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Background: The introduction of a systematic framework for the licensing of health care professions, which is a crucial step in ensuring the quality of human resources for health (HRH), is still evolving in Lao People's Democraic Republic. The aim of this study was to review and document the evolution of Lao HRH policies and the development of its national licensing system.Case Presentation: A qualitative descriptive case study methodology was applied to document and describe how Lao People's Democratic Republic laid the foundation for the development of a licensing system. The results demonstrate that Lao People's Democratic Republic is currently in the process of transitioning the focus of its HRH policies from the quantity and deployment of services to remote areas to improvements in the quality of services. The key events in the process of developing the licensing system are as follows: (1) the systematic development of relevant policies and legislation, (2) the establishment of responsible organizations and the assignment of responsible leaders, (3) the acceleration of development efforts in response to the Association of Southeast Asian Nations Mutual Recognition Arrangement for standard qualifications, (4) the strengthening of educational systems for fostering competent health care professionals, (5) the introduction of a 3-year compulsory service component in rural areas for newly recruited government servants, and (6) the introduction of a requirement to obtain a professional health care certificate to work in a private hospital. The Lao Ministry of Health (MOH) has endorsed a specific strategy for licensing to realize this system.Conclusion: The need for licensing systems has increased in recent years due to regional economic integration and a shift in policy toward achieving universal health coverage. A national licensing system would be a significant milestone in health system development, helping to ensure the competency of health care professionals by means of a national examination, continuing professional development, and the revoking of licenses when appropriate. [ABSTRACT FROM AUTHOR]

The goal of this paper is to outline the major tensions between the monopoly face of licensing versus potential consumer protection goals of occupational regulation in the health care industry. Historically, health care occupations limited supply as a method of raising earnings, but with the growth in the number of newly regulated occupations, many professions have come in conflict over who gets to do the work. Rather than having consumers decide, state legislatures and licensing boards determine the allocation of tasks. The paper outlines policies that may allow consumers rather than service providers determine the direct allocation of these jobs. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to explore how 'new role' and other social carers and stakeholders involved in providing enhanced health and social care for older people perceive the social care support worker's professional status. Method: Three different enhanced care approaches, of which two trained social care support workers to undertake new clinical support roles were studied in three residential homes: a local authority home, a voluntary sector home and a 'not for profit' independent sector home for older people. Participants were staff with national vocational qualifications at level 3 as new role carers with and without additional basic health skills awards. Other participant groups included care staff of other grades, care home managers, their parent organisation managers, and local and national stakeholders. Results: Staff in all three care settings believed themselves to be professionals in the homes in which they worked but were less sure of their status in the wider health and care landscape. Conclusion: If the social carer workforce is to be considered a profession, it requires a professional framework in the form of a representative organisation, a code of conduct for practice and clarity as to how its new role activities interact with those of other established health professionals. [ABSTRACT FROM AUTHOR]

Background Physical activity (PA) programs for adults with intellectual disability (ID) have positive impacts, at least in the short term. No research has been reported on the effect of long-term engagement in PA programs for adults with ID. This paper explores the physical and psychosocial benefits gained by two individuals with mild ID who participated in a long-term PA program. Method Accelerometery was used to collect PA data during the program and for 7-day periods outside of the program. To explore the psychosocial outcomes gained from participating in the program, participants and their caregivers were interviewed about their participation experiences. Results Across time, a decrease in the amount of light activity engaged in during sessions was found, with participants gradually increasing their moderate to vigorous activity. Psychosocial benefits, including meeting new people and gaining social acknowledgement were reported by participants and caregivers. Conclusions Long-term, sustainable, low cost PA programs (such as the one under investigation) can minimise barriers to physical activity for people with ID. [ABSTRACT FROM AUTHOR]

The federal government has established rapid identification, linkage, and engagement in medical care of HIV-positive individuals as a high priority. Outreach workers and other linkage coordinators are identified as key personnel in implementing this policy. Young racial/ethnic minority men who have sex with men (MSM) have relatively high and growing rates of HIV infection and would benefit from the services of outreach workers. In this article, we describe the characteristics of outreach workers employed by eight demonstration sites participating in the federal Special Projects of National Significance (SPNS) Young MSM of Color Initiative, the linkage and retention models used by the sites, and the number of outreach/ linkage contacts and individuals referred to HIV care. We summarize rates of retention of outreach workers in employment, factors associated with worker turnover, and costs associated with their replacement. We also summarize the experiences of demonstration sites in employing and retaining outreach workers and improving their performance. The insights of outreach workers are reported regarding the challenges they experienced while conducting outreach. Recommendations from demonstration site project managers and outreach workers are offered to improve workplace performance and job retention. Outreach and retention strategies, as well as lessons learned in employing outreach workers, are useful to programs serving young racial/ethnic minority MSM and other HIV-positive groups. [ABSTRACT FROM AUTHOR]

