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PubMedDate not supplied

The clinical achievement portfolio: an outcomes-based assessment project in nursing education.

Dynamic healthcare market forces impel educators to search for innovative methods of academic assessment to measure learning outcomes. The clinical achievement portfolio is a creative and systematic tool for documenting continuous improvement of student clinical learning. The authors describe the use of the portfolio as a pilot project aimed at introducing reflective thinking and measuring clinical learning in undergraduate nursing education. Potential benefits of the clinical portfolio and implications for future research are proposed.

Attitude of Health Personnel↗

PubMedDate not supplied

Piloting an information literacy program for staff nurses: lessons learned.

Intrinsic to all models of evidence-based practice is the need for information literacy and the critical assessment of information. As part of a house-wide evidence-based practice initiative, the objective of this pilot project was to develop the information literacy skills of staff nurses to increase their ability to find and assess available electronic resources for clinical decision making. An intensive care unit was chosen to pilot a unit-based approach to educate staff nurses to perform patient care-related electronic literature searches. An additional goal was to determine the effectiveness of unit-based training sessions on the frequency and quality of electronic literature searches by participating nurses. In addition to the unit-based instruction, nursing and library staff collaborated to develop a Web-based tutorial to supplement and reinforce the content of the training sessions. A pretest-post-test design was used to evaluate the initiative and to assess the effect of the educational intervention over time. Among the lessons learned from this pilot study was that unit-based instruction presents significant obstacles for effective learning of new technological skills for staff nurses.

Adult↗

PubMed1997

Charting by exception on a clinical pathway.

A study at one medical center showed that nurses were spending 2.5 hours per shift documenting patient care. After charting by exception was integrated with a clinical pathway, charting time dropped to 0.82 hours per shift. Results of a pilot project on an orthopedic/neurologic patient care unit are discussed.

Critical Pathways↗

PubMedDate not supplied

Trialing collaborative nursing Models of Care: the impact of change.

OBJECTIVE: The aim of the project was to develop and trial a nursing Model of Care (MoC) and devise a framework to investigate the impact of nursing staff mix on patient outcomes and job satisfaction (nurses). SETTING AND SUBJECTS: In 2001-2002 a pilot project was undertaken to explore issues related to the delivery of patient care by nurses on two medical inpatient wards, one acute and one subacute, at a referral teaching hospital in New South Wales (NSW), Australia. The framework employed was an adaptation of, and based on, the Clinical Practice Improvement (CPI) model developed by NSW Health. PRIMARY ARGUMENT: Countries across the world are seeking solutions to a shortage of registered nurses and their ability to sustain quality care services. It becomes imperative that organisations develop strategies to attract and retain nurses in the health care system. CONCLUSIONS: Results of the project highlighted areas related to the quality of care delivery: clinical supervision; continuity of staffing; trust; employer of choice; more effective nurse to patient ratios; educational preparation; and recognition of prior experience.

Continuity of Patient Care↗

PubMed1998

Cultural factors related to the peer review of teaching.

Since 1994, the American Association for Higher Education Peer Review of Teaching Project has sought to popularize the notion that teaching is both a scholarly activity and community property to be shared with and critiqued by the larger academic community. In order to accomplish these goals, each of the three academic units at the twelve participating universities developed a pilot project that conformed to its own institutional, academic unit, and disciplinary culture. At a large Midwestern university, the academic units of mathematics, history, and nursing developed different projects. Each of these projects took account of the unit's specific culture, and this fact helps to account, in large part, for each project's success.

Education, Nursing, Baccalaureate↗

PubMed1995

Telemedicine--the diagnostic tool of the future.

The most immediate concern in the development of telemedicine programs, technology, and equipment is the continuation of federal funding. As Congress continues its efforts to balance this year's federal budget, funds for research generally and particularly for the pilot programs discussed above could be cut or eliminated. Federal funding is surprisingly important to the rapid maturation of telemedicine. Without these pilot projects, HCFA believes that it would be unable to assess the effect of Medicare reimbursement for telemedicine consultations. Without such assessment, HCFA may be unwilling to relax the current restrictions on reimbursement for telemedicine outside of pilot programs. HMOs and third-party payors would then be less likely to support telemedicine programs and reimburse providers who participate in them. Similarly, without the promise of federal or private reimbursement, the telecommunications industry will find it harder to justify continuing research and development in new technologies. Nonetheless, even a complete elimination of all federal research monies is likely only to slow the growth of telemedicine, not stop it.

Centers for Medicare and Medicaid Services, U.S.↗

PubMed1995

Interventional telemedicine for noninvasive neuroradiosurgery: remote-site high-performance computing, mathematical optimization, and virtual scenario simulation.

