Cardiac nursing: Achieving Competent Practitioners

2005 ◽  
Vol 4 (1) ◽  
pp. 15-21 ◽  
Author(s):  
Jillian Riley ◽  
Lyndell Brodie ◽  
Caroline Shuldham
Keyword(s):  
Care Delivery ◽  
Waiting Times ◽  
Models Of Care ◽  
Quality Of Services ◽  
Cardiac Care ◽  
Routine Practice ◽  
Knowledge And Skills ◽  
Career Pathway ◽  
Fit For Purpose

This paper describes how competency statements were integrated into an academic framework to provide a transparent yet flexible career pathway for the nurse working in acute cardiac care. Nurses are expanding and developing their roles and use wide ranging skills and knowledge to care for patients. Additionally, models of care delivery are changing and patients are cared for in a variety of settings. Where evidence exists, these models demonstrate improvement in the provision and quality of services and contribute to improved quality of life, maximise medication and therapy and reduce waiting times for investigations. However, whilst many studies have demonstrated benefit, translating these results into routine practice requires skilled nurses who are “fit for purpose”, and to support this, professional competencies can be used to measure competence in practice whilst informing educational initiatives. This paper outlines the development of competency statements that identify the knowledge and skills required for safe, effective and competent care and direct the cardiac nurse acquire skills and knowledge in a focused and coherent way.

Managing the Digital Disruption Associated with COVID-19-Driven Rapid Digital Transformation in Brisbane, Australia

2021 ◽  
Vol 12 (05) ◽  
pp. 1135-1143
Author(s):  
Amalie Dyda ◽  
Magid Fahim ◽  
Jon Fraser ◽  
Marianne Kirrane ◽  
Ides Wong ◽  
...  
Keyword(s):  
Care Delivery ◽  
Digital Health ◽  
Clinical Care ◽  
Models Of Care ◽  
Digital Transformation ◽  
Lessons Learned ◽  
Digital Data ◽  
Routine Practice ◽  
Action Research Project ◽  
Digital Disruption

Abstract Background The COVID-19 pandemic has forced rapid digital transformation of many health systems. These innovations are now entering the literature, but there is little focus on the resulting disruption. Objective We describe the implementation of digital innovations during the COVID-19 response of Australia's largest health service, Metro North (in Brisbane, Queensland), the challenges of the subsequent digital disruption, how these were managed, and lessons learned. Methods Prior to the COVID-19 pandemic, the Australian state of Queensland created the Queensland Digital Clinical Charter, which provides guidance for the development of digital health programs. The guidelines utilize three horizons: digitizing workflows, leveraging digital data to transform clinical care, and reimagining new and innovative models of care. The technical response to COVID-19 in Metro North is described across these horizons. The rapid digital response caused significant disruption to health care delivery; management of the disruption and the outcomes are detailed. This is a participatory action research project, with members of the research team assisting with leading the implementation project informing the case report content. Results Several digital innovations were introduced across Metro North during the COVID-19 response. This resulted in significant disruption creating digital hypervigilance, digital deceleration, data discordance, and postdigital “depression.” Successful management of the digital disruption minimized the negative effects of rapid digital transformation, and contributed to the effective management of the pandemic in Queensland. Conclusion The rapid digital transformation in Metro North during COVID-19 was successful in several aspects; however, ongoing challenges remain. These include the need to improve data sharing and increase interoperability. Importantly, the innovations need to be evaluated to ensure that Metro North can capitalize on these changes and incorporate them into long-term routine practice. Moving forward, it will be essential to manage not only the pandemic, but increasingly, the resultant digital disruption.

scholarly journals European Association of Veterinary Diagnostic Imaging

2017 ◽  
Vol 73 (7) ◽  
pp. 445-447
Author(s):  
Karolina Naumowicz ◽  
Józef Szarek ◽  
Mariusz Zbigniew Felsmann
Keyword(s):  
Computed Tomography ◽  
Nuclear Medicine ◽  
Diagnostic Imaging ◽  
Technological Progress ◽  
European Association ◽  
Quality Of Services ◽  
New Techniques ◽  
Knowledge And Skills ◽  
Veterinary Surgeons

