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PubMed2002

Demonstrating quality at the physician-office level.

A multidisciplinary task force consisting of administration, quality management, directors of service, and network development staff of a nonprofit organization developed and implemented a comprehensive report card process for its 50 physician-office sites. The goals were to develop and implement a process that would provide a comprehensive summary of the administrative and clinical activity of all network sites, to develop a framework for identifying best practices within the network, and to enhance motivation to improve performance through benchmarking with physician offices within the network. This initiative also sought to transform the voluminous data collected into meaningful information that could be used to improve the process of operations and outcomes.

Benchmarking↗
PubMedDate not supplied

Nurses' views on sexuality. Why, what, and how to change.

What practicing professional nurses believe about the sexual functioning of their patients has a direct influence on the patients' psychological well being. A preliminary investigation identifying some of nurses' beliefs demonstrated their attitudes and knowledge about the effects of chronic disease on sexuality. Staff development educators can assist nursing staff to change attitudes and improve knowledge through an educational program outlined in this article.

Adult↗
PubMedDate not supplied

Nursing process, nursing diagnoses, and care plans in a clinical setting.

Staff development educators assist professional nursing staff in providing personalized, quality patient care that is documented in an accurate, time-saving manner with periodic evaluation of outcomes. They also seek ways to assist administrators in improving quality assurance in health care facilities. This article describes nursing care plans based on North American Nursing Diagnosis Association (NANDA) taxonomy that can meet recognized standards of patient care and be adapted for acute or long-term care facilities.

Education, Nursing, Continuing↗
PubMedDate not supplied

Research utilization: making the link to practice.

One goal of nursing staff development educators is to update staff practice through the application of nursing research findings. A multi-site study was conducted to determine what factors are related to a nurse's use of research findings. The study suggests that staff involvement in research-related activities such as data collection is the best predictor of use of research findings in the clinical setting. This finding was used to design strategies for facilitating the transfer of research findings to practice.

Clinical Nursing Research↗
PubMed1994

A staff journal club as a method of continuing education.

The journal club has proven to be an effective method for staff development in the ambulatory surgery unit at Rochester General Hospital. It has increased the staff members' awareness and comfort with research and has fostered discussions around pertinent clinical issues. Collegial relationships have been strengthened by staff members' shared commitment to presenting articles at monthly meetings. A journal club is a simple method for continuing education that can be adapted to many clinical settings.

Ambulatory Surgical Procedures↗
PubMed1993

Peer coaching: building collegial support for using innovative health programs.

To ensure students achieve intended benefits from effective health programs, it is necessary to maximize program implementation and maintenance. Peer coaching provides a post-inservice staff development approach for health educators to strengthen teacher use of new health programs during implementation trials. While peer coaching positively influences teacher behavior and student outcomes, previous coaching programs have been limited in scope, have not been theoretically derived or adequately evaluated, and have not been systematically applied to health programs. This paper addresses teacher needs during trials, reviews peer coaching program features, and proposes a model to guide future planning, evaluation, and research. In this model, critical components of the coaching program include classroom assessments, coaching team cluster meetings, and administrative support. Strategies based on Social Learning Theory and Diffusion Theory are incorporated into the peer coaching program to influence teacher perceptions of their work roles, capability to implement a program, and commitment to the new instructional program. Interrelations among components are discussed and directions for future research and practice are suggested.

Curriculum↗
PubMedDate not supplied

Preparing staff to deliver age-appropriate nursing care to elderly patients.

Meeting the Joint Commission on Accreditation of Healthcare Organizations accreditation standard for age-appropriate care cannot be accomplished by a once-a-year inservice educational program. Educational offerings that address the specialty of gerontological nursing require deliberate decision-making regarding the generic and advanced competencies necessary for care of elderly patients. Finding the resources to effectively teach the essential (generic and advanced) content is challenging. This article suggests that a staff development department may use existing resources and personnel from other organizations to prepare nursing staff to deliver age-appropriate care to elderly patients.

Aged↗
PubMed1997

Peer evaluation. A visual picture.

To meet the criteria of role accountability, nursing competence and ongoing staff development, an improved peer-evaluation system was designed to continuously monitor these new roles. This peer-evaluation process converts evaluation input into data, giving staff a visual picture of how their performance compares within their peer group. This peer-evaluation process was designed as a tool to assist in staff growth and development, not as a punitive system.

Clinical Competence↗
PubMedDate not supplied

From school to work: employer perceptions of nursing skills.

