Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Credentialing”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,711 records · Page 95Linked to original sources
PubMed2006

Substance abuse prevention infrastructure: a survey-based study of the organizational structure and function of the D.A.R.E. program.

BACKGROUND: The only national drug abuse prevention delivery system that supports the rapid diffusion of new prevention strategies and includes uniform training and credentialing of instructors who are monitored for quality implementation of prevention programming is the Drug Abuse Resistance Education network (D.A.R.E.) linking community law enforcement to schools. Analysis of the organizational structure and function of D.A.R.E. provides an understanding of the essential parameters of this successful delivery system that can be used in the development of other types of national infrastructures for community-based prevention services. Information regarding organizational structure and function around funding issues, training, quality control and community relationships was gathered through telephone surveys with 50 state D.A.R.E. coordinators (including two major cities), focus groups with local D.A.R.E. officers and mentors, and interviews with national D.A.R.E. office staff. RESULTS: The surveys helped identify several strengths inherent in the D.A.R.E. program necessary for building a prevention infrastructure, including a well-defined organizational focus (D.A.R.E. America), uniform training and means for rapid dissemination (through its organized training structure), continuing education mechanisms (through the state and national conference and website), mechanisms for program monitoring and fidelity of implementation (formal and informal), branding and, for several states, predictable and consistent financing. Weaknesses of the program as currently structured include unstable funding and the failure to incorporate components for the continual upgrading of curricula reflecting research evidence and "principles of prevention". CONCLUSION: The D.A.R.E. organization and service delivery network provides a framework for the rapid dissemination of evidence-based prevention strategies. The major strength of D.A.R.E. is its natural affiliation to local law enforcement agencies through state coordinators. Through these affiliations, it has been possible for D.A.R.E. to become established nationally within a few years and internationally within a decade. Understanding how this structure developed and currently functions provides insights into how other such delivery systems could be developed.

Community-Institutional Relations↗
PubMed2005

Establishing an integrative medicine center.

Cast a wide net, and include internal and external customers in planning. Keep communicating about the results of the needs assessment and each plan as it emerges. Ask everyone involved for feedback. Employ clinicians with experience and solid credentials, and have a plan for measuring outcomes.

Health Facility Planning↗
PubMed2003

The evolution of perfusion education in America.

Clinical cardiopulmonary perfusion has evolved significantly during its 50 years. The science, technology and educational processes related to cardiopulmonary bypass have undergone continual change and metamorphosis. Perfusionists were initially trained on the job or in the laboratory, but with the advent of myocardial revascularization and the explosion in cardiac surgery, the need for formal educational training programs became apparent. The American Society of Extracorporeal Technology began the arduous processes of credentialing and developing certification guidelines that have continued under the American Board of Cardiovascular Perfusion. Licensure has also been adopted in many states during the past 10 years where nearly 50% of all perfusionists are covered by some legislative act. One additonal challenge has been developing minimal standards in which perfusionists practice. The initial standards included the use of a checklist and have evolved to monitoring and recording the significant events and parameters of each clinical procedure. The education of perfusionists will continue to be a challenge related primarily to reduced fiscal resources, the applicant pool and the ever-changing demands for extracorporeal circulation services. According to demographic and census information, it is expected the overall number of cardiovascular interventions will increase dramatically towards the latter end of the current decade in the US. The question arises as to what role perfusionists will play, as treatment strategies continue to change. If the number of education programs and new graduates continue to decline, the total number of perfusionists will decline, especially as many senior perfusionists leave the field or retire. It may be difficult to predict the total number of cardiovascular interventions that will be required in the next several years. However, if the total number of cardiovascular interventions that require perfusion services increase as a function of the aging population and if the overall incidence of cardiovascular treatment does not change, it will be imperative that perfusion education ramp up and train more perfusionists to meet the supply and demand or a shortage of skilled personnel may develop.

Accreditation↗
PubMed2006

Nurses' fears and professional obligations concerning possible human-to-human avian flu.

