This document discusses the role of nurses in general practice in Australia. It provides an overview of practice nursing roles, how nurses are funded, and their involvement in chronic disease management and lifestyle risk factor management. It also reviews the development of practice nursing over time, including the introduction of item numbers, and discusses advanced nursing roles in areas like chronic disease management and lifestyle risk factor counseling. Finally, it mentions future challenges for further integrating nurses into general practice teams.
This document provides a summary of Maria Gabriela Moreno's career experience. It details that she has worked as a sports medicine doctor and personal trainer in Ecuador since 2012. She received an MSc in Sports and Exercise Medicine from the University of Nottingham in 2012. Her experience includes establishing her own practice in Ecuador, working with various athletes and populations, and gaining clinical experience in orthopedic surgery and sports medicine. She focuses on injury prevention, treatment, and exercise prescription using various assessment methods and equipment.
Needs, Demands and Reality of People with Neuromuscular Disorders Users of Wheelchair by Thais Pousada in Examines in Physical Medicine & Rehabilitation
The document discusses the role and responsibilities of diabetes nursing as a nursing specialization in advanced practice. It describes diabetes nursing as focusing on managing a specific disease through assessing risk, providing education to patients, and ensuring adequate self-management. The roles of advanced practice nurses are explored, including diagnosing, treating, and coordinating complex care for diabetes patients. Challenges include balancing duties as both educators and medical providers to improve patient outcomes and quality of life.
This document discusses a 2013 California court case that allowed unlicensed school personnel to administer insulin injections to diabetic students. Nurses argued this was unsafe as school staff have no medical training. The document outlines diabetes management, the court arguments, and impact on nursing. It recommends only licensed nurses administer insulin, as unlicensed staff lack needed education and could put children at risk.
1. NPs primarily addressed periodic health examinations and acute respiratory infections, while FPs primarily addressed cardiovascular diseases and musculoskeletal conditions.
2. NPs provided more disease prevention and supportive services per FTE than FPs, while FPs provided more curative and rehabilitative services per FTE than NPs.
3. Referral patterns showed that FPs were more likely to recommend follow-up with another FP, while NPs were more likely to recommend follow-up with another NP, indicating little evidence of shared care between NPs and FPs.
This document discusses the potential role of a health psychologist in the Parkinson's service at Western General Hospital in Edinburgh. It provides an overview of the Parkinson's service and notes two key health behaviors - medication adherence and physical activity - that impact patient outcomes. The document argues that a health psychologist could address these issues by introducing theory-based interventions, like motivational interviewing and cognitive behavioral therapy, to increase medication adherence and physical activity. A health psychologist could also provide training to nurses on these interventions and theories of health behavior.
This document highlights the work being led by NHS Improvement to support the delivery of the National Cancer Survivorship Initiative (NCSI) vision for those living with and beyond cancer. This survivorship agenda is a priority which was outlined in the Cancer Reforms Strategy (2007) and Improving Outcomes: A Strategy For Cancer (2011)
(Published May 2011)
This document provides a summary of Maria Gabriela Moreno's career experience. It details that she has worked as a sports medicine doctor and personal trainer in Ecuador since 2012. She received an MSc in Sports and Exercise Medicine from the University of Nottingham in 2012. Her experience includes establishing her own practice in Ecuador, working with various athletes and populations, and gaining clinical experience in orthopedic surgery and sports medicine. She focuses on injury prevention, treatment, and exercise prescription using various assessment methods and equipment.
Needs, Demands and Reality of People with Neuromuscular Disorders Users of Wheelchair by Thais Pousada in Examines in Physical Medicine & Rehabilitation
The document discusses the role and responsibilities of diabetes nursing as a nursing specialization in advanced practice. It describes diabetes nursing as focusing on managing a specific disease through assessing risk, providing education to patients, and ensuring adequate self-management. The roles of advanced practice nurses are explored, including diagnosing, treating, and coordinating complex care for diabetes patients. Challenges include balancing duties as both educators and medical providers to improve patient outcomes and quality of life.
This document discusses a 2013 California court case that allowed unlicensed school personnel to administer insulin injections to diabetic students. Nurses argued this was unsafe as school staff have no medical training. The document outlines diabetes management, the court arguments, and impact on nursing. It recommends only licensed nurses administer insulin, as unlicensed staff lack needed education and could put children at risk.
1. NPs primarily addressed periodic health examinations and acute respiratory infections, while FPs primarily addressed cardiovascular diseases and musculoskeletal conditions.
2. NPs provided more disease prevention and supportive services per FTE than FPs, while FPs provided more curative and rehabilitative services per FTE than NPs.
3. Referral patterns showed that FPs were more likely to recommend follow-up with another FP, while NPs were more likely to recommend follow-up with another NP, indicating little evidence of shared care between NPs and FPs.
This document discusses the potential role of a health psychologist in the Parkinson's service at Western General Hospital in Edinburgh. It provides an overview of the Parkinson's service and notes two key health behaviors - medication adherence and physical activity - that impact patient outcomes. The document argues that a health psychologist could address these issues by introducing theory-based interventions, like motivational interviewing and cognitive behavioral therapy, to increase medication adherence and physical activity. A health psychologist could also provide training to nurses on these interventions and theories of health behavior.
This document highlights the work being led by NHS Improvement to support the delivery of the National Cancer Survivorship Initiative (NCSI) vision for those living with and beyond cancer. This survivorship agenda is a priority which was outlined in the Cancer Reforms Strategy (2007) and Improving Outcomes: A Strategy For Cancer (2011)
(Published May 2011)
This document discusses rehabilitation, including definitions, models, approaches, and services. It defines rehabilitation as using medical, social, educational, and vocational measures to train individuals to their highest functional ability level. The main models discussed are biomedical, social, biopsychosocial, ICIDH, CBR, and HRQOL. Approaches include institution-based rehabilitation, community-based rehabilitation, homes, day care centers, outpatient clinics, and camp approaches. Current rehabilitation services in India are also outlined.
