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Sample records for advanced practice registered

  1. Advanced Practice Registered Nurses. Final rule with comment period.

    PubMed

    2016-12-14

    The Department of Veterans Affairs (VA) is amending its medical regulations to permit full practice authority of three roles of VA advanced practice registered nurses (APRN) when they are acting within the scope of their VA employment. Certified Registered Nurse Anesthetists (CRNA) will not be included in VA's full practice authority under this final rule, but comment is requested on whether there are access issues or other unconsidered circumstances that might warrant their inclusion in a future rulemaking. The final rulemaking establishes the professional qualifications an individual must possess to be appointed as an APRN within VA, establishes the criteria under which VA may grant full practice authority to an APRN, and defines the scope of full practice authority for each of the three roles of APRN. The services provided by an APRN under full practice authority in VA are consistent with the nursing profession's standards of practice for such roles. This rulemaking increases veterans' access to VA health care by expanding the pool of qualified health care professionals who are authorized to provide primary health care and other related health care services to the full extent of their education, training, and certification, without the clinical supervision of physicians, and it permits VA to use its health care resources more effectively and in a manner that is consistent with the role of APRNs in the non-VA health care sector, while maintaining the patient-centered, safe, high-quality health care that veterans receive from VA.

  2. Barriers to advanced practice registered nurse scope of practice: issue analysis.

    PubMed

    Villegas, Whitney J; Allen, Patricia E

    2012-09-01

    Advanced practice registered nurses (APRNs) have the unique potential to affect the changing needs of health care in the United States, but are restricted in care provision by varying state regulations and reimbursement policies. Although research shows APRN care to be safe, cost-effective, and of high quality, most medical professional organizations continue to oppose the removal of scope-of-practice barriers, citing patient safety concerns. Nursing organizations at the state and national levels have already begun to invest the time and resources needed for policy change. However, empirical evidence of APRN quality of care must be shared with policymakers, funding entities, and the public. Additionally, support must be garnered from the public and other health care disciplines. Scope-of-practice policy change will occur through the emergence of strong individuals within nursing professional organizations and the joining together of organizations to form one voice.

  3. The advanced registered nurse practitioner in rural practice.

    PubMed

    Schmidt, L; Brandt, J; Norris, K

    1995-10-01

    Availability of health care to rural areas is limited. FNP's in rural practice have the ability to address rural needs and tailor interventions to the specific attributes of rural populations. The objective of this article is to define the role and the functions of the FNP and to support and defend this role in the rural setting. Much of the FNP research presented in the literature to date focuses on urban populations; therefore, the unique health care problems and needs of rural populations will first be defined as they relate to the FNP's scope of practice.

  4. Full Practice Authority for Advanced Practice Registered Nurses is a Gender Issue

    PubMed

    Rudner Lugo, Nancy

    2016-05-04

    In the United States, Advanced Practice Registered Nurse (APRN) regulations are determined at the state level, through legislation and rule making. The lack of an evidence base to APRN regulation has resulted in a patchwork of varied regulations and requirements for nurse practitioners. The author begins this article by reviewing the history of the Equal Rights Amendment (ERA) in the United States and describing her study that assessed APRN fullpractice authority in states that ratified the ERA versus states that opposed it. She presents the study findings, limitations of the comparison, and discussion of the findings and implications. In conclusion, the findings demonstrated that progress toward full APRN practice will require building strategies for political support and framing the need to update APRN regulations in a manner that aligns with each state’s social and political values.

  5. The role of the nurse executive in fostering and empowering the advanced practice registered nurse.

    PubMed

    Talbert, Tukea L

    2012-06-01

    The nurse executive plays a critical role in the design, oversight, and outcomes of the delivery of care and a key role in the success of the integration of advanced practice registered nurses (APRNs) into an organization. The critical areas that nurse executives must consider to foster and empower APRNs are: (1) knowledge and self preparation, especially of political initiatives that affect the role, (2) visionary leadership and development of clear role expectations and appropriate credentialing, (3) strategies to reduce disconnection between the APRN and their practice setting, and (4) appropriate education and marketing of the role to stakeholders.

  6. Opioid therapy for chronic low back pain: prescribing considerations for advanced practice registered nurses.

    PubMed

    Lall, Maureen Patricia

    2014-12-01

    Chronic low back pain is a common, disabling, and costly condition, and advanced practice registered nurses (APRNs) must carefully evaluate patients before considering long-term opioid therapy as a management strategy. APRNs should refer patients suspected of having a serious condition, or identifiable etiology, for specialist evaluation, as many patients improve with physical therapy, interventional pain management procedures, or surgical intervention. For patients unresponsive to nonopioid treatment, APRNs with an understanding of opioids, and the experience to assess and manage the risks of opioid misuse, abuse, and diversion, may consider long-term opioid therapy as part of a multimodal management plan. Such prescribing necessitates careful patient selection; informed consent; prudent opioid dosing and titration; and monitoring for response to treatment, adverse effects, and aberrant drug-taking behavior. Treatment and regulatory guidelines can assist APRNs in providing safe and effective care to patients with chronic low back pain.

  7. Advanced Practice Registered Nurses: Gateway to Screening for Bipolar Disorder in Primary Care

    PubMed Central

    Kriebel-Gasparro, Ann Marie

    2016-01-01

    Objective: The goal of this mixed methods descriptive study was to explore Advanced Practice Registered Nurses’ (APRNs’) knowledge of bipolar disorder (BPD) and their perceptions of facilitators and barriers to screening patients with known depression for BPD. Methods: A mixed method study design using surveys on BPD knowledge and screening practices as well as focus group data collection method for facilitators and barriers to screening. Results: 89 APRNs completed the survey and 12 APRNs participated in the focus groups. APRNs in any practice setting had low knowledge scores of BPD. No significant differences in screening for BPD for primary and non primary care APRNs. Qualitative findings revealed screening relates to tool availability; time, unsure of when to screen, fear of sigma, symptoms knowledge of BPD, accessible referral system, personal experiences with BPD, and therapeutic relationships with patients. Conclusion: Misdiagnosis of BPD as unipolar depression is common in primary care settings, leading to a long lag time to optimal diagnosis and treatment. The wait time to diagnosis and treatment could be reduced if APRNs in primary care settings screen patients with a diagnosis of depression by using validated screening tools. These results can inform APRN practice and further research on the effectiveness of screening for reducing the morbidity and mortality of BPDs in primary care settings; underscores the need for integration of mental health care into primary care as well as the need for more APRN education on the diagnosis and management of bipolar disorders. PMID:27347256

  8. Advanced practice registered nurse usability testing of a tailored computer-mediated health communication program.

    PubMed

    Lin, Carolyn A; Neafsey, Patricia J; Anderson, Elizabeth

    2010-01-01

    This study tested the usability of a touch-screen-enabled Personal Education Program with advanced practice RNs. The Personal Education Program is designed to enhance medication adherence and reduce adverse self-medication behaviors in older adults with hypertension. An iterative research process was used, which involved the use of (1) pretrial focus groups to guide the design of system information architecture, (2) two different cycles of think-aloud trials to test the software interface, and (3) post-trial focus groups to gather feedback on the think-aloud studies. Results from this iterative usability-testing process were used to systematically modify and improve the three Personal Education Program prototype versions-the pilot, prototype 1, and prototype 2. Findings contrasting the two separate think-aloud trials showed that APRN users rated the Personal Education Program system usability, system information, and system-use satisfaction at a moderately high level between trials. In addition, errors using the interface were reduced by 76%, and the interface time was reduced by 18.5% between the two trials. The usability-testing processes used in this study ensured an interface design adapted to APRNs' needs and preferences to allow them to effectively use the computer-mediated health-communication technology in a clinical setting.

  9. Advanced Practice Registered Nurses and Physician Assistants in Sleep Centers and Clinics: A Survey of Current Roles and Educational Background

    PubMed Central

    Colvin, Loretta; Cartwright, Ann; Collop, Nancy; Freedman, Neil; McLeod, Don; Weaver, Terri E.; Rogers, Ann E.

    2014-01-01

    Study Objectives: To survey Advanced Practice Registered Nurse (APRN) and Physician Assistant (PA) utilization, roles and educational background within the field of sleep medicine. Methods: Electronic surveys distributed to American Academy of Sleep Medicine (AASM) member centers and APRNs and PAs working within sleep centers and clinics. Results: Approximately 40% of responding AASM sleep centers reported utilizing APRNs or PAs in predominantly clinical roles. Of the APRNs and PAs surveyed, 95% reported responsibilities in sleep disordered breathing and more than 50% in insomnia and movement disorders. Most APRNs and PAs were prepared at the graduate level (89%), with sleep-specific education primarily through “on the job” training (86%). All APRNs surveyed were Nurse Practitioners (NPs), with approximately double the number of NPs compared to PAs. Conclusions: APRNs and PAs were reported in sleep centers at proportions similar to national estimates of NPs and PAs in physicians' offices. They report predominantly clinical roles, involving common sleep disorders. Given current predictions that the outpatient healthcare structure will change and the number of APRNs and PAs will increase, understanding the role and utilization of these professionals is necessary to plan for the future care of patients with sleep disorders. Surveyed APRNs and PAs reported a significant deficiency in formal and standardized sleep-specific education. Efforts to provide formal and standardized educational opportunities for APRNs and PAs that focus on their clinical roles within sleep centers could help fill a current educational gap. Citation: Colvin L, Cartwright Ann, Collop N, Freedman N, McLeod D, Weaver TE, Rogers AE. Advanced practice registered nurses and physician assistants in sleep centers and clinics: a survey of current roles and educational background. J Clin Sleep Med 2014;10(5):581-587. PMID:24812545

  10. American Dietetic Association and the National Kidney Foundation Standards of Practice and Standards of Professional Performance for registered dietitians (generalist, specialty, and advanced) in nephrology care.

    PubMed

    Brommage, Deborah; Karalis, Maria; Martin, Cathi; McCarthy, Maureen; Benner, Deborah; Goeddeke-Merickel, Catherine M; Wiesen, Karen; Byham-Gray, Laura; House, Jennie Lang; Pavlinac, Jessie; McCann, Linda

    2009-09-01

    The American Dietetic Association (ADA) Renal Dietitians Practice Group (RPG) and the National Kidney Foundation Council on Renal Nutrition (NKF CRN), under the guidance of the ADA Quality Management Committee and Scope of Dietetics Practice Framework Sub-Committee, have developed the Standards of Practice (SOP) and Standards of Professional Performance (SOPP) for Registered Dietitians (Generalist, Specialty, and Advanced) in Nephrology Care (Supplementary Figures 1, 2, and 3 are available only online at www.jrnjournal.org). The SOP and SOPP documents are based upon the 2008 Revised Standards of Practice in Nutrition Care and Standards of Professional Performance for Registered Dietitians (RDs)(1), which are part of ADA's Scope of Dietetics Practice Framework(2). The 2008 Revised SOP in Nutrition Care and SOPP, along with the Code of Ethics(3), guide the practice and performance of RDs in all settings.

  11. Education and Practice Barriers for Certified Registered Nurse Anesthetists.

    PubMed

    Malina, Debra P; Izlar, Janice J

    2014-05-31

    Of the recognized advanced practice registered nursing (APRN) specialties, Certified Registered Nurse Anesthetists (CRNAs) have historically experienced the most vigorous and organized resistance from outside entities regarding rights to practice to the full scope of their education and experience. Opposition to nurse anesthetists practicing to the full scope of their education and training is present in the clinical arena and educational milieu.

  12. A proof-of-concept implementation of a unit-based advanced practice registered nurse (APRN) role: structural empowerment, role clarity and team effectiveness.

    PubMed

    Feistritzer, Nancye R; Jones, Pam O

    2014-03-01

    The quest for decreased cost of care and improved outcomes has created the need for highly effective clinical roles and teams. This article describes the role of a unit-based advanced practice registered nurse (APRN) within a proof-of-concept implementation of a new care delivery model, the Vanderbilt Anticipatory Care Team. Role clarity is central to both structural empowerment of the APRN and team effectiveness. A modified PeaceHealth Team Development Measure tool measured baseline role clarity as a component of overall team effectiveness. A role description for the unit-based APRN based on a comprehensive assessment of the proof-of-concept unit is provided.

  13. Interprofessional Obstetric Ultrasound Education: Successful Development of Online Learning Modules; Case-Based Seminars; and Skills Labs for Registered and Advanced Practice Nurses, Midwives, Physicians, and Trainees.

    PubMed

    Shaw-Battista, Jenna; Young-Lin, Nichole; Bearman, Sage; Dau, Kim; Vargas, Juan

    2015-01-01

    Ultrasound is an important aid in the clinical diagnosis and management of normal and complicated pregnancy and childbirth. The technology is widely applied to maternity care in the United States, where comprehensive standard ultrasound examinations are routine. Targeted scans are common and used for an increasing number of clinical indications due to emerging research and a greater availability of equipment with better image resolution at lower cost. These factors contribute to an increased demand for obstetric ultrasound education among students and providers of maternity care, despite a paucity of data to inform education program design and evaluation. To meet this demand, from 2012 to 2015 the University of California, San Francisco nurse-midwifery education program developed and implemented an interprofessional obstetric ultrasound course focused on clinical applications commonly managed by maternity care providers from different professions and disciplines. The course included matriculating students in nursing and medicine, as well as licensed practitioners such as registered and advanced practice nurses, midwives, and physicians and residents in obstetrics and gynecology and family medicine. After completing 10 online modules with a pre- and posttest of knowledge and interprofessional competencies related to teamwork and communication, trainees attended a case-based seminar and hands-on skills practicum with pregnant volunteers. The course aimed to establish a foundation for further supervised clinical training prior to independent practice of obstetric ultrasound. Course development was informed by professional guidelines and clinical and education research literature. This article describes the foundations, with a review of the challenges and solutions encountered in obstetric ultrasound education development and implementation. Our experience will inform educators who wish to facilitate obstetric ultrasound competency development among new and experienced

  14. Advanced urology nursing practice.

    PubMed

    Crowe, Helen

    2014-03-01

    Urology nursing has developed as a specialty over the past few decades in response to several factors, workload demands being a prime reason. Nurses are taking on additional roles and activities including procedures such as cystoscopy and prostate biopsy, and running nurse-led clinics for a variety of urological conditions. Audits of advanced urological nursing practice have shown this care to be of a high standard and investigative procedures performed by these nurses match the diagnostic quality of existing services. Professional urological nursing organizations support the professional needs of these nurses, but the provision of education and training for advanced practice activities remains an unaddressed need. A range of confusing advanced urology nursing titles exists, and uncertainty regarding the roles and scope of practice for these nurses remains a concern. Acceptance and support from medical colleagues is required for the success of advanced urological nursing practice, but opinions on these roles remain divided.

  15. The Career Advancement for Registered Nurse Excellence Program.

    PubMed

    Fusilero, Jane; Lini, Linda; Prohaska, Priscilla; Szweda, Christine; Carney, Katie; Mion, Lorraine C

    2008-12-01

    Nurse administrators focus on factors that influence nurses' levels of satisfaction to reduce turnover and improve retention. One important determinant of nurses' satisfaction is the opportunity for professional development. On the basis of feedback from the nurses, a professional development program, Career Advancement for Registered Nurse Excellence, was instituted. The authors describe one approach to create opportunities to improve professional nurse development and the necessity for ongoing assessment of its impact on nurses' job satisfaction.

  16. 16 CFR 1011.4 - Forms of advance public notice of meetings; Public Calendar/Master Calendar and Federal Register.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ...; Public Calendar/Master Calendar and Federal Register. 1011.4 Section 1011.4 Commercial Practices CONSUMER... meetings; Public Calendar/Master Calendar and Federal Register. Advance notice of Agency activities is... Calendar/Master Calendar. (1) The printed Public Calendar and the Master Calendar maintained in the...

  17. 16 CFR 1011.4 - Forms of advance public notice of meetings; Public Calendar/Master Calendar and Federal Register.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ...; Public Calendar/Master Calendar and Federal Register. 1011.4 Section 1011.4 Commercial Practices CONSUMER... meetings; Public Calendar/Master Calendar and Federal Register. Advance notice of Agency activities is... Calendar/Master Calendar. (1) The printed Public Calendar and the Master Calendar maintained in the...

  18. 16 CFR 1011.4 - Forms of advance public notice of meetings; Public Calendar/Master Calendar and Federal Register.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ...; Public Calendar/Master Calendar and Federal Register. 1011.4 Section 1011.4 Commercial Practices CONSUMER... meetings; Public Calendar/Master Calendar and Federal Register. Advance notice of Agency activities is... Calendar/Master Calendar. (1) The printed Public Calendar and the Master Calendar maintained in the...

  19. Registered nurse scope of practice in Australia: an integrative review of the literature.

    PubMed

    Birks, Melanie; Davis, Jenny; Smithson, John; Cant, Robyn

    2016-10-01

    The nursing profession comprises Australia's largest regulated health workforce yet its practice boundaries are poorly understood. The ambiguity surrounding the practice scope of nurses limits the profession's ability to fully respond to Australia's current and emerging health system challenges. The aim of this review is to explore the concept of scope of practice of registered nurses (RN) in Australia, as reflected in contemporary literature. An integrative review of literature relating to the scope of practice of the Australian registered nurse published between 2007 and 2014 was conducted. Twenty primary papers and nine secondary source papers were included in the review. Themes that arose from the analysis are: Scope of practice - an elusive concept; Scope of practice and context; Scope of practice and boundaries; and Scope of practice and advanced practice. Discussion of these themes includes consideration of the professional, legal and ethical significance of scope of practice for the RN, as well as the legislative, professional and contextual influences on, and challenges to, defining scope of practice at both a professional and individual level. For the Australian registered nursing workforce to continue to be a significant and influential contributor to Australia(')s dynamic healthcare context, a clearly articulated scope of practice is both necessary and overdue.

  20. 16 CFR 1011.4 - Forms of advance public notice of meetings; Public Calendar/Master Calendar and Federal Register.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... meetings, selected staff meetings, advisory committee meetings, and other activities such as speeches and... 16 Commercial Practices 2 2011-01-01 2011-01-01 false Forms of advance public notice of meetings... meetings; Public Calendar/Master Calendar and Federal Register. Advance notice of Agency activities...

  1. 16 CFR 1011.4 - Forms of advance public notice of meetings; Public Calendar/Master Calendar and Federal Register.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Forms of advance public notice of meetings; Public Calendar/Master Calendar and Federal Register. 1011.4 Section 1011.4 Commercial Practices CONSUMER... meetings, selected staff meetings, advisory committee meetings, and other activities such as speeches...

  2. Advanced Practice Nursing Education: Challenges and Strategies

    PubMed Central

    Fitzgerald, Cynthia; Kantrowitz-Gordon, Ira; Katz, Janet; Hirsch, Anne

    2012-01-01

    Nursing education programs may face significant difficulty as they struggle to prepare sufficient numbers of advanced practice registered nurses to fulfill the vision of helping to design an improved US healthcare system as described in the Institute of Medicine's “Future of nursing” report. This paper describes specific challenges and provides strategies to improve advanced practice nursing clinical education in order to ensure that a sufficient number of APRNs are available to work in educational, practice, and research settings. Best practices are identified through a review of classic and current nursing literature. Strategies include intensive interprofessional collaborations and radical curriculum revisions such as increased use of simulation and domestic and international service work. Nurse educators must work with all stakeholders to create effective and lasting change. PMID:22220273

  3. Developing practice protocols for advanced practice nursing.

    PubMed

    Paul, S

    1999-08-01

    In most states, the role of an advanced practice nurse is dependent on practice protocols that provide an organized method for analyzing and managing a disease or major symptom. They are also used to control the process of medical care and to specify steps in the delivery of that care. Creating appropriate practice protocols is one of the most important precursors to implementing the advanced practice role, because they virtually drive the clinician's ability to treat or manage clinical situations or disease states. This article outlines the steps involved in developing practice protocols and discusses the content that should be included in a protocol, providing an example of narrative and algorithm format protocols. Pros and cons, as well as legal issues related to practice protocols, are also presented.

  4. A clinical advancement program for registered nurses with an outpatient focus.

    PubMed

    Streeter, Bonnie L

    2007-01-01

    Clinical advancement programs have been in use for almost 30 years. Although clinical advancement programs have been designed for many areas, it appears that one has never been developed specific to the outpatient-focused registered nurse. This article describes the development of a clinical advancement program for non-hospital-based registered nurses employed at the Guthrie Clinic in Sayre, Pennsylvania and highlights recommendations for instituting this program in any outpatient setting.

  5. 20 CFR 655.670 - Federal Register notice of determination of prevailing practice.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Federal Register notice of determination of... Federal Register notice of determination of prevailing practice. (a) Pursuant to § 655.625(b), the Administrator shall publish in the Federal Register a notice of the Administrator's determination of...

  6. 20 CFR 655.670 - Federal Register notice of determination of prevailing practice.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 3 2013-04-01 2013-04-01 false Federal Register notice of determination of... Federal Register notice of determination of prevailing practice. (a) Pursuant to § 655.625(b), the Administrator shall publish in the Federal Register a notice of the Administrator's determination of...

  7. 20 CFR 655.670 - Federal Register notice of determination of prevailing practice.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 3 2012-04-01 2012-04-01 false Federal Register notice of determination of... Federal Register notice of determination of prevailing practice. (a) Pursuant to § 655.625(b), the Administrator shall publish in the Federal Register a notice of the Administrator's determination of...

  8. 20 CFR 655.670 - Federal Register notice of determination of prevailing practice.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Federal Register notice of determination of... Federal Register notice of determination of prevailing practice. (a) Pursuant to § 655.625(b), the Administrator shall publish in the Federal Register a notice of the Administrator's determination of...

  9. 20 CFR 655.670 - Federal Register notice of determination of prevailing practice.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 3 2014-04-01 2014-04-01 false Federal Register notice of determination of... Federal Register notice of determination of prevailing practice. (a) Pursuant to § 655.625(b), the Administrator shall publish in the Federal Register a notice of the Administrator's determination of...

  10. Nursing Home Registered Nurses' and Licensed Practical Nurses' Knowledge of Causes of Falls.

    PubMed

    Gray-Miceli, Deanna; de Cordova, Pamela B; Crane, Giles L; Quigley, Patricia; Ratcliffe, Sarah J

    2016-01-01

    Reducing falls in nursing homes requires a knowledgeable nursing workforce. To test knowledge, 8 validated vignettes representing multifactorial fall causes were administered to 47 nurses from 3 nursing homes. Although licensed practical nurses scored higher than registered nurses in individual categories of falls, when we computed the average score of all 8 categories between groups of registered nurses and licensed practical nurses, registered nurses scored higher (F = 4.106; P < .05) in identifying 8 causal reasons for older adults to fall.

  11. Private practice--an advanced practice option.

    PubMed

    Wilson, Anne; Jarman, Heather

    2002-10-01

    Currently there is considerable debate on the role and function of nurses in Australia and internationally. This debate stems from developments within the nursing profession itself from political and economic issues in health platforms, due to restructuring of the health care system, consumer expectations of health care and nurses' expectations of a career. This paper provides the opportunity to reflect on the development of the role of the private practice (independent nurse) and where that role is situated in the nursing profession. This forms the basis for discussion of the development of specialty practice at an advanced level in Australia and to demonstrate its relationship with the nurse practitioner movement in Australia.

  12. Register and Genre in Course Design for Advanced Learners of Russian

    ERIC Educational Resources Information Center

    Moskver, Katherine V.

    2008-01-01

    This article explores the possibility of combining in the same course heritage learners who are borderline or seminative speakers with advanced language learners of Russian. After providing typology of advanced language learners in Russian and establishing that register and genre can be the focal point of such a course, the article discusses the…

  13. Knowledge, attitudes, and predictors of advance directive discussions of registered nurses.

    PubMed

    Lipson, Amy R; Hausman, Alice J; Higgins, Patricia A; Burant, Christopher J

    2004-11-01

    The purpose of this study was to describe nurses' knowledge, attitudes, and experiences regarding advance directives. A secondary purpose was to examine predictors of advance directive discussions between nurses and patients. Seven-hundred and nineteen respondents, randomly selected from a list of registered nurses in the state of Ohio, completed mailed questionnaires. Descriptive t test, chi-square, and logistic regression statistics were used in the data analyses. The respondents were knowledgeable and possessed positive attitudes about advance directives. Higher self-perceived confidence in advance directive discussion skills and the experience of caring for at least one patient with a current advance directive were found to be significant predictors of advance directive discussions. These findings suggest that experience with advance directives documents is critical for nurses' comfort and that developing interventions to further nurses' confidence in their discussion skills may increase advance directive discussions.

  14. Nursing Practice Environment and Registered Nurses' Job Satisfaction in Nursing Homes

    ERIC Educational Resources Information Center

    Choi, JiSun; Flynn, Linda; Aiken, Linda H.

    2012-01-01

    Purpose: Recruiting and retaining registered nurses (RNs) in nursing homes is problematic, and little research is available to guide efforts to make nursing homes a more attractive practice environment for RNs. The purpose of this study was to examine relationships between aspects of the nursing practice environment and job satisfaction among RNs…

  15. Use of three evidence-based postoperative pain assessment practices by registered nurses.

    PubMed

    Carlson, Cathy L

    2009-12-01

    To provide optimal postoperative pain relief, nursing practice should be based on the best evidence available. For over 20 years, results of studies regarding nurses' use of evidence-based practices, including postoperative pain assessment practices, have shown that nurses use the practices inconsistently. The present cross-sectional survey study was conducted to: 1) determine the extent to which registered nurses caring for postoperative patients experiencing pain used three evidence-based postoperative pain assessment practices; and 2) identify relationships among the level of adoption of evidence-based postoperative pain assessment practices and selected characteristics of registered nurses. Data were collected from a convenience sample of all nurses caring for adult postoperative patients in two Midwestern hospitals where 443 surveys (46.9%) were returned. Respondents were aware of, but not using, three evidence-based postoperative pain assessment practices consistently. Registered nurses who used multiple sources to identify solutions to clinical practice problems or read one or two professional journals regularly were more likely to have adopted the three evidence-based postoperative pain assessment practices. Registered nurses need to be encouraged to use multiple sources to identify solutions to clinical practice problems, including professional nursing journals. Innovative approaches to promote the application of research to education and practice settings are needed. It is important to identify opinion leaders, because opinion leaders are an important resource in overcoming the barriers so that adoption of pain of evidence-based postoperative pain assessment practices can proceed. Additional research is needed to identify what variables effect the adoption of evidence-based practices and identify interventions to improve the level of adoption.

  16. ASRC Aerospace Corporation Selects Dynamically Reconfigurable Anadigm(Registered Trademark) FPAA For Advanced Data Acquisition System

    NASA Technical Reports Server (NTRS)

    Mata, Carlos T.

    2003-01-01

    Anadigm(registered trademark) today announced that ASRC Aerospace Corporation has designed Anadigm's dynamically reconfigurable Field Programmable Analog Array (FPAA) technology into an advanced data acquisition system developed under contract for NASA. ASRC Aerospace designed in the Anadigm(registered trademark) FPAA to provide complex analog signal conditioning in its intelligent, self-calibrating, and self-healing advanced data acquisition system (ADAS). The ADAS has potential applications in industrial, manufacturing, and aerospace markets. This system offers highly reliable operation while reducing the need for user interaction. Anadigm(registered trademark)'s dynamically reconfigurable FPAAs can be reconfigured in-system by the designer or on the fly by a microprocessor. A single device can thus be programmed to implement multiple analog functions and/or to adapt on-the-fly to maintain precision operation despite system degradation and aging. In the case of the ASRC advanced data acquisition system, the FPAA helps ensure that the system will continue to operating at 100% functionality despite changes in the environment, component degradation, and/or component failures.

  17. National agenda for advanced practice nursing: the practice doctorate.

    PubMed

    Clinton, Patricia; Sperhac, Arlene M

    2006-01-01

    The purpose of this article was to provide the background and rationale for the practice doctorate in nursing. The American Association of Colleges of Nursing's Position Statement on the Practice Doctorate in Nursing, approved in October 2004, will be discussed. Outlined are some of the changes that will be needed in education, regulation, and advanced practice. Common questions and concerns that advanced practice nurses have, including titling, salary, and transitioning to the doctor of nursing practice degree, will be addressed.

  18. The Swedish National Diabetes Register in clinical practice and evaluation in primary health care.

    PubMed

    Hallgren Elfgren, Ing-Marie; Grodzinsky, Ewa; Törnvall, Eva

    2016-11-01

    Aim The purpose of this project is to describe the use of the Swedish National Diabetes Register (NDR) in clinical practice in a Swedish county and to specifically monitor the diabetes care routines at two separate primary health-care centres (PHCC) with a special focus on older patients.

  19. Examination of Motivating Factors Attracting Licensed Practical Nurses into a Registered Nursing Program.

    ERIC Educational Resources Information Center

    Care, Wm. Dean

    A study identified characteristics and motivating factors that influenced licensed practical nurses (LPNs) to participate in a registered nursing (RN) upgrading program at a hospital in western Canada. A literature review considered the concepts of motivation, participation, adult learning, and life transitions and explored a variety of models and…

  20. Proportion of pet cats registered with a veterinary practice and factors influencing registration in the UK.

    PubMed

    Murray, Jane K; Gruffydd-Jones, Timothy J

    2012-06-01

    Registration of a cat with a veterinary practice is likely to be a critical factor for access to key preventative medicine. A cross-sectional study was conducted to collect data in the United Kingdom on the registration status of cats and potential explanatory variables. These data were also used to identify potential sources of bias associated with selecting controls from veterinary registered populations of cats due to differences between registered and unregistered cats. Cat owners reported that 13.6% (84/616) of their cats had not been registered with a veterinary practice since living at their current address. Multivariable logistic regression indicated that unregistered cats were significantly more likely than registered cats to be entire, to have not been vaccinated within the previous year, to be living in households in Northern Ireland and in households with an annual income <£10,000.(1) Whilst the neuter status and the vaccination status of the cat are likely to result from non-registration, the household location and annual income are factors that can be used to inform future interventions designed to increase the proportion of veterinary registered cats.

  1. 76 FR 31306 - Admittance to Practice and Roster of Registered Patent Attorneys and Agents Admitted to Practice...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-31

    ... Patent and Trademark Office Admittance to Practice and Roster of Registered Patent Attorneys and Agents... Attorney, Office of Enrollment and Discipline, United States Patent and Trademark Office (USPTO), P.O. Box... regulations governing the recognition and conduct of agents, attorneys or other persons...

  2. Advances in grazing distribution practices

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Grazing distribution management practices are intended to improve livestock production efficiency while conserving or enhancing environmental conditions, and sustaining or promoting other ecosystem services on grazed lands. Ancient practices such as herding, fencing, vegetation treatment (e.g., fi...

  3. The subject of pedagogy from theory to practice--the view of newly registered nurses.

    PubMed

    Ivarsson, Bodil; Nilsson, Gunilla

    2009-07-01

    The aim was to describe, from the newly registered nurses' perspective, specific events when using their pedagogical knowledge in their everyday clinical practice. The design was qualitative and the critical incident technique was used. Data was collected via interviews with ten newly registered nurses who graduated from the same University program 10 months earlier and are now employed at a university hospital. Two categories emerged in the analyses. The first category was "Pedagogical methods in theory" with the sub-categories Theory and the application of the course in practice, Knowledge of pedagogy and Information as a professional competence. The second category was "Pedagogical methods in everyday clinical practice" with sub-categories Factual knowledge versus pedagogical knowledge, Information and relatives, Difficulties when giving information, Understanding information received, Pedagogical tools, Collaboration in teams in pedagogical situations, and Time and giving information. By identifying specific events regarding pedagogical methods the findings can be useful for everyone from teachers and health-care managers to nurse students and newly registered nurses, to improve teaching methods in nurse education.

  4. Education of advanced practice nurses in Canada.

    PubMed

    Martin-Misener, Ruth; Bryant-Lukosius, Denise; Harbman, Patricia; Donald, Faith; Kaasalainen, Sharon; Carter, Nancy; Kilpatrick, Kelley; DiCenso, Alba

    2010-12-01

    In Canada, education programs for the clinical nurse specialist (CNS) and nurse practitioner (NP) roles began 40 years ago. NP programs are offered in almost all provinces. Education for the CNS role has occurred through graduate nursing programs generically defined as providing preparation for advanced nursing practice. For this paper, we drew on pertinent sections of a scoping review of the literature and key informant interviews conducted for a decision support synthesis on advanced practice nursing to describe the following: (1) history of advanced practice nursing education in Canada, (2) current status of advanced practice nursing education in Canada, (3) curriculum issues, (4) interprofessional education, (5) resources for education and (6) continuing education. Although national frameworks defining advanced nursing practice and NP competencies provide some direction for education programs, Canada does not have countrywide standards of education for either the NP or CNS role. Inconsistency in the educational requirements for primary healthcare NPs continues to cause significant problems and interferes with inter-jurisdictional licensing portability. For both CNSs and NPs, there can be a mismatch between a generalized education and specialized practice. The value of interprofessional education in facilitating effective teamwork is emphasized. Recommendations for future directions for advanced practice nursing education are offered.

  5. Registered nurses' constructed meaning of concepts of solution and their use in clinical practice

    NASA Astrophysics Data System (ADS)

    Wilkes, Lesley M.; Batts, Judith E.

    1991-12-01

    Since the introduction of nursing into tertiary institutions in Australia in 1975, there has been increasing interest in the teaching of physical science to nurses. Various courses in physical science for nurse students have been developed. They vary in length and content but there is agreement that concepts taught should be closely related to nursing applications. The choice of relevant concepts tends to be made by individual curriculum developers. This paper reports an examination of the use of physical science concepts and their relevance from the perspective of registered nurses practising in general ward areas. Inherent in this study is the premise that for registered nurses to have ideas of the physical science underlying their practice they must have constructed meaning first for these concepts. Specific chemical concepts related to solutions are discussed in these terms.

  6. Establishing radiation therapy advanced practice in New Zealand

    SciTech Connect

    Coleman, Karen; Jasperse, Marieke; Herst, Patries; Yielder, Jill

    2014-02-15

    Introduction: Advanced practice (AP) is of increasing interest to many radiation therapists (RTs) both nationally and internationally. In New Zealand, initial research (2005–2008) showed strong support for the development of an AP role for medical radiation technologists (MRTs). Here, we report on a nationwide survey in which RTs validated and prioritised nine AP profiles for future development. Methods: All registered RTs in New Zealand (n = 260) were invited to take part in a survey in December 2011; 73 of whom returned a complete response. Results: RTs supported the implementation of AP roles in New Zealand and the requirement of a Master's degree qualification to underpin clinical knowledge. Most RTs endorsed the criteria attributed to each of the nine proposed AP profiles. The study identified that activities may qualify as either advanced practice or standard practice depending on the department. All participants agreed that an advanced practitioner should be a leader in the field, able to initiate and facilitate future developments within as well as outside this specific role. Acceptance of the AP roles by RTs and other health professionals as well as the availability of resources for successful implementation, were concerns expressed by some RTs. Conclusion: The authors recommend (1) the development of one scope of practice titled ‘advanced practitioner’ with generic and specialist criteria for each profile as the future career pathway, (2) promotion and support for the AP pathway by the New Zealand Institute of Medical Radiation Technology and the New Zealand Medical Radiation Technologists Board.

  7. Training Advanced Practice Palliative Care Nurses.

    ERIC Educational Resources Information Center

    Sherman, Deborah Witt

    1999-01-01

    Describes the role and responsibilities of advanced-practice nurses in palliative care and nursing's initiative in promoting high-quality care through the educational preparation of these nurses. (JOW)

  8. Algorithm linking patients and general practices in Denmark using the Danish National Health Service Register

    PubMed Central

    Kjaersgaard, Maiken Ina Siegismund; Vedsted, Peter; Parner, Erik Thorlund; Bech, Bodil Hammer; Vestergaard, Mogens; Flarup, Kaare Rud; Fenger-Grøn, Morten

    2016-01-01

    Background The patient list system in Denmark assigns virtually all residents to a general practice. Nevertheless, historical information on this link between patient and general practice is not readily available for research purposes. Objectives To develop, implement, and evaluate the performance of an algorithm linking individual patients to their general practice by using information from the Danish National Health Service Register and the Danish Civil Registration System. Materials and methods The National Health Service Register contains information on all services provided by general practitioners from 1990 and onward. On the basis of these data and information on migration history and death obtained from the Civil Registration System, we developed an algorithm that allocated patients to a general practice on a monthly basis. We evaluated the performance of the algorithm between 2002 and 2007. During this time period, we had access to information on the link between patients and general practices. Agreement was assessed by the proportion of months for which the algorithm allocated patients to the correct general practice. We also assessed the proportion of all patients in the patient list system for which the algorithm was able to suggest an allocation. Results The overall agreement between algorithm and patient lists was 98.6%. We found slightly higher agreement for women (98.8%) than for men (98.4%) and lower agreement in the age group 18–34 years (97.1%) compared to all other age groups (≥98.6%). The algorithm had assigned 83% of all patients in the patient list system after 1 year of follow-up, 91% after 2 years of follow-up, and peaked at 94% during the fourth year. Conclusion We developed an algorithm that enables valid and nearly complete linkage between patients and general practices. The algorithm performs better in subgroups of patients with high health care needs. The algorithm constitutes a valuable tool for primary health care research. PMID

  9. Moral distress in certified registered nurse anesthetists: implications for nursing practice.

    PubMed

    Radzvin, Linda Clerici

    2011-02-01

    Registered nurses are frequently confronted with ethical dilemmas in their nursing practice. As a consequence of their decisions regarding ethical challenges, nurses report experiencing moral distress. This experience is often manifested by such feelings as anger, guilt, and sadness, and has been identified as a contributing factor to burnout and turnover in nursing. The purpose of this exploratory, descriptive study was to determine if Certified Registered Nurse Anesthetists (CRNAs) experience moral distress in their nursing practice. A random sample of 800 CRNAs from the registry of the American Association of Nurse Anesthetists was selected to participate in this study. Participating nurses were asked to complete a demographic data survey and the Ethics Stress Scale. Three hundred surveys were analyzed for this study. The data supported the assumption that CRNAs do experience moral distress in their nursing practice. Although a small number of nurse anesthetists experienced high levels of moral distress, CRNAs generally experienced moderate levels of moral distress. Moral distress was associated with situations in which anesthetists believed they were aware of the morally correct course of action but were unable to follow through with these behaviors. Also, CRNAs reported physical and psychological manifestations in relation to moral distress.

  10. Teaching Research Synthesis to Advanced Practice Nurses.

    ERIC Educational Resources Information Center

    Upchurch, Sandra; Brosnan, Christine A.; Grimes, Deanna E.

    2002-01-01

    A process for teaching research synthesis to advanced practice nurses includes two courses: a first research applications course in which students build bibliographic databases, practice statistical analysis, and develop search skills; and a second course in which they complete literature reviews or meta analyses of research on clinical practice…

  11. Immersion scenarios bridge the education-practice gap for new graduate registered nurses.

    PubMed

    Mowry, Marianne J; Crump, Mark D

    2013-07-01

    An education gap exists for new graduate registered nurses in mental health because of insufficient clinical experience. In an effort to bridge this gap, defined competencies and assessments provided the framework and direction for educational immersion scenarios with standardized patients. Kirkpatrick's (1995) model directed the evaluation of the learning achieved through the immersion scenarios. A qualitative evaluation provided themes of realism, safety, and opportunity. Formative and summative competencies were met effectively and efficiently. This educational method can be used to actively achieve competency and enhance the transition to clinical practice.

  12. Story theory: advancing nursing practice scholarship.

    PubMed

    Smith, Mary Jane; Liehr, Patricia

    2005-01-01

    Stories are a fundamental dimension of human experience and nursing practice. Story theory describes a narrative happening that occurs through intentional nurse-person dialogue. Seven inquiry phases are associated with story theory, including gathering the story, reconstructing the story, connecting it to the literature, naming the complicating health challenge, describing the story plot, identifying movement toward resolving, and gathering additional stories. This article describes the use of story theory to advance nursing practice scholarship in both academic and everyday nursing practice.

  13. Retainment incentives in three rural practice settings: variations in job satisfaction among staff registered nurses.

    PubMed

    Stratton, T D; Dunkin, J W; Juhl, N; Geller, J M

    1995-05-01

    Researchers have demonstrated repeatedly the importance of the relationship linking job satisfaction to employee retention. In rural areas of the country, where a persistent maldistribution of nurses continues to hamper health care delivery, the potential benefits of bolstering retention via enhancements in job satisfaction are of utmost utility to administrators and providers alike. Data were gathered from a multistate survey of registered nurses (RNs) practicing in rural hospitals, skilled nursing facilities, and community/public health settings (N = 1,647; response rate = 40.3%). The investigators found that the use of tuition reimbursement corresponded significantly with increased levels of job satisfaction among nurses in all three practice environments, as did day care services for nurses in acute care settings. Also, among hospital-based RNs, level of nursing education was found to be a significant factor in the relationship between tuition reimbursement and job satisfaction, with the highest level occurring among diploma-prepared nurses.

  14. Pain Management: Knowledge and Attitudes of Senior Nursing Students and Practicing Registered Nurses

    ERIC Educational Resources Information Center

    Messmer, Sherry

    2009-01-01

    Despite scientific advances in pain management, inadequate pain relief in hospitalized patients continues to be an on-going phenomenon. Although nurses do not prescribe medication for pain, the decision to administer pharmacological or other interventions for pain relief is part of nursing practice. Nurses play a critical role in the relief of…

  15. Using advanced mobile devices in nursing practice--the views of nurses and nursing students.

    PubMed

    Johansson, Pauline; Petersson, Göran; Saveman, Britt-Inger; Nilsson, Gunilla

    2014-09-01

    Advanced mobile devices allow registered nurses and nursing students to keep up-to-date with expanding health-related knowledge but are rarely used in nursing in Sweden. This study aims at describing registered nurses' and nursing students' views regarding the use of advanced mobile devices in nursing practice. A cross-sectional study was completed in 2012; a total of 398 participants replied to a questionnaire, and descriptive statistics were applied. Results showed that the majority of the participants regarded an advanced mobile device to be useful, giving access to necessary information and also being useful in making notes, planning their work and saving time. Furthermore, the advanced mobile device was regarded to improve patient safety and the quality of care and to increase confidence. In order to continuously improve the safety and quality of health care, advanced mobile devices adjusted for nursing practice should be further developed, implemented and evaluated in research.

  16. Nursing Practice Environment and Registered Nurses’ Job Satisfaction in Nursing Homes

    PubMed Central

    Choi, JiSun; Flynn, Linda; Aiken, Linda H.

    2012-01-01

    Purpose: Recruiting and retaining registered nurses (RNs) in nursing homes is problematic, and little research is available to guide efforts to make nursing homes a more attractive practice environment for RNs. The purpose of this study was to examine relationships between aspects of the nursing practice environment and job satisfaction among RNs in nursing homes. Design and Methods: The sample included 863 RNs working as staff RNs in 282 skilled nursing facilities in New Jersey. Two-level hierarchical linear modeling was used to account for the RNs nested by nursing homes. Results: Controlling for individual and nursing home characteristics, staff RNs’ participation in facility affairs, supportive manager, and resource adequacy were positively associated with RNs’ job satisfaction. Ownership status was significantly related to job satisfaction; RNs working in for-profit nursing homes were less satisfied. Implications: A supportive practice environment is significantly associated with higher job satisfaction among RNs working in nursing homes. Unlike other nursing home characteristics, specific dimensions of the nursing practice environment can be modified through administrative actions to enhance RN job satisfaction. PMID:21908803

  17. Developing the Advanced Practice Nurse in Catalonia.

    PubMed

    Comellas-Oliva, Montserrat

    2016-01-01

    The development of advanced practice nurses (APN) has proved a challenge for nurses in countries such as the USA, Canada, Great Britain, and Australia among others. It is only in recent years that the system has been considered in Catalonia and Spain as a way to develop new roles to bring effectiveness and efficiency to the health system. From the standpoint of training and implementation of the above-mentioned new nursing roles, the following article aims to conceptualise APN and its reference models, as well as to contextualise and reflect on APN in Catalonia in order to assimilate them into advanced practice.

  18. 31 CFR 306.26 - Redemption of registered securities at maturity, upon prior call, or for prerefunding or advance...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... at maturity, upon prior call, or for prerefunding or advance refunding. 306.26 Section 306.26 Money... Payment § 306.26 Redemption of registered securities at maturity, upon prior call, or for prerefunding or... to a call for redemption before maturity need not be assigned, unless the owner desires that...

  19. 27th Annual APRN legislative update: advancements continue for APRN practice.

    PubMed

    Phillips, Susanne J

    2015-01-16

    As the tides of healthcare in the United States continue to change, advanced practice registered nurses (APRNs) are at the forefront of legislative history. This overview provides a snapshot of legislative and regulatory activity in 2014 as reported by state Boards of Nursing and nursing organizations representing APRNs.

  20. Registered nurses' ideas of physical science concepts relevant to their clinical practice

    NASA Astrophysics Data System (ADS)

    Wilkes, Lesley M.; Batts, Judith E.

    1996-09-01

    Experience in teaching science to nurses has raised the question of whether nurses' expressions of their understanding of concepts in physical science are adequate for professional practice. Nurses' descriptions of physical science concepts relevant to their practice must be explicated before educators can develop strategies to enhance nurses' learning of science. A cross-sectional study was undertaken to establish registered nurses' conceptions of physical science in their clinical practice. Data were collected using a multiple choice question survey, field work and focused interviews. Six categories of conceptions emerged from data analysis. Of the three which related to complexity of understanding “association” and “definition” were predominant and related in the main, to two of the three contextual categories “instrumentation/equipment” and “procedure.” There were few examples of the other two categories of “elaboration” and “body processes.” We argue that the conceptions held by the nurses were not adequate to allow them to fulfil their roles as professional practitioners in health care.

  1. Academy of nutrition and dietetics: revised 2014 standards of practice and standards of professional performance for registered dietitian nutritionists (competent, proficient, and expert) in sports nutrition and dietetics.

    PubMed

    Steinmuller, Patricia L; Kruskall, Laura J; Karpinski, Christine A; Manore, Melinda M; Macedonio, Michele A; Meyer, Nanna L

    2014-04-01

    Sports nutrition and dietetics addresses relationships of nutrition with physical activity, including weight management, exercise, and physical performance. Nutrition plays a key role in the prevention and treatment of obesity and chronic disease and for maintenance of health, and the ability to engage in physical activity, sports, and other aspects of physical performance. Thus, the Sports, Cardiovascular, and Wellness Nutrition Dietetic Practice Group, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, has developed the Revised 2014 Standards of Practice and Standards of Professional Performance as a resource for Registered Dietitian Nutritionists working in sports nutrition and dietetics to assess their current skill levels and to identify areas for further professional development in this emerging practice area. The revised document reflects advances in sports nutrition and dietetics practice since the original standards were published in 2009 and replaces those standards. The Standards of Practice represents the four steps in the Nutrition Care Process as applied to the care of patients/clients. The Standards of Professional Performance covers six standards of professional performance: quality in practice, competence and accountability, provision of services, application of research, communication and application of knowledge, and utilization and management of resources. Within each standard, specific indicators provide measurable action statements that illustrate how the standards can be applied to practice. The indicators describe three skill levels (competent, proficient, and expert) for Registered Dietitian Nutritionists working in sports nutrition and dietetics. The Standards of Practice and Standards of Professional Performance are complementary resources for Registered Dietitian Nutritionists in sports nutrition and dietetics practice.

  2. Advanced practice nurse as outcomes manager.

    PubMed

    Houston, S; Luquire, R

    1997-01-01

    Outcomes management as a patient management system has been designed to impact and improve select outcomes. Central to the development and implementation of best practice senario identified throughout outcomes management is the advanced practice nurse. SLEH has been in the forefront of development and implementation of an outcomes management program. This article describes the outcomes management position and shares the job description and performance evaluation used at this institution. The tools allow for measuring and quantifying the impact of the outcomes manager position on improving patient outcomes. The improvement of outcomes has increased the value of the advanced practice nurse and provided the institution with a solid future necessary for survival in a managed care market.

  3. Development of a postbasic critical care program for registered nurses: a collaborative venture between education and practice.

    PubMed

    Tobin, Brenda

    2007-01-01

    This article describes a collaborative venture between nursing education and nursing practice focused on continuing education. A province-wide assessment of the educational needs of registered nurses identified the need to create a critical care education program. A critical care project team was established to develop a Postbasic Critical Care Program for registered nurses. The development of the project team, initiation of the program, and the mutual benefits and challenges posed by this collaborative venture are presented.

  4. Advanced paternal age and childhood cancer in offspring: A nationwide register-based cohort study.

    PubMed

    Urhoj, Stine Kjaer; Raaschou-Nielsen, Ole; Hansen, Anne Vinkel; Mortensen, Laust Hvas; Andersen, Per Kragh; Nybo Andersen, Anne-Marie

    2017-03-03

    Cancer initiation is presumed to occur in utero for many childhood cancers and it has been hypothesized that advanced paternal age may have an impact due to the increasing number of mutations in the sperm DNA with increasing paternal age. We examined the association between paternal age and specific types of childhood cancer in offspring in a large nationwide cohort of 1,904,363 children born in Denmark from 1978 through 2010. The children were identified in the Danish Medical Birth Registry and were linked to information from other national registers, including the Danish Cancer Registry. In total, 3,492 children were diagnosed with cancer before the age of 15 years. The adjusted hazard ratio of childhood cancer according to paternal age was estimated using Cox proportional hazards regressions. We found a 13% (95% confidence interval: 4-23%) higher hazard rate for every 5 years advantage in paternal age for acute lymphoblastic leukemia, while no clear association was found for acute myeloid leukemia (hazard ratio pr. 5 years = 1.02, 95% confidence interval: 0.80-1.30). The estimates for neoplasms in the central nervous system suggested a lower hazard rate with higher paternal age (hazard ratio pr. 5 years = 0.92, 95% confidence interval: 0.84-1.01). No clear associations were found for the remaining childhood cancer types. The findings suggest that paternal age is moderately associated with a higher rate of childhood acute lymphoblastic leukemia, but not acute myeloid leukemia, in offspring, while no firm conclusions could be made for other specific cancer types.

  5. Advanced practice nursing for congestive heart failure.

    PubMed

    McCormick, S A

    1999-02-01

    Congestive heart failure (CHF) is an enormous burden on society and the health care system. The role of the advanced practice nurse (APN) in CHF is multifaceted and combines inpatient, outpatient, and community patient care skills. Case management and quality management have been traditional focuses, with a high level of practice impact on patient care. Outcomes management in the APN role for CHF care is the future for measurable outcomes and maximum impact on organizational values. Because outcomes management is an evolving field for the APN, focus on a chronic disease such as CHF is a very valuable tool for implementation.

