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PubMed1990

The use of the Ethnograph program to identify the perceptions of nursing staff following the introduction of primary nursing in an acute medical ward for elderly people.

Interviews with a small group of nurses working in a primary nursing ward were content analysed using the Ethnograph computer program. In response to some very general questions about their views of primary nursing, the respondents talked at some length about their improved knowledge of patients, about better communication, about their relationships with patients and relatives and about personal responsibility. They did not talk spontaneously about controlling their own practice, decision-making, autonomy or accountability. Such terms did not form part of their vocabulary in describing their work though these issues were raised obliquely in the conversations. The value of the change in the way of organizing the delivery of nursing care was seen more in terms of its potential for developing therapeutic relationships rather than in terms of personal professional development. Increased knowledge of and responsibility for specific patients coupled with the greater continuity of care they were able to provide, gave them greater job satisfaction than they had previously experienced.

Aged↗

PubMed1992

Chronic pain and depression.

Because of the increased incidence of chronic disease and other health problems associated with aging, chronic pain is a common companion for the elderly. Pain is of great clinical importance, often associated with disability, loss of independence, and reduced quality of life. A fact that is of interest to psychiatric nurses is that many elderly with complaints of chronic pain also exhibit signs and symptoms of depressive disorders. Treating chronic pain conditions is complex and difficult, and health-care professionals are increasingly recognizing that psychological factors are often involved in the development and continuation of chronic pain problems. Depression is one of these influential variables. Increased understanding of the role of depression in the etiology and maintenance of chronic pain can improve assessment and intervention for the elderly with chronic pain complaints.

Aged↗

PubMed1993

The career ladder.

With the addition of the proposed Certificate of Continuing Professional Studies (CCPS) which has not yet been implemented, the Society will have developed an open-ended career ladder for medical laboratory technologists. Moving from one step to the next may entail a return to school; it will certainly entail hard work and commitment. There are no barriers to prevent a motivated individual from progressing up the ladder. The ladder is illustrated in diagrammatic form below. The shaded areas represent the elements that are not yet in place.

Canada↗

PubMedDate not supplied

[Depression: viewpoints and knowledge of the nurses in th basic health network].

This study aimed at identifying the viewpoints and the knowledge on depression of nurses working in the basic health network. The 73 participants who answered two self-applicable questionnaires were distributed in 28 health units. The general results concerning their viewpoints and knowledge are, in most answers, in accordance with what was expected and showed average knowledge related to depression. However, the individual analysis of such answers indicate that these professionals are not in direct contact with and do not know how to identify depressed patients. They do not observe these indicators in the patients that they assist or do not understand that it is their task to do so. Reflections appeared concerning the possible relationship between mental health actions and their professional education. In this way, undergraduate and continuing education become more important in the development of nursing actions for mental health.

Brazil↗

PubMed1992

Indium-111 antimyosin antibody imaging: a promising new technique in the diagnosis of M.I.

Extensive clinical research has demonstrated that the administration of indium-111 antimyosin antibodies is useful in the diagnosis of acute myocardial infarction. It is specific for acute myocardial necrosis, as opposed to ischemia or chronic infarction, and therefore identifies patients who have had an acute MI. It is most useful in patients whose ECGs are indeterminate for the diagnosis of acute myocardial infarction (eg, left bundle branch block or permanent pacemaker) or those with inconclusive CK or CK-MB. Diagnostic accuracy and safety of antimyosin imaging has been established. This new cardiac imaging agent holds great potential for future clinical use in the diagnosis and management of patients with known or suspected acute myocardial infarction. Presuming FDA approval, the critical care nurse will see antimyosin used as an innovative and viable alternative in the diagnosis of acute myocardial infarction. Critical care nurses need to continually increase their knowledge of technologic advances and clinical applications for their own professional development, as well as to provide accurate information to patients and their families. In the area of nuclear cardiology, this includes antimyosin imaging and other state-of-the-art imaging techniques such as magnetic resonance imaging, positron emission tomography and computed tomography.

Antibodies, Monoclonal↗

PubMed1978

Ethiopian experience in health manpower training. A review of the Public Health College.

Health manpower development in Ethiopia, mainly the paramedical personnel training programmes of the Public Health College, is reviewed and discussed. The 'health team' training programme in Gondar is the most practical and a significant development in the field of paramedical training for developing countries. The pattern and experience of the Gondar training programme could contribute to the world's knowledge of training and utilization of health teams for rural health services. It could serve as a model, with appropriate modifications, for other developing countries. The 'team' approach during training and services, the Health Officer, supported by paramedical personnel, who serves as the team leader, and the gradual development of medical education are realistic, and effective means for producing health manpower in the developing countries. The establishment of a definite career structure, with prospects for future continuing professional advancement, respectable status, appropriate authority, adequate technical supervision, administrative support, decent working and living conditions are vital for the success of this programma in Ethiopia.

