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Women's health. Changing definitions; changing times.

The implications of the above observations and questions are far from prescriptive. During this time of rapid social change and economic retrenchment, there is a need for both individual and professional clarification of values. An awareness of one's philosophy of life and philosophy of nursing requires constant re-evaluation and may reflect personal developmental changes, changes within nursing, and changes in social demands. Woods' schema for evaluating health phenomena by considering variables in context and with an awareness of developmental dimensions might well be used as a model for such personal and professional self-evaluation. It is only following such efforts that it will be possible to make knowledgeable decisions about the relationship between philosophy and public policy, personal/private behavior, and public/social consequences. Social change is invariably accompanied by a disquieting ambivalence. Whether one agrees with the philosophies of the women's health movement, one fact is clear. Change has occurred and it is no longer possible to ignore the paternalistic tendencies within the health care field. When lay magazines proclaim that the women's health movement is in the forefront of the consumer movement, it behooves all health care professionals to be aware that consumers will be seeking more information, more power in decision making, and will expect professionals to share responsibility for the development of treatment plans and for the evaluation of such treatments. Consumers and nurses can be expected to continue to demand that their experiences and perspectives be valued and taken into consideration.

Education, Nursing↗

[Peripheral specimen collecting centers. Preanalytical control].

UNLABELLED: The progressive decentralization in the process of sample drawing and collection of biological samples has produced a socio-economical improvement for the general public and for health systems specifically even though this requires a higher degree of control to avoid pre-analytical errors derived from this procedure by the laboratories receiving these aforementioned samples. This study is based on 372,243 drawings, taken from June 1994 until December 1996 at 74 sample drawing centers and the systematic recording of any errors committed during the drawing, conservation and transportation of the diverse biological samples drawn. The results indicate an overall incident rate of 1.5% broken down by year as 1.3% in 1994, 1.3% in 1995 and 1.9% in 1996 and broken down by type as 0.7% in blood samples, 0.7% in urine samples, and 0.07% due to other errors such as transportation. DISCUSSION AND CONCLUSIONS: 1. The incident rate is slightly lower than that obtained in a prior study of similar characteristics. 2. The small increase in the incident rate which occurred in 1996 is attributed to an improvement in the error recording system. 3. We recommend continuing applying strategies which permit one to detect, limit, and if possible, reduce these types of errors. These strategies include periodical meetings and professional development.

Bias↗

The professional identity of the nurse: concept analysis and development.

The aim of this paper is to highlight the concept of professional identity of the nurse in order to promote theoretical clarity and examine implications for nursing practice. A modification of the hybrid model for concept development was followed. Accordingly, the theoretical analysis of conceptualizations and corresponding theoretical frameworks were combined with empirical data gathered from the field, from semi-structured interviews with eight registered nurses. The sampling was strategic and continuous. Personal and interpersonal dimensions and socio-historical aspects of the concept were found in the literature review as well as in the interview data. Attributes, antecedents and consequences of professional identity of the nurse in relation to the identified dimensions were stated. The analysis ends with a comprehensive description of the concept. Further, the relations to the concepts of self-esteem, self-image, professionalism and professional self-image, as well as professional function and roles of the nurse, are outlined. Finally, the importance of the developed concept is discussed, and suggestions for further research are presented.

Humans↗

Professional staff education. Quantifying costs and outcomes.

In today's cost-conscious marketplace, it is critical to identify the true costs of professional staff development within a healthcare organization. Many hidden costs can be difficult to quantify. This article will help administrators identify these costs, and decide whether their professional staff education would be done better internally or using outside resources.

Computer-Assisted Instruction↗

Contemporary UK paramedical training and education. How do we train? How should we educate?

