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At least 1,045 records · Page 58Linked to original sources
PubMed1996

1994 athletic trainer employment and salary characteristics.

OBJECTIVE: THE PURPOSE OF THIS STUDY WAS TO DETERMINE: 1) demographics and professional credentials of recently hired athletic trainers, 2) the association between these characteristics and the high school, clinical, and collegiate setting, and 3) which of these factors best predicted salary. DESIGN AND SETTING: A survey was sent to all prospective employers. Of the 472 surveys sent, 282 (60%) were returned. SUBJECTS: Prospective employers who were listed on the NATA job vacancy notices from January 1, 1994 to October 1, 1994. MEASUREMENTS: Employers selected a job description for their position opening and indicated the characteristics of the people they hired. The job descriptions were placed into three categories. A chi-square analysis was used to determine the degree of association between applicant characteristics and job descriptions. Employee characteristics were coded and a stepwise multiple regression analysis was performed to determined which of the characteristics best predicted salary. Analyses of variance were performed to determine differences among the three practice settings and as follow-up analyses to the multiple regression. An analysis of variance was also performed to compare salaries based on job description and teaching responsibilities. RESULTS: No association was found between the employment setting and gender, ethnicity, marital status, educational route, physical therapy, credential, or EMT certification. There was an association between the CPR instructor's credential and employment setting and between highest degree attained and employment setting. CONCLUSIONS: The results suggest that these factors were most closely associated with employment in the collegiate setting. With regard to salary, it was determined that a doctoral degree, a master's degree, and marital status were the best predictors of salary.

Journal Article↗
PubMed1999

Milestones in athletic trainer certification.

OBJECTIVE: To summarize the history of athletic trainer certifaction. BACKGROUND: The single most significant public pronouncement a professional society or organization can bestow upon an individual is certification. One of the underlying goals of professional societies or organizations that certify individuals is to promote the public's reliance on the credential and the individuals who hold that credential. In this paper, I will identify the significant milestones the National Athletic Trainers' Association (NATA) and the NATA Board of Certification (NATABOC) have achieved for the athletic training profession, promoting and sustaining the public's reliance on the certified athletic trainer. DESCRIPTION: This paper presents the significant milestones in the certification of athletic trainers by the NATA and the NATABOC. ADVANTAGES: The milestones related to athletic trainer certification that I present in this paper will enhance the reader's understanding of the underlying reasons for the initiation of athletic trainer certification and the development and recognition of the athletic training profession as a credentialing agency for the athletic training profession.

Journal Article↗
PubMed1995

Regulation of advanced nursing practice: Part Two--Certification.

PURPOSE/OBJECTIVE: To present an overview of issues related to the use of advanced practice nursing (APN) certification. DATA SOURCES: Published articles, position papers, and colleague experiences. DATA SYNTHESIS: Certification is used for credentialing APNs at the state level, and in some states, it is a requirement for second licensure. Presently, a great deal of variability exists in the purposes and procedures related to certification processes, thus devaluing its use. CONCLUSION: The lack of consistency among certifying agencies and the lack of documented impact of certified advanced nursing practice can negatively affect the value placed on certification as an advanced practice credential. In the current climate of increased regulation, nursing must maintain control of practice regulation. IMPLICATIONS FOR NURSING PRACTICE: Inconsistencies between states and among nursing organizations can negatively affect the mobility and career flexibility of APNs. The evaluation of outcomes related to certified advanced nursing practice must be a research priority in the current climate. Collaboration among specialty organizations also must occur to increase the credibility of certification as a nursing credential.

Certification↗
PubMedDate not supplied

Ethnic disparity in the performance of prenatal nutrition risk assessment among Medicaid-eligible women.

