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At least 1,189 records · Page 66Linked to original sources
PubMed2006

Putting conflict management into practice: a nursing case study.

AIM: This paper is intended to put knowledge in conflict management into practice through reflecting on a nursing case study. BACKGROUND: Nursing organizations are particularly vulnerable to conflict as the context of nurses' work may be difficult and stressful. Power conflict is argued to be an important source of tension within nursing units. Learning to manage conflict at an early stage is therefore crucial to the effective functioning of nursing organizations. EVALUATION: A nursing case study that illustrates power conflict in an oncology nursing unit is displayed and reflection on conflict management from the case is provided. KEY ISSUES: There is no appropriate or inappropriate strategy to deal with conflict. However, detecting initial symptoms of conflict and adopting the most effective behaviour to conflict resolution is essential in nursing units. CONCLUSION: Further nursing education in conflict management for staff nurses and nurse managers is greatly needed.

Adaptation, Psychological↗
PubMedDate not supplied

Management of acute airway obstruction using extracorporeal membrane oxygenation.

The authors describe, to their knowledge, the first management of acute airway obstruction in a newborn infant using Extracorporeal Membrane Oxygenation (ECMO). The infant had a primary diagnosis of gram negative sepsis complicated by pulmonary hemorrhage resulting in a left main stem bronchus obstruction. Despite full ventilatory support, the infant could not be adequately oxygenated. The infant was placed on venovenous ECMO. Airway management also included vigorous physiotherapy, suctioning, and bronchoscopy. The infant was successfully weaned from ECMO after 208 hours. The authors suggest that ECMO could be useful to manage life threatening airway obstruction in the neonate.

Adult↗
PubMed2004

Developing service quality in mental healtlh services.

Through a literature review, this paper demonstrates that there is a lack of knowledge about quality management within the mental health services. Ideas about quality from the wider services sector are then discussed, and a case study of a mental health scenario is provided. It is argued that health service generally, and mental health services in particular, have much to gain from becoming more closely aligned with the wider field of knowledge of quality management. Concludes that the wider techniques of managing service quality may prove useful, particularly in mental health services, due to the nature of such services and their inherent variability.

Bibliometrics↗
PubMed2003

Development and adoption of a simple nonpoint source pollution model for Port Phillip Bay, Australia.

New computing tools and approaches allow tailored development of software to meet the needs of environmental managers. The processes required for such tailoring fit well with adaptive management concepts where, as knowledge and system understanding develop among managers, the software can be developed or replaced to match. This paper reports on development and adoption of a simple nonpoint source pollution modeling tool, including technical aspects of data support for modeling and social aspects of software design. The software, named FILTER, used a unit load model to generate expected pollutant loads from subcatchments of Port Phillip Bay, Australia. Monitoring data were used for calibration to modify the delivery of generated pollutants to receiving waters. Spatial, tabular, and charting software components were used to provide alternative forms of output visualization. FILTER was developed using a process that resulted in manager-stakeholders taking responsibility for setting of model parameter values and operation of the user interface, thereby encouraging uptake. The inclusive development process, tailoring of the software to manager needs and styles of usage, and matching of model complexity to data and knowledge, resulted in a successful application that has become the current agreed system representation among disparate stakeholder organizations.

Australia↗
PubMed2006

A study on the knowledge, attitudes and practices of Southeast Asian dermatologists in the management of atopic dermatitis.

INTRODUCTION: This study evaluated the knowledge, attitudes and practices of Southeast Asian dermatologists in the management of atopic dermatitis (AD). MATERIALS AND METHODS: A questionnaire survey of 255 dermatologists in Indonesia, Malaysia, the Philippines, Singapore, Thailand and Vietnam. RESULTS: Familiarity with diagnostic criteria varied considerably. The usage of moisturisers by the respondents from Vietnam and Indonesia was significantly less frequent than the other countries. Most respondents (91% to 100%) used topical corticosteroids in children with mild-to-moderately severe dermatitis. Some respondents in the Philippines (17% to 19%) and Vietnam (11% to 25%) only used topical corticosteroids for severe disease. For infected eczema, most respondents would prescribe systemic antibiotics for mild-to-moderate infection. A minority in the Philippines (14%) and Vietnam (11%) did so only for severe infection. The top 4 systemic antibiotics prescribed most frequently were: erythromycin, cloxacillin, cephalosporin and amoxicillin/clavulanic acid. In Indonesia, a large proportion of the respondents (47%) prescribed amoxicillin most frequently. The majority of respondents (60% to 100%) prescribed both sedating and non-sedating oral antihistamines. Most respondents used oral corticosteroids to treat severe AD. Some in Malaysia, Singapore and Vietnam used cyclosporin (7% to 58%), azathioprine (5% to 31%) and methotrexate (5% to 14%). With the exception of those in Singapore, the majority of respondents (71% to 97%) did not use phototherapy. CONCLUSION: Familiarity with diagnostic criteria, the early and judicious use of moisturisers and topical corticosteroids, as well as the treatment of Staphylococcus aureus superinfection with penicillinase-stable antibiotics should be emphasised in this region.

