Utilizing the SPICES model to evaluate the continuous improvement of a clinical development programme facilitated by Clinical Squadron, 22 Field Hospital.
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Clinical Clerkship↗
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Results for “continuing professional development”
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.
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Computerized information system for ICU patient management.
To solve the problem of data management, a digital computer was introduced in this ICU in 1977. Data are manually entered at the bedside alpha-numeric keyboards; two beds are directly connected to the computer. The system was especially designed to work in the 11-bed ICU; its functions are: (1) admission, discharge, and transfer data of patients; (2) management of doctors' and nurses' notes in a free text form; (3) management of the problem-oriented record; (4) management of physical and bio chemical variables, medical disorders, and fluid balance; and (5) diagnostic and therapeutic decision-making. Since 1977, the authors have computerized over 2600 patients and now conclude: (1) data management and communication have improved, thus, allowing nurses more time for direct patient care; (2) teaching of the residents and nurses has been facilitated and minimizes disparities from their diverse experience; (3) it has contributed to the development of protocols for many of the procedures; and (4) it has led to a more systematic approach to patient care. The assistance of a professional computer programmer and continuous maintenance of the software are essential.
Computers↗
Numeracy for adults with Down syndrome: it's a matter of quality of life.
BACKGROUND: Numeracy development is widely accepted as critical for adults in the general community which is equally the case for adults with Down syndrome. This paper reports some of the findings of a study including the research question: What is the justification for numeracy development for adults with Down syndrome? Investigating this question led to the search for a framework to support the ongoing development of numeracy. METHOD: The research used a case study methodology. Five adults were observed and interviewed in two contexts each. The data were analyzed to identify links to the quality of life model. RESULTS: The research illustrates how a quality of life approach can be used to justify and guide the lifelong development of numeracy. Data from the case studies linked numeracy to quality of life under the principles of personal contexts, variability, life-span perspective, values, choices and personal control, perceptions and self-image. CONCLUSIONS: The principles of quality of life can provide a framework for the development of numeracy in the context of adulthood and Down syndrome. Preparation for the numeracy needs of a long and satisfying adulthood should begin in early childhood, continue in schools with the teaching of underlying mathematics concepts and skills, and be modified and refined throughout adulthood by the use of a numeracy development plan. Carers and professionals interacting in the contexts need to adopt a teaching role for numeracy.
Adult↗
The phenomenology of life phenomena--in a nursing context.
The purpose of this article is to describe and develop knowledge about life phenomena in a life-philosophical and nursing context. Knowledge about life phenomena is part of a care-ethical understanding with a focus on relations. Life phenomena are to be understood as a generalized label for the various phenomena which are given with human existence. The Danish life philosophical tradition with the perspective of life as experienced has something to say in relation to a further refinement of the phenomenology of life phenomena. The refinement will be described as an ethical and existential understanding of the phenomena of nursing. The first part of the article takes a philosophical approach to the phenomenology of life phenomena. It attempts to locate life phenomena in relation to, respectively, needs, senses, and feelings. In order to maintain an overview, the attempt is made to separate needs, senses, and feelings, although in real life these are closely interwoven. The article also describes philosophy and life phenomena in relation to nursing as an empirical field. In nursing there is a risk that life phenomena become invisible to those whose task is to help the ill person adjust to a new life situation. For the nurse, it will be a continuing task, never completed, to develop a sensory-based, situation-determined attention to the patient. And the nurse must be continually aware of whether mere 'need-oriented' nursing is controlling her professional actions as a nurse. Taking a point of departure in the nurse's sensory, situationally determined attention, the last part of the article focuses on needs, senses, and feelings in connection with the nurse being able to direct her attention to the patient's life phenomena.
Attention↗
Adolescent mothers and breastfeeding: experiences and support needs--an exploratory study.
