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PubMed2004

Tying it all together--The PASS to Success: a comprehensive look at promoting job retention for workers with psychiatric disabilities in a supported employment program.

Job initiation rates are steadily improving for people with severe and persistent mental illnesses. Yet, job retention rates, especially for those individuals who historically have had difficulty maintaining employment, continue to concern vocational rehabilitation professionals. In this paper, the author develops and refines her ideas that were presented in a previous research paper titled "Differences in Job Retention in a Supported Employment Program, Chinook Clubhouse." A more complete model, "The PASS to Success," is suggested by incorporating existing research with the author's revised work. Components of the model (Placement, Attitude, Support, Skills), can be used to predict vocational success and promote job retention.

Adaptation, Psychological↗
PubMed2004

View from industry.

The transformation of the cardiothoracic specialty requires a complete mind-set and skill-set change such that the specialty repositions itself in this era of complex cardiac disease, increased competition, technology innovation, financial constraints, rationed access to technology and increased scrutiny on clinical outcomes. The future offers a variety of surgical treatment options for patients suffering from disease states that have traditionally not been treated by cardiothoracic surgeons such as ablation for atrial fibrillation and cell therapy for heart failure. In addition, patient expectations for prolonged and quality-improved years are higher as they educate themselves on options that are less invasive. Failure to build a new repertoire of skills will mean diminished access to patients because referrals will be made to those cardiothoracic surgeons who are seen as innovators. Time is of the essence, as market dynamics are taking their toll. Cardiothoracic surgery today is still one of the most profitable specialties within the hospital and therefore, hospitals should be willing to support and differentiate their heart programs through new technology adoption. But cardiothoracic surgeons need to be open to explore new methods for treating cardiac disease and to work with industry in proving the efficacy and patient benefits of new procedures. At a higher level, pan-European approaches to new technology adoption need to focus on increased governmental spending on healthcare and on reimbursement strategies that make this possible. The medical device industry continues to invest heavily in new techniques and technologies and should be viewed as a strategic partner by individual surgeons as well as by the surgical societies. As industry continues to focus on areas such as research, product development, market development, professional and resident education, reimbursement, and patient access issues, it is imperative for surgeons to work collaboratively with industry to drive change for the cardiothoracic specialty and to maximize the resources that each offers to the other. Though not always understood, a common unity of purpose does exist and constructive methods to dealing with change can be developed together. Frost & Sullivan predicts a medical device industry compound annual growth rate of 8% in the next 12 years. Achieving that same level of growth specifically across cardiothoracic surgery would be tremendous.

Atrial Fibrillation↗
PubMed1988

The National High Blood Pressure Education Program: measuring progress and assessing its impact.

The National High Blood Pressure Education Program has been designed to translate the results of basic and clinical research to medical practice through a program of education for the public, patients, and health professionals. It has continuously used health-education principals of media development, patient education, social networking, community organizations, theories of social change, and program evaluation and measurement to reach its objectives. After 15 years, public knowledge regarding blood pressure and its sequelae has improved dramatically.

Health Education↗
PubMed1979

MLA Certification by examination under the 1964 code: a survey of 1975-1976 participants.

The increased attention being given to an examination in the Medical Library Association certification process prompted a study of a group taking the examination under the old (1964 revision) code. Completed questionnaires were received from fifty-three of the sixty-five persons who took the examination in 1975 and 1976. Backgrounds of individuals varied, especially in years of experience. The majority of those responding had worked in both health sciences and other libraries. Experience in health sciences libraries was reported by 92% of those replying. A number of reasons for seeking MLA certification were given. Problems in being able to take MLA-approved courses prompted the choice of the examination process. Preparation for the examination was chiefly by self-directed study. Continuing education courses were considered as of greater value for professional development than as help on the examination. The examination was rated "moderately difficult" by 57% of those responding. Opinions were expressed on the skills and areas of expertise which were considered by this group to be important in an examination for professional competence.

Certification↗
PubMed1996

An archival perspective of the history of dentistry in Louisiana.

Records from the Louisiana Dental Association deposited in the Louisiana State University School of Dentistry Library provide a history of dentistry in Louisiana. Documents from dental organizations, dental schools, professional journals, and significant individuals illustrate the origins of professional dentistry in Louisiana during the nineteenth century and its continued development in the early twentieth century.

