Journal articles on the topic 'Historical nursing practices'
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Vieira, Amanda Nicácio, Stéfany Petry, and Maria Itayra Padilha. "Best Practices in Historical Studies of Nursing and Health (1999-2017)." Revista Brasileira de Enfermagem 72, no. 4 (August 2019): 973–78. http://dx.doi.org/10.1590/0034-7167-2018-0538.
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ABSTRACT Objective: to analyze the best practices thematic in dissertations and theses produced by a research group of history of nursing and health from 1999 to 2017. Method: a documentary socio-historical research with a qualitative approach. Documentary sources were dissertations and theses using content analysis. Results: 30 dissertations and 20 theses were found with compliance with the objective. Best practices refer to care and assistance practices, the history of institutions and organizational entities, and the implementation of nursing practices in each institution. Educational process addresses best practices in support groups, educational institutions and specialty construction. Other studies bring the milestones of the nursing profession, confrontation situations and social reflection regarding vulnerabilities. Final considerations: the studies address best practices in nursing that go through several settings in the attempt to raise problems and promote scientific research to support nursing actions in care.
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Fortuna, Cinira Magali, Silvia Matumoto, Silvana Martins Mishima, and Anna Maria Meyer Maciel Rodríguez. "Collective Health Nursing: desires and practices." Revista Brasileira de Enfermagem 72, suppl 1 (February 2019): 336–40. http://dx.doi.org/10.1590/0034-7167-2017-0632.
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ABSTRACT Objective: To discuss and reflect on collective health nursing practices, presenting the work-related experience of nurses. Method: This was a reflection paper based on the labor process theory. Results: Studies conducted in research groups, discussions at scientific events, and professional experiences point to the importance of recognizing the intentionality of health work. Furthermore, it is essential t understand the health-illness-care process adopted and advocated by health professionals, and the role of social determinants and the entire historical, political, economic and social context of professional training, healthcare service organization and society. Conclusion: Collective health nursing practices play an important role in the health care provided to the population. Nurses are reference professionals in health care in all stages of life; however, further reflection is required on professional training, politicization, and the concepts of health and illness that guide professional practices.
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Moreno Mojica, Claudia María, and Julián Andrés Barragán Becerra. "Pedagogical practices and learning processes." ÁNFORA 26, no. 46 (December 12, 2018): 91–100. http://dx.doi.org/10.30854/anf.v26.n46.2019.559.
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Objective: to identify the configuration and institutionalization of pedagogical practices and teaching processes in the discipline of nursing, as well as the proposals that emerge for the integral human development, according to the humanistic approach underlying the profession.
Methodology: integrative literature review based on the question: What are the scientific products that suggest the configuration and institutionalization of pedagogical practices and learning processes in nursing?
Results: 78 articles were selected of which 58 formed the final sample which allowed for the structuring and analysis of two categories: pedagogical practices, a process of reflection and transition; critical pedagogy and learning processes, a challenge for the discipline.
Conclusions: Nursing has a legacy of biomedical-traditional educational models, which have shaped a positivist teaching-learning process. In this historical process, one of the priorities is knowing the model institutionalized by academic programs with the aim of discussing and rethinking its coherence with the disciplinary phenomenon: care.
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Guimarães, Juliana Cabral da Silva, Bárbara Lima dos Santos, Pacita Geovana Gama de Souza Aperibense, Gizele da Conceição Soares Martins, Maria Angélica de Almeida Peres, and Tania Cristina Franco Santos. "Electroconvulsive therapy: historical construction of nursing care (1989-2002)." Revista Brasileira de Enfermagem 71, suppl 6 (2018): 2743–50. http://dx.doi.org/10.1590/0034-7167-2018-0168.
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ABSTRACT Objective: to describe the nursing care performed by the nursing team to the person with mental disorder submitted to ECT and to analyze the implications of the Psychiatric Reform in this care. Method: socio-historical study, which uses the Thematic Oral History method. Results: the nursing team is present in a continuous way in the monitoring of people submitted to ECT, performing care before, during and after the same, as well as visualizing the evolution of the technique and also of nursing care itself, however, does not recognize the Psychiatric Reform as agent for this change. Final considerations: the Brazilian Psychiatric Reform triggered a process of humanization of nursing knowledge, influencing the care of the person with mental disorder submitted to ECT, with this, care practices also changed, a law was approved, regulating its practice, and its application was decreasing.
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Machado, Wiliam César Alves. "Gender, health and nursing: the male inclusion in the nursing care." Online Brazilian Journal of Nursing 3, no. 2 (July 27, 2004): 58–68. http://dx.doi.org/10.17665/1676-4285.20044922.
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It is treated of a bibliographical revision concerning the insert of the masculine in the contexts of clinical and social practice of taking care in the nursing ambit, drawing new contours for what was instituted by the feminist optics the historical record of the professional formation process in Brazil. It presents and it discusses with property the specifiable certain areas of the professionals' of the area performance, where the masculine presence is as indispensable as in other feminine spaces, for subjects of good sense and measures of comfort promotion, safety, privacy and the clients' well-being under cares and therapeutic nursing interventions to care. It proposes a wider to read again of the historical conjunctures on gender and practices of health care, suggesting larger interaction and the valorization of the positive aspects of both polarities to adapt the new order of the third millennium.
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Oliveira, Rebeca Nunes Guedes de, and Rosa Maria Godoy Serpa da Fonseca. "Violence as a research object and intervention in the health field: an analysis from the production of the Research Group on Gender, Health and Nursingi." Revista da Escola de Enfermagem da USP 48, spe2 (December 2014): 31–38. http://dx.doi.org/10.1590/s0080-623420140000800006.
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The study aimed to describe how violence is revealed in the production of the Research Group on Gender, Health and Nursing. This is a historical research of qualitative approach, which evaluated the production of the Research Group, through content analysis. The results show gender as a central category in determining violence and health practices. This aspect determines limitations on professional practices of coping, such as the invisibility of the problem. The female autonomy, the use of alcohol and drugs and social vulnerability play an important relation with the phenomenon and the bond is revealed as potentiality of health practices to address the problem. Conclusion: The gender perspective in nursing research is an innovative field and counter-hegemonic, a possibility to assume a meaning of praxis by transforming potential of understanding and modes of intervention in the phenomenon of gender violence.
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Kletemberg, Denise Faucz, Maria Itayra Padilha, Isabel Alves Maliska, Mariana Vieira Villarinho, and Roberta Costa. "The labor market in gerontological nursing in Brazil." Revista Brasileira de Enfermagem 72, suppl 2 (2019): 97–103. http://dx.doi.org/10.1590/0034-7167-2018-0178.
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ABSTRACT Objective: to analyze the development of the labor market in Gerontological Nursing in Brazil, between 1970 and 1996. Method: a descriptive-qualitative study with a historical approach that uses the oral history of 14 research nurses working in the historical period, based on the ideas of Eliot Freidson. Results: Nursing overcame barriers to change the care practices to elderly people in the period described, considering the lack of a specific labor market; the need for theoretical knowledge for Gerontology care; the scarcity of research and researchers in the field; the emergence of caregivers for elderly people; the construction of multidisciplinarity and the transformation of institutions for a long-term stay. Final considerations: the expansion of the labor market at the time was grounded on advances on the production of knowledge of the aging process, supported by the demographic transition, that determined the increase in the demand by elderly people for health services and the enactment of specific laws protecting this population.
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Carter, Brigit Maria, and G. Rumay Alexander. "Entrenched White Supremacy in Nursing Education Administrative Structures." Creative Nursing 27, no. 1 (February 1, 2021): 14–18. http://dx.doi.org/10.1891/crnr-d-20-00084.
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The National League for Nursing, the American Nurses Association, and the American Association of Colleges of Nursing each have published directives or position statements that support initiatives that would diversify faculty in nursing education; some initiatives very specifically address increasing diversity within nursing faculty leadership ranks. Despite support for these initiatives, there is a lack of faculty members of color in higher-level leadership positions in nursing academia. This article explores two questions that unfold contributing factors. Is the absence of faculty members of color due to historical exclusionary practices of institutional racism? Or is it due to components of internalized racism that may cause faculty members of color to devalue their own potential and ability to rise to leadership roles? Either answer helps explain how entrenched white supremacy continues to be a barrier to diversifying nursing academia. Are we strong enough to dismantle the obstacles to achieving diversity in nursing academic leadership?
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Rodrigues, Rosalina Aparecida Partezani, Alacoque Lorenzini Erdmann, Isília Aparecida Silva, Josicélia Dumet Fernandes, Thelma Leite Araújo, Lucila Amaral Carneiro Vianna, Rosangela da Silva Santos, and Marta Júlia Marques Lopes. "Doctoral education in nursing in Brazil." Revista Latino-Americana de Enfermagem 16, no. 4 (August 2008): 665–71. http://dx.doi.org/10.1590/s0104-11692008000400003.
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This study aimed to present the trajectory of doctoral education in nursing in Brazil from 1981 to 2004. A descriptive and analytical study was carried out, using documents available at the Brazilian Federal Agency for Support and Evaluation of Graduate Education, a body responsible for the recognition, evaluation and coordination of graduate studies in Brazil. Data analysis revealed that there are 13 doctoral courses in nursing, most of which are concentrated in the Southeast (69.2%), and that teaching and scientific production have been influenced by demographic and epidemiological transitions and by historical, social and political movements. Knowledge production is related to Nursing Care, Health Management and Practices and Theoretical Foundations of Care. Doctoral programs have prepared leaders in the fields of education, research and public policy development, in health institutions as well as in public policies, health institutions and governmental entities.
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Peterson, Steven. "Father Surrogate: Historical Perceptions and Perspectives of Men in Nursing and Their Relationship with Fathers in the NICU." Neonatal Network 27, no. 4 (July 2008): 239–43. http://dx.doi.org/10.1891/0730-0832.27.4.239.
