTIVE: Changes in the ability of midwives to perform practical skills, after completion of the Maternal Care Manual of the Perinatal Education Program, were determined. STUDY DESIGN: A prospective, controlled trial in a study town and two control towns. The practical skills of midwives caring for pregnant women in the towns were determined. Subsequently the Maternal Care Manual was studied by midwives in the study town, and the skills of all midwives were subsequently evaluated. RESULTS: A total of 34 midwives in the study town and 39 midwives in the two control towns were studied. The marks showed a significant (p < or = 0.000) improvement in the study town when comparing the pre- and postintervention marks. The mean improvement in the study town was 36.6%. DISCUSSION: The practical skills of midwives improved significantly. The Perinatal Education Program can be implemented with confidence as a distance learning program that is especially suited to the needs of health workers in remote regions.

Adult↗
PubMed1997

Project 2000. Perception of the philosophy and practice of nursing: preparation for practice.

As part of a comprehensive study of perceptions of the philosophy and practice of nursing Project 2000 students and newly qualified diplomates were asked to reflect on their Project 2000 course as a preparation for professional practice. Data were collected from both students and diplomates through self-completion questionnaires and a small number of interviews with diplomates in two study centres, one in the north and the other in the south of England. Nurse managers and G grade practitioners were invited in focus group interviews to discuss the Project 2000 preparation and assess the diplomates 'fitness for purpose'. Findings suggest that the majority of students and diplomates acknowledged that the course had prepared them well. They acknowledged the importance of the inter-personal skills component of the course, together with the life sciences input. The diplomates particularly valued the theoretical aspect of the course, being well versed in research and keen to continue their learning. Perceived limitations of the course were the management preparation and course organization. Practical skill deficits were perceived as initial skills deficits only. Managers and practitioners were keen to employ the diplomates, whilst acknowledging their need for support and preceptorship. Three important issues for nursing and nurse education are discussed, including the balance of the Project 2000 course, preceptorship and support, and preparation for a role in the community.

Attitude of Health Personnel↗
PubMed1999

Implementing and sustaining evidence-based clinical practice in Australia: the Evidence Based Clinical Practice Research Initiative.

Evidence-based medicine is a process by which clinicians translate clinical information needs into answerable questions, track down answers to those needs as efficiently and effectively as possible using the best evidence available, apply the information to patients and evaluate their performance. Implementing evidence-based medicine is fragmented and variable. The National Health and Medical Research Council of Australia has implemented a research program to determine successful strategies for implementation and sustaining of evidence-based clinical practice. In addition this research program will help to answer whether evidence-based practice improves patient outcomes. This paper describes this program and other strategies that improve the application of evidence-based practice in clinical settings.

Australia↗
PubMed2000

Reflective practice and its role in mental health nurses' practice development: a year-long study.

The study reported in this paper lasted over a year, and identifies a conceptual framework of nursing practice based upon a relationship-building process. It also identifies six characteristics of nursing roles inherent within the practice of mental health nurses on a Nursing Development Unit. The paper presents a structure and process of reflection for nursing practice as illustrated by the work of a group of nurses working in a NDU. The purpose of the study was to help them better understand their work with patients. The findings from the study are used to explore how the nurses described and implemented individualized, patient-focused care. This care was based upon the ability of the nurse to communicate well and to build a relationship with a patient, bound within a context of change.

Humans↗
PubMed1980

[On the practice of clinical therapy with psychotropic drugs -- retrospective investigation of physicians prescribing practices in a psychiatric hospital (author's transl)].

1. At the psychiatric hospital of the University of Munich physicians' practices in prescribing psychotropic drugs have been analyzed retrospectively for 1974. Case report of 2,100 patients from a total of 2,118 newly admitted inpatients in 1974 have been evaluated and various methods of analyzing data are compared. 2. 414 (19.7%) patients out of a total of 2100 have not been medicated by any drugs. On the average 2.7 psychotropic drugs/patient have been precribed in the remaining 1,186 patients (80.3%). 3. 37.4% of 4627 applications made have been allotted to neuroleptics. Clozapine has been found to be the drug most extensively used (37.4%). It was prescribed to 595 patients, followed by chloralhydrate (425 patients) and amitriptyline (374 patients). 4. Out of a total of 5373 prescriptions, 2,004 were allotted to a single substance and 3,369 to a combination of different drugs. With regard to combined medications, in 1,856 prescriptions two drugs were combined, in 1,015 three, in 404 four, in 70 five, in 18 six and finally in 6 prescriptions seven medications were applied to one patient. 5. Antidepressants and neuroleptics have been combined on the same patient in 768 prescriptions. As to neuroleptics most frequently clozapine and haloperidol have been prescribed together. 6. The mean time during which a defined combination of drugs was given continuously, never exceeded a quarter of the total time the individual had been admitted to the hospital. 7. It is evident that in clinical practice the combinations of psychotropic drugs are widely used. This pattern of psychopharmacological drug treatment is in conflict with the present accepted rules of psychotropic pharmacotherapy. Furthermore it is a remarkable result of the present studies that in therapeutical practice the single components of drug combinations are changed very often. Compounds with sedative effects are preferred within all classes of psychotropic drugs.

