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The article presents a court case which deals with delimitation of the relevant area of ​​medicine, which is necessary for the granting of a sectoral alternative practitioner license, does not require a normative framework of the professional profile created by the legislator in Germany. It mentions rejection of the request for a non-medical practitioner license limited to the field of chiropractic, which goes beyond this.

The increased use of nurse practitioners (NPs) and physician assistants (PAs) represents an important option for increasing access to healthcare. I explore the effect of two types of laws on the supply of NPs and PAs: occupational licensing laws that limit the practices of NPs and PAs and caps on noneconomic damages. Relaxing licensing laws to allow NPs to practice with less physician oversight increases the supply of NPs in areas with few practicing physicians by 60 percent—though the size of this increase decreases as the supply of physicians grows. I find similar, but weaker, evidence for granting PAs more autonomy. Noneconomic damages caps increase the supply of both NPs and PAs by about 60 percent at the lowest levels of physician supply. Examining the effects of these laws on the prevalence of health professional shortage areas, I find that licensing laws have meaningful effects on access to care. [ABSTRACT FROM AUTHOR]

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]

Educators often seek to demonstrate the equivalence of groups, such as whether or not students achieve comparable success regardless of the site at which they trained. A methodological consideration that is often underappreciated is how to operationalize equivalence. This study examined whether a distribution-based approach, based on effect size, can identify an appropriate equivalence threshold for medical education data. Thirty-nine individuals rated program site equivalence on a series of simulated pairwise bar graphs representing one of four measures with which they had prior experience: (1) undergraduate academic achievement, (2) a student experience survey, (3) an Objective Structured Clinical Exam global rating scale, or (4) a licensing exam. Descriptive statistics and repeated measures ANOVA examined the effects on equivalence ratings of (a) the difference between means, (b) variability in scores, and (c) which program site (the larger or smaller) scored higher. The equivalence threshold was defined as the point at which 50 % of participants rated the sites as non-equivalent. Across the four measures, the equivalence thresholds converged to average effect size of Cohen's d = 0.57 (range of 0.50-0.63). This corresponded to an average mean difference of 10 % (range of 3-13 %). These results are discussed in reference to findings from the health-related quality of life field that has demonstrated that d = 0.50 represents a consistent threshold for perceived change. This study provides preliminary empirically-based guidance for defining an equivalence threshold for researchers and evaluators conducting equivalence tests. [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]

The article discusses the integration of the refugee doctors in the health care system in U.S and Great Britain. It talks about the right of asylum for the refugees. It discusses the regulations pertaining to employment of the refugee doctors. It discusses the employment related training provided to the doctors and the license offered to them for practicing medicine.

Post-licensure medical product safety surveillance is important for detecting adverse events potentially not identified pre-licensure. Historically, post-licensure safety monitoring has been accomplished using passive reporting systems and by conducting formal Phase IV randomized trials or large epidemiological studies, also known as safety surveillance or pharmacovigilance studies. However, crucial gaps in the safety evidence base provided by these approaches have led to high profile product withdrawals and growing public concern about unknown health risks associated with licensed products. To address the limitations of existing surveillance systems and to facilitate more accurate and rapid detection of safety problems, new systems involving active surveillance of large, population-based cohorts using observational health care databases are being developed. In this article, we review common statistical methods that have been employed previously for post-licensure safety monitoring, including data mining and sequential hypothesis testing, and assess which methods may be promising for potential use within this newly proposed prospective observational cohort monitoring framework. We discuss gaps in existing approaches and identify areas where methodological development is needed to improve the success of safety surveillance efforts in this setting. [ABSTRACT FROM AUTHOR]

The article discusses the legal aspects of complaint reviews before the Ontario Health Professions Appeal and Review Board, and it mentions issues related to jurisdiction and the regulation of the conduct of health professionals in Ontario. The enactment of Ontario's Regulated Health Professions Act 1991 is mentioned, along with the licensing of individuals in various health disciplines such as medicine, dentistry, and nursing. Ontario's Health Professions Procedural Code is also examined.

