Allied Health Care Workers Research Articles

Evaluation of the 12-hour Shift Trial in a Regional Intensive Care Unit

Given the shortage of critical care nurses, emphasis has been placed upon improving their working lives through the implementation of flexible work hours. This descriptive exploratory study evaluated the effects of the implementation of the 12-hour roster in a regional intensive care unit (ICU). Staff (n = 19) completed a survey 12 weeks following the implementation of the 12-hour roster. The study demonstrated widespread acceptance (92%) positive impact on physical and psychological well-being and increased work satisfaction (58%) for the nursing participants. Similarly, nurses working both the 8- and 12-hour rosters (75%), the doctors and allied health care workers all identified increased continuity of patient care as an outcome of the 12-hour shift. Participants strongly agreed that 12-hour rostering was a good recruitment (67%) and retention (75%) strategy. In an environment with considerable shortages of experienced critical care nurses, the use of flexible shift patterns such as the 12-hour roster was a positive recruitment and recruitment strategy.

21. Optimal care in rheumatoid arthritis: Preliminary findings from a focus group study

The objective of our work was to identify facilitators of optimal care, as well as potential barriers, for patients with rheumatoid arthritis (RA). The design was a focus group study. Individuals with established RA were identified through invitation letters sent using a random sample of the Quebec Arthritis Society mailing list. Patients were eligible for participation if they had a diagnosis of RA confirmed by a rheumatologist and if they had sought care within the McGill Réseau Universitaire Intégré de Santé network. We planned a series of focus group meetings (90 minutes each) to obtain sufficient data in terms of spectrum of ideas. In each moderator-led group, participants were asked to discuss five questions related to quality care. A co-moderator was available to document non-verbal communication, with audio-taping of all sessions and professional transcription for data analysis. Qualitative content analysis, based on grounded theory, was the chosen means of identifying recurring themes and categories. 
 Two focus group sessions have been completed with two more scheduled. Preliminary findings indicate the importance of good communication between family physicians, specialists, and allied health care workers. Final coding of transcripts and computer-assisted content analysis is being completed. However it appears that focus group may be useful in studying optimal care for chronic diseases such as RA. Our preliminary findings emphasize the necessity of good communication among health care providers. Ultimately we hope to generate knowledge that can be transformed into better health for Canadians with arthritis and other chronic diseases.

Establishment of an Australian motor neurone disease registry

Motor neurone disease (MND) is a relentlessly progressive neurodegenerative disease with a median survival of 1–3 years. It results in the death of nearly 400 Australians per year.1 The management of MND remains problematic, tending to be offered in a heterogeneous and ad-hoc fashion across Australia. This heterogeneity arises in part from a lack of understanding of the aetiology of the disease and its progression in different patients,2 the absence of established guidelines for standard care,3 and a lack of concentrated experience among medical practitioners, nursing and allied health care workers in treating patients with MND.

The Business of Ethics: Gender, Medicine, and the Professional Codification of the American Physiotherapy Association, 1918–1935

The history of codes of ethics in health care has almost exclusively been told as a story of how medical doctors developed their own professional principles of conduct. Yet telling the history of medical ethics solely from the physicians' perspective neglects not only the numerous allied health care workers who developed their own codes of ethics in tandem with the medical profession, but also the role that gender played in the writing of such professional creeds. By focusing on the predominantly female organization of the American Physiotherapy Association (APA) and its 1935 "Code of Ethics and Discipline," I demonstrate how these women used their creed to at once curry favor from and challenge the authority of the medical profession. Through their Code, APA therapists engaged in a dynamic dialogue with the male physicians of the American Medical Association (AMA) in the name of professional survival. I conclude that, contrary to historians and philosophers who contend that professional women have historically operated under a gender-specific ethic of care, the physiotherapists avoided rhetoric construed as feminine and instead created a "business-like" creed in which they spoke solely about their relationship with physicians and remained silent on the matter of patient care.

Influenza vaccination rate among emergency department personnel: a survey of four teaching hospitals

To determine influenza vaccination rates and attitudes toward vaccination among emergency department health care workers at 4 Ontario teaching hospitals. During the influenza season of 1999-2000 a confidential 28-item survey was distributed to emergency physicians and residents, nurses, respiratory therapists, and other allied health care workers at the emergency departments of 4 London, Ontario teaching hospitals. Of 426 surveys distributed, 343 were returned, for an overall response rate of 80.5%. The mean age of respondents was 38.5 years (standard deviation = 8.3), 74.3% were female, and 86.6% were non-smokers. The overall vaccination rate was 37.0% (95% confidence interval, 31.9%-42.4%). Vaccination rates were 45.9% for respiratory therapists, 35.3% for emergency physicians and residents, 34.5% for nurses and 27.1% for other allied health care workers (p = 0.083). Multivariate logistic regression analysis revealed that age >or=41 and a chronic medical condition were positively associated with influenza vaccination (p < 0.05). Close to one-third of respondents (28.3%) believed that adverse affects were common, 51.6% believed vaccination was effective, 52% would support a program to improve vaccination rates among emergency department staff, and 24.4% would support mandatory vaccination for this population. Only 26.8% believed that patients were at increased risk of contracting influenza from emergency department staff, but 58.3% perceived that emergency department staff were at increased risk of contracting influenza through exposure to patients. In this study, only 37% of emergency department health care workers were immunized against influenza, with chronic illness and older age being the only 2 significant correlates. Strategies to improve emergency department health care worker attitudes toward influenza vaccination for themselves and to increase vaccination rates for this population should be developed.