Carol J. Inskeep has over 35 years of nursing experience including director roles at Temple University Hospital, St. Mary Medical Center, Riddle Memorial Hospital, Friends Hospital, and Albert Einstein Medical Center. She holds a MSN in Adult Psychiatric Mental Health Nursing and is certified as a PMHCNS-BC. As current Director of Nursing at Temple University Hospital, she oversees 10 units and manages a $33 million budget and 375 employees. She has led several successful initiatives improving quality, efficiency and patient satisfaction.
By Nancy Hutchison, MD. The role of cancer rehabilitation in adding value to oncology care and its contribution to achieving the Triple Aim of health care.
Enhancing the quality of life for palliative care cancer patients in Indonesi...UniversitasGadjahMada
Palliative care in Indonesia is problematic because of cultural and socio-economic factors. Family in Indonesia is an integral part of caregiving process in inpatient and outpatient settings. However, most families are not adequately prepared to deliver basic care for their sick family member. This research is a pilot project aiming to evaluate how basic skills training (BST) given to family caregivers could enhance the quality of life (QoL) of palliative care cancer patients in Indonesia. The study is a prospective quantitative with pre and post-test design. Thirty family caregivers of cancer patients were trained in basic skills including showering, washing hair, assisting for fecal and urinary elimination and oral care, as well as feeding at bedside. Patients’ QoL were measured at baseline and 4 weeks after training using EORTC QLQ C30. Hypothesis testing was done using related samples Wilcoxon Signed Rank. A paired t-test and one-way ANOVA were used to check in which subgroups was the intervention more significant. The intervention showed a significant change in patients’ global health status/QoL, emotional and social functioning, pain, fatigue, dyspnea, insomnia, appetite loss, constipation and financial hardship of the patients. Male patient’s had a significant effect on global health status (qol) (p = 0.030); female patients had a significant effect on dyspnea (p = 0.050) and constipation (p = 0.038). Younger patients had a significant effect in global health status/ QoL (p = 0.002). Patients between 45 and 54 years old had significant effect on financial issue (p = 0.039). Caregivers between 45 and 54 years old had significant effect on patients’ dyspnea (p = 0.031). Thus, it is concluded that basic skills training for family caregivers provided some changes in some aspects of QoL of palliative cancer patients. The intervention showed promises in maintaining the QoL of cancer patients considering socioeconomic
and cultural challenges in the provision of palliative care in Indonesia.
Living as Well as you Can for As Long as you CanBCCPA
Sit down buffet breakfast featuring keynote speaker Dr. Romayne Gallagher, Head Division of Palliative Care, Department of Family & Community Medicine, Providence Health Care; Clinical Professor, Division of Palliative Care, UBC
This study examined the prognosis of 118 patients with chronic low back pain who participated in a private, community-based group exercise program over 12 months. The patients experienced substantial improvements in pain intensity, disability, function and bothersomeness during the study period. Pain intensity and bothersomeness improved most in the first 6 months, while disability and function continued improving throughout the full year. At 12 months, 25% of patients were fully recovered from their back pain. Baseline pain intensity predicted 10% of the variation in pain outcomes at 12 months, while duration of current episode, disability, and education level together predicted 15% of the variation in disability outcomes.
This document discusses comprehensive rehabilitation care for oral cancer survivors. It describes the stages of rehabilitation as preventive, restorative, supportive, and palliative therapy. The roles of various healthcare professionals in a multidisciplinary rehabilitation team are outlined, including the oral physician's focus on prevention of osteoradionecrosis and radiation caries. Current barriers to effective rehabilitation like a lack of oncology training and interprofessional collaboration are addressed. Overcoming these barriers through education and coordinated care is emphasized.
This document provides a summary of Marilyn Nurse's qualifications, licensure, education, experience, and community involvement. She has over 20 years of experience as a nurse practitioner with a background in acute care, mental health, radiology, family medicine, women's health, and case management. She holds several certifications and a Master of Science in Nursing degree. Her clinical experience includes working in internal medicine, pediatrics, gynecology, neurology intensive care, and emergency departments. She also has experience in case management, utilization review, and community outreach activities.
Renny E. Ully's curriculum vitae summarizes her experience and qualifications as a midwife in Indonesia. She has over 15 years of experience providing maternal and child health care in various community health centers and hospitals. Her educational background includes a Master's degree in Midwifery from Auckland University of Technology and she currently works as a midwife and lecturer at Oepoi Community Health Center and Citra Husada Mandiri Kupang Health College.
Psychosocial Interventions in Dementia Careanne spencer
This document discusses psychosocial interventions for dementia care. It provides background on dementia prevalence and costs in Ireland. It then reviews the theoretical foundations and models for understanding dementia, including the biological, personhood, citizenship, and social models. The document evaluates the context, history, and quality of psychosocial intervention studies. It describes common intervention types and outcomes measured. As an example, it summarizes a randomized controlled trial on reminiscence therapy in Ireland that found improvements in quality of life and depression. Finally, it discusses guidelines for psychosocial interventions across European countries.
Impact of Intervention Program on Quality of End of Life Care Provided by Ped...iosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care. Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice. The journal publishes original papers, reviews, special and general articles, case management etc.
This document discusses rehabilitation for cancer patients. It describes how physical medicine and rehabilitation aims to restore and maintain function and quality of life for cancer patients and survivors. The rehabilitation team typically includes a physiatrist and physical or occupational therapists. Complications from cancer and its treatment that rehabilitation addresses include issues affecting the neuromuscular, skeletal, and lymphatic systems. Rehabilitation interventions can include therapeutic exercise, modalities like heat and cold therapy, orthotics, non-pharmacological pain management, and assistive devices. The overall goal is to improve patients' physical and functional abilities and independence.