  6. Advancing practice relating to SEA alternatives

    SciTech Connect

    González, Ainhoa; Thérivel, Riki; Fry, John; Foley, Walter

    2015-07-15

    Developing and assessing alternatives is a key and central stage to Strategic Environmental Assessment (SEA). However, research has repeatedly reported this stage as one of the most poorly undertaken aspects of the SEA process. Current practice limitations include belated consideration of reasonable alternatives, narrow scope of alternatives that often include unrealistic or retrofitted options, limited stakeholder and public involvement in their identification, assessment and selection, lack of systematic approaches to their assessment and comparison, and inadequate reporting of the ‘storyline’ on how they were identified, what the potential impacts are and why the preferred alternative was selected. These issues have resulted in objections and judicial reviews. On the positive side, a number of good practice case studies enable extraction of key lessons and formulation of a set of general recommendations to advance practice in SEA alternatives. In this paper, practical guidance on the identification and development of alternatives, their assessment and comparison, selection of the preferred option, and documentation of the process and the reasons for selection is provided and discussed to frame good practice approaches. - Highlights: • Alternatives are one of the most poorly completed aspects of Strategic Environmental Assessment. • Current practice limitations need to be addressed to enhance SEA effectiveness. • A set of recommendations are extracted from good practice case studies. • These recommendations can be applied across jurisdictions and sectors and tailored as necessary.

  7. Compiling a register of patients with moderate or severe learning disabilities: experience at one United Kingdom general practice.

    PubMed

    Lodge, Keri-Michèle; Milnes, David; Gilbody, Simon M

    2011-03-01

    Background Identifying patients with learning disabilities within primary care is central to initiatives for improving the health of this population. UK general practitioners (GPs) receive additional income for maintaining registers of patients with learning disabilities as part of the Quality and Outcomes Framework (QOF), and may opt to provide Directed Enhanced Services (DES), which requires practices to maintain registers of patients with moderate or severe learning disabilities and offer them annual health checks.Objectives This paper describes the development of a register of patients with moderate or severe learning disabilities at one UK general practice.Methods A Read code search of one UK general practice's electronic medical records was conducted in order to identify patients with learning disabilities. Confirmation of diagnoses was sought by scrutinising records and GP verification. Cross-referencing with the practice QOF register of patients with learning disabilities of any severity, and the local authority's list of clients with learning disabilities, was performed.Results Of 15 001 patients, 229 (1.5%) were identified by the Read code search as possibly having learning disabilities. Scrutiny of records and GP verification confirmed 64 had learning disabilities and 24 did not, but the presence or absence of learning disability remained unclear in 141 cases. Cross-referencing with the QOF register (n=81) and local authority list (n=49) revealed little overlap.Conclusion Identifying learning disability and assessing its severity are tasks GPs may be unfamiliar with, and relying on Read code searches may result in under-detection. Further research is needed to define optimum strategies for identifying, cross-referencing and validating practice-based registers of patients with learning disabilities.

  8. Descriptors of anesthesia support personnel from the perspective of practicing certified registered nurse anesthetists.

    PubMed

    Ford, Mary Bryant

    2012-12-01

    Anesthesia support personnel provide direct support to anesthesia providers. They bring extra supplies or equipment, prepare equipment for the case, maintain and clean equipment, and generally function as directed by the anesthesia provider. Given the importance of anesthesia support personnel in maintaining equipment essential to safe anesthesia practice, it is necessary to ensure that these individuals are properly trained and capable of complying with safety standards. However, the literature describing this population is limited and shows variation in the utilization and qualifications of these personnel. A prospective, descriptive survey of Certified Registered Nurse Anesthetists was conducted to describe the education, training, job functions, and work environment of anesthesia support personnel. Results (N = 354) indicated that utilization of anesthesia support personnel varies by hospital but has a propensity to be greater at larger medical centers that have a level I or II trauma center. Formal supervision of these personnel is limited. Their tasks tended to be more frequently directed at equipment management, with a smaller portion of anesthesia support personnel performing tasks related to direct patient care. Further research is needed to adequately describe this population.

  9. The Designing and Development of a Program to Prepare Inactive Registered Nurses for Reentry into Practice. Curriculum Development.

    ERIC Educational Resources Information Center

    Belock, Shirley

    The planning and design of a course for the inactive registered nurse desiring to return to active practice is reported in this practicum paper. Current literature was reviewed with emphasis on the needs in rural states, such as Vermont, and characteristics of the target group. The first three modules of the course were developed, entitled: The…

  10. Educational Changes to Support Advanced Practice Nursing Education

    PubMed Central

    LeFlore, Judy L.; Thomas, Patricia E.

    2016-01-01

    Educational factors limit the number of advanced practice registered nurse (APRN) graduates to meet the growing workforce demands. Healthcare dynamics are necessitating a shift in how nursing education envisions, creates, and implements clinical learning opportunities. The current clinical education model in APRN programs continues to be the same as it was 45 years ago when the student numbers were much smaller. New approaches in graduate nursing education are needed to address the shortage of APRNs in primary and acute care areas. Determining competency based on the number of clinical hours can be inefficient, ineffective, and costly and limits the ability to increase capacity. Little research exists in graduate nursing education to support the effectiveness and efficiency of current hours of clinical required for nurse practitioner students. Simulation and academic-practice partnership models can offer innovative approaches to nurse practitioner education for clinical training, with the goal of producing graduates who can provide safe, quality care within the complex practice-based environment of the nation's evolving healthcare system. PMID:27465446

  11. Trauma advanced practice nurses: implementing the role.

    PubMed

    Martin, Kathleen D; Molitor-Kirsch, Shirley; Elgart, Heidi; Ruffolo, Daria C; Sicoutris, Corinna; Meredith, Denise

    2004-01-01

    The need for advanced practice nurses (APN) has expanded over the past several decades as a result of the changing healthcare environment. Increased patient acuity and decreased resident work hours have lead to a need for additional clinical expertise at the bedside. APNs are becoming an integral part of the acute care delivery team in many trauma programs and intensive care units. To date little has been published regarding the role of the APN in Trauma Centers. This article outlines the wide variety of responsibilities and services provided by a select group of nurse practitioners who work in trauma centers throughout the United States.

  12. Teaching nursing students and newly registered nurses strategies to deal with violent behaviors in the professional practice environment.

    PubMed

    Thomas, Cynthia M

    2010-07-01

    Direct and indirect violent behaviors toward nursing students and newly registered nurses must be eliminated. Nursing students and newly registered nurses are particularly vulnerable to acts of violence. The article discusses the effect of violence on students and newly registered nurses, the role of the continuing education nurse in eliminating violence, examples of aggressive situations, and strategies to educate and support students and new nurses and empower them to eliminate violence directed toward them. Strategies include confrontation tips, implementation of violence-free contracts, participation in role-play activities, adoption of a professional communication technique, reflection journaling and cognitive recognition, promotion of carefronting, introduction of dialogue through the World Café, and use of nurse preceptors, practice partnerships, residency programs.

  13. Advancing Cybersecurity Capability Measurement Using the CERT(registered trademark)-RMM Maturity Indicator Level Scale

    DTIC Science & Technology

    2013-11-01

    Institute at permission@sei.cmu.edu. * These restrictions do not apply to U.S. government entities. CERT® and CMMI ® are registered marks of Carnegie...Attributes 4 1.3.4 Appraisal and Scoring Methods 5 1.3.5 Improvement Roadmaps 5 2 Introducing the Maturity Indicator Level (MIL) Concept 6 2.1...CERT®-RMM v1.2) utilizes the maturity architecture (levels and descriptions) as provided in the Capability Maturity Model Integration ( CMMI

  14. Neonatal resuscitation: advances in training and practice

    PubMed Central

    Sawyer, Taylor; Umoren, Rachel A; Gray, Megan M

    2017-01-01

    Each year in the US, some four hundred thousand newborns need help breathing when they are born. Due to the frequent need for resuscitation at birth, it is vital to have evidence-based care guidelines and to provide effective neonatal resuscitation training. Every five years, the International Liaison Committee on Resuscitation (ILCOR) reviews the science of neonatal resuscitation. In the US, the American Heart Association (AHA) develops treatment guidelines based on the ILCOR science review, and the Neonatal Resuscitation Program (NRP) translates the AHA guidelines into an educational curriculum. In this report, we review recent advances in neonatal resuscitation training and practice. We begin with a review of the new 7th edition NRP training curriculum. Then, we examine key changes to the 2015 AHA neonatal resuscitation guidelines. The four components of the NRP curriculum reviewed here include eSim®, Performance Skills Stations, Integrated Skills Station, and Simulation and Debriefing. The key changes to the AHA neonatal resuscitation guidelines reviewed include initial steps of newborn care, positive-pressure ventilation, endotracheal intubation and use of laryngeal mask, chest compressions, medications, resuscitation of preterm newborns, and ethics and end-of-life care. We hope this report provides a succinct review of recent advances in neonatal resuscitation. PMID:28096704

  15. Identifying components of advanced-level clinical nutrition practice: a Delphi study.

    PubMed

    Brody, Rebecca A; Byham-Gray, Laura; Touger-Decker, Riva; Passannante, Marian R; O'Sullivan Maillet, Julie

    2012-06-01

    The dietetics profession lacks a comprehensive definition of advanced-level practice. Using a three-round Delphi study with mailed surveys, expert consensus on four dimensions of advanced-level practice that define advanced practice registered dietitians (RDs) in clinical nutrition was explored. Purposive sampling identified 117 RDs who met advanced-level practice criteria. In round 1, experts rated the essentiality of statements on a 7-point ordinal scale and generated open-ended practice activity statements regarding the following four dimensions of advanced-level practice: professional knowledge, abilities and skills, approaches to practice, roles and relationships, and practice behaviors. Median ratings of 1.0 to 3.0 were defined as essential, 4.0 was neutral, and 5.0 to 7.0 were nonessential. In rounds 2 and 3, experts re-rated statements not reaching consensus by evaluating their previous responses, group median rating, and comments. Consensus was reached when the interquartile range of responses to a statement was ≤2.0. Eighty-five experts enrolled (72.6%); 76 (89.4%) completed all rounds. In total, 233 statements were rated, with 100% achieving consensus; 211 (90.6%) were essential to advanced practice RD clinical practice. Having a master's degree; completing an advanced practice residency; research coursework; and advanced continuing education were essential, as were having 8 years of experience; clinical nutrition knowledge/expertise; specialization; participation in research activities; and skills in technology and communication. Highly essential approaches to practice were systematic yet adaptable and used critical thinking and intuition and highly essential values encompassed professional growth and service to patients. Roles emphasized patient care and leadership. Essential practice activities within the nutrition care process included provision of complex patient-centered nutrition care using application of advanced knowledge/expertise and

  16. Advanced paternal age and stillbirth rate: a nationwide register-based cohort study of 944,031 pregnancies in Denmark.

    PubMed

    Urhoj, Stine Kjaer; Andersen, Per Kragh; Mortensen, Laust Hvas; Davey Smith, George; Nybo Andersen, Anne-Marie

    2017-03-01

    Advanced paternal age has been associated with a variety of rare conditions and diseases of great public health impact. An increased number of de novo point mutations in sperm with increasing age have been suggested as a mechanism, which would likely also affect fetal viability. We examined the association between paternal age and stillbirth rate in a large nationwide cohort. We identified all pregnancies in Denmark from 1994 to 2010 carried to a gestational age of at least 22 completed weeks (n = 944,031) as registered in national registers and linked to individual register data about the parents. The hazard ratio of stillbirth according to paternal age was estimated, adjusted for maternal age in 1-year categories, year of outcome, and additionally parental educational levels. The relative rate of stillbirth (n = 4946) according to paternal age was found to be J-shaped with the highest hazard ratio for fathers aged more than 40 years when paternal age was modelled using restricted cubic splines. When modelled categorically, the adjusted hazard ratios of stillbirth were as follows: <25, 1.16 (95% confidence interval, CI 1.01-1.34); 25-29, 1.03 (95% CI 0.95-1.11); 35-39, 1.16 (95% CI 1.07-1.26); 40-44, 1.41 (95% CI 1.26-1.59); 45-49, 1.20 (95% CI 0.97-1.49); 50+, 1.58 (95% CI 1.18-2.11), compared with fathers aged 30-34 years. These estimates attenuated slightly when further adjusted for parental education. Our study showed that paternal age was associated with the relative rate of stillbirth in a J-shaped manner with the highest hazard ratios among fathers aged more than 40 years.

  17. Advanced practice in paediatric intensive care: a review.

    PubMed

    Heward, Yvonne

    2009-02-01

    Advanced nursing roles are one way of encouraging experienced nurses to stay in clinical practice so they can provide expert care, develop practice and be role models for junior staff. A search for literature about advanced nurse practice in paediatric intensive care units in the UK identified just four articles, including one survey, but no reports of empirical research. There is some consensus on the nature and educational requirements for advanced practice but delays in agreeing a regulatory framework and failure to recognise the potential contribution of advanced roles mean that development is hindered. Although several UK units have developed or are developing the role, more insight and better evidence is needed on how nursing can be advanced in paediatric intensive care settings.

  18. Advanced practice nursing in Latin America and the Caribbean: regulation, education and practice

    PubMed Central

    Zug, Keri Elizabeth; Cassiani, Silvia Helena De Bortoli; Pulcini, Joyce; Garcia, Alessandra Bassalobre; Aguirre-Boza, Francisca; Park, Jeongyoung

    2016-01-01

    Abstract Objective: to identify the current state of advanced practice nursing regulation, education and practice in Latin America and the Caribbean and the perception of nursing leaders in the region toward an advanced practice nursing role in primary health care to support Universal Access to Health and Universal Health Coverage initiatives. Method: a descriptive cross-sectional design utilizing a web-based survey of 173 nursing leaders about their perceptions of the state of nursing practice and potential development of advanced practice nursing in their countries, including definition, work environment, regulation, education, nursing practice, nursing culture, and perceived receptiveness to an expanded role in primary health care. Result: the participants were largely familiar with the advanced practice nursing role, but most were unaware of or reported no current existing legislation for the advanced practice nursing role in their countries. Participants reported the need for increased faculty preparation and promotion of curricula reforms to emphasize primary health care programs to train advanced practice nurses. The vast majority of participants believed their countries' populations could benefit from an advanced practice nursing role in primary health care. Conclusion: strong legislative support and a solid educational framework are critical to the successful development of advanced practice nursing programs and practitioners to support Universal Access to Health and Universal Health Coverage initiatives. PMID:27508923

  19. The Influence of Organizational Culture on Affinity for Knowledge Management Practices of Registered Nurses

    ERIC Educational Resources Information Center

    Allen, Gregory

    2013-01-01

    This study addressed the problems of hospitals' duplicated effort and ad hoc knowledge management (KM) practices. The purpose of this quantitative study was to examine the focus and type of organizational culture in order to describe and predict the relationship between organizational culture and the affinity for KM of nurses working in health…

  20. Articulating Scientific Practice: Understanding Dean Hamer's "Gay Gene" Study as Overlapping Material, Social and Rhetorical Registers

    ERIC Educational Resources Information Center

    Lynch, John A.

    2009-01-01

    Rhetoricians have tried to develop a better understanding of the connection between words and things, but these attempts often employ a logic of representation that undermines a full examination of materiality and the complexity of scientific practice. A logic of articulation offers a viable alternative by focusing attention on the linkages…

  1. Genres and Registers of Student Report Writing: An SFL Perspective on Texts and Practices

    ERIC Educational Resources Information Center

    Gardner, Sheena

    2012-01-01

    Academic literacies research has tended to focus on writers in context, while systemic functional linguistic research has tended to focus on texts in context. While literacy practices and written texts may be usefully analysed independently, this paper describes how an investigation of genres of academic writing in the BAWE (British Academic…

  2. Exploring Best Practices in Advance Care Planning

    DTIC Science & Technology

    2016-05-11

    Background: The factors that influence completion of advance care planning for elderly adults in the primary care setting are poorly understood...System factors such as expansion of technological and medical options added to lists of tasks primary care providers are expected to complete in ever...to low rates of completion. We hypothesized that prioritized utilization of motivational interviewing during a visit specified to address advance care planning will enhance completion rates of appropriate planning.

  3. Implementation of a professional portfolio: a tool to demonstrate professional development for advanced practice.

    PubMed

    Chamblee, Tracy B; Dale, Juanita Conkin; Drews, Barbie; Spahis, Joanna; Hardin, Teri

    2015-01-01

    The literature has a gap related to professional development for APRNs. In the United States, many health care organizations use clinical advancement programs for registered nurses, but APRNs are not often included in these programs. If APRNs are included, advancement opportunities are very limited. At CMC, implementation of a professional portfolio resulted in increased satisfaction among APPs regarding their ability to showcase professional growth and expertise, as well as the uniqueness of their advanced practice. Use of the professional portfolio led to improved recognition by APS and organizational leaders of APP performance excellence during the annual performance evaluation, as well as improved recognition among APP colleagues in terms of nominations for honors and awards.

  4. Accrediting advanced practice: who will benefit?

    PubMed

    2017-02-27

    Last month I attended the 2017 RCN advanced nurse practitioner (ANP) conference in London. The title of the conference referred to 'moving the agenda forward' and there were many examples of ANPs pioneering developments in emergency care, primary care, acute medicine, mental health and other services.

  5. Voices That Care: Licensed Practical Nurses and the Emotional Labour Underpinning Their Collaborative Interactions with Registered Nurses

    PubMed Central

    Huynh, Truc; Alderson, Marie; Nadon, Michelle; Kershaw-Rousseau, Sylvia

    2011-01-01

    Recognizing the emotional labour underlying interprofessional collaborations (IPCs) could be considered a crucial step towards building a cohesive nursing team. Although IPCs between registered nurses (RNs) and licensed practical nurses (LPNs) have been linked to quality nursing care, little is known about the emotions experienced by LPNs during their interactions with RNs or those factors that influence IPCs. A questionnaire administered to 309 LPNs found that (1) the professional identity of LPNs has evolved into a that of a unique social group; (2) LPNs define IPC as an interpersonal process of exploring similar or dissimilar assessments of a patient's status with RNs and, together, establishing a course of nursing actions; (3) the primary organizational factor facilitating IPCs is inclusive nursing leadership; (4) the interpersonal factor promoting IPCs is the level of trust RNs extend to LPNs; and (5) an LPN's emotional labour (i.e., internal emotional regulation) is most tangible during uncollaborative interactions with RNs. PMID:22135732

  6. Registered Nurses in Primary Care: Emerging New Roles and Contributions to Team-Based Care in High-Performing Practices.

    PubMed

    Flinter, Margaret; Hsu, Clarissa; Cromp, DeAnn; Ladden, MaryJoan D; Wagner, Edward H

    2017-03-20

    The years since the passage of the Affordable Care Act have seen substantial changes in the organization and delivery of primary care. These changes have emphasized greater team involvement in care and expansion of the roles of each team member including registered nurses (RNs). This study examined the roles of RNs in 30 exemplary primary care practices. We identified the emergence of new roles and activities for RNs characterized by greater involvement in face-to-face patient care and care management, their own daily schedule of patient visits and contacts, and considerable autonomy in the care of their patients.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

  7. Developing entry-to-practice nursing informatics competencies for registered nurses.

    PubMed

    Nagle, Lynn M; Crosby, Kristine; Frisch, Noreen; Borycki, Elizabeth; Donelle, Lorie; Hannah, Kathryn; Harris, Alexandra; Jetté, Sylvie; Shaben, Tracy

    2014-01-01

    Information and communication technologies (ICT) have brought about significant changes to the processes of health care delivery and changed how nurses perform in clinical, administrative, academic, and research settings. Because the potential benefits of ICT are significant, it is critical that new nurses have the knowledge and skills in informatics to provide safe and effective care. Despite the prevalence of technology in our day to day lives, and the potential significant benefits to patients, new nurses may not be prepared to work in this evolving reality. An important step in addressing this need for ICT preparation is to ensure that new graduates are entering the work force ready for technology-enabled care environments. In this paper, we describe the process and outcomes of developing informatics entry-to-practice competencies for adoption by Canadian Schools of Nursing.

  8. Does Moral Distress Differ Between California Certified Registered Nurse Anesthetists in Independent Versus Medically Supervised Practice: An Exploratory Study.

    PubMed

    Dumouchel, Michael; Boytim, Michael; Gorman, Nicholas; Weismuller, Penny

    2015-06-01

    The purpose of this exploratory, descriptive study was to determine if moral distress levels differed between certified registered nurse anesthetists (CRNAs) working in medically supervised versus independent practice in California. A 63-question survey was administered to 1,190 California CRNAs. Moral distress was measured by the included Ethics Stress Scale. The response rate was 14.7%, yielding demographic and Ethics Stress scores for 175 respondents. Sixty-five participants answered an open-ended question about moral distress yielding qualitative data. Medically supervised CRNAs had a lower mean moral distress scores (176.8) versus independent practice CRNAs (187.8) (p = .002). Lower scores on the ESS indicate higher moral distress. Qualitative data demonstrated that CRNAs experienced moral distress in the following situations: when pressured to give anesthesia to unoptimized patients, when differences of opinion regarding anesthetic plans occurred, in dealing with end-of-life issues, when working with incompetent providers, and during interprofessional struggles between CRNAs and anesthesiologists. In order to reduce moral distress among CRNAs, implications for practice include increased administrative support, increased communication and reciprocated collegial respect between anesthesiologists and CRNAs, and CRNA representation on ethics committees.

  9. AORN guidance statement: safe on-call practices in perioperative practice settings. Association of periOperative Registered Nurses.

    PubMed

    2005-05-01

    Call staffing and the associated long work hours can be challenging for both perioperative staff members and the health care organization. A change in culture is needed to recognize exhaustion as an unacceptable risk to patients and perioperative personnel safety. Perioperative health care providers have a personal responsibility to arrive at work fully rested. Health care organizations have a responsibility to create work and call schedules that consider the effect of long work hours on patient safety as well as perioperative staff members' welfare. The development of standardized safe work hours and call practices should reflect current recommendations emerging from authoritative sources, legislation, and empirical data. Prolonged work periods without adequate rest may contribute to diminished performance by perioperative personnel, placing both patients and workers at risk. This guidance statement may assist managers and clinicians in developing policies and procedures for safe call practices.

  10. Doctoral education for WOC nurses considering advanced practice nursing.

    PubMed

    Pieper, Barbara; Colwell, Janice

    2012-01-01

    Advanced practice nursing education is at a crossroads. Societal changes, increased health care demands, and leadership nursing organizations have identified the need of a doctor of nursing practice (DNP) degree as the advanced practice degree. WOC nurses need to examine DNP programs when considering returning for an advanced practice degree. This article explores nursing education at the doctorate level and areas the WOC nurse should consider when making a decision about attending a program. The WOC nurse needs to understand the similarities and differences of the doctor of philosophy and the DNP, issues about each program and its completion, personal factors, and the application process. Although selecting a doctoral program is a daunting experience, the education will provide opportunities for the WOC nurse to excel as a scholar, thus influencing the profession and the practice.

  11. Factors associated with evidence-based practice among registered nurses in Sweden: a national cross-sectional study

    PubMed Central

    2013-01-01

    Background Evidence-based practice (EBP) is emphasized to increase the quality of care and patient safety. EBP is often described as a process consisting of distinct activities including, formulating questions, searching for information, compiling the appraised information, implementing evidence, and evaluating the resulting practice. To increase registered nurses’ (RNs’) practice of EBP, variables associated with such activities need to be explored. The aim of the study was to examine individual and organizational factors associated with EBP activities among RNs 2 years post graduation. Methods A cross-sectional design based on a national sample of RNs was used. Data were collected in 2007 from a cohort of RNs, included in the Swedish Longitudinal Analyses of Nursing Education/Employment study. The sample consisted of 1256 RNs (response rate 76%). Of these 987 RNs worked in healthcare at the time of the data collection. Data was self-reported and collected through annual postal surveys. EBP activities were measured using six single items along with instruments measuring individual and work-related variables. Data were analyzed using logistic regression models. Results Associated factors were identified for all six EBP activities. Capability beliefs regarding EBP was a significant factor for all six activities (OR = 2.6 - 7.3). Working in the care of older people was associated with a high extent of practicing four activities (OR = 1.7 - 2.2). Supportive leadership and high collective efficacy were associated with practicing three activities (OR = 1.4 - 2.0). Conclusions To be successful in enhancing EBP among newly graduated RNs, strategies need to incorporate both individually and organizationally directed factors. PMID:23642173

  12. Broadening horizons: engaging advanced practice nursing students in faculty research.

    PubMed

    Weiss, Josie A

    2009-01-01

    Inviting advanced practice nursing students to participate in faculty research can be an innovative way to interest students in using current evidence as the basis for their practice. The author discusses strategies for effectively engaging graduate nursing students into research projects in ways that broaden the students' perspectives and strengthen their healthcare decision-making skills.

  13. Establishment of Pediatric Cardiac Intensive Care Advanced Practice Provider Services.

    PubMed

    Gilliland, Jill; Donnellan, Amy; Justice, Lindsey; Moake, Lindy; Mauney, Jennifer; Steadman, Page; Drajpuch, David; Tucker, Dawn; Storey, Jean; Roth, Stephen J; Koch, Josh; Checchia, Paul; Cooper, David S; Staveski, Sandra L

    2016-01-01

    The addition of advanced practice providers (APPs; nurse practitioners and physician assistants) to a pediatric cardiac intensive care unit (PCICU) team is a health care innovation that addresses medical provider shortages while allowing PCICUs to deliver high-quality, cost-effective patient care. APPs, through their consistent clinical presence, effective communication, and facilitation of interdisciplinary collaboration, provide a sustainable solution for the highly specialized needs of PCICU patients. In addition, APPs provide leadership, patient and staff education, facilitate implementation of evidence-based practice and quality improvement initiatives, and the performance of clinical research in the PCICU. This article reviews mechanisms for developing, implementing, and sustaining advance practice services in PCICUs.

  14. A survey of threats and violent behaviour by patients against registered nurses in their first year of practice.

    PubMed

    McKenna, Brian G; Poole, Suzette J; Smith, Naumai A; Coverdale, John H; Gale, Chris K

    2003-03-01

    The purpose of the present study was to determine the prevalence of aggressive behaviours by patients against nurses in the first year of practice, and to determine the psychological impact of this behaviour. An anonymous survey was sent to registered nurses in their first year of practice. From the 1169 survey instruments that were distributed, 551 were returned completed (a response rate of 47%). The most common inappropriate behaviour by patients involved verbal threats (n = 192, 35%), verbal sexual harassment (n = 167, 30%) and physical intimidation (n = 161, 29%). There were 22 incidents of assault requiring medical intervention and 21 incidents of participants being stalked by patients. Male graduates and younger nurses were especially vulnerable. Mental health was the service area most at risk. A most distressing incident was described by 123 (22%) of respondents. The level of distress caused by the incident was rated by 68 of the 123 respondents (55%) as moderate or severe. Only half of those who described a most distressing event indicated they had some undergraduate training in protecting against assault or in managing potentially violent incidents (n = 63 of 123; 51%). After registration, 45 (37%) indicated they had had such training. The findings of this study indicate priorities for effective prevention programmes. The issues highlighted need to be addressed in undergraduate nursing curricula and in the development of orientation programmes supporting new graduates.

  15. Phase II study of capecitabine (Xeloda (registered) ) and concomitant boost radiotherapy in patients with locally advanced rectal cancer

    SciTech Connect

    Krishnan, Sunil; Janjan, Nora A.; Skibber, John M.; Rodriguez-Bigas, Miguel A.; Wolff, Robert A.; Das, Prajnan; Delclos, Marc E.; Chang, George J.; Hoff, Paulo M.; Eng, Cathy; Brown, Thomas D.; Crane, Christopher H.; Feig, Barry W.; Morris, Jeffrey; Vadhan-Raj, Saroj; Hamilton, Stanley R.; Lin, Edward H. . E-mail: elin@u.washington.edu

    2006-11-01

    Purpose: The aim of this study was to determine the efficacy of capecitabine (Xeloda (registered) ), an oral fluoropyrimidine, as a radiosensitizer in the neoadjuvant treatment of locally advanced rectal cancer (LARC). Methods and Materials: We conducted a phase II study of capecitabine (825 mg/m{sup 2} orally, twice daily continuous) with radiotherapy (52.5 Gy/30 fractions to the primary tumor and perirectal nodes) in 54 patients with LARC (node-negative {>=}T3 or any node-positive tumor) staged by endoscopic ultrasound (EUS). The primary endpoint was pathologic response rate; secondary endpoints included toxicity profiles and survival parameters. Results: Of the 54 patients (median age, 56.7 years; range, 21.3-78.7 years; male:female ratio, 1.7; Eastern Cooperative Oncology Group performance status 0-1: 100%), 51 patients (94%) had T3N0 or T3N1 disease by EUS. Surgery was not performed in 3 patients; 2 of these patients had metastatic disease, and the third patient refused after a complete clinical response. Of the 51 patients evaluable for pathologic response, 9 patients (18%) achieved complete response, and 12 patients (24%) had microscopic residual disease (<10% viable cells). In addition, 26 patients of all 54 patients (51%) achieved T-downstaging, and 15 patients of 29 patients (52%) achieved N-downstaging. Grade 3/4 toxicities were radiation dermatitis (9%) and diarrhea (2%). Sphincter preservation rate for tumor {<=}5 cm from the anal verge was 67% (18/27). Conclusion: This regimen of radiotherapy plus capecitabine is well tolerated and is more convenient than protracted venous infusion of 5-FU. The pathologic response rate is comparable to our previous experience using protracted venous infusion 5-FU for LARC.

  16. An overview of Medicare reimbursement regulations for advanced practice nurses.

    PubMed

    Frakes, Michael A; Evans, Tracylain

    2006-01-01

    The federal government spends nearly 15% of the budget on Medicare services annually, and advanced practice nurses are eligible for reimbursement from that pool. The regulations governing reimbursement are complex because of the social, political, and financial pressures involved in their development. Although economic viability and due diligence considerations make it incumbent on advanced practice nurses to understand the rules, the profession, as a whole, has knowledge deficits in this area. The essentials of regulatory development and structure are reviewed and considerations for optimizing reimbursement are described.

  17. Professional development for an advanced practice nursing team.

    PubMed

    Pye, Sherry; Green, Angela

    2011-05-01

    Since its development in 1998, the Cardiology Advanced Practice Nurse team has been plagued by retention issues. The coordinator for the team developed this leadership project while participating in the 2008 to 2009 Maternal-Child Health Leadership Academy sponsored by Sigma Theta Tau International and Johnson & Johnson. The focus of this project was to develop, implement, and evaluate initiatives to empower the advanced practice nurse team, promote their professional development, and ultimately improve retention of team members. Although evaluation data show progress toward addressing work environment issues, retention remains an ongoing problem.

  18. Advance Notice for Transition-Related Problem Behavior: Practice Guidelines.

    PubMed

    Brewer, Adam T; Strickland-Cohen, Kathleen; Dotson, Wesley; Williams, D Courtney

    2014-10-01

    Transitions between daily activities can occasion or elicit problem behavior in individuals with intellectual and developmental disabilities (IDD). Providing advance notice to signal an upcoming transition is a common practice in early and special education settings (e.g., Riffel 2010; Sandall et al. 2005). While the literature contains many demonstrations of the efficacy of various advance notice procedures, other studies have shown negative results. Practitioners are faced with the challenge of deciding whether advance notice is a viable treatment option for transition-related problem behavior in light of these contradictory findings. To assist the practitioner in this decision-making process, we provide a brief review of the advance notice literature, concentrating on the studies reporting that advance notice is ineffective at reducing transition-related problems. The goal is to provide practitioners with a better understanding of the environmental conditions under which advance notice is likely to be ineffective at decreasing problem behavior as well as the conditions under which it can be effective at reducing transition-related problem behavior. Discriminating these conditions may yield a useful set of practice guidelines for deciding when advance notice is a viable treatment option for decreasing transition-related problem behavior.

  19. Training Advanced Writing Skills: The Case for Deliberate Practice

    ERIC Educational Resources Information Center

    Kellogg, Ronald T.; Whiteford, Alison P.

    2009-01-01

    The development of advanced writing skills has been neglected in schools of the United States, with even some college graduates lacking the level of ability required in the workplace (National Commission on Writing, 2003, 2004). The core problem, we argue, is an insufficient degree of appropriate task practice distributed throughout the secondary…

  20. Residency and Fellowship Programs for RNs and Advanced Practice RNs.

    PubMed

    Cosme, Sheryl

    2015-09-01

    In this month's column, the Senior Accreditation Operations Manager of the American Nurses Credentialing Center (ANCC) discusses the value of nursing residency programs and current discussion in the profession, along with criteria offered by the ANCC to support this imperative for both RNs and advanced practice RNs including new graduates and those transitioning between clinical settings.

  1. Advancing Empirical Scholarship to Further Develop Evaluation Theory and Practice

    ERIC Educational Resources Information Center

    Christie, Christina A.

    2011-01-01

    Good theory development is grounded in empirical inquiry. In the context of educational evaluation, the development of empirically grounded theory has important benefits for the field and the practitioner. In particular, a shift to empirically derived theory will assist in advancing more systematic and contextually relevant evaluation practice, as…

  2. A Pilot of a Gerontological Advanced Practice Nurse Preventive Intervention

    ERIC Educational Resources Information Center

    Hahn, Joan Earle; Aronow, Harriet Udin

    2005-01-01

    Background: Persons with an intellectual and developmental disability frequently face barriers in accessing preventive services in community-based health care systems. As they age into middle years, they are at increased risk for functional decline. This paper presents a description of an advanced practice nurse (APN) intervention used in a pilot…

  3. Establishing advanced practice for medical imaging in New Zealand

    SciTech Connect

    Yielder, Jill; Young, Adrienne; Park, Shelley; Coleman, Karen

    2014-02-15

    Introduction: This article presents the outcome and recommendations following the second stage of a role development project conducted on behalf of the New Zealand Institute of Medical Radiation Technology (NZIMRT). The study sought to support the development of profiles and criteria that may be used to formulate Advanced Scopes of Practice for the profession. It commenced in 2011, following on from initial research that occurred between 2005 and 2008 investigating role development and a possible career structure for medical radiation technologists (MRTs) in New Zealand (NZ). Methods: The study sought to support the development of profiles and criteria that could be used to develop Advanced Scopes of Practice for the profession through inviting 12 specialist medical imaging groups in NZ to participate in a survey. Results: Findings showed strong agreement on potential profiles and on generic criteria within them; however, there was less agreement on specific skills criteria within specialist areas. Conclusions: The authors recommend that one Advanced Scope of Practice be developed for Medical Imaging, with the establishment of generic and specialist criteria. Systems for approval of the overall criteria package for any individual Advanced Practitioner (AP) profile, audit and continuing professional development requirements need to be established by the Medical Radiation Technologists Board (MRTB) to meet the local needs of clinical departments. It is further recommended that the NZIMRT and MRTB promote and support the need for an AP pathway for medical imaging in NZ.

  4. Academy of Nutrition and Dietetics: Revised 2012 Standards of Practice in Nutrition Care and Standards of Professional Performance for Registered Dietitians.

    PubMed

    2013-06-01

    RDs face complex situations every day. Competently addressing the unique needs of each situation and applying standards appropriately is essential to providing safe, timely, person-centered quality care and service. All RDs are advised to conduct their practice based on the most recent edition of the Academy's Code of Ethics and the Scope of Practice in Nutrition and Dietetics, the Scope of Practice for the Registered Dietitian, the 2012 Standards of Practice in Nutrition Care and Standards of Professional Performance for RDs, and the applicable focus area SOP and SOPP for RDs. These resources provide minimum standards and tools for demonstrating competence and safe practice, and are used collectively to gauge and guide an RD's performance in nutrition and dietetics practice. The SOP and SOPP for the RD are self-evaluation tools that promote quality assurance and performance improvement. Self-assessment provides opportunities to identify areas for enhancement, new learning, and skill development, and to encourage progression of career growth. All RDs are advised to have in their personal libraries the most recent copy of the Academy's Scope of Practice in Nutrition and Dietetics and its components: The 2012 Academy Standards of Practice in Nutrition Care and Standards of Professional Performance for Registered Dietitians; applicable focus area SOP and SOPP; the Code of Ethics; and the Scope of Practice for the Registered Dietitian. To ensure that credentialed dietetics practitioners always have access to the most current materials, each resource is maintained on the Academy's website. The documents will continue to be reviewed and updated as new trends in the profession of nutrition and dietetics and external influences emerge.

  5. Academy of Nutrition and Dietetics: standards of practice and standards of professional performance for registered dietitian nutritionists (competent, proficient, and expert) in adult weight management.

    PubMed

    Jortberg, Bonnie; Myers, Eileen; Gigliotti, Linda; Ivens, Barbara J; Lebre, Monica; Burke March, Susan; Nogueira, Isadora; Nwankwo, Robin; Parkinson, Meredith R; Paulsen, Barbara; Turner, Tonya

    2015-04-01

    Weight management encompasses the inter-relationship of nutrition, physical activity, and health behavior change. Nutrition is key for the prevention and treatment of obesity and chronic disease and maintenance of overall health. Thus, the Weight Management Dietetic Practice Group, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, has developed Standards of Practice and Standards of Professional Performance for Registered Dietitian Nutritionists (RDNs) in Adult Weight Management as a resource for RDNs working in weight management. This document allows RDNs to assess their current skill levels and to identify areas for further professional development in this expanding practice area. This document describes the current standards for weight management practice for RDNs. The Standards of Practice represent the four steps in the Nutrition Care Process as applied to the care of patients/clients. The Standards of Professional Performance consist of six domains of professionalism: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. Within each standard, specific indicators provide measurable action statements that illustrate how the standard can be applied to practice. The indicators describe three skill levels (competent, proficient, and expert) for RDNs working in weight management. The Standards of Practice and Standards of Professional Performance are complementary resources for the Registered Dietitian Nutritionist in weight management.

  6. Advanced practice geriatric nursing education. New options in Kansas.

    PubMed

    Bonnel, W B

    1999-01-01

    Knowledgeable practitioners with the skills needed to serve in a variety of clinical settings are the primary objective of the Adult-Geriatric Advanced Nursing Program and the FNP elective, Advanced Practice Nursing Care of the Frail Elderly. The continued blending of long term and acute care settings will further cloud and challenge the school responsible for educating APNs in the care of older adults, particularly the frail elderly. Education needs to provide flexibility for students through new service designs such as interactive computer courses. Nurses with an orientation to the future should consider geriatric nursing education.

  7. Defining features of advance directives in law and clinical practice.

    PubMed

    Olick, Robert S

    2012-01-01

    In the > 30 years since the New Jersey Supreme Court's seminal opinion in the case of Karen Ann Quinlan, all 50 states and the District of Columbia have enacted legislation to recognize the legal right of competent adults to write advance directives. The purpose of advance directives is to provide direction for health-care decisions near the end of life, when the ravages of illness, disease, or injury have taken the ability to decide for one's self. This article reviews the defining features of advance directives and the governing law, discusses some common practical concerns regarding the use and effectiveness of advance directives, and identifies several significant ethical-legal challenges for honoring advance directives at the bedside. With a primary focus on the health-care proxy, the anatomy of advance directives is analyzed under four general rubrics: formal requirements, decisional capacity and when the directive takes effect, rights and responsibilities of proxies and health-care providers, and the scope and limitations of decisions to forego life-sustaining treatment. There is much common ground among state laws, but particular legal provisions may vary from state to state. Physicians, nurses, social workers, and other health-care professionals should be familiar with the law of their home state.

  8. Advanced practice nursing in performing arts health care.

    PubMed

    Weslin, Anna T; Silva-Smith, Amy

    2010-06-01

    Performing arts medicine is a growing health care profession specializing in the needs of performing artists. As part of the performing arts venue, the dancer, a combination of athlete and artist, presents with unique health care needs requiring a more collaborative and holistic health care program. Currently there are relatively few advanced practice nurses (APNs) who specialize in performing arts health care. APNs, with focus on collaborative and holistic health care, are ideally suited to join other health care professionals in developing and implementing comprehensive health care programs for the performing artist. This article focuses on the dancer as the client in an APN practice that specializes in performing arts health care.

  9. Cognitive therapy: a training model for advanced practice nurses.

    PubMed

    Reilly, Christine E; McDanel, Heather

    2005-05-01

    1. Mental health needs exist in medically underserved areas and can be addressed in nurse-managed, community-based health centers. 2. Cognitive therapy techniques can be used in community-based health centers to intervene and alleviate patients' distress and improve their adherence to treatment. 3. A training program in cognitive therapy can help advanced practice nurses and other health care providers implement the techniques needed to address many behavioral and mental health problems.

  10. Consultant pharmacists, advanced practice nurses, and the interdisciplinary team.

    PubMed

    Resnick, Barbara

    2014-03-01

    Although in geriatrics we are better than many other clinical disciplines in terms of providing interdisciplinary care to older adults, I hope that we will continue to recognize how much more could actually be done. Before addressing the relationship between advanced practice nurses (APNs) and consultant pharmacists in real world settings, I want to review teamwork in geriatrics in general. It is critical to define what we mean by team, what type of team, and what the goals are of this teamwork.

  11. [Advance Directives: theoretical concept and practical significance in the USA].

    PubMed

    Vollmann, J; Pfaff, M

    2003-07-04

    The article examines on the basic of empirical data the discrepancy between the theoretical demand and the practical role of advance directives. Often advance directives have no influence on medical decision-making in clinical care of critically ill patients. The vague language of the widely used standard living wills and the lack of physician-patient communication in the process of delivering an advance directives are contributing factors. However, many physicians even disregard patients' preferences in concrete and meaningful living wills at the end of life. Besides the lack of information many even seriously ill patients do not deliver an advance because they misjudge their medical prognosis and life expectancy. Often the communication between patients and doctors are blocked because they expect from the each other the first step to talk about end of life decisions and advance directives. In this context physicians claim lack of time, training in communication skills and their discomfort in talking about death and dying with their patients.

  12. [Anticoagulant therapy clinic: moving towards Advanced Nursing Practice].

    PubMed

    Romero Ruiz, Adolfo; Parrado Borrego, Gema; Rodríguez González, José; Caparrós Miranda, Isabel S; Vargas Lirio, M Isabel; Ortiz Fernández, Primitiva

    2014-01-01

    There is currently around one million people receiving oral anticoagulants in Spain. The drug most used is acenocoumarol, which requires coagulation monitoring to ensure that the patient is within its normal therapeutic range. Patients usually start this treatment in a hospital clinic and, when they are stabilised, they are referred to primary care, where they are followed-up by their community nurses. The usual practice is that nurses are responsible for changes in the dose when the patients are outside the range. This practice is not performed by hospital nurses, despite having sufficient experience and knowledge to adequately manage these types of patients. An Advanced Nursing Practice model has been introduced into the Haematology management unit of the Hospital Universitario Virgen de la Victoria, Málaga. This involves various aspects of attention and care of patients on anticoagulant therapy, and includes adjusting the doses of their treatment following a catalogue of therapeutic and diagnostic ranges.

  13. Mini Review of Integrated Care and Implications for Advanced Practice Nurse Role

    PubMed Central

    McIntosh, Diana; Startsman, Laura F.; Perraud, Suzanne

    2016-01-01

    Literature related to primary care and behavioral health integration initiatives is becoming abundant. The United States’ 2010 Patient Protection and Affordable Care Act included provisions encouraging increased collaboration of care for individuals with behavioral and physical health service needs in the public sector. There is relatively little known of Advanced Practice Registered Nurses’ (APRNs) roles with integrating primary and behavioral healthcare. The goal of this review article is to: (a) define integration of physical and behavioral healthcare and potential models; (b) answer the question as to what are effective evidence based models/strategies for integrating behavioral health and primary care; (c) explore the future role and innovations of APRNs in the integration of physical and behavioral healthcare. Results: The evidence- based literature is limited to three systematic reviews and six randomized controlled trials. It was difficult to generalize the data and the effective integration strategies varied from such interventions as care management to use of sertraline to depression management and to access. There were, though, implications for the integrated care advanced practice nurse to have roles inclusive of competencies, leadership, engagement, collaboration and advocacy. PMID:27347258

  14. Mindfulness-Based Stress Reduction in Advanced Nursing Practice

    PubMed Central

    Williams, Hants; Simmons, Leigh Ann; Tanabe, Paula

    2015-01-01

    The aim of this article is to discuss how advanced practice nurses (APNs) can incorporate mindfulness-based stress reduction (MBSR) as a nonpharmacologic clinical tool in their practice. Over the last 30 years, patients and providers have increasingly used complementary and holistic therapies for the nonpharmacologic management of acute and chronic diseases. Mindfulness-based interventions, specifically MBSR, have been tested and applied within a variety of patient populations. There is strong evidence to support that the use of MBSR can improve a range of biological and psychological outcomes in a variety of medical illnesses, including acute and chronic pain, hypertension, and disease prevention. This article will review the many ways APNs can incorporate MBSR approaches for health promotion and disease/symptom management into their practice. We conclude with a discussion of how nurses can obtain training and certification in MBSR. Given the significant and growing literature supporting the use of MBSR in the prevention and treatment of chronic disease, increased attention on how APNs can incorporate MBSR into clinical practice is necessary. PMID:25673578

  15. Advanced Practice Nursing Competency Assessment Instrument (APNCAI): clinimetric validation

    PubMed Central

    Sastre-Fullana, Pedro; Morales-Asencio, Jose Miguel; Sesé-Abad, Albert; Fernández-Domínguez, Juan Carlos; De Pedro-Gómez, Joan

    2017-01-01

    Objective To describe the development and clinimetric validation of the Advanced Practice Nursing Competency Assessment Instrument (APNCAI) through several evidence sources about reliability and validity in the Spanish context. Design and setting APNCAI development was based on a multisequential and systematic process: literature review, instrument content consensus through qualitative Delphi method approach (a panel of 51 Advanced Practice in Nursing –APN– experts was selected) and the clinimetric validation process based on a sample of 600 nurses from the Balearic Islands public healthcare setting. Methods An initial step for tool's content development process based on Delphi method approach of expert consensus was implemented. A subsequent phase of tool validation started from the analysis of APN core competencies latent measurement model, including exploratory and confirmatory techniques. Reliability evidence for each latent factor was also obtained. Items' scores were submitted to descriptive analysis, plus univariate and multivariate normality tests. Results An eight-factor competency assessment latent model obtained adequate fit, and it was composed by ‘Research and Evidence-Based Practice’, ‘Clinical and Professional Leadership’, ‘Interprofessional Relationship and Mentoring’, ‘Professional Autonomy’, ‘Quality Management’, ‘Care Management’, ‘Professional Teaching and Education’ and ‘Health Promotion’. Conclusions Adequate empirical evidence of reliability and validity for APNCAI makes it useful for application in healthcare policy programmes for APN competency assessment in Spain. PMID:28235968

  16. Partner for Promotion: An Innovative Advanced Community Pharmacy Practice Experience

    PubMed Central

    Legg, Julie E.; Casper, Kristin A.

    2008-01-01

    Objectives To implement the Partner for Promotion (PFP) program which was designed to enhance the skills and confidence of students and community pharmacy preceptors to deliver and expand advanced patient care services in community pharmacies and also to assess the program's impact. Design A 10-month longitudinal community advanced pharmacy practice experience was implemented that included faculty mentoring of students and preceptors via formal orientation; face-to-face training sessions; online monthly meetings; feedback on service development materials; and a web site offering resources and a discussion board. Pre- and post-APPE surveys of students and preceptors were used to evaluate perceptions of knowledge and skills. Assessment The skills survey results for the first 2 years of the PFP program suggest positive changes occurring from pre- to post-APPE survey in most areas for both students and preceptors. Four of the 7 pharmacies in 2005-2006 and 8 of the 14 pharmacies in 2006-2007 were able to develop an advanced patient care service and begin seeing patients prior to the conclusion of the APPE. As a result of the PFP program from 2005-2007, 14 new experiential sites entered into affiliation agreements with The Ohio State University College of Pharmacy. Conclusion The PFP program offers an innovative method for community pharmacy faculty members to work with students and preceptors in community pharmacies in developing patient care services. PMID:19325954

  17. Advancing the practice of systems engineering at JPL

    NASA Technical Reports Server (NTRS)

    Jansma, Patti A.; Jones, Ross M.

    2006-01-01

    In FY 2004, JPL launched an initiative to improve the way it practices systems engineering. The Lab's senior management formed the Systems Engineering Advancement (SEA) Project in order to "significantly advance the practice and organizational capabilities of systems engineering at JPL on flight projects and ground support tasks." The scope of the SEA Project includes the systems engineering work performed in all three dimensions of a program, project, or task: 1. the full life-cycle, i.e., concept through end of operations 2. the full depth, i.e., Program, Project, System, Subsystem, Element (SE Levels 1 to 5) 3. the full technical scope, e.g., the flight, ground and launch systems, avionics, power, propulsion, telecommunications, thermal, etc. The initial focus of their efforts defined the following basic systems engineering functions at JPL: systems architecture, requirements management, interface definition, technical resource management, system design and analysis, system verification and validation, risk management, technical peer reviews, design process management and systems engineering task management, They also developed a list of highly valued personal behaviors of systems engineers, and are working to inculcate those behaviors into members of their systems engineering community. The SEA Project is developing products, services, and training to support managers and practitioners throughout the entire system lifecycle. As these are developed, each one needs to be systematically deployed. Hence, the SEA Project developed a deployment process that includes four aspects: infrastructure and operations, communication and outreach, education and training, and consulting support. In addition, the SEA Project has taken a proactive approach to organizational change management and customer relationship management - both concepts and approaches not usually invoked in an engineering environment. This paper'3 describes JPL's approach to advancing the practice of

  18. The Role of Certified Registered Nurse Anesthetists in Patient Education

    DTIC Science & Technology

    2000-10-01

    As advanced practice nurses, certified registered nurse anesthetists (CRNAs) have a responsibility to engage in patient education about health...Categories and themes include; engaging in perioperative patient education , focusing on explanations about anesthesia and surgery, prior nursing...experiences make patient education easier, documenting patient education is important and uncertainty about where to document it. Common topics and themes

  19. Status of the Advanced Mirror Technology Development (AMTD) Phase 2, 1.5m ULE(Registered Trademark) Mirror

    NASA Technical Reports Server (NTRS)

    Egerman, Robert; Matthews, Gary W.; Johnson, Matthew; Ferland, Albert; Stahl, H. Philip; Eng, Ron; Effinger, Michael R.