This survey aimed to illustrate factors that contribute to nurses' fear when faced with a possible human-to-human avian flu pandemic and their willingness to care for patients with avian flu in Taiwan. The participants were nursing students with a lesser nursing credential who were currently enrolled in a bachelor degree program in a private university in southern Taiwan. Nearly 42% of the nurses did not think that, if there were an outbreak of avian flu, their working hospitals would have sufficient infection control measures and equipment to prevent nosocomial infection in their working environment. About 57% of the nurse participants indicated that they were willing to care for patients infected with avian influenza. Nurses' fear about an unknown infectious disease, such as the H5N1 influenza virus, could easily be heightened to levels above those occurring during the 2003 severe acute respiratory syndrome outbreak in Taiwan.

Adult↗
PubMed2004

Frequency of incomplete abdominal aorta visualization by emergency department bedside ultrasound.

OBJECTIVES: To determine how often emergency physicians (EPs) scanning the abdominal aorta (AA) of nonfasted emergency department (ED) patients are able to visualize the entire AA. METHODS: The authors performed a retrospective study of patients receiving ultrasound (US) by EPs to rule out abdominal aortic aneurysm (AAA) at a suburban Level I ED. For patients being evaluated for possible AAA, EPs evaluated the entire length of the AA with US in short axis, making standard proximal, middle, and distal measurements. AAA was defined as dilation of the AA to >3 cm. Video of each US and data sheets were evaluated by a hospital-credentialed sonologist for visualization of the AA. Any portions of the AA not visualized were noted. If one third or more of the length of the AA was not seen, the examination was considered inadequate, allowing for potentially missing an AAA. Statistical analysis included descriptive statistics. RESULTS: Ultrasounds of 207 patients were completed. In 35 patients (17%), a portion of the AA less than one third its length was not seen. In 17 patients (8%), a significant portion of the AA (at least one third its length) could not be visualized and therefore could have potentially concealed an AAA. In four patients, the AA could not be seen at all. There were 29 AAAs discovered (14%), and none were missed. CONCLUSIONS: Significant portions of AA (at least one third of its length) were not visualized on bedside US in 8% of nonfasted patients; this rate is higher than radiology studies of fasted patients receiving US for evaluation of their aortas.

Abdominal Pain↗
PubMed2004

Ultrasound image quality comparison between an inexpensive handheld emergency department (ED) ultrasound machine and a large mobile ED ultrasound system.

UNLABELLED: Questions have been raised regarding image quality (IQ) provided by portable ultrasound (US) machines. OBJECTIVES: To determine if a difference exists between images obtained with a common portable US machine and those obtained with a more expensive, larger US machine when comparing typical views used by emergency physicians. METHODS: The authors performed a cross-sectional, blinded comparison of images from similar sonographic windows obtained on healthy models using a SonoSite 180 Plus and a General Electric (GE) 400 US machine. Both machines were optimized by company representatives. Images obtained included typical abdominal and vascular applications using the abdominal and linear transducers on each machine. All images were printed on identical high-resolution printers and then digitized using a bitmap format at 300 dots-per-inch resolution (RES). Images were then cropped, masked, and placed into random order comparing each view per model by a commercial Web design company (loracs.com). Three credentialed emergency physician sonologists, blinded to machine type, rated each image pair for RES, detail (DET), and total IQ as previously defined in the literature using a ten-point Likert scale; 10 was the best rating for each category. Paired t-test, 95% confidence intervals (95% CIs), and interobserver correlation were calculated. RESULTS: A total of 49 image pairs were evaluated. Mean GE 400 RES, DET, and IQ scores were 6.8, 6.8, and 6.6, respectively. Corresponding SonoSite means were 6.3, 6.3, and 6.0, respectively. The difference of 0.5 (95% CI = 0.13 to 1.1) for DET was not statistically significant (p = 0.06). The differences of 0.5 (95% CI = 0.1 to 1.1) and 0.6 (95% CI = 0.2 to 1.2) for RES and IQ were statistically significant, with p = 0.01 and 0.01. There was good interobserver agreement (kappa = 0.71; 95% CI = 0.67 to 0.78). CONCLUSIONS: A statistically significant difference was seen between GE 400 and SonoSite in IQ and RES, but not DET.

Abdomen↗
PubMed2005

Intraoral ultrasound in the diagnosis and treatment of suspected peritonsillar abscess in the emergency department.

