Minimum standards, rules and regulations for classification and licensure of skilled nursing facilities and intermediate care facilities.

Loose-leaf for updating.

Minimum standards, rules and regulations for classification and licensure of skilled nursing facilities and intermediate care facilities.

"Effective July 28, 1980; codified September 28, 1984."

Preliminary report to the General Assembly regarding identified offenders in nursing homes and potential segregation of identified offenders into special units or facilities /

"Prepared January 11, 2005 [6]."

Recent Developments in the Autonomy and Governance of Higher Education Institutions in Hungary: the Introduction of the Chancellor System

After the change of regime in 1989, Hungarian higher education started to return to its Humboldtian tradition. It was widely accepted that academic freedom could be guaranteed by high degree of institutional autonomy manifested especially in structures of self-governance and avoidance of direct state supervision/interventions. Attempts to introduce boards and other supervising bodies were successfully resisted until 2011. The new government coming into power in 2010, however, introduced new mechanisms of supervision and changed institutional governance and reduced institutional autonomy considerably. Changes in the selection of rectors, the appearance of state-appointed financial inspectors and the newly appointed Chancellors responsible for the finance, maintenance and administration of institutions are important milestones in this process. In the paper I review these developments focusing especially on the analysis of the Chancellor system.

Autonomy and authority in the lives of children who work as domestic servants in Ghana

Limited literature exists on Ghana's child domestic servants, and researchers have found it difficult to locate and study these children. The research for this dissertation used qualitative research methodologies and non-probabilistic sampling techniques to make it possible to interview child domestic servants, their parents, employers and recruiters in Ghana. The findings from the qualitative analyses informed the second part of this study, which was quantitative and tested hypotheses using crosstabulations and logistic regression analyses that were based on survey data from the Ghana Statistical Service. Explanatory variables in the quantitative analyses included lineage, level of education and relationships to the household head. ^ This study located findings about the processes of children's recruitment into domestic servitude, their working conditions and methods of remuneration in theories of slavery to answer the question of whether or not child domestic servants are slaves. According to the findings, elite households in Ghana exploit children from rural regions because they have taken advantage of a historical practice that allowed children to live with older members of their extended families to provide domestic services and in return, be given the chance to receive formal education or to learn a trade. The participants in the qualitative part of this research described the treatments that they receive from their employers as slavery. Nevertheless, the processes of their recruitment and the age at which most of them accepted such job offers made it difficult to categorize a majority of them as contemporary slaves. ^

Beliefs of Icelandic elderly living in the greater Reykjavik area toward autonomy and paternalism in caregiving of the elderly

With the aging population and the increase in health care costs, issues of independence and autonomy will have a greater impact on formal and informal health care. Changes in occupational functioning that accompany increased age has raised the demandfor family assistance to the elderly. It is important for occupational therapists to understand the elderly's perceptions toward autonomy and paternalism in caregiving of the elderly because it is assumed that attitudes and beliefs affect how people interact and care for the elderly. A convenience sample of 57 Icelandic elderly were surveyed regarding their attitudes toward autonomy and paternalism in caregiving of the elderly. Results indicated that Icelandic elderly held strong beliefs toward autonomy but were undecided toward paternalism. Significant differences were found between groups. Elderly living at home indicated stronger beliefs on both autonomy and paternalism compared to those living in senior housing complexes. Elderly women held stronger beliefs in autonomy in contrast to the males, who were more paternalistic, and married subjects held stronger beliefs than did single respondents.

Nurses’ perceptions of nursing presence and the relationship between nursing presence and moral sensitivity in nurses working with people with dementia in residential care

