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Sample records for early nursing reform

  1. Reformation and Resistance in American Nursing Education.

    ERIC Educational Resources Information Center

    Miller, Lucy Heim

    The American Nurses' Association's "First Position on Nursing" (1965), one instance of attempted reformation in American nursing education, recommends that nursing education should take place in institutions of higher education. Failures of this suggested reform seem to relate directly to the reform's incongruence with the continued or…

  2. Skilled nursing facilities reform.

    PubMed

    1998-06-01

    The Medicare prospective payment system for skilled nursing facilities will take effect with cost reporting years beginning on or after July 1, 1998. HCFA is working on the implementation details. While final details are not expected to be published until Summer 1998, the following information has been provided through HCFA and/or the Nursing Home Case-Mix and Quality (NHCMQ) Demonstration project (RUGs-III) procedures.

  3. Social reform versus education reform: university nursing education in Canada, 1919-1960.

    PubMed

    Baumgart, A J; Kirkwood, R

    1990-05-01

    Nurses' struggle to attain educational parity with other professional groups is closely aligned with the struggle of women for social equality within Canadian institutions. The attempts of nursing educators to shift their perspective from social reform to educational reform and to develop nursing scholarship has been restricted by the cultural views of women. Consequently, nurses' gains in attaining higher education have been realized by reforms in social and health care policies thought suitable for women. With advancement in university nursing education closely tied to social reform, nurses were not expected, nor did they expect, to pursue scholarly enquiry or develop research endeavours. This paper suggests that the feminist movement offers nurses a social and psychological basis from which to complete the educational reform of nursing.

  4. Tort reform: an issue for nurse practitioners.

    PubMed

    Klutz, Diane L

    2004-02-01

    To inform nurse practitioners (NPs) about the issues related to tort reform and its relationship to malpractice insurance costs. Current journals, newspapers, professional newsletters, and Internet sites. NPs are paying more for their malpractice premiums, and many are losing their places of employment as clinics close due to the increased cost of premiums. One method proposed for curbing the flow of monies spent on premiums and litigation is tort law reform. California serves as an example; its Medical Injury Compensation Reform Act (MICRA) tort reform law was passed 25 years ago, and it has maintained stable malpractice premiums. Other states have proposed similar laws, but some have not had similar success. To curb litigation costs, not only should tort laws be reformed, but NPs and physicians should keep abreast of current practice standards in order to provide quality medical care. Like physicians, NPs are affected directly by tort laws. These laws hold NPs accountable at the same level as physicians. In addition, many states limit NPs' practice to delegation of authority by a physician. Liability is therefore transferred from the NP to the physician and vice versa in cases of injury or wrongful act. In addition, many NPs are finding it increasingly difficult to locate insurers who will write policies for medical liability.

  5. Health Care Reform: How Will It Affect Nursing?--Nursing Education.

    ERIC Educational Resources Information Center

    Zalon, Margarete Lieb

    Nursing educators have the opportunity to advance nursing's agenda for health care reform to ensure effective health care for all members of society. They have a key role in fostering the political involvement of student nurses and nurses who have returned to school for baccalaureate or graduate education. Role modeling is critical to increasing…

  6. Nursing Home Litigation and Tort Reform: A Case for Exceptionalism

    ERIC Educational Resources Information Center

    Studdert, David M.; Stevenson, David G.

    2004-01-01

    The medical malpractice crisis that is currently spreading across the United States bears many similarities to earlier crises. One novel aspect of the current crisis is the explicit inclusion of litigation against nursing homes as a target of reform. Encouraged by the nursing home industry, policymakers are considering the extension of…

  7. Nursing Home Staffing and Quality under the Nursing Home Reform Act

    ERIC Educational Resources Information Center

    Zhang, Xinzhi; Grabowski, David C.

    2004-01-01

    Purpose: We examine whether the Nursing Home Reform Act (NHRA) improved nursing home staffing and quality. Design and Methods: Data from 5,092 nursing homes were linked across the 1987 Medicare/Medicaid Automated Certification System and the 1993 Online Survey, Certification and Reporting system. A dummy-year model was used to examine the effects…

  8. Australia's health care reform agenda: implications for the nurses' role in chronic heart failure management.

    PubMed

    Betihavas, Vasiliki; Newton, Phillip J; Du, Hui Yun; Macdonald, Peter S; Frost, Steven A; Stewart, Simon; Davidson, Patricia M

    2011-08-01

    The importance of the nursing role in chronic heart failure (CHF) management is increasingly recognised. With the recent release of the National Health and Hospitals Reform Commission (NHHRC) report in Australia, a review of nursing roles in CHF management is timely and appropriate. This paper aims to discuss the implications of the NHHRC report and nursing roles in the context of CHF management in Australia. The electronic databases, Thomson Rheuters Web of Knowledge, Scopus and the Cumulative Index to Nursing and Allied Health Literature (CINAHL), were searched using keywords including; "heart failure", "management", "Australia" and "nursing". In addition policy documents were reviewed including statements and reports from key professional organisations and Government Departments to identify issues impacting on nursing roles in CHF management. There is a growing need for the prevention and control of chronic conditions, such as CHF. This involves an increasing emphasis on specialist cardiovascular nurses in community based settings, both in outreach and inreach health service models. This review has highlighted the need to base nursing roles on evidence based principles and identify the importance of the nursing role in coordinating and managing CHF care in both independent and collaborative practice settings. The importance of the nursing role in early chronic disease symptom recognition and implementing strategies to prevent further deterioration of individuals is crucial to improving health outcomes. Consideration should be given to ensure that evidence based principles are adopted in models of nursing care. Copyright © 2010 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

  9. [Graduation from nursing: learning about the Brazilian psychiatric reform].

    PubMed

    Olschowsky, A; Barros, S

    1999-12-01

    This paper aims at identifying the changes that became part of the teaching of psychiatric nursing. The study points out the concern regarding teaching updating in this area in which the teacher's transformation, participation and the creation of a new concept about psychiatric knowledge and practice make it possible to have new ways to learn how to learn the brazilian psychiatric reform.

  10. Shaping the future: reforming routine emergency nursing work.

    PubMed

    Sbaih, L C

    2001-10-01

    The provision of emergency care, for many A&E nurses, is dependent upon taken-for-granted assumptions, associated with the ongoing management of the changing shape of the work. In particular, routine working practices and procedures reflect a collective ideology of A&E nursing labour which involves moving people on and out of the emergency department. Subscribing to this ideology and realizing good shape provides nurses with a feeling that they are in control of their work and have done a good job. Analysis of the NHS Plan has identified that the Government's goals for reform support as well as challenge the ways in which nurses currently strive towards maintaining the good shape of their work. In particular, the ideology of patient-centredness and the Chief Nursing Officer's ten key roles for nurses, provide an opportunity for nurses to explore the ways in which they can cultivate their routine activities and contribute to the shape of future emergency nursing work.

  11. Beginning Together: Reforming Schools by Investing in Early Childhood Education

    ERIC Educational Resources Information Center

    Kaufman, Michael J.; Kaufman, Sherelyn R.; Nelson, Elizabeth C.

    2015-01-01

    The most productive way to reform education would be to invest in effective early childhood education programs. Such an investment would produce remarkable educational, social, and economic benefits. It would also transcend the current divisive debates about education reform by uniting advocates with different perspectives on issues of funding,…

  12. Care systematization in psychiatric nursing within the psychiatric reform context.

    PubMed

    Hirdes, A; Kantorski, L P

    2002-02-01

    The aim of this study was to approach care systematization in psychiatric nursing in two psychiatric disorder patients who attended 'Nossa Casa', São Lourenço do Sul, RS, Brazil. Nossa Casa services psychiatric patients in the community, focussing on: (i) permanence in their environment, allowing patients to remain close to their families and social spheres; (ii) integral attendance to meet individual needs; (iii) respecting individual differences; (iv) rehabilitation practices; and (v) social reinsertion. Concepts and assumptions of the psychiatric reform and the Irving's nursing process were used as theoretical-methodological references to elaborate this systematization. A therapeutic project for the psychiatric patient was elaborated, in accordance with the interdisciplinary proposal accepted by Nossa Casa. Interdisciplinary team intervention, guided by a previously discussed common orientation and defined through an individualized therapeutic project, allowed for an effective process of psychosocial rehabilitation. The authors concluded that a therapeutic project based on the mentioned premises leads to consistent, comprehensive, dialectical and ethical assistance in mental health, thereby reinstating the citizenship of psychiatric patients.

  13. Balancing the Readiness Equation in Early Childhood Education Reform

    ERIC Educational Resources Information Center

    Brown, Christopher P.

    2010-01-01

    As policy-makers continue to implement early childhood education reforms that frame the field as a mechanism that is to ready children for elementary school success, questions arise as to how the multiple variables in the readiness equation, such as the child, family, and program, are affected by these policies. The instrumental case study…

  14. Nursing education reform in South Africa – lessons from a policy analysis study

    PubMed Central

    Blaauw, Duane; Ditlopo, Prudence; Rispel, Laetitia C.

    2014-01-01

    Background Nursing education reform is identified as an important strategy for enhancing health workforce performance, and thereby improving the functioning of health systems. Globally, a predominant trend in such reform is towards greater professionalisation and university-based education. Related nursing education reform in South Africa culminated in a new Framework for Nursing Qualifications in 2013. Objective We undertook a policy analysis study of the development of the new Nursing Qualifications Framework in South Africa. Design We used a policy analysis framework derived from Walt and Gilson that interrogated the context, content, actors, and processes of policy development and implementation. Following informed consent, in-depth interviews were conducted with 28 key informants from national and provincial government; the South African Nursing Council; the national nursing association; nursing academics, managers, and educators; and other nursing organisations. The interviews were complemented with a review of relevant legislation and policy documents. Documents and interview transcripts were coded thematically using Atlas-ti software. Results The revision of nursing qualifications was part of the post-apartheid transformation of nursing, but was also influenced by changes in the education sector. The policy process took more than 10 years to complete and the final Regulations were promulgated in 2013. The two most important changes are the requirement for a baccalaureate degree to qualify as a professional nurse and abolishing the enrolled nurse with 2 years training in favour of a staff nurse with a 3-year college diploma. Respondents criticised slow progress, weak governance by the Nursing Council and the Department of Health, limited planning for implementation, and the inappropriateness of the proposals for South Africa. Conclusions The study found significant weaknesses in the policy capacity of the main institutions responsible for the leadership and

  15. Nursing education reform in South Africa--lessons from a policy analysis study.

    PubMed

    Blaauw, Duane; Ditlopo, Prudence; Rispel, Laetitia C

    2014-01-01

    Nursing education reform is identified as an important strategy for enhancing health workforce performance, and thereby improving the functioning of health systems. Globally, a predominant trend in such reform is towards greater professionalisation and university-based education. Related nursing education reform in South Africa culminated in a new Framework for Nursing Qualifications in 2013. We undertook a policy analysis study of the development of the new Nursing Qualifications Framework in South Africa. We used a policy analysis framework derived from Walt and Gilson that interrogated the context, content, actors, and processes of policy development and implementation. Following informed consent, in-depth interviews were conducted with 28 key informants from national and provincial government; the South African Nursing Council; the national nursing association; nursing academics, managers, and educators; and other nursing organisations. The interviews were complemented with a review of relevant legislation and policy documents. Documents and interview transcripts were coded thematically using Atlas-ti software. The revision of nursing qualifications was part of the post-apartheid transformation of nursing, but was also influenced by changes in the education sector. The policy process took more than 10 years to complete and the final Regulations were promulgated in 2013. The two most important changes are the requirement for a baccalaureate degree to qualify as a professional nurse and abolishing the enrolled nurse with 2 years training in favour of a staff nurse with a 3-year college diploma. Respondents criticised slow progress, weak governance by the Nursing Council and the Department of Health, limited planning for implementation, and the inappropriateness of the proposals for South Africa. The study found significant weaknesses in the policy capacity of the main institutions responsible for the leadership and governance of nursing in South Africa, which

  16. Nurses' experiences of practice and political reform in long-term aged care in Australia: implications for the retention of nursing personnel.

    PubMed

    Venturato, Lorraine; Kellett, Ursula; Windsor, Carol

    2007-01-01

    The aim of the study was to explore registered nurses' experiences in long-term aged care in light of the political reform of aged care services in Australia. In Australia, the aged care industry has undergone a lengthy period of political and structural reform. Despite reviews into various aspects of these reforms, there has been little consideration of the effect these are having on the practice experiences and retention of nursing staff in long-term care. In this critical hermeneutic study, 14 nurses from long-term care facilities in Australia were interviewed about their experiences during the reform period. The data revealed a sense of tension and conflict between nurses' traditional values, roles and responsibilities and those supported by the reforms. Nurses struggled to re-negotiate both their practice roles and values as the reforms were implemented and the system evolved. Nursing management support was an important aspect in mediating the effect of reforms on nursing staff. This research highlights both the tensions experienced by nurses in long-term aged care in Australia and the need to re-negotiate nursing roles, responsibilities and values within an evolving care system. This research supports a role for sensitive and proactive nursing management during periods of industry reform as a retention strategy for qualified nursing personnel.

  17. Job satisfaction trends during nurses' early career.

    PubMed

    Murrells, Trevor; Robinson, Sarah; Griffiths, Peter

    2008-06-05

    Job satisfaction is an important component of nurses' lives that can impact on patient safety, productivity and performance, quality of care, retention and turnover, commitment to the organisation and the profession. Little is known about job satisfaction in early career and how it varies for different groups of nurses. This paper investigates how the components of job satisfaction vary during early career in newly qualified UK nurses. Nurses were sampled using a combined census and multi-stage approach (n = 3962). Data were collected by questionnaire at 6 months, 18 months and 3 years after qualification between 1998 and 2001. Scores were calculated for seven job satisfaction components and a single item that measured satisfaction with pay. Scores were compared longitudinally and between nursing speciality (general, children's, mental health) using a mixed model approach. No single pattern across time emerged. Trends varied by branch and job satisfaction component. Rank order of job satisfaction components, from high to low scores, was very similar for adult and child branch nurses and different for mental health. Nurses were least satisfied with pay and most satisfied with relationships at 6 and 18 months and with resources (adult and child) and relationships (mental health) at 3 years. Trends were typically upwards for adult branch nurses, varied for children's nurses and downwards for mental health nurses. The impact of time on job satisfaction in early career is highly dependent on specialism. Different contexts, settings and organisational settings lead to varying experiences. Future research should focus on understanding the relationships between job characteristics and the components of job satisfaction rather than job satisfaction as a unitary construct. Research that further investigates the benefits of a formal one year preceptorship or probationary period is needed.

  18. Job satisfaction trends during nurses' early career

    PubMed Central

    Murrells, Trevor; Robinson, Sarah; Griffiths, Peter

    2008-01-01

    Background Job satisfaction is an important component of nurses' lives that can impact on patient safety, productivity and performance, quality of care, retention and turnover, commitment to the organisation and the profession. Little is known about job satisfaction in early career and how it varies for different groups of nurses. This paper investigates how the components of job satisfaction vary during early career in newly qualified UK nurses. Methods Nurses were sampled using a combined census and multi-stage approach (n = 3962). Data were collected by questionnaire at 6 months, 18 months and 3 years after qualification between 1998 and 2001. Scores were calculated for seven job satisfaction components and a single item that measured satisfaction with pay. Scores were compared longitudinally and between nursing speciality (general, children's, mental health) using a mixed model approach. Results No single pattern across time emerged. Trends varied by branch and job satisfaction component. Rank order of job satisfaction components, from high to low scores, was very similar for adult and child branch nurses and different for mental health. Nurses were least satisfied with pay and most satisfied with relationships at 6 and 18 months and with resources (adult and child) and relationships (mental health) at 3 years. Trends were typically upwards for adult branch nurses, varied for children's nurses and downwards for mental health nurses. Conclusion The impact of time on job satisfaction in early career is highly dependent on specialism. Different contexts, settings and organisational settings lead to varying experiences. Future research should focus on understanding the relationships between job characteristics and the components of job satisfaction rather than job satisfaction as a unitary construct. Research that further investigates the benefits of a formal one year preceptorship or probationary period is needed. PMID:18534023

  19. Challenges experienced by nurses in the implementation of a healthcare reform plan in Iran.

    PubMed

    Salarvand, Shahin; Azizimalekabadi, Maryam; Jebeli, Azadeh Akbari; Nazer, Mohamadreza

    2017-04-01

    The Healthcare Reform Plan is counted as a plan for improving healthcare services in Iran. Undoubtedly pros and cons can be seen either in plan or implementation. This study was conducted to describe nurses' challenges in implementing healthcare reform in Iran. A qualitative method centered upon conventional content analysis was applied. We used purposive sampling and data saturation was obtained by 30 participants. Data were analyzed using MAXQDA software. Challenges experienced by nurses in the implementation of this reform include; unsuitable infrastructure, unfavorable vision, a complicated challenge, the necessity of monitoring, control plan outcomes, the impact on nurses, people's misconceptions and solutions. The Healthcare Reform Plan in Iran is a solution to establish equality in the health system, however, to eliminate these challenges, revision and appropriate foundation of infrastructures is called for.

  20. Nursing Faculty Development at California Community Colleges amidst Healthcare Reform

    ERIC Educational Resources Information Center

    Tsao, Jane Ming Yao

    2017-01-01

    As the frontline nurse leaders, associate degree nursing (ADN) faculty members represent the key players for a seamless RN-BSN academic progression at the fundamental level of nursing education, which requires a balanced academic-clinical practice teaching. However, the Institute of Medicine's recommendation on expanded scope of nursing practice…

  1. Challenges experienced by nurses in the implementation of a healthcare reform plan in Iran

    PubMed Central

    Salarvand, Shahin; Azizimalekabadi, Maryam; Jebeli, Azadeh Akbari; Nazer, Mohamadreza

    2017-01-01

    Introduction The Healthcare Reform Plan is counted as a plan for improving healthcare services in Iran. Undoubtedly pros and cons can be seen either in plan or implementation. This study was conducted to describe nurses’ challenges in implementing healthcare reform in Iran. Methods A qualitative method centered upon conventional content analysis was applied. We used purposive sampling and data saturation was obtained by 30 participants. Data were analyzed using MAXQDA software. Results Challenges experienced by nurses in the implementation of this reform include; unsuitable infrastructure, unfavorable vision, a complicated challenge, the necessity of monitoring, control plan outcomes, the impact on nurses, people’s misconceptions and solutions. Conclusions The Healthcare Reform Plan in Iran is a solution to establish equality in the health system, however, to eliminate these challenges, revision and appropriate foundation of infrastructures is called for. PMID:28607646

  2. The early NHS and the crisis of public health nursing.

    PubMed

    Webster, C

    2000-01-01

    Establishment of the NHS in 1948 is rightly seen as a major turning point in health care in the United Kingdom. Notwithstanding conditions of severe austerity, the NHS succeeded remarkably well in its basic remit to make all essential medical care available to the entire population, free at point of delivery. The benefits of the new system extended across the entire front of its services. However, it is important to recognise that the reforms of 1948 were uniformly advantageous. It has for instance long been recognised that the NHS failed to bring about the expected transformation in standards of general medical practice. In this short paper the author argues that public health represented a further major sphere of underdevelopment. The fact that, with minor exceptions, public health is the least studied aspect of the early NHS is itself suggestive of its status as the Cinderella of the modern health services. The author also underlines the adverse implications of this inferior position for domiciliary midwifery, district nursing and health visiting. These constituted small but strategically important sectors of nursing, all of which fell under public health administration in the new health service. The author concentrates on the first phase of the NHS, the period between 1948 and 1974, now often regarded as its golden age. For the purposes of this discussion, most of the evidence relates to the formative phase of the new service, when many major policy questions relating to public health were first confronted. It is suggested that the early neglect of public health and its constituent nursing functions has left a legacy of problems that have still not entirely been resolved. For the purposes of this paper the term will be used to embrace the totality of health functions administered by departments of local government in the period from 1948 to 1974. Most of these services fell within the public health departments of local government, headed by the Medical Office

  3. Health Sector Reform, Emotional Exhaustion, and Nursing Burnout: A Retrospective Panel Study in Iran.

    PubMed

    Sadati, Ahmad Kalateh; Rahnavard, Farnaz; Heydari, Seyed Taghi; Hemmati, Soroor; Ebrahimzadeh, Najmeh; Lankarani, Kamran Bagheri

    2017-10-01

    Nursing burnout is affected by various factors, including work overload. Since the inauguration of the Health Sector Evolution Plan (HSEP) in Iran in 2014, government hospitals have been required to provide health services to the public at all levels. This decision, however, has increased the volume of patients admitted to government hospitals. Because nurses are on the front line of health services, they are faced with a greater load of care provision. This study aimed to evaluate nursing burnout before and after HSEP in Iran, with an emphasis on the differences between government and private hospitals. This retrospective panel study used Maslach's burnout inventory to evaluate nursing burnout in 371 nurses working in government and private hospitals in Shiraz, Iran, before and 7 months after the health sector reform. Chi-square test and paired t test were used to compare burnout scores. The results showed that nursing burnout had changed significantly after HSEP was launched (p = .030). A more detailed assessment found that burnout and emotional exhaustion had both increased significantly in the government-hospital group (ps = .014 and .001, respectively). However, no significant change in burnout was found in the private-hospital group over the same period. The findings of this study indicate an increase in nursing burnout in government hospitals. An important issue in every health sector reform is nursing resource management, with a focus on burnout. Accordingly, policymakers should consider the work overload situation of nurses and work to prevent increased burnout, especially emotional exhaustion.

  4. Rising to the challenge of health care reform with entrepreneurial and intrapreneurial nursing initiatives.

    PubMed

    Wilson, Anne; Whitaker, Nancy; Whitford, Deirdre

    2012-05-31

    Health reform worldwide is required due to the largely aging population, increase in chronic diseases, and rising costs. To meet these needs, nurses are being encouraged to practice to the full extent of their skills and take significant leadership roles in health policy, planning, and provision. This can involve entrepreneurial or intrapreneurial roles. Although nurses form the largest group of health professionals, they are frequently restricted in their scope of practice. Nurses can help to improve health services in a cost effective way, but to do so, they must be seen as equal partners in health service provision. This article provides a global perspective on evolving nursing roles for innovation in health care. A historical overview of entrepreneurship and intrapreneurship is offered. Included also is discussion of a social entrepreneurship approach for nursing, settings for nurse entre/intrapreneurship, and implications for research and practice.

  5. Health Care Reform: Implications of the President's Plan for Nursing Education.

    ERIC Educational Resources Information Center

    Bednash, Geraldine

    This paper discusses factors emerging from the health care reform movement that will shape health care service delivery in general and nursing practice and education in particular. First, cost concerns will increase moves toward managed competition which will, in turn, create changes in service use patterns. These patterns seem overall to tend…

  6. A comparative analysis of the changes in nursing practice related to health sector reform in five countries of the Americas.

    PubMed

    Guevara, Edilma B; Mendias, Elnora P

    2002-11-01

    To identify changes in nursing practice and the nursing-practice environment that have occurred with implementation of health sector reform in five countries in the Americas. An exploratory study of selected settings in Argentina, Brazil, Colombia, Mexico, and the United States of America was conducted between 1997 and 1999 to collect narrative data from 125 professional nurses about their perceptions of nursing practice and changes in work environments. Descriptions of characteristics and trends in nursing practice in the study sites were also obtained. Reorganization of health services has occurred in all five of the countries, responding to health sector reform initiatives and affecting nursing practice in each country. Respondents from all five countries mentioned an emphasis on private enterprise, changes in payment systems for patients and providers, redistributions in the nursing workforce, changes in the personnel mix and nursing-practice functions, work shifting from the hospital to the community, and greater emphasis on cost control and prevention in practice settings. The study provides initial information about current nursing issues that have arisen as a result of health care reform initiatives. Regardless of differences in service models or phases of health sector reform implementation, in all the countries the participating nurses identified many common themes, trends, and changes in nursing practice. The driving forces for change and their intensity have been different in the five countries. Nurses maintain their core values despite increased work stress and greater patient care needs in all the countries as well as economic crises in the Latin American countries.

  7. Nurses hold the key to purchasing reforms in the NHS.

    PubMed

    Canning, S

    1994-07-13

    JUST over a year ago health minster Brian Mawhinney, speaking to the Royal College of Physicians, sowed a seed which could eventually lead to the nation's nurses branching out and playing the lead role in health care purchasing.

  8. The role of nurse practitioners in health sector reform in Iran (2011).

    PubMed

    Vatankhah, Soudabe; Khalesi, Nader; Ebadifardazar, Farbod; Ferdousi, Masoud; Naji, Homayon; Farahabadi, Seyed Mohammad Ehsaan

    2013-09-01

    Most countries use educated nurses called "nurse practitioners" (NPs) besides the family physicians for diagnosis, treatment, and specifically health education of the family. The main goal of this study was to redefine the role of NPs for better use of their capabilities in the so-called "family physician reform" in Iran. This is a qualitative and comparative study carried out in three stages (triangulation method) in 2011. In the first stage, we conducted a literature review to design a conceptual framework. The second stage was a comparative study on four countries. In this study, we focused on the role of NPs, which in turn helped to redefine this role in the health sector reform of Iran. In the third stage, two expert panels were involved and the suggested roles were confirmed. In the United States, NPs are licensed by the state in which they practice and have a national board certification. In Canada, nurses involved in clinics should participate in specific training course of diagnosis and management of health care after registration. In Austria, nurses in Nursing homes and maternity do some of the medical procedures under the supervision of the physicians. In the United Kingdom, NPs increasingly substitute for GPs in the care of minor illness and routine management of chronic diseases. There is still debate in nursing and medical circles about what the focus of the NP roles should be. In Iran, whereas a noticeable reform toward "family physician" is ongoing, redefining the nurses' role is essential. They can perform more active roles in associating with GPs in the clinics of family physicians, both in urban and rural areas, even with higher degrees of autonomy.

  9. Nursing and Health Care Reform: Implications for Curriculum Development.

    ERIC Educational Resources Information Center

    Bowen, Mary; Lyons, Kevin J.; Young, Barbara E.

    2000-01-01

    A survey of registered nurses who graduated in 1986 (n=50) and 1991 (n-58) revealed these opinions: insurance companies increasingly control patient care; workload and paperwork have increased; and there are fewer jobs and less job security. A significant number reported decreased job satisfaction. (SK)

  10. Drivers for renewal and reform of contemporary nursing curricula: a blueprint for change.

    PubMed

    Waters, Cheryl Denise; Rochester, Suzanne Freda; McMillan, Margaret Anna

    2012-06-01

    The creation of a curriculum blueprint appropriate to the development of a professional nurse who is practice-ready for the current and future context of health service delivery must take account of the extant context as well as an unpredictable and sometimes ambiguous future. The curriculum renewal process itself ought to challenge existing long held ideals, practices, and sacred cows within the health and higher education sectors. There is much to consider and importantly curriculum developers need to be mindful of reform within the health sector and health workforce education, as well as the concomitant vision and requirements of the nursing profession. Curriculum must develop more than discipline knowledge and skills: it must provide an infrastructure for generic abilities both social and intellectual in order to better prepare students for the registered nurse role. This paper discusses a number of forces that are essential to consider in curriculum development in undergraduate nursing education.

  11. Nursing and health care reform: implications for curriculum development.

    PubMed

    Bowen, M; Lyons, K J; Young, B E

    2000-01-01

    The health care system is undergoing profound changes. Cost containment efforts and restructuring have resulted in cutbacks in registered nurse (RN) positions. These changes are often related to the increased market penetration by managed care companies. To determine how RN graduates perceive these changes and their impact on the delivery of patient care, Healthcare Environment Surveys were mailed to graduates of the classes of 1986 and 1991. Using the Survey's 5-point Likert Scale, we measured the graduates' satisfaction with their salary, quality of supervision they received, opportunities for advancement, recognition for their job, working conditions, the overall job and the changes in their careers over the previous five year period. Our study suggests that the changes in the health care system are having an impact on how health care is being delivered and the way nurses view their jobs. Respondents reported that insurance companies are exerting increased control over patient care and perceive that the quality of patient care is declining. Increased workloads and an increase in the amount of paperwork were reported. Participants perceived that there were fewer jobs available and that job security was decreasing. The percentage of nurses who see job satisfaction as remaining the same or increasing are a majority. However, the relatively high percent of nurses who see job satisfaction as declining should provide a note of warning. The major implications of this study are that the professional nursing curriculum must be modified to include content on communication, organization, legislative/policy skills, and leadership. The nation's health care system is undergoing profound changes. There are numerous forces at work that are effecting the delivery of care and, consequently, the work of health professionals. These forces include significant efforts at cost containment, restructuring and downsizing of hospitals, and the movement of health care delivery out of acute

  12. Design and Evaluation of Reform Plan for Local Academic Nursing Challenges Using Action Research.

    PubMed

    Asadizaker, Marziyeh; Abedsaeedi, Zhila; Abedi, Heidarali; Saki, Azadeh

    2016-12-01

    This study identifies challenges to the first nurse training program for undergraduate nursing students at a nursing and midwifery school in Iran using a collaborative approach in order to improve the program. Action research was used as a research strategy with qualitative content analysis and quantitative evaluation. The participants were 148 individuals from nursing academic and clinical settings, including administrators, faculty members, students, and staff nurses. We obtained approval from the research deputy and ethics committee of Shahid Beheshti University of Medical Sciences in Tehran, Iran for this study. Lack of coherence in the educational program and implementation of the program, inadequate communication between management inside and outside the organization, insufficient understanding of situations by students, and improper control of inhibitors and use of facilitators in teaching and in practice were among the major challenges in the first training process in the context of this study. After classification of problems, the educational decision-making authorities of the school developed an operational program with stakeholder cooperation to plan initial reforms, implementation of reforms, reflection about the actions, and evaluation. Comparison of student satisfaction with the collaborative learning process versus the traditional method showed that except for the atmosphere in the clinical learning environment (p>.05), the mean differences for all dimensions were statistically significant. The results confirm the overall success of the revised partnership program, but stressed the need for further modification of some details for its implementation in future rounds. Copyright © 2016. Published by Elsevier B.V.

  13. Early nurse attrition in New Zealand and associated policy implications.

    PubMed

    Walker, L; Clendon, J

    2018-03-01

    To examine the factors contributing to nurses choosing to exit the nursing profession before retirement age. Population growth, ageing and growing demand for health services mean increased demand for nurses. Better retention could help meet this demand, yet little work has been done in New Zealand to understand early attrition. An online survey of registered and enrolled nurses and nurse practitioners who had left nursing was used. This study reports analysis of responses from 285 ex-nurses aged under 55. The primary reasons nurses left the profession were as follows: workplace concerns; personal challenges; career factors; family reasons; lack of confidence; leaving for overseas; unwillingness to complete educational requirements; poor work-life balance; and inability to find suitable nursing work. Most nurses discussed their intentions to leave with a family member or manager and most reported gaining transferrable skills through nursing. Nurses leave for many reasons. Implementing positive practice environments and individualized approaches to retaining staff may help reduce this attrition. Generational changes in the nature of work and careers mean that nurses may continue to leave the profession sooner than anticipated by policymakers. If the nursing workforce is to be able to meet projected need, education, recruitment and retention policies must urgently address issues leading to early attrition. In particular, policies improving the wider environmental context of nursing practice and ensuring that working environments are safe and nurses are well supported must be developed and implemented. Equally, national nursing workforce planning must take into account that nursing is no longer viewed as a career for life. © 2017 International Council of Nurses.

  14. From Toyota to the bedside: nurses can lead the lean way in health care reform.

    PubMed

    Johnson, Joyce E; Smith, Amy L; Mastro, Kari A

    2012-01-01

    The advent of health care reform means new pressures on American hospitals, which will be forced to do more with less. In the next decade, increased use of "Lean" principles and practices in hospitals can create real value by reducing waste and improving productivity, costs, quality, and the timely delivery of patient care services. In 2010, the Institute of Medicine recommended that nurses lead collaborative quality improvement efforts and assume a major role in redesigning health care in the United States. In this article, we provide an overview of the use of Lean techniques in health care and 2 case studies of successful, nurse-directed Lean initiatives at the Robert Wood Johnson University Hospital. The article concludes with some lessons we have learned and implications for nursing education in the future that must include the concepts, tools, and skills required for adapting Lean to the patient care environment.

  15. From Caterpillars to Butterflies: Engaging Nurse Leaders in Evidence-Based Practice Reform.

    PubMed

    Sanares-Carreon, Dolora

    2016-01-01

    Evidence-based practice (EBP) occurs when the integration of best evidence is brought to the bedside to ground patient care decisions. Barriers to EBP have lingered for years and held unabated. The experiences of an academic medical center offer fresh perspectives in devolving the accountability for EBP where care is provided and received by patients. More specifically, the initiative is a focused engagement of nurse leaders in administrative positions for energizing bedside nurses to reform the enculturation of EBP. The goal is not to control but to explore approaches of handling the barriers with a complexity mindset amidst uncertainties. Nurses' collective engagement is envisioned to spark or refine creative ideas that will steer and account for EBP outcomes. The flight of the butterfly is used as a metaphor; hence, the title for the Monarch Moments Initiative.

  16. Concept formation: a supportive process for early career nurses.

    PubMed

    Thornley, Tracey; West, Sandra

    2010-09-01

    Individuals come to understand abstract constructs such as that of the 'expert' through the formation of concepts. Time and repeated opportunity for observation to support the generalisation and abstraction of the developing concept are essential if the concept is to form successfully. Development of an effective concept of the 'expert nurse' is critical for early career nurses who are attempting to integrate theory, values and beliefs as they develop their clinical practice. This study explores the use of a concept development framework in a grounded theory study of the 'expert nurse'. Qualitative. Using grounded theory methods for data collection and analysis, semi-structured interviews were conducted with registered nurses. The participants were asked to describe their concept of the 'expert nurse' and to discuss their experience of developing this. Participants reported forming their concept of the 'expert nurse', after multiple opportunities to engage with nurses identified as 'expert'. This identification did not necessarily relate to the designated position of the 'expert nurse' or assigned mentors. When the early career nurse does not successfully form a concept of the 'expert nurse', difficulties in personal and professional development including skill/knowledge development may arise. To underpin development of their clinical practice effectively, early career nurses need to be provided with opportunities that facilitate the purposive formation of their own concept of the 'expert nurse'. Formation of this concept is not well supported by the common practice of assigning mentors. Early career nurses must be provided with the time and the opportunity to individually develop and refine their concept of the 'expert nurse'. To achieve this, strategies including providing opportunities to engage with expert nurses and discussion of the process of concept formation and its place in underpinning personal judgments may be of assistance. © 2010 Blackwell Publishing

  17. The challenges of primary health care nurse leaders in the wake of New Health Care Reform in Norway.

    PubMed

    Tingvoll, Wivi-Ann; Sæterstrand, Torill; McClusky, Leon Mendel

    2016-01-01

    The local municipality, whose management style is largely inspired by the New Public Management (NPM) model, has administrative responsibilities for primary health care in Norway. Those responsible for health care at the local level often find themselves torn between their professional responsibilities and the municipality's market-oriented funding system. The introduction of the new health care reform process known as the Coordination Reform in January 2012 prioritises primary health care while simultaneously promoting a more collaborative and multidisciplinary approach to health care. Nurse leaders experience constant cross-pressure in their roles as members of the municipal executive team, the execution of their professional and administrative duties, and the overall political aims of the new reform. The aim of this article is to illuminate some of the major challenges facing nurse leaders in charge of nursing homes and to draw attention to their professional concerns about the quality of nursing care with the introduction of the new reform and its implementation under NPM-inspired municipal executive leadership. This study employs a qualitative design. In-depth interviews were conducted with 10 nurse leaders in 10 municipalities, with a phenomenological-hermeneutic approach used for data analysis and interpretation. Findings highlighted the increasingly complex challenges facing nurse leaders operating in the context of the municipality's hierarchical NPM management structure, while they are required to exercise collaborative professional interactions as per the guidelines of the new Coordination Reform. The interview findings were interpreted out of three sub-themes 1) importance of support for the nurse leader, 2) concerns about overall service quality, and 3) increased tasks unrelated to nursing leadership. The priorities of municipal senior management and the focus of the municipality's care service need clarification in the light of this reform. The voices

  18. [Health care reform and changes in nursing practice in philanthropic hospitals in Ribeirão Preto (SP), Brazil].

    PubMed

    Corrêa, A K; Ferraz, C A; Galvão, C M; Zanetti, M L; Dantas, R A

    2000-09-01

    This paper describes part of a multicenter study sponsored by the Pan American Health Organization to assess health care reforms and their implications for nursing in several countries. The objective of this research was to learn the views of nurses working in philanthropic hospitals in Ribeirão Preto, in the state of São Paulo, Brazil, regarding the changes in nursing practice coming from Brazil's health care reform and implementation of the Unified Health System (UHS). Data were obtained through structured interviews with seven nurses who met the selection criteria, from the three philanthropic hospitals in Ribeirão Preto. The nurses reported a decline in the quality of care and in the number of beds for UHS patients. The nurses reported that UHS implementation initially led to infrastructure improvements in the philanthropic hospitals. However, the reforms eventually shifted toward improving the care of private and privately insured patients. In addition, the nurses emphasized their heavy work loads and low pay. The nurses' reports indicated that Brazil's UHS is going through a crisis. In general, the nurses linked this crisis to problems in funding and allocation of resources.

  19. Disrupting Communities of Practice? How "Reluctant" Practitioners View Early Years Workforce Reform in England

    ERIC Educational Resources Information Center

    Payler, Jane K.; Locke, Rachel

    2013-01-01

    This article reports on the views of early years practitioners in England from settings that were identified as "reluctant to engage" with one of the government's key policies, the introduction of Early Years Professional Status (EYPS), to drive forwards workforce reform. Focus groups, interviews and a survey were undertaken in 2009 with…

  20. Integrated Practice in the Early Years in Australia: The Assumptions, Omissions and Contradictions of Policy Reform

    ERIC Educational Resources Information Center

    Macfarlane, Kym; Nolan, Andrea; Cartmel, Jennifer

    2016-01-01

    The aim of this article is to examine current national early years' policy reform, which emphasises the importance of service integration, national quality standards and a quality knowledge base for educators concerning the provision of early childhood education and care. Using Queensland, Australia, as an example, a policy discourse analysis…

  1. Healthcare reforms: implications for the education and training of acute and critical care nurses.

    PubMed

    Glen, S

    2004-12-01

    This paper offers a wide ranging analysis of the drivers that resulted in scrutiny of medical, nursing, and healthcare professional roles. It suggests that what is needed is a coherent vision of the future shape of the health workforce. This requires moving beyond the presumption that reforming working practices primarily involves "delegating doctors" responsibilities to nurses. The paper argues that it is self evident that the implications of changes in healthcare roles and the ability of existing professionals to function effectively in the future will require education, training, and human resource investment supportive of the changes. It suggests a clear definition of competence and a national standard to practice is essential for nurses working in acute and acute critical settings. There should therefore be a correlation between levels of practice, levels of education, and remuneration. Furthermore, education programmes for senior nurses should sit coherently alongside the education programmes required by Modernising Medical Careers. Finally, the realisation of the government's service and modernisation agenda will require a culture change within higher education institutions, postgraduate deaneries, professional organisations, workforce development confederations, and NHS trusts.

  2. Involvement of family nurses in home visits during an 8-year period encompassing primary healthcare reforms in Poland.

    PubMed

    Marcinowicz, Ludmiła; Chlabicz, Sławomir; Konstantynowicz, Jerzy; Gugnowski, Zbigniew

    2009-07-01

    Home visits by doctors and nurses are considered an important indicator of the quality of healthcare. Published data are scarce regarding the role of family nurses in providing professional home care in Central and Eastern European countries that have recently introduced reforms to their primary care systems. The objective of the present study was to describe the involvement of family nurses in home visits in the context of organizational and legal changes in service provision, that is, to analyse the role of the family nurses employed by family doctors (1998) versus family nurses working in autonomous positions (2002 and 2006). The proportion of patients in the community receiving a home visit from a family nurse, the purpose of the family nurse's home visit and patient expectations towards the family nurse were studied. A series of cross-sectional studies were conducted in a small town in northeastern Poland, based on three consecutive surveys taken at 4-year intervals (1998, 2002, 2006, surveys I, II and III, respectively). During each survey, 1000 patients were interviewed (face to face) with structured questionnaires. In 1998, family nurses were employed by family doctors, but by 2002, nurses had established their own practices and held direct contracts with the National Health Fund. A significant increase in the percentage of patients receiving home visits from a family nurse was observed between surveys I and II (12.8% and 30.0%); however, the number of respondents reporting a home visit in survey III decreased to 23.9%. Patients over 75 years of age were the major demographic group receiving family nursing at home. This study suggests that reform of the primary healthcare system in Poland has produced changes in the family nursing system. Independence, contractual obligations and self-employment of Polish family nurses have resulted in their greater participation in home visits.

  3. Nursing homes and the affordable care act: a cease fire in the ongoing struggle over quality reform.

    PubMed

    Hawes, Catherine; Moudouni, Darcy M; Edwards, Rachel B; Phillips, Charles D

    2012-01-01

    Most provisions in the Affordable Care Act that affect nursing homes originated in two earlier attempts at reform, both of which failed multiple times in prior Congressional sessions: the Elder Justice Act and the Nursing Home Transparency and Improvement Act. Both of these earlier efforts focused on improving quality and reducing elder abuse in nursing homes by strengthening oversight and enforcement penalties, expanding staff training, and increasing the information on nursing home quality available to consumers and regulators. Each bill addressed problems that were serious, widespread, and had persisted for years, but each failed to pass on its own. The Affordable Care Act, with its own momentum, became the vehicle for their passage. However, the reasons the bills failed in these earlier efforts suggest implementation challenges now that they have ridden into law on the coattails of the more general effort to reform the health care sector.

  4. Medical students' professional identity development in an early nursing attachment.

    PubMed

    Helmich, Esther; Derksen, Els; Prevoo, Mathieu; Laan, Roland; Bolhuis, Sanneke; Koopmans, Raymond

    2010-07-01

    The importance of early clinical experience for medical training is well documented. However, to our knowledge there are no studies that assess the influence of very early nursing attachments on the professional development and identity construction of medical students. Working as an assistant nurse while training to be a doctor may offer valuable learning experiences, but may also present the student with difficulties with respect to identity and identification issues. The aim of the present study was to describe first-year medical students' perceptions of nurses, doctors and their own future roles as doctors before and after a nursing attachment. A questionnaire containing open questions concerning students' perceptions of nurses, doctors and their own future roles as doctors was administered to all Year 1 medical students (n=347) before and directly after a 4-week nursing attachment in hospitals and nursing homes. We carried out two confirmatory focus group interviews. We analysed the data using qualitative and quantitative content analyses. The questionnaire was completed by 316 students (response rate 91%). Before starting the attachment students regarded nurses as empathic, communicative and responsible. After the attachment students reported nurses had more competencies and responsibilities than they had expected. Students' views of doctors were ambivalent. Before and after the attachment, doctors were seen as interested and reliable, but also as arrogant, detached and insensible. However, students maintained positive views of their own future roles as doctors. Students' perceptions were influenced by age, gender and place of attachment. An early nursing attachment engenders more respect for the nursing profession. The ambivalent view of doctors needs to be explored further in relation to students' professional development. It would seem relevant to attune supervision to the age and gender differences revealed in this study.

  5. Nurses' experiences using a nursing information system: early stage of technology implementation.

    PubMed

    Lee, Ting-Ting

    2007-01-01

    Adoption of information technology in nursing practice has become a trend in healthcare. The impact of this technology on users has been widely studied, but little attention has been given to its influence at the beginning stage of implementation. Knowing the barriers to adopting technology could shorten this transition stage and minimize its negative influences. The purpose of this study was to explore nurses' experiences in the early stage of implementing a nursing information system. Focus groups were used to collect data at a medical center in Taiwan. The results showed that nurses had problems with the system's content design, had insufficient training, were concerned about data security, were stressed by added work, and experienced poor interdisciplinary cooperation. To smooth this beginning stage, the author recommends involving nurses early in the system design, providing sufficient training in keyboard entry skills, redesigning workflow, and improving interdisciplinary communication.

  6. Starting RIGHT: Reforming Education in the Early Grades (Prekindergarten through Grade 3). Carnegie Meeting Papers.

    ERIC Educational Resources Information Center

    Copple, Carol E.

    Noting that students' failure to master the basic skills by third grade places them at high academic and social risk, this report provides a synthesis of the findings from a meeting that drew 30 of the nation's leading experts on early childhood education and school reform to discuss the plight of primary education. The meeting was designed to…

  7. Whose Quality? The (Mis)Uses of Quality Reform in Early Childhood and Education Policy

    ERIC Educational Resources Information Center

    Hunkin, Elise

    2018-01-01

    This paper reports on the findings of an in-depth genealogical study of the discourse of quality in Australian Early Childhood Education and Care (ECEC) policy. Quality reform has become the foremost global policy agenda for ECEC due to assumptions about the economic potentials of quality services. In Australia, the recent National Quality…

  8. Evidence-Based Reform: Enhancing Language and Literacy in Early Childhood Education

    ERIC Educational Resources Information Center

    Slavin, Robert E.; Chambers, Bette

    2017-01-01

    Evidence-based reform is transforming education at all levels, both in providing effective models for use in schools and in linking policy to effective practice on a broad scale. As early education moves from a concern with effects of preschool versus no preschool to focus on creating and evaluating effective preschool models capable of improving…

  9. Improving Urban Student Achievement Through Early Childhood Reform: What State Policymakers Can Do. Issue Paper. Early Childhood Reform Issue Paper

    ERIC Educational Resources Information Center

    Kagan, Sharon Lynn

    2004-01-01

    For over four decades, American policymakers have focused their attention on readying young children for school. Despite noble policy efforts, durable investments and a persistent belief in the ability of early childhood education to offset social inequities, significant challenges exist for America's urban young children as they enter school.…

  10. History of Higher Education: Educational Reform and the Emergence of the Nursing Professorate.

    ERIC Educational Resources Information Center

    Ruby, Jane

    1999-01-01

    In the late 19th century, visionary leaders pursued liberal education for nurses, moving nursing education from hospitals to universities. The nursing professorate might never have developed had nursing education remained under the jurisdiction of hospitals. (SK)

  11. A pilot project using evidence-based clinical pathways and payment reform in China's rural hospitals shows early success.

    PubMed

    Cheng, Tsung-Mei

    2013-05-01

    Reforming China's public hospitals to curb widespread overtreatment and improve the quality and affordability of care has been the most challenging aspect of that nation's ambitious health reform, which began in 2009. This article describes a pilot project under way in several of China's provinces that combines payment reform with the implementation of evidence-based clinical pathways at a few hospitals serving rural areas. Results to date include reduced length-of-stay and prescription drug use and higher patient and provider satisfaction. These early results suggest that the pilot may be achieving its goals, which may have far-reaching and positive implications for China's ongoing reform.

  12. Becoming a nurse: a meta-study of early professional socialization and career choice in nursing.

    PubMed

    Price, Sheri L

    2009-01-01

    This paper is a report of a meta-study of early professional socialization and career choice in nursing. The current and growing shortage of nurses is a global issue, and nursing recruitment and retention are recognized priorities internationally. The future of nursing will lie in the ability to recruit and retain the next generation to the profession. Studies were identified through a search of the CINAHL, PsycInfo, Sociological Abstracts, PubMed; Medline and Embase databases from 1990 to 2007. Studies were included if they gave insight into the experience of choosing nursing as a career, used qualitative methodology and methods, and were published in English. Analysis was undertaken using Paterson et al.'s framework for qualitative meta-synthesis. Ten primary studies were included in the review. Their methodologies included: ethnography (4); descriptive qualitative (3); grounded theory (2); and phenomenology (1). The location of the research was Canada (3), United Kingdom (2), United States of America (2), Australia (1), Japan (1) and Sweden (1). Three main themes were identified: influence of ideals; paradox of caring and role of others. Career choice and early professional socialization are influenced by multiple factors. In future recruitment and retention strategies to address the critical nursing shortage, it is important to consider the role of mentors, peers and role models in the formulation of career expectations, and career choice decisions. It is also necessary to consider the role of mentors, peers and role models in the formulation of career expectations, and career choice decisions.

  13. Verbal abuse from nurse colleagues and work environment of early career registered nurses.

    PubMed

    Budin, Wendy C; Brewer, Carol S; Chao, Ying-Yu; Kovner, Christine

    2013-09-01

    This study examined relationships between verbal abuse from nurse colleagues and demographic characteristics, work attributes, and work attitudes of early career registered nurses (RNs). Data are from the fourth wave of a national panel survey of early career RNs begun in 2006. The final analytic sample included 1,407 RNs. Descriptive statistics were used to describe the sample, analysis of variance to compare means, and chi square to compare categorical variables. RNs reporting higher levels of verbal abuse from nurse colleagues were more likely to be unmarried, work in a hospital setting, or work in a non-magnet hospital. They also had lower job satisfaction, and less organizational commitment, autonomy, and intent to stay. Lastly, they perceived their work environments unfavorably. Data support the hypothesis that early career RNs are vulnerable to the effects of verbal abuse from nurse colleagues. Although more verbal abuse is seen in environments with unfavorable working conditions, and RNs working in such environments tend to have less favorable work attitudes, one cannot assume causality. It is unclear if poor working conditions create an environment where verbal abuse is tolerated or if verbal abuse creates an unfavorable work environment. There is a need to develop and test evidence-based interventions to deal with the problems inherent with verbal abuse from nurse colleagues. © 2013 Sigma Theta Tau International.

  14. Growth in retail-based clinics after nurse practitioner scope of practice reform.

    PubMed

    Brooks Carthon, J Margo; Sammarco, Therese; Pancir, Darcy; Chittams, Jesse; Wiltse Nicely, Kelly

    Retail clinics are largely staffed by nurse practitioners (NPs) and are a popular destination for nonemergent care. We examined if there was a relationship between NP practice regulations and retail clinic growth after the passage of a scope of practice (SOP) reform bill in Pennsylvania. General linear regression models were used to compare retail clinic openings in Pennsylvania, New Jersey, and Maryland between 2006 and 2013. From 2006 to 2008, Pennsylvania experienced a significant growth rate in net retail clinic openings per capita (p = .046), whereas New Jersey and Maryland experienced no significant increase (p = .109 and .053, respectively). From 2009 to 2013, Pennsylvania opened 0.20 clinics (p = .129), New Jersey opened 0.23 clinics (p = .086), and Maryland opened 0.34 clinics per capita per year (p = .017). Our study of three states with varying levels of SOP restraint reveals an association between relaxation of practice regulations and retail clinic growth. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. The impact of deficit reduction on the nursing labour market in Canada: unintended consequences of fiscal reform.

    PubMed

    Vujicic, Marko; Evans, Robert G

    2005-01-01

    Beginning in 1992, governments throughout Canada began reducing expenditures in an effort to eliminate fiscal deficits and reduce their alarmingly high debt burden. As part of this deficit-fighting era, governments reduced hospital expenditure levels quite dramatically. Some of the current problems in the Canadian healthcare system - the recent unrest in the nursing labour market in particular - are often attributed to this hospital downsizing era. This article examines trends in the labour market for registered nurses in Canada during the hospital downsizing period. Of particular interest is the effect of hospital spending reforms on nurse employment levels in hospitals and on the age structure of the nursing workforce. After identifying the trends, the main factors driving the trends are discussed. Results indicate that a decrease in the demand for nursing labour resulted in large staff layoffs during the restructuring period, particularly among the youngest age groups. The evidence does not support the claim that deteriorating wages and working conditions in hospitals led nurses to quit their jobs during the hospital downsizing period.

  16. Retaining early career registered nurses: a case study.

    PubMed

    Mills, Jane; Chamberlain-Salaun, Jennifer; Harrison, Helena; Yates, Karen; O'Shea, Andrea

    2016-01-01

    A core objective of the Australian health system is to provide high quality, safe health care that meets the needs of all Australians. To achieve this, an adequate and effective workforce must support the delivery of care. With rapidly changing health care systems and consumer demographics, demand for care is increasing and retention of sufficient numbers of skilled staff is now a critical priority to meet current and future health care demands. Nurses are the largest cohort of professionals within the health workforce. Reducing the rates at which nurses leave the profession and supporting nurses to practice in their profession longer will have beneficial implications for the sustainability of a nursing workforce and, ultimately, to patient outcomes. The aim of the study was to describe and explain early career registered nurses' (ECRNs) experiences and support requirements during the first five years of practice for the purposes of identifying strategies that would support greater retention of ECRNs. A single case study design focused on early career registered nurses (ECRNs) working in a hospital and health service in northern Australia. The research team adopted Djukic et al's definition of ECRNs as "RNs who have practiced for less than 5 years". Data was collected via three individual interviews and two focus groups. Thirty-five ECRNs participated in the study. Qualitative analysis of data generated during interviews and focus groups, identified the key themes of receiving career advice and choice or no choice . Analysis of study data in the context of the broader literature resulted in the researchers identifying six areas of focus for ECRN retention: 1) well-planned, supported and structured transition periods; 2) consideration of rotation through different areas with a six month minimum for skills development; 3) empowering decision making; 4) placement opportunities and choice in decisions of where to work; 5) career advice and support that considers ECRNs

  17. Understanding the space of nursing practice in Colombia: A critical reflection on the effects of health system reform.

