Journal of nursing management
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Comparative Study
From competition to collaboration in the delivery of health care: England and Scotland compared.
The purpose of this paper is to outline and critically appraise the NHS reforms that were operationalized in April 1999. ⋯ The paper concludes by indicating that a major challenge exists in the change management agenda with reference to primary care. Thus, while differences exist both north and south of the border, a shared feature is that the change management agenda in both England and Scotland is formidable. The main element of this challenge is that GPs have, in different ways, had to be drawn into the mainstream of the NHS.
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Multicenter Study
Community nurses', home carers' and patients' perceptions of factors affecting venous leg ulcer recurrence and management of services.
This study examines the feasibility of utilizing social service home carers (SSHC) to provide a collaborative approach with community nurses for the provision of leg ulcer aftercare in four National Health Service (NHS) Trusts. The purpose of this study was to gain insight into what community nurses and people with healed venous leg ulcers felt influenced leg ulcer recurrence. ⋯ A strategy aimed at supporting healing behaviour in elderly people has the potential to reduce the recurrence of leg ulceration and improve quality of life. The findings suggest that such a strategy needs to rationalize delivery of leg ulcer aftercare to provide seamless care. It needs to improve carers' and patients' understanding of factors influencing leg ulcer recurrence and facilitate development of a more balanced professional--patient relationship.
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This paper aims to describe how shared governance can be successfully integrated into existing management structures in a large medical directorate. It will show how the shared governance philosophy can lead to the creation of a culture where nurses feel important and valued and also consider its use as a foundation for the implementation of the nursing strategy. ⋯ The national nursing strategy puts nurses in a position to positively influence health care for the advantage of patients, however, for nurses to grasp this opportunity cultural change is required. This practical example of shared governance demonstrates how it can be used to create a proactive culture, focused on improving patient care. The nurturing and developing of clinically-based nurses provides them with the knowledge and skills to challenge the status quo and lead change. Thus, shared governance is an excellent foundation from which to develop the nursing strategy.
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This action research project aimed to investigate students', newly qualified staff nurses' and ward managers' views about the management skills and knowledge required by staff nurses, and how best students could be prepared for their management role. ⋯ Preparation of students for their management role as staff nurses benefits from being closely linked to practical experience, with clear learning outcomes and supportive clinical staff. Using an action research approach to investigate the problem and develop a strategy was found to be an appropriate methodology.