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Femininity is often associated with the nursing profession, but is not one of its defining characteristics. Men have been providing care to the sick and injured for many centuries, and they continue to do so for many reasons. Male nurses display a wide range of caring practices, which may not always be interpreted as such by their female counterparts. This article presents the male perspective and approach to caring, including the unique relationship that male nurses can have with fathers in the NICU.
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Sortvik, Wenche, Jeanne Boge, Staf Callewaert, and Karin Anna Petersen. "Korleis sjukepleievitskap materialiserer seg i lys av historisk oppkomst – kunnskapsgenerering i spenningsfeltet mellom klinikk og akademia." Nordisk tidsskrift for helseforskning 12, no. 1 (June 23, 2016): 77. http://dx.doi.org/10.7557/14.3777.
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How nursing science materializes related to historical origin – knowledge in the field of tension between the clinic and academia The focus of this paper is on the scientific development in nursing, and is based on an analysis of master-thesis in nursing science at the University of Bergen in the period 2005-2010 when the master title came to Norway (Sortvik 2011). The aim of this paper is on what focus a new scientific discipline as nursing science has developed through the thesis, and how it constitutes during a certain amount of time. The article starts with a presentation of themes and the basis of recognition. Then philosophy of science and methodologies that are the dominant tendencies will be discussed related to the historical origin of nursing science at the University of Bergen. The empirical theoretical and methodological approach is based upon the theory of the French sociologist Pierre Bourdieu about understanding current practices in light of historical origin.Results: Majority uses qualitative method (71.4%), and is using phenomenological and hermeneutical approaches. The quantitative tasks (26.2%) are mainly anchored in medical terminology and are using medical statistics. Issues are mainly from the nurses own practices and practical utility are emphasized. Only one work is using mixed methods. Questions that will be discussed are why these master-thesis materialize in the way they do, and what kind of factors that influence opportunities and choices in nursing science?Artikkelen omhandlar sjukepleievitskapleg kunnskapsproduksjon, og er basert på ein analyse av mastergradsoppgåver i sjukepleievitskap ved Universitetet i Bergen frå perioden 2005-2010 (Sortvik 2011). Spørsmål som belysast er korleis eit ungt vitskapsfag som sjukepleievitskap gjennom eit tidsrom konstituerer seg som produsent av ny kunnskap. Artikkelen startar med presentasjon av erkjenningsgrunnlaget og tematikkane i mastergradsoppgåvene. Deretter diskuterast dominerande tendensar i lys av sjukepleievitskapens historiske oppkomst ved Universitetet i Bergen. Arbeidsmåten vert gjort i forlenging av sosiologen Pierre Bourdieus teori om å forstå notidige praktikkar i historisk lys.Resultat: Fleirtalet av oppgåvene er kvalitative (71,4%), og nyttar fenomenologisk og hermeneutisk tilnærming. Dei kvantitative oppgåvene (26,2%) er hovudsakleg forankra i medisinsk fagterminologi. Problemstillingane er i hovudsak frå eigen praksis og praktisk nytteeffekt vert vektlagt. Ei av mastergradsoppgåvene kombinerer kvalitativ og kvantitativ tilnærming.Spørsmål som vert diskutert er korleis det kan ha seg at mastergradsoppgåvene framstår som dei gjer, og kva som påverkar sjukepleias handlerom i det akademiske felt?
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Carvalho, Brígida Gimenez, Marina Peduzzi, Edir Nei Teixeira Mandú, and José Ricardo de Carvalho Mesquita Ayres. "Work and Inter-subjectivity: a theoretical reflection on its dialectics in the field of health and nursing." Revista Latino-Americana de Enfermagem 20, no. 1 (February 2012): 19–26. http://dx.doi.org/10.1590/s0104-11692012000100004.
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This theoretical reflection intends to show the inter-subjective relationship that takes place in health and nursing practices under the following theoretical perspectives: Institutional Analysis, Psychodynamics of Labor and the Theory of Communicative Action, with an emphasis on the latter. Linking these concepts to the Marxist approach to work in the field of health emerges from recognizing the need for its continuous reconstruction-in this case, with a view to understand the interaction and communication intrinsic to work in action. The theory of Communicative Action seeks to consider these two inextricable dimensions: work as productive action and as interaction. The first corresponds to instrumental action based on technical rules with a production-guided rationale. The second refers to the interaction that takes place as communicative action and seeks understanding among subjects. We assume that adopting this theoretical perspective in the analysis of health and nursing practices opens new possibilities for clarifying its social and historical process and inter-subjective connections.
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Jessee, Erin. "‘There Are No Other Options?’: Rwandan Gender Norms and Family Planning in Historical Perspective." Medical History 64, no. 2 (March 17, 2020): 219–39. http://dx.doi.org/10.1017/mdh.2020.4.
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This article surveys the evolution of Rwandan family planning practices from the nation’s mythico-historical origins to the present. Rwanda is typically regarded as a patriarchal society in which Rwandan women have, throughout history, endured limited rights and opportunities. However, oral traditions narrated by twentieth-century Rwandan historians, storytellers and related experts, and interpreted by the scholars and missionaries who lived in Rwanda during the nation’s colonial period, suggest that gender norms in Rwanda were more complicated. Shifting practices related to family planning – particularly access to contraception, abortion, vasectomies and related strategies – are but one arena in which this becomes evident, suggesting that women’s roles within their families and communities could be more diverse than the historiography’s narrow focus on women as wives and mothers currently allows. Drawing upon a range of colonial-era oral traditions and interviews conducted with Rwandans since 2007, I argue that Rwandan women – while under significant social pressure to become wives and mothers throughout the nation’s past – did find ways to exert agency within and beyond these roles. I further maintain that understanding historical approaches to family planning in Rwanda is essential for informing present-day policy debates in Rwanda aimed at promoting gender equality, and in particular for ensuring women’s rights and access to adequate healthcare are being upheld.
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Fairchild, Amy L. "Twentieth-Century Ethics of Human Subjects Research: Historical Perspectives on Values, Practices, and Regulations (review)." Bulletin of the History of Medicine 80, no. 3 (2006): 602–4. http://dx.doi.org/10.1353/bhm.2006.0093.
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Apple, Rima D. "School health is community health: school nursing in the early twentieth century in the USA." History of Education Review 46, no. 2 (October 2, 2017): 136–49. http://dx.doi.org/10.1108/her-01-2016-0001.
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Purpose The purpose of this paper is to investigate the evolution of school nursing in the USA in the early decades of the twentieth century, highlighting the linkages between schools and public health and the challenges nurses faced. Design/methodology/approach This historical essay examines the discussions about school nursing and school nurses’ descriptions of their work. Findings In the Progressive period, though the responsibilities of school nurse were never clearly defined, nurses quickly became accepted, respected members of the school, with few objecting to their practices. Nonetheless, nurses consistently faced financial complications that limited, and continue to limit, their effectiveness in schools and communities. Originality/value Few histories of school health have documented the critical role nurses have played and their important, although contested, position today. This paper points to the obstacles restricting the development of dynamic school nurse programs today.
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Leonello, Valéria Marli, and Maria Amélia de Campos Oliveira. "Higher education in nursing: the faculty work process in different institutional contexts." Revista da Escola de Enfermagem da USP 48, no. 6 (December 2014): 1093–102. http://dx.doi.org/10.1590/s0080-623420140000700018.
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Objective To analyze the characteristics of faculty work in nursing higher education. Method An exploratory qualitative study with a theoretical-methodological framework of dialectical and historical materialism. The faculty work process was adopted as the analytical category, grounded on conceptions of work and professionalism. Semi-structured interviews were conducted with 24 faculty members from three higher education institutions in the city of São Paulo, classified according to the typology of institutional contexts. Results The faculty members at these higher education institutions are a heterogeneous group, under different working conditions. Intensification and precarious conditions of the faculty work is common to all three contexts, although there are important distinctions in the practices related to teaching, research and extension. Conclusion Faculty professionalization can be the starting point for analyzing and coping with such a distinct reality of faculty work and practice.
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Bourque Bearskin, R. Lisa, Brenda L. Cameron, Malcolm King, and Cora Weber Pillwax. "Mâmawoh Kamâtowin, "Coming together to help each other in wellness": Honouring Indigenous Nursing Knowledge." International Journal of Indigenous Health 11, no. 1 (June 30, 2016): 18. http://dx.doi.org/10.18357/ijih111201615024.
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<p>This paper is the result of coming to know and better understand Indigenous nursing experience in First Nations, Inuit and Métis communities. Using an Indigenous research approach, I (first author) drew from the collective experience of four Indigenous nurse scholars and attended to the question of how Indigenous knowledge manifests itself in the practices of Indigenous nurses and how it can better serve individuals, families, and communities. This research framework centered on Indigenous principles, processes, and practical values as expressed in Indigenous nursing practice. The results were woven from key understandings and meanings of Indigeneity as a way of being. Central to this study was that Indigenous knowledge has always been fundamental to the ways that these Indigenous nurses have undertaken nursing practice, regardless of the systemic and historical barriers they faced in providing healthcare for Indigenous people. The results of this research demonstrated how Indigenous nurses consistently drew on their inherited Indigenous knowledge to deliver nursing care to Indigenous people. Their identity as Indigenous persons was integral to their identities as Indigenous nurses. Of significance is the personal and particular description of how these Indigenous nurse scholars developed their nursing approaches in relevance to how health and healthcare delivery must be integrated into healthcare systems as a pathway to reducing health disparities. </p>
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Oguisso, Taka, Paulo Fernando De Souza Campos, and Almerinda Moreira. "Enfermagem pré-profissional no Brasil: questões e personagens." Enfermagem em Foco 2, SUP (May 16, 2011): 68–72. http://dx.doi.org/10.21675/2357-707x.2011.v2.nsup.85.
