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Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

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PubMed2006

Perceptions of infection control practices among health professionals.

Infection control practice is a cornerstone of modern health care. However, there is minimal research into health professionals' perception of infection control practices and how those perceptions influence staff compliance with recommended protocols. The objective of this study was to explore health care professionals' perceptions of infection control practices in relation to the management of infectious diseases. A grounded theory approach was used as the research framework. Semi-structured interviews were completed with a sample of 16 nurses and doctors working at hospitals in Western Australia. Four major categories emerged from the data. These were: knowledge, culture, conflict, and risk assessment. The findings indicate the importance of both individual and organisational factors in determining clinicians' levels of compliance with recommended infection control practices. Identification of the factors that influence health professionals' level of compliance can be used to develop strategies to support long-term compliance with infection control practices.

Attitude of Health Personnel↗
PubMed1989

Acquired immunodeficiency syndrome. The impact on professional nursing practice.

The epidemic of human immunodeficiency virus (HIV) infection and all of its consequences has had a significant impact on our society and on the delivery of health care. This article explores the impact that HIV infection and AIDS has had on professional nursing practice. The risk of occupational exposure, the question of obligation to care, the need for reexamination of values, philosophy of nursing, and some of the ethical issues, the need for learning and relearning, and the need for supporting each other as individuals, co-workers, and co-professionals are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Does telling people what they have been doing change what they do? A systematic review of the effects of audit and feedback.

BACKGROUND: Many people advocate audit and feedback as a strategy for improving professional practice. The main results of an update of a Cochrane review on the effects of audit and feedback are reported. DATA SOURCES: The Cochrane Effective Practice and Organisation of Care Group's register up to January 2004 was searched. Randomised trials of audit and feedback that reported objectively measured professional practice in a healthcare setting or healthcare outcomes were included. REVIEW METHODS: Data were independently extracted and the quality of studies were assessed by two reviewers. Quantitative, visual and qualitative analyses were undertaken. MAIN RESULTS: 118 trials are included in the review. In the primary analysis, 88 comparisons from 72 studies were included that compared any intervention in which audit and feedback was a component to no intervention. For dichotomous outcomes, the median-adjusted risk difference of compliance with desired practice was 5% (interquartile range 3-11). For continuous outcomes, the median-adjusted percentage change relative to control was 16% (interquartile range 5-37). Low baseline compliance with recommended practice and higher intensity of audit and feedback appeared to predict the effectiveness of audit and feedback. CONCLUSIONS: Audit and feedback can be effective in improving professional practice. The effects are generally small to moderate. The absolute effects of audit and feedback are likely to be larger when baseline adherence to recommended practice is low and intensity of audit and feedback is high.

Education, Medical, Continuing↗
PubMed1995

Developing group practices: a management challenge.

The advantages and disadvantages of forming larger professional practices are often debated. This paper reports an exploration of the issues through three case studies involving clusters of Sydney general medical practitioners who had expressed a desire to amalgamate their solo or small group practices. Their most frequently stated goals were to reduce financial overheads, to improve the range of services offered to their patients and to improve the opportunities for recreational and study leave. Several barriers to successful amalgamation were identified, and methods of overcoming these were explored. Practices can successfully amalgamate, but only where there is a group of like-minded general practitioners who are willing to invest time to achieve mutually agreed objectives. Amalgamation will not be appropriate in all circumstances. Larger group practices should benefit from the employment of a professional practice manager. These findings may be relevant to veterinary and dental practices.

Animals↗
PubMed2004

The principles of ethical practice in professional clinical photography.

Rules and regulations founded on ethical principles permeate healthcare practice. NHS Trusts formulate policy to govern their activities in which duties and responsibilities are defined to protect patients from harm and protect themselves from potential litigation. Clinical photographers are not immune from the demands of ethical practice and need to have clearly defined duties and responsibilities. This paper maps the dynamics of ethical practice and how this may be expressed in codes of practice related to the principles of professional clinical photography.

Ethics, Clinical↗
PubMedDate not supplied

Implementing a holistic approach to diabetes care.

The concept of case assignment is an important development in diabetes education because it encourages a problem-solving approach to care, including evaluation of education, which is the basis of accountability and autonomous professional practice. Furthermore, case assignment and holistic care of clients with diabetes is a model of professional practice that benefits clients, practitioners, and administrators. Case assignment encourages comprehensive and efficient use of human and administrative resources, and provides a foundation for professional development and practitioner autonomy. Effective implementation of holistic care requires a reassessment by health professionals of practice protocols and a reorganization of policy and procedures. The expansion of professional skills necessary for the introduction of a holistic approach will (a) break down traditional practice barriers, and (b) extend the professional knowledge of diabetes care practitioners. Case assignment for diabetes education and follow-up, if extensively adopted, is a mechanism that could contribute to achieving recognition of diabetes educators as independent practitioners, recognition of diabetes education as a practice specialty, and reimbursement for private practitioners.

