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Practice Site (practice + site)
Selected AbstractsCaring for people in the ,virtual ward': the practical ramifications for acute nursing workJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 4 2003M. DEACON, ba (hons) m.phil rmn srn enb(810) This paper discusses an aspect of data analysis arising from an ethnographic study of acute mental health nursing conducted in an inner city psychiatric unit. The data were collected in the form of field notes. These were made during and following episodes of participant observation on one acute ward and on a psychiatric intensive care unit over a period of 20 months. Acute wards have been subject to continuing criticism as both sites of care and treatment for mentally ill people and of nursing work. However, the practical operations of this social world remain largely unexamined. It is argued that without this understanding, mundane work methods will always be regarded as an impediment to work that is regarded as ,therapeutic' and therefore, of importance. The focus will be on phenomena named the ,virtual ward'. The research has demonstrated that the boundaries of nurses' responsibility reach far beyond the ward's spatial environment, both physically and communicatively. The complexity of the work that takes place within the virtual ward and the skills required for its successful completion are taken for granted, but are also a practical source of frustration. Anonymized examples from the practice site studied are used to illuminate the discussion. Working within the virtual ward is part of the messy reality of nurses' work. It is argued that understanding and respecting this reality is necessary if we are to be seriously and consistently ambitious about practice development. [source] Chronic statin therapy and the risk of colorectal cancer,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 9 2008MSCE, Yu-Xiao Yang MD Abstract Background and Aims Epidemiologic studies on a potential chemopreventive effect of statin therapy have yielded conflicting results. We sought to clarify whether long-term statin therapy has a chemopreventive effect on the risk of colorectal cancer (CRC) in a large, population-representative cohort. Methods A nested case,control study was conducted among patients ,50 years of age and with ,5 years of CRC-free initial follow-up in the General Practice Research Database (GPRD; 1987,2002). Cases consisted of all patients with incident CRC. Up to 10 controls were matched with each case on practice site and both duration and calendar time of follow-up prior to the index date. The primary exposure of interest was ,5 years of cumulative statin use. Results We identified 4432 incident CRC cases and 44,292 controls. The adjusted odds ratio (OR) for ,5 years of statin exposure was 1.1 (95% confidence interval (CI): 0.5,2.2). Chronic NSAID/aspirin use did not modify this primary association (test for interaction, p,=,0.5). Compared to statin non-users, the adjusted OR for 10 years of statin exposure was 1.3 (95% CI: 0.6,2.7), and the adjusted OR associated with the highest quartile of cumulative statin dose was 1.2 (95% CI: 0.9,1.7). There was a non-statistically significant trend towards a possible reduction in CRC risk among users of high daily statin dose. Conclusion Long-term statin therapy at usual doses was not associated with a significantly reduced risk of CRC. A chemopreventive effect at high daily doses cannot be excluded. Copyright © 2008 John Wiley & Sons, Ltd. [source] Nurse-Midwives' Experiences with Planned Home Birth: Impact on Attitudes and PracticeBIRTH, Issue 4 2009Saraswathi Vedam RM, SciD(h.c.) ABSTRACT: Background: Health care providers' attitudes toward maternity care options influence the nature of informed decision-making discussions and patient choice. A woman's choice of birth site may be affected by her provider's opinion and practice site. The objectives of this study were to describe American nurse-midwives' attitudes toward, and experiences with, planned home birth, and to explore correlates and predictors of their attitudes toward planned home birth as measured by the Provider Attitudes towards Planned Home Birth (PAPHB) scale.Methods: A survey instrument, which incorporates the PAPHB and assesses demographic, education, practice, personal experience, and external barrier variables that may predict attitudes toward planned home birth practice, was completed by 1,893 nurse-midwives. Bivariate analysis identified associations between variables and attitudes. Linear regression modeling identified predictors of attitudes.Results: Variables that significantly predicted favorable attitudes to planned home birth were increased clinical and educational experiences with planned home birth (p < 0.001), increased exposure to planned home birth (p < 0.001), and younger age (p < 0.001). External barriers that significantly predicted less favorable attitudes included financial (p = 0.03) and time (p < 0.001) constraints, inability to access medical consultation (p < 0.001), and fear of peer censure (p < 0.001). Willingness to practice in the home was correlated with factors related to nurse-midwives' confidence in their management abilities and beliefs about planned home birth safety.Conclusions: The results suggest that nurse-midwives' choice of practice site and comfort with planned home birth are strongly influenced by the nature and amount of exposure to home birth during professional education or practice experiences, in addition to interprofessional, logistic, and environmental factors. Findings from this research may inform interdisciplinary education and collaborative practice in the area of planned home birth. [source] Getting Your Feet Wet: Becoming a Public Health Nurse, Part 1PUBLIC HEALTH NURSING, Issue 1 2004D.N.Sc., Lee SmithBattle R.N. Abstract While the competencies and theory relevant to public health nursing (PHN) practice continue to be described, much less attention has been given to the knowledge derived from practice (clinical know-how) and the development of PHN expertise. A study was designed to address this gap by recruiting nurses with varied levels of experience and from various practice sites. A convenience sample of 28 public health nurses and seven administrators/supervisors were interviewed. A subsample, comprised of less-experienced public health nurses, were followed longitudinally over an 18-month period. Data included more than 130 clinical episodes and approximately 900 pages of transcripts and field notes. A series of interpretive sessions focused on identifying salient aspects of the text and comparing and contrasting what showed up as compelling, puzzling, and meaningful in public health nurses' descriptions. This interpretive analysis revealed changes in understanding of practice and captured the development of clinical know-how. In Part 1, we describe the sample, study design, and two aspects of clinical knowledge development,grappling with the unfamiliar and learning relational skills,that surfaced in nurses' descriptions of early clinical practice. In Part 2, which is to be published in the next issue of Public Health Nursing (SmithBattle, Diekemper, & Leander, 2004), we explore gradual shifts in public health nurses' understanding of practice that led to their engagement in upstream, population-focused activities. Implications of these findings for supporting the clinical learning of public health nurses and the development of expertise are described. [source] A Win,Win Model for an Academic Nursing Center: Community Partnership Faculty PracticePUBLIC HEALTH NURSING, Issue 2 2002Stella Shiber Ph.D. A number of schools of nursing have established community nursing centers to provide faculty practice sites, student learning experiences, and a service to the community, most often to a poor underserved population. The current literature concludes that these centers provide a quality clinical service and improve access to health care, and they also provide an avenue for research, training, and faculty practice. Acquiring necessary financial support and the ability to achieve financial independence appear to be the most common difficulties for these centers. Most of the current literature includes an examination of issues relating to funding. The model presented in this article focuses on organizational variables that include both the center and its placement in relationship to other functions and programs in the school and a broadening of the meaning of fiscal responsibility to include an awareness of the broad spectrum of benefits that the community nursing center brings to the entire school. Efforts to coordinate and integrate the needs and functions of several groups are described. Establishing goals and priorities that simultaneously meet the needs of all or most of these groups has been an important outcome. The activities of the center have become an integral part of the everyday life of the school. Achieving financial independence and being fiscally aware and responsible is not the same thing. [source] | ||||||||||