Antidepressive Agents↗
PubMed2005

The status of asthma control and asthma prescribing practices in the United States: results of a large prospective asthma control survey of primary care practices.

Control of asthma symptoms is, unfortunately, not a reality for many people with asthma. Asthma control is an ongoing challenge, requiring a multidisciplinary treatment approach. The National Asthma Education and Prevention Program (NAEPP) of the National Heart, Lung, and Blood Institute published its Guidelines for the Diagnosis and Management of Asthma in 1997, but the extent of implementation of recommendations in physician's practices remains to be determined. We sought to determine if a systematic implementation of the NAEPP practice guidelines would impact physician's treatment decisions for patients with asthma. The Asthma Care Network is a large, national, point-of-care program developed to assist health care providers in the assessment and management of their patients with asthma. Outcome measurements for the program included level of asthma control, activity limitation, sleep disruption, use of rescue medications, use of controller medications, and urgent care services. A total of 4,901 primary care physicians at 2,876 practice sites enrolled more than 60,000 patients. Nearly three fourths of patients reported symptoms consistent with a lack of asthma control (mean 74%, range 69-81%). Approximately 68% of pediatric patients and 78% of adult patients reported limited activities due to asthma in the past week. Sixty-two percent of pediatric patients and 68% of adult patients reported more than two symptomatic days in the past week. Approximately 40% of the patients surveyed were not using controller therapy. The overall percentage of patients reporting uncontrolled asthma who were prescribed a controller medication increased from 60% to 81%, and the use of inhaled corticosteroids containing medications among these patients increased by 52%. As a result of the assessment of the patients' level of asthma control during the office visit, physicians changed their patterns of prescribing controller therapy in patients with uncontrolled asthma.

Adolescent↗
PubMed1991

Subjective appraisal of orthodontic practices. An investigation into perceived practice characteristics associated with patient and parent treatment satisfaction.

Based on a comprehensive in-practice questionnaire survey among 254 school-age patients and their parents, the subjective perception and evaluation of orthodontic care was investigated. By means of refined statistical analysis, three types of practice showing significantly distinct image profiles were identified. Likewise, the set of discriminating variables was reduced and assigned to the fundamental concepts of 'interpersonal satisfaction' and 'perceived efficacy' which appeared to play a crucial part in the crystallization of both patients' and parents' contentedness with the treatment received. To take account of the interdependence of instrumental and social factors, a model of perceived practice similarity is suggested; its significance regarding treatment decisions and future research efforts is pointed out.

Adolescent↗
PubMed1995

Specialist and general practice views on routine follow-up of breast cancer patients in general practice.

The practice of routinely following-up breast cancer in hospital clinics is of widespread concern: studies have shown that it is not an effective way of detecting recurrent disease and it places great strain on cancer services which are already overstretched. A general practice centred system of routine follow-up may be a solution to this problem in those countries which have a strong primary care base. Such a system would have other benefits such as continuity of care for the patient. The objective of this study was to determine the views of general practitioners and specialists on follow-up of patients with breast cancer in remission, with special emphasis on their views on the transfer of routine follow-up from the hospital to general practice. A postal questionnaire survey of British breast cancer specialists (response rate 77.0%) and a personal interview survey of British general practitioners (response rate 81.8%) were conducted. The results show that British general practitioners are willing to take on greater responsibility for the routine follow-up care of their patients with breast cancer. However, there was frequently a mis-match between specialists' and general practitioners' views on this subject.

Aftercare↗
PubMed2003

Practising what we preach? A practical approach to bringing research, policy and practice together in relation to children and health inequalities.

This paper explores the need for better links between research and practice in relation to work with children and health inequalities. Despite continuing discussion about the need to improve dissemination of research activity in general, study of this area remains largely neglected. As a result, despite the rhetoric, the research and practice gap continues to exist. An attempt to remedy this was undertaken through the support of a user fellowship as part of the UK Economic and Social Research Council Health Variations Programme. The paper describes a number of activities that were undertaken during the fellowship, and discusses the implications of these for improving connections and minimizing the research and practice 'gap'. It argues that a need exists for researchers to develop innovative dissemination strategies and suggests that potential exists for an interactive model of dissemination. Such a model implies a more active role for users of research in the shaping of research agendas.