Diabetes Mellitus↗
PubMed1999

Influence of managed care on professional nursing practice.

PURPOSE: To explore how nurses in one U.S. state perceived that managed care influenced professional nursing in that state. The nursing community is challenged to move with haste in demonstrating, through research, the clinical and economic value that nurses add to cost-effective outcomes. DESIGN: A Delphi survey in 1996 of a convenience sample of 84 clinical nurse specialists (CNSs) and nurse practitioners (NPs) in California. METHODS: CNSs and NPs contributed to the list of managed care influences on nursing practice. fifty-seven (68%) completed the third and final round. FINDINGS: Panelist agreement was the highest for (a) exploring new approaches to providing quality care more cost-effectively, (b) expanding nurse practitioners' role in primary care, and (c) more effectively partnering with clients in helping them assume greater self-responsibility for their health. Greatest threats were perceived to be hassles involved in seeking authorization for care and responding to payment denials; the tenuous job market for nurses; and encroachment on nursing practice by others. CONCLUSIONS: The findings can assist nurses in states with low managed-care concentration to create their preferred future within health care delivery. A more highly educated nurse workforce will be needed for 21st century health systems in which more care is likely to be delivered outside hospitals.

Adult↗
PubMed1989

Shortage of professional nursing practice: a reframing of the shortage problem.

The nursing shortage is discussed in terms of supply, demand, and wages, and the current situation is compared with previous nursing shortages. Reasons for the shortage are examined and reframing the problem from a shortage of nurses to a shortage of professional nursing practice is suggested as a strategic first step in solving the problems of nurse staffing in acute care general hospitals. Four kinds of shortage situations are identified; only one kind, vacancy, results from vacant positions. The other three types, transient, position, and scheduling, are the result of administrative decisions regarding the use of nursing personnel. A fundamental restructuring of how hospitals use nurses is needed, and this solution will in the long run be more effective in solving the shortage problem than is the effort simply to add more nurses into the existing system.

Critical Care↗
PubMed1999

Longitudinal evaluation of professional nursing practice redesign.

OBJECTIVES: The authors describe a 5-year study at a western university teaching hospital that evaluated the effect of organizational redesign on nurse job satisfaction, autonomy, and patient satisfaction. BACKGROUND: Change in institutional status from public to private authority stimulated this hospital to map a new direction for professional nursing practice, to strengthen autonomy and job satisfaction while improving quality care outcomes. Evaluating redesign changes systematically provided significant longitudinal trended data to guide nurse executive actions. METHODS: Phase-I evaluation, from 1992 to 1995, was a quasi-experimental design comparing pre- and poststudy outcomes of facilitator-led activities on units receiving interventions compared with control units. Of 12 outcome variables measured, 3 were sustained longitudinally into Phase II: nursing job satisfaction using the McCloskey Mueller Satisfaction Scale (MMSS), autonomy using Schutzenhofer's Scale, and patient satisfaction using the Picker Institute survey. Data were trended across units and departments over a 5-year period. RESULTS: Phase-I results reported that control units held higher nursing documentation scores than the experimental units. There were no significant differences in aggregate nurse job satisfaction scores. Nurse autonomy scores significantly improved. Other results are reported descriptively. Phase II continued the evaluation, reporting no differences in nurse job satisfaction aggregate scores a decline in autonomy, and decreased patient satisfaction scores. There were significant differences by units and across departments. CONCLUSIONS: Longitudinal evaluation provides significant data to guide nurse executives in an uncertain healthcare environment. Of theoretical interest is the absence of congruence in nurse job satisfaction and autonomy scores, suggesting more independence between these variables than previously reported.

Colorado↗
PubMedDate not supplied

Building quality practice settings: an attributes model.

To practice effectively nurses need an environment that supports quality professional practice. This article describes the development of a model identifying seven (7) key system attributes of a quality practice setting. The defined attributes are essential in supporting professional practice and quality care. The Quality Practice Setting Attributes Model developed by the College of Nurses of Ontario in Canada provides the foundational framework for the Practice Setting Consultation Program (PSCP), a unique quality improvement approach to creating quality practice environments.

Focus Groups↗