    2015-01-01

    The Decadal Survey stated that an advanced large-aperture ultraviolet, optical, near-infrared (UVOIR) telescope is required to enable the next generation of compelling astrophysics and exoplanet science; and, that present technology is not mature enough to affordably build and launch any potential UVOIR mission concept. Under Science and Technology funding, NASA's Marshall Space Flight Center (MSFC) and Exelis have developed a more cost effective process to make up to 4m monolithic spaceflight UV quality, low areal density, thermally and dynamically stable primary mirrors. Under a Phase I program, a proof of concept mirror was completed at Exelis and tested down to 250K at MSFC which would allow imaging out to 2.5 microns. In 2014, Exelis and NASA started a Phase II program to design and build a 1.5m mirror to demonstrate lateral scalability to a 4m monolithic primary mirror. The current status of the Phase II development program will be provided along with a Phase II program summary.

  20. Advancing practice through prescribing: is there a better way?

    PubMed

    Harding, Stephen; Gardner, Andrew

    2006-07-01

    The literature demonstrates a clear relationship between the rate of adverse effects and the number of prescribers that a service consumer may consult. This brings into question the benefits, for the service consumer, of nurses prescribing. Given the complexities of care for certain population groups, for example older people, it is suggested that there is greater benefit in professionals working collaboratively toward the best outcome for the person in care, with nurses offering more informed advice to their partners in service delivery. Nurses who advance their practice through the development of an expert knowledge base relevant to their area of expertise can contribute to the diagnosis and management of particular client groups by providing specialist advice to primary and direct care professionals. It is proposed that this could be achieved using an 'academic detailing' approach rather than becoming another prescriber of pharmacotherapy.

  1. Blueprint for development of the advanced practice psychiatric nurse workforce.

    PubMed

    Hanrahan, Nancy P; Delaney, Kathleen R; Stuart, Gail W

    2012-01-01

    The mental health system is inefficient and ineffective in providing behavioral health care services to the 1 in 4 Americans who have a mental illness or a substance abuse problem. Current health care reform initiatives present a significant opportunity for advanced practice psychiatric nurses-psychiatric mental health (APRN-PMH) to develop action-oriented recommendations for developing their workforce and thereby increasing access to high-quality and full-spectrum behavioral health care services. If endorsed by the professional nursing associations and the APRN-PMH workforce, the strategies presented in this paper provide a blueprint for developing the APRN-PMH workforce. Achieving these goals will significantly reform the APRN-PMH workforce, thereby contributing to the overall goal of supporting an integrated model of behavioral health care. No change has as much potential to influence the APRN-PMH workforce as the uniting of all APRN-PMHs in a "Blueprint for APRN-PMH Workforce Development."

  2. A Quality Improvement Course Review of Advanced Pharmacy Practice Experiences

    PubMed Central

    Hornsby, Lori B.; Phillippe, Haley M.; Kelley, Kristi; McDonough, Sharon

    2011-01-01

    Objectives. To determine strengths of and quality improvements needed in advanced pharmacy practice experiences (APPE) through a systematic course review process. Design. Following the “developing a curriculum” (DACUM) format, course materials and assessments were reviewed by the curricular subcommittee responsible for experiential education and by key stakeholders. Course sequence overview and data were presented and discussed. A course review worksheet was completed, outlining strengths and areas for improvement. Assessment. Student feedback was positive. Strengths and areas for improvement were identified. The committee found reviewing the sequence of 8 APPE courses to be challenging. Conclusions. Course reviews are a necessary process in curricular quality improvement but can be difficult to accomplish. We found overall feedback about APPEs was positive and student performance was high. Areas identified as needing improvement will be the focus of continuous quality improvement of the APPE sequence. PMID:21931454

  3. Advanced nursing practice and Newton's three laws of motion.

    PubMed

    Sturgeon, David

    This article considers the reasons for the development of advanced practice roles among nurses and other healthcare professions. It explores the implications of financial constraints, consumer preferences and the development of new healthcare services on the reorganization of professional boundaries. It makes use of Sir Isaac Newton's three laws of motion to demonstrate how professional development in nursing has taken place in response to a number of external influences and demands. It also considers the significance of skill mix for the nursing profession, in particular the development and likely expansion of the physician assistant role. The application of different professionals and grades within a healthcare team or organization is central to the Government's Agenda for Change proposals and nurses have successfully adopted a number of roles traditionally performed by doctors. Nurses have demonstrated that they are capable of providing high quality care and contributing directly to positive patient outcome. Advanced nursing roles should not only reflect the changing nature of healthcare work, they should also be actively engaged in reconstructing healthcare boundaries.

  4. Supporting children whose parent has a mental health problem: an assessment of the education, knowledge, confidence and practices of registered psychiatric nurses in Ireland.

    PubMed

    Houlihan, D; Sharek, D; Higgins, A

    2013-04-01

    Health professionals, including nurses, stand accused of ignorance or oversight of children whose parent experience a mental health problem. Psychiatric nurses are in an ideal position to respond to children's needs and support their parents in a proactive and sensitive manner. The aim of this study was to explore psychiatric nurses' education, knowledge, confidence and practice with regard to the support needs of children whose parent has a mental health problem. This study employed a self-completion anonymous survey design with a sample of registered psychiatric nurses from one integrated mental health service in Ireland. The sample reported relatively low levels of education, knowledge, confidence and supportive clinical practice when it came to children whose parent has a mental health problem. There is an urgent need for education on family-focused care, and the development of guidelines and child focused services if the needs of parents and children are to be met.

  5. Academy of Nutrition and Dietetics: Standards of Practice and Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Public Health and Community Nutrition.

    PubMed

    Bruening, Meg; Udarbe, Adrienne Z; Yakes Jimenez, Elizabeth; Stell Crowley, Phyllis; Fredericks, Doris C; Edwards Hall, Leigh Ann

    2015-10-01

    The need and demand for population-level disease prevention has increased, especially with the passage of the Affordable Care Act, a worldwide increase in obesity and chronic disease, and a global emphasis on preventative health care that includes behavioral, environmental, and policy interventions. In response to these evolving needs, the Public Health and Community Nutrition Dietetic Practice Group, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, has developed Standards of Practice and Standards of Professional Performance as tools for registered dietitian nutritionists (RDNs) currently in practice or interested in working in public health and community nutrition, to assess their current skill levels and to identify areas for professional development. The Standards of Practice address the four steps of the Nutrition Care Process for community and public health RDNs, which are assessment, diagnosis, intervention, and evaluation/monitoring. The Standards of Professional Performance consist of the following six domains of professional performance for community and public health RDNs: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. Within each standard, specific indicators provide measurable action statements that illustrate the ways in which RDNs can address client and population nutrition and health. The indicators describe three skill levels (competent, proficient, and expert) for RDNs. These tools highlight the unique scope of expertise that RDNs provide to the field of public health and community nutrition.

  6. Advancing technician practice: Deliberations of a regulatory board.

    PubMed

    Adams, Alex J

    2017-02-16

    In 2016, the Idaho State Board of Pharmacy (U.S.) undertook a major rulemaking initiative to advance pharmacy practice by broadening the ability of pharmacists to delegate tasks to pharmacy technicians. The new rules of the Board thus moved the locus of control in technician scope of practice from law to pharmacist delegation. Pharmacist delegation is individualistic and takes into account the individual technician's capabilities, the pharmacist's comfort level, facility policies, and the risk mitigation strategies present at the facility, among other factors. State law limits, by contrast, are rigid and can mean that pharmacists are unable to delegate tasks that are or could otherwise be within the abilities of their technicians. The expanded technician duties are in two domains: 1) medication dispensing support (e.g., tech-check-tech, accepting verbal prescriptions, transferring prescriptions, and performing remote data entry); and 2) technical support for pharmacist clinical services (e.g., administering immunizations). This commentary reviews the evidence behind these expanded duties, as well as the key regulatory decision points for each task. The Board's rules and approach may prove useful to other states and even other governing bodies outside the U.S. as they consider similar issues.

  7. Use of information technology by advanced practice nurses.

    PubMed

    Gaumer, Gary L; Koeniger-Donohue, Rebecca; Friel, Christina; Sudbay, Mary Beth

    2007-01-01

    The purpose of this study is to describe the use of information technology by advance practice nurses. A survey of 519 graduates of the Simmons College nurse practitioner program was conducted. Areas of investigation included the nurse practitioner's use of informatics technology, perception of information technology competence, adequacy of information technology training and support in the workplace, specific information technology health functions used in the workplace, and perceived benefits of using information technology. The data on the 249 usable responses were analyzed using descriptive statistics. These analyses compare the use of information technology by type of job, specialty, years of practice, and setting of work. Results indicate that more than 90% of nurse practitioners utilize computers at work, yet a large fraction of them still have low self-perception of information technology competence, believe initial training at the work site was inadequate, and believe that academic preparation for information technology was also inadequate. There is considerable variation in these measures across nurse practitioner specialties, settings of care, job characteristics, and experience.

  8. 37 CFR 2.47 - Supplemental Register.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2013-07-01 2013-07-01 false Supplemental Register. 2.47... COMMERCE RULES OF PRACTICE IN TRADEMARK CASES The Written Application § 2.47 Supplemental Register. (a) In an application to register on the Supplemental Register under section 23 of the Act, the...

  9. 37 CFR 2.47 - Supplemental Register.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2012-07-01 2012-07-01 false Supplemental Register. 2.47... COMMERCE RULES OF PRACTICE IN TRADEMARK CASES The Written Application § 2.47 Supplemental Register. (a) In an application to register on the Supplemental Register under section 23 of the Act, the...

  10. 37 CFR 2.47 - Supplemental Register.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2011-07-01 2011-07-01 false Supplemental Register. 2.47... COMMERCE RULES OF PRACTICE IN TRADEMARK CASES The Written Application § 2.47 Supplemental Register. (a) In an application to register on the Supplemental Register under section 23 of the Act, the...

  11. Advanced training for primary care and general practice nurses: enablers and outcomes of postgraduate education.

    PubMed

    Hallinan, Christine M; Hegarty, Kelsey L

    2016-01-01

    The aims of the present study were to understand enablers to participation in postgraduate education for primary care nurses (PCNs), and to explore how postgraduate education has advanced their nursing practice. Cross-sectional questionnaires were mailed out in April 2012 to current and past students undertaking postgraduate studies in primary care nursing at The University of Melbourne, Victoria, Australia. Questionnaires were returned by 100 out of 243 nurses (response rate 41%). Ninety-one per cent (91/100) of the respondents were first registered as nurses in Australia. Fifty-seven per cent were hospital trained and 43% were university educated to attain their initial nurse qualification. The respondents reported opportunities to expand scope of practice (99%; 97/98), improve clinical practice (98%; 97/99), increase work satisfaction (93%; 91/98) and increase practice autonomy (92%; 89/97) as factors that most influenced participation in postgraduate education in primary care nursing. Major enablers for postgraduate studies were scholarship access (75%; 71/95) and access to distance education (74%; 72/98). Many respondents reported an increased scope of practice (98%; 95/97) and increased job satisfaction (71%; 70/98) as an education outcome. Only 29% (28/97) cited an increase in pay-rate as an outcome. Of the 73 PCNs currently working in general practice, many anticipated an increase in time spent on the preparation of chronic disease management plans (63%; 45/72), multidisciplinary care plans (56%; 40/72) and adult health checks (56%; 40/72) in the preceding 12 months. Recommendations emerging from findings include: (1) increased access to scholarships for nurses undertaking postgraduate education in primary care nursing is imperative; (2) alternative modes of course delivery need to be embedded in primary care nursing education; (3) the development of Australian primary care policy, including policy on funding models, needs to more accurately reflect the

  12. The psychiatric advanced practice nurse with prescriptive authority: role development, practice issues, and outcomes measurement.

    PubMed

    Cornwell, C; Chiverton, P

    1997-04-01

    Within the rapidly changing health care system, there is an increased need for professionals who can provide cost-effective primary health care for mentally ill patients. This article discusses the role of the Psychiatric Advanced Practice Nurse (APN) with Prescriptive Authority as a cost-effective, high-quality component of comprehensive mental health care delivery. Historical aspects of the development of the Nurse Practitioner (NP) role are discussed, as well as issues specific to the role in psychiatric nursing. The implementation of this role at Rochester is described, followed by recommendations for studying the impact of the psychiatric NP on care delivery, including process and outcome variables.

  13. Providing a navigable route for acute medicine nurses to advance their practice: a framework of ascending levels of practice.

    PubMed

    Lees-Deutsch, Liz; Christian, Jan; Setchfield, Ian

    2016-01-01

    This article conveys concerns raised by delegates at the International SAM Conference (Manchester, 2015) regarding how to advance nursing practice in acute medicine. It endeavors to capture the essence of 'how to advance practice' and 'how to integrate advanced practice' within the workforce structures of an acute medicine unit (AMU). It addresses the production of tacit knowledge and the recognition and integration of this to developing the nursing workforce. The current context of NHS efficiencies and recruitment issues emphasize the value of retaining tacit knowledge. Uniquely, this article offers an early conceptual framework through which levels of advancement and potential transition points to advance nursing practice in acute medicine are articulated. Determining how to advance requires identification of prior accomplishments such as, tacit knowledge, experiential learning, CPD, specialist courses and management experience. This requires nurses to make judicious decisions to advance their practice and the distinction between 'amassing experience' and 'career progression'. It aims to stimulate thinking around the practicalities of advancement, the value of tacit knowledge and potential realization through the framework trajectory.

  14. Impact of an Introductory Pharmacy Practice Experience on Students' Performance in an Advanced Practice Experience

    PubMed Central

    Johnson, Thomas J.; Hedge, Dennis D.

    2010-01-01

    Objective To determine the impact of an introductory pharmacy practice experience (IPPE) on students' clinical skills during their initial advanced pharmacy practice experience (APPE). Design A 4-week First Steps course that focused on students developing pharmacy practice skills, clinical communications skills, and effective use of reference materials was introduced in 2006 at the end of the third-year curriculum, prior to students beginning their APPEs. Assessment During the third week of the first APPE, faculty members rated students' demonstration of 9 clinical skills on a 5-point Likert scale (1 being always and 5 being never). The evaluation was performed in 2005 prior to implementation of the course (control group) and again in 2006 after implementation of the course. Students who completed the First Steps course scored better on all 9 skills and had a better average clinical skills value (2.3) compared to the control group (2.6, p < 0.01). Conclusion Completion of an IPPE course that focused on critical pharmacy practice aspects, clinical communication skills, and use of reference materials resulted in increased frequency of desired clinical behaviors on a subsequent APPE. PMID:20221362

  15. 28th Annual APRN Legislative Update: Advancements continue for APRN practice.

    PubMed

    Phillips, Susanne J

    2016-01-16

    The Annual Legislative Update discusses the legislative accomplishments in the areas of practice authority, reimbursement, and prescriptive authority that have the most impact on nurse practitioners and other advanced practice nurses across the country.

  16. Infusing gerontological nursing content into advanced practice nursing education.

    PubMed

    Kohlenberg, Eileen; Kennedy-Malone, Laurie; Crane, Patricia; Letvak, Susan

    2007-01-01

    The inclusion of gerontology content in the nursing curriculum is paramount as our population of older adults grows. As one of 10 recipients of the John A. Hartford Foundation/AACN awards for Enhancing Gerontological and Geriatric Nursing Education for Advanced Practice Nursing Programs, we successfully integrated gerontological/ geriatric content throughout core courses for all concentrations taught at the master's level. The Nurse Practitioner and Clinical Nurse Specialist Competencies for Older Adult Care were used as a guide to integrate gerontological nursing content across the core courses. We present examples of content, strategies, and evaluation methods that demonstrate infusion of gerontology in a nursing theory course, research course, and healthcare law and policy course. Twenty-two of the competencies are addressed in these core courses and provide a foundation for further development in the support and specialty courses for the nurse practitioner, clinical nurse specialist, nursing administrator, nurse educator, and nurse anesthetist. We also present helpful Web-based resources for older adult care.

  17. Energy Therapies in Advanced Practice Oncology: An Evidence-Informed Practice Approach

    PubMed Central

    Potter, Pamela J.

    2013-01-01

    Advanced practitioners in oncology want patients to receive state-of-the-art care and support for their healing process. Evidence-informed practice (EIP), an approach to evaluating evidence for clinical practice, considers the varieties of evidence in the context of patient preference and condition as well as practitioner knowledge and experience. This article offers an EIP approach to energy therapies, namely, Therapeutic Touch (TT), Healing Touch (HT), and Reiki, as supportive interventions in cancer care; a description of the author’s professional experience with TT, HT, and Reiki in practice and research; an overview of the three energy healing modalities; a review of nine clinical studies related to oncology; and recommendations for EIP. These studies demonstrate a response to previous research design critiques. Findings indicate a positive benefit for oncology patients in the realms of pain, quality of life, fatigue, health function, and mood. Directionality of healing in immune response and cell line studies affirms the usual explanation that these therapies bring harmony and balance to the system in the direction of health. Foremost, the research literature demonstrates the safety of these therapies. In order to consider the varieties of evidence for TT, HT, and Reiki, EIP requires a qualitative examination of patient experiences with these modalities, exploration of where these modalities have been integrated into cancer care and how the practice works in the oncology setting, and discovery of the impact of implementation on provider practice and self-care. Next steps toward EIP require fleshing out the experience of these modalities by patients and health-care providers in the oncology care setting. PMID:25031994

  18. Energy therapies in advanced practice oncology: an evidence-informed practice approach.

    PubMed

    Potter, Pamela J

    2013-05-01

    Advanced practitioners in oncology want patients to receive state-of-the-art care and support for their healing process. Evidence-informed practice (EIP), an approach to evaluating evidence for clinical practice, considers the varieties of evidence in the context of patient preference and condition as well as practitioner knowledge and experience. This article offers an EIP approach to energy therapies, namely, Therapeutic Touch (TT), Healing Touch (HT), and Reiki, as supportive interventions in cancer care; a description of the author's professional experience with TT, HT, and Reiki in practice and research; an overview of the three energy healing modalities; a review of nine clinical studies related to oncology; and recommendations for EIP. These studies demonstrate a response to previous research design critiques. Findings indicate a positive benefit for oncology patients in the realms of pain, quality of life, fatigue, health function, and mood. Directionality of healing in immune response and cell line studies affirms the usual explanation that these therapies bring harmony and balance to the system in the direction of health. Foremost, the research literature demonstrates the safety of these therapies. In order to consider the varieties of evidence for TT, HT, and Reiki, EIP requires a qualitative examination of patient experiences with these modalities, exploration of where these modalities have been integrated into cancer care and how the practice works in the oncology setting, and discovery of the impact of implementation on provider practice and self-care. Next steps toward EIP require fleshing out the experience of these modalities by patients and health-care providers in the oncology care setting.

  19. Factors influencing the development and implementation of advanced radiographer practice in Australia – a qualitative study using an interpretative phenomenological approach

    SciTech Connect

    Page, Barbara A; Bernoth, Maree; Davidson, Rob

    2014-09-15

    The purpose of this study was to explore the factors influencing the implementation or the lack of implementation of advanced practitioner role in Australia. This study uses an interpretative phenomenological approach to explore the in-depth real life issues, which surround the advanced practitioner as a solution to radiologist workforce shortages in Australia. Research participants are radiographers, radiation therapists and health managers registered with the Australian Institute of Radiography (AIR) and holding senior professional and AIR Board positions with knowledge of current advanced practice. In total, seven interviews were conducted revealing education, governance, technical, people issues, change management, government, costs and timing as critical factors influencing advanced practice in Australia. Seven participants in this study perceived an advanced practice role might have major benefits and a positive impact on the immediate and long-term management of patients. Another finding is the greater respect and appreciation of each other's roles and expertise within the multidisciplinary healthcare team. Engagement is required of the critical stakeholders that have been identified as ‘blockers’ (radiologists, health departments) as well as identified allies (e.g. emergency clinicians, supportive radiologists, patient advocacy groups). The research supports that the AIR has a role to play for the professional identity of radiographers and shaping the advanced practice role in Australia.

  20. Current coding practices and patterns of code use of registered dietitian nutritionists: the Academy of Nutrition and Dietetics 2013 coding survey.

    PubMed

    Parrott, J Scott; White, Jane V; Schofield, Marsha; Hand, Rosa K; Gregoire, Mary B; Ayoob, Keith T; Pavlinac, Jessie; Lewis, Jaime Lynn; Smith, Karen

    2014-10-01

    Coding, coverage, and reimbursement for nutrition services are vital to the dietetics profession, particularly to registered dietitian nutritionists (RDNs) who provide clinical care. The objective of this study was to assess RDN understanding and use of the medical nutrition therapy (MNT) procedure codes in the delivery of nutrition services. Its design was an Internet survey of all RDNs listed in the Academy of Nutrition and Dietetics (Academy)/Commission on Dietetics Registration database as of September 2013 who resided in the United States and were not retired. Prior coding and coverage surveys provided a basis for survey development. Parameters assessed included knowledge and use of existing MNT and/or alternative procedure codes, barriers to code use, payer reimbursement patterns, complexity of the patient population served, time spent in the delivery of initial and subsequent care, and practice demographics and management. Results show that a majority of respondents were employed by another and provided outpatient MNT services on a part-time basis. MNT codes were used for the provision of individual services, with minimal use of the MNT codes for group services and subsequent care. The typical patient carries two or more diagnoses. The majority of RDNs uses internal billing departments and support staff in their practices. The payer mix is predominantly Medicare and private/commercial insurance. Managers and manager/providers were more likely than providers to carry malpractice insurance. Results point to the need for further education regarding the full spectrum of Current Procedural Terminology codes available for RDN use and the business side of ambulatory MNT practice, including the need to carry malpractice insurance. This survey is part of continuing Academy efforts to understand the complex web of relationships among clinical practice, coverage, MNT code use, and reimbursement so as to further support nutrition services codes revision and/or expansion.

  1. Primary total hip replacement: a comparison of a nationally agreed guide to best practice and current surgical technique as determined by the North West Regional Arthroplasty Register.

    PubMed Central

    Malik, M. H. A.; Gambhir, A. K.; Bale, L.; Pradhan, N.; Porter, M. L.

    2004-01-01

    BACKGROUND: In 1999, a statement of best practice in primary total hip replacement was approved by the Council of the British Orthopaedic Association (BOA) and by the British Hip Society (BHS) to provide a basis for regional and national auditable standards. We have compared practice in the North West Region of England to this document to ascertain adherence to this guide to best practice. METHODS: A total of 86 surgeons from 26 hospitals were included in a questionnaire study. RESULTS: A mean of 93.3% of operations were performed in the surgeon's usual theatre. All of these theatres had vertical laminar air flow systems. Of respondents, 42.2% routinely used exhaust suits, 68.1% routinely used impermeable disposable gowns, and 26.1% used impermeable re-usable gowns. The Charnley femoral and acetabular prostheses were the most commonly used prostheses. All surgeons used some form of anti-thromboembolic prophylaxis: 66.2% use a combination of both mechanical and chemical means. All surgeons used antibiotic prophylaxis. The most popular choice of antibiotic was a cephalosporin--70.7% used a 3-dose regimen over 24 h, 2.6% of surgeons continued antibiotic prophylaxis for 48 h after surgery, and 93.7% of surgeons routinely use antibiotic-loaded cement. All surgeons routinely cleaned, irrigated and dried the acetabulum and femur before cement insertion. Only one surgeon did not use any form of femoral canal occlusion. 69.4% used an intramedullary bone block. Retrograde filling of the femoral shaft by means of a cement gun was practised by 65.1%. CONCLUSIONS: This study has demonstrated considerable variation of practice in total hip arthroplasty across the North West Region and significant divergence from the statement of best practice approved by the BOA and BHS. The introduction of a properly funded national hip register will surely help to clarify the effect of such diverse practice on patient outcome. We would recommend that all trusts locally audit their practices

  2. Advances in endodontics: Potential applications in clinical practice

    PubMed Central

    Kishen, Anil; Peters, Ove A.; Zehnder, Matthias; Diogenes, Anibal R.; Nair, Madhu K.

    2016-01-01

    Contemporary endodontics has seen an unprecedented advance in technology and materials. This article aimed to review some of the challenges and advances in the following sections: (1) endodontic imaging, (2) root canal preparation, (3) root canal disinfection, (4) root canal filling, and (4) regenerative endodontic procedures (REPs). Jointly, these advances are aimed at improving the state of the art and science of root canal treatment. PMID:27217630

  3. Implementation of Advanced Access in a Family Medicine Residency Practice.

    PubMed

    Tseng, Ann; Wiser, Eric; Barclay, Emily; Aiello, Karen

    2015-01-01

    Several models of scheduling have been documented in the literature, including the traditional model, the carve-out model, and the advanced access model. We describe the implementation of the advanced access model in our clinic, which has been very successful. Advanced access has decreased third next available appointments to less than seven days for many of our providers and has increased individual primary care physician continuity for 40% of our providers. Interestingly, we had no gains in patient satisfaction, which is consistent with other previously published studies on advanced access.

  4. Evolution: Advancing Communities of Practice in Naval Intelligence

    DTIC Science & Technology

    2003-06-01

    and determine which ones will be included in the overall lessons learned message to other units. A certain amount of self -censorship takes place...Communities of Practice will be examined. The self - organizing Community of Practice is found at one end of the spectrum and the sponsored Community of...Practice is located at the other. Successful Communities of Practice exist at both ends and many places in between. a) Self Organizing 32 Self

  5. Practical use of advanced mouse models for lung cancer.

    PubMed

    Safari, Roghaiyeh; Meuwissen, Ralph

    2015-01-01

    To date a variety of non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) mouse models have been developed that mimic human lung cancer. Chemically induced or spontaneous lung cancer in susceptible inbred strains has been widely used, but the more recent genetically engineered somatic mouse models recapitulate much better the genotype-phenotype correlations found in human lung cancer. Additionally, improved orthotopic transplantation of primary human cancer tissue fragments or cells into lungs of immune-compromised mice can be valuable tools for preclinical research such as antitumor drug tests. Here we give a short overview of most somatic mouse models for lung cancer that are currently in use. We accompany each different model with a description of its practical use and application for all major lung tumor types, as well as the intratracheal injection or direct injection of fresh or freeze-thawed tumor cells or tumor cell lines into lung parenchyma of recipient mice. All here presented somatic mouse models are based on the ability to (in) activate specific alleles at a time, and in a tissue-specific cell type, of choice. This spatial-temporal controlled induction of genetic lesions allows the selective introduction of main genetic lesions in an adult mouse lung as found in human lung cancer. The resulting conditional somatic mouse models can be used as versatile powerful tools in basic lung cancer research and preclinical translational studies alike. These distinctively advanced lung cancer models permit us to investigate initiation (cell of origin) and progression of lung cancer, along with response and resistance to drug therapy. Cre/lox or FLP/frt recombinase-mediated methods are now well-used techniques to develop tissue-restricted lung cancer in mice with tumor-suppressor gene and/or oncogene (in)activation. Intranasal or intratracheal administration of engineered adenovirus-Cre or lentivirus-Cre has been optimized for introducing Cre

  6. Documenting Student Engagement Using an Intention/Reflection Exercise during an Advanced Pharmacy Practice Experience

    ERIC Educational Resources Information Center

    Fierke, Kerry K.; Lepp, Gardner A.

    2015-01-01

    The article shares the outcomes of a practice called Intention/Reflection (I/R) when applied to a group of ten students in a five-week course involving an international advanced pharmacy practice experience. Developed by the authors and founded on a combination of theoretical principles, this practice is unique because of the blend of formative…

  7. Assuring Quality and Access in Advanced Practice Nursing: A Challenge to Nurse Educators.

    ERIC Educational Resources Information Center

    Mundinger, Mary O.; Cook, Sarah Sheets; Lenz, Elizabeth R.; Piacentini, Karen; Auerhahn, Carolyn; Smith, Jennifer

    2000-01-01

    Advanced practice nurses are assuming increasingly accountable roles in primary health care. A doctor of nursing practice degree would signify the high level of competency they achieve. Columbia University's training model is an example of the preparation needed for this level of professional practice. (SK)

  8. 37 CFR 2.46 - Principal Register.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2013-07-01 2013-07-01 false Principal Register. 2.46... COMMERCE RULES OF PRACTICE IN TRADEMARK CASES The Written Application § 2.46 Principal Register. All applications will be treated as seeking registration on the Principal Register unless otherwise stated in...

  9. 37 CFR 2.46 - Principal Register.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2012-07-01 2012-07-01 false Principal Register. 2.46... COMMERCE RULES OF PRACTICE IN TRADEMARK CASES The Written Application § 2.46 Principal Register. All applications will be treated as seeking registration on the Principal Register unless otherwise stated in...

  10. 31 CFR 8.27 - Enrollment registers.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance: Treasury 1 2014-07-01 2014-07-01 false Enrollment registers. 8.27 Section 8... ALCOHOL, TOBACCO AND FIREARMS Enrollment Procedures § 8.27 Enrollment registers. The Director shall maintain, for public inspection, a register of all persons enrolled to practice before the Bureau and...

  11. 37 CFR 2.46 - Principal Register.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2011-07-01 2011-07-01 false Principal Register. 2.46... COMMERCE RULES OF PRACTICE IN TRADEMARK CASES The Written Application § 2.46 Principal Register. All applications will be treated as seeking registration on the Principal Register unless otherwise stated in...

  12. 31 CFR 8.27 - Enrollment registers.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Enrollment registers. 8.27 Section 8... ALCOHOL, TOBACCO AND FIREARMS Enrollment Procedures § 8.27 Enrollment registers. The Director shall maintain, for public inspection, a register of all persons enrolled to practice before the Bureau and...

  13. 37 CFR 2.46 - Principal Register.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2014-07-01 2014-07-01 false Principal Register. 2.46... COMMERCE RULES OF PRACTICE IN TRADEMARK CASES The Written Application § 2.46 Principal Register. All applications will be treated as seeking registration on the Principal Register unless otherwise stated in...

  14. 31 CFR 8.27 - Enrollment registers.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance: Treasury 1 2012-07-01 2012-07-01 false Enrollment registers. 8.27 Section 8... ALCOHOL, TOBACCO AND FIREARMS Enrollment Procedures § 8.27 Enrollment registers. The Director shall maintain, for public inspection, a register of all persons enrolled to practice before the Bureau and...

  15. 31 CFR 8.27 - Enrollment registers.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance: Treasury 1 2013-07-01 2013-07-01 false Enrollment registers. 8.27 Section 8... ALCOHOL, TOBACCO AND FIREARMS Enrollment Procedures § 8.27 Enrollment registers. The Director shall maintain, for public inspection, a register of all persons enrolled to practice before the Bureau and...

  16. 37 CFR 2.46 - Principal Register.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Principal Register. 2.46... COMMERCE RULES OF PRACTICE IN TRADEMARK CASES The Written Application § 2.46 Principal Register. All applications will be treated as seeking registration on the Principal Register unless otherwise stated in...

  17. 31 CFR 8.27 - Enrollment registers.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance: Treasury 1 2011-07-01 2011-07-01 false Enrollment registers. 8.27 Section 8... ALCOHOL, TOBACCO AND FIREARMS Enrollment Procedures § 8.27 Enrollment registers. The Director shall maintain, for public inspection, a register of all persons enrolled to practice before the Bureau and...

  18. A System Approach to Advanced Practice Clinician Standardization and High Reliability.

    PubMed

    Okuno-Jones, Susan; Siehoff, Alice; Law, Jennifer; Juarez, Patricia

    Advanced practice clinicians (APCs) are an integral part of the health care team. Opportunities exist within Advocate Health Care to standardize and optimize APC practice across the system. To enhance the role and talents of APCs, an approach to role definition and optimization of practice and a structured approach to orientation and evaluation are shared. Although in the early stages of development, definition and standardization of accountabilities in a framework to support system changes are transforming the practice of APCs.

  19. Current Practices in Global/International Advanced Pharmacy Practice Experiences: Preceptor and Student Considerations

    PubMed Central

    Ratka, Anna; Gleason, Shaun E.; Ombengi, David N.; Tofade, Toyin; Wigle, Patricia R.; Zapantis, Antonia; Ryan, Melody; Connor, Sharon; Jonkman, Lauren J.; Ochs, Leslie; Jungnickel, Paul W.; Abrons, Jeanine P.; Alsharif, Naser Z.

    2016-01-01

    The objective of this article is to describe the key areas of consideration for global/international advanced pharmacy practice experience (G/I APPE) preceptors, students and learning objectives. At the 2013 Annual Meeting of the American Association of Colleges of Pharmacy (AACP), the GPE SIG prepared and presented an initial report on the G/IAPPE initiatives. Round table discussions were conducted at the 2014 AACP Annual Meeting to document GPE SIG member input on key areas in the report. Literature search of PubMed, Google Scholar and EMBASE with keywords was conducted to expand this report. In this paper, considerations related to preceptors and students and learning outcomes are described. Preceptors for G/I APPEs may vary based on the learning outcomes of the experience. Student learning outcomes for G/I APPEs may vary based on the type of experiential site. Recommendations and future directions for development of G/IAPPEs are presented. Development of a successful G/I APPE requires significant planning and consideration of appropriate qualifications for preceptors and students. PMID:27170810

  20. Current Practices in Global/International Advanced Pharmacy Practice Experiences: Preceptor and Student Considerations.

    PubMed

    Dornblaser, Emily K; Ratka, Anna; Gleason, Shaun E; Ombengi, David N; Tofade, Toyin; Wigle, Patricia R; Zapantis, Antonia; Ryan, Melody; Connor, Sharon; Jonkman, Lauren J; Ochs, Leslie; Jungnickel, Paul W; Abrons, Jeanine P; Alsharif, Naser Z

    2016-04-25

    The objective of this article is to describe the key areas of consideration for global/international advanced pharmacy practice experience (G/I APPE) preceptors, students and learning objectives. At the 2013 Annual Meeting of the American Association of Colleges of Pharmacy (AACP), the GPE SIG prepared and presented an initial report on the G/IAPPE initiatives. Round table discussions were conducted at the 2014 AACP Annual Meeting to document GPE SIG member input on key areas in the report. Literature search of PubMed, Google Scholar and EMBASE with keywords was conducted to expand this report. In this paper, considerations related to preceptors and students and learning outcomes are described. Preceptors for G/I APPEs may vary based on the learning outcomes of the experience. Student learning outcomes for G/I APPEs may vary based on the type of experiential site. Recommendations and future directions for development of G/IAPPEs are presented. Development of a successful G/I APPE requires significant planning and consideration of appropriate qualifications for preceptors and students.

  1. Advance directive communications practices:social worker's contributions to the interdisciplinary health care team.

    PubMed

    Black, Kathy

    2005-01-01

    This article presents a comparative study about social workers' interdisciplinary advance directive communication practices with patients at several hospitals located in upstate New York. The sample consisted of physicians (n=32), nurses (n=74), and social workers (n=29). The research surveyed advance directive communication practices by discipline utilizing a self-administered questionnaire. Advance directive communication was operationalized as a cumulative process incorporating the following phases that were measured as scales: initiation of the topic, disclosure of information, identification of a surrogate decision-maker, discussion of treatment options, elicitation of patient values, interaction with family members, and collaboration with other health care professionals. Results suggest that social workers offer distinct skills in their advance directive communication practices and discuss advance directives more frequently than either physicians or nurses.

  2. 19 CFR 181.92 - Definitions and general NAFTA advance ruling practice.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 19 Customs Duties 2 2012-04-01 2012-04-01 false Definitions and general NAFTA advance ruling... Procedures § 181.92 Definitions and general NAFTA advance ruling practice. (a) Definitions. For purposes of... that interprets and applies the provisions of NAFTA to a specific set of facts involving any...

  3. 19 CFR 181.92 - Definitions and general NAFTA advance ruling practice.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 19 Customs Duties 2 2014-04-01 2014-04-01 false Definitions and general NAFTA advance ruling... Procedures § 181.92 Definitions and general NAFTA advance ruling practice. (a) Definitions. For purposes of... that interprets and applies the provisions of NAFTA to a specific set of facts involving any...

  4. 19 CFR 181.92 - Definitions and general NAFTA advance ruling practice.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 19 Customs Duties 2 2011-04-01 2011-04-01 false Definitions and general NAFTA advance ruling... Procedures § 181.92 Definitions and general NAFTA advance ruling practice. (a) Definitions. For purposes of... that interprets and applies the provisions of NAFTA to a specific set of facts involving any...

  5. 19 CFR 181.92 - Definitions and general NAFTA advance ruling practice.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false Definitions and general NAFTA advance ruling... Procedures § 181.92 Definitions and general NAFTA advance ruling practice. (a) Definitions. For purposes of... that interprets and applies the provisions of NAFTA to a specific set of facts involving any...

  6. 19 CFR 181.92 - Definitions and general NAFTA advance ruling practice.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 19 Customs Duties 2 2013-04-01 2013-04-01 false Definitions and general NAFTA advance ruling... Procedures § 181.92 Definitions and general NAFTA advance ruling practice. (a) Definitions. For purposes of... that interprets and applies the provisions of NAFTA to a specific set of facts involving any...

  7. Nothing out of the ordinary: advanced fertility nursing practice.

    PubMed

    Allan, Helen; Barber, Debbie

    2004-12-01

    This paper discusses data from a case study of fertility nursing practice. An ethnographic case study approach using participant observation and nine semi-structured interviews with staff and patients was undertaken. The data were analysed thematically and these themes are discussed in this paper. We present the meaning a small group of nurses working in a fertility unit in the UK attach to new roles and the ways in which changes in practice may be influenced. The nurses in this study believed that nature of the task demanded changes to practice and they identified personal, interpersonal and socio-cultural factors which influenced these changes. These new roles facilitated greater continuity of care for patients. This paper discusses the effects of these new roles on knowing and intimacy in nurse - patient relationships. The data suggests that new nursing roles, which are based on "traditional" nursing and "new" technical skills, are fragile and may not be shared across a professional community.

  8. Translating Advances in Reading Comprehension Research to Educational Practice

    ERIC Educational Resources Information Center

    McNamara, Danielle S.; Kendeou, Panayiota

    2011-01-01

    The authors review five major findings in reading comprehension and their implications for educational practice. First, research suggests that comprehension skills are separable from decoding processes and important at early ages, suggesting that comprehension skills should be targeted early, even before the child learns to read. Second, there is…

  9. Integrating Social Neuroscience and Social Work: Innovations for Advancing Practice-Based Research

    ERIC Educational Resources Information Center

    Matto, Holly C.; Strolin-Goltzman, Jessica

    2010-01-01

    Throughout the social work profession, there is ongoing interest in building a social science agenda that can address the complex practice-based questions faced by social work professionals today. Methodological innovations and unique funding opportunities have already significantly advanced research on social work practice. Still, there is…

  10. Cost-effectiveness of a WOC Advanced Practice Nurse in the Acute Care and Outpatient Setting

    PubMed Central

    2014-01-01

    Increasing numbers of advanced practice nurses who practice within the WOC specialty are challenged by the need to justify their role by demonstrating clinical and fiscal benefits to the employing agency. This View From Here column describes the steps I took while completing such an analysis for a position for a nurse practitioner with WOC certification in upstate New York. PMID:24918767

  11. Collagenase Clostridium histolyticum : emerging practice patterns and treatment advances

    PubMed Central

    Warwick, David; Arandes-Renú, José M.; Pajardi, Giorgio; Witthaut, Jörg; Hurst, Lawrence C.

    2016-01-01

    Abstract Objective: This study aims to provide a comprehensive review of the role of Collagenase Clostridium histolyticum (CCH). Methods: This review is based on a literature review and practical experience. Results: This review provides practical management strategies for using collagenase by sharing clinical experiences over the past few years; logistical aspects of in-clinic treatment, lessons learned, and novel approaches to correct traditionally hard-to-treat contractures are discussed. In addition a brief, yet comprehensive overview is provided on the pathophysiology of the disease, the mechanism of collagenase action and results of clinical studies. Conclusion: CCH has an evolving role as one of the tools available for treating Dupuytren's disease. PMID:27050718

  12. Unpacking University-Community Partnerships to Advance Scholarship of Practice.

    PubMed

    Suarez-Balcazar, Yolanda; Mirza, Mansha Parven; Hansen, Anne Marie Witchger

    2015-01-01

    Today, more than ever, occupational therapists are engaged in close partnerships with community organizations and community settings such as service agencies, refugee and immigrant enclaves, and faith-based organizations, to name a few, for the purpose of engaging in scholarship of practice. However, we know little about the views of community partners regarding the development and sustainability of university-community partnerships. The purpose of this article is twofold: First, we will describe a pilot study in which we gathered qualitative data from community partners engaged in scholarship of practice with faculty and students, regarding their views about benefits of partnerships, challenges, and characteristics of sustainable partnerships. Second, based on this pilot study and extensive experience of the authors, we propose a revised version of a partnerships model available in the literature. We illustrate the model through examples of the authors' collective experiences developing and sustaining successful university-community partnerships.

  13. Monitoring for opioid-induced advancing sedation and respiratory depression: ASPMN membership survey of current practice.

    PubMed

    Jungquist, Carla R; Willens, Joyce S; Dunwoody, Danielle R; Klingman, Karen J; Polomano, Rosemary C

    2014-09-01

    Adverse events secondary to opioid-induced advancing sedation and respiratory depression continue to occur during hospitalizations despite efforts to increase awareness and clinical practice guidelines to address prevention strategies. In 2009, ASPMN surveyed membership on current practices surrounding this topic. ASPMN clinical practice guidelines were then published in 2011. In winter of 2013, ASPMN membership was again surveyed to assess progress in preventing adverse events. This is a report of the follow-up membership survey. In general, monitoring practices are slowly improving over time, but there are many facilities that have not instituted best practices for avoiding adverse events.

  14. Prosthodontics in a general practice program of advanced dental education.

    PubMed

    Plekavich, E J

    1976-01-01

    The problems involved in teaching prosthodontics in a general practice program outwardly appear to be due to the lack of sufficient basic prosthodontic training dispensed by the dental schools. This lack of sufficient training is not the fault of dental school faculties. The students are not learning what they are taught. What they need is more repetition, which means more time. The problems are not insurmountable. We just must find the route.

  15. Advanced-practice pharmacists: practice characteristics and reimbursement of pharmacists certified for collaborative clinical practice in New Mexico and North Carolina.

    PubMed

    Murawski, Matthew; Villa, Kristin R; Dole, Ernest J; Ives, Timothy J; Tinker, Dale; Colucci, Vincent J; Perdiew, Jeffrey

    2011-12-15

    PURPOSE The results of a survey assessing the practice settings, clinical activities, and reimbursement experiences of pharmacists with advanced-practice designations are reported. METHODS A questionnaire was sent to all certified Pharmacist Clinicians in New Mexico and all Clinical Pharmacist Practitioners in North Carolina (a total of 189 pharmacists at the time of the survey in late 2008) to elicit information on practice settings, billing and reimbursement methods, collaborative drug therapy management (CDTM) protocols, and other issues. RESULTS Of the 189 targeted pharmacists, 64 (34%) responded to the survey. On average, the reported interval from pharmacist licensure to certification as an advanced practitioner was 11 years. The majority of survey participants were practicing in community or institutional settings, most often hospital clinics or physician offices. About two thirds of the respondents indicated that their employer handled the billing of their services using standard evaluation and management codes, with estimated total monthly billings averaging $6500. At the time of the survey, about 80% of the respondents were engaged in a CDTM protocol. The survey results suggest that pharmacists with advanced-practice designations are perceived favorably by patients and physicians and their services are in high demand, but more than one third of respondents indicated a need to justify their advanced-practice positions to administrators. CONCLUSION Pharmacists with advanced-practice designations are providing clinical services in various settings under collaborative practice arrangements that include prescribing privileges. Despite growing patient and physician acceptance, reimbursement challenges continue to be a barrier to wider use of CDTM programs.

  16. Advancing the Practice of Health Coaching: Differentiation From Wellness Coaching.

    PubMed

    Huffman, Melinda H

    2016-09-01

    The increasing demand for health coaches and wellness coaches in worksite health promotion and the marketplace has resulted in a plethora of training programs with wide variations in coaching definitions, content, attributes, and eligibility of those who may train. It is in the interest of public awareness and safety that those in clinical practice take the lead in this discussion and offer a reasonable contrast and comparison focusing on the risks and responsibilities of health coaching in particular. With the endorsement of the American Association of Occupational Health Nurses (AAOHN), the National Society of Health Coaches, whose membership is primarily nurses, discusses the issue and states its position here.

  17. Meeting report: advancing practical applications of biodiversity ontologies

    PubMed Central

    2014-01-01

    We describe the outcomes of three recent workshops aimed at advancing development of the Biological Collections Ontology (BCO), the Population and Community Ontology (PCO), and tools to annotate data using those and other ontologies. The first workshop gathered use cases to help grow the PCO, agreed upon a format for modeling challenging concepts such as ecological niche, and developed ontology design patterns for defining collections of organisms and population-level phenotypes. The second focused on mapping datasets to ontology terms and converting them to Resource Description Framework (RDF), using the BCO. To follow-up, a BCO hackathon was held concurrently with the 16th Genomics Standards Consortium Meeting, during which we converted additional datasets to RDF, developed a Material Sample Core for the Global Biodiversity Information Framework, created a Web Ontology Language (OWL) file for importing Darwin Core classes and properties into BCO, and developed a workflow for converting biodiversity data among formats.

  18. Review: Coastal groundwater optimization—advances, challenges, and practical solutions

    NASA Astrophysics Data System (ADS)

    Ketabchi, Hamed; Ataie-Ashtiani, Behzad

    2015-09-01

    Decision models are essential tools for coastal groundwater management (CGM). A combined simulation-optimization framework is employed to develop these models. One of the main barriers in the widespread application of these models for real-world cases is their large computational burden. Recent advances in efficient computational approaches and robust optimization methods can crack this barrier. This study surveys the scientific basis of CGM to provide an overview on this subject and reviews the-state-of-the-art to clarify recent developments and to outline ideas for improving the computational performance. Key details are presented on the performance and choice of possible robust tools such as efficient evolutionary algorithms (EAs), surrogate models, and parallel processing techniques. Then, the potential challenges remaining in this context are scrutinized, demonstrating open fields for further research, which include issues related to advances in simulating and optimizing phases such as introducing new robust algorithms and considering multi-objective purposes, implementing novel and high-performance tools, considering global concerns (e.g. climate change impacts), enhancing the existing models to fit the real world, and taking into account the complexities of real-world applications (e.g. uncertainties in the modeling parameters, and data acquisition). Finally, the outcomes of the systematic review are applied to solve a real-world CGM problem in Iran, to quantitatively examine the performance of combined implementation of some of the suggested tools. It is revealed that the required computational time is considerably reduced by as much as three orders of magnitude when correct combinations of robust EAs, surrogate model, and parallelization technique are utilized.

  19. Advanced practice clinicians as abortion providers: current developments in the United States.

    PubMed

    Joffe, Carole; Yanow, Susan

    2004-11-01

    A hopeful note in the contemporary abortion environment in the United States is the expanding role of advanced practice clinicians--nurse practitioners, physician assistants and nurse-midwives--in first trimester abortion provision. A large percentage of primary health care in the U.S. is currently provided by these non-physicians but their involvement in abortion care is promising, especially in light of the shortage of physician providers. Two national symposia in 1990 and 1996 approved the expansion of early abortion care to non-physicians. As of January 2004, trained advanced practice clinicians were providing medical, and in some cases, early surgical abortion in 14 states. This has required not only medical training but also political organising to achieve the necessary legal and regulatory changes, state by state, by groups such as Clinicians for Choice and the Abortion Access Project, described here in examples in two states and the reflections of three advanced practice clinicians. Recent surveys in three states show a substantial interest among advanced practice clinicians in abortion training, leading to cautious optimism about the possibility of increased abortion access for women. Most encouraging, advanced practice clinicians, like their physician counterparts, show a level of passionate commitment to the work that is rare elsewhere in health care in the U.S. today.

  20. Creating a framework for clinical nursing practice to advance in the West Midlands region.

    PubMed

    Dunn, L; Morgan, E

    1998-05-01

    The West Midlands Regional Health Authority identified a lack of opportunities for nurses to develop advanced clinical practice through a recognized programme at Postgraduate diploma/Masters degree level. Education for clinical practice must be equally grounded in theory and practice. Advanced clinical practice requires more than just skills acquisition, it has a much wider remit incorporating elements of clinical expertise and higher level decision making, research awareness, teaching and role modelling, informing policy making and leading in the provision of patient care within individual Trusts. This initiative has encouraged universities, trusts and provider units to work together to identify and prepare students and staff for their changes in role, and to review existing boundaries for practice which will enable new approaches to team work and the provision of holistic patient care.

  1. Advance Care Planning: practicalities, legalities, complexities and controversies.

    PubMed

    Horridge, Karen A

    2015-04-01

    Increasing numbers, complexities and technology dependencies of children and young people with life-limiting conditions require paediatricians to be well prepared to meet their changing needs. Paediatric Advance Care Planning provides a framework for paediatricians, families and their multidisciplinary teams to consider, reflect and record the outcome of their conversations about what might happen in the future in order to optimise quality of clinical care and inform decision-making. For some children and young people this will include discussions about the possibility of death in childhood. This may be unexpected and sudden, in the context of an otherwise active management plan or may be expected and necessitate discussions about the process of dying and attention to symptoms. Decision-making about appropriate levels of intervention must take place within a legal and ethical framework, recognising that the UK Equality Act (2010) protects the rights of disabled children and young people and infants and children of all ages to the same high quality healthcare as anyone else.

  2. Illuminating the clinical nurse specialist role of advanced practice nursing: a qualitative study.

    PubMed

    Canam, Connie

    2005-12-01

    As the advanced practice nursing initiative in Canada gains momentum, effort is being directed towards clarifying and defining advanced practice roles. A qualitative study was undertaken to increase understanding of the clinical nurse specialist role of advanced practice. Sixteen nurses who worked in advanced practice roles, organizing and providing healthcare for children with complex health needs and their families across the continuum of care, participated in in-depth conversations about the nature of their practice, the knowledge that informs it and the factors that influence it. Findings suggest that clinical nurse specialists have a unique role in the organization and delivery of healthcare for specialized populations with complex health needs in their dual focus on the system level of healthcare and on population health needs. Initiatives directed to children and families within the study participants' specialties included program development, consultation and educational outreach and the development of clinical guidelines and policies. Although the nurses described their practice as focusing both on individual children and families and on the population of children and families within their specialty, it is at the population level that they see their greatest potential for contributing to the delivery of high-quality, cost-effective healthcare.

  3. Practice Paper of the Academy of Nutrition and Dietetics: Role of the Registered Dietitian Nutritionist in the Diagnosis and Management of Food Allergies.

    PubMed

    Collins, Sherry Coleman

    2016-10-01

    Incidence of food allergy has increased significantly over the past decade and represents an important health issue for millions of Americans. Diagnosis of immunoglobulin E-mediated food allergies is sometimes difficult because blood and skin tests have high rates of false positives, and oral food challenges are uncommon due to the expense and potential for serious reactions. Accurate diagnosis is crucial to avoid unnecessary dietary restriction, especially in children. Because registered dietitian nutritionists often work independently, receiving referrals for dietary education and guidance for a patient who is followed by one or several other practitioners, navigating the data available and making the appropriate follow-up contact optimizes treatment. The purpose of this paper is to provide guidance to the registered dietitian nutritionists and nutrition and dietetics technician, registered on appropriate and evidence-based nutrition counseling for diagnosis and management of food allergies.