The experiences and support needs of adolescent mothers who commenced breastfeeding were elicited using focus groups and in-depth semistructured interviews. The study took place in the North West of England, UK. The qualitative data were analyzed using thematic networks analysis. Five themes related to experiences emerged: feeling watched and judged, lacking confidence, tiredness, discomfort, and sharing accountability. A further 5 themes were developed to describe the adolescents' support needs: emotional support, esteem support, instrumental support, informational support, and network support. These forms of support were most effective when provided together in a synergistic way and within a trusting relationship. Key supporters identified were the mother's mother, the partner, and the midwife employed in a teenage pregnancy coordinator role. Health professionals need to further explore the ways in which relationships may be developed and sustained that provide the range of support required by adolescent mothers to enable them to continue breastfeeding.
Adolescent↗
The evolution of social work in a community hospital.
Since 1905 social work has had the privilege of working with great medical leaders who have respected and assisted our profession. As predicted in 1984 by Abraham Lurie, The social work department of the future will be more decentralized ... develop stronger links administratively ... knowledge of changing social problems ... legislation, research, computerization, data gathering and retrieval. The Columbus Regional Hospital Social Work department is still early in its development, yet the above predictors have occurred which strengthened social work role and professional practice. By 1992 the following areas served as a strong foundation for the department's continued growth: Resource acquisition Hospital Integration Physician Support We must continue to advocate for improved care along with providing an environment of compassion for the patients and their families who seek services. Through continued participation on hospital committees such as ethics, and utilization review, we can demonstrate our practice and influence the environment. By creatively accessing resources we can influence and shape opportunities for colleagues. As a social work manager I thank those who have come before me who laid framework, fought battles and defined territory. We need to continue to support one another through collaborative processes and shared experiential learnings.
Community-Institutional Relations↗
Administrative skills for academic physicians.
To function effectively within the multifaceted environment of the academic medical center, academic physicians need to heighten their understanding of the economics of the health care system, and further develop their leadership and managerial skills. A literature base on organizational development and management education now exists that addresses the unique nature of the professional organization, including academic medical centers. This article describes an administration development curriculum for academic physicians. Competency statements, instructional strategies and references provide the academic physician with guidelines for expanding their professional expertise to include organizational and management skills. The continuing success of the academic medical center as a responsive health care system may depend upon the degree to which academic physicians gain sophistication in self-management and organizational administration.
Academic Medical Centers↗
Quality assurance to quality improvement: the impact of the agenda for changes.
Health care professionals are committed to the continual improvement of the quality of patient care. The Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) has launched a major research and development project intended to improve its ability to evaluate health care organizations and encourage greater attention to the quality of daily patient care. This chapter describes JCAHO's challenge to evaluate capability and performance of health care organizations and practitioners. The intent of JCAHO's agenda for change is to focus on patient outcomes and quality improvement through a more precise and objective evaluation of both clinical and managerial performance. Through the agenda for change, JCAHO and the health care organization will participate in a continuous-flow monitoring system in which clinical and organizational data are transmitted from the field to JCAHO, analyzed, and fed back to the health care organization.
Delivery of Health Care↗
Ward leadership.
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Attitude of Health Personnel↗
Sharing good practice: developing network forums.
In this report the authors describe how bringing together nurses from different specialties to share innovations and developments can enhance personal, professional and practice development on a much wider scale.
Benchmarking↗
Developing a quality management program for coded data.
Improving the process of coding data is one important way health information professionals can fulfill their mission of "Quality Healthcare through Quality Information." This article describes principles of continuous quality improvement applied to the coding process.
Abstracting and Indexing↗
Reflections by the families of organ donors in Japan.
The number of kidney grafts in Japan is remarkably small compared to that in Europe and America. We conducted a questionnaire survey to donor families in order to examine problems surrounding kidney grafts, from their viewpoints. Thirty one families of post-mortem kidney donors responded and the majority perceived the donation positively. The survey also revealed that in most cases, donation was decided by the family without knowing the patient's wishes, families who made organ donations were apprehensive about Japanese society being critical of organ donations, and some families later regretted their decision of organ donation. In Japanese society, organ donation continues to face some resistance. It is important that medical professionals concerned with organ grafts understand with compassion the feelings of donor families, and make a greater effort in developing public understanding and support for organ grafts.
