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The nursing climate identifies units where the likelihood of adverse events is greater or lower than the hospital's average. Such information can guide prevention efforts in selected units. These data encourage the development of additional climate subscales subsumed under the healthcare climate model (e.g., physicians subclimate).

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This descriptive exploratory study was designed to gain insight into how young people experience growing up with cystic fibrosis (CF). The retrospective longitudinal, life-history method was used to generate grounded theory from 60 accounts by 21 informants (10 with CF and 11 of their family members). Data from repeated in-depth interviews were analyzed using the constant comparative method. An ordinary lifestyle model emerged. Youngsters with CF maintained a dynamic balance between their own perceptions of the disease, others' perceptions of them, and the influence of contextual factors. The disease was found to be of little centrality to their psychosocial lives, and their illness perception followed developmental changes. Managing disease-related information was related to the perceived ability of the listeners to deal with the information and the situational context. The model was compared with competing models, and implications for health care practice and research are discussed.

This replicated study explores the ordinary people theory generated in the original research among American youth with cystic fibrosis through the experience of Israeli youth with epilepsy. The authors used the qualitative life history method in a sample of 14 adolescents and young adults with epilepsy. They employed the constant comparative method of analysis to analyze the data collected from the in-depth interviews. The results show that epilepsy was not central to the participants' everyday lives. Their perceptions of the disease followed developmental stages. The authors found that coping methods were adaptive and took into account social stigma and practical outcomes. This study provides a positive and normalcy perspective of exploring the lifestyle of people with chronic diseases and disabilities as opposed to deficit models. It adds to the trustworthiness of the model's cross-cultural applicability through its use in a different context among a population with a different diagnosis.

A mass-casualty situation (MCS) usually is short in duration and resolves itself. To minimize the risks to patients during MCS, planning is essential. This article summarizes the preparations needed at the hospital level, for a local MCS involving numerous trauma victims arriving to the Emergency Department at a short notice. Experiences and conclusions related to the implementation of the Israeli strategy in one hospital that combines the responsibilities of both the military and civilians are summarized.The Ministry of Health distributes the master MCS plan to each hospital where a local committee adapts it to the specific situation in a format of standing orders. After its approval by the Ministry of Health, an annual inspection is conducted to check the ability of the staff to manage a MCS. A full-scale drill is conducted every second year during which each site's readiness level and the continuity of the flow of care are tested.In building the strategy for treating trauma victims during a MCS, a few assumptions were taken into account. The goal of treatment in a MCS is to deliver an acceptable quality of care while preserving as many lives as is possible. In theory, the capacity of the hospital is its ability to manage a load of patients in the range of 20% of the hospital bed capacity. Planning and drilling are the ways to minimize deviations from the guidelines and to avoid management mistakes. Special attention should be paid to problems related to the initial phase of receiving the first message, outside communication, inside hospital communication, and staff recruitment. Other issues include: free access to the hospital; opening a public information center; and dealing with the media and very important persons (VIPs).A new method for creating the needed MCS plan in the hospital is suggested. It is based upon knowledge of management techniques that used multi-level documents, which are spread via Intranet between the different key figures. Using this method, it is possible to keep the strategy, the source documentation, and reasons for choosing it, as well as immediate release of checklists for each functions. This detailed, time consuming work is worthwhile in the long run, when the benefits of easy updating and better preparedness are apparent.

This review examines ways to decrease preventable effects of hospitalization on older adults in acute care medical (non-geriatric) units, with a focus on the Israeli experience at the Rambam Health Care Campus, a large tertiary care hospital in northern Israel. Hospitalization of older adults is often followed by an irreversible decline in functional status affecting their quality of life and well-being after discharge. Functional decline is often related to avoidable effects of in-hospital procedures not caused by the patient’s acute disease. In this article we review the literature relating to the recognized effects of hospitalization on older adults, pre-hospitalization risk factors, and intervention models for hospitalized older adults. In addition, this article describes an Israeli comprehensive research study, the Hospitalization Process Effects on Functional Outcomes and Recovery (HoPE-FOR), and outlines the design of a combined intervention model being implemented at the Rambam Health Care Campus. The majority of the reviewed studies identified preadmission personal risk factors and psychosocial risk factors. In-hospital restricted mobility, under-nutrition care, over-use of continence devices, polypharmacy, and environmental factors were also identified as avoidable processes. Israeli research supported the findings that preadmission risk factors together with in-hospital processes account for functional decline. Different models of care have been developed to maintain functional status. Much can be achieved by interdisciplinary teams oriented to the needs of hospitalized elderly in making an impact on hospital processes and continuity of care. It is the responsibility of health care policy-makers, managers, clinicians, and researchers to pursue effective interventions to reduce preventable hospitalization-associated disability.