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The process and outcomes of a multimethod needs assessment at a homeless shelter.

Many factors contribute to homelessness, including extreme poverty, extended periods of unemployment, shortages of low-income housing, deinstitutionalization, and substance abuse. As a result, the needs of people who are homeless are broad and complex. This needs assessment used literature reviews, review of local documents and reports, participant observation, locus groups, and reflective journals to guide the development of an occupational performance skills program at one homeless shelter in south Florida. Through these methods, the role of occupational therapy was extended beyond direct service to include program and resource development, staff education, advocacy, and staff-resident mediation. The findings of the needs assessment and the actions taken as a result of this work point to the huge potential for occupational therapists and students to work together with staff and residents of homeless shelters.

Florida↗

Influences on positive family involvement in aged care: an ethnographic view.

This paper examines the experiences of family members who have previously been primary carers of residents of residential aged care services to identify factors, which have encouraged them to remain involved in a caring role. The context for this study was a residential aged care facility in Western Australia that was selected on the basis of its reputation of being highly sought after by relatives requiring formal care for older family members and also having a high level of ongoing involvement of relatives. Findings from the study provide evidence of the importance of staff developing relationships with relatives, supporting relatives through the change process and developing care partnerships where relatives could define new caring roles in providing social and emotional support for residents. This study is part of a larger study investigating relational quality in aged care environment.

Aged↗

Prolonged outbreak of Norwalk gastroenteritis in an isolated guest house.

During November and December 1982, a persistent outbreak of gastroenteritis took place in an isolated guest house. An estimated 26% of the changing population of guests and staff developed symptoms. Laboratory studies implicated Norwalk agent as the cause of illness, although the original source of the outbreak could not be established. Information on clinical features of the illness, its mode of spread, and eventual control is presented.

Adolescent↗

Cytomegalovirus infection in dialysis patients and personnel.

In a 12-month prospective study of cytomegalovirus infection on an acute hemodialysis unit, 10 of 80 patients (13%) and none of 26 staff developed active cytomegalovirus infection. Seven infections were coincidental with renal allograft rejection; three occurred 3 to 6 weeks after the transfusion of multiple units of conventional blood into seronegative patients. No person-to-person transmission was documented. In contrast to the effects of transfusing conventional blood, all 21 patients who entered dialysis without detectable cytomegalovirus antibody and received 2 to 10 U of frozen deglycerolyzed erythrocytes (total of 157 U) remained seronegative. Transmission of cytomegalovirus infection with transfusion with conventional blood is probably secondary to passage of leukocyte-borne virus that is lost during the freezing and deglycerolization procedure. Frozen erythrocytes prepared by cytoagglomeration procedures appear to be free of viable leukocytes and appear to carry a minimal risk of transmitting cytomegalovirus infection.

Acute Disease↗

Joint training for mental health key workers: Part 2.

The first part of this series last week outlined a joint training initiative for key workers in mental health. This week, the author describes the impressions of some of those who took part in the programme and reviews the implications for clinical practice and staff development.

Allied Health Personnel↗

Evidence-based care through clinical practice.

This article describes how a working group examined ways to overcome difficulties with applying research findings to clinical practice. The group developed a ward-based distance learning package to assist in developing staff skills and ultimately enhance patient health care. The package has implications for all registered nurses in all nursing contexts.

Clinical Nursing Research↗

Professional development support for community nurses.

This article presents the outline of a programme developed to support quality nursing care and provide professional development for staff nurses in a grade mixed, community nursing team. The initiative has been a joint venture between First Community Health NHS Trust and the University of Wolverhampton, School of Health Sciences, and shows the value of working together to establish a sound underpinning for practice.

Community Health Nursing↗

Issues in training and development.

In the last report in this series describing re-engineering at The Leicester Royal Infirmary NHS Trust, the implications of a re-engineered patient process on the training and development of staff are discussed.

England↗

Diabetes initiatives: hospital education.

This article is the first of two which concentrate on training initiatives in diabetes care for nurses. The articles focus on two initiatives--one hospital-based, the other for community nurses--which aim to improve nurses' knowledge and skills in relation to this important area of practice. The first article describes a programme introduced into a major hospital to improve and develop staff skills in measuring patients' blood glucose levels.

Blood Glucose↗

Conducting a workshop.

Conducting a successful workshop is a rewarding accomplishment. To be successful, organization and planning are key factors. Important steps are started early and performed systematically. This article outlines the steps for a successful workshop.

Budgets↗

A change from the top. One system self-manages its reorganization project.

Changes in healthcare arising from economic, legislative, social, and medical pressures will place greater demands on senior managers' future decision making. To maintain its position as a healthcare leader during these volatile times, the Sisters of Charity of the Incarnate Word Health Care System (SCH), Houston, embarked on a self-managed reorganization project in January 1989. The system's senior management team (SMT) established guiding principles that served as the basis for its goals and objectives. A mission statement helped keep the team focused on its goals. A revised SCH Strategic Direction served as the foundation for change. After analyzing the corporate office organizational chart in light of the new strategic direction, the SMT began a reorganization process. This involved the redefinition of many roles, elimination of some positions, and relocation of some functions. Staff attended workshops to adjust to the reorganization. At the workshops employees were given the opportunity to ask questions and participate in the organization's reshaping. The new collaborative management style has been in place two years. As staff develop more supportive cross-functional teams and specialized committees, they are able to tap deeper into their extensive creative resources and collaborate on a vision for SCH.

Catholicism↗

Workforce literacy: do we have a choice?

Rapidly occurring demographic change and the demand for higher and higher skills in the workforce present a challenge for business and education. The investment the workplace makes in basic education for its employees will not only increase skills, but positively affect attitudes toward the employer, stimulate a desire for education and promotion and raise self-esteem. The rich mix of racial, ethnic and global experiences represented in today's workforce is a great potential advantage. We must face the question of best developing this potential for the future. Investment in personnel is not only worth-while--there is no other choice. We must not lose the opportunity.

Educational Status↗

An operational decision-making model for the cognitively sensing-thinking manager.

Whereas all managers face decision-making situations, not all managers discharge the decision-making process in the same manner. Individuals possess different personalities that influence how they gather and process information and subsequently make decisions. Research has reported a link between personality type and a preferred cognitive decision-making style. ST personalities prefer structured methods to resolve problems. For ST managers, a three-dimensional decision-making models is proposed. The model is based on the decision-making process initiated by Dewey and evolved by theorists and practitioners over time. Unique to the model is the institution of a second dimension of operational categories. Thus, the decision process is not conducted within a vacuum but within a context defined by the problem to be resolved. A further degree of thoroughness is achieved by unfolding the categorical dimension into sub-categories and conducting the decision-making process at that level. Several additional managerial tools exist that are compatible with the ST cognitive style and that facilitate an effective and efficiency decision process. What does this mean for the practicing health information manager? The manager's first step is to identify his or her personality type. The popularity of the MBTI as an organizational and career counseling tool has received wide acceptance across industries, including health care. The MBTI can be obtained, administered, scored, and interpreted only by trained personnel. Such individuals may be found in human resource and staff development departments; career centers and seminars; and vocational-technical schools, community colleges, and universities.

Decision Making, Organizational↗

Journal club: a tool for health care management and development.

While the journal club concept has its roots in medical practice, the premise of the concept can easily and effectively be assimilated into health care management practice. Health care executives and managers can greatly facilitate the journal club process by establishing a solid methodology for article presentations that focuses on critical and timely issues related to health care management. With upper management support and member commitment, the journal club can be a powerful vehicle for ongoing management and personal career development.

Education, Continuing↗