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An institutional staff training and self-management program for developing multiple self-care skills in severely/profoundly retarded individuals.

Although considerable attention has been given to the development of institutional staff training and management programs, the generalized effects of such programs on staff and resident behavior have seldom been examined. This study evaluated a program for teaching institutional staff behavioral training and self-management skills during self-care teaching sessions with severely and profoundly retarded residents. Following baseline observations in three self-care situations (toothbrushing, haircombing, handwashing), four direct care staff were sequentially taught to use verbal instruction, physical guidance, and contingent reinforcement in the toothbrushing program. During maintenance, staff were simultaneously taught to record, graph, and evaluate resident and their own behavior in the toothbrushing sessions. Staff were taught use of the training and self-management skills through a sequence of written instructions, videotaped and live modeling, rehearsal, and videotaped feedback. Observer presence and experimenter supervision were gradually decreased during the maintenance condition. Results indicated that during training and maintenance staff: (a) learned to use the training skills appropriately and consistently in the example situation (toothbrushing); (b) applied the skills in the generalization situations (haircombing and handwashing); and thereafter (c) maintained consistent and appropriate use of the skills with infrequent supervision. In addition, important changes in retarded residents' independent self-care responding occurred as staff training skills developed. Results are discussed in terms of their implications for future research and continued development of effective staff training and management programs.

Activities of Daily Living↗

Breaking the boundaries: collaborating to develop a model ventilator training program.

Changes in the health care system have created new opportunities for acute care nurses to establish collaborative relationships with their rehabilitation partners. When a rehabilitation facility decided to establish a ventilator weaning rehabilitation program, an acute care facility joined forces with the institution to develop an educational plan for the nursing staff. The development and implementation of the educational program as well as the collaborative relationship established between the two facilities are highlighted in this continuing education article.

Curriculum↗

Development of an ostomy competency.

Staff educators and staff nurses developed an ostomy competency, with the guidance and expertise of the advanced practitioner and enterostomal nurse at a large teaching hospital. The competency improved the quality of care for surgical ostomy patients. Care was standardized and staff nurses' clinical knowledge was enhanced. Following the sessions, staff nurses verbalized increased confidence in working with patients with ostomies and demonstrated increased autonomy and problem-solving abilities. No variances in educational aspects of care were noted on clinical pathways.

Clinical Competence↗

The quality improvement process: one approach to education.

Quality improvement (QI) is a practice now expected of the healthcare industry. The Joint Commission on Accreditation of Healthcare Organizations has incorporated continuous QI into its standards; furthermore, the implementation of QI is a major challenge facing healthcare institutions today. The authors describe the educational approach taken by one institution as it implemented the QI process in a facility that recently merged three acute care hospitals and explain the necessary commitment and structure for a successful QI program. The importance of the educational process cannot be overemphasized.

Education, Continuing↗

The effects of training in nonaversive behavior management on the attitudes and understanding of direct care staff.

Recent developments in behavior therapy for persons with developmental disabilities and behavior disorders emphasize positive treatment designs that focus on understanding the causes of behavior, teaching functional alternatives, and enhancing the quality of daily experiences, rather than simple contingency management. There is little information on how well direct care staff can support these nonaversive strategies. This study examined the effects of training in traditional (positive) behavior management versus nonaversive principles on the understanding and attitudes of direct care staff. Overall, nonprofessional level staff receiving the nonaversive training showed increased sophistication in understanding the range of possible causes of behavior and were able to generate treatment suggestions based on skill development and environmental change. The effectiveness of staff in implementing state-of-the-art behavior therapy procedures is likely to be an important component of the continued success of behavior therapy, especially in residential settings, both institutional and community-based.

Adult↗

Leadership development: a collaborative approach to curriculum development and delivery.

The Leadership Programme in the National Health Service, Lanarkshire, Scotland began in 2002. The programme has been endorsed by the employer, accredited by a higher education institution and approved by the National Health Service Education Board in Scotland as a recognised continuing professional development programme. The success of the programme is due to the combined efforts of the teaching team from the Practice Development Centre, the different stakeholders within the health service in Lanarkshire and Queen Margaret University College, Edinburgh. The focus of this article is the nature of the collaboration between the partners from the initial ideas to the initiation, validation and ongoing delivery of the programme. The article will provide an account of the criteria for partners and key features of the collaboration as well as quality assurance aspects. It will also draw upon the outcomes of the programme in terms of student views and achievement as well as the benefits to the partners.

Adult↗

The implementation of problem-based learning: changing pedagogy in nurse education.

Problem-based learning (PBL) employs approaches to teaching and learning in nurse education that develop meaningful links between theory and practice. The adoption of such approaches, however, may require changes in pedagogical beliefs and practices which reflect a student-centred approach to teaching and learning. This paper focuses on a group of volunteer nurse educators (n = 14) who attended a 7-month professional development programme centred on introducing pedagogical changes when adopting PBL. From this group, three nurse educators participated in an in-depth study which aimed to examine the processes of conceptual change associated with adopting PBL as part of alternative teaching strategies. These three participants held common concerns about the changes required to their current teaching practices when moving to a new pedagogical approach. On completion of the programme, varying degrees of change in existing instructional practices were evident. This change was found to result from engaging educators in reflection about practice, providing opportunities to implement the new approaches on a trial basis, and providing feedback and support throughout the change process.

Education, Nursing↗

Systematic planning of continuing nursing education.

To avoid omissions and to promote efficient use of time, it is important to plan continuing nursing education (CNE) activities systematically. A detailed and comprehensive planning checklist is provided to assist the novice planner to organize and implement a CNE offering competently.

Congresses as Topic↗

Involving doctors in management. A survey of the management development career needs of selected doctors in NHS Wales.

Reports the results of a survey of 209 senior registrars and 269 consultants throughout Wales to identify the management development needs of doctors and ascertain their views of the value and utility of current management development course offerings in Wales. Finds that, currently, management development for doctors in Wales is unstructured and uncoordinated but, despite this, many doctors, especially senior registrars, appeared keen to increase their future involvement in management and held positive views regarding management and management development. The questionnaire also required doctors to rank order six managerial topics and their elements: financial, human resource, strategic, operational, service quality and self-management. Of these, self-management issues were rated highest and there was some congruity in the rankings of the six topics by senior registrars and the other three consultant categories. Overall, managing a budget, medical and clinical audit, negotiating skills and leadership skills were ranked highest for inclusion in management development while project management, quality circles and equal opportunities received the lowest ratings.

Attitude of Health Personnel↗

Business planning: learning by doing.

Places business planning in health care within a contextual and conceptual framework as a background to describing a development programme for the NHS in Scotland to facilitate the learning of key managers about the business planning process. The programme highlighted a "learning-by-doing" approach, whereby a number of change initiatives were triggered and future prospects for planning and learning identified.

Administrative Personnel↗