    PubMed

    Camargo Plazas, Pilar

    2018-04-11

    Worldwide, healthcare has been touched by neoliberal policies to the extent that it has some of its characteristics, such as being asymmetrical, competitive, dehumanized, and profit driven. In Colombia, Law 100/93 was created as an ambitious reform aimed at integrating the social security and public sectors of healthcare in order to create universal access, and at the same time to generate market competence with the objective of improving effectiveness and responsiveness. Instead, however, Colombian health reform has served to generate competition which has aggravated inequalities among people. Within this context, we practice nursing. As nurses, our responsibility is to advocate for our patients. We cannot ignore what is happening worldwide in hospitals and community health settings because our responsibility is to promote health, prevent disease, and care for human beings. So, today, when the world pushes for economical profit and competence on one hand, and, on the other, for moral compromises to care, respect, and advocacy for all human beings, being a nurse in the Colombian health system represents a challenge for us. This challenge is especially significant because harm and benefit, justice and injustice, respect and disrespect are separated by a fine line that is easy to transgress. © 2018 John Wiley & Sons Ltd.

  18. "Coming to grips with the nursing question": the politics of nursing education reform in 1960s America.

    PubMed

    Tobbell, Dominique A

    2014-01-01

    The 1950s and 1960s were decades of change for the American nursing profession. A new generation of nurse educators sought to create greater professional autonomy for the nurse by introducing new models of education that emphasized science-based learning over technical skills and bedside care, and creating new clinical roles for the nurse, based on advanced graduate education. They confronted resistance from an older generation of nurses who feared becoming "second-class citizens" in increasingly academic nursing schools, and from academic health care institutions all too comfortable with the gendered hierarchy on which the traditional model of nursing education and practice was predicated. Using the University of Minnesota and University of California-Los Angeles (UCLA) as case studies, and based on institutional records and more than 40 oral histories with nursing and medical faculty, this article describes the generational conflicts this new cadre of nurse educators confronted within schools of nursing, and the institutional politics they struggled with as they sought to secure greater institutional status for the schools among the universities' other health science units.

  19. The Early Childhood and Elementary Education Continuum: Constructing an Understanding of P-3 as State-Level Policy Reform

    ERIC Educational Resources Information Center

    Kauerz, Kristie Anne

    2009-01-01

    State-level policy attention to young children's early learning opportunities burgeons; a sense of urgency exists to identify reform agendas that are both effective and sustainable. "P-3" often is used as the term for the first level of a seamless P-20 system that stretches from early childhood through post-secondary education. While it…

  20. Helping Preservice Teachers Learn to Teach for Understanding in This Era of High-Stakes Early Education Reform

    ERIC Educational Resources Information Center

    Brown, Christopher Pierce

    2009-01-01

    As early childhood education becomes more regulated through a range of education reforms and mandates, early childhood teacher educators are seeking ways to prepare their preservice teachers to address these policy constraints through appropriate teaching practices that foster learning with understanding. Using the National Research Council's…

  1. Are We There Yet? Early Years Reform in Queensland: Stakeholder Perspectives on the Introduction of Funded Preschool Programs in Long Day Care Services

    ERIC Educational Resources Information Center

    Irvine, Susan; Farrell, Ann

    2013-01-01

    Australian educators are currently engaging with wide-ranging, national early childhood reform that is reshaping Early Childhood Education and Care (ECEC). The Australian reform agenda reflects many of the early childhood policy directions championed by bodies, such as the Organisation for Economic Cooperation and Development and the United…

  2. Where Are the Early Years of School in Contemporary Early Childhood Education Reforms? An Historical Perspective

    ERIC Educational Resources Information Center

    Krieg, Susan; Whitehead, Kay

    2015-01-01

    Although international definitions of early childhood repeatedly refer to a birth-8 age span, there are complex, institutional divides within this age range. This paper explores the divide between pre-compulsory and compulsory early childhood institutions. In countries such as Finland this divide is not such an issue because children do not begin…

  3. Texas Medicaid Payment Reform: Fewer Early Elective Deliveries And Increased Gestational Age And Birthweight.

    PubMed

    Dahlen, Heather M; McCullough, J Mac; Fertig, Angela R; Dowd, Bryan E; Riley, William J

    2017-03-01

    Infants born at full term have better health outcomes. However, one in ten babies in the United States are born via a medically unnecessary early elective delivery: induction of labor, a cesarean section, or both before thirty-nine weeks gestation. In 2011 the Texas Medicaid program sought to reduce the rate of early elective deliveries by denying payment to providers for the procedure. We examined the impact of this policy on clinical care practice and perinatal outcomes by comparing the changes in Texas relative to comparison states. We found that early elective delivery rates fell by as much as 14 percent in Texas after this payment policy change, which led to gains of almost five days in gestational age and six ounces in birthweight among births affected by the policy. The impact on early elective delivery was larger in magnitude for minority patients. Other states may look to this Medicaid payment reform as a model for reducing early elective deliveries and disparities in infant health. Project HOPE—The People-to-People Health Foundation, Inc.

  4. 'Unladylike Commotion': Early feminism and nursing's role in gender/trans dialogue.

    PubMed

    Fowler, Marsha D

    2017-01-01

    From nursing's history comes the impetus and grounding for our current voice in gender/trans dialogue. Modern nursing struggled its way into being against restrictive, unjust, and oppressive social structures. Many of the obstructions and constraints that nurses and nursing leaders faced were shared by the general populace of women, and yet nurses were different from other women. Nurses worked outside the home, caring for strangers, including unrelated men, in a period when women were otherwise confined to the home. Nurses fought for women's suffrage, for child labor laws, for the welfare of factory workers, for garment workers, for unionization, for vaccination, for housing reform, for the humane treatment of mentally ill persons, for access to birth control, for the amelioration of a panoramic terrain of terrible social injustices, and for the control of nursing education, registration, and practice. For 150 years, nursing has been intrinsically, practically, and politically feminist. The hard-fought gains would eventually position nursing in tension with emerging trans issues. And yet, its history is exactly what situates nursing for fruitful participation in the developing trans discourse and to address issues of transinvisibility and unjust social and health structures that impede dignified and respectful health care. © 2017 John Wiley & Sons Ltd.

  5. A public health nursing early intervention program for adolescent mothers: outcomes from pregnancy through 6 weeks postpartum.

    PubMed

    Koniak-Griffin, D; Anderson, N L; Verzemnieks, I; Brecht, M L

    2000-01-01

    Adolescent pregnancy and parenting remain a major public concern because of their impact on maternal-child health and on the social and economic well-being of the nation. Federal welfare reform legislation has created an urgent need for community-based nursing intervention programs to improve health and social outcomes for disadvantaged adolescent mothers and to promote their self-sufficiency. To evaluate the effects of an early intervention program (EIP) that uses a public health nursing model on health and social outcomes of adolescent mothers and their children and on the quality of mother-child interaction. Pregnant adolescents referred to a county health department were randomly assigned to an experimental (EIP) or control (traditional public health nursing [TPHN]) group. The sample included 121 adolescents from predominantly minority and impoverished backgrounds who were followed from pregnancy through 6 weeks postpartum. Intense and comprehensive home visitation by public health nurses and preparation-for-motherhood classes were provided to adolescents in the EIP. Health outcomes were determined on the basis of medical record data. Other measures included maternal self-report on selected behaviors, nurse interviews, and the Nursing Child Assessment Teaching Scale (NCATS). Early findings indicate reduced premature birth and low-birth-weight (LBW) rates for young mothers receiving both forms of public health nursing care. No significant differences between groups were found for infant birth weight or type of delivery. Infants in the EIP had significantly fewer total days of birth-related hospitalization and rehospitalization than those in the TPHN group during the first 6 weeks of life (chi2(1) = 6.41; p = 0.01). Adolescents in the EIP demonstrated significantly more positive educational outcomes (e.g., lower school dropout rates) than those in the TPHN group (chi2(1) = 6.76; p < 0.009). The early findings of this study demonstrate that pregnant adolescents

  6. Spiritual formation, secularization, and reform of professional nursing and education in antebellum America.

    PubMed

    Libster, Martha Mathews

    The origin story of professional nursing associated with antebellum American faith communities is all but lost. This paper provides historical evidence for professional nursing for that period using a case study approach that examines three faith communities: the Sisters and Daughters of Charity, the Shakers, and the Church of Jesus Christ of Latter Day Saints. The purpose is to present an historical analysis of the three communities' health beliefs, recipes and remedies that were foundational to the spiritual formation and education of professional nurses within their communities. The focus of the analysis is to place the evidence for professional nursing in these faith communities within the broader context of the contemporary American narrative of the "secularization" of professional nursing associated with the adoption of the Nightingale Training Model after 1873. Nursing became a profession in America because of the courage and passion of many for spiritual formation in community around a need to relieve suffering and demonstrate kindness. The history of American nursing is comprised of stories of powerful nurse ancestors that have the potential to inspire and unite us in that same purpose today despite the ambiguities that may still exist around spirituality, religiosity, and secularization. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Early 20th century untrained nursing staff in the Rockhampton district: a necessary evil?

    PubMed

    Madsen, Wendy

    2005-08-01

    This paper explores the role of untrained nursing staff within the nursing services of the Rockhampton region, Queensland, Australia, throughout the early 20th century. It details who these nurses were, where they worked and how their work was affected by factors such as legislation and social changes. Despite the increasing prevalence of trained nurses from the late 19th century, nurses who had never undergone any formal training continued to gain work in hospitals, institutions and their local communities. This paper is an historical analysis of a wide range of primary source material relating to untrained nursing staff. The primary source material used related specifically to a limited geographical region in Australia. Untrained nursing staff primarily worked as private duty nurses at the beginning of the 20th century. However, as the century progressed, their opportunities to work as untrained nursing staff tended towards institutions dealing with the chronically ill and the aged. As a result of this transition, their profile altered from that of a married/widowed woman living at home with dependents to one who could live on-site at the institution with no dependents. Furthermore, the level of autonomy of the untrained nurse decreased dramatically throughout this period from being relatively independent to being under the control of a trained nurse within the institution. Consideration of the historical evolution of untrained nursing staff challenges some of the assumptions made about this category of nurse, assumptions that can affect current relationships between professional nurses and others who undertake nursing work.

  8. Revenue Generation in the Wake of Welfare Reform: Summary of the Pilot Learning Cluster on Early Childhood Finance.

    ERIC Educational Resources Information Center

    Finance Project, Washington, DC.

    Creating more comprehensive, community-based support systems and reforming early childhood financing systems are critical to advancing the goal of having all children enter school ready to learn. The Finance Project is a national initiative to improve effectiveness, efficiency, and equity of financing for education, children's services, and…

  9. Early Childhood Curriculum Reform in China: Perspectives from Examining Teachers' Beliefs and Practices in Chinese Literacy Teaching

    ERIC Educational Resources Information Center

    Li, Hui; Wang, X. Christine; Wong, Jessie Ming Sin

    2011-01-01

    Two waves of reform have been conducted in China since the 1980s to transform its early childhood curriculum into a Western-style, progressive model. Western curricula and programs such as the Montessori method, the project approach, the Reggio Emilia method, and the high/scope method have been imported and adopted all over the country. But the…

  10. Enhanced early warning system impact on nursing practice: A phenomenological study.

    PubMed

    Burns, Kathleen A; Reber, Tracey; Theodore, Karen; Welch, Brenda; Roy, Debra; Siedlecki, Sandra L

    2018-05-01

    To determine how an enhanced early warning system has an impact on nursing practice. Early warning systems score physiologic measures and alert nurses to subtle changes in patient condition. Critics of early warning systems have expressed concern that nurses would rely on a score rather than assessment skills and critical thinking to determine the need for intervention. Enhancing early warning systems with innovative technology is still in its infancy, so the impact of an enhanced early warning system on nursing behaviours or practice has not yet been studied. Phenomenological design. Scripted, semistructured interviews were conducted in September 2015 with 25 medical/surgical nurses who used the enhanced early warning system. Data were analysed using thematic analysis techniques (coding and bracketing). Emerging themes were examined for relationships and a model describing the enhanced early warning system experience was developed. Nurses identified awareness leading to investigation and ease of prioritization as the enhanced early warning system's most important impact on their nursing practice. There was also an impact on organizational culture, with nurses reporting improved communication, increased collaboration, increased accountability and proactive responses to early changes in patient condition. Rather than hinder critical thinking, as many early warning systems' critics claim, nurses in this study found that the enhanced early warning system increased their awareness of changes in a patient's condition, resulting in earlier response and reassessment times. It also had an impact on the organization by improving communication and collaboration and supporting a culture of proactive rather than reactive response to early signs of deterioration. © 2017 John Wiley & Sons Ltd.

  11. Nurses' knowledge to identify early acute kidney injury.

    PubMed

    Nascimento, Roseli Aparecida Matheus do; Assunção, Murillo Santucci Cesar; Silva, João Manoel; Amendola, Cristina Prata; Carvalho, Taysa Martindo de; Lima, Emerson Quintino; Lobo, Suzana Margareth Ajeje

    2016-01-01

    To evaluate the knowledgeof nurses on early identification of acute kidney injury (AKI) in intensive care, emergency and hospitalization units. A prospective multi-center study was conducted with 216 nurses, using a questionnaire with 10 questions related to AKI prevention, diagnosis, and treatment. 57.2% of nurses were unable to identify AKI clinical manifestations, 54.6% did not have knowledge of AKI incidence in patients admitted to the ICU, 87.0% of the nurses did not know how to answer as regards the AKI mortality rate in patients admitted to the ICU, 67.1% answered incorrectly that slight increases in serum creatinine do not have an impact on mortality, 66.8% answered incorrectly to the question on AKI prevention measures, 60.4% answered correctly that loop diuretics for preventing AKI is not recommended, 77.6% answered correctly that AKI does not characterize the need for hemodialysis, and 92.5% said they had no knowledge of the Acute Kidney Injury Networkclassification. Nurses do not have enough knowledge to identify early AKI, demonstrating the importance of qualification programs in this field of knowledge. Avaliar o conhecimento do enfermeiro na identificação precoce da Injúria Renal Aguda (IRA) em Unidade de Terapia Intensiva, Unidade de Internação e Emergência. Estudo multicêntrico, prospectivo.Participaram do estudo 216 enfermeiros,por meio de questionário com 10 questões relacionadas à prevenção, ao diagnóstico e ao tratamento da IRA. 57,2% não souberam identificar as manifestações clínicas da IRA, 54,6% não têm conhecimento da incidência de IRA em pacientes internados na UTI, 87,0% dos enfermeiros não souberam responder ao índice de mortalidade de IRA em pacientes internados na UTI, 67,1% responderam incorretamente que aumentos discretos da creatinina sérica não têm impacto na mortalidade, 66,8% responderam incorretamente à questão sobre as medidas de prevenção da IRA, 60,4% acertaram quando responderam que não

  12. Nursing, social contexts, and ideologies in the early United States birth control movement.

    PubMed

    Lagerwey, M D

    1999-12-01

    Using historical discourse analysis, this study provides a thematic analysis of writings of nursing and birth control as found in The Birth Control Review from 1917 to 1927. The author contrasts this publication with the official journal of the American Nurses Association, the American Journal of Nursing from the same years to explore nursing voices and silences in early birth control stories. In dialogue with social contexts, nursing endeavors and inactivity have played important yet conflicting roles in the birth control movement in the United States. Nursing writings from the early twentieth century reflect eugenic beliefs, national fears of immigrants, and ambivalence about women's roles in society and the home. Nurses simultaneously empowered women to choose when to become pregnant and reinforced nativist and paternalistic views of the poor.

  13. The "Quare" Women: Reformers and Settlement Workers in the Kentucky Mountains.

    ERIC Educational Resources Information Center

    Duff, Betty Parker

    Among the many outside influences on Appalachian culture in the late 19th-early 20th centuries were reformers and educators, many of them women who came to the mountains to work as teachers, settlement workers, and nurses. This paper focuses on settlement schools in eastern Kentucky as the locus of interaction between reformers and mountain women.…

  14. Early Black Nursing Schools and Responses of Black Nurses to Their Educational Programs.

    ERIC Educational Resources Information Center

    Sloan, Patricia E.

    1985-01-01

    Traces the history of nursing education for Blacks since the 1880s. Discusses the establishment and activities of the four earliest Black nursing schools: Spelman Seminary Nurse Training School (Atlanta, Georgia), Provident Hospital and Training School (Chicago, Illinois), Hampton (Virginia) Training School for Nurses, and Tuskegee (Alabama)…

  15. Navajo nation public health nurses inspire thoughts on health care reform.

    PubMed

    Douglas, Kathy S

    2012-01-01

    The wisdom and experience of pubic health nurses serving on a Navajo Reservation, who work far from the typical hospital setting, may well hold some of the keys to how we can successfully plan for and navigate the future of our shifting health care system. As more of the nursing workforce moves outside the walls of the hospital, competencies in autonomy, clinical judgment, decision making, and communication will increase in importance. long with safety and quality implications, this may also influence changes in nursing education, job requirements, hiring, and measuring performance. In addition, there may be implications around how new nurses are oriented and how they get the experience needed to function in more independent roles. Within their routine days, the conditions they work in, the situations they face, and the many ways public health nurses find to meet the needs of the people they serve, is a wealth of knowledge that may well translate into solutions for some of the challenges our nation's health care system is facing.

  16. The relationship between social skills and early resignation in Japanese novice nurses.

    PubMed

    Niitsuma, Mayuko; Katsuki, Takeshi; Sakuma, Yumiko; Sato, Chifumi

    2012-07-01

    The aim of this study was to reveal the relationship between social skills and early resignation in Japanese novice nurses. The early resignation of novice nurses has become increasingly prevalent in recent years. This study was conducted to investigate the relationship between the personal sociality of novice nurses and their early resignation. We surveyed 272 nurses with 1-3 years of experience. Instances of early resignation were studied by using a questionnaire, and their social skills were measured using Kikuchi's Scale of Social Skills:18 items (KiSS-18), a tool developed by Kikuchi to estimate sociality. Nurses with low sociality were more likely to resign than those with higher sociality. The lack of advanced social skills was closely associated with a higher likelihood of early resignation. The presence of advanced social skills appeared to potentially prevent resignation among novice nurses. Further investigation is needed to determine the causal relationship between sociality and early resignation. Social skills training for novice nurses may be of benefit in preventing early resignation. © 2011 Blackwell Publishing Ltd.

  17. Nursing participation in health care reform efforts of 1993 to 1994: advocating for the national community.

    PubMed

    Rubotzky, A M

    2000-12-01

    This report of a postmodern feminist oral history tells a contemporary story of the success of nursing in overcoming the impediments of tradition, organizing and acting as an identifiable group, and speaking out with clarity as advocates for the health of American society. This was an important historical, transitional, and celebratory time for nursing. Continuing advocacy for health care for all Americans requires developing expertise in both traditional and feminist leadership, understanding how political theories and history affect policy development, and active participation in American democracy. Future actions require incorporation of lessons from the recent past.

  18. The use of early warning scores to recognise and respond to patient deterioration in district nursing.

    PubMed

    Tucker, Guy; Lusher, Adele

    2018-02-02

    This discussion article focuses on the literature surrounding early warning scoring systems and their use in primary care, specifically within district nursing. Patient deterioration is a global concern, associated with high mortality rates and avoidable deaths. Early recognition and response by nursing and other health care staff has been attributed to early warning scoring systems (EWSS) and tools. However, the use of equivalent tools in the community appears to be lacking. This review concludes that there is no consensus over the use of EWSS in district nursing and culture of practice is varied, rather than standardised.

  19. Philosophy and Methods for China's Vocational Education Curriculum Reforms in the Early Twenty-First Century

    ERIC Educational Resources Information Center

    Xu, Guoqing

    2014-01-01

    Curriculum reform is an important aspect of progress in China's vocational education in the twenty-first century. The past decade's round of reforms were unprecedented in China in terms of both the scope and depth of their impact. They have and will continue to dramatically alter the nation's vocational education curriculum and teaching methods.…

  20. In Flesh and Bone: Bodily Image and Educational Patterns in Early Reformation Theatre

    ERIC Educational Resources Information Center

    Salvarani, Luana

    2018-01-01

    From its very beginning, the Protestant Reformation adopted the theatre as one of its educational tools. Together with choral music, visual arts, and preaching, Luther, Melanchthon, Oekolampad, and other Reformers promoted both the cultivated school theatre and the popular street theatre in order to spread the new faith, create a community ethos,…

  1. Welfare Reform's Impact on Adolescents: Early Warning Signs. Child Trends Research Brief.

    ERIC Educational Resources Information Center

    Brooks, Jennifer L.; Hair, Elizabeth C.; Zaslow, Martha J.

    With the passage of the 1996 welfare reform law, numerous commentators expressed concern about the impact of welfare reform on young children of welfare recipients, while few expressed concern about adolescents. However, recent evidence suggests that adolescents are affected negatively when their parents participate in welfare-to-work programs.…

  2. Lessons from Early Medicaid Expansions Under Health Reform: Interviews with Medicaid Officials

    PubMed Central

    Sommers, Benjamin D; Arntson, Emily; Kenney, Genevieve M; Epstein, Arnold M

    2013-01-01

    Background The Affordable Care Act (ACA) dramatically expands Medicaid in 2014 in participating states. Meanwhile, six states have already expanded Medicaid since 2010 to some or all of the low-income adults targeted under health reform. We undertook an in-depth exploration of these six “early-expander” states—California, Connecticut, the District of Columbia, Minnesota, New Jersey, and Washington—through interviews with high-ranking Medicaid officials. Methods We conducted semi-structured interviews with 11 high-ranking Medicaid officials in six states and analyzed the interviews using qualitative methods. Interviews explored enrollment outreach, stakeholder involvement, impact on beneficiaries, utilization and costs, implementation challenges, and potential lessons for 2014. Two investigators independently analyzed interview transcripts and iteratively refined the codebook until reaching consensus. Results We identified several themes. First, these expansions built upon pre-existing state-funded insurance programs for the poor. Second, predictions about costs and enrollment were challenging, indicating the uncertainty in projections for 2014. Other themes included greater than anticipated need for behavioral health services in the expansion population, administrative challenges of expansions, and persistent barriers to enrollment and access after expanding eligibility—though officials overall felt the expansions increased access for beneficiaries. Finally, political context—support or opposition from stakeholders and voters—plays a critical role in shaping the success of Medicaid expansions. Conclusions Early Medicaid expansions under the ACA offer important lessons to federal and state policymakers as the 2014 expansions approach. While the context of each state’s expansion is unique, key shared experiences were significant implementation challenges and opportunities for expanding access to needed services. PMID:24834369

  3. Influence of Social Support and Self-Efficacy on Resilience of Early Career Registered Nurses.

    PubMed

    Wang, Lin; Tao, Hong; Bowers, Barbara J; Brown, Roger; Zhang, Yaqing

    2018-05-01

    The aim of this study was to examine the relationships among social support, self-efficacy, and resilience in early career registered nurses. A cross-sectional study was conducted with a convenience sample of 747 early career registered nurses. Data collection was performed between August and November 2015. Data were analyzed using structural equation modeling. Among the three factors of social support, only the impact of coworker support on nurse resilience is fully mediated by self-efficacy; friend support had a significant positive direct effect on self-efficacy and an indirect effect on nurse resilience. This would suggest the importance of administrators/managers understanding how to promote coworker support, increase self-efficacy, foster a positive work climate, and develop effective mentorship programs to improve early career registered nurses resilience and mitigate factors leading to turnover.

  4. Does Contact by a Family Nurse Practitioner Decrease Early School Absence?

    ERIC Educational Resources Information Center

    Kerr, Jill; Price, Marva; Kotch, Jonathan; Willis, Stephanie; Fisher, Michael; Silva, Susan

    2012-01-01

    Chronic early school absence (preschool through third grade) is associated with school failure. The presence of school nurses may lead to fewer absences, and nurse practitioners in school-based health centers (SBHCs) can facilitate a healthier population resulting in improved attendance. Efforts to get students back to school are unexplored in…

  5. Patient turnover and nursing employment in Massachusetts hospitals before and after health insurance reform: implications for the Patient Protection and Affordable Care Act.

    PubMed

    Shindul-Rothschild, Judith; Gregas, Matt

    2013-01-01

    The Affordable Care Act is modeled after Massachusetts insurance reforms enacted in 2006. A linear mixed effect model examined trends in patient turnover and nurse employment in Massachusetts, New York, and California nonfederal hospitals from 2000 to 2011. The linear mixed effect analysis found that the rate of increase in hospital admissions was significantly higher in Massachusetts hospitals (p<.001) than that in California and New York (p=.007). The rate of change in registered nurses full-time equivalent hours per patient day was significantly less (p=.02) in Massachusetts than that in California and was not different from zero. The rate of change in admissions to registered nurses full-time equivalent hours per patient day was significantly greater in Massachusetts than California (p=.001) and New York (p<.01). Nurse staffing remained flat in Massachusetts, despite a significant increase in hospital admissions. The implications of the findings for nurse employment and hospital utilization following the implementation of national health insurance reform are discussed.

  6. Early exposure to geriatric nursing through an externship program.

    PubMed

    Souder, Elaine; Beverly, Claudia J; Kitch, Stephanie; Lubin, Sandie A

    2012-01-01

    The Summer Geriatric Extern Program was developed in 2004 to provide nursing students between the junior and senior year an opportunity to learn more about careers in geriatric nursing.This full-time, eight-week commitment provides students with a stipend and a faculty mentor in their area of interest. Of the 24 externs since the inception of the program, seven have enrolled in graduate programs. The findings suggest that the summer geriatric externship program is effective in developing interest in a geriatric nursing career and providing exposure to nursing research and other aspects of the faculty role.

  7. The clinical nurse leader: prepared for an era of healthcare reform.

    PubMed

    Jeffers, Brenda Recchia; Astroth, Kim S

    2013-01-01

    Passage of the 2010 Patient Protection and Affordable Care Act will require change in the healthcare systems. The clinical nurse leader must be prepared to lead and shape the changing environment to achieve maximum outcomes for patients and families. Movement toward integrated care delivery across the care continuum, the transition of the Centers for Medicare & Medicaid Services to a value-based funding model, and accountability for high-quality, cost-effective care are just some of the drivers of this new integrated healthcare system. Reimbursement models that reward those health systems that are able to meet benchmark performance standards will result in major shifts in how health systems operate. Expertise in care coordination across the healthcare continuum is essential for maximum reimbursement. Payment for value instead of volume delivered is a major reimbursement transition coming to the acute care setting, necessitating increased attention to mining data necessary to capture quality patient outcomes for maximum reimbursement. The clinical nurse leader is ideally suited to function within these integrated systems of the future, and possesses the skills needed to assist healthcare systems to meet this challenge. © 2013 Wiley Periodicals, Inc.

  8. Missionaries and the early development of nursing in China.

    PubMed

    Chen, K

    1996-01-01

    By the late 1930s, nursing, which had come into being in China in the 1880s, had developed into a profession represented by a well-organized national association with a membership of 6,000, which was continuously expanding by hundreds of new recruits trained at nearly 200 nursing schools all over the country. The progress was remarkable. In retrospect, we can easily discern the outstanding contribution made by the Western medical missionaries. To the latter's dedication, the profession owed its birth and its incipient growth in particular. Trained missionary nurses, following in the footsteps of missionary pioneers, penetrated into all parts of the country to start dispensaries and hospitals literally from nothing. In 1923, China had 53 percent of the missionary hospital beds and 48 percent of the missionary doctors in the world. Missionary nurses constituted 32 percent of the total number of nurses in China in 1923 and their number reached a peak of nearly 700 in 1927. Although the number of medical missionaries, physicians, and nurses was tiny compared to the size of the nation's population, and although their interest in "healing the sick" aimed to serve their primary goal of "saving the soul," their contribution to nursing development in China, especially their efforts in training native nurses at numerous missionary hospitals and nursing schools, can hardly be overestimated. Derived from missionary involvement was another important contributor to the rapid progress of nursing: the Nurses' Association of China. Born in a critical stage of nursing development in the country, the NAC organized the profession and regulated its training through sponsoring registration, holding examinations, and developing a standard required curriculum. Essentially, it played the role of a great organizer and paved the way for the further growth of the profession. Coming from a totally different culture, missionaries had to overcome a lot of difficulty to adapt themselves to the

  9. Development and early application of the Scottish Community Nursing Workload Measurement Tool.

    PubMed

    Grafen, May; Mackenzie, Fiona C

    2015-02-01

    This article describes the development and early application of the Scottish Community Nursing Workload Measurement Tool, part of a suite of tools aiming to ensure a consistent approach to measuring nursing workload across NHS Scotland. The tool, which enables community nurses to record and report their actual workload by collecting information on six categories of activity, is now being used by all NHS boards as part of a triangulated approach. Data being generated by the tool at national level include indications that approximately 50% of band 6 district nurses' time is spent in face-to-face and non-face-to-face contact and planned sessions with patients, and that over 60% of face-to-face contacts are at 'moderate' and 'complex' levels of intervention (2012 data). These data are providing hard evidence of key elements of community nursing activity and practice that will enable informed decisions about workforce planning to be taken forward locally and nationally. The article features an account of the early impact of the tool's implementation in an NHS board by an associate director of nursing. Positive effects from implementation include the generation of reliable data to inform planning decisions, identification of issues around nursing time spent on administrative tasks, clarification of school nursing roles, and information being fed back to teams on various aspects of performance.

  10. Insights on leadership from early career nurse academics: findings from a mixed methods study.

    PubMed

    Halcomb, Elizabeth; Jackson, Debra; Daly, John; Gray, Joanne; Salamonson, Yenna; Andrew, Sharon; Peters, Kath

    2016-03-01

    To explore the perceptions of early career nursing academics on leadership in academia. There is growing emphasis on leadership capacity building across all domains of nursing. However, there is limited evidence on leadership capacity in early career academics. This study tested an intervention to develop leadership capacity amongst early career nursing academics in two Australian universities. A sequential mixed methods design, using online surveys and semi-structured interviews, was used to collect data. Twenty-three early career nursing academics participated. Most had experience of formal leadership roles and were aware of its importance to them as they developed their academic careers. Participants were able to discuss their own views of themselves as leaders; their perceptions of their own needs for leadership development, and ways in which they could seek to develop further as leaders. There is a need to provide initial and ongoing opportunities for leadership development amongst nurse academics. These opportunities should be contextualised and recognise factors such as gender, and the effects of structural oppression. Nurse academics are involved in the preparation of the next generation of clinical leaders and it is imperative that they are able to articulate a clear view of leadership. © 2015 John Wiley & Sons Ltd.

  11. Implementation and Early Outcomes of the Comprehensive School Reform Demonstration (CSRD) Program. Doc # 2004-15

    ERIC Educational Resources Information Center

    LaPointe, Michelle; Stullich, Stephanie

    2004-01-01

    The Comprehensive School Reform (CSR) program provides financial assistance to help schools develop and implement systematic approaches to schoolwide improvement that are grounded in scientifically based research and effective practices. The goal of the program is to enable all children to meet challenging state academic content and achievement…

  12. Qatar's K-12 Education Reform Has Achieved Success in Its Early Years. Research Brief

    ERIC Educational Resources Information Center

    Larson, Judy

    2009-01-01

    To evaluate progress made in the first years of Qatar's implementation of K-12 education reform, RAND analyzed data from school-level observations, national surveys, and national student assessments. The study found that students in the new, Independent schools were performing better than those in Ministry schools, and there was greater student…

  13. Early appraisal of China's huge and complex health-care reforms.

    PubMed

    Yip, Winnie Chi-Man; Hsiao, William C; Chen, Wen; Hu, Shanlian; Ma, Jin; Maynard, Alan

    2012-03-03

    China's 3 year, CN¥850 billion (US$125 billion) reform plan, launched in 2009, marked the first phase towards achieving comprehensive universal health coverage by 2020. The government's undertaking of systemic reform and its affirmation of its role in financing health care together with priorities for prevention, primary care, and redistribution of finance and human resources to poor regions are positive developments. Accomplishing nearly universal insurance coverage in such a short time is commendable. However, transformation of money and insurance coverage into cost-effective services is difficult when delivery of health care is hindered by waste, inefficiencies, poor quality of services, and scarcity and maldistribution of the qualified workforce. China must reform its incentive structures for providers, improve governance of public hospitals, and institute a stronger regulatory system, but these changes have been slowed by opposition from stakeholders and lack of implementation capacity. The pace of reform should be moderated to allow service providers to develop absorptive capacity. Independent, outcome-based monitoring and evaluation by a third-party are essential for mid-course correction of the plans and to make officials and providers accountable. Copyright © 2012 Elsevier Ltd. All rights reserved.

  14. Early-career registered nurses' participation in hospital quality improvement activities.

    PubMed

    Djukic, Maja; Kovner, Christine T; Brewer, Carol S; Fatehi, Farida K; Bernstein, Ilya

    2013-01-01

    We surveyed 2 cohorts of early-career registered nurses from 15 states in the US, 2 years apart, to compare their reported participation in hospital quality improvement (QI) activities. We anticipated differences between the 2 cohorts because of the growth of several initiatives for engaging nurses in QI. There were no differences between the 2 cohorts across 14 measured activities, except for their reported use of appropriate strategies to improve hand-washing compliance to reduce nosocomial infection rates.

  15. Education Reform Policy and Early Childhood Teacher Education in Hong Kong before and after the Transfer of Sovereignty to China in 1997

    ERIC Educational Resources Information Center

    Yuen, Gail

    2008-01-01

    Built on a sociocultural framework of policy analysis and Wertsch's concept of mediation, the present study examines how early childhood teacher education has changed as a result of interactions between reform policy and the action of teacher educators. Ten teacher educators participated in the study, along with eight early childhood leaders, 15…

  16. Capturing early signs of deterioration: the dutch-early-nurse-worry-indicator-score and its value in the Rapid Response System.

    PubMed

    Douw, Gooske; Huisman-de Waal, Getty; van Zanten, Arthur R H; van der Hoeven, Johannes G; Schoonhoven, Lisette

    2017-09-01

    To determine the predictive value of individual and combined dutch-early-nurse-worry-indicator-score indicators at various Early Warning Score levels, differentiating between Early Warning Scores reaching the trigger threshold to call a rapid response team and Early Warning Score levels not reaching this point. Dutch-early-nurse-worry-indicator-score comprises nine indicators underlying nurses' 'worry' about a patient's condition. All indicators independently show significant association with unplanned intensive care/high dependency unit admission or unexpected mortality. Prediction of this outcome improved by adding the dutch-early-nurse-worry-indicator-score indicators to an Early Warning Score based on vital signs. An observational cohort study was conducted on three surgical wards in a tertiary university-affiliated teaching hospital. Included were surgical, native-speaking, adult patients. Nurses scored presence of 'worry' and/or dutch-early-nurse-worry-indicator-score indicators every shift or when worried. Vital signs were measured according to the prevailing protocol. Unplanned intensive care/high dependency unit admission or unexpected mortality was the composite endpoint. Percentages of 'worry' and dutch-early-nurse-worry-indicator-score indicators were calculated at various Early Warning Score levels in control and event groups. Entering all dutch-early-nurse-worry-indicator-score indicators in a multiple logistic regression analysis, we calculated a weighted score and calculated sensitivity, specificity, positive predicted value and negative predicted value for each possible total score. In 3522 patients, 102 (2·9%) had an unplanned intensive care/high dependency unit admissions (n = 97) or unexpected mortality (n = 5). Patients with such events and only slightly changed vital signs had significantly higher percentages of 'worry' and dutch-early-nurse-worry-indicator-score indicators expressed than patients in the control group. Increasing number

  17. Clinical imprinting: the impact of early clinical learning on career long professional development in nursing.

    PubMed

    Andrew, Nicola

    2013-05-01

    The literature recognises a relationship between clinical experience and a successful undergraduate experience in nursing; however what constitutes an effective approach remains the subject of debate, particularly in relation to first year of learning. There is evidence from a biological standpoint that early experience impacts on the behavioural development of animals, described by Konrad Lorenz (1903-1989) as 'imprinting'. The concept of imprinting has resonance for nursing. In this article the importance of 'getting it right at the beginning' is explored and what, if anything, Lorenz's theory tells us about the impact of early clinical learning on subsequent professional development. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Cultivating the Role of Nurse Practitioners in Providing Primary Care to Vulnerable Populations in an Era of Health-Care Reform.

    PubMed

    Xue, Ying; Intrator, Orna

    2016-02-01

    The evolving role of nurse practitioners (NPs) as primary care providers, especially for vulnerable populations, is central to the debate regarding strategies to address the growing need for primary care services. The current article provides policy recommendations for leveraging and expanding the historic role of NPs in caring for vulnerable populations, by focusing on three key policy levers: NP scope-of-practice regulation, distribution of the NP workforce, and NP education. These policy levers must go hand in hand to build a sufficient and equitably distributed NP workforce, to help meet the escalating need for primary care in an era of health-care reform. © The Author(s) 2016.

  19. Responding to health care reform by addressing the institute of medicine report on the future of nursing.

    PubMed

    Ellerbe, Suellyn; Regen, Debra

    2012-01-01

    The current health care environment has heightened the importance of achieving positive patient outcomes and excellent customer satisfaction. To remain competitive, health care organizations must adapt quickly to changing regulatory requirements, quality improvement initiatives, and customer expectations. To ensure nursing practice at the Saint Clare's Health System in Northwest New Jersey is at the forefront of leading change, the nursing staff has embraced the Institute of Medicine report The Future of Nursing: Leading Change. The empowered nursing team has applied Benner's Novice to Expert model and McCauley's Careful Nursing Theory as the foundation for nursing practice. The ability to apply evidence-based nursing research and cultivate professional development at the bedside has resulted in retention of expert nurses at the bedside. Engaging the nursing team has resulted in increased patient satisfaction and improved clinical outcomes. Advanced practice nurses play an important role to mentor the nursing staff and promote an interdisciplinary, collaborative relationship between all health care disciplines and community support programs. Nurses are recognized for their accomplishments and encouraged to obtain specialty certification, advanced degrees, and earn state and national recognition through professional organizations. The professional nurses at the Saint Clare's Health System are prepared to work in whatever environment the new normal creates.

  20. Reaching their potential: Perceived impact of a collaborative academic-clinical partnership programme for early career nurses in New Zealand.

    PubMed

    McKillop, Ann; Doughty, Lesley; Atherfold, Cheryl; Shaw, Kathy

    2016-01-01

    The dynamic nature of healthcare ensures that early career nurses enter an uncertain and complex world of practice and consequently require support to develop their practice, build confidence and reach their potential. The New Zealand Nurse Entry to Practice programme for registered nurses in their first year of practice has been operating since 2005 to enable safe and confident practice, improve the quality of care, and positively impact on recruitment and retention. This academic and clinical programme was offered as a partnership between a university and a clinical provider with postgraduate academic credits gained. The aim of this study was to explore the perceived impact of postgraduate university education for early career nurses in one regional health area of New Zealand. Participants were registered nurses who had completed the early career nurse programme and their clinical preceptors. The research was conducted via an online survey of 248 nurses and three focus groups to explore how the programme was experienced and its impact on knowledge and practice. Early career nurses and their preceptors found that the programme enables improved knowledge and skills of patient assessment, application of critical thinking to clinical practice, perceived improvement in patient care delivery and outcomes, enhanced interprofessional communication and knowledge sharing, and had a positive impact on professional awareness and career planning. This clinical-academic partnership positively impacted on the clinical practice and transition experience of early career nurses and was closely aligned to an organization's strategic plan for nursing workforce development. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Science in the Early Years. The Progress of Education Reform. Volume 15, Number 2

    ERIC Educational Resources Information Center

    Brenneman, Kimberly

    2014-01-01

    Recent research suggests early math, science, and social studies knowledge may boost achievement for the nation's youngest students and provides a better chance at future reading success--more so even than early reading skills. This issue explores the benefits of including a strong science curriculum in the early years and includes recommendations…

  2. Does contact by a family nurse practitioner decrease early school absence?

    PubMed

    Kerr, Jill; Price, Marva; Kotch, Jonathan; Willis, Stephanie; Fisher, Michael; Silva, Susan

    2012-02-01

    Chronic early school absence (preschool through third grade) is associated with school failure. The presence of school nurses may lead to fewer absences, and nurse practitioners in school-based health centers (SBHCs) can facilitate a healthier population resulting in improved attendance. Efforts to get students back to school are unexplored in nursing literature. This article describes a nursing intervention to decrease early school absence in two elementary schools K-3 (N = 449) and a Head Start program (N = 130). The Head Start Family Nurse Practitioner (FNP) contacted families of chronically and excessively absent students by telephone, clinic visit at school, or home visit. The aggregate percentage attendance was evaluated by grades (preschool to third grade), schools (Head Start, Elementary Schools 1 and 2), and grades and schools and compared with publicly available school district aggregate data. There were statistically significant increases in attendance from Year 1 to Year 2 at p < .05 at the elementary level but not at the Head Start level. Student demographics, types of contacts, absence reasons (including sick child), and medical diagnoses are described.

  3. American Early Education Reform: Adaptation Not Adoption from Reggio Emilia, Italy.

    ERIC Educational Resources Information Center

    Firlik, Russell J.

    The Reggio Emilia preschools in Italy have much to offer U.S. early education practitioners. If adapted, based on an understanding of American culture and of how American children learn, four components of the Reggio Emilia model can be useful in American early childhood settings. First, projects based on the interests of children can be used to…

  4. Becoming Professional? Exploring Early Years Professional Status and Its Implications for Workforce Reform in England

    ERIC Educational Resources Information Center

    Simpson, Donald

    2010-01-01

    Across the "European learning space" (Lawn, 2006) professionalisation of early years workforces has become a key priority and there has been a flow of this policy between borders (Oberhuemer, 2005). Early Years Professional Status (EYPS) is central to these developments in England. Within what is regarded as a traditionally…

  5. Travelling Policy Reforms Reconfiguring the Work of Early Childhood Educators in Australia

    ERIC Educational Resources Information Center

    Nuttall, Joce; Thomas, Louise; Wood, Elizabeth

    2014-01-01

    Interventions in the field of early childhood education policy, drawn from global policy flows, are reconfiguring the work of early childhood educators in Australia. One such intervention is the requirement to designate an "educational leader" (EL) in each service for young children and their families. This policy intervention has its…

  6. Linguistically Diverse Children and Educators (Re)Forming Early Literacy Policy

    ERIC Educational Resources Information Center

    Spencer, Tamara Glupczynski; Falchi, Lorraine; Ghiso, Maria Paula

    2011-01-01

    The current context of increased accountability and the proliferation of skills-based literacy mandates at the early childhood level pose particular tensions for multilingual children and educators. In this article, we draw on data from two ethnographic studies to examine how educators and children negotiate the constraints of early childhood…

  7. Lessons Learned: How Early College High Schools Offer a Pathway for High School Reform

    ERIC Educational Resources Information Center

    Kaniuka, Theodore Stefan; Vickers, Melinda

    2010-01-01

    In 2002, Early College High Schools Initiative became a reality across the United States for students and educators looking for ways to improve student graduation rates, college attendance, and overall student achievement. This mixed method case study found that (a) the early college high school environment supported the academic success of…

  8. A structural equation model of turnover for a longitudinal survey among early career registered nurses.

    PubMed

    Brewer, Carol S; Chao, Ying-Yu; Colder, Craig R; Kovner, Christine T; Chacko, Thomas P

    2015-11-01

    Key predictors of early career nurses' turnover are job satisfaction, organizational commitment, job search, intent to stay, and shock (back injuries) based on the literature review and our previous research. Existing research has often omitted one of these key predictors. The purpose of this study in a sample of early career nurses was to compare predictors of turnover to nurses' actual turnover at two time points in their careers. A multi-state longitudinal panel survey of early career nurses was used to compare a turnover model across two time periods. The sample has been surveyed five times. The sample was selected using a two-stage sample of registered nurses nested in 51 metropolitan areas and nine non-metropolitan, rural areas in 34 states and the District of Columbia. The associations between key predictors of turnover were tested using structural equation modeling and data from the earliest and latest panels in our study. We used predictors from the respondents who replied to the Wave-1 survey in 2006 and their turnover status from Wave 2 in 2007 (N=2386). We compared these results to the remaining respondents' predictors from Wave 4 in 2011 and their turnover status in Wave 5 in 2013 (N=1073). We tested and found no effect for missingness from Wave 1-5 and little evidence of attrition bias. Strong support was found for the relationships hypothesized among job satisfaction, organizational commitment, intent to stay, and turnover, with some support for shock and search in the Wave 1-2 sample. However, for Wave 4-5 sample (n=1073), none of the paths through search were significant, nor was the path from shock to turnover. Nurses in the second analysis who had matured longer in their career did not have a significant response to search or shock (back injuries), which may indicate how easily experienced registered nurses find new jobs and/or accommodation to jobs requiring significant physicality. Nurse turnover is a major concern for healthcare organizations

  9. Expanding the capacity of nursing education.

    PubMed

    Cleary, Brenda L; McBride, Angela Barron; McClure, Margaret L; Reinhard, Susan C

    2009-01-01

    Assuring a nurse workforce that is large enough and possesses the right competencies for the changing demographic and health reform scenarios of the early twenty-first century is nothing short of an imperative. Getting there will involve continual recruitment of a talented and diverse group of people and increasing nurses' progression to a more highly educated workforce, no matter where they enter the profession. These actions will enable the United States to fill vacant nursing faculty positions as we simultaneously re-create how nursing education is delivered in this country. The nation's health is dependent on the actions we now take.

  10. Enhancing and Well-Being of Young Children and Families in the Context of Welfare Reform: Lessons from Early Childhood, TANF, and Family Support Programs.

    ERIC Educational Resources Information Center

    Knitzer, Jane; Cauthen, Nancy K.

    This report presents findings about emerging approaches to enhance the well-being of young children and families in the context of welfare reform. Information on programs and initiatives was obtained from nomination forms sent to over 300 key informants, including child care officials, Head Start collaboration directors, governors' early childhood…

  11. Policy into Practice in Hong Kong Pre-Primary Kindergartens: The Impact of a Reform Agenda Viewing Early Childhood as The Foundation for Lifelong Learning

    ERIC Educational Resources Information Center

    Yelland, Nicola J.; Leung, Wai Man Vivienne

    2018-01-01

    In this paper we outline the provision of pre-primary education in the Hong Kong SAR and discuss how the educational reform initiatives of 2000 (Learning to Learn) and global imperatives provided the impetus to reshape a new educational approach to early childhood education. We use the example of a half-day pre-primary (kindergarten) programme to…

  12. The Early Care and Education Teaching Workforce at the Fulcrum: An Agenda for Reform (2016). Early Childhood Education Series

    ERIC Educational Resources Information Center

    Kagan, Sharon Lynn; Kauerz, Kristie; Tarrant, Kathleen C.

    2016-01-01

    In this important new book, Sharon Lynn Kagan and her colleagues focus on the more than 2 million individuals who care for and educate nearly two thirds of the American children under age 5 participating in nonparental care. Providing the most thorough synthesis of current research on the early care and education teaching workforce to date, the…

  13. Educational gaps and solutions for early-career nurse managers' education and participation in quality improvement.

    PubMed

    Djukic, Maja; Kovner, Christine T; Brewer, Carol S; Fatehi, Farida; Jun, Jin

    2015-04-01

    The objective of this study was to examine early-career frontline nurse managers' (FLNMs') reported educational preparedness and participation in quality improvement (QI). Frontline nurse managers are vitally important for leading QI. However, it is not well known if they have adequate knowledge and skills to lead this important function. We examined cross-sectional survey data from 42 FLNMs using descriptive statistics. About 30% of FLNMs reported being very prepared across 12 measured QI skills by schools or employers and 35% reported participating in a specific clinical effort to improve patient care on their unit more than once a month. More than 50% reported having good organizational support for QI, but only about 30% reported being rewarded for their contributions to QI. Our study highlights opportunities for development in QI for FLNMs and offers some solutions for nurse executives that can bridge the educational gaps.

  14. Before Nugent took charge: early efforts to reform chiropractic education, 1919-1941

    PubMed Central

    Keating, Joseph C

    2003-01-01

    John J. Nugent, D.C. is remembered by many as either the “Abraham Flexner of Chiropractic” or the “anti-Christ of Chiropractic.” From 1941 until his forced retirement in 1959, the Irish-born Palmer graduate was one of the most important factors in the profession's educational reforms. Yet Nugent's work as the National Chiropractic Association's (NCA's) director of research was not the beginning of the campaign to upgrade chiropractic education. This paper looks at earlier influences and events which set the stage for Nugent's campaign. Among these were the introduction of licensure for chiropractors, the self-defeating actions of B.J. Palmer, the introduction of basic science legislation, the lethargy of the schools, and the struggle for control of education between the schools, on the one hand, and the NCA and the Council of State Chiropractic Examining Boards on the other ImagesFigure 1Figure 3Figure 4Figure 5Figure 6Figure 7Figure 9Figure 10Figure 11Figure 12Figure 13Figure 14Figure 15Figure 16Figure 17Figure 18Figure 19Figure 20Figure 21Figure 22Figure 23Figure 24Figure 25Figure 26Figure 28Figure 29Figure 30Figure 31Figure 32Figure 33Figure 34Figure 35Figure 36Figure 37Figure 38

  15. Reforming primary health care: is New Zealand's primary health care strategy achieving its early goals?

    PubMed

    Cumming, Jacqueline; Mays, Nicholas; Gribben, Barry

    2008-11-06

    In 2001, the New Zealand government introduced its Primary Health Care Strategy (PHCS), aimed at strengthening the role of primary health care, in order to improve health and to reduce inequalities in health. As part of the Strategy, new funding was provided to reduce the fees that patients pay when they use primary health care services in New Zealand, to improve access to services and to increase service use. In this article, we estimate the impact of the new funding on general practitioner and practice nurse visit fees paid by patients and on consultation rates. The analyses involved before-and-after monitoring of fees and consultation rates in a random sample of 99 general practices and covered the period from June 2001 (pre-Strategy) to mid-2005. Fees fell particularly in Access (higher need, higher per capita funded) practices over time for doctor and nurse visits. Fees increased over time for many in Interim (lower need, lower per capita funded) practices, but they fell for patients aged 65 years and over as new funding was provided for this age group. There were increases in consultation rates across almost all age, funding model (Access or Interim), socio-demographic and ethnic groups. Increases were particularly high in Access practices. The Strategy has resulted in lower fees for primary health care for many New Zealanders, and consultation rates have also increased over the past few years. However, fees have not fallen by as much as expected in government policy given the amount of extra public money spent since there are limited requirements for practices to reduce patients' fees in line with increases in public funding for primary care.

