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PubMed2006

Continuing medical education: a needs analysis of anaesthetists.

The continuing medical education (CME) needs of anaesthetists within Australia, New Zealand, Hong Kong, Malaysia and Singapore have been largely unknown. The aim of this study was to undertake a comprehensive survey of the attitude to CME, learning preferences, attitudes and abilities relating to self-paced material, literature and information searching, preferred content and preferred approach to CME of anaesthetists within these countries. A survey tool was developed and refined for ease of use by pilot-testing. The survey was mailed to 3,156 anaesthetists throughout Australia, New Zealand, Hong Kong, Malaysia and Singapore. Three options for data return were offered; postal reply, facsimile and a data entry web-page. There were 1,800 responses, which represented a response rate of 57%. The demographics of the respondents were similar to the overall demographics of Fellows of the Australian and New Zealand College of Anaesthetists. A large majority of respondents (92%) stated that their involvement in CME improved patient care. However, almost half the respondents reported that they have difficulty either in participating in current CME activities (31%) or implementing new knowledge into their workplace (14%). Anaesthetists within this region appear to be motivated by the need to make better decisions based on independent standards of practice. While Australia is a world leader in flexible education, it is still emerging as a discipline. Flexible education may be used to facilitate anaesthetists' participation in CME activities and in implementation of new knowledge in their workplace.

Anesthesiology↗
PubMed2006

Practice education: delivering the vision.

While acknowledging the inherent challenges of the practice education rhetoric being translated into reality, the aim of this paper is to examine the challenges, issues and innovations surrounding the delivery of education in practice within a departmental context. Organisational context, national initiatives, political directives and departmental challenges were added to the intrinsic educational issues which were required to be addressed in order for the authors' shared educational vision to be delivered within their own sphere of responsibility.

Education, Nursing, Continuing↗
PubMed2006

International health links: an evaluation of partnerships between health-care organizations in the UK and developing countries.

Increasingly, international health links are evolving between UK health-care institutions and those in developing countries, the core aims of which are to seek the transfer of ideas, knowledge, skills and training. This study aimed to evaluate established health links, what constitutes them and how they are supported. Benefits and challenges associated with the links, as perceived both by link coordinators in the UK and their overseas partners, were explored. Fourteen links between health-care organizations in the UK and those in developing countries were identified and interviews were successfully conducted with 22 link coordinators: 13 in the UK and nine in developing countries. The interviews indicated that health links offer mutual benefits to both partners in terms of shared skills and the promotion of global awareness. Links can act as important catalysts; stimulating increases in institutional capacity for research and training. They provide opportunities for personal and professional development of staff and promote the development of friendships and supportive networks between diverse communities. Many of the health links showed signs of evolving from uniprofessional links between individual institutions into broader, multidisciplinary community partnerships. The main challenges facing health links arise from cultural differences, funding problems, communication difficulties and bureaucracy. There was broad agreement that greater recognition of the value and importance of health links by the NHS and closer collaboration between government departments to provide support and resources could promote wider and more effective link partnerships.

Africa South of the Sahara↗
PubMed1992

Building a home care therapy department.

Therapy services have been less visible in home care than other services, which raises the question of a serious patient need that is not being met. Agencies need to put more emphasis on therapy, including recruiting and retaining quality therapists to address community and patient needs.

Administrative Personnel↗
PubMedDate not supplied

Five years in the life of a nursing research and professional development division.

The Nursing Research and Professional Development Directorate was established to support the growth of research of professional practice in the Nursing Department. Designed as an innovative work structure, it elicited high commitment from its members, contributed to their satisfaction and freed their creative potential. The organizational structure and processes were designed to satisfy the important work criteria of involvement in decision-making, equity, dignity, security, job challenge, autonomy, mutual trust and open communication. The Directorate not only brought together expertise in research and professional development but also created mechanisms to ensure the expertise was available at the bedside. With a mandate of developing and transmitting knowledge, the availability of that knowledge in the practice arena is a mark of our success. This article describes our formative experiences including the structure, processes and outcomes of our work. The challenges we faced are also discussed.

Humans↗
PubMed1992

[Current and future work roles of hospital nursing directors].

This study has three aims: 1) to examine the present role of hospital nurse directors; 2) to find out what changes will occur in their role in the near future; and 3) to explore what their future role should be. The data were collected by a means of a mail questionnaire in winter 1990 from 50 nurse directors and 42 chief physicians of departments and 50 head nurses of wards from five Finnish university hospitals and from five other large acute hospitals. The nurse directors assessed their present role as being the most active and the head nurses as the least active in the examined 27 leadership functions. Largest differences were found in the evaluation of the hospital nurse directors' present role between the nurse directors themselves and the head nurses. However, in respect to the future work role the head nurses and nurse directors had rather similar expectations. Both emphasized research and development of the nursing staff and nursing care. The chief physicians thought that nurse directors should concentrate more on the internal leadership functions of the hospitals such as personnel management, solving the conflicts between the staff and performing routine functions of personnel management. The nurse directors themselves emphasized the external functions of hospitals in their present and future work role, such as networking and negotiations outside the hospitals and financial management. The differences in the evaluations of the present role and in the expectations concerning the future role of nurse directors indicate conflicting views between the the three groups. All respondents perceived nurse directors as being important and needed in hospitals. They also considered that non-nurses cannot function as directors of nursing services.

Clinical Nursing Research↗
PubMed1997

Studying the future: a Delphi survey of how multi-disciplinary clinical staff view the likely development of two community mental health centres over the course of the next two years.

