Fall prevention through patient partnerships

Falls in community-dwelling older adults are often preventable, yet remain the leading cause of deaths due to injury and a major cost to the healthcare system. Primary care nurse practitioners who care for older adults can minimize the risk for falls by using specific assessment and prevention strategies.     

Improving patient care through the use of research

Developing research-based clinical practice is a challenging goal. Practice based on rigorously acquired knowledge is preferred to tradition, trial and error, or simply the advice of a colleague. The use of a systematic approach for this process will facilitate the clinician's ability to reach such a goal. An eight-step method is described as a basic guide to complete the process--from problem identification to dissemination of the results of the experience. Other important steps include summarizing the related research, development of an innovation, analysis of the setting, planning and implementing the change process, and evaluation of the outcomes. Rewards for engaging in this activity as well as limitations are addressed.     

Leadership: improving the quality of patient care

The satisfaction staff achieve from their work is in part determined by the style of management they work under. This article analyses the impact of a proactive leadership style on team performance and the quality of patient care.     

Enhancing patient safety: improving the patient handoff process through appreciative inquiry

Patient transfers from one care giver to another are an area of high safety consequence, as is evident by many studies and the Joint Commission on Accreditation of Healthcare Organization's Patient Safety Goals. The authors describe how one hospital made measurable improvements in a patient handoff process by using an unconventional approach to change called appreciative inquiry. Rather than identifying the root causes of ineffective handoffs, appreciative inquiry was used to engage staff in identifying and building on their most effective handoff experiences.     

A nurse-led ear care clinic: sharing knowledge and improving patient care

This article covers the nursing role within an ear care clinic in the hospital setting. The range of conditions managed in the clinic are listed and some of the current issues affecting ear care and ear, nose and throat (ENT) are discussed. The author conveys her enthusiasm for the appropriate management of wax encouraging colleagues to appreciate the negative affect wax impaction can have on patients. Hearing impairment is briefly mentioned and a screening list is provided to assess the hearing of older adults. Patient care is discussed and there are suggestions for the improvement of the provision of ear care within the community. The nurse practitioner discusses how to facilitate the sharing of knowledge with community practitioners. Study seminars, publications, the use of the hospital intranet site, treatment and discharge summaries can all be used to communicate new developments in patient care.     

Understanding partnerships in developing disabled entrepreneurs through participatory action research

Purpose.?The paper reports on a community disability entrepreneurship project in Khayelitsha and Nyanga, Cape Town, South Africa. Disabled people, Disabled People South Africa ( a national organization made up by disabled people's organizations), a non-governmental organisation and occupational therapists from the University of Cape Town collaborated with the focus to achieve economic empowerment of disabled people though the establishment of micro-enterprises.

Method.?Participatory Action Research strategies, which informed and monitored the effective development of the community disability entrepreneurship project, were carefully integrated with the existing principles of community development.

Results.?The participatory action research process provided an opportunity for shared learning and development. This article reports on the challenges and strategies faced by disabled people in the quest to establish themselves as entrepreneurs. The challenges that were identified through analysis from the experiences of participants were starting with nothing, lack of capacity and complexity of establishing working relationships. The strategies used were building group identity and developing capacity together. Indicators of positive outcome that emerged from an inductive content analysis are presented and discussed.     

Understanding partnerships in developing disabled entrepreneurs through participatory action research

Purpose. The paper reports on a community disability entrepreneurship project in Khayelitsha and Nyanga, Cape Town, South Africa. Disabled people, Disabled People South Africa ( a national organization made up by disabled people's organizations), a non-governmental organisation and occupational therapists from the University of Cape Town collaborated with the focus to achieve economic empowerment of disabled people though the establishment of micro-enterprises.

Method. Participatory Action Research strategies, which informed and monitored the effective development of the community disability entrepreneurship project, were carefully integrated with the existing principles of community development.

Results. The participatory action research process provided an opportunity for shared learning and development. This article reports on the challenges and strategies faced by disabled people in the quest to establish themselves as entrepreneurs. The challenges that were identified through analysis from the experiences of participants were starting with nothing, lack of capacity and complexity of establishing working relationships. The strategies used were building group identity and developing capacity together. Indicators of positive outcome that emerged from an inductive content analysis are presented and discussed.     

The role of Clinical Support Workers in reducing junior doctors' hours and improving quality of patient care

AIM: The aim of the study was to see if the introduction of Clinical Support Workers (CSWs) at a teaching hospital could reduce the medical work intensity for junior doctors without compromising the quality of patient care. BACKGROUND: The 'New Deal' and 'European Working Time Directive' have prompted hospitals to take a close look at junior doctors' hours and work intensity in order to make posts compliant. Following the Department of Health's publication 'reducing junior doctors' hours', it was felt that certain clinical duties could be shared with nursing staff. METHODS: Two audits were undertaken 8 months apart. The first was to determine the areas where the introduction of CSW would make the biggest impact. The second was to determine if this impact had had an effect on the intensity of work carried out by the junior doctors. FINDINGS: The CSW greatly reduced the number of cannulations and venepunctures performed by the doctors without any compromise to patient care. RELEVANCE TO CLINICAL PRACTICE: This study shows that other allied health professionals can be trained to carry out certain tasks that previously were only performed by doctors. This not only reduces the impact on junior doctors' hours but can also improve patient care, with fewer delays encountered when patients are waiting for a procedure.