看護とケアのジャーナル

There is no agreed-upon minimum standard for what constitutes competent and safe nursing care. It is difficult to establish a minimum standard because of constraints imposed by organizations and limited resources. Nursing care rationing and prioritizing what to postpone, exclude, or omit is a daily occurrence for nurses. A minimum level of healthcare is a patient right in developed nations where public healthcare is paid for by taxes; However, it is unclear what this actually means for a particular patient. As a result, establishing a minimum standard of nursing care would be beneficial to both patients and nurses. Clarity in this area is also important from a moral and legal standpoint. In order to guarantee competent and safe nursing care, we examine the need for a minimum standard.

The core of primary medical care for adults and children is provided by highly trained nurses in rural Australia, one of the wealthier nations. Locally trained nurses typically work in hospitals and private clinics in towns in many developing nations (such as Bangladesh and China), whereas lay medical assistants and occasionally doctors provide rural communities' health care. In the United States, chronic disease care is managed by nurses. Some nurses in the UK work for independent contractor general practitioners (GPs), while others, like health visitors, are attached to general practice teams but paid and managed by primary care organizations. They have collaborated with GPs for a long time: Patients with complex clinical and social issues receive better care when these primary care professionals communicate well.

Since the first clinical description of the disease cystic fibrosis (CF) in 1938, there have been innumerable milestones in relation to delineation of disease pathogenesis and subsequent treatment which continue to this day. This narrative review: 1) details key discoveries that have significantly impacted overall CF patient health, 2) correlates these important advancements specifically to clinical observations from providers at the Penn State Health Milton S. Hershey Medical Center (PSH-HMC) adult CF program and 3) provides potential future directions since the regulatory approval of cystic fibrosis transmembrane conductance regulator (CFTR) protein therapies. With the availability of highly effective CFTR modulator therapies, providers from the PSH-HMC adult CF center have observed the following major changes in the health and lives of adult CF patients including: 1) improved survival, 2) reduced hospitalizations and 3) an increase in the number of women with CF successfully completing pregnancy, child-birth and subsequently entering into motherhood. This changing clinical landscape of all patients with CF will probably necessitate revisions in current practice patterns and adjustments by multiple care providers and care systems including the addition of providers previously minimally involved in CF patient care.