Questions periodically arise regarding clinical competencies and students' ability to perform in the employment setting after graduating from a baccalaureate nursing (BSN) program. This article describes a collaborative project between a nurse administrator in an acute care facility and a nurse educator in a baccalaureate nursing program. The project was designed to evaluate whether expected competencies of BSN graduates were evident in the work setting. Skills and behaviors of BSN graduates were evaluated by 68 nurses in an acute care setting. The findings provide data for nurse administrators to assist with planning staff development and continuing education programs for nursing staff. The results also provide data for nurse educators to assist with evaluation of effectiveness of nursing programs.

Acute Disease↗
PubMedDate not supplied

A pilot program to promote professional growth for neuroscience nurses.

A pilot program was developed as a strategy to increase professional growth on a neuroscience unit. The primary objective of the program was to allow staff nurses to participate in activities that interface with the neuroscience patient population. Nurses could choose an area of interest that related to their unit responsibilities. This experience provided the participants with the unique opportunity to participate in patient care from the perspective of another discipline. The staff were enthusiastic about the experience and shared it eagerly with their peers. Participants' evaluation of the program was overwhelmingly favorable. The data suggest that this program was an effective means of increasing professional growth and staff development.

Education, Nursing, Continuing↗
PubMed2005

Can skill-development training alleviate burnout in hospital social workers?.

Staff development programs, which focus on imparting and improving intervention skills, are acknowledged as an efficient way to reduce burnout, but few studies have examined this effect. The aim of the present study was to detect any difference in the level of social worker's burnout before and after attending two different skill-development groups, namely group-intervention skills for more experienced social workers and general hospital social-work skills for less experienced. Twenty-five hospital social workers participated in the study. The three dimensions of burnout, namely emotional exhaustion, depersonalization, and personal accomplishment, changed between the pre-training and post-training measures: personal accomplishment rose by 12.39% and depersonalization fell by 29.75%. The difference was significant for the two dimensions in both groups. Emotional exhaustion significantly declined in the hospital social-work skills group only, and revealed a group-time effect. The level of peer support rose in the hospital-skills group and was positively related to a lowering of emotional exhaustion. This was an exploratory study, with a rather small sample, and the results are preliminary, but they show a promising possibility of burnout reduction among professional workers. Further research on the effect of skill development training on reducing burnout is needed.

Adaptation, Psychological↗
PubMed2001

Meeting the challenge of problem-based learning: developing the facilitators.

Problem-based learning methodologies are now extensively utilized within contemporary nursing curricula. One factor which has been found to be vital to the successful use of these methodologies is the effectiveness of the facilitator. For some teachers, the facilitation of problem-based learning tutorials demands a shift from teacher- to student-centred instruction; for others it requires continuing development of present practice. It is proposed that this transformation or modification of teacher practice can be achieved through the use of group reflection for teacher development. This paper suggests that a group reflective practice strategy for facilitator development is more likely to prepare teachers to meet the demands of problem-based learning than traditional forms of staff development. The strategy proffered for teacher development has two phases: phase one establishes the group and centres discussion on the practice of problem-based learning facilitation; phase two involves critical analysis of personal practice of facilitation in the context of problem-based learning with a view to increased self-knowledge, ultimately leading to a change in practice. Changes to personal practice will be sustained by repeated participation in phase two. Essential to this ongoing participation will be recognition and support from the host organization.

Communication↗
PubMed1991

Pharmacist career ladder with clinical privilege categories.

The development of a career ladder program for staff pharmacists at a Department of Veterans Affairs (VA) medical center is recounted. Center policy required the establishment of clinical privileges for all pharmacists with direct patient contact and specified three VA privilege categories with increasing degrees of autonomy. The pharmacy department supported the need for all pharmacists to incorporate clinical activities into their daily practice but faced several problems, including inadequate instruction, insufficient incentives, fragmentation of clinical services, and subjectivity of measures of competence. In response, a pharmacy credentialing committee created a career ladder with three levels based on the established system of clinical privileges. Level A integrated basic clinical pharmacy knowledge with dispensing activities. Level B increased the number of clinical skills required and allowed the pharmacist to act as a therapeutic consultant. Level C incorporated the skills necessary for specialty practice. Instructors were designated for each clinical service area, readings and sample problems were assigned, and staff development presentations were improved. Objective tests of skills were designed. Combining the three levels on the career ladder with the three categories of clinical privileges formed a matrix of nine options for advancement. Pharmacists applying for advancement must master all requisite skills and submit relevant documentation. Each level carries a pay increase of 2%. A total of 53% of the staff pharmacists have participated in the program, which has had a favorable impact on staff retention. By combining nationally established categories of clinical privileges with an institution-specific career ladder, a pharmacy department helped ensure the consistency of services and promote the development of clinical practitioners.

Career Mobility↗
PubMedDate not supplied

Staff nurses' career development relationships and self-reports of professionalism, job satisfaction, and intent to stay.

