Developing evidence-based nursing roles: lessons learned from the health care integrator role

PURPOSE: This study examined a unique nursing role in the United States Air Force to determine if it had been well institutionalized and to identify barriers and facilitators during the implementation process. SOURCE OF INFORMATION: Individuals functioning in the role were surveyed to measure time spent on specific job-related tasks, additional duties, and positive and negative experiences. CONCLUSIONS: Eighty-seven percent of the respondents (n = 45) indicated that the role had been well implemented, although wide variation existed in tasks performed and major organizational barriers identified. Findings of this study can be used to guide the development of other evidence-based positions.     

Interdisciplinary training for rural care: some North American experiences

Government policy emphasises teamworking in primary care, but this development has prompted professional anxiety that continuing personal care may suffer. There is evidence that patients themselves, particularly older ones, do value a continuing personal relationship with their GP, but also that attitudes are changing as people become better informed about health matters and more self-confident in seeking advice. Partnership is more appropriate today than paternalism and potentially lends itself to teamworking. Much remains to be done however, to ensure that teamworking operates effectively and that a sense of personal worth remains at the heart of patient/professional relationships in the interests of both parties.     

Safe patient handling program in critical care using peer leaders: lessons learned in the Netherlands

Occupational back pain remains a serious problem for nurses. In Dutch health care, ergonomic changes are stimulated through convenants. For acute and critical care, a covenant was drawn up and guidelines for nursing practice developed and implemented. Because of the diverse and rapidly changing nature of ergonomic problems, the process has to be specific. A strong emphasis thus was placed on self-management and empowerment of nurses. One or two nurses were appointed per ward as peer leaders, called ergocoaches. They received additional training and were given responsibility for safe work practices. This article reports on progress made to date, viewed as work in progress.     

Reducing health disparities by improving quality of care: lessons learned from culturally diverse women

Disparities in health care for culturally diverse populations in the United States lead to poorer health outcomes. This article focuses on decreasing health disparities by improving the quality of care for culturally diverse women. Findings from 3 pilot studies are organized using Fongwa's Quality of Care Model, which demonstrate specific modifications suggested by culturally diverse women that can potentially improve health care services for these women.     

Evacuation of a rural community hospital: lessons learned from an unplanned event.

A credible bomb threat forced the complete evacuation of a rural community hospital. An Incident Command System was implemented, and all 46 patients were temporarily transported and maintained at 2 local sites. They were returned to the hospital approximately 24 hours later. Only one patient experienced a complication possibly associated with the evacuation. This article discusses pertinent strategies and considerations involved in the planning and execution of a rural hospital evacuation. It further highlights the role of the emergency department medical and nursing staff throughout the evacuation process.     

Practical implementation of globally priced episodes of care: lessons learned from Oxford's specialty management program.

Globally priced episodes of care afford payers a more efficient method of allocating risk and simultaneously accommodating the now permanent demand for choice and access at the point of service. Foreseeing the trend away from capitated delivery systems, in April of 1996. Oxford Health Plans began to invest considerable resources to implement global fees. When Oxford ran afoul of Wall Street and New York State insurance regulators (for reasons unrelated to the subject of this article), it was forced to abandon the new program. For the growing number of payers interested in pursuing similar contracting strategies, this article may serve as a useful source of information.     

Implementing a nursing program via live interactive video: lessons learned

Flexibility in scheduling and sensitivity to meeting the educational needs of today's diverse student population is a must in nursing education. The authors present an overview of how a college of nursing implemented an entire generic BSN program via live interactive television for nursing students 45 miles from the main campus. The authors describe the experience of initiating the program, facilitating faculty and student adaptation to the challenges of live interactive video education, and a summary of the first five years.     

A case for the use of Q-methodology in disability research: lessons learned from a training workshop

Purpose.?Q-methodology was developed to analyse subjective responses to a range of items dealing with specific topics. This article describes the use of Q-methodology and presents the results of a Q-study on perspectives on disability carried out in a training workshop as evidence for its usefulness in disability research.

Method.?A Q-sort was administered in the context of a training workshop on Q-method. The Q-sort consisted of statements related to the topic of disability. The responses were analysed using specifically developed software to identify factors that represent patterns of responses.

Results.?Twenty-two of the 23 respondents loaded on four factors. These factors appeared to represent different paradigms relating to the social, medical and disability rights models of disability. The fourth factor appeared to be that of a family perspective. These are all models evident in the disability research literature and provide evidence for the validity of Q-method in disability research.

Conclusion.?Based on this opportunistic study, it would appear that Q-methodology is a useful tool for identifying different view points related to disability.     

Neonatal nursing care issues following a natural disaster: lessons learned from the Katrina experience

The massive evacuation of sick and at-risk infants from a large metropolitan area following a natural disaster provides many lessons for neonatal nurses. Planning and education are of utmost importance, and disaster education and training are essential for all nurses. Unit-specific disaster plans can serve as a guide for nurses but the real test occurs during and after the event. Nurses must learn to adapt neonatal care to the rapidly changing environment during a disaster. Supporting high-risk infants without the aid of technology requires a back-to-the-basics approach. The ability to maintain communication and facilitate transportation of neonates out of a disaster area is essential. Nurses must also consider their own well-being in the aftermath of a disaster. Planning for future disasters should include lessons learned from the past events. This article addresses nursing care issues and lessons learned from the events that unfolded in the New Orleans area neonatal units during and after Hurricane Katrina, and guidance in support of disaster education for neonatal nurses.     

Social support in cyberspace: lessons learned.

The lessons learned from the implementation of phase one of Women to Women (WTW1), a research-based computer outreach program for rural women with chronic illness, and their influence on the development of phase two of Women to Women (WTW2) are discussed in this article. The changes implemented in WTW2 included moving from the FirstClass delivery platform to WebCT; increasing the intra- and interdisciplinary nature of the team by adding nurse experts in Web skills and women's health and non-nurse colleagues in family finance and nutrition; expanding the geographical area to be served from Montana to adjoining states; developing health teaching units that harness the internet as the major source of ever-current health information; including a control group in the study design; and selecting more pertinent, repeated measurement instruments to assess psychosocial variables.