Experience and Educationis the best concise statement on education ever published by John Dewey, the man acknowledged to be the pre-eminent educational theorist of the twentieth century. Written more than two decades after Democracy and Education(Dewey's most comprehensive statement of his position in educational philosophy), this book demonstrates how Dewey reformulated his ideas as a result of his intervening experience with the progressive schools and in the light of the criticisms his theories had received. Analysing both "traditional" and "progressive" education, Dr. Dewey here insists that neither the old nor the new education is adequate and that each is miseducative because neither of them applies the principles of a carefully developed philosophy of experience. Many pages of this volume illustrate Dr. Dewey's ideas for a philosophy of experience and its relation to education. He particularly urges that all teachers and educators looking for a new movement in education should think in terms of the deeped and larger issues of education rather than in terms of some divisive "ism" about education, even such an "ism" as "progressivism." His philosophy, here expressed in its most essential, most readable form, predicates an American educational system that respects all sources of experience, on that offers a true learning situation that is both historical and social, both orderly and dynamic.

经验与教育 = Experience and education

Doing Qualitative Research

https://www.cdc.gov/coronavirus/mers/downloads/Isolation2007.pdf

2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Health Care Settings.

Committee for assessing progress on implementing the recommendations of the institute of medicine report the future of nursing: leading change, advancing health

Statistical Methods for Health Care Research

(OR, 0.49; 95% CI, 0.36‐0.67), respiratory failure (OR, 0.40; 95% CI, 0.27‐0.59), and cardiac arrest (OR, 0.72; 95% CI, 0.62‐0.84) in ICUs, with a lower risk of failure to rescue (OR, 0.84; 95% CI, 0.79‐0.90) in surgical patients. Length of stay was shorter by 24% in ICUs (OR, 0.76; 95% CI, 0.62‐0.94) and by 31% in surgical patients (OR, 0.69; 95% CI, 0.55‐0.86). Conclusions: Studies with different design show associations between increased RN staffing and lower odds of hospital related mortality and adverse patient events. Patient and hospital characteristics, including hospitals’ commitment to quality of medical care, likely contribute to the actual causal pathway.

http://www.safestaffing.org.uk/shared/cms/file.asp?e=35&i=187801

The association of registered nurse staffing levels and patient outcomes: systematic review and meta-analysis.

OBJECTIVES
To assess how nurse to patient ratios and nurse work hours were associated with patient outcomes in acute care hospitals, factors that influence nurse staffing policies, and nurse staffing strategies that improved patient outcomes.

Nurse staffing and quality of patient care.

The purpose of this study was to determine the effect on clinical outcomes for newly admitted nursing home residents when advanced practice gerontological nurses (APNs) worked with staff to implement scientifically based protocols for incontinence, pressure ulcers, depression, and aggressive behavior. Use of APNs in this manner differs from the usual way APNs have been used in nursing homes, in which their primary focus has been to augment the physician's role. The APN treatment was randomly assigned to two nursing homes and usual care was assigned to a third. Trajectories from admission to 6 months revealed that residents with APN input into their care (n = 86) experienced significantly greater improvement or less decline in incontinence, pressure ulcers, and aggressive behavior, and they had higher mean composite trajectory scores compared with residents receiving usual care (n = 111). Significantly less deterioration in affect was noted in cognitively impaired residents in the treatment group. Findings suggest that APNs can be effective links between current scientific knowledge about clinical problems and nursing home staff.

/pdf/value-added-outcomes-the-use-of-advanced-practice-nurses-in-2obtiz3x1m.pdf

Value-Added Outcomes The Use of Advanced Practice Nurses in Long-Term Care Facilities

Purpose: This study reviews staffing standards from the 50 states and the District of Columbia to determine if these standards are related to nursing home staffing levels. Design and Methods: Rules and regulations for states’ nursing home staffing standards were obtained for the 50 states and the District of Columbia. Nurse staffing data were obtained from the Centers for Medicare and Medicaid Services OnLine Survey, Certification, and Reporting (known as OSCAR) database. The minimum hours per resident day (HPRD) staffing standards for each state were categorized according to the following: no statespecific HPRD standard (adheres only to federal staffing guidelines); low HPRD standard (� 2.5 HPRD); and high HPRD standard (. 2.5 HPRD). A series of hierarchical linear models examined the relationships between state staffing standards and actual facility staffing (total, licensed, and certified nurse aide HPRD), using a number of covariates. Results: The variance in facility staffing was much greater within than between states. Facilities in states with high staffing standards had somewhat higher staffing than states with no standards or low standards, whereas facility staffing in states with low standards was not significantly different from that in states with no standards. Other factors, such as resident acuity and average state Medicaid rate, also were related to staffing. Implications: State staffing standards may not be effective policy tools because they are only one of many factors that affect facility staffing levels. Setting a low minimum HPRD standard may fail to raise staffing, or it may even have a dampening effect on staffing rates in facilities.

Nursing home staffing standards : Their relationship to nurse staffing levels

It has been documented that up to 40% of the workday of nurses is taken up by meeting the ever-increasing demands of the systems of healthcare delivery in which nurses are employed. These demands include the need for increasing documentation, for learning new and seemingly ever-changing procedures, and for adapting to turnover in management and administration. Attention to these issues also means that 40% of that workday is not available to patients. Believing that these increasing demands are affecting nurses’ decisions to remain in nursing or to leave, a group of Minnesota nurses and nurse educators examined the work environments of nurses and the issues related to those environments. The result of this examination was discovery of a phenomenon affecting all nurses that may be central to the projected shortage of nurses. The phenomenon is complexity compression—what nurses experience when expected to assume additional, unplanned responsibilities while simultaneously conducting their multiple responsibilities in a condensed time frame. The phenomenon was validated by a group of 58 nurses who participated in focus groups that led to the identification of factors influencing the experience of complexity compression. These factors were clustered into six major themes: personal, environmental, practice, systems and technology, administration/management, and autonomy/control. Further validation studies are planned with the population of practicing professional nurses in the state of Minnesota.

Christine A Mueller

Papers

The association of registered nurse staffing levels and patient outcomes: systematic review and meta-analysis.

Nurse staffing and quality of patient care.

Value-Added Outcomes The Use of Advanced Practice Nurses in Long-Term Care Facilities

Nursing home staffing standards : Their relationship to nurse staffing levels

Complexity compression: nurses under fire.