Interprofessional perceptions of health care students

Effective interprofessional working, which is widely considered as essential to high-quality health care, is influenced by the attitudes of health care professionals towards their own and other professional groups. Relatively little is known, however, about interprofessional attitudes, particularly of students in health care professions. This study aimed to increase our understanding of students' attitudes towards their own and other professional groups on entry to a programme of professional education. Hypothesised relationships between stereotypes, professional identity and readiness for professional learning were tested by means of a questionnaire survey of 933 undergraduate health care students drawn from five health care groups (medicine, nursing, dietetics, pharmacy and physiotherapy) within a multi-faculty UK university. Positive statistically significant correlations were found between stereotypes, professional identity and readiness for interprofessional learning. As predicted, students identified strongly with their own professional group at the start of pre-registration education. They were also willing to engage in interprofessional learning. More unexpected was the positive association found between heterostereotype and professional identity scores. There are potential benefits of introducing active interprofessional education activities at an early stage of professional preparation to capitalise on students' positive attitudes towards their own and other professional groups.     

Interprofessional perceptions of health care students

Effective interprofessional working, which is widely considered as essential to high-quality health care, is influenced by the attitudes of health care professionals towards their own and other professional groups. Relatively little is known, however, about interprofessional attitudes, particularly of students in health care professions. This study aimed to increase our understanding of students' attitudes towards their own and other professional groups on entry to a programme of professional education. Hypothesised relationships between stereotypes, professional identity and readiness for professional learning were tested by means of a questionnaire survey of 933 undergraduate health care students drawn from five health care groups (medicine, nursing, dietetics, pharmacy and physiotherapy) within a multi-faculty UK university. Positive statistically significant correlations were found between stereotypes, professional identity and readiness for interprofessional learning. As predicted, students identified strongly with their own professional group at the start of pre-registration education. They were also willing to engage in interprofessional learning. More unexpected was the positive association found between heterostereotype and professional identity scores. There are potential benefits of introducing active interprofessional education activities at an early stage of professional preparation to capitalise on students′ positive attitudes towards their own and other professional groups.     

通过医院评审提升专业性照护水平

通过实际评审以及解读评审标准，分析与评价评审中专业性照护行为，强调以专业性照护为根本的护理质量的重要性。等级医院评审过程中实施专业性照护对患者安全和护理质量有重要影响。通过等级医院评审可进一步提升护理人员的专业性照护水平，保障患者安全和护理质量。     

Professional competence and palliative care: an ethical perspective

The aim of this article is to explore an ethical view of professional competence by examining the professional competence of physicians in the context of palliative care. A discussion of the four dimensions of professional competence--knowledge, technical skills, relationships, and affective and moral attitude--leads us to the conclusion that "habits of mind" are important in every aspect of professional competence. This observation is then considered in the context of virtue ethics and ethics of care. Virtue ethics focuses on personal qualities and moral attitudes, while the ethics of care concentrates on the way these qualities are lived out in specific care relationships. Our conclusion points up the importance of education in ethics in the development of professional competence, and argues that because palliative care involves intense human interactions, integrating palliative care into the medical curriculum may improve the ethical culture of health care as a whole.     

Professional nurses' perceptions of the skills required to render comprehensive primary health care services

As multidisciplinary health team members, professional nurses play a vital role in the delivery of primary health care services. They require specific knowledge and skills to function effectively in the primary health care settings. In South Africa, however, professional nurses followed various training programmes. This has made it difficult for the professional nurses to be competent in rendering the full spectrum of comprehensive primary health care services, focussing on preventive, promotive, curative as well as rehabilitative care. In a setting where professional nurses have different qualifications it is possible that they do not recognise their own limitations. The research aimed to explore and describe the perceptions of professional nurses about the skills required and their own level of skills to render comprehensive primary health care services. A further aim of the research was to formulate guidelines for the facilitation of trained professional nurses to truly render quality comprehensive primary health care services, based on the findings. A qualitative design was followed. Participants were identified by means of purposive voluntary sampling and data was collected by utilising a semi-structured interview schedule. Twenty two participants were interviewed. After each interview field notes were written. Ethical aspects and confidentiality were taken into consideration. The researcher and a co-coder analysed the transcribed interviews by means of open coding. The findings indicated that the more comprehensively the professional nurses were trained, the more competent they felt. The less comprehensively trained, the more negative they experienced their work. They viewed their skills as ranging from adequate to inadequate, depending on their training. The conclusion was drawn that professional nurses' perceptions were congruent with the skills they possessed. Recommendations for nursing research, education and practice, including guidelines to facilitate trained professional nurses to truly render comprehensive primary health care, were formulated.     