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O presente artigo recupera experiências efetivadas por homens e mulheres em contextos distintos da história da enfermagem pré-profissional brasileira, anterior à institucionalização da formação acadêmica. Pretende-se atualizar conteúdos específicos, recuar o tempo histórico e evidenciar personagens que atuaram no âmbito do cuidar. O objetivo deste trabalho é contribuir para o reconhecimento de ações derivadas do cuidado pré-profissional, desvelando questões pertinentes à pesquisa em enfermagem. Acredita-se que os conteúdos relativos ao período pré-profissional transformam interpretações existentes sobre as origens do cuidado no Brasil, cujas matrizes históricas fundamentam práticas e teorias contemporâneas (humanização, equidade), indicativos seguros da utilidade da análise histórica em relação ao desenvolvimento da profissão.Descritores: História da Enfermagem, Cuidadores, Pesquisa em Enfermagem.Pre-professional nursing in Brazil: issues and charactersThis article recovers past experiences by men and women within distinct contexts of the Brazilian pre-professional nursing history, prior to the academicals education institutionalization. This paper aims to up to date specific contents, go back in the historical time and to evidence who have worked within caring scope and to contribute for the recognition of derived actions in the pre-professional caring scope, showing issues related to nursing research. It is believed that contents related to the pre-professional period may change existent interpretations on the caring origins in Brazil, whose historical sources are based on contemporaneous practices and theories (humanization, equity) may safely indicate the utility of the historical analysis in relation to the development of the profession.Descriptors: Nursing History, Carers, Nursing Research.Enfermería pre-profesional en Brasil: cuestiones y personajesEl presente artículo recupera experiencias vividas por hombres y mujeres en contextos distintos de la historia de la enfermería pre-profesional brasileña, anterior a la institucionalización de la formación académica. Los objetivos intentan actualizar contenidos específicos, retroceder en el tiempo histórico y evidenciar personajes que actuaron en el ámbito del cuidar. El intento es contribuir para el reconocimiento de las acciones derivadas del cuidado pre-profesional desvelando cuestiones pertinentes a la investigación en Enfermería. Se cree que los contenidos relativos al período pre-profesional transforman interpretaciones existentes sobre los orígenes del cuidado en el Brasil, cuyas bases históricas embasan prácticas y teorías contemporáneas (humanización, equidad) indicativos seguros de la utilidad del análisis históricos en relación al desarrollo de la profesión.Descriptores: Historia de la Enfermería, Cuidadores, Investigacíón en Enfermería.
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Macduff, Colin, Anne Marie Rafferty, Alison Prendiville, Kay Currie, Enrique Castro-Sanchez, Caroline King, Fernando Carvalho, and Rick Iedema. "Fostering nursing innovation to prevent and control antimicrobial resistance using approaches from the arts and humanities." Journal of Research in Nursing 25, no. 3 (May 2020): 189–207. http://dx.doi.org/10.1177/1744987120914718.
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Background Efforts to address the complex global problem of antimicrobial resistance (AMR) highlight the need for imagination and innovation. However, nursing has not yet leveraged its potential to innovate to prevent AMR advancing. Aims This paper focuses on the initial phase of an ongoing research and development study that seeks to foster nursing imagination and innovation by enhancing the meaningfulness of AMR for practising nurses and by facilitating their creative ideas. Methods This aim is addressed through application of arts and humanities approaches, in particular the use of visualisation, co-design and historical methods, underpinned by the Design Council Double Diamond process model. The first phase with 20 UK participants explored how hospital and community-based nurses understand and respond to the priorities and consequences of AMR within their everyday working lives. Results Nurses varied in their conceptualisations of AMR and in their depictions and explanations of its meaning and priority within everyday practices. Some saw infection prevention and control as bound up with AMR, whereas others differentiated in the context of specific work activities. Insights into related reasoning and practice tactics were also generated. Conclusions The initial project phase provides a basis for fostering nursing innovation in this important field.
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Javier, Noelle Marie. "Palliative care needs, concerns, and affirmative strategies for the LGBTQ population." Palliative Care and Social Practice 15 (January 2021): 263235242110392. http://dx.doi.org/10.1177/26323524211039234.
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The Lesbian, Gay, Bisexual, Transgender, and Queer/Questioning population, also known as sexual and gender minorities, are an incredibly marginalized and vulnerable population that have been disproportionately affected by the provision, delivery, and optimal access to high-quality medical care including palliative, hospice, and end-of-life care. The long-standing and unique experiences shaped by positive and negative historical events have led to a better understanding of significant barriers and gaps in equitable healthcare for this population. The intersection of both internal and external stressors as well as minority identities in the context of discriminatory political and societal infrastructures have resulted in variable health outcomes that continues to be plagued by economic barriers, oppressive legislative policies, and undesirable societal practices. It could not be more urgent and timely to call upon the government and healthcare systems at large to execute reforms in policies and regulations, engage in cultural competency training, and promote cultural shifts in beliefs, attitudes, and practices that will ultimately recognize, prioritize, and address the needs of this population. After all, health care access is a universal right regardless of personal, social, political, and economic determinants of comprehensive medical care.
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Coombe, Paul. "The Cassel Hospital, London." Australian & New Zealand Journal of Psychiatry 30, no. 5 (October 1996): 672–80. http://dx.doi.org/10.3109/00048679609062664.
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This paper is an account of the principles and practices of treatment offered at the Cassel Hospital, London, with a particular focus on the Inpatient Families Unit. The Cassel Hospital is an internationally renowned therapeutic community, the operation of which is based on psychoanalytic principles and which has operated within the British National Health Service for nearly 50 years. An account of the historical development of the hospital is given as well as a description of its structure and function. The following three innovative structures are elaborated: a complex network within which patients can develop, Cassel-style nursing care, and nurse-therapist supervision. Theoretical underpinnings are outlined, which together with two case studies facilitate an appreciation of the capacity of the therapeutic network to foster the successful treatment of a range of severely disordered individuals and families. Such treatment may approach a level perhaps otherwise unattainable and which is widely applicable in the public hospital and clinic settings in Australia.
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Mor, Vincent, Angelo E. Volandes, Roee Gutman, Constantine Gatsonis, and Susan L. Mitchell. "PRagmatic trial Of Video Education in Nursing homes: The design and rationale for a pragmatic cluster randomized trial in the nursing home setting." Clinical Trials 14, no. 2 (January 9, 2017): 140–51. http://dx.doi.org/10.1177/1740774516685298.
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Background/Aims Nursing homes are complex healthcare systems serving an increasingly sick population. Nursing homes must engage patients in advance care planning, but do so inconsistently. Video decision support tools improved advance care planning in small randomized controlled trials. Pragmatic trials are increasingly employed in health services research, although not commonly in the nursing home setting to which they are well-suited. This report presents the design and rationale for a pragmatic cluster randomized controlled trial that evaluated the “real world” application of an Advance Care Planning Video Program in two large US nursing home healthcare systems. Methods PRagmatic trial Of Video Education in Nursing homes was conducted in 360 nursing homes (N = 119 intervention/N = 241 control) owned by two healthcare systems. Over an 18-month implementation period, intervention facilities were instructed to offer the Advance Care Planning Video Program to all patients. Control facilities employed usual advance care planning practices. Patient characteristics and outcomes were ascertained from Medicare Claims, Minimum Data Set assessments, and facility electronic medical record data. Intervention adherence was measured using a Video Status Report embedded into electronic medical record systems. The primary outcome was the number of hospitalizations/person-day alive among long-stay patients with advanced dementia or cardiopulmonary disease. The rationale for the approaches to facility randomization and recruitment, intervention implementation, population selection, data acquisition, regulatory issues, and statistical analyses are discussed. Results The large number of well-characterized candidate facilities enabled several unique design features including stratification on historical hospitalization rates, randomization prior to recruitment, and 2:1 control to intervention facilities ratio. Strong endorsement from corporate leadership made randomization prior to recruitment feasible with 100% participation of facilities randomized to the intervention arm. Critical regulatory issues included minimal risk determination, waiver of informed consent, and determination that nursing home providers were not engaged in human subjects research. Intervention training and implementation were initiated on 5 January 2016 using corporate infrastructures for new program roll-out guided by standardized training elements designed by the research team. Video Status Reports in facilities’ electronic medical records permitted “real-time” adherence monitoring and corrective actions. The Centers for Medicare and Medicaid Services Virtual Research Data Center allowed for rapid outcomes ascertainment. Conclusion We must rigorously evaluate interventions to deliver more patient-focused care to an increasingly frail nursing home population. Video decision support is a practical approach to improve advance care planning. PRagmatic trial Of Video Education in Nursing homes has the potential to promote goal-directed care among millions of older Americans in nursing homes and establish a methodology for future pragmatic randomized controlled trials in this complex healthcare setting.
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Rodney, Ruth. "Decolonization in health professions education: reflections on teaching through a transgressive pedagogy." Canadian Medical Education Journal 7, no. 3 (December 5, 2016): e10-18. http://dx.doi.org/10.36834/cmej.36840.
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Background: Canadian health educators travel to the global south to provide expertise in health education. Considering the history of relations between the north and south, educators and healthcare providers from Canada should critically examine their practices and consider non-colonizing ways to relate to their Southern colleagues.Methods: Using her experience as a teacher with the Toronto Addis Ababa Academic Collaboration in Nursing, the author explored issues of identity and representation as a registered nurse and PhD candidate teaching in Ethiopia. Transgressive pedagogy was used to question how her personal, professional, and institutional identities impacted her role as a teacher.Results: Thinking and acting transgressively can decrease colonizing relations by acknowledging boundaries and limitations within present ideas of teaching and global health work and help moving beyond them. The act of being transgressive begins with a deeper understanding and consciousness of who we are as people and as educators.Conclusion: Working responsibly in the global south means being critical about historical relations and transparent about one’s own history and desires for teaching abroad.