  4. Identifying landmark articles for advancing the practice of geriatrics.

    PubMed

    Vaughan, Camille P; Fowler, Rachel; Goodman, Richard A; Graves, Taylor R; Flacker, Jonathan M; Johnson, Theodore M

    2014-11-01

    Landmark articles from the peer-reviewed literature can be used to teach the fundamental principles of geriatric medicine. Three approaches were used in sequential combination to identify landmark articles as a resource for geriatricians and other healthcare practitioners. Candidate articles were identified first through a literature review and expert opinion survey of geriatric medicine faculty. Candidate articles in a winnowed list (n = 30) were then included in a bibliometric analysis that incorporated the journal impact factor and average monthly citation index. Finally, a consensus panel reviewed articles to assess each manuscript's clinical relevance. For each article, a final score was determined by averaging, with equal weight, the opinion survey, bibliometric analysis, and consensus panel review. This process ultimately resulted in the identification of 27 landmark articles. Overall, there was weak correlation between articles that the expert opinion survey and bibliometric analysis both rated highly. This process demonstrates a feasible method combining subjective and objective measures that can be used to identify landmark papers in geriatric medicine for the enhancement of geriatrics education and practice.

  5. Psychological Well-Being Revisited: Advances in Science and Practice

    PubMed Central

    Ryff, Carol D.

    2014-01-01

    This article reviews the research and interventions that have grown up around a model of psychological well-being (Ryff, 1989) generated more than two decades ago to address neglected aspects of positive functioning, such as purposeful engagement in life, realization of personal talents and capacities, and enlightened self-knowledge. The conceptual origins of this formulation are revisited and scientific products emerging from six thematic areas are examined: (1) how well-being changes across adult development and later life, (2) what are the personality correlates of well-being, (3) how well-being is linked with experiences in family life, (4) how well-being relates to work and other community activities, (5) what are the connections between well-being and health, including biological risk factors, (6) and via clinical and intervention studies, how psychological well-being can be promoted for ever greater segments of society. Together, these topics illustrate flourishing interest across diverse scientific disciplines in understanding adults as striving, meaning-making, proactive organisms who are actively negotiating the challenges of life. A take-home message is that increasing evidence supports the health protective features of psychological well-being in reducing risk for disease and promoting length of life. A recurrent and increasingly important theme is resilience – the capacity to maintain or regain well-being in the face of adversity. Implications for future research and practice are considered. PMID:24281296

  6. The Vanderbilt Professional Nursing Practice Program, part 2: Integrating a professional advancement and performance evaluation system.

    PubMed

    O'Hara, Nancy F; Duvanich, Mary; Foss, Julie; Wells, Nancy

    2003-10-01

    Developing a performance-based advancement system requires evaluation tools that capture essential behaviors and outcomes reflective of key nursing functions. To ensure relevance to clinical practice and enhance buy-in from nursing staff, the behaviors and outcomes were defined by a broad cross-section of nursing staff and administrators. The first article (September 2003) in this 3-part series described the foundation for and the philosophical background of the Vanderbilt Professional Nursing Practice Program (VPNPP), the career advancement program under way at Vanderbilt University Medical Center. This second article describes the development of the evaluation tools used in the VPNPP, the implementation and management of this new system, program evaluation, and improvements since the inception of the program. Additionally, the authors present the challenges and lessons we learned in development and implementation of a dynamic evaluation system that supports our career advancement program. The process of advancing within the program will be described in part 3.

  7. Academy of Nutrition and Dietetics and National Kidney Foundation: revised 2014 Standards of Practice and Standards of Professional Performance for registered dietitian nutritionists (competent, proficient, and expert) in nephrology nutrition.

    PubMed

    Kent, Pamela S; McCarthy, Maureen P; Burrowes, Jerrilynn D; McCann, Linda; Pavlinac, Jessie; Goeddeke-Merickel, Catherine M; Wiesen, Karen; Kruger, Sarah; Byham-Gray, Laura; Pace, Rory C; Hannahs, Valarie; Benner, Debbie

    2014-09-01

    Compelling evidence indicates that the incidence of chronic kidney disease (CKD) is increasing because of an aging population and a higher prevalence of cardiovascular disease, diabetes, and hypertension. Nutrition management of patients with CKD requires early disease recognition, appropriate interpretation of the markers and stages of CKD, and collaboration with other health care practitioners. Better management of CKD can slow its progression, prevent metabolic complications, and reduce cardiovascular related outcomes. Caring for patients with CKD necessitates specialized knowledge and skills to meet the challenges associated with this growing epidemic. The Academy of Nutrition and Dietetics Renal Dietitians Practice Group and the National Kidney Foundation Council on Renal Nutrition, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, have updated the 2009 Standards of Practice in Nutrition Care and Standards of Professional Performance as a tool for registered dietitian nutritionists working in nephrology nutrition to assess their current skill levels and to identify areas for additional professional development in this practice area. The Standards of Practice apply to the care of patients/clients with kidney disease. The Standards of Professional Performance consist of six domains of professionalism, including: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. Within each standard, specific indicators provide measurable action statements that illustrate how nephrology nutrition principles can be applied to practice. The indicators describe three skill levels (ie, competent, proficient, and expert) for registered dietitian nutritionists working in nephrology nutrition.

  8. Academy of Nutrition and Dietetics and National Kidney Foundation: revised 2014 standards of practice and standards of professional performance for registered dietitian nutritionists (competent, proficient, and expert) in nephrology nutrition.

    PubMed

    Kent, Pamela S; McCarthy, Maureen P; Burrowes, Jerrilynn D; McCann, Linda; Pavlinac, Jessie; Goeddeke-Merickel, Catherine M; Wiesen, Karen; Kruger, Sarah; Byham-Gray, Laura; Pace, Rory C; Hannahs, Valarie; Benner, Debbie

    2014-09-01

    Compelling evidence indicates that the incidence of chronic kidney disease (CKD) is increasing because of an aging population and a higher prevalence of cardiovascular disease, diabetes, and hypertension. Nutrition management of patients with CKD requires early disease recognition, appropriate interpretation of the markers and stages of CKD, and collaboration with other health care practitioners. Better management of CKD can slow its progression, prevent metabolic complications, and reduce cardiovascular related outcomes. Caring for patients with CKD necessitates specialized knowledge and skills to meet the challenges associated with this growing epidemic. The Academy of Nutrition and Dietetics Renal Dietitians Practice Group and the National Kidney Foundation Council on Renal Nutrition, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, have updated the 2009 Standards of Practice in Nutrition Care and Standards of Professional Performance as a tool for registered dietitian nutritionists working in nephrology nutrition to assess their current skill levels and to identify areas for additional professional development in this practice area. The Standards of Practice apply to the care of patients/clients with kidney disease. The Standards of Professional Performance consist of six domains of professionalism, including: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. Within each standard, specific indicators provide measurable action statements that illustrate how nephrology nutrition principles can be applied to practice. The indicators describe three skill levels (ie, competent, proficient, and expert) for registered dietitian nutritionists working in nephrology nutrition.

  9. Premature rupture of the fetal membranes. An update for advanced practice nurses.

    PubMed

    Weitz, B W

    2001-01-01

    Advanced practice nurses in obstetric settings are frequently required to diagnose premature rupture of fetal membranes; co-management of care with physicians is becoming more common in many health care facilities. Therefore, Advanced practice nurses must have an in-depth understanding of this potentially severe obstetric complication. This article presents a review of the current literature focusing on the epidemiology, physiology, pathophysiology, prevention measures, subjective and objective assessment, diagnostic tests, and management of premature rupture of membranes. Psychosocial aspects of this event, often upsetting for the family, are also discussed.

  10. Making the Grade through the Front Door: Evaluation and Innovation in a Registered Practical Nurse to Bachelor of Science in Nursing Program

    ERIC Educational Resources Information Center

    Coffey, Sue; Lindsay, Gail M.; Cochrane, Marianne; Cummings, Katherine; Macdonald, Karen; Mairs, Sandra; Sproul, Susan; Bouchard, Shelley; Lulat, Zainab; Salamat, Nadia; Bell, Ronald

    2016-01-01

    Background: Education of nurses from a diploma to a degree is a global phenomenon. However, bridging is often seen as a "backdoor" route to becoming a Registered Nurse and very little evaluation data exists to challenge this notion. Objectives: This research project was undertaken to explore student characteristics, academic performance,…

  11. Practice Leadership at the Front Line in Supporting People with Intellectual Disabilities and Challenging Behaviour: A Qualitative Study of Registered Managers of Community-Based, Staffed Group Homes

    ERIC Educational Resources Information Center

    Deveau, Roy; McGill, Peter

    2016-01-01

    Background: The front-line management role in services for people with intellectual disabilities remains rather under-researched. The aim of this study was to examine the experiences of registered managers in services for adults with intellectual disability who exhibit challenging behaviour. Method: Interviews, primarily focussed upon staff…

  12. The Vanderbilt Professional Nursing Practice Program, part 3: managing an advancement process.

    PubMed

    Steaban, Robin; Fudge, Mitzie; Leutgens, Wendy; Wells, Nancy

    2003-11-01

    Consistency of performance standards across multiple clinical settings is an essential component of a credible advancement system. Our advancement process incorporates a central committee, composed of nurses from all clinical settings within the institution, to ensure consistency of performance in inpatient, outpatient, and procedural settings. An analysis of nurses advanced during the first 18 months of the program indicates that performance standards are applicable to nurses in all clinical settings. The first article (September 2003) in this 3-part series described the foundation for and the philosophical background of the Vanderbilt Professional Nursing Practice Program (VPNPP), the career advancement program underway at Vanderbilt University Medical Center. Part 2 described the development of the evaluation tools used in the VPNPP, the implementation and management of this new system, program evaluation, and improvements since the program's inception. The purpose of this article is to review the advancement process, review the roles of those involved in the process, and to describe outcomes and lessons learned.

  13. Educators' expectations of roles, employability and career pathways of registered and enrolled nurses in Australia.

    PubMed

    Jacob, Elisabeth R; McKenna, Lisa; D'Amore, Angelo

    2016-01-01

    In Australia, like other countries, two levels of nurse are registered for entry to practice. Educational changes for second level nurses in Australia have led to questions regarding roles and career options. This paper reports on interviews with nursing course coordinators to examine educator expectations of roles and career pathways of registered and enrolled nurses. Coordinators of eight degree (registered) and diploma (enrolled) nursing programs were interviewed to determine their opinions on roles and careers that students were prepared for. Transcripts were thematically analysed. Educators reported similar graduate roles, although high acuity care was primarily the role of registered nurses. Career expectations differed with enrolled nurses having limited advancement opportunity, and registered nurses greater career options. Health organisations were unprepared to accommodate increased practice scope of enrolled nurses and limited work practice through policies stipulating who could perform procedures. Organisational health policies need to accommodate increased enrolled nurse skill base. Education of practising nurses is necessary regarding increased scope of enrolled nurse practice to ensure they are used to their full potential. Increasing patient acuity requires more registered nurses, as enrolled nurses are unprepared to care for complex or deteriorating patients.

  14. The evolution of the advanced practice role in psychiatric mental health in New Jersey: 1960-2010.

    PubMed

    Caldwell, Barbara A; Sclafani, Michael; Piren, Karen; Torre, Carolyn

    2012-04-01

    This historical perspective is focused on the contribution of Hildegard E. Peplau in laying the foundation for advanced practice nursing and the development of the roles of clinical nurse specialists and psychiatric nurse practitioners. An overview is provided of legal developments within the state that enabled Advanced Practice Nurses to provide mental health services. A description of a recent specialized state-funded initiative is outlined, focused on the development and contributions of psychiatric advanced practice nurses in community settings in New Jersey. Implications for the advanced practice nursing role in New Jersey are presented based on national and state initiatives.

  15. Redefining perioperative advanced practice. Scope of practice: measuring impact and sustainability.

    PubMed

    Radford, Mark; Abbassi, Ann; Williamson, Alastair; Johnston, Paul

    2003-12-01

    There are increasing demands placed upon the modern NHS, particularly in emergency care. In combating these demands, new approaches to practice will form an overall strategy for improving care delivered to patients. This is the second in a series by authors from the Good Hope Hospital NHS Trust and explains their experience of developing an innovative approach to the management of surgical emergencies through the specialist nurse role in anaesthesia and emergency surgery. It examines the scope of practice, clinical and operational impact of the role, and future developments.

  16. Advancing general practice nursing in Australia: roles and responsibilities of primary healthcare organisations.

    PubMed

    Lane, Riki; Halcomb, Elizabeth; McKenna, Lisa; Zwar, Nicholas; Naccarella, Lucio; Davies, Gawaine Powell; Russell, Grant

    2016-04-21

    Objectives Given increased numbers and enhanced responsibilities of Australian general practice nurses, we aimed to delineate appropriate roles for primary health care organisations (PHCOs) to support this workforce.Methods A two-round online Delphi consensus process was undertaken between January and June 2012, informed by literature review and key informant interviews. Participants were purposively selected and included decision makers from government and professional organisations, educators, researchers and clinicians from five Australian states and territoriesResults Of 56 invited respondents, 35 (62%) and 31 (55%) responded to the first and second invitation respectively. Participants reached consensus on five key roles for PHCOs in optimising nursing in general practice: (1) matching workforce size and skills to population needs; (2) facilitating leadership opportunities; (3) providing education and educational access; (4) facilitating integration of general practice with other primary care services to support interdisciplinary care; and (5) promoting advanced nursing roles. National concerns, such as limited opportunities for postgraduate education and career progression, were deemed best addressed by national nursing organisations, universities and peak bodies.Conclusions Advancement of nursing in general practice requires system-level support from a range of organisations. PHCOs play a significant role in education and leadership development for nurses and linking national nursing organisations with general practices.What is known about the topic? The role of nurses in Australian general practice has grown in the last decade, yet they face limited career pathways and opportunities for career advancement. Some nations have forged interprofessional primary care teams that use nurses' skills to the full extent of their scope of practice. PHCOs have played important roles in the development of general practice nursing in Australia and internationally

  17. Comparison of Quality Oncology Practice Initiative (QOPI) Measure Adherence Between Oncology Fellows, Advanced Practice Providers, and Attending Physicians.

    PubMed

    Zhu, Jason; Zhang, Tian; Shah, Radhika; Kamal, Arif H; Kelley, Michael J

    2015-12-01

    Quality improvement measures are uniformly applied to all oncology providers, regardless of their roles. Little is known about differences in adherence to these measures between oncology fellows, advance practice providers (APP), and attending physicians. We investigated conformance across Quality Oncology Practice Initiative (QOPI) measures for oncology fellows, advance practice providers, and attending physicians at the Durham Veterans Affairs Medical Center (DVAMC). Using data collected from the Spring 2012 and 2013 QOPI cycles, we abstracted charts of patients and separated them based on their primary provider. Descriptive statistics and the chi-square test were calculated for each QOPI measure between fellows, advanced practice providers (APPs), and attending physicians. A total of 169 patients were reviewed. Of these, 31 patients had a fellow, 39 had an APP, and 99 had an attending as their primary oncology provider. Fellows and attending physicians performed similarly on 90 of 94 QOPI metrics. High-performing metrics included several core QOPI measures including documenting consent for chemotherapy, recommending adjuvant chemotherapy when appropriate, and prescribing serotonin antagonists when prescribing emetogenic chemotherapies. Low-performing metrics included documentation of treatment summary and taking action to address problems with emotional well-being by the second office visit. Attendings documented the plan for oral chemotherapy more often (92 vs. 63%, P=0.049). However, after the chart audit, we found that fellows actually documented the plan for oral chemotherapy 88% of the time (p=0.73). APPs and attendings performed similarly on 88 of 90 QOPI measures. The quality of oncology care tends to be similar between attendings and fellows overall; some of the significant differences do not remain significant after a second manual chart review, highlighting that the use of manual data collection for QOPI analysis is an imperfect system, and there may

  18. Delta's Key to the TOEFL iBT[R]: Advanced Skill Practice. Revised Edition

    ERIC Educational Resources Information Center

    Gallagher, Nancy

    2012-01-01

    Delta's Key to the TOEFL iBT: Advanced Skill Practice is a revised and updated edition of Delta's Key to the Next Generation TOEFL Test. Since the introduction of the TOEFL iBT in 2005, there have been significant changes to some of the test questions, particularly the integrated writing and integrated speaking tasks. The new 2011 edition of…

  19. Advances in circulating tumor cells (ACTC): from basic research to clinical practice

    PubMed Central

    2013-01-01

    The first 'Advances in Circulating Tumor Cells (ACTC): from Basic Research to Clinical Practice' meeting was held in Athens, Greece, September 26–29, 2012 (abstracts, presentations and a more detailed meeting report are freely available online: http://www.actc2012.org). We summarize in this report most major findings presented and the main conclusions derived during the expert panel sessions. PMID:24314311

  20. Literacy Agents Online: E-Discussion Forums for Advancing Adults' Literacy Practices

    ERIC Educational Resources Information Center

    Guzzetti, Barbara J.; Foley, Leslie M.

    2014-01-01

    This study explored how adults used a self-selected online forum to advance their own and others' literacy practices. The study was a discourse-centered online ethnography using triangulated methods, including analysis of list archives, semi-structured and informal interviews, and document collection. These data were analyzed by discourse…

  1. Enhancing Success in Advanced Practice Nursing: a grant-funded project.

    PubMed

    McNeal, Gloria J; Walker, Donita

    2006-01-01

    The Enhancing Success in Advanced Practice Nursing (ESAPN) Project is designed to improve access to a diverse and culturally competent and sensitive health professions workforce by increasing the number of Hispanic, African-American and Asian nurses recruited, enrolled in and graduated from the MSN program at the University of Medicine and Dentistry of New Jersey-School of Nursing (UMDNJ-SN). In addition, the project plan includes the development and implementation of a comprehensive program that incorporates academic support services, career advisement and mentoring activities to retain and graduate an increased number of culturally, racially and ethnically diverse advanced practice nurses for the State of New Jersey. The project also seeks to improve the quality of care by preparing advanced practice nurses to provide culturally competent and sensitive care by assuring that the MSN curriculum includes content and clinical experiences relevant to the development of cultural competence. Faculty participation in workshops, designed to increase knowledge of cultural competence, is a key component. The success of the project will be evaluated using a variety of measures that track increases in the number of diverse students recruited and enrolled, the number of students accessing services associated with the ESAPN program, and increased retention and graduation of Hispanic, African-American and Asian nurses prepared as advanced practice nurses.

  2. A Qualitative Analysis of an Advanced Practice Nurse-Directed Transitional Care Model Intervention

    ERIC Educational Resources Information Center

    Bradway, Christine; Trotta, Rebecca; Bixby, M. Brian; McPartland, Ellen; Wollman, M. Catherine; Kapustka, Heidi; McCauley, Kathleen; Naylor, Mary D.

    2012-01-01

    Purpose: The purpose of this study was to describe barriers and facilitators to implementing a transitional care intervention for cognitively impaired older adults and their caregivers lead by advanced practice nurses (APNs). Design and Methods: APNs implemented an evidence-based protocol to optimize transitions from hospital to home. An…

  3. Addressing Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome in Advanced Practice Nursing Education.

    ERIC Educational Resources Information Center

    Nokes, Kathleen M.; Stein, Gary L.

    1997-01-01

    A survey of 23 advanced practice nursing programs showed only 3 had HIV-specific graduate-level nursing courses. Recommendations were made for HIV-specific courses, integration of HIV content into other courses, use of Centers for Disease Control and Occupational Safety and Health Administration guidelines, and subspecialties in HIV nursing. (SK)

  4. A survey of role diversity among advanced practice nurses in pediatric gastroenterology.

    PubMed

    McDuffie, Adelina F; Huffman, Shari

    2005-01-01

    A survey of advanced practice nurses in the Association of Pediatric Gastroenterology and Nutrition Nurses (APGNN) was conducted to assess role diversity in anticipation of sharing these results with our international colleagues at the World Congress in 2004. A single-page, 14-item survey was sent via e-mail or fax to 79 APGNN advanced practice nurses identified by their credentials (MS, PNP, FNP) in the membership database. Forty surveys were returned via e-mail or fax for an overall response rate of 51%. Most reported working full time as nurse practitioners in an outpatient gastrointestinal clinic, yet almost one third were hospital based. Additional job titles included clinical nurse specialist, researcher, and case manager or clinical coordinator. Slightly more than one half reported seeing any patients in their outpatient practice, whereas 43% saw specific populations, with constipation, gastroesophageal reflux, and abdominal pain being the most common diagnoses. Seventy percent had prescriptive privileges. Billing practices were the most diverse, with 30% always billing under their own number, 23% sometimes billing under their own number, and 40% never billing under their own number (5% not applicable). Overall, most advanced practice nurses in APGNN are pediatric nurse practitioners with a primary focus on outpatient care but also are involved in patient and family teaching, nutrition support, home care, and research. Only a few were involved with procedures, which may be surprising to our adult counterparts.

  5. International Society for Advancement of Cytometry (ISAC) flow cytometry shared resource laboratory (SRL) best practices.

    PubMed

    Barsky, Lora W; Black, Michele; Cochran, Matthew; Daniel, Benjamin J; Davies, Derek; DeLay, Monica; Gardner, Rui; Gregory, Michael; Kunkel, Desiree; Lannigan, Joanne; Marvin, James; Salomon, Robert; Torres, Carina; Walker, Rachael

    2016-11-01

    The purpose of this document is to define minimal standards for a flow cytometry shared resource laboratory (SRL) and provide guidance for best practices in several important areas. This effort is driven by the desire of International Society for the Advancement of Cytometry (ISAC) members in SRLs to define and maintain standards of excellence in flow cytometry, and act as a repository for key elements of this information (e.g. example SOPs/training material, etc.). These best practices are not intended to define specifically how to implement these recommendations, but rather to establish minimal goals for an SRL to address in order to achieve excellence. It is hoped that once these best practices are established and implemented they will serve as a template from which similar practices can be defined for other types of SRLs. Identification of the need for best practices first occurred through discussions at the CYTO 2013 SRL Forum, with the most important areas for which best practices should be defined identified through several surveys and SRL track workshops as part of CYTO 2014. © 2016 International Society for Advancement of Cytometry.

  6. [Chronic diseases and complexity: new roles in nursing. Advanced practice nurses and chronic patient].

    PubMed

    Sánchez-Martín, C Inmaculada

    2014-01-01

    The increase in chronic diseases and the progressive ageing of the population is a source of concern for the different agencies with responsibility for health care. This has led to the creation of many documents focused on the analysis of the current situation and care of chronic diseases, including the WHO recommendations intended to assist countries and health services design and implement strategies that will address the existing demand, control and prevention of chronic diseases. In addition, there is a need to respond to the demand generated by chronic diseases in every sense, and from the different systems it is becoming more difficult to get enough support from multidisciplinary teams where the nurse has a central importance. While chronic diseases are becoming a threat due to the costs they generate, it is also an opportunity for nursing to be at the forefront for advanced care requirements, performed by professionals with recognized advanced clinical skills and ability for case management while monitoring and controlling complex chronic patients. The different services of the National Health System have introduced nurses that play different roles (cases managers, liaison nurses, advanced practice nurses and so on). However, it could be argued that they are not being trained to a desirable development level. It is therefore time for health care authorities to determine the role of the advanced practice nurse in relation to functional positions, and allow them to make an advance in the development of unified skills for the whole National Health System. From our experience we have learned that the advanced practice nurse is a resource that helps in the sustainability of services, thanks to the efficiency shown in the results obtained from the care given to both chronic and complex chronic patients.

  7. Capacity Ratios to Assess the Solvency of a College’s Advanced Pharmacy Practice Experience Program

    PubMed Central

    McClellan, Nicole H.; Byrd, Debbie C.

    2013-01-01

    Objective. To use the capacity ratio to determine solvency in 10 advanced pharmacy practice experiences (APPEs) offered by a college of pharmacy. Methods. Availability in each APPE was determined based on preceptor responses, and student need was tabulated from 3 preference forms. Capacity ratios were calculated by dividing preceptor availability by the sum of student requests plus 20% of student requests; ratios ≥ 1 indicated solvency. For the 3 required APPEs, minimum capacity ratios were calculated by dividing availability by the sum of student number plus 20% of the student number. When possible, the capacity ratio for the APPE was calculated by geographic zone. Results. The 3 required APPEs had statewide minimum capacity ratios that were consistent with solvency: advanced community (2.8), advanced institutional (1.6), and ambulatory care (2.5). Only 3 of 7 elective APPEs demonstrated solvency. The elective APPEs for which requests exceeded availability were association management (0.8), emergency medicine (0.8), cardiology (0.6), and human immunodeficiency virus (HIV) ambulatory care clinic (0.4). Analysis by zone revealed additional insolvent practice experiences in some locations. Conclusions. The capacity ratio allowed for assessment of 10 APPEs and identification of practice experience areas that need expansion. While the capacity ratio is a proposed standardized assessment, it does have some limitations, such as an inability to account for practice experience quality, scheduling conflicts, and geographic zone issues. PMID:23519687

  8. Registers for Networked Medical Research in Germany

    PubMed Central

    Stausberg, J.; Altmann, U.; Antony, G.; Drepper, J.; Sax, U.; Schütt, A.

    2010-01-01

    Background Several disease specific registers are operated by members of the ‘TMF – Technology, Methods, and Infrastructure for Networked Medical Research’, an umbrella organization of research networks in Germany. Objective To describe the coverage and the current state as well as financial and organizational issues of registers operated by member networks of the TMF, to identify their requirements and needs, and to recommend best practice models. Methods A survey with a self-completion questionnaire including all 55 TMF member networks was carried out in winter 2007/2008. Interviews focusing on technological issues were conducted and analyzed in summer 2009 with a convenience sample of 10 registers. Results From 55 TMF member networks, 11 provided information about 14 registers. Six registers address diseases of the circulatory system with more than 150,000 registered patients. The interviews revealed a typical setting of “research registers”. Research registers are an important mean to generate hypotheses for clinical research, to identify eligible patients, and to share data with clinical trials. Concerning technical solutions, we found a remarkable heterogeneity. The analysis of the most efficient registers revealed a structure with five levels as best practice model of register management: executive, operations, IT-management, software, hardware. Conclusion In the last ten years, the TMF member networks established disease specific registers in Germany mainly to support clinical research. The heterogeneity of organizational and technical solutions as well as deficits in register planning motivated the development of respective recommendations. The TMF will continue to assist the registers in quality improvement. PMID:23616850

  9. Optimizing Music Learning: Exploring How Blocked and Interleaved Practice Schedules Affect Advanced Performance

    PubMed Central

    Carter, Christine E.; Grahn, Jessica A.

    2016-01-01

    Repetition is the most commonly used practice strategy by musicians. Although blocks of repetition continue to be suggested in the pedagogical literature, work in the field of cognitive psychology suggests that repeated events receive less processing, thereby reducing the potential for long-term learning. Motor skill learning and sport psychology research offer an alternative. Instead of using a blocked practice schedule, with practice completed on one task before moving on to the next task, an interleaved schedule can be used, in which practice is frequently alternated between tasks. This frequent alternation involves more effortful processing, resulting in increased long-term learning. The finding that practicing in an interleaved schedule leads to better retention than practicing in a blocked schedule has been labeled the “contextual interference effect.” While the effect has been observed across a wide variety of fields, few studies have researched this phenomenon in a music-learning context, despite the broad potential for application to music practice. This study compared the effects of blocked and interleaved practice schedules on advanced clarinet performance in an ecologically valid context. Ten clarinetists were given one concerto exposition and one technical excerpt to practice in a blocked schedule (12 min per piece) and a second concerto exposition and technical excerpt to practice in an interleaved schedule (3 min per piece, alternating until a total of 12 min of practice were completed on each piece). Participants sight-read the four pieces prior to practice and performed them at the end of practice and again one day later. The sight-reading and two performance run-throughs of each piece were recorded and given to three professional clarinetists to rate using a percentage scale. Overall, whenever there was a ratings difference between the conditions, pieces practiced in the interleaved schedule were rated better than those in the blocked schedule

  10. Advancing the practice of health impact assessment in Canada: Obstacles and opportunities

    SciTech Connect

    McCallum, Lindsay C.; Ollson, Christopher A.; Stefanovic, Ingrid L.

    2015-11-15

    Health Impact Assessment (HIA) is recognized as a useful tool that can identify potential health impacts resulting from projects or policy initiatives. Although HIA has become an established practice in some countries, it is not yet an established practice in Canada. In order to enable broader support for HIA, this study provides a comprehensive review and analysis of the peer-reviewed and gray literature on the state of HIA practice. The results of this review revealed that, although there is an abundance of publications relating to HIA, there remains a lack of transparent, consistent and reproducible approaches and methods throughout the process. Findings indicate a need for further research and development on a number of fronts, including: 1) the nature of HIA triggers; 2) consistent scoping and stakeholder engagement approaches; 3) use of evidence and transparency of decision-making; 4) reproducibility of assessment methods; 5) monitoring and evaluation protocols; and, 6) integration within existing regulatory frameworks. Addressing these issues will aid in advancing the more widespread use of HIA in Canada. - Highlights: • Reviewed current state of practice in the field of HIA • Identified key obstacles and opportunities for HIA advancement • Major issues include lack of consistent approach and methodology. • No national regulatory driver hinders opportunity for widespread use of HIA. • Identified research opportunities vital to developing HIA practice in Canada.

  11. Developing a professional poster: four "ps" for advanced practice nurses to consider.

    PubMed

    Bindon, Susan L; Davenport, Joan M

    2013-01-01

    Professional posters play an important role in the dissemination of knowledge and the professional development of advanced practice nurses, graduate students, and clinical faculty. Posters should be considered an integral component in communication of professional work in practice, research, and education. The invitation to submit a poster abstract is an important opportunity for clinicians and faculty alike to consider. Though sometimes misperceived as less prestigious than a podium presentation, posters add a unique element to professional and academic events. The argument is made for posters as an equal among scholarly presentation formats. The poster serves as a tremendous opportunity for collaboration between partners and a way to communicate important findings and advertise the presenters' work. For the advanced practice nurse who is a novice in presenting best practice or evidence from research trials, the poster format may be less intimidating while allowing the invaluable sharing of results. Four critical elements of professional poster development are deciding on a clear Purpose, targeting the right People, outlining key steps in the Process, and delivering a memorable Presentation. Using the "4 Ps" as cornerstones for the work of developing, preparing, and delivering the poster to an audience, the authors aim to help organize the entire process into these essential considerations. The poster, as a means of scholarly work, is a viable and essential activity, as interdisciplinary collaboration and sharing of best practice becomes the expectation for all professional development.

  12. Oncology Gold Standard™ practical consensus recommendations 2016 for treatment of advanced clear cell renal cell carcinoma

    PubMed Central

    Batra, U; Parikh, PM; Prabhash, K; Tongaonkar, HB; Chibber, P; Dabkara, D; Deshmukh, C; Ghadyalpatil, N; Hingmire, S; Joshi, A; Raghunath, SK; Rajappa, S; Rajendranath, R; Rawal, SK; Singh, Manisha; Singh, R; Somashekhar, SP; Sood, R

    2016-01-01

    The Oncology Gold Standard (OGS) Expert Group on renal cell carcinoma (RCC) developed the consensus statement to provide community oncologists practical guidelines on the management of advanced clear cell (cc) RCC using published evidence, practical experience of experts in real life management, and results of a nationwide survey involving 144 health-care professionals. Six broad question categories containing 33 unique questions cover major situations in the routine management of RCC. This document serves as a ready guide for the standard of care to optimize outcome. The table of “Take Home Messages” at the end is a convenient tool for busy practitioners. PMID:28032079

  13. On Vocal Registers.

    ERIC Educational Resources Information Center

    Hollien, Harry

    A vocal register is a series or range of consecutive frequencies that can be produced with nearly identical voice quality. On the basis of research three fundamental registers can be defined and described: pulse, a low range of phonation; modal, a middle or "normal" range; and loft, a high range, described by some as falsetto. These…

  14. Registered Nurse (Associate Degree).

    ERIC Educational Resources Information Center

    Ohio State Univ., Columbus. Center on Education and Training for Employment.

    This document, which is designed for use in developing a tech prep competency profile for the occupation of registered nurse (with an associate degree), lists technical competencies and competency builders for 19 units pertinent to the health technologies cluster in general and 5 units specific to the occupation of registered nurse. The following…

  15. Evidence based practice and advanced competencies in a MHS-CLS program.

    PubMed

    Russell, Barbara; Kraj, Barbara; Pretlow, Lester; Ranne, Anne; Leibach, Elizabeth K

    2011-01-01

    The goals, curriculum, implementation, and immediate impacts of an entry-level Master of Health Science in Clinical Laboratory Science (MHS-CLS) degree are described as compared to the baccalaureate program (BS-CLS) in the same institution. The MHS-CLS program was instituted in fall semester, 2008; the inaugural class graduated in spring semester 2010. To document the need for the MHS-CLS, program statistics, such as the number of students entering the current BS-CLS program with previous baccalaureate degrees, numbers of students graduating with biology and chemistry degrees in the United States, CLS workforce shortages and pending retirement statistics were used. The shortage of CLS practitioners able to perform and publish evidence-based practice research also supported program need. The MHS-CLS curriculum includes advanced courses, advanced competencies incorporated into existing BS-CLS courses, and a capstone research project in evidence based practice.

  16. Infusing informatics into interprofessional education: the iTEAM (Interprofessional Technology Enhanced Advanced practice Model) project.

    PubMed

    Skiba, Diane J; Barton, Amy J; Knapfel, Sarah; Moore, Gina; Trinkley, Katy

    2014-01-01

    The iTEAM goal is to prepare advanced practice nurses, physicians and pharmacists with the interprofessional (IP) core competencies (informatics, patient centric, quality-focused, evidence based care) to provide technology enhanced collaborative care by: offering technology enhanced learning opportunities through a required informatics course, advanced practice courses (team based experiences with both standardized and virtual patients) and team based clinical experiences including e-health experiences. The innovative features of iTEAM project will be achieved through use of social media strategies, a web accessible Electronic Health Records (EHRs) system, a Virtual Clinic/Hospital in Second Life, various e-health applications including traditional telehealth tools and consumer oriented tools such as patient portals, social media consumer groups and mobile health (m-health) applications for health and wellness functions. It builds upon the schools' rich history of IP education and includes clinical partners, such as the VA and other clinical sites focused on care for underserved patient populations.

  17. Implications for Advanced Nursing Practice in the Patient with Heat Stress

    DTIC Science & Technology

    1993-05-01

    systemic vascular resistance), while elderly patients are hypodynamic (increased heart rate, decreased cardiac output and decreased systemic vascular...resistance). By the time elderly patients are seen, massive volume deficits may exist, requiring hemodynamic monitoring to differentiate pump...TITLE AND SUBTITLE 5. FUNDING NUMBERS Implications for Advanced Nursing Practice in the Patient with Heat Stress 6. AUTHOR(S) Patricia A Skelton S 7

  18. Developing Structured-Learning Exercises for a Community Advanced Pharmacy Practice Experience

    PubMed Central

    Thomas, Renee Ahrens

    2006-01-01

    The recent growth in the number of pharmacy schools across the nation has resulted in the need for high-quality community advanced pharmacy practice experience (APPE) sites. A vital part of a student's education, these APPEs should be structured and formalized to provide an environment conducive to student learning. This paper discusses how to use a calendar, structured-learning activities, and scheduled evaluations to develop students' knowledge, skills, and abilities in a community pharmacy setting. PMID:17136164

  19. Advanced practice nursing for enduring health needs management: a global perspective.

    PubMed

    Koskinen, Liisa; Mikkonen, Irma; Graham, Iain; Norman, Linda D; Richardson, Jim; Savage, Eileen; Schorn, Mavis

    2012-07-01

    Advanced practice nursing expertise has been acknowledged worldwide as one response to the challenges arising from changes in society and health care. The roots of advanced practice nursing education are at the University of Colorado where the first known programme started in 1965. In many countries advanced practice nurses (APNs) have taken responsibility for routine patient care formerly carried out by physicians in order to reduce their workload. However, more and more, APNs have taken responsibility for new service areas and quality programmes not previously provided. Chronic disease management is one of these new service areas because long-term diseases are increasingly challenging service systems globally. This article is based on an international APN partnership. The aim of the article is to describe how the partnership will design a 15 ECTS credit course on Enduring Health Need Management as a cross-cultural collaborative endeavour. The adaptation of an inquiry based learning framework will be described drawing on four main principles of the theory: authentic learning communities; student encouragement in analysing gradually more complicated problems; networking in knowledge creation and; student engagement and activity. The cross-cultural online course aims to increase APNs' intercultural competence as well as their global and international work orientation.

  20. A descriptive study of point-of-care reference resource use by advanced practice RNs in Texas.

    PubMed

    Bischoff, Whitney Rogers; Hinojosa, Rogelio H

    2013-11-01

    This descriptive study replicates and extends previous research on advanced practice RNs and the (1) reference resources available to them at the point of care, (2) resources they use to inform their clinical practice, and (3) resources they are accessing from handheld electronic devices such as PDAs, smartphones, and tablet computers during practice. These elements formed the purpose of the current study. A sample of advanced practice RNs from Texas Public Health Region 11 was surveyed. Available resources were current journals appropriate to setting and current clinical guidelines. These advanced practice RNs "always or frequently" based their professional practice on personal experience of caring for patients/clients over time, information learned in college/university, and information learned about each patient/client as an individual. Responses for Hispanic respondents as well as electronic device users were similar. Content and features accessed daily by handheld computer devices were reference materials, e-mail, address/phonebook, Internet access other than e-mail, calendar/date book, alarm/reminder, calculator, and memo pad. Software installed on handheld devices and used daily included drug references, medical text/reference book, medical math/formula calculator, practice guidelines, and language translator/dictionary. Respondents who did not report using handheld devices at work were older, had more years in advanced practice nursing, and were more likely to work in a hospital, birthing center, or institution such as a prison, school, or military facility. There was no difference in resource or electronic device use by Hispanic advanced practice RNs. Electronic resources for practice are growing and being used by advanced practice RNs. Consideration should be given to incorporating evaluation and implementation of electronic clinical resources into advanced practice RN educational programs. Future research should include greater detail about the origin of

  1. American Society for Parenteral and Enteral Nutrition and Academy of Nutrition and Dietetics: Revised 2014 Standards of Practice and Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Nutrition Support.

    PubMed

    Brantley, Susan L; Russell, Mary K; Mogensen, Kris M; Wooley, Jennifer A; Bobo, Elizabeth; Chen, Yimin; Malone, Ainsley; Roberts, Susan; Romano, Michelle M; Taylor, Beth

    2014-12-01

    This 2014 revision of the Standards of Practice (SOP) and Standards of Professional Performance (SOPP) for Registered Dietitians Nutritionists (RDNs) in Nutrition Support represents an update of the 2007 Standards composed by content experts of the American Society for Parenteral and Enteral Nutrition and the Academy of Nutrition and Dietetics. The revision is based upon the Revised 2012 SOP in Nutrition Care and SOPP for RDs, which incorporates the Nutrition Care Process and the six domains of professionalism: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. These SOP and SOPP are designed to promote the provision of safe, effective, and efficient nutrition support services, facilitate evidence-based practice, and serve as a professional evaluation resource for RDNs who specialize or wish to specialize in nutrition support therapy. These standards should be applied in all patient/client care settings in which RDNs in nutrition support provide care. These settings include, but are not limited to, acute care, ambulatory/outpatient care, and home and alternate site care. The standards highlight the value of the nutrition support RDN's roles in quality management, regulatory compliance, research, teaching, consulting, and writing for peer-reviewed professional publications. The standards assist the RDN in nutrition support to distinguish his or her level of practice (competent, proficient, or expert) and would guide the RDN in creating a personal development plan to achieve increasing levels of knowledge, skill, and ability in nutrition support practice.

  2. Training Advanced Practice Providers to Collect Functional Outcomes After Fragility Fractures

    PubMed Central

    Wang, Tiffany L.; Ames, Tyler D.; Le, Khoi M.; Wee, Corinne; Phieffer, Laura S.

    2015-01-01

    Objective: The objective of this study was to determine whether advanced practice providers could learn to collect objective functional assessment data accurately and efficiently with commercially available devices that measure kinematics and kinetics (Nintendo Wii Balance Board [WBB] and Level Belt [LB]) to aid in the assessment of fall risk and outcomes after fragility fractures. Methods: Nine advanced practice providers participated in a 1-hour clinical assessment tools (CATs) training session on equipment use, providing standardized instructions, and practice of the testing procedures. Afterward, they participated in a skills demonstration evaluation and completed a postsession survey. Results: Participants successfully achieved a mean of 18.22 (standard deviation 1.56) of 20 performance measures. Of the incomplete or omitted tasks, the majority (10 of 16) occurred within the first of 3 CATs activities. Postsession survey results revealed that 9 of 9 participants reported that the 1 hour provided for training on the CATs was sufficient. All participants reported that after the training, they felt confident they could reliably carry out the tasks to test patients on both the WBB and the LB. The majority of participants reported that they believed that the WBB (7 of 9) and LB (8 out of 9) would be good assets to clinics in assessing patient functionality after fragility fractures. Conclusion: These results indicate that advanced practice providers can confidently learn and effectively test patients with the WBB and LB within 1 hour of training. In the future, adoption of CATs in the clinical setting may allow for objective, easy-to-use, portable, noninvasive, and relatively inexpensive measures to assess functional outcomes in patients with fragility fracture. PMID:26328225

  3. Attitude, Knowledge, and Practice on Evidence-Based Nursing among Registered Nurses in Traditional Chinese Medicine Hospitals: A Multiple Center Cross-Sectional Survey in China

    PubMed Central

    Hao, Yufang; Guo, Hong

    2016-01-01

    Objective. This study was to describe RNs' attitude, knowledge, and practice on evidence-based practice (EBP) in traditional Chinese nursing field and to estimate the related sociodemographic and professional factors. Methods. A multiple institutional cross-sectional survey design with self-reported EBP Questionnaire (EBPQ) and self-designed questionnaires were used. Results. The average scores of the total EBPQ were with a mean of 4.24 (SD = 0.79). The score of attitude was the highest one, followed by the knowledge score, and the lowest one is practice. RNs with longer experience reported stronger EBP knowledge (H = 6.64, P < 0.05). And RNs under higher working pressure reported less positive attitudes (ρ = 0.17, P < 0.001), whereas RNs holding negative professional attitude reported lower scores (Spearman's ρ: 0.12 to 0.15, P < 0.001). Significant statistics were found between RNs with research experience and without in attitude (t = −2.40, P < 0.05) and knowledge (t = −2.43, P < 0.05). Conclusions. Respondents generally viewed EBP positively and their attitudes towards EBP tended to be more positive than knowledge and practice of EBP. Data also showed that longer working experience, having administrative position, research experience, lighter working load, and better professional attitude might facilitate EBP. PMID:27528882

  4. Improved feedback shift register

    NASA Technical Reports Server (NTRS)

    Perlman, M.

    1972-01-01

    Design of feedback shift register with three tap feedback decoding scheme is described. Application for obtaining sequence synchronization patterns is examined. Operation of the circuitry is described and drawings of the systems are included.

  5. Molecular Electronic Shift Registers

    NASA Technical Reports Server (NTRS)

    Beratan, David N.; Onuchic, Jose N.

    1990-01-01

    Molecular-scale shift registers eventually constructed as parts of high-density integrated memory circuits. In principle, variety of organic molecules makes possible large number of different configurations and modes of operation for such shift-register devices. Several classes of devices and implementations in some specific types of molecules proposed. All based on transfer of electrons or holes along chains of repeating molecular units.

  6. 49 CFR 1103.1 - Register of practitioners.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 8 2014-10-01 2014-10-01 false Register of practitioners. 1103.1 Section 1103.1... OF TRANSPORTATION RULES OF PRACTICE PRACTITIONERS General Information § 1103.1 Register of practitioners. The Board maintains a register containing the names of all non-attorneys entitled to...

  7. 49 CFR 1103.1 - Register of practitioners.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 8 2012-10-01 2012-10-01 false Register of practitioners. 1103.1 Section 1103.1... OF TRANSPORTATION RULES OF PRACTICE PRACTITIONERS General Information § 1103.1 Register of practitioners. The Board maintains a register containing the names of all non-attorneys entitled to...

  8. 49 CFR 1103.1 - Register of practitioners.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 8 2013-10-01 2013-10-01 false Register of practitioners. 1103.1 Section 1103.1... OF TRANSPORTATION RULES OF PRACTICE PRACTITIONERS General Information § 1103.1 Register of practitioners. The Board maintains a register containing the names of all non-attorneys entitled to...

  9. 49 CFR 1103.1 - Register of practitioners.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 8 2010-10-01 2010-10-01 false Register of practitioners. 1103.1 Section 1103.1... OF TRANSPORTATION RULES OF PRACTICE PRACTITIONERS General Information § 1103.1 Register of practitioners. The Board maintains a register containing the names of all non-attorneys entitled to...

  10. 49 CFR 1103.1 - Register of practitioners.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 8 2011-10-01 2011-10-01 false Register of practitioners. 1103.1 Section 1103.1... OF TRANSPORTATION RULES OF PRACTICE PRACTITIONERS General Information § 1103.1 Register of practitioners. The Board maintains a register containing the names of all non-attorneys entitled to...

  11. [Challenges and opportunities: contributions of the Advanced Practice Nurse in the chronicity. Learning from experiences].

    PubMed

    Appleby, Christine; Camacho-Bejarano, Rafaela

    2014-01-01

    Undoubtedly, our society is facing new economic, political, demographic, social and cultural challenges that require healthcare services able to meet the growing health needs of the population, especially in dealing with chronic conditions. In this new context, some countries such as the United Kingdom have made a firm commitment to develop new models for chronic patients care based on the introduction of new figures of Advanced Practice Nurses, which includes 4 cornerstones of professional practice: advanced clinical skills, clinical management, teaching and research. The implementation of this new figures implies a redefinition of professional competencies and has its own accreditation system and a specific catalogue of services adapted to the population requirements, in order to provide chronic care support from Primary Care settings. This trajectory allows us analysing the process of design and implementation of these new models and the organizational structure where it is integrated. In Spain, there are already experiences in some regions such as Andalucia and the Basque Country, focused on the creation of new advanced nursing roles. At present, it is necessary to consider suitable strategic proposals for the complete development of these models and to achieve the best results in terms of overall health and quality of life of patients with chronic conditions, improving the quality of services and cost-effectiveness through a greater cohesion and performance of healthcare teams towards the sustainability of healthcare services and patient satisfaction.

  12. Current Practices in Global/International Advanced Pharmacy Practice Experiences: Home/Host Country or Site/Institution Considerations.

    PubMed

    Alsharif, Naser Z; Dakkuri, Adnan; Abrons, Jeanine P; Williams, Dennis; Ombengi, David N; Zheng, HaiAn; Al-Dahir, Sara; Tofade, Toyin; Gim, Suzanna; O'Connell, Mary Beth; Ratka, Anna; Dornblaser, Emily

    2016-04-25

    International outreach by schools and colleges of pharmacy is increasing. In this paper, we provide current practice guidelines to establish and maintain successful global/international advanced pharmacy practice experiences (G/I APPEs) with specific recommendations for home/host country and host site/institution. The paper is based on a literature review (2000-2014) in databases and Internet searches with specific keywords or terms. Educational documents such as syllabi and memoranda of understanding (MoUs) from pharmacy programs were also examined. In addition, a preliminary draft was developed and the findings and recommendations were reviewed in a 90-minute roundtable discussion at the 2014 American Association of Colleges of Pharmacy Annual Meeting. Recommendations for the host country include travel considerations (eg, passport, visa, air travel), safety, housing, transportation, travel alerts and warnings, health issues, and financial considerations. For the home country, considerations for establishment of G/I APPE site (eg, vetting process, MoU, site expectations) are described. The paper is a resource for development of new G/I APPEs and provides guidance for continuous quality improvement of partnerships focusing on G/I pharmacy education.

  13. Current Practices in Global/International Advanced Pharmacy Practice Experiences: Home/Host Country or Site/Institution Considerations

    PubMed Central

    Dakkuri, Adnan; Abrons, Jeanine P.; Williams, Dennis; Ombengi, David N.; Zheng, HaiAn; Al-Dahir, Sara; Tofade, Toyin; Gim, Suzanna; O’Connell, Mary Beth; Ratka, Anna; Dornblaser, Emily

    2016-01-01

    International outreach by schools and colleges of pharmacy is increasing. In this paper, we provide current practice guidelines to establish and maintain successful global/international advanced pharmacy practice experiences (G/I APPEs) with specific recommendations for home/host country and host site/institution. The paper is based on a literature review (2000-2014) in databases and Internet searches with specific keywords or terms. Educational documents such as syllabi and memoranda of understanding (MoUs) from pharmacy programs were also examined. In addition, a preliminary draft was developed and the findings and recommendations were reviewed in a 90-minute roundtable discussion at the 2014 American Association of Colleges of Pharmacy Annual Meeting. Recommendations for the host country include travel considerations (eg, passport, visa, air travel), safety, housing, transportation, travel alerts and warnings, health issues, and financial considerations. For the home country, considerations for establishment of G/I APPE site (eg, vetting process, MoU, site expectations) are described. The paper is a resource for development of new G/I APPEs and provides guidance for continuous quality improvement of partnerships focusing on G/I pharmacy education. PMID:27170809

  14. Pharmacy Student Learning During Advanced Pharmacy Practice Experiences in Relation to the CAPE 2013 Outcomes

    PubMed Central

    May, Dianne W.; Kanmaz, Tina J.; Reidt, Shannon L.; Serres, Michelle L.; Edwards, Heather D.

    2016-01-01

    Outcomes from The Center for Advancement of Pharmacy Education (CAPE) are intended to represent the terminal knowledge, skills, and attitudes pharmacy students should possess and have guided delivery of pharmacy education for more than two decades. Advanced pharmacy practice experiences (APPEs) are the endpoint of pharmacy curricula where demonstration and assessment of terminal learning occurs. This review examines published literature in relation to the most recent CAPE outcomes to determine the extent to which they have been addressed during APPEs since 1996. Details related to the APPE focus, intervention(s)/learning setting(s), and assessments are summarized according to the 15 CAPE outcomes. Further, the assessments are categorized according to the level of learning achieved using an available method. Common CAPE outcomes are highlighted, as well as those for which published reports are lacking for APPEs. The range and quality of assessments are discussed and emphasize the need for continuous improvement of scholarly design and assessment. PMID:27756935

  15. Pioneering a National Advanced Practice Leadership Council to Enhance Care Delivery in a Large 19-State Health System.

