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At least 865 records · Page 48Linked to original sources
PubMed1985

Mental health in health planning agencies.

Two models of organizational behavior were tested using a population of 200 Health Systems Agencies (HSAs) in the U.S.A. A 'needs' model, based on mental health high-risk sociodemographic indicators, and a 'resources' model, based on a mental health manpower, facilities and system-activation indicators, were used to predict 1978 HSA activities in mental health governing board representation, Health Systems Plan development and Certificate of Need (CON) project review. Where there were differences, resource indicators explained more variance in HSA activities than did need indicators. HSA project review activity was better explained by both sets of indicators than were board and plan activities. HSA recommendations were most often consistent with the aims of health planning.

Certificate of Need↗
PubMed2003

Status of practice guidelines in the United States: CDC guidelines as an example.

BACKGROUND: Clinical practice guidelines have proliferated in the past several decades, starting with only a handful in the 1980s to over 1000 approved through The National Guideline Clearinghouse in 2002. METHODS: The purposes of this article to review research related to guideline adoption and impact and to make recommendations for assessing the outcomes of guidelines, using the CDC guideline process as an example. RESULTS: Despite the national movement toward standardization of evidence-based practice, few studies have been conducted to assess the costs of guideline development and implementation, and some practice guidelines have been implemented without concomitant assessment on patient outcomes and costs and benefits of changes in care. CONCLUSIONS: An immediate mandate is to ensure that when guidelines are promulgated, they include an evaluation plan, developed by the implementer of the guideline, which takes advantage of existing qualitative and quantitative data and programs (e.g., patient-centered care, quality assurance, risk management) not limited to expensive and sophisticated clinical trials.

Centers for Disease Control and Prevention, U.S.↗
PubMed2004

Life cycle assessment for sustainable metropolitan water systems planning.

Life Cycle Assessment (LCA) is useful as an information tool for the examination of alternative future scenarios for strategic planning. Developing a life cycle assessment for a large water and wastewater system involves making methodological decisions about the level of detail which is retained through different stages of the process. In this article we discuss a methodology tailored to strategic planning needs which retains a high degree of model segmentation in order to enhance modeling of a large, complex system. This is illustrated by a case study of Sydney Water, which is Australia's largest water service provider. A prospective LCA was carried out to examine the potential environmental impacts of Sydney Water's total operations in the year 2021. To our knowledge this is the first study to create an LCA model of an integrated water and wastewater system with this degree of complexity. A "base case" system model was constructed to represent current operating assets as augmented and upgraded to 2021. The base case results provided a basis for the comparison of alternative future scenarios and for conclusions to be drawn regarding potential environmental improvements. The scenarios can be roughly classified in two categories: (1) options which improve the environmental performance across all impact categories and (2) options which improve one indicator and worsen others. Overall environmental improvements are achieved in all categories by the scenarios examining increased demand management, energy efficiency, energy generation, and additional energy recovery from biosolids. The scenarios which examined desalination of seawater and the upgrades of major coastal sewage treatment plants to secondary and tertiary treatment produced an improvement in one environmental indicator but deteriorations in all the other impact categories, indicating the environmental tradeoffs within the system. The desalination scenario produced a significant increase in greenhouse gas emissions due to coal-fired electricity generation for a small increase in water supply. Assessment of a greenfield scenario incorporating water demand management, on-site treatment, local irrigation, and centralized biosolids treatment indicates significant environmental improvements are possible relative to the assessment of a conventional system of corresponding scale.

City Planning↗
PubMed2001

Contemporary issues in Australian midwifery regulation.

This paper reports on research that examined the Nurses' Acts, regulations and current policies of each state and territory in Australia, in order to determine their adequacy in regulating the education and practice of midwifery. This is part of a three-year study (Australian Midwifery Action Project) set up to identify and investigate barriers to midwifery within the provision of mainstream maternity services in Australia. Through an in-depth examination and comparison of key factors in the various statutes, the paper identifies their effect on contemporary midwifery roles and practices. The work assessed whether the current regulatory system that subsumes midwifery into nursing is adequate in protecting the public appropriately and ensuring that minimum professional standards are met. This is of particular importance in Australia, where many maternity health care services are seeking to maximise midwives' contributions through the development of new models of care that increase midwives' autonomy and level of accountability. A lack of consistency and evidence of discrepancies in the standards of midwifery education and practice regulation nationally are identified. When these are considered alongside the planned development of a three-year Bachelor of Midwifery, due to be introduced into Australia in mid-2002, there exists an urgent need for regulatory change. The need is also identified for appropriate national midwifery competency standards that meet consumer, employer and practitioner expectations, which can be used to guide state and territory regulations. We argue the importance of a need for change in the view and legal positioning of the Australian Nursing Council and all Nurses Boards regarding the identification of midwifery as distinct from nursing, and substantiate it with a rationale for a national and consistent approach to midwifery regulation.

