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Practice Issues (practice + issues)
Selected AbstractsETHICAL, LEGAL, AND PROFESSIONAL PRACTICE ISSUES INVOLVED IN ACTING AS A PSYCHOLOGIST PARENT COORDINATOR IN CHILD CUSTODY CASESFAMILY COURT REVIEW, Issue 3 2004Matthew J. Sullivan The use of Psychologist Parent Coordinators in child custody cases (called Special Masters in California) is becoming increasingly prevalent across the country. This postdivorce parenting coordination role is a legal/psychological hybrid, demanding knowledge and skill in legal domains (legal procedure, relevant case law, etc.), psychological domains (child development, family systems, etc.), and dispute resolution (mediation and settlement processes). Situated in the interface of legal and psychological paradigms, Parent Coordination may be reviewed by multiple legal and psychological regulatory bodies. Coming from varying perspectives, the practice guidelines and mandates of these legal, ethical, and licensing agencies impose multiple standards of review of Parent Coordination. A brief overview of the legal and psychological review processes applicable to Special Master work in California, as they relate to common issues that confront the Parenting Coordinator across the country, is the focus of this article. They suggest that the current lack of coordination of review processes creates a minefield of professional risk for the psychologist who chooses to practice in this role. [source] Narrative Methods and Children: Theoretical Explanations and Practice IssuesJOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING, Issue 1 2008Lorna Bennett RN TOPIC:,The Narrative approach is an innovative way of working with children and adolescents experiencing mental health problems. This approach can be effectively integrated with the expressive arts and other nonverbal ways of accessing the life world of children. In addition, the approach promotes respect for and collaboration with the child in working towards healing and growth. PURPOSE:,In this paper core features of the narrative approach are described; the theoretical and philosophical and evidence base for this approach as well as its congruence with the special nature and needs of children will be explored. Finally, the benefits and challenges of this approach in relation to a specific clinical situation will be highlighted. SOURCES USED:,Published literature and the author's clinical experiences. CONCLUSION:,Narrative methods are ideally suited for addressing needs of children experiencing mental health problems and can enhance therapeutic effectiveness. Some of the challenges associated with its use include: finding creative ways to apply specific narrative concepts and methods with diverse clinical issues/problems; learning to collaborate with children and respect them as experts in their own lives; and shifting the nursing focus from a problem-focused orientation to a strength-oriented and child-centered approach. [source] Women in Academic Emergency MedicineACADEMIC EMERGENCY MEDICINE, Issue 9 2000Rita K. Cydulka MD Abstract. Objective: To evaluate the achievement gof women in academic emergency medicine (EM) relative to men. Methods: This study was a cross-sectional mail survey of all emergency physicians who were employed at three-fourths full-time equivalent or greater at the 105 EM residency programs in the United States from August 1997 to December 1997. The following information was obtained: demographics, training and practice issues, roles and responsibilities in academic EM, percentage of time spent per week in clinical practice, teaching, administrative and research activities, academic productivity, and funding. Results: Of the 1,575 self-administered questionnaires distributed by the office of the chairs, 1,197 (76%) were returned. Two hundred seventy-four (23%) of the respondents were women, and 923 (77%) were men. There was a significant difference noted between men and women in all demographic categories. The numbers of respondents who were nonwhite were extremely small in the sample and, therefore, the authors are hesitant to draw any conclusions based on race/ethnicity. There was no difference in training in EM between men and women (82% vs 82%, p = 0.288), but a significantly higher proportion of male respondents were board-certified in EM (84% vs 76%, p < 0.002). Women in academic EM were less likely to hold major leadership positions, spent a greater percentage of time in clinical and teaching activities, published less in peer-reviewed journals, and were less likely to achieve senior academic rank in their medical schools. Conclusions: These findings mirror those of most medical specialties: academic achievement of women in academic EM lags behind that of men. The paucity of minority physicians in academic EM didn't permit analysis of their academic achievements. [source] MAKING FAMILIES AND CHILDREN A HIGH PRIORITY IN THE COURTSFAMILY COURT REVIEW, Issue 4 2002California's Center for Families, Children & the Courts This article describes the