The article offers information on the regulatory and legislative approaches to analyze the accountability of performance or tort liability of the unregistered health practitioners' under the civil and criminal law in Australia. It discusses the significance of the negative licensing model of legislation in dealing the the medical malpractice complaints against the unregistered health practitioners.

Objectives: Amended in 2013, the current version of the German Medical Licensure Regulation contains structural specifications that are also required of non-university institutions involved in Practical Year clinical training. The criteria are worded in relatively general terms. Furthermore, not all of the structural specifications can be readily applied to every subject area. In order to ensure commensurability in Practical Year instruction in Germany, not least in light of recently introduced Practical Yearmobility, it is necessary to define consistent quality criteria for Practical Year training. The authors therefore propose a catalogue of criteria for the quality management process in Practical Year instruction facilities. Methods: In January 2014, the board of directors of the German Society for Medical Education decided to establish a committee comprised of representatives from various German medical faculties. In a process similar to the Delphi methodology, the group developed criteria for structure, process and outcome quality in Practical Year training in Germany. Results: The criteria developed for structure, process and outcome quality apply to Practical Year training in academic teaching hospitals and university medical centres. Furthermore, modalities for review are proposed. Conclusions: The present catalogue of criteria is intended to contribute to the formation of a basis for the most consistent quality standards possible for Practical Year instruction in Germany. [ABSTRACT FROM AUTHOR]

Introduction: Continuing professional development (CPD) with corresponding crediting system is recognized as essential for the laboratory medicine specialists to provide optimal service for the patients. Article presents results of the survey evaluating current CPD crediting practice among members of European Federation of Clinical Chemistry and Laboratory Medicine (EFLM). Materials and methods: A questionnaire had been forwarded to presidents/national representatives of all EFLM members, with invitation to provide information about CPD programmes and crediting policies, as well as feedback on individual CPD categories, through scoring their relevance. Results: Complete or partial answers were received from 28 of 38 members. In 23 countries, CPD programmes exist and earn credits, with 19 of them offering access to non-medical scientists. CPD activities are evaluated in all participating countries, regardless to the existence of an official CPD programme. Among participating members with mandatory specialists' licensing (22/28), CPD is a prerequisite for relicensing in 13 countries. Main categories recognized as CPD are: continuing education (24 countries), article/book (17/14 countries) authorship and distance learning (14 countries). The highest median score of relevance (20) is allocated to professional training, editor/authorship and official activities in professional organizations, with the first category showing the least variation among scores. Conclusions: Majority of EFLM members have developed CPD programmes, regularly evaluated and accompanied by crediting systems. Programmes differ in accessibility for non-medical scientists and impact on relicensing eligibility. Continuing education, authorship and e-learning are mainly recognized as CPD activities, although the professional training is appreciated as the most important individual CPD category. [ABSTRACT FROM AUTHOR]

Aim. The aim of this study was to evaluate a pressure ulcer prevention programme for nursing homes to ascertain the feasibility of its implementation, impact on care staff and outcomes for pressure ulcer knowledge and skills and pressure ulcer reduction. Background. No pressure ulcer prevention protocol for long-term care settings has been established to date. The first author of this study thus developed a pressure ulcer prevention programme for nursing homes. Design. A quasi-experimental pretest and post-test design was adopted. Methods. Forty-one non-licensed care providers and eleven nurses from a government-subsidised nursing home voluntarily participated in the study. Knowledge and skills of the non-licensed care providers were assessed before, immediately after and six weeks after the training course, and pressure ulcer prevalence and incidence were recorded before and during the protocol implementation. At the end of the programme implementation, focus group interviews with the subjects were conducted to explore their views on the programme. Results. A statistically significant improvement in knowledge and skills scores amongst non-licensed care providers was noted. Pressure ulcer prevalence and incidence rates dropped from 9-2·5% and 2·5-0·8%, respectively, after programme implementation. The focus group findings indicated that the programme enhanced the motivation of non-licensed care providers to improve their performance of pressure ulcer prevention care and increased communication and cooperation amongst care staff, but use of the modified Braden scale was considered by nurses to increase their workload. Conclusion. A pressure ulcer prevention programme for nursing homes, which was feasible and acceptable, with positive impact and outcome in a nursing home was empirically developed. Relevance to clinical practice. The study findings can be employed to modify the programme and its outcomes for an evaluation of effectiveness of the programme through a randomised controlled trial. [ABSTRACT FROM AUTHOR]