Aim: The aim of this study was to measure nursing presence among nurses caring for people with dementia in residential care settings, and to investigate the relationship between nursing presence and moral sensitivity. Background: Nursing presence is a core relational skill in nursing and holds many benefits for nurses and their patients. Moral sensitivity is defined as how one recognises the moral elements of a situation, and how one’s moral or ethical decision making may impact on an individual. Methods: A descriptive, cross sectional quantitative methodology was used with a sample of 150 registered nurses. The Presence of Nursing Scale for Registered Nurses was used to investigate nursing presence, and the Moral Sensitivity Questionnaire for moral sensitivity. Results: Findings from the study demonstrated that participants agreed with the majority of elements of nursing presence, (mean 76.97, SD= 7.51). A mean score of 36.22 was evidence of a well developed level of moral sensitivity in participants. Nurses who perceived themselves to be highly present to their patients also scored highest on certain elements of moral sensitivity such as moral strength. Nursing presence was also found to be more developed in those participants that rated themselves as having higher levels of expertise based on Benner’s (1984) definitions. Older nurses also scored higher on nursing presence. There was a high level of agreement that factors such as lack of time (n=133), and heavy workload influenced nursing presence. Nurses, who were older and had longer clinical experience, were shown to have greater moral strength. There were differences in elements of moral sensitivity between groups of nurses who ranked themselves according to Benner’s (1984) competence framework with higher scores evident in the more expert groups. Conclusion: Overall, this study showed that participants had a well developed level of nursing presence, and certain elements of moral sensitivity are positively related to nursing presence. Nursing presence appears to be linked to the level of expertise of the nurse but factors such as time and workload do influence nursing presence.

Exploring Forensic Nursing Ethics and Practice: Roles, Loyalties and Photodocumentation Practices

Thesis (Ph.D.)--University of Washington, 2016-08

Professionalizing school governance: the disciplinary effects of school autonomy and inspection on the changing role of school governors

Since the 1980s, state schools in England have been required to ensure transparency and accountability through the use of indicators and templates derived from the private sector and, more recently, globally circulating discourses of ‘good governance’ (an appeal to professional standards, technical expertise, and performance evaluation as mechanisms for improving public service delivery). The rise of academies and free schools (‘state-funded independent schools’) has increased demand for good governance, notably as a means by which to discipline schools, in particular school governors – those tasked with the legal responsibility of holding senior leadership to account for the financial and educational performance of schools. A condition and effect of school autonomy, therefore, is increased monitoring and surveillance of all school governing bodies. In this paper, I demonstrate how these twin processes combine to produce a new modality of state power and intervention; a dominant or organizing principle by which government steer the performance of governors through disciplinary tools of professionalization and inspection, with the aim of achieving the ‘control of control’. To explain these trends, I explore how various established and emerging school governing bodies are (re)constituting themselves to meet demands for good governance.

Intensive care survivors’ experiences of ward-based care: Meleis’ theory of nursing transitions and role development among critical care outreach services.

Aims and objectives. To explore the psychosocial needs of patients discharged from intensive care, the extent to which they are captured using existing theory on transitions in care and the potential role development of critical care outreach, follow-up and liaison services. Background. Intensive care patients are at an increased risk of adverse events, deterioration or death following ward transfer. Nurse-led critical care outreach, follow-up or liaison services have been adopted internationally to prevent these potentially avoidable sequelae. The need to provide patients with psychosocial support during the transition to ward-based care has also been identified, but the evidence base for role development is currently limited. Design and methods. Twenty participants were invited to discuss their experiences of ward-based care as part of a broader study on recovery following prolonged critical illness. Psychosocial distress was a prominent feature of their accounts, prompting secondary data analysis using Meleis et al.’s mid-range theory on experiencing transitions. Results. Participants described a sense of disconnection in relation to profound debilitation and dependency and were often distressed by a perceived lack of understanding, indifference or insensitivity among ward staff to their basic care needs. Negotiating the transition between dependence and independence was identified as a significant source of distress following ward transfer. Participants varied in the extent to which they were able to express their needs and negotiate recovery within professionally mediated boundaries. Conclusion. These data provide new insights into the putative origins of the psychosocial distress that patients experience following ward transfer. Relevance to clinical practice. Meleis et al.’s work has resonance in terms of explicating intensive care patients’ experiences of psychosocial distress throughout the transition to general ward–based care, such that the future role development of critical care outreach, follow-up and liaison services may be more theoretically informed.

