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PubMedDate not supplied

How the gastroenterology nurse can establish and meet career goals.

A career goal promotes professional growth for the gastroenterology nurse. Short-term goals (achievable in less than one year) focus toward attaining a long-term goal (achievable in 5 to 10 years). The steps to achieving a career goal are self-assessment, career goal development, action plan development, implementation of the action plan, evaluation, and the establishment of a new goal. A career goal must be specific, measurable, achievable, realistic, and have a specified time frame. A tailor-made action plan is a list of interventions to promote goal achievement within the specified time frame. A goal posted in a prominent area is less likely to be forgotten and can guide day-to-day activities. A career goal should be reviewed and revised at least annually. A professional resume documents these career achievements.

Career Mobility↗
PubMed1990

Cross-national models of fertility, family planning, and development: testing for reciprocal effects.

Cross-national models of fertility, family planning, and development commonly assume that there are no reciprocal effect between fertility and other variables in the model and that when path models are used, there are no reciprocal or nonrecursive effects among any set of variables in the model. The present study tests for nonrecursiveness using 2-wave panel data, and finds that nonrecursive effects are present among variables commonly used in model of fertility, family planning, and development. In addition, the pattern of relationships found has implications for the explanation of the relationship between mortality and fertility in demographic transition theory.

Birth Rate↗
PubMed2005

Financing and reimbursement of elders' oral health care: lessons from the present, opportunities for the future.

This article describes current financing and reimbursement for elders' oral health care and presents innovative options and opportunities for the future. Current health and dental care financing data from the Centers for Medicare and Medicaid Services and Agency for Health Care Research and Quality are reviewed. Existing and potential reimbursement options for the future are presented. Options for future financing and reimbursement include extending dental insurance into retirement, inclusion of oral health care into existing comprehensive health care plans, developing retiree plans for selected, well-defined (by the sponsor) groups of retirees, pre-paying dental care during employment, development of an Elders Health Insurance Program for the poor and near poor, and developing optional "Part D (for Dental)" plans within the Medicare program. Given the absence of universal oral health insurance, a mix of financing options and reimbursement schema will be required to cover the costs of oral health care and eliminate disparities in oral health access and outcomes for the growing elderly population.

Aged↗
PubMed2002

Systematic review of involving patients in the planning and development of health care.

OBJECTIVE: To examine the effects of involving patients in the planning and development of health care. DATA SOURCES: Published and grey literature. STUDY SELECTION: Systematic search for worldwide reports written in English between January 1966 and October 2000. DATA EXTRACTION: Qualitative review of papers describing the effects of involving patients in the planning and development of health care. RESULTS: Of 42 papers identified, 31 (74%) were case studies. Papers often described changes to services that were attributed to involving patients, including attempts to make services more accessible and producing information leaflets for patients. Changes in the attitudes of organisations to involving patients and positive responses from patients who took part in initiatives were also reported. CONCLUSIONS: Evidence supports the notion that involving patients has contributed to changes in the provision of services across a range of different settings. An evidence base for the effects on use of services, quality of care, satisfaction, or health of patients does not exist.

Attitude to Health↗
PubMed1990

The future of psychiatry. Council on Long Range Planning and Development.

The American Medical Association Council on Long Range Planning and Development has been publishing a series of reports that assess trends in the environment of medicine and their impact on physicians and health care provision. The Council believes each specialty in medicine will respond differently to changes in the health care arena. This report, developed in cooperation with the American Psychiatric Association, provides an overview and environmental analysis of the specialty of psychiatry. Socioeconomic data pertinent to psychiatry are reviewed first, followed by a review of scientific and clinical developments in the specialty. Next, the changing provision patterns of psychiatric care, the emerging patient populations served by psychiatrists, and recent developments in graduate medical education in psychiatry are reviewed. The Council also addresses changes in the financing of psychiatric care. In conclusion, the Council suggests implications of these and other environmental trends for psychiatry.

American Medical Association↗
PubMed1987

The future of pathology. Council on Long Range Planning and Development.

The American Medical Association Council on Long Range Planning and Development has identified trends in the environment of medicine and has assessed their likely implications for the pathology specialty. Competition and economic pressures focused on the hospital setting are likely to continue to affect the choice of delivery site for pathology practice. During the past decade, the pathology specialty has been subject to extensive regulation, placing a new focus on the role of the laboratory within the hospital and generating new ventures for the provision of pathology services. A continuing challenge to the specialty is management innovation and adaptation in the face of regulatory restrictions and cost-containment experiments. The significant forces for change affecting the demand for services and the shape of future provision of pathology services include rapid advances in technology and scientific knowledge, funding for biomedical research, training for research pathologists, demographic trends in the population, and medical liability trends. Finally, with renewed emphasis on quality of care in the health professions, the pathology specialty has the potential to make substantial contributions to the quality and art of medical practice and is likely to remain at the center of efforts to refine methods of quality assessment and implementation.

