Classics from our heritage. The need for legislation for licensure to practice professional nursing.
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Humans↗
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Results for “Professional Practice”
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.
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GP selection of postgraduate education courses has implications for colleagues: messages for course providers and for those writing practice professional development plans.
BACKGROUND: The Department of Health's review of continuing professional development in general practice advocates setting team and individual goals. AIM: To explore how general practitioners (GPs) share learning experiences with colleagues, focusing on how GPs choose courses as one factor influencing sharing. METHOD: Interviews were conducted with 21 GPs using grounded theory methodology. The responses were coded by six researchers from psychology, education, and general practice. RESULTS: Much sharing with colleagues took place, though not always immediately following a course. GP explanations revealed four reasons for course selection that influenced the degree of sharing: 1. Attendance to meet group needs encouraged rapid sharing and could involve course attendance with colleagues. 2. Attendance to enhance 'special interests' could either encourage or inhibit sharing. 3. Attendance in pursuit of 'personal interests' peripheral to general practice did not result in sharing within the primary care team. 4. Attendance to meet personal learning needs did not involve sharing when needs were not currently shared with colleagues. CONCLUSION: Course selection and subsequent sharing have implications for course providers and those writing personal and practice professional development plans.
Curriculum↗
Practice management up-dates: professional practice cycle and marketing principles relevant to dental practice.
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Humans↗
Computer-generated patient education materials: do they affect professional practice? A systematic review.
A systematic search of seven electronic databases was done to identify randomized controlled trials that assessed the effect of computer-generated patient education material (PEM) on professional practice. Three studies met the authors' criteria. All three studies involved preventive care. All used a complex intervention of which computer-generated PEM was a major component. Improvements in practice were seen in all studies, although these gains were generally modest. One study showed improvement in patient outcomes. Mann-Whitney statistics calculated for the studies' outcome measures ranged from 0.48 to 0.66, equivalent to risk differences of -4 to 32 percent. Computer-generated PEM seems to have a small, positive effect on professional practice. The small number of included studies and the complex nature of the interventions makes it difficult to draw conclusions about the ability of computer-generated PEM to change professional practice. Future work should involve well-defined interventions that can be clearly evaluated in terms of effect and cost.
Humans↗
Learning needs assessment as a vehicle for integrating staff development into a professional practice model.
Restructured nursing roles resulting from innovative professional practice models and participative governance systems create a demand for new and expanded competencies. The impact for nursing staff development is the concurrent requirement to develop programs that match the skill/competency requirements of nurses in emerging practice models. This article recounts how one nursing department implemented a learning needs assessment (LNA) process as a means of integrating staff development into professional nursing practice.
Clinical Competence↗
Towards effective professional practice.
Within the limited resources available for health care, it is important to ensure that health care professionals provide effective patient care to achieve the twin objectives of improvements in patient outcome and the efficient use of resources. There are two pre-requisites for effective professional practice: the identification of effective health care interventions; and the use of effective dissemination and implementation strategies to ensure the adoption of effective interventions in practice. Systematic reviews and valid guidelines represent the most efficient methods of identifying effective health care interventions. There are many different dissemination and implementation strategies; however, traditional passive dissemination methods (for example, publication in professional journals, mailing practice recommendations to health care professionals) are generally ineffective. Greater attention needs to be given to co-ordinating active dissemination and implementation strategies to ensure effective professional practice.
Controlled Clinical Trials as Topic↗
[Ethical issues linked to the professional practice of nurses in a hospital infection control committee].
This qualitative work was developed according to Bardin's method of content analysis. It aimed at finding out the perceptions of nurses that are members of a Hospital Infection Control Commission about ethical issues that are inherent to their professional practice as well as understanding the clinical nurses opinion regarding the professional practice of the nurses that are members of the Hospital Infection Control Commission, considering the ethical aspects. In order to achieve an ethical, efficient and effective professional practice, there is a need for governmental changes and professional recognition through autonomy, respect and exclusivity in the Service of Hospital Infection Control, as well as improvements regarding information, the care provided to the patient and professional secret. The predominance of bureaucratic activities and team work were mentioned by the clinical nurses as differentiating factors of the activities performed by nurses that are members of the Commission.