California Administrative Office of the Court's (AOC's) Center for Families, Children & the Courts (CFCC). CFCC is an interdisciplinary unit that brings together all of the AOC's work on statewide policies and practices related to families and children in the court system. CFCC thus models the unified family court model within the state AOC. CFCC's projects and activities are described to show the effectiveness of its multidisciplinary and collaborative approach in addressing complex policy and practice issues. It is hoped that readers may discover aspects of CFCC's work that could be adapted to their own jurisdiction or practice. [source] The North American Immune Tolerance Registry: contributions to the thirty-year experience with immune tolerance therapyHAEMOPHILIA, Issue 1 2009D. DIMICHELE Summary., The North American Immune Tolerance Registry (NAITR) began in 1992 as a project of the ISTH Factor VIII/IX Subcommittee with the goal of further determining immune tolerance induction (ITI) practices in Canada and the United States. This retrospective registry study, published in 2002, was limited in its capacity to provide definitive answers to many unresolved ITI practice issues. Nonetheless, it played a role in developing guidelines for current ITI practice and in generating hypotheses that must now be examined through rigorous prospective data collection efforts. For haemophilia A, the logical next step has been the initiation of international prospective randomized studies of ITI outcome relative to factor VIII (FVIII) dose and purity for subjects with high titre inhibitors. Both trials will additionally provide platforms for translational study of the immunology of tolerance, a prelude to the next generation of safe and effective tolerizing strategies. For the less common problem of FIX inhibitor eradication, prospective randomized studies will not be a feasible way to confirm the NAITR observations. Coordinated international efforts will still be required to prospectively collect data on ITI outcome to document new potentially effective therapeutic strategies for inhibitor eradication. These registries will hopefully also serve to identify potential subjects for scientific studies of immunology of haemophilia B-related allergic phenomena, a devastating complication of FIX antibody development. [source] Scoping practice issues in the Australian mental health nursing workforceINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 3 2000Michael Clinton ABSTRACT This is the third of four articles on the scoping study of the Australian mental health nursing workforce conducted on behalf of the Australian and New Zealand College of Mental Health Nurses (ANZCMHN) for the Australian Health Ministers Advisory Council (AHMAC) National Working Group on Mental Health (NWGMH). Its purpose is to focus on factors that significantly affect mental health nursing practice. The issues of advanced practice, regulation of nursing, accreditation, credentialling and demarcation with other disciplines are addressed. [source] Puzzling practice: A strategy for working with clinical practice issuesINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 2 2008Kenneth Walsh RPN RN BNurs PhD In this paper we aim to share the evolution of innovative ways to explore, ,unpack' and reframe clinical issues that exist in everyday practice. The elements of these processes, which we call ,puzzling practice', and the techniques associated with them, were delineated over a two year period by the four authors using action theory based processes. The authors have evolved several different frameworks for ,puzzling practice' which we draw on and use in our practice development work and in our research practice. This paper pays attention to a particular form of puzzling practice that we have found to be useful in assisting individual clinicians and teams to explore and find workable solutions to practice issues. The paper uses a semi-fictitious example of ,Puzzling Practice' gleaned from our experience as practice development facilitators. In this example ,puzzling practice' uses seven different elements; naming the issue; puzzling the issue; testing the puzzle exploring the heart of out practice; formulating the puzzle question; visualizing the future; and generating new strategies for action. Each of the elements is illustrated by the story and the key foundations and ideas behind each element is explored. [source] Tourism and socio-economic development: UK tour operators' business approaches in the context of the new international agendaINTERNATIONAL JOURNAL OF TOURISM RESEARCH, Issue 5 2001Richard Tapper Abstract Rapid growth of tourism to developing countries has led to new international expectations for tourism as an agent of socio-economic development. This paper describes these new expectations, reviews the influence of tour operators on tourism-dependent economies, and reports research into ways that UK outbound tour operators could respond to the new international expectations of their business ethic and practices. It shows that structural