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Health Care Institutions (health + care_institution)
Selected AbstractsNursing care of dead bodies: a discursive analysis of last officesJOURNAL OF ADVANCED NURSING, Issue 6 2003Beverleigh Quested BN MN RN DipAppSc Background.,Nurses care for patients before they are born, after they have died and during the lifetime in between. This paper explores nursing care of the patient after they have died including the actions by nurses in preparation of the body, the covering with a shroud, and the transfer to the mortuary. Aims.,The analysis of a procedure manual excerpt Last Offices, which directs care of the dead patient aims to explore nursing care practices in regard to dead patients, as well as the impact of the health care institution and society at large on these care practices. Method.,An acute care teaching hospital located in a major Australian city was approached and permission was granted to access their procedure and policy manuals. The Last Offices excerpt of the procedure manual was discursively analysed. Findings.,It is the contention of this paper that, through their care, nurses enact the transition between life and death, and from person to corpse. Furthermore, nurses mediate the move from embodied person to becoming dead, and in so doing traverse the cultural, ontological and epistemological breaks that death entails. [source] Methodology for evaluating physician order entry (POE) implementationsJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 4 2003Glen Geiger MD CM MASc BASc FRCPC Abstract The body of physician order entry (POE) implementations literature uses statistical evaluation methods to demonstrate changes in specified variables after POE implementation. To understand and manage the holistic impact of POE on the health care institution, a methodology that utilizes feedback to guide the POE implementation towards the satisfaction of stakeholder objectives is presented. Stakeholders jointly define quantitative and qualitative metrics for their objectives, establish target value vectors for the metrics that represent acceptable implementation outcomes and specify evaluation milestones. These are used to compare pre- and post-POE implementation clinical performance, enabling a socio-technical feedback,improvement cycle. A case study is provided to illustrate how the methodology is being used at Sunnybrook and Women's College Health Science Centre in Toronto, Canada. [source] Stability of the Infant Car Seat Challenge and Risk Factors for Oxygen Desaturation EventsJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 4 2007Michele DeGrazia Objectives:, To explore the stability of the one-point Infant Car Seat Challenge and risk factors that may be associated with oxygen desaturation events. Design, Setting, and Participants:, This descriptive, nonexperimental, observational study examined the responses of 49 premature infants during two 90-minute Infant Car Seat Challenges at a tertiary health care institution. Main Outcome Measures:, Three Infant Car Seat Challenge outcomes were explored: (a) pass/fail rates following two Infant Car Seat Challenge observation periods, (b) oxygen saturation and desaturation patterns during two Infant Car Seat Challenges, and (c) the association between oxygen desaturation events and infants' chronological, gestational, and corrected gestational ages. Results:, The findings indicated that 86% of premature infants had stable results, 8% passed Infant Car Seat Challenge 1 but not Infant Car Seat Challenge 2, and 6% failed Infant Car Seat Challenge 1 and passed Infant Car Seat Challenge 2. In addition, the odds for oxygen desaturation events increased for infants born at less than or equal to 34 weeks gestation and hospitalized longer than 7 days. Conclusions:, The Infant Car Seat Challenge success rate for identifying infants at risk for oxygen desaturation events was equal to or better than that of other screening tests for newborn medical conditions. The findings of this study will assist neonatal health care providers in making appropriate recommendations for infants' safe travel at discharge. JOGNN, 36, 300-307; 2007. DOI: 10.1111/J.1552-6909.2007.00161.x [source] Estimation of health-care costs for work-related injuries in the Mexican Institute of social securityAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 3 2009Fernando Carlos-Rivera MScE Abstract Background Data on the economic consequences of occupational injuries is scarce in developing countries which prevents the recognition of their economic and social consequences. This study assess the direct heath care costs of work-related accidents in the Mexican Institute of Social Security, the largest health care institution in Latin America, which covered 12,735,856 workers and their families in 2005. Methods We estimated the cost of treatment for 295,594 officially reported occupational injuries nation wide. A group of medical experts devised treatment algorithms to quantify resource utilization for occupational injuries to which unit costs were applied. Total costs were estimated as the product of the cost per illness and the severity weighted incidence of occupational accidents. Results Occupational injury rate was 2.9 per 100 workers. Average medical care cost per case was $2,059 USD. The total cost of the health care of officially recognized injured workers was $753,420,222 USD. If injury rate is corrected for underreporting, the cost for formal injured workers is 791,216,460. If the same costs are applied for informal workers, approximately half of the working population in Mexico, the cost of healthcare for occupational injuries is about 1% of the gross domestic product. Conclusions Health care costs of occupational accidents are similar to the economic direct expenditures to compensate death and disability in the social security system in Mexico. However, indirect costs might be as important as direct costs. Am. J. Ind. Med. 52:195,201, 2009. © 2008 Wiley-Liss, Inc. [source] Decentralization and health care in the former Yugoslav Republic of MacedoniaINTERNATIONAL JOURNAL OF HEALTH PLANNING AND MANAGEMENT, Issue 1 2006Sonia Menon Abstract Since its independence in 1991, the Republic of Macedonia became a highly centralized state, with most relevant decisions taken at the central level in Skopje, resembling the highly centralized system, which once characterized Former Yugoslavia. As agreed in the Framework Agreement, which ended six months of internal conflict, the Macedonian Government will decentralize public services delivery, including social protection, health, education, and infrastructure over the course of the next few years. Within health care, it is argued that by placing policy-making authority and operating control closer to the client, decentralization will reduce some of the inequities in service provision and inefficiencies present within the current centrally controlled system. In principle, local voters will have more information on the price and quality of services, thereby increasing competition in the sector and strengthening the private sector. The emphasis on market incentives resulting in greater efficiency and better management of health care institutions is viewed as one of the benefits of privatization. Critics of decentralization