History, 19th Century↗
PubMedDate not supplied

Laboratory cross training needs assessment.

OBJECTIVE: To define the continuing education topics and methods in the area of chemistry and hematology, that if developed, would best support the cross-training needs of hospital based laboratories in the State of Georgia. DESIGN: A cross sectional study of hospital based laboratories in Georgia was completed using surveys sent to 181 hospital laboratory managers and administrators. Descriptive statistics were used to evaluate the survey results. SETTING: Department of Medical Technology, Medical College of Georgia, Augusta GA. PARTICIPANTS: Laboratory managers and administrators. INTERVENTION: Not applicable. MAIN OUTCOME MEASUREMENTS: Four descriptive outcome measurements were requested from each participant: 1) demographic questions, 2) cross-training topics desired, 3) training material desired, and 4) computer literacy and equipment assessment. RESULTS: Sixty-six surveys were completed and returned in a usable form (36% return rate). Demographically, the respondent group is a representative sample of hospital based laboratories in the State of Georgia with 46% of the respondents from facilities of 100 hospital beds or less. Respondents desired that case study training topics be developed using paper and computer assisted instruction mediums. Additionally, respondents desired that Professional Acknowledgement for Continuing Education (P.A.C.E.) be associated with the training material. They were willing to pay for this administrative service. CONCLUSION: This cross sectional study assessed the cross-training needs of hospital based laboratories in Georgia. Findings will allow educators to focus and develop continuing education packages that best meet the needs of the laboratorian workforce.

Chemistry, Clinical↗
PubMed1988

Innovations in human genetics education. Genetic applications for health professionals: an outreach continuing-education model program.

A system for extending continuing education in genetics to nurses and other practicing health professionals was developed in an eight-state area. Coordinators from state agencies received special training at the University of Colorado to administer the course in local communities. A combination of classroom instruction, independent study, computer-assisted instruction, and case-study methods for course delivery was included. More than 300 health professionals have completed the course, and 14 coordinators from seven states have been prepared to administer future courses. The model has demonstrated high potential for replication in other regions.

Colorado↗
PubMed2002

Developing professional judgment.

The concept of professional judgment is considered, including its theoretical foundations, how it is developed, and how it may be assessed. Professionals are asked to engage in complex and unpredictable tasks on society's behalf, and in doing so must exercise their discretion, making judgments--decide what is "best" in the particular situation rather than what is "right" in some absolute sense. Inevitably, some of these judgments lead to "error," which is endemic to professional practice. This challenges some current ideologies in health care regarding the primacy of evidence-based practice and the application of protocols. At the foundation of professional judgment is a form of knowledge--called practical wisdom--which is not formally taught and learnt but is acquired largely through experience and informal conversations with respected peers. Wisdom develops through "the critical reconstruction of practice," including deliberation, which is distinguished from mere reflection. Professionals need to engage in the appreciation of their practice--not just to understand what informs their own practice but to consider critically the contestable issues endemic to practicing as a professional.

Decision Making↗
PubMed1995

Communication standards: impact on nursing practice.

1. BACKGROUND INFORMATION. In order to meet the demands of processing large amounts of data, hospitals must look to innovative methods of information handling. One new method currently in use is the computerized patient record (CPR) (Dick & Steen, 1991). To successfully implement the CPR, many factors must be considered, including: (a) the fact that the database is dependent upon several different departments and resources for information; (b) the information needs of each department differs, making selection of a single information system that encompasses all users' needs difficult; and (c) operating systems may be incompatible, hampering the process of networking and exchanging, processing, and retrieving data in an integrated manner. Yet the integration of systems is central to the successful development of the CPR. 2. PURPOSE. Establishment of communication standards for health care promotes the effective integration of patient information across various computer systems (McDonald, 1990). To achieve this level of automation, standard organizations must unite in the development and implementation of communication standards for health care. This poster will explore: (a) data on communication standards; (b) the process of reaching standards; (c) established communication standards; and (d) the impact of communication standards on nursing practice. In addition, we will present a model for an integrated patient focused system of the future. Today, communication standards continue to evolve in health care. Many professional organizations share the goal of developing communication standards between clinical systems (McDonald, 1990). Standards to be explored in this poster include: the American Society for Testing and Materials (ASTM), the Medical Data Interchange Standard (MEDIX), the Medical Information Bus (MIB), and Health Level (HL7). Evolving standards will define protocols and procedures for the effective exchange of easy integration of information systems. Once standards are established for health care, society will benefit from the ability to: (a) compare health care costs; (b) measure the effectiveness of treatment; and (c) provide clinicians with comprehensive patient information (Rishel, 1992). 3. IMPLICATIONS. There is very little in existing literature and research studies on the impact of communication standards on nursing practice. Nurse researchers willing to assume the challenge of conducting studies on the impact of communication standards on nursing practice will forge new territory. Implications for nursing from the development of communication standards include: (a) increased productivity, (b) definition of a clinical data set, (c) improved quality patient care, and (d) easier system implementations.

