Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Credentialing”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,405 records · Page 78Linked to original sources
PubMedDate not supplied

Proposed nurse educator competencies: development and validation of a model.

As the concern for adequate numbers of well-prepared nurse educators grows, the Council on Collegiate Education for Nursing, an affiliate of the Southern Regional Education Board (SREB), has developed and validated competencies to guide the preparation of nurse educators. The 37 competency statements reflect the requisite knowledge, skills, and abilities that all nurse educators must demonstrate within the roles of teacher, scholar, and collaborator. The competencies, together with the ideologies, values, and essential core knowledge from which the competencies were derived, are vital to guide educational programs preparing nurse educators and for structuring recognition and evaluation processes for certifying, credentialing, and accrediting bodies.

Faculty, Nursing↗
PubMedDate not supplied

State regulations for the pediatric nurse practitioner in acute care.

INTRODUCTION: In response to economic factors affecting health care costs in caring for acutely ill children, pediatric nurse practitioner (PNP) practice has expanded to include the acute care pediatric nurse practitioner (PNP-AC). With this change in practice and in educational preparation, there have been changes in credentialing, certification, and, in some cases, state regulations. This study was conducted to clarify the state regulations for the PNP-AC. METHOD: A survey of the practice chairs, executive directors, or both, from each state Board of Nursing and the District of Columbia (n=51) was performed to determine whether PNP-ACs are recognized in each state and if not, what they would need to do to become eligible for recognition. RESULTS: The majority of states (31) require that PNP-ACs take the AC certification examination, and 10 require the primary care examination. The remainder of the states have variations in their requirements. DISCUSSION: Because this is an area that is changing rapidly, PNPs working in acute care settings need to stay abreast of changes in their state requirements.

Acute Disease↗
PubMed2005

Chemical complementation: a definitive phenotypic strategy for identifying small molecule inhibitors of elusive cellular targets.

Forward Pharmacology seeks to identify small or large molecules that modulate a normal or abnormal biological process in living cells or whole organisms and historically has been responsible for the discovery of many clinically used drugs. Forward Pharmacology approaches have become particularly attractive because advances in combinatorial chemistry and laboratory automation have made it possible to generate and interrogate large compound collections in a short period of time. Because many drug discovery efforts are now directed against specific biochemical targets, however, the utility of Forward Pharmacology is limited by the fact that assays to investigate compounds in biological systems are often phenotypic rather than target specific. We discuss here a novel strategy to discover target-based small molecules in intact cells using contemporary Forward Pharmacology in cells with specific genetic manipulations. The method, which we have termed "chemical complementation", is defined as the ability of small molecules to reverse a genetically induced phenotypic change in intact cells. Chemical complementation represents an extension of the commonly used genetic complementation approach, where cDNA libraries are used to investigate the function of genes based on their ability to rescue a specific genetic defect. We present examples of how chemical complementation has been used to identify and credential cell-active, small molecule inhibitors of 2 dual-specificity phosphatases, Cdc25A and MKP-3, which heretofore have eluded small molecule drug discovery efforts.

Animals↗
PubMedDate not supplied

Preparing nurses for the 21st century: reenvisioning nursing education and practice.

Significant advances in biomedical science and in the complexity of health care, coupled with a worsening nursing shortage and numerous reports of unsafe and inadequate patient care, have prompted concerns about both nursing education and nursing practice. Beginning in 2000, the American Association of Colleges of Nursing (AACN) made a thorough study of nursing education, regulation, and practice issues. Input and consultation were sought from AACN members, nursing practice leaders, regulators, and other health professionals. Results of this work indicated the need for a new nursing professional, the clinical nurse leader, who could effectively coordinate, manage and evaluate care for groups of patients in complex health systems. Master's-degree education is proposed for piloting the preparation of clinical nurse leaders. Close coordination with nurse executives and administrators to develop the new education program and new models for care delivery is planned. Critical components of the pilot testing will be evaluation of the patient and nurse outcomes associated with the use of clinical nurse leaders and focused work to develop a new legal scope and credentials for them.

Education, Nursing, Graduate↗
PubMed2005

The next generation of respiratory therapists: student recruitment and selection.