American Medical Association↗
PubMed1988

General practitioners' plans for developments in the inner city: a review by a primary care project.

This paper describes part of the work of a development project, working in Tower Hamlets in east London in 1983-87, with the wider remit for facilitating primary care development in the inner city. Thirty-nine of the 43 practices in the district were visited and general practitioners discussed their plans for development and the problems they encountered. The paper presents the results of the discussions and the follow-up work, which explored how further developments could be brought about. It concludes that many general practitioners are considering and introducing a wide range of new developments in their inner city practices. Planning for development of primary care in the inner city should focus more closely at local levels on what practices are already planning and provide more encouragement and practical help than at present.

Adult↗
PubMed2006

Scientific research, stakeholders, and policy: continuing dialogue during research on radionuclides on Amchitka Island, Alaska.

It is increasingly clear that a wide range of stakeholders should be included in the problem formulation phase of research aimed at solving environmental problems; indeed the inclusion of stakeholders at this stage has been formalized as an integral part of ecological risk assessment. In this paper, we advocate the additional inclusion of stakeholders in the refinement of research methods and protocols and in the execution of the research, rather than just at the final communication and reporting phase. We use a large study of potential radionuclide levels in marine biota around Amchitka Island as a case study. Amchitka Island, in the Aleutian Island Chain of Alaska, was the site of three underground nuclear tests (1965-1971). The overall objective of the biological component of the study was to collect a range of marine biota for radionuclide analysis that could provide data for assessing current food safety and provide a baseline for developing a plan to monitor human and ecosystem health in perpetuity. Stakeholders, including regulators (State of Alaska), resource trustees (US Fish and Wildlife Service, State of Alaska), representatives of the Aleut and Pribilof Island communities, the Department of Energy (DOE), and others, were essential for plan development. While these stakeholders were included in the initial problem formulation and approved science plan, we also included them in the refinement of protocols, selection of bioindicators, selection of a reference site, choice of methods of collection, and in the execution of the study itself. Meetings with stakeholders resulted in adding (or deleting) bioindicator species and tissues, prioritizing target species, refining sampling methods, and recruiting collection personnel. Some species were added because they were important subsistence foods for the Aleuts, and others were added because they were ecological equivalents to replace species deleted because of low population numbers. Two major refinements that changed the research thrust were (1) the inclusion of Aleut hunters and fishers on the biological expedition itself to ensure that subsistence foods and methods were represented, and (2) the addition of a fisheries biologist on a NOAA research trawler to allow sampling of commercial fishes. Although the original research design called for the collection of biota by Aleut subsistence fishermen, and by a commercial fishing boat, the research was modified with continued stakeholder input to actually include Aleuts and a fisheries biologist on the expeditions to ensure their representation. The inclusion of stakeholders during the development of protocols and the research itself improved the overall quality of the investigation, while making it more relevant to the interested and affected parties. Final responsibility for the design and execution of the research and radionuclide analysis rested with the researchers, but the process of stakeholder inclusion made the research more valuable as a source of credible information and for public policy decisions.

Alaska↗
PubMed2001

Career planning and development for nurses: the time has come.

Developments in how the nursing profession is perceived by nurses and by society, along with unparalleled changes in health care systems, have created an environment in which individual nurses must take control of their careers and futures. Educators, employers and professional organizations also have a key role to play in fostering the career planning and development of nurses, usually the largest employee group in most health care organizations. This article provides an overview of what career planning and development is and why it is important for nurses. A career planning and development model is described that provides nurses with a focused strategy to take greater responsibility for engaging in the ongoing planning process that is crucial throughout the major stages of their career. Finally, educators, employers and professional organizations are challenged to collaborate with individual nurses on career-development activities that will enable nurses to continue to provide high-quality care in ever-changing health care systems.

Career Choice↗
PubMed1992

A universal precautions monitoring system adaptable to any health care department.

The Occupational Safety and Health Administration has proposed monitoring employee compliance with universal precautions, as recommended by the Centers for Disease Control. Our respiratory care department, following a four-step system development plan, has developed and implemented a universal precautions monitoring system that is easy to adapt to any health care department. The results from monitoring can be used for educational planning, quality assurance purposes, and employee performance reviews.

Cooperative Behavior↗
PubMed1980

Public Health Service--Health systems agency and state health planning and development agency reviews: certificate of need programs. Final regulation.