Two community mental health centres (CMHCs) in North Staffordshire, England were the sites for a recent Delphi survey of multi-disciplinary clinical staff. The views of staff were sought on the likely developments over the next 2 years, at the CMHC where they worked. Each group of staff independently produced healthy numbers of suggestions, with few contradictions; and displayed predominantly positive attitudes, both towards particular suggestions and the future in general. Summarized results were classified within seven themes, producing similar distribution patterns for both CMHCs. The most frequently occurring themes were changing staff roles and CMHC functions and developments in therapies and skills. Mid-placed themes concerned community development and communication/continuity. The least frequently reported themes covered general management, user involvement and quality assurance. Issues raised by the study are discussed and related to other published works, followed by consideration of how the findings might be utilized. Clinical staff have generated a large number of suggestions and, importantly, via rounds of confidential voting, indicated the group consensus on each item. Consequently, management of change should stand a high chance of success. Finally, one means of taking the findings forward is described.

Attitude of Health Personnel↗
PubMed1998

The Extended Staff Observation Aggression Scale (SOAS-E): development, presentation and evaluation.

The Staff Observation Aggression Scale (SOAS) was developed as a scale for reporting aggressive incidents involving psychiatric in-patients. The SOAS -- Extended Version (SOAS-E) has the same aim, but has additional categories and subcategories. The SOAS-E clearly distinguishes between violent and non-violent aggressive behaviour and characterizes in more detail the associated situation. However, the main contribution of the SOAS-E is the introduction of a category of 'warning signals' that precede the releasing 'provocation factor' as a separate and primary aspect of the cyclus of aggressive incidents. The development of the SOAS-E is described, and the testing and inter-rater reliability of the warning signals category are examined. Compared to the SOAS, the additional categories of the SOAS-E are found to increase the scope for a detailed characterization of aggressive behaviour in psychiatric wards.

Adult↗
PubMedDate not supplied

Clinical governance development needs in health service staff.

This paper reports on a study to ascertain the development needs in terms of clinical governance of 220 health service staff across all the key professions from primary and secondary care, including chief executives and clinical governance leads. Interviews suggested that the development of clinical governance was progressing through the structures created by the leads, and that there was considerable goodwill shown towards it in most of the interviews conducted. Of the participants 69 per cent had heard of clinical governance, though detailed knowledge was rare. The author suggests that development overall needs to be carried out using a multi-disciplinary and multi-agency approach where possible, perhaps using pathways of care. It needs also to take account of the expressed fears from medical staff of discussing their care in a multi-disciplinary setting, and of the two potential conflicting themes that are apparent to chief executives of change towards no-blame cultures, while encouraging account-ability and the recognition of risk.

Governing Board↗
PubMed2005

Development of an index to measure oral health care priority among nursing staff.

OBJECTIVE: To develop an index to measure oral health care priority among nursing staff. BACKGROUND: Nursing staff, working on hospital wards, at nursing homes and at other facilities, have to deal with oral health care and there are many reports about the low priority that is given to oral health care by nursing staff. It is difficult to measure oral health care priority among nursing staff. A Dental Coping Beliefs Scale (DCBS) index was used in an intervention study and was found to be easy to handle but did not have the ability to reveal significant differences in small study samples. A development process consisting of added items and item numbering by chance was carried out. During this process, different nursing staff test groups were used. The aim was to develop an oral health care priority index that can be used both on hospital wards and at special facilities to measure oral health care priority among nursing staff over time and between groups. MATERIAL AND METHODS: Nursing staff at both special facilities and hospital wards and nursing students. RESULTS: It was found that the index, the nursing DCBS, was more stable compared with the version that was used in the initial intervention study. It was also noted that its ability to discriminate between the items was improved. CONCLUSION: The nursing DCBS index is a suitable tool for use in further studies where the aim is to measure how different nursing staff groups give priority to and allocate responsibility for oral health care, even where study samples are small.

Adaptation, Psychological↗
PubMed1986

A multidisciplinary patient education workshop to integrate staff training with program development.

A four session multidisciplinary workshop was held to teach Veterans Administration (VA) Medical Center staff basic patient education design principles. During the sessions, staff, working in teams, designed patient education programs on a wide variety of health care topics. Guidance to teams was provided at each step of program development so that at the end of the workshop, programs were ready for implementation. Medical Center standards for patient education and documentation were integrated into program designs.

California↗
PubMed1990

Implementing a philosophy of care on a children's ward using action research.

This paper charts the progress of an action research project initially implemented to assist the staff of a pediatric ward in the development of primary nursing. The use of ward meetings to identify needs and clarify objectives is discussed; from this emerged a broader remit to implement the ward's philosophy of care. Five areas of clinical practice development were identified for work: development of a staff development strategy, identification of resource people, movement to primary nursing, development of standards of care, and development of the ward environment. Progress in these five areas is explored, and the use of evaluation strategies such as visual analogue scales, unstructured interviews and personal diaries are discussed. Description and discussion of some of the difficulties associated with this project are given. In conclusion, the authors address the issue of whether action research is in fact a specific methodology or a philosophy.

Clinical Nursing Research↗
PubMedDate not supplied

How to facilitate the orientation of new nurses into the workplace.

The orientation of new nursing graduates into the workplace is an impressive challenge. A research study was performed to identify the key elements of a program that would address the various issues regarding this orientation. A team of researchers from Laval University and the Centre Hospitalier Universitaire de Quebec (CHUQ) used a descriptive and participative research method and identified five key elements that must be considered in order for this orientation to succeed.

Clinical Competence↗