The article presents a study identifying and determining the barriers that inhibit effective registered nurse-unlicensed assistive personnel (RN-UAP) teamwork. The study also ascertained if and how dysfunctional teamwork is responsible for the problems in quality of care and patient safety. The study found that there was a lack of working together as a team as both RNs and UAP were practicing almost in isolation. The study also noticed a lack of conflict management and feedback skills. Many examples of quality and safety problems were identified by the authors of the study.

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]

Objectives: We explore the risks reported to picuriste (injectionist) use in a non-probability sample of Haitian immigrant residents of Miami-Dade, Florida, using a mixed method approach. Picuristes typically have no formal medical training, and may use non-sterile needles. Methods: Face to face semi-structured interviews were conducted of picuristes (n=10) and picuriste users (n=25). We sought to corroborate the qualitative findings by fielding a survey based on the interviews in a community-based sample of 205 Haitian immigrants. Results: The findings from the interviews indicate picuriste injections do not adhere 100% to established standards for safe injections, and may pose health risks that are similar to those that exist for injection drug users. Yet, of the survey respondents (n=205), 17.6% reported obtaining picuriste injections. Conclusion: Our findings shed light on a normally hidden cultural health behavior enhancing our understanding of picuriste practice and use among Haitian immigrant residents of Miami-Dade County, Florida. We suggest that medical care must be delivered in a culturally competent, culturally sensitive manner, with open dialogue between physician and patient regarding health beliefs and practices. [ABSTRACT FROM AUTHOR]

Background Affective and reciprocal interactions with others are essential for persons with profound intellectual and multiple disabilities (PIMD), but it is a challenge to assess their quality. This study aimed to investigate the usefulness of instruments from parent-infant research to evaluate these interactions. Method Eighteen videotaped staff-client interactions were coded with the Emotional Availability Scales, the Maternal/Child Behavior Rating Scales, and the Revised Erickson Scales. Results The scales could generally be applied to persons with PIMD and substantial interobserver agreement was found. The tools' subscales appeared to be distinct but there was also evidence that they measure an overarching construct. Client and staff interactive behaviours were highly related. Convergent validity was demonstrated by strong correlations between theoretically related dimensions. An acceptable range in scores, a ceiling-effect, and relative high mean scores occurred. Conclusions The instruments' applicability and usefulness was demonstrated in this study, which offers directions for future research and intervention. [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]

Background. Although mutual support and self-help groups based on shared experience play a large part in recovery, the employment of peer support workers (PSWs) in mental health services is a recent development. However, peer support has been implemented outside the UK and is showing great promise in facilitating recovery. Aims. This article aims to review the literature on PSWs employed in mental health services to provide a description of the development, impact and challenges presented by the employment of PSWs and to inform implementation in the UK. Method. An inclusive search of published and grey literature was undertaken to identify all studies of intentional peer support in mental health services. Articles were summarised and findings analysed. Results. The literature demonstrates that PSWs can lead to a reduction in admissions among those with whom they work. Additionally, associated improvements have been reported on numerous issues that can impact on the lives of people with mental health problems. Conclusion. PSWs have the potential to drive through recovery-focused changes in services. However, many challenges are involved in the development of peer support. Careful training, supervision and management of all involved are required. [ABSTRACT FROM AUTHOR]

A review of the articles related to primary care including "Diagnostic Value of Symptoms for Colorectal Cancer in Primary Care," by W. Hamilton and colleagues, "How Satisfied Are We With the NHS?," by J. Appleby and "Factors Associated With Dropout in Medical Education: A Literature Review," by L. D. O'Neill is presented.

