The role of the dean in the pastoral care structure of a secondary school

<p>Pastoral care structures in New Zealand schools often include a middle management role of dean. This position has existed in New Zealand schools for decades, influenced by the existing systems and structures adopted from the United Kingdom. The responsibilities included in this role are often defined by schools at the local level in order to satisfy growing expectations of schools’ responsibility for student well-being and achievement. There has been little research concerning this position within the pastoral care structure of schools. This study aimed to explore the perceptions of members of the school community on the role of the year-level deans within one New Zealand secondary school. Senior managers, deans, teachers, and students from a state co-educational, urban, secondary school were interviewed regarding their views on the role, responsibilities, and effectiveness of the position of the year-level dean within their school. Deans also completed a daily log to record the nature of their tasks completed pertaining to this responsibility. Participants’ responses were analysed for major themes. The themes discussed include the intention of the role of the dean, tensions between the management of academic and pastoral issues, the exploration of the challenge in providing care for all students, and how resources available to the school and the dean can impact their role. A difference in the role between the junior school (Years 9 and 10) and senior school (Years 11, 12, and 13) was reported by all participants. Deans reported engaging in reactive tasks more than proactive, preventative tasks. Defining the role of the dean and its relationship to other roles within the school proved challenging for the perspectives, and this confusion was evident through a lack of clarity around lines of authority described in the job descriptions. Deans reported some difficulty in understanding their role in relation to managing form teachers, particularly where that staff member may hold a position of responsibility in curriculum. The reactive nature of the role was revealed. This indicated that deans continue to provide predominantly reactive care concerned with individual students, often meaning that only a small group of students receive direct care from deans. The predominantly reactive nature of the role creates implications for schools in the challenge of delivering care to all students. A more collaborative approach to pastoral care from all staff members may improve the provision of pastoral care for students. A proposed job description that may reflect the role of the dean more accurately is presented.</p>

The role of the dean in the pastoral care structure of a secondary school

<p>Pastoral care structures in New Zealand schools often include a middle management role of dean. This position has existed in New Zealand schools for decades, influenced by the existing systems and structures adopted from the United Kingdom. The responsibilities included in this role are often defined by schools at the local level in order to satisfy growing expectations of schools’ responsibility for student well-being and achievement. There has been little research concerning this position within the pastoral care structure of schools. This study aimed to explore the perceptions of members of the school community on the role of the year-level deans within one New Zealand secondary school. Senior managers, deans, teachers, and students from a state co-educational, urban, secondary school were interviewed regarding their views on the role, responsibilities, and effectiveness of the position of the year-level dean within their school. Deans also completed a daily log to record the nature of their tasks completed pertaining to this responsibility. Participants’ responses were analysed for major themes. The themes discussed include the intention of the role of the dean, tensions between the management of academic and pastoral issues, the exploration of the challenge in providing care for all students, and how resources available to the school and the dean can impact their role. A difference in the role between the junior school (Years 9 and 10) and senior school (Years 11, 12, and 13) was reported by all participants. Deans reported engaging in reactive tasks more than proactive, preventative tasks. Defining the role of the dean and its relationship to other roles within the school proved challenging for the perspectives, and this confusion was evident through a lack of clarity around lines of authority described in the job descriptions. Deans reported some difficulty in understanding their role in relation to managing form teachers, particularly where that staff member may hold a position of responsibility in curriculum. The reactive nature of the role was revealed. This indicated that deans continue to provide predominantly reactive care concerned with individual students, often meaning that only a small group of students receive direct care from deans. The predominantly reactive nature of the role creates implications for schools in the challenge of delivering care to all students. A more collaborative approach to pastoral care from all staff members may improve the provision of pastoral care for students. A proposed job description that may reflect the role of the dean more accurately is presented.</p>

Headache Characteristics in the Neurological Emergency Department: A Retrospective Study