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Steel, Rona, and Tri Bui. "Contemporary Australian priming constituents for adult perfusion centres: a survey." Perfusion 35, no. 8 (March 9, 2020): 778–85. http://dx.doi.org/10.1177/0267659120906043.
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Aim: Evidence for the ideal/best practice priming solution remains meagre and largely historical. The aim of this survey was to determine the constituents of contemporary priming solutions in adult open-heart centres across Australia. This would provide insight on the level of variation within current Australian priming practices and inform perfusionists of how their current priming methods compare to the spectrum of Australian practice. Method: A total of 15 survey questions covering various aspects of priming constituents were sent via email to perfusionists in all 63 adult open-heart centres across Australia. Results: This prime survey received a 100% response rate across Australia. All units prime with a balanced physiological solution, 73% of units prime with Plasma-Lyte 148 and 19% with Hartmann’s solution. No synthetic colloids are used for priming in Australia. Up to 6,520 (30%) cases per annum receive heparin as the only additive to their prime base solution. All other cases had various combinations of sodium bicarbonate, mannitol and albumin added for a variety of recorded reasons. Conclusion: Contemporary Australian priming practices show a marked level of conformity between units. Variation exists in the rationale for adding sodium bicarbonate, mannitol and albumin. Further investigations into the clinical effects of these additives are required to determine if the rationale for their addition is historical or judicious in this contemporary era of low prime volumes, physiological base solutions and coated bypass circuits.
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Osorio, Maribel. "Experiencia de las docentes en la enseñanza del cuidado a los estudiantes durante las practicas hospitalarias." GACETA DE PEDAGOGÍA, no. 37 (December 1, 2018): 272–98. http://dx.doi.org/10.56219/rgp.vi37.734.
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Para el docente de enfermería, la enseñanza del cuidado en los centros de pasantía es un desafío en términos de conjugar la teoría con la práctica a fin de que el estudiante desarrolle competencias en un contexto real. El sector salud se enfrenta a situaciones que dificultan las prácticas, entre ellas: déficit de insumos, equipos y materiales, disminución de la planta profesional, precarias condiciones de higiene, entre otras. El objetivo de la investigación fue develar la experiencia en enseñanza del cuidado en las docentes de enfermería. La investigación fue con un diseño de campo con un enfoque fenomenológico interpretativo. Los informantes, cinco profesoras de la Escuela de Enfermería de la Universidad Central de Venezuela. Para la recolección de información se utilizó la entrevista fenomenológica. En los resultados destacan las categorías: concepción y las subcategorías docencia en enfermería y cuidado de enfermería, la categoría experiencia y las subcategorías entorno de aprendizaje y emociones, y la categoría contradicción con las subcategorías referidas a teoría/ practica, riesgos para el estudiante y aspectos éticos. La experiencia de las docentes de enfermería en los entornos de práctica asistencial denota una realidad política, histórica y social que impacta su práctica docente y los principios éticos por cuanto afecta la dignidad de la persona humana, en consecuencia, afecta al estudiante y al propio docente. Las educadoras señalan en su discurso preocupaciones pedagógicas que sin dejar de lado, superan la dimensión instrumental de las prácticas para considerar el aspecto ético, relacional y reflexivo de la enseñanza del cuidado
ABSTRACT
For the nursing teacher, the teaching of care in the internship centers is a challenge in terms of combining theory with practice so that the student can develop competences in a real context. The health sector is facing situations that make it difficult to carry out practices, including: supplies, equipment and materials deficit, decrease of the professional team, poor hygiene conditions, among others. The objective of the research was to reveal the experience in nursing care teaching. The research was descriptive with a field design with an interpretive phenomenological approach. The informants, five professors from the School of Nursing of the Central University of Venezuela. For the collection of information, the phenomenological interview was used. The results highlight the categories: conception and the subcategories teaching in nursing and nursing care, the experience category and the subcategories learning environment and emotions, and the category contradiction with the subcategories referred to theory / practice, risks for the student and aspects ethical. The experience of nursing teachers in healthcare practice environments denotes a political, historical and social reality that impacts their teaching practice and ethical principles because it affects the dignity of the human person, consequently, affects the student and the teacher himself. The educators point out in their speech pedagogical concerns that, without neglecting, exceed the instrumental dimension of the practices to consider the ethical, relational and reflexive aspect of the teaching of care
Key words: Teaching, Care, Nursing
RÉSUMÉ
Pour l’infirmière enseignante, l’enseignement des soins dans les centres de stage est un défi en termes de combinaison de la théorie à la pratique afin que l’étudiant puisse développer des compétences dans un contexte réel. Le secteur de la santé est confronté à des situations qui rendent difficile la mise en œuvre de pratiques telles que: pénurie de fournitures, d’équipements et de matériel, diminution de l’usine professionnelle, mauvaises conditions d’hygiène, entre autres. L'objectif de la recherche était de révéler l'expérience acquise dans l'enseignement des soins infirmiers. La recherche était descriptive avec une conception de terrain avec une approche phénoménologique interprétative. Les informateurs, cinq professeurs de l’École des sciences infirmières de l’Université centrale du Venezuela. Pour la collecte d'informations, l'entretien phénoménologique a été utilisé. Les résultats mettent en évidence les catégories: conception et sous-catégories d'enseignement en soins infirmiers et infirmiers, la catégorie d'expérience et les sous-catégories environnement d'apprentissage et émotions, et la contradiction de catégorie avec les sous-catégories relatives à la théorie / pratique, les risques pour l'étudiant et les aspects éthique. L'expérience des enseignants infirmiers dans des environnements de pratique de soins de santé dénote une réalité politique, historique et sociale qui influe sur leur pratique pédagogique et leurs principes éthiques, car elle affecte la dignité de la personne humaine et, par conséquent, affecte l'étudiant et l'enseignant lui-même. Les éducateurs soulignent dans leur discours des préoccupations pédagogiques qui, sans négliger, dépassent la dimension instrumentale des pratiques pour prendre en compte l’aspect éthique, relationnel et réflexif de l’enseignement des soins.
Mots-clés: enseignement, soins, soins infirmiers
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Seegmiller, Jeff G., David H. Perrin, Kellie C. Huxel Bliven, and Russell T. Baker. "Part I: Doctoral Education in Athletic Training. The Post-Professional Education Committee Doctoral Education Workgroup Report." Athletic Training Education Journal 13, no. 3 (July 1, 2018): 196–204. http://dx.doi.org/10.4085/1303196.
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Context:The academic environment for athletic training is changing following the degree recommendations for professional education programs.Objective:To provide historical context by presenting definitions and information on doctoral degree programs in other health professions.Background:The National Athletic Trainers' Association called for a detailed analysis on doctoral education, and a workgroup was appointed by the Post-Professional Education Committee to fulfill this charge.Synthesis:Expert panel consensus. Data were extracted from a search of 38 databases in the University of Washington library, limiting results to full-text articles published in English between the years 2006 and 2016. Various supporting sources, including professional organizations, accrediting-body Web sites, and the US Department of Labor database, were used for regulatory and professional practice data. Two historical references were used to clarify definitions and provide context.Results:Many health professions began with apprenticeship or certificate models, professional growth led to progressive degree designations such that the majority have now adopted a professional doctorate educational model wherein the professional degree is the terminal degree for professional advancement. Some health professions use residency training as the graduate education equivalent for advanced-practice education, whereas others do not. Only nursing continues to offer professional education at the baccalaureate level.Recommendation(s):There is a growing need for research to further understand best practices in doctoral education and the educational routes athletic trainers pursue. Collection and analysis of new data and examination of past and present doctoral education programs will facilitate recommendations for the future of doctoral education in athletic training.Conclusion(s):Various postprofessional educational models exist among health professions, with different impacts on professional roles, clinical opportunities, student interest, research productivity, and faculty recruitment and retention. The recently created doctor of athletic training programs may be considered a hybrid model providing advanced training in both clinical and research skills.
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Koretzky, Maya Overby. "1328. Medical Education in an Epidemic: Historical Lessons From the Early Days of HIV in America (1982–1986)." Open Forum Infectious Diseases 5, suppl_1 (November 2018): S405—S406. http://dx.doi.org/10.1093/ofid/ofy210.1161.
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Abstract Background Much historical work has investigated the impact of HIV on patient rights, American culture, and medical research; however, there is little scholarship on the impact of HIV on medical education. This study asks how the process of training at the epicenter of an epidemic disease that was poorly understood, incurable, and contagious shaped a cohort of physicians’ experience of residency, beliefs about the role of the doctor in society, and their approach to practicing medicine. Methods Members of the University of California San Francisco (UCSF) intern classes of 1982 and 1983 were interviewed, as well as individuals who were young faculty at San Francisco hospitals in the 1980s. Other sources included academic publications from the 1980s on HIV and medical education, archival documents, nursing and volunteer communications books from the SF General Hospital AIDS Ward, and patient ephemera such as thank you notes and obituaries. Results These interviews and documents highlight themes of commitment to care for HIV patients regardless of risk, lack of formal institutional support for residents engaged in HIV care, and differences in professional norms that allowed nurses and volunteers access to modes of reflection that were unavailable to trainee physicians. For residents, the day to day experience of the HIV epidemic became an important locus for a narrative of medical professionalism and resilience that continues to animate medical education today. Provider narratives about the encounter with HIV served a parallel function to the creation of HIV clinics and public health programs—both were interventions that made HIV into an intelligible cultural and biological entity that could be managed by the medical profession. Conclusion Using the HIV epidemic in San Francisco as a historical example, this project argues that formalizing narrative practices by setting aside time for journaling and verbal reflection in residency and fellowship training can build resilience and prevent burnout. Historical narratives of provider experience, like the oral histories collected in this project, may also be valuable in undergraduate medical education to generate discussion about professional ethics and the responsibilities of providers in an epidemic. Disclosures All authors: No reported disclosures.
