美国临终关怀护士资格认证现状及其启示

专科护士资格认证制度为达到专业标准的护理从业人员提供认证。在国外被高度重视[1],1991年,美国成立了国家唯一许可的资格认证机构———美国专科护士认证委员会(The Accreditation Board     

养老机构心理服务中的问题及对策

介绍心理服务开展现状,指出目前存在心理服务对象和内容局限、心理服务开展的管理机制不够完善、心理服务的提供者服务能力不强等问题,认为需通过加强内部管理,分类开展心理服务工作,提高心理服务的针对性,加强养老机构工作人员的心理照护培训,提高机构心理服务的专业化水平,提升志愿者服务队伍素质,建立长期、有效的志愿服务,加强政策扶持等一系列措施,有效促进养老机构心理服务质量提升。     

美国养老机构服务质量评价的特点及启示

随着全球人口老龄化的快速发展,有效应对激增的养老服务需求成为世界性难题.日益严重的高龄化趋势,提高了失能、半失能老年人对养老机构生活照料、康复护理和紧急救援等服务的依赖.养老机构作为社会养老服务体系中的重要组成和基础支撑,其社会作用和价值逐步突显.美国作为最早进入老龄化社会的国家之一[1-2],在应对人口老龄化方面经验丰富,建立了相对完善的社会保障制度和养老服务模式,也在养老机构的运行与管理,特别是养老机构的服务质量监管方面积累了大量实践经验,有着世界上非常成熟的养老机构服务质量评价体系[3-5].我国养老体系建设处于初步阶段,机构养老尚在发展过程中[6],存在着养老服务质量评价标准有待厘清,服务规范有待加强,服务队伍专业水平有待提高等诸多问题.本文对美国养老机构服务质量评价体系进行综述,旨在为我国养老机构服务质量评价体系的建设提供参考.     

中美养老服务研究热点的可视化对比分析

[目的]了解近25年养老服务研究热点并预测未来我国养老服务发展趋势。[方法]以"Web of ScienceTM核心合集"(WOS)和中国知网数据库中1993年—2017年发表的养老服务文献作为研究对象,利用CiteSpace软件,展现近25年中美养老服务关键词共现知识图谱。[结果]美国养老服务的研究热点总结为五大类:一是关于护理院养老质量的研究;二是关于家庭和社区养老服务的研究;三是关于老年人心理服务的研究;四是关于老年人长期护理的研究;五是关于老年人健康老龄化的研究。我国养老服务研究热点为"养老模式""养老服务体系""医养结合""智慧养老""政府购买"5个方面。[结论]中国养老服务在未来将会以构建养老服务生态圈、多元化养老模式、建立专业化养老服务队伍以及提供个性化养老服务内容为主要发展趋势。     

全国357家省、市两级采供血机构无偿献血者服务队伍的发展现状与问题

目的通过对全国无偿献血者服务队伍现状调查,分析全国无偿献血者服务队伍总体发展趋势。方法对全国357家采供血机构无偿献血者服务队伍建设、发展请况、在册人数、有效运行人数进行统计,采用SPSS13.0软件进行数据分析。结果血液中心无偿献血者服务队伍有效运行率为39.70%(18 181/45 797)远低于中心血站的72.49%(99 862/137 769),差异有统计学意义;按采血量比较献血者服务队伍有效运行率:<2吨组(603/1 670=36.11%)和≥25吨组(50 425/90 625=55.64%)都低于2吨≤采血量<5吨组(5 914/8 764=67.48%),差异有统计学意义。结论由于地理位置、资源配置、人员流动性等因素,使得采血量<2吨、≥25吨以及血液中心组献血者服务队伍有效运行率都不理想。我国无偿献血志愿服务事业刚刚起步,发展中仍面临着诸多问题与困境。但随着社会的进步,越来越多献血者服务队伍发展的先进经验和理念应运而生,献血志愿服务工作必将卓有成效的服务于献血事业。     

北京地区护理专业专科层次成人学历教育情况的调查

成人学历教育的发展与社会需求患患相关,为能更好地为北京市医药卫生事业贡献力量,首都医科大学继续教育学院对北京地区各级各类医院进行了问卷调查,以了解用人单位、从业人员对成人学历教育专科层次护理专业的意见和建议.系统地研究护理专业的社会需求状况、生源综合素质及学生的学习愿望,将有利于准确把握当前护理专业专科层次教育教学的状况和趋势.     

建立社区护理服务中心的构想

本文就建立社区护理服务中心的领导体制、服务队伍、服务模式等主要问题进行了初探，提出了相应的可行性构想。     

我国家庭照顾者的研究现状分析

家庭照顾者,简言之就是在家里为特殊对象提供医疗服务和生活帮助的人,他们也是卫生服务队伍中的重要一员.     