The article discusses a study which determine if indicators of registered nurses (RN) job demands, specifically overtime, absenteeism, and experience, are related to greater sitter use. It offers details related to the nested case-control study which included patient from the academic health center in Montreal, Canada and assess the association between RN job demand indicators and sitter use. Findings suggested further research to evaluate the impact of sitter use on patient outcomes.

Purpose of the Study: Use archived public data from Arizona to explore relationships among selected institutional and resident risk and situation-specific factors and complaints and substantiated allegations of various types of mistreatment in assisted living facilities (ALFs). Design and Methods: An exploratory/descriptive 2-group design was used. Facilities in the complaint group were identified from narrative data that appeared suspicious for mistreatment based on definitions for physical, verbal, psychological, medication, sexual abuse, neglect, financial exploitation, and physical restraint. Facilities in the comparison group were those that had no citations or complaints in 2007–2008. Narrative data were content analyzed, and chi-square analysis was used to answer 3 research questions. Results: The complaint group was comprised of significantly more assisted living centers, large facilities (51–101+), facilities licensed to provide personal care services, and facilities owned by national corporations. Substantiated allegations were significantly more frequent in assisted living centers, facilities with more than 51 beds, and those owned by national corporations. Facility risk factors were related to some types of substantiated mistreatment and not others. Implications: Findings suggest the need to evaluate use of only unlicensed assistive personnel in facilities, increase oversight of care by professional nurses, rethink the practice of not licensing small facilities, and monitor more closely practices and procedures in facilities operated by national corporations. [ABSTRACT FROM PUBLISHER]

Given that students with autism spend the majority of their days in school settings, largely supported by paraprofessionals, it is important that these paraprofessionals receive adequate training. The author investigated a training package consisting of modeling and video-based feedback as a means of enabling paraprofessionals to implement Pivotal Response Treatment (PRT) in the inclusive school setting. A multiple baseline design across four paraprofessional -focal student pairs was employed. The findings suggest that the training package was effective and efficient in improving paraprofessional PRT implementation and levels of involvement as well as social communication target behaviors of the students with autism. Generalization across activities and students, maintenance, and social validity were also assessed. [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]

Delegation of nursing procedures and medication in school is fraught with legal and ethical concerns for the school nurse. Because nurses may be responsible for coordinating care for several school buildings, delegation of nursing care and medication administration has occurred out of necessity. Nurse Practice Acts in some states, but not all, allow for delegation of medication to unlicensed assistive personnel. This article explores Glucagon® delegation laws in the United States and presents an argument against such delegation in states where Nurse Practice Acts do not allow for delegation of medication to unlicensed assistive personnel. [ABSTRACT FROM PUBLISHER]

Introduction Male circumcision for religious reasons is not available in the NHS. In this report, we present the results of an investigation conducted by the Thames Valley Health Protection Unit (TVHPU) at an unregulated circumcision ‘camp’ in Oxford in 2006. Methods A detailed investigation was initiated following notification by a general practitioner of two children with circumcision-related complications at a ‘camp’. Telephone interviews were conducted with the ‘camp’ organizers, the operating surgeon, GPs and paediatric surgeons. A field visit was carried out by TVHPU staff to assess implementation of infection control practices. Results Thirty-two children were circumcised over a 3 day period in the library of an Islamic faith school by a single, medically qualified individual. Among the 29 children with follow-up information, 13 (44.8%) developed complications requiring medical intervention. Information obtained from interviews and the field visit confirmed the lack of implementation of standard infection control practices. Conclusion This incident highlights the harm associated with circumcision in young children by unregulated operators due to lack of compliance with best surgical and infection control guidance. There is an urgent need for commissioning circumcision services for religious reasons in the NHS. [ABSTRACT FROM PUBLISHER]