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Duncan, Peter. "Failing to Professionalise, Struggling to Specialise: The Rise and Fall of Health Promotion as a Putative Specialism in England, 1980–2000." Medical History 57, no. 3 (May 30, 2013): 377–96. http://dx.doi.org/10.1017/mdh.2013.19.
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AbstractSignificant attention has been paid to the history of public health in England during the final part of the twentieth century. Within this, however, the field that came to be known as specialist health promotion (SHP) has been relatively neglected. Between 1980 and 2000 those working in this field, generally known as health promotion specialists (HPSs), enjoyed a relative rise in policy and practice prominence before SHP was effectively abandoned by government and others charged with developing and sustaining public-health structures. This paper seeks to explain why the fall of SHP is important; to move towards explaining its rise and decline; and to argue for greater historical attention to be paid to an important but neglected field within health and health care. Essentially, SHP emerged from a set of loose and contingent practices known as health education. A range of important social, economic, organisational and political influences contributed to the slow construction of a putative specialism in health promotion, accompanied by the desire on the part of some (but not all) HPSs to ‘professionalise’ their role. Finally the projects of both specialisation and professionalisation failed, again as a result of then prevailing organisational and political influences. The importance of such a failure in a so-called era of public health is discussed. In the light of this, the paper concludes by briefly setting out an agenda for further research related to the history of SHP.
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Gnatta, Juliana Rizzo, Leonice Fumiko Sato Kurebayashi, Ruth Natalia Teresa Turrini, and Maria Júlia Paes da Silva. "Aromatherapy and nursing: historical and theoretical conception." Revista da Escola de Enfermagem da USP 50, no. 1 (February 2016): 127–33. http://dx.doi.org/10.1590/s0080-623420160000100017.
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Abstract Aromatherapy is a Practical or Complementary Health Therapy that uses volatile concentrates extracted from plants called essential oils, in order to improve physical, mental and emotional well-being. Aromatherapy has been practiced historically and worldwide by nurses and, as in Brazil is supported by the Federal Nursing Council, it is relevant to discuss this practice in the context of Nursing through Theories of Nursing. This study of theoretical reflection, exploratory and descriptive, aims to discuss the pharmacognosy of essential oils, the historical trajectory of Aromatherapy in Nursing and the conceptions to support Aromatherapy in light of eight Nursing Theorists (Florence Nightingale, Myra Levine, Hildegard Peplau, Martha Rogers, Callista Roy, Wanda Horta, Jean Watson and Katharine Kolcaba), contributing to its inclusion as a nursing care practice.
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Dantas, Rodrigo Assis Neves, Walkíria Gomes da Nóbrega, Luiz Alves Morais Filho, Eurides Araújo Bezerra de Macêdo, Patrícia De Cássia Bezerra Fonseca, Bertha Cruz Enders, Rejane Maria Paiva de Menezes, and Gilson De Vasconcelos Torres. "Paradigms in health care and its relationship to the nursing theories: an analytical test." Revista de Enfermagem UFPE on line 4, no. 2 (March 29, 2010): 467. http://dx.doi.org/10.5205/reuol.609-7346-1-le.0402201003.
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ABSTRACTObjective: to stablish association between the prevailing paradigms in health care and current nursing practices in Brazil, also their predominant theoretical approaches. Methodology: it's an analytical test based on discussion of theories, concepts and knownledges of some authors on the subject. The research was conducted through online databases, books, theses and dissertations. The inclusion criteria were classic and recent studies that address the theme of this study. Results: the discussion was started by addressing the historical trajectory of care/caring, pointing its changes, its prospects and influence of the current and emerging paradigms, with the focus on nursing care. Conclusion: nursing nowadays is running through several changes, due to the professionals inability to find solutions to the quotidian practical issues. In this context, nursing tries to rescue the essence of human caring as its unifying focus, essential to the practice, although there is awareness that caring does not compose a paradigm in the context of human health experience. Descriptors: professional practice; nursing history; nursing phylosophy; cultural evolution; nursing theory; education, nursing; models, nursing.RESUMOObjetivo: relacionar os paradigmas prevalentes na atenção à saúde com as práticas de enfermagem atuais no Brasil e as suas abordagens teóricas predominantes. Metodologia: trata-se de um ensaio analítico concebido com base na discussão de teorias, conceitos e entendimentos de alguns autores sobre a temática. A pesquisa foi realizada em bases de dados, livros, teses e dissertações de mestrado, utilizando como critério de inclusão, estudos clássicos e atualizados que versassem sobre a temática em questão. Resultados: iniciamos as discussões, abordando a trajetória histórica do cuidar/cuidado, apontando suas mudanças, suas perspectivas e a influência dos paradigmas vigentes e emergentes no foco do cuidado em enfermagem. Conclusão: a enfermagem atual perpassa por diversas mudanças, devido à impossibilidade dos profissionais encontrarem soluções para as questões práticas do cotidiano. Neste contexto, a enfermagem tenta resgatar a essência do cuidado humano como seu foco unificador, fundamental à prática embora haja consciência de que o cuidar não se constitui em um paradigma no contexto da experiência humana em saúde. Descritores: prática profissional; história da enfermagem; filosofia em enfermagem; evolução cultural; teoria de enfermagem; educação em enfermagem; modelos de enfermagem.RESUMENObjetivo: relacionar los paradigmas imperantes en la atención en salud con las prácticas de enfermería en curso en Brasil y sus enfoques teórico predominante. Metodologia: se trata de un ensayo analítico diseñado con base en la discusión de teorías, conceptos y interpretaciones de algunos autores sobre el tema. La busca fue realizada en bases de datos, libros, tesis y disertaciones, utilizando como criterio de inclusión, los artículos clásicos y actuales que abordan el tema central de este estudio. Resultados: el debate se inició abordando la trayectoria histórica del cuidar/cuidado, señalando sus cambios, sus perspectivas y la influencia de los paradigmas actuales y emergentes en el foco de atención de enfermería. Conclusión: la enfermería actual permea por los varios cambios, debido a la incapacidad de los profesionales para encontrar soluciones a los problemas prácticos de la vida cotidiana. En este contexto, la enfermería intenta rescatar la esencia del cuidado humano como su enfoque unificador, fundamental en la práctica, aunque hay conciencia de que el cuidado no constituye un paradigma en el contexto de la experiencia humana en salud. Descriptores: práctica profissional; história de la enfermería; filosofia en enfermería; evolución cultural; teoría de enfermería; educación em enfermería; modelos de enfermería.
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Lamb, Susan. "Social Skills: Adolf Meyer’s Revision of Clinical Skill for the New Psychiatry of the Twentieth Century." Medical History 59, no. 3 (June 19, 2015): 443–64. http://dx.doi.org/10.1017/mdh.2015.29.
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Adolf Meyer (1866–1950) exercised considerable influence over the development of Anglo-American psychiatry during the first half of the twentieth century. The concepts and techniques he implemented at his prominent Phipps Psychiatric Clinic at Johns Hopkins remain important to psychiatric practice and neuro-scientific research today. In the 1890s, Meyer revised scientific medicine’s traditional notion of clinical skill to serve what he called the ‘New Psychiatry’, a clinical discipline that embodied social and scientific ideals shared with other ‘new’ progressive reform movements in the United States. This revision conformed to his concept ofpsychobiology– his biological theory of mind and mental disorders – and accorded with his definition of scientific medicine as a unity of clinical–pathological methods and therapeutics. Combining insights from evolutionary biology, neuron theory and American pragmatist philosophy, Meyer concluded that subjective experience and social behaviour were functions of human biology. In addition to the time-honoured techniques devised to exploit the material data of the diseased body – observing and recording in the clinic, dissecting in the morgue and conducting histological experiments in the laboratory – he insisted that psychiatrists must also be skilled at wielding social interaction and interpersonal relationships as investigative and therapeutic tools in order to conceptualise, collect, analyse and apply the ephemeral data of ‘social adaptation’. An examination of his clinical practices and teaching at Johns Hopkins between 1913 and 1917 shows how particular historical and intellectual contexts shaped Meyer’s conceptualisation of social behaviour as a biological function and, subsequently, his new vision of clinical skill for twentieth-century psychiatry.
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Barnes, Priscilla, Bianca Cureton, Nenette Jessup, Natalie Sutton, Carl Hill, Patrick Shih, Hugh Hendrie, and Yvonne Lu. "COMMUNITY CENTERED APPROACHES TO INCREASE PARTICIPATION OF AFRICAN AMERICANS IN BRAIN HEALTH AND ADRD RESEARCH." Innovation in Aging 6, Supplement_1 (November 1, 2022): 842–43. http://dx.doi.org/10.1093/geroni/igac059.3020.
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Abstract African Americans/Blacks continue to be underrepresented as participants in Alzheimer’s Disease and related dementia (ADRD) and brain research. Numerous challenges such as lack of information about the Alzheimer’s Disease and related dementia (ADRD), socioeconomic barriers, historical and systemic racism, and distrust of research goals and processes persist in research participation. Research approaches tend to be more recruitment oriented rather than partnership driven that do not address these challenges. As a result, community engagement approaches are increasingly being recognized as a means of building trust and creating new pathways for participation in ADRD studies. This poster focuses on the preliminary work of the Collaborative on Aging Research and Engagement (CARE) --- a community academic partnership comprising the CARE Advisory Team (a community action team of 10 African American leaders), Alzheimer’s Association, the Alzheimer’s Association Greater Indiana Chapter, IU Schools of Nursing, Public Health, and Informatics, Computer Science, and Engineering, and the Indiana Alzheimer’s Disease Research Center. The goal of the partnership is to facilitate active engagement of African Americans aged 45 years and older in research opportunities taking place in in Central and Northwest Indiana. Experiences and perspectives shared at the CARE Advisory Team meetings as well as memos from the researcher staff generated five lessons learned in building relationship oriented, as opposed to recruitment driven, processes. These lessons will be used to develop a community engagement framework focused on the integration of culturally relevant outreach practices in promoting ADRD research opportunities in African American/Black communities.
