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Assessment Skills (assessment + skill)
Selected AbstractsDelirium and older people: what are the constraints to best practice in acute care?INTERNATIONAL JOURNAL OF OLDER PEOPLE NURSING, Issue 3 2008BHSc (Nursing), Jenny Day ADCHN, MEd (Adult Education) An Australian research team conducted a six-month acute care pilot study in a medical ward of a large hospital in New South Wales. Aim., To explore ways health practitioners might redesign their practice to include prevention, early detection and management of delirium in older people based on the best current practice. Method and design., Participatory action research (PAR) was selected as the best approach for involving ward staff to make sustainable clinical practice decisions. The PAR group comprised research academics and eight clinicians from the ward. Thirteen PAR sessions were held over 5 months. Clinicians described care of patients with delirium. Stories were analysed to identify constraints to best practice. Following PAR group debate about concerns and issues, there were actions toward improved practice taken by clinicians. Relevance to clinical practice., The following constraints to best practice were identified: delayed transfer of patients from the Emergency Department; routine ward activities were not conducive to provision of rest and sleep; assisting with the patient's orientation was not possible as relatives were not able to accompany and/or stay with the older patient. Underreporting of delirium and attributing confusion to dementia was viewed as an education deficit across disciplines. A wide range of assessment skills was identified as prerequisites for working in this acute care ward, with older people and delirium. Clinicians perceived that management driven by length of a patient's stay was incongruent with best practice delirium care which required more time for older patients to recover from delirium. Two significant actions towards practice improvement were undertaken by this PAR group: (i) development of a draft delirium alert prevention protocol and (ii) a separate section of the ward became a dedicated space for the care of patients with delirium. A larger study is being planned across a variety of settings. [source] The role of gastroesophageal reflux disease in asthmaJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 5 2008CCRN (Family Nurse Practitioner Student), Sandra Huggins RN Abstract Purpose: To emphasize the relationship between gastroesophageal reflux disease (GERD) and asthma symptoms or exacerbations. Data sources: Selective review of the scientific literature. Conclusions: Although studies in recent years have offered insight into the relationship between GERD and asthma symptoms, many nurse practitioners (NPs) fail to recognize atypical GERD symptoms, which may explain difficult-to-treat asthma and exacerbation. It has become evident that patients suffering from persistent asthma display an increased prevalence of GERD. Implications for practice: While there are increasing constraints that limit the provider,patient interaction time, it is imperative that NPs develop keen assessment skills to effectively diagnose and treat asthma symptoms that are a product of GERD. Awareness of the asthma,GERD relationship allows NPs to quickly obtain pertinent information and successfully determine how to efficiently treat symptomatic asthmatic patients. [source] A randomized, controlled, single-blind trial of teaching provided by a computer-based multimedia package versus lectureMEDICAL EDUCATION, Issue 9 2001Christopher Williams Background Computer-based teaching may allow effective teaching of important psychiatric knowledge and skills. Aims To investigate the effectiveness and acceptability of computer-based teaching. Method A single-blind, randomized, controlled study of 166 undergraduate medical students at the University of Leeds, involving an educational intervention of either a structured lecture or a computer-based teaching package (both of equal duration). Results There was no difference in knowledge between the groups at baseline or immediately after teaching. Both groups made significant gains in knowledge after teaching. Students who attended the lecture rated their subjective knowledge and skills at a statistically significantly higher level than students who had used the computers. Students who had used the computer package scored higher on an objective measure of assessment skills. Students did not perceive the computer package to be as useful as the traditional lecture format, despite finding it easy to use and recommending its use to other students. Conclusions Medical students rate themselves subjectively as learning less from computer-based as compared with lecture-based teaching. Objective measures suggest equivalence in knowledge acquisition and significantly greater skills acquisition for computer-based teaching. [source] Regulatory impact assessment and regulatory governance in developing countries,PUBLIC ADMINISTRATION & DEVELOPMENT, Issue 4 2004Colin Kirkpatrick Regulatory impact assessment (RIA) offers the means to improve regulatory decision-making and practice. RIA involves a systematic appraisal of the costs and benefits associated with a proposed new regulation and evaluation of the performance of existing regulations. So far, the adoption of RIA has been confined mainly to OECD countries. The purpose of this article is to assess the contribution that RIA can make to ,better regulation' in developing countries. Results from a survey of a small number of middle-income countries suggest that a number of developing countries apply some form of regulatory assessment, but that the methods adopted are partial in their application and are certainly not systematically applied across government. The article discusses the capacity building requirements for the adoption of RIA in developing countries, in terms of regulatory assessment skills, including data collection methods and public consultation practices. The article also proposes a framework for RIA that can be applied in low and middle-income countries to improve regulatory decision-making and outcomes. Copyright © 2004 John Wiley & Sons, Ltd. [source] Geographic Information Systems: A New Tool for Environmental Health AssessmentsPUBLIC HEALTH NURSING, Issue 5 2006Mona Choi ABSTRACT Objectives: (1) To develop tools for health care professionals and communities to assess environmental exposures and (2) to evaluate the utility of integrating patient-reported environmental health