英国社区护士现状及面临的挑战

本文介绍了英国社区护士的分类,各自的工作职责,社区医疗保健现状,及社区护士面临的竞争与挑战:社区护士的就业已由国家及地区卫生保健机构的统一安排而转向通过与私人诊所签订合同的劳务市场。面对现实,英国社区护士也采取了相应的对策。     

英国护士主导服务的启示

英国护士在其医疗卫生体系中发挥越来越重要的作用,尤其是在社区卫生保健、护理专家门诊等方面。该文通过介绍英国"护士主导服务"的发展条件、发展现状,结合我国护理现状,给出切实可行的实施建议,为护理教育、社区、门诊护理的发展提供借鉴。     

社区护士工作压力源研究

社区护士不同于临床护士，其工作压力不仅影响社区护士健康，而且影响社区护理质量。国内对临床护士压力源研究报道较多，而对日益发展的社区护士压力源的研究较少见到。本研究旨在探讨社区护士工作压力源，以帮助管理层制订减压措施，保障社区护理质量，促进社区护理的发展。     

英国护士在慢性病管理中的作用及启示

由于英国人口老龄化的加剧以及初级卫生保健医生的短缺,英国护士在慢性病管理中发挥着重要作用,提供了有效且具有成本效益的初级医疗保健。 文章阐述了英国慢性病管理现状、护士在慢性病管理中承担的角色及效果,结合我国慢性病护理工作现状,建议应加强我国社区护士人力资源配置,规范继续教育培训,应用临床实践指 南,重视护士在慢性病管理中的作用。     

英国社区护理见闻及借鉴

英国是护理事业的发源地,本文介绍了英国优质的服务理念、科学的管理机制、相对独立的工作体系和完善的教育培训计划.借鉴英国的做法,建议应加强人文教育宣传,进一步转变社区护理理念,提高护理服务的意识;加强社区护理人才队伍建设,提高社区护理综合水平;加强对全科团队中社区护理角色功能的研究,充分发挥社区护士的功能.     

英国开业护士概况及启示

在英国,开业护士参与了社区诊所、急诊、儿科等领域的卫生服务。开业护士拥有处方权,提高了服务效率,改善了医疗服务效果,节约了社会成本。该文对英国开业护士的历史、现状、培养及能力要求、管理、优势评价方面进行介绍,建议我国应探索开业护士参与卫生服务模式,建立完善培养体系,制订明确的管理体制,扩充开业护士人力资源。     

临床护士转型社区护士培训的研究进展

人类健康对社区护理、社区保健的需求越来越迫切,社区护理已成为21世纪护理发展的方向.学校培养目前无法满足社会对社区护士的大量需求,由医院临床护士通过转型培训的社区护士已成为社区护士的主要来源,培养合格的社区护理人才是亟待关注的重要课题,借鉴国内外先进的社区护士培养经验,探讨一条有效的临床护士转型社区护士的培训模式.     

我国社区护士的现状及对策

指出目前我国社区护士数量严重不足；社区护士素质偏低；知识结构不适应社区护理的要求；社区护士的护理活动内容局限；社会地位低下。提出有必要建立完善的社区护理教育体系；加强对在职社区护士的继续教育和培训；增加社区护士的人员配备；逐渐扩展社区护理内容；呼吁社会扶持社区护理，提高社区护理人员的社会地位，以促进社区护理健康发展，为使我国社区护士成为初级卫生保健的主要力量做好准备。     

三级甲等医院高年资护士向社区护士转型的调查分析

目的:了解医院高年资护士向社区护士转型的情况。方法:采用自行设计的问卷调查表对柳州市2所三级甲等医院转型社区工作的高年资护士进行调查。结果:有71.11%的护士已转变了护理观念,28.89%的观念未转变;对社区护理角色的认同度较高;拓展了社区护理业务,但仍有待加强;71.11%护士认为应加强培训公共卫生等相关学科知识;只有8.89%的护士对社区工作感到满意,不满意的主要原因是待遇差。结论:应加强培训,提升综合素质,进一步转变护理观念,改善社区护士待遇,提高护士积极性,社区护理队伍配备应考虑梯队建设,以促进社区护理良性发展。     