Diagnostic imaging is a branch of medicine that has been developing for over a century. Technological progress in this area has contributed to the emergence of new techniques such as nuclear medicine, computed tomography, and magnetic resonance. Mastering these techniques and skillfully using them requires physicians to continuously deepen their knowledge and skills. Therefore, the European Association of Veterinary Diagnostic Imaging (EAVDI) has been established to ensure that the quality of services provided by veterinary surgeons is of the highest quality.

scholarly journals Next Generation Telehealth

2011 ◽  
Vol 20 (01) ◽  
pp. 15-20
Author(s):  
S.B. Gogia ◽  
G. Hartvigsen ◽  
A.J. Maeder
Keyword(s):  
State Of The Art ◽  
Care Delivery ◽  
Models Of Care ◽  
Current Status ◽  
Human Communication ◽  
Communication Practices ◽  
Access And Quality ◽  
Political Economic ◽  
Remote Health

SummaryTelehealth has long been seen as a means of increasing access and quality of care while decreasing costs and logistical burden for remote health care delivery. Underlying technology to support Telehealth has been developed commercially. However, its widespread adoption has been hindered by numerous clinical, social, political, economic and management factors. This paper examines trends which may help to address this situation.First we consider the current status of Telehealth based on some state-of-the-art reviews. Then we present some new future modes of Telehealth services, as described by various prominent authors. From these we identify some common directional themes and fundamental issues affecting the success of future Telehealth innovations.This position paper advances a view that Telehealth in the future will be much more driven by widespread pressure from two different drivers: more ubiquitous connectivity and related technological capabilities due to greater diversity in human communication practices, and new models of care emerging from diverse widespread movements towards health services reform.The IMIA Working Group on Telehealth work agenda will address some specific items within the areas described above.

scholarly journals Patient and nurse perspectives of a nurse-led community-based model of HIV care delivery in Malawi: a qualitative study

2020 ◽  
Author(s):  
Odala Sande ◽  
Doris Burtscher ◽  
Daneck Kathumba ◽  
Hannock Tweya ◽  
Sam Phiri ◽  
...  
Keyword(s):  
Care Delivery ◽  
Quality Care ◽  
Waiting Times ◽  
Physical Structure ◽  
Models Of Care ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Care Providers ◽  
Health Care Information ◽  
Community Based

Abstract Background Differentiated models of care (DMOC) are used to make antiretroviral therapy (ART) accessible to people living with HIV (PLHIV). In Malawi, Lighthouse Trust has piloted various DMOCs aimed at providing quality care while reducing personal and logistical barriers when accessing clinic-based healthcare. One of the approaches was community-based provision of ART by nurses to stable patients. Methods To explore how the nurse-led community ART programme (NCAP) is perceived, we interviewed eighteen purposively selected patients receiving ART through NCAP and the four nurses providing the community-based health care. Information obtained from them was complemented with observations by the study team. Interviews were recorded and transcribed. Data was analysed using manual coding and thematic analysis. Results Through the NCAP, patients were able to save money on transportation and the time it took them to travel to a health facility. Caseloads and waiting times were also reduced, which made patients more comfortable and gave nurses the time to conduct thorough consultations. Closer relationships were built between patients and care providers, creating a space for more open conversations (although this required care providers to set clear boundaries and stick to schedule). Patients’ nutritional needs and concerns related to stigma remain a concern, while operational issues affect the quality of the services provided in the community. Considerations for community-led healthcare programmes include the provision of transportation for care providers; the physical structure of community sites (in regard to private spaces); the timely consolidation of data collected in the field to a central database; and the need for care providers to cover multiple facility-based staff roles. Conclusions The patients interviewed in this study preferred the NCAP approach to the facility-based model of care because it saved them money on transport, reduced waiting-times, and allowed for a more thorough consultation, while continuing to provide quality HIV care. However, when considering a community-level DMOC approach, certain factors – including staff transportation and workload – must be taken into consideration and purposefully planned.