    PubMed

    Harms, Dixie; Ewen, Julianne Z; Metsker, Matt; Swanson, Jay; Oas, Kimberly H

    This article describes an innovative approach to enhancing the capacity of advanced practice clinicians (APCs) in a large faith-based health system consisting of multiple markets across the United States. With the challenges in health care today, promotion of advanced practice is vital to increasing quality and access to care while maintaining cost-effectiveness. The development of a national Advanced Practice Leadership Council led by the Vice President of Advanced Practice at Catholic Health Initiatives has been a progressive approach in mitigating the challenges facing APCs in today's health care arena. The success of the Council has led to its inclusion on the health system's national clinical governance structure. The authors discuss development of the Council along with specific information regarding various committee work, including APC state regulations, delineation of privileges, quality measures, and total compensation.

  16. Advanced Energy Retrofit Guide: Practical Ways to Improve Energy Performance; Grocery Stores (Revised) (Book)

    SciTech Connect

    Hendron, B.

    2013-07-01

    The U.S. Department of Energy developed the Advanced Energy Retrofit Guides (AERGs) to provide specific methodologies, information, and guidance to help energy managers and other stakeholders successfully plan and execute energy efficiency improvements. Detailed technical discussion is fairly limited in these guides. Instead, we emphasize actionable information, practical methodologies, diverse case studies, and unbiased evaluations of the most promising retrofit measures for each building type. A series of AERGs is under development, addressing key segments of the commercial building stock. Grocery stores were selected as one of the highest priority sectors, because they represent one of the most energy-intensive market segments.

  17. Advancing Research and Practice: The Revised APA Division 30 Definition of Hypnosis.

    PubMed

    Elkins, Gary R; Barabasz, Arreed F; Council, James R; Spiegel, David

    2015-04-01

    This article describes the history, rationale, and guidelines for developing a new definition of hypnosis by the Society of Psychological Hypnosis, Division 30 of the American Psychological Association. The definition was developed with the aim of being concise, being heuristic, and allowing for alternative theories of the mechanisms (to be determined in empirical scientific study). The definition of hypnosis is presented as well as definitions of the following related terms: hypnotic induction, hypnotizability, and hypnotherapy. The implications for advancing research and practice are discussed. The definitions are presented within the article.

  18. Culture care theory: a major contribution to advance transcultural nursing knowledge and practices.

    PubMed

    Leininger, Madeleine

    2002-07-01

    This article is focused on the major features of the Culture Care Diversity and Universality theory as a central contributing theory to advance transcultural nursing knowledge and to use the findings in teaching, research, practice, and consultation. It remains one of the oldest, most holistic, and most comprehensive theories to generate knowledge of diverse and similar cultures worldwide. The theory has been a powerful means to discover largely unknown knowledge in nursing and the health fields. It provides a new mode to assure culturally competent, safe, and congruent transcultural nursing care. The purpose, goal, assumptive premises, ethnonursing research method, criteria, and some findings are highlighted.

  19. Advancing research and practice: the revised APA Division 30 definition of hypnosis.

    PubMed

    Elkins, Gary R; Barabasz, Arreed F; Council, James R; Spiegel, David

    2015-01-01

    This article describes the history, rationale, and guidelines for developing a new definition of hypnosis by the Society of Psychological Hypnosis, Division 30 of the American Psychological Association. The definition was developed with the aim of being concise, heuristic, and allowing for alternative theories of the mechanisms (to be determined in empirical scientific study). The definition of hypnosis is presented as well as definitions of the following related terms: hypnotic induction, hypnotizability, and hypnotherapy. The implications for advancing research and practice are discussed. The definitions are presented within the article.

  20. Advanced Energy Retrofit Guide: Practical Ways to Improve Energy Performance, K-12 Schools (Book)

    SciTech Connect

    Not Available

    2013-02-01

    The U.S. Department of Energy developed the K-12 Advanced Energy Retrofit Guide to provide specific methodologies, information, and guidance to help energy managers and other stakeholders plan and execute energy efficiency improvements. We emphasize actionable information, practical methodologies, diverse case studies, and unbiased evaluation of the most promising retrofit measure for each building type. K-12 schools were selected as one of the highest priority building sectors, because schools affect the lives of most Americans. They also represent approximately 8% of the energy use and 10% of the floor area in commercial buildings.

  1. Factors affecting incident reporting by registered nurses: the relationship of perceptions of the environment for reporting errors, knowledge of the nursing practice act, and demographics on intent to report errors.

    PubMed

    Throckmorton, Terry; Etchegaray, Jason

    2007-12-01

    Patient safety has assumed an international focus. In the past, the focus on detecting and preventing errors was up to the individual clinician, often the registered nurse. With impetus from the Institute of Medicine and other national agencies, a shift to emphasis on systems and processes and near miss and error reporting has occurred. Information from caregiver reporting has taken on new importance. This study was conducted to explore nurses' willingness to report errors of varying degrees of severity and the factors that impacted that intent. Registered nurses were selected randomly from the Texas Board of Nurse Examiners' roster and surveyed regarding perceptions of the environment for reporting, perceptions of reasons for not reporting, knowledge of the nursing practice act, and demographic variables. A majority of nurses were willing to report all levels of errors. Primary position, reasons for not reporting, and years since initial licensure were predictors of intent to report incidents with no injury and those with minimal injury. All but four nurses (99%) indicated that they would report incidents resulting in moderate to severe injury or death.

  2. Variables Affecting Pharmacy Students’ Patient Care Interventions during Advanced Pharmacy Practice Experiences

    PubMed Central

    Patterson, Brandon J.; Sen, Sanchita; Bingham, Angela L.; Bowen, Jane F.; Ereshefsky, Benjamin; Siemianowski, Laura A.

    2016-01-01

    Objective. To identify the temporal effect and factors associated with student pharmacist self-initiation of interventions during acute patient care advanced pharmacy practice experiences (APPE). Methods. During the APPE, student pharmacists at an academic medical center recorded their therapeutic interventions and who initiated the intervention throughout clinical rotations. At the end of the APPE student pharmacists completed a demographic survey. Results. Sixty-two student pharmacists were included. Factors associated with lower rates of self-initiated interventions were infectious diseases and pediatrics APPEs and an intention to pursue a postgraduate residency. Timing of the APPE, previous specialty elective course completion, and previous hospital experience did not result in any significant difference in self-initiated recommendations. Conclusion. Preceptors should not base practice experience expectations for self-initiated interventions on previous student experience or future intentions. Additionally, factors leading to lower rates of self-initiated interventions on infectious diseases or pediatrics APPEs should be explored. PMID:27756924

  3. Variables Affecting Pharmacy Students' Patient Care Interventions during Advanced Pharmacy Practice Experiences.

    PubMed

    Bio, Laura L; Patterson, Brandon J; Sen, Sanchita; Bingham, Angela L; Bowen, Jane F; Ereshefsky, Benjamin; Siemianowski, Laura A

    2016-09-25

    Objective. To identify the temporal effect and factors associated with student pharmacist self-initiation of interventions during acute patient care advanced pharmacy practice experiences (APPE). Methods. During the APPE, student pharmacists at an academic medical center recorded their therapeutic interventions and who initiated the intervention throughout clinical rotations. At the end of the APPE student pharmacists completed a demographic survey. Results. Sixty-two student pharmacists were included. Factors associated with lower rates of self-initiated interventions were infectious diseases and pediatrics APPEs and an intention to pursue a postgraduate residency. Timing of the APPE, previous specialty elective course completion, and previous hospital experience did not result in any significant difference in self-initiated recommendations. Conclusion. Preceptors should not base practice experience expectations for self-initiated interventions on previous student experience or future intentions. Additionally, factors leading to lower rates of self-initiated interventions on infectious diseases or pediatrics APPEs should be explored.

  4. A practical approach to nutritional support for patients with advanced cancer.

    PubMed

    Hill, D; Hart, K

    2001-07-01

    Palliative care can last from a few days to months and, in some cases, years. Consequently the nutritional needs of palliative care patients also vary, as does the extent to which nutrition intervention is pursued. Anorexia and cachexia are common side-effects of advanced cancer. They are characterized by physical depletion of the patients and an emotional drain on them, their families and carers. Pulling together the practical aspects of nutrition support and the emotional and social significance of food requires a skillful practitioner; an experienced dietitian can be a valued member of the palliative care team. This article examines the role of nutrition support in the palliative care setting, focusing upon practical advice including food modification, the use of oral supplements and enteral feeding.

  5. Gerontology found me: gaining understanding of advanced practice nurses in geriatrics.

    PubMed

    Campbell-Detrixhe, Dia D; Grassley, Jane S; Zeigler, Vicki L

    2013-10-01

    Examining the meanings of the experiences of advanced practice nurses (APNs) who chose to work with older adults and why they continue to work with this population was the focus of this hermeneutic qualitative research study. Twelve geriatric APNs currently practicing in two South Central states were interviewed using an open-ended interview guide. Using Gadamerian hermeneutics, the researchers identified Gerontology Found Me as the significant expression that reflected the fundamental meaning of the experience as a whole. Four themes emerged that further described the meanings of the participants' personal, educational, and professional experiences: Becoming a Gerontology Nurse, Being a Gerontology Nurse, Belonging to Gerontology, and Bringing Others to Gerontology. This study concluded that APNs' personal and professional experiences were more influential than educational experiences to become geriatric nurses, and having these personal and professional experiences of being in relationship with older individuals further contributed to their choice of gerontology.

  6. Advancing the practice of online psychotherapy: An application of Rogers' diffusion of innovations theory.

    PubMed

    Lovejoy, Travis I; Demireva, Petya D; Grayson, Jessica L; McNamara, John R

    2009-03-01

    With the advancements of technology and its increasing use in all spheres of life, clinicians too are faced with the decision of whether to adopt or refrain from adopting certain innovations in their practice. This article discusses the process of adopting clinical innovations within a theoretical framework, namely diffusion of innovations theory (DIT; Rogers, 2003). DIT constructs are applied to the example of online therapy adoption into clinical practice. Nine adoption barriers are identified, including issues of dehumanizing the therapeutic environment, start-up cost and reimbursement, infrastructure and training, licensure and jurisdiction concerns, ethical guidelines, both client and clinician suitability factors, and professional reputation and acceptance within the field. The authors conclude with a theory-based discussion of activities that may help to accelerate the adoption of online therapy among professional psychologists. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  7. Health Care Providers’ Attitudes and Practices Regarding the use of Advance Directives in a Military Health Care Setting

    DTIC Science & Technology

    2007-11-02

    and skills about advance directives have been cited for low completion rates. Family nurse practitioners ( FNPs ), in both civilian and military settings...receive training on ethical and moral implications of advanced nursing practice. These characteristics make the FNP an ideal candidate for promoting...environment (Hunter et al., 1997). Advanced Nursing Role Family nurse practitioners ( FNPs ) are well suited to initiate conversations concerning end-of-life

  8. Research for the advancement of green chemistry practice: Studies in atmospheric and educational chemistry

    NASA Astrophysics Data System (ADS)

    Cullipher, Steven Gene

    Green chemistry is a philosophy of chemistry that emphasizes a decreasing dependence on limited non-renewable resources and an increasing focus on preventing pollution byproducts of the chemical industry. In short, it is the discipline of chemistry practiced through the lens of environmental stewardship. In an effort to advance the practice of green chemistry, three studies will be described that have ramifications for the practice. The first study examines the atmospheric oxidation of a hydrofluorinated ether, a third-generation CFC replacement compound with primarily unknown atmospheric degradation products. Determination of these products has the potential to impact decisions on refrigerant usage in the future. The second study examines chemistry students' development of understanding benefits-costs-risks analysis when presented with two real-world scenarios: refrigerant choice and fuel choice. By studying how benefits-costs-risks thinking develops, curricular materials and instructional approaches can be designed to better foster the development of an ability that is both necessary for green chemists and important in daily decision-making for non-chemists. The final study uses eye tracking technology to examine students' abilities to interpret molecular properties from structural information in the context of global warming. Such abilities are fundamental if chemists are to appropriately assess risks and hazards of chemistry practice.

  9. Processor register error correction management

    SciTech Connect

    Bose, Pradip; Cher, Chen-Yong; Gupta, Meeta S.

    2016-12-27

    Processor register protection management is disclosed. In embodiments, a method of processor register protection management can include determining a sensitive logical register for executable code generated by a compiler, generating an error-correction table identifying the sensitive logical register, and storing the error-correction table in a memory accessible by a processor. The processor can be configured to generate a duplicate register of the sensitive logical register identified by the error-correction table.

  10. Working with previously anonymous gamete donors and donor-conceived adults: recent practice experiences of running the DNA-based voluntary information exchange and contact register, UK DonorLink.

    PubMed

    Crawshaw, Marilyn; Gunter, Christine; Tidy, Christine; Atherton, Freda

    2013-03-01

    This article describes recent practice experiences with donor conceived adults, donors, non-donor-conceived adult children of donors using the voluntary DNA-based register, UK DonorLink. It highlights additional complexities faced when using DNA rather than paper records for searching, in particular from the risk of false positives, low chances of success and potential inclusion of biological parents' DNA. Professionals' experiences in supporting those being "linked" suggest challenges as well as rewards. Registration carries the potential to be therapeutic for donor-conceived adults and donors and to enhance their political awareness regardless of links being made. Registrants value both peer and professional support, providing the latter can respond flexibly and be delivered by staff experienced in intermediary work. Given that the majority of those affected by donor conception internationally come from anonymous donation systems, these findings are highly pertinent and argue the need for political and moral debate about such service provision.

  11. Register file soft error recovery

    DOEpatents

    Fleischer, Bruce M.; Fox, Thomas W.; Wait, Charles D.; Muff, Adam J.; Watson, III, Alfred T.

    2013-10-15

    Register file soft error recovery including a system that includes a first register file and a second register file that mirrors the first register file. The system also includes an arithmetic pipeline for receiving data read from the first register file, and error detection circuitry to detect whether the data read from the first register file includes corrupted data. The system further includes error recovery circuitry to insert an error recovery instruction into the arithmetic pipeline in response to detecting the corrupted data. The inserted error recovery instruction replaces the corrupted data in the first register file with a copy of the data from the second register file.

  12. How Do General Practitioners Conceptualise Advance Care Planning in Their Practice? A Qualitative Study

    PubMed Central

    De Vleminck, Aline; Pardon, Koen; Beernaert, Kim; Houttekier, Dirk; Vander Stichele, Robert; Deliens, Luc

    2016-01-01

    Objectives To explore how GPs conceptualise advance care planning (ACP), based on their experiences with ACP in their practice. Methods Five focus groups were held with 36 GPs. Discussions were analysed using a constant comparative method. Results Four overarching themes in the conceptualisations of ACP were discerned: (1) the organisation of professional care required to meet patients’ needs, (2) the process of preparing for death and discussing palliative care options, (3) the discussion of care goals and treatment decisions, (4) the completion of advance directives. Within these themes, ACP was both conceptualised in terms of content of ACP and/or in terms of tasks for the GP. A specific task that was mentioned throughout the discussion of the four different themes was (5) the task of actively initiating ACP by the GP versus passively waiting for patients’ initiation. Conclusions This study illustrates that GPs have varying conceptualisations of ACP, of which some are more limited to specific aspects of ACP. A shared conceptualisation and agreement on the purpose and goals of ACP is needed to ensure successful implementation, as well as a systematic integration of ACP in routine practice that could lead to a better uptake of all the important elements of ACP. PMID:27096846

  13. Enhancing presentation skills for the advanced practice nurse: strategies for success.

    PubMed

    Vollman, Kathleen M

    2005-01-01

    Professional speaking is a component of the professional practice role of the advanced practice nurse (APN). The skills to communicate effectively to one person or an audience of 100 provide the APN with the essential tools for implementing change, collaborating effectively, presenting information at professional meetings, or communicating the impact of clinical outcomes in the boardroom. Public speaking skills, a professional image, and improved communication can facilitate advancement along any career ladder. The greater your fear, the more self-confidence you will gain by stepping up to a challenge and conquering it. This article describes strategies for organizing and presenting your message in a clear and concise format. Techniques to manage the anxiety produced when attempting to articulate your thoughts is essential for effective communication. Skills for enhancing the delivery of your message through effective body language, professional image, voice modulation, and use of audiovisual aids are addressed. Creative techniques for fielding questions are key in promoting a dynamic closure and provide consistent reinforcement of the key message content.

  14. Hello! Are You Registered?

    ERIC Educational Resources Information Center

    Institute for Political/Legal Education, Sewell, NJ.

    Organizational procedures and appropriate forms for high school students to conduct a community survey of non-registered voters are provided. Duties for student coordinator, field staff, and clerical staff are described and a flow chart depicts the relationship of personnel to one another and to the community. Students are instructed to notify…

  15. Factors influencing intentions to integrate tobacco education among advanced practice nursing faculty.

    PubMed

    Heath, Janie; Crowell, Nancy A

    2007-01-01

    We report on the findings of a national survey that examined factors that influence faculty's intentions to integrate tobacco education in their advanced practice nursing curricula. The addiction component of tobacco use is taking its toll on the health of 48 million smokers in the United States. Several national health authorities recommend and/or mandate that tobacco prevention and tobacco cessation be addressed at every point of entry in the health care delivery system. However, there is increasing evidence that health care providers may not be adequately prepared to meet national goals and/or standards. One hundred sixty-one advanced practice nursing faculty in the United States completed an 88-item survey regarding external factors (e.g., personal history of tobacco use, clinical practice, and current tobacco topics taught) and components of the Theory of Reasoned Action model (including perceived self-efficacy, behavioral beliefs, subjective norms, and control beliefs related to tobacco education). Descriptive statistics, chi(2) analysis, Pearson correlation, and linear regression were used to analyze the data. The findings revealed that sex (chi(2) = 7.949, P = .024), level of education (chi(2) = 26.853, P = .0005), years of academic teaching (chi(2) = 19.418, P = .013), and combined clinical and course responsibility (chi(2) = 10.430, P = .0236) were significant external (demographic) factors and that behavioral beliefs (attitude about tobacco education) demonstrated the strongest relationship with intention scores (r = 0.876, P < .0005). Overall, 62.7% of nurse practitioners reported high scores (>or=5, on a scale of 1-7) for intentions to integrate tobacco education, as compared with 37.5% of nurse midwives, 30.3% of clinical nurse specialists, and 8.7% of nurse anesthetists. This study adds to the growing body of evidence that nursing curricular gaps with tobacco education exist and that national efforts are needed to ensure that widespread changes occur

  16. Health Care Reform and the Federal Transformation Initiatives: Capitalizing on the Potential of Advanced Practice Psychiatric Nurses

    PubMed Central

    Hanrahan, Nancy P.; Delaney, Kathleen; Merwin, Elizabeth

    2012-01-01

    In the last decade the US federal government proposed a transformation vision of mental health service delivery; patient-centered, evidence-based and recovery oriented treatment models. Health care reform brings additional expectations for innovation in mental/substance use service delivery, particularly the idea of creating systems where physical health, mental health and substance use treatment is fully integrated. Psychiatric nurses, as one of the four core US mental health professions, have the potential to play a significant role in the both the transformation initiative and health care reform vision. However, psychiatric nurses, particularly advanced practice psychiatric nurses, are an untapped resource due in part to significant state regulatory barriers that limit their scope of practice in many states. The purpose of this paper is to document what is currently known about advanced practice psychiatric nurses and discuss policy implications for tapping into the strengths of this workforce. Strategies for facilitating utilization of advanced practice psychiatric nurses discussed. PMID:21233135

  17. Geographic Medical History: Advances in Geospatial Technology Present New Potentials in Medical Practice

    NASA Astrophysics Data System (ADS)

    Faruque, F. S.; Finley, R. W.

    2016-06-01

    Genes, behaviour, and the environment are known to be the major risk factors for common diseases. When the patient visits a physician, typical questions include family history (genes) and lifestyle of the patient (behaviour), but questions concerning environmental risk factors often remain unasked. It is ironic that 25 centuries ago Hippocrates, known as the father of medicine, noted the importance of environmental exposure in medical investigation as documented in his classic work, "Airs, Waters, Places", yet the practice of routinely incorporating environmental risk factors is still not in place. Modern epigenetic studies have found that unhealthy lifestyle and environmental factors can cause changes to our genes that can increase disease risk factors. Therefore, attempting to solve the puzzle of diseases using heredity and lifestyle alone will be incomplete without accounting for the environmental exposures. The primary reason why environmental exposure has not yet been a routine part of the patient's medical history is mostly due to our inability to provide clinicians useful measures of environmental exposures suitable for their clinical practices. This presentation will discuss advances in geospatial technology that show the potential to catalyse a paradigm shift in medical practice and health research by allowing environmental risk factors to be documented as the patient's "Geographic Medical History". In order to accomplish this we need information on: a) relevant spatiotemporal environmental variables, and b) location of the individual in that person's dynamic environment. Common environmental agents that are known to interact with genetic make-up include air pollutants, mold spores, pesticides, etc. Until recently, the other component, location of an individual was limited to a static representation such as residential or workplace location. Now, with the development of mobile technology, changes in an individual's location can be tracked in real time if

  18. Interactive Web-based Learning Modules Prior to General Medicine Advanced Pharmacy Practice Experiences

    PubMed Central

    Walton, Alison M.; Nisly, Sarah A.

    2015-01-01

    Objective. To implement and evaluate interactive web-based learning modules prior to advanced pharmacy practice experiences (APPEs) on inpatient general medicine. Design. Three clinical web-based learning modules were developed for use prior to APPEs in 4 health care systems. The aim of the interactive modules was to strengthen baseline clinical knowledge before the APPE to enable the application of learned material through the delivery of patient care. Assessment. For the primary endpoint, postassessment scores increased overall and for each individual module compared to preassessment scores. Postassessment scores were similar among the health care systems. The survey demonstrated positive student perceptions of this learning experience. Conclusion. Prior to inpatient general medicine APPEs, web-based learning enabled the standardization and assessment of baseline student knowledge across 4 health care systems. PMID:25995515

  19. Canadian consensus conference on the development of training and practice standards in advanced minimally invasive surgery

    PubMed Central

    Birch, Daniel W.; Bonjer, H. Jaap; Crossley, Claire; Burnett, Gayle; de Gara, Chris; Gomes, Anthony; Hagen, John; Maciver, Angus G.; Mercer, C. Dale; Panton, O. Neely; Schlachta, Chris M.; Smith, Andy J.; Warnock, Garth L.

    2009-01-01

    Despite the complexities of minimally invasive surgery (MIS), a Canadian approach to training surgeons in this field does not exist. Whereas a limited number of surgeons are fellowship-trained in the specialty, guidelines are still clearly needed to implement advanced MIS. Leaders in the field of gastrointestinal surgery and MIS attended a consensus conference where they proposed a comprehensive mentoring program that may evolve into a framework for a national mentoring and training system. Leadership and commitment from national experts to define the most appropriate template for introducing new surgical techniques into practice is required. This national framework should also provide flexibility for truly novel procedures such as natural orifice translumenal endoscopic surgery. PMID:19680520

  20. Fostering the scholarship of discovery and integration for advanced practice education.

    PubMed

    Fisher, Elaine M; Riley, Tracy A

    2005-01-01

    Graduate faculty are challenged to foster the scholarship of discovery and integration in their students. Fostering this scholarship requires that faculty critically analyze their approach to teaching and learning with the ultimate goal of helping students grow exponentially in ways that will continue after completion of their course or class. This article describes a course activity designed to enhance students' abilities to read, critique, and apply literature from multiple scientific disciplines to a clinical realm while maintaining their focus on their health-related scientific discipline. Applied to a course in advanced pathophysiology, the course activity described is amenable for adoption to multiple graduate-level courses and encourages individual, collective, and practice-specific growth.

  1. [Towards universal access to health care: incorporation of advanced practice nurses in primary care].

    PubMed

    Aguirre-Boza, Francisca; Achondo, Bernardita

    2016-10-01

    To move towards universal access to health, the Pan American Health Organization recommends strengthening primary health care (PHC). One of the strategies is to increase the number qualified professionals, both medical and non-medical, working in PHC. In Chile there is a lack of professionals in this level of care, hampering the provision of health. Physicians still prefer secondary and tertiary levels of health. International experience has shown that advanced practice nurses (APN), specialists in PHC are cost-effective professionals able to deliver a complete and quality care to patients. Strong evidence demonstrates the benefits that APN could provide to the population, delivering nursing care that incorporates medical tasks, for example in patients with chronic diseases, allowing greater availability of medical hours for patients requiring more complex management. The success in the implementation of this new role requires the support of the health team, especially PHC physicians, endorsing and promoting the benefits of the APN for the population.

  2. Role of the advanced practice physiotherapist in decreasing surgical wait times.

    PubMed

    Aiken, Alice B; Harrison, Mark M; Hope, John

    2009-01-01

    The role of the advanced practice physiotherapist (APP) in outpatient orthopedic clinics has been present in Ontario for over five years. These professionals have additional duties beyond those of a regular physiotherapist in order to screen patients pre- and post-operatively, triage patients for surgery, prescribe conservative management and monitor patients on an ongoing basis. The purpose of this role is to improve patient access to timely surgical care by reducing wait times for hip and knee replacement surgeries. Several positive outcomes have been reported in the literature. It has been established that an APP can effectively manage over 30% of the patients referred to a surgeon for hip or knee replacement surgery because these patients do not require surgery; rather, they require conservative management.

  3. Tracking Patient Encounters and Clinical Skills to Determine Competency in Ambulatory Care Advanced Pharmacy Practice Experiences

    PubMed Central

    Pereira, Chrystian R.; Harris, Ila M.; Moon, Jean Y.; Westberg, Sarah M.; Kolar, Claire

    2016-01-01

    Objective. To determine if the amount of exposure to patient encounters and clinical skills correlates to student clinical competency on ambulatory care advanced pharmacy practice experiences (APPEs). Design. Students in ambulatory care APPEs tracked the number of patients encountered by medical condition and the number of patient care skills performed. At the end of the APPE, preceptors evaluated students’ competency for each medical condition and skill, referencing the Dreyfus model for skill acquisition. Assessment. Data was collected from September 2012 through August 2014. Forty-six responses from a student tracking tool were matched to preceptor ratings. Students rated as competent saw more patients and performed more skills overall. Preceptors noted minimal impact on workload. Conclusions. Increased exposure to patient encounters and skills performed had a positive association with higher Dreyfus stage, which may represent a starting point in the conversation for more thoughtful design of ambulatory care APPEs. PMID:26941440

  4. Impact of Instruction and Feedback on Reflective Responses during an Ambulatory Care Advanced Pharmacy Practice Experience

    PubMed Central

    Spangler, Mikayla; Klug, Laura; Tilleman, Jennifer; Coover, Kelli

    2016-01-01

    Objective. To investigate whether instruction and feedback on reflective responses are beneficial in developing pharmacy students to become more reflective practitioners. Methods. Students on an advanced pharmacy practice experience answered weekly reflection questions and were randomly assigned to either an intervention (received instruction and feedback on reflection) or control group. The final week’s responses were de-identified and two blinded faculty members independently categorized them as reflective or nonreflective. The primary outcome measure was comparing the number of “reflective” responses in each group. Results. The responses were classified as reflective in 83.3% of students in the intervention group (n=18) compared to 37.5% of the control group (n=16). The odds that the response was categorized as reflective were 8.3 times higher in the intervention group. Conclusion. Providing instruction and feedback to students improved the likelihood that their work was reflective. PMID:27402984

  5. A survey to determine current practice patterns in the surgical treatment of advanced thumb carpometacarpal osteoarthrosis

    PubMed Central

    Brunton, Lance M.

    2010-01-01

    Background The purpose of this study was to determine current practice patterns and examine the influence of recent evidence in the surgical treatment of advanced thumb carpometacarpal (CMC) osteoarthrosis. Methods A survey was sent to 2,536 American Society for Surgery of the Hand members. Information regarding specialty training, years of experience, annual cases performed, treatment of choice, technique, and postoperative immobilization was collected. Respondents were asked whether their current treatment of choice differs from what they performed 5 years ago and about the importance of ligament reconstruction and “interposition” to thumb CMC arthroplasty success. Results One thousand twenty-four respondents completed the survey (40% response rate). Treatment of choice was trapeziectomy with ligament reconstruction and tendon interposition (68%), regardless of specialty training, years of experience, and annual cases performed. Over 70% favored treatment that was not different from what they performed 5 years ago. Less than 3% of respondents perform a trapeziectomy alone; only 14 surgeons have changed to this procedure in the last 5 years. Only 35% of the 822 respondents who perform a ligament reconstruction and 14% of the 764 respondents who perform an interposition believe those techniques are “extremely important” to thumb CMC arthroplasty success. Conclusions Despite recent evidence that suggests neither ligament reconstruction nor tendon interposition confers any additional benefit over trapeziectomy alone, few respondents have converted to the simpler procedure. Either the current evidence is not convincing enough to drastically change practice patterns, or other factors apart from this evidence have a greater influence on surgical decision-making for advanced thumb CMC osteoarthrosis. Electronic supplementary material The online version of this article (doi:10.1007/s11552-010-9275-7) contains supplementary material, which is available to

  6. Advanced Energy Retrofit Guide (AERG): Practical Ways to Improve Energy Performance; Healthcare Facilities (Book)

    SciTech Connect

    Hendron, R.; Leach, M.; Bonnema, E.; Shekhar, D.; Pless, S.

    2013-09-01

    The Advanced Energy Retrofit Guide for Healthcare Facilities is part of a series of retrofit guides commissioned by the U.S. Department of Energy. By presenting general project planning guidance as well as detailed descriptions and financial payback metrics for the most important and relevant energy efficiency measures (EEMs), the guides provide a practical roadmap for effectively planning and implementing performance improvements in existing buildings. The Advanced Energy Retrofit Guides (AERGs) are intended to address key segments of the U.S. commercial building stock: retail stores, office buildings, K-12 schools, grocery stores, and healthcare facilities. The guides' general project planning considerations are applicable nationwide; the energy and cost savings estimates for recommended EEMs were developed based on energy simulations and cost estimates for an example hospital tailored to five distinct climate regions. These results can be extrapolated to other U.S. climate zones. Analysis is presented for individual EEMs, and for packages of recommended EEMs for two project types: existing building commissioning projects that apply low-cost and no-cost measures, and whole-building retrofits involving more capital-intensive measures.

  7. Advanced Glycation End Products in Foods and a Practical Guide to Their Reduction in the Diet

    PubMed Central

    URIBARRI, JAIME; WOODRUFF, SANDRA; GOODMAN, SUSAN; CAI, WEIJING; CHEN, XUE; PYZIK, RENATA; YONG, ANGIE; STRIKER, GARY E.; VLASSARA, HELEN

    2013-01-01

    Modern diets are largely heat-processed and as a result contain high levels of advanced glycation end products (AGEs). Dietary advanced glycation end products (dAGEs) are known to contribute to increased oxidant stress and inflammation, which are linked to the recent epidemics of diabetes and cardiovascular disease. This report significantly expands the available dAGE database, validates the dAGE testing methodology, compares cooking procedures and inhibitory agents on new dAGE formation, and introduces practical approaches for reducing dAGE consumption in daily life. Based on the findings, dry heat promotes new dAGE formation by >10- to 100-fold above the uncooked state across food categories. Animal-derived foods that are high in fat and protein are generally AGE-rich and prone to new AGE formation during cooking. In contrast, carbohydrate-rich foods such as vegetables, fruits, whole grains, and milk contain relatively few AGEs, even after cooking. The formation of new dAGEs during cooking was prevented by the AGE inhibitory compound aminoguanidine and significantly reduced by cooking with moist heat, using shorter cooking times, cooking at lower temperatures, and by use of acidic ingredients such as lemon juice or vinegar. The new dAGE database provides a valuable instrument for estimating dAGE intake and for guiding food choices to reduce dAGE intake. PMID:20497781

  8. The Role of Social Work in Advancing the Practice of Indigenous Education: Obstacles and Promises in Empowerment-Oriented Social Work Practice.

    ERIC Educational Resources Information Center

    Yellow Bird, Michael J.; Chenault, Venida

    The mission of social work is to help people meet their basic needs and enhance their well-being. Through a strong empowerment orientation, the profession can aid people vulnerable to oppression as a result of racism, discrimination, and poverty. Social work can be a powerful force in advancing the practice of Indigenous education. Social workers…

  9. 37 CFR 2.47 - Supplemental Register.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... COMMERCE RULES OF PRACTICE IN TRADEMARK CASES The Written Application § 2.47 Supplemental Register. (a) In... shall so indicate and shall specify that the mark has been in use in commerce. (b) In an application to... statement of lawful use in commerce may be omitted. (c) An application under section 66(a) of the Act is...

  10. 37 CFR 2.47 - Supplemental Register.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... COMMERCE RULES OF PRACTICE IN TRADEMARK CASES The Written Application § 2.47 Supplemental Register. (a) In... shall so indicate and shall specify that the mark has been in use in commerce. (b) In an application to... statement of lawful use in commerce may be omitted. (c) An application under section 66(a) of the Act is...

  11. Discovering the nature of advanced nursing practice in high dependency care: a critical care nurse consultant's experience.

    PubMed

    Fairley, Debra

    2005-06-01

    This paper describes how a critical care nurse consultant's clinical role has evolved within a surgical high dependency unit (SHDU) in a large teaching hospitals trust. In order to provide some background to role development, an overview of the research exploring the nature of advanced nursing practice in the context of critical care will be presented. From the outset, advanced nursing practice was not perceived as the acquisition and application of technical procedures usually undertaken by doctors, but possibly an integration of medicine and nursing where holistic nursing assessment is combined with symptom-focused physical examination. A reflective account of practical problems encountered relating to role integration, professional autonomy, legal and consent issues, non-medical prescribing, and role evaluation will be presented. A model of working that can be applied to high dependency units, integrating the role of the advanced nurse practitioner within the clinical team, will be described.

  12. The Impact of New Technologic and Molecular Advances in the Daily Practice of Gastrointestinal and Hepatobiliary Pathology.

    PubMed

    Xue, Yue; Farris, Alton Brad; Quigley, Brian; Krasinskas, Alyssa

    2017-04-01

    The practice of anatomic pathology, and of gastrointestinal pathology in particular, has been dramatically transformed in the past decade. In addition to the multitude of diseases, syndromes, and clinical entities encountered in daily clinical practice, the increasing integration of new technologic and molecular advances into the field of gastroenterology is occurring at a fast pace. Application of these advances has challenged pathologists to correlate newer methodologies with existing morphologic criteria, which in many instances still provide the gold standard for diagnosis. This review describes the impact of new technologic and molecular advances on the daily practice of gastrointestinal and hepatobiliary pathology. We discuss new drugs that can affect the gastrointestinal tract and liver, new endoluminal techniques, new molecular tests that are often performed reflexively, new imaging techniques for evaluating hepatocellular carcinoma, and modified approaches to the gross and histologic assessment of tissues that have been exposed to neoadjuvant therapies.

  13. Assessing the productivity of advanced practice providers using a time and motion study.

    PubMed

    Ogunfiditimi, Folusho; Takis, Lisa; Paige, Virginia J; Wyman, Janet F; Marlow, Elissa

    2013-01-01

    The Resource-Based Relative Value Scale is widely used to measure healthcare provider productivity and to set payment standards. The scale, however, is limited in its assessment of pre- and postservice work and other potentially non-revenue-generating healthcare services, what we have termed service-valued activity (SVA). In an attempt to quantify SVA, we conducted a time and motion study of providers to assess their productivity in inpatient and outpatient settings. Using the Standard Time and Motion Procedures checklist as a methodological guide, we provided personal digital assistants (PDAs) that were prepopulated with 2010 Current Procedural Terminology codes to 19 advanced practice providers (APPs). The APPs were instructed to identify their location and activity each time the PDA randomly alarmed. The providers collected data for 3 to 5 workdays, and those data were separated into revenue-generating services (RGSs) and SVAs. Multiple inpatient and outpatient departments were assessed. The inpatient APPs spent 61.6 percent of their time on RGSs and 35.1 percent on SVAs. Providers in the outpatient settings spent 59.0 percent of their time on RGSs and 38.2 percent on SVAs. This time and motion study demonstrated an innovative method and tool for the quantification and analysis of time spent on revenue- and non-revenue-generating services provided by healthcare professionals. The new information derived from this study can be used to accurately document productivity, determine clinical practice patterns, and improve deployment strategies of healthcare providers.

  14. An elective pharmaceutical care course to prepare students for an advanced pharmacy practice experience in Kenya.

    PubMed

    Schellhase, Ellen M; Miller, Monica L; Ogallo, William; Pastakia, Sonak D

    2013-04-12

    OBJECTIVE. To develop a prerequisite elective course to prepare students for an advanced pharmacy practice experience (APPE) in Kenya. DESIGN. The course addressed Kenyan culture, travel preparation, patient care, and disease-state management. Instructional formats used were small-group discussions and lectures, including some Web-based presentations by Kenyan pharmacists on disease states commonly treated in Kenya. Cultural activities include instruction in conversational and medical Kiswahili and reading of a novel related to global health programs. ASSESSMENT. Student performance was assessed using written care plans, quizzes, reflection papers, a formulary management exercise, and pre- and post-course assessments. Student feedback on course evaluations indicated that the course was well received and students felt prepared for the APPE. CONCLUSION. This course offered a unique opportunity for students to learn about pharmacy practice in global health and to apply previously acquired skills in a resource-constrained international setting. It prepares students to actively participate in clinical care activities during an international APPE.

  15. Diagnosis and treatment of patients with bipolar disorder: A review for advanced practice nurses

    PubMed Central

    Murray, Bethany; McNew, Brittany

    2015-01-01

    Abstract Purpose This review article provides an overview of the frequency, burden of illness, diagnosis, and treatment of bipolar disorder (BD) from the perspective of the advanced practice nurses (APNs). Data sources PubMed searches were conducted using the following keywords: “bipolar disorder and primary care,” restricted to dates 2000 to present; “bipolar disorder and nurse practitioner”; and “bipolar disorder and clinical nurse specialist.” Selected articles were relevant to adult outpatient care in the United States, with a prioritization of articles written by APNs or published in nursing journals. Conclusions BD has a substantial lifetime prevalence in the population at 4%. Because the manic or depressive symptoms of BD tend to be severe and recurrent over a patient's lifetime, the condition is associated with significant burden to the individual, caregivers, and society. Clinician awareness that BD may be present increases the likelihood of successful recognition and appropriate treatment. A number of pharmacological and nonpharmacological treatments are available for acute and maintenance treatments, with the prospect of achieving reduced symptom burden and increased functioning for many patients. Implications for practice Awareness of the disease burden, diagnostic issues, and management choices in BD has the potential to enhance outcome in substantial proportions of patients. PMID:26172568

  16. Establishment and Implementation of a Required Medication Therapy Management Advanced Pharmacy Practice Experience

    PubMed Central

    Gilliam, Eric; Thompson, Megan; Griend, Joseph Vande

    2017-01-01

    Objective. To develop a community pharmacy-based medication therapy management (MTM) advanced pharmacy practice experience (APPE) that provides students with skills and knowledge to deliver entry-level pharmacy MTM services. Design. The University of Colorado Skaggs School of Pharmacy & Pharmaceutical Sciences (SSPPS) partnered with three community pharmacy chains to establish this three-week, required MTM APPE. Students completed the American Pharmacists Association MTM Certificate Course prior to entering the APPE. Students were expected to spend 90% or more of their time at this experience working on MTM interventions, using store MTM platforms. Assessment. All 151 students successfully completed this MTM APPE, and each received a passing evaluation from their preceptor. Preceptor evaluations of students averaged above four (entry-level practice) on a five-point Likert scale. The majority of students reported engagement in MTM services for more than 80% of the time on site. Students’ self-reporting of their ability to perform MTM interventions improved after participation in the APPE. Conclusion. The SSPPS successfully implemented a required MTM APPE, preparing students for entry-level delivery of MTM services. PMID:28381896

  17. Advanced Energy Retrofit Guide: Practical Ways to Improve Energy Performance, K-12 Schools (Book)

    SciTech Connect

    Not Available

    2013-12-01

    The U.S. Department of Energy developed the Advanced Energy Retrofit Guides (AERGs) to provide specific methodologies, information, and guidance to help energy managers and other stakeholders plan and execute energy efficiency improvements. Detailed technical discussion is fairly limited. Instead, we emphasize actionable information, practical methodologies, diverse case studies, and unbiased evaluations of the most promising retrofit energy efficiency measures for each building type. A series of AERGs is under development, addressing key segments of the commercial building stock. K-12 schools were selected as one of the highest priority building sectors, because schools affect the lives of most Americans. They also represent approximately 8% of the energy use and 10% of the floor area in commercial buildings nationwide. U.S. K-12 school districts spend more than $8 billion each year on energy - more than they spend on computers and textbooks combined. Most occupy older buildings that often have poor operational performance - more than 30% of schools were built before 1960. The average age of a school is about 42 years - which is nearly the expected serviceable lifespan of the building. K-12 schools offer unique opportunities for deep, cost-effective energy efficiency improvements, and this guide provides convenient and practical guidance for exploiting these opportunities in the context of public, private, and parochial schools.

  18. Advanced practice physiotherapy in patients with musculoskeletal disorders: a systematic review

    PubMed Central

    2012-01-01

    Background The convergence of rising health care costs and physician shortages have made health care transformation a priority in many countries resulting in the emergence of new models of care that often involve the extension of the scope of practice for allied health professionals. Physiotherapists in advanced practice/extended scope roles have emerged as key providers in such new models, especially in settings providing services to patients with musculoskeletal disorders. However, evidence of the systematic evaluation of advance physiotherapy practice (APP) models of care is scarce. A systematic review was done to update the evaluation of physiotherapists in APP roles in the management of patients with musculoskeletal disorders. Methods Structured literature search was conducted in 3 databases (Medline, Cinahl and Embase) for articles published between 1980 and 2011. Included studies needed to present original quantitative data that addressed the impact or the effect of APP care. A total of 16 studies met all inclusion criteria and were included. Pairs of raters used four structured quality appraisal methodological tools depending on design of studies to analyse included studies. Results Included studies varied in designs and objectives and could be categorized in four areas: diagnostic agreement or accuracy compared to medical providers, treatment effectiveness, economic efficiency or patient satisfaction. There was a wide range in the quality of studies (from 25% to 93%), with only 43% of papers reaching or exceeding a score of 70% on the methodological quality rating scales. Their findings are however consistent and suggest that APP care may be as (or more) beneficial than usual care by physicians for patients with musculoskeletal disorders, in terms of diagnostic accuracy, treatment effectiveness, use of healthcare resources, economic costs and patient satisfaction. Conclusions The emerging evidence suggests that physiotherapists in APP roles provide equal

  19. Toward Advancing Nano-Object Count Metrology: A Best Practice Framework

    PubMed Central

    Boyko, Volodymyr; Meyers, Greg; Voetz, Matthias; Wohlleben, Wendel

    2013-01-01

    Background: A movement among international agencies and policy makers to classify industrial materials by their number content of sub–100-nm particles could have broad implications for the development of sustainable nanotechnologies. Objectives: Here we highlight current particle size metrology challenges faced by the chemical industry due to these emerging number percent content thresholds, provide a suggested best-practice framework for nano-object identification, and identify research needs as a path forward. Discussion: Harmonized methods for identifying nanomaterials by size and count for many real-world samples do not currently exist. Although particle size remains the sole discriminating factor for classifying a material as “nano,” inconsistencies in size metrology will continue to confound policy and decision making. Moreover, there are concerns that the casting of a wide net with still-unproven metrology methods may stifle the development and judicious implementation of sustainable nanotechnologies. Based on the current state of the art, we propose a tiered approach for evaluating materials. To enable future risk-based refinements of these emerging definitions, we recommend that this framework also be considered in environmental and human health research involving the implications of nanomaterials. Conclusion: Substantial scientific scrutiny is needed in the area of nanomaterial metrology to establish best practices and to develop suitable methods before implementing definitions based solely on number percent nano-object content for regulatory purposes. Strong cooperation between industry, academia, and research institutions will be required to fully develop and implement detailed frameworks for nanomaterial identification with respect to emerging count-based metrics. Citation: Brown SC, Boyko V, Meyers G, Voetz M, Wohlleben W. 2013. Toward advancing nano-object count metrology: a best practice framework. Environ Health Perspect 121:1282–1291;

  20. Advancing efforts to achieve health equity: equity metrics for health impact assessment practice.

    PubMed

    Heller, Jonathan; Givens, Marjory L; Yuen, Tina K; Gould, Solange; Jandu, Maria Benkhalti; Bourcier, Emily; Choi, Tim

    2014-10-24

    Equity is a core value of Health Impact Assessment (HIA). Many compelling moral, economic, and health arguments exist for prioritizing and incorporating equity considerations in HIA practice. Decision-makers, stakeholders, and HIA practitioners see the value of HIAs in uncovering the impacts of policy and planning decisions on various population subgroups, developing and prioritizing specific actions that promote or protect health equity, and using the process to empower marginalized communities. There have been several HIA frameworks developed to guide the inclusion of equity considerations. However, the field lacks clear indicators for measuring whether an HIA advanced equity. This article describes the development of a set of equity metrics that aim to guide and evaluate progress toward equity in HIA practice. These metrics also intend to further push the field to deepen its practice and commitment to equity in each phase of an HIA. Over the course of a year, the Society of Practitioners of Health Impact Assessment (SOPHIA) Equity Working Group took part in a consensus process to develop these process and outcome metrics. The metrics were piloted, reviewed, and refined based on feedback from reviewers. The Equity Metrics are comprised of 23 measures of equity organized into four outcomes: (1) the HIA process and products focused on equity; (2) the HIA process built the capacity and ability of communities facing health inequities to engage in future HIAs and in decision-making more generally; (3) the HIA resulted in a shift in power benefiting communities facing inequities; and (4) the HIA contributed to changes that reduced health inequities and inequities in the social and environmental determinants of health. The metrics are comprised of a measurement scale, examples of high scoring activities, potential data sources, and example interview questions to gather data and guide evaluators on scoring each metric.

  1. Survey of Advanced Education in Prosthodontics Directors and Residents on Practices in Esthetic Dentistry.

    PubMed

    Sheets, James L; Yuan, Judy Chia-Chun; Sukotjo, Cortino; Wee, Alvin G

    2016-10-01

    The aim of this study was to determine the difference between the intended education by advanced education in prosthodontics (AEP) program directors and the perceived education received by AEP residents with respect to concepts of esthetic dentistry. Residents' confidence levels and current practices were also determined based on program level, with first- and second-year residents combined into "junior residents" and third- and fourth-year residents combined into "senior residents." Surveys were distributed to all U.S. and Canadian AEP program directors (N=52) in 2014 and residents (N=393) in 2015. The seven questions asked of directors and 20 asked of residents assessed resident training. The response rate for directors was 59.6% and for residents was 27.3%. Statistically significant results were found between the responding program directors' perceived education on esthetic principles and the responding residents' perceived education. The senior-level residents were more confident in each of the categories than residents at the junior level, although the difference was only significant for selecting porcelain systems to match inherent translucency, transfer of information to the laboratory, and surface staining or characterization. There was a difference between the program directors' intended teaching and the residents' perceptions with regards to bleaching, shade matching, selection of porcelain systems, transfer of information to the laboratory, and surface staining or characterization. The residents' confidence levels were higher at the senior level than those at the junior level in selecting porcelain systems, transfer of information to the laboratory, and staining/characterization. Faculty members in advanced prosthodontics programs may be able to use these findings to improve their residents' education in these areas.

  2. Inter-professional work based learning within an MSc in Advanced Practice: lessons from one UK higher education programme.

    PubMed

    Gaskell, Lynne; Beaton, Susan

    2010-09-01

    This paper will describe the implementation of inter-professional work based education (IPE) in one postgraduate Advanced Practitioner programme in the UK. The concept of Advanced Practice has developed as a response of a number of drivers including change in junior doctor training; government policy and increasing demands on the central government funded UK health service (the NHS). The programme was commissioned by the then greater Manchester Strategic Health Authority (now NHS North West) to meet service needs. The educational philosophy underpinning the MSc Advanced Practice (health and social care) provided by the University of Salford is IPE linked to work based learning. The process of work based learning (WBL) and inter-professional learning underpinning the programme will be discussed in relation to feedback from university staff, Advanced Practitioner (AP) students and employer feedback taken from programme and module evaluations. We argue that IPE at this level facilitates a greater understanding of the connectivity between professionals working in the health care system in the UK; a better understanding of the skills and knowledge base of colleagues; more inter-professional working and appropriate referrals in the work place. This has raised the profile of Advanced Practice (AP) in the region and ultimately resulted in better patient care with more effective and efficient use of resources (Acton Shapiro, 2006, 2008).

  3. The stigmatized patient with AIDS in the intensive care unit: the role of the advanced practice nurse.

    PubMed

    Mosier, L

    1994-11-01

    As the incidence of HIV infection rises, so will cases of HIV positive intensive care unit admissions. Factors affecting nurses' care of these patients include fear of contagion, homophobia, and lack of knowledge. A multidimensional approach must be taken by the advanced practice nurse to decrease stigmatization by changing knowledge and attitudes of intensive care unit nurses.

  4. Feeding Tube Placement in Patients with Advanced Dementia: The Beliefs and Practice Patterns of Speech-Language Pathologists

    ERIC Educational Resources Information Center

    Sharp, Helen M.; Shega, Joseph W.

    2009-01-01

    Purpose: To describe the beliefs and practices of speech-language pathologists (SLPs) about the use of percutaneous endoscopic gastrostomy (PEG) among patients with advanced dementia and dysphagia. Method: A survey was mailed to a geographically stratified random sample of 1,050 medical SLPs. Results: The response rate was 57%, and 326 surveys met…

  5. The Institute for the Advancement of Social Work Research: Working to Increase Our Practice and Policy Evidence Base

    ERIC Educational Resources Information Center

    Zlotnik, Joan Levy; Solt, Barbara E.

    2006-01-01

    This invitational update on the Institute for the Advancement of Social Work Research (IASWR) provides an overview of the work and progress toward strengthening the evidence base for social work practice and policy through research. The article includes information regarding IASWR work with its supporting social work organizations to provide a…

  6. Some Misconceptions in Meiosis Shown by Students Responding to an Advanced Level Practical Examination Question in Biology.

    ERIC Educational Resources Information Center

    Brown, C. R.