(2011) Journal of Nursing Management, 534-541 To describe how registered nurses (RNs) perceive delegation to unlicensed personnel (UP) in a municipal healthcare context in Sweden. Within municipal health care RNs often delegate tasks to UP. The latter have practical training, but lack formal competence. Twelve RNs were interviewed and the material was analysed using a phenomenographic approach. Owing to a shortage of RNs, delegation is seen as a prerequisite for a functioning organization. This necessity also involves a number of perceived contradictions in three areas: (1) the work situation of RNs - facilitation and relief vs. lack of control, powerlessness, vagueness regarding responsibility, and resignation; (2) the relationship with unlicensed personnel - stimulation, possibility for mentoring, use of UP competence and the creation of fairness vs. questioning UP competence; and (3) The patients - increase in continuity, quicker treatment, and increased security vs. insecurity (with respect to, for example, the handling of medicine). Registered nurses perceptions of delegation within municipal healthcare involve their own work situation, the UP and the patients. Registered nurses who delegate to UP must be given time for mentoring such that the nursing care is safe care of high quality. [ABSTRACT FROM AUTHOR]

Background. Occupational support workers in the mental healthcare sector are exposed to considerable occupational stress and have little access to stress management facilities. Aims. This article describes the process behind creating a web-based stress management intervention (SMI) for occupational support workers in the mental healthcare sector. Method. Mixed methods were used to inform the content of the web-based SMI, following MRC strategy for designing interventions and PRIMA-EF guidelines for best practice in SMI design. We conducted a literature review to ascertain the content of interventions that had been shown to be successful in reducing stress in mental healthcare populations. In addition, we conducted focus groups in order to assess specific stressors that individuals in the occupational support sector deemed to be important. Results. The literature review showed that a variety of methods had been successful for reducing occupational stress in the mental healthcare sector including: Relaxation and Cognitive Behavioural Therapy techniques, and skills training in; time management, problem-solving and communication. Individuals in the focus groups identified both personal and organisational stressors to be addressed in the intervention. Conclusions. This intervention was developed with reference to a design strategy, using input from the target population. [ABSTRACT FROM AUTHOR]

Background Individuals with severe disability exiting school are likely to be enrolled in day activity and sheltered workshops at least as often as in supported employment. Such facilities are often staffed by paraprofessionals who may not have the skills to engage clients in meaningful activities. This article describes a 3-phase staff training project designed to increase client engagement in an adult habilitation centre. Method The first phase of the project was to develop curriculum guidelines. The second phase was conducting a series of training for paraprofessional staff. And the third was the implementation of the clinical experience. The first author conducted a graduate level methods class on site at the adult habilitation centre. Staff participants ((paraprofessional staff, supervisors, and graduate students)) learned the components of systematic instruction and developed and implemented activities for clients. Engagement was measured before and after the 5-week clinical experience. Results and conclusions The engagement of clients increased with the implementation of systematic instruction following staff training. The implications are discussed. [ABSTRACT FROM AUTHOR]

This article is based on focus group reports on the experiences of people with mental health problems who have undertaken training to be peer support workers in mental health services. In focus groups, trainees stated that the completed training programme empowered them to help and support their peers, and led them to explore wider issues in the mental health services. The professional involved also benefited from the programme. The authors suggest that adequate guidance and support from the Department of Health and local trusts may establish peer support as a welcome and effective component of recovery-oriented mental health services. [ABSTRACT FROM AUTHOR]

