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PubMedDate not supplied

Reaching and educating the global tobacco control community: innovative approaches to tobacco control training.

To slow and end the growing global burden of tobacco-related death and disease, schools of public health need to provide tobacco control education and training for public health professionals generally, and for the next generation of tobacco control professionals in low- and middle-income countries specifically. As the tobacco epidemic continues to grow, there is an increasing need for training to develop the research and intervention skills required to stem the epidemic and reduce the inevitable burden of disease and death. A wide range of educational approaches has been developed to increase tobacco control educational capacity in high-, middle-, and low-income countries, including traditional on-site classes, on-line courses, open source courseware, summer school programs, and training workshops. This article provides a perspective on the education and training needs of tobacco control researchers around the world and reviews the strengths and weaknesses of education and training approaches currently being used in tobacco control by schools of public health. In each case, we draw on the experience of the Johns Hopkins Bloomberg School of Public Health in educating national and international audiences in tobacco control.

Baltimore↗
PubMed1997

Trends in medical equipment service.

Driven by the recent emphasis on cost containment in the healthcare industry as a whole, hospitals, manufacturers, and service providers have been spurred to try to find ways to reduce their costs and increase their revenues. As a result of the measures taken to achieve these goals, the medical equipment service industry has been experiencing a period of rapid change. In this environment, traditional alternatives for servicing medical equipment are being challenged, and new alternatives are being developed. The changes occurring in this industry are of vital interest to clinical engineers and technicians because it is those changes that will determine the future role of these professionals in the hospital. While such technology experts will not become obsolete-the reliance on medical technology to provide optimal healthcare will certainly continue in the United States and throughout the rest of the developed world-the roles of these experts could very likely change. As hospitals focus more narrowly on their core functions, noncore functions such as servicing and managing technology will come under scrutiny as possible candidates for outsourcing to reduce the hospital's administrative responsibilities and cut its cost burden. In this article, we review the recent past of the medical equipment service industry and describe some current trends that will play a role in shaping the future of this industry. We also discuss how the changes currently taking place will likely affect the viability of in-house clinical engineering departments. In our discussion, we spotlight service issues related to radiology equipment because (1) this equipment dominates service expenditures and (2) the servicing of these devices has spawned some of the changes causing hospitals to reexamine how all their medical equipment is being serviced and managed.

Contract Services↗
PubMed1999

[Monitoring quality of health care using indicators].

In a modern health care system continuing measurement and monitoring of relevant clinical data comprise the base of documentation for the quality of care. Internationally there has been increasing focus on monitoring and measuring the quality of care using principals from clinical epidemiology, including quality monitoring using clinical indicators. Indicators can be derived with regard to structure, process and outcome. The indicators should be in a form which can be used within the individual department and for comparison between hospitals nationally and internationally. The idea of professional indicators is to be able to track developments over time, as well to be able to respond at relevant times. The work with quality indicators will support continuing work with quality development in the medical specialities as well as giving a possibility for dialogue between politicians, the management system and the medical specialities about priority of resources and the structure of the hospital system, which extend further than the simpler issues of finance, which have been dominating until now.

Denmark↗
PubMed2003

Ethical issues in palliative care: considerations.

Discussions on ethics in palliative care often concentrate on issues like patient autonomy or euthanasia. However, the reality in the developing world begs discussion on an entirely different set of problems altogether. One should have a good death, no doubt, but one should also have an opportunity for a good life. Globalization unfortunately seems to worsen many of the burdens of the developing world, like the negative influence of the mighty pharmaceutical industry. Continuing medical education offered only by the pharmaceutical industry instills bias into the minds of most medical professionals. Prescription practices by many professionals are influenced by the industry; so much so, inexpensive drugs or formulations are abandoned in favor of expensive ones, adding to the burden of a much-suffering individual. Palliative care should have been a major force against such evils, but it seems to get more clinical and institutionalized with time, with the social issues taking a back seat. Unethical research practices and preferential treatment in drug availability are practices that continue to marginalize the less privileged. Adoption of the dominant ideology from the West in the developing world also raises problems like cultural unsuitability. Considering that the bulk of the suffering in the world is in poorer countries, these issues need to be addressed.

Analgesics, Opioid↗
PubMed1989

Medical education: how is change to come about?

The challenge to medical education as we enter the last decade of the century and face the next millenium is how to utilize the new knowledge of human learning to train medical students in applying the fruits of rapidly advancing science and technology to the moral imperative of fulfilling social needs. To bring about the reforms defined in the Edinburgh Declaration, adopted as globally applicable by the World Conference on Medical Education, intrinsic and extrinsic elements must act in synergy. The intrinsic elements are teachers, students and institutional frameworks; the extrinsic elements political will, administrative commitment and societal pressure. In the developing world, while there is much that medical schools themselves can do through intrinsic changes, their dependence on government support is so pervasive that such government support becomes an essential prerequisite for change. The creation of a cohesive organizational framework involving health and education ministries, the academic sector and professional bodies for a systematic and continuing study of medical education and for inducing and sustaining change are essential to facilitate the change process.

Developing Countries↗
PubMedDate not supplied

Impact of management development on nurse retention.

