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PubMedDate not supplied

Conflict management: assessing educational needs.

In today's healthcare environment, the potential for conflict among healthcare providers exists as changes are occurring at a supersonic pace. The outcomes of conflict may affect patient care and are directly related to the effectiveness of the resolution. Clinical educators and staff development educators are essential in resolution if they assess strategies that are currently being used in managing conflict and then offer more effective resolution strategies.

Adolescent↗
PubMed2006

Assessing and monitoring override medications in automated dispensing devices.

BACKGROUND: Medication override is not without risk because the absence of pharmacist review may increase the potential for a medication error. The University of Pittsburgh Medical Center's Department of Pharmacy and Therapeutics assessed the safety of the automated dispensing device (ADD) override process to reduce the number of override medications stored in the ADD. METHODS: A representative expert panel developed criteria for override access and revised the override medication list; an override monitoring tool was used to perform random audits and determine nursing compliance; and changes in override practices for use of opioids, a high-alert medication class, were measured. RESULTS: The expert panel reduced the number of medications and dosage forms on the override list by 42%, from 119 different medications (in 244 different dosage forms) in 2001 to 92 different medications (in 163 different dosage forms) by December 2003. By May 2004 the opioid override rates were significantly decreased; although slight increases in rates occurred by December 2004, possibly reflecting the lack of formal override monitoring by nursing and pharmacy, the rates were still significantly lower than the baseline in October 2003. CONCLUSION: Pharmacists, in collaboration with the medical and nursing staffs, developed a sustainable process for preventing unauthorized and inappropriate override medication dispensing from ADDs.

Hospital Bed Capacity, 500 and over↗
PubMed2004

Comparison of nurse competence in different hospital work environments.

AIM: This study examines nurses' perceptions of competence in different university hospital work environments. BACKGROUND: Nurses' self-recognition of own level of competence is essential in maintaining high standards of care. The demands for nurse competence may vary between work environments. However, there are very few studies that compare nurse competence in different hospital work environments. METHODS: We analysed self-assessments of competence of 593 Registered Nurses working in wards, emergency/outpatient or intensive care units or in operation rooms. The instrument used was a pretested 73-item questionnaire consisting of seven competence categories. The level of competence was assessed on a Visual Analogue Scale (VAS) scale of 0-100 and the frequency of using items of competencies in clinical practice was assessed on a four-point scale. RESULTS: Nurses reported their overall level of competence as good. They felt most competent in the categories of Managing situations, Diagnostic functions and Helping role (VAS-means 68-69), and least competent in Ensuring quality category (VAS-mean 56). Operation room nurses compared with other nurses reported lower level of competence and lower frequency of using items of competencies in several competence categories. In general, the self-assessed level of competence was greater the higher the frequency of using of competencies. Correlations between both age and length of work experience and the self-assessed overall level of competence were positive. CONCLUSIONS: Nurse competence profiles differed in both the level of and in frequency of using competencies between work environments. Context-specific knowledge of nurse competence from real work life situations provides direction on how to structure work environments and staff development interventions to provide qualified care.

Adult↗
PubMed2002

The Youth Risk Behavior Surveillance System: updating policy and program applications.

To monitor behaviors that place adolescents at increased risk for premature morbidity and mortality, the Centers for Disease Control and Prevention developed the Youth Risk Behavior Surveillance System (YRBSS). This system measures six categories of behaviors, including behaviors that contribute to violence and unintentional injuries; tobacco use; alcohol and other drug use; sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases, including HIV infection; unhealthy dietary behaviors; and inadequate physical activity. This article summarizes how some education and health agencies and nongovernmental organizations, in collaboration with community agencies, school boards, parents, and youth, use YRBSS data to describe risk behaviors, create awareness, supplement staff development, set and monitor program goals, develop health education programs, support health-related legislation, and seek funding. Ways in which YRBSS data are distributed electronically also are summarized.

Adolescent↗
PubMed1992

Developing a poster for disseminating research findings.