The Medicare Conditions for Coverage for End Stage Renal Disease facilities, published April 15, 2008, mandated national certification of hemodialysis patient care technicians (PCTs). PCTs working before October 15, 2008, had until April 15, 2010, to become certified. PCTs hired after October 15, 2008, had 18 months to become certified. Unfortunately, PCTs have had difficulty with the certification examination. Many PCTs have had to take the examination multiple times before eventually passing, and some have still not passed. A lack of standardized education programs and exposure to standardized testing, as well as test anxiety, can all contribute to this outcome. This article addresses a strategy for remediating the lack of exposure to standardized testing and discusses domains of learning, the test blueprint, and the development of quality test questions. The steps needed for the development of practice tests for PCTs are reviewed. The development and administration of such tests can serve to familiarize PCTs with both the required content and testing procedures of a national certification examination and can contribute to their successfully meeting the certification requirements. [ABSTRACT FROM AUTHOR]

This paper reports on the first ever national study in the UK of the needs of disabled women experiencing domestic violence and of the services available to meet these needs. The study found that, in general, support services frequently overlook or respond inappropriately to disabled women in this situation. The overall findings of the research were very wide-ranging, as were the resultant recommendations for statutory agencies, disability organisations, domestic violence services and wider strategic and commissioning frameworks. In this paper, the general findings are discussed briefly, followed by a discussion of abuse by paid carers/personal assistants in the context of the personalisation agenda, with a focus on issues for adult care services. [ABSTRACT FROM PUBLISHER]

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]

In this article the author discusses aspects of the increasing demands on Australian disability support workers (DSWs), which include workers who provide direct and daily care to individuals with intellectual disability (ID). She notes that many of the DSWs have insufficient education to carry out the roles and responsibilities of support work, which requires far ranging skills. Topics include the need for expanding the roles and responsibilities of DSWs, such as monitoring client health, household management, and skill development, concerns about the ability of DSWs to meet workplace demands, and strategies to ensure that DSWs have the basic competencies required to provide direct support to people with ID.

Advocates for the eldercare workforce can point with some pride to key advancements in workforce policy made under ACA. In looking to the future, advocates should be mindful of the need to defend the ground gained under ACA. This will require consistent, interdisciplinary advocacy efforts and attention to appropriations funding, sweeping system redesign, the crucial rule making already underway at the various agencies charged with implementation. Eldercare workforce advocates should be commended for their ability to work together and articulate with one voice what is needed to ensure we are providing the highest quality care for older Americans. This team approach, the heart of a well-coordinated delivery system, will serve advocates in good stead as ACA moves to implementation. [ABSTRACT FROM AUTHOR]

While the need to recruit and retain a competent, caring direct care workforce is acute for many long-term care providers, the transformation from hierarchical to empowering work and workplaces is proving difficult. Management practices that are deeply held artifacts of entrenched cultures, absent radical change, tend to change incrementally. Incremental change allows new ideas to infiltrate an organization without completely destroying the established values and assumptions that provide an organization's operating framework. Using the array of incremental changes made in many of the provider organizations that participated in the Better Jobs Better Care demonstration, we suggest several ways that leaders use management practice change to move the organization forward in its effort to change its culture. [ABSTRACT FROM AUTHOR]

The aging of our population is shaping today's society, and the workforce destined to undergird this era is the direct-care workforce-a rapidly expanding workforce of more than 3 million personal-care aides, home health aides, and nursing and psychiatric aides. This article examines the parameters of this historically unprecedented workforce and why it is important. It considers the opportunities state and federal policy makers and employer-providers have to leverage this workforce to improve care for elders, rein in healthcare costs within the eldercare-disabilities sector, and bolster job growth and job quality for low-income workers. [ABSTRACT FROM AUTHOR]

While the need to recruit and retain a competent, caring direct care workforce is acute for many long-term care providers, the transformation from hierarchical to empowering work and workplaces is proving difficult. Management practices that are deeply held artifacts of entrenched cultures, absent radical change, tend to change incrementally. Incremental change allows new ideas to infiltrate an organization without completely destroying the established values and assumptions that provide an organization's operating framework. Using the array of incremental changes made in many of the provider organizations that participated in the Better Jobs Better Care demonstration, we suggest several ways that leaders use management practice change to move the organization forward in its effort to change its culture. [ABSTRACT FROM AUTHOR]