To compare rates of medication errors committed by assisted living staff with different training and to examine characteristics of errors. Observation of medication preparation and passes, chart review, interviews, and questionnaires. Stratified random sample of 11 assisted living communities in South Carolina (which permits nonnurses to administer medications) and Tennessee (which does not). All staff who prepared or passed medications: nurses (one registered nurse and six licensed practical nurses (LPNs)); medication aides (n=10); and others (n=19), including those with more and less training. Rates of errors related to medication, dose and form, preparation, route, and timing. Medication preparation and administration were observed for 4,957 administrations during 83 passes for 301 residents. The error rate was 42% (20% when omitting timing errors). Of all administrations, 7% were errors with moderate or high potential for harm. The odds of such an error by a medication aide were no more likely than by a LPN, but the odds of one by staff with less training was more than two times as great (odds ratio=2.10, 95% confidence interval=1.27-3.49). A review of state regulations found that 20 states restrict nonnurses to assisting with self-administration of medications. Medication aides do not commit more errors than LPNs, but other nonnurses who administered a significant number of medications and assisted with self-administration committed more errors. Consequently, all staff who handle medications should be trained to the level of a medication aide. [ABSTRACT FROM AUTHOR]

Universal screening for intimate partner violence has been recommended for health care settings. However, provider adherence to this recommendation is low, and little research has explored perspectives on relevant policies and procedures among providers in family planning centers. In 2009, a sample of 75 health care staff from a large, urban family planning organization that has a protocol for screening for partner violence participated in focus group discussions about their attitudes toward, perceptions of barriers to and preparedness for such screening; 64 of them also completed a brief survey. Multiple analysis of variance was used to assess differences between licensed practitioners (advanced practice clinicians and social workers) and unlicensed health care assistants; findings were analyzed for congruence with and divergence from the focus group data. Barriers included lack of time, training and referral resources, but were reported less by licensed than by unlicensed providers. Overall, participants rated screening as helpful to clients, but licensed providers had more positive attitudes toward and felt more prepared for it than unlicensed ones. In the focus groups, some providers expressed frustration with clients' responses to referrals, concern about taking too much time away from other health care matters and opinions that it was more appropriate for licensed professionals than for unlicensed practitioners to conduct screening. Both licensed and unlicensed staff wanted more training on responding to disclosures of violence. Family planning providers who are working under an institutional protocol continue to perceive barriers to screening and may benefit from ongoing professional development. [ABSTRACT FROM AUTHOR]

Accessible summary: • Support staff were asked what were the important things they did to support people with learning/intellectual disabilities, and what training and support they needed to do their job.• Support staff said they had difficulties in communicating with each other, and feel stressed when asked to do things which did not make the people they support happy.• Support staff also stated that there should be more training and support for new staff.• Support staff need more help to learn: how to give each other advice and how to cope with being stressed. Summary: This study explores the perceptions of support workers working with adults with learning/intellectual disabilities, training and support needs. Data was collected by focus group (n = 3) and semi‐structured interviews (n = 5). Participants saw their key role as maximising quality of life, identified 'Trial and error' as the main mode of skill development for new staff and experienced stress as a result of conflict between their beliefs and demands of the service. Participants recognised their responsibility to model good and challenge poor practice; however, poor communication and assertiveness skills affected their ability to do this. A preference for more on site supervision to provide leadership was indicated. Training by the community learning disability team was highly regarded; however, there were indications that carers found this difficult to put into practice. It is suggested that development of personal skills and relating training to human rights and person‐centred planning perspectives would best enable staff to carry out their roles. [ABSTRACT FROM AUTHOR]

The author reflects on the methods used to ensure and monitor safe and effective healthcare services of licensed health professionals in the U.S. She cites the research by Hess and colleagues that attempt to establish healthcare practice benchmarks and challenges its result with a hypothetical scenario of public expectations of safe and effective healthcare in an outcome-based quality situation. Furthermore, she raises the issue of the maintenance of certification program (MOC) primary goals.