Stratified pathways of care...from concept to innovationNHS Improvement
This document summarizes work done by NHS Improvement to redesign care pathways for cancer patients after initial treatment. It focuses on pathways for breast, colorectal, lung, and prostate cancers. The traditional medical model of long-term follow-up is replaced with a stratified model that classifies patients based on needs. Lower-risk patients are supported to self-manage, while higher-risk patients receive professional-led care. Sites tested various interventions like holistic needs assessments, education events, and remote monitoring. Early results found the stratified model improved patient experience and outcomes while reducing costs compared to traditional follow-up.
Statistics show that as of 2017, more than one million Canadians have survived cancer for more than 10 years. Yet, the physical rehabilitation needs of cancer survivors in Canada have received little attention and few services.
Dr. Jennifer M. Jones, PhD, is a senior Scientist and Director of the Cancer Rehabilitation & Survivorship Program at the Princess Margaret Cancer Centre in Toronto. Along with her colleague Stephanie Phan, Clinical Lead for the program, they provided an overview of her program, one of the best in the world and the only one of its kind in Canada.
Canadian Cancer Survivor Network staff Allison MacAlister and Jaymee Maaghop joined in the conversation to discuss the current national landscape, and what CCSN is doing to raise awareness for cancer rehabilitation in Canada.
Impact of palliative care education on nurses' knowledge, attitude and exper...Alexander Decker
1) The study evaluated the impact of palliative care education on nurses' knowledge, attitude, and experience in caring for chronically ill children.
2) A questionnaire was used to assess nurses' knowledge, attitude, and experience before and after receiving education based on guidelines developed by the researchers.
3) The results showed that the majority of nurses had a bachelor's degree but none had cared for dying children in the past year. There were also significant improvements in nurses' knowledge, attitude, and experience regarding palliative care after receiving the educational intervention.
Penny George Institute for Health and Healing Outcomes Reportmpmcginnis
The Penny George Institute for Health and Healing is the largest hospital-based integrative health program in the country. It provides holistic care to patients through inpatient services, an outpatient clinic, fitness center, education programs, and research. The Institute treats the whole person by blending conventional and complementary therapies. It focuses on empowering patients and preventing illness through lifestyle changes and wellness promotion.
This document summarizes information about Parkinson's disease and the associated healthcare services. It discusses the epidemiology of Parkinson's, including common symptoms and treatments. It then describes the healthcare context, noting that the Parkinson's service lacks a dedicated multidisciplinary team. Finally, it discusses applications of health psychology for understanding issues like medication adherence and increasing physical activity among Parkinson's patients.
Usage of family planning practices and its effects on women healthmustafa farooqi
This document provides an introduction and literature review for a study on the usage of family planning practices and their effects on women's health in rural areas of Khanewal, Pakistan. The introduction discusses the importance of family planning for women's empowerment and health benefits. It also outlines the study's objectives to examine the role of financial factors and effects on family size, health, and future fertility intentions. The literature review covers past research on cultural perceptions of fertility, socioeconomic influences on contraceptive use, and programs to increase usage. The methodology describes the study design, including sampling techniques, to collect data on family planning practices in the target population.
This document discusses key terms in health promotion and factors affecting health and wellness. It outlines the goals of Healthy People 2030 to promote health and well-being across all life stages. Physical activity objectives include aerobic activity, muscle strengthening, and reducing screen time for all ages. Physiotherapists can play a role in health promotion through screening, education, exercise interventions, and fall prevention programs. Measures for assessing health, wellness, and behaviors include clinical measures like BMI and self-reported surveys. Recommendations for physical activity include age-appropriate aerobic and resistance exercise for infants through older adults.
The document discusses the enhanced role of women's health nurse practitioners Lorna Scott and Carolyn Enks in rural Australia. It provides background on their roles since 1986/1991 and authorization as nurse practitioners in 2001/2005. The nurse practitioners see over 1,000 rural women annually based on guidelines for common women's health issues. Between 2008-2009, clinic visits increased by 20% while management based on nurse practitioner guidelines increased by 30%. The conclusion states that the extended practice of nurse practitioners improves primary health care outcomes for rural women.
This document discusses the Facility-Integrated Management of Neonatal and Childhood Illnesses (F-IMNCI), which aims to reduce child mortality by improving the skills of health workers. F-IMNCI builds on the original IMNCI approach by adding a focus on care of sick newborns, asphyxia management, and care at health facilities. It discusses the components of F-IMNCI including training, improving health systems, and improving family/community practices. Institutional arrangements for F-IMNCI implementation include establishing coordinators at the state and district levels and using medical colleges and district hospitals for training programs.
This document discusses rehabilitation, including definitions, models, approaches, and services. It defines rehabilitation as using medical, social, educational, and vocational measures to train individuals to their highest functional ability level. The main models discussed are biomedical, social, biopsychosocial, ICIDH, CBR, and HRQOL. Approaches include institution-based rehabilitation, community-based rehabilitation, homes, day care centers, outpatient clinics, and camp approaches. Current rehabilitation services in India are also outlined.
Carol J. Inskeep has over 35 years of nursing experience including director roles at Temple University Hospital, St. Mary Medical Center, Riddle Memorial Hospital, Friends Hospital, and Albert Einstein Medical Center. She holds a MSN in Adult Psychiatric Mental Health Nursing and is certified as a PMHCNS-BC. As current Director of Nursing at Temple University Hospital, she oversees 10 units and manages a $33 million budget and 375 employees. She has led several successful initiatives improving quality, efficiency and patient satisfaction.
By Nancy Hutchison, MD. The role of cancer rehabilitation in adding value to oncology care and its contribution to achieving the Triple Aim of health care.