Successful outcomes are vital for respiratory care education programs. These outcomes rely heavily on student recruitment and selection. Future graduates practicing respiratory care must have a basic understanding of respiratory care and possess the advanced skills that enable them to problem solve, communicate effectively, and become active leaders in the health care team. It is the responsibility of respiratory care educators to produce the respiratory therapists of the future. It is crucial for the faculty of respiratory care education programs to recruit and select candidates who will complete the educational program and develop the technical and critical-thinking skills needed to pass the advanced level credentialing examinations and succeed in the respiratory care profession.

Educational Measurement↗
PubMed2006

Obesity disease burden and surgical risk.

BACKGROUND: The rapid national expansion in bariatric surgical procedures has been accompanied by recent reports of significant complication rates. This has resulted in increased public scrutiny of bariatric surgery outcomes, restrictions on patient eligibility criteria by payors, and credentialing requirements for providers. This focus on outcomes has resulted in interest in bariatric risk analysis. METHODS: During an 8-year period, 1210 patients were evaluated for bariatric surgery. Clinical information was recorded prospectively. Co-morbid medical conditions were analyzed according to proven surgical risk factors: age, body mass index (BMI), and male gender. RESULTS: The prevalence of many co-morbid conditions and the total number of co-morbid conditions correlate highly with increasing age, increasing BMI, and male gender. CONCLUSION: The established surgical risk factors, age, BMI, and male gender, are markers for a sicker patient population, as evidenced by a greater obesity disease burden.

Adolescent↗
PubMed2004

Carotid artery stenting.

Efficacy for carotid artery stenting (CAS) has not been confirmed by randomized clinical trial methodology in conventional risk patients. Although carotid endarterectomy (CEA) is considered the preferred method for carotid revascularization in the management of patients with symptomatic and asymptomatic extracranial carotid occlusive disease, comparisons between CAS and CEA are now underway. In North America, the CREST (Carotid Revascularization Endarterectomy versus Stent Trial) protocol is now completing its lead-in or credentialing phase as randomization of cases is initiated. In Europe, the CAVATAS (Carotid and Vertebral Artery Transluminal Angioplasty Study) and Stent Protected Angioplasty versus Carotid Endarterectomy trials are recruiting symptomatic patients for randomization between CEA and CAS. It is anticipated that these trials will publish definitive results within the next 1 to 3 years, and help guide the referral of patients for CAS and CEA in the future.

Blood Vessel Prosthesis Implantation↗
PubMed2006

Do we need neurosurgical coverage in the trauma center?

The undersupply and maldistribution of neurosurgeons coupled with the apparent abandonment of trauma care by a significant number of rank and file neurosurgeons, and perhaps an over demand for their services, has created a crisis in access to neurotrauma care across the country. There is evidence to support that the immediate availability of a neurosurgeon to participate in the care of all trauma patients, including those who have documented head injury, may not be essential to providing optimal care, calling the American College of Surgeons' mandated criterion for trauma center verification into question. Given the volume, nature, and timeliness of head injury and its care, it seems this crisis can be resolved to a great extent by having trauma surgeons or other properly trained, credentialed, and monitored providers assume nonoperative, in-patient neurotrauma care when hospital admission is actually indicated. Although part of the solution lies in increased supply of neurotrauma services regardless of provider type, a second component rests in decreasing demand for these services in cases of mild and extremely severe head injury. Such a solution seems feasible and advantageous in several respects and should be seriously considered by healthcare policy makers, trauma system planners, and the leaders of the neurosurgical and trauma surgery disciplines. What is truly needed in hospitals treating trauma patients (ie, trauma centers) is a philosophy centered on patient services rather than the specific provider. What is needed is a provider who is committed, capable, and competent, who recognizes and meets the patients' needs and provides the appropriate services. These providers, regardless of pedigree, must be supported and valued by the healthcare system and society. In the future this may require regionalization of services. In some hospitals and systems the primary person responsible for providing these services will be a neurosurgeon. In others, it may not and perhaps need not be.

Brain Injuries↗
PubMed2004

The value of certification--a research journey.

