777 resultados para advanced nursing practice
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The Year 2000 Survey of Registered Nurses in Illinois reported within these pages is the seventh such study since 1986. The 2000 survey report presents information on all RN's registered in Illinois, but focuses primarily on those currently working in the state. A final chapter of this report provides information on the advanced practice nurse workforce in the state.
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Thesis (Ph.D.)--University of Washington, 2016-06
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Background: Periodontitis has been associated with a number of systemic diseases such as atherosclerosis, coronary heart diseases, and respiratory diseases. This study aimed to determine whether there is a significant difference in the prevalence of systemic diseases (a) in patients referred for periodontal care compared to the general practice population, (b) in patients attending a public hospital and private practices, (c) in patients attending public and private periodontal practices, and (d) among patients with periodontitis of varying severity. Methods: Charts of 1000 adult patients were selected from four clinics (University of Queensland (UQ) School of Dentistry Admissions Clinic, UQ School of Dentistry Periodontics Clinic, Private Periodontal Practice, and Private General Dental Practice). The prevalence of medical conditions was evaluated using validated self-reported health questionnaires. The periodontal condition was assessed from the most recent relevant radiographs in the files. Results: Periodontal patients had a higher prevalence of systemic diseases compared to the general practice population. Public patients had a greater prevalence of systemic diseases compared to patients in private practice for both general practice and periodontal patients. In patients with advanced periodontitis, bronchitis, hepatitis and rheumatoid arthritis were most prevalent. Patients with periodontitis also took more medications and were more likely to suffer from multiple conditions compared to the general dental population. Conclusions: Patients attending public dental facilities have an increased prevalence of systemic disease compared to those attending private practices. Furthermore periodontal patients have a greater prevalence of disease compared to general practice patients. Patients with moderate or advanced periodontitis show an increase in the prevalence of some systemic diseases previously reported to be risk factors for periodontal disease.
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This article reviews literature about the impact of advanced breast cancer on children and families. It is clear that the adjustment of the family is influenced by disease stage and maternal adjustment, the needs of the particular child relating closely to their developmental stage. Interventions with children and families to promote adjustment when a parent has advanced cancer are also discussed, including implications for clinical practice.
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We reviewed the use of advanced display technologies for monitoring in anesthesia. Researchers are investigating displays that integrate information and that, in some cases, also deliver the results continuously to the anesthesiologist. Integrated visual displays reveal higher-order properties of patient state and speed in responding to events, but their benefits under an intensely timeshared load is unknown. Head-mounted displays seem to shorten the time to respond to changes, but their impact on peripheral awareness and attention is unknown. Continuous auditory displays extending pulse oximetry seem to shorten response times and improve the ability to time-share other tasks, but their integration into the already noisy operative environment still needs to be tested. We reviewed the advantages and disadvantages of the three approaches, drawing on findings from other fields, such as aviation, to suggest outcomes where there are still no results for the anesthesia context. Proving that advanced patient monitoring displays improve patient outcomes is difficult, and a more realistic goal is probably to prove that such displays lead to better situational awareness, earlier responding, and less workload, all of which keep anesthesia practice away from the outer boundaries of safe operation.
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In many Australian hospitals a medical officer is available for urgent review of in-patients outside normal working hours. Current practice in nurse-initiated requests for medical officer involvement out of hours may adversely affect patient outcome as well as medical and nursing resource use at these times. Of 10 523 nurse-initiated requests for out-of-hours review recorded by medical officers at our hospital in 2002-2003, the most frequent reasons for the requests were medication review, IV fluid orders, IV resite, venesection and pathology review, none of which are related to acute changes in clinical condition. Requests for routine review of medication and fluid orders were found to be rarely essential and often inappropriate. Medical officer activity was highest before midnight and least after midnight, suggesting most requests are fulfilled in the evening. Several strategies to reduce inappropriate out-of-hours requests were identified. Routine tasks could be completed by primary treating unit staff before going off-duty. IV cannulation and venesection may be performed by appropriately trained phlebotomists or skilled advanced practice nursing staff. Meticulous ordering of 'as required' analgesia and night sedation would reduce unnecessary requests. Clinical protocols for nurse-initiated adjustment of drugs with variable dosing may also decrease inefficiencies. This would leave the ward cover medical officers more available for their primary function of urgent patient review.
