Organisational strategies to implement hospital pressure ulcer prevention programmes: findings from a national survey.

AIM: To describe the presence and operationalisation of organisational strategies to support implementation of pressure ulcer prevention programmes across acute care hospitals in a large, integrated health-care system. BACKGROUND: Comprehensive pressure ulcer programmes include nursing interventions such as use of a risk assessment tool and organisational strategies such as policies and performance monitoring to embed these interventions into routine care. The current literature provides little detail about strategies used to implement pressure ulcer prevention programmes. METHODS: Data were collected by an e-mail survey to all chief nursing officers in Veterans Health Administration acute care hospitals. Descriptive and bivariate statistics were used to summarise survey responses and evaluate relationships between some variables. RESULTS: Organisational strategies that support implementation of a pressure ulcer prevention programme (policy, committee, staff education, wound care specialists, and use of performance data) were reported at high levels. Considerable variations were noted in how these strategies were operationalised within individual hospitals. CONCLUSION: Organisational strategies to support implementation of pressure ulcer preventive programmes are often not optimally operationalised to achieve consistent, sustainable performance. IMPLICATIONS FOR NURSING MANAGEMENT: The results of the present study highlight the role and influence of nurse leaders on pressure ulcer prevention program implementation.

[We must remove the taxi driver from the tumour committee]. / Debemos eliminar al taxista del comité de tumores.

The increasing complexity of cancer care makes organisation of clinical decision-making one of the key elements in high-quality cancer care. The great number of professionals involved in this disease means that communication and co-ordination among such professionals is of pivotal importance. The prospect of an organised multidisciplinary care is highlighted for its ability to move from a sequential model of care to progress towards an inclusive process led by a multidisciplinary team. Scientific evidence shows that such a perspective contributes to improved survival and quality of life of cancer patients. In the context of highly frequent, costly and clinically complex cancer diseases, the priority is to develop a different approach to its management, based on the expertise of professionals and teams by tumour location. The organisation and management of many hospitals, however, does not generally reflect this dimension. The process of care is based on very rigid hospital services which restrict cross-communication. This hinders a redistribution of responsibilities of the professionals with the greatest potential to improve clinical effectiveness. The present paper shows the difficulty in developing a model of integrated professional cooperation and identifies the different models of implementation of multidisciplinary care, using cancer as an example, in the context of the Spanish National Health System.

An analysis of the editorial committee of the Journal of Music Therapy, 1964-2007.

Editorial committees review article submissions and subsequently influence the content of professional journals. In this bibliographical study, the researchers investigated the characteristics of Journal of Music Therapy (JMT) editorial committee between 1964 and 2007 using four publication periods. Data were tabulated using the journal's masthead and online library databases. Results indicated that the number of editors who had publications in JMT prior to their initial appointment, the percentage of female editors, and the number of listed affiliated institutions increased over time. Female editors published more articles than did male editors during the last two decades. University of Kansas, Florida State University, and New York University contributed the most alumni to the committee. The researchers identified a possible link between certain historical events, such as the formation of the American Music Therapy Association, and the composition, and the size of the committee's roster.

Increasing minority enrollment utilizing dental admissions workshop strategies.

Oral Health in America, the landmark U.S. surgeon general's report, inextricably connects oral health disparities with poor access to oral care by vulnerable populations. Furthermore, the report associates an insufficiently diverse dental workforce with oral health disparities among some minority groups. Successful strategies to curtail oral health disparities and remedy work-force issues require collaboration among all involved in dental education. As gatekeepers to dental programs, admissions committees are significant stakeholders in diversifying the dental workforce. The purpose of this article is to demonstrate that a workshop on diversity in admissions can modify the perceptions of individuals involved in the student recruitment and admissions processes and lead to increased matriculation of underrepresented minority students. Emerging from the workshop were key concepts and action steps for promoting a holistic review of dental applicants. Results since implementing the workshop recommendations have been positive, with underrepresented minority dental student acceptances increasing sixfold. The workshop was cosponsored by the Robert Wood Johnson Foundation and facilitated by two nationally recognized dental educators.

Rationalising public participation in the health service: the case of research ethics committees.

This paper seeks to raise questions about the growing emphasis on public participation in decision-making in the health service. It examines the case study of lay participation on Local Research Ethics Committees (LRECs'). In the light of contested theoretical conceptions of the value of lay participation and an absence of a centrally defined role this paper examines practice. It uses qualitative evidence collected in 45 semi-structured interviews with committee members and observations of twenty committee meetings. It examines members' own conceptualisations of lay involvement and the contributions they are able to make in meetings as a result of these conceptualisations. It concludes that without better-defined roles for lay members on these committees they do not possess the authority or knowledge to challenge the experts' technical rendering of research.

Ethical review of multi-centre research: a survey of local research ethics committees in the south Thames region.

OBJECTIVE: To generate baseline data about the standards of practice of local research ethics committees (LRECs) in order to describe accurately the situation of ethical review procedures prior to the establishment of multi-centre research ethics committees (MRECs). DESIGN: The LERECs in the South Thames NHS Region were asked to describe their current practices, and to send us a copy of their application forms and guidance notes for researchers. RESULTS: All of the 27 LRECs approached for the survey responded. The results indicate that there are generally high standards of practice, and that most LRECs work in accordance with published guidelines. CONCLUSION: The problems that researchers face in seeking to obtain ethical approval for multi-centre research (pages 242-5) do not seem to have been caused by substandard LRECs. Hence the new system needs to sustain the high standards of practice whilst confronting the difficulties.