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Expanded scope of practice

Ellen Ernst Kossek, Matthew M Piszczek, Kristie L Mcalpine, Leslie B Hammer, Lisa Burke
Although work schedulers serve an organizational role influencing decisions about balancing conflicting stakeholder interests over schedules and staffing, scheduling has primarily been described as an objective activity or individual job characteristic. The authors use the lens of job crafting to examine how schedulers in 26 health care facilities enact their roles as they "fill holes" to schedule workers. Qualitative analysis of interview data suggests that schedulers expand their formal scope and influence to meet their interpretations of how to manage stakeholders (employers, workers, and patients)...
August 2016: Industrial & Labor Relations Review
Wim G M Bastiaanssen, Pasquale Steduto
Scarce water resources are one of the major constraints to achieve more food production. Food production needs therefore also to be evaluated in terms of water consumption, besides the conventional unit of land. Crop Water Productivity (CWP) is defined as the crop yield per unit of water evaporated. Contrary to crop yield, local benchmark values for CWP do not exist. This paper shows how operational earth observation satellites can measure CWP indirectly on a pixel-by-pixel basis, which provides an opportunity to define local, regional and global benchmark values...
October 3, 2016: Science of the Total Environment
Ross T Tsuyuki, Meagen Rosenthal, Glen J Pearson
BACKGROUND: Dyslipidemia is an important risk factor for cardiovascular disease but is suboptimally managed. Pharmacists are accessible primary care professionals and with expanded scopes of practice (including prescribing), could identify and manage patients with dyslipidemia. We sought to evaluate the effect of pharmacist prescribing of dyslipidemia medications on the proportion of participants achieving target LDL-cholesterol (LDL-c) levels. METHODS: We conducted a randomized controlled trial in 14 community pharmacies in Alberta, Canada...
September 2016: Canadian Pharmacists Journal: CPJ, Revue des Pharmaciens du Canada: RPC
Paul Grimshaw, Linda McGowan, Elaine McNichol
Purpose For leadership and management of Western health systems, good quality relationships are a fundamental cornerstone of organising health and social care (H&SC) delivery, delivering benefits across organisations and communities. The purpose of this paper is to explore the extant management, H&SC literature, grounded in older people care, reveal behaviours, processes and practices that if readily identified across a context will support healthy relationships across the "whole system" of stakeholders. Design/methodology/approach An academic/practitioner group designed and guided a scoping literature review of the H&SC and broader management literature to identify and extract important behaviours, processes and practices underlying the support of high-quality relationships...
October 10, 2016: Journal of Health Organization and Management
Anthony J Culyer
Daniels, Porteny and Urrutia et al make a good case for the idea that that public decisions ought to be made not only "in the light of" evidence but also "on the basis of" budget impact, financial protection and equity. Health technology assessment (HTA) should, they say, be accordingly expanded to consider matters additional to safety and cost-effectiveness. They also complain that most HTA reports fail to develop ethical arguments and generally do not even mention ethical issues. This comment argues that some of these defects are more apparent than real and are not inherent in HTA - as distinct from being common characteristics found in poorly conducted HTAs...
May 16, 2016: International Journal of Health Policy and Management
Joseph A Dikun, Ashley S Crumby, Zainab Shahpurwala, Jill Hall, Theresa L Charrois, Meagen M Rosenthal
OBJECTIVES: The objective was to identify literature providing a description of characteristics contributing to pharmacists' individual level success in providing advanced patient care. DESIGN: An interpretive scoping review was conducted to synthesize knowledge and address the study objective. SETTING: Searches were undertaken in Ovid MEDLINE (1946-2015), EMBASE (1974-2015), and International Pharmaceutical Abstracts (1970-2015). PARTICIPANTS: Not applicable...