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Copeland, Amy, Angela Criswell, Andrew Ciupek, and Jennifer C. King. "Effectiveness of Lung Cancer Screening Implementation in the Community Setting in the United States." Journal of Oncology Practice 15, no. 7 (July 2019): e607-e615. http://dx.doi.org/10.1200/jop.18.00788.
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PURPOSE: The National Lung Screening Trial demonstrated a 20% relative reduction in lung cancer mortality with low-dose computed tomography screening, leading to implementation of lung cancer screening across the United States. The Centers for Medicare and Medicaid Services approved coverage, but questions remained about effectiveness of community-based screening. To assess screening implementation during the first full year of CMS coverage, we surveyed a nationwide network of lung cancer screening centers, comparing results from academic and nonacademic centers. METHODS: One hundred sixty-five lung cancer screening centers that have been designated Screening Centers of Excellence responded to a survey about their 2016 program data and practices. The survey included 21 pretested, closed- and open-ended quantitative and qualitative questions covering implementation, workflow, numbers of screening tests completed, and cancers diagnosed. RESULTS: Centers were predominantly community based (62%), with broad geographic distribution. In both community and academic centers, more than half of lung cancers were diagnosed at stage I or limited stage, demonstrating a clear stage shift compared with historical data. Lung-RADS results were also comparable. There are wide variations in the ways centers address Centers for Medicare and Medicaid Services requirements. The most significant barriers to screening implementation were insurance and billing issues, lack of provider referral, lack of patient awareness, and internal workflow challenges. CONCLUSION: These data validate that responsible screening can take place in a community setting and that lung cancers detected by low-dose computed tomography screening are often diagnosed at an early, more treatable stage. Lung cancer screening programs have developed different ways to address requirements, but many implementation challenges remain.
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Pessoa Júnior, João Mário, and Francisco Arnoldo Nunes de Miranda. "Historical record of an extinct and intermediary service in mental health: reconstituted and recalled scenery by collaborators." Revista de Enfermagem UFPE on line 6, no. 2 (January 7, 2012): 480. http://dx.doi.org/10.5205/reuol.2052-14823-1-le.0602201231.
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ABSTRACT Objective: to narrate the historical record of an extinct Psychiatric Day Hospital, in Natal/RN, through multidisciplinary team professionals and professors who used it as field of disciplinary practices. Method: documental and qualitative study based on oral narrative thematic technique following the phases: respondent’s authorization, interview recording, transcription, material textualization and transcreation. Documents, inherent administrative rules, general reports of activities and interviews from fifteen collaborators, who used this service, will be used. This comprises 13 professionals of the multidisciplinary team and two professors from Nursing and Medicine undergraduation. Collected histories will be organized according to chosen and associated technique by respecting their phases and the corpus elaboration which will be submitted to ALCEST computing program, prioritizing thus the vital aspect for formation of analysis categories and the classes elected by it. Ethical principles in research are respected, being approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte under the protocol number 38/08 and CAAE: 0041.0.051.000-08. Expected results: the study aims at contributing to discussing the structure of mental health system of the mentioned town, having as starting point the model transition process of mental hospital/hospice care to the psychosocial one, focusing on the extinction of an intermediary service for the construction of other model of communitarian bases. Descriptors: mental health; day hospitals; nursing. RESUMO Objetivo: narrar a trajetória de um hospital-dia (HD) psiquiátrico extinto no município de Natal/RN através dos profissionais da equipe multidisciplinar e dos professores que o utilizaram como campo de práticas disciplinares. Método: estudo documental e qualitativo, respaldado na técnica da história oral temática, seguindo as fases: autorização do depoente, gravação da entrevista, transcrição, a textualização e a transcriação do material. Utilizar-se-á documentos, portarias inerentes, relatórios gerais de atividades e entrevistas com quinze colaboradores que utilizaram esse serviço, sendo 13 profissionais da equipe multidisciplinar e dois docentes da graduação da área da saúde, Enfermagem e Medicina. As histórias coletadas serão organizadas conforme a técnica escolhida associada respeitada respeitando-se suas etapas e para a preparação do corpus o qual será submetido ao programa informático ALCESTE, priorizando o tom vital para a formação das categorias de análise e das classes elegidas por ele. Respeitam-se os princípios éticos em pesquisa, sendo aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal do Rio Grande do Norte sob protocolo n°38/08 e CAAE: 0041.0.051.000-08. Resultados esperados: o estudo se propõe a contribuir no para o debate da estruturação da rede de saúde mental do referido município, partindo do processo de transição do modelo de atenção manicomial/asilar para o psicossocial, focalizando a extinção de um serviço intermediário para a construção de outro modelo de bases comunitárias. Descritores: saúde mental; hospitais-dia; enfermagem. RESUMEN Objetivo: narrar la trayectoria de un hospital diurno (HD) psiquiátrico extinguido en el municipio de Natal/RN a través de los profesionales del equipo multidisciplinar y de los profesores que lo utilizaron como campo de prácticas disciplinarias. Método: estudio documental y cualitativo, respaldado en la técnica de la historia oral temática, siguiendo las fases: autorización del testimonio, grabación de la entrevista, trascripción, textualización y trascripción del material. Se emplearán documentos, circulares inherentes, informes generales de actividades y entrevistas a quince colaboradores que emplearon este servicio, integrado por 13 profesionales del equipo multidisciplinario y dos docentes de graduación del área de Sanidad, Enfermería y Medicina. Los testimonios recogidos se organizarán según la técnica elegida asociada, respetando sus etapas y para la preparación del corpus, que será procesado a través del programa informático ALCESTE, priorizando el tono vital para la formación de las categorías de análisis y de las clases elegidas por este. Se respetan los principios éticos de investigación, habiéndose aprobado por el Comité de Ética en Investigación de la Universidade Federal de Rio Grande do Norte bajo protocolo nº38/08 y CAAE: 0041.0.051.000-08. Resultados esperados: el estudio pretende enriquecer el debate de la estructuración de la red sanitaria mental del referido municipio, partiendo del proceso de transición del modelo de atención de manicomio/ asilo hacia el psicosocial, por medio en la extinción de un servicio intermediario para partir hacia la construcción de otro modelo de bases comunitarias. Descriptores: Salud mental; hospitales de dia; enfermería.
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Da Hora, Kenia Oliveira Barbosa, Glaucia Valente Valadares, and Jussara Regina Martins. "Desafios do cuidado para o advento da saúde sustentável [Care challenges for the advent of sustainable health] [Cuida los desafíos para el advenimiento de la salud sostenible]." Revista Enfermagem UERJ 27 (April 2, 2020): e44070. http://dx.doi.org/10.12957/reuerj.2019.44070.
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Objetivo: analisar a saúde sustentável com o cuidado nas práticas de saúde na enfermagem. Conteúdo: um dos objetivos da Agenda 2030 para o desenvolvimento sustentável é a saúde, e o conceito desta vem se transformando a partir dos momentos históricos vivenciados, com reflexos no aparecimento de novas formulações e propostas de mudanças nos modelos assistenciais de saúde. Faz-se necessário reassumir os compromissos éticos na revalorização do cuidado holístico e na responsabilidade pela vida. Conclusão: não é possível mais admitir que a saúde seja vista somente na forma objetiva e o cuidado do outro possa ser situação estanque e não geradora de reflexões no tocante ao cuidar de si. Ainda que estudos possam garantir avanços inúmeros no combate eficaz a uma doença que acomete de forma implacável toda a sociedade, é preciso ampliar também as questões que possam reforçar os cuidados relacionados à subjetividade.ABSTRACTObjective: to analyze sustainable health with care in nursing health practices. Content: one of the objectives of the 2030 Agenda for sustainable development is health, and the concept of this has been changing from the historical moments experienced, with reflexes in the appearance of new formulations and proposals for changes in health care models. It is necessary to resume ethical commitments in the revaluation of holistic care and responsibility for life. Conclusion: it is no longer possible to admit that health is seen only in an objective way and the care of the other can be a watertight situation and not generating reflections regarding self-care. Although studies can guarantee countless advances in the effective fight against a disease that relentlessly affects the whole of society, it is also necessary to expand the issues that can reinforce the care related to subjectivity.RESUMENObjetivo: analizar la salud sostenible con cuidado en las prácticas de salud de enfermería. Contenido: uno de los objetivos de la Agenda 2030 para el desarrollo sostenible es la salud, y el concepto de esto ha ido cambiando desde los momentos históricos experimentados, con reflejos en la aparición de nuevas formulaciones y propuestas para cambios en los modelos de atención médica. Es necesario retomar los compromisos éticos en la revaluación del cuidado holístico y la responsabilidad por la vida. Conclusión: ya no es posible admitir que la salud se ve solo de manera objetiva y que el cuidado del otro puede ser una situación estanca y no generar reflexiones sobre el autocuidado. Aunque los estudios pueden garantizar innumerables avances en la lucha efectiva contra una enfermedad que afecta implacablemente a toda la sociedad, también es necesario ampliar los problemas que pueden reforzar la atención relacionada con la subjetividad.
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Lauck, Sandra B., Jae-Yung Kwon, David A. Wood, Jennifer Baumbusch, Tone M. Norekvål, Nay Htun, Leo Stephenson, and John G. Webb. "Avoidance of urinary catheterization to minimize in-hospital complications after transcatheter aortic valve implantation: An observational study." European Journal of Cardiovascular Nursing 17, no. 1 (June 26, 2017): 66–74. http://dx.doi.org/10.1177/1474515117716590.
