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PubMed2003

Royal Rehabilitation Centre Sydney: towards Clinical Development Units (Nursing).

Clinical Development Units (Nursing), also known as Practice Development Units and Nursing Development Units, are nursing units that continually strive for excellence in nursing practice. Nursing units endeavouring to attain, or having achieved, the standards required of a Clinical Development Unit (Nursing)--CDU(N)--provide a very motivating and stimulating environment for nursing professional development. This paper provides readers with an understanding of the underpinnings of a CDU(N) along with why and how a nursing unit would strive for this status. A priority of senior nurse management at a rehabilitation facility in Sydney, the Royal Rehabilitation Centre, has been working towards the upgrading of every nursing unit in their facility to the level of a CDU(N) over the past three years. By way of an innovative course, the Clinical Development and Leadership course developed by Professor Jennifer Greenwood in 1997, senior nurses are being provided with the knowledge and skills to enable them to work towards their goal of becoming part of a Clinical Development Unit (Nursing).

Credentialing↗
PubMed1996

Information retrieval patterns and needs among practicing general surgeons: a statewide experience.

Information retrieval has progressed from a reliance on traditional print sources to the modern era of computer databases and online networks. Surgeons, many from remote areas not served by professional medical libraries, must develop and maintain skills in information retrieval and management in both electronic and standard formats. One hundred thirty-three New Mexico general surgeons were surveyed to identify their information-seeking patterns in five areas: retrieval purposes, retrieval sources, barriers to access, techniques used, and continuing education needs. Ninety-nine (74.4%) surgeons responded to the survey. Ninety-five percent utilize professional meetings, the medical literature, and physician colleagues as information sources. Only 17% utilize the outreach services of the state's only medical school library. Common retrieval barriers were practice demands (71%), isolation from medical schools (30%), computer illiteracy (28%), and rural environment (25%). Continuing education topics related to information management would be valuable to 61% of the surgeons. Sixty-nine percent believe their current ability to access biomedical information is adequate, despite most frequently accessing their personal libraries for information related to decision-making or patient management. These data suggest that, despite significant information needs, surgeons have not embraced newer forms of information retrieval. It is imperative that surgeons acquire and maintain modern information retrieval skills as a means of remaining up-to-date in their profession. Professional surgical organizations and medical librarians should collaborate on these continuing education ventures.

Chi-Square Distribution↗
PubMedDate not supplied

Preceptorship: a model to empower nurses in rural health settings.

Continuing education and staff development help nurses meet new needs and demands caused by rapid changes in society, demography, technology, politicoeconomic structure, and disease patterns. Rural nurses have a unique, generalist role within their practice but are disadvantaged in accessing professional development because of geographical and professional isolation. A preceptorship program was developed to empower individual nurses in rural health units in South Australia. This program equipped them with the knowledge, skills, and attitudes necessary to make changes in their health units. At the same time, it enabled participants to act as mentors to colleagues in collaborative partnerships designed to meet the complex health needs of their rural clients.

Curriculum↗
PubMed1990

Correlation of nurses' knowledge and valuation of the quality assurance process.

Nurses are expected to use the QA process as a means of improving the quality of patient care and as a means of professional accountability. The responsibility for preparing nurses to meet this expectation falls first on nurse educators and then on nurse administrators. If a positive relationship had been found between nurses' knowledge of and valuation of the QA process, nurse educators and administrators could have used the relationship in curriculum development and in continuing education planning for students and nurses. By including QA theory and process in nursing curricula, beginning with early nursing education and continuing through educational inservice sessions in the workplace, nurses would be more likely to internalize the concepts of QA. With earlier and continued exposure to the concepts of QA, nurses should gain both knowledge and valuation of the process and would subsequently be better prepared to use the QA process. Since participation in QA activities has been identified as a required function in nursing, there is a need in nursing education and practice for the development of QA programs that attract the attention and participation of staff nurses. To facilitate the development of such programs, the variables that influence nurses' use of the QA process must be identified. As long as the profession of nursing and the regulating bodies over nursing require accountability for professional services and the improvement of patient care in the form of QA programs, nurses' use of the QA process will be of major importance. Some research suggests that implicit or explicit norms of accountability or responsibility regulate individual conduct, rather than personal valuation of the activity. This proposition could be the focus of future studies in nursing QA. Previous studies point to the fact that increased knowledge of a subject or phenomenon is positively related to personal valuation and activity related to the subject or phenomenon. Although this relationship was not found in this study, identification of factors that contribute to an increased valuation of or participation in nursing QA activities should continue to be the subject of nursing research.