ONE MEASURE OF NURSING EXCELLENCE is achieving specialty certification, which denotes a more advanced level of knowledge and practice. THE CERTIFICATION BOARD Perioperative Nursing (CBPN) provides specialty certification for perioperative nurses. The organization's mission is to be the leader in competency credentialing and education that promotes safe, quality patient care in the perioperative arena. THIS ARTICLE PRESENTS study findings regarding the perceived value of a barriers to obtaining certification.

Certification↗
PubMed1988

Origin and health risks of indoor radon.

Radon has always been a component of ground and air and it has been present in increased concentrations from the moment humans first sought shelter inside dwellings. Recent improvements in the energy efficiency of dwellings have led to increased concentrations of radon and to increased risks of lung cancer. To quantify the magnitude of this risk, well-designed epidemiological studies, including surveys of representative dwellings, are needed, and several are being implemented. In the meantime, the EPA and other agencies have offered guidance on monitoring procedures and remedial measures appropriate for the problem on indoor radon. Recent disclosures of relatively high concentrations of radon and radon decay products in homes in several parts of the country have increased public concern about the problem. More information and education are needed about the health risks of radon, the desirability of implementing monitoring procedures for radon, and about remediation measures when detected levels are above average. Educational resources are needed in communities to address local issues when they arise. These resources should include knowledgeable individuals who can work with state and county health officials to put public concerns into perspective within the local context. Physicians, other health professionals, and medical scientists have the knowledge and credentials to be these individuals. To provide health professionals with knowledge and skills to communicate with the public about the health risks of radon, the American Medical Association has prepared an authoritative report and initiated a series of regional seminars on the origin and health risks of radon.(ABSTRACT TRUNCATED AT 250 WORDS)

Air Pollutants↗
PubMed1996

Radiopharmaceutical regulation and Food and Drug Administration policy.

The regulatory policy of the Food and Drug Administration (FDA) on radiopharmaceuticals flows from a rigid, traditional, drug-like interpretation of the FDC Act on the licensing of radiopharmaceuticals. This contributes to significant delays in the drug-approval process for radiopharmaceuticals, which are very costly to the nuclear medicine community and the American public. It seems that radiopharmaceuticals would be better characterized as molecular devices. Good generic rule-making principles include: use of a risk/benefit/cost analysis; intent based on sound science; performance standards prepared by outside experts; a definite need shown by the regulatory agency; to live with the consequences of any erroneous cost estimates; and design individual credential requirements so that additional training results in enhanced professional responsibility. When these common elements are applied to current FDA policy, it seems that the agency is out of sync with the stated goals for revitalizing federal regulatory policies as deemed necessary by the Clinton administration. Recent FDA rulings on positron-emission tomography, Patient Package inserts, and on medical device service accentuate the degree of such asynchronization. Radiopharmaceutical review and licensing flexibility could be dramatically improved by excluding radiopharmaceuticals from the drug category and reviewing them as separate entities. This new category would take into account their excellent record of safety and their lack of pharmacological action. Additionally, their evaluation of efficacy should be based on their ability to provide useful scintiphotos, data, or responses of the physiological system it portends to image, quantitate, or describe. To accomplish the goal of transforming the FDA's rigid, prescriptive policy into a streamlined flexible performance-based policy, the Council on Radionuclides and Radiopharmaceuticals proposal has been presented. In addition, it is suggested that the United States Pharmacopeia write radiopharmaceutical review standards, that an independent scientific body review the data submitted, and that the FDA either accept or reject the recommendation.

Humans↗
PubMed2000

Minority recruitment and retention in dietetics: issues and interventions.

To better understand the reasons why minorities and males are underrepresented among registered dietitians (RDs) and dietetic technicians, registered, (DTRs) and to develop focuses for intervention, the investigators performed a telephone survey of newly credentialed RDs and DTRs and directors of RD and DTR education programs. Using lists of students recruited by the American Dietetic Association for participation in the survey, the investigators interviewed 83 RDs and DTRs and 20 education program directors. RDs and DTRs attributed minority underrepresentation primarily to the field's lack of visibility and underrepresentation of men to the traditional association with women. Education program directors attributed minority underrepresentation to educational disadvantages, particularly in scientific subjects. Findings from this study support program-level interventions such as increasing program flexibility, initiating outreach to K-12 schools and lower-division college students, providing tutoring in a nondemeaning atmosphere, and visibly expressing commitment to minority representation. More fundamental changes in the profession itself appear necessary for large-scale increases in minority representation. These include increasing internship opportunities; raising the profession's level of remuneration, prestige, and independence; increasing scholarship support; and advertising nationally through channels capable of reaching minorities.