September 28, 2016: Journal of the American Pharmacists Association: JAPhA
Timothy P Gauthier, Eva Moreira, Chantal Chan, Alexandria Cabrera, Maribel Toro, Mara Z Carrasquillo, Mark Corentin, Elizabeth M Sherman
OBJECTIVES: To describe an innovative hepatitis C virus (HCV) care program and treatment outcomes resulting from pharmacist services. SETTING: Adult ambulatory care HCV clinic within the Miami Veteran Affairs Healthcare System. PRACTICE DESCRIPTION: Pharmacists with limited prescriptive authority are integrated into a medical hepatology care team. PRACTICE INNOVATION: Pharmacists screen patients with HCV infection for treatment eligibility, counsel patients upon treatment initiation, assess ongoing treatment success and toxicity through patient appointments, telephone calls, and the ordering of pertinent laboratory data, and provide oversight of all patients on HCV therapies...
September 22, 2016: Journal of the American Pharmacists Association: JAPhA
Aaron R Lyon, Cara C Lewis, Abigail Melvin, Meredith Boyd, Semret Nicodimos, Freda F Liu, Nathaniel Jungbluth
BACKGROUND: Health information technologies (HIT) have become nearly ubiquitous in the contemporary healthcare landscape, but information about HIT development, functionality, and implementation readiness is frequently siloed. Theory-driven methods of compiling, evaluating, and integrating information from the academic and commercial sectors are necessary to guide stakeholder decision-making surrounding HIT adoption and to develop pragmatic HIT research agendas. This article presents the Health Information Technologies-Academic and Commercial Evaluation (HIT-ACE) methodology, a structured, theory-driven method for compiling and evaluating information from multiple sectors...
2016: Implementation Science: IS
Elaine C Meyer, Giulia Lamiani, Donna Luff, Stephen D Brown
OBJECTIVE: Traditionally, radiologists have practiced their profession behind the scenes. Today, radiologic practitioners face mounting expectations to communicate more directly with patients. However, their experiences with patient communication are not well understood. The aim of this study was to describe the challenges of radiologic practitioners when communicating with patients. METHODS: Twelve day-long interprofessional communication skills workshops for radiologic clinicians were held at Boston Children's Hospital...
July 30, 2016: Patient Education and Counseling
John S Ikonomidis
BACKGROUND: The Society of Thoracic Surgeons (STS) has intermittently surveyed its workforce, providing isolated accounts of the current state of thoracic surgical practice. METHODS: The 63-question survey instrument was received by 4,343 surgeon members of the STS, and responses were gathered between October 1 and November 5, 2014. The return rate was 29.1%. RESULTS: The median age of the active United States thoracic surgeons is 54 years...
September 7, 2016: Annals of Thoracic Surgery
Susan R Wilcox, Michael Ries, Ted A Bouthiller, E Dean Berry, Travis L Dowdy, Sharon DeGrace
Critical care transport (CCT) teams are specialized transport services, comprised of highly trained paramedics, nurses, and occasionally respiratory therapists, offering an expanded scope of practice beyond advanced life support (ALS) emergency medical service teams. We report 4 cases of patients with severe acute respiratory distress syndrome from influenza in need of extracorporeal membrane oxygenation evaluation at a tertiary care center, transported by ground. Our medical center did not previously have a ground CCT service, and therefore, in these cases, a physician and/or a respiratory therapist was sent with the paramedic team...
September 13, 2016: Journal of Intensive Care Medicine
Margaret Gray, Tania Mysak
PURPOSE: The implementation of policy within a health organization to support a new legislative and regulatory framework of pharmacist prescribing in the Canadian province of Alberta is described. SUMMARY: The evolution of pharmacists' practice activities to encompass medication management through independent prescribing authority has occurred in many jurisdictions around the world. In 2007, Alberta pharmacists were granted the most progressive scope of practice in all of North America...
September 15, 2016: American Journal of Health-system Pharmacy: AJHP
Heather Ourth, Julie Groppi, Anthony P Morreale, Kimberly Quicci-Roberts
PURPOSE: A comprehensive overview of clinical pharmacist prescribing authority and collaborative drug therapy management activities within the Veterans Health Administration (VHA) is presented. SUMMARY: In VHA terminology, "scope of practice" (SOP) denotes authorization to perform as an advanced practice provider, autonomously or collaboratively managing all facets of a patient's disease or condition; VHA clinical pharmacists with an SOP have prescribing authority...