    1990-01-01

    Discussed are problems revealed in student responses to a practical task which formed part of an advanced level examination. The frequencies with which some misconceptions about cell reproduction and genetics occurred are presented. The nature of these misconceptions is analyzed and their implications discussed. (CW)

  7. Australian immunisation registers: established foundations and opportunities for improvement.

    PubMed

    Chin, L K; Crawford, N W; Rowles, G; Buttery, J P

    2012-04-19

    The National Immunisation Program Schedule in Australia is formulated and funded nationally under the population-wide Medicare system. The policy is implemented by the eight state and territory jurisdictions. The national immunisation registers consist of the Australian Childhood Immunisation Register (ACIR), and, more recently, the National Human Papillomavirus (HPV) Vaccination Program Register. Moreover, a variety of jurisdiction-based registers and primary care practice software systems exist, which interact with the national registers. General practitioners can obtain reports listing patients under seven years attending their practice and recorded as 'not fully immunised', and immunisation coverage rates for their practice linked to government incentives through Medicare. A 2011 report documents national coverage of 91.8% fully immunised at 12 months, and 92.6% at 24 months. The HPV register provides information on vaccination coverage with the potential to link with a register of cervical cancer screening results. Limitations of current national register include inability to easily access immunisation histories beyond seven years of age, and issues of underreporting and timeliness, which impact significantly the immunisation coverage estimates. The linkage of these registers with healthcare outcome data will further enhance public health outcomes by enabling rapid, population-level vaccine safety and effectiveness investigations in a nation with a track record as an 'early adopter' of new childhood vaccines.

  8. Restructuring registered nurse curricula.

    PubMed

    Hegge, M

    1995-01-01

    National initiatives in higher education, health reform, and the nursing curriculum revolution are applied to five curricular patterns for registered nurse (RN) upward mobility baccalaureate education. American Association of Higher Education principles for quality baccalaureate education are applied to the curricular models. The patterns described are: community model, health promotion model, nursing diagnosis model, case management model, and caring model. Three educational strategies for prompting paradigm shifts in RNs who return to school are discussed: collaborative learning, portfolios, and self-assessments. These learning strategies are designed to move the adult student through Perry's phases of cognitive development from duality to relativism. The combination of fresh new curriculum patterns and collaborative learning strategies can empower nurses to discover new paradigms with which to transform the profession.

  9. Traumatic brain injury: advanced multimodal neuromonitoring from theory to clinical practice.

    PubMed

    Cecil, Sandy; Chen, Patrick M; Callaway, Sarah E; Rowland, Susan M; Adler, David E; Chen, Jefferson W

    2011-04-01

    Traumatic brain injury accounts for nearly 1.4 million injuries and 52 000 deaths annually in the United States. Intensive bedside neuromonitoring is critical in preventing secondary ischemic and hypoxic injury common to patients with traumatic brain injury in the days following trauma. Advancements in multimodal neuromonitoring have allowed the evaluation of changes in markers of brain metabolism (eg, glucose, lactate, pyruvate, and glycerol) and other physiological parameters such as intracranial pressure, cerebral perfusion pressure, cerebral blood flow, partial pressure of oxygen in brain tissue, blood pressure, and brain temperature. This article highlights the use of multimodal monitoring in the intensive care unit at a level I trauma center in the Pacific Northwest. The trends in and significance of metabolic, physiological, and hemodynamic factors in traumatic brain injury are reviewed, the technical aspects of the specific equipment used to monitor these parameters are described, and how multimodal monitoring may guide therapy is demonstrated. As a clinical practice, multimodal neuromonitoring shows great promise in improving bedside therapy in patients with traumatic brain injury, ultimately leading to improved neurological outcomes.

  10. Advanced Practice Nursing: A Strategy for Achieving Universal Health Coverage and Universal Access to Health

    PubMed Central

    Bryant-Lukosius, Denise; Valaitis, Ruta; Martin-Misener, Ruth; Donald, Faith; Peña, Laura Morán; Brousseau, Linda

    2017-01-01

    ABSTRACT Objective: to examine advanced practice nursing (APN) roles internationally to inform role development in Latin America and the Caribbean to support universal health coverage and universal access to health. Method: we examined literature related to APN roles, their global deployment, and APN effectiveness in relation to universal health coverage and access to health. Results: given evidence of their effectiveness in many countries, APN roles are ideally suited as part of a primary health care workforce strategy in Latin America to enhance universal health coverage and access to health. Brazil, Chile, Colombia, and Mexico are well positioned to build this workforce. Role implementation barriers include lack of role clarity, legislation/regulation, education, funding, and physician resistance. Strong nursing leadership to align APN roles with policy priorities, and to work in partnership with primary care providers and policy makers is needed for successful role implementation. Conclusions: given the diversity of contexts across nations, it is important to systematically assess country and population health needs to introduce the most appropriate complement and mix of APN roles and inform implementation. Successful APN role introduction in Latin America and the Caribbean could provide a roadmap for similar roles in other low/middle income countries. PMID:28146177

  11. Advanced practice nursing, health care teams, and perceptions of team effectiveness.

    PubMed

    Kilpatrick, Kelley; Lavoie-Tremblay, Mélanie; Ritchie, Judith A; Lamothe, Lise

    2014-01-01

    This article summarizes the results of an extensive review of the organizational and health care literature of advanced practice nursing (APN) roles, health care teams, and perceptions of team effectiveness. Teams have a long history in health care. Managers play an important role in mobilizing resources, guiding expectations of APN roles in teams and within organizations, and facilitating team process. Researchers have identified a number of advantages to the addition of APN roles in health care teams. The process within health care teams are dynamic and responsive to their surrounding environment. It appears that teams and perceptions of team effectiveness need to be understood in the broader context in which the teams are situated. Key team process are identified for team members to perceive their team as effective. The concepts of teamwork, perceptions of team effectiveness, and the introduction of APN roles in teams have been studied disparately. An exploration of the links between these concepts may further our understanding the health care team's perceptions of team effectiveness when APN roles are introduced. Such knowledge could contribute to the effective deployment of APN roles in health care teams and improve the delivery of health care services to patients and families.

  12. Advanced practice nursing, health care teams, and perceptions of team effectiveness.

    PubMed

    Kilpatrick, Kelley; Lavoie-Tremblay, Mélanie; Ritchie, Judith A; Lamothe, Lise

    2011-01-01

    This article summarizes the results of an extensive review of the organizational and health care literature of advanced practice nursing (APN) roles, health care teams, and perceptions of team effectiveness. Teams have a long history in health care. Managers play an important role in mobilizing resources, guiding expectations of APN roles in teams and within organizations, and facilitating team process. Researchers have identified a number of advantages to the addition of APN roles in health care teams. The process within health care teams are dynamic and responsive to their surrounding environment. It appears that teams and perceptions of team effectiveness need to be understood in the broader context in which the teams are situated. Key team process are identified for team members to perceive their team as effective. The concepts of teamwork, perceptions of team effectiveness, and the introduction of APN roles in teams have been studied disparately. An exploration of the links between these concepts may further our understanding the health care team's perceptions of team effectiveness when APN roles are introduced. Such knowledge could contribute to the effective deployment of APN roles in health care teams and improve the delivery of health care services to patients and families.

  13. Identifying contamination with advanced visualization and analysis practices: metagenomic approaches for eukaryotic genome assemblies.

    PubMed

    Delmont, Tom O; Eren, A Murat

    2016-01-01

    High-throughput sequencing provides a fast and cost-effective mean to recover genomes of organisms from all domains of life. However, adequate curation of the assembly results against potential contamination of non-target organisms requires advanced bioinformatics approaches and practices. Here, we re-analyzed the sequencing data generated for the tardigrade Hypsibius dujardini, and created a holistic display of the eukaryotic genome assembly using DNA data originating from two groups and eleven sequencing libraries. By using bacterial single-copy genes, k-mer frequencies, and coverage values of scaffolds we could identify and characterize multiple near-complete bacterial genomes from the raw assembly, and curate a 182 Mbp draft genome for H. dujardini supported by RNA-Seq data. Our results indicate that most contaminant scaffolds were assembled from Moleculo long-read libraries, and most of these contaminants have differed between library preparations. Our re-analysis shows that visualization and curation of eukaryotic genome assemblies can benefit from tools designed to address the needs of today's microbiologists, who are constantly challenged by the difficulties associated with the identification of distinct microbial genomes in complex environmental metagenomes.

  14. Identifying contamination with advanced visualization and analysis practices: metagenomic approaches for eukaryotic genome assemblies

    PubMed Central

    Delmont, Tom O.

    2016-01-01

    High-throughput sequencing provides a fast and cost-effective mean to recover genomes of organisms from all domains of life. However, adequate curation of the assembly results against potential contamination of non-target organisms requires advanced bioinformatics approaches and practices. Here, we re-analyzed the sequencing data generated for the tardigrade Hypsibius dujardini, and created a holistic display of the eukaryotic genome assembly using DNA data originating from two groups and eleven sequencing libraries. By using bacterial single-copy genes, k-mer frequencies, and coverage values of scaffolds we could identify and characterize multiple near-complete bacterial genomes from the raw assembly, and curate a 182 Mbp draft genome for H. dujardini supported by RNA-Seq data. Our results indicate that most contaminant scaffolds were assembled from Moleculo long-read libraries, and most of these contaminants have differed between library preparations. Our re-analysis shows that visualization and curation of eukaryotic genome assemblies can benefit from tools designed to address the needs of today’s microbiologists, who are constantly challenged by the difficulties associated with the identification of distinct microbial genomes in complex environmental metagenomes. PMID:27069789

  15. Advancing the Scientific Foundation for Evidence-Based Practice in Clinical Child and Adolescent Psychology.

    PubMed

    Roberts, Michael C; Blossom, Jennifer B; Evans, Spencer C; Amaro, Christina M; Kanine, Rebecca M

    2016-05-24

    Evidence-based practice (EBP) has become a central focus in clinical child and adolescent psychology. As originally defined, EBP in psychology is the integration of the best available research evidence, patient characteristics, and clinical expertise. Although evidence-based perspectives have garnered widespread acceptance in recent years, there has also been some confusion and disagreement about the 3-part definition of EBP, particularly the role of research. In this article, we first provide a brief review of the development of EBP in clinical child and adolescent psychology. Next, we outline the following 4 points to help clarify the understanding of EBP: (a) knowledge should not be confused with epistemic processes, (b) research on clinician and client factors is needed for EBP, (c) research on assessment is needed for EBP, and (d) the 3-part conceptualization of EBP can serve as a useful framework to guide research. Based on these principles, we put forth a slightly revised conceptualization of EBP, in which the role of research is expanded and more clearly operationalized. Finally, based on our review of the literature, we offer illustrative examples of specific directions for future research to advance the evidence base for EBP in clinical child and adolescent psychology.

  16. The Impact of Advanced Pharmacy Practice Experiences on Students' Readiness for Self-directed Learning

    PubMed Central

    Haines, Stuart T.; Plaza, Cecilia M.; Sturpe, Deborah A.; Williams, Greg; Rodriguez de Bittner, Magaly A.; Roffman, David S.

    2009-01-01

    Objective To evaluate the impact of advanced pharmacy practice experiences (APPEs) on doctor of pharmacy (PharmD) students' readiness for self-directed learning. Methods The Self-Directed Learning Readiness Scale (SDLRS) was administered to students prior to and after completing their APPEs. SDLRS is a validated instrument that determines the relative degree to which students have the attitudes and motivation to engage in self-directed learning. Results Seventy-seven (64%) students completed the SDLRS prior to starting their APPEs and 80 (67%) students completed the instrument after completing their APPEs. Forty-six (38%) students completed both. Prior to starting their APPEs, 74% of students scored greater than 150 on the SDLRS, indicating a high level of readiness for self-directed learning. No significant difference was found between the mean scores of students who took the SDLRS both prior to (159 ± 20) and after completing their APPEs (159 ± 24; p > 0.05). Conclusion Students at our institution appear to be ready for self-directed learning but APPEs had a minimal impact on their readiness for self-directed learning. PMID:19657498

  17. Professional Identity Formation in an Advanced Pharmacy Practice Experience Emphasizing Self-Authorship

    PubMed Central

    Chauvin, Sheila

    2016-01-01

    Objective. To examine the extent to which reflective essays written by graduating pharmacy students revealed professional identity formation and self-authorship development. Design. Following a six-week advanced pharmacy practice experience (APPE) grounded in Baxter-Magolda’s Learning Partnerships Model of self-authorship development, students completed a culminating reflective essay on their rotation experiences and professional identity formation. Assessment. Thematic and categorical analysis of 41 de-identified essays revealed nine themes and evidence of all Baxter-Magolda’s domains and phases of self-authorship. Analysis also suggested relationships between self-authorship and pharmacist professional identity formation. Conclusion. Results suggest that purposeful structuring of learning experiences can facilitate professional identity formation. Further, Baxter-Magolda’s framework for self-authorship and use of the Learning Partnership Model seem to align well with pharmacist professional identify formation. Results of this study could be used by pharmacy faculty members when considering how to fill gaps in professional identity formation in future course and curriculum development. PMID:28179721

  18. Web-based Multimedia Vignettes in Advanced Community Pharmacy Practice Experiences

    PubMed Central

    Vanderbush, Ross E.; Hastings, Jan K.; West, Donna

    2010-01-01

    Objectives To evaluate the effectiveness of Web-based multimedia vignettes on complex drug administration techniques to augment the training of pharmacy students in advanced community pharmacy practice experiences. Design During the orientation for a community APPE, students were randomly assigned to either a study group or control group After they began their APPE, students in the study group were given an Internet address to access multimedia vignettes which they were required to watch to augment their training and standardize their counseling of patients in the use of inhalers and ear and eye drops. Assessment A 12-item questionnaire was administered to students in both groups at the orientation and again on the last day of the APPE to evaluate their knowledge of counseling patients in the use of inhalers and ear and eye drops. The control group did not experience any improvement in their counseling knowledge of the research topics during their month-long experience. Students in the intervention group scored higher on their postintervention test than students in the control group (p < 0.001). Conclusions Student learning outcomes from experiential training can be improved through the use of Web-based multimedia instructional vignettes. PMID:20498732

  19. Sexual Advances by Patients in Dental Practice: Implications for the Dental and Dental Hygiene Curricula.

    ERIC Educational Resources Information Center

    Chiodo, Gary T.; And Others

    1992-01-01

    A survey of Oregon dentists (n=248) and dental hygienists (n=235) investigated frequency of patient-initiated sexual advances and methods of dealing with them. Up to 44 percent experienced 1 or more patient verbal advances, and 23 percent experienced physical advances during a 5-year period. Inclusion of related issues in professional curricula is…

  20. Care coordination for children with complex special health care needs: the value of the advanced practice nurse's enhanced scope of knowledge and practice.

    PubMed

    Looman, Wendy S; Presler, Elizabeth; Erickson, Mary M; Garwick, Ann W; Cady, Rhonda G; Kelly, Anne M; Finkelstein, Stanley M

    2013-01-01

    Efficiency and effectiveness of care coordination depends on a match between the needs of the population and the skills, scope of practice, and intensity of services provided by the care coordinator. Existing literature that addresses the relevance of the advanced practice nurse (APN) role as a fit for coordination of care for children with special health care needs (SHCN) is limited. The objective of this article is to describe the value of the APN's enhanced scope of knowledge and practice for relationship-based care coordination in health care homes that serve children with complex SHCN. The TeleFamilies project is provided as an example of the integration of an APN care coordinator in a health care home for children with SHCN.

  1. Advances in management of adjuvant chemotherapy in rectal cancer: Consequences for clinical practice.

    PubMed

    Netter, Jeanne; Douard, Richard; Durdux, Catherine; Landi, Bruno; Berger, Anne; Taieb, Julien

    2016-11-01

    More than half the patients with rectal cancer present with locally advanced rectal disease at diagnosis with a high risk of recurrence. Preoperative chemoradiotherapy and standardized radical surgery with total mesorectal excision have been established as the 'gold standard' for treating these patients. Pathological staging using the ypTNM classification system to decide on adjuvant chemotherapy (ACT) is widely used in clinical practice, but the delivery of ACT is still controversial, as many discrepancies persist in the conclusions of different trials, due to heterogeneity of the inclusion criteria between studies, lack of statistical power, and variations in preoperative and adjuvant regimens. In 2014, a meta-analysis of four randomized phase-III trials (EORTC 22921, I-CNR-RT, PROCTOR-SCRIPT, CHRONICLE) failed to demonstrate any statistical efficacy of fluorouracil (5FU)-based ACT. Three recent randomized trials aimed to compare 5FU with 5FU plus oxaliplatin-based chemotherapy. Two of them (ADORE, CAO/ARO/AIO-04) appeared to find a disease-free survival benefit for patients treated with the combination therapy. Thus, while awaiting new data, it can be said that, as of 2015, patients with yp stage I tumors or histological complete response derived no benefit from adjuvant therapy. On the other hand, the FOLFOX chemotherapy regimen should be proposed for yp stage III patients, and may be considered for yp stage II tumors in fit patients with high-risk factors. Nevertheless, well-designed and sufficiently powered clinical trials dedicated to adjuvant treatments for rectal cancer remain justified in future to achieve a high level of proof in keeping with evidence-based medical standards.

  2. Exploring the use of standardized patients for simulation-based learning in preparing advanced practice nurses.

    PubMed

    Kowitlawakul, Yanika; Chow, Yeow Leng; Salam, Zakir Hussian Abdul; Ignacio, Jeanette

    2015-07-01

    The use of standardized patients for simulation-based learning was integrated into the Master of Nursing curriculum in the 2012-2013 academic year. The study aimed to explore the Master of Nursing students' experiences with and perceptions of using standardized patients in simulations, and to identify the students' learning needs in preparing to become advanced practice nurses. The study adopted an exploratory descriptive qualitative design, using a focus group interview. The study was conducted at a university in Singapore. Seven Master of Nursing students who were enrolled in the Acute Care Track of Master of Nursing program in the 2012-2013 academic year participated in the study. The data were gathered at the end of the first semester. Content analysis was used to analyze the data. Three main categories - usefulness, clinical limitations, and realism - were identified in the study. The results revealed that the students felt using standardized patients was useful and realistic for developing skills in history taking, communication, and responding to an emergency situation. On the other hand, they found that the standardized patients were limited in providing critical signs and symptoms of case scenarios. To meet the learning objectives, future development and integration of standardized patients in the Master of Nursing curriculum might need to be considered along with the use of a high-fidelity simulator. This can be an alternative strategy to fill the gaps in each method. Obviously, using standardized patients for simulation-based learning has added value to the students' learning experiences. It is highly recommended that future studies explore the impact of using standardized patients on students' performance in clinical settings.

  3. Advancing the State-of-the-Practice for Liquid Rocket Engine Injector Design

    NASA Technical Reports Server (NTRS)

    Tucker, P. K.; Kenny, R. J.; Richardson, B. R.; Anderso, W. E.; Austin, B. J.; Schumaker, S. A.; Muss, J. A.

    2015-01-01

    Current shortcomings in both the overall injector design process and its underlying combustion stability assessment methodology are rooted in the use of empirically based or low fidelity representations of complex physical phenomena and geometry details that have first order effects on performance, thermal environments and combustion stability. The result is a design and analysis capability that is often inadequate to reliably arrive at a suitable injector design in an efficient manner. Specifically, combustion instability has been particularly difficult to predict and mitigate. Large hydrocarbon-fueled booster engines have been especially problematic in this regard. Where combustion instability has been a problem, costly and time-consuming redesign efforts have often been an unfortunate consequence. This paper presents an overview of a recently completed effort at NASA Marshall Space Flight Center to advance the state-of-the-practice for liquid rocket engine injector design. Multiple perturbations of a gas-centered swirl coaxial (GCSC) element that burned gaseous oxygen and RP-1 were designed, assessed for combustion stability, and tested. Three designs, one stable, one marginally unstable and one unstable, were used to demonstrate both an enhanced overall injector design process and an improved combustion stability assessment process. High-fidelity results from state-of-the-art computational fluid dynamics CFD simulations were used to substantially augment and improve the injector design methodology. The CFD results were used to inform and guide the overall injector design process. They were also used to upgrade selected empirical or low-dimensional quantities in the ROCket Combustor Interactive Design (ROCCID) stability assessment tool. Hot fire single element injector testing was used to verify both the overall injector designs and the stability assessments. Testing was conducted at the Air Force Research Laboratory and at Purdue University. Companion papers

  4. Practical Considerations of Waste Heat Reuse for a Mars Mission Advanced Life Support System

    NASA Technical Reports Server (NTRS)

    Levri, Julie; Finn, Cory; Luna, Bernadette (Technical Monitor)

    2000-01-01

    Energy conservation is a key issue in design optimization of Advanced Life Support Systems (ALSS) for long-term space missions. By considering designs for conservation at the system level, energy saving opportunities arise that would otherwise go unnoticed. This paper builds on a steady-state investigation of system-level waste heat reuse in an ALSS with a low degree of crop growth for a Mars mission. In past studies, such a system has been defined in terms of technology types, hot and cold stream identification and stream energy content. The maximum steady-state potential for power and cooling savings within the system was computed via the Pinch Method. In this paper, several practical issues are considered for achieving a pragmatic estimate of total system savings in terms of equivalent system mass (ESM), rather than savings solely in terms of power and cooling. In this paper, more realistic ESM savings are computed by considering heat transfer inefficiencies during material transfer. An estimate of the steady-state mass, volume and crewtime requirements associated with heat exchange equipment is made by considering heat exchange equipment material type and configuration, stream flow characteristics and associated energy losses during the heat exchange process. Also, previously estimated power and cooling savings are adjusted to reflect the impact of such energy losses. This paper goes one step further than the traditional Pinch Method of considering waste heat reuse in heat exchangers to include ESM savings that occur with direct reuse of a stream. For example, rather than exchanging heat between crop growth lamp cooling air and air going to a clothes dryer, air used to cool crop lamps might be reused directly for clothes drying purposes. When thermodynamically feasible, such an approach may increase ESM savings by minimizing the mass, volume and crewtime requirements associated with stream routing equipment.

  5. Advancing the Interdisciplinary Collaborative Health Team Model: Applying Democratic Professionalism, Implementation Science, and Therapeutic Alliance to Enact Social Justice Practice.

    PubMed

    Murphy, Nancy

    2015-01-01

    This essay reframes the interdisciplinary collaborative health team model by proposing the application of 3 foundational pillars-democratic professionalism, implementation science, and therapeutic alliance to advance this practice. The aim was to address challenges to the model, enhance their functional capacity, and explicate and enact social justice practices to affect individual health outcomes while simultaneously addressing health inequities. The pillars are described and examples from the author's dissertation research illustrate how the pillars were used to bring about action. Related theories, models, and frameworks that have negotiation, capacity building, collaboration, and knowledge/task/power sharing as central concepts are presented under each of the pillars.

  6. Building Shared Experience to Advance Practical Application of Pathway-Based Toxicology: Liver Toxicity Mode-of-Action

    PubMed Central

    Willett, Catherine; Rae, Jessica Caverly; Goyak, Katy O.; Minsavage, Gary; Westmoreland, Carl; Andersen, Melvin; Avigan, Mark; Duché, Daniel; Harris, Georgina; Hartung, Thomas; Jaeschke, Hartmut; Kleensang, Andre; Landesmann, Brigitte; Martos, Suzanne; Matevia, Marilyn; Toole, Colleen; Rowan, Andrew; Schultz, Terry; Seed, Jennifer; Senior, John; Shah, Imran; Subramanian, Kalyanasundaram; Vinken, Mathieu; Watkins, Paul

    2016-01-01

    Summary A workshop sponsored by the Human Toxicology Project Consortium (HTPC), “Building Shared Experience to Advance Practical Application of Pathway-Based Toxicology: Liver Toxicity Mode-of-Action” brought together experts from a wide range of perspectives to inform the process of pathway development and to advance two prototype pathways initially developed by the European Commission Joint Research Center (JRC): liver-specific fibrosis and steatosis. The first half of the workshop focused on the theory and practice of pathway development; the second on liver disease and the two prototype pathways. Participants agreed pathway development is extremely useful for organizing information and found that focusing the theoretical discussion on a specific AOP is helpful. It is important to include several perspectives during pathway development, including information specialists, pathologists, human health and environmental risk assessors, and chemical and product manufacturers, to ensure the biology is well captured and end use is considered. PMID:24535319

  7. Assessment of advanced practice palliative care nursing competencies in nurse practitioner students: implications for the integration of ELNEC curricular modules.

    PubMed

    Shea, Joyce; Grossman, Sheila; Wallace, Meredith; Lange, Jean

    2010-04-01

    Advanced practice nurses (APRNs) have key roles in the care of patients who are nearing death and those living with a disabling chronic disease. This article describes a mixed-method formative assessment of 36 graduate nursing students' knowledge about and attitudes toward palliative care preliminary to curricular integration of the End-of-Life Nursing Education Consortium (ELNEC) graduate core modules. Students' knowledge about palliative care was assessed using the 106-item ELNEC examination. In addition, qualitative data were gathered regarding students' definitions of palliative care, the role of the APRN in palliative care, and their definitions of a "good" and "bad" death. Results revealed students' limited knowledge about palliative care. Qualitative findings indicated that most students exclusively linked palliative care with end-of-life care and believed that the treatment they provide should have the goal of prolonging life over maintaining quality of life. Implications for curriculum design, advanced practice role development, and collaboration with community health partners are discussed.

  8. Sandia National Laboratories Advanced Simulation and Computing (ASC) software quality plan : ASC software quality engineering practices Version 3.0.

    SciTech Connect

    Turgeon, Jennifer L.; Minana, Molly A.; Hackney, Patricia; Pilch, Martin M.

    2009-01-01

    The purpose of the Sandia National Laboratories (SNL) Advanced Simulation and Computing (ASC) Software Quality Plan is to clearly identify the practices that are the basis for continually improving the quality of ASC software products. Quality is defined in the US Department of Energy/National Nuclear Security Agency (DOE/NNSA) Quality Criteria, Revision 10 (QC-1) as 'conformance to customer requirements and expectations'. This quality plan defines the SNL ASC Program software quality engineering (SQE) practices and provides a mapping of these practices to the SNL Corporate Process Requirement (CPR) 001.3.6; 'Corporate Software Engineering Excellence'. This plan also identifies ASC management's and the software project teams responsibilities in implementing the software quality practices and in assessing progress towards achieving their software quality goals. This SNL ASC Software Quality Plan establishes the signatories commitments to improving software products by applying cost-effective SQE practices. This plan enumerates the SQE practices that comprise the development of SNL ASC's software products and explains the project teams opportunities for tailoring and implementing the practices.

  9. The law and practice associated with advance directives in Canada and Australia: similarities, differences and debates.

    PubMed

    Brown, Margaret

    2003-08-01

    This article is a summary of research that investigated the Canadian and Australian legislative framework associated with advance directives in health care. The research focused on the context in which older people are encouraged to use advance directives. These are directions about refusal of medical treatment given in advance of incompetence. An advance directive may be given in a written document (living will) expressing one's wishes, by appointing another person (proxy) to make the decisions, or as a combination of the two. A lack of consistency and clarity about the terminology was found in both countries. This could be a barrier for older people to express their wishes in advance. Several confusing issues were also identified with the legislation related to advance directives. There appears to be a move towards appointing a substitute decision-maker, but with significant differences across the Australian States and in Canadian Provinces. The "conversation" about future decisions emerged as an important theme, together with an emphasis on the process of "advance care planning" replacing the focus on advance directive forms.

  10. Advanced Technologies and Data Management Practices in Environmental Science: Lessons from Academia

    ERIC Educational Resources Information Center

    Hernandez, Rebecca R.; Mayernik, Matthew S.; Murphy-Mariscal, Michelle L.; Allen, Michael F.

    2012-01-01

    Environmental scientists are increasing their capitalization on advancements in technology, computation, and data management. However, the extent of that capitalization is unknown. We analyzed the survey responses of 434 graduate students to evaluate the understanding and use of such advances in the environmental sciences. Two-thirds of the…

  11. Caring for older cancer patients: practical decision-making guidelines with a focus on advance directives.

    PubMed

    Sachs, G A

    1992-02-01

    There are no simple solutions to difficult ethical problems. Advance directives, however, offer a way to help prevent ethical dilemmas from occurring in the care of older cancer patients. Studies show that there is overwhelming support from both older patients and physicians for advance treatment planning through the use of living wills, durable powers of attorney for health care, and less formal means. Despite this support, few physicians and patients discuss advance directives. This paper discusses potential barriers to this dialogue and suggests specific ways to incorporate advance directive into routine cancer care of older patients. The Patient Self-Determination Act of 1990 represents additional pressure from society on the medical profession to carry out advance directive discussions.

  12. Best Practices in Weathering Climate Risks: Advancing Corporate and Community Resilience

    NASA Astrophysics Data System (ADS)

    Klima, K.; Winkelman, S.

    2012-12-01

    As the annual costs of severe weather events in the US grow into the billions of dollars, companies and communities are examining how best to plan ahead to protect their assets and bolster their bottom line. The Center for Clean Air Policy's Weathering Climate Risks program aims to help cities and companies enhance resilience to the economic impacts of severe weather and a changing climate. This presentation will highlight three communication techniques aimed at different types of audiences such as businesses, policymakers, the media, and society. First, we find that although planning for natural hazards now saves money later, stakeholders must fi¬nd their own self-interest if they are going to engage in a solution. Thus we research best practices and hold informational, off-the-record interviews to better understand the different stakeholders' perspectives, key concerns, and issues surrounding adaptation, resilience, and/or hazard mitigation. Diverse stakeholders find it attractive when a solution has multiple co-benefits such as climate resilience, greenhouse gas reduction, reduced costs, and social benefits. Second, we use off-the-record dialogues emphasizing candid public-private discussion to promote collaborative problem solving. Our high-level workshops typically consist of 30-40 scientists, companies, communities, and policymakers. We begin with presenting background material, such as geographic information systems (GIS) maps. Then we move to informal conservation. Topics include ideas such as "Ask the Climate Question": How will infrastructure, land development, and investment decisions affect GHG emissions and resilience to climate change impacts? We find these dialogues help stakeholders share their perspectives and advance public-private collaboration on climate resilience to protect critical urban infrastructure, ensure business continuity, and increase extreme weather resilience. Third, we find that communication to the general public must capture

  13. Validation of an advanced practice physiotherapy model of care in an orthopaedic outpatient clinic

    PubMed Central

    2013-01-01

    Background In Canada, new models of orthopaedic care involving advanced practice physiotherapists (APP) are being implemented. In these new models, aimed at improving the efficiency of care for patients with musculoskeletal disorders, APPs diagnose, triage and conservatively treat patients. Formal validation of the efficiency and appropriateness of these emerging models is scarce. The purpose of this study is to assess the diagnostic agreement of an APP compared to orthopaedic surgeons as well as to assess treatment concordance, healthcare resource use, and patient satisfaction in this new model. Methods 120 patients presenting for an initial consult for hip or knee complaints in an outpatient orthopaedic hospital clinic in Montreal, Canada, were independently assessed by an APP and by one of three participating orthopaedic surgeons. Each health care provider independently diagnosed the patients and provided triage recommendations (conservative or surgical management). Proportion of raw agreement and Cohen’s kappa were used to assess inter-rater agreement for diagnosis, triage, treatment recommendations and imaging tests ordered. Chi-Square tests were done in order to compare the type of conservative treatment recommendations made by the APP and the surgeons and Student t-tests to compare patient satisfaction between the two types of care. Results The majority of patients assessed were female (54%), mean age was 54.1 years and 91% consulted for a knee complaint. The raw agreement proportion for diagnosis was 88% and diagnostic inter-rater agreement was very high (κ=0.86; 95% CI: 0.80-0.93). The triage recommendations (conservative or surgical management) raw agreement proportion was found to be 88% and inter-rater agreement for triage recommendation was high (κ=0.77; 95% CI: 0.65-0.88). No differences were found between providers with respect to imaging tests ordered (p≥0.05). In terms of conservative treatment recommendations made, the APP gave significantly

  14. Registering Researchers in Authority Files

    ERIC Educational Resources Information Center

    Smith-Yoshimura, Karen; Altman, Micah; Conlon, Michael; Cristán, Ana Lupe; Dawson, Laura; Dunham, Joanne; Hickey, Thom; Hook, Daniel; Horstmann, Wolfram; MacEwan, Andrew; Schreur, Philip; Smart, Laura; Wacker, Melanie; Woutersen, Saskia

    2014-01-01

    Written by OCLC Research Program Officer Karen Smith-Yoshimura and the 13 members of the Registering Researchers in Authority Files Task Group comprised of specialists from the US, UK, and the Netherlands, this report summarizes their research into approaches to providing authoritative researcher identifiers. Registering researchers in some type…

  15. The Swedish Rheumatology Quality Register: optimisation of rheumatic disease assessments using register-enriched data.

    PubMed

    Eriksson, J K; Askling, J; Arkema, E V

    2014-01-01

    New therapeutic options are constantly emerging for the treatment of rheumatic diseases. To evaluate the safety and efficacy of newly introduced anti-rheumatic treatment alternatives, registers are an important source of information. The Swedish Rheumatology Quality Register (SRQ) collects clinical data on patients with rheumatoid arthritis, as well as other rheumatic diseases, and may be enriched with data on comorbid conditions, prescription drug dispensings, and mortality from national data sources in Sweden. In this setting, many different outcomes can be investigated over a long period of time in a diverse population of patients recruited in daily clinical practice.

  16. Power and promise of narrative for advancing physical therapist education and practice.

    PubMed

    Greenfield, Bruce H; Jensen, Gail M; Delany, Clare M; Mostrom, Elizabeth; Knab, Mary; Jampel, Ann

    2015-06-01

    This perspective article provides a justification for and an overview of the use of narrative as a pedagogical tool for educators to help physical therapist students, residents, and clinicians develop skills of reflection and reflexivity in clinical practice. The use of narratives is a pedagogical approach that provides a reflective and interpretive framework for analyzing and making sense of texts, stories, and other experiences within learning environments. This article describes reflection as a well-established method to support critical analysis of clinical experiences; to assist in uncovering different perspectives of patients, families, and health care professionals involved in patient care; and to broaden the epistemological basis (ie, sources of knowledge) for clinical practice. The article begins by examining how phronetic (ie, practical and contextual) knowledge and ethical knowledge are used in physical therapy to contribute to evidence-based practice. Narrative is explored as a source of phronetic and ethical knowledge that is complementary but irreducible to traditional objective and empirical knowledge-the type of clinical knowledge that forms the basis of scientific training. The central premise is that writing narratives is a cognitive skill that should be learned and practiced to develop critical reflection for expert practice. The article weaves theory with practical application and strategies to foster narrative in education and practice. The final section of the article describes the authors' experiences with examples of integrating the tools of narrative into an educational program, into physical therapist residency programs, and into a clinical practice.

  17. Advancing HIV Nursing Practice: The Doctor of Nursing Practice HIV Specialty at Rutgers, the State University of New Jersey.

    PubMed

    Willard, Suzanne; Nelson, John; Reyes, Darcel; Linn, Annē

    2016-01-01

    The move to integrate HIV treatment and care into primary care is a major obstacle for the current U.S. health care workforce. Many HIV specialty providers will soon retire, while few primary care clinicians have been adequately trained in the diagnosis, care, and treatment of people living with HIV. The Health Resources and Services Administration (HRSA) has supported the development of a Doctor of Nursing Practice (DNP) program with an HIV specialty at Rutgers, the State University of New Jersey, to assure successful transition to an HIV primary care workforce. The Rutgers School of Nursing has been at the forefront of the DNP education movement and is among the first to develop an HIV-focused DNP program. Thirty-seven students have enrolled in the 3-year program, and two have graduated from the first cohort. Here we discuss the planning, implementation, successes, and recommendations of the new program.

  18. Advancing Your Career: Concepts of Professional Nursing. Second Edition.

    ERIC Educational Resources Information Center

    Kearney, Rose

    This textbook, intended for registered nurses (RN's) returning to school, is designed to provide practicing RN's with professional concepts to advance their careers. The book contains 22 chapters organized in five sections. Each chapter includes chapter objectives, key terms, key points, chapter exercises, references, and a bibliography. Section I…

  19. The Arts and Family Social Work: A Call for Advancing Practice, Research, and Education

    ERIC Educational Resources Information Center

    Mazza, Nicholas

    2009-01-01

    This brief report serves as a call for creative and artistic works relative to family social work. Recognizing the "art" of family social work, Mazza's (2003) multidimensional poetry therapy practice model is used as a framework for addressing all arts-based approaches to practice and research.

  20. Leading the Ongoing Development of Collaborative Data Practices: Advancing a Schema for Diagnosis and Intervention

    ERIC Educational Resources Information Center

    Cosner, Shelby

    2012-01-01

    Research suggests that school leaders play an important role in cultivating and developing collaborative data practices by teachers. Although diagnosis and intervention are critical facets of leaders' work to support collaborative data practice development, this work remains poorly understood. Missing from data-use literature is more explicit and…

  1. The Influence of Advanced General Dentistry Training on Practice Patterns of Iowa Dental Graduates.

    ERIC Educational Resources Information Center

    Bolden, Aljernon J.; And Others

    1992-01-01

    A study compared the practice patterns of 41 dentists with graduate training in general dentistry with those of 41 dentists without such training, in terms of number and types of procedures performed, patient characteristics, professional and community activities, and practice characteristics. Some differences were found, particularly in patient…

  2. Theory and Practice in Early Childhood Teaching. Advances in Early Education and Day Care.

    ERIC Educational Resources Information Center

    Chafel, Judith A., Ed.; Riefel, Stuart, Ed.

    Reflecting the complexity of the early childhood education enterprise--classroom practice, teacher preparation, research, and conceptualization--this volume reflects an examination of the literature for illumination as to the value of early education theory and its usefulness to practice. The book has 10 chapters divided into three parts that…

  3. Catching the Wave: Next Steps in Advancing the Vision-in-Practice Agenda

    ERIC Educational Resources Information Center

    Pekarsky, Daniel

    2008-01-01

    Building on insights of Seymour Fox, I explore the often-decisive role of "good timing" in the introduction of potentially powerful innovations (ideas, practices, etc.) into practical domains like education. After examining key readiness conditions that make for good timing, I argue that the field of Jewish education is in many ways now ready to…

  4. Evaluation of the Penn Macy Initiative To Advance Academic Nursing Practice.

    ERIC Educational Resources Information Center

    Evans, Lois K.; Swan, Beth Ann; Lang, Norma E.

    2003-01-01

    In the Penn Macy Initiative, 21 nursing schools participated in summer institutes and follow-up consultations to refine practice. Evaluation data from participants' daily and postinstitute feedback, institutional self-evaluations, and comparison of school accomplishments identified critical indicators of progress in academic practice. A key…

  5. Community Introduction of Practice Parameters for Autistic Spectrum Disorders: Advancing Early Recognition

    ERIC Educational Resources Information Center

    Holzer, Laurent; Mihailescu, Raluca; Rodrigues-Degaeff, Catherine; Junier, Laurent; Muller-Nix, Carole; Halfon, Oliver; Ansermet, Francois

    2006-01-01

    Objectives: Within a strong interdisciplinary framework, improvement in the quality of care for children with autistic spectrum disorders through a 2 year implementation program of Practice Parameters, aimed principally at improving early detection and intervention. Method: We developed Practice Parameters (PPs) for Pervasive Developmental…

  6. Exploring factors affecting registered nurses' pursuit of postgraduate education in Australia.

    PubMed

    Ng, Linda; Eley, Robert; Tuckett, Anthony

    2016-12-01

    The aim of this study was to explore the factors influencing registered nurses' pursuit of postgraduate education in specialty nursing practice in Australia. Despite the increased requirement for postgraduate education for advanced practice, little has been reported on the contributory factors involved in the decision to undertake further education. The Nurses' Attitudes Towards Postgraduate Education instrument was administered to 1632 registered nurses from the Nurses and Midwives e-Cohort Study across Australia, with a response rate of 35.9% (n = 568). Data reduction techniques using principal component analysis with varimax rotation were used. The analysis identified a three-factor solution for 14 items, accounting for 52.5% of the variance of the scale: "facilitators," "professional recognition," and "inhibiting factors." Facilitators of postgraduate education accounted for 28.5% of the variance, including: (i) improves knowledge; (ii) increases nurses' confidence in clinical decision-making; (iii) enhances nurses' careers; (iv) improves critical thinking; (v) improves nurses' clinical skill; and (vi) increased job satisfaction. This new instrument has potential clinical and research applications to support registered nurses' pursuit of postgraduate education.

  7. Register of hydrogen technology experts

    NASA Technical Reports Server (NTRS)

    Ludtke, P. R.

    1975-01-01

    This register presents the names of approximately 235 individuals who are considered experts, or very knowledgeable, in various fields of technology related to hydrogen. Approximately 90 organizations are represented. Each person is listed by organizational affiliation, address, and principal area of expertise. The criteria for selection of names for the register are extensive experience in a given field of work, participation in or supervision of relevant research programs, contributions to the literature, or being recognized as an expert in a particular field. The purpose of the register is to present, in easy form, sources of dependable information regarding highly technical areas of hydrogen technology, with particular emphasis on safety. The register includes two indexes: an alphabetical listing of the experts and an alphabetical listing of the organizations with which they are affiliated.

  8. The Swedish Knee Arthroplasty Register

    PubMed Central

    Robertsson, O.; Ranstam, J.; Sundberg, M.; W-Dahl, A.; Lidgren, L.

    2014-01-01

    We are entering a new era with governmental bodies taking an increasingly guiding role, gaining control of registries, demanding direct access with release of open public information for quality comparisons between hospitals. This review is written by physicians and scientists who have worked with the Swedish Knee Arthroplasty Register (SKAR) periodically since it began. It reviews the history of the register and describes the methods used and lessons learned. Cite this article: Bone Joint Res 2014;3:217–22. PMID:24986492

  9. The ConNECT Framework: a model for advancing behavioral medicine science and practice to foster health equity.

    PubMed

    Alcaraz, Kassandra I; Sly, Jamilia; Ashing, Kimlin; Fleisher, Linda; Gil-Rivas, Virginia; Ford, Sabrina; Yi, Jean C; Lu, Qian; Meade, Cathy D; Menon, Usha; Gwede, Clement K

    2017-02-01

    Health disparities persist despite ongoing efforts. Given the United States' rapidly changing demography and socio-cultural diversity, a paradigm shift in behavioral medicine is needed to advance research and interventions focused on health equity. This paper introduces the ConNECT Framework as a model to link the sciences of behavioral medicine and health equity with the goal of achieving equitable health and outcomes in the twenty-first century. We first evaluate the state of health equity efforts in behavioral medicine science and identify key opportunities to advance the field. We then discuss and present actionable recommendations related to ConNECT's five broad and synergistic principles: (1) Integrating Context; (2) Fostering a Norm of Inclusion; (3) Ensuring Equitable Diffusion of Innovations; (4) Harnessing Communication Technology; and (5) Prioritizing Specialized Training. The framework holds significant promise for furthering health equity and ushering in a new and refreshing era of behavioral medicine science and practice.

  10. 16 CFR 300.4 - Registered identification numbers.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Registered identification numbers. 300.4 Section 300.4 Commercial Practices FEDERAL TRADE COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF CONGRESS RULES AND REGULATIONS UNDER THE WOOL PRODUCTS LABELING ACT OF 1939 Labeling § 300.4...

  11. E-Mentoring: Confidence Intervention for Senior Nursing Students Preparing for Readiness to Practice

    ERIC Educational Resources Information Center

    LaRose, Patrick S., Sr.

    2013-01-01

    The role of the registered nurse has evolved over the years as technology has changed and the practice of nursing has advanced. There are many factors that influence how a new nurse enters practice; however, confidence appears to play a large role in the way nursing students see themselves and how this self perception regulates transition to…

  12. Multisectoral Strategies for Advancing Girls' Education: Principles and Practice. SAGE Technical Report.

    ERIC Educational Resources Information Center

    Williams, Howard

    This paper describes issues, experiences, and strategies used in developing successful multisectoral partnerships to advance girls' education, using Guinea and Morocco as examples. Chapter 1 introduces the issue, discussing barriers to girls' education and describing the multisectoral response to interrelated barriers. Chapter 2 defines the…

  13. Strategies for Increasing Advanced Placement Participation for Underrepresented Students: Barriers, Practices, and Positive Outcomes

    ERIC Educational Resources Information Center

    Flores, Sergio; Gomez, Martin O.

    2011-01-01

    Some school leaders have viewed programs such as Advanced Placement (AP) as an attractive option to resolve the ongoing achievement gap problem. However, the ongoing debate in the field about maintaining the ostensible purity of the AP program versus diluting it with program expansion has hindered the full utilization of AP classes to close the…

  14. Meeting Students Where They Are: Advancing a Theory and Practice of Archives in the Classroom

    ERIC Educational Resources Information Center

    Saidy, Christina; Hannah, Mark; Sura, Tom

    2011-01-01

    This article uses theories of technical communication and archives to advance a pedagogy that includes archival production in the technical communication classroom. By developing and maintaining local classroom archives, students directly engage in valuable processes of appraisal, selection, collaboration, and retention. The anticipated outcomes…

  15. Behavioral Disorders: Practice Concerns and Students with EBD. Advances in Special Education. Volume 23

    ERIC Educational Resources Information Center

    Bakken, Jeffrey P., Ed.; Obiakor, Festus E., Ed.; Rotatori, Anthony F., Ed.

    2012-01-01

    Volumes 22 and 23 of the "Advances in Special Education" address the current top perspectives and issues in the field of emotional and behavioral disorders (EBD) by providing chapters written by active researchers and scholarly university professors who specialize in this area. Volume 22 first delineates legal issues, themes, and dimensions…

  16. Do Geriatricians Practice What They Preach?: Geriatricians' Personal Establishment of Advance Directives

    ERIC Educational Resources Information Center

    Lester, Paula E.; Sykora, Alzbeta; Wolf-Klein, Gisele P.; Pekmezaris, Renee; Auerbach, Charles; Feuerman, Martin

    2009-01-01

    Previous research has been conducted regarding preferences of physicians for life-sustaining treatments for themselves, but there is a dearth of data on personal use of advance directives (ADs) by geriatricians specifically. Using a phone survey, we contacted all graduates of the geriatric fellowship program to assess their personal use of advance…

  17. Assessment Practices of Preparatory Year English Program (PYEP): Investigating Student Advancement through Third and Fourth Levels

    ERIC Educational Resources Information Center

    Obaid, Rana

    2016-01-01

    This small-scale mixed method research focuses on investigating the way Preparatory Year English Program (PYEP) female students in a Saudi tertiary level institution context are assessed and how they are advanced from level three (Pre-intermediate) and level four (Intermediate). A four-point agreement scale survey was conducted with fifteen…

  18. Joint crisis plans and psychiatric advance directives in German psychiatric practice.

    PubMed

    Radenbach, Katrin; Falkai, Peter; Weber-Reich, Traudel; Simon, Alfred

    2014-05-01

    This study explores the attitude of German psychiatrists in leading positions towards joint crisis plans and psychiatric advance directives. This topic was examined by contacting 473 medical directors of German psychiatric hospitals and departments. They were asked to complete a questionnaire developed by us. That form contained questions about the incidence and acceptance of joint crisis plans and psychiatric advance directives and previous experiences with them. 108 medical directors of psychiatric hospitals and departments responded (response rate: 22.8%). Their answers demonstrate that in their hospitals these documents are rarely used. Among the respondents, joint crisis plans are more accepted than psychiatric advance directives. There is a certain uncertainty when dealing with these instruments. Our main conclusion is that German psychiatry needs an intensified discussion on the use of instruments for patients to constitute procedures for future critical psychiatric events. For this purpose it will be helpful to collect more empirical data. Furthermore, the proposal of joint crisis plans in psychiatric hospitals and departments should be discussed as well as the possibility of consulting an expert during the preparation of a psychiatric advance directive.

  19. Advancing High-Quality Literacy Research in Juvenile Justice: Methodological and Practical Considerations

    ERIC Educational Resources Information Center

    Houchins, David E.; Jolivette, Kristine; Shippen, Margaret E.; Lambert, Richard

    2010-01-01

    Special education researchers have made noteworthy progress toward conceptualizing literacy research questions, designing quality studies, and disseminating the results of their research. These advancements have been made through the establishment and refinement of quality research indicators. Unfortunately, this progress has mostly eluded the…

  20. Student Access to Advanced Placement[R] (AP[R]) Coursework: Principals' Beliefs and Practices

    ERIC Educational Resources Information Center

    Wood, Steven M.

    2010-01-01

    Advanced Placement[R] (AP[R]) courses provide high school students an opportunity to be exposed to the rigors of college while they are still in high school. Since school policies play a role in the opportunities for students to pursue these courses, educational leaders must be aware of the ways in which their personal beliefs and school practices…

  1. The DNP by 2015: A Study of the Institutional, Political, and Professional Issues That Facilitate or Impede Establishing a Post-Baccalaureate Doctor of Nursing Practice Program

    ERIC Educational Resources Information Center

    Auerbach, David I.; Martsolf, Grant R.; Pearson, Marjorie L.; Taylor, Erin Audrey; Zaydman, Mikhail; Muchow, Ashley; Spetz, Joanne; Dower, Catherine

    2015-01-01

    In 2004, members of the American Association of Colleges of Nursing (AACN) voted to endorse a position statement identifying the doctor of nursing practice (DNP) degree as the most appropriate degree for advanced-practice registered nurses (APRNs) to enter practice. At the same time, AACN members voted to approve the position that all master's…

  2. Liminality in cultural transition: applying ID-EA to advance a concept into theory-based practice.

    PubMed

    Baird, Martha B; Reed, Pamela G

    2015-01-01

    As global migration increases worldwide, nursing interventions are needed to address the effects of migration on health. The concept of liminality emerged as a pivotal concept in the situation-specific theory of well-being in refugee women experiencing cultural transition. As a relatively new concept in the discipline of nursing, liminality is explored using a method, called ID-EA, which we developed to advance a theoretical concept for application to nursing practice. Liminality in the context of cultural transition is further developed using the five steps of inquiry of the ID-EA method. The five steps are as follows: (1) inductive inquiry: qualitative research, (2) deductive inquiry: literature review, (3) synthesis of inductive and deductive inquiry, (4) evaluation inquiry, and (5) application-to-practice inquiry. The overall goal of this particular work was to develop situation-specific, theory-based interventions that facilitate cultural transitions for immigrants and refugees.

  3. Advancing performance measurement in oncology: quality oncology practice initiative participation and quality outcomes.