Anti-Bacterial Agents↗
PubMed1998

[Aids in the management of pathological pregnancies. Advances in current knowledge of corpus luteum function].

Technological advances during the past decade have yielded new knowledge of luteal function and its regulation. A number of new substances with luteotrophic and lutcolytic properties have been identified in the corpus luteum, and the picture which emerges of the mechanisms responsible for physiological luteolysis is becoming increasingly complex. As luteal function/regulation during the menstrual cycle in the absence of pregnancy differs both from that in normal pregnancy, and from that in pathological pregnancy, these advances in our knowledge should prove clinically useful, particularly with regard to the early diagnosis and management of pathological pregnancy.

Corpus Luteum↗
PubMed1980

Psychographic profiles: aid to health care marketing.

Psychographic data contribute to health care promotion by providing a marketing tool for the health care manager. A complete knowledge of the patient populations' characteristics provides the health care manager with answers to many patient needs. Health care facilities can change or strengthen staff to meet consumer expectations thanks to the information provided by psychographic data.

Boston↗
PubMedDate not supplied

Nurses' willingness to manage the pain of specific groups of patients.

Effective pain management remains a challenge for the nursing profession. While nurses' knowledge of appropriate pain strategies has improved considerably, additional research needs to be conducted into the influence of factors other than knowledge on the management of pain. This study examined the willingness of nurses (n = 157) and nursing students (n = 265) to spend time and energy managing the pain of different groups of patients, when told that all patients had the same degree of pain. The willingness of nurses to spend time and energy in managing patients' pain was used as a proxy for preconceived notions relative to particular groups of patients. A pattern emerged that suggested that nurses' and nursing students' willingness to spend time and energy managing patients' pain in influenced by their perceptions of different groups of patients.

Adult↗
PubMedDate not supplied

Health outcomes skills for care management.

There are several skills nurses can develop or expand to improve their ability to manage outcomes. This is an exciting area for nurses and one that is valued during times of cost reduction in healthcare. In addition to increasing skills in the health outcomes management arena, nurses will benefit from a continual increase in knowledge of case management, clinical pathways, and guidelines. The healthcare market-place is likely to reward nurses with these skills.

Case Management↗
PubMed1997

HyperCare: a prototype of an active database for compliance with essential hypertension therapy guidelines.

HyperCare is a prototype of a decision support system for essential hypertension care management. The medical knowledge implemented in HyperCare derives from the guidelines for the management of mild hypertension of the World Health Organization/International Society of Hypertension, and from the recommendations of the United States Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure. HyperCare has been implemented using Chimera, an active database language developed at the Politecnico di Milano. HyperCare proves the possibility to use active database systems in developing a medical data-intensive application where inferential elaboration of moderate complexity is required.

Databases as Topic↗
PubMed2002

Skills, knowledge, aptitudes, and interests for veterinary practice management: fitting personal characteristics to situational demands.

Recent studies of veterinary practices and services have suggested that more attention must be focused on business practices and on the skills, knowledge, and abilities (SKAs) of veterinarians related to veterinary practice management (VPM). Responses to these concerns have been directed at the selection and education of veterinarians in veterinary school. While this position is supported in the present article, it is argued that the values and interests of persons who are likely to enter the field, as well as the nature of the experiences encountered across the career of veterinarians, will moderate the potential effectiveness of veterinary school practices and experiences regarding SKAs in VPM. The paper explores some potential implications of these moderators on the effectiveness of selection and education for increasing SKAs in VPM.

Animals↗
PubMed1991

Reliability and validity of the objective structured clinical examination in paediatrics.

The assessment of clinical competence has traditionally been carried out through standard evaluations such as multiple choice question and bedside oral examinations. The attributes which constitute clinical competence are multidimensional, and we have modified the objective structured clinical examination (OSCE) to measure these various competencies. We have evaluated the validity and reliability of the OSCE in a paediatric clinical clerkship. We divided the examination into the four components of competence (clinical skills, problem-solving, knowledge, and patient management) and evaluated the performance of 77 fourth-year medical students. The skill and content domains of the OSCE were carefully defined, agreed upon, sampled and reproduced. This qualitative evaluation of the examination was both adequate and appropriate. We achieved both acceptable interstation and intertask reliability. When correlated with concurrent methods of evaluation we found the OSCE to be an accurate measure of paediatric knowledge and patient management skills. The OSCE did not correlate, however, with traditional measures of clinical skills including history-taking and physical examination. Our OSCE, as outlined, offers an objective means of identifying weaknesses and strengths in specific areas of clinical competence and is therefore an important addition to the traditional tools of evaluation.