In this study, the authors compare perinatal health outcomes and nutrition risk assessments in Latina, African American, and white women receiving Medicaid enhanced perinatal services. The objective is to analyze how proper assessment of obesity and underweight depend upon ethnic group, provider practice setting and credentials, and the implications for perinatal outcomes. The medical records of women who received enhanced perinatal services from specially certified Medicaid providers in California were abstracted for information on nutrition risk assessment and outcomes. Logistic regression analysis was used to test the associations first of obesity and underweight with adverse outcomes in Latina, African American and white women, then the associations of ethnicity with the failure of these women to be classified as overweight or underweight during assessment. Finally, the associations between misclassification of body mass with provider practice setting type and credentials are also tested. Obese Latinas are twice as likely not to be properly classified as overweight, despite evidence of substantial risk of unfavorable outcomes. For all three ethnic groups, underweight women are uniformly underreported as being at risk. The appropriate classifications of obesity and underweight are not associated with private or public types of obstetric practice settings or whether nutrition risk assessors are registered dietitians, health workers, or nurses of any particular credential. Providers of prenatal care to low-income women could improve the quality of nutrition risk assessment of overweight Latina women and underweight women of all ethnic groups with expectations of improving perinatal outcomes.

Adolescent↗
PubMed2003

A prospective analysis of 3525 esophagogastroduodenoscopies performed by surgeons.

BACKGROUND: This study was undertaken to evaluate the safety and efficacy of surgeons performing esophagogastroduodenoscopy (EGD) and to use these results to assess existing credentialing guidelines for surgeons. METHODS: A prospective outcomes study was designed to accept input from members of SAGES. End points were the time taken and rate of success in reaching the duodenum, the frequency of arriving at a diagnosis, and complications of EGD as related to operator experience. RESULTS: Information from a total of 3,525 EGDs was prospectively entered into a database between December 2001 and December 2002. Common indications were abdominal pain/nausea/vomiting (34.8%), gastroesophageal reflux disease (24.9%) and dysphagia (17.4%). The findings were inflammation in 1,895 (53.8%), hiatus hernia in 1,010 (28.7%), nonbleeding ulcer in 462 (13.1%), bleeding ulcer in 59 (1.7%), stricture in 344 (9.8%), and polyp/tumor in 206 (5.8%). Biopsies were obtained in 2080 (59.0%). Concomittant procedures performed were dilation in 253 (7.2%), removal of a foreign body (FB) or removal/insertion of a percutaneous endoscopic gastrostomy tube (PEG) in 190 (5.4%), and polypectomy in 59 (1.7%). The EGD was completed to the duodenum in 3282 patients (93.1%) with a mean procedure time of 9.2 min (range 1-60 min). Examination of the duodenum was not attempted in 231 patients for reasons such as previous gastric surgery ( n = 119), obstruction ( n = 58) or because the EGD was done for FB/PEG removal or PEG placement ( n = 36). Attempted EGD could not be completed in 12 patients (0.3%). The most common complication was hypoxia ( n = 57, 1.6%), which was treated with supplemental oxygen and observation. New bleeding occurred in eight patients and the procedure failed to control bleeding in three others. No complications occurred in 3447 patients (97.8%). Completion rates and major complications were not correlated to experience, but there was a significant association between experience and the time required for completion of the procedure ( p < 0.0001). CONCLUSIONS: This study shows that surgeons can perform EGD with a high degree of success and low morbidity. On the basis of this large prospective study, no minimum number of cases could be proposed for credentialing surgeons to safely perform either diagnostic or therapeutic esophagogastroduodenoscopy.

Adult↗
PubMed1987

Taking care of the doctors: the hospital's duty to evaluate, monitor, and discipline its medical staff.

The heart of a hospital's credentialing responsibilities lies in its duties to evaluate, to monitor, and to discipline its medical staff. Some key elements of an effective credentialing system are the skills of the medical staff coordinator, the use of physician proctors to evaluate new applicants, careful investigation of applicants for initial appointment and for reappointment, and education for department chairmen. Inevitable problems include physicians who do not work harmoniously with others and allegations of incompetence and impairment.

Clinical Competence↗
PubMed1999

Advanced practice nursing: parameters for successful integration.

This article analyzes advanced practice nursing roles through a literature review and a pilot stakeholder survey in relation to five strategic areas: (1) definitions and scope of practice; (2) education, credentialing and regulation; (3) new roles in healthcare; (4) costs and benefits in health reform; and (5) implementation and relationships. The Canadian health services environment is best served by a multifaceted APN role, defined by a nursing paradigm that invokes collaborative relationships with physicians, and education and credentialing that is based on national standardization.

