SEARCH · PubMed Health

Results for “Policy--changes”

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.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 91 records · Page 5Linked to original sources

PubMed1991

The public health policy advocate: fostering the health of communities.

The community health clinical nurse specialist (CNS) is unique among CNSs in defining the client as a community of people. This nurse specialist operates in partnership with the community using policy development and policy advocacy in nursing interventions. These nursing interventions enable and empower communities to explore pathways to public policy change. Such changes include improving accessibility, availability, and affordability of health services, and changing social conditions found at the root of many health problems. A case study is presented to illustrate the application of this CNS role.

Community Health Nursing↗

PubMed1991

Implications of smoking bans in the workplace. A nursing perspective.

1. The occupational health nurse is in a strategic position to promote changes in smoking policies, participate in effective planning and implementation of policy changes, and encourage workers to participate in smoking cessation programs. 2. Nursing process, including data collection and assessment, development of a plan, implementation, and evaluation, provides a framework for action for the informed occupational health nurse. 3. Those policies that are part of an overall health promotion program, including individualized health risk assessment, are most successful in encouraging employees to stop smoking. 4. Development of or changes in smoking policies are emotionally laden issues that require considerable planning, effective communication, and involvement of employees at every level of the organization.

Ethics, Nursing↗

PubMedDate not supplied

Occupational stress and RANs.

This paper explores nurses' self-reported stress during a time of policy changes in the Northern Territory Health Department. It is argued that current research tends to associate nurses' stress with their personality or type of work, offering a psychological or occupational explanation. Little consideration is given to the complex structural subordination and ambivalence remote area nurses experience on Aboriginal settlements vis a vis their immediate superiors and clients. It is proposed that the nurses' self-reported stress can be partly accounted for by their marginal position between these two groups. The sociological concept of marginality can explain this.

Australia↗

PubMed1990

Economic behaviour of heroin users and effects of policy measures.

The object of this study is to describe the behaviour of heroin users from an economic point of view in such a way as to enable tracing the influence of policy measures. In order to describe the heroin users' behaviour, data have been collected regarding relevant variables and relations between variables by interviewing 80 heroin users in the Netherlands. Based on these data a computer model has been developed. The objective of the model is two-fold: 1) Describing the behaviour of a group of heroin users in connection with the process of obtaining money and heroin in order to determine the factors which influence the quantity of heroin bought and consumed. 2) Carrying out some scenario analyses in order to examine the effects policy changes might have on variables such as heroin use and quantity of money obtained illegally.

Computer Simulation↗

PubMedDate not supplied

Multidisciplinary management of vascular access devices.

Many problems associated with the use of vascular access devices (VADs) can be circumvented with an organized, systematic approach to management. This paper describes an approach that includes several key components: 1) A nurse coordinator of parenteral therapy (CPT) follows all patients with a VAD; records demographic and clinical data on an ongoing basis; monitors complications and outcomes; serves as a consultant for VAD-related questions; develops policies, procedures, and guidelines for catheter care; and oversees inservice nursing and basic patient education. 2) A data coordinator enters all data into a data base management system, compiles complication and other statistics on a periodic basis, and retrieves selected data for specific purposes. 3) A VAD Committee, composed of the above two individuals, a nurse epidemiologist, and physicians representing medical oncology, hematology, transplantation, pediatrics, and surgery, meets monthly to collectively evaluate and assign cause for complications, consider new products, and discuss policy changes regarding VADs. As a result of this multidisciplinary process, responsibility and accountability for VAD insertion and care are appropriately placed, statistics on complications are compiled, and treatment and policy decisions are made. These outcomes have resulted in a significant reduction in complications, an increase in average catheter life, enhancement of quality assurance, and overall improved patient care.

Algorithms↗

PubMed1990

How have PPS changes affected allocation of Medicare spending for hospital care? A case study of New York State.

Complex national factors went into the development of key policies of the federal prospective payment system, and the effects of these policies varied in different parts of the country. One state particularly affected by these changes, and for the most part in a positive way, was New York. This paper focuses on the Medicare PPS policy changes and their impact nationally. An analysis of the experience of New York state, which had been under a stringent hospital cost containment system before PPS, provides a laboratory to understand how key federal policies affected different types of hospitals in that state as well as nationally.

Cost Allocation↗

PubMed1990

Public opinion on alcohol policies.