scholarly journals Primary Care Reform in Montenegro

2013 ◽  
Vol 52 (4) ◽  
pp. 247-254 ◽  
Author(s):  
Ljiljana Cvejanov Kezunović ◽  
Mara Drecun ◽  
Igor Švab
Keyword(s):  
Primary Care ◽  
Health Care ◽  
European Union ◽  
Waiting Times ◽  
Educational Interventions ◽  
Quality Of Services ◽  
Independent State ◽  
Primary Care Reform ◽  
Initial Results

Abstract Background: Montenegro is a newly independent state. As with many countries of that region, the country was faced with the need to reform its health care system. The overall aims of the reform were to improve the quality of services. This paper describes the process of implementation of the reform and its first achievements in patient satisfaction and quality of services since it has been introduced. Methods: The ministry of health introduced a series of steps that included changes to legislation, financing and manpower structure. Investments in primary care have been made and informatics support was developed. Educational interventions at the undergraduate and postgraduate levels were also introduced. Results: The initial results show that the changes have improved the quality of care provided: the composition of professionals in primary care has improved; preventive activities have remained high. Primary care is more accessible and organization of services is better, which can be seen in reduced waiting times for consultation in primary care and improved satisfaction with health care. Conclusions: The initial results show some progress since the reform was put into place. New measures aimed at raising the level of health care to reach European Union standards are still to be introduced.

scholarly journals Patients’ experiences and preferences for primary care delivery: a focus group analysis

2019 ◽  
Vol 20 ◽  
Author(s):  
Patrícia Norwood ◽  
Isabel Correia ◽  
Paula Veiga ◽  
Verity Watson
Keyword(s):  
Primary Care ◽  
Focus Groups ◽  
Continuity Of Care ◽  
Interpersonal Relations ◽  
Care Delivery ◽  
Current System ◽  
Waiting Times ◽  
Group Analysis ◽  
Models Of Care ◽  
Policy Implications

Abstract Background: In 2005, the Portuguese government launched a primary care (PC) reform. After a promising start, the reform is still incomplete and has been compromised by low investment. The incomplete nature of the reforms has resulted in the coexistence of different models of care delivery and heterogeneity in resource allocation and performance. PC has been extensively evaluated, but little is known about the patients’ views and preferences regarding PC and the ongoing reform. Aim: This study aims to examine patients’ experiences of and preferences for PC in Portugal and to explore their experience of the recent reforms. Methods: A qualitative study was undertaken which collected data from eight focus groups in the city of Braga, Portugal. Participants were recruited with the collaboration of eight local institutions. Focus groups’ discussions focused on patients’ experiences of and preferences for PC as well as their views on the reforms. Audio recordings were transcribed and analysed using an inductive thematic content analysis. Findings: The majority of participants perceived that the reform was positive. However, the improvements achieved by the reform were insufficient to lead to most participants having a positive experience of PC delivery in Portugal. Participants’ satisfaction/dissatisfaction with primary care was strongly associated with interpersonal relations and communication with doctors. Participants valued continuity of care, but felt the levels of responsiveness, flexibility and coordination in the current system were still unsatisfactory. Access and waiting times were seen as challenging and led participants to seek PC from emergency departments and private doctors. Policy Implications: The perception of increased inequity and the lack of effective choice undermined the social acceptability of the reform. Policies aimed at improving doctor–patient communication and continuity of care, as well as choice, may therefore lead to better satisfaction and more efficient use of health care settings.

scholarly journals Patient and nurse perspectives of a nurse-led community-based model of HIV care delivery in Malawi: a qualitative study

2020 ◽  
Author(s):  
Odala Sande ◽  
Doris Burtscher ◽  
Daneck Kathumba ◽  
Hannock Tweya ◽  
Sam Phiri ◽  
...  
Keyword(s):  
Care Delivery ◽  
Quality Care ◽  
Waiting Times ◽  
Physical Structure ◽  
Models Of Care ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Care Providers ◽  
Health Care Information ◽  
Community Based