Nurse qualifications and perceptions of patient safety and quality of care in South Africa

A plethora of research links professional nurses' qualifications to patient outcomes. Also, research has shown that reports by nurses on the quality of care correspond with process or outcome measures of quality in a hospital. New to the debate is whether professional nurses' qualifications impact on their perceptions of patient safety and quality of care. This research aims to investigate professional nurses' perceptions of patient safety and quality of care in South Africa, and the relationship between these perceptions and professional nurses' qualifications. A cross‐sectional survey of 1117 professional nurses from medical and surgical units of 55 private and 7 public hospitals was conducted. Significant problems with regard to nurse‐perceived patient safety and quality of care were identified, while adverse incidents in patients and professional nurses were underreported. Qualifications had no correlation with perceptions of patient safety and quality of care, although perceptions may serve as a valid indicator of patient outcomes. Creating an organizational culture that is committed to patient safety and encourages the sharing of adverse incidents will contribute to patient safety and quality of care in hospitals.     

新升格本科院校护生人文关怀能力现状及影响因素

目的了解新升格本科院校护生人文关怀能力现状及影响因素。方法采用人文关怀能力量表和大学生专业承诺量表对184名护理本科生进行调查。结果护生人文关怀能力得分为(171.01±12.96)分,低于国内常模,并与专业承诺呈正相关;专业承诺作为重要影响因素,可解释人文关怀能力16.60%的变异量。结论新升格本科院校处于特殊的转型时期,护生人文关怀能力总体偏低,应增加人文关怀教育的投入,重视对护生专业态度的引导和专业承诺的提高,促进其人文关怀能力的提升。     

护理业务管理模式的改革与成效

目的:医院抓护理业务建设,满足病人需求,提高护理内涵。方法:医院建立护理业务技术管理小组;引入竞争机制,开展病人选护士活动;运用目标战略管理模式实行临床护士规范化培训;尝建新型护理业务管理制度;试点开展“专病专护”,加强护理人员知识库管理;全面推进整体护理。结果:护理科技含量、护理技术满意度、护士任职能力和护理人员知识层次都有了明显的提高,结构多元化。结论:护士中形成了“有为才有位”的护理观。     

ICU护士人文关怀能力与职业认同感现状及相关性研究

目的：探讨ICU护士人文关怀能力和职业认同感现状及其相关性,以期为ICU管理人员采取措施提高护士关怀能力及职业认同水平提供理论依据。方法：采用人文关怀能力量表和护士职业认同感量表对天津市7所医院共218名ICU护士进行问卷调查。结果：ICU护士人文关怀能力总分为（178.06±30.98）分,认知（71.56±13.92）分、耐心（54.54±9.82）分、勇气（51.96±13.37）分各维度均低于国外常模;职业认同感总分为（106.16±22.29）分,处于中等水平。ICU护士人文关怀能力各维度与职业认同感维度均呈正相关（P<0.01）,线性回归分析结果显示,控制人口学变量后,人文关怀能力中的认知和耐心对职业认同感具有预测作用。结论：ICU护士人文关怀能力和职业认同水平均处于较低水平且两者存在联系。护理管理者可以采取措施提高ICU护士人文关怀能力,进而增强其职业认同感。     