Enhancing the quality of life for palliative care cancer patients in Indonesi...UniversitasGadjahMada
Palliative care in Indonesia is problematic because of cultural and socio-economic factors. Family in Indonesia is an integral part of caregiving process in inpatient and outpatient settings. However, most families are not adequately prepared to deliver basic care for their sick family member. This research is a pilot project aiming to evaluate how basic skills training (BST) given to family caregivers could enhance the quality of life (QoL) of palliative care cancer patients in Indonesia. The study is a prospective quantitative with pre and post-test design. Thirty family caregivers of cancer patients were trained in basic skills including showering, washing hair, assisting for fecal and urinary elimination and oral care, as well as feeding at bedside. Patients’ QoL were measured at baseline and 4 weeks after training using EORTC QLQ C30. Hypothesis testing was done using related samples Wilcoxon Signed Rank. A paired t-test and one-way ANOVA were used to check in which subgroups was the intervention more significant. The intervention showed a significant change in patients’ global health status/QoL, emotional and social functioning, pain, fatigue, dyspnea, insomnia, appetite loss, constipation and financial hardship of the patients. Male patient’s had a significant effect on global health status (qol) (p = 0.030); female patients had a significant effect on dyspnea (p = 0.050) and constipation (p = 0.038). Younger patients had a significant effect in global health status/ QoL (p = 0.002). Patients between 45 and 54 years old had significant effect on financial issue (p = 0.039). Caregivers between 45 and 54 years old had significant effect on patients’ dyspnea (p = 0.031). Thus, it is concluded that basic skills training for family caregivers provided some changes in some aspects of QoL of palliative cancer patients. The intervention showed promises in maintaining the QoL of cancer patients considering socioeconomic
and cultural challenges in the provision of palliative care in Indonesia.
Living as Well as you Can for As Long as you CanBCCPA
Sit down buffet breakfast featuring keynote speaker Dr. Romayne Gallagher, Head Division of Palliative Care, Department of Family & Community Medicine, Providence Health Care; Clinical Professor, Division of Palliative Care, UBC
This study examined the prognosis of 118 patients with chronic low back pain who participated in a private, community-based group exercise program over 12 months. The patients experienced substantial improvements in pain intensity, disability, function and bothersomeness during the study period. Pain intensity and bothersomeness improved most in the first 6 months, while disability and function continued improving throughout the full year. At 12 months, 25% of patients were fully recovered from their back pain. Baseline pain intensity predicted 10% of the variation in pain outcomes at 12 months, while duration of current episode, disability, and education level together predicted 15% of the variation in disability outcomes.
This document discusses comprehensive rehabilitation care for oral cancer survivors. It describes the stages of rehabilitation as preventive, restorative, supportive, and palliative therapy. The roles of various healthcare professionals in a multidisciplinary rehabilitation team are outlined, including the oral physician's focus on prevention of osteoradionecrosis and radiation caries. Current barriers to effective rehabilitation like a lack of oncology training and interprofessional collaboration are addressed. Overcoming these barriers through education and coordinated care is emphasized.
This document provides a summary of Marilyn Nurse's qualifications, licensure, education, experience, and community involvement. She has over 20 years of experience as a nurse practitioner with a background in acute care, mental health, radiology, family medicine, women's health, and case management. She holds several certifications and a Master of Science in Nursing degree. Her clinical experience includes working in internal medicine, pediatrics, gynecology, neurology intensive care, and emergency departments. She also has experience in case management, utilization review, and community outreach activities.
Renny E. Ully's curriculum vitae summarizes her experience and qualifications as a midwife in Indonesia. She has over 15 years of experience providing maternal and child health care in various community health centers and hospitals. Her educational background includes a Master's degree in Midwifery from Auckland University of Technology and she currently works as a midwife and lecturer at Oepoi Community Health Center and Citra Husada Mandiri Kupang Health College.
Psychosocial Interventions in Dementia Careanne spencer
This document discusses psychosocial interventions for dementia care. It provides background on dementia prevalence and costs in Ireland. It then reviews the theoretical foundations and models for understanding dementia, including the biological, personhood, citizenship, and social models. The document evaluates the context, history, and quality of psychosocial intervention studies. It describes common intervention types and outcomes measured. As an example, it summarizes a randomized controlled trial on reminiscence therapy in Ireland that found improvements in quality of life and depression. Finally, it discusses guidelines for psychosocial interventions across European countries.
Impact of Intervention Program on Quality of End of Life Care Provided by Ped...iosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care. Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice. The journal publishes original papers, reviews, special and general articles, case management etc.
This document discusses rehabilitation for cancer patients. It describes how physical medicine and rehabilitation aims to restore and maintain function and quality of life for cancer patients and survivors. The rehabilitation team typically includes a physiatrist and physical or occupational therapists. Complications from cancer and its treatment that rehabilitation addresses include issues affecting the neuromuscular, skeletal, and lymphatic systems. Rehabilitation interventions can include therapeutic exercise, modalities like heat and cold therapy, orthotics, non-pharmacological pain management, and assistive devices. The overall goal is to improve patients' physical and functional abilities and independence.
Stratified pathways of care...from concept to innovationNHS Improvement
This document summarizes work done by NHS Improvement to redesign care pathways for cancer patients after initial treatment. It focuses on pathways for breast, colorectal, lung, and prostate cancers. The traditional medical model of long-term follow-up is replaced with a stratified model that classifies patients based on needs. Lower-risk patients are supported to self-manage, while higher-risk patients receive professional-led care. Sites tested various interventions like holistic needs assessments, education events, and remote monitoring. Early results found the stratified model improved patient experience and outcomes while reducing costs compared to traditional follow-up.
Statistics show that as of 2017, more than one million Canadians have survived cancer for more than 10 years. Yet, the physical rehabilitation needs of cancer survivors in Canada have received little attention and few services.
Dr. Jennifer M. Jones, PhD, is a senior Scientist and Director of the Cancer Rehabilitation & Survivorship Program at the Princess Margaret Cancer Centre in Toronto. Along with her colleague Stephanie Phan, Clinical Lead for the program, they provided an overview of her program, one of the best in the world and the only one of its kind in Canada.
Canadian Cancer Survivor Network staff Allison MacAlister and Jaymee Maaghop joined in the conversation to discuss the current national landscape, and what CCSN is doing to raise awareness for cancer rehabilitation in Canada.