Interventional Telemedicine may have potential utility in providing connectivity and access to specialized high performance computing and advanced software resources in support of clinical procedures in the field of Minimally-Invasive Surgery and Stereotactic Linear Accelerator (LINAC) Radiosurgery. Such interventions may benefit from application of nonlinear quadratic inverse solution methods designed to provide the capability to reverse optimize a 'best case' treatment plan. The formidable decision-making challenges posed by increasingly complex optimized data and progressively versatile LINAC delivery systems require volume visualization of projected treatment data and imaging anatomy via photorealistic rendering and virtual scenario simulation techniques. Both these new directions are heavily dependent on access to specialized high performance computing platforms solely accessible via broad-bandwidth network connectivity. This pilot project presents resimulation of retrospective radiosurgical case data using inverse solution optimization models running on workstation clusters and then volume rendered and simulated on the Princeton Graphics Engine Supercomputer. Evidence for effective utilization of such optimization and virtual simulation methods running on remotely accessed, distant high performance computing resources is discussed in view of the potential for long-term clinical investigation and eventual development of Interventional Telemedicine as a clinically practical approach for providing support to remote or non-urban radiosurgery centers in the industrialized and developing world.

Algorithms↗

PubMed2003

Diabetes demo project puts pharmacists in DM driver's seat.

The American Pharmaceutical Association Foundation is implementing a pharmacist-driven DM program that aims to help diabetic participants bring their blood sugar under optimal control. In this model, pharmacists advise and coach patients about their disease on a regular basis, all the while keeping PCPs informed about their patients' progress. The program will begin as a pilot project with five employers, but developers hope early success will make the program attractive to many workplace settings.

Diabetes Mellitus↗

PubMed2005

Theatre-based hospital placements for firefighters.

Airway obstruction is the most common cause of death in the prehospital environment. It is estimated that 85% of these patients had otherwise survivable injuries. The aim of the project was to increase firefighters' skills in airway management techniques, to include the laryngeal mask airway (LMA), by providing theatre-based hospital placements under the supervision of a consultant anaesthetist. The training in the use of the LMA by firefighters is currently a pilot project to assess the potential for its use operationally, based on ease of training to a competent level and retention of skills after one year.

Airway Obstruction↗

PubMedDate not supplied

CASH--an innovative approach to sustainable OSH improvement at workplace.

Occupational health department of a large private enterprise located in India launched Project CASH--Change Agents for Safety and Health, at manufacturing units of the enterprise to bring about a positive change in work environment and improvement in work practices to reduce occupational health risk. Multidisciplinary teams of change agents were constituted and were given intensive training inputs. Reduction in exposure to noise, dust and heat stress were identified as specific objectives after a baseline survey of the work environment. Occupational safety and health knowledge and training was imparted to all field personnel to improve their work practices and attitudes. The focus of the actions was on engineering control measures and process engineering changes necessary for workplace improvement. Noise levels were reduced by an average of more than 9dBA in most of the top ten high noise locations. Out of two locations identified for dust exposure, one was fully eliminated and dust levels at other location were significantly reduced. Heat stress was reduced in all three identified locations with an average reduction of more than 3 degrees C in WBGT levels. Thus, final evaluation of workplace environments revealed significant reduction in exposure to all identified agents, viz noise, dust and heat fulfilling the project objectives. Educating and empowering the team led to reduction of occupational health risks in the work environment. There was positive attitudinal and behavioural change in safety and occupational health awareness & practices among employees. The monetary savings resulting from improvements far outweighed the investments. Success of this pilot project was followed up with further similar projects and their number has grown in geometric proportion for the last three years indicating the sustainability of the project.

Chemical Industry↗

PubMed1996

Incorporating psychometric measures in selecting and developing surgeons.

Provides a review of the recent literature on the selection and development of surgical trainees and surgeons, and discusses findings on the validity of psychometric measures of ability and personality in such processes. Drawing on this body of research, outlines the pilot project recently completed by the authors at St George's Hospital in London, which sought to test the appropriateness of incorporating psychometrics in supporting the career development of junior doctors applying for surgical training. The results of this pilot study tend to confirm those provided by similar research on surgeons, as well as other clinical groups--that psychometric measures have a significant role to play in aiding the assessment and career development of doctors.

Attitude of Health Personnel↗

PubMed2006

Using the interpretive narrative research method in interdisciplinary research projects.

Researchers from different disciplines bring to a project their different perspectives of the research problem. Differences in education, experiences, and understanding create a research project that has more depth and breadth than one designed by researchers from a single discipline. The purpose of this article is to describe how faculty from two disciplines, nursing and education, used the interpretive narrative method, a qualitative research method, in a pilot project to examine issues related to the recruitment and retention of Hispanic nurses. The researchers chose the interpretive narrative method for the flexibility it offers interdisciplinary research, its power in eliciting comprehensive narratives from participants, and the possibilities it offers for analysis.

Cultural Characteristics↗

PubMed2001

Quality control of the physical and technical aspects of mammography in the Norwegian breast-screening programme.

