Presenting patient data in the electronic care record: the role of timelines

OBJECTIVE: To establish the current level of awareness and investigate the use of timelines within clinical computing systems as an organized display of the electronic patient record (EPR). DESIGN: Multicentre survey conducted using questionnaires and interview. SETTING: Seven UK hospitals and several general practice surgeries. PARTICIPANTS: A total of 120 healthcare professionals completed a questionnaire which directed structured interviews. Participants fell into two cohorts according to whether or not they had used clinical timelines, which gave 60 timeline users and 60 prospective timeline users. MAIN OUTCOME MEASURES: To investigate the awareness of timelines, and the potential benefits of timelines within clinical computing systems. RESULTS: Fifty-eight percent of participants had not heard of the specific term timelines despite 75% of users utilizing a form of timeline on a daily basis. The potential benefits of future timelines were clinical audit (95%CI 77.6-91.6), increased time efficiency (95%CI 77.7-91.6%), reduced clinical error (95%CI 71.0-86.7) and improved patient safety (95%CI 70.0-85.9). One continuous timeline view between primary and secondary care was considered to be of great potential benefit in allowing communication via a unified patient record. CONCLUSIONS: The concept of timelines has enjoyed proven success in healthcare in the USA and in other sectors worldwide. Clinicians are supportive of timelines in healthcare. Formal input from clinicians should be sought when designing and implementing computer systems in healthcare. Timelines in healthcare support clinicians cognitive processes by improving the amount of data available and improving the way in which data are presented

Evaluating the effectiveness of a radiation safety training intervention for oncology nurses: a pretest – intervention – posttest study

BACKGROUND: Radiation, for either diagnosis or treatment, is used extensively in the field of oncology. An understanding of oncology radiation safety principles and how to apply them in practice is critical for nursing practice. Misconceptions about radiation are common, resulting in undue fears and concerns that may negatively impact patient care. Effectively educating nurses to help overcome these misconceptions is a challenge. Historically, radiation safety training programs for oncology nurses have been compliance-based and behavioral in philosophy. METHODS: A new radiation safety training initiative was developed for Memorial Sloan-Kettering Cancer Center (MSKCC) adapting elements of current adult education theories to address common misconceptions and to enhance knowledge. A research design for evaluating the revised training program was also developed to assess whether the revised training program resulted in a measurable and/or statistically significant change in the knowledge or attitudes of nurses toward working with radiation. An evaluation research design based on a conceptual framework for measuring knowledge and attitude was developed and implemented using a pretest-intervention-posttest approach for 15% of the study population of 750 inpatient registered oncology nurses. RESULTS: As a result of the intervention program, there was a significant difference in nurse's cognitive knowledge as measured with the test instrument from pretest (58.9%) to posttest (71.6%). The evaluation also demonstrated that while positive nursing attitudes increased, the increase was significant for only 5 out of 9 of the areas evaluated. CONCLUSION: The training intervention was effective for increasing cognitive knowledge, but was less effective at improving overall attitudes. This evaluation provided insights into the effectiveness of training interventions on the radiation safety knowledge and attitude of oncology nurses

Global Health Actors Claim To Support Health System Strengthening—Is This Reality or Rhetoric?

Bruno Marchal and colleagues argue that most current strategies aimed at health systems strengthening remain selectively targeted at specific diseases

The differential effects of concurrent planning practice elements on reunification and adoption

Objective: The child welfare practice of concurrent planning attempts to shorten children\u27s stays in foster care. There is very little quantitative research on concurrent planning\u27s effects. This study examines the influence of concurrent planning practice elements (reunification prognosis, concurrent plan, full disclosure, and discussion of voluntary relinquishment) on reunification and adoption. Method: Using a sample of 885 children, an observational design, and statistical controls, children who received concurrent planning elements were compared to those who did not. Results: Findings show discussion of voluntary relinquishment to be positively associated with adoption and full disclosure to be negatively associated with reunification. Conclusions: Concurrent planning\u27s benefits may require more intensive services to be fully realized. Care should be taken to ensure activities achieve their intended effects

Human resource management as a profession in South Africa

Orientation: Various countries recognise human resource (HR) management as a bona fide profession. Research purpose: The objective of this study was to establish whether one could regard HR management, as practised in South Africa, as a profession. Motivation for the study: Many countries are reviewing the professionalisation of HR management. Therefore, it is necessary to establish the professional standing of HR management in South Africa. Research design, approach and method: The researchers used a purposive sampling strategy involving 95 participants. The researchers achieved triangulation by analysing original documents of the regulating bodies of the medical, legal, engineering and accounting professions internationally and locally as well as the regulating bodies of HR management in the United Kingdom (UK), the United States of America (USA) and Canada. Seventy- eight HR professionals registered with the South African Board for People Practices (SABPP) completed a questionnaire. The researchers analysed the data using content analysis and Lawshe’s Content Validity Ratio (CVR). Main findings: The results confirm that HR management in South Africa adheres to the four main pillars of professionalism and is a bona fide profession. Practical/managerial implications: The article highlights the need to regulate and formalise HR management in South Africa. Contribution/value-add: This study identifies a number of aspects that determine professionalism and isolates the most important elements that one needs to consider when regulating the HR profession