  16. Reforming primary health care: is New Zealand's primary health care strategy achieving its early goals?

    PubMed Central

    Cumming, Jacqueline; Mays, Nicholas; Gribben, Barry

    2008-01-01

    Background In 2001, the New Zealand government introduced its Primary Health Care Strategy (PHCS), aimed at strengthening the role of primary health care, in order to improve health and to reduce inequalities in health. As part of the Strategy, new funding was provided to reduce the fees that patients pay when they use primary health care services in New Zealand, to improve access to services and to increase service use. In this article, we estimate the impact of the new funding on general practitioner and practice nurse visit fees paid by patients and on consultation rates. The analyses involved before-and-after monitoring of fees and consultation rates in a random sample of 99 general practices and covered the period from June 2001 (pre-Strategy) to mid-2005. Results Fees fell particularly in Access (higher need, higher per capita funded) practices over time for doctor and nurse visits. Fees increased over time for many in Interim (lower need, lower per capita funded) practices, but they fell for patients aged 65 years and over as new funding was provided for this age group. There were increases in consultation rates across almost all age, funding model (Access or Interim), socio-demographic and ethnic groups. Increases were particularly high in Access practices. Conclusion The Strategy has resulted in lower fees for primary health care for many New Zealanders, and consultation rates have also increased over the past few years. However, fees have not fallen by as much as expected in government policy given the amount of extra public money spent since there are limited requirements for practices to reduce patients' fees in line with increases in public funding for primary care. PMID:18990236

  17. Nursing student profiles and occurrence of early academic failure: Findings from an explorative European study.

    PubMed

    Dante, Angelo; Ferrão, Sónia; Jarosova, Darja; Lancia, Loreto; Nascimento, Carla; Notara, Venetia; Pokorna, Andrea; Rybarova, Lubica; Skela-Savič, Brigita; Palese, Alvisa

    2016-03-01

    In the European context regulated by the Bologna Process principles, there is little evidence to date on the different profiles, if any, of nursing students enrolled in the 1st academic year and their academic outcomes. To describe and compare the nursing student profiles and their academic outcomes at the end of the 1st year across European Bachelor of Nursing Science (BNS) courses. An exploratory multicentre cohort study involving five countries: Nursing students who were enrolled in nursing programmes for the academic year 2011/2012 in the participating BNS courses, willing to participate and regularly admitted to the 2nd academic year, were included in this study undertaken in 2013. Individual and faculty level variables were collected after having ensured the validity of the tools developed in English and then appropriately translated into the language of each participating country. A total of 378/710 (53.2%) students participated in the study. They attended from 390 to 810h of lessons, while clinical experience ranged from 162 to 536h. The students reported a mean average age of 21.4 (Confidence of Interval [CI] 95%, 21.0-22.3) and foreign students were limited in number (on average 3.7%). The students reported adopting mainly individual learning strategies (92.9%), duplicating notes or lecture notes prepared by professors (74.4%), and concentrating their study before exams (74.6%). The majority reported experiencing learning difficulties (49.7%) and a lack of academic support (84.9%). Around 33.2% reported economic difficulties and the need to work while studying nursing on average for 24h/week. Personal expectations regarding the nursing role were different (45.6%) than the role encountered during the 1st year, as learning workloads were higher (57.2%) with regard to expectations. Around one-third of students reported the intention to leave nursing education while the proportion of those reporting early academic failure was on average 5.6%. More strategies

  18. The rise of practice development with/in reformed bureaucracy: discourse, power and the government of nursing.

    PubMed

    Rudge, Trudy; Holmes, Dave; Perron, Amélie

    2011-10-01

    Using a neo-Foucauldian approach, a critique of texts explicitly dealing with the definitional work for practice development (PD) was undertaken. PD has been taken up by many organizations as a way of focusing on nurses' practices to benefit patients and the organization. Literature pertaining to the PD phenomenon was examined and the present study explores those texts accomplishing definitional work. The discourse corpus collected together articles in nursing journals, book chapters and textbooks. The corpus was analysed using the discourse analysis method. PD uses and manipulates its location in a network of managerialism, evidence-based nursing, safety and quality discourses in healthcare to verify (and confirm) its definition and its position as central to progress in nursing practice. We argue that while PD is portrayed as 'emancipatory' and transforming, nurses bear the responsibility for the system and its failures in a web of intricate power relations. The present study offers a review of the PD ideology in nursing where a critical perspective has yet to be found. Nursing managers should understand that PD is not a panacea for improving patient care. © 2011 Blackwell Publishing Ltd.

  19. Positive work environments of early-career registered nurses and the correlation with physician verbal abuse.

    PubMed

    Brewer, Carol S; Kovner, Christine T; Obeidat, Rana F; Budin, Wendy C

    2013-01-01

    Verbal abuse in the workplace is experienced by registered nurses (RNs) worldwide; physicians are one of the main sources of verbal abuse. To examine the relationship between levels of physician verbal abuse of early-career RNs and demographics, work attributes, and perceived work environment. Fourth wave of a mailed national panel survey of early career RNs begun in 2006. RNs' perception of verbal abuse by physicians was significantly associated with poor workgroup cohesion, lower supervisory and mentor support, greater quantitative workload, organizational constraints, and nurse-colleague verbal abuse, as well as RNs' lower job satisfaction, organizational commitment, and intent to stay. RNs working in unfavorable work environments experience more physician abuse and have less favorable work attitudes. Causality is unclear: do poor working conditions create an environment in which physicians are more likely to be abusive, or does verbal abuse by physicians create an unfavorable work environment? Copyright © 2013 Elsevier Inc. All rights reserved.

  20. Early Momentum Metrics: Why They Matter for Higher Education Reform. CCRC Research Brief. Number 65

    ERIC Educational Resources Information Center

    Jenkins, Davis; Bailey, Thomas

    2017-01-01

    In this brief, the authors propose three measures of "early momentum" for two reasons: Research is beginning to show that these near-term metrics predict long-term success, and the metrics focus attention on initial conditions at colleges that are particularly important for solidifying the foundation for student success. While these…

  1. "Old, Borrowed, and Renewed": A Review of Early Childhood Education Policy in Post-Reform Indonesia

    ERIC Educational Resources Information Center

    Octarra, Harla Sara; Hendriati, Agustina

    2018-01-01

    Early childhood education (ECE) is not new in Indonesia. However, in the past decade, it has received more attention, as shown by the growing number of ECE centres in both urban and rural areas. This growth is accompanied by policy development that corresponds to the global agenda of ECE. Policy development is inevitably linked with the support of…

  2. Current Educational Reforms in Nursing in the United Kingdom and Their Impact on the Role of Nursing Lecturers in Practice: A Case Study Approach.

    ERIC Educational Resources Information Center

    Camiah, Sada

    1998-01-01

    Observations of and interviews with 41 British nurse educators found that they are expected to spend more time doing clinical teaching, developing links with clinical staff, supporting the development of the clinical learning environment, and participating in educational audits. (SK)

  3. Improvement of resident perceptions of nurse practitioners after the introduction of a collaborative care model: a benefit of work hour reform?

    PubMed

    Bellini, Lisa M; Shea, Judy A

    2006-01-01

    Nurse practitioners (NPs) are assuming larger roles in many residency programs as a result of work hour reform, which is creating the potential for collaboration with interns and residents. To assess housestaff perceptions of NPs. We used a 17-item survey before and after the implementation of a collaborative care model in a university-based medicine residency. The majority of residents held favorable attitudes about NPs before the introduction of the collaborative care model. After 1 year, more interns and residents appreciated NPs' clinical judgment (effect size [ES] = .26, p =.02), thought they should be able to order laboratory tests (ES = .23, p = .05) and perform basic procedures (ES = .67, p < .0001), and viewed them as colleagues (ES = .25, p = .04). Only a minority felt NPs contributed to their education. The promotion of collaborative care can be an unintended consequence of work hour reform. Educators are encouraged to think about how changes in the curriculum structure can provide opportunities for positive collaborative care experiences.

  4. Barriers to innovation: nurses' risk appraisal in using a new ethics screening and early intervention tool.

    PubMed

    Pavlish, Carol L; Hellyer, Joan Henriksen; Brown-Saltzman, Katherine; Miers, Anne G; Squire, Karina

    2013-01-01

    We developed and assessed feasibility of an Ethics Screening and Early Intervention Tool that identifies at-risk clinical situations and prompts early actions to mitigate conflict and moral distress. Despite intensive care unit and oncology nurses' reports of tool benefits, they noted some risk to themselves when initiating follow-up actions. The riskiest actions were discussing ethical concerns with physicians, calling for ethics consultation, and initiating patient conversations. When discussing why initiating action was risky, participants revealed themes such as "being the troublemaker" and "questioning myself." To improve patient care and teamwork, all members of the health care team need to feel safe in raising ethics-related questions.

  5. Identification of ICF categories relevant for nursing in the situation of acute and early post-acute rehabilitation

    PubMed Central

    Mueller, Martin; Boldt, Christine; Grill, Eva; Strobl, Ralf; Stucki, Gerold

    2008-01-01

    Background The recovery of patients after an acute episode of illness or injury depends both on adequate medical treatment and on the early identification of needs for rehabilitation care. The process of early beginning rehabilitation requires efficient communication both between health professionals and the patient in order to effectively address all rehabilitation goals. The currently used nursing taxonomies, however, are not intended for interdisciplinary use and thus may not contribute to efficient rehabilitation management and an optimal patient outcome. The ICF might be the missing link in this communication process. The objective of this study was to identify the categories of the International Classification of Functioning, Disability and Health (ICF) categories relevant for nursing care in the situation of acute and early post-acute rehabilitation. Methods First, in a consensus process, "Leistungserfassung in der Pflege" (LEP) nursing interventions relevant for the situation of acute and early post-acute rehabilitation were selected. Second, in an integrated two-step linking process, two nursing experts derived goals of LEP nursing interventions from their practical knowledge and selected corresponding ICF categories most relevant for patients in acute and post-acute rehabilitation (ICF Core Sets). Results Eighty-seven percent of ICF Core Set categories could be linked to goals of at least one nursing intervention variable of LEP. The ICF categories most frequently linked with LEP nursing interventions were respiration functions, experience of self and time functions and focusing attention. Thirteen percent of ICF Core Set categories could not be linked with LEP nursing interventions. The LEP nursing interventions which were linked with the highest number of different ICF-categories of all were "therapeutic intervention", "patient-nurse communication/information giving" and "mobilising". Conclusion The ICF Core Sets for the acute hospital and early post

  6. Medicaid Issues in Family Welfare and Nursing Home Reform. Including H.R. 2270, a Bill To Amend Title XIX of the Social Security Act To Change the Medicaid Requirements for Nursing Facilities Based on Recommendations of the Institute of Medicine of the National Academy of Sciences. Hearings before the Subcommittee on Health and the Environment of the Committee on Energy and Commerce, House of Representatives, One Hundredth Congress, First Session (April 24 and May 12, 1987).

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House Committee on Energy and Commerce.

    Two hearings held a month apart examine major issues concerning Medicaid benefits in family welfare and nursing home reform. The first set of hearings discusses the proposed Family Welfare Reform Act of 1987 (H.R. 1720), which is intended to replace the Aid to Families with Dependent Children (AFDC) program of the Social Security Act Title IV.…

  7. Curiosity, forbidden knowledge, and the reformation of natural philosophy in early modern England.

    PubMed

    Harrison, P

    2001-06-01

    From the patristic period to the beginning of the seventeenth century curiosity was regarded as an intellectual vice. Curious individuals were considered to be proud and "puffed up," and the objects of their investigations were deemed illicit, dispute engendering, unknowable, or useless. Seventeenth-century projects for the advancement of learning had to distance themselves from curiosity and its dubious fruits or, alternatively, enhance the moral status of the curious sensibility. Francis Bacon's proposals for the instauration of knowledge were an integral part of a process by which curiosity underwent a remarkable transformation from vice to virtue over the course of the seventeenth century. The changing fortunes of this human propensity highlight the morally charged nature of early modern debates over the status of natural philosophy and the particular virtues required of its practitioners. The rehabilitation of curiosity was a crucial element in the objectification of scientific knowledge and led to a gradual shift of focus away from the moral qualities of investigators and the propriety of particular objects of knowledge to specific procedures and methods.

  8. Reforming Science: Structural Reforms

    PubMed Central

    2012-01-01

    Science has a critical role to play in addressing humanity's most important challenges in the twenty-first century. However, the contemporary scientific enterprise has developed in ways that prevent it from reaching maximum effectiveness and detract from the appeal of a research career. To be effective, the methodological and culture reforms discussed in the accompanying essay must be accompanied by fundamental structural reforms that include a renewed vigorous societal investment in science and scientists. PMID:22184420

  9. Student nurses' recognition of early signs of abnormal vital sign recordings.

    PubMed

    Leonard, Martha M; Kyriacos, Una

    2015-09-01

    There is increasing urgency for nurses to recognize early signs of deterioration in patients and to take appropriate action to prevent serious adverse effects. To assess respondents' ability to identify abnormal recordings for respiratory and heart rate, oxygen saturation level, systolic blood pressure, level of consciousness, urinary output and normal temperature. A descriptive observational survey. A nursing college in Cape Town, South Africa. A sample of 77/212 (36.3%) fourth year students. A self-administered adapted questionnaire was employed to collect demographic data and respondents' selections of recorded physiological values for the purpose of deciding when to call for more skilled help. The median age for 62/77 (80.5%) of the respondents was 25years; 3/76 (3.9%) had a previous certificate in nursing. Most respondents were female (66/76, 85.7%). Afrikaans was the first language preference of 33 (42.9%) respondents, followed by isiXhosa (31/77, 40.3%) and English (10/77, 13.0%). Most respondents (48/77, 62.3%) recognized a normal temperature reading (35-38.4°C). However, overall there would have been delays in calling for more skilled assistance in 288/416 (69.2%) instances of critical illness for a high-score MEWS of 3 and in 226/639 (35.4%) instances at a medium-score MEWS of 2 for physiological parameters. In 96/562 (17.1%) instances, respondents would have called for assistance for a low-score MEWS of 1. Non-recognition of deterioration in patients' clinical status and delayed intervention by nurses has implications for the development of serious adverse events. The MEWS is recommended as a track-and-trigger system for nursing curricula in South Africa and for implementation in practice. Copyright © 2015. Published by Elsevier Ltd.

  10. Early Childhood Reform in Seven Communities: Front-Line Practice, Agency Management, and Public Policy. Volume III: Technical Appendix--Research Design and Methodology. Studies of Education Reform.

    ERIC Educational Resources Information Center

    Lopez, Elena

    The administration and funding of early childhood education programs has engendered recent federal policy debates. This volume is the third report in a series of three, which are derived from a study that examined how local organizations implement complex government programs for early childhood education. The study analyzed and documented…

  11. Early Childhood Reform in Seven Communities: Front-Line Practice, Agency Management, and Public Policy. [Volume I: Final Technical Report.] Studies of Education Reform.

    ERIC Educational Resources Information Center

    Schultz, Tom; And Others

    An era of substantial growth in investment of resources, program development, and research has led to tangible gains in the scope and quality of early childhood education programs. However, the system of early childhood education programs is plagued by unequal access and inconsistent, inadequate levels of quality. Additionally, the focus of…

  12. The impact of Early Warning Score and Rapid Response Systems on nurses' competence: An integrative literature review and synthesis.

    PubMed

    Jensen, Jørghild Karlotte; Skår, Randi; Tveit, Bodil

    2018-04-01

    To describe, interpret and synthesise the current research findings on the impact of the Early Warning Score and Rapid Response Systems on nurses' competence in identifying and managing deteriorating patients in general hospital wards. As patient safety initiatives designed to ensure the early identification and management of deteriorating patients, the Early Warning Score and Rapid Response Systems have broad appeal. However, it is still unclear how these systems impact nurses' competence when these systems are used in general hospital wards. CINAHL, PubMed, Cochrane, EMBASE and Ovid MEDLINE databases were systematically searched for relevant articles. Articles were appraised, a thematic analysis was conducted, and similar and divergent perspectives on emergent themes and subthemes were extracted by a team of researchers. Thirty-six studies met the inclusion criteria. The analysis of findings showed how the Early Warning Score and Rapid Response Systems impacted three competence areas: (i) Nurses' competence in assessing and caring for patients related to the subthemes: (a) sensing clinical deterioration and (b) the development of skills and knowledge. (ii). Nurses' competence in referring patients, related to the subthemes: (a) deciding whether to summon help and (b) the language and communication lines in the referral process. (ii) Nurses' coping and mastery experiences. The impact of the Early Warning Score and Rapid Response Systems on nurses' competence in identifying and managing deteriorating patients is beneficial but also somewhat contradictory. A greater understanding of nurses' development of competence when using the Early Warning Score and Rapid Response Systems will facilitate the design of implementation strategies and the use of these systems to improve practice. © 2017 John Wiley & Sons Ltd.

  13. Personal Background Preparation Survey for early identification of nursing students at risk for attrition.

    PubMed

    Johnson, Craig W; Johnson, Ronald; Kim, Mira; McKee, John C

    2009-11-01

    During 2004 and 2005 orientations, all 187 and 188 new matriculates, respectively, in two southwestern U.S. nursing schools completed Personal Background and Preparation Surveys (PBPS) in the first predictive validity study of a diagnostic and prescriptive instrument for averting adverse academic status events (AASE) among nursing or health science professional students. One standard deviation increases in PBPS risks (p < 0.05) multiplied odds of first-year or second-year AASE by approximately 150%, controlling for school affiliation and underrepresented minority student (URMS) status. AASE odds one standard deviation above mean were 216% to 250% those one standard deviation below mean. Odds of first-year or second-year AASE for URMS one standard deviation above the 2004 PBPS mean were 587% those for non-URMS one standard deviation below mean. The PBPS consistently and significantly facilitated early identification of nursing students at risk for AASE, enabling proactive targeting of interventions for risk amelioration and AASE or attrition prevention. Copyright 2009, SLACK Incorporated.

  14. A qualitative descriptive exploration of the educational and career plans of early career neonatal nurses and midwives: An Irish perspective.

    PubMed

    Coughlan, Linda Martina; Patton, Declan

    2018-01-01

    The scarcity of appropriately qualified nurses and midwives is a major obstacle in achieving an effective health system. Neonatal nurses and midwives require a high level of skill and education to fulfil their role. It is also an area that sees high staff turnover rates. For this study a descriptive qualitative approach was used to ascertain early career neonatal nurses' and midwives' experiences of further education, their future career plans, and their perceived facilitators and barriers to further education and career progression. After receiving ethical approval, twelve nurses and midwives were recruited across three tertiary level neonatal units in Ireland. Semi structured interviews were carried out and interview transcripts were subsequently analysed using Attride-Stirling's (2001) Thematic Networks to deduce themes from the data. Support and involvement, mentoring, and career progression and retention were the three main themes identified upon analysis of the data. The majority of participants identified definitive career plans but some felt their goals were unachievable in their current workplace. Consequently a large number of participants have plans to leave their employment in neonates and pursue a career in other areas of nursing. Staff appraisals and succession planning programmes may assist early career nurses and midwives in focusing on their individual career goals, leading to a greater uptake of further specialised education and improved retention of neonatal nurses and midwives. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Overcoming nursing barriers to intensive care unit early mobilisation: A quality improvement project.

    PubMed

    Hunter, Oluwatobi O; George, Elisabeth L; Ren, Dianxu; Morgan, Douglas; Rosenzweig, Margaret; Klinefelter Tuite, Patricia

    2017-06-01

    To increase adherence with intensive care unit mobility by developing and implementing a mobility training program that addresses nursing barriers to early mobilisation. An intensive care unit mobility training program was developed, implemented and evaluated with a pre-test, immediate post-test and eight-week post-test. Patient mobility was tracked before and after training. A ten bed cardiac intensive care unit. The training program's efficacy was measured by comparing pre-test, immediate post-test and 8-week post-test scores. Patient mobilisation rates before and after training were compared. Protocol compliance was measured in the post training group. Nursing knowledge increased from pre-test to immediate post-test (p<0.0001) and pre-test to 8-week post-test (p<0.0001). Mean test scores decreased by seven points from immediate post-test (80±12) to 8-week post-test (73±14). Fear significantly decreased from pre-test to immediate post-test (p=0.03), but not from pre-test to 8-week post-test (p=0.06) or immediate post-test to 8-week post-test (p=0.46). Post training patient mobility rates increased although not significantly (p=0.07). Post training protocol compliance was 78%. The project successfully increased adherence with intensive care unit mobility and indicates that a training program could improve adoption of early mobility. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Health care reform: clarifying the concepts.

    PubMed

    Miller, A M

    1993-01-01

    Despite agreement about problems with the health care system, there is disagreement about the remedy. Like most health care reform debates, this article focuses on financing methods rather than service delivery. Reform strategies are intentionally oversimplified into four categories: employer-based or "play or pay"; single-payer and modifications, such as expanding Medicaid or Medicare; market competition; and managed competition, which appears to be favored by the Clinton administration. Cost-control mechanisms and insurance reforms are applicable to all four financing methods. Reform is inevitable. The challenge for nurses is to understand reform issues and then influence policymakers to initiate reforms that make essential medical and preventive services universally available.

  17. Integration of Early Specialist Palliative Care in Cancer Care: Survey of Oncologists, Oncology Nurses, and Patients.

    PubMed

    Salins, Naveen; Patra, Lipika; Usha Rani, M R; Lohitashva, S O; Rao, Raghavendra; Ramanjulu, Raghavendra; Vallath, Nandini

    2016-01-01

    Palliative care is usually delivered late in the course of illness trajectory. This precludes patients on active disease modifying treatment from receiving the benefit of palliative care intervention. A survey was conducted to know the opinion of oncologists, oncology nurses, and patients about the role of early specialist palliative care in cancer. A nonrandomized descriptive cross-sectional study was conducted at a tertiary cancer care center in India. Thirty oncologists, sixty oncology nurses, and sixty patients were surveyed. Improvement in symptom control was appreciated by oncologists, oncology nurses, and patients with respect to pain (Z = -4.10, P = 0.001), (Z = -5.84, P = 0.001), (Z = -6.20, P = 0.001); nausea and vomiting (Z = -3.75, P = 0.001), (Z = -5.3, P = 0.001), (Z = -5.1, P = 0.001); constipation (Z = -3.29, P = 0.001), (Z = -4.96, P = 0.001), (Z = -4.49, P = 0.001); breathlessness (Z = -3.57, P = 0.001), (Z = -5.03, P = 0.001), (Z = -4.99, P = 0.001); and restlessness (Z = -3.68, P = 0.001), (Z = -5.23, P = 0.001), (Z = -3.22, P = 0.001). Improvement in end-of-life care management was appreciated by oncologists and oncology nurses with respect to communication of prognosis (Z = -4.04, P = 0.001), (Z = -5.20, P = 0.001); discussion on limitation of life-sustaining treatment (Z = -3.68, P = 0.001), (Z = -4.53, P = 0.001); end-of-life symptom management (Z = -4.17, P = 0.001), (Z = -4.59, P = 0.001); perimortem care (Z = -3.86, P = 0.001), (Z = -4.80, P = 0.001); and bereavement support (Z = -3-80, P = 0.001), (Z = -4.95, P = 0.001). Improvement in health-related communication was appreciated by oncologists, oncology nurses, and patients with respect to communicating health related information in a sensitive manner (Z = -3.74, P = 0.001), (Z = -5.47, P = 0.001), (Z = -6.12, P = 0.001); conducting family meeting (Z = -3.12, P = 0.002), (Z = -4.60, P = 0.001), (Z = -5.90, P = 0.001); discussing goals of care (Z = -3.43, P = 0.001), (Z = -5.49, P = 0

  18. Big Cities and Welfare Reform: Early Implementation and Ethnographic Findings from the Project on Devolution and Urban Change.

    ERIC Educational Resources Information Center

    Quint, Janet; Edin, Kathryn; Buck, Maria L.; Fink, Barbara; Padilla, Yolanda C.; Simmons-Hewitt, Olis; Valmont, Mary Eustace

    This is the first report on the Project on Devolution and Urban Change, a multidisciplinary 5-year study of welfare reform in 4 large urban counties and their major cities (Cleveland, Los Angeles, Miami, and Philadelphia). It uses data from interviews and focus groups conducted with welfare agency officials and line staff, observations of…

  19. Early Dysphagia Screening by Trained Nurses Reduces Pneumonia Rate in Stroke Patients: A Clinical Intervention Study.

    PubMed

    Palli, Christoph; Fandler, Simon; Doppelhofer, Kathrin; Niederkorn, Kurt; Enzinger, Christian; Vetta, Christian; Trampusch, Esther; Schmidt, Reinhold; Fazekas, Franz; Gattringer, Thomas

    2017-09-01

    Dysphagia is a common stroke symptom and leads to serious complications such as aspiration and pneumonia. Early dysphagia screening can reduce these complications. In many hospitals, dysphagia screening is performed by speech-language therapists who are often not available on weekends/holidays, which results in delayed dysphagia assessment. We trained the nurses of our neurological department to perform formal dysphagia screening in every acute stroke patient by using the Gugging Swallowing Screen. The impact of a 24/7 dysphagia screening (intervention) over swallowing assessment by speech-language therapists during regular working hours only was compared in two 5-month periods with time to dysphagia screening, pneumonia rate, and length of hospitalization as outcome variables. Overall, 384 patients (mean age, 72.3±13.7 years; median National Institutes of Health Stroke Scale score of 3) were included in the study. Both groups (pre-intervention, n=198 versus post-intervention, n=186) were comparable regarding age, sex, and stroke severity. Time to dysphagia screening was significantly reduced in the intervention group (median, 7 hours; range, 1-69 hours) compared with the control group (median, 20 hours; range, 1-183; P =0.001). Patients in the intervention group had a lower rate of pneumonia (3.8% versus 11.6%; P =0.004) and also a reduced length of hospital stay (median, 8 days; range, 2-40 versus median, 9 days; range, 1-61 days; P =0.033). 24/7 dysphagia screening can be effectively performed by nurses and leads to reduced pneumonia rates. Therefore, empowering nurses to do a formal bedside screening for swallowing dysfunction in stroke patients timely after admission is warranted whenever speech-language therapists are not available. © 2017 American Heart Association, Inc.

  20. De-Marginalizing Science in the Early Elementary Classroom: Fostering Reform-Based Teacher Change through Professional Development, Accountability, and Addressing Teachers' Dilemmas

    NASA Astrophysics Data System (ADS)

    Berg, Alissa

    To develop a scientifically literate populace, students must acquire the motivation and foundational skills for success in science beginning at an early age. Unfortunately, science instruction is often marginalized in elementary schools for reasons including teachers' lack of confidence in teaching science and an overemphasis on literacy and mathematics. This study employed a case study design to examine the impact of teachers' dilemmas, career stage, coaching, and other forms of support on elementary teachers' abilities to teach science more often and in more reform-based ways. The conceptual lenses used to guide this dissertation include the theory related to teacher change, dilemmas, reform-oriented science teaching, and the professional learning continuum. Findings suggest that teachers' dilemmas must be addressed in order for them to move toward more reform-based science teaching practices. It was found that how teachers reconcile their dilemmas is due in part to their career stage, level of readiness, and access to a more knowledgeable other who can assist them in learning and enacting reform-based instruction. Moreover, the likelihood and extent of teacher change appears to be related to teachers recognizing a need to change their practice, developing the capacity to change, feeling accountable to change, and possessing the motivation to change. Implications for teacher educators, professional development providers, and curriculum developers are presented. It is argued that teachers require support the length of their career and, to be effective, this support must be personalized to their diverse and changing needs and responsive to the context in which they teach.

  1. The shift to early palliative care: a typology of illness journeys and the role of nursing.

    PubMed

    Wittenberg-Lyles, Elaine; Goldsmith, Joy; Ragan, Sandra

    2011-06-01

    For the current study, clinical observations of communication between patients, families, and clinicians during chronic, serious, or terminal illness in a cancer care trajectory were examined for patterns and trends. Five communication characteristics were concluded, which informed a typology of illness journeys experienced by patients with cancer and their families. The isolated journey characterizes an illness path in which communication about terminal prognosis and end-of-life care options are not present; communication is restricted by a curative-only approach to diagnosis as well as the structure of medical care. The rescued journey signifies a transition between curative care (hospital narrative) to noncurative care (hospice narrative), challenging patients and their families with an awareness of dying. The rescued journey allows communication about prognosis and care options, establishes productive experiences through open awareness, and affords patients and families opportunities to experience end-of-life care preferences. Finally, palliative care prior to hospice provides patients and families with an illness journey more readily characterized by open awareness and community, which facilitates a comforted journey. Nurses play a pivotal role in communicating about disease progression and plans of care. The typology presented can inform a structured communication curriculum for nurses and assist in the implementation of early palliative care.

  2. Evaluation of a peer mentoring program for early career gerontological nursing faculty and its potential for application to other fields in nursing and health sciences.

    PubMed

    Brody, Abraham A; Edelman, Linda; Siegel, Elena O; Foster, Victoria; Bailey, Donald E; Bryant, Ashley Leak; Bond, Stewart M

    2016-01-01

    As the retirement rate of senior nursing faculty increases, the need to implement new models for providing mentorship to early career academics will become key to developing and maintaining an experienced faculty. This evaluation of a peer mentorship program for predoctoral and postdoctoral gerontological nurses examined its efficacy, utility, and potential for improvement. A web-based survey was developed, implemented, and completed by 22 mentees and 17 mentors (71% and 61% response rates, respectively) as part of the evaluation. The peer mentorship program was found to be valuable by both mentors (64.7%) and mentees (72.7%) in helping mentees further develop their careers and networks and providing mentors with supported mentorship experience. The peer mentorship program could serve as a model for other professional organizations, academic institutions, and consortiums to enhance and extend the formal vertical mentorship provided to early academic career individuals. Published by Elsevier Inc.

  3. Evaluation of a peer mentoring program for early career gerontological nursing faculty and its potential for application to other fields in nursing and health sciences

    PubMed Central

    Brody, Abraham A.; Edelman, Linda; Siegel, Elena O.; Foster, Victoria; Bailey, Donald E.; Bryant, Ashley Leak; Bond, Stewart M.

    2018-01-01

    Background As the retirement rate of senior nursing faculty increases, the need to implement new models for providing mentorship to early career academics will become key to developing and maintaining an experienced faculty. Purpose This evaluation of a peer mentorship program for predoctoral and postdoctoral gerontological nurses examined its efficacy, utility, and potential for improvement. Methods A web-based survey was developed, implemented, and completed by 22 mentees and 17 mentors (71% and 61% response rates, respectively) as part of the evaluation. Discussion The peer mentorship program was found to be valuable by both mentors (64.7%) and mentees (72.7%) in helping mentees further develop their careers and networks and providing mentors with supported mentorship experience. Conclusion The peer mentorship program could serve as a model for other professional organizations, academic institutions, and consortiums to enhance and extend the formal vertical mentorship provided to early academic career individuals. PMID:27156778

  4. Nurses' worry or concern and early recognition of deteriorating patients on general wards in acute care hospitals: a systematic review.

    PubMed

    Douw, Gooske; Schoonhoven, Lisette; Holwerda, Tineke; Huisman-de Waal, Getty; van Zanten, Arthur R H; van Achterberg, Theo; van der Hoeven, Johannes G

    2015-05-20

    Nurses often recognize deterioration in patients through intuition rather than through routine measurement of vital signs. Adding the 'worry or concern' sign to the Rapid Response System provides opportunities for nurses to act upon their intuitive feelings. Identifying what triggers nurses to be worried or concerned might help to put intuition into words, and potentially empower nurses to act upon their intuitive feelings and obtain medical assistance in an early stage of deterioration. The aim of this systematic review is to identify the signs and symptoms that trigger nurses' worry or concern about a patient's condition. We searched the databases PubMed, CINAHL, Psychinfo and Cochrane Library (Clinical Trials) using synonyms related to the three concepts: 'nurses', 'worry/concern' and 'deterioration'. We included studies concerning adult patients on general wards in acute care hospitals. The search was performed from the start of the databases until 14 February 2014. The search resulted in 4,006 records, and 18 studies (five quantitative, nine qualitative and four mixed-methods designs) were included in the review. A total of 37 signs and symptoms reflecting the nature of the criterion worry or concern emerged from the data and were summarized in 10 general indicators. The results showed that worry or concern can be present with or without change in vital signs. The signs and symptoms we found in the literature reflect the nature of nurses' worry or concern, and nurses may incorporate these signs in their assessment of the patient and their decision to call for assistance. The fact that it is present before changes in vital signs suggests potential for improving care in an early stage of deterioration.

  5. Nursing strategies to reduce the incidence of early childhood caries in culturally diverse populations.

    PubMed

    Hallas, Donna; Fernandez, Jill; Lim, Lily; Carobene, Macy

    2011-06-01

    In the United States, early childhood caries (ECC) is a major unmet health care need adversely affecting the overall health of young children from diverse ethnic populations. Nurses who work in the newborn nursery, pediatrics, public, and community health centers have a unique opportunity to positively influence a change in this epidemic of ECC. Guided by Leininger's theory of cultural care, these authors describe ways to implement a comprehensive culturally sensitive oral health education program for parents of newborns and infants. Interventions based on the best available evidence for oral health education, a culturally sensitive caries risk assessment, recommendations for fluoride varnish treatments, and ways for parents to establish a dental home for the infant by 12 months old are presented. Copyright © 2011 Elsevier Inc. All rights reserved.

  6. Nursing

    ERIC Educational Resources Information Center

    Arlton, Donna

    1977-01-01

    Persons desiring to prepare themselves as nurses represent a highly varied group. This article discusses the educational routes and employment opportunities available to Hispanic students. The names and addresses of three organizations which are supportive at the national and local level to Hispanic students and short biographies of three notable…

  7. A Systematic Review of Early Warning Systems' Effects on Nurses' Clinical Performance and Adverse Events Among Deteriorating Ward Patients.

    PubMed

    Lee, Ju-Ry; Kim, Eun-Mi; Kim, Sun-Aee; Oh, Eui Geum

    2018-04-25

    Early warning systems (EWSs) are an integral part of processes that aim to improve the early identification and management of deteriorating patients in general wards. However, the widespread implementation of these systems has not generated robust data regarding nurses' clinical performance and patients' adverse events. This review aimed to determine the ability of EWSs to improve nurses' clinical performance and prevent adverse events among deteriorating ward patients. The PubMed, CINAHL, EMBASE, and Cochrane Library databases were searched for relevant publications (January 1, 1997, to April 12, 2017). In addition, a grey literature search evaluated several guideline Web sites. The main outcome measures were nurses' clinical performance (vital sign monitoring and rapid response team notification) and patients' adverse events (in-hospital mortality, cardiac arrest, and unplanned intensive care unit [ICU] admission). The search identified 888 reports, although only five studies fulfilled the inclusion criteria. The findings of these studies revealed that EWSs implementation had a positive effect on nurses' clinical performance, based on their frequency of documenting vital signs that were related to the patient's clinical deterioration. In addition, postimplementation reductions were identified for cardiac arrest, unplanned ICU admission, and unexpected death. It seems that EWSs can improve nurses' clinical performance and prevent adverse events (e.g., in-hospital mortality, unplanned ICU admission, and cardiac arrest) among deteriorating ward patients. However, additional high-quality evidence is needed to more comprehensively evaluate the effects of EWSs on these outcomes.

  8. Emotional learning of undergraduate medical students in an early nursing attachment in a hospital or nursing home.

    PubMed

    Helmich, Esther; Bolhuis, Sanneke; Prins, Judith; Laan, Roland; Koopmans, Raymond

    2011-01-01

    Entering medicine for the first time is highly impressive for students, but we know little about the actual emotional learning processes taking place. We aimed to get more insight into expectations, experiences and emotions of students during their first clinical experiences in a hospital compared to a nursing home. We carried out a qualitative and a quantitative survey by administering questionnaires about expectations, impressive experiences and learning activities within two cohorts of first-year medical students before and after a 4-week nursing attachment. Despite different expectations, students reported similar experiences and learning activities for the nursing home and the hospital. Most impressive events were related to patient care, being a trainee, or professional identities being challenged. Students in nursing homes most often referred to their own relationships with patients. Students expressed different emotions, and frequently experienced positive and negative emotions at the same time. Rewarding experiences (not only difficult or stressful events) do matter for medical professional development. Students need to learn how to deal with and feel strengthened by the emotions evoked during clinical experiences, which should be supported by educators. The nursing home and the hospital seem to be equally suited as learning environments.

  9. A survey of critical care nurses' practices and perceptions surrounding early intravenous antibiotic initiation during septic shock.

    PubMed

    Roberts, Russel J; Alhammad, Abdullah M; Crossley, Lindsay; Anketell, Eric; Wood, LeeAnn; Schumaker, Greg; Garpestad, Erik; Devlin, John W

    2017-08-01

    Delays in antibiotic administration after severe sepsis recognition increases mortality. While physician and pharmacy-related barriers to early antibiotic initiation have been well evaluated, those factors that affect the speed by which critical care nurses working in either the emergency department or the intensive care unit setting initiate antibiotic therapy remains poorly characterized. To evaluate the knowledge, practices and perceptions of critical care nurses regarding antibiotic initiation in patients with newly recognised septic shock. A validated survey was distributed to 122 critical care nurses at one 320-bed academic institution with a sepsis protocol advocating intravenous(IV) antibiotic initiation within 1hour of shock recognition. Among 100 (82%) critical care nurses responding, nearly all (98%) knew of the existence of the sepsis protocol. However, many critical care nurses stated they would optimise blood pressure [with either fluid (38%) or both fluid and a vasopressor (23%)] before antibiotic initiation. Communicated barriers to rapid antibiotic initiation included: excessive patient workload (74%), lack of awareness IV antibiotic(s) ordered (57%) or delivered (69%), need for administration of multiple non-antibiotic IV medications (54%) and no IV access (51%). Multiple nurse-related factors influence IV antibiotic(s) initiation speed and should be incorporated into sepsis quality improvement efforts. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. The effect of adult Early Warning Systems education on nurses' knowledge, confidence and clinical performance: A systematic review.

    PubMed

    Saab, Mohamad M; McCarthy, Bridie; Andrews, Tom; Savage, Eileen; Drummond, Frances J; Walshe, Nuala; Forde, Mary; Breen, Dorothy; Henn, Patrick; Drennan, Jonathan; Hegarty, Josephine

    2017-11-01

    This review aims to determine the effect of adult Early Warning Systems education on nurses' knowledge, confidence and clinical performance. Early Warning Systems support timely identification of clinical deterioration and prevention of avoidable deaths. Several educational programmes have been designed to help nurses recognize and manage deteriorating patients. Little is known as to the effectiveness of these programmes. Systematic review. Academic Search Complete, CINAHL, MEDLINE, PsycINFO, PsycARTICLES, Psychology and Behavioral Science Collection, SocINDEX and the UK & Ireland Reference Centre, EMBASE, the Turning Research Into Practice database, the Cochrane Central Register of Controlled Trials (CENTRAL) and Grey Literature sources were searched between October and November 2015. This is a quantitative systematic review using Cochrane methods. Studies published between January 2011 - November 2015 in English were sought. The risk of bias, level of evidence and the quality of evidence per outcome were assessed. Eleven articles with 10 studies were included. Nine studies addressed clinical performance, four addressed knowledge and two addressed confidence. Knowledge, vital signs recording and Early Warning Score calculation were improved in the short term. Two interventions had no effect on nurses' response to clinical deterioration and use of communication tools. This review highlights the importance of measuring outcomes using standardized tools and valid and reliable instruments. Using longitudinal designs, researchers are encouraged to investigate the effect of Early Warning Systems educational programmes. These can include interactive e-learning, on-site interdisciplinary Early Warning Scoring systems training sessions and simulated scenarios. © 2017 John Wiley & Sons Ltd.

  11. Most Likely to Achieve: Predicting Early Success of the Practical Nurse Student

    ERIC Educational Resources Information Center

    Cline, April P.

    2013-01-01

    It is important that practical nurse (PN) educators be able to identify which students are likely to be successful in their programs. However, the majority of literature related to predicting success of nursing students has been done on baccalaureate nursing students in the university setting. This study sought to determine whether the same…

  12. Influence of primary care professionals on early detection of breast cancer: different perception between family physicians and nursing professionals.

    PubMed

    Esteban-Vasallo, María D; Aerny-Perreten, Nicole; García-Riolobos, Carmen; López Rubio, Aranzazu; Domínguez-Berjón, Felicitas

    2017-01-01

    The aim of this study was to assess the level of self-perceived influence on early detection of breast cancer among nurses and family physicians (FP) working in primary care and to identify the factors associated with a lower perception in each group. In the Autonomous Community of Madrid, an online questionnaire on cancer prevention was sent to a random sample of primary care professionals (3586 FP and nurses). The data included sex, age, profession, years in primary care, specific postgraduate training, and opinions and attitudes toward cancer prevention. A descriptive analysis was carried out. Factors associated with a low/null self-perceived influence on early detection of breast cancer were analyzed separately for FP and nurses with multivariate logistic regression models. In all, 76.4% of the participants considered that their influence on the early detection of breast cancer was enough/high. FP attributed to themselves a higher influence than nurses (enough/high: 86.0 vs. 64.6%, P<0.01), and a lower perception was associated with a low/null perceived utility of their individual intervention [odds ratio (OR): 6.42, 95% confidence interval (CI) 2.77-14.85]. Among nurses, also associated with this low/null perceived utility [adjusted odds ratio (aOR): 2.81, 95% CI 1.37-5.77] were the absence of postgraduate training in the matter (aOR: 2.56, 95% CI 1.05-6.25), and a low/null perception of feasibility of prevention programs in their centers (aOR: 1.93, 95% CI 1.25-2.98). Primary care professionals perceive their activity in the early detection of breast cancer as relevant, especially FP. To increase knowledge of the utility of individual interventions, specific training and improvement of the feasibility of these programs could enhance this perception.

  13. Early and late signs that precede dying among older persons in nursing homes: the multidisciplinary team's perspective.

    PubMed

    Åvik Persson, Helene; Sandgren, Anna; Fürst, Carl-Johan; Ahlström, Gerd; Behm, Lina

    2018-06-04

    Nursing home residents in Sweden are old, frail and usually have multiple morbidities which often make dying a prolonged suffering. It has been found that older persons at nursing homes receive far less palliative care than younger persons, partly because it is difficult to identify when the final stage of life begins. The identification may help the staff to enable the older person and their families to participate in planning the care in accordance with their own preferences and values. With this in mind the aim was to explore the experiences of early and late signs preceding dying in older persons in nursing homes from the multidisciplinary team's perspective. The focus group method was used to interview 20 health-care professionals on the basis of semi-structured questions. Four focus groups were conducted at four nursing homes in two counties in southern Sweden. The groups included different professionals such as assistant nurses, registered nurses, occupational therapists, physiotherapists, social workers and unit managers. The analysis was conducted according to the focus group method developed by Kruger and Casey. The analysis revealed one major theme, from unawareness to obviousness, which illustrates that the participants experienced dying as a happening, not a process, and found it difficult to identify early signs. Even though it was a new way of thinking, several suggestions of early signs were presented. The main category "Going into a bubble" illustrates early signs, which meant that the older person showed signs of wanting to withdraw from the outside world. The main category "The body begins to shut down" illustrates late signs, which meant that the older person showed signs that indicate that the body starts to prepare for death. This study conveys new knowledge concerning the multidisciplinary team's collective experience of early and late signs that precede dying. This knowledge can increase the understanding of when a palliative care approach

  14. School Reform: Past and Present.

    ERIC Educational Resources Information Center

    Parker, Franklin

    United States educational history is full of uncertain reform attempts beginning with colonial New England's school reform goal of salvation in this world as a preparation for eternal life in the next. A more practical type of education characterized the Early National Period. Monitorial schools and communal schools, as in New Harmony, Indiana,…

  15. Integration of Early Specialist Palliative Care in Cancer Care: Survey of Oncologists, Oncology Nurses, and Patients

    PubMed Central

    Salins, Naveen; Patra, Lipika; Usha Rani, MR; Lohitashva, SO; Rao, Raghavendra; Ramanjulu, Raghavendra; Vallath, Nandini

    2016-01-01

    Introduction: Palliative care is usually delivered late in the course of illness trajectory. This precludes patients on active disease modifying treatment from receiving the benefit of palliative care intervention. A survey was conducted to know the opinion of oncologists, oncology nurses, and patients about the role of early specialist palliative care in cancer. Methods: A nonrandomized descriptive cross-sectional study was conducted at a tertiary cancer care center in India. Thirty oncologists, sixty oncology nurses, and sixty patients were surveyed. Results: Improvement in symptom control was appreciated by oncologists, oncology nurses, and patients with respect to pain (Z = −4.10, P = 0.001), (Z = −5.84, P = 0.001), (Z = −6.20, P = 0.001); nausea and vomiting (Z = −3.75, P = 0.001), (Z = −5.3, P = 0.001), (Z = −5.1, P = 0.001); constipation (Z = −3.29, P = 0.001), (Z = −4.96, P = 0.001), (Z = −4.49, P = 0.001); breathlessness (Z = −3.57, P = 0.001), (Z = −5.03, P = 0.001), (Z = −4.99, P = 0.001); and restlessness (Z = −3.68, P = 0.001), (Z = −5.23, P = 0.001), (Z = −3.22, P = 0.001). Improvement in end-of-life care management was appreciated by oncologists and oncology nurses with respect to communication of prognosis (Z = −4.04, P = 0.001), (Z = −5.20, P = 0.001); discussion on limitation of life-sustaining treatment (Z = −3.68, P = 0.001), (Z = −4.53, P = 0.001); end-of-life symptom management (Z = −4.17, P = 0.001), (Z = −4.59, P = 0.001); perimortem care (Z = −3.86, P = 0.001), (Z = −4.80, P = 0.001); and bereavement support (Z = −3-80, P = 0.001), (Z = −4.95, P = 0.001). Improvement in health-related communication was appreciated by oncologists, oncology nurses, and patients with respect to communicating health related information in a sensitive manner (Z = −3.74, P = 0.001), (Z = −5.47, P = 0.001), (Z = −6.12, P = 0.001); conducting family meeting (Z = −3.12, P = 0.002), (Z = −4.60, P = 0

  16. [Health reform in the USA].

    PubMed

    Ganduglia, Cecilia

    2010-01-01

    The United States of America passed early this year the bill enforcing their health reform. this reform aims at achieving universal insurance, cost containment and improving quality of care. The debate around this reform has been long and unable to arrive to an agreement between the parts. Even if the expansion in the medical coverage system does not reduce to zero the current degree of inaccessibility to the health system, these achievements could be considered a very important first step. Nonetheless, chances are that this reform will continue being as polemic as the negotiations previous to its conception.

  17. Health reform: a bipartisan view.

    PubMed

    Cooper, Jim; Castle, Michael

    2009-01-01

    This optimistic assessment of the prospects for health reform from senior Democratic and Republican congressmen spells out several reasons why reform can be achieved early in the first year of the Obama administration. Political and policy factors suggest that President-elect Barack Obama is in a much better position than his predecessors to achieve comprehensive health reform, including universal coverage. The Obama administration will have to overcome numerous obstacles and resistance to enact reform. Still, after decades of frustration and disappointment, policymakers should set aside their differences and enable the United States to join the ranks of developed nations by making sure every American has health insurance.

  18. Clinical guideline for nurse-led early extubation after coronary artery bypass: an evaluation.

    PubMed

    Hawkes, Claire; Foxcroft, David R; Yerrell, Paul

    2010-09-01

    This paper is a report of an investigation of the development, implementation and outcomes of a clinical guideline for nurse-led early extubation of adult coronary artery bypass graft patients. Healthcare knowledge translation and utilization is an emerging but under-developed research area. The complex context for guideline development and use is methodologically challenging for robust and rigorous evaluation. This study contributes one such evaluation. This was a mixed methods evaluation, with a dominant quantitative study with a secondary qualitative study in a single UK cardiac surgery centre. An interrupted time series study (N = 567 elective coronary artery bypass graft patients) with concurrent within person controls was used to measure the impact of the guideline on the primary outcome: time to extubation. Semi-structured interviews with 11 clinical staff, informed by applied practitioner ethnography, explored the process of guideline development and implementation. The data were collected between January 2001 and January 2003. There was no change in the interrupted time series study primary outcome as a consequence of the guideline implementation. The qualitative study identified three themes: context, process and tensions highlighting that the guideline did not require clinicians to change their practice, although it may have helped maintain practice through its educative role. Further investigation and development of appropriate methods to capture the dynamism in healthcare contexts and its impact on guideline implementation seems warranted. Multi-site mixed methods investigations and programmes of research exploring knowledge translation and utilization initiatives, such as guideline implementation, are needed.

  19. The Influence of Nursing Faculty Workloads on Faculty Retention: A Case Study

    ERIC Educational Resources Information Center

    Wood, Jennifer J.

    2013-01-01

    Nursing faculty workloads have come to the forefront of discussion in nursing education. The National League of Nursing (NLN) has made nursing faculty workloads a high priority in nursing education. Included in the priorities are areas of creating reform through innovations in nursing education, evaluating reform through evaluation research, and…

  20. Socialising Nurse Probationers in the Late 19th and Early 20th Centuries--Relevance of Historical Reflection for Modern Policy Makers.

    ERIC Educational Resources Information Center

    Lorentzon, Maria

    2003-01-01

    Historical records from London hospitals in the late 19th-early 20th centuries were analyzed for their depiction of nursing trainees. Analysis reveals a strong emphasis on character traits rather than intellectual ability. In contrast, the literature of the last 3 decades shows a contemporary concern for nurses as knowledgeable doers. (Contains 31…

  1. Early Identification of Transformation in the Proficiency Level of Critical Thinking Skills (CTS) for the First Semester Associate Degree Nursing (ADN) Student

    ERIC Educational Resources Information Center

    Swing, Velmarie K.

    2014-01-01

    Critical thinking (CT) in the new nursing graduate continues to be a topic of concern in the academic and acute care settings. While research studies have analyzed critical thinking skills (CTS) at the beginning and end of nursing programs, few have focused on early program evaluation of CT. In this non-experimental, explanatory, quantitative…

  2. [The alteration of Japanese anatomical terminology in the early Showa period and the Japanese language reform campaign].

    PubMed

    Sawai, Tadashi; Sakai, Tatsuo

    2010-03-01

    In the second decade of the Showa period, great changes were made in the Japanese anatomical terms. It has been proposed that the presentation of JNA (Jenaer nomina anatomica) was one of the factors leading to the change. The Japanese language reform campaign, however, played an important role. The party kokugoaigo doumei and its successor kokugo kyokai required concise and unified technical terms. The anatomical nomenclature committee of the Japanese Association of Anatomists worked to satisfy this requirement. The committee consulted with nomenclature committees of other medical associations and took account of their opinions. The anatomical nomenclature committee abandoned the literal translation from Latin to Japanese and shaped a succinct Japanese terminology. Modern Japanese anatomical terms are based on this terminology.

  3. From Universalism to Selectivity? The Background, Discourses and Ideas of Recent Early Childhood Education and Care Reforms in Finland

    ERIC Educational Resources Information Center

    Lundkvist, Marina; Nyby, Josefine; Autto, Janne; Nygård, Mikael

    2017-01-01

    Universal public childcare for children under seven has been central in Finland since the mid-1990s, capacitating both gender equality and children's human capital and wellbeing. In 2015, as a further step in the development of this system, early learning and childhood pedagogy was strengthened through the early childhood education and care (ECEC)…

  4. Obesity prevention in early life: an opportunity to better support the role of Maternal and Child Health Nurses in Australia.

    PubMed

    Laws, R; Campbell, K J; van der Pligt, P; Ball, K; Lynch, J; Russell, G; Taylor, R; Denney-Wilson, E

    2015-01-01

    Because parents with young children access primary health care services frequently, a key opportunity arises for Maternal and Child Health (MCH) nurses to actively work with families to support healthy infant feeding practices and lifestyle behaviours. However, little is known regarding the extent to which MCH nurses promote obesity prevention practices and how such practices could be better supported. This mixed methods study involved a survey of 56 MCH nurses (response rate 84.8 %), 16 of whom participated in semi-structured qualitative interviews. Both components aimed to examine the extent to which nurses addressed healthy infant feeding practices, healthy eating, active play and limiting sedentary behavior during routine consultations with young children 0-5 years. Key factors influencing such practices and how they could be best supported were also investigated. All data were collected from September to December 2013. Survey data were analysed descriptively and triangulated with qualitative interview findings, the analysis of which was guided by grounded theory principles. Although nurses reported measuring height/length and weight in most consultations, almost one quarter (22.2 %) reported never/rarely using growth charts to identify infants or children at risk of overweight or obesity. This reflected a reluctance to raise the issue of weight with parents and a lack of confidence in how to address it. The majority of nurses reported providing advice on aspects of infant feeding relevant to obesity prevention at most consultations, with around a third (37 %) routinely provided advice on formula preparation. Less than half of nurses routinely promoted active play and only 30 % discussed limiting sedentary behaviour such as TV viewing. Concerns about parental receptiveness and maintaining rapport were key barriers to more effective implementation. While MCH nurses are well placed to address obesity prevention in early life, there is currently a missed

  5. What Prevents Nurses from Entering Faculty Positions Early in Their Professional Career: A Qualitative Study

    ERIC Educational Resources Information Center

    Moreland, Jack E.

    2011-01-01

    There is a nursing faculty shortage in the United States today and projections are that over the next decade nurses will retire at a rate faster than they are being replaced. The projected shortage at a time when the largest part of the population will begin to retire and enter the ranks of the elderly could potentially cause serious problems…

  6. Early nursing career experience for 1994-2000 graduates from the University of Nottingham.

    PubMed

    Park, Jennifer R; Chapple, Mary; Wharrad, Heather; Bradley, Sue

    2007-05-01

    This paper reports the views of nurses graduating from the University of Nottingham School of Nursing, UK, 1994-2000, Bachelor of Nursing (Hons) course, concerning career aspirations, progress and reflections on their qualification. Alongside academic knowledge and practical skills, this four-year Bachelor of Nursing course aimed to develop students' critical thinking and research skills. The degree's effect on nurses' career trajectories is unknown. Self-completion questionnaires employing open and closed questions were sent to graduates 9 months after graduation and at intervals over the next 6 years. Most respondents were confident and motivated in their nursing careers. Promotion, increased responsibility, further study, specialization and qualifications were career priorities. Recent qualifiers also focused on changing jobs, travel and working overseas. The graduates' experience has salience for nurse managers, especially when matching graduates against post outlines within the knowledge and skills framework, considering staff skill mix, and advising graduates about their development and assisting them to find satisfaction in their nursing careers.