对老年护理职业教育多元化的思考

随着人口老龄化的快速进展和高龄老人对护理需求的不同,养老服务日益差异化、多样化,服务岗位和从业人员包括老年人自身、子女、保姆、护工、老年护理员、社区护士、注册护士和社区卫生服务机构和养老机构的管理人员.差异化养老对老年护理教育提出了严重的挑战,应对的主要措施应该是多元化的职业教育,包括全民的健康教育、养老机构护工的职业教育、临床护士的转岗培训和高校老年护理专业及课程设置,既要培养全民的养老、防老意识,又要造就一支强大的有老年护理专业技能的养老队伍,同时要加速高级老年护理与管理人员的培养.     

国际认证哺乳顾问发展现状及研究进展

我国母乳喂养现状严峻,为孕产妇提供专业的母乳喂养服务迫在眉睫。本文介绍了国际认证哺乳顾问(IBCLC)认证条件、认证培训、认证考试和资格再认证的情况,归纳了哺乳顾问国外的应用现状,并针对国内存在的问题进行分析,提出推进队伍建设、明确角色定位和借助网络推动哺乳顾问向基层社区和农村地区发展。     

消毒供应中心院级资格认证的培训方法与效果

目的探讨消毒供应中心实施院级资格认证的培训方法与效果。方法成立消毒供应中心岗位规范化培训小组,实施师资的选拔及培训,建立岗位规范化培训教材和题库,组织规范化培训和考核,考核合格者颁发证书。结果 24名工作人员中有22名通过考核,获得消毒供应中心"院级岗位资格认证书";提高了消毒灭菌检测合格率(P0.01或P0.05)。结论经过培训及认证,可以提高消毒供应中心工作人员专科水平及工作服务质量。     

宜春市养老现状调查与对策

目的:了解宜春市老龄化状况及养老机构现状。方法:采用统计资料收集、问卷调查和个人深入访谈等方式对宜春市60岁以上的老人及各登记注册正常运营的养老机构进行调查分析。结果:通过调查发现,我市60岁以上的老人75.48万人,占总人口的13.8%。宜春市养老机构多为公办性质,占91.6%,从业人员存在学历低、年龄偏大且大多数人没有经过专业培训,多数机构存在辅助器具配置低的状况。结论:宜春市人口老龄化形势严峻,养老问题复杂,已是未富先老,未备先老。养老机构主要由政府承办,存在着总量不足、床位缺口大、机构设施水平参差不齐且管理不规范、养老护理队伍数量短缺、医疗康复与精神慰藉等专业性服务供给不足的问题。现有的养老服务市场与人们的养老需求发展不同步,社会养老力量非常薄弱,构建多元化养老模式、加强养老护理队伍建设及规范养老机构市场管理势在必行。     

Pelvic floor dysfunction: a scoping study exploring current service provision in the UK, interprofessional collaboration and future management priorities

Objective: Pelvic floor dysfunction (PFD) has a significant socioeconomic and healthcare cost. This study aimed to investigate current service provision for PFD in the UK, highlighting any gaps and areas for improvement to inform future service improvement. Methods: A three‐phase design comprised a scoping literature review, consultation survey with frontline practitioners from four key professional groups and an overarching synthesis. An interpretative analytical framework was informed by the concepts of interdisciplinary and interprofessional collaboration. Results: Empirical evidence on PFD service provision is limited. No overarching strategic approach to PFD as a single clinical entity in the UK was identified. Two hundred and forty‐three medical, nursing and physiotherapy practitioners from different clinical subspecialties participated in the survey. Access and availability to services, models of delivery and individual practice vary widely within and across the disciplines. Time restrictions, mixed professional attitudes, lack of standardisation and low investment priority were identified as major barriers to optimal service provision. Five overlapping areas for improvement are highlighted: access and availability, team working and collaboration, funding and investment, education, training and research, public and professional awareness. Conclusions: Current services are characterised by a fragmented approach with asynchronous delivery, limited investment and poor interprofessional integration. An improved service delivery model has the potential to improve outcomes through better interdisciplinary collaboration and efficient use of resources.     

Trust and managerialism: exploring discourses of care

AIM: This paper reports a study that explored the relationship between trust and managerialism through an analysis of professional discourse. BACKGROUND: Managerialism is a distinct set of discourses and practices related to managerial effectiveness, flexibility and consumer responsiveness that have come to characterize debates over the provision of health and welfare services across the developed world. At the same time, trust has attracted increasing academic and political interest. Managerial discourses are critical of healthcare professions and the way they operate. Professional opinions are challenged as representing the interests of professions rather than service users; as a consequence trust is contested. However, where practitioners are both professionals and managers, the boundaries between these discourses become blurred. Moreover, paradoxical development occurs where increasing autonomy for practitioners is accompanied by a strengthening of managerial controls over their activity. METHOD: Discourse analysis was used to explore the text from two genres, academic literature and interviews (n = 17), in the context of community residential services for people with learning disabilities. The study was conducted in 2001. FINDINGS: Two broad themes were identified, each with a number of sub-themes. The first focuses on the relationship between managerialism and trust located around the management of expectations. The second, 'the politics of care', explores the way professional and managerial discourse articulate to produce complementary and contradictory positions. CONCLUSION: The colonization of professional activity by managerial discourse has produced a context where professional activity is defined by a series of managerial imperatives; trust, which was once the product of intimate social activity is now shaped through techniques based on distrust such as audits and quality monitoring. Nevertheless, the persistence of tensions between trust and managerialism suggest an ongoing struggle for professional autonomy in the face of increasing managerial controls.     

