Quality Patient Care (quality + patient_care)

Distribution by Scientific Domains

Selected Abstracts

Testing of a measurement model for baccalaureate nursing students' self-evaluation of core competencies

Li-Ling Hsu
Abstract Title.,Testing of a measurement model for baccalaureate nursing students' self-evaluation of core competencies. Aim. This paper is a report of a study to test the psychometric properties of the Self-Evaluated Core Competencies Scale for baccalaureate nursing students. Background. Baccalaureate nursing students receive basic nursing education and continue to build competency in practice settings after graduation. Nursing students today face great challenges. Society demands analytic, critical, reflective and transformative attitudes from graduates. It also demands that institutions of higher education take the responsibility to encourage students, through academic work, to acquire knowledge and skills that meet the needs of the modern workplace, which favours highly skilled and qualified workers. Methods. A survey of 802 senior nursing students in their last semester at college or university was conducted in Taiwan in 2007 using the Self-Evaluated Core Competencies Scale. Half of the participants were randomly assigned either to principal components analysis with varimax rotation or confirmatory factor analysis. Results. Principal components analysis revealed two components of core competencies that were named as humanity/responsibility and cognitive/performance. The initial model of confirmatory factor analysis was then converged to an acceptable solution but did not show a good fit; however, the final model of confirmatory factor analysis was converged to an acceptable solution with acceptable fit. The final model has two components, namely humanity/responsibility and cognitive/performance. Both components have four indicators. In addition, six indicators have their correlated measurement errors. Conclusion. Self-Evaluated Core Competencies Scale could be used to assess the core competencies of undergraduate nursing students. In addition, it should be used as a teaching guide to increase students' competencies to ensure quality patient care in hospitals. [source]

Review: the legal duty of care for nurses and other health professionals

Andy Young
Aims and objectives., To explore the nature and extent of the legal duty of care in relation to contemporary healthcare practice. Background., The paper seeks to re-frame and update the legal duty of care for clinical nursing practice in the 21st century, taking into account collaborative and partnership working in healthcare practice. Design., Doctrinal legal ,approach'. Method., ,Black letter' legal research methodology used for data collection and analysis. Literature search using Westlaw and LexisNexis database(s) to identify recent common law decisions. Results., There has been a perceptible doctrinal shift away from paternalism and toward patient empowerment and autonomy in the last decade. This has implications for nurses and other healthcare professionals in terms of consenting patients and acting reasonably to ensure quality patient care. Conclusions., A number of experienced nurses are currently assuming extended roles and some are completing medical tasks, traditionally allocated to doctors. These specialist practitioners must remember that additional responsibility invariably means increased professional risk and accountability. Therefore, it is essential that those engaging in advanced nursing practice, fully understand the nature and reach of their professional duty of care and the significance of statutory and common law developments. Relevance to clinical practice., Nurses and other healthcare professionals must update their clinical skills and practice within a legal framework and to certain standards. The cases cited and discussed are relevant to all branches of nursing and indeed to all health professions. [source]

Agency nursing work in acute care settings: perceptions of hospital nursing managers and agency nurse providers

Elizabeth Manias BPHARM, FRCNA, MNursStud, MPharm
Summary ,,There is a paucity of research in investigating agency nursing work from the perspectives of hospital nursing managers and agency nurse providers. ,,This exploratory paper examines the hospital nursing managers' and agency nurse providers' perceptions and experiences of agency nursing work. ,,Individual, in-depth interviews were conducted with three agency nurse providers and eight hospital nursing managers. Because of the lack of previous research in this area, an exploratory, semi-structured interviewing technique was deemed appropriate. ,,Three major themes emerged from interview data: planning for ward allocation, communication and professionalism. ,,In planning for ward allocation, hospital managers were primarily concerned with maintaining adequate numbers of nursing staff in the ward settings. A major concern for agency nurse providers was inappropriate allocation of temporary staff. ,,Communication was valued in different ways. While hospital managers focused on communication between the agency nurse and other permanent members of the health care team, agency providers were concerned with exchanges between agencies and hospital organizations, and between the agencies and agency nurses. ,,For both groups, responsibility for professional development and the status of agency nursing as a career choice for graduate and experienced nurses were the focal aspects for consideration. ,,A limitation of this study is the small number of individual interviews conducted with hospital nursing managers and agency nurse providers. Nevertheless, the findings represent the views of 11 individuals in senior managerial roles. ,,The findings reinforce the need to enhance collaboration between hospitals and nursing agencies, and to examine how divergent views of agency nursing work could be reconciled , with the aim of providing quality patient care. [source]

The characteristics, qualities and skills of practice developers

Brendan Mccormack BSc, DPhil, PGCEA
Summary ,,There is a growing interest in practice development as a systematic process for the development of quality patient care. ,,Whilst there is a range of accounts of practice development in the literature, little work has been undertaken to develop an understanding of the systems and processes involved and there is even less on the roles involved in practice development. ,,This paper explores in particular the characteristics, qualities and skills of practice developers, i.e. professionals who have formal responsibility for developing practice in organizations. ,,The paper represents part of a larger study exploring the conceptual basis of the term ,practice development'. ,,Data for this part of the project were collected through literature analysis, seven focus groups involving 60 practice developers and telephone interviews with 25 practising nurses with experience of working with practice developers. The data were analysed using cognitive mapping processes. ,,Four role functions are presented in the paper, as well as qualities and skills needed to operationalize the identified role functions. ,,A clear picture of the skills and qualities required by practice developers emerges from the data. [source]

Psychopharmacological and electroconvulsive treatment of anxiety and depression in the elderly

