In 1987, nursing administrators effected radical changes on a pediatric psychiatry ward: A bachelor's degree in nursing science became mandatory for nursing staff, family systems nursing was introduced, and postdischarge nursing follow-up was instituted. To convey how they accomplished the changes, a case history of change on the ward is presented. It suggests that there were many driving forces. Factors most important to nursing's success included a strong vision of nursing, sufficient pain or discomfort to motivate change, the ability to recognize and seize opportunities, and the linking of change to existing institutional practices, policies, and values.
To describe the administrative functioning of all current Canadian psychiatry residency training programs (RTPs) and to suggest available improvements to existing systems.
We obtained data about the 2004 RTPs by distributing 2 questionnaires to all Canadian psychiatry RTPs.
Residency program committees (RPCs) are mainly consultative and carry only a small amount of the workload of managing a residency program. Program directors (PDs) manage more than 80% of the work and report that the time allowance to perform their duties is suboptimal. PDs remain in office for about 5 years, departing during or at the end of a predetermined second term.
RPCs bear only a small amount of the workload generated by the RTP. We piloted administrative changes that led to more equitable work distribution.
The present investigation, which was part of a larger study, was designed to answer the question 'Has telemedicine produced changes in the distribution of tasks between the general practitioner and specialist, or between the local hospital and university/central hospital?' Qualitative interviews were carried out with 30 persons involved in four telemedicine services in Norway: teledermatology, tele-otolaryngology, telepsychiatry, and a telepathology frozen-section service. The results indicated that telemedicine does not produce large changes in the distribution of tasks. The reported effects were largest and most complex for telepsychiatry, followed by teledermatology. Local variations in how telemedicine is practised may explain the variation in the findings between telemedicine applications.
Recent reorganization of psychiatric services implies separation of psychiatric and general health care services. Liaison-psychiatry is not widely recognized in Denmark, albeit a psychiatric subspeciality in other countries. Research at the interface between psychiatric and somatic illness has resulted in significant developments in the understanding and treatment of patients with complex medical disorders. A model for the future cooperation between liaison-psychiatry, the general hospital and general practise is proposed.
The state of medical psychiatric service and the outlook for its improvement in Armed Forces of Russian Federation have been analyzed. In peace time it is reasonable to organize medical psychological and psychiatric care to military men with border disorders, to psychosomatic patients and also to really healthy men, who are in critical situation, to elaborate a new organized structure of staff, providing psychoprophylactic care. During war conflicts it is important to foresee in forward zone the corrective activities and treatment of patients with psychological stress reactions and addict disorders, to provide the wounded with psychiatric correction and care.