The article discusses the need to address problems arising from the intrahospital transport of patients who are not in intensive care units (ICUs). It describes transport incidents recorded in the Pennsylvania Patient Safety Reporting System, such as the completion of a chest X-ray on the wrong patient and the disconnection of an intravenous nitroglycerine drip. The implementation of handoff communication procedures, the use of specialized transport teams and the assessment of transport policies are discussed.

The article presents a study concerning the contribution of therapy extenders during inpatient stroke rehabilitation. It mentions the use of descriptive analysis for the observational cohort study to examine the outcomes of the rehabilitation activities where seven inpatient rehabilitation facilities (IRFs) from the U.S. and New Zealand participated the study. Several factors affecting the therapy practice were taken into consideration such as the type of therapy and the years of experience.

Home care is considered an essential pillar of the health care systems in many industrialized countries. With an increased demand for home health workers, there has been growing interest in examining recruitment and retention of these workers. With a focus on recruitment of home support workers, in this study we draw on data from interviews with 57 home support workers in three Canadian provinces, to examine the factors that attract individuals to employment in this sector. These factors include: previous experience, financial considerations, and enjoying working with people. Understanding these overlapping factors can aide in the recruitment of future workers. [ABSTRACT FROM AUTHOR]

butler-williams c.,james j.,cox h. & hunt j. (2010) Journal of Nursing Management 18, 789-795 The hidden contribution of the health care assistant: a survey-based exploration of support to their role in caring for the acutely ill patient in the general ward setting Aim To examine the feelings, support and feedback available to health care assistants (HCA) when caring for acutely ill ward patients. Background The role of the HCA continues to evolve with increased responsibility for patient care. Contextual issues that affect their contribution to acute care management of the ward patient have been given limited attention. Methods A survey of HCAs ( n = 131) was conducted within two district general hospitals. Results There were a number of emotions and stressors associated with the care of acutely ill patients. While normal hierarchical systems were in place in order to obtain help HCAs additionally bypassed these normal channels. Support mechanisms included registered nurses, ward doctors, peers and family. Feedback regarding performance was limited. Conclusion HCAs play a significant role in the care of the acutely ill patient. Feedback mechanisms need to be developed and associated emotions recognized. Implications for nursing management HCAs support needs to be more evident and clinical feedback mechanisms need to be reviewed in order to improve care delivery. [ABSTRACT FROM AUTHOR]

Birthrate Plus is a specifically midwifery-focused workforce planning methodology, which was designed to assess the numbers of midwives required to match the standard of providing all women with a minimum of one-to-one care from a midwife during labour. It uses a number of workforce planning strategies, such as a classification system for intrapartum care, recording of actual midwife hours required per category, further recording of all other maternal/midwife activity within hospital and community services, including home births, and uses a professional judgment and 'expert group' approach to assessing midwife hours per defined client need or activity. This article provides an outline of the theoretical framework and an overview of the results of Birthrate Plus studies within the NHS and beyond since 2001. [ABSTRACT FROM AUTHOR]

Driven by health care reform and the advent of the private sector in the late 1980s, and by commitments made to the Association of Southeast Asian Nations (ASEAN), Vietnam is faced with a need to increase the regulation and training of its health care professionals. Previously, a diploma from an accredited health professional school was sufficient to practice for a lifetime. Legislation has recently been passed that will institute a licensing system, will require continuing medical education (CME) to maintain the license, and will probably place a large burden on the health professional schools and training institutes to provide CME. Supported by international nongovernmental organizations and foreign universities, the medical universities in Vietnam are responding and are preparing for their new and expanded role. [ABSTRACT FROM AUTHOR]