In-service education for home health aides by home health aides

Gerontological nursing as an emerging specialty is now recognized by all professional nurses as a legitimate professional entity capable of governing the care of older adults through implementation of standards of care. The historical upgrading of care is now reaching its culmination in the newly revised document titled Scope and Standards of Gerontological Nursing as published in 1988 by the Council of Gerontological Nursing of the American Nurses Association. The utilization of these standards should continue to assist nurses in whatever facility they may practice to upgrade the care delivered through partnership with the older adult and their family to a high degree of satisfaction for the consumer and the gerontological nurse practitioner. Expanded knowledge, expertise in skill and care measured by the standards of care are key components in achieving success as a professional nurse and bring pride to the profession of nursing.     

Reframing the meaning of life and professional values: A theoretical framework of facilitating professional care for terminally ill patients

Professional values reflect nurses' understanding of how to deliver professional care, which might influence nurses' attitudes and caring behaviors during end‐of‐life care. However, limited research has been conducted to explore nurses' experiences of professional development during end‐of‐life care, and theoretical explanations are scarce about how nurses enact their professional values during the caring process. This study explored the social process of professional values involved in end‐of‐life care in the Chinese cultural context by adopting a constructivist grounded theory approach. Twenty semi‐structured in‐depth interviews with 15 nurses from three hospitals in southeastern China were conducted. A theoretical framework emerged when focusing on the social process of “reframing the meaning of life and professional values” to facilitate professional care for terminally ill patients. Three main categories were sequentially identified as “recognizing the dilemmas when caring for terminally ill patients,” “applying strategies to deal with values conflict,” and “reconstructing values.” This theoretical framework may be applied as a practical framework for equipping nurses with effective strategies to cultivate professional values, including the provision of adequate end‐of‐life knowledge, and a supportive workplace environment.     

Consumer impact of a Cold Self-Care Center in a prepaid ambulatory care setting

A Cold Self-Care Center was developed to be an alternative to professional care and to encourage more active involvement of consumers in their own care. A sample of the self-selected user population (n = 74) was studied by comparison with a random sample of plan members (n = 104), and the program was evaluated for cost, consumer satisfaction, and impact on behavior, knowledge and attitudes. Users demonstrated higher levels of knowledge about cold care than non-users, indicated more dependency on professional resources, and differed in health-related attitudes and cold-care behavior. The Cold Self-Care Center appears to have had little impact on self-medication behavior. However, it did affect care-seeking behavior. Knowledge of criteria for seeking professional care was greater than in non-users; 20 per cent sought professional care, and 6 per cent anticipated seeking professional care for future colds. General satisfaction with the program was quite high. Speed and ease of use were cited most often as reasons for satisfaction. The Center also was demonstrated to have a favorable impact on clinic costs. A flexible system which is convenient to use and which retains access to professional care when appropriate both can relieve clinic overload and meet the needs of a large percentage of cold patients.     

Preparation for becoming members of health care teams: findings from a 5-year evaluation of a student interprofessional training ward

Setting.?An orthopaedic interprofessional training ward manned by students at a University Hospital.Objective.?To assess to what extent students from different undergraduate programmes evaluated the effects of a 2-week rotation at the ward on their professional roles and the value of teamwork within health care.Method.?A questionnaire was filled in by 841 students by the end of a 2-week rotation at the ward over 5 years. Questions concerned students’ estimate of how the rotation had strengthened their insight into their own future professional role, into other students’ professional roles and into the value of teamwork within health care. Differences between the different student categories and possible associations between the different estimates were statistically analysed.Results.?Students from all programmes reported that the rotation at the student ward had dramatically strengthened their insight about their own future professional role as well as the roles of the other professions and the value of teamwork within health care.Conclusion.?Health care is a complicated system based on cooperation and professionalism. We suggest that interprofessional training of students from all professions within health care should be a part of their education as a worthwhile preparation for their future professional work and to ensure high-quality health care.     