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Background: Contemporary transcatheter aortic valve implantation (TAVI) devices and approach present opportunities to review historical practices initially informed by early treatment development and cardiac surgery. The avoidance of urinary catheterization in the older TAVI population is a strategy to minimize in-hospital complications. The purpose of the study was to explore elimination-related complications following the phased implementation of a default strategy of avoiding urinary catheterization in patients undergoing transfemoral (TF) TAVI. Methods: We conducted an observational study using a retrospective chart review of patients treated between 2011 and 2013 to identify patient characteristics, peri-procedure details, in-hospital outcomes and elimination-related complications in patients who did or did not receive a peri-procedure indwelling catheter. Descriptive analyses were used to report differences between the groups; we conducted a regression analysis to explore the relationship between the practice of urinary catheterization and total procedure time. Results: Of the 408 patients who underwent TF TAVR, 188 (46.1%) received a peri-procedure indwelling urinary catheter and 220 (53.9%) did not. There was no difference in in-hospital mortality (2.2%), disabling stroke (0.5%), or other major cardiac adverse events. The avoidance of a urinary catheter resulted in significantly lower rates of urinary tract infection requiring a new antibiotic regimen (1.4% versus 6.1%, p = 0.014), haematuria documented by medicine or nursing (3.7% versus 17.6%, p = 0.001), and the need for continuous bladder irrigation (2.7% versus 0%, p = 0.027). Conclusion: The avoidance of a urinary catheter may contribute to improved outcomes in patients undergoing TAVI. The intervention should be further evaluated within the broader study of minimalist TAVI.
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Kulikowski, Casimir A. "Donald A. B. Lindberg: Inspiring Leader and Visionary in Biomedicine, Healthcare, and Informatics." Yearbook of Medical Informatics 29, no. 01 (April 17, 2020): 253–58. http://dx.doi.org/10.1055/s-0040-1701972.
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Summary Background: As Director of the US National Library of Medicine (NLM) for 30 years, Dr. Donald A. B. Lindberg was instrumental in bringing biomedical research and healthcare worldwide into the age of genomic and translational medicine through the informatics systems developed by the NLM. Lindberg opened free access and worldwide public dissemination of all the NLM's biomedical literature and databases, thus helping transform not only biomedical research like the Human Genome Project and its successors, but also the practices of medicine and healthcare internationally. Guiding, leading, and teaching-by-example at national, regional, and global levels of biomedical and healthcare informatics, Lindberg helped coalesce a dynamic discipline that provides a foundation for the human understanding which promotes the future health of our world. Objectives: To provide historical insight into the scientific, technological, and practical clinical accomplishments of Donald Lindberg, and to describe how this led to contributions in the worldwide interdisciplinary evolution of informatics, and its impact on the biosciences and practices of medicine, nursing, and other healthcare-related disciplines. Methods: Review and comment on the publications, scientific contributions, and leadership of Donald Lindberg in the evolution of biomedical and health informatics which anticipate the vision, scholarship, research in the field, and represent the deeply ethical humanism he exhibited throughout his life. These were essential in producing the informatics systems, such as the Unified Medical Language System (UMLS), MEDLINE, PubMed, PubMed Central, and ClinicalTrials.gov, which, together with NLM training programs and conferences, made possible the interactions among researchers and practitioners leading to the past quarter-century of rapid and dramatic advances in biomedical scientific inquiry and clinical discoveries, openly shared across the globe. Conclusion: Dr. Lindberg was a uniquely talented physician and pioneering researcher in biomedical and health informatics. As the main leader in developing and funding innovative informatics research for more than 30 years as Director of the National Library of Medicine, he helped bring together the most creative interdisciplinary researchers to bridge the worlds of biomedical research, education, and clinical practice. Lindberg's emphasis on open-access to the biomedical literature through publicly shared computer-mediated methods of search and inquiry are seen as an example of ethical scientific openness.
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Trotter, Latonya J. "Making A Career: Reproducing Gender within a Predominately Female Profession." Gender & Society 31, no. 4 (July 20, 2017): 503–25. http://dx.doi.org/10.1177/0891243217716115.
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In this study, I apply the perspective of gendered organizations to nursing and use ethnographically informed career biographies of nurse practitioners, a subset of highly credentialed nurses, to investigate the reproduction of gender by inclusionary institutional practices. My findings illustrate how nursing’s historically subordinate position as a female profession has led to institutional arrangements and aspirational resources for contemporary careers. Features such as flexible educational institutions and an extended credentials ladder allow women to recast structural constraints into individual possibilities. This recasting allows individuals to make careers but also recirculates notions of “flexible women” whose careers are institutionalized as secondary to family concerns.
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Meade, Jeremy. "Improving infusion therapy efficiency at the Woodlands Regional Care Center (RCC)." Journal of Clinical Oncology 30, no. 34_suppl (December 1, 2012): 84. http://dx.doi.org/10.1200/jco.2012.30.34_suppl.84.
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84 Background: The Woodlands RCC opened the Ambulatory Treatment Center in September 2010. The center houses 14 infusion units. Within 1 year, the demand for its infusion therapy services had more than doubled with continued rapid growth expected. The perception was that more patients could not be accommodated without additional space and staff. Therefore, a performance improvement team was formed in August 2011 with the goal to increase operational efficiency to satisfy patient demand, while maintaining the highest level of quality care. The increased access for patients allows for treatment to start sooner. Methods: The six sigma Define-Measure-Analyze-Improve-Control methodology was used to manage the project, and several lean and six sigma tools were utilized. The project commenced with a project charter with a measureable AIM statement to increase infusion volumes from 1.7 to 2.4 patients/unit per 9 hour day. Historical data was extracted, and all patients’ movements were timed for 3 weeks. Benchmarking, observations, and process mapping were also performed. Baseline performance was measured using SPC charts. Sources of variation were uncovered using statistical quality tools, brainstorming techniques, and cause/effect analysis. Key interventions consisted of standardized scheduling practices, development of a scheduling template, creation of a fast track room, new processes for overbooks and preschedules, and work balancing of nursing staff using an acuity rating system. In addition, staff workload was redistributed, and the lab was reorganized. Results: Within 3 months, the center met targeted capacity and provided regional care access to 41% more patients without additional staff, space, or working hours. By March 2012, the center accommodated 67% more patients (2.9/unit or 40/day) without adversely affecting patient wait time. Infusion room utilization increased by 15%. Conclusions: Although space constrained, The Woodlands RCC was presented with the challenge to provide patients’ open access to infusion therapy services. The team successfully applied lean and six sigma principles to evaluate the current state, perform a gap analysis, and deploy interventions to support quality and operate more efficiently.
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Algeri, Simone, and Luccas Melo de Souza. "Violence against children and adolescents: a challenge in the daily work of the nursing team." Revista Latino-Americana de Enfermagem 14, no. 4 (August 2006): 625–31. http://dx.doi.org/10.1590/s0104-11692006000400023.
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This article aims to reflect on various forms of violence against children and adolescents practiced in the family context, and the importance of professional nursing care in view of this phenomenon. We discuss possibilities of care and violence prevention as well as the problems violence causes to society. Violence is a social and historical problem, constructed in society, and needs to be adequately addressed in academic nursing education.
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Connolly, Cynthia Anne. "“I Am a Trained Nurse”: The Nursing Identity of Anarchist and Radical Emma Goldman." Nursing History Review 18, no. 1 (January 2010): 84–99. http://dx.doi.org/10.1891/1062-8061.18.84.
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For more than a century, scholars have analyzed the many dimensions of Emma Goldman. Remembered as an agent of revolution, feminism, sexual freedom, anarchy, and atheism, Goldman’s motives, personality, and actions have generated an entire subgenre of historical scholarship. But although Goldman practiced nursing in New York City for ten years, one facet of her life that has been neglected is her nursing identity. Goldman’s autobiography, Living My Life, reveals the way her nursing experiences informed her evolving anarchist political philosophy and international activism. She valued nursing for many reasons—for the economic independence it offered, identity it provided, and sense of community and connectivity she believed it encouraged. Finally, for Goldman, nursing represented was a vehicle to understand people’s struggles and as a way of translating political philosophy into meaningful, practical solutions.
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Lu, Huiqun, RuiLing Wang, and Zhenju Huang. "Application of Data Mining in Performance Management of Public Hospitals." Mobile Information Systems 2022 (February 9, 2022): 1–10. http://dx.doi.org/10.1155/2022/2412928.
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With the rapid development of computer technology, information technology covers all aspects of daily life, and the medical industry is also paying more attention to information construction. Conventional management methods have been unable to further improve the hospital’s management capabilities. At the same time, countries that are better in terms of hospital management practices have set a benchmark for mainland hospitals and reformed hospitals in order to stand out in the future. In addition to evaluating the economic benefits and work efficiency of doctors, hospitals must also consider that hospitals, as a special service industry, cannot be measured by economic indicators. Therefore, there is a multiparty game in the performance appraisal of hospitals, and it is necessary to consider not only economic factors but also the characteristics of public services. This article is based on the case of a large domestic tertiary hospital, combined with the hospital’s performance management reform plan, through the design idea of performance management and incentive performance pay distribution, using data mining technology as an auxiliary means. It successfully helped the hospital complete the performance and incentive performance pay aspects reform. The main research work of this paper is divided into the following three aspects. (1) Using data mining technology, according to each nursing unit’s workload, risk level, the difficulty of internship, and other objective factors in the past year for patient outpatient visits, surgery implementation, critical first aid, etc., are classified in line with the actual situation and provide a reliable basis for the reasonable and efficient allocation of hospital human resources. (2) In the performance management system, we integrate the third-party data mining tool weka to assist in the evaluation of the performance distribution plan and the calculation of the follow-up incentive performance pay. (3) We use the mathematical model of data mining to measure and evaluate the reasonableness of historical workload and performance appraisal, determine a new incentive performance pay distribution model, and use the software as a calculation tool for the internal distribution of performance wages to provide monthly incentive performance wage statistics in the future.
