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High Quality Care (high + quality_care)
Selected AbstractsThe Government of Health Care and the Politics of Patient Empowerment: New Labour and the NHS Reform Agenda in EnglandLAW & POLICY, Issue 3 2010KENNETH VEITCH This article considers the issue of patient empowerment in the context of New Labour's proposed reforms to the National Health Service (NHS) in England. Through an exploration of some of the key measures in the government's white paper High Quality Care for All, the article argues for a conceptualization of patient empowerment as a political technique of governing. Patient empowerment, it is contended, can no longer be understood solely as a quantitative phenomenon to be balanced within the doctor-patient relationship. Rather, its deployment by the government as a way of governing health and health care more broadly demands that we consider what political functions,including, importantly, it is argued here, managing the problem of the increasing cost of illness and health care,patient empowerment may be involved in performing. In order to assist in this enquiry, the article draws on some of Michel Foucault's work on the art of governing. It is suggested that his understanding of the neoliberal mode of governing best captures the proposed changes to the NHS and the role patient empowerment plays in their implementation. [source] The Long Road to Better ACHD CareCONGENITAL HEART DISEASE, Issue 3 2010Gary Webb MD ABSTRACT The care of adult patients with congenital heart defects in the United States is spotty at best, and needs to improve greatly if the needs of these patients are to be met. The care of American children with congenital heart defects is generally excellent. Pediatric cardiac services are well established and well supported. The care of adults with congenital heart disease (CHD) is well established in only a few American centers. While there are an increasing number of clinics, they are generally poorly resourced with relatively few patients. If located in adult cardiology programs, they are usually minor players. If located in pediatric cardiac programs, they are usually minor players as well. Training programs for adult CHD (ACHD) caregivers are few, informal, and poorly funded. To improve the situation, we need perhaps 25 well-resourced and well-established regional ACHD centers in the United States. We need to stop the loss to care of CHD patients at risk of poor outcomes. We need to educate patients and families about the need for lifelong and skilled surveillance and care. We need to effect an orderly transfer from pediatric to adult care. We need to strengthen the human resource infrastructure of ACHD care through the training and hiring of healthcare professionals of a quality equivalent to those working in the pediatric care environment. We need to demonstrate that adult care is high quality care. We need more high-quality ACHD research. The ACHD community needs to establish its credibility with pediatric cardiac providers, adult cardiology groups, with governments, with professional organizations, and with research funding agencies. Accordingly, there is a need for strong political action on behalf of American ACHD patients. This must be led by patients and families. These efforts should be supported by pediatric cardiologists and children's hospitals, as well as by national professional organizations, governments, and health insurance companies. The goal of this political action should be to see that ACHD patients can receive high-quality lifelong surveillance, that we lose fewer patients to care, and that the staff and other services needed are available nationwide. [source] The importance of ,knowing the patient': community nurses' constructions of quality in providing palliative careJOURNAL OF ADVANCED NURSING, Issue 4 2000Karen A. Luker PhD BNurs RGN RHV NDNCert The importance of ,knowing the patient': community nurses' constructions of quality in providing palliative care This paper reports findings from a study conducted in one community health care trust where 62 members of the district nursing team (grades B,H) were interviewed. An adaptation of the critical incident technique was used to determine factors which contributed or detracted from high quality care for a number of key areas including palliative care. The centrality of knowing the patient and his/her family emerged as an essential antecedent to the provision of high quality palliative care. Factors enabling the formation of positive relationships were given prominence in descriptions of ideal care. Strategies used to achieve this included establishing early contact with the patient and family, ensuring continuity of care, spending time with the patient and providing more than the physical aspects of care. The characteristics described by the community nurses are similar to those advocated in ,new nursing' which identifies the uniqueness of patient needs, and where the nurse,patient relationship is objectified as the vehicle through which therapeutic nursing can be delivered. The link with ,new nursing' emerges at an interesting time for community nurses. The past decade has seen many changes in the way that community nursing services are configured. The work of the district nursing service has been redefined, making the ideals of new nursing, for example holism, less achievable than they were a decade ago. This study reiterates the view that palliative care is one aspect of district nursing work that is universally valued as it lends itself to being an exemplar of excellence in terms of the potential for realizing the ideals of nursing practice. This is of increasing importance in the context of changes that militate against this ideal. [source] Caring for older people in prehospital emergency care: can nurses make a difference?JOURNAL OF CLINICAL NURSING, Issue 9 2005MPhil, PGCTHE, Vidar Melby BSc Aims and objectives., The aim of this paper is to explore older people's experiences in prehospital emergency care, and