Roles and responsibilities of the student nurse mentor: an update.

Facilitating the learning of student nurses in the workplace is an integral role of the registered nurse. This article aims to provide an overview of the role and responsibilities of the mentor in supporting pre-registration nursing students in clinical practice. The professional obligations for the mentor to meet the Nursing and Midwifery Council (NMC) standards (NMC, 2008a) will be explored, including the ongoing requirements to keep up to date in mentoring practices. Some of the challenges within the role will be identified, including the importance of recognizing and supporting the failing student. Recent changes to the preparation requirements for sign-off mentors will be discussed. The article concludes by presenting the potential benefits to both the individual and the practice placement provider

Chronic Pain Management With Opioids: An Assessment of Alaska Nurse Practitioner Practices

Presented to the Faculty of the University of Alaska Anchorage in Partial Fulfillment of the Requirements for the Degree of MASTER OF SCIENCEThe purpose of this project was to determine chronic opioid pain management practices of Alaskan Nurse Practitioners (NPs) in primary care, compare them to best practices, and describe perceived barriers to evidence-based guideline use. Participants included NPs in Alaska who work in primary care and currently have an active Alaska NP license and Alaska mailing address. This project answered the questions of to what extent primary care NP practices are consistent with current Federation of State Medical Boards (2013) guidelines when managing chronic non-cancer pain with opioid therapy as well as identified the perceived barriers to guideline use. A cross sectional, descriptive design was used. The principal investigator mailed a paper survey to a convenience sample of NPs in Alaska. Nurse practitioners in Alaska follow guidelines when initiating opioid therapy most of the time, with all but three guidelines being followed ‘very frequently’ by at least 50% of respondents. Respondents follow guidelines less often when managing opioid therapy with only one guidelines being followed ‘very frequently’ by at least 50% of respondents. Two major barriers to guideline use include resource and knowledge barriers. The findings of this project were used to make clinical recommendations for improved practice.Signature Page / Title Page / Abstract / Table of Contents / List of Figures / List of Tables / List of Appendices / Introduction / Significance to Alaska Advance Nursing Practice / Purpose / Literature Review / Research Question / Methods / Results / Discussion / Implications / Dissemination / References / Appendice

Guidance for the inspection of further education institutions, from September 2010

"This guidance sets out the way the inspectorate will inspect further education institutions for the six-year inspection cycle from 2010. It will be reviewed during 2012-2013 in preparation for the second half of the inspection cycle." - Introduction

College Student Perceptions of ADHD: Links Between Prior Knowledge and Stigma

Attention deficit hyperactivity disorder (ADHD) is characterized by persistent inattention, which might or might not accompany hyperactivity and impulsivity, that noticeably interferes with functioning and development in at least two settings. It is a commonly diagnosed childhood mental health disorder. Public knowledge and attitudes towards ADHD are an important consideration for those who are going to potentially be working with that population. Research has shown older children and parents may attribute ADHD behavior to poor social skills or immaturity. Teachers often report feeling unprepared to have a student with ADHD and would like more training. Some research has shown the perpetuation of common misconceptions of ADHD by parents and teachers. This research sought to determine if there was a correlation between knowledge of ADHD and stigma towards individuals with ADHD and to determine if students majoring in psychology differed from their peers on knowledge about ADHD or attitudes towards individuals with ADHD. After surveying 131 students from a faith-based, private university in Virginia, it was found that those majoring in psychology did not have significant differences in knowledge of ADHD or stigma towards people with ADHD when compared to students in other majors. Both knowledge and stigma scores were high across groups and no significant correlation between knowledge and attitudes was found. Findings have implications for university students diagnosed with ADHD and administrators working to reduce the stigma of ADHD on campus

Discussing uncertainty and risk in primary care: recommendations of a multi-disciplinary panel regarding communication around prostate cancer screening.