`A Reporter's Paper': The National Thrift News, Journalistic Autonomy and the Savings and Loan Crisis

Business journalism comes under persistent criticism for serving its historic readership of brokers and business people while lacking sufficient autonomy and failing to sufficiently question or challenge powerful corporate and economic interests. This is a dominant theme in media criticism of the savings and loan crisis⁠ and 2008 financial crisis.⁠ Against this backdrop, this dissertation asks: Is this critique valid, and if so, how can business journalism improve? To engage these questions, this dissertation examines the question of autonomy in business journalism in an unlikely place: the trade press. The central case study is coverage of the savings and loan crisis by the National Thrift News, a small financial services newspaper that won a George Polk award for its reporting in 1988. How could a small trade newspaper succeed in some instances when larger news organizations failed to connect the dots? The National Thrift News created a newsroom environment that celebrated reporter autonomy and independence. In some cases, it used its insider knowledge and consistent beat reporting to serve both its core readers and the broader society by uncovering savings and loan corruption. This study will highlight a long-running debate among theorists of journalistic professionalism by arguing that the commercial and advertising model in journalism does not inevitably compromise journalistic independence⁠ but rather can help pave a way forward for a more independent press. It therefore challenges the political economy critique of journalism, which holds that external forces such as capitalism harm press independence. This case suggests journalistic independence and individual agency remain powerful forces in newsrooms. Lastly, the dissertation argues that in an era of media downsizing, the trade press can perform an even more useful watchdog role over industry if the mainstream news media acknowledges and pursues some of the innovative trade reporting.

Computer and laboratory simulation in the teaching of neonatal nursing: innovation and impact on learning

Objectives: to evaluate the cognitive learning of nursing students in neonatal clinical evaluation from a blended course with the use of computer and laboratory simulation; to compare the cognitive learning of students in a control and experimental group testing the laboratory simulation; and to assess the extracurricular blended course offered on the clinical assessment of preterm infants, according to the students. Method: a quasi-experimental study with 14 Portuguese students, containing pretest, midterm test and post-test. The technologies offered in the course were serious game e-Baby, instructional software of semiology and semiotechnique, and laboratory simulation. Data collection tools developed for this study were used for the course evaluation and characterization of the students. Nonparametric statistics were used: Mann-Whitney and Wilcoxon. Results: the use of validated digital technologies and laboratory simulation demonstrated a statistically significant difference (p = 0.001) in the learning of the participants. The course was evaluated as very satisfactory for them. The laboratory simulation alone did not represent a significant difference in the learning. Conclusions: the cognitive learning of participants increased significantly. The use of technology can be partly responsible for the course success, showing it to be an important teaching tool for innovation and motivation of learning in healthcare.

Knowledge, perceptions and attitudes on the sexuality of nursing students and teachers

Introduction: The personal attitudes regarding specific aspects of sexuality are of interest to practices of personal concern, as they are to practices inserted in professional roles. General attitudes towards sexuality and sexual health were evaluated. Objectives: To describe the perceptions and attitudes of students and nursing teachers about sexuality. Methods: We used a mixed methods design with a sequential strategy: QUAN→qual of descriptive and explanatory type. 646 students and teachers participated. The Sexual Attitudes Scale (EAS) of Hendrick & Hendrick (Alferes, 1999) and Attitude Scale Address Sexual and Reproductive Health (EAFSSR) of Nemčić et al (Abreu, 2008) were used. Results: There are significant differences in the level of knowledge about sexuality depending on the sample (χ2KW (2)=18.271; p=.000): students of 1st year have lower levels. The profile of the four dimensions of EAS per sample is identical in all 3 samples, having responsibility the highest average value. In subscales EAFSSR per sample and sex there are significant diferences (p<.05) for all samples and uniform pattern was noted: females have higher median values, indicating that they have more favorable attitudes towards sexual health. Conclusions: Sexual attitudes reveal a multidimensional structure based in the female identity, that shows responsibility towards family planning and sexual education, as well as towards individual self-care regarding the body and sexual and reproductive health. An attitudinal profile by gender emerges, accentuating the polarity between male and female. The importance of the training process in nursing following the personal and social development of students is corroborated.