Canada↗
PubMed2000

Credentialling Australian critical care nurses: the pilot study.

In October 1998, the Australian College of Critical Care Nurses (ACCCN) launched a model to credential specialist level critical care nurses. This model was 'road tested' during a pilot study, when experienced critical care nurses were invited to apply to become the first Australian credentialled critical care nurses. The pilot study was designed to ensure all individuals taking part in the process were surveyed regarding adequacy of the credentialling package and the credentialling process. Applicants were required to provide evidence of practise at the specialist level, as described in the Competency Standards for Specialist Level Critical Care Nurses. Evidence was presented via curriculum vitae, professional journal and supported by three peer reviewers and two referees. Each application was sent to a three-person assessor panel, which assessed the evidence in the application against the Competency Standards for Specialist Level Critical Care Nurses. A total of six applications from five states and one territory were received by April 1999. Five of the applicants were assessed to have met the Competency Standards and were awarded the credential, Australia Credentialled Critical Care Nurse (ACCN), which they will hold for a period of 3 years. Feedback from assessors, applicants, peer reviewers and referees involved in the pilot study has resulted in the further refinement of the credentialling package and processes. Australian critical care nurses will now have the opportunity to seek to be credentialled four times per year.

Australia↗
PubMedDate not supplied

The midwife as first assistant for cesarean section.

Across the United States, midwives have expanded their role to include serving as first assistants at cesarean sections. An American College of Nurse-Midwives (ACNM) Position Statement adopted in 1998 recognizes the practice as a "frequently-performed advanced midwifery practice skill." Workshops have been offered nationally in 1997, 1998, 2000, and 2001 as well as locally in some states to educate and guide the midwife in completing the didactic and clinical preparation. Yet, there is a dearth of published literature on the subject. This article reviews the evolution of the role from its origins in perioperative nursing, including the requirements for the Registered Nurse First Assistant as established by the Association of peri-Operative Registered Nurses that are referenced in the regulations of several states in regard to the practice of midwives as surgical assistants. The authors report the results of a survey of state regulatory agencies that reveals a wide variation in laws, regulations, and interpretations ranging from statutory acceptance to prohibition with suggestions on how to effect needed change. This article also includes a process for credentialing that is consistent with the ACNM "Guidelines for the Incorporation of New Procedures into Midwifery Practice." The importance of documentation of the educational and credentialing process from a medico-legal perspective is stressed.

Cesarean Section↗
PubMed2005

Best practice recommendations for surgical care in weight loss surgery.

OBJECTIVE: To establish evidence-based guidelines for best practices for surgical care in weight loss surgery (WLS). RESEARCH METHODS AND PROCEDURES: We carried out a systematic search of English-language literature on WLS in MEDLINE and the Cochrane Library. Key words were used to narrow the field for a selective review of abstracts. Data extraction was performed, and evidence categories were assigned according to a grading system based on established evidence-based models. RESULTS: We assessed types of WLS, recommended guidelines for appropriateness, developed strategies for medical error reduction, established criteria for credentialing of systems and practitioners, and specified research needed for the future. DISCUSSION: Surgeon training, credentialing, and type of surgery performed were identified as key factors in patient safety. Other important issues in the delivery of best practice care included appropriate patient selection; use of a multidisciplinary treatment team; facility staffing, equipment, and administrative support; and early recognition and proper management of complications.

Biliopancreatic Diversion↗
PubMedDate not supplied

Magnet designation in a community hospital.

Hospitals across the country have been struggling with nursing shortages for more than 2 decades. Today, more than 126,000 nursing positions are vacant, according to the American Nurses Credentialing Center, and that number is expected to sky-rocket as an aging population puts unprecedented demands on the nation's healthcare system. Through the Magnet Designation program established by the American Nurses Credentialing Center, hospitals around the country are finding creative ways to attract and retain quality nurses. At Poudre Valley Hospital, the program also has improved patient outcomes, boosted market share, and created an employee culture of teamwork, empowerment, respect, integrity, and caring.

Benchmarking↗
PubMed2006

Celebrating 50 years of experience: an ECFMG perspective.