BackgroundShared decision making improves value-concordant decision-making around prostate cancer screening (PrCS). Yet, PrCS discussions remain complex, challenging and often emotional for physicians and average-risk men.ObjectiveIn July 2011, the Centers for Disease Control and Prevention convened a multidisciplinary expert panel to identify priorities for funding agencies and development groups to promote evidence-based, value-concordant decisions between men at average risk for prostate cancer and their physicians.DesignTwo-day multidisciplinary expert panel in Atlanta, Georgia, with structured discussions and formal consensus processes.ParticipantsSixteen panelists represented diverse specialties (primary care, medical oncology, urology), disciplines (sociology, communication, medical education, clinical epidemiology) and market sectors (patient advocacy groups, Federal funding agencies, guideline-development organizations).Main measuresPanelists used guiding interactional and evaluation models to identify and rate strategies that might improve PrCS discussions and decisions for physicians, patients and health systems/society. Efficacy was defined as the likelihood of each strategy to impact outcomes. Effort was defined as the relative amount of effort to develop, implement and sustain the strategy. Each strategy was rated (1-7 scale; 7 = maximum) using group process software (ThinkTank(TM)). For each group, intervention strategies were grouped as financial/regulatory, educational, communication or attitudinal levers. For each strategy, barriers were identified.Key resultsHighly ranked strategies to improve value-concordant shared decision-making (SDM) included: changing outpatient clinic visit reimbursement to reward SDM; development of evidence-based, technology-assisted, point-of-service tools for physicians and patients; reframing confusing prostate cancer screening messages; providing pre-visit decision support interventions; utilizing electronic health records to promote benchmarking/best practices; providing additional training for physicians around value-concordant decision-making; and using re-accreditation to promote training.ConclusionsConference outcomes present an expert consensus of strategies likely to improve value-concordant prostate cancer screening decisions. In addition, the methodology used to obtain agreement provides a model of successful collaboration around this and future controversial cancer screening issues, which may be of interest to funding agencies, educators and policy makers

Equality in Health: An Annotated Bibliography With Resources on Health Disparities and Cultural and Linguistic Competency

Provides citations for articles, reports, books, and online resources on racial/ethnic disparities in health and health care, strategies to reduce them, assessment tools for cultural and linguistic competency, training and education, and other issues

District Health Managers' Perceptions of Supervision in Malawi and Tanzania.

Mid-level cadres are being used to address human resource shortages in many African contexts, but insufficient and ineffective human resource management is compromising their performance. Supervision plays a key role in performance and motivation, but is frequently characterised by periodic inspection and control, rather than support and feedback to improve performance. This paper explores the perceptions of district health management teams in Tanzania and Malawi on their role as supervisors and on the challenges to effective supervision at the district level. This qualitative study took place as part of a broader project, "Health Systems Strengthening for Equity: The Power and Potential of Mid-Level Providers". Semi-structured interviews were conducted with 20 district health management team personnel in Malawi and 37 council health team members in Tanzania. The interviews covered a range of human resource management issues, including supervision and performance assessment, staff job descriptions and roles, motivation and working conditions. Participants displayed varying attitudes to the nature and purpose of the supervision process. Much of the discourse in Malawi centred on inspection and control, while interviewees in Tanzania were more likely to articulate a paradigm characterised by support and improvement. In both countries, facility level performance metrics dominated. The lack of competency-based indicators or clear standards to assess individual health worker performance were considered problematic. Shortages of staff, at both district and facility level, were described as a major impediment to carrying out regular supervisory visits. Other challenges included conflicting and multiple responsibilities of district health team staff and financial constraints. Supervision is a central component of effective human resource management. Policy level attention is crucial to ensure a systematic, structured process that is based on common understandings of the role and purpose of supervision. This is particularly important in a context where the majority of staff are mid-level cadres for whom regulation and guidelines may not be as formalised or well-developed as for traditional cadres, such as registered nurses and medical doctors. Supervision needs to be adequately resourced and supported in order to improve performance and retention at the district level

What do measures of patient satisfaction with the doctor tell us?

Objective: To gain an understanding of how patient satisfaction (PS) with the doctor (PSD) is conceptualized through an empirical review of how it is currently being measured. The content of PS questionnaire items was examined to (a) determine the primary domains underlying PSD, and (b) summarize the specific doctor-related characteristics and behaviors, and patient-related perceptions, composing each domain. Methods: A scoping review of empirical articles that assessed PSD published from 2000 to November 2013. MEDLINE and PsycINFO databases were searched. Results: The literature search yielded 1726 articles, 316 of which fulfilled study inclusion criteria. PSD was realized in one of four health contexts, with questions being embedded in a larger questionnaire that assessed PS with either: (1) overall healthcare, (2) a specific medical encounter, or (3) the healthcare team. In the fourth context, PSD was the questionnaire's sole focus. Five broad domains underlying PSD were revealed: (1) Communication Attributes; (2) Relational Conduct; (3) Technical Skill/Knowledge; (4) Personal Qualities; and (5) Availability/Accessibility. Conclusions: Careful consideration of measurement goals and purposes is necessary when selecting a PSD measure. Practice implications: The five emergent domains underlying PSD point to potential key areas of physician training and foci for quality assessment