Adult↗
Developing critical reflection for professional practice through problem-based learning.
AIMS: To explore the influence of current learning traditions in nursing on the development of reflection and critical reflection as professional practice skills and to offer suggestions for nursing education that will specifically facilitate the development of critical reflection. ORGANIZATIONAL CONSTRUCTS: Mezirow's transformative learning theory, Barrows conceptualization of problem-based learning (PBL). METHODS: Integrative literature review of published literature related to nursing, health science education and professional education from 1983-2000. FINDINGS: Professional education scholars concur that specialized knowledge is clearly essential for professional practice, however, they also suggest that self-consciousness (reflection) and continual self-critique (critical reflection) are crucial to continued competence. While strategies to facilitate reflection have been outlined in the literature, specific strategies to facilitate the development of critical reflection and implications for nursing education are much less clear. Advocates of reflective and critically reflective practice suggest that the development of these abilities should be inextricably linked to professional development and can be developed through active repeated guided practice. In health care, PBL based on constructivism, has been identified as one way to facilitate the development of these skills. CONCLUSIONS: Nursing learners exposed to PBL develop the ability to be reflective and critically reflective in their learning and acquire the knowledge and skill within the discipline of nursing by encountering key professional practice situations as the stimulus and focus of their classroom learning. The learners' ability to be both reflective and critically reflective in their learning is developed by critical questioning of the faculty tutor during situational analysis, learning need determination, application of knowledge, critique of resources and personal problem-solving processes, and summarization of what was learned.
Education, Nursing↗
Some experiences of professional practice and beneficial changes derived from clinical supervision by community Macmillan nurses.
This is a report of an interpretative study that explored some 'lived experiences' of community Macmillan nurses as they recounted them during clinical supervision meetings. This discussion is concerned with serious illness, dying and bereavement and the potential of supervision to reach the 'life-world' of professional practice but also potential benefits for Macmillan nurses. Accounts of professional practice are considered in the context of clinical supervision meetings. Five nurses--four women and one man--undertook individual clinical supervision with the researcher for 6 months over three phases for 18 months in total. Meetings took place in the clinics and health centres in which the Macmillan nurses worked. The method of clinical supervision drew on and developed established ideas from the health science literatures to guide supervisory practice. A synthesis of psychoanalytic ways of thinking and existential phenomenology provided a framework for understanding the data. Five salient themes were identified as emerging from accounts of professional practice: Biographical Determinants, Compulsion, Existential Concerns, Empathic Insufficiency in the Organisation of Palliative Care and Empathic Attainment in the Organisation of Palliative Care. The study shows a need to consider structuring environments that both help and protect community Macmillan nurses and fellow workers. Methods of clinical supervision should be informed by and complement lived experiences of working with serious illness, dying and bereavement.
Empathy↗
The quality of the professional practice of community pharmacists: what can still be improved in Europe?
This article describes a research project concerning the professional practice of community pharmacists in Western Europe. In 1990 interviews were held with key figures and practising pharmacists in the Netherlands, Belgium, Great Britain, Sweden and Portugal. In 1991 a questionnaire was sent which was answered by 929 pharmacists. Concerning the quality of the professional practice it appeared that pharmacists have integrated certain structure aspects such as the use of a computer or a separate patient consultation room to varying degrees. Also concerning process aspects with regard to quality, for example the degree to which attention is given to counter work and prescription controls, there are large differences between pharmacists from the different countries. These differences between pharmacists appeared to depend upon differences in legal rules (such as the compulsory presence of a pharmacist in Belgium, Sweden and Portugal or the compulsory prescription control by a pharmacist before delivery in Great Britain), financial and economic circumstances, internal organizational characteristics of the pharmacy and the individual personal task conceptions of the pharmacist. New developments, for example in areas of patient information and computer use, seem to be followed most in the Netherlands and Sweden. General statements about differences in quality are not easily made because the community pharmacy in other countries also has certain positive aspects, such as being easily accessible (Portugal), personal involvement of the pharmacist (Belgium) and personal control by the pharmacist (Great Britain). Looking at the diversity within Europe the conclusion can be reached that the European pharmacist' does not yet exist.
