Home About us Contact
|
Home About us Contact | ||
|
|
||
Advanced Skills (advanced + skill)
Selected AbstractsThe Acute Care Nurse Practitioner: challenging existing boundaries of emergency nurses in the United KingdomJOURNAL OF CLINICAL NURSING, Issue 3 2006Tracey Norris BSc Hons Aim., This study explored the opinions of nurses and doctors working in emergency departments towards the development of the Acute Care Nurse Practitioner service in the United Kingdom. Background., Studies carried out in the United States and Canada suggest that the Acute Care Nurse Practitioner can have a positive impact on the critically ill or injured patients' experiences in the emergency department. This role is well developed in the United States and Canada, but is still in its infancy in the United Kingdom. Design and methods., A descriptive, exploratory design incorporating questionnaires (n = 98) and semi-structured interviews (n = 6) was employed. The sample included nurses and doctors from seven emergency departments and minor injury units. Results., Respondents felt it was important for the Acute Care Nurse Practitioner to have obtained a specialist nurse practitioner qualification and that the Acute Care Nurse Practitioner should retain a clinical remit. While participants seemed comfortable with nurses undertaking traditional advanced skills such as suturing, reluctance was displayed with other advanced skills such as needle thoracocentesis. Three main themes were identified from the interviews: inter-professional conflict, autonomy and the need for the Acute Care Nurse Practitioner. Discussions., Doctors were reluctant to allow nurses to practise certain additional advanced skills and difficulties appear to be centred on the autonomy and other associated inter-professional conflicts with the role of the Acute Care Nurse Practitioner. Conclusion., Nurses and doctors identified a need for the Acute Care Nurse Practitioner, but the blurring of boundaries between doctors and nurses can result in inter-professional conflict unless this is addressed prior to the introduction of such advanced practitioners. Relevance to clinical practice., As the role of the emergency nurse diversifies and expands, this study re-affirms the importance of inter-professional collaboration when seeking approval for role expansions in nursing. [source] A Bronze Ingot-bearer from CyprusOXFORD JOURNAL OF ARCHAEOLOGY, Issue 4 2001Vassos Karageorghis Cypriot bronze four-sided stands represent some of the most impressive metal artefacts produced in the Eastern Mediterranean. As such they offer insight into the high level of the Cypriot bronzework of the Late Bronze Age and witness the advanced skills of the Cypriot metalsmiths. A bronze fragment depicting a man bearing an oxhide ingot, detached from a four-sided stand and housed in the Royal Ontario Museum, Toronto, Canada, is now added to the corpus of these works. Although unprovenanced, its Cypriot origin is proven by its close typological, technological and stylistic affinities when compared to other Cypriot stands. The discussion of technology, style and chronology of this fragment serves as an opportunity for the evaluation of the stands as a whole and their establishment as products of great technical and artistic virtuosity. [source] Laparo-endoscopic single-site surgery: preliminary advances in renal surgeryBJU INTERNATIONAL, Issue 8 2009Sashi S. Kommu We reviewed the preliminary advances in laparo-endoscopic single-site surgery (LESS) as applied to renal surgery, and analyzed current publications based on animal models and human patients. We searched published reports in major urological meeting abstracts, Embase and Medline (1966 to 25 August 2008), with no language restrictions. Keyword searches included: ,scarless', ,scar free', ,single port/trocar/incision', ,intraumbilical', and ,transumbilical', ,natural orifice transluminal endoscopic surgery' (NOTES), ,SILS', ,OPUS' and ,LESS'. The lessons learnt from the studies using the porcine model are that further advances in instrumentation are essential to achieve optimum results, and that testing survival in animals is also necessary to further expand the NOTES and LESS techniques. Further advances in instrument technology together with increasing experience in NOTES and LESS approaches have driven the transition from porcine models to human patients. In the latter, studies show that the techniques are feasible provided that both optimal surgical technical expertise with advanced skills, and optimal instrumentation, are available. The next step towards minimal access/minimally invasive urological surgery is NOTES and LESS. It is inevitable that LESS will be extended to involve more complex and technically demanding procedures such as laparoscopic radical prostatectomy and partial nephrectomy. [source] 19 A Novel Approach to Residency Education in EMS: The MD-PM AmbulanceACADEMIC EMERGENCY MEDICINE, Issue 2008Angela Fiege Challenge:, Indiana University EM residents have actively provided prehospital care as crew members on a hospital-based air ambulance service. This service functions as a secondary responder for high acuity patients who have already had first tier evaluation and care. First response, ground EMS experiences have been observational only as residents have ridden along with a two-paramedic team on an urban ambulance service for 24 hours during their residency careers. Resident understanding of first response care and challenges faced by initial EMS providers has been limited to that gleaned during their observational period. Solution:, Most EM residencies do not provide opportunities for residents to function as first response providers. Therefore, we developed a Physician-Paramedic team to provide first response care within a busy metropolitan area. This two-member team operates within a "geozone" that includes a diverse patient population with both medical and trauma complaints. Unlike other residency ground EMS programs, the MD-PM truck responds primarily to all ambulance requests within their designated geozone and assists outside their designated geozone for multi-patient casualties in which a physician response would benefit patient care (fires, motor vehicle accidents, multiple gunshot victims). Residents on the MD-PM truck not only provide care equivalent to that expected of a nationally certified paramedic (IVs, drug administration, splinting, packaging), but also perform advanced skills such as RSI which is outside the scope of a traditional two-paramedic team. Immersion into the first response ground EMS system will provide valuable insight into the challenges of providing care outside of the hospital. [source] | ||||||||||