UNLABELLED: Peritonsillar abscess (PTA) can be a life-threatening disease and may lead to significant complications without drainage. OBJECTIVES: To describe the utility of ultrasound (US) in the evaluation of potential PTA and US-guided PTA drainage. METHODS: The authors performed a retrospective US quality assurance review of all patients over 18 years of age scanned by emergency physicians for possible PTA. All patients presenting with PTA signs and symptoms including erythema and swelling of the tonsillar pillar and uvular deviation were eligible to be scanned. Patients confirmed to have an abscess on US had US-guided drainage followed by intravenous antibiotics in the emergency department and discharge home on oral antibiotics. Scans were performed by credentialed attending emergency physicians and residents. Researchers recorded patient symptoms, US findings, results of abscess drainage if performed, and any complications of drainage. All US examinations were performed with sheathed endocavity broadband US transducers on minimum depth and maximum resolution settings. Statistical analysis included descriptive statistics. RESULTS: Forty-three patients received intraoral US examinations for suspected PTA. Thirty-five (81%) were diagnosed as having abscess on US. All abscesses were drained with an 18- or 14-gauge needle under US guidance. There were no drainage complications. There was one false positive with a focal area of edema yielding no pus on needle aspiration under direct US visualization. No patient returned unexpectedly after drainage. CONCLUSIONS: These data suggest that intraoral US of suspected PTA allows for reliable diagnosis and safe and accurate abscess drainage.

Anti-Bacterial Agents↗
PubMed2006

Confirmation of endotracheal tube placement after intubation using the ultrasound sliding lung sign.

OBJECTIVES: To evaluate the performance of the ultrasound (US) sliding lung sign as a predictor of endotracheal tube (ETT) placement. Many other tools and examination findings have been used to confirm ETT placement; erroneous placement of the ETT has even been confirmed by US. METHODS: This was a laboratory study using fresh, recently dead cadavers. Cadavers were obtained at a medical school anatomy laboratory on the basis of availability during a four-month period. Subjects who died from significant trauma or after thoracic surgery were excluded. A numerical randomization tool was used to direct where the tube would be placed on intubation. Laryngoscopy was performed, and the ETT was placed in the esophagus, in the trachea, or in the right main stem (RMS) bronchus. Placement was confirmed by direct laryngoscopic visualization of ETT passage through vocal cords or with fiber optic visualization, as needed. US images of the sliding lung sign, sliding of visceral and parietal pleura past each other, were taken on both sides of the chest at the mid axillary line during ventilation with an ambu bag. Two board-certified emergency physicians with hospital credentialing in emergency US used a 4-2 MHz micro-convex transducer on a Sonosite 180 Plus for imaging. The sonologists were blinded to the location of the endotracheal tube and imaged and recorded their results individually. A positive sliding lung sign was taken to signify lung expansion with ventilation in a hemithorax. Endotracheal versus esophageal ETT placement, as well as tracheal versus RMS, was determined on the basis of sliding lung findings on both sides of the chest. Interpreter agreement, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and likelihood ratios (LHR) were calculated for tracheal (including RMS) versus esophageal, as well as main trachea versus RMS intubation. RESULTS: Nine cadavers yielded 68 intubations. For esophageal versus tracheal (including RMS) intubation, sonologist 1 (S1) had a sensitivity of 95.4% (95% CI = 84.2% to 99.4%), a specificity of 100% (95% CI = 86.3% to 100%), an NPV of 92.6% (95% CI = 75.7% to 99.1%), and a PPV of 100% (95% CI = 91.4% to 100%) with an LHR of 0.05 (95% CI = 0.01 to 0.2) for a negative test. Sonologist 2 (S2) had a sensitivity of 100% (95% CI = 91.8% to 100%), a specificity of 100% (95% CI = 86.3% to 100%), an NPV of 100% (95% CI = 86.3% to 100%), and a PPV of 100% (95% CI = 91.8% to 100%); agreement was 97% (kappa = 0.94; 95% CI = 0.7 to 1.2). In RMS versus tracheal, S1 had a sensitivity of 69.2% (95% CI = 48.2% to 85.7%), a specificity of 93.3% (95% CI = 68.1% to 99.8%), a PPV of 94.7% (95% CI = 73.9% to 99.9%), and an NPV of 63.6% (95% CI = 40.7% to 82.8%) with an LHR for a positive test of 10.4 (95% CI = 2.2 to 59.1) and of 0.4 (95% CI = 0.2 to 0.6) for negative test. S2 had a sensitivity of 78.6% (95% CI = 59.1% to 91.7%), a specificity of 100% (95% CI = 78.2% to 100%), a PPV of 100% (95% CI = 84.6% to 100%), NPV of 71.4% (95% CI = 47.8% to 88.7%), with an LHR for a negative test of 0.2 (95% CI = 0.1 to 0.4); agreement was 85.9% (kappa = 0.6; 95% CI = 0.4 to 0.9). CONCLUSIONS: These results show that US imaging of the sliding lung sign in a cadaver model is an accurate method for confirmation of ETT placement. Further, the technique may have some utility in differentiating RMS bronchus from main tracheal intubations.