Education, Pharmacy↗
A report on the Council on Certification 1996 Professional Practice Analysis.
The purpose of this article is to provide an overview of the Council on Certification of Nurse Anesthetists 1996 Professional Practice Analysis. This analysis was used to update the previous content validation studies. Surveys were mailed to a select group and a practitioner group of 2,859 Certified Registered Nurse Anesthetists with a response rate of 63.7%. Respondents were asked survey questions related to demographics, practice settings, education, and fundamental knowledge related to nurse anesthesia practice. Respondents were asked for the frequency and level of expertise related to patient conditions, procedures, anesthesia agents and techniques, equipment, instrumentation, and technology of anesthesia practice. The results for both groups were consistent with the previous studies. The Rasch rating scale model was used to transform the results from ordinal data onto a linear, equal-interval scale. Members of the Council on Certification of Nurse Anesthetists carefully reviewed all of the Professional Practice Analysis results and voted to maintain the current test blueprint and percentage of test items in each area.
Certification↗
Case study: nursing professional practice councils: the quest for nursing excellence.
The quest for nursing excellence requires enthusiasm, commitment and a dedicated team of nurses. The desire to create an environment where nurses were valued, supported and empowered led to the development of a Nursing Professional Practice Council within an Ontario Public Health Unit. The journey is described in detail, from planning and implementation through lessons learned and recommendations for organizations embarking on a similar quest. As a direct result of the Nursing Professional Practice Council, experiences within the organization have exceeded expectations, justified the financial costs and improved relationships among all parties.
Decision Making, Organizational↗
Professional practice plans: recommendations from the 2005 Council of Faculties-Council of Deans Task Force.
OBJECTIVES: Determine the degree to which AACP member schools have established professional practice plans, characterize the nature of existing practice plans, and provide recommendations on the implementation of practice plans at AACP member schools. DESIGN: Survey of CEO Deans of AACP member institutions administered via online survey instrument. RESULTS: Sixty-five schools responded, with 29 (45%) indicating that they had an active practice plan in place. Fifty-two percent of those who do no have practice plans in place anticipate having plans established within three years. A variety of revenue sources are addressed by existing practice plans including sponsored research, patient care, educational activities and consulting. CONCLUSIONS: Academic pharmacy lacks sophistication in regards to developing comprehensive professional practice plans. Colleges of pharmacy should consider differentiating plans that address monies collected from sponsored research vs. professional services. AACP should continue to monitor this topic as increasing participation by member schools is expected.
Data Collection↗
Implementation challenges of a renal nursing professional practice model.
A city-wide steering-committee developed and introduced a program wide renal nursing professional practice model (PPM) using a variety of strategies. The PPM outlines values, practice guidelines, professional relationships, and the care delivery model. Challenges are inherent when implementing changes on multiple sites amidst a city-wide merger. Key challenges included maintenance of the model and measurement of its impact on practice. This paper summarizes the leadership team s learning regarding both the support required to successfully implement the model and the developments that competed against a successful implementation. The authors also discuss qualitative evaluation of the nurses experiences during model implementation.
Continuity of Patient Care↗
Nurses', midwives' and health visitors' perceptions of the impact of higher education on professional practice.