Background: The care of patients with headache in the emergency department (ED) represents a diagnostic and clinical challenge. Data on the prevalence and characteristics of headache patients in purely neurological EDs are sparse. The aim of the present study is to examine patient profiles with the cardinal symptom of headache in an academic neurological ED, to analyze correlations between headache characteristics and search for differences compared to the interdisciplinary ED.Methods: This retrospective cross-sectional study assessed all patients who presented to the ED of the Department of Neurology at Rostock University Medical Center between November 2013 and November 2016 with the main symptom of headache. Epidemiological, clinical, diagnostic data as well as key data regarding the care structure were recorded. Correlations between headache characteristics and diagnosis at discharge were analyzed and risk profiles were identified using binary logistic regression analysis.Conclusion: This study comprehensively characterized a large collective of patients with the cardinal symptom of headache presenting to a purely neurology emergency department.

How to improve the quality of care for people on home mechanical ventilation from the perspective of healthcare professionals: a qualitative study

Background The rapid increase in the use of home mechanical ventilation (HMV) for people with chronic respiratory failure poses extreme challenges for the healthcare system. People on HMV have complex care needs and require support from an interprofessional team. In Germany, HMV is criticised for inadequate quality standards, particularly in outpatient intensive care practice. The objective of this study was to describe the quality of care for people on outpatient HMV in Germany, Bavaria and provide recommendations for improvement from the perspective of healthcare professionals (HCPs). Methods Semi-structured qualitative telephone interviews with HCPs (i.e., nurses, equipment providers, therapists, and physicians) were analysed using the framework method. The quality framework of Health Improvement Scotland (HIS), which aims to improve the quality of person-centred care, was used to build a deductive analysis matrix. The framework includes the three key areas: (1) Outcomes and impact, (2) Service delivery, and (3) Vision and leadership. The domains (meta-codes) and quality indicators (sub-codes) of the quality framework were used for deductive coding. Results Overall, 87 HCPs (51 female, mean age of 44.3 years, mean professional experience in HMV of 9.4 years) were interviewed (mean duration of 31 min). There was a complex interaction between the existing health care system (Outcomes and impact, 955 meaning units), the delivery of outpatient intensive care (Service delivery, 939 meaning units), and improvement-focused leadership (Vision and leadership, 70 meaning units) that influenced the quality of care for people on HMV. The main barriers were an acceleration in transition management, a neglect of weaning potential, a shortage of qualified professionals and missing quality criteria. The central recommendations for promoting person-centred care were training and supervision of staff and an inspiring leadership. An integrated care structure supporting medical home visits and outpatient rehabilitation should be developed. Conclusion This study describes a heterogeneous and partly deficient care situation for people on HMV, but demonstrates that high quality care is possible if person-centred care is successfully implemented in all areas of service provision. The recommendations of this study could inform the development of a person-centred integrated care structure for people on HMV.

A saúde coletiva: vivenciando a teoria na prática, como um relato de experiência

RESUMO Introdução: Este trabalho é um relato de experiência da disciplina saúde coletiva, do curso de graduação em Enfermagem, de uma faculdade privada de São Luís/MA, realizado nas Unidades de Estratégia Saúde da Família (UESFs). Objetivo: Dialogar sobre a experiência vivenciada pelos acadêmicos do 5º período e reforçar a importância da contextualização das aulas teóricas de saúde coletiva, contribuindo para a aprendizagem e sensibilização dos graduandos para a real situação da atenção básica. Metodologia: Relato de experiência, de visitas técnicas, dos alunos aos futuros campos de estágio, com escolha de cada grupo por um programa de saúde pública já implantado; ao final da visita cada grupo elaborou um relatório especificando: dados da estrutura de atendimento em saúde e da realidade social que o cerca, para tanto foi fornecido um roteiro de observações. Resultados: Foi possível identificar as potencialidades dos programas de saúde, suas lacunas, o perfil epidemiológico da população adscrita e contribuiu para a aproximação do alunado com a real situação de saúde no Brasil, desmistificando assuntos que pareciam estar longe da realidade dos acadêmicos. ABSTRACT Introduction: This work is an experience report of the collective health discipline, of the undergraduate Nursing course, of a private college in São Luís/MA, carried out in the Family Health Strategy Units (UESFs). Objective: Dialogue on the experience lived by students in the 5th period and reinforce the importance of contextualizing the theoretical classes of collective health, contributing to the learning and awareness of undergraduates about the real situation of primary care. Methodology: Experience report, technical visits, by students to future internship fields, with each group being chosen by an already implemented public health program; at the end of the visit, each group prepared a report specifying: data from the health care structure and the social reality that surrounds them, for which a script of observations was provided. Results: It was possible to identify the potential of health programs, their gaps, the epidemiological profile of the enrolled population and contributed to bringing students closer to the real health situation in Brazil, demystifying issues that seemed to be far from the reality of academics.