    PubMed

    Campion, Francis X; Larson, Leanne R; Kadlubek, Pamela J; Earle, Craig C; Neuss, Michael N

    2011-05-01

    The American health care system, including the cancer care system, is under pressure to improve patient outcomes and lower the cost of care. Government payers have articulated an interest in partnering with the private sector to create learning communities to measure quality and improve the value of health care. In 2006, the American Society for Clinical Oncology (ASCO) unveiled the Quality Oncology Practice Initiative (QOPI), which has become a key component of the measurement system to promote quality cancer care. QOPI is a physician-led, voluntary, practice-based, quality-improvement program, using performance measurement and benchmarking among oncology practices across the United States. Since its inception, ASCO's QOPI has grown steadily to include 973 practices as of November 2010. One key area that QOPI has addressed is end-of-life care. During the most recent data collection cycle in the Fall of 2010, those practices completing multiple data collection cycles had better performance on care of pain compared with sites participating for the first time (62.61% v 46.89%). Similarly, repeat QOPI participants demonstrated meaningfully better performance than their peers in the rate of documenting discussions of hospice and palliative care (62.42% v 54.65%) and higher rates of hospice enrollment. QOPI demonstrates how a strong performance measurement program can lead to improved quality and value of care for patients.

  4. Conducting Reflective, Hands-On Research with Advanced Characterization Instruments: A High-Level Undergraduate Practical Exploring Solid-State Polymorphism

    ERIC Educational Resources Information Center

    Coles, S. J.; Mapp, L. K.

    2016-01-01

    An undergraduate practical exercise has been designed to provide hands-on, instrument-based experience of advanced characterization techniques. A research experience approach is taken, centered around the concept of solid-state polymorphism, which requires a detailed knowledge of molecular and crystal structure to be gained by advanced analytical…

  5. The Danish Hip Arthroplasty Register

    PubMed Central

    Gundtoft, Per Hviid; Varnum, Claus; Pedersen, Alma Becic; Overgaard, Søren

    2016-01-01

    Aim of database The aim of the Danish Hip Arthroplasty Register (DHR) is to continuously monitor and improve the quality of treatment of primary and revision total hip arthroplasty (THA) in Denmark. Study population The DHR is a Danish nationwide arthroplasty register established in January 1995. All Danish orthopedic departments – both public and private – report to the register, and registration is compulsory. Main variables The main variables in the register include civil registration number, indication for primary and revision surgery, operation date and side, and postoperative complications. Completeness of primary and revision surgery is evaluated annually and validation of a number of variables has been carried out. Descriptive data A total of 139,525 primary THAs and 22,118 revisions have been registered in the DHR between January 1, 1995 and December 31, 2014. Since 1995, completeness of procedure registration has been high, being 97.8% and 92.0% in 2014 for primary THAs and revisions, respectively. Several risk factors, such as comorbidity, age, specific primary diagnosis and fixation types for failure of primary THAs, and postoperative complications, have been identified through the DHR. Approximately 9,000 primary THAs and 1,500 revisions are reported to the register annually. Conclusion The DHR is important for monitoring and improvement of treatment with THA and is a valuable tool for research in THA surgery due to the high quality of prospective collected data with long-term follow-up and high completeness. The register can be used for population-based epidemiology studies of THA surgery and can be linked to a range of other national databases. PMID:27822092

  6. PS2-06: Best Practices for Advancing Multi-site Chart Abstraction Research

    PubMed Central

    Blick, Noelle; Cole, Deanna; King, Colleen; Riordan, Rick; Von Worley, Ann; Yarbro, Patty

    2012-01-01

    Background/Aims Multi-site chart abstraction studies are becoming increasingly common within the HMORN. Differences in systems among HMORN sites can pose significant obstacles to the success of these studies. It is therefore crucial to standardize abstraction activities by following best practices for multi-site chart abstraction, as consistency of processes across sites will increase efficiencies and enhance data quality. Methods Over the past few months the authors have been meeting to identify obstacles to multi-site chart abstraction and to address ways in which multi-site chart abstraction processes can be systemized and standardized. The aim of this workgroup is to create a best practice guide for multi-site chart abstraction studies. Focus areas include: abstractor training, format for chart abstraction (database, paper, etc), data quality, redaction, mechanism for transferring data, site specific access to medical records, IRB/HIPAA concerns, and budgetary issues. Results The results of the workgroup’s efforts (the best practice guide) will be presented by a panel of experts at the 2012 HMORN conference. The presentation format will also focus on discussion among attendees to elicit further input and to identify areas that need to be further addressed. Subsequently, the best practice guide will be posted on the HMORN website. Discussion The best practice guide for multi-site chart abstraction studies will establish sound guidelines and serve as an aid to researchers embarking on multi-site chart abstraction studies. Efficiencies and data quality will be further enhanced with standardized multi-site chart abstraction practices.

  7. Interprofessional education in the clinical setting: A qualitative look at the preceptor's perspective in training advanced practice nursing students.

    PubMed

    Chen, Angel K; Rivera, Josette; Rotter, Nicole; Green, Emily; Kools, Susan

    2016-11-01

    With the shift towards interprofessional education to promote collaborative practice, clinical preceptors are increasingly working with trainees from various professions to provide patient care. It is unclear whether and how preceptors modify their existing precepting approach when working with trainees from other professions. There is little information on strategies for this type of precepting, and how preceptors may foster or impede interprofessional collaboration. The purpose of this qualitative description pilot study was to identify current methods preceptors use to teach trainees from other professions in the clinical setting, particularly advanced practice nursing and medical trainees, and to identify factors that support or impede this type of precepting. Data collected through observations and interviews were analyzed by the research team using thematic analysis procedures. Three major themes were identified: 1) a variety of teaching approaches and levels of engagement with trainees of different professions, 2) preceptor knowledge gaps related to curricula, goals, and scope of practice of trainees from other professions, and 3) administrative, structural and logistical elements that impact the success of precepting trainees from different professions in the clinical setting. This study has implications for faculty development and evaluation of current precepting practices in clinical settings.

  8. Regenerative dentistry: translating advancements in basic science research to the dental practice.

    PubMed

    Garcia-Godoy, Franklin; Murray, Peter

    2010-01-01

    Scientific advances in the creation of restorative biomaterials, in vitro cell culture technology, tissue engineering, molecular biology and the human genome project provide the basis for the introduction of new technologies into dentistry. This review provides an assessment of how tissue engineering, stem cell, genetic transfer, biomaterial and growth factor therapies can be integrated into clinical dental therapies to restore and regenerate oral tissues. In parallel to the creation of a new field in general medicine called "regenerative medicine," we call this field "regenerative dentistry." While the problems of introducing regenerative therapies are substantial, the potential benefits to patients and the profession are equally ground-breaking. In this review, we outline a few areas of interest for the future of oral and dental medicine in which advancements in basic science have already been adapted to fit the goals of 21st century dentistry.

  9. Technological Advances in the Treatment of Trauma: A Review of Promising Practices

    ERIC Educational Resources Information Center

    Paul, Lisa A.; Hassija, Christina M.; Clapp, Joshua D.

    2012-01-01

    Given the availability of empirically supported practices for addressing posttraumatic stress disorder and other forms of trauma-related distress, the development and implementation of new technology to deliver these treatments is exciting. Technological innovations in this literature aim to expand availability of empirically based intervention,…

  10. The diagnosis of autism in community pediatric settings: does advanced training facilitate practice change?

    PubMed

    Swanson, Amy R; Warren, Zachary E; Stone, Wendy L; Vehorn, Alison C; Dohrmann, Elizabeth; Humberd, Quentin

    2014-07-01

    The increased prevalence of autism spectrum disorder and documented benefits of early intensive intervention have created a need for flexible systems for determining eligibility for autism-specific services. This study evaluated the effectiveness of a training program designed to enhance autism spectrum disorder identification and assessment within community pediatric settings across the state. Twenty-seven pediatric providers participated in regional trainings across a 3.5-year period. Trainings provided clinicians with strategies for conducting relatively brief within-practice interactive assessments following positive autism spectrum disorder screenings. Program evaluation was measured approximately 1.5 years following training through (a) clinician self-reports of practice change and (b) blind diagnostic verification of a subset of children assessed. Pediatric providers participating in the training reported significant changes in screening and consultation practices following training, with a reported 85% increase in diagnostic identification of children with autism spectrum disorder within their own practice setting. In addition, substantial agreement (86%-93%) was found between pediatrician diagnostic judgments and independent, comprehensive blinded diagnostic evaluations. Collaborative training methods that allow autism spectrum disorder identification within broader community pediatric settings may help translate enhanced screening initiatives into more effective and efficient diagnosis and treatment.

  11. Advancing Transdisciplinary and Translational Research Practice: Issues and Models of Doctoral Education in Public Health

    ERIC Educational Resources Information Center

    Neuhauser, Linda; Richardson, Dawn; Mackenzie, Sonja; Minkler, Meredith

    2007-01-01

    Finding solutions to complex health problems, such as obesity, violence, and climate change, will require radical changes in cross-disciplinary education, research, and practice. The fundamental determinants of health include many interrelated factors such as poverty, culture, education, environment, and government policies. However, traditional…

  12. Conditions for building a community of practice in an advanced physics laboratory

    NASA Astrophysics Data System (ADS)

    Irving, Paul W.; Sayre, Eleanor C.

    2014-06-01

    We use the theory of communities of practice and the concept of accountable disciplinary knowledge to describe how a learning community develops in the context of an upper-division physics laboratory course. The change in accountable disciplinary knowledge motivates students' enculturation into a community of practice. The enculturation process is facilitated by four specific structural features of the course and supported by a primary instructional choice. The four structural features are "paucity of instructor time," "all in a room together," "long and difficult experiments," and "same experiments at different times." The instructional choice is the encouragement of the sharing and development of knowledge and understanding by the instructor. The combination of the instructional choice and structural features promotes the development of the learning community in which students engage in authentic practices of a physicist. This results in a classroom community that can provide students with the opportunity to have an accelerated trajectory towards being a more central participant of the community of a practice of physicists. We support our claims with video-based observations of laboratory classroom interactions and individual, semistructured interviews with students about their laboratory experiences and physics identity.

  13. A University-Community Partnership to Advance Research in Practice Settings: The HUB Research Model

    ERIC Educational Resources Information Center

    Dulmus, Catherine N.; Cristalli, Maria E.

    2012-01-01

    Human service organizations are uniquely positioned, given their scope of practice and access to consumers with the widest range of needs to significantly increase the national capacity for research if they were effectively equipped with the knowledge, skills, and funding to integrate research and development into their ongoing organizational…

  14. Teacher Characteristics and Practices and Student Performance on Advanced Placement Examinations

    ERIC Educational Resources Information Center

    Glenn, James E.

    2012-01-01

    This study investigated AP U.S. History teacher characteristics, school and classroom context, instructional and assessment practices, and the relationship of all these variables with student achievement on the AP U.S. History Exam. The study sample consisted AP U.S. History teachers in the state of Georgia (N = 93) representing 14 of the state's…

  15. Evaluating and Advancing the Effective Teaching of Special Educators with a Dynamic Instructional Practices Portfolio

    ERIC Educational Resources Information Center

    Elliott, Stephen N.; Roach, Andrew T.; Kurz, Alexander

    2014-01-01

    We describe the concept of a dynamic instructional practices portfolio to evaluate special education teachers. This portfolio features the My Instructional Learning Opportunities Guidance System (MyiLOGS) as the core component. MyiLOGS is an online, daily self-report measure of opportunity to learn (OTL) that provides detailed information on…

  16. Can the Institute of Medicine trump the dominant logic of nursing? Leading change in advanced practice education.

    PubMed

    Dreher, Melanie C; Clinton, Patricia; Sperhac, Arlene

    2014-01-01

    The Institute of Medicine (IOM; 2010) has called for a transformation of the nursing profession to lead the redesign of health care in the United States. It acknowledges the need for profound change in nursing education, particularly advanced practice education, to produce the next generation of leaders in sufficient quantity to expand access, improve quality, and reduce cost. Although the IOM provides welcome validation of nursing's significant role, most of the recommendations are not new and have been advocated by nurse educators for decades. What has prevented us from creating the nimble and responsive educational programs that would ensure a sufficient corpus of advanced practice nurses with the relevant knowledge and skill to transform our ailing health system? Conceptualizing nursing as a complex, adaptive system (J.W. Begun and K. White, 1997), this article explores three examples of the dominant logic, grounded in a historical legacy that has kept the nursing profession from realizing its promise as a potent force: (a) the continuing preference for experience over education, (b) the belief that only nurses can teach nurses, and (c) the hegemony of the research doctorate.

  17. A single institution experience on 314 newly diagnosed advanced Hodgkin lymphoma patients: the role of ABVD in daily practice.

    PubMed

    Andjelic, Bosko; Antic, Darko; Jakovic, Ljubomir; Todorovic, Milena; Bogdanovic, Andrija; Djurasinovic, Vladislava; Bila, Jelena; Mihaljevic, Biljana

    2014-11-01

    Based on the results of clinical trials, there is no global consensus on the optimal first-line therapy for patients with advanced Hodgkin lymphoma (HL) with both ABVD and BEACOPP currently being used. However, the results of clinical trials are usually better than those in daily practice. We thus describe here our experience on 314 advanced classical HL patients treated with ABVD at the Clinical Center of Serbia and associated centers between 1997 and 2008. The median follow-up for all patients was 91 months; the estimated 5-yr event-free survival was 62% and the 5-yr overall survival (OS) 76%. Multivariate Cox regression analysis revealed that patients with IPS ≥ 3 and extranodal disease involving more than one site have a poorer outcome. The data presented here show on overall improvement in outcome as compared to more previous data and illustrate the problems of treating advanced stage HL outside the setting of a clinical trial.

  18. Registered Nurse Education and the Registered Nurse Job Market.

    ERIC Educational Resources Information Center

    Hunt, Howard Allan

    This effort compares the graduates of the three types of Registered Nurse (RN) education programs (three-year Diploma in Nursing, two-year Associate Degree in Nursing (ADN), and four-year Bachelor of Science Degree in Nursing). The basic objective is to determine whether they are perfect substitutes, especially whether ADN graduates can adequately…

  19. Data Management Practices and Advanced Technologies in Environmental Science: Lessons from Academia

    NASA Astrophysics Data System (ADS)

    Hernandez, R. R.; Mayernik, M. S.; Murphy-Mariscal, M. L.; Allen, M. F.

    2013-12-01

    Environmental scientists are increasing their capitalization on advancements in technology, computation, and data management. However, the extent of that capitalization is unknown. We analyzed the survey responses of 434 graduate students to evaluate the understanding and use of such advances in the environmental sciences. Two-thirds of the students had not taken courses related to information science and the analysis of complex data. Seventy-four percent of the students reported no skill in programming languages or computational applications. Of the students who had completed research projects, 26% had created metadata for research data sets, and 29% had archived their data so that it was available online. One-third of these students used an environmental sensor. The results differed according to the students' research status, degree type, and university type. Changes may be necessary in the curricula of university programs that seek to prepare environmental scientists for this technologically advanced and data-intensive age. Figure 1. Weighted mean percent of graduate students who had none, basic, proficient, or expert knowledge in programming languages or computational applications. Weights were assigned to university means (n = 23). Error bars are 95% confidence interval. Table 1. Weighted mean percent of graduate students who responded 'YES' they plan to (n = 326) or have already completed (n = 131) research decisions 1-5. Weights were assigned to university means (n = 23). Uncertainties are 95% confidence intervals. Statistical differences are reported between responses of 1) students with thesis/dissertation research ';in progress' and 2) students who have ';completed' their research.

  20. Advances in research, education and practice in geriatric medicine, 1982-2012.

    PubMed

    Flicker, Leon

    2013-10-01

    Over the last 30 years, major advances in the provision of services for frail older people in Australasia have taken place. This has been spurred on by the accumulation of the evidence for benefits of the multidisciplinary team model of comprehensive geriatric assessment and management. Current research is now uncovering mechanisms of frailty associated with the ageing process and will lead to further interventions in the management of the health problems of older people. These interventions will almost certainly include both medical and lifestyle strategies. Although there have been major improvements in the education of health professionals in aspects of geriatrics, more concerted efforts are required for the ageing population.

  1. Role for Occupational Therapy in Community Mental Health: Using Policy to Advance Scholarship of Practice.

    PubMed

    Mahaffey, Lisa; Burson, Kathrine A; Januszewski, Celeste; Pitts, Deborah B; Preissner, Katharine

    2015-01-01

    Occupational therapists must be aware of professional and policy trends. More importantly, occupational therapists must be involved in efforts to influence policy both for the profession and for the people they serve (Bonder, 1987). Using the state of Illinois as an example, this article reviews the policies and initiatives that impact service decisions for persons with psychiatric disabilities as well as the rationale for including occupational therapy in community mental health service provision. Despite challenges in building a workforce of occupational therapists in the mental health system, this article makes the argument that the current climate of emerging policy and litigation combined with the supporting evidence provides the impetus to strengthen mental health as a primary area of practice. Implications for scholarship of practice related to occupational therapy services in community mental health programs for individuals with psychiatric disability are discussed.

  2. A spirit-focused conceptual model of nursing for the advanced practice nurse.

    PubMed

    Swanson, C S

    1995-01-01

    A spirit-focused conceptual model of nursing views the person as a spiritual being whose life and purpose arise from a personal relationship with God. The individual's definition of God determines how he or she responds to stimuli, sets goals, and establishes purpose in life. Consequently, this definition influences the professional nursing relationship, and the nurse's and patient's concepts of health and perceptions of the environment. The pediatric nurse practitioner and client are the primary examples of practice examined in this study.

  3. Mastery Learning of Advanced Cardiac Life Support Skills by Internal Medicine Residents Using Simulation Technology and Deliberate Practice

    PubMed Central

    Wayne, Diane B; Butter, John; Siddall, Viva J; Fudala, Monica J; Wade, Leonard D; Feinglass, Joe; McGaghie, William C

    2006-01-01

    BACKGROUND Internal medicine residents must be competent in advanced cardiac life support (ACLS) for board certification. OBJECTIVE To use a medical simulator to assess postgraduate year 2 (PGY-2) residents' baseline proficiency in ACLS scenarios and evaluate the impact of an educational intervention grounded in deliberate practice on skill development to mastery standards. DESIGN Pretest-posttest design without control group. After baseline evaluation, residents received 4, 2-hour ACLS education sessions using a medical simulator. Residents were then retested. Residents who did not achieve a research-derived minimum passing score (MPS) on each ACLS problem had more deliberate practice and were retested until the MPS was reached. PARTICIPANTS Forty-one PGY-2 internal medicine residents in a university-affiliated program. MEASUREMENTS Observational checklists based on American Heart Association (AHA) guidelines with interrater and internal consistency reliability estimates; deliberate practice time needed for residents to achieve minimum competency standards; demographics; United States Medical Licensing Examination Step 1 and Step 2 scores; and resident ratings of program quality and utility. RESULTS Performance improved significantly after simulator training. All residents met or exceeded the mastery competency standard. The amount of practice time needed to reach the MPS was a powerful (negative) predictor of posttest performance. The education program was rated highly. CONCLUSIONS A curriculum featuring deliberate practice dramatically increased the skills of residents in ACLS scenarios. Residents needed different amounts of training time to achieve minimum competency standards. Residents enjoy training, evaluation, and feedback in a simulated clinical environment. This mastery learning program and other competency-based efforts illustrate outcome-based medical education that is now prominent in accreditation reform of residency education. PMID:16637824

  4. Response Assessment in Myeloma: Practical Manual on Consistent Reporting in an Era of Dramatic Therapeutic Advances.

    PubMed

    Garderet, Laurent; D'Souza, Anita; Jacobs, Paulette; van Biezen, Anja; Schönland, Stefan; Kroeger, Nicolaus; Morris, Curly; Hari, Parameswaran

    2017-03-08

    The understanding and treatment of multiple myeloma (MM) have dramatically improved in recent years. However, accurate assessment of the response of myeloma to therapy and its subsequent relapse remains a difficult task. Criteria have changed over time and new parameters have recently been incorporated to evaluate minimal residual disease status. We present a practical approach to assess response and relapse/progression in myeloma in the context of its treatment. A robust reporting schema is crucial to correctly evaluate any treatment protocol and compare results across trials. MM is a highly heterogeneous disease with multifarious manifestations. To assess the tumor load decline after treatment and its increase during relapse/progression, numerous parameters need to be taken into account. As our ability and the tools to measure low levels of disease have improved over time, so have the accepted definitions of response, most recently in August 2016. The goal of this article is to define, describe, and clarify the practical methodological aspects of disease evaluation in response to therapy and in progression or relapse. We expect this practical manual will help myeloma professionals and research workers in data collection for registries and databases and clinical trial reporting.

  5. Work force policy perspectives: registered nurses.

    PubMed

    Friss, L O

    1981-01-01

    If the decline in full-time labor force participation by registered nurses in hospitals is to be reversed, the issue of equal pay for comparable work must be addressed. Under pressure for cost containment, policies tend to focus on labor force economics rather than on limitations of services. While the two are interrelated, wage policies must be considered independently. This article describes the network which determines how nurse salaries are set: the relationship between the private sector, the general schedule and the Veteran's Administration. The effects of this system are documented, using testimony from a case in the tenth circuit, as well as comparisons with other reference groups: policemen, teachers, laborers, and VA career fields. The evidence suggests that there is a need for policy intervention. Prime areas for action are the comparability practices by governments, particularly in the areas of classification standards and pay setting. Hospital personnel practices which continue past effects of occupational segregation also should be changed.

  6. Patient Simulation to Demonstrate Students’ Competency in Core Domain Abilities Prior to Beginning Advanced Pharmacy Practice Experiences

    PubMed Central

    Bhutada, Nilesh S.; Feng, Xiaodong

    2012-01-01

    Objective. To implement a simulation-based introductory pharmacy practice experience (IPPE) and determine its effectiveness in assessing pharmacy students’ core domain abilities prior to beginning advanced pharmacy practice experience (APPE). Design. A 60-hour IPPE that used simulation-based techniques to provide clinical experiences was implemented. Twenty-eight students were enrolled in this simulation IPPE, while 60 were enrolled in hospital and specialty IPPEs within the region. Assessment. The IPPE assessed 10 out of 11 of the pre-APPE core domain abilities, and on the practical examination, 67% of students passed compared to 52% of students in the control group. Students performed better on all 6 knowledge quizzes after completing the simulation IPPE. Based on scores on the Perception of Preparedness to Perform (PREP) survey, students felt more prepared regarding “technical” aspects after completing the simulation experience (p<0.001). Ninety-six percent of the respondents agreed with the statement “I am more aware of medication errors after this IPPE.” Conclusion. Simulation is an effective method for assessing the pre-APPE abilities of pharmacy students, preparing them for real clinical encounters, and for making them more aware of medication errors and other patient safety issues. PMID:23193340

  7. Putting Central Registers to Work

    ERIC Educational Resources Information Center

    Besharov, Douglas J.

    1977-01-01

    Cites shortcomings of existing centralized state systems for processing child protection case records. Diagnostic, monitoring and statistical functions of these registers are described as severely limited by inaccurate and incomplete reporting. Confidentiality of records, subjects' access to records and problems of verification are discussed. (BF)

  8. Advancing the theory and practice of impact assessment: Setting the research agenda

    SciTech Connect

    Pope, Jenny; Bond, Alan; Morrison-Saunders, Angus; Retief, Francois

    2013-07-15

    Impact assessment has been in place for over 40 years and is now practised in some form in all but two of the world's nations. In this paper we reflect on the state of the art of impact assessment theory and practice, focusing on six well-established forms: EIA, SEA, policy assessment, SIA, HIA and sustainability assessment. We note that although the fundamentals of impact assessment have their roots in the US National Environmental Policy Act 1969 (NEPA) each branch of the field is distinct in also drawing on other theoretical and conceptual bases that in turn shape the prevailing discourse in each case, generating increasing degrees of specialisation within each sub-field. Against this backdrop, we consider the strengths and weaknesses of collective impact assessment practice, concluding that although there are substantial strengths, the plethora of specialist branches is generating a somewhat confusing picture and lack of clarity regarding how the pieces of the impact assessment jigsaw puzzle fit together. We use this review to suggest an overarching research agenda that will enable impact assessment to evolve in line with changing expectations for what it should deliver. -- Highlights: ► Strengths, weakness, opportunities and threats for IA are explored in this paper ► EIA, SEA, policy assessment, SIA, HIA and sustainability assessment are reviewed ► Diversity of practice is both a strength and weakness in the current economic climate ► There are opportunities to simplify IA by focusing on common and fundamental elements ► Continued research into theory related to IA effectiveness is also essential.

  9. Bench to bedside: integrating advances in basic science into daily clinical practice.

    PubMed

    McGoldrick, Rory B; Hui, Kenneth; Chang, James

    2014-08-01

    This article focuses on the initial steps of commercial development of a patentable scientific discovery from an academic center through to marketing a clinical product. The basics of partnering with a technology transfer office (TTO) and the complex process of patenting are addressed, followed by a discussion on marketing and licensing the patent to a company in addition to starting a company. Finally, the authors address the basic principles of obtaining clearance from the Food and Drugs Administration, production in a good manufacturing practice (GMP) facility, and bringing the product to clinical trial.

  10. Mind-Body Therapies: Evidence and Implications in Advanced Oncology Practice

    PubMed Central

    Mayden,, Kelley D.

    2012-01-01

    The idea that thoughts and emotions influence health outcomes is an ancient concept that was initially abandoned by Western medicine researchers. Today, researchers are showing a renewed interest in the interactions of the mind and body and the role these interactions play in disease formation and recovery. Complementary and alternative interventions, such as mind-body therapies, are increasingly being used by cancer survivors for disease prevention, immune system enhancement, and symptom control. Traditional training has not been structured to provide advanced practitioners with an in-depth knowledge of the clinical applications of mind-body therapies. The aim of this article is to acquaint the reader with common mind-body modalities (meditation/mindfulness-based stress reduction, relaxation therapy, cognitive-behavioral therapy, hypnosis, biofeedback, music therapy, art therapy, support groups, and aromatherapy) and to examine important evidence in support of or against their clinical application. PMID:25031967

  11. Mind-body therapies: evidence and implications in advanced oncology practice.

    PubMed

    Mayden, Kelley D

    2012-11-01

    The idea that thoughts and emotions influence health outcomes is an ancient concept that was initially abandoned by Western medicine researchers. Today, researchers are showing a renewed interest in the interactions of the mind and body and the role these interactions play in disease formation and recovery. Complementary and alternative interventions, such as mind-body therapies, are increasingly being used by cancer survivors for disease prevention, immune system enhancement, and symptom control. Traditional training has not been structured to provide advanced practitioners with an in-depth knowledge of the clinical applications of mind-body therapies. The aim of this article is to acquaint the reader with common mind-body modalities (meditation/mindfulness-based stress reduction, relaxation therapy, cognitive-behavioral therapy, hypnosis, biofeedback, music therapy, art therapy, support groups, and aromatherapy) and to examine important evidence in support of or against their clinical application.

  12. Improving medical graduates’ training in palliative care: advancing education and practice

    PubMed Central

    Head, Barbara A; Schapmire, Tara J; Earnshaw, Lori; Chenault, John; Pfeifer, Mark; Sawning, Susan; Shaw, Monica A

    2016-01-01

    The needs of an aging population and advancements in the treatment of both chronic and life-threatening diseases have resulted in increased demand for quality palliative care. The doctors of the future will need to be well prepared to provide expert symptom management and address the holistic needs (physical, psychosocial, and spiritual) of patients dealing with serious illness and the end of life. Such preparation begins with general medical education. It has been recommended that teaching and clinical experiences in palliative care be integrated throughout the medical school curriculum, yet such education has not become the norm in medical schools across the world. This article explores the current status of undergraduate medical education in palliative care as published in the English literature and makes recommendations for educational improvements which will prepare doctors to address the needs of seriously ill and dying patients. PMID:26955298

  13. Improving medical graduates' training in palliative care: advancing education and practice.

    PubMed

    Head, Barbara A; Schapmire, Tara J; Earnshaw, Lori; Chenault, John; Pfeifer, Mark; Sawning, Susan; Shaw, Monica A

    2016-01-01

    The needs of an aging population and advancements in the treatment of both chronic and life-threatening diseases have resulted in increased demand for quality palliative care. The doctors of the future will need to be well prepared to provide expert symptom management and address the holistic needs (physical, psychosocial, and spiritual) of patients dealing with serious illness and the end of life. Such preparation begins with general medical education. It has been recommended that teaching and clinical experiences in palliative care be integrated throughout the medical school curriculum, yet such education has not become the norm in medical schools across the world. This article explores the current status of undergraduate medical education in palliative care as published in the English literature and makes recommendations for educational improvements which will prepare doctors to address the needs of seriously ill and dying patients.

  14. Perceptions of select registered nurses of the continuing competence program of the Saskatchewan registered nurses' association.

    PubMed

    Bassendowski, Sandra; Petrucka, Pammla

    2009-12-01

    Nursing is a self-regulating profession, and most professional nursing jurisdictions across Canada have undertaken the creation of Continuing Competence Programs (CCPs), with the goals of promoting good nursing practice, encouraging continuous learning, contributing to the quality of nursing practice, and optimizing client outcomes. Most CCPs call for a professional portfolio to collect, synthesize, and analyze professional experiences, including documentation of peer feedback and preparation of a learning plan. In the province of Saskatchewan, Canada, there is a self-reflective tool that enables registered nurses to self-rate their achievement of a set of foundational competencies. This article explores the perceptions that select registered nurses have about the CCP in Saskatchewan and how their view of the degree of professional control (as assessed through locus of control) that they have affects their perspective about the outcomes of the program. The study was designed to assess how perceived locus of control was related to how registered nurses view the implementation of the CCP in Saskatchewan.

  15. 1 CFR 11.2 - Federal Register.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 1 General Provisions 1 2011-01-01 2011-01-01 false Federal Register. 11.2 Section 11.2 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER AVAILABILITY OF OFFICE OF THE FEDERAL REGISTER PUBLICATIONS SUBSCRIPTIONS § 11.2 Federal Register. (a) The subscription price for the paper edition of...

  16. 1 CFR 11.2 - Federal Register.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 1 General Provisions 1 2010-01-01 2010-01-01 false Federal Register. 11.2 Section 11.2 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER AVAILABILITY OF OFFICE OF THE FEDERAL REGISTER PUBLICATIONS SUBSCRIPTIONS § 11.2 Federal Register. (a) The subscription price for the paper edition of...

  17. 1 CFR 11.2 - Federal Register.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 1 General Provisions 1 2014-01-01 2012-01-01 true Federal Register. 11.2 Section 11.2 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER AVAILABILITY OF OFFICE OF THE FEDERAL REGISTER PUBLICATIONS SUBSCRIPTIONS § 11.2 Federal Register. (a) The subscription price for the paper edition of...

  18. 37 CFR 3.58 - Governmental registers.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Governmental registers. 3.58... Governmental registers. (a) The Office will maintain a Departmental Register to record governmental interests required to be recorded by Executive Order 9424. This Departmental Register will not be open to...

  19. 1 CFR 12.1 - Federal Register.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 1 General Provisions 1 2014-01-01 2012-01-01 true Federal Register. 12.1 Section 12.1 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER AVAILABILITY OF OFFICE OF THE FEDERAL REGISTER PUBLICATIONS OFFICIAL DISTRIBUTION WITHIN FEDERAL GOVERNMENT § 12.1 Federal Register. (a) Copies of the...

  20. 1 CFR 12.1 - Federal Register.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 1 General Provisions 1 2012-01-01 2012-01-01 false Federal Register. 12.1 Section 12.1 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER AVAILABILITY OF OFFICE OF THE FEDERAL REGISTER PUBLICATIONS OFFICIAL DISTRIBUTION WITHIN FEDERAL GOVERNMENT § 12.1 Federal Register. (a) Copies of the...

  1. 1 CFR 11.2 - Federal Register.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 1 General Provisions 1 2012-01-01 2012-01-01 false Federal Register. 11.2 Section 11.2 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER AVAILABILITY OF OFFICE OF THE FEDERAL REGISTER PUBLICATIONS SUBSCRIPTIONS § 11.2 Federal Register. (a) The subscription price for the paper edition of...

  2. 1 CFR 12.1 - Federal Register.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 1 General Provisions 1 2013-01-01 2012-01-01 true Federal Register. 12.1 Section 12.1 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER AVAILABILITY OF OFFICE OF THE FEDERAL REGISTER PUBLICATIONS OFFICIAL DISTRIBUTION WITHIN FEDERAL GOVERNMENT § 12.1 Federal Register. (a) Copies of the...

  3. 37 CFR 3.58 - Governmental registers.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2012-07-01 2012-07-01 false Governmental registers. 3.58... Governmental registers. (a) The Office will maintain a Departmental Register to record governmental interests required to be recorded by Executive Order 9424. This Departmental Register will not be open to...

  4. 37 CFR 3.58 - Governmental registers.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2013-07-01 2013-07-01 false Governmental registers. 3.58... Governmental registers. (a) The Office will maintain a Departmental Register to record governmental interests required to be recorded by Executive Order 9424. This Departmental Register will not be open to...

  5. 1 CFR 11.2 - Federal Register.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 1 General Provisions 1 2013-01-01 2012-01-01 true Federal Register. 11.2 Section 11.2 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER AVAILABILITY OF OFFICE OF THE FEDERAL REGISTER PUBLICATIONS SUBSCRIPTIONS § 11.2 Federal Register. (a) The subscription price for the paper edition of...

  6. 20 CFR 346.1 - Central register.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Central register. 346.1 Section 346.1... RAILROAD HIRING § 346.1 Central register. (a) The Board shall maintain a central register of railroad... employment. The register shall indicate which of those employees claims a first right of hire. (b)...

  7. 37 CFR 3.58 - Governmental registers.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2014-07-01 2014-07-01 false Governmental registers. 3.58... Governmental registers. (a) The Office will maintain a Departmental Register to record governmental interests required to be recorded by Executive Order 9424. This Departmental Register will not be open to...

  8. 37 CFR 3.58 - Governmental registers.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2011-07-01 2011-07-01 false Governmental registers. 3.58... Governmental registers. (a) The Office will maintain a Departmental Register to record governmental interests required to be recorded by Executive Order 9424. This Departmental Register will not be open to...

  9. Web-conference supervision for advanced psychotherapy training: a practical guide.

    PubMed

    Abbass, Allan; Arthey, Stephen; Elliott, Jason; Fedak, Tim; Nowoweiski, Dion; Markovski, Jasmina; Nowoweiski, Sarah

    2011-06-01

    The advent of readily accessible, inexpensive Web-conferencing applications has opened the door for distance psychotherapy supervision, using video recordings of treated clients. Although relatively new, this method of supervision is advantageous given the ease of use and low cost of various Internet applications. This method allows periodic supervision from point to point around the world, with no travel costs and no long gaps between direct training contacts. Web-conferencing permits face-to-face training so that the learner and supervisor can read each other's emotional responses while reviewing case material. It allows group learning from direct supervision to complement local peer-to-peer learning methods. In this article, we describe the relevant literature on this type of learning method, the practical points in its utilization, its limitations, and its benefits.

  10. Use of modified Delphi to plan knowledge translation for decision makers: an application in the field of advanced practice nursing.

    PubMed

    Carter, Nancy; Lavis, John N; MacDonald-Rencz, Sandra

    2014-01-01

    Disseminating research to decision makers is difficult. Interaction between researchers and decision makers can identify key messages and processes for dissemination. To gain agreement on the key findings from a synthesis on the integration of advanced practice nurses, we used a modified Delphi process. Nursing decision makers contributed ideas via e-mail, discussed and clarified ideas face to face, and then prioritized statements. Sixteen (89%) participated and 14 (77%) completed the final phase. Priority key messages were around access to care and outcomes. The majority identified "NPs increase access to care" and "NPs and CNSs improve patient and system outcomes" as priority messaging statements. Participants agreed policy makers and the public were target audiences for messages. Consulting with policy makers provided the necessary context to develop tailored policy messages and is a helpful approach for research dissemination.

  11. Increasing the activity and enantioselectivity of lipases by sol-gel immobilization: further advancements of practical interest.

    PubMed

    Tielmann, Patrick; Kierkels, Hans; Zonta, Albin; Ilie, Adriana; Reetz, Manfred T

    2014-06-21

    The entrapment of lipases in hydrophobic silicate matrices formed by sol-gel mediated hydrolysis of RSi(OCH3)3/Si(OCH3)4 as originally reported in 1996 has been improved over the years by a number of modifications. In the production of second-generation sol-gel lipase immobilizates, a variety of additives during the sol-gel process leads to increased activity and enhanced stereoselectivity in esterifying kinetic resolution. Recent advances in this type of lipase immobilization are reviewed here, in addition to new results regarding the sol-gel entrapment of the lipase from Burkholderia cepacia. It constitutes an excellent heterogeneous biocatalyst in the acylating kinetic resolution of two synthetically and industrially important chiral alcohols, rac-sulcatol and rac-trans-2-methoxycyclohexanol. The observation that the catalyst can be used 10 times in recycling experiments without losing its significant activity or enantioselectivity demonstrates the practical viability of the sol-gel approach.

  12. Determining the hydraulic properties of saturated, low-permeability geological materials in the laboratory: Advances in theory and practice

    USGS Publications Warehouse

    Zhang, M.; Takahashi, M.; Morin, R.H.; Endo, H.; Esaki, T.; ,

    2002-01-01

    The accurate hydraulic characterization of low-permeability subsurface environments has important practical significance. In order to examine this issue from the perspective of laboratory-based approaches, we review some recent advancements in the theoretical analyses of three different laboratory techniques specifically applied to low-permeability geologic materials: constant-head, constant flow-rate and transient-pulse permeability tests. Some potential strategies for effectively decreasing the time required to confidently estimate the permeability of these materials are presented. In addition, a new and versatile laboratory system is introduced that can implement any of these three test methods while simultaneously subjecting a specimen to high confining pressures and pore pressures, thereby simulating in situ conditions at great depths. The capabilities and advantages of this innovative system are demonstrated using experimental data derived from Shirahama sandstone and Inada granite, two rock types widely encountered in Japan.

  13. Incorporating a health policy practicum in a graduate training program to prepare advanced practice nursing health services researchers.

    PubMed

    DiCenso, Alba; Housden, Laura; Heale, Roberta; Carter, Nancy; Canitz, Brenda; MacDonald-Rencz, Sandra; Buckley, Christine Rieck

    2012-11-01

    Health services research benefits from the active engagement of researchers and policy makers from generation through to application of research-based knowledge. One approach to help graduate students learn about the policy world is through participation in a policy practicum. This is an opportunity to work for a defined period of time in a setting where policy decisions are made. This article focuses on the integration of the policy practicum into graduate nursing education for advanced practice nurses. Ten graduate students and two postdoctoral fellows who had recently completed their practicums and three policy makers who had recently supervised students in provincial, federal, and international practicum projects were invited to submit a narrative about the experience. Based on qualitative analysis of the narratives, this article outlines objectives of the practicum, the policy practicum journey, student learning, and finally, the benefits and challenges of the experience.

  14. Feminist and queer phenomenology: a framework for perinatal nursing practice, research, and education for advancing lesbian health.

    PubMed

    Goldberg, Lisa; Ryan, Annette; Sawchyn, Jody

    2009-06-01

    A queer phenomenology would involve an orientation toward queer, a way to inhabit the world that gives "support" to those whose lives and loves make them appear oblique, strange, and out of place. (Ahmed, 2006) The climate of the health care system is a reflection of society, which often hesitates to support individuals who choose paths other than those, that are heteronormatively constructed. Consequences of such limited directedness include fear, misunderstanding, avoidance, and discrimination on the part of nurses toward individuals involved in same-sex partnerships (Goldberg, 2005/2006). A feminist and queer phenomenological framework offers an approach for perinatal nurses to advance lesbian health and, in particular, lesbian couples' experiences of birthing, in the context of nursing practice, research, and education.

  15. Swedish Students' and Preceptors' Perceptions of What Students Learn in a Six-Month Advanced Pharmacy Practice Experience

    PubMed Central

    Sporrong, Sofia Kälvemark; Gustavsson, Maria; Lindblad, Åsa Kettis; Johansson, Markus; Ring, Lena

    2011-01-01

    Objective. To identify what pharmacy students learn during the 6-month advanced pharmacy practice experience (APPE) in Sweden. Methods. Semi-structured interviews were conducted with 18 pharmacy APPE students and 17 pharmacist preceptors and analyzed in a qualitative directed content analysis using a defined workplace learning typology for categories. Results. The Swedish APPE provides students with task performance skills for work at pharmacies and social and professional knowledge, such as teamwork, how to learn while in a work setting, self-evaluation, understanding of the pharmacist role, and decision making and problem solving skills. Many of these skills and knowledge are not accounted for in the curricula in Sweden. Using a workplace learning typology to identify learning outcomes, as in this study, could be useful for curricula development. Conclusions. Exploring the learning that takes place during the APPE in a pharmacy revealed a broad range of skills and knowledge that students acquire. PMID:22345716

  16. The outcome of interprofessional education: Integrating communication studies into a standardized patient experience for advanced practice nursing students.

    PubMed

    Defenbaugh, Nicole; Chikotas, Noreen E

    2016-01-01

    The purpose of this qualitative study was to examine the impact of standardized patient experiences (SPE) in the education of the Advanced Practice Nurse (APN). The education of the APN requires educators to make every attempt to promote competency in the areas of communication and clinical-decision making. SPE programs have been found to improve the interpersonal, problem solving, and critical thinking skills of nursing students. For this research twenty-nine APN students participated in SPEs over the course of two semesters. Fifteen student volunteers of those 29 participants were then interviewed three months after the experience. Results revealed that having an expert in the field of communication studies increased awareness of communication skills and how to improve nurse-patient encounters in the clinical setting. The interprofessional collaboration during the SPEs assisted in facilitating the application of learned communication skills into patient-centered care of the APN student.

  17. A practical, rapid generation-advancement system for rice breeding using simplified biotron breeding system

    PubMed Central

    Tanaka, Junichi; Hayashi, Takeshi; Iwata, Hiroyoshi

    2016-01-01

    A new plant breeding method—the biotron breeding system (BBS)—can rapidly produce advanced generations in rice (Oryza sativa L.) breeding. This method uses a growth chamber (biotron) with CO2 control, accompanied by tiller removal and embryo rescue to decrease the period before seed maturity. However, tiller removal and embryo rescue are laborious and impractical for large populations. We investigated the influences of increased CO2, tiller removal, and root restriction on the days to heading (DTH) from seeding in growth chambers. The higher CO2 concentration significantly decreased DTH, but tiller removal and root restriction had little effect on DTH and drastically reduced seed yield. Based on these findings, we propose a simplified BBS (the sBBS) that eliminates the need for tiller removal and embryo rescue, but controls CO2 levels and day-length and maintains an appropriate root volume. Using the sBBS, we could reduce the interval between generations in ‘Nipponbare’ to less than 3 months, without onerous manipulations. To demonstrate the feasibility of the sBBS, we used it to develop isogenic lines using ‘Oborozuki’ as the donor parent for the low-amylose allele Wx1-1 and ‘Akidawara’ as the recipient. We were able to perform four crossing cycles in a year. PMID:27795679

  18. Data Generation in the Discovery Sciences—Learning from the Practices in an Advanced Research Laboratory

    NASA Astrophysics Data System (ADS)

    Roth, Wolff-Michael

    2013-08-01

    General scientific literacy includes understanding the grounds on which scientific claims are based. The measurements scientists make and the data that they produce from them generally constitute these grounds. However, the nature of data generation has received relatively little attention from those interested in teaching science through inquiry. To inform curriculum designers about the process of data generation and its relation to the understanding of patterns as these may arise from graphs, this 5-year ethnographic study in one advanced research laboratory was designed to investigate how natural scientists make decisions about the inclusion/exclusion of certain measurements in/from their data sources. The study shows that scientists exclude measurements from their data sources even before attempting to mathematize and interpret the data. The excluded measurements therefore never even enter the ground from and against which the scientific phenomenon emerges and therefore remain invisible to it. I conclude by encouraging science educators to squarely address this aspect of the discovery sciences in their teaching, which has both methodological and ethical implications.

  19. [Theory and Practice of the Constructive Jigsaw Method in Advancing Domain Knowledge and Skills in Parallel].

    PubMed

    Masukawa, Hiroyuki

    2016-01-01

    The Learning Sciences constitute a rapidly expanding discipline that focuses on the learning potential of humans. In this paper, I will discuss the particular learning mechanism involved in the concomitant advancement of domain knowledge and 21st century skills, as well as the Constructive Jigsaw Method of knowledge construction through collaboration-that is, collaborative problem solving. An especially important focus on knowledge construction separates routine experts from adaptive experts. While routine experts develop a core set of skills that they apply throughout their lives with increasing efficiency, adaptive experts are much more likely to change their core skills and continually expand the depth of their expertise. This restructuring of core ideas and skills may reduce their efficiency in the short run but make them more flexible in the long run. The Constructive Jigsaw Method employs a learning mechanism that encourages the development of adaptive experts. Under this method, students first study a piece of material in an expert group. One member from each of several expert groups then joins a new study group, a jigsaw group. The members of this new group then combine what they have learned, creating new knowledge and a deeper understanding of the concept through collaboration, communication, and innovation.

  20. Develop, Discuss, and Decide: How New Science Teachers Use Technologies to Advance Their Practice

    NASA Astrophysics Data System (ADS)

    Ellis, Joshua Alexander

    For decades, there has been a nationwide demand to increase the number of science teachers in K-12 education (National Commission on Excellence in Education, 1983; National Research Council [NRC], 2007). This demand is in large part due to increases in state science graduation requirements. Teacher preparation programs have been preparing new science teachers on pace with the resulting increase in demand (Ingersoll & Merrill, 2010), however, shortages have continued as up to 50% of these new teachers leave the profession within their first five years of teaching (Smith & Ingersoll, 2004), creating a "revolving door" phenomenon as districts scramble to address this early attrition with yet more beginning teachers. We need to address what Ingersoll (2012) describes as the "greening" of the teaching force: the fact that an increasingly large segment of the teaching force is comprised of beginning teachers who are at a high risk of leaving the profession. The three related studies that comprise this dissertation focus on the role of technological interventions for in-service and pre-service science teachers. The context for the first two studies is TIN, an online induction program for beginning secondary science teachers. These two studies consider the impact of technological supports on the reflective practice of participating teachers. The design interventions included VideoANT (an online video annotation tool) and Teachers as Leaders roles (a structured response protocol) for the Venture/Vexation online forum activity. The context for the third study is T3-S, a university licensure course for pre-service science teachers designed to explore technology integration in secondary science classrooms. This study investigated the impact of pre-service teacher participation in the creation of an Adventure Learning (AL) environment (Doering, 2006) on their understanding of technological, pedagogical, and content knowledge (TPACK) and its role in their future science

  1. Sandia National Laboratories Advanced Simulation and Computing (ASC) software quality plan part 2 mappings for the ASC software quality engineering practices, version 2.0.

    SciTech Connect

    Heaphy, Robert; Sturtevant, Judith E.; Hodges, Ann Louise; Boucheron, Edward A.; Drake, Richard Roy; Minana, Molly A.; Hackney, Patricia; Forsythe, Christi A.; Schofield, Joseph Richard, Jr.; Pavlakos, Constantine James; Williamson, Charles Michael; Edwards, Harold Carter

    2006-09-01

    The purpose of the Sandia National Laboratories Advanced Simulation and Computing (ASC) Software Quality Plan is to clearly identify the practices that are the basis for continually improving the quality of ASC software products. The plan defines the ASC program software quality practices and provides mappings of these practices to Sandia Corporate Requirements CPR001.3.2 and CPR001.3.6 and to a Department of Energy document, ''ASCI Software Quality Engineering: Goals, Principles, and Guidelines''. This document also identifies ASC management and software project teams' responsibilities in implementing the software quality practices and in assessing progress towards achieving their software quality goals.

  2. Sandia National Laboratories Advanced Simulation and Computing (ASC) software quality plan. Part 1: ASC software quality engineering practices, Version 2.0.

    SciTech Connect

    Sturtevant, Judith E.; Heaphy, Robert; Hodges, Ann Louise; Boucheron, Edward A.; Drake, Richard Roy; Minana, Molly A.; Hackney, Patricia; Forsythe, Christi A.; Schofield, Joseph Richard, Jr.; Pavlakos, Constantine James; Williamson, Charles Michael; Edwards, Harold Carter

    2006-09-01

    The purpose of the Sandia National Laboratories Advanced Simulation and Computing (ASC) Software Quality Plan is to clearly identify the practices that are the basis for continually improving the quality of ASC software products. The plan defines the ASC program software quality practices and provides mappings of these practices to Sandia Corporate Requirements CPR 1.3.2 and 1.3.6 and to a Department of Energy document, ASCI Software Quality Engineering: Goals, Principles, and Guidelines. This document also identifies ASC management and software project teams responsibilities in implementing the software quality practices and in assessing progress towards achieving their software quality goals.

  3. Building a Thriving Nation: 21st-Century Vision and Practice to Advance Health and Equity.

    PubMed

    Cohen, Larry

    2016-04-01

    It is a great time for prevention. As the United States explores what health in our country should look like, it is an extraordinary time to highlight the role of prevention in improving health, saving lives, and saving money. The Affordable Care Act's investment in prevention has spurred innovation by communities and states to keep people healthy and safein the first place This includes growing awareness that community conditions are critical in determining health and that there is now a strong track record of prevention success. Community prevention strategies create lasting changes by addressing specific policies and practices in the environments and institutions that shape our lives and our health-from schools and workplaces to neighborhoods and government. Action at the community level also fosters health equity-the opportunity for every person to achieve optimal health regardless of identity, neighborhood, ability, or social status-and is often the impetus for national-level decisions that vitally shape the well-being of individuals and populations.

  4. Introductory lecture. Advanced laser spectroscopy in combustion chemistry: from elementary steps to practical devices.

    PubMed

    Wolfrum, J

    2001-01-01

    In recent years a large number of linear and nonlinear laser-based diagnostic techniques for nonintrusive measurements of species concentrations, temperatures, and gas velocities in a wide pressure and temperature range with high temporal and spatial resolution have been developed and have become extremely valuable tools to study many aspects of combustion. Beside the nonintrusive diagnostics of technical combustion devices the kinetics and microscopic dynamics of elementary chemical combustion reactions can be investigated in great detail by laser spectroscopy. These investigations show, that a small number of relatively simple elementary steps like H + O2-->OH + O, H2O2-->2OH, O + N2-->NO + N, NH2 + NO-->H2O + N2, OH + N2H control a large variety of combustion phenomena and pollutant formation processes. Laminar flames are ideal objects to develop the application of laser spectroscopic methods for practical combustion systems and to test and improve the gas-phase reaction mechanism in combustion models. Nonintrusive laser point and field measurements are of basic importance in the validation and further development of turbulent combustion models. Nonlinear laser spectroscopic techniques using infrared-visible sum-frequency generation can now bridge the pressure and materials gap to provide kinetic data for catalytic combustion. Finally, the potential of laser techniques for active combustion control in municipal waste incinerators is illustrated.