AIM: This study examines the perceptions of qualified nurses, midwives and health visitors of the impact of higher education on professional practice. METHODOLOGY: This is a qualitative study using a phenomenological approach. A non-probability convenience sample of 12 qualified nurses, midwives and health visitors who had enrolled upon a Master of Science programme in Professional Practice at a United Kingdom Higher Education Institution in the East Midlands were interviewed using semi-structured interviews, which were audio-taped and analysed using Colaizzi (1978) [Colaizzi, P., 1978. Psychological research as a phenomenologist views it. In: Valle, R., King, M., (Eds.), Existential Phenomenological Alternatives for Psychology. Oxford University Press, New York, pp. 48-71] approach. Approval to undertake this study was received from the University's Research Ethics Committee. RESULTS: Four themes emerged from the interview data. These were personal and professional motivation, workplace constraints, valuing "hands-on" nursing and client contact, and challenging and questioning practice. From the respondents' perspective, there was a strong view that higher education has a positive effect in practice, but a significant number of factors including time and support seemed to inhibit the possible benefits in practice. These are discussed in relation to the findings from similar studies. CONCLUSION: This study has highlighted the need for further research to explore the impact of higher education on client care and service delivery.
Adaptation, Psychological↗
Target payments in primary care: effects on professional practice and health care outcomes.
BACKGROUND: The method by which physicians are paid may affect their professional practice. Although payment systems may be used to achieve policy objectives (e.g. improving quality of care, cost containment and recruitment to under-served areas), little is known about the effects of different payment systems in achieving these objectives. Target payments are a payment system which remunerate professionals only if they provide a minimum level of care. OBJECTIVES: To evaluate the impact of target payments on the professional practice of primary care physicians (PCPs) and health care outcomes. SEARCH STRATEGY: We searched the Cochrane Effective Practice and Organisation of Care Group specialised register; the Cochrane Controlled Trials Register; MEDLINE (1966 to October 1997); BIDS EMBASE (1980 to October 1997); BIDS ISI (1981 to October 1997); EconLit (1969 to October 1997); HealthStar (1975 to October 1997) Helmis (1984 to October 1997); health economics discussion paper series of the Universities of York, Aberdeen, Sheffield, Bristol, Brunel, and McMaster; Swedish Institute of Health Economics; RAND corporation; and reference lists of articles. SELECTION CRITERIA: Randomised trials, controlled before and after studies and interrupted time series analyses of interventions comparing the impact of target payments to primary care professionals with alternative methods of payment, on patient outcomes, health services utilisation, health care costs, equity of care, and PCP satisfaction with working environment. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data and assessed study quality. MAIN RESULTS: Two studies were included involving 149 practices. The use of target payments in the remuneration of PCPs was associated with improvements in immunisation rates, but the increase was statistically significant in only one of the two studies. REVIEWER'S CONCLUSIONS: The evidence from the studies identified in this review is not of sufficient quality or power to obtain a clear answer to the question as to whether target payment remuneration provides a method of improving primary health care. Additional efforts should be directed in evaluating changes in physicians' remuneration systems. Although it would not be difficult to design a randomised controlled trial to evaluate the impact of such payment systems, it would be difficult politically to conduct such trials.
Humans↗
[Programs for supervised professional practice and for rural oral health promoters in Guatemala].
The experiences of the programs of Supervised Professional Practice and for Rural Oral Health Promoters conducted by the School of Dentistry of San Carlos University in Guatemala are described. The first of these programs was designed to have students practice the profession during an eight-month academic period in hinterland towns under periodical supervision by their professors, and the second resulted as an unexpected offshoot during the initial stages of the program of Supervised Professional Practice in a northwestern district of Guatemala. The history and progress of both programs are described, some results are presented, and the salient features of university-community interaction, as exemplified by these programs, are discussed in terms of a theoretical model designed by one of the authors.
Community Dentistry↗
[Nursing education and professional practice: what is the relationship?].
This paper focuses on the relation between nurse's education and professional practice, through the experiences of nurses that were graduated at the same School of Nursing and that were working in hospitals in Porto Alegre. The discussion of the aspects that are involved in the categories of analysis give elements for nursing education, emphasizing the fact that it is disconnected of the reality of the professional practice, which characterizes dissociation between theory and practice.
Clinical Competence↗