Thoracic Electric Bio-Impedance Artifacts Removal by Block Related Adaptive Eliminators for Remote Health Care

Study of thoracic-electrical- bio-impedance (TEB) simplifies heart attack volume during abrupt cardiac detention. Here in this paper we presented various effective and arithmetically reduced flexible techniques to show high quality TEB element. In scientific circumstances, TEB wave accounts several natural and un-natural events that veil the small things which are needed in finding the depth of the heart attack. In addition to that arithmetical convolution is the significant factor in a present-day wearable health based detecting device. Thus we used a novel signal processing method for TEB improvement in distant health-care structures. To do this we selected higherorder adaptive-filter as an essential component in designing TEB. To boost purifying capacity, merging velocity, to decrease mathematical difficulty of signal processing method, we used information normalization and cutting the data-regressor. The designed applications were checked on original TEB signals and the executed outcome established that the designed regressor eliminated the normalized high order purifier which is apt for a pragmatic health-care structure.

Priorities of hybrid clinician-managers: a qualitative study of how managers balance clinical quality among competing responsibilities

Objective Oversight of clinical quality is only one of physical therapy managers’ multiple responsibilities. With the move to value-based care, organizations need sound management to navigate this evolving reimbursement landscape. Previous research has not explored how competing priorities impact physical therapy managers’ oversight of clinical quality. The purpose of this study was to create a preliminary model of the competing priorities, motivations, and responsibilities of managers while overseeing clinical quality. Methods This qualitative study utilized the Rapid Qualitative Inquiry method. A purposive sample of 40 physical therapy managers and corporate leaders was recruited. A research team performed semistructured interviews and observations in outpatient practices. The team utilized a grounded theory-based immersion/crystallization analysis approach. Identified themes delineated the competing priorities and workflows these managers utilize in their administrative duties. Results Six primary themes were identified that illustrate how managers (1) balance managerial and professional priorities; (2) are susceptible to stakeholder influences; (3) experience internal conflict; (4) struggle to measure and define quality objectively; (5) are influenced by the culture and structure of their respective organizations; and (6) have professional needs apart from the needs of their clinics. Conclusion Generally, managers’ focus on clinical quality is notably less comprehensive than their focus on clinical operations. Additionally, the complex role of hybrid clinician-manager leaves limited time beyond direct patient care for administrative duties. Managers in organizations that hold them accountable to quality-based metrics have more systematic clinical quality oversight processes. Impact This study gives physical therapy organizations a framework of factors that can be influenced to better facilitate managers’ effective oversight of clinical quality. Organizations offering support for those managerial responsibilities will be well positioned to thrive in the new fee-for-value care structure.

Ações de lideranças da Enfermagem na organização do atendimento hospitalar a pacientes com COVID-19