  7. Reductions in Sepsis Mortality and Costs After Design and Implementation of a Nurse-Based Early Recognition and Response Program

    PubMed Central

    Jones, Stephen L.; Ashton, Carol M.; Kiehne, Lisa; Gigliotti, Elizabeth; Bell-Gordon, Charyl; Disbot, Maureen; Masud, Faisal; Shirkey, Beverly A.; Wray, Nelda P.

    2016-01-01

    Background Sepsis is a leading cause of death, but evidence suggests that early recognition and prompt intervention can save lives. In 2005 Houston Methodist Hospital prioritized sepsis detection and management in its ICU. In late 2007, because of marginal effects on sepsis death rates, the focus shifted to designing a program that would be readily used by nurses and ensure early recognition of patients showing signs suspicious for sepsis, as well as the institution of prompt, evidence-based interventions to diagnose and treat it. Methods The intervention had four components: organizational commitment and data-based leadership; development and integration of an early sepsis screening tool into the electronic health record; creation of screening and response protocols; and education and training of nurses. Twice-daily screening of patients on targeted units was conducted by bedside nurses; nurse practitioners initiated definitive treatment as indicated. Evaluation focused on extent of implementation, trends in inpatient mortality, and, for Medicare beneficiaries, a before-after (2008–2011) comparison of outcomes and costs. A federal grant in 2012 enabled expansion of the program. Results By year 3 (2011) 33% of inpatients were screened (56,190 screens in 9,718 unique patients), up from 10% in year 1 (2009). Inpatient sepsis-associated death rates decreased from 29.7% in the preimplementation period (2006–2008) to 21.1% after implementation (2009–2014). Death rates and hospital costs for Medicare beneficiaries decreased from preimplementation levels without a compensatory increase in discharges to postacute care. Conclusion This program has been associated with lower inpatient death rates and costs. Further testing of the robustness and exportability of the program is under way. PMID:26484679

  8. Detached concern of forensic mental health nurses in therapeutic relationships with patients the application of the early recognition method related to detached concern.

    PubMed

    Fluttert, Frans; van Meijel, Berno; Nijman, Henk; Bjørkly, Stål; Grypdonck, Mieke

    2010-08-01

    Improvement of the interaction between forensic mental health nurses and patients may lead to a reduction of inpatient violence. The concept under study is detached concern, which refers to nurses' skills to neutralize the emotional appeal of patients by a balanced attitude between objectivity and emotional involvement. The Patient Contact Questionnaire (PCQ) aims at measuring the degree of concern of nurses for their patients. The PCQ was applied in a pretest-posttest design, evaluating the effects of the Early Recognition Method (ERM). This method aims at the prevention of inpatient violence in forensic psychiatry. Subjects were 116 forensic mental heath nurses working on 16 wards of a large Dutch forensic hospital. First, the baseline scores were compared to scores reported in an earlier study conducted in general psychiatry. Second, pretest-posttest comparisons were carried out for all nurses, and for subgroups of nurses with regard to gender, educational level, years of working experience, and patient population. Third, pretest-posttest comparisons were made on the PCQ item level. The baseline scores of male nurses indicated significantly higher levels of concern than those of female nurses. In addition, more experienced nurses scored significantly higher with regard to concern than less experienced nurses. When comparing the scores before and after applying ERM, no significant differences were found. However, the sores of female nurses showed a tendency toward more concern after implementation of ERM. Detached concern may be a meaningful concept in forensic mental health nursing in measuring nurses' concern for their patients. Levels of detached concern did not change significantly after application of ERM. However, the application of the PCQ could contribute to a better understanding of the interaction between nurses and their patients. 2010 Elsevier Inc. All rights reserved.

  9. Technology Readiness of Early Career Nurse Trainees: Utilization of the Technology Readiness Index (TRI).

    PubMed

    Odlum, Michelle

    2016-01-01

    Health Information Technology (HIT) adoption by clinicians, including nurses, will lead to reduction in healthcare costs and clinical errors and improve health outcomes. Understanding the importance of technology adoption, the current study utilized the Technology Readiness Index to explore technology perceptions of nursing students. Our analysis identifies factors that may influence perceptions of technology, including decreased optimism for students with clinical experience and increased discomfort of US born students. Our study provides insight to inform training programs to further meet the increasing demands of skilled nursing staff.

  10. The Democratic School and the Pedagogy of Janusz Korczak: A Model of Early Twentieth Century Reform in Modern Israel

    ERIC Educational Resources Information Center

    Engel, Liba H.

    2013-01-01

    This article explores the history and pedagogy of Janusz Korczak within the context of his contemporary early Twentieth-Century European Innovative Educators which include Maria Montessori, Homer Lane, A.S. Neill, and Anton Semyonovitch Makarenko. The pedagogies of the aforementioned are compared and contrasted within the literature.

  11. Early malnutrition screening and low cost protein supplementation in elderly patients admitted to a skilled nursing facility.

    PubMed

    Harding, Krystal M; Dyo, Melissa; Goebel, Joy R; Gorman, Nik; Levine, Julia

    2016-08-01

    Malnutrition among skilled nursing facility (SNF) patients can lead to hospital readmissions and multiple complications. To evaluate the effect of an existing malnutrition screening and management program on prealbumin levels of patients in skilled nursing facilities. A retrospective design was used to evaluate baseline admission data including a prealbumin level. Patients with malnutrition received an oral protein supplement according to protocol. A comparison prealbumin level was obtained at 30days. Nearly half of the patients were severely malnourished on admission. Patients receiving the prescribed protocol had significantly increased prealbumin levels at 30days than those patients that did not receive the protocol as prescribed. A prealbumin level upon admission at a SNF could represent a reliable tool to evaluate malnutrition. Initiation of an early malnutrition screening and protein supplement program in this setting is essential to identifying and treating at-risk patients before complications occur. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Preparing the nursing workforce of the future.

    PubMed

    Ellenbecker, Carol H

    2010-05-01

    Nurse shortages coupled with the need for national healthcare reform present a challenge. We are not preparing enough nurses nor are we preparing nurses with the right skills to fully participate in a reformed healthcare system. Historical forces in nursing education have resulted in multiple levels of entry into nursing practice and an inadequate nursing workforce. Today's environment of expanding knowledge, the call for interdisciplinary healthcare delivery teams, and evidence of the relationship between nurse education and improved patient outcomes strongly indicate the need for nurses prepared at the baccalaureate level. Requiring a baccalaureate degree for entry into nursing practice, and as the initial degree of nursing education would prepare nurses earlier for graduate education and the much needed roles of educator, researcher and advanced practice nurse. The nursing profession should take the lead in advocating for educational policies that would adequately prepare the nurse workforce of the future.

  13. Student Success Survey: Supporting Academic Success for At-Risk Nursing Students Through Early Intervention.

    PubMed

    McLain, Rhonda M; Fifolt, Matthew; Dawson, Martha A; Su, Wei; Milligan, Gary; Davis, Sandra; Hites, Lisle

    Diversity in the nursing workforce has a positive impact on the quality of care provided to minority patients. Although the number of students from diverse backgrounds entering nursing programs has increased, the attrition rate of these students remains high. This study assessed the construct validity of a self-assessment tool that can be used by faculty advisors to determine individual academic needs of students.

  14. Early predictors of study success in a Dutch advanced nurse practitioner education program: A retrospective cohort study.

    PubMed

    Bossema, Ercolie R; Meijs, Tineke H J M; Peters, Jeroen W B

    2017-10-01

    Study delay and attrition are major concerns in higher education. They cost time and effort, and threaten the availability of higher qualified professionals. Knowing early what factors contribute to delay and attrition may help prevent this. The aim of this study was to examine whether student characteristics, including a literature study report grade as a proxy of cognitive abilities, predicted study success in a dual advanced nurse practitioner education program. Retrospective cohort study, including all 214 students who between September 2009 and September 2015 started the two-year program at the HAN University of Applied Sciences in Nijmegen, the Netherlands. Study success was defined as having completed the program within the envisaged period. Variables examined included: age, gender, previous education (bachelor's degree or in-service training in nursing), work setting (general health, mental health, public health, or nursing home care), and literature study report grade (from 1 to 10). A hierarchical logistic regression analysis was performed. Most students were female (80%), had a bachelor's degree in nursing (67%), and were employed in a general healthcare setting (58%). Mean age was 40.5years (SD 9.4). One hundred thirty-seven students (64%) had study success. Being employed in a general healthcare setting (p≤0.004) and a higher literature study report grade (p=0.001) were associated with a higher study success rate. In advanced nurse practitioner education, study success rate seems associated with the student's cognitive abilities and work field. It might be worthwhile to identify students 'at risk of failure' before the start of the program and offer them extra support. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. The cost effectiveness of an early transition from hospital to nursing home for stroke patients: design of a comparative study

    PubMed Central

    2010-01-01

    Background As the incidence of stroke has increased, its impact on society has increased accordingly, while it continues to have a major impact on the individual. New strategies to further improve the quality, efficiency and logistics of stroke services are necessary. Early discharge from hospital to a nursing home with an adequate rehabilitation programme could help to optimise integrated care for stroke patients. The objective is to describe the design of a non-randomised comparative study evaluating early admission to a nursing home, with multidisciplinary assessment, for stroke patients. The study is comprised of an effect evaluation, an economic evaluation and a process evaluation. Methods/design The design involves a non-randomised comparative trial for two groups. Participants are followed for 6 months from the time of stroke. The intervention consists of a redesigned care pathway for stroke patients. In this care pathway, patients are discharged from hospital to a nursing home within 5 days, in comparison with 12 days in the usual situation. In the nursing home a structured assessment takes place, aimed at planning adequate rehabilitation. People in the control group receive the usual care. The main outcome measures of the effect evaluation are quality of life and daily functioning. In addition, an economic evaluation will be performed from a societal perspective. A process evaluation will be carried out to evaluate the feasibility of the intervention as well as the experiences and opinions of patients and professionals. Discussion The results of this study will provide information about the cost effectiveness of the intervention and its effects on clinical outcomes and quality of life. Relevant strengths and weaknesses of the study are addressed in this article. Trial registration Current Controlled Trails ISRCTN58135104 PMID:20504313

  16. The cost effectiveness of an early transition from hospital to nursing home for stroke patients: design of a comparative study.

    PubMed

    Heijnen, Ron W H; Evers, Silvia M A A; van der Weijden, Trudy D E M; Limburg, Martien; Schols, Jos M G A

    2010-05-26

    As the incidence of stroke has increased, its impact on society has increased accordingly, while it continues to have a major impact on the individual. New strategies to further improve the quality, efficiency and logistics of stroke services are necessary. Early discharge from hospital to a nursing home with an adequate rehabilitation programme could help to optimise integrated care for stroke patients.The objective is to describe the design of a non-randomised comparative study evaluating early admission to a nursing home, with multidisciplinary assessment, for stroke patients. The study is comprised of an effect evaluation, an economic evaluation and a process evaluation. The design involves a non-randomised comparative trial for two groups. Participants are followed for 6 months from the time of stroke. The intervention consists of a redesigned care pathway for stroke patients. In this care pathway, patients are discharged from hospital to a nursing home within 5 days, in comparison with 12 days in the usual situation. In the nursing home a structured assessment takes place, aimed at planning adequate rehabilitation. People in the control group receive the usual care. The main outcome measures of the effect evaluation are quality of life and daily functioning. In addition, an economic evaluation will be performed from a societal perspective. A process evaluation will be carried out to evaluate the feasibility of the intervention as well as the experiences and opinions of patients and professionals. The results of this study will provide information about the cost effectiveness of the intervention and its effects on clinical outcomes and quality of life. Relevant strengths and weaknesses of the study are addressed in this article. Current Controlled Trails ISRCTN58135104.

  17. Early Discharge and Home Care After Unplanned Cesarean Birth: Nursing Care Time

    PubMed Central

    Brooten, Dorothy; Knapp, Helen; Borucki, Lynne; Jacobsen, Barbara; Finkler, Steven; Arnold, Lauren; Mennuti, Michael

    2013-01-01

    Objective This study examined the mean nursing time spent providing discharge planning and home care to women who delivered by unplanned cesarean birth and examined differences in nursing time required by women with and without morbidity. Design A secondary analysis of nursing time from a randomized trial of transitional care (discharge planning and home follow-up) provided to women after cesarean delivery. Setting An urban tertiary-care hospital. Patients The sample (N = 61) of black and white women who had unplanned cesarean births and their full-term newborns was selected randomly. Forty-four percent of the women had experienced pregnancy complications. Interventions Advanced practice nurses provided discharge planning and 8-week home follow-up consisting of home visits, telephone outreach, and daily telephone availability. Outcome Measure Nursing time required was dictated by patient need and provider judgment rather than by reimbursement plan. Results More than half of the women required more than two home visits; mean home visit time was 1 hour. For women who experienced morbidity mean discharge planning time was 20 minutes more and mean home visit time 40 minutes more. Conclusions Current health care services that provide one or two 1-hour home visits to childbearing women at high risk may not be meeting the education and resource needs of this group. PMID:8892128

  18. Florence Nightingale and healthcare reform.

    PubMed

    Kudzma, Elizabeth Connelly

    2006-01-01

    The purpose of this article was to examine the work of Florence Nightingale in light of her collaboration with William Farr, the eminent medical statistician. Nightingale's epidemiological investigations supported by Farr illustrated that attention to environmental cleanliness was an important factor in preventing spread of disease. Nightingale channeled her investigations to support hospital reforms and the need for an educated nurse who could provide better management of the hospital environment. Statistical support and solicited criticism allowed Nightingale to argue more forcefully for her reforms.

  19. Evaluation of a possible predictor for Federal Joint Committee decisions on early benefit assessments according to the German act on the reform of the market for medicinal products.

    PubMed

    Schwander, Björn; Banz, Kurt; Kaier, Klaus; Walzer, Stefan

    2014-09-01

    As of 1st January 2011 the German drug market is regulated by the act on the reform of the market for medicinal products (AMNOG). Since then the normal procedure for reimbursement of a new pharmaceutical is a benefit assessment by the joint federal committee (G-BA) which determines one of six additional benefit levels. In order to evaluate a possible predictor of G-BA decisions, the 'evaluation of pharmaceutical innovations (EVITA)' score was calculated for 40 out of 63 dossiers and compared with published G-BA appraisals. Univariate ordinary least squares (p<0.001) and ordered logit regression (p=0.008) analyses show statistically significant correlations between EVITA scores and the G-BA additional benefit levels. Moreover, for the prediction of an additional benefit level of at least 'minor', an EVITA score cutpoint of ≥3 is associated with a sensitivity of 100% and a specificity of 80%. For the prediction of an additional benefit level of at least 'considerable', an EVITA score cutpoint of ≥7.5 is associated with a sensitivity of 100% and a specificity of 93.1%. The present investigation indicates that the EVITA score may have some potential to act as a possible predictor of G-BA decisions related to AMNOG early benefit assessments. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  20. Payment Reform

    PubMed Central

    Schneider, Eric C.; Hussey, Peter S.; Schnyer, Christopher

    2011-01-01

    Abstract Insurers and purchasers of health care in the United States are on the verge of potentially revolutionary changes in the approaches they use to pay for health care. Recently, purchasers and insurers have been experimenting with payment approaches that include incentives to improve quality and reduce the use of unnecessary and costly services. The Patient Protection and Affordable Care Act of 2010 is likely to accelerate payment reform based on performance measurement. This article provides details of the results of a technical report that catalogues nearly 100 implemented and proposed payment reform programs, classifies each of these programs into one of 11 payment reform models, and identifies the performance measurement needs associated with each model. A synthesis of the results suggests near-term priorities for performance measure development and identifies pertinent challenges related to the use of performance measures as a basis for payment reform. The report is also intended to create a shared framework for analysis of future performance measurement opportunities. This report is intended for the many stakeholders tasked with outlining a national quality strategy in the wake of health care reform legislation. PMID:28083159

  1. The historical social positioning of nursing and medicine: implications for career choice, early socialization and interprofessional collaboration.

    PubMed

    Price, Sheri; Doucet, Shelley; Hall, Linda McGillis

    2014-03-01

    For almost half a century, research has identified that effective teamwork is essential in order to enhance care provision and health outcomes for patients. Although the value of teamwork is well-recognized in healthcare, the historically rooted dynamics of workplace relationships create a myriad of challenges to creating collaborative teams. Understanding the history of interpersonal dynamics between health professionals can provide direction for future interprofessional education and collaboration strategies. The aim of this paper is to provide a historical overview of the social positioning of nursing and medicine in the context of interprofessional collaboration. Few professions work as closely as nursing and medicine. Despite the well-recognized benefits of interprofessional collaboration, these two professions are often socially positioned in opposition to one another and depicted as adversarial. This analysis will seek to advance our understanding of the historical roots between these two professions and their relationships with and among each other in relation to career choice, early socialization and patient care delivery. An exploration of the historical social positioning of nursing and medicine can provide an enhanced understanding of the barriers to interprofessional collaboration and inform future successes in interprofessional education and practice among all health and social care professions.

  2. [Influence of in-home nursing care on the weight of the early discharged preterm newborn].

    PubMed

    Alvarez Miró, R; Lluch Canut, M T; Figueras Aloy, J; Esqué Ruiz, M T; Arroyo Gili, L; Bella Rodríguez, J; Carbonell Estrany, X

    2014-12-01

    In-Home nursing care of the preterm newborn helps to bring the family situation to normal, promotes breastfeeding and development of the newborn, and enables the reorganization of health care resources. The purpose of this paper is to demonstrate that in-home nursing care of the preterm newborn leads to an increase in weight and a similar morbidity. A total of 65 cases and 65 controls (matched by weight, age and sex) were studied, all of them preterm newborns born in hospital and weighing less than 2100 g at discharge. In-home nursing care was carried out by a pediatrician neonatologist, as well as two nurses specialized in neonatology who made several visits to the home. Weight gain was calculated as g/day and g/Kg/day, comparing the first week of the study with the week prior to the beginning of the study. The groups were comparable. Weight gain in the group with home nursing care was 38 g per day, significantly higher than the weight gain in the control group (31 g/day). The independent predictive variables of the increase in g/Kg/day during the study were in-home nursing care, male gender, breastfeeding less, and not having suffered from a peri-intraventricular hemorrhage. Neonatal morbidity was similar in both groups. In-home care was associated with a greater weight gain of the newborn at home than during their stay in the hospital, and can be considered safe because neonatal morbidity was not increased. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  3. Emotional intelligence levels in baccalaureate-prepared early career registered nurses.

    PubMed

    Reemts, Glenda S

    2015-01-01

    The increasing complexity of the healthcare environment calls for increasing emotional intelligence (EI) competence in nurses. This study assessed the EI competence of 164 baccalaureate nursing alumni who graduated during the years 2007-2010 from three Benedictine institutions located in the Midwestern United States to see if there was growth of EI with experience as a registered nurse (RN), and to determine if age, gender, grade point average (GPA), and years of total healthcare work experience prior to graduation predicted EI. Participants completed the web-based Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) and a demographic survey. Findings indicated 79.4% of participants were competent or higher on the MSCEIT total EI score. Percentages of nurses scoring in the competent or higher range on each of the four branch scores of perceiving, using, understanding and managing emotions were 80.6%, 72.7%, 84.2%, and 84.9% respectively. There were no significant differences on EI scores between graduates with 1-2 years compared to 3-5 years of experience as a RN. Results of a linear stepwise regression indicated being female was a significant predictor on the MSCEIT total EI score ( P = 0.015) and using emotions branch ( P = 0.047). Findings also indicated GPA ( P < 0.001) and being female ( P = 0.023) were significant predictors of EI on the understanding emotions branch. The findings indicate there is work to be done to improve the EI competence of nursing graduates. Continued research on the topic of EI and nursing is needed to build the knowledge base on how to promote positive patient outcomes.

  4. Reforming process

    SciTech Connect

    Mitsche, R.T.; Pope, G.N.

    A process for reforming a naphtha feedstock is disclosed. The reforming process is effected at reforming conditions in contact with a catalyst comprising a platinum group metal component and a group iv-a metal component composited with an alumina support wherein said support is prepared by admixing an alpha alumina monohydrate with an aqueous ammoniacal solution having a ph of at least about 7.5 to form a stable suspension. A salt of a strong acid, e.g., aluminum nitrate, is commingled with the suspension to form an extrudable paste or dough. On extrusion, the extrudate is dried and calcined to form saidmore » alumina support.« less

  5. Knowledge of risk factors and early detection methods and practices towards breast cancer among nurses in Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.

    PubMed

    Fotedar, Vikas; Seam, Rajeev K; Gupta, Manoj K; Gupta, Manish; Vats, Siddharth; Verma, Sunita

    2013-01-01

    Breast cancer is an increasing health problem in India. Screening for early detection should lead to a reduction in mortality from the disease. It is known that motivation by nurses influences uptake of screening methods by women. This study aimed to investigate knowledge of breast cancer risk factors and early detection methods and the practice of screening among nurses in Indira Gandhi Medical College, Shimla, Himachal Pradesh. A cross-sectional study was conducted using a self-administered questionnaire to assess the knowledge of breast cancer risk factors, early detection methods and practice of screening methods among 457 nurses working in an Indira Gandhi Medical College, Shimla-H.P. Chi square test, Data was analysed using SPSS version 16. Test of significance used was chi square test. The response rate of the study was 94.9%. The average knowledge of risk factors about breast cancer of the entire population is 49%. 10.5% of nurses had poor knowledge, 25.2% of the nurses had good knowledge, 45% had very good knowledge and 16.3% of the nurses had excellent knowledge about risk factors of breast cancer and early detection methods. The knowledge level was significantly higher among BSC nurses than nurses with Diploma. 54% of participants in this study reportedly practice BSE at least once every year. Less than one-third reported that they had CBE within the past one year. 7% ever had mammogram before this study. Results from this study suggest the frequent continuing medical education programmes on breast cancer at institutional level is desirable.

  6. Early career experiences and perceptions - a qualitative exploration of the turnover of young registered nurses and intention to leave the nursing profession in Finland.

    PubMed

    Flinkman, Mervi; Salanterä, Sanna

    2015-11-01

    To describe why young registered nurses (RNs) had previously left an organisation and why they intend to leave the profession. Currently, many young registered nurses, including those in Finland, are considering leaving their job or have an intention to leave the profession. An in-depth, descriptive approach was adopted. Data were collected in 2012 from interviews with 15 registered nurses (under the age of 30 years). The interviews were semi-structured and analysed using conventional content analysis. The main questions addressed were: 'Why had the young registered nurses left their previous organisation?' and 'Why do young registered nurses have an intention to leave the profession?' The findings centre on three themes: poor nursing practice environments; lack of support, orientation and mentoring, and nursing as a 'second best' or serendipitous career choice. The first years of nursing are particularly stressful for newly-graduated and inexperienced registered nurses. An in-depth, qualitative approach reveals more complex reasons behind the turnover of registered nurses and intention to leave the profession than questionnaire surveys. Young registered nurses need social support from nurse managers and experienced colleagues to successfully transition into nursing practice environments. Adequate orientation and mentoring programmes are needed to facilitate this transition. © 2014 John Wiley & Sons Ltd.

  7. Slab reformer

    NASA Technical Reports Server (NTRS)

    Spurrier, Francis R. (Inventor); DeZubay, Egon A. (Inventor); Murray, Alexander P. (Inventor); Vidt, Edward J. (Inventor)

    1984-01-01

    Slab-shaped high efficiency catalytic reformer configurations particularly useful for generation of fuels to be used in fuel cell based generation systems. A plurality of structures forming a generally rectangular peripheral envelope are spaced about one another to form annular regions, an interior annular region containing a catalytic bed and being regeneratively heated on one side by a hot comubstion gas and on the other side by the gaseous products of the reformation. An integrally mounted combustor is cooled by impingement of incoming oxidant.

  8. Slab reformer

    DOEpatents

    Spurrier, Francis R.; DeZubay, Egon A.; Murray, Alexander P.; Vidt, Edward J.

    1984-02-07

    Slab-shaped high efficiency catalytic reformer configurations particularly useful for generation of fuels to be used in fuel cell based generation systems. A plurality of structures forming a generally rectangular peripheral envelope are spaced about one another to form annular regions, an interior annular region containing a catalytic bed and being regeneratively heated on one side by a hot comubstion gas and on the other side by the gaseous products of the reformation. An integrally mounted combustor is cooled by impingement of incoming oxidant.

  9. Slab reformer

    DOEpatents

    Spurrier, Francis R.; DeZubay, Egon A.; Murray, Alexander P.; Vidt, Edward J.

    1985-03-12

    Slab-shaped high efficiency catalytic reformer configurations particularly useful for generation of fuels to be used in fuel cell based generation systems. A plurality of structures forming a generally rectangular peripheral envelope are spaced about one another to form annular regions, an interior annular region containing a catalytic bed and being regeneratively heated on one side by a hot combustion gas and on the other side by the gaseous products of the reformation. An integrally mounted combustor is cooled by impingement of incoming oxidant.

  10. Slab reformer

    DOEpatents

    Spurrier, F.R.; DeZubay, E.A.; Murray, A.P.; Vidt, E.J.

    1984-02-07

    Slab-shaped high efficiency catalytic reformer configurations are disclosed particularly useful for generation of fuels to be used in fuel cell based generation systems. A plurality of structures forming a generally rectangular peripheral envelope are spaced about one another to form annular regions, an interior annular region containing a catalytic bed and being regeneratively heated on one side by a hot combustion gas and on the other side by the gaseous products of the reformation. An integrally mounted combustor is cooled by impingement of incoming oxidant. 14 figs.

  11. Slab reformer

    NASA Technical Reports Server (NTRS)

    Spurrier, Francis R. (Inventor); DeZubay, Egon A. (Inventor); Murray, Alexander P. (Inventor); Vidt, Edward J. (Inventor)

    1985-01-01

    Slab-shaped high efficiency catalytic reformer configurations particularly useful for generation of fuels to be used in fuel cell based generation systems. A plurality of structures forming a generally rectangular peripheral envelope are spaced about one another to form annular regions, an interior annular region containing a catalytic bed and being regeneratively heated on one side by a hot combustion gas and on the other side by the gaseous products of the reformation. An integrally mounted combustor is cooled by impingement of incoming oxidant.

  12. Retaining the mental health nursing workforce: early indicators of retention and attrition.

    PubMed

    Robinson, Sarah; Murrells, Trevor; Smith, Elizabeth M

    2005-12-01

    In the UK, strategies to improve retention of the mental health workforce feature prominently in health policy. This paper reports on a longitudinal national study into the careers of mental health nurses in the UK. The findings reveal little attrition during the first 6 months after qualification. Investigation of career experiences showed that the main sources of job satisfaction were caregiving opportunities and supportive working relationships. The main sources of dissatisfaction were pay in relation to responsibility, paperwork, continuing education opportunities, and career guidance. Participants were asked whether they predicted being in nursing in the future. Gender and ethnicity were related to likelihood to remain in nursing in 5 years time. Age, having children, educational background, ethnic background, and time in first job were associated with likelihood of remaining in nursing at 10 years. Associations between elements of job satisfaction (quality of clinical supervision, ratio of qualified to unqualified staff, support from immediate line manager, and paperwork) and anticipated retention are complex and there are likely to be interaction effects because of the complexity of the issues. Sustaining positive experiences, remedying sources of dissatisfaction, and supporting diplomats from all backgrounds should be central to the development of retention strategies.

  13. Bell's Palsy in Children: Role of the School Nurse in Early Recognition and Referral

    ERIC Educational Resources Information Center

    Gordon, Shirley C.

    2008-01-01

    Bell's palsy is the most common condition affecting facial nerves. It is an acute, rapidly progressing, idiopathic, unilateral facial paralysis that is generally self-limiting and non-life threatening that occurs in all age groups (Okuwobi, Omole, & Griffith, 2003). The school nurse may be the first person to assess facial palsy and muscle…

  14. Toothless Reform?

    ERIC Educational Resources Information Center

    Smarick, Andy

    2010-01-01

    To many education reformers, the passage of the federal government's massive stimulus plan, the American Recovery and Reinvestment Act (ARRA), appeared to be a final bright star falling into alignment. The ARRA seemed to complete the constellation: an astounding $100 billion of new federal funds--nearly twice the annual budget of the U.S.…

  15. Implications of early workplace experiences on continuing interprofessional education for physicians and nurses.

    PubMed

    Veerapen, Kiran; Purkis, Mary Ellen

    2014-05-01

    Formative experiences, identities and collaborative strategies of nurses and physicians need to be appreciated to develop transformative interprofessional education for them. This article develops the collaborative profiles of recently graduated physicians and nurses based on a phenomenological study conducted at tertiary training hospitals in Canada and the United Kingdom. Recent nursing and medical graduates were interviewed to study the impact of undergraduate professional education on their ability to practice collaboratively in the workplace. The impact of undergraduate professional education on teamwork was found to be diluted by internal contradictions and overshadowed by the demands and contingencies of the workplace reported here. Initiation into the workplace was frequently precipitous and for residents the workplace environment was fluid and repeatedly new, as they rotated through various disciplines in the hospital. In busy wards, interdependent but competing priorities led to the development of adversarial uniprofessional identities and derogatory stereotyping of the other. Both groups were overwhelmed by high workload, unpreparedness and responsibility. Cross generational and gender based interactions also provoked resentment. Over time collaborative attitudes became blunted and interprofessional identities were renegotiated. Continuing interprofessional education, for recent graduates that prioritises problem areas, alongside appropriate structural changes could potentially transform the prevalent culture and impact teamwork downstream.

  16. The English and Swedish health care reforms.

    PubMed

    Glennerster, H; Matsaganis, M

    1994-01-01

    England and Sweden have two of the most advanced systems of universal access to health care in the world. Both have begun major reforms based on similar principles. Universal access and finance from taxation are retained, but a measure of competition between providers of health care is introduced. The reforms therefore show a movement toward the kind of approach advocated by some in the United States. This article traces the origins and early results of the two countries' reform efforts.

  17. Early weaning food for infants (0-6 months old) in madurese people based on transcultural nursing theory

    NASA Astrophysics Data System (ADS)

    Has, Eka Mishbahatul M.; Syaltut, M.; Kusumaningrum, Tiyas; Efendi, Ferry

    2018-02-01

    The World Health Organization recommend weaning food is given to infants aged 624 months. In Madura culture still exist the practice of giving weaning food before infants reach six months old. The purpose of this study was to analyze the factors of giving weaning food for infants (0-6 months old) based on transcultural nursing theory. Design used was descriptive with cross-sectional approach. Population was Madurese mothers who have infants (0-6 months old) who has been given early weaning food. A total of 61 respondents were chosen by cluster sampling method. Variables in this study were education, economic, political and legal, cultural values and lifestyles, kinship and social, religious and philosophical, and technology. Data were collected by using structured interview and described by using frequency and percentage distribution. The results had showed educational mostly were primary and middle education (92%). Economic mostly come from low economic status (70%). Political and legal mostly positive (54%). Cultural values and lifestyles mostly negative (62%). Kinship and social mostly negative (64%). Religious and philosophical mostly positive (64%). Technology factor dominantly low (56%). Based on transcultural nursing theory it is shown a diversity in positive and negative values. Further research was suggested to reduce the practice of giving weaning food behavior of Madurese mothers which suits with local culture.

  18. Reducing Readmissions among Heart Failure Patients Discharged to Home Health Care: Effectiveness of Early and Intensive Nursing Services and Early Physician Follow-Up.

    PubMed

    Murtaugh, Christopher M; Deb, Partha; Zhu, Carolyn; Peng, Timothy R; Barrón, Yolanda; Shah, Shivani; Moore, Stanley M; Bowles, Kathryn H; Kalman, Jill; Feldman, Penny H; Siu, Albert L

    2017-08-01

    To compare the effectiveness of two "treatments"-early, intensive home health nursing and physician follow-up within a week-versus less intense and later postacute care in reducing readmissions among heart failure (HF) patients discharged to home health care. National Medicare administrative, claims, and patient assessment data. Patients with a full week of potential exposure to the treatments were followed for 30 days to determine exposure status, 30-day all-cause hospital readmission, other health care use, and mortality. An extension of instrumental variables methods for nonlinear statistical models corrects for nonrandom selection of patients into treatment categories. Our instruments are the index hospital's rate of early aftercare for non-HF patients and hospital discharge day of the week. All hospitalizations for a HF principal diagnosis with discharge to home health care between July 2009 and June 2010 were identified from source files. Neither treatment by itself has a statistically significant effect on hospital readmission. In combination, however, they reduce the probability of readmission by roughly 8 percentage points (p < .001; confidence interval = -12.3, -4.1). Results are robust to changes in implementation of the nonlinear IV estimator, sample, outcome measure, and length of follow-up. Our results call for closer coordination between home health and medical providers in the clinical management of HF patients immediately after hospital discharge. © Health Research and Educational Trust.

  19. Reform in American Public Higher Education.

    ERIC Educational Resources Information Center

    Robles, Harriett J.

    This paper provides an overview of higher education reform movements in the United States. While some of the 18th and 19th century reforms in the country are described, the emphasis is on the 20th century. Early in this period, the debate over general education and the need for a required core curriculum was central. McCarthyism influenced higher…

  20. [Jealousy between siblings in early childhood. Nursing assessment based on a case study].

    PubMed

    Puig-Plana, María Pilar

    2010-01-01

    Childhood jealousy, when a little brother or sister is born, has always been a subject treated within the family environment. Parent's attitude in their interaction with their offspring may increase the response of the jealous child. The emotional expressions of the jealous child may lead to behaviour changes, that may occasionally put the physical integrity of the newborn at risk, since it is the most vulnerable in the family group. In view of the above mentioned, a case of a three-year-old child living with his parents and his nine-month-old sister, is presented. The child shows characteristic behaviour changes of jealousy, such as, rebelliousness, aggressiveness and hyperactivity. The brother's psychomotor discomfort leads to a proneness to accidents for the baby girl and the obvious parental concern. For these reasons nursing intervention in the family group was proposed, based on the theoretical Virginia Henderson Needs Model. The actions will come from the older brother and parents. The aim of the nursing intervention is to lead the behaviour changes in order to re-establish a safe and healthy family environment. Copyright 2009 Elsevier España, S.L. All rights reserved.

  1. Status of costing hospital nursing work within Australian casemix activity-based funding policy.

    PubMed

    Heslop, Liza

    2012-02-01

    Australia has a long history of patient level costing initiated when casemix funding was implemented in several states in the early 1990s. Australia includes, to some extent, hospital payment based on nursing intensity adopted within casemix funding policy and the Diagnostic Related Group system. Costing of hospital nursing services in Australia has not changed significantly in the last few decades despite widespread introduction of casemix funding policy at the state level. Recent Commonwealth of Australia National Health Reform presents change to the management of the delivery of health care including health-care costing. There is agreement for all Australian jurisdictions to progress to casemix-based activity funding. Within this context, nurse costing infrastructure presents contemporary issues and challenges. An assessment is made of the progress of costing nursing services within casemix funding models in Australian hospitals. Valid and reliable Australian-refined nursing service weights might overcome present cost deficiencies and limitations. © 2012 Blackwell Publishing Asia Pty Ltd.

  2. Parent Perceptions of How Nurse Encounters Can Provide Caring Support for the Family in Early Acute Care Following Children’s Severe Traumatic Brain Injury

    PubMed Central

    Roscigno, Cecelia I.

    2016-01-01

    Objective A child’s severe traumatic brain injury (TBI) creates a family crisis requiring extensive cultural, informational, psychological, and environmental support. Nurses need to understand parents’ expectations of caring in early acute care so they can tailor their attitudes, beliefs, and behaviors appropriately to accommodate the family’s needs. Methods In a previous qualitative study of 42 parents or caregivers from 37 families of children with moderate to severe TBI, parents of children with severe TBI (n = 25) described their appraisals of nurse caring and uncaring behaviors in early acute care. Swanson’s theory of caring was used to categorize parents’ descriptions in order to inform nursing early acute care practices and family-centered care. Results Caring nurse encounters included: (a) involving parents in the care of their child and reflecting on all socio-cultural factors shaping family resources and responses (knowing); (b) respecting that family grief can be co-mingled with resilience, and that parents are typically competent to be involved in decision-making (maintaining belief); (d) actively listening and engaging parents in order to fully understand family values and needs (being with); (e) decreasing parents’ workload to get information, emotional support, and providing a safe cultural, psychological, and physical environment for the family (doing for), and; (f) providing anticipatory guidance to navigate the early acute care system and giving assistance to learn and adjust to their situation (enabling). Conclusion Application of Swanson’s caring theory is prescriptive in helping individual nurses and early acute care systems to meet important family needs following children’s severe TBI. PMID:26871242

  3. School Improvement Grants: Early Implementation under Way, but Reforms Affected by Short Time Frames. Report to Congressional Requesters. GAO-11-741

    ERIC Educational Resources Information Center

    Scott, George A.

    2011-01-01

    The School Improvement Grants (SIG) program, which was created in 2002, funds reforms in the country's lowest-performing schools with the goal of improving student outcomes, such as standardized test scores and graduation rates. Congress greatly increased SIG program funding from $125 million available in fiscal year 2007--the first year the…

  4. Nursing students' early exposure to clinical practice: an innovation in curriculum development.

    PubMed

    Hoyles, A; Pollard, C; Lees, S; Glossop, D

    2000-08-01

    This paper describes a pilot study addressing issues surrounding the balance and status given to both theory and practice in the foundation part of a pre-registration programme. Contemporary thinking seems to suggest that there is a need to reverse recent trends which have placed an emphasis on theory. To facilitate this a framework for clinical learning was adapted to guide students' early exposure to clinical practice. The focus was to develop the students' observational and reflective skills whilst also providing the students with a frame of reference within which they could explore their theoretical studies. The information and experiences gained as a result of this study have led to the integration of an Orientation Framework to support students' early clinical experiences in a pre-registration programme.

  5. Role of Geography and Nurse Practitioner Scope-of-Practice in Efforts to Expand Primary Care System Capacity: Health Reform and the Primary Care Workforce.

    PubMed

    Graves, John A; Mishra, Pranita; Dittus, Robert S; Parikh, Ravi; Perloff, Jennifer; Buerhaus, Peter I

    2016-01-01

    Little is known about the geographic distribution of the overall primary care workforce that includes both physician and nonphysician clinicians--particularly in areas with restrictive nurse practitioner scope-of-practice laws and where there are relatively large numbers of uninsured. We investigated whether geographic accessibility to primary care clinicians (PCCs) differed across urban and rural areas and across states with more or less restrictive scope-of-practice laws. An observational study. 2013 Area Health Resource File (AHRF) and US Census Bureau county travel data. The measures included percentage of the population in low-accessibility, medium-accessibility, and high-accessibility areas; number of geographically accessible primary care physicians (PCMDs), nurse practitioners (PCNPs), and physician assistants (PCPAs) per 100,000 population; and number of uninsured per PCC. We found divergent patterns in the geographic accessibility of PCCs. PCMDs constituted the largest share of the workforce across all settings, but were relatively more concentrated within urban areas. Accessibility to nonphysicians was highest in rural areas: there were more accessible PCNPs per 100,000 population in rural areas of restricted scope-of-practice states (21.4) than in urban areas of full practice states (13.9). Despite having more accessible nonphysician clinicians, rural areas had the largest number of uninsured per PCC in 2012. While less restrictive scope-of-practice states had up to 40% more PCNPs in some areas, we found little evidence of differences in the share of the overall population in low-accessibility areas across scope-of-practice categorizations. Removing restrictive scope-of-practice laws may expand the overall capacity of the primary care workforce, but only modestly in the short run. Additional efforts are needed that recognize the locational tendencies of physicians and nonphysicains.

  6. Exploring direct and indirect influences of physical work environment on job satisfaction for early-career registered nurses employed in hospitals.

    PubMed

    Djukic, Maja; Kovner, Christine T; Brewer, Carol S; Fatehi, Farida; Greene, William H

    2014-08-01

    We explored direct and indirect influences of physical work environment on job satisfaction in a nationally representative sample of 1,141 early-career registered nurses. In the fully specified model, physical work environment had a non-significant direct effect on job satisfaction. The path analysis used to test multiple indirect effects showed that physical work environment had a positive indirect effect (p < .05) on job satisfaction through ten variables: negative affectivity, variety, workgroup cohesion, nurse-physician relations, quantitative workload, organizational constraints, distributive justice, promotional opportunity, local and non-local job opportunities. The findings make important contributions to the understanding of the relationship between physical work environment and job satisfaction. The results can inform health care leaders' insight about how physical work environment influences nurses' job satisfaction. © 2014 Wiley Periodicals, Inc.

  7. Nurse and patient factors that influence nursing time in chest tube management early after open heart surgery: A descriptive, correlational study.

    PubMed

    Cook, Myra; Idzior, Laura; Bena, James F; Albert, Nancy M

    2017-10-01

    Determine nurse characteristics and patient factors that affect nurses' time in managing chest tubes in the first 24-hours of critical-care stay. Prospective, descriptive. Cardiovascular critical-care nurses and post-operative heart surgery patients with chest tubes were enrolled from a single center in Ohio. Nurses completed case report forms about themselves, comfort and time in managing chest tubes, chest tube placement and management factors. Analysis included correlational and comparative statistics; Bonferroni corrections were applied, as appropriate. Of 29 nurses, 86.2% were very comfortable managing chest tubes and oozing/non-secure dressings, but only 41.4% were very comfortable managing clogged chest tubes. Of 364 patients, mean age was 63.1 (±12.3) years and 36% had previous heart surgery. Total minutes of chest tube management was higher with≥3 chest tubes, tube size <28 French, and when both mediastinal and pleural tubes were present (all p<0.001). In the first 4-hours, time spent on chest tubes was higher when patients had previous cardiac surgeries (p≤0.002), heart failure (p<0.001), preoperative anticoagulant medications (p=0.031) and reoperation for postoperative bleeding/tamponade (p=0.005). Time to manage chest tubes can be anticipated by patient characteristics. Nurse comfort with chest tube-related tasks affected time spent on chest tube management. Published by Elsevier Ltd.

  8. Reforming Again: Now Teachers

    ERIC Educational Resources Information Center

    Marx, Ronald W.

    2014-01-01

    Background: Educational reform responds to local and national pressures to improve educational outcomes, and reform efforts cycle as similar pressures recur. Currently, reform efforts focus on teachers, even though confidence in a host of American social institutions is dropping. One of the most widespread reforms regarding teachers is the…

  9. Grade-Level Differences in Future-Oriented Self-Concept During Early Adolescence: Potential Relevance to School Nursing.

    PubMed

    Stoddard, Sarah A; Pierce, Jennifer; Schmidt, Carissa J

    2016-12-01

    The middle school and early high school years are a time of significant development, including an increasing ability to envision oneself in the future. Little is known about how adolescents' future-oriented self-concept (i.e., possible selves) differs across grade levels, although this knowledge may aid in establishing rapport with students and building effective health promotion and risk reduction interventions. Therefore, this study explored grade-level differences in hoped for and feared possible selves in a sample of sixth- to ninth-grade students (n = 2,498; M age = 12.72, SD = 1.15; 51.3% female). Findings suggest that adolescents list a variety of possible selves, and the content differs according to grade level. These findings offer helpful insight for intervention work aimed at improving student outcomes and preventing risk behavior. Understanding what adolescents hope and fear for themselves in the future may be particularly beneficial for school nurses in identifying the unique challenges students experience and tailoring health promotion efforts. © The Author(s) 2016.

  10. Grade-Level Differences in Future-Oriented Self-Concept During Early Adolescence: Potential Relevance to School Nursing

    PubMed Central

    2016-01-01

    The middle school and early high school years are a time of significant development, including an increasing ability to envision oneself in the future. Little is known about how adolescents’ future-oriented self-concept (i.e., possible selves) differs across grade levels, although this knowledge may aid in establishing rapport with students and building effective health-promotion and risk reduction interventions. Therefore, this study explored grade-level differences in hoped for and feared possible selves in a sample of 6th – 9th grade students (n = 2,498; Mage = 12.72, SD = 1.15; 51.3% female). Findings suggest that adolescents list a variety of possible selves, and the content differs according to grade-level. These findings offer helpful insight for intervention work aimed at improving student outcomes and preventing risk behavior. Understanding what adolescents hope and fear for themselves in the future may be particularly beneficial for school nurses in identifying the unique challenges students experience and tailoring health-promotion efforts. PMID:27222444

  11. Nurse educators' perceived challenges in mandatory continuing nursing education.

    PubMed

    Xiao, L D

    2006-09-01

    This paper reports a study that leads to understanding challenges facing nurse educators implementing mandatory continuing nursing education in The People's Republic of China. Mandatory continuing nursing education was instituted to maintain and develop registered nurses' competence in the context of healthcare reform in China in 1996. However, there is an increasing complaint of credit-focused and teacher-centred learning in Chinese literature. Despite an increasing appeal to improve the learning situation, little consensus has been reached. By examining nurse educators' perceived challenges and their coping strategies in implementing mandatory continuing nursing education, this study illuminates the possibilities for reform in mandatory continuing nursing education. Data were collected through in-depth interactive dialogues between the researcher and five nurse educators in five healthcare organizations in China, utilizing Gadamer's philosophical hermeneutics. Three themes were found in this study described as finding a way to support nurses' competence within a constrained situation, reconciling credit requirements and representing all stakeholders' interests. A tension between the mandatory continuing nursing education policy and the context of implementing the policy can contribute to credit-focused and teacher-centred learning. Regular policy review and educational support for nurse educators are crucial aspects to improve mandatory continuing nursing education.

  12. Structured scoring of supporting nursing tasks to enhance early discharge in geriatric rehabilitation: The BACK-HOME quasi-experimental study.

    PubMed

    Holstege, M S; Bakkers, E; van Balen, R; Gussekloo, J; Achterberg, W P; Caljouw, M A A

    2016-12-01

    In geriatric rehabilitation it is important to have timely discharge of patients, especially if they have low nursing support needs. However, no instruments are available to identify early discharge potential. To evaluate if weekly scoring of a nursing support scorecard in the evenings/nights and discussing the results in the multidisciplinary team meeting, leads to potential differences in discharge of geriatric rehabilitation patients. Quasi-experimental study with a reference cohort (n=200) and a Back-Home implementation cohort (n=283). Patients in geriatric rehabilitation in the four participating skilled nursing facilities in the Netherlands. Implementation of the nursing support scorecard during one year consisted of (1) weekly scoring of the scorecard to identify the supporting nursing tasks during the evenings/nights by trained nurses, and (2) discussion of the results in a multidisciplinary team meeting to establish if discharge home planning was feasible. Data on patients' characteristics and setting before admission were collected at admission; at discharge, the length of stay, discharge destination and barriers for discharge were collected by the nursing staff. Both cohorts were comparable with regard to median age, gender [reference cohort: 81 (IQR 75-88) years; 66% females vs. Back-Home cohort 82 (IQR 76-87) years; 71% females] and reasons for admission: stroke (23% vs. 23%), joint replacement (12% vs. 13%), traumatic injuries (31% vs. 34%), and other (35% vs. 30%). Overall, the median length of stay for the participants discharged home in the reference cohort was 56 (IQR 29-81) days compared to 46 (IQR 30-96) days in the Back-Home cohort (p=0.08). When no home adjustments were needed, participants were discharged home after 50 (IQR 29.5-97) days in the reference cohort, and after 42.5 (IQR 26-64.8) days in the Back-Home cohort (p=0.03). Reasons for discharge delay were environmental factors (36.7%) and patient-related factors, such as mental (21

  13. Scholar Alumni: Options in the Early Career Years. New Careers in Nursing. Research Report. ETS RR-15-28

    ERIC Educational Resources Information Center

    Millett, Catherine M.; Stickler, Leslie M.; Wang, Haijiang

    2015-01-01

    The New Careers in Nursing (NCIN) Alumni Survey was designed to advance knowledge in the field of nursing education by looking at post-degree experiences of NCIN scholarship recipients, such as employment and graduate degree attainment. The NCIN Alumni Study also focused on the reflections of NCIN scholars who have graduated and moved into the…

  14. Young Registered Nurses' Intention to Leave the Profession and Professional Turnover in Early Career: A Qualitative Case Study

    PubMed Central

    Salanterä, Sanna

    2013-01-01

    In a time of global nursing shortages an alarming number of young registered nurses have expressed a willingness to leave the profession. In this qualitative case study we investigate in depth why young nurses leave nursing profession and reeducate themselves for a new career. The study is based on longitudinal interviews of three young registered nurses in Finland. These nurses were first interviewed between December 2006 and May 2007, when they were 29–32 years old and having an intention to leave the profession. The second interview took place four years later, from January 2011 to March 2011 when all of them had made the transition to a new career. Data were analyzed in two stages. In the first stage, comprehensive career story narratives were formed on the basis of the interviews. In the second stage, emerging themes in these stories were compared, contrasted, and interpreted in the context of the overall career histories. Nursing as a second career choice and demanding work content as well as poor practice environment and the inability to identify with the stereotypical images of nurses were main themes that emerged from these career stories. The results of this interpretative qualitative study reflect a shift toward insights into understanding professional turnover as a complex and long-lasting process. PMID:24027640

  15. Comparing the Number of Ill or Injured Students Who Are Released Early from School by School Nursing and Nonnursing Personnel

    ERIC Educational Resources Information Center

    Wyman, Linda L.

    2005-01-01

    There is a growing demand for research linking specific educational services with positive student outcomes. Little empirical evidence exists to show that school nursing services improve student success. School attendance is one of many factors that has been associated with improved learning; school nurses can affect that factor. This study…

  16. Young registered nurses' intention to leave the profession and professional turnover in early career: a qualitative case study.

    PubMed

    Flinkman, Mervi; Isopahkala-Bouret, Ulpukka; Salanterä, Sanna

    2013-01-01

    In a time of global nursing shortages an alarming number of young registered nurses have expressed a willingness to leave the profession. In this qualitative case study we investigate in depth why young nurses leave nursing profession and reeducate themselves for a new career. The study is based on longitudinal interviews of three young registered nurses in Finland. These nurses were first interviewed between December 2006 and May 2007, when they were 29-32 years old and having an intention to leave the profession. The second interview took place four years later, from January 2011 to March 2011 when all of them had made the transition to a new career. Data were analyzed in two stages. In the first stage, comprehensive career story narratives were formed on the basis of the interviews. In the second stage, emerging themes in these stories were compared, contrasted, and interpreted in the context of the overall career histories. Nursing as a second career choice and demanding work content as well as poor practice environment and the inability to identify with the stereotypical images of nurses were main themes that emerged from these career stories. The results of this interpretative qualitative study reflect a shift toward insights into understanding professional turnover as a complex and long-lasting process.

  17. Commentary: Malpractice Reform in Policy Perspective

    PubMed Central

    Bovbjerg, Randall R

    2007-01-01

    Enacted caps on malpractice awards and proposed early offer reform address the sometimes excessive verdicts of conventional liability and its very high overhead costs. However, such reforms greatly benefit medical defendants while doing too little for claimants or patients in general. Caps and early offer only affect current claims; far broader reforms are therefore needed to improve the woeful performance of liability as a general promoter of patient safety and injury compensation. Broad reforms, however desirable, seldom surmount high political and practical hurdles. A good, more evenhanded start would seek to make claims resolution faster, more accurate, more predictable, and less expensive, while separately promoting medical quality and safety as well as greater transparency for law, medicine, and insurance. PMID:17517117

  18. School nursing.

    PubMed

    Igoe, J B

    1994-09-01

    School nursing has been in a process of transition since its inception. This role evolution parallels the growing complexity of the health, education, and social needs of America's youth. The workplace within which school nurses practice is equally complicated because health and education administrators often hold differing philosophies of management, and school health programs are ill-defined. Fortunately, there is growing support for an integrated services approach and the development of school health systems with nurses joining an interdisciplinary team rather than continuing to function as "boundary dwellers." The roles of the school nurse as primary care provider, school health coordinator, case manager, and epidemiologist are emerging and replacing outdated nursing functions. As the role of the school nurse shifts and expands, it produces a cascade effect. The role of the school health assistant to aid the nurse surfaces as the next logical step in planning. Numerous model school health programs exist today. The emphasis, and rightfully so, is preventive in nature and should be targeted at the preparation of a new generation of health consumers who are more self-reliant than their predecessors. Unfortunately, all these programs are plagued with financing problems that could be alleviated with the right plan for health care reform, such as an expansion of maternal and child health funds (Title V) to health departments and the introduction of school nursing leadership into the DASH office at the Centers for Disease Control and Prevention, a health education unit largely run by health educators, to reallocate some of these resources to the clinical preventive services needed in schools to reduce health risk behaviors. Finally, total quality management is the next issue on the horizon for this nursing specialty; benchmarking would be the place to start. In summary, systems development in the school health field is now underway, and it will not be easy, but this

  19. Gilligan: a voice for nursing?

    PubMed

    Harbison, J

    1992-12-01

    The current reform of nursing education is resulting in major changes in the curricula of colleges of nursing. For the first time, ethical and moral issues are being seen as an important theme underpinning the entire course. The moral theorist with whose work most nurse teachers are acquainted is Kohlberg. In this paper, it is suggested that his work, and the conventions of morality which he exemplifies, may not be the most appropriate from which to address the moral issues facing the nurse. The author suggests that the work of Carol Gilligan of Harvard university is of great significance, not only for nurses involved in the teaching of ethics, but for all nurses. Gilligan's emphasis on caring and relationships accords with the common experience of the nurse, and echoes the current revival of interest within nursing in examining, and valuing, the phenomenon of caring.