One of the goals of research should be the dissemination of research findings. Presentation of research findings to an audience of interest can be accomplished through formal or informal presentations at professional conferences or on a departmental level, publication in a variety of professional journals, and presentation as a poster session. Poster presentations attract an audience of similar interest, permit interaction and clarification of the research process and findings by the researcher, allow creative expression in presentation, and help to build collegial relationships with others who hold similar interests. Posters are also a way for educators to present the research findings of others that answer specific clinical questions or provide a means of staff development. A well-designed poster gives the viewer a concise overview of the research problem/purpose, research methodology, sample, results, and implications. Since the less formal poster presentation is viewed as less intimidating to some researchers and conference participants, posters may provide a more relaxed atmosphere in which the exchange of information takes place.

Audiovisual Aids↗
PubMedDate not supplied

Nurses as end-user searchers of the literature on CD-ROM.

As the resource center for nursing information, the staff development department is the ideal location for facilitation of end-user searching of the nursing and medical literature. The authors report on a project undertaken to encourage searching of CD-ROM databases to improve patient care.

Abstracting and Indexing↗
PubMedDate not supplied

Continuing professional education and interacting variables affecting behavioral change in practice: instrument development and administration.

BACKGROUND: Instruments were developed to measure variables identified by Cervero that evaluate the complex processes and effectiveness of continuing professional education. METHOD: Content validity was established with a panel of experts. Four studies were conducted to determine reliability. Data were merged to conduct factor analysis. RESULTS: Reliability was confirmed across studies using Cronbach's alpha. Stability was confirmed in a test-retest study. Factor analysis confirmed instrument items measure the concepts of Cervero's Model. CONCLUSION: The reliable and valid instruments may be useful for continuing education and staff development nurses to measure the effectiveness of education on behavioral change in practice.

Education, Nursing, Continuing↗
PubMed1999

Interdisciplinary ambulatory education and service in primary care at the University of New Mexico.

To compete and survive in a managed care market, academic health centers must develop integrated delivery systems in general and an integrated primary care system in particular. However, the departmental-based structure at most academic health centers is ill-suited to this purpose. Service and education are usually segregated by department, and the professional activities of primary care faculty in different departments are fragmented, leaving them weakened as a political force within the institution. The University of New Mexico established a model of integrated primary care education and service by creating three interdisciplinary primary care clinics staffed by primary care residents and faculty. The clinics attracted a substantial portion of each department's faculty and residents. The clinics united primary care providers from different departments as a stronger, more unified voice in negotiating with the hospital and in fostering needed changes for primary care in the institution. Interdisciplinary teams require considerable time and labor both in planning (because of joint decision making) and in operation. Better staff structures and staff development must be learned through trial and error because there are not established benchmarks for interdisciplinary teams. Governance presents problems, primarily because loyalties to departments may supersede those to the clinic practice, and sometimes the departments' teaching priorities are challenged by clinic directors' need to ensure filling their interdisciplinary staff needs. These obstacles to collaboration can be addressed creatively, and ultimately the comprehensiveness and quality of care convinces providers and the institution.

Academic Medical Centers↗
PubMed1984

Patients perception of care under primary and team nursing.

The relationship between the structure of nursing care and patient satisfaction is examined after equalizing the quantity and quality of nursing staff. An all-registered-nurse model of primary nursing is compared to team nursing. The nursing competency scores of registered nurses (as measured by the Slater scale) on two patient care units were equalized through 6 months of continuing education and staff development programs. A patient checklist was used to determine satisfaction with care and perceived omissions in care. No significant differences in satisfaction with care were found between the two units. The unit with primary nursing was perceived as having significantly higher omissions in care in three categories: dietary needs, reaction to therapy, and contact with nurses. The results suggest that the effect of nursing care structures on patient perception of care may be contingent upon the efficiency of the support systems and the competency of the nursing staff.

Clinical Competence↗
PubMedDate not supplied

Learning environment: the catalyst for work excitement.