Attitude of Health Personnel↗
PubMed1990

Top management program: management development in New Zealand's health services.

This article describes New Zealand's program for developing managers in health services, called the National Management Development Program (NMDP), run by a newly established unit of the Department of Health. This is a set of programs for training various groups of individuals in health administration: those with no experience who wish to enter the field, those in a particular area of health, and those who are already managers in the health field. The Top Management Program, designed for professionals already heading health agencies, offers continuing education as a sustained approach to improving individual management ability.

Education, Continuing↗
PubMed2003

AHEC in West Virginia: a case study. Area health education centers.

This case study describes the area health education centers (AHEC) program in West Virginia, spanning 30 years from a first-generation project at Charleston in 1972 (AHEC 1) to a newly funded statewide program (AHEC 2). The outcome is an evolving university-community partnership designed to meet changing work-force and community health needs in the heart of rural Appalachia. West Virginia University's (WVU's) application of the original Carnegie Commission AHEC recommendations (1970) resulted in the Charleston AHEC, now part of the Robert C. Byrd Health Sciences Center of WVU. AHEC today trains more than 135 residents and interns, and one-third of the third-year and fourth-year WVU medical students. Charleston offers clinical and continuing education for nurses, dentists, pharmacists, and allied health professionals. A health sciences library, distance learning, and a network of primary care clinics help define Charleston's unique AHEC role. This AHEC hub continues to meet the classic Carnegie goals of recruiting and retaining health professionals, and providing access to care in the original service area and statewide. Based on the Charleston experience, four new federally funded AHECs are being developed to link rural primary care residencies with the state-funded West Virginia rural health education partnerships. These rural consortia AHECs are applying the concept of community competency, a performance-based methodology, to integrate learning while achieving the goals of Healthy People 2010.

Academic Medical Centers↗
PubMed2001

Six steps to compliance for small practices.

Developing a compliance plan for a small physician practice can be easier than you'd think. The author offers six things HIM professionals can do to ensure a practice's compliance.

Documentation↗
PubMed2005

What makes a good GP? An empirical perspective on virtue in general practice.

This paper takes a virtuist approach to medical ethics to explore, from an empirical angle, ideas about settled ways of living a good life. Qualitative research methods were used to analyse the ways in which a group of 15 general practitioners (GPs) articulated notions of good doctoring and the virtues in their work. I argue that the GPs, whose talk is analysed here, defined good general practice in terms of the ideals of accessibility, comprehensiveness, and continuity. They regarded these ideals significant both for the way they dealt with morally problematic situations and for how they conducted their professional lives more generally. In addition, I argue that the GPs who articulated these ideals most clearly were able to, in part, because they shared the experience of working in rural areas. This experience helped them to develop an understanding of the nature of general practice that their urban colleagues were less able to draw on. In that sense, the structural and organisational framework of general practice in rural areas provided the context for their understanding of ideals in general practice.

Adult↗
PubMedDate not supplied

Developing healthcare educators. The application of a conceptual model.

The staff development faculty is a unique group of educators who are at the very core of processes in today's healthcare environment. Even so, little guidance is available for their professional development from novice to expert. The conceptual model presented in this article defines a developmental continuum for healthcare staff educators. The model serves as a comprehensive framework to guide staff development activities from initial orientation to educational opportunities that lead to the expert role.

Education, Nursing, Continuing↗
PubMed1998

A randomized controlled trial of an intervention designed to improve the care given in general practice to Type II diabetic patients: patient outcomes and professional ability to change behaviour.