Impact of palliative care education on nurses' knowledge, attitude and exper...Alexander Decker
1) The study evaluated the impact of palliative care education on nurses' knowledge, attitude, and experience in caring for chronically ill children.
2) A questionnaire was used to assess nurses' knowledge, attitude, and experience before and after receiving education based on guidelines developed by the researchers.
3) The results showed that the majority of nurses had a bachelor's degree but none had cared for dying children in the past year. There were also significant improvements in nurses' knowledge, attitude, and experience regarding palliative care after receiving the educational intervention.
Penny George Institute for Health and Healing Outcomes Reportmpmcginnis
The Penny George Institute for Health and Healing is the largest hospital-based integrative health program in the country. It provides holistic care to patients through inpatient services, an outpatient clinic, fitness center, education programs, and research. The Institute treats the whole person by blending conventional and complementary therapies. It focuses on empowering patients and preventing illness through lifestyle changes and wellness promotion.
This document summarizes information about Parkinson's disease and the associated healthcare services. It discusses the epidemiology of Parkinson's, including common symptoms and treatments. It then describes the healthcare context, noting that the Parkinson's service lacks a dedicated multidisciplinary team. Finally, it discusses applications of health psychology for understanding issues like medication adherence and increasing physical activity among Parkinson's patients.
Usage of family planning practices and its effects on women healthmustafa farooqi
This document provides an introduction and literature review for a study on the usage of family planning practices and their effects on women's health in rural areas of Khanewal, Pakistan. The introduction discusses the importance of family planning for women's empowerment and health benefits. It also outlines the study's objectives to examine the role of financial factors and effects on family size, health, and future fertility intentions. The literature review covers past research on cultural perceptions of fertility, socioeconomic influences on contraceptive use, and programs to increase usage. The methodology describes the study design, including sampling techniques, to collect data on family planning practices in the target population.
This document discusses key terms in health promotion and factors affecting health and wellness. It outlines the goals of Healthy People 2030 to promote health and well-being across all life stages. Physical activity objectives include aerobic activity, muscle strengthening, and reducing screen time for all ages. Physiotherapists can play a role in health promotion through screening, education, exercise interventions, and fall prevention programs. Measures for assessing health, wellness, and behaviors include clinical measures like BMI and self-reported surveys. Recommendations for physical activity include age-appropriate aerobic and resistance exercise for infants through older adults.
The document discusses the enhanced role of women's health nurse practitioners Lorna Scott and Carolyn Enks in rural Australia. It provides background on their roles since 1986/1991 and authorization as nurse practitioners in 2001/2005. The nurse practitioners see over 1,000 rural women annually based on guidelines for common women's health issues. Between 2008-2009, clinic visits increased by 20% while management based on nurse practitioner guidelines increased by 30%. The conclusion states that the extended practice of nurse practitioners improves primary health care outcomes for rural women.
This document discusses the Facility-Integrated Management of Neonatal and Childhood Illnesses (F-IMNCI), which aims to reduce child mortality by improving the skills of health workers. F-IMNCI builds on the original IMNCI approach by adding a focus on care of sick newborns, asphyxia management, and care at health facilities. It discusses the components of F-IMNCI including training, improving health systems, and improving family/community practices. Institutional arrangements for F-IMNCI implementation include establishing coordinators at the state and district levels and using medical colleges and district hospitals for training programs.
This document discusses the Facility-Integrated Management of Neonatal and Childhood Illnesses (F-IMNCI), which aims to reduce child mortality by improving healthcare worker skills, health systems, and family/community practices. F-IMNCI builds on the original IMNCI approach by adding a focus on care of sick newborns and asphyxia management at healthcare facilities. It is implemented through training of medical officers and frontline workers, strengthening referral systems, and promoting healthy behaviors through community engagement. States establish coordination bodies and identify priority districts for rollout, while districts appoint coordinators, train personnel, and ensure supplies and supervision.
Daniel Elkeles: Integrated care in North West LondonNuffield Trust
The document describes integrated care efforts in North West London led by the Integrated Care Pilot (ICP). It summarizes barriers overcome like aligned incentives, joint governance, and information sharing. It outlines the pilot's goals of improving outcomes, reducing costs through better coordinated care across providers. It details how practices were organized into 10 multi-disciplinary groups to provide coordinated care for over 550,000 patients, and how the pilot has begun showing reductions in emergency admissions and A&E attendances.
Dr. barbara liu senior friendly hospitalsLornestar
This document outlines the need for senior friendly hospitals and describes a framework to address the challenge. It notes that hospitalized seniors have longer lengths of stay, lose independence, and have higher rates of adverse events. The framework focuses on processes of care, emotional/behavioral environment, ethics, physical environment, and organizational support. It provides an example of an early mobilization improvement plan using this framework. The goal is to minimize risk, improve outcomes and experiences for patients and staff through a senior friendly approach.
Caring for retirees: It's more fun in the PhilippinesMarc Evans Abat
There is a growing elderly population both in the US and Philippines that is straining healthcare resources. The Philippines has a limited number of geriatricians, about 100, to care for over 5 million senior citizens. Various levels of geriatric care and facilities exist in the Philippines, including hospital, outpatient, home care and nursing facilities. However, further improvements are still needed, such as accreditation for chronic care facilities and incorporating geriatrics training for medical and nursing students.
The document outlines a presentation given at the 2nd National Primary Care Conference on better outcomes with scarce resources through primary care. It discusses the case for primary care and delivery solutions using total quality management approaches including mechanisms, methods and case studies from the UK of increasing practice capacity and delivering cardiovascular risk assessments through general practices. Examples are provided of monitoring and improving various clinical areas and outcomes.