  5. Rocket Altitude Test Facilities Register

    DTIC Science & Technology

    1987-03-01

    Classification of Document UNCLASSIFIED 5. Originator Advisory Group for Aerospace Research and Development North Atlantic Treaty Organization...Emphasis was put on facilities capable of performing research and development tests. This AGARDograph was prepared at the request of the Propulsion... RESEARCH & DEVELOPMENT 7RUEANCELLE 92200 NEUILLY SUR SEINE FRANCE AGARDo^raph N0^97 , Rocket Altitude Test Facilities Register /^ri c^ris

  6. Interfacing theories of program with theories of evaluation for advancing evaluation practice: Reductionism, systems thinking, and pragmatic synthesis.

    PubMed

    Chen, Huey T

    2016-12-01

    Theories of program and theories of evaluation form the foundation of program evaluation theories. Theories of program reflect assumptions on how to conceptualize an intervention program for evaluation purposes, while theories of evaluation reflect assumptions on how to design useful evaluation. These two types of theories are related, but often discussed separately. This paper attempts to use three theoretical perspectives (reductionism, systems thinking, and pragmatic synthesis) to interface them and discuss the implications for evaluation practice. Reductionism proposes that an intervention program can be broken into crucial components for rigorous analyses; systems thinking view an intervention program as dynamic and complex, requiring a holistic examination. In spite of their contributions, reductionism and systems thinking represent the extreme ends of a theoretical spectrum; many real-world programs, however, may fall in the middle. Pragmatic synthesis is being developed to serve these moderate- complexity programs. These three theoretical perspectives have their own strengths and challenges. Knowledge on these three perspectives and their evaluation implications can provide a better guide for designing fruitful evaluations, improving the quality of evaluation practice, informing potential areas for developing cutting-edge evaluation approaches, and contributing to advancing program evaluation toward a mature applied science.

  7. Factors associated with the use of advanced practice nurses/physician assistants in a fee-for-service nursing home practice: a comparison with primary care physicians.

    PubMed

    Bakerjian, Debra; Harrington, Charlene

    2012-07-01

    The purpose of this research was to examine factors associated with the use of advanced practice nurse and physician assistant (APN/PA) visits to nursing home (NH) patients compared with those by primary care physicians (PCPs). This was a secondary analysis using Medicare claims data. General estimation equations were used to determine the odds of NH residents receiving APN/PA visits. Ordinary least squares analyses were used to examine factors associated with these visits. A total of 5,436 APN/PAs provided care to 27% of 129,812 residents and were responsible for 16% of the 1.1 million Medicare NH fee-for-service visits in 2004. APN/PAs made an average of 33 visits annually compared with PCPs (21 visits). Neuropsychiatric and acute diagnoses and patients with a long-stay status were associated with more APN/PA visits. APN/PAs provide a substantial amount of care, but regional variations occur, and Medicare regulations constrain the ability of APN/PAs to substitute for physician visits.

  8. Nitrogen Use Efficiency of California Almond Orchards Using Advanced Farming Practices

    NASA Astrophysics Data System (ADS)

    Smart, David; Schellenberg, Daniel; Saa Silva, Sebastian; Muhammad, Saiful; Sanden, Blake; Brown, Patrick

    2014-05-01

    Mobilization of reactive nitrogen species (NH3, NH4+, NOx, N2O, NO2- and NO3-) is perceived as one of the foremost challenges for modern agricultural production systems. Yet information to address the question of how advanced nitrogen (N) management alters reactive N mobilization is lacking. During 2009 to 2012 we monitored spatially constrained N2O emissions and potential leachable NO3-, along with yield-N content to examine their contribution to nitrogen use efficiency (NUE, fruit-N exported/fertilizer-N applied) for a modern, high yielding almond production system. This modern production system schedules irrigation to match evapotranspiration (ETc) estimated from the Penman-Montieth calculation of a reference evapotranspiration (ETo) times a seasonal crop coefficient (Kc) which was verified using eddy covariance and surface renewal latent heat flux estimates. Split N-fertilizer applications were targeted to tree-N demand and root proliferation. These production systems demand upwards of 300 kg N ha-1. NUE was found to be nearly 80% at an N application level allowing for economic sustainability of the system (308 kg N ha-1). When mobilization of N2O and NO3- were included in the NUE assessment, these systems were still highly sustainable in terms of N applied. We also monitored production and consumption of the greenhouse gases of carbon dioxide (CO2) and methane (CH4). These systems had relatively low levels of N2O emissions with emissions of N2O as a fraction of N-fertilizer applied being consistently less than IPCC Tier 1 emissions factors, and lower than the average estimated for most continental US farming systems. The system also demonstrated a capacity for net CH4 oxidation over the course of a season that occurred mainly in the driveways between tree rows that are kept dry over the course of the season in this arid environment. Our study indicated that tight management of water resources and targeted applications of N-fertilizer resulted in net positive

  9. Development of Appropriate Spot Welding Practice for Advanced High Strength Steels (TRP 0114)

    SciTech Connect

    Brian Girvin; Warren Peterson; Jerry Gould

    2004-09-17

    This program evaluated the effects of common manufacturing variables on spike-tempering effectiveness. The investigation used design-of-experiment (DOE) techniques, and examined both dual-phase and martensitic grades of high-strength steels (HSS). The specific grades chosen for this project were: Dual-phase (DP) 600, galvannealed (GA), 1.55 mm (DP) 600; Dual-phase (DP) 980 (uncoated), 1.55 mm (DP) 980; and Martensitic (M) 1300, 1.55 mm (M) 1300. Common manufacturing conditions of interest included tempering practice (quench and temper time), button size, simulated part fitup (sheet angular misalignment and fitup), and electrode wear (increased electrode face diameter). All of these conditions were evaluated against mechanical performance (static and dynamic tensile shear). Weld hardness data was also used to examine correlations between mechanical performance and the degree of tempering. Mechanical performance data was used to develop empirical models. The models were used to examine the robustness of weld strength and toughness to the selected processing conditions. This was done using standard EWI techniques. Graphical representations of robustness were then coupled with metallographic data to relate mechanical properties to the effectiveness of spike tempering. Mechanical properties for all three materials were relatively robust to variation in tempering. Major deviations in mechanical properties were caused by degradation of the weld itself. This was supported by a lack of correlation between hardness data and mechanical results. Small button sizes and large electrode face diameters (worn electrodes) produced large reductions in both static and dynamic strength levels when compared to standard production setups. Dynamic strength was further degraded by edge-located welds.

  10. Diagnosing COPD: advances in training and practice – a systematic review

    PubMed Central

    Koblizek, Vladimir; Novotna, Barbora; Zbozinkova, Zuzana; Hejduk, Karel

    2016-01-01

    Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung syndrome, caused by long-term inhalation of noxious gases and particles, which leads to gradual airflow limitation. All health care professionals who care for COPD patients should have full access to high-quality spirometry testing, as postbronchodilator spirometry constitutes the principal method of COPD diagnosis. One out of four smokers 45 years or older presenting respiratory symptoms in primary care, have non-fully reversible airflow limitation compatible with COPD and are mostly without a known diagnosis. Approximately 50.0%–98.3% of patients are undiagnosed worldwide. The majority of undiagnosed COPD patients are isolated at home, are in nursing or senior-assisted living facilities, or are present in oncology and cardiology clinics as patients with lung cancers and coronary artery disease. At this time, the prevalence and mortality of COPD subjects is increasing, rapidly among women who are more susceptible to risk factors. Since effective management strategies are currently available for all phenotypes of COPD, correctly performed and well-interpreted postbronchodilator spirometry is still an essential component of all approaches used. Simple educational training can substantially improve physicians’ knowledge relating to COPD diagnosis. Similarly, a physician inhaler education program can improve attitudes toward inhaler teaching and facilitate its implementation in routine clinical practices. Spirometry combined with inhaled technique education improves the ability of predominantly nonrespiratory physicians to correctly diagnose COPD, to adequately assess its severity, and to increase the percentage of correct COPD treatment used in a real-life setting. PMID:27099544

  11. Management practices for end-of-life cathode ray tube glass: Review of advances in recycling and best available technologies.

    PubMed

    Iniaghe, Paschal O; Adie, Gilbert U

    2015-11-01

    Cathode ray tubes are image display units found in computer monitors and televisions. In recent years, cathode ray tubes have been generated as waste owing to the introduction of newer and advanced technologies in image displays, such as liquid crystal displays and high definition televisions, among others. Generation and subsequent disposal of end-of-life cathode ray tubes presents a challenge owing to increasing volumes and high lead content embedded in the funnel and neck sections of the glass. Disposal in landfills and open dumping are anti-environmental practices considering the large-scale contamination of environmental media by the potential of toxic metals leaching from glass. Mitigating such environmental contamination will require sound management strategies that are environmentally friendly and economically feasible. This review covers existing and emerging management practices for end-of-life cathode ray tubes. An in-depth analysis of available technologies (glass smelting, detoxification of cathode ray tube glass, lead extraction from cathode ray tube glass) revealed that most of the techniques are environmentally friendly, but are largely confined to either laboratory scale, or are often limited owing to high cost to mount, or generate secondary pollutants, while a closed-looped method is antiquated. However, recycling in cementitious systems (cement mortar and concrete) gives an added advantage in terms of quantity of recyclable cathode ray tube glass at a given time, with minimal environmental and economic implications. With significant quantity of waste cathode ray tube glass being generated globally, cementitious systems could be economically and environmentally acceptable as a sound management practice for cathode ray tube glass, where other technologies may not be applicable.

  12. A Survey of Registered Nurses in New York State.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany. Bureau of Postsecondary Research and Information Systems.

    As part of the 1989 triennial registration of registered nurses (RNs) in New York State, a survey of professional, personal, and practice characteristics of nurses was conducted. Basic information from this survey is enhanced by information from earlier surveys to illustrate significant trends. Usable survey questionnaires were received from…

  13. Human Resource Management in Australian Registered Training Organisations

    ERIC Educational Resources Information Center

    Smith, Andrew; Hawke Geof

    2008-01-01

    This report forms part of a comprehensive research program that has examined issues related to building the organisational capability of vocational education and training providers. In particular, this report focuses on the current state of human resource management practice in both technical and further education and private registered training…

  14. Barriers to Research Utilization by Certified Registered Nurse Anesthetists

    ERIC Educational Resources Information Center

    Palmer, Timothy J.

    2013-01-01

    At present, no documentation pertaining to the factors influencing utilization of research into clinical practice by Certified Registered Nurse Anesthetists (CRNAs) exists. An investigation was undertaken to determine perceptions of CRNAs regarding factors within the context of the work setting, which may serve to influence their utilization of…

  15. Sorafenib treatment of radioiodine-refractory advanced thyroid cancer in daily clinical practice: a cohort study from a single center.

    PubMed

    Gallo, Marco; Michelon, Federica; Castiglione, Anna; Felicetti, Francesco; Viansone, Alessandro Adriano; Nervo, Alice; Zichi, Clizia; Ciccone, Giovannino; Piovesan, Alessandro; Arvat, Emanuela

    2015-08-01

    Treatment options for recurrent or metastatic differentiated thyroid cancer (DTC) refractory to radioactive iodine (RAI) are inadequate. Multitargeted kinase inhibitors have recently shown promising results in phase 2-3 studies. This retrospective study aimed to document our clinical experience on the effects of sorafenib in the setting of daily clinical practice. Retrospective study evaluating the efficacy and safety of sorafenib in a cohort of patients consecutively treated with sorafenib at a single center. Twenty patients with advanced RAI-refractory thyroid carcinoma were enrolled (March 2011-March 2014). Patients generally started with 400 mg of sorafenib twice daily, tapering the dose in case of side effects. Radiological response and toxicity were measured during follow-up, together with safety parameters. CT scans were performed by a single experienced radiologist every 3-4 months. Five patients stopped sorafenib within 90 days due to severe toxicities. Median progression-free survival was 248 days. Five patients had a partial response (PR), achieved in all cases within 3 months, whereas 5 had stable disease (SD) at 12 months. Durable response rate (PR plus SD) for at least 6 months was 50 %, among those who received sorafenib for at least 3 months. Commonest adverse events included skin toxicity, gastrointestinal and constitutional symptoms. In our cohort of patients with advanced RAI-refractory thyroid carcinoma, sorafenib confirmed antitumor activity leading to SD or PR in the majority of cases, at the expense of clinically relevant side effects. More effective and tolerable agents are still needed in the treatment of RAI-refractory DTC.

  16. Increasing the activity and enantioselectivity of lipases by sol-gel immobilization: further advancements of practical interest

    NASA Astrophysics Data System (ADS)

    Tielmann, Patrick; Kierkels, Hans; Zonta, Albin; Ilie, Adriana; Reetz, Manfred T.

    2014-05-01

    The entrapment of lipases in hydrophobic silicate matrices formed by sol-gel mediated hydrolysis of RSi(OCH3)3/Si(OCH3)4 as originally reported in 1996 has been improved over the years by a number of modifications. In the production of second-generation sol-gel lipase immobilizates, a variety of additives during the sol-gel process leads to increased activity and enhanced stereoselectivity in esterifying kinetic resolution. Recent advances in this type of lipase immobilization are reviewed here, in addition to new results regarding the sol-gel entrapment of the lipase from Burkholderia cepacia. It constitutes an excellent heterogeneous biocatalyst in the acylating kinetic resolution of two synthetically and industrially important chiral alcohols, rac-sulcatol and rac-trans-2-methoxycyclohexanol. The observation that the catalyst can be used 10 times in recycling experiments without losing its significant activity or enantioselectivity demonstrates the practical viability of the sol-gel approach.The entrapment of lipases in hydrophobic silicate matrices formed by sol-gel mediated hydrolysis of RSi(OCH3)3/Si(OCH3)4 as originally reported in 1996 has been improved over the years by a number of modifications. In the production of second-generation sol-gel lipase immobilizates, a variety of additives during the sol-gel process leads to increased activity and enhanced stereoselectivity in esterifying kinetic resolution. Recent advances in this type of lipase immobilization are reviewed here, in addition to new results regarding the sol-gel entrapment of the lipase from Burkholderia cepacia. It constitutes an excellent heterogeneous biocatalyst in the acylating kinetic resolution of two synthetically and industrially important chiral alcohols, rac-sulcatol and rac-trans-2-methoxycyclohexanol. The observation that the catalyst can be used 10 times in recycling experiments without losing its significant activity or enantioselectivity demonstrates the practical viability of

  17. 77 FR 38342 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-27

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice AGENCY HOLDING THE MEETINGS: Nuclear Regulatory Commission. DATE: Week of June 25, 2012. PLACE: Commissioners' Conference Room, 11555 Rockville Pike, Rockville,...

  18. 77 FR 1521 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-10

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice AGENCY HOLDING THE MEETINGS: Nuclear Regulatory Commission. DATE: Weeks of January 9, 16, 23, 30, February 6, 13, 2012. PLACE: Commissioners' Conference Room,...

  19. 76 FR 8788 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-15

    ... From the Federal Register Online via the Government Publishing Office ] NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice AGENCY HOLDING THE MEETINGS: Nuclear Regulatory Commission. DATE: Weeks of February 14, 21, 28, March 7, 14, 21, 2011. PLACE: Commissioners' Conference Room,...

  20. Queuing register uses fluid logic elements

    NASA Technical Reports Server (NTRS)

    1966-01-01

    Queuing register /a multistage bit-shifting device/ uses a series of pure fluid elements to perform the required logic operations. The register has several stages of three-state pure fluid elements combined with two-input NOR gates.

  1. 76 FR 10410 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-24

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice AGENCY: Nuclear Regulatory Commission. DATES: Weeks of February 21, 28, March 7, 14, 21, 28, 2011. PLACE: Commissioners' Conference Room, 11555 Rockville...

  2. 77 FR 61644 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-10

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice AGENCY HOLDING THE MEETINGS: Nuclear Regulatory Commission. DATE: Weeks of October 8, 15, 22, 29, November 5, 12, 2012. PLACE: Commissioners' Conference Room,...

  3. 77 FR 5063 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-01

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice AGENCY HOLDING THE MEETINGS: Nuclear Regulatory Commission, DATE: Week of January 30, 2012. PLACE: Commissioners' Conference Room, 11555 Rockville Pike,...

  4. 77 FR 59678 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-28

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice AGENCY HOLDING THE MEETINGS: Nuclear Regulatory Commission. DATES: Weeks of October 1, 8, 15, 22, 29, November 5, 2012. PLACE: Commissioners' Conference Room,...

  5. 77 FR 15142 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-14

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice AGENCY HOLDING THE MEETINGS: Nuclear Regulatory Commission. DATE: Week of March 12, 2012. PLACE: Commissioners' Conference Room, 11555 Rockville Pike,...

  6. 75 FR 80083 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-21

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice AGENCY HOLDING THE MEETINGS: Nuclear Regulatory Commission. DATES: Weeks of December 20, 27, 2010, January 3, 10, 17, 24, 2011. PLACE: Commissioners' Conference...

  7. 77 FR 2572 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-18

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice AGENCY HOLDING THE MEETINGS: Nuclear Regulatory Commission. DATES: Weeks of January 16, 23, 30, February 6, 13, 20, 2012. PLACE: Commissioners' Conference Room,...

  8. 76 FR 55718 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-08

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice Agency Holding The Meetings: Nuclear Regulatory Commission. DATE: Week of September 5, 2011. PLACE: Commissioners' Conference Room, 11555 Rockville Pike,...

  9. 76 FR 16459 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-23

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice AGENCY HOLDING THE MEETINGS: Nuclear Regulatory Commission. DATE: Week of March 21, 2011. PLACE: Commissioners' Conference Room, 11555 Rockville Pike,...

  10. 76 FR 46329 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-02

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice AGENCY HOLDING THE MEETINGS: Nuclear Regulatory Commission. DATE: Weeks of August 1, 8, 15, 22, 29, September 5, 2011. PLACE: Commissioners' Conference Room,...

  11. 75 FR 55832 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-14

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice AGENCY HOLDING THE MEETINGS: Nuclear Regulatory Commission [NRC-2010- 0002]. DATES: Weeks of September 13, 20, 27, October 4, 11, 18, 2010. PLACE:...

  12. 77 FR 17102 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-23

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice AGENCY HOLDING THE MEETINGS: Nuclear Regulatory Commission, [NRC-2012- 0002]. DATE: Week of March 26, 2012. PLACE: Commissioners' Conference Room, 11555 Rockville...

  13. 75 FR 64367 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-19

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice AGENCY HOLDING THE MEETINGS: Nuclear Regulatory Commission, DATE: Weeks of October 18, 25, November 1, 8, 15, 22, 2010. PLACE: Commissioners' Conference Room,...

  14. 77 FR 48564 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-14

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice AGENCY HOLDING THE MEETINGS: Nuclear Regulatory Commission. DATE: Weeks of August 13, 20, 27, September 3, 10, 17, 2012. PLACE: Commissioners' Conference Room,...

  15. 75 FR 62894 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-13

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice Agency Holding the Meetings: Nuclear Regulatory Commission. Date: Weeks of October 11, 18, 25, November 1, 8, 15, 2010. Place: Commissioners' Conference Room,...

  16. 75 FR 28303 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-20

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice AGENCY HOLDING THE MEETINGS: Nuclear Regulatory Commission, [NRC-2010- 0002]. DATE: Week of May 24, 2010. PLACE: Commissioners' Conference Room, 11555 Rockville...

  17. 77 FR 57597 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-18

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice AGENCY HOLDING THE MEETINGS: Nuclear Regulatory Commission, DATE: Weeks of September 17, 24, October 1, 8, 15, 22, 2012. PLACE: Commissioners' Conference Room,...

  18. 75 FR 34489 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-17

    ... From the Federal Register Online via the Government Publishing Office ] NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice AGENCY HOLDING THE MEETINGS: Nuclear Regulatory Commission. DATES: Week of June 14, 2010. PLACE: Commissioners' Conference Room, 11555 Rockville Pike, Rockville,...

  19. 76 FR 52717 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-23

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice AGENCY HOLDING THE MEETINGS: Nuclear Regulatory Commission. ] DATE: Weeks of August 22, 29, September 5, 12, 19, 26, 2011. PLACE: Commissioners' Conference...

  20. 76 FR 1653 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-11

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice AGENCY HOLDING THE MEETINGS: Nuclear Regulatory Commission. DATES: Weeks of January 10, 17, 24, 31, February 7, 14, 2011. PLACE: Commissioners' Conference Room,...

  1. 76 FR 62868 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-11

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice AGENCY HOLDING THE MEETINGS: Nuclear Regulatory Commission. DATE: Week of October 10, 2011. PLACE: Commissioners' Conference Room, 11555 Rockville Pike,...

  2. 77 FR 3804 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-25

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice AGENCY HOLDING THE MEETINGS: Nuclear Regulatory Commission, [NRC-2012- 0002]. DATE: Week of January 30, 2012. PLACE: Commissioners' Conference Room, 11555...

  3. 76 FR 48919 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-09

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice AGENCY HOLDING THE MEETINGS: Nuclear Regulatory Commission. DATE: Weeks of August 8, 15, 22, 29, September 5, 12, 2011. PLACE: Commissioners' Conference Room,...

  4. 76 FR 41529 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-14

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice AGENCY HOLDING THE MEETINGS: Nuclear Regulatory Commission [NRC-2011- 0006]. DATE: Week of July 11, 2011. PLACE: Commissioners' Conference Room, 11555 Rockville...

  5. 76 FR 4393 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-25

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice Agency Holding the Meetings: Nuclear Regulatory Commission. Dates: Weeks of January 24, 31, February 7, 14, 21, 28, 2011. Place: Commissioners' Conference Room,...

  6. 77 FR 70488 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-26

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice AGENCY HOLDING THE MEETINGS: Nuclear Regulatory Commission DATES: Weeks of November 26, December 3, 10, 17, 24, 31, 2012 PLACE: Commissioners' Conference Room,...

  7. Shift register generators and applications to coding

    NASA Technical Reports Server (NTRS)

    Morakis, J. C.

    1968-01-01

    The most important properties of shift register generated sequences are exposed. The application of shift registers as multiplication and division circuits leads to the generation of some error correcting and detecting codes.

  8. 76 FR 70779 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-15

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice AGENCY: Agency Holding the Meetings: Nuclear Regulatory Commission. DATES: Weeks of November 14, 21, 28, December 5, 12, 19, 2011. Place: Commissioners'...

  9. 77 FR 67689 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-13

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice AGENCY HOLDING THE MEETINGS: Nuclear Regulatory Commission. DATE: Week of November 5, 2012. PLACE: Commissioners' Conference Room, 11555 Rockville Pike,...

  10. 75 FR 65674 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-26

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice AGENCY HOLDING THE MEETINGS: Nuclear Regulatory Commission. DATE: Weeks of October 25; November 1, 8, 15, 22, 29, 2010. PLACE: Commissioners' Conference Room,...

  11. 77 FR 304 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-04

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice AGENCY HOLDING THE MEETINGS: Nuclear Regulatory Commission. DATES: Weeks of January 2, 9, 16, 23, 30, February 6, 2012. PLACE: Commissioners' Conference Room,...

  12. 76 FR 78952 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-20

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice AGENCY HOLDING THE MEETINGS: Nuclear Regulatory Commission, [NRC-2011- 0006]. DATE: Week of December 19, 2011. PLACE: Commissioners' Conference Room, 11555...

  13. 76 FR 64400 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-18

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice AGENCY HOLDING THE MEETINGS: Nuclear Regulatory Commission, [NRC-2011- 0006]. DATE: Weeks of October 17, 24, 31, November 7, 14, 21, 2011. PLACE:...

  14. 76 FR 11525 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-02

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORTY COMMISSION Sunshine Federal Register Notice AGENCY HOLDING THE MEETINGS: Nuclear Regulatory Commission. DATES: Week of February 28, 2011. PLACE: Commissioners' Conference Room, 11555 Rockville Pike,...

  15. 75 FR 67408 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-02

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice Agency Holding the Meetings: Nuclear Regulatory Commission. Date: Weeks of November 1, 8, 15, 22, 29, December 6, 2010. Place: Commissioners' Conference Room,...

  16. 75 FR 68630 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-08

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice Agency Holding the Meetings: Nuclear Regulatory Commission. Date: Week of November 1, 2010. Place: Commissioners' Conference Room, 11555 Rockville Pike,...

  17. 75 FR 59749 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-28

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice Agency Holding The Meetings: Nuclear Regulatory Commission. DATES: Weeks of September 27, October 4, 11, 18, 25, and November 1, 2010. Place: Commissioners'...

  18. 76 FR 24540 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-02

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice AGENCY HOLDING THE MEETINGS: Nuclear Regulatory Commission. DATE: Week of April 25, 2011. PLACE: Commissioners' Conference Room, 11555 Rockville Pike,...

  19. 78 FR 127 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-02

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice AGENCY HOLDING THE MEETINGS: Nuclear Regulatory Commission. DATE: Weeks of December 31, 2012, January 7, 14, 21, 28, February 4, 2013. PLACE: Commissioners'...

  20. 77 FR 67838 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-14

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice AGENCY HOLDING THE MEETINGS: Nuclear Regulatory Commission. DATE: Weeks of November 12, 19, 26, December 3, 10, 17, 2012. PLACE: Commissioners' Conference Room,...

  1. 76 FR 66095 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-25

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice AGENCY HOLDING THE MEETINGS: Nuclear Regulatory Commission, [NRC-2011- 0006]. DATE: Weeks of October 24, 31, November 7, 14, 21, 28, 2011. PLACE:...

  2. 76 FR 6837 - Sunshine Federal Register Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-08

    ... From the Federal Register Online via the Government Publishing Office NUCLEAR REGULATORY COMMISSION Sunshine Federal Register Notice AGENCY HOLDING THE MEETINGS: Nuclear Regulatory Commission. DATE: Weeks of February 7, 14, 21, 28, March 7, 14, 2011. PLACE: Commissioners' Conference Room,...

  3. California OCS Delegation Agreements Federal Register Notices

    EPA Pesticide Factsheets

    These federal register notices notify to the public that EPA has delegated authority to the agencies in the Federal Register Notices for sources within the 25 nautical miles of California's seaward boundary.

  4. EPA-Registered Bed Bug Products

    MedlinePlus

    ... Pest Bed Bugs EPA Registered Bed Bug Products EPA-Registered Bed Bug Products Resources Bed Bug Main ... Bugs Tips Joint Statement on Bed Bug Control EPA has developed a search tool that can help ...

  5. 20 CFR 346.1 - Central register.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 1 2013-04-01 2012-04-01 true Central register. 346.1 Section 346.1 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT RAILROAD HIRING § 346.1 Central register. (a) The Board shall maintain a central register of...

  6. 20 CFR 346.1 - Central register.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 1 2014-04-01 2012-04-01 true Central register. 346.1 Section 346.1 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT RAILROAD HIRING § 346.1 Central register. (a) The Board shall maintain a central register of...

  7. 20 CFR 346.1 - Central register.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false Central register. 346.1 Section 346.1 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT RAILROAD HIRING § 346.1 Central register. (a) The Board shall maintain a central register of...

  8. 1 CFR 12.1 - Federal Register.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 1 General Provisions 1 2010-01-01 2010-01-01 false Federal Register. 12.1 Section 12.1 General... PUBLICATIONS OFFICIAL DISTRIBUTION WITHIN FEDERAL GOVERNMENT § 12.1 Federal Register. (a) Copies of the daily Federal Register in paper or microfiche form shall be made available to the following without charge:...

  9. 1 CFR 12.1 - Federal Register.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 1 General Provisions 1 2011-01-01 2011-01-01 false Federal Register. 12.1 Section 12.1 General... PUBLICATIONS OFFICIAL DISTRIBUTION WITHIN FEDERAL GOVERNMENT § 12.1 Federal Register. (a) Copies of the daily Federal Register in paper or microfiche form shall be made available to the following without charge:...

  10. 5 CFR 351.404 - Retention register.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 1 2013-01-01 2013-01-01 false Retention register. 351.404 Section 351... FORCE Scope of Competition § 351.404 Retention register. (a) When a competing employee is to be released from a competitive level under this part, the agency shall establish a separate retention register...

  11. 36 CFR 1253.8 - Federal Register.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 36 Parks, Forests, and Public Property 3 2011-07-01 2011-07-01 false Federal Register. 1253.8... AVAILABILITY AND USE LOCATION OF NARA FACILITIES AND HOURS OF USE § 1253.8 Federal Register. The location and business hours of the Office of the Federal Register are posted at http://www.archives.gov, and codified...

  12. 36 CFR 1253.8 - Federal Register.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 36 Parks, Forests, and Public Property 3 2013-07-01 2012-07-01 true Federal Register. 1253.8... AVAILABILITY AND USE LOCATION OF NARA FACILITIES AND HOURS OF USE § 1253.8 Federal Register. The location and business hours of the Office of the Federal Register are posted at http://www.archives.gov, and codified...

  13. What If? Conditionals in Educational Registers

    ERIC Educational Resources Information Center

    Louwerse, Max M.; Crossley, Scott A.; Jeuniaux, Patrick

    2008-01-01

    Many corpus linguistic studies have investigated classification of texts into genres and registers, but relatively few of these studies have looked at linguistic features in educational registers. From a pedagogical perspective it is important to determine whether certain linguistic features behave differently across registers within particular…

  14. 36 CFR 1253.8 - Federal Register.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 36 Parks, Forests, and Public Property 3 2012-07-01 2012-07-01 false Federal Register. 1253.8... AVAILABILITY AND USE LOCATION OF NARA FACILITIES AND HOURS OF USE § 1253.8 Federal Register. The location and business hours of the Office of the Federal Register are posted at http://www.archives.gov, and codified...

  15. 5 CFR 351.404 - Retention register.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 1 2014-01-01 2014-01-01 false Retention register. 351.404 Section 351... FORCE Scope of Competition § 351.404 Retention register. (a) When a competing employee is to be released from a competitive level under this part, the agency shall establish a separate retention register...

  16. 5 CFR 351.404 - Retention register.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 1 2012-01-01 2012-01-01 false Retention register. 351.404 Section 351... FORCE Scope of Competition § 351.404 Retention register. (a) When a competing employee is to be released from a competitive level under this part, the agency shall establish a separate retention register...

  17. 36 CFR 1253.8 - Federal Register.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 36 Parks, Forests, and Public Property 3 2014-07-01 2014-07-01 false Federal Register. 1253.8... AVAILABILITY AND USE LOCATION OF NARA FACILITIES AND HOURS OF USE § 1253.8 Federal Register. The location and business hours of the Office of the Federal Register are posted at http://www.archives.gov, and codified...

  18. 5 CFR 351.404 - Retention register.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Retention register. 351.404 Section 351... FORCE Scope of Competition § 351.404 Retention register. (a) When a competing employee is to be released from a competitive level under this part, the agency shall establish a separate retention register...

  19. 5 CFR 351.404 - Retention register.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Retention register. 351.404 Section 351... FORCE Scope of Competition § 351.404 Retention register. (a) When a competing employee is to be released from a competitive level under this part, the agency shall establish a separate retention register...

  20. Continuous-data FIFO bubble shift register

    NASA Technical Reports Server (NTRS)

    Chen, T. T.

    1977-01-01

    Simple loop first-in-first-out (FIFO) bubble memory shift register has continuous storage capability. Bubble shift register simplifies chip-control electronics by enabling all control functions to be alined at same bit. FIFO shift register is constructed from passive replicator and annihilator combinations.

  1. The National Register of Historic Places.

    ERIC Educational Resources Information Center

    Greenberg, Ronald M., Ed

    2002-01-01

    This journal contains articles and materials to help teachers instruct students about U.S. historical and cultural heritage. Articles and materials are: "The National Register of Historic Places Today" (C. D. Shull); "The (Economic) Value of National Register Listing" (D. D. Rypkema); "The National Register and Heritage…

  2. [Quality of advanced practice nurse counseling in home care settings (APN-BQ): psychometric testing of the instrument].

    PubMed

    Petry, Heidi; Suter-Riederer, Susanne; Kerker-Specker, Carmen; Imhof, Lorenz

    2014-12-01

    Hintergrund: Patientenzentrierte und individuell ausgerichtete Angebote, wie die häusliche Beratung durch Pflegeexpertinnen-APN (Advanced Practice Nurses), eignen sich besonders, chronisch kranke alte Menschen in einer möglichst selbstständigen Lebensführung zu unterstützen. Methode: Um die Qualität einer patientenzentrierten Beratung zu evaluieren, wurde ein 23-Item Instrument entwickelt und seine psychometrischen Eigenschaften mit einer Stichprobe von 206 Personen, die 80 Jahre und älter waren getestet. Ziel: Ziel dieses Artikels ist es, die Entwicklung und Evaluation des APN-BQ zu beschreiben. Die psychometrische Testung des Instruments erfolgte anhand einer Hauptkomponentenanalyse mit Varimax-Rotation. Ergebnisse: Die Analyse ergab eine stabile vier Faktorenstruktur (FS = 0,91) mit 19 Items. Alle Faktoren hatten eine Faktorladung > 0,45. Die interne Konsistenz der Gesamtskala ergab einen Wert von Cronbachs alpha 0,86. Die hohe Rücklaufquote der Fragebogen und die Tatsache, dass 98,8 % der Fragen beantwortet wurden, bestätigten die Anwendungsfreundlichkeit und Akzeptanz des Instruments. Schlussfolgerungen: Das APN-BQ erwies sich als zuverlässiges und in Bezug auf Inhalt und Konstrukt valides Instrument, die Struktur-, Prozess- und Ergebnisqualität einer patientenzentrierten Beratungsintervention in der gemeindenahen Versorgung sowie das Ausmaß der Partizipation und Selbstbefähigung (Empowerment) der zu Beratenden zu messen.

  3. Computer vision-based technologies and commercial best practices for the advancement of the motion imagery tradecraft

    NASA Astrophysics Data System (ADS)

    Phipps, Marja; Capel, David; Srinivasan, James

    2014-06-01

    Motion imagery capabilities within the Department of Defense/Intelligence Community (DoD/IC) have advanced significantly over the last decade, attempting to meet continuously growing data collection, video processing and analytical demands in operationally challenging environments. The motion imagery tradecraft has evolved accordingly, enabling teams of analysts to effectively exploit data and generate intelligence reports across multiple phases in structured Full Motion Video (FMV) Processing Exploitation and Dissemination (PED) cells. Yet now the operational requirements are drastically changing. The exponential growth in motion imagery data continues, but to this the community adds multi-INT data, interoperability with existing and emerging systems, expanded data access, nontraditional users, collaboration, automation, and support for ad hoc configurations beyond the current FMV PED cells. To break from the legacy system lifecycle, we look towards a technology application and commercial adoption model course which will meet these future Intelligence, Surveillance and Reconnaissance (ISR) challenges. In this paper, we explore the application of cutting edge computer vision technology to meet existing FMV PED shortfalls and address future capability gaps. For example, real-time georegistration services developed from computer-vision-based feature tracking, multiple-view geometry, and statistical methods allow the fusion of motion imagery with other georeferenced information sources - providing unparalleled situational awareness. We then describe how these motion imagery capabilities may be readily deployed in a dynamically integrated analytical environment; employing an extensible framework, leveraging scalable enterprise-wide infrastructure and following commercial best practices.

  4. Student Knowledge, Skills, and Self-Efficacy Gains After Completing an Advanced Pharmacy Practice Experience in Geriatrics

    PubMed Central

    Drisaldi, Aulbrey G.; Alotaibi, Fawaz M.; Bonas, Tabatha N.; Shibley, Edward M.; Slattum, Patricia W.

    2016-01-01

    Objective. To assess changes in pharmacy students’ knowledge, skills, and self-efficacy after completing an advanced pharmacy practice experience (APPE) in geriatrics. Design. During the 2013-2014 academic year, 30 Virginia Commonwealth University (VCU) School of Pharmacy students were required to complete a 5-week Geriatrics APPE at Plaza Professional Pharmacy in Richmond, Virginia. All students completed a 25-point knowledge-based pre- and post-assessment to measure students’ self-efficacy. The average time required to accurately fill one unit dose prescription card before and after completing the APPE was also evaluated. Assessment. Students’ average score on the knowledge component improved significantly from 54% to 88% after completing the APPE. The average time required to fill one prescription decreased significantly from 4.0 minutes to 2.5 minutes. Students reported an increase in self-efficacy in the following areas: communication, immunizations, geriatrics-specific pharmacotherapy knowledge, and the ability to fill and check monthly unit dose prescription cards. Conclusion. Requiring fourth-year pharmacy students to complete a geriatrics APPE as a capstone experience to the integrated geriatrics content covered in the first through third years of the doctor of pharmacy (PharmD) curriculum provides an important opportunity to improve students’ knowledge, skills, and self-efficacy in providing care to older adults. PMID:28090105

  5. The Development of Evidence Briefs to Transfer Knowledge About Advanced Practice Nursing Roles to Providers, Policymakers and Administrators.

    PubMed

    Kilpatrick, Kelley; Carter, Nancy; Bryant-Lukosius, Denise; Charbonneau-Smith, Renee; DiCenso, Alba

    2015-03-01

    The transfer of health-related research knowledge between producers and users is a complex, dynamic and iterative process. There has been little research describing the preferred knowledge transfer strategies used by different stakeholder groups, including healthcare providers, policymakers and administrators. The purpose of the survey was to gain an understanding of the content and preferred dissemination strategies of knowledge users of briefing notes about the effectiveness of advanced practice nursing (APN) roles in Canada. An on-line cross-sectional survey was conducted from December 2011 to January 2012. Purposeful sampling was used to identify the target audience. The questionnaire included six items. The response rate was 44% (n=75/170). Participants identified that the briefing note should concisely summarize definitions for APN roles and information about the safety, effectiveness, cost savings and effective role implementation strategies. Multiple approaches were favoured to disseminate the information. Preferred dissemination strategies included personalized emails, meeting with briefing note recipients, engaging nurse practitioners and clinical nurse specialists in organizations where APN roles have been successfully implemented, engaging the media and using social media. The use of briefing notes has shown promise. More research is needed to evaluate the effectiveness of tailored briefing notes.

  6. Effectiveness and safety of first-generation protease inhibitors in clinical practice: Hepatitis C virus patients with advanced fibrosis

    PubMed Central

    Salmerón, Javier; Vinaixa, Carmen; Berenguer, Rubén; Pascasio, Juan Manuel; Sánchez Ruano, Juan José; Serra, Miguel Ángel; Gila, Ana; Diago, Moisés; Romero-Gómez, Manuel; Navarro, José María; Testillano, Milagros; Fernández, Conrado; Espinosa, Dolores; Carmona, Isabel; Pons, José Antonio; Jorquera, Francisco; Rodriguez, Francisco Javier; Pérez, Ramón; Montero, José Luis; Granados, Rafael; Fernández, Miguel; Martín, Ana Belén; Muñoz de Rueda, Paloma; Quiles, Rosa

    2015-01-01

    AIM: To evaluates the effectiveness and safety of the first generation, NS3/4A protease inhibitors (PIs) in clinical practice against chronic C virus, especially in patients with advanced fibrosis. METHODS: Prospective study and non-experimental analysis of a multicentre cohort of 38 Spanish hospitals that includes patients with chronic hepatitis C genotype 1, treatment-naïve (TN) or treatment-experienced (TE), who underwent triple therapy with the first generation NS3/4A protease inhibitors, boceprevir (BOC) and telaprevir (TVR), in combination with pegylated interferon and ribavirin. The patients were treatment in routine practice settings. Data on the study population and on adverse clinical and virologic effects were compiled during the treatment period and during follow up. RESULTS: One thousand and fifty seven patients were included, 405 (38%) were treated with BOC and 652 (62%) with TVR. Of this total, 30% (n = 319) were TN and the remaining were TE: 28% (n = 298) relapsers, 12% (n = 123) partial responders (PR), 25% (n = 260) null-responders (NR) and for 5% (n = 57) with prior response unknown. The rate of sustained virologic response (SVR) by intention-to-treatment (ITT) was greater in those treated with TVR (65%) than in those treated with BOC (52%) (P < 0.0001), whereas by modified intention-to-treatment (mITT) no were found significant differences. By degree of fibrosis, 56% of patients were F4 and the highest SVR rates were recorded in the non-F4 patients, both TN and TE. In the analysis by groups, the TN patients treated with TVR by ITT showed a higher SVR (P = 0.005). However, by mITT there were no significant differences between BOC and TVR. In the multivariate analysis by mITT, the significant SVR factors were relapsers, IL28B CC and non-F4; the type of treatment (BOC or TVR) was not significant. The lowest SVR values were presented by the F4-NR patients, treated with BOC (46%) or with TVR (45%). 28% of the patients interrupted the treatment

  7. Wavefunctions for topological quantum registers

    SciTech Connect

    Ardonne, E. . E-mail: ardonne@kitp.ucsb.edu; Schoutens, K.

    2007-01-15

    We present explicit wavefunctions for quasi-hole excitations over a variety of non-abelian quantum Hall states: the Read-Rezayi states with k {>=} 3 clustering properties and a paired spin-singlet quantum Hall state. Quasi-holes over these states constitute a topological quantum register, which can be addressed by braiding quasi-holes. We obtain the braid properties by direct inspection of the quasi-hole wavefunctions. We establish that the braid properties for the paired spin-singlet state are those of 'Fibonacci anyons', and thus suitable for universal quantum computation. Our derivations in this paper rely on explicit computations in the parafermionic conformal field theories that underly these particular quantum Hall states.

  8. 21 CFR 606.171 - Reporting of product deviations by licensed manufacturers, unlicensed registered blood...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... manufacturers, unlicensed registered blood establishments, and transfusion services. 606.171 Section 606.171...) BIOLOGICS CURRENT GOOD MANUFACTURING PRACTICE FOR BLOOD AND BLOOD COMPONENTS Records and Reports § 606.171 Reporting of product deviations by licensed manufacturers, unlicensed registered blood establishments,...

  9. 21 CFR 606.171 - Reporting of product deviations by licensed manufacturers, unlicensed registered blood...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... manufacturers, unlicensed registered blood establishments, and transfusion services. 606.171 Section 606.171...) BIOLOGICS CURRENT GOOD MANUFACTURING PRACTICE FOR BLOOD AND BLOOD COMPONENTS Records and Reports § 606.171 Reporting of product deviations by licensed manufacturers, unlicensed registered blood establishments,...

  10. 21 CFR 606.171 - Reporting of product deviations by licensed manufacturers, unlicensed registered blood...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... manufacturers, unlicensed registered blood establishments, and transfusion services. 606.171 Section 606.171...) BIOLOGICS CURRENT GOOD MANUFACTURING PRACTICE FOR BLOOD AND BLOOD COMPONENTS Records and Reports § 606.171 Reporting of product deviations by licensed manufacturers, unlicensed registered blood establishments,...

  11. Evaluation of an Advanced-Practice Physical Therapist in a Specialty Shoulder Clinic: Diagnostic Agreement and Effect on Wait Times

    PubMed Central

    Robarts, Susan; Kennedy, Deborah; McKnight, Cheryl; MacLeod, Anne Marie; Holtby, Richard

    2013-01-01

    ABSTRACT Purpose: To examine the role of an advanced-practice physiotherapist (APP) with respect to (1) agreement with an orthopaedic surgeon on diagnosis and management of patients with shoulder problems; (2) wait times; and (3) satisfaction with care. Methods: This prospective study involved patients with shoulder complaints who were referred to a shoulder specialist in a tertiary care centre. Agreement was examined on seven major diagnostic categories, need for further examination and surgery, and type of surgical procedure. Wait times were compared between the APP- and surgeon-led clinics from referral date to date of initial consultation, date of final diagnostic test, and date of confirmed diagnosis and planned treatment. A modified and validated version of the Visit-Specific Satisfaction Instrument assessed satisfaction in seven domains. Kappa (κ) coefficients and bias- and prevalence-adjusted kappa (PABAK) values were calculated, and strength of agreement was categorized. Wait time and satisfaction data were examined using non-parametric statistics. Results: Agreement on major diagnostic categories varied from 0.68 (good) to 0.96 (excellent). Agreement with respect to indication for surgery was κ=0.75, p<0.001; 95% CI, 0.62–0.88 (good). Wait time for APP assessment was significantly shorter than wait time for surgeon consultation at all time points (p<0.001); the surgeon's wait time was significantly reduced over 3 years. High satisfaction was reported in all components of care received from both health care providers. Conclusions: Using experienced physiotherapists in an extended role reduces wait times without compromising patient clinical management and overall satisfaction. PMID:24381382

  12. Sandia National Laboratories Advanced Simulation and Computing (ASC) software quality plan. Part 1 : ASC software quality engineering practices version 1.0.

    SciTech Connect

    Minana, Molly A.; Sturtevant, Judith E.; Heaphy, Robert; Hodges, Ann Louise; Boucheron, Edward A.; Drake, Richard Roy; Forsythe, Christi A.; Schofield, Joseph Richard, Jr.; Pavlakos, Constantine James; Williamson, Charles Michael; Edwards, Harold Carter

    2005-01-01

    The purpose of the Sandia National Laboratories (SNL) Advanced Simulation and Computing (ASC) Software Quality Plan is to clearly identify the practices that are the basis for continually improving the quality of ASC software products. Quality is defined in DOE/AL Quality Criteria (QC-1) as conformance to customer requirements and expectations. This quality plan defines the ASC program software quality practices and provides mappings of these practices to the SNL Corporate Process Requirements (CPR 1.3.2 and CPR 1.3.6) and the Department of Energy (DOE) document, ASCI Software Quality Engineering: Goals, Principles, and Guidelines (GP&G). This quality plan identifies ASC management and software project teams' responsibilities for cost-effective software engineering quality practices. The SNL ASC Software Quality Plan establishes the signatories commitment to improving software products by applying cost-effective software engineering quality practices. This document explains the project teams opportunities for tailoring and implementing the practices; enumerates the practices that compose the development of SNL ASC's software products; and includes a sample assessment checklist that was developed based upon the practices in this document.

  13. Perceptions of North Dakota Registered Nurses Regarding Advance Directives

    DTIC Science & Technology

    2005-05-01

    directives as affecting their management of care (Langerman et al., 2000). A recent study that reviewed the charts of patients undergoing high -risk...greatly affected by a number of essential concepts, such as perception, time, interaction, role, power, status, comfort level, and decision-making. This...directives for themselves reflected the low national averages. Finally, the majority of participants reported encountering multiple barriers to discussing

  14. Reaching for the stars: career advancement and the registered nurse.

    PubMed

    Walker, Kim

    2005-08-01

    Clinical nursing has long struggled to secure the place of primacy it deserves in the profession's hierarchy of importance and worth. It is ironic that, even at the beginning of the 21st century, a clinical nurse is generally not as well-recognized, rewarded or remunerated as a colleague working in nursing management, education or research. Until the profession recognizes and takes serious action to remedy this situation, the crisis of recruitment and retention in nursing currently ravaging the globe is likely to continue. In this paper, I present a discursive account of an exciting initiative by a leading private, acute-care hospital which addresses this very problem. A new ladder for clinical nurse specialists (CNSs) introduces a rigorous and systematic approach to the appointment of three classifications of CNS, each requiring evidence of successively higher levels of competency, and which are accompanied by fiscal reward and stronger peer recognition.

  15. An innovative approach to enhance dermatology competencies for advanced practice nurses: service–learning with a migrant farm worker health clinic.

    PubMed

    Downes, Elizabeth A; Connor, Ann; Howett, Maeve

    2014-12-01

    The purpose of this article is to describe a novel service–learning opportunity for graduate nursing students that promotes competency in dermatology. A hybrid service–learning course with online didactic content is described, along with tools for evaluation of dermatology competencies. Student evaluation of the course is discussed, and selected research articles are reviewed. Advanced practice nursing and medical education frequently does not adequately prepare primary care providers to be competent in the assessment and management of dermatologic conditions. Embedding dermatology content in a service–learning program can optimize the provision of care, strengthen competencies in dermatology and inter-professional care, and allow students to gain a deeper understanding of the population with which they work. The innovative service–learning program presented is a model for advanced practice nursing education. Tools for evaluating clinical competency and courses often need validation.

  16. Register of Validated Short Dietary Assessment Instruments

    Cancer.gov

    The register contains descriptive information about the instruments identified (over 135) along with any associated validation studies and publications, and copies of the instruments themselves when available.

  17. Public Health Asks of Systems Science: To Advance Our Evidence-Based Practice, Can You Help Us Get More Practice-Based Evidence?

    PubMed Central

    Green, Lawrence W.

    2006-01-01

    Public health asks of systems science, as it did of sociology 40 years ago, that it help us unravel the complexity of causal forces in our varied populations and the ecologically layered community and societal circumstances of public health practice. We seek a more evidence-based public health practice, but too much of our evidence comes from artificially controlled research that does not fit the realities of practice. What can we learn from our experience with sociology in the past that might guide us in drawing effectively on systems science? PMID:16449580

  18. Public health asks of systems science: to advance our evidence-based practice, can you help us get more practice-based evidence?

    PubMed

    Green, Lawrence W

    2006-03-01

    Public health asks of systems science, as it did of sociology 40 years ago, that it help us unravel the complexity of causal forces in our varied populations and the ecologically layered community and societal circumstances of public health practice. We seek a more evidence-based public health practice, but too much of our evidence comes from artificially controlled research that does not fit the realities of practice. What can we learn from our experience with sociology in the past that might guide us in drawing effectively on systems science?

  19. Exploring the experience of Canadian registered psychiatric nurses: a phenomenological study.

    PubMed

    Jackson, J; Morrissette, P J

    2014-03-01

    This paper describes a phenomenological study that was conducted in 2012 and investigated the experiences of registered psychiatric nurses working in the province of Manitoba. Ten registered psychiatric nurses participated in semistructured, audio-recorded interviews, during which they described their experiences, yielding written protocols that were thematically analysed. Results from this study revealed six predominant themes that included (1) perception of psychiatric nursing; (2) patient aggression; (3) patient family involvement; (4) nurse-doctor relationship; (5) responsibility and worry; and (6) shift in practice and educational standards. The results of this study can assist in better understanding registered psychiatric nursing practice, inform educational programmes, and spawn future research.

  20. Plagiarism and registered health professionals: navigating the borderlands between scholarly and professional misconduct.

    PubMed

    Wardle, Jon

    2013-12-01

    As access to published materials becomes more readily available, the ability to plagiarise material, deliberately or unwittingly has become easier than ever. This article explores important recent decisions in Australia and the United Kingdom regarding registered health practitioners who have engaged in plagiarism, both related and unrelated to their clinical practice, and explores the ways in which regulatory authorities in these countries have viewed scholarly misconduct committed by registered health professionals. This article also examines the implications of plagiarism for the registered health professions, and makes suggestions for strategies to reduce its influence and incidence in modern clinical practice.