Attitude to Health↗
[50 years among the pioneers of a new medical specialty; the development of modern traumatology].
On the basis of his half a century medical experiences the author analyses how the traumatology became an independent branch of medicine.--L. Markusovszky's scientific achievements in the domain of the field surgery, organization, education and professional policy considerably influenced the development of the traumatology. Derived from the surgery, the present-day traumatology's basis feature is to provide a high-level professional education and a well organised continuing medical attendance.--The achievements of the last fifty years are now disclosed to the readers on the strength of the experiences of the author and his contemporary collegues. He breaks the national events into 10 years periods which are in fact representing the efforts and the results of the European shools. Finally in the approach of the second millennium he is looking toward the future. With the full knowledge of the nowadays difficulties he is trying to answer how will advance all that has been founded in the last fifty years. Especially as in the next few decades the harmonization European, an internationally similar high-quality medical attendance will be a considerable task.
History, 20th Century↗
Practice management in pediatric dentistry.
Good practice management in the pediatric dental office is not piecemeal, sporadic, or a series of random, uncoordinated activities. Instead, it encompasses the philosophy of the practice; is centered around the patient; and is a fluid, consistent management function. It begins with the pediatric dentist as the leader and continues in all phases of daily activity. It is a well-developed, highly functioning system. It results in staff and patient loyalty and high patient satisfaction. It is an ongoing, continuously active, evolutionary process. It permits a positive attitude of professional growth for the entire pediatric dental staff team.
Attitude of Health Personnel↗
Retooling practitioners in the information age.
For "retooling" one needs two components: new hardware and new skills. "Hardware" in the Medical Informatics environment includes not only hardware in a narrow definition, but operating and application software, network services, security services etc. Since the sixties, Medical Informatics has slowly moved from fighting computer hardware to fighting the complexity of application software and its installation. Thus the hardware part in the retooling process has changed but did not decrease in importance. Retooling medical professionals also means retraining of professionals--often a major investment. Regarding the necessary skills, we have to adapt existing medical curricula and continuous medical education (CME). So far, these have not successfully been adjusted to the retooling needs. The international community has to address these matters, specifically in the context of medical curriculum and CME.
Aged↗
A virtual surgical simulator for the lower limbs.
As the body of knowledge concerning human anatomy and physiology continues to grow, new techniques must emerge to convey it more efficiently to future health care professionals. Computer simulation, interaction and visualization technologies are now being used in the development of virtual training environments. This paper presents a real-time virtual surgical simulator that integrates scientific visualization tools into a surround-screen projection-based (SSPB) immersive environment. This environment focuses on procedures for the lower limbs; however, the techniques described can be applied to other portions of the body. The research consists of three phases: environment modeling, volume visualization and immersive surgical simulation. Environment modeling involved modeling an operating room with all of the relevant elements. The volume visualization phase required the application of marching cubes and decimation techniques to the Visible Human Project (VHP) dataset to generate models of the lower limbs. The simulator integrated modeling and volume visualization to facilitate the rehearsal of medical procedures and interaction with medical information. Interactive cutting, suturing and X-Ray CT placement over the virtual patient's legs were used to probe underlying structures. The simulator is intended to aid medical students in learning anatomy, physiology and radiological analysis without jeopardizing patient care.
Computer Simulation↗
Worth the investment.
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Education, Nursing, Continuing↗
Professional corporations--recent developments.
A lengthy, detailed article reviewing legal and tax problems of professional corporations has been withdrawn from this issue of California Medicine. Instead, we are presenting a status report which is simply another chapter in a continuing saga.
Economics, Medical↗