Parallel Session 2.9 Scrutiny and Improvement – The Integrated CycleNHSScotlandEvent
This document outlines Scotland's approach to integrating scrutiny and improvement efforts to enhance care for older people in acute hospitals. It discusses the policy context, a timeline of inspection efforts beginning in 2011, key themes and areas for improvement identified in initial inspections, and an integrated cycle of local self-assessment, inspection, and improvement using evidence-based standards and practices to drive sustainable change. The approach centers patients and aims to address issues like nutrition, hydration, falls prevention, and dementia care through prototype testing of ideas and spreading proven practices.
The Role of Health Services Research in a Learning Healthcare SystemAcademyHealth
Dr. David Atkins, U.S. Department of Veterans Affairs, presented at AcademyHealth's 2012 Capitol Hill briefing entitled "Health and the Deficit: Using Health Services Research to Reduce Costs and Improve Quality."
Daniel Elkeles: Making the business case for integrated workingThe King's Fund
Daniel Elkeles, Director of Strategy, NHS North West London, discusses how to write a business case for integrated care in the current financial climate.
This document discusses challenges facing healthcare in Ireland and the potential role of primary care/general practice in addressing these challenges. It notes policies aimed at putting "more care in the community" and increasing GP training places. Research is cited showing associations between strong primary care systems and better health outcomes/lower costs. The document outlines studies demonstrating positive impacts of primary care interventions on conditions like heart disease and diabetes. It concludes that primary care faces many challenges but can respond and deliver, and has long-term potential to be part of the solution for sustainable healthcare.
This document discusses ambulatory care services provided by pharmacists. It defines ambulatory care as health services for patients who do not require overnight hospital stays. The value of ambulatory pharmacy services includes increasing physician availability, decreasing hospitalization rates, and improving quality of care. Pharmacists play roles in health screening, medication management, and patient education in areas such as diabetes and falls prevention. Studies show pharmacist telephone follow-ups with seniors reduce drug-related problems. Future opportunities for ambulatory care include expanding reimbursement models and measuring quality and patient outcomes.
Participatory women's groups have been shown to effectively reduce neonatal and maternal mortality rates in rural areas with high child mortality. The MIRA Makwanpur study in Nepal found that monthly women's group meetings over two years led by a local female facilitator reduced neonatal mortality by 30% and had a major impact on reducing maternal mortality. The low-cost intervention involved problem identification, planning, implementation and evaluation of strategies through discussion to address key issues like postnatal care, breastfeeding and clean delivery. Similar approaches replicated in other countries have also found positive effects, demonstrating the potential of this community-based model for improving child survival in resource-poor settings.
Five priorities for care of the dying personMarie Curie
Dr Bill Noble, Medical Director of Marie Curie Cancer Care, speaks at the end of life sesion with Dr Adam Firth (RCGP Clinical Support Fellow for End of Life Care).
This session was chaired by Dr Peter Nightingale, Marie Curie and RCGP End of life lead at the RCGP Annual Conference, ACC Liverpool, 2-4 October, 2014.
For more information visit: mariecurie.org.uk/rcgp
This document provides information about community health nursing and reproductive health. It discusses the role of community health nurses in promoting health, preventing disease, providing education and care. It also outlines the role of reproductive nurses in caring for individuals with infertility or other reproductive health issues. The document then discusses women's health topics like preventative care, breast care, sexual health, pregnancy and more. It describes the links between poverty and poor health.
This document discusses the Nephrology Nursing Scope and Standards of Practice. It begins by differentiating between standards and guidelines, and identifying the components of the nursing process. The document then covers the scope of nephrology nursing practice, including definitions, components, and how it relates to the nursing process. Standards of nephrology nursing practice are presented as authoritative statements that describe nurses' duties and can be used to gauge the quality of patient care. The nursing process and standards are applied to various areas of nephrology nursing clinical practice.
Competition or Collaboration - 2015 Policy Prescriptions® SymposiumCedric Dark
The symposium is designed for clinicians – physicians, nurses, nurse practitioners, physician assistants, and students – and healthcare executives interested in expanding their scope of knowledge about currently popular health policy topics.
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The document provides information on independent nurse practitioners (INPs) including:
1. It defines INPs as skilled healthcare providers who can perform comprehensive assessments, make diagnoses, and prescribe pharmacological treatments to manage illnesses.
2. The role of INPs originated to increase access to primary care. By the 1990s, many INP programs were developed in response to healthcare reform demands.
3. INPs focus on prevention, wellness, and patient education. They make fewer prescriptions and less expensive treatment while informing and involving patients in their care.
4. INPs must have advanced nursing education, usually a master's degree. They are trained to practice independently or collaboratively in settings like community clinics
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2. Overview
• Overview of nursing in general practice in
Australia and overseas
• Practice Nurse role broadly
• What does a practice nurse look like
• How are nurses funded in general practice
• Nursing roles in chronic disease management and
lifestyle risk factor management
• Challenges for the role and future opportunities
2
3. Numbers of General Practice Nurses
State 2005 2007 2009 % change since 2007 % change since 2005
NSW 1157 2010 2441 21% 111%
VIC 1515 1926 2026 5% 34%
QLD 1112 1707 2061 21% 85%
SA 203 663 764 15% 276%
WA 722 895 986 10% 37%
TAS 126 266 332 25% 163%
NT 59 186 197 6% 234%
ACT 30 75 107 43% 257%
Total 4924 7728 8914 15% 81%
3
4. Practice nursing overseas
United Kingdom
• Specialty started to develop in 1980’s
• From 1900 nurses in 1984 to 25000 in 2003
• Largely due to GP contract and focus on health promotion/chronic disease
• Role developed further- nurse partners, sub-providers etc
• Nurse prescribing rights
4
5. New Zealand
• 1970- Practice nurse subsidy
• 1983- Government introduced requirement that role include specific clinical
duties
• Population health basis for funding
• Some great models of teamwork and has been greater room for role
expansion
5
6. Australian context
MBS definition
A general practice nurse is
• RN/Div 1
• EN/Div 2
• Employed in a general practice
• Or whose services are retained by a general practice
One part of a wider group of nurses working in primary health care
including community nurses, school nurses, maternal child
health nurses, occupation health nurses, sexual health,
women’s health and more.