AIM: Our objective was to evaluate the effect of training in a patient-centred intervention for GPs and practice nurses on outcomes for patients with Type II diabetes. METHODS: We carried out a randomized controlled trial within general practices as the basis for randomization and a before-and-after design for measures of patient outcome. A parallel process study examined the use of the method by professionals. The study was carried out in 29 general practices in South Glamorgan who had participated for at least 2 years in a local scheme of audit and CME in relation to Type II diabetes care. The subjects were 252 Type II diabetic patients recruited by 15 experimental and 14 control practices. The main outcome measures were changes in glycosylated haemoglobin, patient satisfaction with care and treatment, functional health status and professional ability to apply the intervention. RESULTS: Professionals adopted the innovative method with enthusiasm, but after 2 years only 19% continued to apply the method systematically. The trial was, therefore, unable to demonstrate significant biochemical or functional improvements. This highlights the need to understand the factors associated with professional uptake and subsequent ability to sustain changes in behaviour. CONCLUSIONS: The efficacy of this behavioural intervention remains unproved, despite its acceptability to professional staff. Detailed and prolonged development and testing of behavioural interventions is an essential first step before embarking on randomized controlled trials which involve complex behavioural changes in professionals or patients.

Adult↗
PubMed2003

Rural health resource databases: a little nurturing goes a long way.

Access to rural health research information together with the type and availability of educational resources in rural areas, are important to rural health care providers, community members, researchers, students, planners and policy makers. The Rural Health Research Register (RHRR) focuses on current and recent research activity being undertaken in Australia in the field of rural health, while the Health Education Rural Remote Resources Database (HERRD) focuses on education courses and resources relevant to the practice and professional development of rural and remote health professionals throughout Australia. Early versions of these databases were established between 1992 and 1997, and in the period 1998-2001 both information resources were systematically updated through targeted promotion, registrations and the creation of web-accessible search facilities. They continue to be maintained and updated. Detailed information is available by searching the RHRR and HERRD databases via the web or by contacting the relevant coordinator. This article examines some of the issues in developing and maintaining these resources and demonstrates the usefulness of their contents to rural healthcare workers.

Journal Article↗
PubMed1993

The relationship between nursing and medical cultures: implications for the design and implementation of a clinicians' workstation.

The culture of different professions is manifest in how members relate to each other and in how they organize and store data and information. For developers of clinical workstations intended to support not only the independent tasks but also the interdependent tasks of multiple health professionals, recognition of cultural differences among groups of health care professionals may be of great importance. Allowance for and adaptation to these differences are likely to be important for both acceptance and effective use of clinical workstations. Examples are drawn from Nursing and Medicine based on a clinician's workstation currently in use and undergoing continuous development.

Clinical Medicine↗
PubMed2002

Developing an integrated care pathway to manage cancer pain across primary, secondary and tertiary care.

Throughout the palliative care journey, the patient encounters many different health professionals in a variety of settings so good channels of communication between these professionals is a prerequisite for successful continuity of care (Scottish Partnership Agency for Palliative and Cancer Care (SPA), 1994). Pain control has also long been documented as being ineffective and it has been indicated that pain affects up to 88% of cancer patients in the last year of their life (Addington-Hall and McCarthy, 1995). In order to attempt to resolve these important issues, a joint project was established between primary, secondary and tertiary care in the south sector of Glasgow to establish an integrated care pathway (ICP) for the management of chronic cancer pain. This article discusses how the joint project was successfully established, was instrumental in breaking down existing barriers across the traditional boundaries and developed a uniform system of assessing and managing chronic cancer pain with ICP documentation held in a patient-held record.

Attitude of Health Personnel↗
PubMed1982

Evaluation of a continuing education program in sex therapy.

This paper describes a multi-dimensional, ongoing approach to evaluation in a sex therapy training program. The Yale Sex Therapy Training program agencies throughout Connecticut who would meet or surpass pre-determined standards for sex therapists. Because sex therapy is a new discipline, it was deemed essential that program evaluation be developed and carried out from the very beginnings of the program and throughout its course. Evaluative findings proved essential to monitoring the quality of teaching and supervisory efforts, in assessing change in knowledge and professional activity of trainees, and in measuring impact upon the communities served. Continuous feedback led to changes in program content and format through identification of needs and problems. The experience in the Yale program confirms the recommendations of others regarding the conduct of a continuing education program. These findings strongly imply that multi-dimensional, ongoing evaluation should be an integral component in any continuing education program.

Connecticut↗