A recent study investigated the relationship between learning environment and work excitement among a group of nurses. In a secondary analysis of the original survey of 268 nurses, approximately 20% were very excited about their work. The learning environment variables (availability of learning opportunities; stimulating, motivating, challenging environment; and opportunity to work with other professionals) were found to be related to the level of work excitement among nurses. Results of this study suggest that enhancement of the learning environment can lead to higher levels of work excitement. Nurses in staff development can use the knowledge obtained in this study to assist nurses to find excitement in their work through new learning and work behaviors. The results suggest the importance of unit-based learning opportunities and flexible work groups that include other health professionals.

Adult↗
PubMed2004

Thinking ahead about reproductive health: contingency planning and emergency preparedness in crisis situations (Iraq and West Africa).

The United Nations Population Fund (UNFPA) coordinated efforts to integrate RH into contingency planning for the 2003 Iraq crisis and the 2003 regional response for displaced populations in West Africa. Using UNFPA's network of country offices in the Middle East, staff developed logistics plans, conducted workshops and pre-positioned RH supplies. Though refugee movements did not occur, the contingency planning enhanced the response capacity of UNFPA offices and made it possible to rapidly provide assistance inside Iraq. In West Africa, multi-country workshops and follow-up resulted in country-level and regional action plans useful during the renewed crises of 2003; scarce funding, however, limited their full implementation. UNFPA's experiences show that contingency planning requires committing resources for crises, some of which will not occur; new staff skills; and follow-up. Moreover, RH is considered by some to be additional to the core elements of contingency planning. RH's political sensitivity, particularly with certain donors, further complicated integrated planning.

Africa, Western↗
PubMed1993

What do inventories of students' learning processes really measure? A theoretical review and clarification.

Research into student learning has been based on two main theoretical sources: information processing (IP), and contextually based work on students' approaches to learning (SAL). The cross-fertilisation has been valuable, but it has led to ambiguities and misunderstandings, evident in the recent literature, about constructs, methodology, and of particular concern here, the development and interpretation of inventories of learning/study processes. The basic issue revolves around a conception of student learning as taking place within-the-student, as IP models appear to assume, or within-the-teaching/learning-context, as the SAL tradition emphasises. It is suggested that student learning is best construed within a teaching/learning context that functions as an 'open system', a model that brings some clarity to the use and interpretation of study process inventories, and that locates their value in yielding functionally useful data to researchers, teachers, and staff developers.

Child↗
PubMed2002

Development and evaluation of an electronic drug and therapeutics bulletin.

OBJECTIVE: To describe the development, implementation, and initial evaluation of a paperless drug and therapeutics bulletin that is distributed by electronic mail from the pharmacy department of an Australian teaching hospital. OUTCOMES: A standardized format for the bulletin was designed and approved in February 2001. The aim of the bulletin is to facilitate the timely dissemination of concise, factual information about issues of current interest in therapeutics, drug safety, and the cost-effective use of medicines. A simple and attractive graphic design was chosen, and the hospital's clinical pharmacists and drug information staff developed an initial bank of content during the period immediately preceding the launch. The bulletin is presented as a 1-page, read-only file in Word for Windows format and was initially distributed by electronic mail to all users of the hospital's computerized communication network. As the popularity of the bulletin increased, healthcare practitioners from outside of the hospital began to request permission for inclusion on the circulation list, and the content was frequently forwarded by E-mail to workers in other hospitals and community-based settings. The bulletin is now distributed to pharmacists around Australia via 2 separate moderated discussion lists, one of which provides an archive site for previous editions. Healthcare workers in Singapore, the US, Canada, and New Zealand also receive the bulletin, which is now also abstracted by a major Australian pharmacy journal. A readership survey (also electronically distributed) was used to seek feedback after the publication of the first 12 editions. Readers indicated a high level of satisfaction with the content, format, and frequency of distribution of the materials. CONCLUSIONS: Although the concept and execution of this project was relatively simple, an extensive literature review did not reveal any previously published reports describing this type of approach to the distribution of a pharmacy bulletin. The development and implementation of the electronic drug and therapeutics bulletin has provided an opportunity to use modern communication technology to promote safe and effective medication use and appears to have been well received.