Black or African American↗
PubMed2003

Position of the American Dietetic Association: child and adolescent food and nutrition programs.

It is the position of the American Dietetic Association that all children and adolescents, regardless of age; gender; socioeconomic status; racial, ethnic, or linguistic diversity; or health status should have access to food and nutrition programs that ensure the availability of a safe and adequate food supply that promotes optimal physical, cognitive, and social growth and development. Appropriate food and nutrition programs include food assistance and meal programs, nutrition education initiatives, nutrition screening and assessment followed by appropriate nutrition intervention, and anticipatory guidance to promote optimal nutrition status. Malnutrition has been linked to delayed physical, psychosocial, and cognitive development and is now recognized as a major contributor to the growing problem of overweight and obesity in the child and adolescent population. Food and nutrition programs create a safety net that ensures that children and adolescents at risk for poor nutritional intakes have access to a safe, adequate, and nutritious food supply and nutrition screening, assessment evaluation, and intervention. It is important that continued funding be provided for these programs, which have been consistently shown to have a positive impact on child and adolescent well-being. Food and nutrition programs will continue to serve not only as a means to combat hunger and food insecurity but also as a vehicle for nutrition education and promotion of physical activity designed to combat overweight and prevent chronic disease. It is the role of the credentialed dietetics professional to support permanent, adequate funding to food and nutrition programs, universal health-care reimbursement for nutrition services, and the use of research and surveillance programs to justify, evaluate, and improve these programs. In addition, the dietetics professional is responsible for serving as a nutrition resource to all groups and individuals working with children and adolescents, acting as an advocate for the establishment of child-care, school, and community settings conducive to the development of good nutrition habits. J Am Diet Assoc. 2003;103:887-893.

Adolescent↗
PubMed1995

Standards of practice for gerontological nutritionists: a mandate for action. The American Dietetic Association.

Dietitians who had been members of the Gerontological Nutritionists dietetic practice group for more than 2 years were sent a questionnaire to determine demographics of members and to ascertain their level of agreement and compliance with 26 suggested criteria and supporting documentation for standards of practice. Standards of practice for gerontological nutritionists were based on the six Standards of Practice of The American Dietetic Association. Of the 1,571 questionnaires mailed, 415 were returned. Data were analyzed using the StatPac Gold statistical analysis package. All correlation analyses were positive with correlation coefficients in the range of 0.0 to 1.0. Correlation coefficients and mean scores were highest for the standards related to maintaining credentials and adhering to a code of ethics. Compliance was weakest for standards related to conducting research to justify reimbursement for nutrition services (correlation of 0.22) and advocating public policies to ensure quality nutrition care and dissemination of information (correlation of 0.25). Results indicate that to comply with the standards of practice, members need to be proactive in showing efficacy and cost-effectiveness of medical nutrition therapy; conduct, document, and apply outcome research to practice; and advocate public policies affecting older people.

Aged↗
PubMed1998

Patients report positive nutrition counseling outcomes.

OBJECTIVE: Assess outcomes of patient nutrition counseling. DESIGN: A descriptive study based on the results of a telephone interview performed 2 to 8 weeks after counseling. SUBJECTS/SETTING: Subjects were 400 adult patients referred for nutrition counseling at 2 academic health centers. Of these, 274 patients received nutrition counseling during hospitalization and 126 as outpatients. STATISTICAL ANALYSIS: Descriptive statistics were used to summarize data and the Mann-Whitney U statistic and logistic regressions were used to test significant differences (P < .05) between inpatient and outpatient counseling outcomes. RESULTS: Most patients (83%) gave a partial or full description of their diet modifications and 79% had a moderate or good understanding of their diet. Most patients reported that the dietitian's advice was suited to their special needs (88%) and that they knew what to eat (83%). A majority (62%) had made dietary changes, but 17% said they had had trouble changing their diets as suggested. After talking with a dietitian, 57% felt better emotionally, 37% felt better physically, 64% felt in control of their condition, and 43% noticed improved health indicators. Initial analysis indicated that outpatients reported better outcomes than inpatients; further analysis showed that these differences could be attributed to younger ages among the outpatient sample. APPLICATIONS/CONCLUSIONS: Patient nutrition counseling has positive outcomes. Therefore, key counseling points should be introduced or reinforced in inpatient settings, in conjunction with multiple-session protocols during the pre- and/or posthospitalization continuum of care. Dietitians, managers, administrators, and credentialing agencies should work together to secure and promote the necessary physical, personnel, and financial resources to make this happen.