The purpose of this study was to investigate the range of career development relationships (CDRs) experienced by staff nurses in relation to the outcomes of professionalism, job satisfaction, and intent to stay. A sample of 390 Army staff nurses completed questionnaires measuring five CDRs--precepting, peer-strategizing, coaching, sponsoring, and mentoring--and the outcome variables. Findings indicated that 61% of the sample experienced a CDR, with the predominant CDR being coaching. No CDR affected professionalism; however, job satisfaction and intent to stay may warrant further investigation in relation to CDRs. The findings suggest that if nurses perceived that an interest was taken in their career development, and felt valued by the developer, then usually staff nurses viewed the relationship as professionally important. The perception of importance often influenced intent to stay in a positive direction.

Adult↗
PubMedDate not supplied

Supporting excellence in turbulent times.

Re-engineering offers an organization the opportunity to identify and strengthen critical system values and enhance employee commitment despite needed downsizing and major role changes. Anticipated distress during turbulent transitions can be decreased by managers paying close attention to employees' realistic concerns and offering opportunities for discussion about unaltered values as well as concretizing operational guideposts during the "in between" phase. Leaders must develop significant new skills to help staff develop competencies related to change management. Chief among the needed capabilities are direct communication techniques, enhanced self knowledge and desired team role behaviors. The expanded span of accountability for managers offers opportunities for staff empowerment through their needed participation in peer reviews, as well as the concomitant changes in position descriptions, role expectations, and financial rewards.

Clinical Competence↗
PubMed2002

Making sense of trying not to teach: an interview study of tutors' ideas of problem-based learning.

PURPOSE: To explore how a cohort of first-ever "foundation" tutors in a new problem-based curriculum characterized and made sense of problem-based learning (PBL). METHOD: The sample consisted of all foundation tutors (n = 34) from The University of Liverpool's undergraduate medical curriculum, 1996-97, the first semester of the first year that PBL became a main vehicle for knowledge acquisition. The cross-sectional study design involved semistructured telephone interviews with the tutors about PBL and problem solving. The author taped and transcribed the interviews and conducted an inductive analysis of these qualitative data. RESULTS: All tutors responded, with interviews lasting about 20 minutes: 26/34 (76%) were men and 23 (68%) were medically qualified. Twenty-nine (85%) facilitated 19-21 of the 21 PBL sessions. Most tutors conceptualized PBL as being student-centered (68%), involving small-group work (53%), but ignored its reflective component. They conceptualized good PBL tutors diversely, but mostly as "knowing" when and how to intervene (41%) and empathizing with students (29%). Few tutors characterized PBL in terms of problem solving, yet over half agreed, cursorily, that they were intimately related. The tutors were generally unclear about this relationship. CONCLUSION: These tutors mostly characterized PBL positively as a philosophy, yet missed its reflective elements and were particularly challenged by their own fallibility in knowing when and how to intervene without teaching. Internal motivation and direct experience of PBL helped balance some of the tutors' confusion with the educational rationale, highlighting possibilities for future staff development.

Education, Medical, Undergraduate↗
PubMed2001

Learning in clinical nursing practice.

In this study, a qualitative interpretivist perspective was used to analyze the following research question: How does clinical nursing practice facilitate learning? Forty nurses working in acute care, long-term care, and home care were interviewed about their clinical practice experiences and the learning that resulted. Data were analyzed using a constant comparative method. Study results indicate that clinical nursing practice facilitates both personal and professional development of nurses by fostering an examination of the concepts of self-respect, hope, control, vulnerability, acceptance, loss, and persistence. Implications for continuing educators and staff development instructors are drawn.

Adult↗
PubMed1998

Training for health care in developing countries: the work of the Tropical Health and Education Trust.

The Tropical Health and Education Trust (THET) was established to strengthen medical education and training for health care in developing countries. The Trust responds to requests from training institutions with a wide range of activities and programmes. Projects to meet specific needs are planned in outline with the Deans or Directors of institutions, as a basis for a long-term link with a similar institution in the United Kingdom. These links are now the preferred method for meeting requests to develop skills, strengthen services and promote staff development. However, funding is always necessary for their support. THET has promoted students' community-based training by enabling students in a team-training programme in Ethiopia to make interventions in primary health care. A prize for the best students' community, clinical or laboratory projects in six African countries encourages enquiry by the students, promotes independent learning, and relates academic work to problems in health care. Work with Ministries of Health includes a continuing medical education programme for rural medical officers in Uganda, courses in basic and life-saving surgery for Ethiopian health and medical officers, and a programme to update the skills of laboratory technologists in rural hospitals in Ghana. The range of projects that THET supports is wide because the needs, defined by those who are working in, and responsible for, training in the health service are diverse.

Africa↗