  20. Gilligan: a voice for nursing?

    PubMed Central

    Harbison, J

    1992-01-01

    The current reform of nursing education is resulting in major changes in the curricula of colleges of nursing. For the first time, ethical and moral issues are being seen as an important theme underpinning the entire course. The moral theorist with whose work most nurse teachers are acquainted is Kohlberg. In this paper, it is suggested that his work, and the conventions of morality which he exemplifies, may not be the most appropriate from which to address the moral issues facing the nurse. The author suggests that the work of Carol Gilligan of Harvard university is of great significance, not only for nurses involved in the teaching of ethics, but for all nurses. Gilligan's emphasis on caring and relationships accords with the common experience of the nurse, and echoes the current revival of interest within nursing in examining, and valuing, the phenomenon of caring. PMID:1460649

  1. Barriers to Early Initiation and Continuation of Breastfeeding in a Tertiary care Institute of Haryana: A Qualitative Study in Nursing Care Providers.

    PubMed

    Majra, Jai Pal; Silan, Vijay Kumar

    2016-09-01

    Ever increasing institutional deliveries in India has shifted the responsibility of timely initiation and continuation of breastfeeding from peripheral health workers and families to the nursing care providers of health facilities where the births take place. While institutional deliveries have increased to 72.6%, only 44.6% of the newborns enjoy early breastfeeding in India. To study the barriers to early initiation of breastfeeding in institutional delivery. A total 34 nursing care providers were selected randomly and five Focus Group Discussions (FGDs) were carried out. This Qualitative Study was conducted through FGDs among the nursing care providers of a tertiary care institute in the Indian State of Haryana, India. The analyses continued throughout the group discussions as the newly emerged themes were tested in the subsequent discussion. FGDs transcripts were analysed to enhance the robustness of the emerged domain. Major barriers to initiation of breast feeding identified included: lack of awareness regarding proper technique of breastfeeding and benefits of colostrum; breast abnormality like inverted/retracted nipples; obstetric/neonatal complications requiring specialised care; and cultural practices like giving pre-lacteals and gender discrimination. It was further reported that the manpower has not been rationalised with ever increasing number of institutional deliveries. The respondents though willing to promote early initiation and continuation of breastfeeding felt excessive workload as one of the major barriers due to multi-tasking nature of their job. The new challenges to the early initiation and continuation of breastfeeding are emerging due to change in the place of delivery which needs to be addressed at the policy level.

  2. Beyond Reform: Transformation

    ERIC Educational Resources Information Center

    Davidson, Jill

    2007-01-01

    The Coalition of Essential Schools (CES) is not a reform movement. To reform is to make a thing again; reformation implies a stasis that doesn't deliver enough for the educational future. This issue of Horace demonstrates that Essential schools and the districts and networks that support them are at various points in the journey of transformation,…

  3. Health system reform.

    PubMed

    Ortolon, Ken

    2009-06-01

    A vote on reforming the nation's health care system seems likely this summer as President Obama makes good on a campaign pledge. Although the Democratic leadership in Congress appears ready to push through reform legislation before the next election, TMA and AMA leaders say very little is known about what that "reform" likely will look like.

  4. Educational Reform in Spain.

    ERIC Educational Resources Information Center

    Marchesi, Alvaro

    1992-01-01

    Reviews the Spanish educational system, focusing on reforms enacted in 1990. Discusses reform movement issues, including quality, curricular control, curricular homogeneity versus diversity, and influence of European context. Describes reform movement aims (i.e., extending basic education and modifying educational levels to improve quality) and…

  5. Sputnik Reform Revisited.

    ERIC Educational Resources Information Center

    Strickland, Charles E.

    1985-01-01

    Educational reforms being called for in the 1980's are compared to reforms of the 1950's. The Sputnik-inspired quest for quality called for reform in the content and structure of basic subjects. Current reports say that what educators are doing in the basic subjects is ok, but they need to do more. (RM)

  6. [The strategies of the symbolic struggle for the training of the visiting nurse in the early twentieth century].

    PubMed

    Ayres, Lílian Fernandes Arial; Amorim, Wellington Mendonça de; Piva, Teresa Cristina de Carvalho; Porto, Fernando Rocha

    2012-09-01

    Based on the historical and social perspective, the scope of this documentary study were the strategies of the symbolic struggle for the training of agents in home visitation in the Courses for Visiting Nurses of the Brazilian Red Cross and the National Department of Public Health in Rio de Janeiro (Federal District), with repercussions in the Department of Health and Welfare of the State of Pernambuco between 1920 and 1926. We adopted the thinking of sociologist Pierre Bourdieu as a theoretical benchmark, showing the symbolic struggle in the field of public health between sanitarians Amaury de Medeiros and José P. Fontenelle and public health nurse Ethel Parsons, to analyze who was responsible for the scientific authority and competence of the training of visiting nurses.

  7. Early-versus Late-Onset Alzheimer Disease: Long-Term Functional Outcomes, Nursing Home Placement, and Risk Factors for Rate of Progression.

    PubMed

    Wattmo, Carina; Wallin, Åsa K

    2017-01-01

    Whether age at onset influences functional deterioration in Alzheimer disease (AD) is unclear. We, therefore, investigated risk factors for progression in activities of daily living (ADL) and nursing home placement (NHP) in cholinesterase inhibitor (ChEI)-treated patients with early-onset AD (EOAD) versus late-onset AD (LOAD). This 3-year, prospective, observational, multicenter study included 1,017 participants with mild-to-moderate AD; 143 had EOAD (onset <65 years) and 874 LOAD (onset ≥65 years). Possible sociodemographic and clinical factors that could affect functional outcome and NHP were analyzed using mixed-effects models and logistic regression, respectively. Younger individuals exhibited longer illness duration before AD diagnosis, whereas 6-month functional response to ChEI therapy, 3-year changes in ADL capacities, time from diagnosis to NHP, and survival time in nursing homes were similar between the groups. In LOAD, a higher ChEI dose, no antidepressant use, and lower education level were protective factors for slower instrumental ADL (IADL) decline. In EOAD, antihypertensives/cardiac therapy implied faster IADL progression but lower risk of NHP. This study highlights the clinical importance of an earlier diagnosis and treatment initiation and the need for functional evaluations in EOAD. Despite the age differences between EOAD and LOAD, a similar need for nursing homes was observed.

  8. Effectiveness and safety of early medication abortion provided in pharmacies by auxiliary nurse-midwives: A non-inferiority study in Nepal

    PubMed Central

    Puri, Mahesh; Shrestha, Prabhakar; Blum, Maya; Maharjan, Dev; Grossman, Daniel; Regmi, Kiran; Darney, Philip D.; Harper, Cynthia C.

    2018-01-01

    Background Expanding access to medication abortion through pharmacies is a promising avenue to reach women with safe and convenient care, yet no pharmacy provision interventions have been evaluated. This observational non-inferiority study investigated the effectiveness and safety of mifepristone-misoprostol medication abortion provided at pharmacies, compared to government-certified public health facilities, by trained auxiliary nurse-midwives in Nepal. Methods Auxiliary nurse-midwives were trained to provide medication abortion through twelve pharmacies and public facilities as part of a demonstration project in two districts. Eligible women were ≤63 days pregnant, aged 16–45, and had no medical contraindications. Between 2014–2015, participants (n = 605) obtained 200 mg mifepristone orally and 800 μg misoprostol sublingually or intravaginally 24 hours later, and followed-up 14–21 days later. The primary outcome was complete abortion without manual vacuum aspiration; the secondary outcome was complication requiring treatment. We assessed risk differences by facility type with multivariable logistic mixed-effects regression. Results Over 99% of enrolled women completed follow-up (n = 600). Complete abortions occurred in 588 (98·0%) cases, with ten incomplete abortions and two continuing pregnancies. 293/297 (98·7%) pharmacy participants and 295/303 (97·4%) public facility participants had complete abortions, with an adjusted risk difference falling within the pre-specified 5 percentage-point non-inferiority margin (1·5% [-0·8%, 3·8%]). No serious adverse events occurred. Five (1.7%) pharmacy and two (0.7%) public facility participants experienced a complication warranting treatment (aRD, 0.8% [-1.0%-2.7%]). Conclusions Early mifepristone-misoprostol abortion was as effective and safe when provided by trained auxiliary nurse-midwives at pharmacies as at government-certified health facilities. Findings support policy expanding provision through

  9. Effectiveness and safety of early medication abortion provided in pharmacies by auxiliary nurse-midwives: A non-inferiority study in Nepal.

    PubMed

    Rocca, Corinne H; Puri, Mahesh; Shrestha, Prabhakar; Blum, Maya; Maharjan, Dev; Grossman, Daniel; Regmi, Kiran; Darney, Philip D; Harper, Cynthia C

    2018-01-01

    Expanding access to medication abortion through pharmacies is a promising avenue to reach women with safe and convenient care, yet no pharmacy provision interventions have been evaluated. This observational non-inferiority study investigated the effectiveness and safety of mifepristone-misoprostol medication abortion provided at pharmacies, compared to government-certified public health facilities, by trained auxiliary nurse-midwives in Nepal. Auxiliary nurse-midwives were trained to provide medication abortion through twelve pharmacies and public facilities as part of a demonstration project in two districts. Eligible women were ≤63 days pregnant, aged 16-45, and had no medical contraindications. Between 2014-2015, participants (n = 605) obtained 200 mg mifepristone orally and 800 μg misoprostol sublingually or intravaginally 24 hours later, and followed-up 14-21 days later. The primary outcome was complete abortion without manual vacuum aspiration; the secondary outcome was complication requiring treatment. We assessed risk differences by facility type with multivariable logistic mixed-effects regression. Over 99% of enrolled women completed follow-up (n = 600). Complete abortions occurred in 588 (98·0%) cases, with ten incomplete abortions and two continuing pregnancies. 293/297 (98·7%) pharmacy participants and 295/303 (97·4%) public facility participants had complete abortions, with an adjusted risk difference falling within the pre-specified 5 percentage-point non-inferiority margin (1·5% [-0·8%, 3·8%]). No serious adverse events occurred. Five (1.7%) pharmacy and two (0.7%) public facility participants experienced a complication warranting treatment (aRD, 0.8% [-1.0%-2.7%]). Early mifepristone-misoprostol abortion was as effective and safe when provided by trained auxiliary nurse-midwives at pharmacies as at government-certified health facilities. Findings support policy expanding provision through registered pharmacies by trained auxiliary nurse

  10. Contested Practice: Political Activism in Nursing and Implications for Nursing Education.

    PubMed

    Buck-McFadyen, Ellen; MacDonnell, Judith

    2017-07-27

    Canadian nurses have a social mandate to address health inequities for the populations they serve, as well as to speak out on professional and broader social issues. Although Canadian nursing education supports the role of nurses as advocates for social justice and leadership for health care reform, little is known about how nurse educators understand activism and how this translates in the classroom. A comparative life history study using purposeful sampling and a critical feminist lens was undertaken to explore political activism in nursing and how nurse educators foster political practice among their students. Findings from interviews and focus groups with 26 Ontario nurse educators and nursing students suggested that neoliberal dynamics in both the practice setting and in higher education have constrained nurses' activist practice and favour a technical rational approach to nursing education. Implications and strategies to inspire political action in nursing education are discussed.

  11. Task shifting from physicians to nurses in primary care in 39 countries: a cross-country comparative study.

    PubMed

    Maier, Claudia B; Aiken, Linda H

    2016-12-01

    Primary care is in short supply in many countries. Task shifting from physicians to nurses is one strategy to improve access, but international research is scarce. We analysed the extent of task shifting in primary care and policy reforms in 39 countries. Cross-country comparative research, based on an international expert survey, plus literature scoping review. A total of 93 country experts participated, covering Europe, USA, Canada, Australia and New Zealand (response rate: 85.3%). Experts were selected according to pre-defined criteria. Survey responses were triangulated with the literature and analysed using policy, thematic and descriptive methods to assess developments in country-specific contexts. Task shifting, where nurses take up advanced roles from physicians, was implemented in two-thirds of countries (N = 27, 69%), yet its extent varied. Three clusters emerged: 11 countries with extensive (Australia, Canada, England, Northern Ireland, Scotland, Wales, Finland, Ireland, Netherlands, New Zealand and USA), 16 countries with limited and 12 countries with no task shifting. The high number of policy, regulatory and educational reforms, such as on nurse prescribing, demonstrate an evolving trend internationally toward expanding nurses' scope-of-practice in primary care. Many countries have implemented task-shifting reforms to maximise workforce capacity. Reforms have focused on removing regulatory and to a lower extent, financial barriers, yet were often lengthy and controversial. Countries early on in the process are primarily reforming their education. From an international and particularly European Union perspective, developing standardised definitions, minimum educational and practice requirements would facilitate recognition procedures in increasingly connected labour markets. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  12. The nurse's load: early-life exposure to brood-rearing affects behavior and lifespan in honey bees (Apis mellifera).

    PubMed

    Amdam, Gro V; Rueppell, Olav; Fondrk, M Kim; Page, Robert E; Nelson, C Mindy

    2009-01-01

    Long-lived honey bees (Apis mellifera) develop in fall. This pattern may be explained by reduced nurse loads. When the amount of brood in colonies declines as a function of adverse foraging conditions, adult bees build up surplus nutrient stores that include vitellogenin, a behavioral affector protein that also can increase lifespan. Although the seasonal reduction in exposure to nursing tasks predictably results in vitellogenin accumulation, the assumption that long-lived adults thereby develop is confounded by a concomitant decline in foraging effort. Foraging activity reduces lifespan, and is influenced by colony resource consumption, brood pheromones, availability of nectar and pollen, and weather. Here, we perform the first controlled experiment where the nursing environment of pre-foraging sister bees was set to vary, while their foraging environment later was set to be the same. We measure vitellogenin, age at foraging onset and lifespan. We establish that reduced brood-rearing increases vitellogenin levels, and delays foraging onset and death. Longevity is largely explained by the effect of nursing on the onset of foraging behavior, but is also influenced by the level of brood-rearing independent of behavioral change. Our findings are consistent with the roles of vitellogenin in regulation of honey bee behavior and lifespan.

  13. Understanding China's Curriculum Reform for the 21st Century

    ERIC Educational Resources Information Center

    Law, Wing-Wah

    2014-01-01

    This article uses curriculum-making frameworks to analyse and reconstruct the Chinese curriculum-making model and unpack the dynamics, complexity and constraints of China's curriculum reform since the early 1990s. It argues that curriculum reform is China's main human capital development strategy for coping with the challenges of the 21st century,…

  14. Coding as a Trojan Horse for Mathematics Education Reform

    ERIC Educational Resources Information Center

    Gadanidis, George

    2015-01-01

    The history of mathematics educational reform is replete with innovations taken up enthusiastically by early adopters without significant transfer to other classrooms. This paper explores the coupling of coding and mathematics education to create the possibility that coding may serve as a Trojan Horse for mathematics education reform. That is,…

  15. Competing Visions of Education in Timor-Leste's Curriculum Reform

    ERIC Educational Resources Information Center

    Ogden, Laura

    2017-01-01

    Timor-Leste's independence in 2002 marked the end of centuries of foreign control. Early post-independence education reforms successfully increased school enrolments and rebuilt education infrastructure, however, teacher qualifications and student outcomes have remained poor. The current Curriculum Reform, initiated in 2013, aims to improve…

  16. The origins of a two-tier profession: a nursing school at a Poor Law infirmary.

    PubMed

    McCrae, Niall; Kuzminska, Katerina

    2017-03-09

    Niall McCrae, Lecturer, and Katerina Kuzminska, Postgraduate Nursing Student, Florence Nightingale Faculty of Nursing and Midwifery, King's College, London, chart the influences of Nightingale's Poor Law infirmary reforms.

  17. Substance abuse disorders in nurses.

    PubMed

    Griffith, J

    1999-01-01

    Substance abuse is a serious concern in the profession of nursing. The American Nurses Association (1997) estimates that 10% to 20% of nurses have substance abuse problems, and that 6% to 8% of registered nurses are impaired due to their abuse of alcohol and other drugs. Chemical dependency is considered a disease that requires treatment. Early identification and treatment of the chemically dependent nurse is important for the safety of the public and for the well-being of the nurse and her profession. This article addresses substance abuse from a biopsychosocial perspective, and includes a description of an approach to treatment and suggestions for the role of nursing administration.

  18. Ellen N. La Motte: the making of a nurse, writer, and activist.

    PubMed

    Williams, Lea M

    2015-01-01

    This article examines the early career of Ellen N. La Motte (1873-1961) to trace how her training at the Johns Hopkins Training School for Nurses and years spent as a tuberculosis nurse in Baltimore shaped her perception of tuberculosis prevention and women's suffrage. Although studies of tuberculosis have frequently alluded to her work, no sustained biocritical discussion of her development as a nurse and scholar exists. Between 1902, when she graduated from nursing school, and 1914, the start of the Great War, La Motte published a textbook and dozens of articles in journals devoted to nursing and social reform and delivered many speeches at local, regional, and national meetings. In addition, as her reputation as an expert in the field of tuberculosis nursing grew, her advocacy for the vote for women increased, and she used her writing and speaking skills on behalf of the suffrage cause. This article assesses how the skills La Motte acquired during these years helped mold her into a successful and respected nurse, writer, and activist.

  19. Health care reform and influenza immunization.

    PubMed

    Tucker, Sharon; Poland, Gregory A

    2013-05-01

    Health care reform calls for the nursing profession, with a focus on disease prevention and health restoration, to innovate and create new models of care that are client-centric, evidence-based, and cost-effective. To do so, nurses must develop a fundamentally different paradigm and epistemology. New care models are required that focus on issues such as evidence-based prevention. Among the prevention foci for hospitals are hospital-acquired infections, including influenza, which kills 36,000 Americans annually. One crucial step in eliminating hospital-acquired influenza is to require influenza vaccination of all health care workers. This article challenges nursing leadership to seize opportunities to lead health care initiatives and encourage courageous innovative actions that depart from old paradigms; these actions must be based on scientific evidence, reduce costs, and promote patient safety and quality care and outcomes. Copyright 2013, SLACK Incorporated.

  20. Nurse Migration: A Canadian Case Study

    PubMed Central

    Little, Lisa

    2007-01-01

    Objective To synthesize information about nurse migration in and out of Canada and analyze its role as a policy lever to address the Canadian nursing shortage. Principal Findings Canada is both a source and a destination country for international nurse migration with an estimated net loss of nurses. The United States is the major beneficiary of Canadian nurse emigration resulting from the reduction of full-time jobs for nurses in Canada due to health system reforms. Canada faces a significant projected shortage of nurses that is too large to be ameliorated by ethical international nurse recruitment and immigration. Conclusions The current and projected shortage of nurses in Canada is a product of health care cost containment policies that failed to take into account long-term consequences for nurse workforce adequacy. An aging nurse workforce, exacerbated by layoffs of younger nurses with less seniority, and increasing demand for nurses contribute to a projection of nurse shortage that is too great to be solved ethically through international nurse recruitment. National policies to increase domestic nurse production and retention are recommended in addition to international collaboration among developed countries to move toward greater national nurse workforce self sufficiency. PMID:17489918

  1. The Future of Nursing: Leading Change, Advancing Health

    ERIC Educational Resources Information Center

    National Academies Press, 2011

    2011-01-01

    "The Future of Nursing" explores how nurses' roles, responsibilities, and education should change significantly to meet the increased demand for care that will be created by health care reform and to advance improvements in America's increasingly complex health system. At more than 3 million in number, nurses make up the single…

  2. Structure and Dynamics of Religious Insurgency: Students and the Spread of the Reformation

    ERIC Educational Resources Information Center

    Kim, Hyojoung; Pfaff, Steven

    2012-01-01

    The Protestant Reformation swept across Central Europe in the early-sixteenth century, leaving cities divided into Evangelical and Catholic camps as some instituted reforms and others remained loyal to the Roman Church. In offering a new explanation of the Reformation, we develop a theory that identifies ideologically mobilized students as bridge…

  3. A multi-state assessment of employer-sponsored quality improvement education for early-career registered nurses.

    PubMed

    Djukic, Maja; Kovner, Christine T; Brewer, Carol S; Fatehi, Farida K; Seltzer, Joanna R

    2013-01-01

    Increasing participation of registered nurses (RNs) in quality improvement (QI) is a promising strategy to close the health care quality chasm. For RNs to participate effectively in hospital QI, they must have adequate QI knowledge and skills. This descriptive study assessed employer-sponsored QI education and RNs' preparedness across a wide range of QI steps and processes. RNs from 15 U.S. states who were employed in hospitals and were initially licensed to practice in 2007 to 2008 were surveyed. Fewer than one third of respondents reported being very prepared across all measured QI topics. More than half reported receiving zero hours of training in these same topics in the last year. Lack of educational offerings on the topic was the top reason respondents gave for not obtaining QI training. The QI education offered by employers to RNs could be substantially improved. Nurse educators play a critical role in making these improvements. Copyright 2013, SLACK Incorporated.

  4. Reading Reform in Egypt: Do the Second-Grade Textbooks Reflect the New Direction?

    ERIC Educational Resources Information Center

    Boyle, Helen N.; Salah, Wail

    2017-01-01

    In light of disappointing scores on the Early Grade Reading Assessment (EGRA) and the Progress in International Reading Literacy Study (PIRLS), Arabic-speaking countries have begun to reexamine, and in some case reform, how they teach reading in the early grades. Egypt was one of the first countries to initiate early-grade reading reforms in 2010.…

  5. How Grading Reform Changed Our School

    ERIC Educational Resources Information Center

    Erickson, Jeffrey A.

    2011-01-01

    In the early 2000s, Minnetonka High School decided that it needed to develop a more consistent, transparent system of grading. The school focused its grading reform efforts on one principle: Grades should reflect only what a student knows and is able to do. As the school staff analyzed their policies and practices, they discovered many practices…

  6. Transcendentalism and the Promise of Educational Reform.

    ERIC Educational Resources Information Center

    Pemberton, Janette E.

    The philosophy of Transcendentalism developed in the early nineteenth century among such thinkers as Ralph Waldo Emerson, Henry David Thoreau, Walt Whitman, Theodore Parker, George Ripley, Bronson Alcott, and Caleb Sprague Henry. Transcendentalism emphasized the need for social reform that would lead the individual to self-reliance, and education…

  7. Thinking about Tax Reform.

    ERIC Educational Resources Information Center

    Boskin, Michael J.

    1985-01-01

    Providing pre-college teachers with an analysis of tax reform is the primary goal of this publication. The present tax system is both inefficient and inequitable. Three goals of tax reform proposals are detailed: (1) fairness--the dimensions of horizontal equity, or equal treatment of equals however defined, and vertical equity, reflecting the…

  8. Reform Disconnection in China

    ERIC Educational Resources Information Center

    Walker, Allan; Qian, Haiyan

    2012-01-01

    This article examines many of the frustrations associated with implementing education reforms in mainland Chinese schools. Our basic argument is that when taken individually, many of the recent reforms are beneficial, but when parceled together and thrust hastily at schools, they are unwieldy and disconnected. We suggest that the inability of the…

  9. Small Schools Reform Narratives

    ERIC Educational Resources Information Center

    Lehman, Beth M.; Berghoff, Beth

    2013-01-01

    This study explored complicated personal narratives of school reform generated by participants in response to a particular small schools reform initiative. Narrative data was dialogically generated in interviews with nine past participants of an urban high school conversion project planned and implemented over a span of five years toward the goal…

  10. Curriculum and Assessment Reform.

    ERIC Educational Resources Information Center

    Hargreaves, Andy

    Large-scale curriculum and assessment reform is neither a local peculiarity, nor a product of national political partisanship. It is a phenomenon of international dimensions. Divided into three sections and nine chapters, this book seeks to explain and interpret the nature, impact, and interrelatedness of recent important and far-reaching reforms.…

  11. Health reform through tax reform: a primer.

    PubMed

    Furman, Jason

    2008-01-01

    Tax incentives for employer-sponsored insurance and other medical spending cost about $200 billion annually and have pervasive effects on coverage and costs. This paper surveys a range of proposals to reform health care, either by adding new tax incentives or by limiting or replacing the existing tax incentives. Replacing the current tax preference for insurance with an income-related, refundable tax credit has the potential to expand coverage and reduce inefficient spending at no net federal cost. But such an approach by itself would entail substantial risks, so complementary reforms to the insurance market are essential to ensure success.

  12. Professionally responsible malpractice reform.

    PubMed

    Brody, Howard; Hermer, Laura D

    2011-07-01

    Medical malpractice reform is both necessary and desirable, yet certain types of reform are clearly preferable to others. We argue that "traditional" tort reform remedies such as stringent damage caps not only fail to address the root causes of negligence and the adverse effects that fear of suit can have on physicians, but also fail to address the needs of patients. Physicians ought to view themselves as professionals who are dedicated to putting patients' interests ahead of their own. Professionally responsible malpractice reform should therefore be at least as patient-centered as it is physician-centered. Examples of more professionally responsible malpractice reform exist where institutions take a pro-active approach to identification, investigation, and remediation of possible malpractice. Such programs should be implemented more generally, and state laws enacted to facilitate them.

  13. Prevention in Poland: health care system reform.

    PubMed Central

    Sheahan, M D

    1995-01-01

    Despite the political and economic reforms that have swept Eastern Europe in the past 5 years, there has been little change in Poland's health care system. The Ministry of Health and Social Welfare has targeted preventive care as a priority, yet the enactment of legislation to meet this goal has been slow. The process of reform has been hindered by political stagnation, economic crisis, and a lack of delineation of responsibility for implementing the reforms. Despite the delays in reform, recent developments indicate that a realistic, sustainable restructuring of the health care system is possible, with a focus on preventive services. Recent proposals for change have centered on applying national goals to limited geographic areas, with both local and international support. Regional pilot projects to restructure health care delivery at a community level, local health education and disease prevention initiatives, and a national training program for primary care and family physicians and nurses are being planned. Through regionalization, an increase in responsibility for both the physician and the patient, and redefinition of primary health care and the role of family physicians, isolated local movements and pilot projects have shown promise in achieving these goals, even under the current budgetary constraints. PMID:7610217

  14. Prevention in Poland: health care system reform.

    PubMed

    Sheahan, M D

    1995-01-01

    Despite the political and economic reforms that have swept Eastern Europe in the past 5 years, there has been little change in Poland's health care system. The Ministry of Health and Social Welfare has targeted preventive care as a priority, yet the enactment of legislation to meet this goal has been slow. The process of reform has been hindered by political stagnation, economic crisis, and a lack of delineation of responsibility for implementing the reforms. Despite the delays in reform, recent developments indicate that a realistic, sustainable restructuring of the health care system is possible, with a focus on preventive services. Recent proposals for change have centered on applying national goals to limited geographic areas, with both local and international support. Regional pilot projects to restructure health care delivery at a community level, local health education and disease prevention initiatives, and a national training program for primary care and family physicians and nurses are being planned. Through regionalization, an increase in responsibility for both the physician and the patient, and redefinition of primary health care and the role of family physicians, isolated local movements and pilot projects have shown promise in achieving these goals, even under the current budgetary constraints.

  15. A pragmatic cluster randomized controlled trial of early intervention for chronic obstructive pulmonary disease by practice nurse-general practitioner teams: Study Protocol

    PubMed Central

    2012-01-01

    Background Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of disability, hospitalization, and premature mortality. General practice is well placed to diagnose and manage COPD, but there is a significant gap between evidence and current practice, with a low level of awareness and implementation of clinical practice guidelines. Under-diagnosis of COPD is a world-wide problem, limiting the benefit that could potentially be achieved through early intervention strategies such as smoking cessation, dietary advice, and exercise. General practice is moving towards more structured chronic disease management, and the increasing involvement of practice nurses in delivering chronic care. Design A pragmatic cluster randomised trial will test the hypothesis that intervention by a practice nurse-general practitioner (GP) team leads to improved health-related quality of life and greater adherence with clinical practice guidelines for patients with newly-diagnosed COPD, compared with usual care. Forty general practices in greater metropolitan Sydney Australia will be recruited to identify patients at risk of COPD and invite them to attend a case finding appointment. Practices will be randomised to deliver either practice nurse-GP partnership care, or usual care, to patients newly-diagnosed with COPD. The active intervention will involve the practice nurse and GP working in partnership with the patient in developing and implementing a care plan involving (as appropriate), smoking cessation, immunisation, pulmonary rehabilitation, medication review, assessment and correction of inhaler technique, nutritional advice, management of psycho-social issues, patient education, and management of co-morbidities. The primary outcome measure is health-related quality of life, assessed with the St George’s Respiratory Questionnaire 12 months after diagnosis. Secondary outcome measures include validated disease-specific and general health related quality of life measures

  16. Changing times: the role of academe in health reform.

    PubMed

    Hewlett, Peggy O'Neill; Bleich, Michael; Cox, Mary Foster; Hoover, Kim Welch

    2009-01-01

    What is the role of nursing educators in the politics surrounding health reform? This critical question is posed, and exemplars of how nurse faculty can and should become more involved in the political arena are shared. The authors issue a call to action for every nurse educator in the country to become actively engaged in health reform discussions to bring this all-important perspective to the table. Recognizing and overcoming traditional roles and barriers for nurse faculty on university campuses are essential parts of the political activism that must be assumed. Opening the doors for increased patient access will result in higher utilization of health care providers, and if the nursing shortage is not abated, then bottlenecking of qualified students in programs with critical faculty shortages will create immense pressure in an overloaded care delivery system. The full impact of legislated health reform changes on academe may not be fully realized until after the fact-and as often experienced in the past, this may come too late for policy makers to adequately address questions that should have been raised by the faculty corps beforehand. The time to get involved is now.

  17. Catalytic reforming methods

    DOEpatents

    Tadd, Andrew R; Schwank, Johannes

    2013-05-14

    A catalytic reforming method is disclosed herein. The method includes sequentially supplying a plurality of feedstocks of variable compositions to a reformer. The method further includes adding a respective predetermined co-reactant to each of the plurality of feedstocks to obtain a substantially constant output from the reformer for the plurality of feedstocks. The respective predetermined co-reactant is based on a C/H/O atomic composition for a respective one of the plurality of feedstocks and a predetermined C/H/O atomic composition for the substantially constant output.

  18. Education Reforms: Lessons from History

    ERIC Educational Resources Information Center

    Hunt, Thomas C.

    2005-01-01

    Policy makers in education have long embraced reform. Unfortunately, education reforms have consistently been plagued by the reformers' lack of knowledge and appreciation of the history of education. Accordingly, the latest reform, touted as a panacea, meets with failure, and the search for the magic elixir begins anew. The ahistorical nature of…

  19. Atuarfitsialak: Greenland's Cultural Compatible Reform

    ERIC Educational Resources Information Center

    Wyatt, Tasha R.

    2012-01-01

    In 2002, Greenlandic reform leaders launched a comprehensive, nation-wide reform to create culturally compatible education. Greenland's reform work spans the entire educational system and includes preschool through higher education. To assist their efforts, reform leaders adopted the Standards for Effective Pedagogy developed at the Center for…

  20. New nursing education structure in Spain.

    PubMed

    Zabalegui, Adelaida; Cabrera, Esther

    2009-07-01

    Nursing education in Spain is developing rapidly in accordance with the European Union growth and within an international globalization movement. The purpose of this article is to present the new nursing education framework in Spain: A brief history together with its recent reform and developments. Since nursing education was integrated into the university level in 1977, the only academic recognition for such an education in Spain was the three year diploma degree. Nurses had to move into other disciplines in order to achieve academic growth or advance their nursing studies abroad. Currently and in compliance with the Bologna declaration for the Higher European Education Area, nursing education in Spain is being transformed into a program which recognizes bachelor, master and doctoral degrees in this field. In January 2005, the Spanish Government published the guidelines for the undergraduate, master's and doctoral levels, and finally, last October 2007, it established the regulations for the official university education. The current nursing specialties in Spain include family and community health nursing, midwifery, mental health nursing, geriatric nursing, health work nursing, medical care nursing and pediatric nursing. This new nursing education structure is expected to improve health care as well as nursing reliability and autonomy.

  1. Trends in Local Therapy Utilization and Cost for Early-Stage Breast Cancer in Older Women: Implications for Payment and Policy Reform

    SciTech Connect

    Shirvani, Shervin M.; Department of Radiation Oncology, Banner MD Anderson Cancer Center, Gilbert, Arizona; Jiang, Jing

    Purpose: Older women with early-stage disease constitute the most rapidly growing breast cancer demographic, yet it is not known which local therapy strategies are most favored by this population in the current era. Understanding utilization trends and cost of local therapy is important for informing the design of bundled payment models as payers migrate away from fee-for-service models. We therefore used the Surveillance, Epidemiology, and End Results Medicare database to determine patterns of care and costs for local therapy among older women with breast cancer. Methods and Materials: Treatment strategy and covariables were determined in 55,327 women age ≥66 withmore » Tis-T2N0-1M0 breast cancer who underwent local therapy between 2000 and 2008. Trends in local therapy were characterized using Joinpoint. Polychotomous logistic regression determined predictors of local therapy. The median aggregate cost over the first 24 months after diagnosis was determined from Medicare claims through 2010 and reported in 2014 dollars. Results: The median age was 75. Local therapy distribution was as follows: 27,896 (50.3%) lumpectomy with external beam radiation, 18,356 (33.1%) mastectomy alone, 6159 (11.1%) lumpectomy alone, 1488 (2.7%) mastectomy with reconstruction, and 1455 (2.6%) lumpectomy with brachytherapy. Mastectomy alone declined from 39.0% in 2000 to 28.2% in 2008, and the use of breast conserving local therapies rose from 58.7% to 68.2%. Mastectomy with reconstruction was more common among the youngest, healthiest patients, whereas mastectomy alone was more common among patients living in rural low-income regions. By 2008, the costs were $36,749 for lumpectomy with brachytherapy, $35,030 for mastectomy with reconstruction, $31,388 for lumpectomy with external beam radiation, $21,993 for mastectomy alone, and $19,287 for lumpectomy alone. Conclusions: The use of mastectomy alone in older women declined in favor of breast conserving strategies between 2000 and

  2. Non-catalytic recuperative reformer

    DOEpatents

    Khinkis, Mark J.; Kozlov, Aleksandr P.; Kurek, Harry

    2015-12-22

    A non-catalytic recuperative reformer has a flue gas flow path for conducting hot flue gas from a thermal process and a reforming mixture flow path for conducting a reforming mixture. At least a portion of the reforming mixture flow path is embedded in the flue gas flow path to permit heat transfer from the hot flue gas to the reforming mixture. The reforming mixture flow path contains substantially no material commonly used as a catalyst for reforming hydrocarbon fuel (e.g., nickel oxide, platinum group elements or rhenium), but instead the reforming mixture is reformed into a higher calorific fuel via reactions due to the heat transfer and residence time. In a preferred embodiment, extended surfaces of metal material such as stainless steel or metal alloy that are high in nickel content are included within at least a portion of the reforming mixture flow path.

  3. Early return visits by primary care patients: a retail nurse practitioner clinic versus standard medical office care.

    PubMed

    Rohrer, James E; Angstman, Kurt B; Garrison, Gregory

    2012-08-01

    The purpose of this study was to compare return visits made by patients within 2 weeks after using retail nurse practitioner clinics to return visits made by similar patients after using standard medical office clinics. Retail medicine clinics have become widely available. However, their impact on return visit rates compared to standard medical office visits for similar patients has not been extensively studied. Electronic medical records of adult primary care patients seen in a large group practice in Minnesota in 2009 were analyzed for this study. Patients who were treated for sinusitis were selected. Two groups of patients were studied: those who used one of 2 retail walk-in clinics staffed by nurse practitioners and a comparison group who used one of 4 regular office clinics. The dependent variable was a return office visit to any site within 2 weeks. Multiple logistic regression analysis was used to adjust for case-mix differences between groups. Unadjusted odds of return visits were lower for retail clinic patients than for standard office care patients. After adjustment for case mix, patients with more outpatient visits in the previous 6 months had higher odds of return visits within 2 weeks (2-6 prior visits: odds ratio [OR]=1.99, P=0.00; 6 or more prior visits: OR=6.80, P=0.00). The odds of a return visit within 2 weeks were not different by clinic type after adjusting for propensity to use services (OR=1.17, P=0.28). After adjusting for case mix differences, return visit rates did not differ by clinic type.

  4. The IOM report on the future of nursing: what perioperative nurses need to know.

    PubMed

    Battié, Renae N

    2013-09-01

    The 2010 Institute of Medicine (IOM) report, The Future of Nursing: Leading Change, Advancing Health, continues to be the most-viewed report in IOM history. Nearly three years after its publication, there are action coalitions of nursing and non-nursing agencies in 50 states and the District of Columbia collaborating to move the eight recommendations for action forward. There is much work to do to reshape health care delivery in the United States, and the IOM has identified nurses as key leaders in driving the reform. Every nurse must be educated on the key messages of the IOM report and become involved in moving these recommendations forward as well as in educating others on what needs to be done. AORN and perioperative nurses have a key role in voicing the unique needs of perioperative patients and in ensuring that perioperative patient care is represented in reform activities. Copyright © 2013 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  5. NETL - Fuel Reforming Facilities

    ScienceCinema

    None

    2018-01-26

    Research using NETL's Fuel Reforming Facilities explores catalytic issues inherent in fossil-energy related applications, including catalyst synthesis and characterization, reaction kinetics, catalyst activity and selectivity, catalyst deactivation, and stability.

  6. Reformer Fuel Injector

    NASA Technical Reports Server (NTRS)

    Suder, Jennifer L.

    2004-01-01

    Today's form of jet engine power comes from what is called a gas turbine engine. This engine is on average 14% efficient and emits great quantities of green house gas carbon dioxide and air pollutants, Le. nitrogen oxides and sulfur oxides. The alternate method being researched involves a reformer and a solid oxide fuel cell (SOFC). Reformers are becoming a popular area of research within the industry scale. NASA Glenn Research Center's approach is based on modifying the large aspects of industry reforming processes into a smaller jet fuel reformer. This process must not only be scaled down in size, but also decrease in weight and increase in efficiency. In comparison to today's method, the Jet A fuel reformer will be more efficient as well as reduce the amount of air pollutants discharged. The intent is to develop a 10kW process that can be used to satisfy the needs of commercial jet engines. Presently, commercial jets use Jet-A fuel, which is a kerosene based hydrocarbon fuel. Hydrocarbon fuels cannot be directly fed into a SOFC for the reason that the high temperature causes it to decompose into solid carbon and Hz. A reforming process converts fuel into hydrogen and supplies it to a fuel cell for power, as well as eliminating sulfur compounds. The SOFC produces electricity by converting H2 and CO2. The reformer contains a catalyst which is used to speed up the reaction rate and overall conversion. An outside company will perform a catalyst screening with our baseline Jet-A fuel to determine the most durable catalyst for this application. Our project team is focusing on the overall research of the reforming process. Eventually we will do a component evaluation on the different reformer designs and catalysts. The current status of the project is the completion of buildup in the test rig and check outs on all equipment and electronic signals to our data system. The objective is to test various reformer designs and catalysts in our test rig to determine the most

  7. Nursing Supplies

    MedlinePlus

    ... Stages Listen Español Text Size Email Print Share Nursing Supplies Page Content Article Body Throughout most of ... budget. (Nursing equipment also makes wonderful baby gifts.) Nursing Bras A well-made nursing bra that comfortably ...

  8. Nursing Homes

    MedlinePlus

    ... our e-newsletter! Aging & Health A to Z Nursing Homes Basic Facts & Information Nursing homes have changed ... guide care in nursing homes. Who lives in nursing homes? Almost half of all people who live ...

  9. Responding to the call for globalization in nursing education: the implementation of the transatlantic double-degree program.

    PubMed

    Hornberger, Cynthia A; Erämaa, Sirkka; Helembai, Kornélia; McCartan, Patrick J; Turtiainen, Tarja

    2014-01-01

    Increased demand for nurses worldwide has highlighted the need for a flexible nursing workforce eligible for licensure in multiple countries. Nursing's curricular innovation mirrors the call for reform within higher education including globalization of curricula (E. J. S. Hovenga, 2004; D. Nayyar, 2008; B. J. G. Wood, S. M. Tapsall, & G. N. Soutar, 2005), increased opportunities for student mobility exchanges, dialogue between different academic traditions, and mutual understanding and transparency between universities (J. González & R. Wagenaar, 2005). The European Union (EU) and United States have combined efforts to achieve these objectives by creating the Atlantis program in 2007 (U.S. Department of Education, 2011). This article describes experiences of four nursing programs participating in an Atlantis project to develop a double-degree baccalaureate program for undergraduate nursing students. Early learnings include increasing awareness and appreciation of essential curricular and performance competencies of the baccalaureate-prepared professional nurse. Challenges include language competency; variations in curriculum, cultural norms, student expectations, and learning assessment; and philosophical differences regarding first-level professional nurse preparation as specialist versus generalist. The Transatlantic Double Degree program has successfully implemented the double-degree program. Members have gained valuable insights into key issues surrounding the creation of a more uniform, yet flexible, educational standard between our countries. © 2014.

  10. Seeing difference: market health reform in Europe.

    PubMed

    Jacobs, A

    1998-02-01

    The comparative literature on health care reform has identified a convergence upon market models as nations respond to similar economic, technological, social, and demographic pressures. In this article I first challenge the conventional view by comparing "market" reforms of the late 1980s and early 1990s in the United Kingdom, the Netherlands, and Sweden. Though these nations did indeed converge upon the instrument of the market incentive, there was considerable divergence in the content and aims of their reform strategies. These nations designed their respective markets to make different tradeoffs among competing values. While all three exploited the principle of provider competition, they appointed different actors to judge the contest: the cost-conscious public authority in the United Kingdom, the quality-conscious patient in Sweden, and the optimizing consumer in the Netherlands. I argue that these countries were thus using common market tools to promote different health policy goals. Distinguishing these reforms further is the fact that--particularly in the Netherlands--there was a gap between market plans and the reality of implemented change. I then ask why nations responded so differently to such similar objective pressures. My contention is that this divergence reflects, in part, the different ideological orientations of the ruling party or coalition in each nation. Yet divergence is also the result of differences in both the design of political institutions and the structure of the pre-reform health system in each country.

  11. Nursing's Code of Ethics, Social Ethics, and Social Policy.

    PubMed

    Fowler, Marsha D

    2016-09-01

    Modern American nursing arose during the Civil War and subsequently adopted the Nightingale educational model in the 1870s. By 1889, the journal Trained Nurse and Hospital Review had been established. It published a six-part series on ethics in nursing. With the establishment of the American Nurses Association in 1893, the articles of incorporation gave the organization its first charge: "to establish and maintain a code of ethics." While the rich and enduring tradition of nursing's ethics has been concerned about individual patients and their relational nexus, nursing ethics has from the beginning been a social ethics, intimately concerned both for the shape of society and for social change. This concern has been for health, conceived broadly and not focused specifically on disease and its treatment, but including the social causes of disease. Nightingale herself was an ardent social reformer, instituting a wide range of types of army sanitation reform, sanitation reform in India, and hospital and nursing reform. Despite her gender, her wealth and privilege granted her access to men in power who furthered her policy and reform agenda. From the start, then, modern nursing was imbued with a social reformist bias. © 2016 The Hastings Center.

  12. Grade-Level Differences in Future-Oriented Self-Concept during Early Adolescence: Potential Relevance to School Nursing

    ERIC Educational Resources Information Center

    Stoddard, Sarah A.; Pierce, Jennifer; Schmidt, Carissa J.

    2016-01-01

    The middle school and early high school years are a time of significant development, including an increasing ability to envision oneself in the future. Little is known about how adolescents' future-oriented self-concept (i.e., possible selves) differs across grade levels, although this knowledge may aid in establishing rapport with students and…

  13. [The Role of Nursing Education in the Advancement of the Nursing Profession].

    PubMed

    Chang Yeh, Mei

    2017-02-01

    The present article discusses the role of nursing education in the advancement of the nursing profession in the context of the three facets of knowledge: generation, dissemination, and application. Nursing is an applied science and the application of knowledge in practice is the ultimate goal of the nursing profession. The reform of the healthcare delivery model requires that nurses acquire and utilize evidence-based clinical knowledge, critical thinking, effective communication, and team collaboration skills in order to ensure the quality of patient care and safety. Therefore, baccalaureate education has become the minimal requirement for pre-licensure nursing education. Schools of nursing are responsible to cultivate competent nurses to respond to the demands on the nursing workforce from the healthcare system. Attaining a master's education in nursing helps cultivate Advanced Practice Registered Nurses (APRNs) to further expand the roles and functions of the nursing profession in order to promote the quality of care in clinical practice. Nursing faculty and scholars of higher education institutions generate nursing knowledge and develop professional scholarship through research. Attaining a doctoral education in nursing cultivates faculties and scholars who will continually generate and disseminate nursing knowledge into the future.

  14. Thermal tolerance during early ontogeny in the common whelk Buccinum undatum (Linnaeus 1785): Bioenergetics, nurse egg partitioning and developmental success

    NASA Astrophysics Data System (ADS)

    Smith, Kathryn E.; Thatje, Sven; Hauton, Chris

    2013-05-01

    Temperature is arguably the primary factor affecting development in ectotherms and, as a result, may be the driving force behind setting species' geographic limits. The shallow-water gastropod Buccinum undatum is distributed widely throughout the North Atlantic, with an overall annual thermal range of below zero to above 22 °C. In UK waters this species is a winter spawner. Egg masses are laid and develop when sea temperatures are at their coolest (4 to 10 °C) indicating future climate warming may have the potential to cause range shifts in this species. In order to examine the potential impacts of ocean warming, we investigate the effects of temperature on the early ontogeny of B. undatum across a thermal range of 0 to 22 °C. Each egg mass consists of approximately 100 capsules, in which embryos undergo direct development. Successful development was observed at temperatures ranging from 6 to 18 °C. Rates of development increased with temperature, but the proportion of each egg mass developing successfully decreased at the same time. With increasing temperature, the mean early veliger weight increased, but the number of early veligers developing per capsule decreased, suggesting a negative impact on the number of crawl-away juveniles produced per capsule. Elemental analysis showed both carbon (C) and nitrogen (N) to increase with temperature in early veligers but not in hatching juveniles, indicating greater energy reserves are accumulated during early ontogeny to compensate for the higher energetic demands of development at higher temperature. The developmental plasticity observed in B. undatum suggests this species to be capable of adapting to temperatures above those it currently experiences in nature. B. undatum may possess a thermal resilience to ocean warming at its current upper temperature distribution limit. This thermal resilience, however, may come at the cost of a reduced offspring number.

  15. American Nurses Association Nursing World

    MedlinePlus

    ... ANA » My ANA » Shop » ANA Nursing Knowledge Center Nursing Insider News 10/13/2017 American Nurses Association ... 17 ANA Enterprise CEO Weston Announces Resignation More Nursing Insider News Upcoming Events 10/17/2017 - 10/ ...

  16. Nursing: What's a Nurse Practitioner?

    MedlinePlus

    ... nurses, or APNs) have a master's degree in nursing (MS or MSN) and board certification in their ... Nurse Practitioners (NAPNAP) and through local hospitals or nursing schools. Also, many doctors share office space with ...

  17. The early childhood oral health program: a qualitative study of the perceptions of child and family health nurses in South Western Sydney, Australia.

    PubMed

    Veale, Maxine; Ajwani, Shilpi; Johnson, Maree; Nash, Linda; Patterson, Tiffany; George, Ajesh

    2016-05-16

    Early childhood caries affects nearly half the population of Australian children aged 5 years and has the potential to negatively impact their growth and development. To address this issue, an Early Childhood Oral Health (ECOH) program, facilitated by Child and Family Health Nurses (CFHNs), commenced in 2007 in New South Wales, Australia. This study builds on the previous evaluation of the program. It aims to explore the perceptions of CFHNs regarding the implementation of the ECOH program in South Western Sydney and the challenges and barriers related to its sustainability. A descriptive qualitative design was used in this study. Two focus groups were conducted with 22 CFHNs who were sampled from two Community Health Centres in South Western Sydney, Australia. Data were transcribed verbatim and thematic analysis was undertaken. Most CFHNs acknowledged the importance of early childhood oral health promotion and were providing education, oral assessments and referrals during child health checks. Many stressed the need for collaboration with other health professionals to help broaden the scope of the program. Some barriers to implementing the program included confusion regarding the correct referral process, limited feedback from dental services and the lack of oral health awareness among parents. The study findings suggest that the ECOH program is being sustained and effectively implemented into practice by CFHNs. Improvement in the referral and feedback process as well as enhancing parental knowledge of the importance of infant and child oral health could further strengthen the effectiveness of the program. Expanding oral health education opportunities into general practice is advocated, while regular on-line training for CFHNs is preferred. Future research should include strategies to reduce non-attendances, and an assessment of the impact on the prevalence of childhood caries of the ECOH program.

  18. On the road to reform: a sociocultural interpretation of reform

    NASA Astrophysics Data System (ADS)

    Mensah, Felicia Moore

    2011-09-01

    In this paper I discuss how reform in science education is interpreted by Barma as she recounts the story of Catherine, a grade 9 biology teacher, who reforms her teaching practices in response to a national curriculum reform in Quebec, Canada. Unlike some cases in response to reform, this case is hopeful and positive. Also in this paper, I address some familiar areas that must be considered when teachers undertake curriculum reform and how science educators may fulfill the role of facilitator and advocate in the support of teachers on the road to reform. The commentary focuses on how Barma retells the story through the lens of activity theory.

  19. Perceptions of Adult Women on Losing Their Mothers at an Early Age: Implications for Nursing Care During Childbirth.

    PubMed

    Gunn, Jennie; Huebner, Carroll Gunn; McCoy, Kristen

    To explore the lived experience of women over the age of 21 who lost their mothers before the age of 18. Using qualitative methodology, motherless child-adult women were gathered through emails, word of mouth, and snowballing techniques. Interviews were conducted at the convenience of the women. The women coparticipated with identification of emerging themes using thematic analysis. Eight women who lost their mothers before the age of 18 participated. Eight themes emerged: (1) Understanding: For wounded hearts only; (2) Coming apart: Finding my mother's daughter and self-worth; (3) Unconditional love: Grieving for and identifying with my champion; (4) Finding help: Filling the empty place with God; (5) Pitying the motherless child: Making it worse; (6) Filling in: Others as mother; (7) The ebb and flow: Grieving; and (8) Becoming mother: Taking on the Role. The nurse has the opportunity to improve care for women who lost their mothers before the age of 18 years. During pregnancy, childbirth, and childrearing, the woman may feel sad and anxious without the guidance of her mother. Special ways of caring may be instituted to provide her comfort such as allowing and encouraging her to bring a special item of her mother's to procedures and events so that she may feel connected with her, allowing someone to stand in for her mother, perhaps assisting in finding of another motherless child adult to be with her as needed, and the voicing of understanding of her loss while remaining nonjudgmental about her emotions during these times.

