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PubMed · 10418409

Establishing and maintaining competency.

J Rudzik
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Abstract

The recruitment and hiring processes are crucial to quality assurance and cost containment in home healthcare. Competency-based orientation programs designed to provide outcome-focused orientation for the intravenous nurse who is new to homecare will benefit both the new employee and the homecare agency. Development of such a program is discussed, and consideration is given to program design, program evaluation, and ongoing employee education. Sample employee and program assessment tools are provided.

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Clinical CompetenceCompetency-Based EducationEducation, Nursing, ContinuingHome Infusion TherapyHumansInfusions, IntravenousNursing StaffOutcome Assessment, Health CareProgram DevelopmentProgram EvaluationQuality Assurance, Health CareSpecialties, NursingStaff DevelopmentJournal Article

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J Rudzik. Establishing and maintaining competency.. https://pubmed.ncbi.nlm.nih.gov/10418409/

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Obstacles to answering doctors' questions about patient care with evidence: qualitative study.

OBJECTIVE: To describe the obstacles encountered when attempting to answer doctors' questions with evidence. DESIGN: Qualitative study. SETTING: General practices in Iowa. PARTICIPANTS: 9 academic generalist doctors, 14 family doctors, and 2 medical librarians. MAIN OUTCOME MEASURE: A taxonomy of obstacles encountered while searching for evidence based answers to doctors' questions. RESULTS: 59 obstacles were encountered and organised according to the five steps in asking and answering questions: recognise a gap in knowledge, formulate a question, search for relevant information, formulate an answer, and use the answer to direct patient care. Six obstacles were considered particularly salient by the investigators and practising doctors: the excessive time required to find information; difficulty modifying the original question, which was often vague and open to interpretation; difficulty selecting an optimal strategy to search for information; failure of a seemingly appropriate resource to cover the topic; uncertainty about how to know when all the relevant evidence has been found so that the search can stop; and inadequate synthesis of multiple bits of evidence into a clinically useful statement. CONCLUSIONS: Many obstacles are encountered when asking and answering questions about how to care for patients. Addressing these obstacles could lead to better patient care by improving clinically oriented information resources.

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