Humans↗
PubMed2002

Transition for youth with chronic conditions: primary care physicians' approaches.

Since the US Surgeon General's conference on health care transitions in 1989, transition from pediatric to adult-oriented health care for youth with chronic conditions continues to develop as an important issue among youth, parents, and health professionals. Key professional organizations, public agencies, and disease-specific organizations have promoted research on transition and the development of transition services. Although there is evidence of the advancement of the science and practice of transition in the context of subspecialty medical care, the same may not be true for transition in the context of primary care practice. Little has been written about the role of the primary care provider in facilitating transition, and little is published in the medical literature about how transition occurs in primary care settings.

Adolescent↗
PubMedDate not supplied

Australian clinicians and educators identify gaps in specialist cardiac nursing practice.

Change is endemic in both the health care and higher education sectors in Australia. Consequently professional roles and educational pathways must also evolve and adapt, often catalysed by those in leadership positions. Two national Delphi panels, one of cardiac nurse educators and the other of cardiac nurses, were convened to answer the question 'What knowledge, skills and attitudes are required for an expert nurse practising in the highly technological cardiac care environment?' Respondents indicated on a Likert scale the importance of 107 items to the nurse's role in both the 'real' and 'ideal' worlds of practice. Overall there was very strong agreement between the two panels with results indicating that Australian nurses perform close to their ideal in many areas of practice. For 31 of the items, both panels identified that the reality of practice is quite far from their ideal. Both panels agree that 10 of the behaviours are carried out or valued very little in practice. Reasons why nurses are not carrying out these elements of the role to their satisfaction are discussed and remediation strategies suggested. The findings can inform both curriculum development and clinical practice. In the dynamic health care arena, the nursing profession continues to respond to community and professional needs, seeking to establish sound research-based practice and maintain a high quality of clinical care and nursing management. The development of competencies by the Confederation of Critical Care Nurses (1996) is a good example of professional groups taking the initiative both in defining the practice role and providing tools that assist educational bodies to develop programs appropriate for a practice based discipline. Specialty nursing practice is 'under the microscope' in Australia as the profession seeks the best methods to weight nursing activities, measure nursing outcomes and recruit, retain and justify the use of specialist practitioners.

Attitude of Health Personnel↗
PubMed1992

The use of continuous quality improvement methods in the development and dissemination of medical practice guidelines.

The federal government is currently supporting the development and dissemination of clinical practice guidelines. Physicians fear that payers who promote guidelines are more interested in reducing variation to control their behavior and contain health care spending than in improving quality of care. There is also apprehension that guidelines will shift the responsibility for quality to parties external to the physician-patient relationship and the local professional community. Continuous quality improvement (CQI) methods provide an avenue for physician responsibility and participation in guideline development which can alleviate these concerns. This article describes the efforts of one health maintenance organization (HMO) to use CQI techniques to mobilize plan physicians to develop, disseminate, and implement practice guidelines in a manner that satisfies the needs of physicians, patients, and the HMO.

Anti-Ulcer Agents↗
PubMed2004

When and where you want it: continuing education from a distance.

Online technology is increasingly being used as a tool for delivery of continuing education to health care professionals. This paper discusses key lessons learned in developing a distance-learning program. It provides practical information on ways to enhance interactivity and overcome obstacles. Preliminary outcomes for learners in a four-state area are summarized.

Adult↗