The aim of this study was to establish a system for quality control of technical and physical aspects of mammography in the national Norwegian breast-screening programme, and to evaluate test results obtained during the 4-year pilot project period. Quality control (QC) procedures for the X-ray unit, film and processing, cassettes and screens, view boxes, and image quality were described in two QC manuals. Frequent and relatively simple tests were performed by radiographers on-site and results reported semi-annually to an inspection group established at the Norwegian Radiation Protection Authority (NRPA). Tests requiring special equipment were performed prior to start of screening (first status controls), then annually by the NRPA group, which also assembled and analysed the data from the first 4 years. The analyses were done mainly with reference to stated standard or guidance levels and the degree of deviation from such values. Results for tests of i.a. focal spot size, exposure time, radiation output, mean absorbed glandular dose, reference optical density, sensitometry, and AEC performance are presented. The standard of the equipment tested was in general high. Although some deviations from optimal performance were seen throughout the project, the equipment mostly performed well within the stated limiting values.

Aged↗

PubMedDate not supplied

The management of venous leg ulcers: a project to improve care.

This article describes a two-year project to develop resources for the improvement of leg ulcer management. It was felt that an audit tool and complementary resources, such as a resource pack and implementation guide, could help practitioners to implement clinical guidelines on leg ulcer management in practice. The audit results from the pilot project are briefly described and discussed in terms of informing future work.

Evidence-Based Medicine↗

PubMedDate not supplied

Strengthening government health and family planning programs: findings from an action research project in rural Bangladesh.

An ongoing study at the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) is based on the premise that public sector health and family planning programs can be improved through an assessment of the dysfunctional aspects of their operations, the development of problem-solving capabilities, and the transfer of strategies successfully tested in a small-scale pilot project. This paper reports findings from a field trial implemented in a subunit of the project area at an early stage of the project. Operational barriers to public sector program implementation are discussed with regard to the quantity of work, the quality of work, supplies and facilities, integration of health and family planning, and leadership, supervision, and decision making. Initial results of the ICDDR,B intervention on these managerial processes are also indicated.

Bangladesh↗

PubMed1997

Flexible electronic patient record: first results from a Dutch hospital.

This paper covers a pilot project that has been done at a dutch general hospital. They searched for the feasibility of a flexible patient record based on intranet technology and a system integrator (CAI). Based on an extended analysis of the organisation (i.c. hospital and pilot specialism), information and communication, the specifications for the interfaces are defined. Furthermore the structure and number of data to be stored in the Patient Data & Result Server are defined. Finally, a prototype of the flexible patient record has been developed. This prototype is not yet in routine use. However, experiences of the clinicians have learned that the web technology in combination with a system integrator could be a major step in the "wide" acceptation of the electronic patient record.

Computer Communication Networks↗

PubMed2000

Reducing unintended pregnancy by increasing access to emergency contraceptive pills.

OBJECTIVES: National and state data on the health, social, and economic consequences of unintended pregnancy prompted Washington policy makers to identify strategies to reduce such pregnancies. Though not well known, emergency contraceptive pills (ECPs) are a safe and effective contraceptive method that can prevent pregnancy if taken within 72 hr after unprotected intercourse. A coalition conceived the idea of enabling pharmacists to prescribe ECPs directly to women through collaborative drug therapy agreements (CDTAs) with physicians. METHODS: Following a feasibility study, five agencies initiated a novel pilot project in western Washington. Key components included informing pharmacists about ECPs and CDTAs; developing tools, providing training, and developing systems to establish pharmacist/ prescriber collaborative agreements; conducting a public awareness campaign; evaluating the impact of the project; and disseminating the results. RESULTS: More than 1000 pharmacists received training in all aspects of providing ECPs and 140 pharmacies participated in the project, with more than 145 CDTA on file. In the 16 months of pharmacy service provision, 11,969 ECP prescriptions were provided, possibly preventing 700 or more unintended pregnancies. The media launch led to 200 broadcast stories and increased calls to the ECP Hotline from 116 to an average of 1160 per month. CONCLUSION: Enabling pharmacists to provide ECPs directly to women is a convenient delivery system for a time-limited therapy. It increases the chances that women will use the therapy effectively and connects women without a provider to a source of care. By increasing access to an effective contraceptive, this projects supports the Washington State goal of reducing unintended pregnancy.

Contraceptives, Postcoital↗

PubMedDate not supplied

[The concept and program of health improvement for children and teenagers].

Described in the paper is the activity of the Russian national children's recreation facility "Orlenok", where up to 16 000 children (mainly teenagers) come annually for recreation and recovery. Information on history, evolution as well on the structure of health-improving, preventive and educational measures is presented. The major provisions and stages of the Concept of development of "Orlenok"--a recreational, methodological, medical and cultural facility--are defined. The recreational facility is regarded as an experimental center, where pilot projects targeted at health improvement and prevention of diseases among the growing generation are tested.

Adolescent↗