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PubMedDate not supplied

Improving patient meal satisfaction with room service meal delivery.

Cancer and cancer therapies cause side effects that prevent patients from consuming adequate amounts of food. As evidenced by patient meal consumption studies conducted at patients' bedside, only 39 percent of patients surveyed consumed greater than 50 percent of their main entree. The Food and Nutrition Services Department at Memorial Sloan-Kettering Cancer Center used the organization's performance improvement process, STRAIGHT-A, to develop and execute a room service program designed to increase patient meal consumption and improve patient meal satisfaction A multidisciplinary task force developed policies and procedures and tested new menu items as part of the room service plan. After program implementation, 88 percent of patients surveyed consumed greater than 50 percent of their main entree.

Cancer Care Facilities↗
PubMed1990

Institutional resources for medical students in committed relationships.

Medical students in committed relationships must balance the demands of the rigorous educational process against such things as their partners' educational and professional priorities, childbearing decisions, domestic and family obligations, financial and geographic constraints, and the desire simply to do things together. Couples may also have to deal with the relative intimacy that often develops between students and their colleagues who function in close, often stressful settings and who tend to rely on each other for emotional and intellectual support. The variety of these challenges has increased as student bodies have become more heterogeneous in age, gender ratio, and cultural background. Medical schools can help couples cope with these challenges by developing policies and programs responsive to the needs of couples and by providing opportunities for partners' involvement in the institutional life of students.

Adaptation, Psychological↗
PubMed1994

The Americans with Disabilities Act: II. Implications and suggestions for compliance for medical schools.

There is a need for more information about the Americans with Disabilities Act that is tailored to colleges of medicine so that faculty, staff, and administrators can understand and carry out their responsibilities under the Act. This report (Part II) and the previous one (Part I) in the same issue of Academic Medicine address this need. In Part I, key terms of the Act are defined; the present report focuses on the educational relationship between medical schools, applicants, and students in the context of the Act. A comprehensive array of the Act's implications are discussed in question-and-answer format. For example, what impact does the Act have on the application and admission process? Can a college of medicine ask students whether they have a disability? When does a school's duty to accommodate a disabled student begin? The report concludes with 15 recommended steps that colleges should take to comply with the Act, such as (1) colleges should develop policies and procedures for applicants and students who want to request accommodation for disabilities; (2) colleges should identify the essential abilities and skills required for admission and for participation in the degree program; and (3) colleges should consider instituting alternate dispute resolution procedures. Although following the recommended steps may seem overwhelming, medical schools are obligated by law to accommodate qualified disabled persons; failure to comply with the Act deprives academically qualified persons with disabilities of the opportunity to demonstrate their ability to fulfill degree requirements and become physicians. Medical educators must continue to adjust their understanding and knowledge of the Act's implications for medical schools, given that the interpretation of the Act will evolve as the courts amplify and implement it.

Persons with Disabilities↗
PubMed1996

Fostering the health of communities: a unifying mission for the University of New Mexico Health Sciences Center.

Fostering the health of communities can serve as a unifying mission of the academic health center (AHC), which can set the AHC apart from other health providers in the community. To achieve this mission, the University of New Mexico's AHC is increasingly focusing education, research, and service upon the identified health and service needs of communities in its state. Since major health problems in our society have social, behavioral, and economic roots, New Mexico's AHC has tapped into the broad expertise of its different components as well as that of its state and community partners to adequately address health problems in the community. Its hospitals offer financing and management resources, its colleges offer innovative approaches to community-based education, and the state department of health offers expertise in health policy development. To adequately respond to the complexity of community health needs, the different colleges and departments at New Mexico's AHC are increasingly merging into integrated governance units. Measures of community outreach success include evidence of strengthened community development, increased health care access, and improved indices of community health. New Mexico's AHC formed an interdisciplinary rural outreach task force, which has demonstrated its ability to form partnerships with state and local agencies and to mobilize institutional resources in education, research, and service from the AHC's different departments, colleges, and hospitals to respond promptly to unique community health needs. Evidence shows that such an integrated, coordinated AHC intervention can generate strong and lasting AHC-community alliances, improve the quality and economic viability of community health systems, and enhance the financial resources of the AHC.

Academic Medical Centers↗
PubMed2000

Enrollees' perceptions of participating in the education of medical students at an academically affiliated HMO.