Australia↗
PubMed1999

Development of a vertically integrated program of services for persons with schizophrenia.

Economic pressures are changing the nature and quality of services available to individuals with chronic psychiatric disorders. Vertical integration of services has been proposed as a strategy for cost-effective merging of resources. This report describes the integration of inpatient, continuing day treatment, and ambulatory clinic services over an 18-month period into a service line for patients with schizophrenia. Key principles in implementing the integrated program included an open admission policy, continuity of care, use of criteria for level of care that were set by external review agencies, rapid transfers between services, and maintenance of the integrity of the treatment plan. Steps toward integration included evaluating and securing treatment resources, establishing core treatment approaches, fostering staff development, implementing outcomes assessment, and presenting the new program to clients, family members, and the community. The integrated program was 15 percent more productive than the combined services before integration, and inpatient length of stay dropped by 66 percent. Vertical integration of services is cost-effective and offers the potential for significant clinical benefits.

Continuity of Patient Care↗
PubMed2003

Designing an HIV counseling and testing program for bathhouses: the Seattle experience with strategies to improve acceptability.

Bathhouses are important venues for providing HIV counseling and testing to high-risk men who have sex with men (MSM), yet relatively few bathhouses routinely provide this service, and few data are available to guide program design. We examine numerous logistic considerations that had been identified in the HIV Alternative Testing Strategies study and that influenced the initiation, effectiveness, and maintenance of HIV testing programs in bathhouses for MSM. Key programmatic considerations in the design of a bathhouse HIV counseling and testing program included building alliances with community agencies, hiring and training staff, developing techniques for offering testing, and providing options for counseling, testing, and disclosure of results. The design included ways to provide client support and follow-up for partner notification and treatment counseling and to maintain relationships with bathhouse management for support of prevention activities. Early detection of HIV infection and HIV prevention can be achieved for some high-risk MSM through an accessible and acceptable HIV counseling and testing program in bathhouses. Keys to success include establishing community prevention collaborations between bathhouse personnel and testing agencies, ensuring that testing staff are supported in their work, and offering anonymous rapid HIV testing. Use of FDA approved, new rapid tests that do not require venipuncture, centrifugation, or laboratory oversight will further decrease barriers to testing and facilitate implementation of bathhouse testing programs in other communities.

AIDS Serodiagnosis↗
PubMedDate not supplied

Knowledge utilization among experienced staff nurses.

The purpose of this descriptive exploratory study was to describe the processes staff nurses use to select and transfer new knowledge to practice. Eleven experienced staff nurses shared 29 examples in which gaining new knowledge resulted in changes in thinking or acting in a clinical situation. Findings indicated that knowledge utilization originated with the nurse who was active in selecting and using new knowledge. Nurses used multiple knowledge utilization processes primarily involving factual knowledge and instrumental utilization. Often, the decision to move knowledge to practice was based on comparison by similarity. There were no variations in utilization processes as nurses floated across units. Sources of new knowledge were primarily informal and unit based. Implications for staff development focus on developing unit-based resources and resource personnel, using innovative ways to introduce new knowledge on the unit, and providing time in formal classes for exchange of ideas on using new knowledge in practice.

Clinical Competence↗
PubMedDate not supplied

Student-oriented learning outlines: a valuable supplement to traditional instruction.

In a time of changing health care and funding restraints in institutions, continuing education and staff development departments are being challenged to produce better prepared nurses at reduced costs per employee. Improvements in how nurses are prepared are needed to ensure higher levels of competence without increasing the cost. This article describes the development and use of a practical strategy for mastery learning known as Student-Oriented Learning Outlines or SOLOs. This approach has been found to be effective in producing improvements in learning and ultimately patient care while reducing cost to the institution.

Clinical Competence↗