W. A. Heffern MN
The pharmacotherapeutics of antianxiety and antidepressant medication in the elderly is reviewed, and the benefits and risks of electroconvulsive therapy (ECT) are discussed. Physiological changes in normal ageing are described, and the pharmacodynamic and pharmacokinetic implications are addressed. Finally, the role of the advanced practice nurse (mental health/psychiatry) is discussed in terms of accountability, collaboration, and the development of empirical knowledge to enhance quality patient care. [source]

An outcomes research perspective on medical education: the predominance of trainee assessment and satisfaction

Jay B Prystowsky
Context A fundamental premise of medical education is that faculty should educate trainees, that is, students and residents, to provide high quality patient care. Yet, there is little research on the effect of medical education on patient outcomes. Objective A content analysis of leading medical education journals was performed to determine the primary foci of medical education research, using a three- dimensional outcomes research framework based on the paradigm of health services outcomes research. Data sources All articles in three medical education journals (Academic Medicine, Medical Education, and Teaching and Learning in Medicine) from 1996 to 1998 were reviewed. Papers presented at the Research in Medical Education conference at the Association of American Medical Colleges annual meeting during the same period, and published as Academic Medicine supplements, were also analysed. Study selection Only data-driven articles were selected for analysis; thus editorials and abstracts were excluded. Data extraction Each article was categorized according to primary participant (i.e. trainee, faculty, provider and patient), outcome (performance, satisfaction, professionalism and cost), and level of analysis (geographic, system, institution and individual(s)). Data synthesis A total of 599 articles were analysed. Trainees were the most frequent participants studied (689%), followed by faculty (194%), providers (81%) and patients (35%). Performance was the most common outcome measured (494%), followed by satisfaction (341%). Cost was the focus of only 23% of articles and patient outcomes accounted for only 07% of articles. Conclusions Medical education research is dominated by assessment of trainee performance followed by trainee satisfaction. Leading journals in medical education contain little information concerning the cost and products of medical education, that is, provider performance and patient outcomes. The study of these medical education outcomes represents an important challenge to medical education researchers. [source]

Adverse Event Protocol for Interventional Pain Medicine: The Importance of an Organized Response

PAIN MEDICINE, Issue S1 2008
B. Todd Sitzman MD
ABSTRACT Although a significant number of interventional pain therapies are performed in office and fluoroscopy suite settings, the incidence of adverse events associated with these procedures is unknown. To minimize patient morbidity and physician liability, the preparation for and response to such events should follow a standardized protocol. This article provides a detailed protocol for responding to adverse events associated with interventional pain procedures performed in private office or fluoroscopy suite settings. The purposes of this protocol are to ensure quality patient care during and after an adverse event, to promote a better understanding of staff responsibilities at those times, to decrease the likelihood that an adverse event will become life-threatening, to suggest an appropriate format for the documentation of such events, and to reduce the likelihood of the recurrence of adverse events from a similar cause. Adherence to this protocol may also mitigate professional liability. [source]

Understanding clinical expertise: Nurse education, experience, and the hospital context,

Matthew D. McHugh
Abstract Clinical nursing expertise is central to quality patient care. Research on factors that contribute to expertise has focused largely on individual nurse characteristics to the exclusion of contextual factors. To address this, we examined effects of hospital contextual factors and individual nurse education and experience on clinical nursing expertise in a cross-sectional analysis of data from 8,611 registered nurses. In a generalized ordered logistic regression analysis, the composition of the hospital staff, particularly the proportion of nurses with at least a bachelor of science in nursing degree, was associated with significantly greater odds of a nurse reporting a more advanced expertise level. Our findings suggest that, controlling for individual characteristics, the hospital context significantly influences clinical nursing expertise. 2010 Wiley Periodicals, Inc. Res Nurs Health 33:276,287, 2010 [source]

The Politics of Palliative Care and the Ethical Boundaries of Medicine: Gonzales v. Oregon as a Cautionary Tale

Bryan HilliardArticle first published online: 2 MAR 200
The U.S.Supreme Court's 6-decision in Gonzales v. Oregon is the latest defeat for the Bush administration in its sustained attack on Oregon's physician-assisted suicide law. Both the majority opinion and the major dissent in Oregon provide an opportunity to assess the dangers inherent in allowing a political agenda that emphasizes the sanctity of life and minimizes professional ethical obligations to overshadow quality patient care at the end of life. [source]

An academy of surgical educators: sustaining education , enhancing innovation and scholarship

John P. Collins
Abstract Context:, The aims of surgical education, training and professional development programmes are to ensure surgeons will provide high quality health care throughout their professional lives. Development and delivery of these programmes requires a mixture of surgeons with a different but complimentary range of competencies in medical education, all eager to facilitate learning and support educational scholarship. Methods:, The Royal Australasian College of Surgeons has undertaken a major review of the challenges, risks and opportunities surrounding the development and delivery of its education and continuing professional development programmes. Results:, Conflicting demands on surgeons' time have compromised their availability for educational activities. At the same time, a decline has occurred in the recognition and value of teaching and educational scholarship as a consequence of financial rewards and prestige now coming principally from patient care and biomedical research. New educational methods have been introduced which have added to the complexities involved and the level of commitments required. In response, the College and its surgical specialty partners have established an Academy of Surgical Educators as a resource for the nine specialties of surgery. It will promote high quality patient care by providing expert educational leadership, guidance and advice and through the advancement and application of educational scholarship. Conclusion:, The establishment of the Academy serves as a powerful symbol of the importance the College places on its core responsibility as an educational body. Working in association with the University Departments of Surgery throughout Australia and New Zealand, the Academy will better equip the College and its partner Specialist Societies and Associations to meet and sustain the increasingly sophisticated requirements involved in higher education. [source]