Australia↗
PubMed2006

Evaluating clinical competence of distant nurse practitioner students.

Developing and evaluating core clinical competencies of nurse practitioner students at distant clinical sites requires dialog among the student, the clinical preceptor and University faculty. Students enter our program with diverse backgrounds, experience and interests. Here we demonstrate an innovative online Clinical Development Scale (CDS) that gathers self assessment data from each student, analyzes, organizes and prioritizes competencies to be accomplished in a clinical practicum, produces midterm and final evaluation summaries from data contributed by both student and preceptor and displays action plans developed by students, for meeting deficient competencies for preceptor and faculty approval.

Clinical Competence↗
PubMed2006

Computerized nursing process in critical care unit using the ICNP--Beta2.

The process of nursing is an assertive solving problem approach to the identification and care of patients' problems as well as an instrument of education in Nursing. At the CCU, due to the complexity of care, constant changes in the clinical situation of patients and the elevated amount of information, the informatics is seen as a way to the development of the nursing process and consequently improvement of the quality of care. Therefore, this methodological study and technological production was developed with 05 nurses of the CCU aiming describing the development of the nursing computerized process in the CCU from the ICNP Beta 2 and demonstrating the contributions to the improvement of nursing care. The ethical principals of the resolution 196/96 of CNS were followed and constituted 03 production phases: planning, development and production of the B version. The evaluation process interposed the system production phases and made it possible necessary modifications to be done. The evaluations make noteworthy that a new conception of nursing care practice is established; the process of nursing informatics makes the care more notorious, organized and permits the early mistake detection; the program allows a continuous learning and explicit clinical decision making of the nurse. Therefore, information systems and related technology are necessary in order to create, democratize, and apply knowledge in nursing.

Brazil↗
PubMed1983

[Extension work and rendering services in the schools of veterinary medicine].

This article reviews the extension work in the schools of veterinary medicine and says that it performs a multiple function: it supports instruction and research, performs intra- and interinstitutional and promotional services, and acts as a link between the academic establishment and the community serves. After citing a variety of recommendations made by international expert groups in veterinary medicine connected mainly with instruction and training programs, the author explains the content of the intra- and extramural services provided by universities and schools through extension programs. In connection with the former, he describes in detail the organization of libraries, audiovisual resources, methodology units, planning, etc. As to extramural services, he gives an equally detailed account of the features and functions of clinics, dispensaries, diagnostic services, experiment stations, and so forth. Finally, the point is made that extension programs should be linked to national development plans, and that they have a series of institutional barriers and negative attitudes to overcome in order to accomplish a true integration of the veterinarian's academic training with the real needs of the community.

Animal Feed↗
PubMed2003

Using continuing education to gain skills to improve patient care.

The first article of a two-part series stresses the importance of offering nurses at all levels of the NHS the opportunity to access continuing education, and explains how personal development plans can support nurses, enabling them to identify their skills needs and access education.

Competency-Based Education↗
PubMedDate not supplied

Redirecting health care spending: consumer-directed health care.

In an environment of rising health care costs, defined contribution plans and closely related consumer-directed health plans are emerging as a possible next phase in health plan development and offer new opportunities for the nursing profession.

Cost Control↗
PubMed1982

A guide for instrument development and validation.

As occupational therapists become increasingly concerned with accountability, the paucity of adequate instrumentation available for documenting therapeutic effectiveness surfaces as a major problem. Therapists will need to construct new or refine existing instruments to satisfy the requirements of third-party payment. The purpose of this paper is to illustrate how a new instrument is planned, developed, and validated. A sequential step-by-step process is illustrated with a flowchart and applied in the hypothetical construction of an attitude scale to assess school administrators' valuing of the role of occupational therapists in the schools. This example is provided to show how general psychometric principles are applied within an occupational therapy context.

Attitude↗
PubMedDate not supplied

Developing an arrhythmia course for obstetric nurses.

The need has increased for high-risk obstetric nurses to interpret cardiac rhythms, owing to the potential cardiovascular side-effects of tocolytic therapy in premature labor. The cardiovascular critical care nurse, educator, and clinical specialist are important to obstetric nurses as consultants for arrhythmia interpretation. These authors describe how to plan, develop, and implement an arrhythmia course for staff nurses working in obstetric units.

Arrhythmias, Cardiac↗
PubMed1997

Managed care: how economic incentive reforms went wrong.