OBJECTIVE: To develop an understanding of the current system and future development of training and education within a large UK ambulance trust, based upon the experiences, beliefs, and opinions of stakeholders. METHODS: This was a qualitative naturalistic inquiry using an interpretative constructivist approach for 44 interviews with a range of ambulance staff. Stakeholder views on training and education were analysed and compared using the constant comparison method. RESULTS: Key emergent themes included: issues around prescribed programme entry levels and methods; the desire for a higher education curriculum with a balance between theory and practice; valid and reliable assessment methods; development of a supportive mentorship framework; an emphasis on self directed professional development with a focus on deskilling issues; and development of interprofessional collaborative links. CONCLUSION: This thematic review suggests that this UK ambulance service is in a transition stage, with significant organisational, professional, and cultural challenges. The dichotomies, boundaries, and development issues are part of the development of an emerging profession for which it is essential that the educational agenda is addressed.

Attitude of Health Personnel↗

A postgraduate sexual assault forensic medicine program: sexual assault medicine from scratch.

A government-funded service to provide forensic and medical care to survivors of sexual assault was established in the Australian Capital Territory (ACT) in 2001. Doctors employed by the service lacked the specific skills required to care comprehensively for survivors. Our aim was to develop, implement and evaluate a sexual assault medical education program. It consisted of an 'in-house' education program, and external university course and incorporated team-building, networking activities and protocol development. Core elements were: forensic evidence collection, assessment and management of injuries, prevention of sexually transmissible infections and pregnancy, counselling and emotional support. Participant satisfaction and knowledge acquisition were evaluated using a semi-structured interview and a questionnaire. Seven doctors participated in a 16-session program conducted by the director and nurse coordinator with help from local forensic, legal and medical experts. All doctors successfully completed the Certificate in Forensic Medicine, and reported satisfaction with the program and their increased knowledge, particularly associated with collection of forensic evidence and court procedures. A compete set of protocols was developed and cohesive networks established. We have designed an effective education program for doctors working in the field of sexual assault and offer it as a template to other health professionals working in this area.

Australian Capital Territory↗

Transcultural Patient Care Committee: actualizing concepts and developing skills.

This article describes activities of a Transcultural Patient Care Committee whose aim is to develop the knowledge and skills of medical center staff to provide culturally congruent care. The activities include staff development offerings, a transcultural patient care resource manual, and communication and assessment tools. These efforts have provided a foundation to assist staff with meeting the challenge of caring for multicultural patients.

Clinical Competence↗

Clinical Tips: The New Commission on Dietetic Registration/Professional Development Portfolio Process: You're in the Driver's Seat.

After more than 25 years of credentialing dietetic professionals, the Commission on Dietetic Registration is revising the format for logging continuing professional education. As of 2001, the new system will be phased in over 5 years. Each registered dietetic professional will now plan a course of continuing education to meet personal and professional growth needs. This is a very exciting process and one that has many asking questions of "why, how, when, and where." This article is designed to put a perspective on the new process.

Journal Article↗

Terminology in evolution: caveats, conundrums and controversies.

Over the past 30 years, there has been an ongoing evolution in the nomenclature used to describe individuals in low-level neurological states. The appropriateness of historically well-entrenched nomenclature germane to persons in low level neurological states following brain injury continues to be debated. The effort to develop a cross disciplinary uniform set of descriptive terms for individuals in such states has continued to evolve as efforts for interdisciplinary collaborative consensus and guideline development has continued to make progress over the last decade. The intent of this article is to provide clinicians with a better understanding of some of the history behind the nomenclature, as well as, some ongoing controversies, caveats and conundrums that face us as health care professionals as related to the development of a rationale, uniform nomenclature for this special population of neurological patients.

Humans↗

A leadership development series.

A detailed step-by-step series--assessment, development, implementation and evaluation--forms a leadership program's structure. Main topics are identified; subtopics, chosen to meet the participants' specific needs, are developed from modules. Participants make the transition from each leadership unit: self-esteem and professional image; assertive communication; collaboration; problem-solving; coaching/mentoring; and time management/resource utilization.

Curriculum↗

Continuing education: balancing team development in four directions.

Continual growth over time will lead to the rewarding practice every dentist envisions. A balanced CE plan that includes programming and dedicated funding for the development of interpersonal, clinical and financial skills leads to greater practice success and professional fulfillment. A substantial CE investment for the dentist and staff members has been the choice of many of the most successful dental practices.

