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Effective clinical policies in a district general hospital

HEALTH CARE ANALYSIS 1998年第4期6卷 295-304页

作者： Gordon, IJ Jones, ES Whiston Hosp Prescot Merseyside England

Effective clinical practice in a hospital needs current knowledge together with the skills and right attitude;these should be applied continuously. Failure of this system can be due to ignorance or arrogance. We attempted to correct these deficiencies by formulating a set of policies which were enforced from 1962 to 1983. The policies related to the following: intensive care (including asthma, nutrition and organ donation), drug prescribing and resuscitation. We believe that these rules improved patient care and the standards of training;the prescribing policy also saved money. (C) 1998 John Wiley & Sons, Ltd.

关键词：哮喘/治疗膳食学/组织和管理药物利用评审英格兰医院区/组织和管理医院区/标准医院综合/组织和管理医院综合/标准重症监护/标准组织方针病人入院病人医疗护理/标准医师诊疗模式卫生保健质量复苏术/标准组织供者人类

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Competency standards in the context of infection control

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AMERICAN JOURNAL OF INFECTION CONTROL 2000年第3期28卷 228-232页

作者： Winchcombe, J So Cross Univ Fac Hlth Sci Lismore NSW Australia

Background: To ensure quality patient care and enhance career development, competency levels of infection control professionals (ICPs) need to be identified and strengthened so that high standards of practice are established and maintained, Objective: The purpose of this study was to apply a modified version of Benner's (1984) "Novice to Expert" model of skill acquisition to levels of competency and to seek to measure practices of the specialist practitioner in the context of infection control. Method: A self-administered questionnaire was developed and mailed to 464 members of the Infection Control Association, New South Wales (NSW) Inc, Australia. Results: Seventeen percent of respondents reported full-time infection control responsibilities, 78% part time, and 5% unknown. The sample comprised 4 groups of ICPs. The largest groups were registered nurses, representing 37% of total respondents and "Other health care professionals" representing 35%. Forty-nine percent of the sample had completed a basic or advanced infection control certificate course, 21% had completed a bachelor of nursing or health science degree, and 21% had completed other studies not related to the specialty. Key findings of this study indicated that the clinical nurse consultant group rated their individual levels of skills and knowledge as proficient (competent). Although a small percentage from this group had completed higher level education, years of service within the specialty contributed to an increase in competent performance. This was also applicable to the other groups studied. Conclusion: The findings highlighted the need for a framework to be developed on which to build a model to measure and reflect progression of infection control competence at the beginner, advanced beginner, competent, and expert levels. Continuing education as a means of achieving competence needs to be further developed, maintained, and nurtured so that the ICP can acquire appropriate specialty knowledge and sk

关键词：教育护理继续感染控制/标准临床护理医生/教育临床护理医生/标准护士/标准病人医疗护理/标准卫生保健质量问卷调查人类

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Dilemma. Role conflict

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Accident and emergency nursing 2000年第2期8卷 79-81页

作者： Dimond, B. Sbaih, L. University of Glamorgan United Kingdom College of Nursing Midwifery and Health University of Manchester United Kingdom

I was in the final year of my nursing degree and had decided to do a research project on ‘stress amongst staff nurses in A&E’. I had planned my data collection carefully and decided to collection information by interviewing a number of colleagues in my department. I approached the nurse manager and discussed my ideas with her and then asked for colleagues to volunteer to be interviewed. Several staff nurses came forward and I arranged to interview them. I thought that my data collection was going really well until one nurse, in one of the interviews, told me that she had been so stressed on her shift, the previous day, that she thought that she may have made a drug error. I didn’t know what to do, I had promised my colleague that information collected during the interview would be confidential, but she had told me that she might have made a mistake. Should I have kept the information confidential? Should I report her? What should I have done?

关键词：冲突(心理学) 数据收集急诊室医院/标准伦理学护理大不列颠护士作用护理管理研究病人医疗护理/标准人类

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Rules in the clinical setting: Pros and cons

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HEALTH CARE ANALYSIS 1998年第4期6卷 305-307页

作者： McKie, J Monash Univ Ctr Human Bioeth Clayton Vic 3168 Australia

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Developing a patient complaint tracking system to improve performance.

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The Joint Commission journal on quality improvement 2000年第4期26卷 217-226页

作者： Allen, L.W. Creer, E. Leggitt, M. Hartford Hospital 06102 Connecticut United States

BACKGROUND: Assessing patient satisfaction exclusively through close-ended scaled survey questions may not provide a complete picture of patients' concerns. Only recently has the role of complaint data as a management tool received attention. FORMATION OF THE TEAM AND THE DATABASE: The Complaint Management Team was created in January 1997 at Hartford Hospital (Conn) to develop a coding and reporting mechanism for complaints (negative comments) gathered from patient surveys. Developing the codebook was an evolutionary process. A database was designed to collect three separate complaints and the verbatim text associated with the code. REPORTING: Department-specific, location-specific, and organization wide reports are generated. Quarterly department-specific reports are used to trend the incidence of complaint themes, identify specific locations with problems, and initiate improvement efforts. OVERALL FINDINGS: Since March 1997, most complaints have fallen into five major categories--accommodations (environment), quality of care (care and treatment), respect and caring (humaneness or attitudes and behaviors), timeliness, and communication. The hospital's real estate department has completed a project focused on increasing patient satisfaction with parking. Two projects are still in progress;one is focused on increasing patient satisfaction with respect and staff caring attitude/behaviors, and one on improving satisfaction with the level of noise on the units. DISCUSSION: Approximately 4,000 survey complaints are coded every year. One limitation of the database is that all sources of complaints received throughout the organization are not yet captured. Another limitation is that the outcomes measurement section has exclusive access to the database. CONCLUSIONS: The patient complaint tracking system enables staff, managers, teams, and departments to develop improvement efforts based on quantitative and qualitative data.

关键词：数据库管理系统卫生保健调查机构管理小组病人医疗护理/标准病人满意度全面质量管理人类

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