6
7. Health
Practice nurse role assessments
•
Immunisation
Clinical care
– Clinical procedures and activities
Wound
• Clinical coordination
– e.g. recall/reminder, population health approach
Management
• Practice administration Women’s health
– Accreditation support
• Integration Chronic disease
– Liaison with other providers
RACGP/RCNA 2004
clinics
Operating Roles
ECGs, Pathology,
Nurse as patient carer
Routine obs
Nurse as quality controller
Nurse as organiser
Nurse as problem solver Patient education
Nurse as educator
Nurse as agent of connectivity Care planning
Phillips et al 2009
To name a few!
7
8. Evolution of role
• From ‘expediency measure’ to career
• GP directed autonomous
• Huge diversity in role
• Rapid evolution
29.4% (2006 26.9%, 2005 21%)
of Practice Nurses run a nurse-
led clinic
8
9. What does a practice nurse look like
• 88.7% RNs,
• 10% EN/Div 2s
• 42.9% aged between 41 -50, 33.4% aged between 51-60
• Mean years spent in practice 7 years
• Employment
– 24.0% full time
– 58.9% part time
– 16.4% casual
9
10. Development of practice nursing
• NiGP program (2001) Commonwealth funded
– Rural PIP Subsidy ($8000 per EFT GP)
– Training and support
• Division of General Practice capacity building
• Consumer information
• Supporting training (scholarships)
• Encourage network and mentoring (APNA Seed funding)
– Rural re-entry scholarships scheme (not just practice nurses) 2005/6 Federal
• Budget 2005 - funding continued $128m including $112m for PIP subsidy
– PIP subsidy extended to areas of workforce shortage
10
11. Development of practice nursing
• PN item numbers introduced
– Immunisation and wound management (2004)
– Pap Smears (2005)
– Pap Smears and preventive care, antenatal care (2006)
– Chronic disease management item numbers (2007) For and on
• GPMP and TCAs replaced EPC and role of nurse expanded within behalf of GP
this
Over 20 million
PN items
claimed since
2004
11
13. Advanced nursing roles in general practice – what do they look
like?
• Chronic disease management
– Nurse first doctor second clinics
– Disease specific management e.g. diabetes, COPD, CVD
– Chronic disease self management/patient education
– System management
– Liaison with other health providers and carers
– And more
• Prevention
– Lifestyle risk factor management including physical activity advice and coaching,
weight management, smoking cessation
• Women’s health, sexual health, family and child health/immunisation, emergency
management/triage, antenatal and postnatal care, pre-employment medicals,
residential aged care, continence management, INR management etc
13
14. Lifestyle risk factor management
• ‘Lifestyle nurse’ model
• Weight management clinics
• Smoking cessation interventions
– Development and evaluation of a primary care smoking cessation
service - Nicholas Zwar,, Robyn Richmond, Gail Forlonge ,Julie Smith
• Pilot of project using practice nurses to provide safe alcohol use education
and undertake brief interventions for high risk alcohol use –South City
General Practice Network
• General health promotion
• Walking group for socially isolated patients with chronic disease
The unique function of the nurse is to assist the
individual, sick or well, in the performance of
those activities contributing to health or its
recovery (or to peaceful death) that he would
perform unaided if he had the necessary
strength, will or knowledge.
14
15. Evidence for roles broadly
• Studies have shown that general practice nurses (GPNs) are as effective [i]
as General Practitioners (GP) in performing certain primary care functions
whilst receiving better results in patient satisfaction surveys.
– Nurse-led care may involve higher levels of patient satisfaction and
quality of life than doctor-led care [ii]
– Nurses are better managers of interpersonal relationships [iii], through
clearer communication, conducting effective counselling and
possessing better interviewing skills
– GPNs can provide long-term care management and promote choice
and positive health [iv]
15
16. Access to PBS and MBS for Nurses Practitioners in 2010
• Federal Budget 2009
• Nurse practitioners vs general practice nurses
• Small numbers but expect to grow
• High level of debate currently
16
17. Future challenges for integration of ‘To succeed as a team
nurses into general practice team is to hold all of the
members accountable
for their expertise’
• Clinical governance
Mitchell Caplan CEO,
E*Trade Group Inc
Indemnity
Funding Employer
Regulatory
authorities
17
18. Other challenges for integration of nurses into general practice
team
• Acceptance of role by other health professionals and
community
• Rapid evolution of the role and influx of ‘novice’
practice nurses
• Funding
• No current career path or definition of specialty or
CPD framework – but happening
• Industrial environment – cottage industry
• Infrastructure
• Practice nurse vs primary health care nurse
18
19. Future
• Key members of clinical team in general practice
• Providing a comprehensive range of services
• ? More specialization within general practice, including teams of nurses with
mental health nursing, domiciliary nursing, maternal child health nursing all
in same building.
19
20. References and links
[i] Horrocks, Sue et al (2002). "Systematic review of whether nurse practitioners
working in primary care can provide equivalent care to doctors. (Primary
Care)." British Medical Journal 324.7341 (April 6, 2002): 819(5).
[ii] Laurent, M et al (2008). ‘Substitution of Doctors by Nurses in Primary Care’, The
Cochrane Library 2008, Issue 2, UK: John Wiley and Sons.
[iii] Chambers, Naomi (1998). ‘Nurse Practitioners for the UK’ in Nurse Practitioners in
Primary Care, UK: Radcliffe Medical Press Ltd., p. 17.
[iv] ‘Key Roles and Responsibilities of Nurses in General Practice’ (2006), National
Health Service, UK, viewed 16 May 2008
<http://www.wipp.nhs.uk/tools_gpn/key_roles_responsibilities_gpns.php>.
