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PubMedDate not supplied

Development of the Applied Liberal Education Competences Scale.

This article describes the development and initial psychometric testing of the Applied Liberal Education Competences Scale, an instrument designed to measure professional nurses' self-reported use of selected applied liberal education competences in professional practice. The ALECS was created using a conceptual model proposed by Stark and Lowther (1988a) and content validity was assessed using an expert panel. Construct validity and internal consistency reliability of the ALECS were examined and the instrument refined. This 67-item instrument consists of six subscales: leadership, contextual practice, professional development, analytic practice, reflective practice, and aesthetic practice. Since the instrument taps dimensions other than technical skills and specific role functions, it will enable educators and service personnel to better understand how nurses think and perform.

Education, Nursing, Associate↗
PubMedDate not supplied

Perceptions and characteristics of registered nurses' involvement in decision making.

PURPOSE: This study aimed to determine the level of actual and preferred decisional involvement and ascertain whether there is decisional dissonance among registered nurses (RNs). SUBJECTS AND METHODS: A convenience sample of 196 RNs completed a demographic form and the Decisional Involvement Scale, a tool that measures actual and preferred decisional involvement for RNs in 6 categories: unit staffing, quality of professional practice, professional recruitment, unit governance and leadership, quality of support staff practice, and collaboration/liaison activities. From these data, the level of and difference between RN's actual and preferred decisional involvement was analyzed. In addition, the impact of level of education, years of experience, hours worked per pay period, and work setting on actual and preferred decisional involvement were measured. RESULTS AND CONCLUSIONS: A statistically significant difference was found between RNs' actual and preferred decisional involvement, with RNs preferring more decisional involvement than they actually experienced. Work setting was the only variable to which a difference could be attributed. Further study is warranted to find causes of decisional dissonance and interventions that could help alleviate the problem and potentially increase job satisfaction.

Adult↗
PubMed1995

[Scientific facts and their public: the history of the diagnosis of syphilis].

In the 1910's and 1920', thanks to the conjunction of scientific views concerning the specificity of anti-bacterial antibodies, of lay ideas about the existence of anti-bacterial antibodies and of the perceived importance of developing a syphilis test for public health officials, the community of serologists collectively transformed a relatively inefficient diagnostic test described by Wassermann in 1906 into an "incontestable scientific fact". This "scientific fact" established the equivalence: Wassermann positive individual=person infected with the germ Treponema pallidum, the etiological agent of syphilis. It modified the boundaries of the nosologic entity "syphilis", medical practices, professional attitudes, lay perceptions of syphilis, and health policies. In the 1950's, however, discrepancies between Wassermann test data and epidemiological data and, on the other hand, the development of specific anti-treponemal tests, destabilized the previously stabilized "scientific fact". A high percentage of Wassermann positive individuals were redefined as "biological false positifs", that is persons who suffered from chronic affections able to induce positive results of the Wassermann test. The equivalence Wassermann positive person=individual infected by Treponema pallidum was replaced by the equation: Wassermann positive person=individual infected by Treponema pallidum or biological false positive. The new perception of the Wassermann test again changed scientific views, professional practices and lay beliefs. The history of the Wassermann reaction illustrates the complicated interaction between "scientific facts" and "social facts", and the mutual shaping of both.

Diagnostic Tests, Routine↗
PubMed2001

Nursing skill assessment within populations: scale development and testing.

This study examined the reliability and validity of an instrument to measure the skill level of registered nurses within an Australian state. Internal consistency and construct validity of the scale and subscales were investigated in a sample of 1223 registered nurses from varying practice areas. The scale consisted of 105 skills within 13 practice domains: nursing practice, professional practice, acute care, community and public health, rural and remote area nursing, service delivery, self-management, supervision, resource management, improving processes, training and development, research, and technology. Twelve subscales obtained reliability co-efficients of 0.85 or more, with one at 0.81. The 13 factors explained 64.5 per cent of the cumulative variance, adequately capturing the concept of nursing skill. This scale, and its subscales, represent valid and reliable tools for the assessment and monitoring of skill levels in a population of nurses, within some limitation.

Australia↗
PubMed1994

Perioperative nursing model redesign.

The Surgical Services Division at a university hospital has created a patient delivery system that integrates the TQM values: continuous improvement, shared governance and staff empowerment. A divisional shared governance model includes specific roles for several councils: departmental shared governance, clinical practice, professional practice and systems. This model has promoted a proactive, monthly approach to quality assessment and improvement, compared to the traditional quarterly review.

Decision Making, Organizational↗
PubMed2005

Professional doctorate and professional nursing practice.

The professional doctorate degree in nursing is a novel approach to gaining a doctoral qualification other than the traditional Doctor of Philosophy (PhD) degree. This taught programme aims at linking theory and practice innovations in addressing clinical nursing problems. This paper outlines the evolution of the professional doctorate in the USA, the UK and Australia and its differences from the traditional PhD. I argue that nurses enrolled in this course work programme will not only have the opportunity to pursue studies at the doctoral level, but it will also facilitate nurses to challenge and share their experiences in solving practice problems in a collegial manner. By understanding the broader perspective of an environment dominated by scarce resources and intricate socio-political relationship, nurses will be able to influence policy decisions and ultimately improve the standard of health care and enhance the professional status of nursing. It may even reduce the antagonism of the anti-intellectual environment of the workplace through practice-oriented research.

Australasia↗
PubMed1992

Redefining the science-practice relationship and professional training.

