ABSTRACT
In order to design a quality assurance tool for midwifery it was necessary to assess current frameworks and standards for practice. With that aim a questionnaire was sent to all midwifery managers in the UK. The findings showed that 'Planned Individualised Care' is the favoured framework for midwifery practice and that the use of nursing models (or adapted versions of these) and midwifery models is widespread but not prevalent. Documentation for midwifery care is not always in accordance with the favoured framework for care as reported. The standards articulated in the three 'Maternity Care in Action' reports are those aspired to by most maternity units. Methods of assessing the quality of maternity care are many and varied but show a clear trend towards giving precedence to gauging client satisfaction with the service.
Subject(s)
Midwifery/standards , Quality Assurance, Health Care/standards , Models, Theoretical , Nursing Process/standards , Surveys and Questionnaires , United KingdomSubject(s)
Bone Diseases/nursing , Hospital Units , Pressure Ulcer/epidemiology , Age Factors , Aged , England , Evaluation Studies as Topic , Female , Humans , Male , Middle Aged , RiskSubject(s)
Community Health Nursing/organization & administration , Public Health Nursing , Adolescent , Adult , Aged , Child , Child, Preschool , England , Female , Home Care Services , Humans , Infant , Male , Middle Aged , Public Health Administration , Regional Health Planning , Surveys and Questionnaires , TravelABSTRACT
Massage has had a long history within orthodox medicine and is not an unknown, untried therapy of dubious origin. Writers on massage usually refer to its long history in ancient cultures but stop with Ling, to whom they attribute the development of modern massage in the early 19th century. Little attention is given to the rich massage literature of the late 19th and early 20th centuries, which reveals massage to have been an orthodox medical therapy practised by doctors and nurses. Analysis of that literature shows massage to have been significantly different in its application to most of today's practice, despite similarity of definition and terminology. Lack of detailed specification of a massage is a limitation of much current research, and this paper suggests a framework, or template, for that specification based on the earlier literature, so that future massages used in research can be replicated and implemented more reliably than at present. Massage as an orthodox therapy almost disappeared after WWII, but has recently reemerged as a complementary therapy which requires a full re-evaluation and audit. The template for its specification, together with the utilization and reconsideration of earlier modes of delivery, offers significant research opportunities for nurses and midwives of today.
Subject(s)
Massage/trends , Forecasting , Humans , Interprofessional Relations , Massage/methods , Massage/nursing , Professional Practice/trends , Research Design/standards , Societies/trends , Terminology as TopicABSTRACT
This paper investigates the predictive power of the Norton score in the problem of anticipating pressure lesions, and looks at some variants on that score. The Norton score is now nearly 20 years old but is still not in frequent use by nurses, and has been the subject of little research, especially in its predictive ability. By following the progress of two matched samples over a 15-month period in a district general hospital it is established that the Norton score does perform at least as well as a number of reasonable variants of it, and that in particular the physical score and incontinence score are the crucial elements. A follow-up sample in which the variants are retested confirms the usefulness of the Norton score.
Subject(s)
Nursing Records , Pressure Ulcer/diagnosis , Aged , Female , Follow-Up Studies , Humans , Male , Methods , Middle Aged , Probability , Risk , Sampling StudiesABSTRACT
In the primary care environment the role of preventive medicine is assuming increasing importance and general practitioners need accurate and up-to-date information about their practice population. Computerization of family practitioner committee registers should provide a readily accessible data base from which data about groups of patients within the practice area can easily be extracted. This paper describes a study carried out in Northumberland, which set out to establish the type of information which would be of interest to general practitioners and how it could be produced.It was found that a data base holding only registration data was of limited value to general practitioners, although useful for identifying target groups for screening programmes and showing demographic trends within the practice. The doctors felt that the inclusion of medical data would make the register a far more effective resource.
Subject(s)
Ambulatory Care Information Systems , Family Practice , Information Systems , Medical Records , Demography , Humans , Professional Staff CommitteesABSTRACT
This paper summarizes the results of the trial of the Beaufort Bead Bed system designed to reduce the incidence and severity of pressure sores. Elderly orthopaedic admissions were allocated alternately to the Beaufort system and to the usual trolley, table and bed surfaces, and followed from admission to hospital until separation. The incidence of pressure sores was 15.6% in the 32 'trial' patients, which was significantly less than the 48.8% in the 43 'control' patients, as was the mean maximum diameter of the pressure sores incurred: 6.4 mm for the 'trials' as against 29.5 mm for the 'controls'. In particular the trial group were free from pressure lesions to the heel, which affected 32.6% of the control group. The groups were well matched on a variety of criteria on admission, and we conclude that the Beaufort system successfully reduces the incidence and severity of pressure sores for elderly orthopaedic patients. The system--renamed recently the 'Neumark-Macclesfield Support System'--is now in regular and satisfactory use.