Educational Needs of Community Health Nursing Supervisors

Recent legislative trends toward early hospital dismissal and cost containment have shifted the setting for health care from the hospital to the home. Consequently, community health nursing supervisors are becoming increasingly responsible both for coordinating care for sicker clients with fewer available resources, and for guiding staff nurses who provide high-tech nursing skills in the home. This has resulted in new educational needs for these supervisors. To determine their educational needs and the barriers to implementing their roles, 160 community health nursing supervisors employed by community health nursing agencies in Michigan were surveyed. They reported educational needs related to labor relations, reimbursement procedures, fiscal management, marketing, and computer systems. Several types of educational experiences were found to influence their abilities to handle supervisory responsibilities, including enrollment in an educational program, highest level of education, and selected content areas taught in their formal educational programs. Nursing implications include using the research results to develop educational programs to meet the needs of community health nursing supervisors. Those who are adequately prepared educationally will be better able to provide effective supervision of staff nurses and ultimately, coordinate high-level client home care.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/74660/1/j.1525-1446.1989.tb00565.x.pd

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Molecular heterogeneity of chondroitin sulphate in the developing rat palatal shelves prior to and after shelf elevation

No abstract available