A revised conception of the relationship between psychological science and professional practice is proposed in the light of postmodern changes in perspectives on knowledge. Positivistic science, which has dominated the traditional interpretation of scientist-practitioner training, is considered from a constructivist point of view to be only one possible foundation of psychological knowledge. It is argued that the knowledge base of the profession should be derived with diverse methods and from multiple sources, including the knowledge of practice. The mutuality of science and practice is emphasized. An evolving framework for understanding the epistemology of practice, based on cognitive psychology, is presented. Emphasis on broadened choices of research methods, the development of reflective skills, and better linkage between teaching in the domains of research and practice are urged. Suggestions for research related to scientific training and the knowledge processes of practice are offered.

Forecasting↗
PubMedDate not supplied

The baccalaureate degree in nursing as an entry-level requirement for professional nursing practice.

The education of professional nurses must take place in institutions of higher learning with a bachelor of science in nursing degree required for beginning professional practice. Nurses educated in these academic settings should be socialized as professionals with a philosophical and value system that is compatible with this role. This education should be flexible, diverse, and directed toward providing the nurse with a solid base for general, professional nursing practice. Nursing as a profession is a social institution and must present itself as a strong, unified profession to survive the inevitable changes occurring on the health care front. By tracing the evolution of the entry-into-practice dilemma, a systems archetype and two mental models that currently drive nursing and jeopardize its potential to meet the demands of the emerging health care market are identified. The authors offer a high-leverage solution to the entry-into-practice dilemma that they believe will strengthen the nursing profession.

American Nurses' Association↗
PubMedDate not supplied

Professional partnerships in primary care practice.

Professional partnerships in pediatric primary care produce opportunities for blending nursing and medical roles to offer optimal health care to children and families. During the Sixth Annual Pediatric Nursing Conference, held October 4-7, 1990 in San Francisco, issues of role delineation, reimbursement or salary schedules, prescriptive authority, on-call status, malpractice coverage, and hospital privileges were discussed among a distinguished panel of PNPs and physicians.

Humans↗
PubMed1986

Liability issues in contact lens practice.

Professional liability issues are an important consideration for clinicians who fit and dispense contact lenses. Among the most important are legal requirements related to patient consent, guarantees concerning materials or services, emergency care, instructions given to patients, termination of care by the doctor, information or services given by employees, and documentation of examination findings, instructions, and recall appointments. Optometrists should observe legal guidelines in order to minimize the risk of injury to patients and to reduce the opportunity for litigation.

Contact Lenses↗
PubMed2000

Professional autonomy and the normative structure of medical practice.

Professional autonomy is often described as a claim of professionals that has to serve primarily their own interests. However, it can also be seen as an element of a professional ideal that can function as a standard for professional, i.e. medical practice. This normative understanding of the medical profession and professional autonomy faces three threats today. 1) Internal erosion of professional autonomy due to a lack of internal quality control by the medical profession; 2) the increasing upward pressure on health care expenses that calls for a health care policy that could imply limitations for the professional autonomy of physicians; 3) a distorted understanding of the profession as being based on a formal type of knowledge and related technology, in which other normative dimensions of medical practice are neglected and which frustrates meaningful communication between physicians and patients. To answer these threats a normative structure analysis of medical practice is presented, that indicates which principles and norms are constitutive for medical practice. It is concluded that professional autonomy, normatively understood, should be maintained to avoid the lure of the technological imperative and to protect patients against third parties' pressure to undertreatment. However, this professional autonomy can only be maintained if members of the profession subject their activities and decisions to a critical evaluation by other members of the profession and by patients and if they continue to critically reflect on the values that regulate today's medicine.

Clinical Medicine↗
PubMed2002

Professional accountability in restructured contexts of occupational therapy practice.

Professional standards for accountability establish essential competencies for clinical practices and provide strategies for professional advancement. This study examines the perspectives of a sample of occupational therapists on their capacity to engage in continuing education, to provide evidence-based practices and to have confidence in the effectiveness of available quality assurance mechanisms within restructured contexts of occupational therapy practice. The analysis of in-depth interviews with participants from program management, managed competition and private practice suggested three urgent needs: the development of strategies to assist therapists' translation of research evidence into clinical practices, research to determine the effectiveness of models of professional leadership within the workplace that promote professional accountability and alliances to advance policies that eliminate workplace barriers to professional accountability.

Education, Continuing↗
PubMedDate not supplied

Relationships of work and practice environment to professional burnout: testing a causal model.

BACKGROUND: Research has established clear links between nurses' experience of professional burnout and many qualities of work environments but more work is needed to clarify interrelationships among aspects of complex organizational settings. OBJECTIVE: To test a nursing worklife model that defined structured relationships among professional practice environment qualities and burnout. METHODS: Hospital-based nurses in Canada (N = 8,597) completed an assessment of worklife (Nursing Work Index, NWI) and burnout (Maslach Burnout Inventory-Human Service Scale, MBI-HSS). RESULTS: A causal model was used to confirm the factor structure of the Professional Environment Scale (NWI-PES) on a subset of NWI items and the factor structure of the MBI-HSS. The analysis provided support for a structural model (nursing worklife model) linking the five worklife factors used to define a fundamental role for nursing leadership in determining the quality of worklife regarding policy involvement, staffing levels, support for a nursing model of care, and physician-nurse relationships. The analysis supported a direct path (negatively weighted) from staffing to emotional exhaustion and a direct path (positively weighted) from nursing model of care to personal accomplishment. DISCUSSION: Implications for refining a model of worklife are discussed. Implications for enhancing the quality of worklife and supporting engagement with work are considered.

Adult↗