and the subsequent privatization of public services fear it may result in an erosion of quality and consistency across regions, leaving some regions, cities, villages and potentially vulnerable groups worse off than others. The paper argues that if the institutional weaknesses in Macedonia have not been addressed, decentralisation could result in further excluding the rural population from health care provision. Similarly, the need for a clear delineation of responsibilities and functions among different levels and institutions is outlined. Copyright © 2006 John Wiley & Sons, Ltd. [source] COPD-intuition or template: nurses' stories of acute exacerbations of chronic obstructive pulmonary diseaseJOURNAL OF CLINICAL NURSING, Issue 6 2004Patricia Hill Bailey MHSc Study rational., A number of nurse-researchers have examined the experience of dyspnoea reduction during non-acute phases of the chronic obstructive pulmonary disease (COPD). However, nurses working on in-patient hospital units are frequently required to care for individuals suffering from acute exacerbations of their disease (AECOPD). These critically ill individuals present at health care institutions incapacitated by severe shortness of breath/dyspnoea that is frequently refractory to treatment. To date, little is known about the nurses' understanding of the care they provide for individuals hospitalized because of these acute episodes of their chronic illness. Study objectives., The research project was undertaken, in part, to develop an understanding of nurses' experience of caregiving for individuals hospitalized for in-patient care during an AECOPD. Methodological design., This focused ethnographic narrative examined the caregiving stories of 10 nurse caregivers. The 10 nurse caregivers were interviewed while caring for a patient and their family during an experience of an AECOPD characterized by incapacitating breathlessness. Results., The nurse caregivers told a number of caregiving stories that illustrated a common care template that appears to be based on intuition or pattern recognition focusing on anxiety sometimes to the exclusion of dyspnoea. Conclusions., Analysis of these stories emphasized the need to facilitate nurses individualization of standard templates. More importantly, this analysis illustrated the critical need to develop strategies to facilitate the reshaping of inaccurate templates in the presence of new knowledge. [source] Leading change through an international faculty development programmeJOURNAL OF NURSING MANAGEMENT, Issue 8 2009LORA C. LACEY-HAUN PhD Aims, The purpose of the study was to evaluate the modification of an American model of academic leadership training for utilization in an African university and to pilot test the efficacy of the resulting model. Background, Traditionally many educators have moved into administrative positions without adequate training. Current world standards require leadership preparation for a wide array of persons. However, this opportunity did not yet exist in the study setting. Method, University leaders from the University of the Western Cape and the University of Missouri collaborated on revising and pilot testing a successful American academic leadership programme for use among African faculty. Cross-cultural adaptations, participant satisfaction and subsequent outcomes were assessed during the 2-year ,train-the-trainer' leadership development programme. Results, African faculty successfully modified the American training model, participated in training activities, and after 2 years, began to offer the service to other institutions in the region, which has increased the number of nurses in Africa who have had, and who will continue to have, the opportunity to move up the career ladder. Conclusion, The impact of the project extended further than originally expected, as the original plan to utilize the training materials at the University of the Western Cape (UWC) for the in-house faculty was expanded to allow UWC to utilize the modified materials to serve leadership development needs of faculty in other African universities. Implications for nursing management, Study findings will inform those interested in university policy and procedure on leadership training issues. The successful development of a self-sustaining leadership programme in which values of multiple cultures must be appropriately addressed has a significant impact for nursing administration. With the severe nursing shortage, health care institutions must develop cost effective yet quality development programmes to assure the succession of current staff into leadership positions. We no longer have the luxury of recruiting broadly and we must identify those talented nurses within our own institutions and prepare them for advanced leadership roles. This succession plan is especially important for the next generation of nurse leaders representing minority populations. In particular, nurse managers will find the overview of the literature for middle managers enlightening, and may find links to key resources that could be revised to be more culturally relevant for use in a wide array of settings. [source] From iron gaze to nursing care: mental health nursing in the era of panopticismJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 1 2001D. Holmes RN CPMHN MSc PhD (cand) The purpose of this paper is to question the utilization of mechanical devices (cameras and microphones) to ensure the surveillance of hospitalized patients on psychiatric wards. The works of French philosopher, Michel Foucault, and those of nursing theorist, Jean Watson, are used to support this analysis. A growing number of Canadian psychiatric health care institutions are using mechanical devices for surveillance. The security of staff and patients as well as therapeutic purposes are stated as rationale for these practices. However, a Foucauldian perspective leads us to think otherwise. The metaphor of the panopticon is then used to uncover another reality: a disciplinary one. Within the scope of this paper, the question of surveillance, disciplinary power, caring philosophy, and mental health nursing will be examined. [source] Prevalence, prevention, and treatment of pressure ulcers: Descriptive study in 89 institutions in The NetherlandsRESEARCH IN NURSING & HEALTH, Issue 2 2002Gerrie J.J.W. Bours Abstract The purpose of the present study was to assess the prevalence of pressure ulcers and the use of Dutch guidelines for the prevention and treatment of pressure ulcers. A survey of 16,344 patients in 89 health care institutions on 1 day showed a mean prevalence of pressure ulcers of 23.1%. It was found that Dutch guidelines on some aspects of prevention and treatment of pressure ulcers were not being followed. Only 53% of the patients who should have been positioned on a support surface were positioned on such a device. Fewer than one-third of the patients who should have been repositioned, should have received nutritional support, or should have been educated received these interventions, and only 33.6% of all pressure ulcers were dressed as recommended. More attention to the dissemination and implementation of the guidelines is needed to reduce this high prevalence of pressure ulcers. © 2002 Wiley Periodicals, Inc. Res Nurs Health 25:99,110, 2002 [source] | ||||||||||