Other references
Eckermann, S. [2009], PHC RIS: practice nurses - enhancing primary health care
services in rural Australia’, Howard, S., Aust J Rural Health, 17(2), 111
Halcomb EJ, Davidson PM, Salamonson Y, Ollerton R, & Griffiths R. (2008). Nurses
in Australian general practice: implications for chronic disease management. J
Clin Nurs, 17(5A), 6-15.
Jolly R. (2007). Practice nursing in Australia. Canberra: Social Policy Section,
Parliament of Australia.
Keleher H, Joyce CM, Parker R, & Piterman L. (2007). Practice nurses in Australia:
current issues and future directions. MJA, 187 (108-110).
Halcomb EJ, & Davidson PM. (2006). The Role of Practice Nurses in an Integrated
Model of Cardiovascular Disease Management in Australian General Practice.
Australian Journal of Primary Health, 12(2), 34-44.
Hegney D, Eley R, Buikstra E, Rees S, & Patterson E. (2006). Consumers' Level of
Comfort with an Advanced Practice Role for Registered Nurses in General
Practice: A Queensland, Australia, Study. Australian Journal of Primary Health,
12(3), 44-51.
20
21. Links
• Primary Health Care: A nursing consensus view
http://www.anf.org.au/anf_pdf/publications/PHC_Australia.pdf
• Australian Practice Nurses website www.apna.asn.au
21
Over 60% of general practices employ one or more practice nurses
Strong role in chronic disease and lifestyle management i.e. well-being clinics, smoking cessation etc
Evidence for nurse role in prevention in general practice It is well-established that a focus on primary care for prevention reaps benefits: Primary care promotes a holistic approach to patient treatment, and the World Health Organisation (WHO) had previously asserted that preventative care techniques ‘help individuals and families to cope with illness and chronic disability’ [i ] , improving their quality of life. General Practice Nurses (GPN) are well-versed in preventative care, and have already been engaged in screening, health promotion and lifestyle risk factor counselling activities. GPNs are key providers of childhood and adult immunisation services in many countries including Australia. In most states there are legislative arrangements in place to support an autonomous role for nurses in immunisation that includes the administration of adrenaline. Research evidence is still scarce about the specific contribution of nurses to lifestyle risk factor counselling. However, an evaluation of a research project of GPNs providing smoking cessation counselling conducted in the Southern Highlands of New South Wales revealed very encouraging results. [ii ] It was found that nurses spend more time counselling patients, increasing their chances of quitting. Practice nurses were also ‘uniquely positioned’ and ideal for the role, as compared to General Practitioners (GP). GPNs possess the opportunity for lifestyle risk factor identification in almost every aspect of their daily activities, allowing the potential for identifying at-risk clients. Nurses establish more contact time with patients. Research indicates that the quality of consultations is relational to the amount of time spent between physician and patient. [iii ] Nurses spend more time with patients than doctors. Extended contact time facilitates nurses’ ability to compile detailed, accurate patient medical histories, to undertake comprehensive assessment of the patients, and to assess the patient’s family’s medical risks. [iv] The patient-nurse interactions act to enhance the therapeutic relationship, which create more opportunities to promote lifestyle changes. Nurses are essential members of the multi-disciplinary team in primary health care as their extensive communication skills enable them to contribute to preventative care by providing a broad scope of knowledge and skills. Studies have shown that general practice nurses (GPN) are as effective[v] as General Practitioners (GP) in performing primary care functions whilst receiving better results in patient satisfaction surveys. Nurse-led care may involve higher levels of patient satisfaction and quality of life than doctor-led care[vi] Nurses are better managers of interpersonal relationships[vii], through clearer communication, conducting effective counselling and possessing better interviewing skills GPNs can provide long-term care management and promote choice and positive health.[viii] Nurses’ roles can be extended to better support frontline care. It must be noted that evidence from other countries has not demonstrated any cost savings in supplementing doctors with nurses. However, practice nurses were found to be as proficient as GPs, and hence, such a practice has demonstrated no adverse outcomes.[ix] Supplementing doctors with practice nurses, if carefully managed, promotes the use of effective chronic disease control and preventative health functions GPNs can coordinate care and function as the pivotal contact person for care providers and patients, ensuring quality care and reducing service overlaps or lapses. [i] World Health Organisation: European Health for All Series; No. 6. Health21: The Health for All Policy Framework for the WHO European Region (1998). Copenhagen: Regional Office for Europe, p. 139. [ii] Zwar, Nicholas et al, Development and Evaluation of a Primary Care Smoking Cessation Service , University of New South Wales, viewed 21 May 2008, <http://customers.ilisys.com.au/rcnao/UserFiles/Forlonge,%20Gail.pdf> [iii] Corrie, Karen and Watts, Ian (2002). Literature on the Relationship Between Quality and Length of Consultations , Royal Australian College of General Practitioners. [iv] Thompson, Lee (2008). ‘The Role of Nursing in Governmentality, Biopower and Population Health: Family Health Nursing’ in Health and Place , no. 14, p. 79. [v] Horrocks, Sue et al (2002). "Systematic review of whether nurse practitioners working in primary care can provide equivalent care to doctors. (Primary Care)." British Medical Journal 324.7341 (April 6, 2002): 819(5). [vi] Laurent, M et al (2008). ‘Substitution of Doctors by Nurses in Primary Care’, The Cochrane Library 2008 , Issue 2, UK: John Wiley and Sons. [vii] Chambers, Naomi (1998). ‘Nurse Practitioners for the UK’ in Nurse Practitioners in Primary Care , UK: Radcliffe Medical Press Ltd., p. 17. [viii] ‘Key Roles and Responsibilities of Nurses in General Practice’ (2006), National Health Service, UK, viewed 16 May 2008 <http://www.wipp.nhs.uk/tools_gpn/key_roles_responsibilities_gpns.php>. [ix] Laurent, M et al (2008), ‘Substitution of Doctors by Nurses in Primary Care’, The Cochrane Library 2008 , Issue 2, UK: John Wiley and Sons.