Clinical Competence↗

Home dialysis: lessons in patient education.

The concept of home haemodialysis for the regular treatment of renal failure was first put into practice in 1964, 30 years ago. It proved extremely successful. This paper describes the epidemiology of renal failure, the reasons for home haemodialysis and the educational role necessary to ensure its success. Continuous ambulatory peritoneal dialysis (CAPD), or autonomous dialysis, is a self-care peritoneal treatment which developed after 1978 for a wider age range of patients. Its rapid expansion needed a professional approach to patient education. Also discussed are the problems patients encounter with conceptual skills, as opposed to the easy acquirement of practical skills and the paper demonstrates how persons, without formal medical and nursing education, can master complex treatment skills.

Attitude of Health Personnel↗

Nursing--the next 100 years.

This paper sets the scene for future patterns of nursing and nursing education and traces the ways in which the nursing profession has reached the present position. It illustrates the development of nursing over the past 100 years, and examines the key influences which have affected, and are likely to continue to affect, nursing, namely: the Government, the Law and the State; wars and disasters; scientific and technological advances; and people. No attempt has been made to predict or to crystal-gaze, yet the emphasis is firmly placed on the need to plan, to think and to recognize the trends that may determine the future of nursing. Research and education are seen as the tools that will enable nurses to adapt their function to the changing needs of society, whilst preserving the essential or central role of caring. The tapestry--the pattern or web of social relationships, that formed the professional nurse in the Victorian and Edwardian eras, and in the first and second World Wars--presents an unfinished canvas. The present generation of nurses are responsible for continuing to develop that tapestry for future decades, within the framework of the changing social scene of the present day.

Education, Nursing↗

Alternative options for earning continuing education credit.

The HIM professional has traditionally been a highly motivated self-starter and a good detective. Today, the profile of the average HIM professional is that of a well-educated person, eager to learn more, who recognizes the necessity of keeping his or her skills up-to-date, and who is willing to take advantage of nontraditional options to further personal and professional goals. All these attributes can be put to good use in developing whatever alternative educational methods are appropriate to the most independent of persons.

Education, Continuing↗

Bioinformatics and medical informatics: collaborations on the road to genomic medicine?

In this report, the authors compare and contrast medical informatics (MI) and bioinformatics (BI) and provide a viewpoint on their complementarities and potential for collaboration in various subfields. The authors compare MI and BI along several dimensions, including: (1) historical development of the disciplines, (2) their scientific foundations, (3) data quality and analysis, (4) integration of knowledge and databases, (5) informatics tools to support practice, (6) informatics methods to support research (signal processing, imaging and vision, and computational modeling, (7) professional and patient continuing education, and (8) education and training. It is pointed out that, while the two disciplines differ in their histories, scientific foundations, and methodologic approaches to research in various areas, they nevertheless share methods and tools, which provides a basis for exchange of experience in their different applications. MI expertise in developing health care applications and the strength of BI in biological "discovery science" complement each other well. The new field of biomedical informatics (BMI) holds great promise for developing informatics methods that will be crucial in the development of genomic medicine. The future of BMI will be influenced strongly by whether significant advances in clinical practice and biomedical research come about from separate efforts in MI and BI, or from emerging, hybrid informatics subdisciplines at their interface.

Biomedical Research↗

Mentorship and competencies for applied chronic disease epidemiology.

To understand the potential and establish a framework for mentoring as a method to develop professional competencies of state-level applied chronic disease epidemiologists, model mentorship programs were reviewed, specific competencies were identified, and competencies were then matched to essential public health services. Although few existing mentorship programs in public health were identified, common themes in other professional mentorship programs support the potential of mentoring as an effective means to develop capacity for applied chronic disease epidemiology. Proposed competencies for chronic disease epidemiologists in a mentorship program include planning, analysis, communication, basic public health, informatics and computer knowledge, and cultural diversity. Mentoring may constitute a viable strategy to build chronic disease epidemiology capacity, especially in public health agencies where resource and personnel system constraints limit opportunities to recruit and hire new staff.

Chronic Disease↗