identify benefits and difficulties associated with developing a nurse-led ambulance service. Data were collected at sites in Sweden and Norway. Focus group interviews were conducted to enable the collection of data from paramedics, ambulance nurses and nursing students, while individual interviews were utilized to gather data from older people. Background., There is little research on the quality of care older people over 65 years old receive in prehospital emergency care. Older people often present with multiple pathology and diverse needs that nurses are well equipped to deal with, but presently there is no clearly defined role for nurses in prehospital emergency care in the United Kingdom, although other countries such as Sweden and Norway are developing an ambulance nurse role. Conclusions., If the multiple needs of older people were addressed in the prehospital field, a reduction in readmissions and increased functional ability might be achieved. Comprehensive training is required for ambulance staff to enable them to meet such needs. While nurses have a great foundation for this care, additional specialist ambulance training is required alongside a need for education on older people's needs and attitudes to older people. Relevance to clinical practice., The introduction of ambulance nurses will result in role differentiation between paramedics and ambulance nurses, which has the potential for creating role conflict. To ensure a smooth transition appropriate training and education for nurses and paramedics should be provided. The end result is a potentially greatly enhanced ambulance care provision, enabling high quality care to all patients. [source] Performance assessment in health care providers: a critical review of evidence and current practiceJOURNAL OF NURSING MANAGEMENT, Issue 8 2007KAREN E. STC. Aim, To evaluate methods of performance assessment through an international literature review and a survey of current practice. Background, Over the past two decades health care organizations have focussed on promoting high quality care in conjunction with retaining motivated staff. Cognisant of such initiatives, we sought to evaluate assessment methods for qualified staff according to their utility in the working environment. Methods, A systematic literature search was completed and each paper independently reviewed. All health care organizations in Northern Ireland submitted details of their performance assessments. Each was critically appraised using a utility index. Results, Performance was not universally defined. A broad range of assessments were identified, each method had advantages and disadvantages. Although many lacked rigorous testing, areas of good practice were also noted. Conclusions, No single method is appropriate for assessing clinical performance. Rather, this study endorses proposals for a multi-method strategy to ensure that performance assessment demonstrates all attributes required for effective nursing and midwifery practice. [source] Competence profiles of recently registered nurses working in intensive and emergency settingsJOURNAL OF NURSING MANAGEMENT, Issue 8 2007ANNE H. SALONEN MNSc Background, Preceptorship is an essential method of supporting nurse competence, guaranteeing high quality care and increasing job satisfaction. Aim, To describe recently registered nurses' perceptions of their competence level, and to identify factors influencing these perceptions. Method, The survey was conducted by using Meretoja's Nurse Competence Scale. The sample comprised 235 registered nurses working in intensive and emergency settings. The data were analysed by using statistical methods. Results, Nurses' self-assessed competence level ranged from moderate to good. A statistically significant association was seen between competence level and age, length of current work experience and the frequency of using competencies. Conclusions, The results shed useful light on the educational needs of nurses and provide important clues for the development of preceptorship programmes. The Nurse Competence Scale proved to be a reliable and valid instrument in assessing the competence of recently registered nurses. Implications for nursing management, We recommend that management strategies be developed to enhance and support positive learning environments for competence development. We recommend preceptorship programmes based on systematic competence assessments made by nurses themselves, their preceptors and managers. [source] Physician assistants: trialling a new surgical health professional in AustraliaANZ JOURNAL OF SURGERY, Issue 6 2010Phyllis Ho Abstract Background:, The Australia health workforce productivity Commission Research Report in 2005 identified workforce shortages. One of the recommendations is that new models of health care be established. As a result South Australia is trialling United States trained physician assistants in a pilot program. This paper summaries the review of literature of the physician assistant role and safety in the surgical setting. Methods:, A literature search using Medline and Pubmed from 1966 until 2009 with key words: physician assistants, midlevel providers, surgery. The references of the results were also searched for suitable articles. The Google search engine was also used with the above keywords to search for latest developments from nontraditional sources. Results:, There were over 200 suitable articles relating to the quality and safety of physician assistants. The overwhelming majority of the articles originate from the United States and these vary in quality. There were 13 published studies identified that documented physician assistants in the surgical setting. Conclusion:, From the published data physician assistants have been shown to provide safe and provide high quality care in surgical units. It is important that prior to their commencement their role is defined to alleviate conflict and confusion in the team. Continued auditing should be conducted to monitor progress and impact. [source] | ||||||||||