As indicated in its mission statement, the Educational Commission for Foreign Medical Graduates (ECFMG), established in 1956, "promotes quality health care for the public by certifying IMGs for entry into U.S. graduate medical education, and by participating in the evaluation and certification of other physicians and health care professionals. In conjunction with its Foundation for Advancement of International Medical Education and Research, and other partners, it actively seeks opportunities to promote international medical education through programmatic and research activities." From 1958 through 2005, the ECFMG certified 287,382 international medical graduates (IMGs); the number per year has varied, depending on the world political situation and other factors. Currently, IMGs constitute 25% of practicing physicians in the United States. India, followed by the United States and the Philippines, has provided the largest number of certified IMGs. The ECFMG has developed extensive resources for verifying medical school diplomas and other credentials of applicants, and it provides credentials verification services to other organizations. Under the U.S. government J-1 Exchange Visitor Program, it also has played a major role in facilitating the entry of foreign physicians to the United States for clinical training and research experience. Over the years, testing of IMGs seeking ECFMG Certification has evolved; whereas initially applicants took examinations specifically for IMGs, they now take the same United States Medical Licensing Examination (USMLE) sequence of examinations as U.S. medical graduates. Passage of the USMLE is required for ECFMG Certification and licensure in all jurisdictions.

Certification↗
PubMed2002

Evolution of a protocol for ketamine-induced sedation as an alternative to general anesthesia for interventional radiologic procedures in pediatric patients.

PURPOSE: To establish a protocol for credentialed pediatric radiology nurses, with radiologist supervision, to administer ketamine to induce sedation and analgesia during interventional radiologic procedures. MATERIALS AND METHODS: This study was conducted in two phases. The goal of the first phase was to develop a sedation protocol to replace that of using general anesthesia for specified pediatric interventional procedures. Ketamine was administered intravenously (with intermittent bolus or continuous infusion) or intramuscularly. Sedation induction times, adverse events, doses, and sedation and recovery durations were recorded. In phase 2, the results of phase 1 were reviewed and a formal ketamine protocol was developed. RESULTS: Neither sedation failures nor substantial adverse events occurred in phase 1. Mean duration of all sedations was 52 minutes, and median recovery room time was 0 minutes. In phase 2, the results of phase 1 were reviewed and a sedation protocol was proposed to a hierarchy of hospital committees before final approval from the medical staff executive committee. Subsequently, standard order forms for radiology nurse administration of ketamine with radiologist supervision were prepared for exclusive use by the pediatric interventional radiology department. CONCLUSION: Ketamine-induced sedation may be a safe and effective alternative to general anesthesia for some interventional radiologic procedures in pediatric patients. Collaboration between anesthesia and radiology departments is important for development of a safe and successful ketamine sedation program. To the authors' knowledge, this is the first report describing the intravenous infusion of ketamine for sedation in pediatric patients and the only report describing the establishment of a protocol for ketamine administration by credentialed radiology nurses with radiologist supervision.

Adolescent↗
PubMed2006

Innovations in health care delivery: responses to global nurse migration--a practice example.

The American Nurses Credentialing Center (ANCC) mission is to promote excellence in nursing and health care globally through credentialing programs and related services. Among these programs, the Magnet Recognition Program recognizes health care institutions that excel at changing their cultures to provide excellent patient care. In recent years, ANCC has partnered with health care organizations and researchers internationally to extend the Magnet Program to other countries. There is flexibility in the Magnet Program to be able to do this; however, we must continue to refine the meaning and necessary level of flexibility to be applied. It is important, as we move forward, that we honor one of the Magnet tenets: to celebrate milestones.

Credentialing↗
PubMed2003

Who should be doing laparoscopic bariatric surgery?