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White, Karolyn. "Nursing as Vocation." Nursing Ethics 9, no. 3 (May 2002): 279–90. http://dx.doi.org/10.1191/0969733002ne510oa.
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In this article the author argues that nursing is best understood as a vocational occupation. Using Blum’s model of vocations it is argued that such occupations are socially expressed within practices embodying traditions, norms and a range of meanings: industrial, social, personal and moral. Vocational workers are those who identify in certain ways with these traditions, norms and meanings. One problem with the vocational model, as it has historically applied to nursing, is that it has been articulated through concepts of motherhood. Nursing was a vocation precisely because the character of the nurse was identified as feminine. The author argues that the vocational model for nursing can be conceptually disentangled from its identification with ideals of motherhood and femininity. It is nursing work and the identification with the moral and social meaning of nursing that give nursing its vocational status, not the feminized character of the nurse.
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Ray, Panchali. "Nursing in Kolkata: Everyday Politics of Labour, Power and Subjectivities." South Asia Research 40, no. 1 (January 31, 2020): 40–57. http://dx.doi.org/10.1177/0262728019894117.
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Research on ‘care work’ tends to focus on relations between gender and ‘care’ at the cost of obfuscating caste and class markings that devalue such labour. This article argues that the service work of the contemporary nursing profession, as observed in Kolkata, continues to be devalued, not because it is care work but because it is linked to low-caste/out-caste women who have historically provided nursing care. To counter such stigma, nursing has witnessed a splintering along the lines of ‘prestigious’ and ‘dirty’ work. This cleavage, based on historically and socially produced structural inequalities, is supported both by organisational strategies and a privileged section of workers, who deploy ‘merit’ or cultural capital to close ranks against others. The article examines how women located at the bottom of this hierarchy resist such strategies. What does ritual, banal everyday resistance imply for processes and practices that reproduce organisational inequalities?
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Searle, Jennifer. "Compulsory Heterosexuality and Lesbian Invisibility in Nursing." Creative Nursing 25, no. 2 (May 1, 2019): 121–25. http://dx.doi.org/10.1891/1078-4535.25.2.121.
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Lesbian nurses have historically been silenced, but diversity initiatives within professional health programs suggest a need to initiate scholarly discussions that explore heteronormativity as increasing the risk of harm for nonheterosexual nurses as compared to their heterosexual counterparts. Nurses can reflect on relative privilege within the profession to better understand the ways in which normative health practices perpetuate adverse health outcomes among vulnerable patient populations. Nurses from diverse backgrounds, such as this lesbian author, offer insight into how the nursing profession might illuminate relational aspects of privilege. As such, the nursing profession could uncover solutions to systemic vulnerabilities which are inadvertently perpetuated within our profession, the health-care system, and society more broadly. The notion of compulsory heterosexuality is discussed in relation to nursing in this opinion piece with an aim to render structural harms visible that have been obscured by the institutionalization of heteronormativity in health care, to build awareness of the ways in which systemic vulnerabilities are unknowingly perpetuated despite health-care professionals being well-intended in their practice.
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Kent, George. "Good Questions 7: How Should Human Milk Banks be Regulated?" World Nutrition 10, no. 2 (June 30, 2019): 8–26. http://dx.doi.org/10.26596/wn.20191028-26.
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The term “human milk” refers to breastmilk used for purposes other than feeding a mother’s own infant, usually to directly meet the needs of other women’s infants especially those who are critically ill. Historically, milk sharing has been done primarily through wet nursing, but human milk banking has been growing rapidly since the beginning of the twentieth century.
There are concerns because some banks operate in ways that are exploitative, unsanitary, or provide milk to people who use it for questionable purposes. There is a clear need for regulation of milk banking, not only to limit undesired practices but also to facilitate good practices. This essay suggests a framework for legislation that supports milk banks in achieving their goals while also ensuring that the public’s interests are served.
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Yourkavitch, Jennifer, and Ellen M. Chetwynd. "Toward Consistency: Updating Lactation and Breastfeeding Terminology for Population Health Research." Journal of Human Lactation 35, no. 3 (June 17, 2019): 418–23. http://dx.doi.org/10.1177/0890334419851488.
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There has, historically, been a lack of consistency in the use and definition of terms and their associated measurement in breastfeeding research. The purpose of this paper is to promote consistency through a taxonomy and lexicon for population-based breastfeeding research with the modern nursing dyad. The taxonomy organizes concepts in categories related to research on feeding human milk to infants, noting the perspective from the provider of human milk (parent or alloparent) and the receiver of human milk (child). The taxonomy includes these categories: psychology, physiology, behavior, and modality. The intensity of behaviors and modalities can be characterized qualitatively or quantitatively. Other terms are introduced or defined for the modern era and measurement standards are posed. These suggestions invite discussion and debate, in an effort to move researchers toward consistent measurement, documentation, and presentation, to build a credible evidence base for breastfeeding and practices related to the provision and consumption of human milk.
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Yusem, Suzanne H., Kenneth D. Rosenberg, Lesa Dixon-Gray, and Jihong Liu. "Public Health Nursing Acceptance of the 5 A's Protocol for Prenatal Smoking Cessation." Californian Journal of Health Promotion 2, SI (December 15, 2004): 1–10. http://dx.doi.org/10.32398/cjhp.v2isi.905.
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Oregon’s efforts in tobacco cessation have historically focused on the general population and have depended on quit line services as the primary intervention. The Oregon Smoke Free Mothers and Babies Program (SFMB) was developed in 2002 to focus on public health nurses and prenatal care providers who work with high risk pregnant women. It seeks to increase smoking cessation among low income and other high risk pregnant women by disseminating the U.S. Public Health Service best practices, the 5 A’s (Ask, Advise, Assess, Assist, Arrange) tobacco brief intervention protocol, to public health nurses and prenatal care providers. Interventions included teaching nurses the 5 A’s, how to use stages of change for pregnant quitters and providing them with client materials. We report the survey results gathered from nurses regarding their use of the 5 A’s. Nurses were questioned at 3 intervals: at the beginning of the SFMB project, 12 months later and 24 months later. While over 45 nurses in 10 counties were involved in the program, staff turnover and budget cuts affected program evaluation and analysis of the survey responses. As a result, only 10 nurses completed all three surveys. We found that, at baseline, all of the nurses were already performing the Ask and Advise components. The training resulted in a significant increase in the nurses using Assess (p
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Crystal, Stephen, Richard Hermida, Olga F. Jarrín, Sheree Neese-Todd, Beth Angell, and Marsha Rosenthal. "REDUCING ANTIPSYCHOTIC PRESCRIBING IN NURSING HOMES: FACILITATORS AND BARRIERS FOR HIGH-IMPACT STATE INITIATIVES." Innovation in Aging 3, Supplement_1 (November 2019): S159—S160. http://dx.doi.org/10.1093/geroni/igz038.572.
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Abstract In conjunction with the National Partnership to Improve Dementia Care in Nursing Homes initiated in 2012, states implemented initiatives to reduce antipsychotic use. All achieved substantial reductions, but improvement varied across states. By 2018, several states had achieved reductions of more than 45%, including several of the largest states. These reductions are noteworthy given the challenging nature of behavioral symptoms of dementia, and difficulties encountered historically and internationally in changing strongly-rooted clinical practices. How were these successful interventions achieved in high-performing state initiatives? What were the barriers encountered and facilitators that helped overcome these barriers? What does this experience suggest for sustainability of change? To address these questions, we draw on a mixed-methods study of antipsychotic prescribing in nursing homes incorporating analyses of prescribing data, state policy case studies, and facility case studies. Successful states integrated large-scale educational initiatives with strong regulatory action, often focusing especially on laggard facilities. Texas’ initiative was particularly noteworthy, achieving a 56.5% reduction across its far-flung network of nearly 100,000 residents and 1,200 facilities. Texas used metrics to identify facilities that achieved notable reductions in antipsychotic prescribing, and encouraged them to share their strategies with “late adopters”. The state deployed a designated Quality Monitoring Program (QMP), distinct from the survey process, to provide on-site technical assistance to laggard facilities, and provided education for all levels of staff and assistance in implementing data-driven improvement strategies. Successful state initiatives achieved considerable buy-in on the need to reduce antipsychotic use, a key factor in achieving successful system change.
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Tsykunov, Grigoriy. "Little Towns of the Irkutsk Region: Analysis of Socio-Economic Situation." Journal of Economic History and History of Economics 21, no. 1 (March 16, 2020): 80–96. http://dx.doi.org/10.17150/2308-2488.2020.21(1).80-96.
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The article examined socio-economic issues of little towns in the Irkutsk region in retrospect and in perspective of their development. The author explored the place and role of little towns in the history of Russia and its regions, identified a group of little towns, conditions for their formation, based on the population settlement and industrial development of the region. In the article the author defined the concepts of a city-forming enterprise and a monotown that are widely practiced in urban settlements of the region, and devoted special attention to the analysis of the demographic status of little towns, population dynamics, and natural and migration movements. The research revealed the processes of natural population decline caused by a decrease in the birth rate and rise in mortality, as well as the migration outflow of residents of little towns. The author examined the social situation of urban settlements that suffered extensive losses in the new economic conditions. The research concluded that bed/population ratio in regional little towns, including the number of doctors and nursing staff, is significantly behind the regional indicators. The author put forwards ideas how to preserve the historical and socio-economic identity of little towns.