information with geographic information systems (GIS) mapping of environmental data in a pilot study. Methods: A survey was used to collect self-reported environmental exposure and health data from a convenience sample of people at an urban community health center (N=101). Environmental exposure and census information were obtained from federal agencies. Analysis was performed using descriptive statistics and GIS. Results: Frequent environmental health risk factors were reported, such as older housing (93%) and household smoking (78%). Health problems including asthma (54%) and lead poisoning (14%) were reported. Odds ratios indicated a statistically significant relationship between mold/mildew and reporting asthma. GIS was found to be a useful tool in displaying environmental risk factors and potentially associated health effects. Conclusions: Given the important role that environmental health risks can play in public health, it is critical that community/public health nurses begin to integrate environmental health assessment skills into their professional practices. Simple community surveys can be an effective means to raise awareness about environmental health risk factors and utilizing GIS can further enhance the accessibility of the combined exposure and health information. [source] Mothers' Decision-Making Processes Regarding Health Care for Their ChildrenPUBLIC HEALTH NURSING, Issue 3 2001Gloria Jean Gross Ph.D. This research study explored mothers' decision-making processes regarding health care for their children. Identifying how decisions are made by mothers about health care for their children will assist health care professionals to be appropriate advocates for mothers, to improve quality of life, and to contain costs of health care for children. A sample of 114 rural mothers (51 with one child, 63 with more than one child) completed questionnaires identifying demographics, social support, client and professional interaction elements, self-determinism, competence in problem-solving skills, and relationships to responses to health care scenarios. Qualitative data were also gathered by structured in-depth interviews of 7 subjects. ANOVA, correlations, and factor analysis were completed to analyze data. Most of the mothers' decisions were based on the perceived degree of seriousness, mother's degree of fear of the child's condition, attitude of the health care provider, previous experience with the situation, and social support for the mother. There were no significant differences in decision-making processes by first time mothers and by mothers with more than one child. Implications include teaching mothers assessment skills to identify serious versus nonserious situations and to utilize other social supports. [source] Factors that influence physicians' detection of distress in patients with cancer,CANCER, Issue 2 2005Can a communication skills training program improve physicians' detection? Abstract BACKGROUND No study to date has assessed the impact of skills acquisition after a communication skills training program on physicians' ability to detect distress in patients with cancer. METHODS First, the authors used a randomized design to assess the impact, on physicians' ability to detect patients' distress, of a 1-hour theoretical information course followed by 2 communication skills training programs: a 2.5-day basic training program and the same training program consolidated by 6 3-hour consolidation workshops. Then, theinvestigate contextual, patient, and communication variables or factors associated with physicians' detection of patients' distress were investigated. After they attended the basic communication skills training program, physicians were assigned randomly to consolidation workshops or to a waiting list. Interviews with a cancer patient were recorded before training, after consolidation workshops for the group that attended consolidation workshops, and , 5 months after basic training for the group that attended basic training without the consolidation workshops. Patient distress was recorded with the Hospital Anxiety and Depression Scale before the interviews. Physicians rated their patients' distress on a visual analog scale after the interviews. Physicians' ability to detect patients' distress was measured through computing differences between physicians' ratings of patients' distress and patients' self-reported distress. Communication skills were analyzed according to the Cancer Research Campaign Workshop Evaluation Manual. RESULTS Fifty-eight physicians were evaluable. Repeated-measures analysis of variance showed no statistically significant changes over time and between groups in physicians' ability to assess patient distress. Mixed-effects modeling showed that physicians' detection of patients' distress was associated negatively with patients' educational level (P = 0.042) and with patients' self-reported distress (P < 0.000). Mixed-effects modeling also showed that physicians' detection of patient distress was associated positively with physicians breaking bad news (P = 0.022) and using assessment skills (P = 0.015) and supportive skills (P = 0.045). CONCLUSIONS Contrary to what was expected, no change was observed in physicians' ability to detect distress in patients with cancer after a communication skills training programs, regardless of whether physicians attended the basic training program or the basic training program followed by the consolidation workshops. The results indicated a need for further improvements in physicians' detection skills through specific training modules, including theoretical information about factors that interfere with physicians' detection and through role-playing exercises that focus on assessment and supportive skills that facilitate detection. Cancer 2005. © 2005 American Cancer Society. [source] Promising practices in understanding and treating child neglectCHILD & FAMILY SOCIAL WORK, Issue 1 2003Marianne Berry ABSTRACT Child neglect is the most common type of child maltreatment in the United States. However, services provided to families who neglect often fail to address and treat the primary concerns associated with child neglect. The information provided in this paper identifies the primary problems contributing to child neglect, and some promising practices in child welfare casework that address these problems and show positive outcomes for the children and families who experience child neglect. Knowledge pertaining to assessment skills, treatment abilities, and model programmes is provided. [source] | |||||||||||||