Emergency Medicine↗
PubMed1992

What's in a name? Child life and the play lady legacy.

Child life specialists can now earn a nationally recognized credential as a "Certified Child Life Specialist" from the Child Life Certifying Commission. Yet, uncertainties linger about the nature of the child life specialist's identity, roles, and status among health care professionals. This article highlights the historical contexts within which a series of significant changes occurred in the profession's name. How Emma Plank and Thesi Bergmann, two pioneering authors in the field, influenced and were influenced by the play lady legacy is shown, and recommendations are made to find ways to honor the profession's past, while addressing the challenges of the 1990s.

Child↗
PubMed1993

Work hours of residents in seven anesthesiology training programs.

Medical educators and credentialing organizations recently have called attention to the long hours that some house staff are required to spend in the hospital during training. To determine the average duration of in-hospital work hours of anesthesiology residents, 148 residents at seven, university-affiliated training programs kept daily logs of their activities for one week. Residents in clinical anesthesia years 1, 2, and 3 spent an average of 66, 65, and 64 hours per week, respectively, in the hospital with a range of 43 to 104 hours per week. Although there was not a difference in in-hospital work time among years of training, there was a statistical difference between two of the seven programs studied. The largest portion of the in-hospital time was devoted to patient care activities in the operating room. Residents had time for educational activities, conferences, and reading while in the hospital. The overall work hours of the residents in the anesthesiology training programs included in this survey appeared to be within current guidelines.

Anesthesiology↗
PubMed2005

The qualifications of pain physicians in Ohio.

Pain physicians in Ohio come from many medical backgrounds and use different medical boards to claim board certification in the field of pain medicine. Our goal was to explore the number, demographics, and qualifications of pain physicians in Ohio. The names of Ohio physicians designating themselves as pain physicians were collected from the State Medical Board of Ohio and the American Medical Association. The directories of the American Board of Medical Specialties (ABMS), the American Board of Pain Medicine, the American Academy of Pain Management, and the American Board of Medical Acupuncture were referenced for certification in pain medicine, pain management, or medical acupuncture. The requirements for these credentials vary widely, yet they have all been used to claim "board certification." Board certification in medicine implies recognition by an ABMS member board as having completed the required training, met the standards, and then passed an examination that validates qualifications, and knowledge in a specific medical field. In 2002, there were 335 Ohio physicians designating themselves as pain physicians. Two-hundred-eighteen (65%) had at least one pain board certification. Ninety-six (29%) of the Ohio pain physicians were certified in pain medicine by the American Board of Anesthesiology, the American Board of Physical Medicine and Rehabilitation, or the American Board of Psychiatry and Neurology, which are all member boards of the ABMS. One-hundred-seventeen (35%) of the self-declared Ohio pain physicians held no pain-related board certification. Anesthesiologists comprise the majority of all pain physicians and are the majority in all four pain boards.

Certification↗
PubMed1997

Cognitive and psychomotor performance tests and experiment design in multiple chemical sensitivity.

People suffering from multiple chemical sensitivity (MCS) complain of a variety of symptoms that could impair cognitive and psychomotor function either directly or indirectly. This paper discusses the use of cognitive and psychomotor performance tests together with some experiment designs that could be considered for use to assess fitness of MCS sufferers for work or the efficacy of diagnostic, preventative, or therapeutic measures. The tests could also contribute to the body of objective information on MCS and help sway the opinion of those who are dubious of its authenticity. The credentials of cognitive and psychomotor performance tests are derived from their successful use in studying the effects of drugs, and the types of tests are illustrated by describing those used by the United Kingdom Defence Evaluation and Research Agency Chemical and Biological Defence Human Studies Group, which has been involved in the assessment of drugs and chemicals on work performance for many years. The tests include mathematical, verbal and spatial processing, tracking, reaction time, attention and vigilance, and memory tests. The discussion of experiment designs includes both repeated measures and parallel groups designs together with their advantages and disadvantages and some suggested modifications to accommodate the particular problems posed by MCS.

