Home About us Contact
|
Home About us Contact | ||
|
|
||
Better Training (good + training)
Selected AbstractsTURNING OFFENDERS INTO RESPONSIBLE PARENTS AND CHILD SUPPORT PAYERS,FAMILY COURT REVIEW, Issue 3 2005Esther Ann Griswold This article describes four demonstration projects that strive to promote responsible behavior with respect to parenting, child support payment, and employment among incarcerated and paroled parents with child support obligations. These projects, conducted in Colorado, Illinois, Massachusetts, and Texas, with support from the federal Office of Child Support Enforcement and evaluated by the Center for Policy Research, led to a number of common outcomes and lessons. The projects revealed that inmates want help with child support, parenting, and employment and that prisons can be effective settings in which to conduct such interventions. Family reintegration programs were popular with inmates and may have helped to avoid the rupture of parent,child relationships commonly associated with incarceration. Although employment is the key to child support payment following release, rates of postrelease employment and earnings at all project sites were low and the employment programs were of limited utility in helping released offenders find jobs. Agencies dealing with child support, employment, and criminal justice need to adopt more effective policies with incarcerated parents including transitional job programs that guarantee immediate, subsidized employment upon release, child support guidelines that adjust for low earnings, and better training and education opportunities during incarceration. [source] Benefits and limitations of nurses taking on aspects of the clinical role of doctors in primary care: integrative literature reviewJOURNAL OF ADVANCED NURSING, Issue 8 2010Claire RashidArticle first published online: 2 JUL 2010 rashid c. (2010) Benefits and limitations of nurses taking on aspects of the clinical role of doctors in primary care: integrative literature review. Journal of Advanced Nursing,66(8), 1658,1670. Abstract Aim., This paper presents an integrative literature review of studies exploring the benefits and limitations of the recent expansion of the clinical role of nurses working in general practice in the United Kingdom. Background., Similar clinical outcomes and high levels of satisfaction with consultations undertaken by nurse practitioners compared to general practitioners in primary care have been reported in a Cochrane review [Cochrane Database of Systematic Reviews (2004) vol. 5, p. CD001271]. Since then, nurse consultations have increased considerably as general practitioners have delegated part of their clinical workload to other general practice nurses. However, whether all general practice nurses can fulfil this extended role remains open to question. Method., An integrative review was performed. Nine electronic databases were searched. UK studies were included if they were published after the previous Cochrane review, i.e. between 2004 and 2009. Results., Eight studies were identified, most using qualitative methodology. The evidence suggested that the changes in nurses' role have been predominantly driven by the perceived increase in workload arising from the new general practitioner contract. Delegating work to nurses provided a means of organizing workload within a practice without necessarily allowing patient choice. Patients generally thought that all general practice nurses would be able to deal with simple conditions, but they would prefer to consult with a general practitioner if they thought it necessary. There were concerns about nurses' knowledge base, particularly in diagnostics and therapeutics, and their levels of training and competence in roles formerly undertaken by general practitioners. Conclusion., There have been few studies in this key area of healthcare policy. There is a need for better training and support for nurses undertaking roles in consultation and for patients' views to be better represented. [source] Training the ideal hospital doctor: the specialist registrars' perspectiveMEDICAL EDUCATION, Issue 10 2001N Khera Background When training for junior doctors is being planned, little discussion is focused on what outcomes hospitals are trying to achieve with regard to education/training, i.e. on what makes the ideal hospital doctor. Instead, the primary focus is on the requirements of the syllabi of the Royal Colleges (credentialing) and the requirements of service delivery (job description). Current literature has no qualitative studies of any longitude in which middle-grade doctors are asked about their vision of the ideal hospital doctor, what they feel can be done to help realize this vision, and how they feel about their own training. Methods This study examined data principally collected through a series of semistructured interviews conducted with eight specialist registrars (SpRs), four each from the North Trent and South Thames rotations over a period of 18 months. Additional information was taken from focus groups, interviews with programme directors, and questionnaires. Findings A model was created of the SpRs' perceptions of the key attributes of an ideal hospital doctor and of how these may be achieved in training. Eight broad areas were identified: clinical knowledge and skills; key clinically related generic/non-clinical skills; self-directed learning and medical education; implementing change management; applying strategic and organizational skills in career planning; consultation skills; research; and key personal attributes. Conclusions SpRs are articulate in expressing their own expectations of their training and have considerable insight into the components of good training. Further improvement could be made and will require significant commitment from both trainees and trainers. [source] Lessons for management of anaphylaxis from a study of fatal reactionsCLINICAL & EXPERIMENTAL ALLERGY, Issue 8 2000Pumphrey Background The unpredictability of anaphylactic reactions and the need for immediate, often improvised treatment will make controlled trials impracticable; other means must therefore be used to determine optimal management. Objectives This study aimed to investigate the circumstances leading to fatal anaphylaxis. Methods A register was established including all fatal anaphylactic reactions in the UK since 1992 that could be traced from the certified cause of death. Data obtained from other sources suggested that deaths certified as due to anaphylaxis underestimate the true incidence. Details of the previous medical history, the reaction and necropsy were sought for all cases. Results Approximately half the 20 fatal reactions recorded each year in the UK were iatrogenic, and a quarter each due to food or insect venom. All fatal reactions thought to have been due to food caused difficulty breathing that in 86% led to respiratory arrest; shock was more common in iatrogenic and venom reactions. The median time to respiratory or cardiac arrest was 30 min for foods, 15 min for venom and 5 min for iatrogenic reactions. Twenty-eight per cent of fatal cases were resuscitated but died 3 h,30 days later, mostly from hypoxic brain damage. Adrenaline (epinephrine) was used in treatment of 62% of fatal reactions but before arrest in only 14%. Conclusions Immediate recognition of anaphylaxis, early use of adrenaline, inhaled beta agonists and other measures are crucial for successful treatment. Nevertheless, a few reactions will be fatal whatever treatment is given; optimal management of anaphylaxis is therefore avoidance of the cause whenever this is possible. Predictable cross-reactivity between the cause of the fatal reaction and that of previous reactions had been overlooked. Adrenaline overdose caused at least three deaths and must be avoided. Kit for self-treatment had proved unhelpful for a variety of reasons; its success depends on selection of appropriate medication, ease of use and good training. [source] | ||||||||||