and business practice issues, especially local economic linkages in the supply chain, need to be addressed if the tourism industry is to contribute effectively to meeting new expectations of its role in socio-economic development in developing countries. Copyright © 2001 John Wiley & Sons, Ltd. [source] Validity in action research: a discussion on theoretical and practice issues encountered whilst using observation to collect dataJOURNAL OF ADVANCED NURSING, Issue 3 2001Christopher Turnock MSc MPhil DANS DPSN RN Validity in action research: a discussion on theoretical and practice issues encountered whilst using observation to collect data Aim.,The paper contributes to an understanding of validity in action research methodology by examining issues arising from our attempts to describe the role of an observer in an action research study. Background.,Our experiences in observing patient care in intensive care settings are used to illuminate discussion on the nature of validity in action research. Content.,The paper examines the nature of validity in action research methodology before briefly describing a study that included observing intensive care staff providing patient care. Various perspectives on observation as a research method are critically examined. These include observer role, level of participation, use of cover, structure and timing of observation. Validity in action research underpins the discussion in the paper. Conclusion.,We conclude that it may not always be possible to categorize the role of the observer within existing definitions. It may be better to summarize the actual observer role as a way of illustrating validity so that the reader can judge the validity of the findings from an action research study. [source] An exploration of the factors that influence the implementation of evidence into practiceJOURNAL OF CLINICAL NURSING, Issue 8 2004Jo Rycroft-Malone PhD Background., The challenges of implementing evidence-based practice are complex and varied. Against this background a framework has been developed to represent the multiple factors that may influence the implementation of evidence into practice. It is proposed that successful implementation is dependent upon the nature of the evidence being used, the quality of context, and, the type of facilitation required to enable the change process. This study sets out to scrutinize the elements of the framework through empirical enquiry. Aims and objectives., The aim of the study was to address the following questions: , What factors do practitioners identify as the most important in enabling implementation of evidence into practice? , What are the factors practitioners identify that mediate the implementation of evidence into practice? , Do the concepts of evidence, context and facilitation constitute the key elements of a framework for getting evidence into practice? Design and methods., The study was conducted in two phases. Phase 1: Exploratory focus groups (n = 2) were conducted to inform the development of an interview guide. This was used with individual key informants in case study sites. Phase 2: Two sites with on-going or recent implementation projects were studied. Within sites semi-structured interviews were conducted (n = 17). Results., A number of key issues in relation to the implementation of evidence into practice emerged including: the nature and role of evidence, relevance and fit with organizational and practice issues, multi-professional relationships and collaboration, role of the project lead and resources. Conclusions., The results are discussed with reference to the wider literature and in relation to the on-going development of the framework. Crucially the growing body of evidence reveals that a focus on individual approaches to implementing evidence-based practice, such as skilling-up practitioners to appraise research evidence, will be ineffective by themselves. Relevance to clinical practice., Key elements that require attention in implementing evidence into practice are presented and may provide a useful checklist for future implementation and evaluation projects. [source] Getting personal: an exploratory study of intimate and personal care provision for people with profound and multiple intellectual disabilitiesJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 2 2002S. Carnaby Abstract Background Intimate and personal care is a major area of support and provision for people with intellectual disability (ID), particularly those with profound and multiple ID. However, its management and practice has largely been neglected outside the use of individual guidelines and same-gender intimate care policies, with little research evidence or theoretical literature to inform the planning, conduct and organization of associated care tasks. Results The present paper reports on the methodology and findings of an exploratory study designed to map the key management and practice issues, and suggest ways forward for the providers of services for people with ID in relation to the quality and outcomes of intimate and