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Review of six ongoing pastoral care programs which make extensive use of volunteer community clergy as Associate Chaplains indicating details of recruitment, orientation, training, volunteer benefits, cost of operation, Associate Chaplain duties, and program design. The pastoral care programs are operating in hospitals with from 227 to 498 beds and which have at least on full-time paid chaplain.
This paper presents details from the field test of two rapid surveys in Ecuador in 1995. It focuses on how the surveys were designed and implemented, including descriptions of the sampling procedures, the preparation and use of preprogrammed palmtop computers for data entry, the selection criteria for the interviewing team, and how the training was designed. Lessons are drawn that will assist health professionals plan and carry out better rapid data collection in the future. The objective of the study was to evaluate the reliability and validity of data gathered during the rapid surveys as compared with a recent "gold standard" national survey. A two-way factorial design was used to control for differences in sampling (probability versus quasi-probability) and methods of data collection (paper versus palmtop computer). Few differences were detected between the surveys done on palmtops as compared to paper ones, but urban and rural differentials in contraceptive use were less pronounced in the rapid surveys than in the earlier, national survey. This suggests that caution should be exercised in interpreting the disaggregated data in these rapid surveys. In-depth interviews revealed two features of the rapid surveys that were especially popular: the palmtops for their speed of data entry, and the short questionnaire for its "low impact" on a respondent's time. The common belief that computers would disturb respondents was not found to be the case. Even with no computer experience, the interviewers rapidly mastered the new technology.
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This notice announces the Secretary's conditional determination of the 15 States in which Medicare supplemental insurance policies (commonly referred to as "Medigap" policies) may be issued as Medicare SELECT policies. The Omnibus Budget Reconciliation Act of 1990 (OBRA '90), Public Law 101-508, amended section 1882 of the Social Security Act to provide for the simplification and standardization of Medicare supplemental insurance policies and to authorize the approval of Medicare SELECT policies in fifteen States, as determined by the Secretary, for a three-year period. Under State-approved Medicare SELECT policies, insurers may restrict full Medicare supplemental insurance benefits to items and services provided by a network of physicians and providers under contract with the insurer. This notice implements section 4358(c) of OBRA '90, which provides for the designation of the 15 States in which Medicare SELECT policies may be approved for issuance during the period January 1, 1992 through December 31, 1994.
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Explore the source record for details and available documents.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
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The federal government continues to expand its initiatives to uncover healthcare fraud, waste, and abuse. It is therefore more important than ever that healthcare organizations have an effective compliance program in place. The organization should have a compliance officer with adequate authority and staff to carry out the compliance program's functions. The program should include an ethics code, an internal hotline that employees can use to report compliance concerns, and education and training for all employees. In addition, the program should be audited periodically to ensure its viability. To be successful, a compliance program also needs the support of the healthcare organization's senior management.
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PURPOSE: The purpose of the study was to explore individual and family experiences after sudden cardiac arrest and automatic internal cardioverter defibrillator implantation during the first year of recovery. This report specifically addresses the domains of concern expressed and helpful strategies used by participants that are relevant to the development of future intervention programs. DESIGN: A grounded theory approach was used to gain an understanding of areas of concern of sudden cardiac arrest survivors and families that could be used when designing future nursing interventions. Semistructured interviews were conducted with both sudden cardiac arrest survivors and 1 family member each at 5 points during the first year of recovery (hospitalization; 1, 3, 6, and 12 months after hospitalization). Participants were asked to identify those specific areas that most concerned them and that they would like assistance with during the first year. A total of 150 interviews were conducted with 176 hours of data generated. SETTING: The study focused on 10 northwest urban community medical centers and participants' homes within a 50-mile driving distance from the medical centers. SAMPLE: The sample included 15 first-time sudden cardiac arrest survivors (13 men and 2 women) and 1 family member each between the ages of 31 and 72 years. RESULTS: Domains of concern identified by participants that can be used to design future nursing intervention programs included preventive care, dealing with automatic internal cardioverter defibrillator shocks, emotional challenges, physical changes, activities of daily living, partner relationships, and dealing with health care providers. Suggestions of helpful strategies used by participants during the first year are outlined. IMPLICATIONS: Domains of concern and helpful strategies identified by participants provide a framework for the development and testing of nursing intervention programs to enhance recovery following sudden cardiac arrest for survivors and their families.
For many reasons patients on hemodialysis treatment have a low physical capacity. In this study the physical capacity was tested in 41 patients with chronic renal failure during their first weeks on hemodialysis and after 18 months of treatment. Compared to reference values the test result showed a significantly decreased physical strength, endurance and balance capacity already at the start of the dialysis. The patients were tested and got individually tailored information at the kidney unit and received some physical training outside the hospital. After 18 months the result for the group was not improved in spite of the fact that the 11 most frail patients had died. Diabetic and elderly patients had a significantly lower result than the rest of the patients. Future research will show, if more regular exercise (predialytic) individually programmed by a specially trained physiotherapist who can obtain up-to-date medical information as working in close contact to a dialysis unit, will further improve the condition of these patients.