We conducted a survey of a probability sample of adult residents in the State of Michigan, assessed public support for various alcohol and drinking-driving policy changes, examined how opinions on various policies clustered, and compared Michigan results with national surveys on these issues. Results showed high levels of public support for raising alcohol excise taxes (82%), prohibiting concurrent sales of alcohol and gasoline (74%), administratively suspending drivers licenses of those over the legal alcohol limit (67%), limiting the numbers of alcohol outlets via government regulation (63%), and lowering the legal alcohol limit for drivers to .05 g/dl (55%). Support for these policies was found across all income and education categories, but was significantly lower among frequent heavy drinkers. Policies with lower levels of public support include liability of commercial servers and social hosts, and stricter limits on hours of alcohol sales. Results are clearly relevant to current policy debates, and point to the need for further research on how opinions concerning alcohol policies are interrelated.

Adolescent↗

PubMed1990

Provincial origin of first-time writers of the Canadian Dental Aptitude Test.

A brief summary of the current status of the Canadian Dental Aptitude Test (CDAT) is presented. The number of first-time writers of the CDAT is reported by the province of their preference as designated by the candidate on the test application form. Anomalies in the numbers taking the test are discussed and relationships with other provincial and regional parameters developed. It is clear that the effect of the policy change at the University of Toronto, where the CDAT is no longer required for admissions purposes, has had a major effect on the numbers taking the test and the information available about the demographics, quality and size of the Canadian dental school applicant pool. The regional and provincial differences highlighted include a relatively smaller applicant pool in British Columbia, Manitoba and the Atlantic Provinces in addition to a relatively limited educational opportunity for potential dental professionals in British Columbia, Ontario and the Atlantic Provinces.

Aptitude Tests↗

PubMed1989

Clinical biochemistry in Singapore.

During the period from 1982 to mid-1989, there has been very significant changes and improvement in the practice and application of clinical biochemistry in Singapore. This paper highlights recent developments in the repertoire of biochemical analyses, utilisation of laboratory tests, biochemical screening in preventive health care, handling and delivery of patient specimens, advances in analytical techniques, automation, computerisation, quality assurance, training of laboratory personnel, and professional activities. It also draws attention to the restructuring of the Singapore General Hospital and the government Department of Pathology which frees these government institutions from the constraints of the civil service so that they would be sufficiently flexible to respond readily to the changing needs and expectations of the patients and users of laboratory services. This is the most prominent event and policy change in the history of health care services in Singapore that is expected to result in more cost-effective utilisation of resources and greater improvement in the quality of health care.

Automation↗

PubMed1989

National survey of recent changes in hospital policies on pharmaceutical sales representatives' activities.

Data from a national survey of recent changes in hospital policies on the activities of pharmaceutical sales representatives (PSRs) are presented. Data were collected by means of a mail survey sent in October 1985 to pharmacy directors of 857 randomly selected hospitals. The questionnaire asked them to identify recent (since 1983) and anticipated changes in restrictions on policies concerning products that PSRs are permitted to detail and sample, persons with whom PSRs can have business contact, requirements for drug exhibits and displays, and areas where PSRs can detail products. Respondents also were asked to describe which PSR services they found to be most useful, which services they would like to see discontinued, and what new services they would like PSRs to provide. Data from 446 of 451 (52.2%) returned questionnaires were included in the analysis. For each of the four policy areas, approximately one fifth of the directors indicated that changes had been made during the previous two years, and nearly all of the changes involved increased restrictions. Half of the respondents reported that their hospitals planned to increase restrictions on products that PSRs would be permitted to detail or sample. The most common reason given for anticipated policy changes was a desire to improve control of the formulary. The directors viewed information about new products as the most useful PSR service, most directors wanted PSRs to discontinue sampling or excessive sampling, and most desired greater educational support from PSRs. From late 1983 to 1986, approximately 20% of hospitals had increased restrictions on the activities of PSRs, and many of the respondents anticipated further increases in restrictions.(ABSTRACT TRUNCATED AT 250 WORDS)

Drug Industry↗

PubMed1989

The first forty years: a personal view.

Discussed below are some of the great public health issues and trends of the period that has elapsed since the foundation of the World Health Organization. They were dominated by the new Malthusian nightmare, the tussle with malaria, the eradication of smallpox, the improved control of some other serious infections, the struggles for family planning, breast-feeding, immunization, and clean water, among other things, and above all, perhaps, by the decline of the doctor and the rise of the planner and manager. More recently there have been the policy changes affecting international health which came from the Declaration of Alma-Ata, and the emergence of primary health care.

