Confronting emerging infectious diseases: the importance of partnerships between clinical medicine and public health.
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This study describes the clinical experiences of doctorally prepared nurses whose primary professional role is providing care as advanced practice nurses. Telephone interviews were conducted with 20 participants who lived and practiced in 13 states. Practice settings for these nurses included inpatient acute care and various outpatient/community health settings. Several themes describe the nature of the participants' practice: management of patient care, interwoven partnerships, leadership, and practice values. Major themes relating to the contribution of doctoral education to practice were abilities gained and changes in image and status. The findings of this study demonstrate that doctorally prepared nurses are actively involved in nursing practice by affecting patient outcomes, promoting cost-effective care, and using clinical research.
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The implementation of a nursing practice model, Disciplined Clinical Inquiry (DCI), in the perioperative arena, is described. Using participatory action research, nurses are empowered to become reflective practitioners, competent in problem solving and evidence-based practices, collaborators, change agents, and patient advocates. Characteristics inherent in this model include flexibility, practicality, and partnerships between academia and clinicians. The successful DCI pilot test has led to a replication study with implications for other specialties.
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This paper explores the partnership between social services and primary care, in one geographical area, in relation to five potential types of obstacle: structural; procedural; financial; professional; and status and legitimacy. It examines the theory of partnership and the Government's attitude towards it. It uses semi-structured interviews with a range of stakeholders to study partnership in practice. Finally, it highlights some of the challenges for the future.
The importance of partnerships and collaborations between different stakeholders in order to achieve health objectives are increasingly recognized. This article aims to: (1) highlight the importance of establishing partnerships and coalitions to achieve health goals; (2) consider the benefits and costs of such collaborations; and (3) identify the conditions which facilitate effective partnerships, from the perspective of nurses working within collaborative ventures in South Africa. A survey of these nurses was undertaken to consider their perceptions of the likely returns from investments in collaborative working and the extent of the relationship between the participation incentives and difficulties encountered. By examining their perceptions to a number of facets of partnership fostering, the article has elaborated on the meaning of collaboration and its rationale, and highlighted the conditions necessary for the success of community partnerships (CPs). The study has also demonstrated the feeling that CPs are beneficial with increased satisfaction along many operational parameters. Working to a shared agenda requires a "give and take attitude" among the stakeholders, designed to produce an outcome that merges multiple and new insights and directions for action, as well as the combined power foundation to do so.
Partnership working has become a central feature of British social welfare policy since 1997. Although this development is applicable to all areas of public welfare, nowhere is it more evident than in the planning and provision of care that overlaps health and social services. The literature survey described in the present paper focused on research examining the impact of partnership working in these areas to assess the evidence concerning its effects and to investigate how partnership 'success' is conceptualised. The literature conceptualised the success of partnerships in two main ways: (1) process issues, such as how well the partners work together in addressing joint aims and the long-term sustainability of the partnership; and (2) outcome issues, including changes in service delivery, and subsequent effects on the health or well-being of service users. The authors found that research into partnerships has centred heavily on process issues, while much less emphasis has been given to outcome success. If social welfare policy is to be more concerned with improving service delivery and user outcomes than with the internal mechanics of administrative structures and decision-making, this is a knowledge gap that urgently needs to be filled.
BACKGROUND: In 1991, an intervention trial of the efficacy of an asthma self-management plan was carried out in partnership with a rural Mäori community. The program relied on Mäori community health workers and other health professionals working in partnership, was delivered through clinics in traditional Mäori community centres and Mäori processes were followed throughout. The plan was shown to be effective in reducing asthma morbidity. OBJECTIVE: To assess whether the long-term benefits of the program extent beyond reduced asthma morbidity and the extent to which any additional benefits may be related to the partnership approach employed by the program. METHOD: Forty-seven (68%) of the original program participants were surveyed in August 1997. Participants were questioned on the program's impact in areas such as cultural development, health service access and lifestyle. RESULTS: In addition to the improvements in asthma morbidity, the program was found to have four key benefits: cultural affirmation; improved access to other health services; a greater sense of control for participants; and positive impacts on the extended family. CONCLUSIONS: The program's benefits extended beyond reduced asthma morbidity and were not due simply to the introduction of the asthma self-management plan but also to the partnership approach employed by the program. IMPLICATIONS: The study provides support for providing public health services for indigenous communities that take a partnership approach, utilise community expertise and are delivered in a way that is consistent with each community's cultural processes.
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