Sex inequalities in ischaemic heart disease in primary care. Designating sex specific total cholesterol targets may be useful.
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Cholesterol↗
Biomedical subjects
M Barter
Publications and source records attributed to M Barter.
BSN by 2010. A California initiative.
The Association of California Nurse Leaders has developed an initiative to require the baccalaureate in nursing as the credential for entry into practice as a registered nurse by the year 2010 in the state of California. When nursing is compared to other healthcare professions, such as pharmacy, physical therapy, and occupational therapy, it becomes obvious that educational requirements for nurses must be updated. Nursing leaders have developed a 10-year action plan to change the entry-level educational requirements for California nurses.
California↗
Health care in Cuba: socialized medicine in a developing country.
Several registered nurses representing the American Organization of Nurse Executives (AONE), the American Association of Critical Care Nurses, and a group of nurses and physicians representing Disease Case Management visited Cuba under the auspices of the People to People Ambassador Program. The purpose of the People to People Ambassador Program is to exchange ideas, foster international friendships, and advance worldwide peace and communication. The authors were a part of the AONE delegation and will share their experiences during their visit to Cuban health care facilities.
Community Health Services↗
Perceptions of registered nurses working with assistive personnel in the United Kingdom and the United States.
This study examines registered nurse perceptions of their role in acute care hospitals that use nursing care assistants (NCA) and unlicensed assistive personnel (UAP). Also studied was registered nurse (RN) satisfaction with nursing care assistants and unlicensed assistive personnel in the United Kingdom (UK) and the United States of America (USA). The purpose of this study is to assist RNs and managers in the re-design of health-care delivery systems by investigating: 1. The differences and similarities of registered nurses in the UK and the USA in the perceptions of changes in the RN role when working with nursing care assistants or unlicensed assistive personnel. 2. The differences between and similarities of registered nurses in the UK and the USA in perceptions of NCA and UAP abilities to perform delegated duties, to communicate pertinent clinical information and to provide more time for professional nursing activities. Registered nurse perceptions in the UK were compared with the findings of a previous study of RN role changes and satisfaction in the USA. Registered nurses in the UK did not perceive a profound change in their role when working with UAP and were more satisfied with their use than were RNs in the USA.
Adult↗
State and territorial boards of nursing approaches to the use of unlicensed assistive personnel.
This study examined U.S. state and territorial boards of nursing approaches to the regulation of the use of: unlicensed assistive personnel (UAP) in acute care hospitals; state and jurisdictional authority, oversight and disciplinary action related to registered nurse (RN) delegation, supervision and assignment; educational preparation requirements for UAP; and future projections for their use. A survey was administered to 53 state and territorial boards of nursing officials in 1998. A majority of the states reported that they had regulations/guidelines for RN's who supervised UAP and regulations that protected the use of the RN title. Few states used the American Nurses Association or National Council of State Boards of Nursing definitions for delegation, supervision, or assignment. The majority have formulated their own definitions. The majority of states reported no standardized curriculum in place for UAP employed in acute care hospitals. More than half of the states reported that no plans existed for developing a curriculum.
Acute Disease↗
Registered nurse role changes and satisfaction with unlicensed assistive personnel.
This study examines registered nurse perceptions of changes in the role of the registered nurse and registered nurse satisfaction with the use of unlicensed assistive personnel in acute hospital care delivery systems. Six major functional areas were examined: leadership, communication patterns, health teaching, evaluation activities, care management responsibilities, and unit tasks. Moderate to profound changes were reported in areas relating to the team leader role. Registered nurses reported dissatisfaction with unlicensed assistive personnel's ability to perform delegated nursing tasks, communicate pertinent information, and provide more time for professional nursing activities.
Adult↗
Managed care and total quality management: a necessary integration.
The process of quality improvement/total quality management (QI/TQM) plays a key role in the delivery of health care in a managed care system. The concepts and ideas surrounding QI/TQM and managed care are interrelated, and the success of health care delivery depends on the integration and coexistence of these two philosophies. In looking more closely at these concepts, it becomes clear that the principles of QI/TQM must underlie strategic decisions involved in the implementation of a managed care system. Nurses play a key role in the success of this integration as nurse case managers, nurse practitioners, and nurse administrators. They have a direct impact on the many variables and goals of both QI/TQM and managed care.
Case Management↗
Changes related to care delivery patterns.