社区护士业务提升需求的调查分析

社区护理的发展需要高素质的社区护士，社区卫生服务能否持久、深入和健康地发展，关键是社区卫生人才建设。发展社区护理，拓展护理服务，探索社区护理管理制度已引起各级政府的高度重视，我国社区护士存在数量紧缺、学历偏底、培训不足、缺乏社区护理理念等问题。我们通过对社区护士的业务需求调查，以探索社区护士业务提升的模式，现将有关结果报道如下。     

Vision for the Future of Public Health Nursing: A Case for Primary Health Care

Abstract Canada has embraced the goal of the World Health Organization to achieve health for all. This has created a paradigm shift from a focus on direct care to include health promotion and community development, consistent with a primary health care approach. Nevertheless, a clearly articulated vision for the role of public health nurses (PHNs) is lacking. Despite the fact that PHNs make up the largest group of health care workers in the community, their collective opinions and ideas regarding their own practice are seldom sought in a systematic manner. We conducted a survey of public health nurses in British Columbia. Using a two-wave Delphi approach, PHNs were asked to define issues for the future of public health nursing, and to state publicly their preferences for change and transformation. The responses were rank ordered, analyzed, and compared with recent nursing and health care literature to interpret their content. The PHNs' visions for tomorrow agree with concepts of primary health care and community development, and have implications for community health nursing's practice and education.     

Health systems and policy in the USA and in the United Kingdom: an overseas programme

An international programme, especially in a developed country, dramatically increases a student's understanding of health care systems. Students from a university programme in the USA learn about the development and structure of the British National Health Service through lectures and discussion in the US and England, and through 2 weeks of experience in England which include working with community health nurses in a district health authority. Related special experiences are planned which may include interviews with nurses involved in policy development, education, administration and specialty areas. Each student identifies an interest to pursue independently from the perspective of community care. As the student participates in the programme, alternative ways to give familiar care challenge formerly held beliefs. Health care emerges as a dynamic system, one that responds to issues, effects policy, and influences the role of health care providers.     

The needs of patients requiring home enteral tube feeding

A report by the British Artificial Nutrition Survey of the British Association for Parenteral and Enteral Nutrition has highlighted the needs of patients using home enteral tube feeding. Many are frail and elderly and require careful discharge planning from hospital and co-ordinated, multidisciplinary care in nursing homes or their own homes on return to the community.     

The functions of the nurse in an integrated national health service.

The British National Health Service was reorganized in 1974 when the hospital services and the community health services, previously administered separately, were brought together into one organization: the Area Health Authority. The reorganization was a culmination of developments triggered off as long ago as 1589 when the first Poor Law Act was passed, but more particularly, the reorganization was the natural outcome of a number of important government and professional nursing reports published during the past 30 years. From 1974 the community and hospital nursing services have, therefore, been amalgamated under the direction of one head of the nursing services: a district (or area) nursing officer, who, together with medical, administrative and financial colleagues, manages the health services on a day-to-day basis in a team managing by consensus. The nurse's role in the management teams is both executive and professional: the nurse's unique contribution is that he/she brings a nursing perspective to management. The new nursing service organization has provided new opportunities for reorientating middle nurse managers to a clinical role. It has also provided opportunities for innovating integrated teams of community and hospital nurses and for developing specialist nursing roles. Nurses are also now able to make other additional contributions to health care by their involvement in health care planning team activities and by their membership of the statutory area and regional nursing and midwifery advisory committees. But, on the whole, changes and influence on health care have been brought about chiefly by changes in the managerial structure of British nursing, which is a perspective of the British nursing profession that seems to have been all pervasive since Florence Nightingale's reforms and which is perpetuated by the powerfully socializing agent of British nurse training. As health care and nursing service organizations should be means towards the end of good patient care, it may be timely to focus on the suggestion of autonomous nurse practitioners supported by a separately organized administrative structure.     