  20. Nursing's Boundary Work: Theory Development and the Making of Nursing Science, ca. 1950-1980.

    PubMed

    Tobbell, Dominique A

    Beginning in the late 1950s and intensifying through the 1960s and 1970s, nurse educators, researchers, and scholars worked to establish nursing as an academic discipline. These nursing leaders argued that the development of nursing theory was not only critical to nursing's academic project but also to improving nursing practice and patient care. The purpose of the article is to examine the context for the development of nursing theory and the characteristics of early theory development from the 1950s through the early 1980s. The methods used were historical research and analysis of the social, cultural, and political context of nursing theory development from the 1950s through the early 1980s. How this context influenced the work of nurse theorists and researchers in these decades was addressed. The development of nursing theory was influenced by a context that included the increasing complexity of patient care, the relocation of nursing education from hospital-based diploma schools to colleges and universities, and the ongoing efforts of nurses to secure more professional autonomy and authority in the decades after World War II. In particular, from the 1960s through the early 1980s, nurse theorists, researchers, and educators viewed the establishment of nursing science, underpinned by nursing theory, as critical to establishing nursing as an academic discipline. To define nursing science, nurse theorists and researchers engaged in critical boundary work in order to draw epistemic boundaries between nursing science and the existing biomedical and behavioral sciences. By the early 1980s, the boundary work of nurse theorists and researchers was incomplete. Their efforts to define nursing science and establish nursing as an academic discipline were constrained by generational and intraprofessional politics, limited resources, the gendered and hierarchical politics, and the complexity of drawing disciplinary boundaries for a discipline that is inherently

  1. Establishing Priorities for Oncology Nursing Research: Nurse and Patient Collaboration.

    PubMed

    Cox, Anna; Arber, Anne; Gallagher, Ann; MacKenzie, Mairead; Ream, Emma

    2017-03-01

    To obtain consensus on priorities for oncology nursing research in the United Kingdom.
. A three-round online Delphi survey.
. Oncology nurses were invited via the United Kingdom Oncology Nursing Society (UKONS) database. Patient participation was invited through patient organizations.
. 50 oncology nurses and 18 patients.
. Eligible and consenting individuals reported five priorities for oncology nursing research (round 1), rated their level of agreement with them (round 2), and restated and revised their responses in light of the group's responses (round 3). Consensus was defined as 80% agreement.
. Research priorities for oncology nursing as reported by oncology nurses and patients. 
. Consensus was reached on 50 of 107 research priorities. These priorities reflected the entire cancer pathway, from diagnosis to palliative care. Highest agreement was reached within and across groups on the need for research relating to prevention, screening, early diagnosis, and psychological care across the cancer trajectory. Little consensus was reached regarding symptoms and side effects. Some evident divergence existed. Oncology nurses and patients do not necessarily prioritize the same research areas. Prevention, screening, and early diagnosis are of the highest priority for future research among oncology nurses and patients. 
. Patients usually play little part in priority setting for research. This study provided the opportunity for meaningful patient and nurse involvement in setting a research agenda for oncology nursing that is relevant and beneficial to oncology nurses and patients.

  2. The pivotal role of nurse managers, leaders and educators in enabling excellence in nursing care.

    PubMed

    McSherry, Robert; Pearce, Paddy; Grimwood, Karen; McSherry, Wilfred

    2012-01-01

    The aims of this paper are to present the findings from a discursive analysis of key issues associated with providing excellence in nursing care; and to provide an exemplar framework to support excellence in nursing care and describe the potential benefits when excellence in nursing care occurs. The challenge facing the nursing profession is in ensuring that the core principles of dignity, respect, compassion and person (people) centered care become central to all aspects of nursing practice. To regain the public and professional confidence in nursing, nurse leaders, managers and educators play a pivotal role in improving the image of nursing. Excellence in nursing care will only happen by ensuring that nurse managers, leaders and educators are able to respond to the complexity of reform and change by leading, managing, enabling, empowering, encouraging and resourcing staff to be innovative and entrepreneurial in practice. Creating healthcare environments that enable excellence in nursing care will not occur without the development of genuine shared working partnerships and collaborations between nurse managers, leaders and educators and their associated organizations. The importance of adopting an authentic sustainable leadership approach to facilitating and supporting frontline staff to innovate and change is imperative in restoring and evidencing that nurses do care and are excellent at what they do. By focusing attention on what resources are required to create a healthcare environment that enables compassion, safety and excellence in nursing care and what this means would be a reasonable start on the journey to excellence in nursing. © 2012 Blackwell Publishing Ltd.

  3. Existing and Emerging Payment and Delivery Reforms in Cardiology

    PubMed Central

    Farmer, Steven A.; Darling, Margaret L.; George, Meaghan; Casale, Paul N.; Hagan, Eileen; McClellan, Mark B.

    2017-01-01

    IMPORTANCE Recent health care reforms aim to increase patient access, reduce costs, and improve health care quality as payers turn to payment reform for greater value. Cardiologists need to understand emerging payment models to succeed in the evolving payment landscape. We review existing payment and delivery reforms that affect cardiologists, present 4 emerging examples, and consider their implications for clinical practice. OBSERVATIONS Public and commercial payers have recently implemented payment reforms and new models are evolving. Most cardiology models are modified fee-for-service or address procedural or episodic care, but population models are also emerging. Although there is widespread agreement that payment reform is needed, existing programs have significant limitations and the adoption ofnew programs has been slow. New payment reforms address some of these problems, but many details remain undefined. CONCLUSIONS AND RELEVANCE Early payment reforms were voluntary and cardiologists’ participation is variable. However, conventional fee-for-service will become less viable, and enrollment in new payment models will be unavoidable. Early participation in new payment models will allow clinicians to develop expertise in new care pathways during a period of relatively lower risk. PMID:27851858

  4. Professional Development in a Reform Context: Understanding the Design and Enactment of Learning Experiences Created by Teacher Leaders for Science Educators

    ERIC Educational Resources Information Center

    Shafer, Laura

    2017-01-01

    Teacher in-service learning about education reforms like NGSS often begin with professional development (PD) as a foundational component (Supovitz & Turner, 2000). Teacher Leaders, who are early implementers of education reform, are positioned to play a contributing role to the design of PD. As early implementers of reforms, Teacher Leaders…

  5. The Historical Evolution of Theories and Conceptual Models for Nursing.

    ERIC Educational Resources Information Center

    Hawkins, Joellen W.

    The development of nursing models can be traced to the inception of nursing as a profession. Florence Nightingale laid the foundation for current nursing practice and differentiated nursing from medicine. The late 19th and early 20th centuries contributed a number of important nurse theorists, better known for other contributions to the neophyte…

  6. Health care reforms.

    PubMed

    Marušič, Dorjan; Prevolnik Rupel, Valentina

    2016-09-01

    In large systems, such as health care, reforms are underway constantly. The article presents a definition of health care reform and factors that influence its success. The factors being discussed range from knowledgeable personnel, the role of involvement of international experts and all stakeholders in the country, the importance of electoral mandate and governmental support, leadership and clear and transparent communication. The goals set need to be clear, and it is helpful to have good data and analytical support in the process. Despite all debates and experiences, it is impossible to clearly define the best approach to tackle health care reform due to a different configuration of governance structure, political will and state of the economy in a country.

  7. Primary Health Care Reform in Portugal: Portuguese, modern and innovative.

    PubMed

    Biscaia, André Rosa; Heleno, Liliana Correia Valente

    2017-03-01

    The 2005 Portuguese primary health care (CSP) reform was one of the most successful reforms of the country's public services. The most relevant event was the establishment of Family Health Units (USF): voluntary and self-organized multidisciplinary teams that provide customized medical and nursing care to a group of people. Then, the remaining realms of CSP were reorganized with the establishment of Health Center Clusters (ACeS). Clinical governance was implemented aiming at achieving health gains by improving quality and participation and accountability of all. This paper aims to characterize the 2005 reform of Portuguese CSP with an analysis of its systemic and local realms. This is a case study of a CSP reform of a health system with documentary analysis and description of one of its facilities. This reform was Portuguese, modern and innovative. Portuguese by not breaking completely with the past, modern because it has adhered to technology and networking, and innovative because it broke with the traditional hierarchized model. It fulfilled the goal of a reform: it achieved improvements with greater satisfaction of all and health gains.

  8. A Case of Reform: The Undergraduate Research Collaboratives

    ERIC Educational Resources Information Center

    Horsch, Elizabeth; St. John, Mark; Christensen, Ronald L.

    2012-01-01

    Despite numerous calls for reform, the early chemistry experience for most college students has remained unchanged for decades. In 2004 the National Science Foundation (NSF) issued a call for proposals to create new models of chemical education that would infuse authentic research into the early stages of a student's college experience. Under this…

  9. Public Health Law Reform

    PubMed Central

    Gostin, Lawrence O.

    2001-01-01

    Public health law reform is necessary because existing statutes are outdated, contain multiple layers of regulation, and are inconsistent. A model law would define the mission and functions of public health agencies, provide a full range of flexible powers, specify clear criteria and procedures for activities, and provide protections for privacy and against discrimination. The law reform process provides an opportunity for public health agencies to draw attention to their resource needs and achievements and to form ties with constituency groups and enduring relations with the legislative branch of government. Ultimately, the law should become a catalyst, rather than an impediment, to reinvigorating the public health system. PMID:11527757

  10. Public health law reform.

    PubMed

    Gostin, L O

    2001-09-01

    Public health law reform is necessary because existing statutes are outdated, contain multiple layers of regulation, and are inconsistent. A model law would define the mission and functions of public health agen cies, provide a full range of flexible powers, specify clear criteria and procedures for activities, and provide protections for privacy and against discrimination. The law reform process provides an opportunity for public health agencies to draw attention to their resource needs and achievements and to form ties with constituency groups and enduring relations with the legislative branch of government. Ultimately, the law should become a catalyst, rather than an impediment, to reinvigorating the public health system.

  11. Comprehensive Solutions for Urban Reform

    ERIC Educational Resources Information Center

    Kilgore, Sally

    2005-01-01

    The comprehensive school reform (CSR) models build consistency throughout a district while addressing the needs of individual schools. The high-quality CSR programs offer a most effective option for urban education reform.

  12. Accredited Baccalaureate Nursing Programs Utilization of an Academic Plan Model and the Factors That Influence Curriculum Decision Making

    ERIC Educational Resources Information Center

    Holmquist, Traci McDonald

    2012-01-01

    Curriculum reform is a topic seen in research for decades, and nursing education has not been excluded in this call for reform (Benner, Sutphen, Leonard, & Day, 2009; Diekelmann, Ironside, & Gunn, 2005; Dracup, 2011). The issue in nursing education relates to the lack of guidance in how to proceed with this radical change process (Benner,…

  13. Psychiatric/mental health nursing.

    PubMed

    DeSalvo Rankin, E A

    1986-09-01

    From a historical perspective, psychiatric/mental health nursing as a specialized area of practice is in its early developmental stages. Within the discipline of nursing and on the interdisciplinary scene, the range and scope of actions of the psychiatric/mental health specialists is still being debated. Professional roles and responsibilities are somewhat blurred. But the role is expanding. Contemporary psychiatric nursing practice has moved to a position of collegial support among the disciplines with shared responsibility. The attitudes of society, of the nursing profession, and of the health care providers will continue to influence the maturation process of the psychiatric/mental health nursing specialty.

  14. A Calvinist account of nursing ethics.

    PubMed

    Cusveller, Bart

    2013-11-01

    A relatively small but intellectually robust strand in the Christian religion is the Reformed tradition. Especially, its Calvinist sensibilities inform this Protestant stance towards human culture in general and vocations in particular. Correspondingly, there are some small but robust contributions to academic discourse in nursing ethics. So far there has been no attempt to bring those together as a distinct approach. This article suggests such a Reformed Christian, especially Calvinist, account of nursing ethics. Central to the Reformed perspective is the notion that God is sovereign over all of creation and culture and hence that there can be no religiously or morally neutral area in human life. Consequently, nursing is not seen as professional to the extent it is based on research evidence or theoretical models, but to the extent it serves the ultimate purpose of the practice of care. In the Reformed view, this purpose is fostering the well-being of human beings in need as intrinsically valuable. Nurses are professionals who accept this responsibility, that is, the whole of expectations holding for personal qualities, conduct and outcomes, required to serve the purpose of care. As this is a moral purpose, succeeding or failing to live up to these expectations is the source of moral issues in nursing.

  15. Rationing nurses: Realities, practicalities, and nursing leadership theories.

    PubMed

    Fast, Olive; Rankin, Janet

    2018-04-01

    In this paper, we examine the practicalities of nurse managers' work. We expose how managers' commitments to transformational leadership are undermined by the rationing practices and informatics of hospital reform underpinned by the ideas of new public management. Using institutional ethnography, we gathered data in a Canadian hospital. We began by interviewing and observing frontline leaders, nurse managers, and expanded our inquiry to include interviews with other nurses, staffing clerks, and administrators whose work intersected with that of nurse managers. We learned how nurse managers' responsibility for staffing is accomplished within tightening budgets and a burgeoning suite of technologies that direct decisions about whether or not there are enough nurses. Our inquiry explicates how technologies organize nurse managers to put aside their professional knowledge. We describe professionally committed nurse leaders attempting to activate transformational leadership and show how their intentions are subsumed within information systems. Seen in light of our analysis, transformational leadership is an idealized concept within which managers' responsibilities are shaped to conform to institutional purposes. © 2017 John Wiley & Sons Ltd.

  16. Women, Class, and School Reform.

    ERIC Educational Resources Information Center

    Mickelson, Roslyn Arlin; Wadsworth, Angela L.

    1996-01-01

    Analyzes ordinary women's role in shaping school reform in their community, highlighting interplay of class conflict, regionalism, and gender roles in reform efforts. The women protesting the Odyssey Project framed the debate as a juncture between a national, elitist reform movement and a local grassroots countermovement protecting children,…

  17. Prospects for Health Care Reform.

    ERIC Educational Resources Information Center

    Kastner, Theodore

    1992-01-01

    This editorial reviews areas of health care reform including managed health care, diagnosis-related groups, and the Resource-Based Relative Value Scale for physician services. Relevance of such reforms to people with developmental disabilities is considered. Much needed insurance reform is not thought to be likely, however. (DB)

  18. The Effects of Educational Reform

    ERIC Educational Resources Information Center

    Vasquez-Martinez, Claudio-Rafael; Giron, Graciela; De-La-Luz-Arellano, Ivan; Ayon-Bañuelos, Antonio

    2013-01-01

    Educational reform implies questions of social production and of state regulation that are the key words in educational reform, education and educational policies. These reforms are always on the political agenda of countries and involve international organisms, since education is a vehicle of development for social progress. A point of departure…

  19. Furthering the Understanding of Parent–Child Relationships: A Nursing Scholarship Review Series. Part 2: Grasping the Early Parenting Experience—The Insider View

    PubMed Central

    Lutz, Kristin F.; Anderson, Lori S.; Riesch, Susan K.; Pridham, Karen A.; Becker, Patricia T.

    2010-01-01

    PURPOSE The purpose of this integrative review is to systematically and critically synthesize nursing scholarship on parents’ perspectives of the parent–child relationship during infancy. CONCLUSION Research has shown that the process of establishing the parent–child relationship is highly individualized and complex. Numerous barriers and facilitators influencing this relationship have been identified that are relevant to nursing. PRACTICE IMPLICATIONS Nurses have an important opportunity to positively affect the developing parent–infant relationship. Screening parents for depression and providing parents with resources and support are key nursing interventions supporting the parent–infant relationship. PMID:19796326

  20. Teenagers and Welfare Reform.

    ERIC Educational Resources Information Center

    Offner, Paul

    This report examines the extent to which welfare reform is changing adolescent behaviors that lead to welfare dependency. It begins by discussing the provisions in the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 that require teenagers to stay in school and live with a parent, concluding that relatively little can be…

  1. Reforming Teacher Pay

    ERIC Educational Resources Information Center

    Burns, Susan Freeman; Gardner, Catherine D.

    2010-01-01

    A recent Google search for information regarding performance pay in education produced 6.1 million results. This number should come as no surprise given the current level of interest in incentives as a popular reform option in public education. Supporters believe pay-for-performance programs encourage less effective teachers to improve and will…

  2. Educational Reform in Turkey

    ERIC Educational Resources Information Center

    Lindquist, Cynthia

    2017-01-01

    As a country seeking admission to the European Union, this paper explores educational reforms in Turkey that enhance its possible entry into the European Union and changes still needed for it to be an equal partner. An overview of the school system in Turkey is provided including information on teacher training and preparation, special education…

  3. Prisons and Sentencing Reform.

    ERIC Educational Resources Information Center

    Galvin, Jim

    1983-01-01

    Reviews current themes in sentencing and prison policy. The eight articles of this special issue discuss selective incapacitation, prison bed allocation models, computer-scored classification systems, race and gender relations, commutation, parole, and a historical review of sentencing reform. (JAC)

  4. The Reformation of Schooling.

    ERIC Educational Resources Information Center

    Rubin, Louis

    The necessity for reforming public education is evidenced in part by the failures of past programs and in part by the requirements of the future. The anti-school mood of the present is forcing a more realistic evaluation of the potentiality education possesses in counteracting the disintegrative forces of family breakdown, individual deprivation,…

  5. Reforming the Undergraduate Experience

    ERIC Educational Resources Information Center

    VanderPol, Diane; Brown, Jeanne M.; Iannuzzi, Patricia

    2008-01-01

    The higher education literature abounds with reports and studies calling for reform in undergraduate education. An alphabet soup of higher education associations creates or advocates desired learning outcomes for postsecondary education and endorses approaches for student learning. This article shows connections between some of the major…

  6. Parents and Educational Reform.

    ERIC Educational Resources Information Center

    Wikeley, Felicity; Hughes, Martin

    This paper discusses the findings of a United Kingdom study that examined the impact of the 1988 Education Reform Act (ERA) on a group of parents whose children would be most affected by the changes. Between the fall of 1989 and the summer of 1992, five rounds of interviews were conducted with the same sample of 138 parents from 11 different…

  7. Accomplishing Districtwide Reform

    ERIC Educational Resources Information Center

    Sharratt, Lyn; Fullan, Michael

    2006-01-01

    This is a mystery story. It is about a district that apparently did the right things but seemed not to get commensurate results across all classrooms and schools. In this article, we look closely at the details and discover an important lesson about districtwide reform. The district is York Region District School Board, which is a large…

  8. Mastering School Reform.

    ERIC Educational Resources Information Center

    Goens, George A.; Clover, Sharon I. R.

    School organizations must become responsive and flexible to address rapidly changing social, economic, and demographic conditions. Reform attempts to date have not worked because they were layered on old structures and perceptions in a fragmented, piecemeal fashion. The fundamental transformation of education that is required demands a paradigm…

  9. Examining Comprehensive School Reform

    ERIC Educational Resources Information Center

    Aladjem, Daniel K., Ed.; Borman, Kathryn M., Ed.

    2006-01-01

    Urban school reformers for decades have tried to improve educational outcomes for underserved and disadvantaged students, with the assistance of constantly evolving federal and state policies. In recent years, education policies have shifted from targeting individual students to developing universal standards for teaching and learning, and…

  10. Reform on the Move

    ERIC Educational Resources Information Center

    Clark, Janet; Otte, Michelle; Fair, Lynn

    2006-01-01

    Aurora (Colorado) Public Schools responded to the Colorado State Model Content Standards for Reading and Writing and the accountability measures attached to the state assessments by implementing the Aurora Achievement Initiative in 2001. Originating from literature on best practices and large-scale school reform, the goal of the districtwide…

  11. Scaling up Education Reform

    ERIC Educational Resources Information Center

    Gaffney, Jon D. H.; Richards, Evan; Kustusch, Mary Bridget; Ding, Lin; Beichner, Robert J.

    2008-01-01

    The SCALE-UP (Student-Centered Activities for Large Enrollment for Undergraduate Programs) project was developed to implement reforms designed for small classes into large physics classes. Over 50 schools across the country, ranging from Wake Technical Community College to Massachusetts Institute of Technology (MIT), have adopted it for classes of…

  12. Welfare Reform and Health

    ERIC Educational Resources Information Center

    Bitler, Marianne P.; Gelback, Jonah B.; Hoynes, Hilary W.

    2005-01-01

    A study of the effect of state and federal welfare reforms over the period 1990-2000 on health insurance coverage and healthcare utilization by single women aged between 20-45 is presented. It is observed that Personal Responsibility and Work Opportunity Act of 1996 which replaced the Aid to Families with Dependent Children program of 1990s with…

  13. Nursing, Nursing Education, and Anxiety.

    ERIC Educational Resources Information Center

    Biggers, Thompson; And Others

    In response to the current crisis in the field of nursing, a study examined nursing students' perceived work-related stress and differences among associate degree, diploma, and baccalaureate nursing programs in their preparation of nursing students. The 171 subjects, representing the three different nursing programs, completed a questionnaire…

  14. Junior doctors' working hours: perspectives on the reforms.

    PubMed

    Wilkinson, Carol

    2008-06-01

    The European Working Time Directive for junior doctors came into force in Britain in August 2004. The reforms themselves have been a long time in development and implementation since the inception and debates regarding the New Deal, to the current formations under health and safety legislation. This study, undertaken within a hospital trust setting in England, provides an insight into the perspectives of doctors, nurses and human resources managers in relation to the European Working Time Directive. Critical consideration is given to the impact of the reforms upon the National Health Service and more specifically to daily working relationships at the point of implementation. The results demonstrate some ambivalence towards the reforms because of the major shift in culture for the professions per se, but also for the future of health-care delivery where there are considerable tensions.

  15. Building competencies for nurse administrators in the Republic of Georgia.

    PubMed

    Nishiyama, M; Wold, J L; Partskhladze, N

    2008-06-01

    To assess the level of competency among nurse administrators in the Republic of Georgia (Georgia) and to recommend interventions to implement effective nursing management practices in a resource constrained setting. The collapse of the Soviet Union in 1991 resulted in deterioration of the healthcare system in Georgia. Even though the 1995 healthcare reformers recognized that baccalaureate educated nurses were essential resources for quality health care, limited resources delayed further steps. Hence, Georgia has struggled to raise nursing education levels and to establish nursing as a professional occupation. Using an exploratory descriptive research technique, surveys of nurse managers were conducted in 2004 and in 2005. This study assessed the level of practice among Georgian nurse administrators compared with the international competencies of the International Council of Nurses. There were no organized procedures to evaluate competencies of nurses on a regular basis. While minimal clinical nursing practice guidelines exist, nurse managers did not fully utilize them for either mentoring the staff nurses or assuring an adequate quality of nursing care. Many nurse managers viewed financial constraints as an obstacle to delivering better nursing care. Recommendations include: (1) establishing effective protocols to evaluate the competencies of nurses, (2) mandating the use of existing nursing guidelines, (3) establishing effective resource inventory systems, and (4) mandating safety education and ensuring a safe work environment.

  16. Potential of China in global nurse migration.

    PubMed

    Fang, Zhiwu Zack

    2007-06-01

    The purpose of this paper is to examine what is known about the nurse workforce and nursing education in China in order to assess the likely potential for nurse migration from China in the future. There is a severe shortage of nurses in China (only one nurse per thousand in population), but at the same time there is a very high level of unemployment and underemployment of nurses. China's nursing education system is huge in size (about 500,000 nursing students in 2005), but weak in quality and career development. As a result of lack of limited job opportunities, low salary, and low job satisfaction, many talented Chinese nurses intend to switch occupation or work outside China. Commercial recruiters have expressed a strong interest in recruitment of nurses in China, but to date there are few examples of successful ventures. Even if the Chinese government were to implement health care financing reforms that led to an increase in nursing jobs and improved work conditions, some level of surplus will remain. As such, it is likely that China will become an important source of nurses for developed nations in the coming years.

  17. [Therapeutic nursing: a systematic review].

    PubMed

    Lautenschläger, S; Müller, C; Immenschuh, U; Muser, J; Behrens, J

    2014-08-01

    For some years therapeutic service catalogues have been established in medical rehabilitation which have broadened our previous understanding of nursing actions. Currently, therapeutic nursing plays a prominent role in neurological early rehabilitation because the operations and procedures coding system (OPS) 8-552 within the DRG-System (Diagnosis Related Groups) states that therapeutic nursing must be carried out by specially trained nursing personnel. This requirement leads to inconsistencies in nursing practice and the medical service of the health insurance (MDK) since a definition of therapeutic nursing is lacking. A previous review of therapeutic nursing in 2003 focused primarily on the development of the therapeutic nursing role, but not on therapeutic nursing itself. The following article contains the first systematic review of the current state of research regarding a definition of therapeutic nursing. For this purpose, a systematic study was conducted to examine if there are, nationally or internationally, any definitions of therapeutic nursing and to identify what the therapeutic aspects of nursing are. The research included following database; Medline, Cinahl and Embase. Additionally, a research by hand of several German journals as well as textbooks and specialized literature was carried out. 5 studies were selected which define the term "therapeutic nursing". Among these are one review, one primary study, one theoretical discussion and one dissertation. Further twenty four studies were identified which do not define the term, but are closely related to the subject, and use or characterize the term in various contexts. The publications examined provided indications of duties, interventions and roles nurses should perform, but not how to carry these out, nor what is therapeutic about the nursing. At the same time, the low number of studies reveals that therapeutic nursing has barely been examined and demonstrates the lack of theoretically grounding

  18. Big bang health care reform--does it work?: the case of Britain's 1991 National Health Service reforms.

    PubMed

    Klein, R

    1995-01-01

    The costs and benefits are examined of one of the very few examples of a government driving through health care reform in the face of near unanimous opposition: Britain's 1991 reforms of the National Health Service (NHS), which sought to inject the dynamics of a market into the framework of a universal, tax-financed service. The political costs to the government have been high. The public continues to see the NHS through the eyes of disgruntled doctors and nurses. The benefits, measured in efficiency gains or service improvements, are as yet difficult to establish. However, the NHS has changed in key respects. The balance has shifted from hospital specialists to general practitioners and from providers to purchasers, with increasing emphasis on professional accountability and consumerism. But the NHS continues to evolve as it strives to resolve the tensions implicit in the reforms, and the only certainty is that no future government can return to the pre-1991 situation.

  19. The Health Promoting Prison (HPP) and its imperative for nursing.

    PubMed

    Whitehead, Dean

    2006-01-01

    The World Health Organisation's (WHO) Ottawa Charter for Health Promotion in 1986 provided the catalyst from which the Health Promoting Prison (HPP) movement emerged. Here, an extensive review of the available prison-related health literature provides the basis for critical discussion and recommendations for nursing services and prison-related health care. The findings suggest that current prison-based nursing services are seriously neglected and woefully lacking in structure and resources. This article recommends strategies for reform that includes nurses who practice in all settings, and not just prison-based nurses. If nurses wish to be at the forefront of future HPP strategies, they must first embrace the radical health promotion reforms that are emerging from the current literature. Building sustainable group capacity into prison-based health care, through developing social interaction, cohesion, participation and political action can only benefit the community at large and further emphasise the health promotion role of nursing.

  20. The sex reform movement and eugenics in interwar Poland.

    PubMed

    Gawin, Magdalena

    2008-06-01

    This paper focuses on the relations between a liberal group of sex reformers, consisting of writers and literary critics, and physicians from the Polish Eugenics Society in interwar Poland. It illustrates the paradoxes of the mutual co-operation between these two groups during the 1930s and analyses the reason why compulsory sterilisation was rejected by politicians. From the early 1930s two movements began to forge an alliance in Poland: the sexual reform movement which advocated freedom of the individual, and eugenics, which called for limiting the freedom of the individual for the collective good. This paper draws attention to several issues which emerged as part of this collaboration: population politics, the relationship between reformers, eugenicists and state institutions, and the question of how both movements--eugenics and sexual reform--perceived the question of sexuality, birth control and abortion. It will also focus on those aspects of their thinking that led to mutual co-operation.

  1. Medical malpractice tort reform.

    PubMed

    Ottenwess, David M; Lamberti, Meagan A; Ottenwess, Stephanie P; Dresevic, Adrienne D

    2011-01-01

    A tort is generally defined as a civil wrong which causes an injury, for which a victim may seek damages, typically in the form of money damages, against the alleged wrongdoer. An overview of the tort system is detailed, specifically in the context of a medical malpractice lawsuit, in order to provide a better understanding of the practical evolution of medical malpractice litigation and its proposed reforms. Rising premiums and defensive medicine are also discussed as part of the tort reform dialogue. Because medical malpractice litigation will never disappear entirely, implementing sound risk management and compliance programs are critical to every radiology department in order to improve the safety and quality of the care that its radiologists and technologists provide.

  2. Methanol partial oxidation reformer

    DOEpatents

    Ahmed, Shabbir; Kumar, Romesh; Krumpelt, Michael

    1999-01-01

    A partial oxidation reformer comprising a longitudinally extending chamber having a methanol, water and an air inlet and an outlet. An igniter mechanism is near the inlets for igniting a mixture of methanol and air, while a partial oxidation catalyst in the chamber is spaced from the inlets and converts methanol and oxygen to carbon dioxide and hydrogen. Controlling the oxygen to methanol mole ratio provides continuous slightly exothermic partial oxidation reactions of methanol and air producing hydrogen gas. The liquid is preferably injected in droplets having diameters less than 100 micrometers. The reformer is useful in a propulsion system for a vehicle which supplies a hydrogen-containing gas to the negative electrode of a fuel cell.

  3. Methanol partial oxidation reformer

    DOEpatents

    Ahmed, S.; Kumar, R.; Krumpelt, M.

    1999-08-17

    A partial oxidation reformer is described comprising a longitudinally extending chamber having a methanol, water and an air inlet and an outlet. An igniter mechanism is near the inlets for igniting a mixture of methanol and air, while a partial oxidation catalyst in the chamber is spaced from the inlets and converts methanol and oxygen to carbon dioxide and hydrogen. Controlling the oxygen to methanol mole ratio provides continuous slightly exothermic partial oxidation reactions of methanol and air producing hydrogen gas. The liquid is preferably injected in droplets having diameters less than 100 micrometers. The reformer is useful in a propulsion system for a vehicle which supplies a hydrogen-containing gas to the negative electrode of a fuel cell. 7 figs.

  4. Methanol partial oxidation reformer

    DOEpatents

    Ahmed, S.; Kumar, R.; Krumpelt, M.

    1999-08-24

    A partial oxidation reformer is described comprising a longitudinally extending chamber having a methanol, water and an air inlet and an outlet. An igniter mechanism is near the inlets for igniting a mixture of methanol and air, while a partial oxidation catalyst in the chamber is spaced from the inlets and converts methanol and oxygen to carbon dioxide and hydrogen. Controlling the oxygen to methanol mole ratio provides continuous slightly exothermic partial oxidation reactions of methanol and air producing hydrogen gas. The liquid is preferably injected in droplets having diameters less than 100 micrometers. The reformer is useful in a propulsion system for a vehicle which supplies a hydrogen-containing gas to the negative electrode of a fuel cell. 7 figs.

  5. Methanol partial oxidation reformer

    DOEpatents

    Ahmed, Shabbir; Kumar, Romesh; Krumpelt, Michael

    2001-01-01

    A partial oxidation reformer comprising a longitudinally extending chamber having a methanol, water and an air inlet and an outlet. An igniter mechanism is near the inlets for igniting a mixture of methanol and air, while a partial oxidation catalyst in the chamber is spaced from the inlets and converts methanol and oxygen to carbon dioxide and hydrogen. Controlling the oxygen to methanol mole ratio provides continuous slightly exothermic partial oxidation reactions of methanol and air producing hydrogen gas. The liquid is preferably injected in droplets having diameters less than 100 micrometers. The reformer is useful in a propulsion system for a vehicle which supplies a hydrogen-containing gas to the negative electrode of a fuel cell.

  6. Quality of nurses' work life: strategies for enhancement.

    PubMed

    Davis, B; Thorburn, B

    1999-01-01

    The radical transformation resulting from health care reform, with its emphasis on restructuring, reorganizing and downsizing, has impacted on the nursing profession and has profoundly effected the quality of nurses' work life. The Health Care Corporation of St. John's experienced the stress associated with change when it simultaneously merged eight health care sites and introduced a programmed-based management structure. This article reviews the strategies developed in response to this transition by the Nurses' Quality of Worklife Team, to help reduce stress and enhance the quality of nurses' work life. In particular, it highlights the development and implementation of a professional support network called the Nursing Peer Support Program.

  7. Gladys Carter - an advocate of higher education for nurses.

    PubMed

    Weir, R I

    Gladys Carter was once well-known as an author of midwifery and nursing texts and articles. She was appointed the first Boots Scholar in Nursing Research at the University of Edinburgh in 1952. The outcome of her work, the Carter Report (unpublished) lent weight to the reform of the Nurse Tutors' course offered at that time by the RCN Scottish Board and to the establishment of the Department of Nursing Studies at the University of Edinburgh. This paper discusses the contributions made by Miss Carter to the case for higher education for nurses.

  8. The Beida Reform

    ERIC Educational Resources Information Center

    Kewen, Shu

    2004-01-01

    Beida is always linked with a sort of fervor, a sort of moral behavior. Although it is not a world-class university, its connections with China's contemporary and modern history make it a great school. The direct motive behind the reform and the mapping out of its system is the pursuit of a sort of efficiency, but it is possible that what will be…

  9. Implementing Security Sector Reform

    DTIC Science & Technology

    2008-12-04

    ownership and genuine reform. His experience in Diyala Province indicated that the most effective means of pursuing transition and transformation among...that I have no solution to the security situation in Afghanistan, or to the questions of violence, crime, insurrection, or militias vs . army vs ...than to merge those interests into a greater whole. Franchising of problems or solutions is often the result. In Afghanistan, problems and

  10. Competence areas of nursing students in Europe.

    PubMed

    Satu, Kajander-Unkuri; Leena, Salminen; Mikko, Saarikoski; Riitta, Suhonen; Helena, Leino-Kilpi

    2013-06-01

    The focus of this study is on European nursing education, where there have been several reforms over the last two decades attempting to harmonise curricula and degree structures. One of the most powerful reforms was started by the Bologna Declaration in 1999; since then, significant progress has been made towards achieving the European Higher Education Area (EHEA) and the implementation of the European Qualifications Framework (EQF) in education practice. The Directive of recognition of professional qualifications (2005/36/EC) regulates nursing education. All these strategies aim to harmonise nursing education, but specific competence areas in nursing are still missing within the European Union (EU). The purpose of this review was to seek competence areas for nursing students within the EU as identified in previous studies and other documents. Altogether, 67 competence areas were identified and classified into eight main categories: (1) professional and ethical values and practice, (2) nursing skills and intervention, (3) communication and interpersonal skills, (4) knowledge and cognitive ability, (5) assessment and improving quality in nursing, (6) professional development, (7) leadership, management and teamwork, and (8) research utilisation. In order to obtain a comprehensive concept of competence, more research is needed on nursing students' competence areas across the EU due to the fact that the EU is a common labour market and nurses are educated for the EU as a whole. Nursing is a global profession and nurse competence is central to patient care outcomes, so it is also internationally important that nurses have good competence. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. [Clinical nursing manpower: development and future prospects].

    PubMed

    Lin, Chiou-Fen; Kao, Ching-Chiu

    2014-04-01

    The significant changes in nursing manpower utilization in Taiwan over the past two decades are due in large part to the implementation of the National Health Insurance program and the rising need for long-term care. The changes have impacted clinical nursing manpower utilization in two important ways. Firstly, there has been a substantial increase in overall demand for nursing manpower. In particular, the need for clinical nurses has nearly quadrupled during this time period. Secondly, the level of difficulty involved in patient care has risen dramatically, with factors including increased disease severity and increased care quality expectations, among others. These changes, coupled with demands on nursing manpower imposed from other sectors, underpin and further exacerbate the problem of nursing manpower shortages throughout the healthcare system. To raise the quality of the nursing work environment, the Ministry of Health and Welfare (MOHW) brought together Taiwan's key professional nursing organizations to promote 10 care-reform strategies, establish the nursing-aid manpower system, and create the nursing classification system as an approach to effectively attract nurses to take positions in the medical system.

  12. The evolution of pediatric critical care nursing: past, present, and future.

    PubMed

    Foglia, Dorothy C; Milonovich, Lisa M

    2011-06-01

    Although current nursing literature is overflowing with information related to the history of nursing in general, and even pediatric nursing, very little is published about PICU nursing. The evolution of pediatric critical care nursing is presented based on a historical context, the current state, and future projections. More specifically, this treatise focuses on the environment, the patient and family, and of course, the PICU nurse. Concluding remarks provide an insight into how health care reforms and how the use of clinical information technology will affect the role of the pediatric critical care nurse in the future. Copyright © 2011 Elsevier Inc. All rights reserved.

  13. In Search of a Croatian Model of Nursing Education

    PubMed Central

    Šimunović, Vladimir J.; Županović, Marija; Mihanović, Frane; Zemunik, Tatijana; Bradarić, Nikola; Janković, Stipan

    2010-01-01

    Aim To analyze the present status and ongoing reforms of nursing education in Europe, to compare it with the situation in Croatia, and to propose a new educational model that corresponds to the needs of the Croatian health care system. Methods The literature on contemporary nursing education in Europe and North America was reviewed, together with European Commission directives and regulations, as well as pertinent World Health Organization documents. In addition, 20 recent annual reports from 2003-2009, submitted by national nursing associations to the Workgroup of European Nurse Researchers, were studied. Results After appraisal of current trends, the Working Group on Reform of Nursing Education drafted The Croatian Model for Education in Nursing and developed a three-cycle curriculum with syllabus. The proposed curriculum is radically different from traditional ones. Responding to modern demands, it focuses on outcomes (developing competencies) and is evidence-based. Conclusions A new, Croatian concept of nursing education is presented that is concordant with reforms in nursing education in other European countries. It holds promise for making nursing education an integral part of a unified European system of higher education. PMID:20960588

  14. In search of a Croatian model of nursing education.

    PubMed

    Simunovic, Vladimir J; Zupanovic, Marija; Mihanovic, Frane; Zemunik, Tatijana; Bradaric, Nikola; Jankovic, Stipan

    2010-10-01

    To analyze the present status and ongoing reforms of nursing education in Europe, to compare it with the situation in Croatia, and to propose a new educational model that corresponds to the needs of the Croatian health care system. The literature on contemporary nursing education in Europe and North America was reviewed, together with European Commission directives and regulations, as well as pertinent World Health Organization documents. In addition, 20 recent annual reports from 2003-2009, submitted by national nursing associations to the Workgroup of European Nurse Researchers (WERN), were studied. After appraisal of current trends, the Working Group on Reform of Nursing Education drafted The Croatian Model for Education in Nursing and developed a three-cycle curriculum with syllabus. The proposed curriculum is radically different from traditional ones. Responding to modern demands, it focuses on outcomes (developing competencies) and is evidence-based. A new, Croatian concept of nursing education is presented that is concordant with reforms in nursing education in other European countries. It holds promise for making nursing education an integral part of a unified European system of higher education.

  15. Primed for Reform: A District's Use of Existing Assets to Drive Improvement

    ERIC Educational Resources Information Center

    Region IX Equity Assistance Center at WestEd, 2014

    2014-01-01

    This brief reports on the early stages and initial successes of turnaround efforts in a California school district. With administrators and educators in the midst of implementing a robust reform agenda, there are clear signs that the district is on the rise. The reform initiatives have stopped a downward slide in student attendance, behavior, and…

  16. Boosting Student Achievement: The Effect of Comprehensive School Reform on Student Achievement

    ERIC Educational Resources Information Center

    Gross, Betheny; Booker, T. Kevin; Goldhaber, Dan

    2009-01-01

    Between the late 1980s and early 2000s, schools, districts, states, and the federal government devoted enormous resources to the implementation of Comprehensive School Reform (CSR) models. With more than 1.6 billion federal dollars distributed through the Comprehensive School Reform Demonstration (CSRD) project and its successor, the CSR project,…

  17. Adequacy, Accountability, Autonomy and Equity in a Middle Eastern School Reform: The Case of Qatar

    ERIC Educational Resources Information Center

    Guarino, Cassandra M.; Tanner, Jeffery C.

    2012-01-01

    This study examines Qatar's recent and ambitious school reform in the early stages of its implementation against a set of four criteria for successful education systems drawn from guidelines developed by the international community: adequacy, accountability, autonomy and gender equity. We investigate both the initial structure of the reform and…

  18. A Broader and Bolder Approach to School Reform: Expanded Partnership Roles for School Counselors

    ERIC Educational Resources Information Center

    Steen, Sam; Noguera, Pedro A.

    2010-01-01

    This article describes a broader, bolder approach to education reform aimed at addressing the social and economic disadvantages that hinder student achievement. Central principles of this approach to reform include the provision of supports such as early childhood and preschool programs, after-school and summer enrichment programs, parent…

  19. Nursing and the nursing workplace in Queensland, 2001-2010: what the nurses think.

    PubMed

    Eley, Robert; Francis, Karen; Hegney, Desley

    2014-08-01

    The purpose of the study was to inform policy for reform in nursing. A survey mailed to members of the Queensland Nurses' Union four times between 2001 and 2010 elicited views on their employment and working conditions, professional development and career opportunities. Results across years and sectors of nursing consistently showed dissatisfaction in many aspects of employment, particularly by nurses working in aged care. However, views on staffing numbers, skill mix, workload, work stress, pay and staff morale all showed significant improvements over the decade. For example in 2001, 48.8% of nurses believed that their pay was poor, whereas in 2010, this had reduced to 35.2%. Furthermore, there was a significant rise throughout the decade in the opinion of the value of nursing as a good career. In light of the need to address nurse workforce shortages, the trends are encouraging; however, more improvements are required in order to support recruitment and retention. © 2013 Wiley Publishing Asia Pty Ltd.

  20. Nursing practice in a post-Soviet country from the perspectives of Armenian nurses: a qualitative exploratory study.

    PubMed

    Poghosyan, Lusine; Poghosyan, Hermine; Berlin, Kristen; Truzyan, Nune; Danielyan, Lusine; Khourshudyan, Kristine

    2012-09-01

    The purpose of this qualitative descriptive study was to explore the views of head and staff nurses about nursing practice in the hospitals of Armenia. Armenia inherited its nursing frameworks from the Soviet Union. After the Soviet collapse, many changes took place to reform nursing. However, to date little has been systematically documented about nursing practice in Armenia. Qualitative descriptive design was implemented. Three major hospitals in Yerevan, the capital city of Armenia, participated in the study. Purposeful sampling was used. Forty-three nurses participated, 29 staff and fourteen head nurses. Data were collected through five focus groups comprised of seven to ten participants. A focus group guide was developed. The researcher facilitated the discussions in Armenian, which were audio taped. The research assistant took notes. Data were transcribed and translated into English, imported into atlas.ti 6.1 qualitative software, and analysed by three authors. Five themes were extracted. Lack of role clarity theme was identified from the head nurse data. The practice environment theme was identified from the staff nurse data. Nursing education, value, respect and appreciation of nursing, and becoming a nurse were common themes identified from both head and staff nurse data. Head nurses lack autonomy, do not have clear roles and are burdened with documentation. Staff nurses practice in challenging work environments with inadequate staffing and demanding workloads. All nurses reported the need to improve nursing education. This is the first study conducted in Armenia exploring nursing practice in the hospitals from the nurses' perspectives. Nurses face challenges that may impact their wellbeing and patient care. Understanding challenges nursing practice faces in the hospitals in Armenia will help administrators and care providers to take actions to improve nursing practice and subsequently patient care. © 2012 Blackwell Publishing Ltd.

  1. Steam reformer with catalytic combustor

    DOEpatents

    Voecks, Gerald E.

    1990-03-20

    A steam reformer is disclosed having an annular steam reforming catalyst bed formed by concentric cylinders and having a catalytic combustor located at the center of the innermost cylinder. Fuel is fed into the interior of the catalytic combustor and air is directed at the top of the combustor, creating a catalytic reaction which provides sufficient heat so as to maintain the catalytic reaction in the steam reforming catalyst bed. Alternatively, air is fed into the interior of the catalytic combustor and a fuel mixture is directed at the top. The catalytic combustor provides enhanced radiant and convective heat transfer to the reformer catalyst bed.

  2. Steam reformer with catalytic combustor

    NASA Technical Reports Server (NTRS)

    Voecks, Gerald E. (Inventor)

    1990-01-01

    A steam reformer is disclosed having an annular steam reforming catalyst bed formed by concentric cylinders and having a catalytic combustor located at the center of the innermost cylinder. Fuel is fed into the interior of the catalytic combustor and air is directed at the top of the combustor, creating a catalytic reaction which provides sufficient heat so as to maintain the catalytic reaction in the steam reforming catalyst bed. Alternatively, air is fed into the interior of the catalytic combustor and a fuel mixture is directed at the top. The catalytic combustor provides enhanced radiant and convective heat transfer to the reformer catalyst bed.

  3. Are nurses prepared for retirement?

    PubMed

    Blakeley, Judith; Ribeiro, Violeta

    2008-09-01

    This study explored various factors and income sources that registered nurses believe are important in retirement planning. In many countries worldwide, many registered nurses are approaching retirement age. This raises concerns related to the level of preparedness of retiring nurses. A mail-out questionnaire was sent to 200 randomly selected nurses aged 45 and older. SPSS descriptors were used to outline the data. Multiple t-tests were conducted to test for significant differences between selected responses by staff nurses and a group of nurse managers, educators and researchers. Of 124 respondents, 71% planned to retire by age 60. Only 24% had done a large amount of planning. The top four planning strategies identified were related to keeping healthy and active, both physically and mentally; a major financial planning strategy ranked fifth. Work pensions, a government pension and a personal savings plan were ranked as the top three retirement income sources. No significant differences were found between the staff nurse and manager groups on any of the items. IMPLICATIONS FOR NURSING MANAGERS/CONCLUSIONS: The results of this study suggest that managers' preparation for retirement is no different from that of staff nurses. All nurses may need to focus more on financial preparation, and begin the process early in their careers if they are to have a comfortable and healthy retirement. Nurse managers are in a position to advocate with senior management for early and comprehensive pre-retirement education for all nurses and to promote educational sessions among their staff. Managers may find the content of this paper helpful as they work with nurses to help them better prepare for retirement. This exploratory study adds to the limited amount of research available on the topic.

  4. [Expectations, requirements and limitations of future task sharing between the nursing profession and the medical profession: results from the Care-N Study M-V].

    PubMed

    Dreier, Adina; Rogalski, Hagen; Homeyer, Sabine; Oppermann, Roman Frank; Hingst, Peter; Hoffmann, Wolfgang

    2015-10-01

    The aging population causes a sustained increase in demand of medical and nursing care services. At the same time health care professionals are aging, too. This leads to a growing number of health care gaps. Therefore, the health care system needs to be reformed. This includes a reallocation of task between some of the health care professions. This article addresses developments, potentials and limitations in the context of the future allocation of tasks between the nursing and the medical profession. Aim is to specify the future task sharing between nurses and physicians regarding expectations, requirements and limitations. We conducted questionnaire based Delphi interviews with an interdisciplinary group of experts. (type aggregation of ideas). In the future, to expert’s point of view, nurses will take over routine tasks in the medical and nursing health care supply. Task sharing by substitution is regarded with skepticism by experts. It requires a long time perspective and an early involvement of all stakeholders. Germany is at the beginning of the process of the future task sharing between nurses and physicians. The realization requires a comprehensive political support and further development of concepts including scientific implementation and evaluation.

  5. Quality assurance guides health reform in Jordan.

    PubMed

    Abubaker, W; Abdulrahman, M

    1996-01-01

    In November 1995, a World Bank mission went to Jordan to conduct a study of the health sector. The study recommended three strategies to reform the health sector: decentralization of Ministry of Health (MOH) management; improvement of clinical practices, quality of care, and consumer satisfaction; and adoption of treatment protocols and standards. The MOH chose quality assurance (QA) methods and quality management (QM) techniques to accomplish these reforms. The Monitoring and QA Directorate oversees QA applications within MOH. It also institutes and develops the capacity of local QA units in the 12 governorates. The QA units implement and monitor day-to-day QA activities. The QM approach encompasses quality principles: establish objectives; use a systematic approach; teach lessons learned and applicable research; use QA training to teach quality care, quality improvement, and patient satisfaction; educate health personnel about QM approaches; use assessment tools and interviews; measure the needs and expectations of local health providers and patients; ensure feedback on QA improvement projects; ensure valid and reliable data; monitor quality improvement efforts; standardize systemic data collection and outcomes; and establish and disseminate QA standards and performance improvement efforts. The Jordan QA Project has helped with the successful institutionalization of a QA system at both the central and local levels. The bylaws of the QA councils and committees require team participation in the decision-making process. Over the last two years, the M&QA Project has adopted 21 standards for nursing, maternal and child health care centers, pharmacies, and medications. The Balqa pilot project has developed 44 such protocols. Quality improvement (COUGH) studies have examined hyper-allergy, analysis of patient flow rate, redistribution of nurses, vaccine waste, and anemic pregnant women. There are a considerable number of on-going clinical and non-clinical COUGH studies

  6. Health services reforms in revolutionary Nicaragua.

    PubMed Central

    Garfield, R M; Taboada, E

    1984-01-01

    Before the Nicaraguan revolution of 1979, access to health services was largely limited to the affluent sectors of the urban population and the minority of workers with social security coverage. Repeated attempts at reform by organized medicine were ineffective. Since the revolution, a tremendous expansion in health services has occurred. The national health system receives approximately one-third of its funds from the social security system. Steadily increasing equity in access is a result of the promotion of primary care, health campaigns involving up to 10 per cent of the general population as volunteers, the use of paramedical aides, and foreign assistance. Private practice nevertheless remains strong. In the coming years, several complex issues must be examined, including: a balance in the number of nurses and doctors trained, the role of private practice, and the relationship of the Ministry of Health to the social security system. Further progress in health reforms may be delayed by the defensive war which Nicaragua is fighting on its northern and southern borders. Despite emergent health problems in the war zones, most of the innovative aspects of the health system remain intact as of this writing. PMID:6476169

  7. Health care reform 2010: a fresh view on tort reform.

    PubMed

    Stimson, C J; Dmochowski, Roger; Penson, David F

    2010-11-01

    We reviewed the state of medical malpractice tort reform in the context of a new political climate and the current debate over comprehensive health care reform. Specifically we asked whether medical malpractice tort reform is necessary, and evaluated the strengths and weaknesses of contemporary reform proposals. The medical, legal and public policy literature related to medical malpractice tort reform was reviewed and synthesized. We include a primer for understanding the current structure of medical malpractice law, identify the goals of the current system and analyze whether these goals are presently being met. Finally, we describe and evaluate the strengths and weaknesses of the current reform proposals including caps on damages, safe harbors and health care courts. Medical malpractice tort law is designed to improve health care quality and appropriately compensate patients for medical malpractice injuries, but is failing on both fronts. Of the 3 proposed remedies, caps on damages do little to advance the quality and compensatory goals, while safe harbors and health care courts represent important advancements in tort reform. Tort reform should be included in the current health policy debate because the current medical malpractice system is not adequately achieving the basic goals of tort law. While safe harbors and health care courts both represent reasonable remedies, health care courts may be preferred because they do not rely on jury determination in the absence of strong medical evidence. Copyright © 2010 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  8. Reforming Reforms: Changing Incentives in Education Finance in Vermont

    ERIC Educational Resources Information Center

    Schmidt, Stephen J.; Scott, Karen

    2006-01-01

    In 1997, Vermont passed Act 60, which reformed its education finance system to achieve greater equality of spending. The reform encouraged wealthy towns to reduce spending; it was politically unpopular and was replaced, in 2004, by Act 68. We analyze the spending incentives created by the two acts and estimate the effects the change will have on…

  9. Nurses who work outside nursing.

    PubMed

    Duffield, Christine; Pallas, Linda O'Brien; Aitken, Leanne M

    2004-09-01

    The desire to care for people, a family history of professional health care work, and security in career choice are documented reasons for entering nursing. Reasons for leaving include workload, unsafe work environments and harassment. The relationship between these factors and the time nurses spend in the profession has not been explored. This paper reports a study with people who have left nursing, to investigate why they became a nurse, how long they stayed in nursing, and their reasons for leaving. A questionnaire was mailed to Registered Nurses currently working outside nursing, seeking respondents' reasons for entering and leaving nursing, and perceptions of the skills gained from nursing and the ease of adjustment to working in a non-nursing environment. Data analysis included descriptive statistics, exploratory and confirmatory factor analysis, correlational analysis and linear and multiple regression analysis. A model incorporating the factors 'altruistic reasons', 'default choice' and 'stepping stone' explained 36.2% of the variance in reasons for becoming a nurse. A model incorporating the factors 'legal and employer', 'external values and beliefs about nursing', 'professional practice', 'work life/home life' and 'contract requirements' explained 55.4% of the variance in reasons for leaving nursing. Forty-eight per cent of the variance in tenure in nursing practice was explained through personal characteristics of nurses (36%), reasons for becoming a nurse (7%) and reasons for leaving (6%). The reasons why nurses entered or left the profession were varied and complex. While personal characteristics accounted for a large component of tenure in nursing, those managing the nursing workforce should consider professional practice issues and the balance between work life and home life.

  10. Perceived Caring of Instructors among Online Doctoral Nursing Students

    ERIC Educational Resources Information Center

    Walters, Gwendolyn M.