personal care. [source] Decisional involvement of senior nurse leaders in Canadian acute care hospitalsJOURNAL OF NURSING MANAGEMENT, Issue 2 2010CAROL A. WONG RN wong c.a., laschinger h., cummings g.g., vincent l. & o'connor p. (2010) Journal of Nursing Management 18, 122,133 Decisional involvement of senior nurse leaders in Canadian acute care hospitals Aim, The aim of the present study was to describe the scope and degree of involvement of senior nurse leaders (SNLs) in executive level decisions in acute care organizations across Canada. Background, Significant changes in SNL roles including expansion of decision-making responsibilities have occurred but little is known about the patterns of SNL decision-making. Methods, Data were collected by mailed survey from 63 SNLs and 49 chief executive officers (CEOs) in 66 healthcare organizations in 10 Canadian provinces. Regression analyses were used to examine whether timing, breadth of content expertise and the number of decision activities predicted SNL decision-making influence and quality of decisions. Results, Breadth of content expertise and number of decision activities with which the SNL was involved were significant predictors of decision influence explaining 22% of the variance in influence. Overall, CEOs rated SNL involvement in decision-making higher than the SNL. Conclusions, Senior nurse leaders contribute to organizational processes in healthcare organizations that are important for nurses and patients, through their participation in decision-making at the senior team level. Implications for nursing management, Findings may be useful to current and future SNLs learning to shape the nature and content of information shared with CEOs particularly in the area of professional practice issues. [source] A Delphi survey of evidence-based nursing priorities in Hong KongJOURNAL OF NURSING MANAGEMENT, Issue 5 2002C PSYCHOL, Peter French PhD The purpose of this study was to inform an evidence-based nursing development project within the Hospital Authority, Hong Kong. It considered the specific question of: what are the nursing practice issues which need to be addressed as a matter of priority in order to improve nursing practice, the quality of care or develop some aspect of nursing practice. A three round Delphi survey was adopted. The methodological problems associated with the use of the Delphi method are addressed. An expert panel consisting of 190 Department Operations Managers (nurses) was identified. The data collection focused on issues related to nursing skills and client care and excluded management or educational issues. Agreed categories were prioritized in the final round by utilizing a 11-point rating scale. The group mean score for each category was calculated and rank ordered. The results provided 45 categories that reflected the nursing practice priorities that required more research evidence to guide practice. The top five ranked items were: nurse patient communication, resuscitation, administration of medicines, counselling and nursing documentation. The top 10 items were used to inform the advisory and selection processes for the evidence-based practice development project. [source] Strategies for Managing Barriers to the Writing ProcessNURSING FORUM, Issue 4 2000Celia E. Wills RN Publication is essential to advancing nursing knowledge for clinical practice, but relatively few nurses publish the results of their research or other writings about clinical practice issues. This article identifies some common barriers to writing for publication-personal factors, such as inadequate knowledge and writing skills, lack of confidence, and low motivation for writing for publication; and situational factors, such as limited time, energy, and other resources constraints-and discusses strategies for managing such barriers. Key words: [source] Forensic Issues in Pain: Review of Current PracticePAIN PRACTICE, Issue 2 2001Ronald J. Kulich PhD Ethical guidelines and recommendations for assessment, documentation, record review, and court testimony are discussed. Specific issues include the assessment of disability and impairment, malingering, and application of the Daubert standard in forensic pain practice. Examples of case law are reviewed for civil liability and CRPS, malpractice with opioid prescribing, and practice issues in a correctional setting. [source] Retention: An unresolved workforce issue affecting rural occupational therapy servicesAUSTRALIAN OCCUPATIONAL THERAPY JOURNAL, Issue 4 2002Anna Mills Failure to retain health professionals in rural areas contributes to the poor health status of these communities through an inability to deliver reliable and consistent services. Considerable attention has been focused on factors affecting recruitment of health professionals. Far less is known about factors affecting the retention of occupational therapists. This was the focus of this study. Ethnographic interviews were used to explore the experiences of 10 occupational therapists who had left rural practice. Six themes emerged from the