September 15, 2016: American Journal of Health-system Pharmacy: AJHP
Cheryl A Thompson
No abstract text is available yet for this article.
September 15, 2016: American Journal of Health-system Pharmacy: AJHP
Claudia B Maier, Hilary Barnes, Linda H Aiken, Reinhard Busse
OBJECTIVES: Many countries are facing provider shortages and imbalances in primary care or are projecting shortfalls for the future, triggered by the rise in chronic diseases and multimorbidity. In order to assess the potential of nurse practitioners (NPs) in expanding access, we analysed the size, annual growth (2005-2015) and the extent of advanced practice of NPs in 6 Organisation for Economic Cooperation and Development (OECD) countries. DESIGN: Cross-country data analysis of national nursing registries, regulatory bodies, statistical offices data as well as OECD health workforce and population data, plus literature scoping review...
2016: BMJ Open
Maria I Rodriguez, K John McConnell, Jonas Swartz, Alison B Edelman
OBJECTIVES: Oregon has implemented legislation expanding the scope of pharmacists to directly prescribe short-acting hormonal contraception (pill and patch) without a medical prescription. Pharmacists are crucial to the success of the new law, but relatively little is known about their intentions to prescribe contraception, or the motivators or barriers in providing this service. METHODS: With the use of a cross-sectional survey of pharmacists practicing in Oregon before the legislative implementation, we analyzed responses to assess contraceptive knowledge, motivation to participate in direct provision, and perception of barriers to pharmacist prescription of contraception...
September 2016: Journal of the American Pharmacists Association: JAPhA
G R Oliver, C D Lynch, B L Chadwick, A Santini, N H F Wilson
Background Much concern appears to exist as to the scope and content of contemporary dental school programmes, with the oft-cited criticism being made that dental graduates are 'no longer as good as they used to be'.Aim The aim of this project was to survey the views of dentists - both new graduates and more established practitioners - on aspects of their own dental school training they felt had been deficient as well as commenting on what aspects of dental school education they would like to see improved/enhanced in current times...
August 26, 2016: British Dental Journal
Peter C Emary, Taco A W Houweling, Martin Wangler, Stephen J Burnie, Katherine J Hood, W Mark Erwin
There is a growing desire within the chiropractic profession to expand the scope of practice to include limited medication prescription rights for the treatment of spine-related and other musculoskeletal conditions. Such prescribing rights have been successfully incorporated into a number of chiropractic jurisdictions worldwide. If limited to a musculoskeletal scope, medication prescription rights have the potential to change the present role of chiropractors within the healthcare system by paving the way for practitioners to become comprehensive specialists in the conservative management of spine / musculoskeletal disorders...
2016: Chiropractic & Manual Therapies
Ruchika Goel, Melissa M Cushing, Aaron A R Tobian
Red blood cell transfusions are a common life-saving intervention for neonates and children with anemia, but transfusion decisions, indications, and doses in neonates and children are different from those of adults. Patient blood management (PBM) programs are designed to assist clinicians with appropriately transfusing patients. Although PBM programs are well recognized and appreciated in the adult setting, they are quite far from standard of care in the pediatric patient population. Adult PBM standards cannot be uniformly applied to children, and there currently is significant variation in transfusion practices...
October 2016: Transfusion Medicine Reviews
Benjamin Lindquist, Matthew C Strehlow, G V Ramana Rao, Jennifer A Newberry
BACKGROUND: Many low- and middle-income countries depend on emergency medical technicians (EMTs), nurses, midwives, and layperson community health workers with limited training to provide a majority of emergency medical, trauma, and obstetric care in the prehospital setting. To improve timely patient care and expand provider scope of practice, nations leverage cellular phones and call centers for real-time online medical direction. However, there exist several barriers to adequate communication that impact the provision of emergency care...
2016: Curēus
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