    2013-01-01

    The concept of caring has been integral to the practice of nursing and nursing education since the early teachings of Florence Nightingale. Significant changes in both the practice and the need for educating increasing numbers of advanced-degree nurses have resulted in an increase in online doctoral-level nursing programs. This internet-based…

  11. Nutrition in Nursing Curricula: Recent Developments and Recommendations.

    ERIC Educational Resources Information Center

    Morse, Winifred; Corcoran-Perry, Sheila

    1993-01-01

    Analyzes developments regarding nutrition content in nursing curricula before 1960, from 1960 to early 1980s, and currently. Describes nursing education, public policy decisions, and the evolution of the professions of nursing and dietetics. Specifies guidelines for essential content for undergraduate nursing curricula. (Author/JOW)

  12. Examining the Challenges Early Childhood Teacher Candidates Face in Figuring Their Roles as Early Educators

    ERIC Educational Resources Information Center

    Brown, Christopher P.; Feger, Beth Smith

    2010-01-01

    Federal, state, and local policy makers' high-stakes standards-based accountability reforms are transforming the early childhood teacher education process. These reforms affect how early education teacher candidates figure their role as teachers. By employing Holland, Lachicotte, Skinner, and Cain's conception of figured worlds to analyze the…

  13. "Doing" Social Justice in Early Childhood: The Potential of Leadership

    ERIC Educational Resources Information Center

    Hard, Louise; Press, Frances; Gibson, Megan

    2013-01-01

    Early childhood education has long been connected with objectives related to social justice. Australian early childhood education and care (ECEC) has its roots in philanthropic and educational reform movements prevalent at the turn of the twentieth century. More recently, with the introduction of the National Early Childhood Reform Agenda, early…

  14. The Universities of the Renaissance and Reformation.

    PubMed

    Grendler, Paul F

    2004-01-01

    European universities had great intellectual and religious influence in the Renaissance and Reformation and exhibited considerable variety. Italian universities taught law and medicine to doctoral students. Their loose organization made it possible for professors to produce original research in law, medicine, philosophy, and the humanities. Northern European universities concentrated on teaching arts to undergraduates, while theology was the most important graduate faculty. Their stronger structure enabled Martin Luther and other professors of theology in German, Dutch, Swiss, and English universities to create and lead the Protestant. By the early seventeenth century universities everywhere were in decline.

  15. New Directions in Education? A Critique of Contemporary Policy Reforms

    ERIC Educational Resources Information Center

    Skourdoumbis, Andrew

    2016-01-01

    This paper draws on facets of Foucault's theoretical resources to critique current education policy reform from within the Australian State of Victoria, namely the Department of Education and Early Childhood Development's (DEECD) discussion paper "New directions for school leadership and the teaching profession." Implicit in the reform…

  16. Reforming Social Studies Education in the United States.

    ERIC Educational Resources Information Center

    Senesh, Lawrence

    The efforts to reform the U.S. educational system should focus on the goal of creating a Learning Society. A Learning Society is based upon the commitment to a set of values and to a system of education that affords all members of the community the opportunity to stretch their minds to full capacity from early childhood through adulthood. This…

  17. It's about Time for Autism Reform Legislation in Utah

    ERIC Educational Resources Information Center

    Shiozawa, Brian J.

    2015-01-01

    On 3 April 2014, Governor Gary Herbert signed into law a health insurance reform bill that requires private insurers to cover autism therapy. Specifically, SB57 requires state-regulated health plans to cover applied behavior analysis (ABA) therapy. While early diagnosis and intervention can reduce the long-term cost of autism, families are finding…

  18. Funding Special Education by Capitation: Evidence from State Finance Reforms

    ERIC Educational Resources Information Center

    Dhuey, Elizabeth; Lipscomb, Stephen

    2011-01-01

    This study examines responses to state capitation policies for special education finance between 1991-92 and 2003-4. Capitation refers to distributing funds based on the entire student enrollment. We find that disability rates tended to fall following capitation reforms, primarily in subjectively diagnosed categories and in early and late grades.…

  19. Teaching and Learning Conditions Improve High School Reform Efforts

    ERIC Educational Resources Information Center

    Center for Teaching Quality, 2007

    2007-01-01

    The North Carolina high school reform movement is focused on creating small, personalized and academically rigorous schools that increase graduation rates, reduce suspension and expulsion rates, increase college going rates and reduce college remediation rates. This report indicates that redesigned and early college high schools in North Carolina…

  20. Grammar and Good Taste: Reforming the American Language.

    ERIC Educational Resources Information Center

    Baron, Dennis E.

    Tracing both current concern for correctness in speech and writing and continued suspicion of formal language regulation, this book explores the history of American language reform and failure. The first three chapters examine early attitudes toward the English language in the New World, and the development of the concept of Federal English in…

  1. Current State and Problems of Higher Education Reform

    ERIC Educational Resources Information Center

    Salnikov, N.; Burukhin, S.

    2009-01-01

    Higher education in Russia is experiencing changes in curriculum and in the specialization and function of institutions in the search for a better model for a post-Soviet society. The early 1990s saw the start of the reform of the system of education in Russia. However, problems of quality and of continuity with secondary education have still not…

  2. Spotlight of a Century of Educational Reform in England.

    ERIC Educational Resources Information Center

    Henry, Thomas B.

    During the past 100 years, there has been an evolution in publicly funded education in England. This report provides a historical perspective for recent reforms and spotlights three related areas. The first section describes the early 19th-century Newcastle Commission's efforts to design a system of sound and cheap elementary education for…

  3. Pension Reform in China.

    PubMed

    Liu, Tao; Sun, Li

    2016-01-01

    This article analyzes China's pension arrangement and notes that China has recently established a universal non-contributory pension plan covering urban non-employed workers and all rural residents, combined with the pension plan covering urban employees already in place. Further, in the latest reform, China has discontinued the special pension plan for civil servants and integrated this privileged welfare class into the urban old-age pension insurance program. With these steps, China has achieved a degree of universalism and integration of its pension arrangement unprecedented in the non-Western world. Despite this radical pension transformation strategy, we argue that the current Chinese pension arrangement represents a case of "incomplete" universalism. First, its benefit level is low. Moreover, the benefit level varies from region to region. Finally, universalism in rural China has been undermined due to the existence of the "policy bundle." Additionally, we argue that the 2015 pension reform has created a situation in which the stratification of Chinese pension arrangements has been "flattened," even though it remains stratified to some extent.

  4. Rural Dimensions of Welfare Reform.

    ERIC Educational Resources Information Center

    Weber, Bruce A., Ed.; Duncan, Greg J., Ed.; Whitener, Leslie A., Ed.

    The 16 chapters in this five-part book, each by different authors, trace the effects of welfare reform (mandated by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996), upon poor people in rural areas of the United States. The book begins with an introduction called "As the Dust Settles: Welfare Reform and Rural…

  5. Engaging Teachers in Ed Reform

    ERIC Educational Resources Information Center

    Steans, Robin

    2012-01-01

    Teacher engagement is crucial to the success of education reforms. Not only can teachers serve as policymakers' eyes and ears on the ground, sharing firsthand knowledge of challenges in the classroom, but their advocacy can be instrumental to passing smart, sensible policies, and their buy-in can make or break reform implementation. Ongoing…

  6. Reforming Teacher Education in Tanzania

    ERIC Educational Resources Information Center

    Hardman, Frank; Abd-Kadir, Jan; Tibuhinda, Audax

    2012-01-01

    It is widely acknowledged that in order to improve the quality of education in primary schools in developing countries there is a need to place pedagogy and its training implications at the centre of teacher education reform. Like many countries in Eastern and Southern Africa, Tanzania has introduced various initiatives and reforms to improve the…

  7. Free Speech and Campaign Reform.

    ERIC Educational Resources Information Center

    Sharp, Harry, Jr.

    The Federal Election Campaign Act of 1971, a political campaign reform measure, was enacted to limit campaign contributions and independent expenditures, to mandate disclosure of contributors, and to establish public financing of campaigns, all to minimize the opportunity for political corruption. Unfortunate implications of such reform on the…

  8. Reform at the Grass Roots.

    ERIC Educational Resources Information Center

    Gaul, Thomas H.; And Others

    1994-01-01

    Survey forms were sent to 6,000 school board members who subscribe to "The American School Board Journal" in an attempt to discover what reform efforts are being utilized and which ones are working best in schools. A total of 1,347 readers (22.5%) responded. Curricular and instructional reforms were cited by 91% of the respondents, and 70% said…

  9. An Ecology of Academic Reform

    ERIC Educational Resources Information Center

    Grant, Gerald; Riesman, David

    1975-01-01

    This article contrasts the more popular educational reforms of the 1960's with reform movements occurring earlier in the century. Included in the article are discussions on the neo-classical university model, the aesthetic-expressive model, the communal-expressive model, and the activist-radical model. (Author/DE)

  10. George's Complaint: Reforming the Dragon

    ERIC Educational Resources Information Center

    Buxton, Bruce

    2007-01-01

    The evangelical tone and history of American culture has long been identified as a force for anti-intellectualism. The metaphors of educational reform are a demonstration of how this plays out. The very nature of the positivist social science research used to support proposed reform is anti-intellectual and feeds a debate that favors extremes over…

  11. International Handbook of Educational Reform.

    ERIC Educational Resources Information Center

    Cookson, Peter W., Jr., Ed.; And Others

    This book provides an overview of education reform in 27 countries. Following the introduction by Peter W. Cookson, Jr., Alan R. Sadovnik, and Susan F. Semel, part 1 offers national case studies of educational reform in the 1980s. Chapters include: (2) "Argentina" (Ana Munoz-Sandoval); (3) "Australia" (Richard Teese); (4) "Brazil" (Robert Cowen…

  12. Compensation Reform in the Schools

    ERIC Educational Resources Information Center

    Laine, Sabrina; Potemski, Amy; Rowland, Cortney

    2010-01-01

    One of the most frequently discussed topics in education reform circles is teacher pay--how much money teachers make, for what work and who decides teachers' salaries. Over time, educator pay reform has included many different reward structures and goes by as many different names, such as merit pay, performance pay and differentiated pay. The…

  13. Middle Grades Reform. Literature Review

    ERIC Educational Resources Information Center

    Blazer, Christie

    2008-01-01

    Researchers and policymakers have pointed to the lagging scores of eighth graders on international, national, and state assessments as evidence that students are not prepared to meet high academic standards and that middle grades reform is needed. In response to these concerns, educators have introduced reforms designed to provide middle-level…

  14. Common morality and moral reform.

    PubMed

    Wallace, K A

    2009-01-01

    The idea of moral reform requires that morality be more than a description of what people do value, for there has to be some measure against which to assess progress. Otherwise, any change is not reform, but simply difference. Therefore, I discuss moral reform in relation to two prescriptive approaches to common morality, which I distinguish as the foundational and the pragmatic. A foundational approach to common morality (e.g., Bernard Gert's) suggests that there is no reform of morality, but of beliefs, values, customs, and practices so as to conform with an unchanging, foundational morality. If, however, there were revision in its foundation (e.g., in rationality), then reform in morality itself would be possible. On a pragmatic view, on the other hand, common morality is relative to human flourishing, and its justification consists in its effectiveness in promoting flourishing. Morality is dependent on what in fact does promote human flourishing and therefore, could be reformed. However, a pragmatic approach, which appears more open to the possibility of moral reform, would need a more robust account of norms by which reform is measured.

  15. Implementing Comprehensive Reform: Implications for Practice

    ERIC Educational Resources Information Center

    Stout, Karen A.

    2016-01-01

    This chapter describes the challenges and practical barriers community colleges face when implementing comprehensive reform, exploring how reforms are leading to some improvements but not often scaled improvements.

  16. The relationship between tort reform and medical utilization.

    PubMed

    Kavanagh, Kevin T; Calderon, Lindsay E; Saman, Daniel M

    2014-12-01

    The hidden cost of defensive medicine has been cited by policymakers as a significant driving force in the increase of our nation's health-care costs. If this hypothesis is correct, one would expect that states with higher levels of tort reform will have a decrease in Medicare utilization and that medical utilization will decrease after tort reform is enacted. State-level reimbursement data for years 1999 to 2010 (the last year available) was obtained from the Dartmouth Atlas of Health Care. Medical tort rankings for the 50 states were obtained from the Pacific Research Institute (PRI) and correlated with state medical utilization for the year 2010. In 3 states, Mississippi, Nevada, and Texas, data were available to make pretort and posttort reform comparisons. Data analysis between total state Medicare Reimbursements and the PRI's tort rankings showed no significant observed correlation. In 6 Medicare utilization categories (total Medicare, hospital and skilled nursing facility, physician, home health agency, hospice, and durable medical equipment), a negative trend was observed when correlated with PRI tort rankings. This trend does not support the hypothesis that defensive medicine is a major driver of health-care expenditures. Tracking expenditures in the states of Texas, Nevada, and Mississippi, before and after passage of comprehensive medical tort reform gave inconsistent results and did not demonstrate substantial or meaningful total Medicare savings. In Mississippi, there was a trend of decreased expenditures after medical tort reform was passed. However, in Texas, where 80% of the analyzed enrollees resided, there was a trend of progressive increasing expenditures after tort reform was passed. The comparison of the Dartmouth Atlas Medicare Reimbursement Data with Malpractice Reform State Rankings, which are used by the PRI, did not support the hypothesis that defensive medicine is a driver of rising health-care costs. Additionally, comparing Medicare

  17. Mixed-Method Nursing Research: "A Public and Its Problems?" A Commentary on French Nursing Research.

    PubMed

    Dupin, Cécile Marie; Debout, Christophe; Rothan-Tondeur, Monique

    2014-02-01

    Nursing in France is undergoing a transition. In 2009, the preregistration nursing education program was reformed in line with the European Bologna Process, bringing nursing education to the universities. In 2010, the French Programme Hospitalier de Recherche Infirmière, the first national French nursing research funding program, was launched by the French Health Ministry. Of the 149 French research proposals submitted by registered nurses in 2010 and 2011, 13 were mixed-method proposals. The registered nurse principal investigator argued for a complementary use of qualitative and quantitative methods. These trends highlight major issues regarding mixed-method and nursing research. We can reasonably assume that mixed-method research has a broad appeal for nurse scholars, particularly for the exploration of complex phenomena related to nursing. Moreover, the recent movement in the domain of nursing education and research experienced in France highlights the need for dedicated research education in the development of nursing research capacity. © The Author(s) 2014 Reprints and permissions:]br]sagepub.co.uk/journalsPermissions.nav.

  18. A structured framework improves clinical patient assessment and nontechnical skills of early career emergency nurses: a pre-post study using full immersion simulation.

    PubMed

    Munroe, Belinda; Curtis, Kate; Murphy, Margaret; Strachan, Luke; Considine, Julie; Hardy, Jennifer; Wilson, Mark; Ruperto, Kate; Fethney, Judith; Buckley, Thomas

    2016-08-01

    The aim of this study was to evaluate the effect of the new evidence-informed nursing assessment framework HIRAID (History, Identify Red flags, Assessment, Interventions, Diagnostics, reassessment and communication) on the quality of patient assessment and fundamental nontechnical skills including communication, decision making, task management and situational awareness. Assessment is a core component of nursing practice and underpins clinical decisions and the safe delivery of patient care. Yet there is no universal or validated system used to teach emergency nurses how to comprehensively assess and care for patients. A pre-post design was used. The performance of thirty eight emergency nurses from five Australian hospitals was evaluated before and after undertaking education in the application of the HIRAID assessment framework. Video recordings of participant performance in immersive simulations of common presentations to the emergency department were evaluated, as well as participant documentation during the simulations. Paired parametric and nonparametric tests were used to compare changes from pre to postintervention. From pre to postintervention, participant performance increases were observed in the percentage of patient history elements collected, critical indicators of urgency collected and reported to medical officers, and patient reassessments performed. Participants also demonstrated improvement in each of the four nontechnical skills categories: communication, decision making, task management and situational awareness. The HIRAID assessment framework improves clinical patient assessments performed by emergency nurses and has the potential to enhance patient care. HIRAID should be considered for integration into clinical practice to provide nurses with a systematic approach to patient assessment and potentially improve the delivery of safe patient care. © 2016 John Wiley & Sons Ltd.

  19. Medicare payment reform and provider entry and exit in the post-acute care market.

    PubMed

    Huckfeldt, Peter J; Sood, Neeraj; Romley, John A; Malchiodi, Alessandro; Escarce, José J

    2013-10-01

    To understand the impacts of Medicare payment reform on the entry and exit of post-acute providers. Medicare Provider of Services data, Cost Reports, and Census data from 1991 through 2010. We examined market-level changes in entry and exit after payment reforms relative to a preexisting time trend. We also compared changes in high Medicare share markets relative to lower Medicare share markets and for freestanding relative to hospital-based facilities. We calculated market-level entry, exit, and total stock of home health agencies, skilled nursing facilities, and inpatient rehabilitation facilities from Provider of Services files between 1992 and 2010. We linked these measures with demographic information from the Census and American Community Survey, information on Certificate of Need laws, and Medicare share of facilities in each market drawn from Cost Report data. Payment reforms reducing average and marginal payments reduced entries and increased exits from the market. Entry effects were larger and more persistent than exit effects. Entry and exit rates fluctuated more for home health agencies than skilled nursing facilities. Effects on number of providers were consistent with entry and exit effects. Payment reform affects market entry and exit, which in turn may affect market structure, access to care, quality and cost of care, and patient outcomes. Policy makers should consider potential impacts of payment reforms on post-acute care market structure when implementing these reforms. © Health Research and Educational Trust.

  20. Medicare Payment Reform and Provider Entry and Exit in the Post-Acute Care Market

    PubMed Central

    Huckfeldt, Peter J; Sood, Neeraj; Romley, John A; Malchiodi, Alessandro; Escarce, José J

    2013-01-01

    Objective To understand the impacts of Medicare payment reform on the entry and exit of post-acute providers. Data Sources Medicare Provider of Services data, Cost Reports, and Census data from 1991 through 2010. Study Design We examined market-level changes in entry and exit after payment reforms relative to a preexisting time trend. We also compared changes in high Medicare share markets relative to lower Medicare share markets and for freestanding relative to hospital-based facilities. Data Extraction Methods We calculated market-level entry, exit, and total stock of home health agencies, skilled nursing facilities, and inpatient rehabilitation facilities from Provider of Services files between 1992 and 2010. We linked these measures with demographic information from the Census and American Community Survey, information on Certificate of Need laws, and Medicare share of facilities in each market drawn from Cost Report data. Principal Findings Payment reforms reducing average and marginal payments reduced entries and increased exits from the market. Entry effects were larger and more persistent than exit effects. Entry and exit rates fluctuated more for home health agencies than skilled nursing facilities. Effects on number of providers were consistent with entry and exit effects. Conclusions Payment reform affects market entry and exit, which in turn may affect market structure, access to care, quality and cost of care, and patient outcomes. Policy makers should consider potential impacts of payment reforms on post-acute care market structure when implementing these reforms. PMID:23557215

  1. Understanding nurse practitioner autonomy.

    PubMed

    Weiland, Sandra A

    2015-02-01

    This Gadamerian hermeneutic study was undertaken to understand the meaning of autonomy as interpreted by nurse practitioners (NPs) through their lived experiences of everyday practice in primary health care. A purposive sample of nine NPs practicing in primary health care was used. Network sampling achieved a broad swath of primary care NPs and practice settings. Data were collected by face-to-face interviews. Because NP autonomy is concerned with gender and marginalization, Gilligan's feminist perspective was utilized during interpretive analysis. Having Genuine NP Practice was the major theme, reflecting the participants' overall meaning of their autonomy. Practicing alone with the patient provided the context within which participants shaped the meaning of Having Genuine NP Practice. Having Genuine NP Practice had four subthemes: relationships, self-reliance, self-empowerment, and defending the NP role. The understanding of Having Genuine NP Practice will enable NPs to articulate their autonomy clearly and better influence healthcare reform. Implications for advanced practice nursing education include integrating findings into classroom discussion to prompt self-reflection of what autonomy means and socialization to the NP role. ©2014 American Association of Nurse Practitioners.

  2. Nursing Integration and Innovation Across a Multisystem Enterprise: Priorities for Nurse Leaders.

    PubMed

    Pappas, Sharon; McCauley, Linda

    There is no escaping the fact that the ability to skillfully influence change is a requirement for nurse leaders. This need is intensified as the national health care system reforms and as the morphology of health care systems continues to change, especially in academic health care systems. The purpose of this article was 2-fold. The first objective was to relay the experience of the integration of nursing practice, education, and research within an academic health care system. The second was to, through this story of integration, expose the uniqueness and importance of nurse leader roles influencing innovation across a multisystem enterprise to fulfill the organization's mission.

  3. Influence of organisational culture on the implementation of health sector reforms in low- and middle-income countries: a qualitative interpretive review.

    PubMed

    Mbau, Rahab; Gilson, Lucy

    2018-01-01

    Health systems, particularly in low- and middle-income countries, are commonly plagued by poor access, poor performance, inefficient use and inequitable distribution of resources. To improve health system efficiency, equity and effectiveness, the World Development Report of 1993 proposed a first wave of health sector reforms, which has been followed by further waves. Various authors, however, suggest that the early reforms did not lead to the anticipated improvements. They offer, as one plausible explanation for this gap, the limited consideration given to the influence over implementation of the software aspects of the health system, such as organisational culture - which has not previously been fully investigated. To identify, interpret and synthesise existing literature for evidence on organisational culture and how it influences implementation of health sector reforms in low- and middle-income countries. We conducted a systematic search of eight databases: PubMed; Africa-Wide Information, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Econlit, PsycINFO, SocINDEX with full text, Emerald and Scopus. Eight papers were identified. We analysed and synthesised these papers using thematic synthesis. This review indicates the potential influence of dimensions of organisational culture such as power distance, uncertainty avoidance, and in-group and institutional collectivism over the implementation of health sector reforms. This influence is mediated through organisational practices such as communication and feedback, management styles, commitment and participation in decision-making. This interpretive review highlights the dearth of empirical literature around organisational culture and therefore its findings can only be tentative. There is a need for health policymakers and health system researchers to conduct further analysis of organisational culture and change within the health system.

  4. Influence of organisational culture on the implementation of health sector reforms in low- and middle-income countries: a qualitative interpretive review

    PubMed Central

    Mbau, Rahab; Gilson, Lucy

    2018-01-01

    ABSTRACT Background: Health systems, particularly in low- and middle-income countries, are commonly plagued by poor access, poor performance, inefficient use and inequitable distribution of resources. To improve health system efficiency, equity and effectiveness, the World Development Report of 1993 proposed a first wave of health sector reforms, which has been followed by further waves. Various authors, however, suggest that the early reforms did not lead to the anticipated improvements. They offer, as one plausible explanation for this gap, the limited consideration given to the influence over implementation of the software aspects of the health system, such as organisational culture – which has not previously been fully investigated. Objective: To identify, interpret and synthesise existing literature for evidence on organisational culture and how it influences implementation of health sector reforms in low- and middle-income countries. Methods: We conducted a systematic search of eight databases: PubMed; Africa-Wide Information, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Econlit, PsycINFO, SocINDEX with full text, Emerald and Scopus. Eight papers were identified. We analysed and synthesised these papers using thematic synthesis. Results: This review indicates the potential influence of dimensions of organisational culture such as power distance, uncertainty avoidance, and in-group and institutional collectivism over the implementation of health sector reforms. This influence is mediated through organisational practices such as communication and feedback, management styles, commitment and participation in decision-making. Conclusion: This interpretive review highlights the dearth of empirical literature around organisational culture and therefore its findings can only be tentative. There is a need for health policymakers and health system researchers to conduct further analysis of organisational culture and change within the health

  5. Nursing Home Checklist

    MedlinePlus

    Nursing home checklist Name of nursing home: ____________________________________________________ Address: ________________________________________________________________ Phone number: __________________________________________________________ Date of visit: _____________________________________________________________ Basic information Yes No Notes Is the nursing home Medicare certified? Is the nursing ...

  6. Can New Zealand achieve self-sufficiency in its nursing workforce?

    PubMed

    North, Nicola

    2011-01-01

    This paper reviews impacts on the nursing workforce of health policy and reforms of the past two decades and suggests reasons for both current difficulties in retaining nurses in the workforce and measures to achieve short-term improvements. Difficulties in retaining nurses in the New Zealand workforce have contributed to nursing shortages, leading to a dependence on overseas recruitment. In a context of global shortages and having to compete in a global nursing labour market, an alternative to dependence on overseas nurses is self-sufficiency. Discursive paper. Analysis of nursing workforce data highlighted threats to self-sufficiency, including age structure, high rates of emigration of New Zealand nurses with reliance on overseas nurses and an annual output of nurses that is insufficient to replace both expected retiring nurses and emigrating nurses. A review of recent policy and other documents indicates that two decades of health reform and lack of a strategic focus on nursing has contributed to shortages. Recent strategic approaches to the nursing workforce have included workforce stocktakes, integrated health workforce development and nursing workforce projections, with a single authority now responsible for planning, education, training and development for all health professions and sectors. Current health and nursing workforce development strategies offer wide-ranging and ambitious approaches. An alternative approach is advocated: based on workforce data analysis, pressing threats to self-sufficiency and measures available are identified to achieve, in the short term, the maximum impact on retaining nurses. A human resources in health approach is recommended that focuses on employment conditions and professional nursing as well as recruitment and retention strategies. Nursing is identified as 'crucial' to meeting demands for health care. A shortage of nurses threatens delivery of health services and supports the case for self-sufficiency in the nursing

  7. Florence Nightingale and Irish nursing.

    PubMed

    McDonald, Lynn

    2014-09-01

    To challenge statements made about 'Careful Nursing' as a 'distinctive system' of nursing established by the Irish Sisters of Mercy, prior to Florence Nightingale, and which is said to have influenced her. Numerous publications have appeared claiming the emergence of a 'distinctive system' of nursing as 'Ireland's legacy to nursing', which, it is claimed, influenced Nightingale's system. One paper argues that the Irish system has its philosophical roots in Thomist philosophy. Several papers argue the ongoing relevance of the Irish system, not Nightingale's, for contemporary nursing theory and practice. Nightingale's influence on and legacy to Irish nursing are not acknowledged. A Discursive paper. Archival and published sources were used to compare the nursing systems of Florence Nightingale and the Irish Sisters of Mercy, with particular attention to nursing during the Crimean War. Claims were challenged of a 'distinctive system' of nursing established by the Irish Sisters of Mercy in the early nineteenth century, and of its stated influence on the nursing system of Florence Nightingale. The contention of great medical satisfaction with the 'distinctive' system is refuted with data showing that the death rate at the Koulali Hospital, where the Irish sisters nursed, was the highest of all the British war hospitals during the Crimean War. Profound differences between the two systems are outlined. Claims for a 'distinctive' Irish system of nursing fail for lack of evidence. Nightingale's principles and methods, as they evolved over the first decade of her school's work, remain central to nursing theory and practice. Nightingale's insistence on respect for patients and high ethical standards remains relevant to practice no less so as specific practices change with advances in medical knowledge and practice. © 2014 John Wiley & Sons Ltd.

  8. Nursing and Twitter: creating an online community using hashtags.

    PubMed

    Moorley, Calvin R; Chinn, Teresa

    2014-01-01

    Social media is becoming a facet of our lives and a tool for connecting, uniting and supporting people. Its use is growing in nursing, medical and health settings. This article describes the process, development and growth of an online community to connect nurses via Twitter using hashtags. Data was analysed to identify the benefits, barriers and enablers for the creation of an online nursing community. Methods consisted of key word searches in Twitter relevant to nursing, visits to the WeNurses website and tracking the number of followers on the website. A social media monitoring tool (SM2) was used to monitor visibility to establish baseline data and identify trends. WeNurses was launched in July 2012 and has over 7000 followers. Visits to the website are between 500 and 1500 each day. The use of a systematic nursing approach including the key principles of both nursing and social media (honesty, transparency, listening and reacting) helped to create and develop an online nursing community. It was found that WeNurses provides a platform for nurses to discuss issues in nursing, or complain about reforms. Nurses are free to question on how they can improve skills and contemplate their understanding of changes in the health service. Enablers included a committed group who openly discussed their thoughts, opinions and practices, a shared identity, an understanding each other's perspective and ownership by members. Using a nursing framework in a digital space added a unique dimension that resonated with members and provided a structured approach to the project. Nurses have begun to not only embrace social media but also use it for their own development. Health employers also need to encourage use of social media to help develop expertise, experience and knowledge in nurses and nursing practice. Social media can provide a social and professional space for nurses, and has potential to influence the health and wellness of different population groups involved in both

  9. Nutrition for Nurses: Nursing 245.

    ERIC Educational Resources Information Center

    Palermo, Karen R.

    A description is presented of "Nutrition for Nurses," a prerequisite course for students anticipating entrance into the junior level of a state university registered nursing program. Introductory material highlights the course focus (i.e., the basics of good nutrition; nutrition through the life cycle; nursing process in nutritional care; and…

  10. When the business of nursing was the nursing business: the private duty registry system, 1900-1940.

    PubMed

    Whelan, Jean C

    2012-05-31

    In the initial decades of the 20th century, most nurses worked in the private sector as private duty nurses dependent on their own resources for securing and obtaining employment with individual patients. To organize and systematize the ways in which nurses sought jobs, a structure of private duty registries, agencies which connected nurses with patients, was established via professional nurse associations. This article describes the origins of the private duty nurse labor market as the main employment field for early nurses and ways in which the private duty registry system connected nurses and patients. The impact of professional nurses associations and two registries, (New York and Chicago) illustrates how the business of nursing was carried out, including registry formation, operation, and administration. Private duty nurses are compelling examples of a previous generation of nurse entrepreneurs. The discussion identifies problems and challenges of private nursing practice via registries, including the decline and legacy of this innovative nurse role. The story of early 20th century nurse owned and operated registries provides an early and critical historical illustration of the realization of nurse power, entrepreneurship, and control over professional practice that we still learn from today.

  11. The Dawn of Learning: What's Working in Early Childhood Education. Hearing before the Subcommittee on Education Reform of the Committee on Education and the Workforce. House of Representatives, One Hundred Seventh Congress, First Session (July 31, 2001).

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House Committee on Education and the Workforce.

    This document presents congressional testimony regarding effective early childhood education. Opening statements presented by Representatives Michael Castle and Dale Kildee focused on the need to examine the effectiveness of early childhood programs and address the "pre-achievement gap" between disadvantaged and advantaged preschoolers.…

  12. Early Childhood Interventions: Public-Private Partnerships. Hearing before the Subcommittee on Human Resources of the Committee on Government Reform and Oversight. House of Representatives, One Hundred Fifth Congress, Second Session.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House Subcommittee on Human Resources.

    These hearings transcripts recount testimony before the U.S. House of Representatives concerning early childhood development programs. Testimony addressed the questions of how public and private investments in early childhood programs contribute to successful outcomes for infants and mothers, and how these successes can be measured and replicated…

  13. Patients of the future: a survey of school nurse competencies with implications for nurse executives in the acute care settings.

    PubMed

    Newell, Mary E

    2013-01-01

    School nursing in the United States has been in existence for many decades but has become increasingly more complex, as student health needs have escalated and the role itself has expanded in scope of practice. Given the changes in health care delivery mandated by the Patient Safety and Affordable Care Reform Act, and the increasing complexity of school nursing practice, it is important to determine whether nurses who enter this area of practice are educationally prepared to do so. The objective of this study was to determine the perceptions of currently practicing school nurses regarding their baccalaureate nursing education and whether they felt adequately prepared to effectively practice as a school nurse. The survey The Perceptions of School Nurses' Educational Preparation: Survey of Washington State School Nurses was sent to school nurses in Washington State. This was a descriptive, quantitative online survey that asked school nurses to assess their initial nursing education and whether their baccalaureate preparation adequately prepared them for this specialty role. There are a total of 17 school nurse standards, and 8 of the standards (47%) were identified as minimally achieved upon graduation. In addition, school nurses self-assessed gaps in their ongoing continuing educational needs, such as needing additional education regarding special education laws (81%), 504 accommodations (90.5%), diabetic care (76%), and delegation skills (68.6%). The findings from this study have illustrated the need for additional didactic and clinical practicum components that could be incorporated into baccalaureate nursing programs to better prepare graduates for school nursing practice in Washington State. Participants were able to identify areas in need of further education within their baccalaureate program, and also during their orientation to the role and responsibilities of a school nurse. Nurse executives must be able to use this knowledge to support staff nurses with an

  14. Nursing service innovation: A case study examining emergency nurse practitioner service sustainability.

    PubMed

    Fox, Amanda; Gardner, Glenn; Osborne, Sonya

    2018-02-01

    This research aimed to explore factors that influence sustainability of health service innovation, specifically emergency nurse practitioner service. Planning for cost effective provision of healthcare services is a concern globally. Reform initiatives are implemented often incorporating expanding scope of practice for health professionals and innovative service delivery models. Introducing new models is costly in both human and financial resources and therefore understanding factors influencing sustainability is imperative to viable service provision. This research used case study methodology (Yin, ). Data were collected during 2014 from emergency nurse practitioners, emergency department multidisciplinary team members and documents related to nurse practitioner services. Collection methods included telephone and semi-structured interviews, survey and document analysis. Pattern matching techniques were used to compare findings with study propositions. In this study, emergency nurse practitioner services did not meet factors that support health service sustainability. Multidisciplinary team members were confident that emergency nurse practitioner services were safe and helped to meet population health needs. Organizational support for integration of nurse practitioner services was marginal and led to poor understanding of service capability and underuse. This research provides evidence informing sustainability of nursing service models but more importantly raises questions about this little explored field. The findings highlight poor organizational support, excessive restrictions and underuse of the service. This is in direct contrast to contemporary expanding practice reform initiatives. Organizational support for integration is imperative to future service sustainability. © 2017 John Wiley & Sons Ltd.

  15. Foul weather friends: big business and health care reform in the 1990s in historical perspective.

    PubMed

    Swenson, Peter; Greer, Scott

    2002-08-01

    Existing accounts of the Clinton health reform efforts of the early 1990s neglect to examine how the change in big business reform interests during the short period between the late 1980s and 1994 might have altered the trajectory of compulsory health insurance legislation in Congress. This article explores evidence that big employers lost their early interest in reform because they believed their private remedies for bringing down health cost inflation were finally beginning to work. This had a discouraging effect on reform efforts. Historical analysis shows how hard times during the Great Depression also aligned big business interests with those of reformers seeking compulsory social insurance. Unlike the present case, however, the economic climate did not quickly improve, and the social insurance reform of the New Deal succeeded. The article speculates, therefore, that had employer health expenditures not flattened out, continuing and even growing big business support might have neutralized small business and other opposition that contributed heavily to the failure of reform. Thus in light of the Clinton administration's demonstrated willingness to compromise with business on details of its plan, some kind of major reform might have succeeded.

  16. Letters to a Young Education Reformer

    ERIC Educational Resources Information Center

    Hess, Frederick M.

    2017-01-01

    In "Letters to a Young Education Reformer," Frederick M. Hess distills knowledge from twenty-five years of working in and around school reform. Inspired by his conversations with young, would-be reformers who are passionate about transforming education, the book offers a window into Hess's thinking about what education reform is and…

  17. Reforming Our Expectations about Juvenile Justice

    ERIC Educational Resources Information Center

    Rodriguez, Pamela F.; Baille, Daphne M.

    2010-01-01

    Typing the term "juvenile justice reform" into a Google[TM] search will result in 60 pages of entries. But what is meant by juvenile justice reform? What does it look like? How will one know when it is achieved? This article defines juvenile justice reform, discusses the principles of effective reform, and describes the practice of…

  18. Nurse migration from India: a literature review.

    PubMed

    Garner, Shelby L; Conroy, Shelley F; Bader, Susan Gerding

    2015-12-01

    review can be used to shape health policy and advocate for nursing reform in India. As India's healthcare infrastructure continues to evolve, effective programs to improve conditions for nurses and retain them in India are needed. Additionally, as the globalization of nurses increases, more research is needed to develop effective programs to aid in a smooth transition for nurses who migrate from India. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. RELIGION & CARE INTERTWINED; NURSING IN CATHOLIC HOSPITALS 1950-1965.

    PubMed

    Anthony, Maureen

    2016-01-01

    This qualitative study explores how Catholicism influenced nursing in Catholic hospitals and how nurses met the religious needs of Catholic patients in the 1950s and early 1960s. Six nurses were interviewed who graduated from Catholic schools of nursing between 1952 and 1965 and worked in Catholic hospitals. Results indicate that nursing care was inexorably entwined with meeting the religious needs of Catholic patients. Religious practices were predictable and largely linked to the Holy Sacraments.

  20. Teaching moral reasoning to student nurses.

    PubMed

    Weber, J R

    1992-09-01

    Teaching moral reasoning to students is a challenge for all nursing educators. The National League for Nursing and American Nurses' Association emphasize the importance of ethical content within the curriculum. Review of the literature indicates that ethics has been part of the nursing curriculum since the early 1900s. However, the focus of nursing ethics has changed to more critical reflective thinking versus duties and etiquette. Educators have used a variety of methods for teaching ethics and integrating it into the curriculum. Yet nursing graduates still lack adequate skills to be morally accountable practitioners. This creates a dilemma for the educator to find ways to integrate more ethics content into an already crowded curriculum. The code of ethics of holistic nurses may serve as a basis to guide nurse educators in resolving some of the problems encountered in promoting moral education.

  1. Prisons and Health Reforms in England and Wales

    PubMed Central

    Hayton, Paul; Boyington, John

    2006-01-01

    Prison health in England and Wales has seen rapid reform and modernization. Previously it was characterized by over-medicalization, difficulties in staff recruitment, and a lack of professional development for staff. The Department of Health assumed responsibility from Her Majesty’s Prison Service for health policymaking in 2000, and full budgetary and health care administration control were transferred by April 2006. As a result of this reorganization, funding has improved and services now relate more to assessed health need. There is early but limited evidence that some standards of care and patient outcomes have improved. The reforms address a human rights issue: that prisoners have a right to expect their health needs to be met by services that are broadly equivalent to services available to the community at large. We consider learning points for other countries which may be contemplating prison health reform, particularly those with a universal health care system. PMID:17008562

  2. The nursing shortage: part way down the slippery slope.

    PubMed

    Cowin, Leanne; Jacobsson, Denise

    2003-07-01

    The shortage of nurses has reached a crisis point for health care services. A number of issues including the effects of economic rationalism, generational differences, working conditions and nurse education are revisited in a discussion that aims to refuel the debate on workplace reform for nurses. Economic rationalism has altered the healthcare service landscape. Attempts to balance service delivery with workforce resources have led to possibly unforeseen changes. Highly skilled nurses are required in acute services, however resource allocation may prevent this. The nursing workforce is aging although the current nursing workforce consists of three generations: baby boomers, generation X and generation Y. There are significant ideological and work organisational differences between these generations leading to possible conflict between nurses. The pool of available nurses to fill employment vacancies is finite. Attracting overseas nurses to fill nurse vacancies will leave vacancies elsewhere and is not a long-term solution to the nursing shortage. Moreover, if the workplace has not addressed the reasons why nurses have left the health care workplace then there is a real danger of losing those recently attracted back into the workplace. Working conditions are a critical element within the retention puzzle. Job satisfaction dimensions such as autonomy and professional relationships are key components for improving working conditions. The final issue explored is the question of whether the tertiary education system is the most appropriate place in which to develop and educate nurses. It is suggested that workplace reforms should be the target of retention strategies rather than changes in the educational process of nursing.

  3. Nursing students assess nursing education.

    PubMed

    Norman, Linda; Buerhaus, Peter I; Donelan, Karen; McCloskey, Barbara; Dittus, Robert

    2005-01-01

    This study assessed the characteristics of nursing students currently enrolled in nursing education programs, how students finance their nursing education, their plans for clinical practice and graduate education, and the rewards and difficulties of being a nursing student. Data are from a survey administered to a national sample of 496 nursing students. The students relied on financial aid and personal savings and earnings to finance their education. Parents, institutional scholarships, and government loans are also important sources, but less than 15% of the students took out bank loans. Nearly one quarter of the students, particularly younger and minority students, plan to enroll in graduate school immediately after graduation and most want to become advanced nursing practitioners. Most of the nursing students (88%) are satisfied with their nursing education and nearly all (95%) provided written answers to two open-ended questions. Comments collapsed into three major categories reflecting the rewards (helping others, status, and job security) and three categories reflecting the difficulties (problems with balancing demands, quality of nursing education, and the admissions process) of being a nursing student. Implications for public policymaking center on expanding the capacity of nursing education programs, whereas schools themselves should focus on addressing the financial needs of students, helping them strike a balance among their school, work, and personal/family responsibilities and modifying certain aspects of the curriculum.

  4. Constitutional Reform for Conflict Management

    DTIC Science & Technology

    2014-04-01

    conflict. Empirical studies reveal that both accommodative and integrative constitutional design can produce political stability , if properly...reform, and the ability of various constitutional designs to promote democracy and political stability .

  5. Preparing Teachers for Curriculum Reform

    ERIC Educational Resources Information Center

    Rutherford, F. James

    1971-01-01

    Describes a set of presuppositions concerning teacher education associated with curriculum reform, including the roles of planning, school involvement, universities, educational technology, and educational research. Strategies of leadership and diffusion of responsibility are also discussed. (AL)

  6. Educator Preparation Reform Act

    THOMAS, 113th Congress

    Rep. Honda, Michael M. [D-CA-17

    2013-05-23

    House - 07/08/2013 Referred to the Subcommittee on Early Childhood, Elementary, and Secondary Education. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  7. Presentation of nursing diagnosis content in fundamentals of nursing textbooks.

    PubMed

    Mahon, S M; Spies, M A; Aukamp, V; Barrett, J T; Figgins, M J; Meyer, G A; Young, V K

    1997-01-01

    The technique and rationale for the use of nursing diagnosis generally are introduced early in the undergraduate curriculum. The three purposes of this descriptive study were to describe the general characteristics and presentation of content on nursing diagnosis in fundamentals of nursing textbooks; describe how the content from the theoretical chapter(s) in nursing diagnosis is carried through in the clinical chapters; and describe how content on diagnostic errors is presented. Although most of the textbooks presented content on nursing diagnosis in a similar fashion, the clinical chapters of the books did not follow the same pattern. Content on diagnostic errors was inconsistent. Educators may find this an effective methodology for reviewing textbooks.

  8. Nurse employment contracts in Chinese hospitals: impact of inequitable benefit structures on nurse and patient satisfaction

    PubMed Central

    2014-01-01

    Purpose Ongoing economic and health system reforms in China have transformed nurse employment in Chinese hospitals. Employment of ‘bianzhi’ nurses, a type of position with state-guaranteed lifetime employment that has been customary since 1949, is decreasing while there is an increase in the contract-based nurse employment with limited job security and reduced benefits. The consequences of inequities between the two types of nurses in terms of wages and job-related benefits are unknown. This study examined current rates of contract-based nurse employment and the effects of the new nurse contract employment strategy on nurse and patient outcomes in Chinese hospitals. Methods This cross-sectional study used geographically representative survey data collected from 2008 to 2010 from 181 hospitals in six provinces, two municipalities, and one autonomous region in China. Logistic regression models were used to estimate the association between contract-based nurse utilization, dissatisfaction among contract-based nurses, nurse intentions to leave their positions, and patient satisfaction, controlling for nurse, patient, and hospital characteristics. Principal Results Hospital-level utilization of contract-based nurses varies greatly from 0 to 91%, with an average of 51%. Contract-based nurses were significantly more dissatisfied with their remuneration and benefits than ‘bianzhi’ nurses who have more job security (P <0.01). Contract-based nurses who were dissatisfied with their salary and benefits were more likely to intend to leave their current positions (P <0.01). Hospitals with high levels of dissatisfaction with salary and benefits among contract-based nurses were rated lower and less likely to be recommended by patients (P < 0.05). Conclusions Our results suggest a high utilization of contract-based nurses in Chinese hospitals, and that the inequities in benefits between contract-based nurses and ‘bianzhi’ nurses may adversely affect both nurse and

  9. Nurse employment contracts in Chinese hospitals: impact of inequitable benefit structures on nurse and patient satisfaction.

    PubMed

    Shang, Jingjing; You, Liming; Ma, Chenjuan; Altares, Danielle; Sloane, Douglas M; Aiken, Linda H

    2014-01-13

    Ongoing economic and health system reforms in China have transformed nurse employment in Chinese hospitals. Employment of 'bianzhi' nurses, a type of position with state-guaranteed lifetime employment that has been customary since 1949, is decreasing while there is an increase in the contract-based nurse employment with limited job security and reduced benefits. The consequences of inequities between the two types of nurses in terms of wages and job-related benefits are unknown. This study examined current rates of contract-based nurse employment and the effects of the new nurse contract employment strategy on nurse and patient outcomes in Chinese hospitals. This cross-sectional study used geographically representative survey data collected from 2008 to 2010 from 181 hospitals in six provinces, two municipalities, and one autonomous region in China. Logistic regression models were used to estimate the association between contract-based nurse utilization, dissatisfaction among contract-based nurses, nurse intentions to leave their positions, and patient satisfaction, controlling for nurse, patient, and hospital characteristics. Hospital-level utilization of contract-based nurses varies greatly from 0 to 91%, with an average of 51%. Contract-based nurses were significantly more dissatisfied with their remuneration and benefits than 'bianzhi' nurses who have more job security (P <0.01). Contract-based nurses who were dissatisfied with their salary and benefits were more likely to intend to leave their current positions (P <0.01). Hospitals with high levels of dissatisfaction with salary and benefits among contract-based nurses were rated lower and less likely to be recommended by patients (P < 0.05). Our results suggest a high utilization of contract-based nurses in Chinese hospitals, and that the inequities in benefits between contract-based nurses and 'bianzhi' nurses may adversely affect both nurse and patient satisfaction in hospitals. Our study provides

  10. Putting conflict management into practice: a nursing case study.

    PubMed

    Vivar, Cristina García

    2006-04-01

    This paper is intended to put knowledge in conflict management into practice through reflecting on a nursing case study. Nursing organizations are particularly vulnerable to conflict as the context of nurses' work may be difficult and stressful. Power conflict is argued to be an important source of tension within nursing units. Learning to manage conflict at an early stage is therefore crucial to the effective functioning of nursing organizations. A nursing case study that illustrates power conflict in an oncology nursing unit is displayed and reflection on conflict management from the case is provided. There is no appropriate or inappropriate strategy to deal with conflict. However, detecting initial symptoms of conflict and adopting the most effective behaviour to conflict resolution is essential in nursing units. Further nursing education in conflict management for staff nurses and nurse managers is greatly needed.

  11. Misrecognition and science education reform

    NASA Astrophysics Data System (ADS)

    Brandt, Carol B.

    2012-09-01

    In this forum, I expand upon Teo and Osborne's discussion of teacher agency and curriculum reform. I take up and build upon their analysis to further examine one teacher's frustration in enacting an inquiry-based curriculum and his resulting accommodation of an AP curriculum. In this way I introduce the concept of misrecognition (Bourdieu and Passeron 1977) to open up new ways of thinking about science inquiry and school reform.

  12. Empowerment in nursing: paternalism or maternalism?

    PubMed

    Christensen, Martin; Hewitt-Taylor, Jaqui

    The aim of this article is to explore whether patient empowerment flourishes in the wake of current health reforms or if there is a power struggle between nursing and medicine as to what is in the patients' best interest. Shifting the balance of power from healthcare professionals to patients has become a key element of healthcare policy in England. The RCN's definition of nursing places patient empowerment as a central remit of nurses. However, achieving genuine patient empowerment is not easy and requires individuals and organizations to alter their beliefs, values and behaviours. To empower patients nurses must be in a position to share power and this may require a realignment of the traditional power base within health care. Although empowerment is often viewed on a one-to-one level between professionals and patients, for true patient empowerment to occur, issues of power and control must also be addressed at a national and political level.

  13. Adequacy, accountability, autonomy and equity in a Middle Eastern school reform: The case of Qatar

    NASA Astrophysics Data System (ADS)

    Guarino, Cassandra M.; Tanner, Jeffery C.

    2012-04-01

    This study examines Qatar's recent and ambitious school reform in the early stages of its implementation against a set of four criteria for successful education systems drawn from guidelines developed by the international community: adequacy, accountability, autonomy and gender equity. We investigate both the initial structure of the reform and its sustainability in light of concerns that movements in these directions might be politically unfeasible. To some degree, these concerns are substantiated by the developments we trace. However, it is important to note that the reform has changed the landscape of primary and secondary education in Qatar and that many reform principles, though diluted, have been retained. This paper highlights lessons learned - both hopeful and cautionary - in the first few years of reform and presents a methodology for evaluating progress along key dimensions that can be applied to school systems in many nations.

  14. Dual Education as the Peculiarity of Specialized Training of Nursing Personnel in Germany

    ERIC Educational Resources Information Center

    Oleskova, Halyna

    2017-01-01

    Specialized training of nursing personnel in Ukraine is being reformed presently. Quality specialized training of nursing personnel is a prerequisite for successful functioning of the health care system in general. In this regard, the article describes dual education system in Germany where educators have accumulated valuable experience in…

  15. A Summary of the October 2009 Forum on the Future of Nursing: Acute Care

    ERIC Educational Resources Information Center

    National Academies Press, 2010

    2010-01-01

    The Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the IOM, seeks to transform nursing as part of larger efforts to reform the health care system. The first of the Initiative's three forums was held on October 19, 2009, and focused on safety, technology, and interdisciplinary collaboration in acute care. Appended are: (1)…

  16. Learning Style Differences between Nursing and Teaching Students in Sweden: A Comparative Study

    ERIC Educational Resources Information Center

    Boström, Lena; Hallin, Karin

    2013-01-01

    The teaching profession has been continually challenged to provide evidence of the effectiveness of teaching and learning methods. Teacher education, as well as nursing education, is currently undergoing reforms in Sweden. At the university where the research was conducted, teaching and nursing programs are two priority educational programs and…

  17. Reform, Inequalities of Process and the Transformative Potential of Communities of Practice in the Pre-School Sector of England

    ERIC Educational Resources Information Center

    Simpson, Donald

    2011-01-01

    The integration of care and education across pre-school sectors of several European countries is currently a key policy priority. In England this necessitates reform aimed at re-modelling a traditionally hierarchical and divided workforce. Drawing on research with early years professionals, this article explores the micro-politics of reform with a…

  18. Reform, change, and continuity in Finnish health care.

    PubMed

    Häkkinen, Unto; Lehto, Juhani

    2005-01-01

    This article describes some essential aspects of the Finnish political and governmental system and the evolution of the basic institutional elements of the health care system. We examine the developments that gave rise to a series of health care reforms and reform proposals in the late 1980s and early 1990s and relate them to changes in health care expenditure, structure, and performance. Finally, we discuss the relationship between policy changes, reforms, and health system changes and the strength of neo-institutional theory in explaining both continuity and change. Much of the change in Finnish health care can be explained by institutional path dependency. The tradition of strong but small local authorities and the lack of legitimate democratic regional authorities as well as the coexistence of a dominant Beveridge-style health system with a marginal Bismarckian element explain the specific path of Finnish health care reform. Public responsibility for health care has been decentralized to smaller local authorities (known as municipalities) more than in any other country. Even an exceptionally deep economic recession in the early 1990s did not lead to systems change; rather, the economic imperative was met by the traditional centralized policy pattern. Some of the developments of the 1990s are, however, difficult to explain by institutional theory. Thus, there is a need for testing alternative theories as well.

  19. Nurses critical to quality, safety, and now financial performance.

    PubMed

    Kohlbrenner, Janis; Whitelaw, George; Cannaday, Denise

    2011-03-01

    Preventable hospital errors are the accepted impetus to the establishment of quality measures and served as a catalyst for the ongoing evolution of healthcare reform. Nurses are crucial members of the hospital quality team, and their actions are integral to the hospital's quality performance. The authors explore some of the practical challenges created by quality performance standards, specifically around venous thromboembolism, and the contribution nurses can make, to patient safety, quality of care, and the institutions financial performance.

  20. Let's make a deal: trading malpractice reform for health reform.

    PubMed

    Sage, William M; Hyman, David A

    2014-01-01

    Physician leadership is required to improve the efficiency and reliability of the US health care system, but many physicians remain lukewarm about the changes needed to attain these goals. Malpractice liability-a sore spot for decades-may exacerbate physician resistance. The politics of malpractice have become so lawyer-centric that recognizing the availability of broader gains from trade in tort reform is an important insight for health policy makers. To obtain relief from malpractice liability, physicians may be willing to accept other policy changes that more directly improve access to care and reduce costs. For example, the American Medical Association might broker an agreement between health reform proponents and physicians to enact federal legislation that limits malpractice liability and simultaneously restructures fee-for-service payment, heightens transparency regarding the quality and cost of health care services, and expands practice privileges for other health professionals. There are also reasons to believe that tort reform can make ongoing health care delivery reforms work better, in addition to buttressing health reform efforts that might otherwise fail politically.