Clinical Clerkship↗
PubMed2003

National Institutes of Health State-of-the-Science Conference Statement: Symptom Management in Cancer: Pain, Depression, and Fatigue, July 15-17, 2002.

BACKGROUND: Despite advances in early detection and effective treatment, cancer remains one of the most feared diseases. Among the most common side effects of cancer and treatments for cancer are pain, depression, and fatigue. Although research is producing increasingly hopeful insights into the causes and cures for cancer, efforts to manage the side effects of the disease and its treatments have not kept pace. The challenge that faces us is how to increase awareness of the importance of recognizing and actively addressing cancer-related distress. The National Institutes of Health (NIH) convened a State-of-the-Science Conference on Symptom Management in Cancer: Pain, Depression, and Fatigue to examine the current state of knowledge regarding the management of pain, depression, and fatigue in individuals with cancer and to identify directions for future research. Specifically, the conference examined how to identify individuals who are at risk for cancer-related pain, depression, and/or fatigue; what treatments work best to address these symptoms when they occur; and what is the best way to deliver interventions across the continuum of care. State-of-the-Science Process: A non-advocate, non-Federal, 14-member panel of experts representing the fields of oncology, radiology, psychology, nursing, public health, social work, and epidemiology prepared the statement. In addition, 24 experts in medical oncology, geriatrics, pharmacology, psychology, and neurology presented data to the panel and to the conference audience during the first 1.5 days of the conference. The panel then prepared its statement, addressing the five predetermined questions and drawing on submitted literature, the speakers' presentations, and discussions held at the conference. The statement was presented to the conference audience, followed by a press conference to allow the panel to respond to questions from the media. After its release at the conference, the draft statement was made available on the Internet. The panel's final statement is available at http://consensus.nih.gov. CONCLUSIONS: The panel concluded that the available evidence supports a variety of interventions for treating cancer patients' pain, depression, and fatigue. Clinicians should routinely use brief assessment tools to ask patients about pain, depression, and fatigue and to initiate evidence-based treatments. Assessment should include discussion about common symptoms experienced by cancer patients, and these discussions should continue over the duration of the illness. Impediments to effective symptom management in cancer patients can arise from different sources and interactions among providers, patients and their families, and the health care system. Numerous factors could interfere with adequate symptom management. Among these factors are incomplete effectiveness of some treatments, a lack of sufficient knowledge regarding effective treatment strategies, patient reluctance to report symptoms to caregivers, a belief that such symptoms are simply a part of the cancer experience that must be tolerated, and inadequate coverage and reimbursement for some treatments. Additional research is needed on the definition, occurrence, the treatment of pain, depression, and fatigue, alone and in combination, in adequately funded prospective studies. The panel also concluded that the state of the science in cancer symptom management should be reassessed periodically.

Biomedical Research↗
PubMed2004

National Institutes of Health State-of-the-Science Conference Statement: Symptom management in cancer: pain, depression, and fatigue, July 15-17, 2002.

BACKGROUND: Despite advances in early detection and effective treatment, cancer remains one of the most feared diseases. Among the most common side effects of cancer and treatments for cancer are pain, depression, and fatigue. Although research is producing increasingly hopeful insights into the causes and cures for cancer, efforts to manage the side effects of the disease and its treatments have not kept pace. The challenge that faces us is how to increase awareness of the importance of recognizing and actively addressing cancer-related distress. The National Institutes of Health (NIH) convened a State-of-the-Science Conference on Symptom Management in Cancer: Pain, Depression, and Fatigue to examine the current state of knowledge regarding the management of pain, depression, and fatigue in individuals with cancer and to identify directions for future research. Specifically, the conference examined how to identify individuals who are at risk for cancer-related pain, depression, and/or fatigue; what treatments work best to address these symptoms when they occur; and what is the best way to deliver interventions across the continuum of care. STATE-OF-THE-SCIENCE PROCESS: A non-advocate, non-Federal, 14-member panel of experts representing the fields of oncology, radiology, psychology, nursing, public health, social work, and epidemiology prepared the statement. In addition, 24 experts in medical oncology, geriatrics, pharmacology, psychology, and neurology presented data to the panel and to the conference audience during the first 1.5 days of the conference. The panel then prepared its statement, addressing the five predetermined questions and drawing on submitted literature, the speakers' presentations, and discussions held at the conference. The statement was presented to the conference audience, followed by a press conference to allow the panel to respond to questions from the media. After its release at the conference, the draft statement was made available on the Internet. The panel's final statement is available at http://consensus.nih.gov. CONCLUSIONS: The panel concluded that the available evidence supports a variety of interventions for treating cancer patients' pain, depression, and fatigue. Clinicians should routinely use brief assessment tools to ask patients about pain, depression, and fatigue and to initiate evidence-based treatments. Assessment should include discussion about common symptoms experienced by cancer patients, and these discussions should continue over the duration of the illness. Impediments to effective symptom management in cancer patients can arise from different sources and interactions among providers, patients and their families, and the health care system. Numerous factors could interfere with adequate symptom management. Among these factors are incomplete effectiveness of some treatments, a lack of sufficient knowledge regarding effective treatment strategies, patient reluctance to report symptoms to caregivers, a belief that such symptoms are simply a part of the cancer experience that must be tolerated, and inadequate coverage and reimbursement for some treatments. Additional research is needed on the definition, occurrence, the treatment of pain, depression, and fatigue, alone and in combination, in adequately funded prospective studies. The panel also concluded that the state of the science in cancer symptom management should be reassessed periodically.