Family Planning Services↗

PubMed1989

Bone scintigraphy in the evaluation of ejection injuries.

The Royal Air Force (RAF) experience on local back injury with all ejection seats is that 50% have vertebral fractures on radiographic examination, with or without symptoms. These aviators are placed under the care of an orthopedic specialist and restricted from flying duties for 3 months or more. About half of the remainder demonstrate positive bone scans. Until recently, RAF policy was to treat these individuals the same as those with radiographically defined fractures. The author recommends this group of pilots be examined by orthopedic surgeons, and reviewed annually to assess long-term sequelae. Meanwhile, if asymptomatic, they are allowed to return to flying duties. The RAF recently incorporated most of these recommendations into a policy change.

Aerospace Medicine↗

PubMed1989

Emergency room visit time: changes over a 16-year period.

A one-week time and motion study was conducted at a large urban hospital replicating a study performed in 1969 in the same hospital, allowing a longitudinal study of emergency room utilization to be reported. Despite a 36% increase in the number of emergency room patients over the 16-year period, the findings from both studies replicate many of the patterns previously reported. Over time, both length of stay and wait times to see physicians have increased, although the values are still well within the ranges found in the literature. As competition increases, hospitals and their emergency room managers will have to determine what constitutes acceptable visit and waiting times in order to compete effectively for emergency room "clientele." Studies such as this one serve as a foundation for hospitals to implement policy changes that will improve health care delivery, and, in fact, this institution has already implemented changes based on this study.

Adult↗

PubMed1978

Health care in early infancy.

The pattern of illness and of health care during the first 16 weeks of life in a cohort of 1210 infants was examined. Children from families in the lower social strata had a significantly increased risk of respiratory illness and gastrointestinal disturbance and received less routine well baby care than children from more socially advantaged backgrounds. A number of policy changes which might improve the distribution of health care resources are examined.

Child Health Services↗

PubMed1988

Dynamics and clinical implications of the nursing home-hospital interface.

Nursing homes and hospitals are dynamically interrelated, and there is much that the clinician can do to optimize patient transitions between institutions. This article approaches this topic in three sections: epidemiology of movement between hospitals and nursing homes, impacts of policy changes and financial incentives on patient transfers, and clinical strategies to reduce unnecessary hospitalizations of nursing home patients.

Aged↗

PubMed1978

External examinations for internal evaluation: the National Board Part I Test as a case.

The appropriateness of the Part I examination of the National Board of Medical Examiners to evaluate second-year curricular performance of students at Case Western Reserve School of Medicine was examined. Review of the June 1974 examination by 37 faculty members revealed that 85% of the items reflected the content of the second-year curriculum and that 60% could be answered from information provided in the second-year teaching. Two-thirds of the items were related to the content of the first-year curriculum, and half could be answered on the basis of first-year material. The school's faculty used the study data in making policy-changing decisions.

Curriculum↗

PubMed1975

Equal treatment and unequal benefits: the Medicare program.

This paper analyzes the distribution of Medicare benefits among elderly persons on the basis of income, race, and geographical location. It first presents available statistical evidence from Medicare on the distribution of benefits and the magnitude of differentials among these elderly. It then sorts out the contribution to differentials arising from differences in the availability of medical resources. prices of medical services, and other demographic factors. The importance of various Medicare program features on remaining differentials--such as the cost-sharing provisions of Medicare, reimbursement policies, and nondiscrimination enforcement procedures--are then investigated. The effect of health status on utilization of medical services by the elderly is also analyzed, and the distribution of Medicare benefits by income for elderly persons of similar health status is presented. The paper concludes with recommendations for reducing differentials in Medicare benefits and indicates those policy changes which would result in a distribution of benefits more closely related to health care needs of the elderly.

Aged↗

PubMed1989

Perinatal mortality in rural Tanzania.

Prolonged labour was the most frequent cause of perinatal death in a rural hospital in the south western highlands of Tanzania. After the introduction of an obstetric policy aiming to prevent prolonged labour by making use of the guidelines of the partogram, perinatal mortality was reduced from 71 to 39 per 1000 births. Baird's clinico-pathological classification is still considered a useful instrument for the discovery of avoidable factors in perinatal deaths. The concept of the partogram should be an integral part of the training of medical auxiliaries in the field of maternal and child health (MCH).

Delivery, Obstetric↗