PURPOSE: Little is known about how enrollees in health maintenance organizations (HMOs) perceive the benefits and risks of participating in the education of medical students. This case study elicited the views of enrollees of one academically affiliated HMO about the education of medical students. METHOD: Data from focus groups were used to design two questionnaires that were mailed to 488 adult patients and 298 parents or guardians of pediatric patients. A sample of non-respondents was followed up by telephone. Descriptive analyses were performed on the responses to the questionnaires. RESULTS: Response rates were 46% (adult) and 43% (parent or guardian). More than 75% of the respondents thought the HMO should be involved in teaching, most because teaching contributes to the training of better doctors and increases the skills of teacher-clinicians. Of those who responded, 28% of adults were concerned about risks to confidentiality and 18% were concerned about increased costs for enrollees. Nearly 50% of adults would be uncomfortable with students participating in visits involving "internal" examinations or emotional problems. Of those who responded, 56% of adults and 33% of parents or guardians were uncomfortable about a student's conducting an unsupervised history and physical examination. A total of 52% of adults preferred that the preceptor and student discuss their case in their presence. Respondents who had seen students previously were more comfortable with student activities associated with their care. CONCLUSIONS: The respondents thought the HMO should be involved in teaching, but they had specific concerns about the effects of student participation. Educators in other settings may wish to explore these concerns among their patient populations and develop policies to maximize the "enrollee-friendliness" of medical education in HMOs. While the study provides a first look at how enrollees at one HMO viewed participation in medical students' education, further research is needed at HMOs elsewhere to determine the representativeness of the study's findings.

Adult↗
PubMed1999

Barriers to effective screening for domestic violence by registered nurses in the emergency department.

Triage nurses in the emergency department are in a unique position to screen for domestic violence. This study, using Orlando's theory with a focus on two of her five major concepts, identifies barriers that prevent effective screening for domestic violence. A quantitative survey was distributed to 101 registered nurses employed in a large emergency department. Results identified three major barriers and a relationship between age and inservice attendance on domestic violence. Education on abuse and resources should be essential in nursing school curricula. Policy development and review should be part of an annual, mandatory inservice for all emergency nurses.

Adolescent↗
PubMed2000

Exploring the clinical nurse specialist role in an AIDS community-based organization.

Although community-based organizations (CBOs) serving persons living with HIV/AIDS have proliferated, the role of advanced practice nurses in these CBOs has not been articulated. This article describes four components of the clinical nurse specialist (CNS) role in a CBO: a nutrition program for ambulatory persons living with HIV disease. The CNS educates clients about strategies to improve and maintain their health and manage complex treatment regimens in daily lives that are often chaotic and limited by severe financial constraints. As a member of a multidisciplinary team, the CNS provides a healthcare perspective in policy development and staff education for a predominantly social service agency.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Enhanced undergraduate public health nursing experience: a collaborative experience with the Kentucky Department for Public Health.

The Kentucky Department for Public Health and the University of Kentucky College of Nursing entered into a collaborative partnership to provide an enhanced public health nursing experience for a select group of undergraduate students. The purpose of the project was to strengthen the public health nursing practices component of the baccalaureate nursing program in the College of Nursing at the University of Kentucky. The objectives of the project related to planning, implementing, and evaluating of this program in partnership with the Kentucky Cabinet for Health Services, State Health Department in Frankfort, Kentucky. The selected baccalaureate students were paired with a preceptor and a state, local, or district public health agency with an identified need in the student's area of interest. The students participated in a mentoring experience with a practicing public health nurse consultant. The experience afforded the students an opportunity to interact at both the practice and policy development levels. An ongoing partnership developed between the state health department, local health departments, and the college of nursing. This partnership led to ongoing practicum placements for students, beneficial for both the health departments and the college of nursing.

Community Health Services↗
PubMed1996

Foot care in the home: nursing and agency responsibilities.

Foot care is an integral component of overall patient care provided in the home. This article categorizes three levels of foot care that can be provided and gives nurses and agencies guidelines for developing policies and procedures that direct this type of care.

Aged↗
PubMed1991

Effective use of action-oriented studies in Pakistan.

Little formal research has been done in special education and rehabilitation in Pakistan because of a lack of basic groundwork and trained researchers. However, the absence of formal structures permits innovative approaches. Several low-cost, action-oriented participatory studies have been carried out at the Mental Health Centre, Peshawar. These have ranged from community survey exercises to more complex studies of attitudes towards disability, childhood developmental skills, trends in polio paralysis and casual educational integration. The studies were undertaken in collaboration with education and welfare authorities. Formal and informal channels were used to disseminate the study findings widely in Pakistan and many other countries, and to generate an on-going movement for policy development and service provision. This article summarizes results from some of these studies. It also considers problems associated with the dissemination of special education and rehabilitation research findings in developing countries like Pakistan.

Child↗
PubMed1995

Nurse managers and their future in New South Wales.

The goal of International Perspectives is to share the views of nurse leaders, from countries other than the United States, on global healthcare issues. The focus is on identifying healthcare management problems and their implications, research priorities, policy development, and ethicalmoral dilemmas faced by nurse administrators. You are encouraged to send the names and addresses of international nurse leaders who might be interested in participating, as well as your ideas, for format and content of the department.

Forecasting↗
PubMedDate not supplied

Nursing in Brazil.