  1. Nursing students' attitudes about home health nursing.

    PubMed

    Prestia, Mindy; Murphy, Susan; Yoder, Marian

    2008-09-01

    In an effort to address the home care nursing shortage, this pilot study was designed to measure nursing students' attitudes toward home health nursing and to test the Home Health Attitude Questionnaire developed specifically for this study based on the Theory of Planned Behavior. Senior undergraduate nursing students and registered nursing to bachelor of science in nursing students completed the questionnaire.

  2. The Nurse Project: an analysis for nurses to take back our work.

    PubMed

    Rankin, Janet M

    2009-12-01

    This paper challenges nurses to join together as a collective in order to facilitate ongoing analysis of the issues that arise for nurses and patients when nursing care is harnessed for health care efficiencies. It is a call for nurses to respond with a collective strategy through which we can 'talk back' and 'act back' to the powerful rationality of current thinking and practices. The paper uses examples from an institutional ethnographic (IE) research project to demonstrate how dominant approaches to understanding nursing position nurses to overlook how we activate practices of reform that reorganize how we nurse. The paper then describes two classroom strategies taken from my work with students in undergraduate and graduate programs. The teaching strategies I describe rely on the theoretical framework that underpin the development of an IE analysis. Taken into the classroom (or into other venues of nursing activism) the tools of IE can be adapted to inform a pedagogical approach that supports nurses to develop an alternate analysis to what is happening in our work.

  3. Falls Risk Prediction for Older Inpatients in Acute Care Medical Wards: Is There an Interest to Combine an Early Nurse Assessment and the Artificial Neural Network Analysis?

    PubMed

    Beauchet, O; Noublanche, F; Simon, R; Sekhon, H; Chabot, J; Levinoff, E J; Kabeshova, A; Launay, C P

    2018-01-01

    Identification of the risk of falls is important among older inpatients. This study aims to examine performance criteria (i.e.; sensitivity, specificity, positive predictive value, negative predictive value and accuracy) for fall prediction resulting from a nurse assessment and an artificial neural networks (ANNs) analysis in older inpatients hospitalized in acute care medical wards. A total of 848 older inpatients (mean age, 83.0±7.2 years; 41.8% female) admitted to acute care medical wards in Angers University hospital (France) were included in this study using an observational prospective cohort design. Within 24 hours after admission of older inpatients, nurses performed a bedside clinical assessment. Participants were separated into non-fallers and fallers (i.e.; ≥1 fall during hospitalization stay). The analysis was conducted using three feed forward ANNs (multilayer perceptron [MLP], averaged neural network, and neuroevolution of augmenting topologies [NEAT]). Seventy-three (8.6%) participants fell at least once during their hospital stay. ANNs showed a high specificity, regardless of which ANN was used, and the highest value reported was with MLP (99.8%). In contrast, sensitivity was lower, with values ranging between 98.4 to 14.8%. MLP had the highest accuracy (99.7). Performance criteria for fall prediction resulting from a bedside nursing assessment and an ANNs analysis was associated with a high specificity but a low sensitivity, suggesting that this combined approach should be used more as a diagnostic test than a screening test when considering older inpatients in acute care medical ward.

  4. Reforming Preschools and Schools.

    PubMed

    Duncan, Greg J; Magnuson, Katherine; Murnane, Richard J

    2016-04-01

    Compared with their higher-income counterparts, children growing up in low-income families in the United States typically complete less schooling, report worse health, and work and earn less in adulthood. Moreover, changes in the American economy over the last 40 years have raised the level of skills and qualifications that children need to obtain a good middle-class job, as well as making it much more difficult for children from low-income families to attend schools that support their learning of these skills. We first review strategies used in the past to improve K-12 schooling-including investing more money, introducing more accountability, and putting in place new governance structures (eg, charter schools)-and show why these strategies have been relatively ineffective. Drawing on the research literature and case studies, we then describe education reform strategies for prekindergarten programs and for elementary, middle, and high schools that may help meet these challenges. All of the initiatives described in our case studies provide ample opportunities for teachers and school leaders to improve their skills through coaching and other professional development activities; incorporate sensible systems of accountability, including requiring teachers to open their classrooms to the scrutiny of colleagues and school leaders and to work with their colleagues to improve their teaching practices; and incorporate high academic standards, such as those described in the Common Core State Standards. By focusing directly on improving teaching and promoting learning, these successful initiatives have boosted the achievement of low-income children. They show that it is indeed possible to make a real difference in the life chances of low-income children. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  5. Developing PhD Nurse Scientists: Do Bachelor of Science in Nursing Honors Programs Help?

    PubMed

    Neuberger, Geri B

    2016-10-01

    The critical need for more nurses with research doctoral degrees to replace vacancies among retiring nursing faculty and nurse administrators is identified. The Future of Nursing report recommends that the number of nurses with PhD degrees double by 2020. Encouraging nursing students to begin doctoral education early in their careers is essential to meeting this goal now and in the future. One method to promote early enrollment into doctoral education is participation in a bachelor of science in nursing (BSN) honors program. We describe the recruitment and application process, mentor selection, scholarly activities, and publication of final manuscripts for one such program. The success of one BSN honors program in enabling graduation with university honors and encouraging enrollment and graduation with doctoral degrees is described. The development of more BSN Honors programs and enhancement of activities of current programs are recommended. [J Nurs Educ. 2016;55(10):579-582.]. Copyright 2016, SLACK Incorporated.

  6. Nursing informatics and nursing ethics: addressing their disconnect through an enhanced TIGER-vision.

    PubMed

    Kaltoft, Mette Kjer

    2013-01-01

    All healthcare visions, including that of The TIGER (Technology-Informatics-Guiding-Educational-Reform) Initiative envisage a crucial role for nursing. However, its 7 descriptive pillars do not address the disconnect between Nursing Informatics and Nursing Ethics and their distinct communities in the clinical-disciplinary landscape. Each sees itself as providing decision support by way of information inputs and ethical insights, respectively. Both have reasons - ideological, professional, institutional - for their task construction, but this simultaneously disables each from engaging fully in the point-of-(care)-decision. Increased pressure for translating 'evidence-based' research findings into 'ethically-sound', 'value-based' and 'patient-centered' practice requires rethinking the model implicit in conventional knowledge translation and informatics practice in all disciplines, including nursing. The aim is to aid 'how nurses and other health care scientists more clearly identify clinical and other relevant data that can be captured to inform future comparative effectiveness research. 'A prescriptive, theory-based discipline of '(Nursing) Decisionics' expands the Grid for Volunteer Development of TIGER's newly launched virtual learning environment (VLE). This provides an enhanced TIGER-vision for educational reform to deliver ethically coherent, person-centered care transparently.

  7. Romania: Education Reform Project.

    ERIC Educational Resources Information Center

    World Bank, Washington, DC.

    Romania, one of the largest but also one of the poorest nations in Eastern Europe, is moving toward a market economy and a pluralistic society. Romania's educational system reflects a failure to appreciate the value of general secondary education over early specialized vocational training. Basic schooling is compulsory through grade eight, but…

  8. From Wall Street to Main Street: how will the economic meltdown impact health care reform?

    PubMed

    Gardner, Deborah B

    2008-01-01

    What will happen to health care in the wake of the financial market crisis? Many health policy and economic experts are asking whether it is possible for any of the promises for health care reform to be realized. We could find ourselves in a catastrophic collision between national security priorities and domestic policy goals. Nurses must be vocal regarding the need to reform health care or it may be sidestepped if budgeting continues to prioritize the war abroad and not the crisis at home.

  9. Reforming the mission of public dental services.

    PubMed

    Wright, F A C; List, P F

    2012-10-01

    Australia has a complex history of providing public dental services to its communities. From the early days of Colonial settlement, the provision of dental care to the Australian public has largely been driven and influenced by organized groups and associations of dentists. The Constitution of Australia, under Section 51 xxiii A, allows for the Commonwealth to provide for medical and dental services. Unlike the United Kingdom, however, dental services have not been embedded into a universal national health service agenda. In 1974, that the Australian Government through the Australian School Dental Program provided the first funding and national direction for public dental services - and that, limited to children. The Commonwealth Dental Health Program 1993-1997 was the second national endeavor to provide public dental services, this time to financially disadvantaged adults. Since that time, public dental service responsibility has been shuttled between States/Territories and the Commonwealth. A new paradigm for public dental services in Australia requires strong Commonwealth leadership, as well as the commitment of State and Territories and the organized dental profession. The National Health and Hospitals Reform Commission provided the most recent scenario for a radical change in mission. This paper canvases the competing roles of strategic, functional, and structural issues in relationship to social network and policy issues, which must be recognized if Australians truly seek to reform public dental services. © 2012 John Wiley & Sons A/S.

  10. Nurse crop

    Treesearch

    Wayne D. Shepperd; John R. Jones

    1985-01-01

    In forestry, a nurse crop generally is a crop of trees or shrubs that fosters the development of another tree species, usually by protecting the second species, during its youth, from frost, insolation, or wind (Ford-Robertson 1971). Aspen may be a nurse crop for shade-tolerant tree species that do not become established in full sunlight (e.g., Engelmann spruce)....

  11. Preparing nurses for leadership roles in cardiovascular disease prevention.

    PubMed

    Lanuza, Dorothy M; Davidson, Patricia M; Dunbar, Sandra B; Hughes, Suzanne; De Geest, Sabina

    2011-07-01

    Cardiovascular disease (CVD) is a critical global health issue, and cardiovascular nurses play a vital role in decreasing the global burden and contributing to improving outcomes in individuals and communities. Cardiovascular nurses require the knowledge, skills, and resources that will enable them to function as leaders in CVD. This article addresses the education, training, and strategies that are needed to prepare nurses for leadership roles in preventing and managing CVD. Building on the World Health Organization core competencies for 21st-century health care workers, the specific competencies of cardiovascular nurses working in prevention are outlined. These can be further strengthened by investing in the development of cultural, system change and leadership competencies. Mentorship is proposed as a powerful strategy for promoting the cardiovascular nursing role and equipping individual nurses to contribute meaningfully to health system reform and community engagement in CVD risk reduction. Copyright © 2011 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.

  12. Preparing nurses for leadership roles in cardiovascular disease prevention.

    PubMed

    Lanuza, Dorothy M; Davidson, Patricia M; Dunbar, Sandra B; Hughes, Suzanne; De Geest, Sabina

    2011-01-01

    Cardiovascular disease (CVD) is a critical global health issue, and cardiovascular nurses play a vital role in decreasing the global burden and contributing to improving outcomes in individuals and communities. Cardiovascular nurses require the knowledge, skills, and resources that will enable them to function as leaders in CVD. This article addresses the education, training, and strategies that are needed to prepare nurses for leadership roles in preventing and managing CVD. Building on the World Health Organization core competencies for 21st-century health care workers, the specific competencies of cardiovascular nurses working in prevention are outlined. These can be further strengthened by investing in the development of cultural, system change and leadership competencies. Mentorship is proposed as a powerful strategy for promoting the cardiovascular nursing role and equipping individual nurses to contribute meaningfully to health system reform and community engagement in CVD risk reduction.

  13. Hydrogen Generation Via Fuel Reforming

    NASA Astrophysics Data System (ADS)

    Krebs, John F.

    2003-07-01

    Reforming is the conversion of a hydrocarbon based fuel to a gas mixture that contains hydrogen. The H2 that is produced by reforming can then be used to produce electricity via fuel cells. The realization of H2-based power generation, via reforming, is facilitated by the existence of the liquid fuel and natural gas distribution infrastructures. Coupling these same infrastructures with more portable reforming technology facilitates the realization of fuel cell powered vehicles. The reformer is the first component in a fuel processor. Contaminants in the H2-enriched product stream, such as carbon monoxide (CO) and hydrogen sulfide (H2S), can significantly degrade the performance of current polymer electrolyte membrane fuel cells (PEMFC's). Removal of such contaminants requires extensive processing of the H2-rich product stream prior to utilization by the fuel cell to generate electricity. The remaining components of the fuel processor remove the contaminants in the H2 product stream. For transportation applications the entire fuel processing system must be as small and lightweight as possible to achieve desirable performance requirements. Current efforts at Argonne National Laboratory are focused on catalyst development and reactor engineering of the autothermal processing train for transportation applications.

  14. Early return visits by pediatric primary care patients with otitis media: a retail nurse practitioner clinic versus standard medical office care.

    PubMed

    Rohrer, James E; Garrison, Gregory M; Angstman, Kurt B

    2012-01-01

    To compare outpatient return visits within 2 weeks experienced by pediatric patients diagnosed with otitis media using retail nurse practitioner clinics to similar patients using standard medical office clinics. The impact of retail clinics on return visit rates has not been extensively studied. Electronic medical records of pediatric primary care patients seen in a large group practice in Minnesota in 2009 for otitis media. Patients seen in retail walk-in clinics staffed by nurse practitioners (N = 627) or regular office clinics (N = 2353). A return visit to any site within 2 weeks. The percentage returning was higher in standard care patients than in retail medicine patients (21.0 vs 11.2, P < .001). The odds of a return visit within 2 weeks were higher in standard care patients than in retail medicine patients after adjusting for propensity to use services, age, and gender (odds ratio = 1.54, P < 0.01). In this group practice, the odds of return visits within 2 weeks for pediatric patients treated for otitis media were lower in retail medicine clinics than in standard office clinics.

  15. Measuring the qualities of nurses: development and testing of the Qualities of Nurses Scale.

    PubMed

    Johnson, Maree; Cowin, Leanne

    2013-01-01

    This paper reports on the creation, development and testing of a new instrument to measure qualities of nurses, known as the Qualities of Nurses (QON) scale, applicable to student nurses. High attrition rates within nursing programs and during early postgraduate years are an international phenomena. Mismatches between idealized perceptions of nursing and the realities of education and clinical experiences have been identified as contributing factors. A survey method was used to elicit responses to scale items from 678 first-year nursing students at a large university. A one-factor 12-item solution explaining 47 percent of variance in the construct was demonstrated. The QON can assist in the initial assessment and ongoing monitoring of changes in students' perceptions of nurses. Using the QON, researchers and educators can identify initial student nurses' perceptions and any changes associated in educational or other events that ultimately could be manipulated to reduce attrition.

  16. Workplace practices for retaining older hospital nurses: implications from a study of nurses with eldercare responsibilities.

    PubMed

    Rosenfeld, Peri

    2007-05-01

    Attempts to address the nursing shortage must consider the aging nursing supply and the decreased labor participation among nurses at age 55 and older. Efforts to retain older, experienced nurses have been meager, and little attention is paid to the role of eldercare in decisions to leave the profession. This pilot study examines current workplace practices that may contribute to early withdrawal of older nurses from the hospital workforce. Interviews with 28 elder caregiving registered nurses and assistive nursing personnel at a New York hospital were conducted. Respondents reported that successful management of their dual roles rests on identifying units and shifts that suit their needs, erecting clear boundaries between home and work, and their love of nursing. "Caregiver-friendly" practices such as creative, flexible scheduling; access to social workers; financial and legal services; and increased awareness among managers about caregiver strains were recommended.

  17. Bringing care to the people: Lillian Wald's legacy to public health nursing.

    PubMed Central

    Buhler-Wilkerson, K

    1993-01-01

    Lillian Wald invented public health nursing in 1893, making this year the field's centennial. One of nursing's visionaries, Wald secured reforms in health, industry, education, recreation, and housing. This historical inquiry examines three of Wald's critical experiments, each of which illuminates the past of public health nursing and its contemporary dilemmas: invention of public health nursing itself, establishment of a nationwide system of insurance payments for home-based care, and creation of a national public health nursing service. Images p1779-a p1780-a p1781-a p1782-a PMID:7695663

  18. National Nursing Shortage Reform and Patient Advocacy Act

    THOMAS, 113th Congress

    Sen. Boxer, Barbara [D-CA

    2013-04-16

    Senate - 04/16/2013 Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  19. National Nursing Shortage Reform and Patient Advocacy Act

    THOMAS, 112th Congress

    Sen. Boxer, Barbara [D-CA

    2011-05-12

    Senate - 05/12/2011 Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  20. National Nursing Shortage Reform and Patient Advocacy Act

    THOMAS, 111th Congress

    Sen. Boxer, Barbara [D-CA

    2009-05-13

    Senate - 05/13/2009 Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  1. Hemodialysis Hospitalizations and Readmissions: The Effects of Payment Reform

    PubMed Central

    Erickson, Kevin F.; Winkelmayer, Wolfgang C.; Chertow, Glenn M.; Bhattacharya, Jay

    2016-01-01

    Background In 2004 the Centers for Medicare & Medicaid Services (CMS) changed reimbursement for physicians and advanced practitioners caring for patients receiving hemodialysis from a capitated to a tiered fee-for-service system, encouraging increased face-to-face visits. This early version of a pay-for-performance initiative targeted a care process: more frequent provider visits in hemodialysis. While more frequent provider visits in hemodialysis are associated with fewer hospitalizations and re-hospitalizations, it is unknown whether encouraging more frequent visits through reimbursement policy also yielded these benefits. Study Design We used a retrospective cohort, interrupted time-series study design to examine whether the 2004 nephrologist reimbursement reform led to reduced hospitalizations and re-hospitalizations. We also used published data to estimate a range of annual economic costs associated with more frequent visits. Setting & Participants Medicare beneficiaries in the United States receiving hemodialysis in the two years prior to and following reimbursement reform. Predictor The two years following nephrologist reimbursement reform. Outcomes Odds of hospitalization and 30-day hospital readmission for all causes and fluid overload; US dollars. Results We found no significant change in all-cause hospitalization or re-hospitalization, and slight reductions in hospitalization and re-hospitalization for fluid overload following reimbursement reform; the estimated economic cost associated with additional visits ranged from $13 to $87 million per year, depending on who (physicians or advanced practitioners) spent additional time visiting patients and how much additional effort was involved. Limitations Due to limited information about how much additional time providers spent seeing patients after reimbursement reform, we could only examine a range of potential economic costs associated with the reform. Conclusions A Medicare reimbursement policy designed to

  2. Stakeholder learning for health sector reform in Lao PDR.

    PubMed

    Phillips, Simone; Pholsena, Soulivanh; Gao, Jun; Oliveira Cruz, Valeria

    2016-09-01

    Development organizations and academic institutions have expressed the need for increased research to guide the development and implementation of policies to strengthen health systems in low- and middle-income countries. The extent to which evidence-based policies alone can produce changes in health systems remains a point of debate; other factors, such as a country's political climate and the level of actor engagement, have been identified as influential variables in effective policy development and implementation. In response to this debate, this article contends that the success of health sector reform depends largely on policy learning-the degree to which research recommendations saturate a given political environment in order to successfully inform the ideas, opinions and perceived interests of relevant actors. Using a stakeholder analysis approach to analyze the case of health sector reform in Lao PDR, we examine the ways that actors' understanding and interests affect the success of reform-and how attitudes towards reform can be shaped by exposure to policy research and international health policy priorities. The stakeholder analysis was conducted by the WHO during the early stages of health sector reform in Lao PDR, with the purpose of providing the Ministry of Health with concrete recommendations for increasing actor involvement and strengthening stakeholder support. We found that dissemination of research findings to a broad array of actors and the inclusion of diverse stakeholder groups in policy design and implementation increases the probability of a sustainable and successful health sector reform. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. Teacher Pension Incentives, Retirement Behavior, and Potential for Reform in Arkansas

    ERIC Educational Resources Information Center

    Costrell, Robert M.; McGee, Josh B.

    2010-01-01

    The authors analyze the Arkansas teacher pension plan and empirically gauge the behavioral response to incentives embedded in that plan and to possible reforms. The pattern of pension wealth accrual creates sharp incentives to work until eligible for early or normal retirement, often in one's early fifties, and to separate shortly thereafter. We…

  4. Nursing empire: travel letters from Africa and the Caribbean

    PubMed Central

    Howell, Jessica

    2012-01-01

    This essay analyses colonial nurses’ travel letters, written from West Africa and the Caribbean between the turn of the century and 1920, in order to better understand the role of nurses in forming satellite versions of home. Though their primary function was to ‘nurse empire’ by helping to repair and maintain the bodies needed for imperial labour, nurses also contributed to written discourses supporting Britain's economic interests and political goals. Through careful consideration of primary archival material, this essay analyses the rhetorical modes that may have helped nurses gain professional and personal authority abroad. It considers nurses as moving within several kinds of imperial networks – geographical, institutional and discursive – and traces the shifts in their written self-representation according to these different contexts. In order to reform nursing, in the mid-nineteenth century Florence Nightingale defined the ‘New Nurse's’ ideal personality as well as her duties. Ever since, the nurse's ‘character’ has often been essentialised in literature and culture. As Julia Hallam observes in Nursing the Image (2000), the nurse is commonly portrayed as ministering angel, potential seductress, battleaxe or doctor's helpmate. The goal of this essay is to resist simplifying nurses’ cultural significance, motivations or experiences by studying the multiple influences to which colonial nurses were subject and the shifting registers in their writing. PMID:24764748

  5. Hospital nurse administrators in Japan: a feminist dimensional analysis.

    PubMed

    Brandi, C L; Naito, A

    2006-03-01

    Nursing administration research is scarce in Japan during a time when health care is rapidly reforming and baccalaureate and graduate nursing programmes are rapidly developing. Additionally, nursing administration content relies heavily on Western and non-nursing theories, some of which have been criticized for male bias. The purpose of this article is to present key findings from a qualitative study that explored the perspectives or viewpoints of 16 Japanese senior female nurse administrators in hospitals in order to learn what was happening in their working situations and how they were managing. This feminist study used dimensional analysis strategies for data collection and analysis. Semi-structured, tape-recorded interviews were conducted by both researchers in Japanese, transcribed into Japanese, and translated into English. The resulting explanatory matrix portrayed a story of 16 nurse administrators, most of whom were able successfully to enact a management role in a context of role ambiguity that was congruent with their relational values and beliefs. Important conditions influencing value-based role enactment included organization mission and purpose, organization structure, nurse-doctor relationships, participant-supervisor relationships, and personal attributes. Many participants were able to overcome barriers in these categories using strategies of tempered radicalism and consequently made positive organizational changes. Advanced formal education, better organizational support, and a raised consciousness among nurses that views nurses and midwives as equal partners with other professionals will enable Japanese nurse administrators to help advance patient-centred care and nursing development and empowerment.

  6. The nursing profession in Sri Lanka: time for policy changes.

    PubMed

    Aluwihare-Samaranayake, D; Ogilvie, L; Cummings, G G; Gellatly, Ian R

    2017-09-01

    We address issues and challenges in nursing in Sri Lanka with the aim of identifying where and how policy changes need to be made. Increased global interconnectivity calls for professional leadership, research, education, and policy reform in nursing as these are identified as enhancing health workforce performance and professionalization, thereby improving health systems. We draw on first-hand knowledge of health care and nursing in Sri Lanka and a recent survey of nurses at a large urban government hospital in Sri Lanka, followed by discussion and proposed action on themes identified through analysis of published and unpublished literature about the nursing profession. Policy and action are needed to: (a) establish mandatory nurse licensure in the public and private healthcare sectors; (b) implement realistic policies to further develop nursing education; (c) develop a professionalization process to support nursing autonomy and voice; and (d) promote systematic processes for educational accreditation, curriculum revision, continuing professional development, evidence-based practice, research, leadership, and information systems. There is a policy vacuum that requires careful analysis and strategic planning by formal nurse leaders. Implementing change will require political and professional power and strategic, innovative, and evolutionary policy initiatives as well as organizational infrastructure modifications best achieved through committed multidisciplinary collaboration, augmented research capacity, bolstered nursing leadership, and promotion of partnerships with policy makers. © 2017 International Council of Nurses.

  7. Improving information technology competencies: implications for psychiatric mental health nursing.

    PubMed

    Fetter, Marilyn S

    2009-01-01

    While substantial evidence links information technology (IT) with improved patient safety, care quality, access, and efficiency, nurses must demonstrate competencies in computers, informatics, and information literacy in order to use IT for practice, education, and research. The nursing profession has established IT competencies for all nurses at beginning and experienced levels. Newly revised standards also articulate role-specific expectations for advanced practice nurses. Unfortunately, there is a concern that many nurses may not possess these capabilities and that nurse educators are not prepared to teach them. IT competency evaluations, which have focused predominately on nursing education, indicate novice skill levels for most faculty and students. In numerous studies, again conducted largely in nursing education, significant improvement in IT competencies has been achieved only with intensive interventions. Deficits in IT competencies are a significant concern, because the federal government has mandated full implementation of Electronic Health Records (EHR) by 2014. EHR will require all nurses to use IT to deliver, document, and obtain reimbursement for patient care. In response to these concerns, two recent initiatives, the "Health Information Technology Scholars (HITS)" and "Technology Informatics Guiding Education Reform (TIGER)" projects, have been launched. By enhancing IT competencies, these projects will enable nurses to use evidence-based practice and other innovations to transform clinical care, education, and research. This report updates psychiatric-mental health nurses on the IT competencies literature, recent enhancement initiatives and innovations, and their implications for the specialty.

  8. Can ICT Reform Public Agencies?

    NASA Astrophysics Data System (ADS)

    Jansen, Arild; Løvdal, Einar

    This study examines the reorganisation of the administration of admission to higher education in Norway, which has also included the development of a nationwide, ICT-based case handling system. This reform process was initiated out of the need to provide politicians with information for control and regulatory purposes, and the reform resulted in a centralised management information system. This system, however, has evolved into a coordinated but also partly locally delegated decision-making instrument which processes most of the applications for admission to higher education in Norway.

  9. Attrition resistant fluidizable reforming catalyst

    DOEpatents

    Parent, Yves O [Golden, CO; Magrini, Kim [Golden, CO; Landin, Steven M [Conifer, CO; Ritland, Marcus A [Palm Beach Shores, FL

    2011-03-29

    A method of preparing a steam reforming catalyst characterized by improved resistance to attrition loss when used for cracking, reforming, water gas shift and gasification reactions on feedstock in a fluidized bed reactor, comprising: fabricating the ceramic support particle, coating a ceramic support by adding an aqueous solution of a precursor salt of a metal selected from the group consisting of Ni, Pt, Pd, Ru, Rh, Cr, Co, Mn, Mg, K, La and Fe and mixtures thereof to the ceramic support and calcining the coated ceramic in air to convert the metal salts to metal oxides.

  10. Bringing electricity reform to the Philippines

    SciTech Connect

    Fe Villamejor-Mendoza, Maria

    2008-12-15

    Electricity reforms will not translate to competition overnight. But reforms are inching their way forward in institutions and stakeholders of the Philippine electricity industry, through regulatory and competition frameworks, processes, and systems promulgated and implemented. (author)

  11. The Feasibility of Collecting School Nurse Data

    ERIC Educational Resources Information Center

    Bergren, Martha Dewey

    2016-01-01

    School nurses cite barriers to collecting comprehensive data on the care they provide. This study evaluated the feasibility of collecting school nurse data on selected child health and education outcomes. Outcome variables included school health office visits; health provider, parent, and staff communication; early dismissal; and medications…

  12. Reel Reform: Documentaries Spur Debate about Educational Reform

    ERIC Educational Resources Information Center

    Hurley, Stephen

    2011-01-01

    Three new American documentaries including "Waiting for Superman," "The Lottery, Race to Nowhere" and one British entry, "We are the People We've Been Waiting For," have animated school reform debates. Each of these documentaries seeks to disturb the entrenched thinking by claiming that our educational institutions…

  13. The National School Reform Faculty: Reforming Schools from the Inside

    ERIC Educational Resources Information Center

    Educational Horizons, 2005

    2005-01-01

    In the Winter 2005 issue of "educational HORIZONS," Charles Glenn wrote that schools designed in a perfect system of educational diversity and choice could nonetheless end up as "uninspired carbon copies produced by educators without the foggiest idea of how to do anything differently." Most school reform tries to avoid that fate with various…

  14. Principles of Reform and Reforming Principal Training: A Theoretical Perspective.

    ERIC Educational Resources Information Center

    Bjork, Lars G.; Ginsberg, Rick

    1995-01-01

    Examines reform debates in educational administration training programs using a theoretical framework derived from Thomas Kuhn's notion of paradigm. Most administrator training programs in the United States are characterized as hybrid/preparadigm departments unlikely to undertake fundamental changes. Using a collaborative school leadership program…

  15. Early warnings: health care preparedness.

    PubMed

    Rebmann, Terri

    2005-11-01

    As nurses, we represent the backbone of the health care system. It is essential that we have a core understanding of infectious disease emergencies and begin to use the strengths that characterize nursing. These strengths include the ability to evaluate situations and use evidence on which to base our actions. Early identification of an infectious disease emergency is one example of using nursing skills to strengthen emergency preparedness. During an infectious disease emergency, nurses certainly will bear the burden of patient management. Because of this, the need for infectious disease emergency preparedness has become a national priority and a moral imperative for all nurses. One topic necessary for ED and OH nurses' preparedness has been discussed in this article, but nurses must take the initiative to learn more about disaster preparedness and incorporate these skills into everyday practice.

  16. The Omaha System as a Structured Instrument for Bridging Nursing Informatics With Public Health Nursing Education: A Feasibility Study.

    PubMed

    Eardley, Debra L; Krumwiede, Kelly A; Secginli, Selda; Garner, Linda; DeBlieck, Conni; Cosansu, Gulhan; Nahcivan, Nursen O

    2018-06-01

    Advancements in healthcare systems include adoption of health information technology to ensure healthcare quality. Educators are challenged to determine strategies to integrate health information technology into nursing curricula for building a nursing workforce competent with electronic health records, standardized terminology, evidence-based practice, and evaluation. Nursing informatics, a growing specialty field, comprises health information technology relative to the profession of nursing. It is essential to integrate nursing informatics across nursing curricula to effectively position competent graduates in technology-laden healthcare environments. Nurse scholars developed and evaluated a nursing informatics case study assignment used in undergraduate level public health nursing courses. The assignment included an unfolding scenario followed by electronic health record charting using standardized terminology to guide the nursing process. The assignment was delivered either online or in class. Seventy-two undergraduate students completed the assignment and a posttest. Fifty-one students completed a satisfaction survey. Results indicated that students who completed the assignment online demonstrated a higher level of content mastery than those who completed the assignment in class. Content mastery was based on posttest results, which evaluated students' electronic health record charting for the nursing assessment, evidence-based interventions, and evaluations. This innovative approach may be valuable to educators in response to the National Academy of Sciences recommendations for healthcare education reform.

  17. What is nursing in the 21st century and what does the 21st century health system require of nursing?

    PubMed

    Scott, P Anne; Matthews, Anne; Kirwan, Marcia

    2014-01-01

    It is frequently claimed that nursing is vital to the safe, humane provision of health care and health service to our populations. It is also recognized however, that nursing is a costly health care resource that must be used effectively and efficiently. There is a growing recognition, from within the nursing profession, health care policy makers and society, of the need to analyse the contribution of nursing to health care and its costs. This becomes increasingly pertinent and urgent in a situation, such as that existing in Ireland, where the current financial crisis has lead to public sector employment moratoria, staff cuts and staffing deficits, combined with increased patient expectation, escalating health care costs, and a health care system restructuring and reform agenda. Such factors, increasingly common internationally, make the identification and effective use of the nursing contribution to health care an issue of international importance. This paper seeks to explore the nature of nursing and the function of the nurse within a 21st century health care system, with a focus on the Irish context. However, this analysis fits into and is relevant to the international context and discussion regarding the nursing workforce. This paper uses recent empirical studies exploring the domains of activity and focus of nursing, together with nurses perceptions of their role and work environment, in order to connect those findings with core conceptual questions about the nature and function of nursing. © 2013 John Wiley & Sons Ltd.

  18. Secondary School Reform and Technology Planning: Lessons Learned from a Ten Year School Reform Initiative

    ERIC Educational Resources Information Center

    Bain, Alan

    2004-01-01

    The lessons learned from a decade long, site based school reform project are used to examine the relationship between technology integration and school reform. The nature of the reforms will be described along with implications and conclusions for technology planning. Six key school reform takeaways will be shared that are necessary to build a…

  19. Fitting the Pieces: Education Reform That Works. Studies of Education Reform.

    ERIC Educational Resources Information Center

    Klein, Steven; And Others

    Nearly all school reforms, regardless of their scope or intended target, share a number of characteristics. This report reviews the essential elements of planning, implementing, and sustaining school reform and presents eight key lessons to guide prospective reformers. The lessons are drawn from 12 major studies of education reform funded by the…

  20. Improving Competition: Reforming the Requirements Process

    DTIC Science & Technology

    2016-07-01

    45 Defense AT&L: July-August 2016 Improving Competition Reforming the Requirements Process Roy Wood, Ph.D. Wood is the Acting Vice President...professional. T ypical acquisition reform efforts have been focused in the margins, achiev­ ing marginal results. The evidence of decades of...acquisition reform indicates that the marginal reforms typically taken are not making the funda­ mental changes needed by the Department of Defense (DoD

  1. Method of steam reforming methanol to hydrogen

    DOEpatents

    Beshty, Bahjat S.

    1990-01-01

    The production of hydrogen by the catalyzed steam reforming of methanol is accomplished using a reformer of greatly reduced size and cost wherein a mixture of water and methanol is superheated to the gaseous state at temperatures of about 800.degree. to about 1,100.degree. F. and then fed to a reformer in direct contact with the catalyst bed contained therein, whereby the heat for the endothermic steam reforming reaction is derived directly from the superheated steam/methanol mixture.

  2. Maternal Early Life Factors Associated with Hormone Levels and the Risk of Having a Child with an Autism Spectrum Disorder in the Nurses Health Study II

    PubMed Central

    Lyall, Kristen; Pauls, David L.; Santangelo, Susan; Spiegelman, Donna; Ascherio, Alberto

    2012-01-01

    It is not known whether reproductive factors early in the mother’s life influence risk of autism spectrum disorders (ASD). We assessed maternal age at menarche, menstrual cycle characteristics during adolescence, oral contraceptive use prior to first birth, body shape, and body mass index (BMI) in association with ASD using binomial regression in a cohort study of 61,596 women, including 743 cases. Overall, early life factors were not associated with ASD, though early age at menarche (RR for age 10 or less = 1.54, 95% CI 1.18, 2.02, p = 0.0002) and BMI at age 18 of ≥30 (RR 2.03, 95% CI 1.34, 3.08, p = 0.0008) were significantly associated with increased risk of ASD. Further work should investigate the potential influence of these factors. PMID:20700638

  3. Maternal early life factors associated with hormone levels and the risk of having a child with an autism spectrum disorder in the nurses health study II.

    PubMed

    Lyall, Kristen; Pauls, David L; Santangelo, Susan L; Santangelo, Susan; Spiegelman, Donna; Ascherio, Alberto

    2011-05-01

    It is not known whether reproductive factors early in the mother's life influence risk of autism spectrum disorders (ASD). We assessed maternal age at menarche, menstrual cycle characteristics during adolescence, oral contraceptive use prior to first birth, body shape, and body mass index (BMI) in association with ASD using binomial regression in a cohort study of 61,596 women, including 743 cases. Overall, early life factors were not associated with ASD, though early age at menarche (RR for age 10 or less = 1.54, 95% CI 1.18, 2.02, p = 0.0002) and BMI at age 18 of ≥30 (RR 2.03, 95% CI 1.34, 3.08, p = 0.0008) were significantly associated with increased risk of ASD. Further work should investigate the potential influence of these factors.

  4. What do nurse managers say about nurses' sickness absenteeism? A new perspective.

    PubMed

    Baydoun, Mohamed; Dumit, Nuhad; Daouk-Öyry, Lina

    2016-01-01

    To explore nurses' sickness absenteeism from the perspective of nurse managers. Sickness absenteeism among health-care providers, especially nurses, remains a significant problem in an era of challenges to provide high quality care with the required skill mix. This in turn compromises the quality of care and adds to the costs of an organisation. A qualitative descriptive design was used. Data were collected from a governmental academic hospital in Lebanon. In-depth tape-recorded interviews were conducted with a total of 20 nurse managers. Data were analysed through a content analysis approach. Data analysis yielded three domains as follows: work-related, individual and organisational factors that lead to nurses' sickness absenteeism. This study conceptualised nurses' absenteeism from the nurse managers' perspective, and it revealed absence antecedents that are rarely reported elsewhere in the literature. The findings from this study can be utilised to design reform initiatives concerned with nurses' absenteeism and to decrease its negative consequences in terms of quality and cost. © 2015 John Wiley & Sons Ltd.

  5. A Design of an Appropriate Early Childhood Education Funding System in China

    ERIC Educational Resources Information Center

    Xiaodong, Zeng

    2008-01-01

    This study analyzes the structural reform of local governments funding for early childhood education (ECE) as the general public still casts doubts about the fairness of ECE system in China. A particular case in point is the Shenzhen Municipal Government's reform on their ECE funding system. Because the reform efforts are more about restructuring…

  6. Values Orientations of Hong Kong's Reform Proposals

    ERIC Educational Resources Information Center

    Che, Fok Shui

    2004-01-01

    Hong Kong has put forward a package of education reform proposals in 2000. The education reform is to set the blueprint for Hong Kong's development of education for the 21st century. An analysis of the values orientation of the reform proposals shows that the impact of globalization and the economic restructuring are the guiding forces. The main…

  7. Whatever Happened to Undergraduate Reform? Carnegie Perspectives

    ERIC Educational Resources Information Center

    Marchese, Theodore J.

    2006-01-01

    The author asks whether higher education reform has run out of new things to say. The final two decades of the twentieth century were a remarkable period for innovation in undergraduate education. Many of higher education's earlier waves of reform had focused on curricular issues, on what should be taught. The new reformers by and large ignored…

  8. Russian Military Reform: Problems and Challenges

    DTIC Science & Technology

    2010-03-25

    RUSSIAN MILITARY REFORM : PROBLEMS AND CHALLENGES BY LIEUTENANT COLONEL ZURAB AGLADZE Georgian Army...USAWC STRATEGIC REASERCH PROJECT RUSSIAN MILITARY REFORM : PROBLEMS AND CHALLENGES by Lieutenant Colonel...noncommissioned officers still continue to be unsolved. Despite some successes, Russian military reform still faces many challenges that will

  9. Assessing Students' Conceptions of Reform Mathematics.

    ERIC Educational Resources Information Center

    Star, Jon R.; Hoffmann, Amanda J.

    As the use of National Science Foundation (NSF)-sponsored, reform- oriented mathematics curricula has become more prevalent across the U.S., an increasing number of researchers are attempting to study the "impact" of reform. In particular, mathematics educators are interested in determining whether reforms are having the desired effects on…

  10. Globalization and Educational Reform in Contemporary Japan

    ERIC Educational Resources Information Center

    Qi, Jie; Zhang, Sheng Ping

    2008-01-01

    This study explores the notions of globalization as embodied in Japanese educational reforms. Modern institutional discourses of educational reform in Japan have shifted over time and all of these reform movements have been constructed by particular social and historical trajectories. Generally speaking, it has been taken for granted that the…

  11. Considerations for Education Reform in British Columbia

    ERIC Educational Resources Information Center

    Santos, Ana

    2012-01-01

    Countries around the world refer to twenty-first century education as essential to maintaining personal and national economic advantage and draw on this discourse to advocate for and embark on educational reform. This paper examines issues around education reform, particularly in British Columbia. It argues that reformers should give careful…

  12. Community Organizing as an Education Reform Strategy

    ERIC Educational Resources Information Center

    Renee, Michelle; McAlister, Sara

    2011-01-01

    Community organizing for school reform offers an urgently needed alternative to traditional approaches to school change. Many current reforms fail to thrive due to lack of trust, understanding, or cultural relevance to the community being targeted. The high turnover of reformers (superintendents, principals, or outside organizations) in high-need…

  13. A Framework for Appraising Educational Reforms.

    ERIC Educational Resources Information Center

    House, Ernest R.

    1996-01-01

    Discusses the use of transaction-cost economics in measuring the impact of educational reforms and whether these reforms are likely to succeed in the "real life" of schools. Several current educational reforms are judged on the basis of their transaction costs and consequent prospects for success. (GR)

  14. 49 CFR 260.13 - Credit reform.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... appropriations, direct payment of a Credit Risk Premium by the Applicant or a non-Federal infrastructure partner... 49 Transportation 4 2010-10-01 2010-10-01 false Credit reform. 260.13 Section 260.13... REHABILITATION AND IMPROVEMENT FINANCING PROGRAM Overview § 260.13 Credit reform. The Federal Credit Reform Act...

  15. School Reform--Does It Really Matter?

    ERIC Educational Resources Information Center

    Bunting, Carolyn

    1999-01-01

    Looks at different waves of school reform beginning with Sputnik in the 1950s. Examines influences in today's reform, including industrial influences and school choice. Argues that the origins and outcomes of school reform have more to do with what is happening outside the school than within it, and that schools must think beyond objective indices…

  16. Improving the Nuclear Reform Implementation for Success

    DTIC Science & Technology

    2016-09-15

    IMPROVING THE NUCLEAR REFORM IMPLEMENTATION FOR SUCCESS GRADUATE RESEARCH PAPER Allen Y. Agnes...United States. AFIT-ENS-MS-16-S-023 IMPROVING THE NUCLEAR REFORM IMPLMENTATION FOR SUCCESS GRADUATE RESEARCH PAPER Presented to the...AFIT-ENS-MS-16-S-023 IMPROVING THE NUCLEAR REFORM IMPLEMENTATION FOR SUCCESS Allen Y. Agnes, BS, MS Major, USAF

  17. General Education Reform: Opportunities for Institutional Alignment

    ERIC Educational Resources Information Center

    Fuess, Scott M., Jr.; Mitchell, Nancy D.

    2011-01-01

    General education reform provides strategic opportunities for departments. This article analyzes reform at the University of Nebraska-Lincoln, illustrating how departments could use the reform process to clarify their strategic planning, align with institutional goals, and steer the university closer to departmental objectives. (Contains 1 table.)

  18. Professional ethics. A case study of infusion nurse consultants.

    PubMed

    Adams, J

    2000-01-01

    As the healthcare system continues to reform, opportunities exist for infusion nurses to expand their practice into the business world. Traditionally, biomedical ethics have been used in nursing education as a framework for identifying and responding to ethical dilemmas. However, in the business world, professional ethics may be more subtle and insidious. A case study of ten infusion nurse consultants and their experiences with professional ethical issues is presented. Data were obtained using interviews, and content analysis revealed emergent themes of integrity and intuitive knowing with related categories.

  19. [Archaeology and genealogy as methodological options of nursing research].

    PubMed

    Azevedo, Rosemeiry Capriata de Souza; Ramos, Flavia Regina Souza

    2003-01-01

    This article is based on the historical contextualization about the development of research in nursing, presents the categories/lines of interest that support the human knowledge applied in the Doctorate Thesis in Nursing in Brazil, points out the archeological and genealogical methods proposed by Michel Foucault, and their possibility to make more difficult the day-to-day tasks of the nursing profession Whether in Institutions, Public Policies, Health Reform, and Vocational Training, in the attempt to understand which strategies, challenges, knowledge base, and practices have influenced the building of the subjects.

  20. Leadership in nursing education: voices from the past.

    PubMed

    Gosline, Mary Beth

    2004-01-01

    When education for nurses became a reality, leaders in the emerging profession spoke out early and often for educational improvements to prepare those who would nurse. The writings and speeches of Isabel Hampton Robb, Mary Adelaide Nutting, Lavinia Lloyd Dock, Lillian Wald, and Isabel Maitland Stewart formed the basis for a qualitative study that documents the voices of early nursing leaders who contributed to the development of nursing education as it moved from "training" toward professional education in a university setting. What is documented in the literature is the desire of these women to enhance the professional status of nursing through improvements in its educational system.

  1. School Reform in the USSR.

    ERIC Educational Resources Information Center

    Perry, Leland M.

    The Soviet Union has embarked upon a five-year plan to improve education at all levels. Some of the major aspects of the reform movement include: (1) improving the status of teachers by providing salary increases from 25 to 35 percent and trying to entice more men to enter teaching; (2) trying to increase the birthrate by emphasizing preschool…

  2. Reform and Resistance at Oxford

    ERIC Educational Resources Information Center

    Labi, Aisha

    2006-01-01

    In recent years, both Harvard and Oxford Universities have been rattled by reform-minded--some say brash--leaders determined to question the status quo. At Harvard, President Lawrence H. Summers proved too controversial for his own good and is scheduled to step down this month after five contentious years in office. But at Oxford, John Hood, who…

  3. The Dilemmas of Educational Reform

    ERIC Educational Resources Information Center

    Cohen, David K.; Spillane, James P.; Peurach, Donald J.

    2018-01-01

    The environment of U.S. schools has changed dramatically over a quarter century as standards tied to test-based accountability and market competition became commonplace. We examine the issues that school systems face in this changing environment, to identify considerations for researchers interested in reform as educational system building. We…

  4. Teacher Empowerment and School Reform

    ERIC Educational Resources Information Center

    Thornburg, Devin G.; Mungai, Anne

    2011-01-01

    Teachers in high-needs settings working with diverse populations are typically cited as a central element for school improvement yet are often described as resistant to such efforts. We sought to investigate the reasons behind teachers' views and beliefs about school reform within the context of collaboration and professional development, rather…

  5. National Standards and Education Reform.

    ERIC Educational Resources Information Center

    Kiernan, Henry, Ed.; Pyne, John, Ed.

    1993-01-01

    This theme issue of "The Docket" is devoted to national standards and their effects on education reform. National standards may provide the first real opportunity for schools to address the issues of student assessment and achievement. As the touchstone for educational equity, they may be the first real opportunity for teachers to…

  6. Steam Hydrocarbon Cracking and Reforming

    ERIC Educational Resources Information Center

    Golombok, Michael

    2004-01-01

    The interactive methods of steam hydrocarbon reforming and cracking of the oil and chemical industries are scrutinized, with special focus on their resemblance and variations. The two methods are illustrations of equilibrium-controlled and kinetically-controlled processes, the analysis of which involves theories, which overlap and balance each…

  7. Misrecognition and Science Education Reform

    ERIC Educational Resources Information Center

    Brandt, Carol B.

    2012-01-01

    In this forum, I expand upon Teo and Osborne's discussion of teacher agency and curriculum reform. I take up and build upon their analysis to further examine one teacher's frustration in enacting an inquiry-based curriculum and his resulting accommodation of an AP curriculum. In this way I introduce the concept of misrecognition (Bourdieu and…

  8. Education Reform: A Managerial Agenda.

    ERIC Educational Resources Information Center

    Bacharach, Samuel B.; Conley, Sharon C.

    1986-01-01

    Education reform has wrongly focused on teacher motivation and rewards, when the organizational system itself is at fault. Research shows that effective school management hinges on increased individual discretion and decision-making opportunities for teachers and less controlling behavior by administrators. Ten characteristics of effective…

  9. School Reform Meets Administrative Realities.

    ERIC Educational Resources Information Center

    Brown, Antoinette B.; And Others

    Maryland's Challenge Grant Program was designed to bring systemic change to schools with relatively low performance levels. This paper presents findings of an ethnographic study that examined the workings of an educational reform effort across several levels of administration. Specifically, the study explored conditions that facilitated and…

  10. Cultural Narcissism and Education Reform

    ERIC Educational Resources Information Center

    Pajak, Edward F.

    2011-01-01

    Background/Context: Scholars have described American culture in recent decades as narcissistic, manifested by displays of self-absorption tantamount to a pathological syndrome that has reached epidemic proportions. An education reform movement that is highly critical of public schools, teachers, and students has simultaneously emerged, espousing a…

  11. EIA: Educational Reform or Repression?

    ERIC Educational Resources Information Center

    Monteith, Dianne S.

    A recent study (Cook, 1989) involving 58 randomly selected South Carolina elementary schools indicated that none of these schools could be characterized as having an "open climate." This paper suggests that this situation may have its origins in the educational reform movement of the 1980s, first ignited by the publication of "A…

  12. Agrarian Reform and Rural Development.

    ERIC Educational Resources Information Center

    Biswas, Margaret R.

    1979-01-01

    This paper presents the plight of the world's poor, which was discussed at The World Conference on Agrarian Reform and Rural Development in July, 1979. Urban bias is attributed to the failure of rural development. More participation of rural people is needed. Progress is being made. Examples of literary programs in Iraq and the Sudan are included.…

  13. School Reform in the Eighties.

    ERIC Educational Resources Information Center

    Trusty, Francis M.

    Eight issues affecting the ability of the schools to meet the public's expectations and concerns are explored in this address. It examines problems, proposed solutions, barriers to change, and possibilities for reform in each of the eight areas. The topics considered are (1) school organization, the need for flexible structuring, and enhancement…

  14. Integrated reformer and shift reactor

    DOEpatents

    Bentley, Jeffrey M.; Clawson, Lawrence G.; Mitchell, William L.; Dorson, Matthew H.

    2006-06-27

    A hydrocarbon fuel reformer for producing diatomic hydrogen gas is disclosed. The reformer includes a first reaction vessel, a shift reactor vessel annularly disposed about the first reaction vessel, including a first shift reactor zone, and a first helical tube disposed within the first shift reactor zone having an inlet end communicating with a water supply source. The water supply source is preferably adapted to supply liquid-phase water to the first helical tube at flow conditions sufficient to ensure discharge of liquid-phase and steam-phase water from an outlet end of the first helical tube. The reformer may further include a first catalyst bed disposed in the first shift reactor zone, having a low-temperature shift catalyst in contact with the first helical tube. The catalyst bed includes a plurality of coil sections disposed in coaxial relation to other coil sections and to the central longitudinal axis of the reformer, each coil section extending between the first and second ends, and each coil section being in direct fluid communication with at least one other coil section.

  15. Welfare Reform: Serving America's Children.

    ERIC Educational Resources Information Center

    Moynihan, Daniel Patrick

    1989-01-01

    The poorest group in our population is children. This article discusses past and present public assistance programs that affect children and the disproportionate number of minority group children and children in single-parent homes who live in poverty. The need for welfare reform is discussed also. (IAH)

  16. Forest policy reform in Brazil

    Treesearch

    S. Bauch; E. Sills; L.C. Rodriguez Estraviz; K. McGinley; F. Cubbage

    2009-01-01

    Rapid deforestation in the Brazilian Amazon, caused by economic, social, and policy factors, has focused global and national attention on protecting this valuable forest resource. In response, Brazil reformed its federal forest laws in 2006, creating new regulatory, development, and incentive policy instruments and institutions. Federal forestry responsibilities are...

  17. Tax Reform and Higher Education.

    ERIC Educational Resources Information Center

    Franck, Gail

    1987-01-01

    The effect of the Tax Reform Act of 1986 on college and university revenues and expenditures is reviewed. Institutional revenues are derived primarily from five sources: tuition, charitable contributions, debt financing, endowment income, and governmental appropriations. The effect of the new law on family and student income, savings, student…

  18. Maternal Early Life Factors Associated with Hormone Levels and the Risk of Having a Child with an Autism Spectrum Disorder in the Nurses Health Study II

    ERIC Educational Resources Information Center

    Lyall, Kristen; Pauls, David L.; Santangelo, Susan; Spiegelman, Donna; Ascherio, Alberto

    2011-01-01

    It is not known whether reproductive factors early in the mother's life influence risk of autism spectrum disorders (ASD). We assessed maternal age at menarche, menstrual cycle characteristics during adolescence, oral contraceptive use prior to first birth, body shape, and body mass index (BMI) in association with ASD using binomial regression in…

  19. The Illinois Articulation Initiative Major Fields Panels' Recommendations for Business, Clinical Laboratory Science, Education--Early Childhood, Education--Elementary, Education--Secondary, Music, Nursing, Psychology.

    ERIC Educational Resources Information Center

    Illinois Community Coll. Board, Springfield.

    Developed by the Illinois Articulation Initiative (IAI), this report provides recommendations for improving articulation through state high schools, community colleges, and institutions of higher education. The recommendations are presented by field of study for business, clinical laboratory science, early childhood education, elementary…

  20. Health sector reform and trends in the United Kingdom hospital workforce.

    PubMed

    Buchan, J; Hancock, C; Rafferty, A M

    1997-10-01

    The authors examine changing trends in the profile and patterns of employment of the workforce in hospitals in the National Health Service (NHS) in the United Kingdom. The effect of the implementation of the NHS reforms is considered, with particular reference to the changing composition of the nursing workforce. The authors note that there are problems with establishing trend data because of altered information requirements as a result of the NHS reforms. Analysis and review of data from secondary sources and research publications. Although hospital activity rates have grown, patient length of hospital stays decreased, and patient activity levels increased, there has not been a linked growth in the size of the nursing workforce. The main changes in the profile of the nursing workforce highlighted are a marked reduction in the numbers of nursing students and alterations in the skill mix between first- and second-level qualified nurses. The authors also note a large increase in the number of managerial and administrative staff employed and growth in medical staff numbers. Changes in working patterns and increases in contracting for support services and in the use of temporary staff also are discussed. There have been pronounced changes in the profile of the hospital workforce but little evaluation of the impact of these changes on outcomes of care.