专科护理小组在预防呼吸机相关性肺炎中的作用

目的:通过介绍该院专科护理小组在预防呼吸机相关性肺炎(VAP)的作用,探讨VAP的专业化护理。方法:在借鉴国内外先进的VAP预防措施的基础上,成立VAP护理的专科小组,选拔高素质的专科护士,从而建立VAP预防的管理机制,制定VAP的临床护理方案。结果:专业化护理实施以后VAP的发生率有所下降,护理质量得到了医生的积极评价,护士的VAP预防护理能力得到了提高。结论:专科护理小组的专业化护理的实施能够有效提高VAP预防的护理质量。     

Coming full circle: mentorship in HIV/AIDS care.

The role of the mentor has been found to be crucial for learning, yet mentorship in HIV/AIDS nursing care has not been well documented. The purpose of this study was to (a) examine the characteristics of a nurse mentor in HIV care as perceived by nursing and medical students and HIV staff, and (b) explore an HIV nurse mentor's perceptions of her role and responsibilities in the professional development of students and staff. Mentorship, as a process of "coming full circle," was highlighted by the mentor's accounts of early influences in her career as well as students' and staff members' intents to facilitate the professional development of the next generation. The legacy of excellent HIV nursing care can be continued if expert HIV nurse mentors are identified and encouraged to work with students, inexperienced nurses, and health care providers. Health care institutions have a responsibility to foster mentorship in HIV/AIDS care to assure quality health care for clients and the professional development of expert nurses in HIV/AIDS care.     

Agreement: the origin of ethical action

The health care setting is an interweaving of human concerns. What is needed in this arena is an ethic--a guidance system centered on, and relevant to, these concerns. Such an ethic must be derived from, and appropriate to, the health care setting and the practice of health care professionals. This is established by the health care professional/patient agreement. This article will describe how a practice-based, symphonological ethic--an ethic based on agreement--can be brought to bear on the adversities faced by nurses and any other health care professional in any setting.     

The self-determination and family empowerment of nursing home residents

Long-term care for the elderly, disabled and handicapped is changing, with the trend shifting away from the prior emphasis on professional qualifications and cost management and toward allowing individuals increased authority to influence care policies and determine services provided. Within this trend, increased participation by family members, expanded care recipient rights, and family empowerment are driving the development of a new cooperative relationship between professional health care providers, care recipients and their families.     

护理专业小组在我院神经外科实施及其效果

目的:探讨神经外科护理专业小组对病区护理质量的影响。方法:该院神经外科分脑血管、脑肿瘤、脑外伤、脑功能康复等4个护理专业小组,并界定各小组的职责和任务。指定专业组长为学科带头人,带领组员开展专业小组活动,以解决本专业临床问题。结果:与实施前比较,实施后病区各项护理质量有所提高(P0.05,P0.01),2007年和2008年该病区连续荣获医院护理质量优秀奖和护理创新成果奖。结论:通过小组活动,调动了护士的主观能动性,提高了组长的整体水平,促进了临床护理质量的改善。     

Special needs of the deaf dying patient

Abstract

After briefly reviewing the advantages and disadvantages of three approaches to bereavement care which are found in the United States of America (professional care, mutual help, and hospice care) this paper describes a fourth type exemplified by the British organization cruse. This provides both individual and group counseling through a national network of selected and trained volunteer counselors backed by professional caregivers.     

社区护士临终关怀知识和态度情况调查及其影响因素研究

目的:了解社区护士临终关怀知识和态度的情况,研究不同背景护士临终关怀知识与态度的差异。方法:通过问卷对6所社区卫生服务中心的211名护士进行调查。结果 :仅19.0%的社区护士对临终关怀知识的掌握程度达到良好;社区护士临终关怀态度的得分处于中等水平。社区护士临终关怀知识的掌握情况与其学历、职称、工作年限有关(P<0.05),而临终关怀态度则与其学历、工作年限、收入、宗教信仰、民族、职称有关(P<0.05)。结论:通过加强社区护士临终关怀基础教育及继续教育,可帮助其具备更专业的临终关怀知识、技能及良好的心理素质,以促进我国临终关怀的发展。