These rules amend the Public Health Service regulations on health systems agency and State health planning and Development agency (State Agency) certificate of need reviews. These final regulations implement changes to Title XV of the Public Health Service Act made by the Health Planning and Resources Development Amendments of 1979 (Pub L. 96-79). Under the amended provisions of the Public Health Service Act, the planning agencies are required to review and determine the need for proposed capital expenditures, institutional health services and major medical equipment. These regulations set forth the minimum requirements for satisfactory certificate of need programs.

Certificate of Need↗
PubMed2004

Substance Use Disorders and Neurologic Illness.

Because of the high rates of substance use disorders among the general and clinical populations, and the abuse potential of many medications commonly used in the treatment of neurologic illnesses, the treating neurologist must deal with drug misuse and abuse in practice. The most important tool neurologists must have in their arsenal is the ability to assess for and recognize substance use disorders in their patients. Any treatment plan developed for such patients must include ongoing management of substance abuse issues. After a substance use disorder is diagnosed, the neurologist must make proper referrals to adjunctive support interventions (Alcoholics Anonymous or Narcotics Anonymous) and chemical dependency specialists, and work closely and in collaboration with these components of the patient's overall treatment. The treating neurologist should be aware of the myriad neurologic sequelae of drug use, because most drugs of abuse, including alcohol, can have neurologic manifestations resulting from acute intoxication, acute withdrawal, or chronic use. Drug use (past and present) should be included in the differential diagnosis for any patient with an atypical constellation of symptoms or with isolated neurologic deficits. If the treatment of a neurologic condition requires the use of a potentially addictive substance, particularly when the patient has a history of substance use disorders, then the clinician must minimize the risk of addiction by giving the least addictive substances and developing a plan to manage the use of the drug throughout the treatment period.

Journal Article↗
PubMed2006

Primary and community care workforce planning and development.

AIM: This article reports a study that provided primary and community care managers with information, allowing them to: (a) evaluate the size and mix of their workforce; and (b) develop knowledgeable and skilled teams to meet the demands of growing and changing services. BACKGROUND: Primary and community care services are growing in the United Kingdom, but workforce planning and development, despite their wide-ranging cost and quality implications, have not received the same attention. Indeed, most primary and community care workforce planning and development issues are universal. Demand 1-1 side workforce planning is concerned not only with the number, but also with staff mix; but how these autonomous and isolated practitioners spend their time is unique. The other side of the equation, workforce supply, raises many recruitment and retention challenges for managers in many countries. Any country's main workforce planning methods apply equally well to primary care, but each is flawed. A second, main problem is that the methods lead to fragmented services, whereas modern workforce planning methods should be multidisciplinary. Consequently, it has never been more important for managers to have data and algorithms to develop appropriate care teams. METHOD: A large and versatile workforce database, profiling 304 English primary care trusts using demographic, socio-economic, mortality, morbidity, staffing and performance workforce-related variables, compiled in 2002 and updated yearly, is described. Data were supplemented with a systematic literature review leading to a 340-item annotated bibliography; and qualitative interviews with managers. RESULTS: Workforce size and mix are historical and irrational at best. Moreover, the number of variables that influence staffing is growing, thereby complicating workforce planning. CONCLUSION: Evaluating and adjusting the size and mix of teams using empirically determined community demand and performance variables based on the area's socio-economic characteristics is feasible.

Community Health Nursing↗
PubMed2003

Using burden of disease information for health planning in developing countries: the experience from Uganda.

Given the growing interest in both the use of evidence in planning and in using the burden of disease measure (BOD) and cost-effectiveness analysis, we explored health planners' perception of the usefulness of the BOD in priority setting and planning in developing countries, using Uganda as an example. An exploratory qualitative approach involving in-depth interviews with key policy makers in health at district and national levels was employed. Interviews were supplemented with a review of relevant documents. Analysis involved identification of key concepts from the interviews. Concepts were grouped into categories, namely, the appeal of quantitative data, data limitations, opaque methodology, planning as a political process and opportunity costs. These form the basis of this article. We found that the BOD study results have been used as the basis for the national health policy and in defining the contents of the national essential health care package. The quantification and ranking of disease burden is appreciated by politicians and used for advocacy, resource mobilization and re-allocation. The results have also provided information for priority setting and strategic planning. Limitations to its use included poor understanding of the methodology, poor quality of data in-puts, low involvement of stakeholders, inability of the methodology to capture key non-economic issues, and the costs of carrying out the study. There is commitment, by Ugandan planners to using evidence in priority setting. Since this was an exploratory study, there is a need for more studies in developing countries to document their experiences with the use of evidence, and specifically, the BOD approach in planning and priority setting. Such information would contribute to further synthesis of the approach.

Cost of Illness↗