The goal of International Perspectives is to share the views of nurse leaders, from countries other than the United States, on global healthcare issues. The focus is on identifying healthcare management problems and their implications, research priorities, policy development, and ethical-moral dilemmas faced by nurse administrators. You are encouraged to send the names and addresses of international nurse leaders who might be interested in participating, as well as your ideas, for format and content of the department.

Brazil↗
PubMed1997

Health and nursing leadership in Taiwan, Republic of China.

The goal of International Perspectives is to share the views of nurse leaders, from countries other than the United States, on global healthcare issues. The focus is on identifying healthcare management problems and their implications, research priorities, policy development, and ethical-moral dilemmas faced by nurse administrators. You are encouraged to send the names and addresses of international nurse leaders who might be interested in participating, as well as your ideas for format and content of the department.

Education, Nursing↗
PubMed1998

The nurse executive role in Hong Kong's transforming healthcare environment.

The goal of International Perspectives is to share the views of nurse leaders, from countries other than the United States, on global healthcare issues. The focus is on identifying healthcare management problems and their implications, research priorities, policy development, and ethical-moral dilemmas faced by nurse administrators. You are encouraged to send the names and addresses of international nurse leaders who might be interested in participating, as well as your ideas, for format and content of the department.

Education, Nursing, Continuing↗
PubMed1976

Consumer participation and social accountability.

Consumer participation in the planning and management of health care programs is prescribed as a method for increasing provider responsiveness to the goals and needs of users of services. However, issues related to the nature of mandates to implement consumer participation has not had the impact on policy development proposed for it. While structural changes can be identified which might enhance the consumer role in decision making, it will also be necessary for the consumer sector to develop a strategy which will prompt major rather than incremental movement.

Community Participation↗
PubMed1998

Reliability and validity of the adolescent health profile-types.

OBJECTIVES: The purpose of this study was to demonstrate the preliminary reliability and validity of a set 13 profiles of adolescent health that describe distinct patterns of health and health service requirements on four domains of health. METHODS: Reliability and validity were tested in four ethnically diverse population samples of urban and rural youths aged 11 to 17-years-old in public schools (N = 4,066). The reliability of the classification procedure and construct validity were examined in terms of the predicted and actual distributions of age, gender, race, socioeconomic status, and family type. School achievement, medical conditions, and the proportion of youths with a psychiatric disorder also were examined as tests of construct validity. RESULTS: The classification method was shown to produce consistent results across the four populations in terms of proportions of youths assigned with specific sociodemographic characteristics. Variations in health described by specific profiles showed expected relations to sociodemographic characteristics, family structure, school achievement, medical disorders, and psychiatric disorders. CONCLUSIONS: This taxonomy of health profile-types appears to effectively describe a set of patterns that characterize adolescent health. The profile-types provide a unique and practical method for identifying subgroups having distinct needs for health services, with potential utility for health policy and planning. Such integrative reporting methods are critical for more effective utilization of health status instruments in health resource planning and policy development.

Adolescent↗
PubMed2000

Health outcomes methodology symposium: summary and recommendations.

BACKGROUND: Interest in the philosophy and techniques of the assessment of health outcomes has burgeoned, prompting research funding agencies and others to examine traditional and emerging methods for outcome measurement. OBJECTIVES: This report summarizes the presentations and discussions at and research recommendations stemming from an invitational symposium on health outcomes methodology convened in September 1999. RESEARCH DESIGN: The summary is based on the preliminary drafts of all formal reports and discussions, transcripts of all presentations and plenary discussions, and notes from breakout groups. RESULTS AND CONCLUSIONS: Existing health outcomes measures drawn from classic test theory and emerging approaches based on item response theory offer exciting opportunities for appreciably expanded applications in biomedical and health services research, clinical practice and decision making, and policy development. The major research agenda reflects the significance of this field of endeavor, its widening acceptance both at home and abroad, and its increasing applicability to many different patient and user communities. Of particular moment are the following: (1) refining and expanding of measurement techniques that rely on item response theory and making these approaches more understandable to potential users; (2) improving measurement tools to make them more culturally appropriate for diverse populations and more conceptually and psychometrically equivalent across such groups; (3) addressing longstanding issues in preference- and utility-based approaches, particularly in the elicitation of preference responses and scoring instruments; and (4) enhancing the ways in which data from outcomes measurement tools are calibrated against commonly understood clinical and lay metrics, are interpreted, and are made usable for different decision-makers.

Cultural Diversity↗
PubMed2000

From theory to practice: community health nursing in a public health neighborhood team.

An interdisciplinary team in a local public health district tested its ability to implement the core public health functions of assessment, policy development, and assurance by changing its practice to a community-driven model of building partnerships for health with groups and communities in a designated locale. Evaluation of this innovation revealed that the public health nurse members of the team enacted their community health nursing knowledge to strengthen agency to cocreate health. Interdisciplinary collaboration was essential to the team's community mobilization efforts. Additional findings suggested that this organizational innovation was associated with developing a more participatory organizational climate, increasing system effectiveness, and building community capacity.

Community Health Nursing↗