Introdução: A prática assistencial do país passa por processo de revisão e análise diante da pandemia Covid-19. Objetivo: Descrever ações desenvolvidas por lideranças da equipe de enfermagem para a organização do atendimento de pacientes com Covid-19 no contexto hospitalar. Metodologia: Estudo descritivo, abordagem qualitativa, tipo relato de experiência realizado no Hospital Alemão Oswaldo Cruz durante os meses de março e abril de 2020. Descrição da Experiência: Estabelecemos inicialmente um comitê multiprofissional de enfrentamento para definir direcionamentos estratificando as ações para atendimento de pacientes em algumas frentes. As principais diretrizes foram relacionadas à estrutura e aos protocolos de cuidado. Outra ação realizada foram os treinamentos para a equipe assistencial. Resultado: Implementação de fluxo para atendimento aos pacientes no Pronto Atendimento; ampliação de leitos para atendimento a pacientes em Unidades de Internação e Intensiva; contratação e treinamentos de profissionais da equipe de enfermagem em tempo reduzido; otimização da equipe de enfermagem com redirecionamento de profissionais conforme a taxa de ocupação dos setores; fortalecimento da atuação multiprofissional. Considerações finais: A experiência obtida nesta vivência nos mostrou que o trabalho em equipe e o estabelecimento de vínculo de confiança entre os profissionais é ponto crucial para o sucesso na implantação de mudanças relevantes e para um cuidado seguro e de qualidade.Descritores: Covid-19; Pandemia; Assistência Hospitalar; Cuidados de Enfermagem. NURSING LEADERSHIP ACTIONS IN THE ORGANIZATION OF HOSPITAL CARE TO PATIENTS WITH COVID-19 Introduction: The country's health care practice goes through a review and analysis process in the face of the Covid-19 pandemic. Objective: To describe actions taken by the leadership of the nursing team to meet the demand of patients with Covid-19. Methodology: Descriptive study, qualitative approach, experience report carried out at Hospital Alemão Oswaldo Cruz during the months of March and April 2020. Experience Description: We initially established a multidisciplinary committee to define guidelines of actions to take care of the patients. The main guidelines were related to the care structure and protocols. Another action was training the nursing team. Results: Implementation of a new flow for patient care in the Emergency Room; Expansion of beds for patient care in inpatient and Intensive Care Units; Hiring and training nursing team professionals in a reduced time; optimization of the nursing team with redirection of professionals according to the occupancy rate of the units; strengthening of multidisciplinary performance. Final considerations: The experience obtained in this experience showed us that teamwork and the establishment of a bond of trust between professionals is a crucial point for the successful implementation of relevant changes and for a safe and quality care.Descriptors: Coronavirus Infection; Pandemic; Hospital Care; Nursing Care. ACCIONES DE LIDERAZGO EN ENFERMERÍA EN LA ORGANIZACIÓN DE LA ATENCIÓN HOSPITALARIA A PACIENTES CON COVID-19Introducción: La práctica de los profesionales del país pasa por un proceso de revisión y análisis debido al nuevo escenario por la pandemia del Covid-19. Objetivo: Describir las acciones tomadas por los liderazgos del equipo de enfermería para atender a la demanda de los pacientes de Covid-19. Metodología: Estudio descriptivo, con abordaje cualitativa, del tipo relato de experiencia realizado en el Hospital Alemão Oswaldo Cruz durante los meses de marzo y abril de 2020. Descripción de la Experiencia: Establecimos inicialmente un comité multiprofesional de enfrentamiento para definir direccionamientos estratificando las acciones para asistir a pacientes en algunas frentes. Las principales directrices fueron relacionadas a la estructura y a protocolos de cuidado. Otra acción realizada fueron los entrenamientos constantes para el equipo asistencial. Resultado: Implementación de un nuevo flujo para asistir a pacientes en Urgencias; Ampliación de camas para la atención de pacientes en unidades de ingreso e intensiva; Contratación y entrenamientos de profesionales del equipo de enfermería en tiempo reducido; Optimización del equipo de enfermería con redireccionamiento de profesionales conforme a la tasa de ocupación de los sectores; Fortalecimiento de la actuación multiprofesional. Consideraciones finales: La experiencia obtenida en esta vivencia nos ha enseñado que el trabajo en equipo y el establecimiento del vínculo de confianza entre los profesionales es punto crucial para el éxito en la implantación de cambios relevantes y para un cuidado seguro y de calidad para la población asistida.Descriptores: Coronavirus; Pandemia; Atención Hospitalaria; Atencion de Enfermeria.