Stress and the community mental health nurse: the development of a measure

BROWN D., LEARY J., CARSON J., BARTLETT H. & FAGIN L. (1995) Journal of Psychiatric and Mental Health Nursing 2 , 9–12: Stress and the community mental health nurse: the development of a measure. : The issue of stress amongst health care professionals is currently a major concern within the British National Health Service. It is important for researchers to develop both reliable and valid psychometric measures to assess occupational stress. This paper outlines the development and piloting of a measure of professional stress for community mental health nurses, the CPN Stress Questionnaire (Revised). Data on the reliability and validity of this new measure are presented. It is concluded that this measure has good psychometric properties. A range of possible research applications is outlined.     

Specialist or generic community nursing care for HIV/AIDS patients?

Improved management of HIV-related illness means that patients spend over 80% of their time in non-institutional settings Most community-based health care in the United Kingdom is provided by primary health care teams general practitioners and community nurses, with support from social workers However, in many areas specialist HIV services have assumed responsibility for the care of HIV/AIDS patients, and primary health care teams have only played a marginal role Our study examined patterns of community nursing for HIV/AIDS patients in one regional health authority, North-East Thames (NETRHA) Interviews with 77 people in seven health districts included community nurse managers, clinical nurse specialists (CNS) HIV/AIDS and palliative care nurses The appropriateness of different nursing models was assessed, taking into account the changing epidemiological and demographic profile of the disease, the influence of dedicated HIV funding, and the effect of recent British National Health Service reforms Three models of care have developed in NETRHA specialist HIV teams, individual CNS HIV/AIDS acting as a resource to generic staff, and care given by generic community nurses Our work suggests that both generic community nurses and patients benefit from specialist input, and that this should be provided using CNSs HIV/AIDS in an advisory and facilitative capacity     

我国社区护理的现状和进展

介绍了我国社区护理的现状和进展 ,重点阐述了社区护理发展的可行性与必然性、社区护理体系、社区护理人才的培养、社区护理的内容、社区护理发展趋势。     

Comox Valley Nursing Centre: From Collaboration to Empowerment

Abstract The Comox Valley Nursing Centre was initiated as a two year demonstration project by the Registered Nurses Association of British Columbia (RNABC) and funded by the Ministry of Health. The purpose of the project was to demonstrate innovative nursing practice in a primary health care context. Findings from the project were expected to inform provincial health care planning, nursing scope of practice, and health and nursing policy development. A free standing nursing center was planned and implemented through a collaborative effort by RNABC, nurses and community residents. An external team of researchers evaluated the project using a variety of methods, including participatory action research. During the project an innovative nursing practice, based on principles of collaboration, developed and has continued during the extended provincial and regional funding of the Centre. Drawing from the evaluation findings, case studies and using Henneman, Lee and Cohen's (1995) concept analysis of collaboration, this paper describes how the principles of collaboration were actualized or suppressed. The paper examines how collaboration impacted empowerment for nurses, clients and the community. Lessons learned about the reciprocal relationships between collaboration and empowerment, implications for nursing practice, and how the approach can contribute to a better understanding of the impact of collaborative practice approaches on health care delivery are discussed.     

Creating a new dynamic in Aboriginal health

In early 2004, an evidence-based prenatal care workshop was held for community health nurses working in First Nations communities in British Columbia. The purpose of the workshop was to begin a dialogue on the use of evidence to improve prenatal care in First Nations communities. Specifically, selected models of knowledge transfer to improve care were introduced and discussed. Of the 81 nurses who participated, 52 completed a feedback questionnaire. Most of the participants (73%) were community health nurses. They worked across diverse geographic settings and health-care administration models (federally managed, band managed, tribal council managed). Seventy-three per cent of the nurses reported that a participatory model of knowledge transfer was important or very important. They also identified priority target audiences (stakeholders) for knowledge transfer strategies. Exploring stakeholders' views, values and priorities related to prenatal care and creating informal dialogue among these groups was identified as a next step in participatory transfer and exchange of knowledge to improve prenatal care in First Nations communities.     

我国老年保健中社区护理问题分析及展望

分析我国老年人的健康问题、社区护理在老年保健中的作用、老年社区护理现状以及老年社区护理目前存在的问题,展望我国老年社区护理的发展模式.