BACKGROUND: The training and credentialing of surgeons for laparoscopic bariatric surgery is controversial. We sought to determine if there is an association between surgeons' practice and choice of open or laparoscopic bariatric surgery. METHODS: Members of the ASBS were surveyed via email. Associations were tested with Cochran-Mantel-Haenszel or Pearson's chi-square. RESULTS: 104/472 members responded; 65% were in private practice; 47% did 1-5 operations/week, 48% offered open procedures only, and 76% undertook gastric bypass. Respondents believe that laparoscopic procedures: should mimic open ones (77%), are safe (63%), should be evaluated by clinical trials (48%), and that expertise in bariatric surgery is more important than laparoscopic experience. 75% believe that courses and preceptorships are important. Regarding laparoscopic operations, surgeons doing only open procedures believe that: 1) the ASBS should be the main credentialing body; 2) surgeons should do > 25 open before laparoscopic ones; and 3) clinical trials are needed (P < 0.02, all). Surgeons with laparoscopic training or practices believe that laparoscopic surgery is safe and effective (P < 0.002). Both laparoscopic and open surgeons believe bariatric surgeons should be the only surgeons doing laparoscopic bariatric procedures (P < 0.008). CONCLUSIONS: There is consensus that laparoscopic bariatric surgery should be undertaken only by surgeons with strong interest in bariatric surgery. Laparoscopic bariatric surgeons should incorporate lessons learned from open surgery. Both laparoscopic and open bariatric surgeons should seek added expertise via courses and preceptorships. The skepticism of surgeons with 'open' practices could be addressed by clinical trials. The ASBS should maintain its leadership position and foster emerging technologies.

Clinical Competence↗
PubMed1997

Rural hospitals' experience with the National Practitioner Data Bank.

OBJECTIVES: This study examined hospital administrators' experiences with the National Practitioner Data Bank. METHODS: One hundred forty-nine rural hospital administrators completed questionnaires assessing their perceptions of the data bank. RESULTS: Nearly 90% of respondents rated the data bank as an important source of information for credentialing. Three percent indicated it had directly affected privileging decisions; 43% and 34%, respectively, believed the costs exceeded or equaled the benefits. Twenty percent reported changes that could decrease disciplinary action reports to the data bank. CONCLUSIONS: While the National Practitioner Data Bank is an important source of information to rural hospitals, it may, affect few credentialing decisions and motivate behavioral changes that could have a paradoxical effect on quality assurance.

Consumer Behavior↗
PubMed2006

Surgical nurse practitioners as registered nurse first assists: the role, historical perspectives, and educational training.

Advanced practice nurses (APN) who practice in the surgical subspecialty areas may have the opportunity to expand their scope of practice to include first assistant at surgery. Surgical APNs who practice as registered nurse first assistants (RNFA) should seek credentialing and apply for institutional privileges to assure the consumer of competent providers. Credentialing as an RNFA documents the educational learning process and skills acquired, and recognizes this area of expertise. The role of the APN as an RNFA at surgery is practiced within the specialty area of perioperative nursing which includes preoperative, intraoperative, and postoperative care. In this study, the nurse practitioners describe the role of the RNFA, its historical evolution over wartime, the required educational training, and the benefits of the role for patient care. The surgical nurse practitioner who undertakes training and education as a surgical RNFA is in an excellent position to provide patient care across the surgical continuum.

Credentialing↗
PubMed1989

Procedural skills of the general internist. A survey of 2500 physicians.

STUDY OBJECTIVE: To determine which of 40 clinical procedures general internists do in their practice, how often these procedures are done, and what training is needed to develop and maintain competence in each. DESIGN: Mailed survey. PARTICIPANTS: A random sample of 2500 American College of Physicians (ACP) members identified as general internists; 1806 (72%) responded. Of these, we excluded 398 who were board eligible or board certified in a subspecialty and 143 with unknown status. The resulting sample of 1179 was augmented in selected analyses by an additional sample of 199 rural internists. RESULTS: General internists did, on average, 16 of the 40 procedures. Practice characteristics markedly affected the number and variety of procedures done. A larger number of different procedures was independently associated with smaller cities, smaller hospitals, younger age, increased hours in patient care, and certain regions of the country. Practice characteristics varied considerably by practice type and location. Many procedures were done infrequently. There was reasonable agreement on the experience needed to attain and maintain competency in each procedure. The majority of respondents favored hospital credentialing for 22 of the 40 procedures. CONCLUSIONS: General internists do a wide variety of procedures, the number and frequency of which are affected by the characteristics and location of their practice. Despite opinion to the contrary, more recently trained general internists do a wider variety of procedures than older colleagues. These results provide data to help define standards for training and credentialing and suggest that we should reexamine general internists' training in procedural skills.

Attitude of Health Personnel↗