Child↗
PubMed1982

Diabetes-related goals, practices, and beliefs of practicing pediatricians.

Practicing pediatricians were surveyed to assess their need for diabetes education programs. Pediatricians generally have fewer than five diabetic patients, frequently see them less than once every four months, prescribe single daily insulin injections, and do not include dietetic services in their treatment program. Among the pediatricians surveyed, practices correlated weakly with therapeutic goals for metabolic control, and goals correlated weakly with belief that hyperglycemia causes microvascular complications of diabetes. Belief in the importance of hyperglycemia did not correlate with actual care practices reported. The data support the idea that presentation of the latest advances in scientific rationale is an inadequate basis for physicians' continuing education.

Child↗
PubMed1995

An advanced practice model: inpatient collaborative practices.

Advanced practice nurses play a key role in optimal patient care. In primary care, their functions include history taking, physical examination, development of a plan of care, instruction and counseling, use of laboratory data, diagnosis of routine illness, prescription of medications or other therapies as allowed by state laws, coordination of services, and referral when necessary. These nursing services may be provided independently or in collaboration with physician providers. Nurse-physician collaborative practices generally occur in the ambulatory care setting. The purpose of this article is to illustrate inpatient collaborative practices with CNSs and staff physicians in an urban, medical-center hospital.

Humans↗
PubMed1999

Enhancing psychiatric nursing practice: role of an advanced practice nurse.

In response to demands for alternative health models that deliver cost-effective quality care, one large Midwestern medical center implemented a change in their nursing practice model. The change involved the introduction of unit-based nursing leadership teams that included advanced practice nurses (APNs). This article reports the findings from an investigation that employed a case study design to evaluate the process and outcomes of integrating an APN on a psychiatric unit with experienced nurses. Data collection methods included a nursing survey (n = 34), interviews with nine randomly selected nurses, and two multidisciplinary open forums. Consistent with the staff nurses' survey ratings of important advanced practice role functions, responses from the nursing interviews and open forums suggested nurses' professional development to be the most positive outcome. Role confusion was identified as a negative outcome. Recommendations for improved integration and use of APNs in today's psychiatric health environments were identified.

Hospital Units↗
PubMed1999

Psychoactive medication prescribing practices for U.S. children: gaps between research and clinical practice.

OBJECTIVE: To determine national pediatric prescribing practices for psychotropic agents and to examine these practices in view of the available evidence concerning their safety and efficacy in this age group. METHOD: Prescribing data from 2 national databases based on surveys of office-based medical practices were determined and reviewed vis-à-vis available safety and efficacy evidence. RESULTS: Data indicate that levels of psychotropic prescribing in children and adolescents are greatest for stimulants, resulting in nearly 2 million office visits and 6 million drug "mentions" in 1995. Selective serotonin reuptake inhibitors were the second most prescribed psychotropic agents, while anticonvulsant mood stabilizers (prescribed for a psychiatric reason), tricyclic antidepressants, central adrenergic agonists, antipsychotics, benzodiazepines, and lithium were also prescribed for a substantial number of office visits. Comparison of prescribing frequencies with available safety and efficacy data indicates significant gaps in knowledge for commonly used agents. CONCLUSIONS: Most psychotropic agents require further sustained study to ensure appropriate health care expenditures and vouchsafe children's safety. Recommendations for researchers, parents, federal agencies, and industry are offered as a means to accelerate the pace of research progress.

Adolescent↗
PubMed2003

The Vanderbilt Professional Nursing Practice Program: part 1: Growing and supporting professional nursing practice.

Professional practice programs are designed to attract, retain, and reward nurses. This three-part series will describe Vanderbilt's performance-based career advancement system, the Vanderbilt Professional Nursing Practice Program (VPNPP). Part 1 outlines the overall program's foundation, philosophical background, and basic structure. The VPNPP is built upon Benner's work, distinguishing among four levels of practice: novice, competent, proficient, and expert. Work by many in the organization identified the expected behaviors for nurses at each level, which were then used to develop clear process evaluation criteria. Part 2 will examine the performance measurement and evaluation system created to support the program. The process of advancing within the program will be described in part 3.

Academic Medical Centers↗
PubMed1996

Advanced practice nurses: change agents for clinical practice.

The article presents the role of advanced practice nurses as change agents in the clinical setting. Research utilization is needed to shape and form the basis of nursing practice. As change agents, the advanced practice nurses in one institution established a research-based minimal stimulation protocol for the very low-birth weight infant and implemented it using a video presentation. Knowledge of change theory, research utilization, and video production was necessary in making this project a success.

Clinical Nursing Research↗