participants' experiences, from when they first considered rural practice to reflections following their departure from it. These themes were initial appeal, facing the challenge, rural practice issues, the social sphere, reasons for leaving and the value of rural experience. These factors gave rise to a proposed Model of Retention Equilibrium, which suggests that retention can be improved by addressing the imbalance between incentives to leave and incentives to stay. The model provides a useful framework for occupational therapists contemplating rural practice, as well as for health services managers responsible for service delivery in rural areas. [source] Baby K's unlawful removal: practice issues in the emergency protection of childrenCHILD ABUSE REVIEW, Issue 3 2010Mike Freel Abstract This paper addresses the legal and practice issues raised by a particular case in the UK. In January 2008, less than three hours after his birth, Baby K was removed from his mother's care by hospital staff and placed in a separate ward. At a High Court hearing later that morning, it was ruled that the removal of Baby K was unlawful. Important practice issues are raised by this ruling. After setting out the circumstances under which Baby K was removed from his mother, this paper considers a number of issues raised by the case: (i) what constitutes lawful removal under domestic law; (ii) European jurisprudence and domestic law in relation to emergency removal at birth; (iii) parental consent to removal; (iv) professionals' liability for breaches of human rights; and (v) the role of child protection plans in safeguarding children. Copyright © 2010 John Wiley & Sons, Ltd. [source] Serious case reviews: learning to use expertiseCHILD ABUSE REVIEW, Issue 3 2005Marian Brandon Abstract While undertaking an analysis of 20 serious case reviews for the Welsh Assembly Government, the authors became aware of important, largely unexplored, practice issues with implications for training, service delivery and the role of the lead professional. The reviews were studied using a ,layered reading' methodology to ensure that emerging themes were grounded entirely in the reports. In looking beyond the familiar recurring themes and practice failings, findings emerged about the use of expertise in its widest sense. The need for more skilled use of expertise was identified, from external specialists and child protection specialists, and from children, siblings and parents. Professionals from agencies who contribute less routinely to the process of safeguarding children should be consulted as experts and be empowered to play a fuller part. Consultation could often be used prior to, or in place of referral. The barrier to the collation and analysis of relevant information often appeared to be a failure to recognize and understand expertise rather than a lack of communication as often postulated in review reports. Skilled use of expertise and consultation in a coordinated manner could result in more rigorous assessments and promote greater professional trust, confidence and challenge. Copyright © 2005 John Wiley & Sons, Ltd. [source] Breaking barriers,provision and participation in an out-of-school centreCHILDREN & SOCIETY, Issue 2 2001Berry Mayall This paper uses a research and development project , the A Space project in Hackney , as an exemplar for discussion of policy and practice issues arising from the recent expansion of out-of-school child care and study support services. In particular, the authors explore children's participation rights and multi-agency working, two key principles upon which A Space is based. The paper suggests that current government out-of-school policy raises key questions about the siting, staffing, coordination and costs of future services; and that underlying these are more fundamental questions about: how children should be spending their time; and whose perspectives on this should be taken into account. Copyright © 2001 John Wiley & Sons, Ltd. [source] Enhancing Mental Health Service Delivery to Ethnically Diverse Populations: Introduction to the Special SeriesCLINICAL PSYCHOLOGY: SCIENCE AND PRACTICE, Issue 4 2003A. Toy Caldwell-ColbertArticle first published online: 11 MAY 200 The American Psychological Association's adoption of guidelines for providing psychological services to diverse populations and the enactment by the National Institutes of Health (NIH) of regulations that required the representation of women and ethnic minorities in NIH-funded research projects called attention to the need to improve mental health services for ethnically diverse populations. This special series illustrates the relevance of cultural and ethnic factors in addressing contemporary mental health needs and the role of these factors in the work of clinicians who serve ethnically diverse clinical populations. The articles comprising the series examine the mental health dimensions of five contemporary clinical practice issues: HIV/AIDS, eating disorders, hate crimes, folk healing, and youth at high risk for drug abuse. [source] | |||||||||||||