A school-based health centre partnership: Faculty practice, nursing student learning and wellness in youth, families and community.

Aims And Objectives: This paper describes the development of a SBHC with an innovative model of care that grew out of a partnership between a public-school district and a university nursing programme in the midwestern region of the United States.

Background And Purpose: Persistent barriers to health and health care experienced by youth are well documented. School-based health centres (SBHCs) can improve educational and health outcomes, positively impacting health equity.

Testing a multi-group model of culturally competent behaviors among underrepresented nurse practitioners.

Diversifying the health professional workforce and enhancing cultural competence are recommended for decreasing health disparities. We tested a structural equation model of the predictors of culturally competent behaviors in a mailed survey of three groups of underrepresented nurse practitioners (n = 474). Our model had good fit and accounted for 29% of the variance in culturally competent behaviors.

Translating social justice into clinical nurse specialist practice.

Translating social justice into clinical nurse specialist (CNS) practice involves not only facilitating equitable access to healthcare resources but also changing the definition of health from individual centric to population based. Clinical nurse specialists working within hospitals or healthcare systems generally have not explored the ethical conflicts between demand and available healthcare resources. Application of social justice to CNS practice requires microallocation decisions in direct patient care and macroallocation decisions in the distribution of all societal goods that alleviate health disparities.

Social justice: added metaparadigm concept for urban health nursing.

Historically, the nursing metaparadigm has been used to describe 4 concepts of nursing knowledge (person, environment, health, and nursing) that reflect beliefs held by the profession about nursing's context and content. The authors offer an assessment of the metaparadigm as it applies to community and public health nursing in urban settings and offer an amendment of the metaparadigm to include the central concept of social justice. Each of the metaparadigm concepts and the central concept of social justice is discussed as it applies to a model of urban health nursing teaching, research, and practice.

Heart failure and weight gain monitoring.

Heart failure is one of the most common diagnoses of the elderly in the United States. The nursing literature has demonstrated that nursing interventions aimed at effective discharge planning and appropriate self-care activities can improve outcomes for patients hospitalized with heart failure. The purpose of this research was to identify, through retrospective medical record review, the discharge instruction related to self-weight monitoring provided to a sample of heart failure patients.

Current issues and challenges in the management of bariatric patients.

Morbid obesity is an increasingly common healthcare problem, and providers and patients currently face numerous challenges in dealing with this problem effectively. Issues addressed in this article include the effect of stigma, the need for more evidence regarding effective management options, and the declining insurance coverage for bariatric surgery. The role of bariatric surgery in effective management of morbid obesity is discussed, along with the effect on and possible reasons for declining coverage.

Social justice issues related to uneven distribution of resources.

This article examines the social justice issues resulting from the uneven distribution of resources. In this article, justice theories are discussed in relation to two of these issues: lack of adequate food and shelter and inequitable access to an appropriate continuum of health care. Public health nurses have the obligation to deal with the results of poverty and the uneven distribution of resources, which pose a threat to the common good in the United States and throughout the global community.

Public health nurses' views on voluntary smallpox vaccination.

Between January and June 2003, voluntary smallpox vaccination of healthcare workers and mandatory vaccination of military personnel was an important public health topic. This paper discusses the attitudes of nurses from two county public health departments in an upper-Midwestern state who were asked to volunteer to take the smallpox vaccine and to prepare to assist in the operation of possible mass immunization clinics. The responses of these healthcare professionals are compared to those of physicians and the general public.

Community health nursing, wound care, and...ethics?

Because of changing demographics and other factors, patients receiving care for wounds, ostomies, or incontinence are being referred in increasing numbers to community health nursing organizations for initial or continued care. As home-based wound care becomes big business, little discussion is being focused on the moral and ethical issues likely to arise in the high-tech home setting. Progressively more complex and expensive home care relies on family members to take on complicated care regimens in the face of decreasing numbers of allowable skilled nursing home visits.

Perceptions of utilization review nurses. "Nurses like us".

The purpose of this research was to describe the characteristics of nurses who perform telephonic care quality assessment, or utilization review, prior to, concurrent with, and after medical interventions and hospitalizations. It compares these nurses demographically to nurses employed in other settings, discusses the nurses' perceptions of the nature of their work, examines assertions that utilization review is a nursing activity, and documents the nurses' education and training for ethical decision-making. Implications for nursing care quality are discussed.

Nurses' ethical conflicts in performance of utilization reviews.

This article describes the ethical conflicts that a sample of US nurse utilization reviewers faced in their work, and also each nurse's self-reported ethical orientation that was used to resolve the dilemmas. Data were collected from a sample of 97 registered nurses who were working at least 20 hours per week as utilization reviewers. Respondents were recruited from three managed care organizations that conduct utilization reviews in a large midwestern city.

Ethical climate in managed care organizations.

Managed care organizations employ nurses as medical utilization reviewers; however, little is known about the ethical climate of these organizations. This study describes different ethical climates in which utilization review nurses work and the implications of these differences for nurse administrators. The nurse participants, although demographically similar across three managed care organizations, perceived distinct ethical climates across the organizations.