Journal of nursing management
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The purpose of this study was to explore the development of public health nursing in a primary care trust that focused around the evaluation of a newly introduced public health nursing role. The intention was to inform role development during the three year evaluation period. ⋯ Four main headings were identified to organise and present the findings -- definitions of public health; continuum of practice; contextual factors in public health development; and inhibitors to public health practice development. The findings suggest that there are a number of factors challenging the health visiting response to the public health agenda. Facilitating clarity of role and purpose must be a management priority. A tool, developed from this study, offers a means to explore practice within a primary care -- public health continuum and provides a schema against which to set and action practice development.
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Nursing autonomy has been associated with better patient-outcomes; therefore, it is a priority for critical care nursing management. Low authority has been a persistent complaint of Hellenic intensive care unit nurses; however, issues of nursing autonomy have not been previously addressed empirically in Hellas. ⋯ The results revealed moderate autonomy in technical tasks and low decisional autonomy among Hellenic intensive care unit nurses. Factors related to the educational preparation of nurses, gender issues and institutional characteristics might hinder intensive care unit nurses' autonomy in Hellas.
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The purpose of this article is to review the management of health and social care provision for Creutzfeldt-Jakob Disease patients within the United Kingdom. The link between the epidemic of bovine spongiform encephalopathy (BSE) in cattle and the subsequent emergence of variant Creutzfeldt-Jakob Disease (vCJD) in humans during the mid 1990s created new mechanisms for the organization of health and social care for Creutzfeldt-Jakob Disease patients. This article draws on the experiences of two National Care Co-ordinators appointed to manage the care of Creutzfeldt-Jakob Disease patients throughout the United Kingdom, and identifies how additional money set aside by the Department of Health (DoH) is spent to overcome local difficulties in the timeliness or availability of services. The key issues that emerge include the positive benefits associated with care co-ordination and the difficulties encountered in developing flexible and individual care packages within existing health and social organizational structures.
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Comparative Study
Assessing patient category/dependence systems for determining the nurse/patient ratio in ICU and HDU: a review of approaches.
A huge range of patient classification systems/tools are used in critical care units to inform workforce planning, however, they are not always applied appropriately. Many of these systems/tools were not originally developed for the purposes of workforce planning and so their use in determining the nurse:patient ratio required in critical care settings raises a number of issues for the organisation and management of these services. ⋯ The implications of these findings for the organization and management of critical care services are discussed. Careful consideration of these areas is vital if a cost efficient and cost-effective critical care service is to be delivered.
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Care attendants, have long assisted nurses in the provision of care for older people in a variety of care settings in Ireland. While there has been recent interest in the provision of formal training for this grade of health care worker the majority remain untrained and unregulated. ⋯ The study indicates a positive view of training for care attendants, also highlighting the importance of role clarification. Results are particularly relevant in the present climate of demographic change, changes in nurse education and staff shortages in Ireland.