Cognition↗
PubMed2003

The relative value of nursing work: a study in progress.

The nursing shortage is likely to continue and, without intervention, may worsen. While retention and recruitment are constantly discussed among nursing leaders, the shortages, particularly in specialty areas, continue. Nurses have frequently stated that they are not valued for their knowledge. Yet many nurses have university degrees, post graduate degrees, specialty certificates and specialty credentials. Nurses seek recognition for what they know and what they do. To date, however, there is no objective method that is used to assess the value of nurses and their work. The study of relative value may provide a method for recognizing nurses' work. The concept of relative value deals with logical operators and facilitates assigning value to a nurse's overall knowledge base and capacity to perform nursing work. Currently, nursing shortages are concentrated in specialty areas. Nurses who work in specialized areas need specialized knowledge in a narrow field of nursing. Specialty nurses are not interchangeable with specialists in other areas or with generalists. A study is in progress to calculate the relative value of nursing work in 15 specialties. The goal is to assess relative value from the point of view of the knowledge base in the specialties and between specialties. In this paper, the research team reports on the background of the study, the study's parameters and its progress to date. Outcomes will include devising a way to recognize nurses' work, developing policies related to retention and recruitment and finding a long-term solution for dealing with the nursing shortage in specialty areas.

British Columbia↗
PubMed1999

Viewing the kaleidoscope of health systems through a patient-centred prism.

I ought to start by giving my credentials for writing this commentary. I have a marked aversion to outsiders with limited first-hand experience telling me about the British National Health Service. This is especially so when their questions and comments raise issues that make me feel uncomfortable.

Canada↗
PubMed2006

Linking health services at the Community level.

This study describes a series of interventions linking hospitals, medical staff physicians, long-term care providers and mental health services in the metropolitan area of Syracuse, New York. The objectives of these interventions were to improve patient outcomes and system-wide efficiency. The study demonstrated that these linkages, including system-wide data feedback, contributed to limitation of emergency department overcrowding, reduction of physician lengths of stay, elimination of duplication of medical staff credentialing, as well as access to and efficiency of long-term care and mental health services.

Catchment Area, Health↗
PubMed1999

No foot in the door: an experimental study of employment discrimination against older workers.

Pairs of testers, one aged 57 and one aged 32, applied for 102 entry-level sales or management jobs in the Washington, DC, metropolitan area. Although their credentials described them as equally qualified, the older applicants received less favorable responses from employers 41.2% of the time. Three quarters of these differences occurred before older applicants could fully present their qualifications. The negative employer assumptions about older workers implied by these differences in outcome were seldom explicitly stated.

Adult↗
PubMed1994

Marketing the mental health care hospital: identification of communication factors.

The current study provides guidance to hospital administrators in their effort to develop more effective marketing communication strategies. Two types of communication factors are revealed: primary and secondary. Marketers of psychiatric hospitals may use the primary factors as basic issues for their communication campaign, while secondary factors may be used for segmentation or positioning purposes. The primary factors are open wards, special treatment for adolescents, temporary absence, while patient, in-patient care, and visitation management. The secondary factors are temporary absence while a patient, voluntary consent to admit oneself, visitation management, health insurance, open staff, accreditation, physical plant, and credentials of psychiatrists.

Analysis of Variance↗
PubMed1992

Gay and lesbian educators: past history/future prospects.

Although lesbians and gay men in education have been an invisible population, modern computer information retrieval techniques provided a mechanism to investigate the history of case law on gay and lesbian teacher dismissal and credential revocation. This legal framework was then augmented by social history gathered from newspapers and articles, and interviews with the parties involved in the legal or political debates. After presenting a history of the emergence of legal rights and political influence, the author discusses current trends in the employment rights and personal freedoms of gay and lesbian educators.

Adult↗