Adult↗
PubMed2000

The future of medical education is no longer blood and guts, it is bits and bytes.

In the United States, medical care consumes approximately $1.2 trillion annually (14% of the gross domestic product) and involves 250,000 physicians, almost 1 million nurses, and countless other providers. While the Information Age has changed virtually every other facet of our life, the education of these healthcare professionals, both present and future, is largely mired in the 100-year-old apprenticeship model best exemplified by the phase "see one, do one, teach one." Continuing medical education is even less advanced. While the half-life of medical information is less than 5 years, the average physician practices 30 years and the average nurse 40 years. Moreover, as medical care has become increasingly complex, medical error has become a substantial problem. The current convulsive climate in academic health centers provides an opportunity to rethink the way medical education is delivered across a continuum of professional lifetimes. If this is well executed, it will truly make medical education better, safer, and cheaper, and provide real benefits to patient care, with instantaneous access to learning modules. At the Center for Advanced Technology in Surgery at Stanford we envision this future: within the next 10 years we will select, train, credential, remediate, and recredential physicians and surgeons using simulation, virtual reality, and Web-based electronic learning. Future physicians will be able to rehearse an operation on a projectable palpable hologram derived from patient-specific data, and deliver the data set of that operation with robotic assistance the next day.

Allied Health Personnel↗
PubMed2001

The learning curve and sentinel node biopsy.

BACKGROUND: The ability of sentinel node biopsy (SNB) to replace axillary node dissection for accurate breast cancer staging is absolutely dependent on the consistent and accurate determination and removal of the "true" sentinel node. There are a wide variety of variables that affect the ability of the physician to achieve this goal. One important and potentially controllable variable is physician training and competence to employ the available techniques successfully. There is a large diversity of opinion regarding the minimum number of cases required under supervision prior to independent utilization of the technique but there are data to support at least 20 cases done in conjunction with axillary dissection or under direct supervision. METHODS: Data from single institution and multicenter trials are reviewed and the learning curves are described. An overview of surgical education methods, testing, and credentialing is also addressed. RESULTS: A review of single institution series show that the false negative rate and identification rates vary considerably. In all cases where authors published a second series success rate improved compared with their initial series. Of the four multicenter trials only two can provide reliable learning curves and these have shown a decrease in the false negative rate to < or = 5% after 20 to 30 procedures are performed. CONCLUSIONS: There are data to show that there is a definite learning curve for SNB that cannot be ignored. It is possible that other factors, (ie, a skin injection with technetium-99, Sappeys plexus injection, and mentoring) could decrease this learning curve but until compelling evidence to suggest otherwise is available, surgeons should obtain a minimum experience of 20 cases.

Clinical Competence↗
PubMed2002

A comparison of rates of lymph node metastases between patients undergoing sentinel and axillary lymphadenectomy.

BACKGROUND: Recommendations regarding credentialing for sentinel lymphadenectomy in the staging of breast cancer emphasize the need for a trial period during which novice surgeons remove both the sentinel lymph node and the axillary packet, to demonstrate acceptably low rates of both operative failure and inaccuracy. METHODS: We initiated sentinel lymph node mapping in our institution without planned axillary dissection. To establish our ability to accurately stage patients using sentinel lymphadenectomy, we compared 225 patients who underwent that procedure and 343 patients previously staged with axillary lymph node dissection. RESULTS: No differences in node positivity were found between the two groups. Among sentinel lymphadenectomy patients, no differences were found between patients in the first and second half of the institutional experience. CONCLUSIONS: We question the need for a trial period of planned axillary node dissection with sentinel lymph node mapping, and review the evidence from other investigators regarding its necessity.

Axilla↗