Nurse administrators, faced with a need to increase productivity and reduce costs in response to lower inpatient volumes and increased competition, are restructuring systems of care delivery. A survey of acute care hospitals was conducted to determine the extent of changes in nursing care delivery models, skill mix, assignment of non-nursing personnel to the nursing department, use of unlicensed assistive personnel, and registered nurse role changes in healthcare delivery systems employing unlicensed personnel.
California↗
The changing health care delivery structure: opportunities for nursing practice and administration.
The increase in national health care expenditures has placed great stress on the economy and has contributed to a widespread consensus that reform of the health care delivery system is necessary. Three interrelated strategies are frequently used to cope with the turbulent environment in the health care industry today: managed care, hospital merger and acquisition to form integrated health care delivery systems, and redefined roles for nurses and other health care workers. These strategies have profound implications and will offer great opportunities for nursing administrators to foster nursing practice in new and improved systems of care delivery.
Career Mobility↗
Nursing's new frontier: reinventing our practice in a restructured health care system.
Nurse managers who are faced with the challenge of maintaining productivity in today's turbulent health care environment need new strategies for managing a redesigned workforce. Registered nurses have assumed leadership responsibilities in work teams that include other nurses, licensed personnel from other disciplines, and unlicensed assistive personnel (UAP). Myths, rumors, and questions deserve thoughtful consideration and response if managers want full cooperation from team leaders. Legal and professional issues relating to assignment, delegation, and supervision of a multidisciplinary team must be understood by everyone. Team leaders must have clearly defined boundaries of authority and an understanding of the competencies of each team member to be effective.
Efficiency, Organizational↗
Unlicensed assistive personnel. Issues relating to delegation and supervision.
The restructuring of healthcare delivery systems has increased the need for professional nurses who are skilled in managing various levels of assistive personnel. The authors provide an overview of issues related to supervision and delegation and discuss the legal responsibilities of registered nurses when delegating nursing care activities to unlicensed assistive personnel.
Humans↗
Spontaneous remission of Cushing's disease. A case report and review of the literature.
A 70 year old man whose severe Cushing's disease remitted spontaneously is described. Medical therapy was instituted as a temporary measure prior to planned adrenalectomy. The patient showed dramatic improvement during medication and has remained well for two and a half years following the discontinuation of drug therapy. The literature is reviewed for other cases of spontaneous resolution of Cushing's.
Aged↗
Methylphenidate and growth retardation.
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Child↗
Unlicensed assistive personnel and lay caregivers in the home.
As a result of the changes in the health care delivery system, professional home health agency staff must provide clinical assessments, care planning, and patient outcome evaluation to higher acuity patients with limited resources. Because the number of home visits per patient is closely monitored by managed care companies, duplication of services may not be reimbursed, causing financial loss to home care agencies. Every aspect of care from admission to discharge must be coordinated to ensure that each patient receives the best care available within the limitation of the number of reimbursable or capitated visits. Professionals on an interdisciplinary team must know the legal scope of practice as well as the competencies of all members of the team. Decisions relating to delegation of patient care tasks to UAP and to lay caregivers are complex. Professional staff must consider the patient's condition, the caregiving environment, and the amount of social support available for the patient and family. The knowledge, skills, and abilities of the caregivers must then be matched to the needs of the patient. Because on-site supervision in the home setting is limited, nurses and therapists are required to know how to safely delegate patient care tasks and supervise others.
Family↗
BSN by 2010: a California initiative.
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California↗
Use of unlicensed assistive personnel by hospitals.
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California↗
Supreme Court decision affects bargaining rights of nurses.
The U.S. Supreme Court, in ruling that nurses who direct lower-level employees are supervisors, has redefined the relationship of staff nurses with management. Nurses who make assignments for and supervise the work of lower-level employees may not be entitled to National Labor Relations Board protection because of this decision.
Collective Bargaining↗
Managed care: employers' influence on the health care system.
Health care reform is a complex issue involving many key sectors including providers, consumers, insurers, employers, and the government. System changes must involve all sectors for reform to be effective. Each sector has a responsibility to understand not only its own role in the health care system, but the roles of others as well. The role of business employers is often not apparent to health care providers, especially nurses. Understanding the influence employers have on the health care system is vital if providers want to be proactive change agents ensuring quality care.
Commerce↗