Preventing childhood obesity: establishing healthy lifestyle habits in the preschool years

Preventing childhood obesity: establishing healthy lifestyle habits in the preschool years

Rave reviews?

Rave reviews?

Genetics of gastrointestinal and hepatobiliary disorders: Working Group Report of the First World Congress of Pediatric Gastroenterology, Hepatology, and Nutrition.

Genetics of gastrointestinal and hepatobiliary disorders: Working Group Report of the First World Congress of Pediatric Gastroenterology, Hepatology, and Nutrition.

Management of Residents' Pain in Extended Care Settings: Resource Issues for Nurses

Objectives: To discuss the issues of poor management and inadequate allocation of resources in the management of chronic pain for residents in an extended care setting.Method: Drew on critical social science and entailed the first author acting as a consultant in the research setting, assisting nurses to identify practices which enhanced pain management and to overcome barriers to adequate pain control with a selected number of clients.Results: Identified a lack of resource allocation. Resourcing difficulties occurred at two levels. Documentation provided minimal opportunity to record nursing time spent dealing with residents in pain or to have pain identified as an area needing resources. Secondly, when pain was identified during the research process it became evident that staffing levels and expectations put upon nurses were an issue.Conclusion: Each case study was a success story in terms of increased knowledge for those individual nurses and allied health care workers involved, and respite for those residents suffering pain. However, the adequate and effective recording of needed resources, and allocation of these resources remains a fundamental issue for the organisation to grapple with.

A European risk model for hepatitis among health care workers

Hepatitis B (HBV) is the most important occupational hazard facing workers in the hearth care and related environments. It is a serious, but underestimated, occupational hazard among such personnel, who are at a 2 to 10 times greater risk of infection than the general population. In the light of recent changes in legislation concerning hepatitis B, we have designed a risk model for health care workers (HCW) in Western Europe to estimate the number of cases of HBV infection in this group. An annual attack rate was derived, based on data from the literature and from hearth registers. The number of HCW exposed to HBV infection was calculated from official registers, taking into account the prevalence and incidence of HBV infection and vaccination coverage. Even with the present vaccination coverage of 40% among traditional HCW and 25% among allied HCW, we estimate that 16,500 cases of HBV infection occur in these groups annually (i.e. over 40 per day). Approximately 5,800 workers will develop acute symptoms and 990 will become carriers, of whom 240 will die due to liver cirrhosis and/or primary hepatocellular cancer. If no further vaccinations are made, the number of infections will rise to approximately 24,000 each per year. An increase in vaccination coverage would greatly decrease these numbers. The amendments to the Biological Agents at Work EC Directive (EC90/679/EEC) were formally adopted on 12 October 1993. Since April 1994, a specific code of practice on vaccination should have been in place in the national legislation of each member state. This represents an important step in achieving consensus on a preventive policy In Western Europe. It is equally important that the legislation obliges employers to identify and vacdnate (free of charge) those workers at risk of infection from hepatitis B.

Psychological Assessment and Treatment of Sexual Dysfunctions Following Spinal Cord Injury

Sexual dysfunction following SCI has received increased attention in recent years. Despite this attention, many physicians and allied health care workers respond to patients' sexual concerns with dismissal or reassurance. Moreover, physiological and medical aspects of sexual dysfunction tend to be emphasized at the exclusion of the emotional aspects of sexuality. A multidimensional, integrative approach to the assessment and treatment of sexual dysfunctions across the entire sexual response cycle following SCI is emphasized. The rationale and procedure of brief sexual counseling is discussed.

Clinical teaching strategies for physicians.

This paper provides advice for the clinical teacher. It reviews the aims of clinical teaching and the skills and strategies required for the teacher. All too often the emphasis in clinical teaching is on an accumulation of theoretical knowledge rather than on the development of clinical competencies required by the student. These include accumulation and recording of information about patients, performance of physical examination, performance of skill procedures, interpretation of data, solving scientific and professional problems, communicating information reliably, familiarity with health care services and facilities and appropriate attitudes to patients and allied health care workers. Teaching methods include bedside small group tutorials, clinical ward rounds, active participation as a member of the patient care team, independent patient contact in outpatients and inpatients, small group discussions away from the bedside, utilisation of model simulation and role playing, video tape and audiotapes and discussion of patient management problems. Each method is better suited for some goals than for others.Considerations such as the clinical teacher as a role model and who should do the clinical teaching are important. Features of an effective clinical teacher include group instructional skills, attitudes to patients, applied problem solving, student-centred instructional strategies, humanistic orientation, the subject expertise and a challenging approach.Clinical teaching activities require preparation and planning followed by conscientious implementation of the tactics selected. Guidelines can be given which may be of assistance at each of these stages.