Depression↗
PubMed1997

Perioperative psychosocial interventions for autistic children undergoing ENT surgery.

Tonsillectomy/adenoidectomy is one of the most frequently performed operations in the United States. It is therefore likely that pediatric ENG surgeons will encounter autistic and developmentally delayed children in routine practice. Autistic children differ from normal children in that they exhibit severe deficits in language and social functioning; abnormal reaction to stimuli such as light, sound, touch, and pain; attachments to particular unusual objects and rigidly stereotyped routines. They are often mentally retarded. With the increasing importance of managed care and continuous quality improvement, knowledge of how to manage the operative course of such children is crucial for the practising surgeon. Based on research and clinical knowledge of these children, certain psychosocial and medical interventions are presented which may improve the operative course of this population. Using the parent as a consultant; decreasing separation from familiar caretakers, objects, and routines; pre-operative role-playing; tailoring anesthetic induction; and using post-operative distractors are suggested techniques.

Adenoidectomy↗
PubMed2000

GPs' attitudes towards the treatment of drug misusers.

General practitioners (GPs) are encouraged to play a major part in the care and treatment of drug users; however, many regularly encounter physical or verbal abuse and feel frustration, disappointment, and disillusionment when treating such patients. Furthermore, communication difficulties between doctor and patient and the advent of HIV serve to intensify these problems. In order to address these issues, a questionnaire survey was carried out to assess what proportion of GPs are commonly employed in the management of drug misusers, and to examine the attitudes towards, and knowledge of, the management of these patients. The results show that this group of GPs are concerned about drug misuse in their immediate geographic area and believe it should be detected in general practice. Despite this, fewer than half of the GPs felt they had adequate knowledge of the issues surrounding opiate misuse. This finding certainly raises the question of the availability of training and education in the area of drug misuse.

Attitude of Health Personnel↗
PubMed2001

Contribution to systematic education of quality management in Slovak health care.

THE AIM: Of the study was to contribute to quality improvement initiatives in Slovak health services through systematic approach to the education and training in quality management (QM). Consequently, the main objectives were to analyse the content of the education in QM abroad, to conduct an audit of perceived training needs in Slovakia, and to propose the design of QM training programme to be applied within CME scheme based on the study results. Triangular method in the design of the study was implemented. Review of relevant information, data from the questionnaire and semi-structured interview in the sample of 67 Slovak trainees from Health Management School and School of Public Health--were adopted in complementary fashion. BETWEEN FINDINGS: Highlighted in the survey are positive attitudes to training in quality management documented by the median score higher than 6 in all tested areas, on scale 0-10. No significant differences in profession groups as physicians, nurses, HC managers or among training institutions involved were displayed. However, potential obstacles were identified in deeper study using interviews. The absence of knowledge and skills in management in general and in quality management approaches especially are observed. Typically, the role of strategic planning is undermined. The large scale of quality management approaches is converted to problems of accreditation. Barriers to participative culture, innovation, devolution of accountability, resistance to change and to team based management are authentic findings as well. CONCLUSIONS: Drawn from the study were related to: fostering managers--"transformational leaders" for locally driven decision making in health care policy and practice; need of training activities for the continuing education in quality with respect to specific target groups interests and their level of knowledge in management; content of training oriented towards combination of rational utilization of information, critical analytical skills and planning for quality with human resource development-interpersonal skills, team building (soft skills), not just reduction of quality management tools to hard techniques (statistics, ISO norms); methods of education, where the usage of experiential learning methods, participative training inclusive action learning is highlighted; team training complemented with individual professional development support inclusive a coaching and mentoring scheme. AS IMPLICATIONS: Four types of CME training: Basic Module QM, Training for QM teams, Training Trainers Scheme and Guiding through Accreditation and Quality Award were proposed. (Tab. 9, Ref. 38.)

Curriculum↗