Family-centered care activities by size of maternity service

Fifty-four of the 55 New York City maternity services in operation as of January 1, 1978 responded to a questionnaire eliciting information as to the availability of certain family-centered care practices. The larger maternity units, especially those in which more than 2,000 live births occur annually, were noted to have a higher prevalence and greater extent of family-centered care activities than the smaller units. Although size alone cannot be isolated as the critical factor in this analysis, its association with other factors helps explain the differences observed.     

Family-centered health care recognizes needs of patients, families, employees

Total patient care includes care for the needs of the patient's family who, up until hospitalization, have been the care-givers. A family-centered hospital attends to needs of patients, employees, and their families.     

Family-centered obstetrics]

Family centralised delivery model program in the Department of Obstetrics of Borsod County Hospital in Miskolc is reviewed. This program has been started since 1986. Significance and positive emotional effects are emphasized. Preparation for the birth, the presence of the husband in the labour ward, the alternative delivery position and the rooming-in system are discussed in detail. The natural birth's behaviour, which is very important in the life of the family, would be realized with this program.     

Family-centered obstetrics in Hungary]

The author has carried out a survey at hospitals in Hungary to examine how general family-centred obstetrics is, and to what extent obstetrics departments are able to meet the increasing demand for this exerted by society. In the course of the survey he focused on the characteristics of obstetrics departments, the preparation for delivery and maternity, open delivery-rooms, delivery with the partner, early mother-baby contact and rooming-in, and to what extent these operate. He describes the findings on the basis of data returned by 87 maternity departments, 81.3% of the total number of institutions in the country. The data reveals that 96.6% of wards have preparatory courses for delivery and maternity, 98.8% of open-delivery rooms welcome the partner at the delivery, early mother-baby contact is possible in 97.7% and 95.6% offer rooming-in. The study gives a comprehensive view of the present state of family-centred obstetrics offering an opportunity for everyone to re-evaluate their practices and to set up new objectives so that every mother and family can have easy access to family-centred obstetrics.     

Integrative specialty care: pursuing a convergent path with medical staff

Physician integration--This phrase raises myriad issues in the minds of health system executives: Can true win-win relationships be developed and sustained? Will moving toward physician integration be disruptive to the hospital environment? How will long-term profitability be affected?     

A study of child care staff turnover

This study grew out of the concern for the high level of child care turnover existing in group care facilities. The results indicate that demographic variables are far superior in predicting turnover than organizational factors. The demographic variable most closely associated with turnover is found to be age. Controlling for tenure revealed that during the first two years of employment, a child care worker's rationale for leaving his job changes based on the number of months he has been employed. The study also revealed that previous studies pertaining to job satisfaction appear to apply only to child care staff in residential settings who are 26 years of age or older.This is a more detailed and comprehensive report of a study initially outlined elsewhere (Ross, 1983).     

Pastoral care staff participate on treatment team

Clinical department members at Marianjoy Rehabilitation Center identified problems with their staffing conferences, in which they plan patient care. The problems included a deemphasis on social and spiritual aspects and an overemphasis on billing concerns. To correct these difficulties, the hospital adopted the Patient Evaluation Conference System (PECS), adding a pastoral care component. Central to the new system is the addition of pastoral care data from scales that assess patient status in four areas: (1) awareness of spiritual dimension of disability, (2) knowledge of spiritual resources, (3) skill in spiritual self-management, and (4) use of spiritual resources. Pastoral care staff write evaluations in easily understood language so other staff members can understand pastoral care's purpose. They formulate specific short-term objectives in order to delineate the pastoral services needed. Integration with the treatment team has resulted in greater accountability for the pastoral care staff. Patient progress charts now include specific pastoral care goals, and a daily report of pastoral care services is included on patient bills, although no fee is charged. Program evaluation and feedback systems to enable pastoral care staff to make more accurate assessments are planned. The new system has enhanced staff communication, service documentation, discharge planning, and the quality of pastoral care.     

Nutritional care in care homes: experiences and attitudes of care home staff

Background: The Food Award Barnsley (FAB) is organised for care homes that meet nutritional criteria based on national recommendations. Research (Thompson, 2003) highlighted that meeting FAB criteria is not an assurance that residents are receiving adequate nutrition. This is supported by studies demonstrating multiple individual/organisational factors influencing rates of malnutrition in care establishments (Abbasi & Rudman 1994; Health Advisory Services, 2000). To develop a training intervention to support FAB, an understanding of the role, perceptions and attitudes of care staff in the process of nutritional care was required. The main research aims were to describe staff's experiences of nutritional care of service users, to explore staff's attitudes towards nutritional care of service users and to highlight issues relating to nutritional care which could be considered when developing training programmes or provide the basis for future research. Methods: A care home that held the silver FAB, offered nursing and residential care and had more than 20 beds was chosen. Maximum variation sampling was used to select a cross‐section of staff in terms of position, level of education and length of service. Twelve semi‐structured interviews were recorded, transcribed and analysed using the template approach as developed by King (1998). The process from which the conclusions of the study were drawn was made clear through documentation. The audit trail within the final report demonstrates dependability and confirmation and hence the rigour of the study. Results: In general staff felt they were effective in identifying and addressing issues of malnutrition. However, from a dietetic perspective there was a fragmented approach to nutritional care. At all levels ‘confused role expectations’, lack of clear action planning, poor communication and attitudes towards malnutrition represented a significant barrier to good nutritional care within the home. Despite using a nutritional screening tool, staff relied more heavily on their own subjective judgement to identify residents who they thought were malnourished. Care home staff at all grades considered a poor appetite to be a ‘normal’ part of ageing and some felt that in conditions such as Parkinson's Disease it was expected that residents would lose weight. Portion sizes were reduced regardless of the need for compensation for reduced nutritional intake. Discussion: The lack of a coherent approach to nutritional care coupled with poor communication at all levels resulted in the risk that residents were not receiving appropriate nutritional care. Staff relied on their own judgement, not an objective measure; to identify residents they thought were at risk of malnutrition. These problems were compounded by attitudes of staff at all levels to nutrition, weight and ageing which resulted in lack of intervention in residents who were malnourished or at risk of malnutrition. Conclusion: This study highlights barriers to changing the process of nutritional care within the home which should be addressed through training, whilst ensuring national nutritional standards for provision of food are met. References Abbasi, A. & Rudman, D. (1994) Under nutrition in the nursing home: Prevalence, consequences, cause and prevention. Nutr. Rev. 52, 113–122. Health Advisory Services. (2000) “Not Because they are Old”. An Independent Inquiry into the Care of Older People on Acute Wards in General Hospitals. London: Health Advisory Services. King, N. (1998) Template analysis. In Qualitative Methods and Analysis in Organisational Research. eds C. Cassell & G. Symons, pp. 118–134. London: Sage. Thompson, L. (2003) Nutritional Perceptions among Staff Working in a Care Home for Elderly People and the Potential for Nutrition Education. BSc thesis, Leeds Metropolitan University.