Abstract Background Differentiated models of care (DMOC) are used to make antiretroviral therapy (ART) accessible to people living with HIV (PLHIV). In Malawi, Lighthouse Trust has piloted various DMOCs aimed at providing quality care while reducing personal and logistical barriers when accessing clinic-based healthcare. One of the approaches was community-based provision of ART by nurses to stable patients. Methods To explore how the nurse-led community ART programme (NCAP) is perceived, we interviewed eighteen purposively selected patients receiving ART through NCAP and the four nurses providing the community-based health care. Information obtained from them was complemented with observations by the study team. Interviews were recorded and transcribed. Data was analysed using manual coding and thematic analysis. Results Through the NCAP, patients were able to save money on transportation and the time it took them to travel to a health facility. Caseloads and waiting times were also reduced, which made patients more comfortable and gave nurses the time to conduct thorough consultations. Closer relationships were built between patients and care providers, creating a space for more open conversations (although this required care providers to set clear boundaries and stick to schedule). Patients’ nutritional needs and concerns related to stigma remain a concern, while operational issues affect the quality of the services provided in the community. Considerations for community-led healthcare programmes include the provision of transportation for care providers; the physical structure of community sites (in regard to private spaces); the timely consolidation of data collected in the field to a central database; and the need for care providers to cover multiple facility-based staff roles. Conclusions The patients interviewed in this study preferred the NCAP approach to the facility-based model of care because it saved them money on transport, reduced waiting-times, and allowed for a more thorough consultation, while continuing to provide quality HIV care. However, when considering a community-level DMOC approach, certain factors – including staff transportation and workload – must be taken into consideration and purposefully planned.

scholarly journals Analysis of Intermodal Terminals Service Quality in the Republic of Croatia

1970 ◽  
Vol 24 (3) ◽  
pp. 253-260 ◽  
Author(s):  
Borna Abramović ◽  
Ivica Lovrić ◽  
Vlatka Stupalo
Keyword(s):  
Service Quality ◽  
Waiting Times ◽  
Price Increase ◽  
Quality Of Services ◽  
Long Time ◽  
The Republic ◽  
The Cost ◽  
Cost Of Transportation

The most common problem that the terminals face is inadequate infrastructure, long waiting times, delays, malfunctions, and unexpected problems due to which terminals are often congested for a long time, high costs, lack of expansion, etc. All this leads to reduced quality of services and the price increase for the user service. These problems do not occur only at the terminal of one type, but at all terminals. At present, the delays and uneconomical operations are unacceptable. Intermodal terminals are not immune to any of the above. In order to increase the service quality and to reduce the cost of transportation and transmission, all the bottlenecks in the process are detected and analyzed in the work. The identification and removal of the bottlenecks in the processes of transport and transfer from the initial to the final terminal increases the quality of services provided to customers. The quality of services includes shorter time of transport and transfer by using shorter routes as well as the acceptable price of the service itself.

Thrombolysis Nurses: Time for Review

2005 ◽  
Vol 4 (2) ◽  
pp. 129-137 ◽  
Author(s):  
Ian Jones
Keyword(s):  
Myocardial Infarction ◽  
Emergency Department ◽  
Coronary Care Unit ◽  
Care Delivery ◽  
Models Of Care ◽  
Quality Of Evidence ◽  
The United Kingdom ◽  
St Elevation ◽  
Coronary Care

Thrombolysis remains the most popular means of reperfusion following an acute ST-elevation myocardial infarction in the United Kingdom today. There is a wealth of evidence to support the early provision of thrombolysis care and a number of models of care delivery have been proposed to reduce the time delay from admission to hospital to administration of thrombolytic therapy. The movement of this treatment from the coronary care unit to the emergency department in association with the employment of specialist cardiac nurses has been associated with some time reductions. However the quality of evidence to support the employment of specialist cardiac nurses working outside the coronary care unit is limited. The author provides an overview of the main literature in this area outlining the models of care in operation and argues that there are lessons to be learned for future nursing research.

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