美国磁性医院认证体系对我国护理的启示

磁性医院是指在护士严重短缺的状况下仍然能像磁铁一样吸引专业护士的加入,降低护士的离职率,拥有高质量的护理人员队伍,提供优质的护理服务的医院.磁性医院的评审已经在许多发达国家实行,并拥有一套健全的认证体系.笔者通过对美国磁性医院主要特点、评审标准、申请资格与程序等认识,对我国严重护士短缺的现状进行思考,并提出自己的建议:合理配置护理人力资源,分层使用护理人员;强化有效的护理人员激励机制;加快专科护士的培养,推进护理专业化发展;尝试在我国创建护患双满意医院的评选等.     

What a discursive understanding of interprofessional team meetings might reveal: an exploration of intellectual (learning) disability managers’ performances

ABSTRACT

Clinical and academic understandings of interprofessional working are focused mainly on individual factors such as knowledge about different professional roles, and organisational opportunities for interprofessional working (IPW). Less research has examined what happens between people at an interactional level, that is, how interprofessional working is conducted in everyday face-to-face interactions in clinical practice. The current paper proposes a discursive framework for understanding what constitutes IPW in interprofessional meetings at this interactional level. Clinical effectiveness meetings held in intellectual (learning) disability services were used as an example site for IPW. The analysis explored how agenda change points were negotiated, appropriate as agenda change points require collaboration (or agreement) between practitioners to progress to the next point The study found changes in agenda points were accomplished by practitioners conjointly through using discursive strategies including closing questions, and resources such as professional identity and laughter. The agenda provided a frame for the institutional order of the meetings, invoking a trajectory towards timely completion. However, this institutional order was at times subordinated to an ‘order of concern’, which seemed to enable challenges by managers to the meeting Chair and the agenda that demonstrated adherence not only to the procedural nature of the meetings, but also to the needs of service users and the services discussed. We suggest discursive strategies, resources, and both institutional orders, and order of concerns might provide a framework for developing future training and research, that is able to illuminate how IPW might be enacted in face-to-face team meetings.     

Mental health service users' and practitioners' experiences of engagement in assertive outreach: a qualitative study

Assertive outreach services have been central to community mental health policy within the UK. These multidisciplinary teams were established to engage with service users who have severe and enduring mental health problems and have found traditional community services unable to meet their needs. Mental health nurses have a pivotal role in these multidisciplinary teams, yet the nature of these relationships from the perspective of those who work in and receive care is poorly understood. This study set out to explore the nature and meaning of engagement for practitioners and service users within assertive outreach services. A qualitative approach, informed by philosophical hermeneutics, underpinned the study. Participants were recruited from a single assertive outreach team in the UK. To be eligible for the study, mental health practitioners needed to be employed within the assertive outreach team. All service users residing in the community and receiving care from the team were also eligible for inclusion. In total 14 interviews were conducted with mental health practitioners and 13 with service users. Data analysis was informed by Turner's method. Four themes emerged from the data; contact, dialogue, transformation and shared understanding. Meaningful engagement was found to manifest itself through experiences such as providing and receiving practical assistance, having a genuine two-way conversation and valuing the experiences and personal attributes of the other person. The findings indicate that engagement is an active, dynamic and skilled process, which leads practitioners and service users to transform together to create a new relationship.     

The Gulbenkian Foundation: The educational programme

Abstract

Integrated services which utilise the expertise of team members along care pathways are evolving. Changes in service structure and subsequent team working arrangements can be a challenge for practitioners expected to redefine how they work with one another. These services are particularly important for the care of frail older people. This exploratory study of one newly forming team presents the views of staff involved in establishing an interprofessional healthcare advisory team for older people within an acute hospital admissions unit. Staff experiences of forming a new service are aligned to a model of team development. The findings are presented as themes relating to the stages of team development and identify the challenges of setting up an integrated service alongside existing services. In particular, team process issues relating to the clarity of goals, role clarification, leadership, team culture and identity. Managers must allow time to ensure new services evolve before setting up evaluation studies for efficiency and effectiveness which might prove against the potential for interprofessional teamworking.     

中美养老机构服务内容研究

随着人口老龄化程度的不断加剧,养老服务需求也逐渐增加。养老机构作为社会养老服务体系的重要组成部分,其作用和价值逐渐突出。本文通过对中美两国养老机构的分类、养老机构提供的服务内容、养老机构的分级及老年人如何选择养老机构进行综述,明确我国养老机构服务发展中所出现的问题,从而对我国养老机构服务的内容提出建议。