Allied Health Personnel↗

PubMed1980

Measurement of physicians' performance using existing techniques.

Existing techniques permit objective and valid measurement of limited elements of physicians' performance. These limited aspects, however, are of considerable importance to patients. The basic components of performance in medicine and surgery can be defined and used as the basis of organized programs for such evaluation. Interhospital comparisons can provide an effective impetus for assessing and improving performance of individual staff members when this is indicated. Professional auspices are needed for the development and application of methods that can provide continuing assurance that the clinical activity of physicians corresponds to contemporary standards.A system of incentives should be provided to physicians to promote their participation in voluntary programs of self-assessment. The incentives should be in the form of performance assessment credits, comparable in definition to continuing medical education credits, but granted for participation in an accredited program that objectively measures physicians' performance against national standards of the respective specialty.

Clinical Competence↗

PubMed1995

A survey of occupational health professionals' preventive pulmonary practices and worksite environments: development and initial findings.

This article describes the development of a worksite survey to evaluate a continuing medical education (CME) program to improve preventive pulmonary practices and worksite environments of occupational physicians and nurses, and baseline findings from the survey. The two-part instrument assessed individual counseling practices for preventing lung disease and worksite environments. Eighty-one occupational physicians and nurses completed the survey before the CME program. Reliability coefficients (Cronbach's alpha) were calculated for five test subsections: smoking counseling (.72), workplace hazards (.70), environmental programs (.78), workplace environment (.94), and smoking policies (.91). Baseline findings indicated that 80% of respondents reported that their employees/patients were exposed to various workplace hazards. This instrument can be used to evaluate occupational health professionals' performance and worksite environments and may be useful for evaluating change over time or following a training program for occupational health professionals.

Education, Continuing↗

PubMedDate not supplied

Competency program development across a merged healthcare network.

Competency validation from initial entry through continued employment is essential to ensure nursing personnel provide safe professional practice. With hospital mergers it becomes quickly apparent that varying methodologies for competency verification exist. Nursing staff educators need a system-wide competency program to ensure a single high standard for the entire healthcare network. This article addresses one healthcare network's response to the challenge of developing and implementing a standardized competency-based program across a wide variety of settings.

Clinical Competence↗

PubMed1999

Clinical practice guidelines in end-stage renal disease: a strategy for implementation.

Clinical practice guidelines (CPGs) for end-stage renal failure (ESRD) were recently published, and represent a comprehensive review of available literature and the considered judgment of experts in ESRD. To prioritize and implement these guidelines, the evidence underlying each guideline should be ranked and the attributes of each should be defined. Strategies to improve practice patterns should be tested. Focused information for each high priority guideline should be disseminated, including a synopsis and assessment of the underlying evidence, the evidence model used to develop that guideline, and suggested strategies for CPG implementation. Clinical performance measures should be developed and used to measure current practice, and the success of changing practice patterns on clinical outcomes. Individual practitioners and dialysis facilities should be encouraged to utilize continuous quality improvement techniques to put the guidelines into effect. Local implementation should proceed at the same time as a national project to convert high priority CPGs into clinical performance measures proceeds. Patients and patient care organizations should participate in this process, and professional organizations must make a strong commitment to educate clinicians in the methodology of CPG and performance measure development and the techniques of continuous quality improvement. Health care regulators should understand that CPGs are not standards, but are statements that assist practitioners and patients in making decisions.

Diffusion of Innovation↗

PubMed2005

Online bioterrorism continuing medical education: development and preliminary testing.

OBJECTIVE: Education to achieve awareness and competency in responding to incidents of bioterrorism is important for health care professionals, especially emergency physicians and nurses, who are likely first points of medical contact. The authors describe the development of a computer-based approach to initial education, incorporating a screensaver to promote awareness and a Web-based approach to provide initial content competency in the areas of smallpox and anthrax. METHODS: Screensavers were developed and tested on emergency department rotating senior medical students and internal medicine interns. Conceptually, screensavers were designed as "billboards" for attracting attention to the educational domain. Five rotating images sequenced at five-second intervals incorporated a teaser question and an interactive toolbar. An interactive toolbar was linked to a Web site that provided content on smallpox and anthrax for hospital-based specialties (emergency physicians and nurses, infection control practitioners, pathologists, and radiologists). The content included both summary and comprehensive content as well as free continuing education credits in an online, specialty-specific, case-scenario format with remediation pop-up boxes. RESULTS: Formal testing indicated that the screensaver and Web site combination deployed on computers in the emergency department and the events of the fall of 2001 significantly increased the percentage of correct responses to five standardized bioterrorism questions. Formal evaluation with a randomized trial and long-term follow-up is ongoing. CONCLUSIONS: Screensavers and Web sites can be used to increase awareness of bioterrorism. Web-based education may provide an effective means of education for bioterrorism.

Awareness↗

PubMed2002