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The Rural and Isolated practice endorsement for Queensland Registered Nurses has attracted interest from other state health authorities with respect to expanding the scope of practice of nurses working in rural and remote Australia. This discussion article outlines the endorsement program and sheds a spotlight on the program for the emergency and greater nursing community. The paper draws a similarity between rural and emergency nursing and stimulates the notion that other states could look to Queensland's model, for scope of practice expansion in other specialties such as emergency Nursing.
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Academic researchers have followed closely the interest of companies in establishing industrial networks by studying aspects such as social interaction and contractual relationships. But what patterns underlie the emergence of industrial networks and what support should research provide for practitioners? Firstly, it appears that manufacturing is becoming a commodity rather than a unique capability, which accounts especially for low-technology approaches in downstream parts of the network, for example in assembly operations. Secondly, the increased tendency towards specialization has forced other, upstream, parts of industrial networks to introduce advanced manufacturing technologies to supply niche markets. Thirdly, the capital market for investments in capacity, and the trade in manufacturing as a commodity, dominates resource allocation to a larger extent than previously was the case. Fourthly, there is a continuous move towards more loosely connected entities that comprise manufacturing networks. More traditional concepts, such as the “keiretsu” and “chaibol” networks of some Asian economies, do not sufficiently support the demands now being placed on networks. Research should address these four fundamental challenges to prepare for the industrial networks of 2020 and beyond.
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This review maps and critically evaluates the rapidly growing body of research in the strategy-as-practice field. Following an introduction on the emergence and foundations of strategy-as-practice, the review is structured in three main parts, based on the terminology, issues and research agendas outlined in the field. First, the paper examines the concepts of practitioners and praxis. A typology of nine possible domains for strategy-as-practice research is developed, based on the way that different studies conceptualize the strategy practitioner and the level of strategy praxis that they aim to explain. Second, the paper reviews the concept of practices, which has been adopted widely but inconsistently within the strategy-as-practice literature. While there is no dominant view on practices, the review maps the various concepts of practices that inform the strategy-as-practice field and outlines avenues for future research. The final section attends to the call for strategy-as-practice research to develop and substantiate outcomes that may better explain or inform strategy praxis. Five categories of outcomes are found within existing empirical studies, and an agenda for building upon this evidence is advanced. The paper concludes with a summation of the current state of the field and some recommendations on how to take strategy-aspractice research forward.
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Since the 1970s breast cancer services have witnessed considerable changes in the management of patients. One significant change was the introduction of specialist core personnel, including the breast care nurse (BCN). The role of the BCN has been gaining credence rapidly in the British NHS and this service is perhaps the paradigm of care for other services. With the lack of specific evidence of the role of specialist nurses in the breast care team, the current study aims to explore this area by in-depth interviews with core team members, and observations of 16 multi-disciplinary teams in England. The study explores the following themes: Nurses' unique informal management leadership role in ensuring the co-ordination, communication and planning of the team work; nurses' innovatory role in making the bureaucracy respond to patients and their relatives needs; nurses supportive role in the provision of expert advice and guidance to other members of the team; nurses confidence and humour in well-performing teams; and the limitations of the professional role of the breast cancer nurse. This study indicates that there is evidence that the BCN is practicing at an advanced level of practice. However, there is a severe lack of evidence-based description of that advanced practice. Cancer nurses including the BCNs should develop and participate in programmes of research in line with cancer legislation in order to build an evidence base that ultimately supports their unique role. © 2004 Elsevier Ltd. All rights reserved.