In its response to pressures to rationalize health care resource allocation, the American health care system has embraced managed care without concurrent comprehensive health care reform, either in the form of the centralized tax-based systems found in Europe and Canada or that of the Clinton reform plan. What survives is managed care without managed competition, employer mandates, or universal access. Two problems inherent in the incentive structure of managed care plans developed in the absence of comprehensive health care reform work against the public interest. First, sacrifices in terms of medical innovation and quality of care may not be offset by greater equity in the distribution of health care. Second, such managed care plans fail to address the need for long-term accountability.

Biomedical Technology↗
PubMed1993

Development and health in the Pacific: which way to die?

Development in the Pacific has largely ignored the importance of health as a pathway and an outcome. This paper reviews the effects of development on health and health services in the region. It aims to highlight the plight of development that happens without considering the sociocultural and physical environments of the small island countries. The review shows that health and social conditions in the Pacific are deteriorating. The process of development has been externally controlled without community participation. Pacific leaders have been preoccupied with economic development and have not been cognisant of health and social consequences. During progress an enjoyable life can be achieved through sustainable development with community participation. However, indicators of economic growth in the Pacific do not correlate with those of health. The increase of rape, suicide, drug abuse, sexual promiscuity and crime suggests that Pacific islanders are increasingly disillusioned by the present developmental approach: they have ceased to enjoy life before death. It is suggested that decentralized development planning with community involvement, integrating health and social considerations, would be the way out of this dilemma.

Attitude to Health↗
PubMed1990

Turbulence and tranquility in the new decade: pharmacy leader--managers in patient care.

Management challenges that face pharmacy in the 1990s are described. Tichy's rope metaphor--intertwined cultural, technical, and political strands of an organization--is applied to problems faced by pharmacy managers; effective managers keep the organization strong by preventing the strands from working at cross-purposes to unravel the rope. Pharmacy's culture--its shared beliefs and values--is changing as "altruistic" institutional pharmacists form home care businesses, pharmacists identify more strongly with the profession than with their institutions, clinical pharmacists identify more strongly with the medical team, and cost control becomes more important. Institutional pharmacy must identify its desired outcomes and apply technology to achieve them. The patient's bedside is the best place for pharmacists to influence prescribing and monitor drug therapy; technology could be used to process patient information at the bedside and to dispense medications there. Current unit dose distribution systems isolate the functions of physician, pharmacist, and nurse, which must be integrated to make the system efficient and responsive. Standardized doses and dosage forms could be developed that are consistent with patient-care protocols; use of protocols allows the effectiveness of treatment methods to be evaluated and eliminates unnecessary therapy. Pharmacy can further its patient-care goals through political success with the medical staff; a pharmacy practice plan developed for a specific clinical area and presented to the medical staff is an example. Collaboration of pharmacists and physicians in a unified institutional strategy for drug use helps ensure appropriate decisions about therapy and prevents manufacturers from attempting to isolate an institution's pharmacists from its medical staff.(ABSTRACT TRUNCATED AT 250 WORDS)

Drug Industry↗
PubMed1994

CQI in action: benefiting our patients.

During 1993, the renal department of a suburban New Jersey hospital made the transition from quality assurance (QA) to continuous quality improvement (CQI). The chronic hemodialysis unit identified a problem based on the patient status at the beginning of the year, initiated steps to correct it, assessed the change by the end of the year, and developed plans to continue and improve the change. The effort to improve patient iron levels demonstrates one CQI activity undertaken.

Hemodialysis Units, Hospital↗
PubMed1998

[Population policies and reproductive health in Paraguay]

The population's high growth rate, age profile, and geographical distribution have aroused increasing public concern in Paraguay. The country is involved in a moderate demographic transition, compatible with the consequences of modernity and the uneven rate of both social and economic changes. Reduction of mortality and the persistence of high birth rate patterns result in an age structure that consolidates demographic growth, with an increased focus on the dependent population. In the late 1960s the need for a systematic approach to population problems was perceived within the framework of economic planning. National governments had, and currently have, an ambivalent perception of this issue, since population growth is simply considered a positive factor. This concept results from an economic view of the consequences of a reduced domestic market in absolute terms. The lack of a Development Plan, the management deficit, and the shortage of training leave doubts as to the establishment of organically connected policies or programs concerning population.

Journal Article↗
PubMed1983

Formal strategic planning in the United States today.

The author sets out an appraisal of the state of corporate-strategic planning in the United States. He deals with the chronology of planning development before appraising the 'state of the art'. The appraisal utilizes the author's own set of criteria which are comprehensive and provide a framework against which individuals and companies can assess their own systems. The author deals in some detail with the nature of planning systems in different types of organization and provides valuable insight into the current state of strategic planning and a useful framework for critical analysis.

Organization and Administration↗