PURPOSE: Nurse retention is essential to maintain quality healthcare organizations. In an effort to mitigate the loss of nurse managers, a management education program was created for new and transitioning nurse managers that included scholarships for nurses from long-term and rural acute care settings. Program evaluation was based upon the outcomes of anticipated turnover and employee satisfaction. DESIGN AND METHODS: Using a preprogram and postprogram evaluation, the Index of Work Satisfaction (IWS) and the Anticipated Turnover Scale (ATS) were used to survey participants. Descriptive statistics as well as Wilcoxon statistics for group comparisons were used for analysis. FINDINGS: ATS scores were significantly reduced (P < .05) for all program participants. Further analysis of scholarship recipients indicated that the management program significantly increased their intent to stay (P < .08) in their current positions. However, because of a large rate of attrition, findings can only be considered preliminary. CONCLUSIONS: While the high level of attrition among the scholarship recipients is disappointing, potential attendance barriers are discussed, particularly from long-term care settings. Management development programs may improve the satisfaction and retention of critically needed managers and enhance development of future nursing leaders.

Adult↗
PubMedDate not supplied

An educational program to prepare acute care nurses for a transition to home health care nursing.

This article describes a continuing education program that prepares nurses with experience in acute care nursing for the transition to home health care nursing. The program is a 12-credit hour, two semester college program consisting of 8 hours of theory and 4 hours of clinical practicum. A coalition of hospitals, home health agencies and an educational institution designed the program to maintain the economic welfare of nurses in an era of hospital layoffs, promote professional development and enhance the transition of nurses to home health nursing.

Acute Disease↗
PubMed1999

Advancing social work practice in end-of-life care.

Insufficient training of health professionals has often been cited as a major barrier to improving the system of care for dying patients and for the bereaved. Although specific problems have been identified for physicians and nurses, the problems of social work in this substantive area have only recently been explored. This study used a practitioner survey, focus groups, and a survey of faculty of schools of social work to broaden the information base. Results suggested that not unlike the professions of medicine and nursing, social work knowledge and skill development in the care of the dying is uneven and not integrated sufficiently with theoretical concepts and research. Social workers felt unprepared for this work by their master's level training and unsupported by continuing education programs. They recognized few social work scholars who could function as role models by providing comprehensive training, knowledge building, innovation, and advocacy. A program for leadership development was created to test new approaches to professional development in the care of the dying and the bereaved.

Bereavement↗
PubMed1991

Implementing a ventricular assist device program. A partnership between nursing and clinical engineering.

VAD programs continue to expand as research evolves and this treatment modality becomes more available. Implementation of these programs requires a strong commitment to team development, collaboration, and ongoing education. We believe that the partnership between nursing and clinical engineering captures these key aspects. This alliance facilitates learning and professional growth and supports overall program goals. Beyond VAD programs, medical and technologic advances will continue to have an impact on the critical care environment, increasing the complexity of patient care. Our successful partnership has set the stage for essential collaboration between nursing and clinical engineering in the future.

Biomedical Engineering↗
PubMedDate not supplied

Personal professional profiles.

This article reports the results of a study into the use of personal professional profiles by nurses, midwives and health visitors in an NHS trust. The author discusses factors in profile development, compares profile use between grades and attempts to identify the need for in-service education and support for profile development.

Adult↗
PubMed1992

Clinical practice guidelines. The Agency for Health Care Policy and Research fosters the development of evidence-based guidelines.

As medical technology increases rapidly and becomes more complex, clinical practice guidelines can help healthcare providers assess current practices and integrate technological advances. Through the Agency for Health Care Policy and Research (AHCPR), the federal government has begun to facilitate the development of clinical practice guidelines. Expert or contract panels, authorized by the AHCPR, develop guidelines on specific clinical conditions. The AHCPR guideline methodology is designed to produce evidence-based guidelines that are valid, clinically applicable, and clinically flexible. Each panel spends a year or more developing the guideline, beginning with an extensive literature search and review. The panel prepares evidence tables, statistically analyzes aggregate data (where appropriate), conducts harm and benefit analyses, and prepares health policy analyses (or cost-impact studies). During this process, the panel holds an open forum to solicit comments on the guideline topic. After this public discussion, the panel prepares a final draft of the guideline. Several hundred individuals review the guideline. Some policymakers believe clinical practice guidelines can lead to better healthcare outcomes. Guidelines can provide information in a useful format for clinicians to use at the bedside or the point of decision making in patient care. Guidelines also provide information that can be used in continuing education and professional education programs.

Decision Making↗
PubMed1996

Benefits of training dietetics students in preprofessional practice programs: a comparison with dietetic internships.

OBJECTIVE: To conduct a nationwide study on the opinions of dietitian preceptors regarding the intangible benefits to hospitals and medical centers of training dietetics students in approved preprofessional practice programs (AP4s) and to compare the findings with a similar survey of dietetic internships. DESIGN: A questionnaire was adapted from a 1990 study of preceptors in dietetic internships to investigate the benefits of training dietetics students in AP4s. SAMPLE: Program directors and dietitians who supervise and teach students in the 117 preprofessional programs approved by The American Dietetic Association were sent pretested questionnaires. Responses to the survey were received from 312 dietitians who supervise students in 74 practice programs. STATISTICAL ANALYSIS: Descriptive statistics were used to calculate frequency of response. t Tests were used to compare mean differences between the opinions of preceptors in AP4s and internships. Analysis of variance and Scheffe post-hoc test were used to determine the demographic characteristics related to the dietitians' opinions of benefits. RESULTS: Strongest agreement (agree to strongly agree) was found for three items: sense of satisfaction from seeing students develop as professionals (4.34); belief that teaching students makes the job more interesting (4.17); and real sense of achievement in working with students (4.05). Significant differences were found between the groups on six items and, in all but one instance, the internship preceptors were more in agreement with the statements on intangible benefits than the AP4 preceptors. APPLICATIONS/CONCLUSIONS: The preceptors generally agreed that intangible benefits exist for departments that are AP4 sites and the professionals that work in them. As programs develop from AP4s into accredited internships, examination of intangible and monetary benefits may affect the continuation of dietetics training programs.

Cost-Benefit Analysis↗