Enhancing the patient's experience through the total joint replacement continuum of care.

The use of a Total Joint Replacement Pathway provides nurses with a process that guides their professional practice. The pathway begins during the preadmission phase and follows the patients throughout their hospital stay. Relationship-based care is demonstrated by the interdisciplinary care that includes the patient and healthcare team. The goal of this article is to describe the continuum of care for total joint replacement patients at Stamford Hospital from preadmission to discharge. A preoperative class is offered weekly to all patients who are scheduled for elective surgery. Approximately 90% of patients attend the preoperative classes. This article provides a framework for guiding the clinical care of total joint replacement patients. Implementation of this framework will ultimately improve patient care and nursing practice in any surgical setting. Pain management and patient education are 2 core components of nursing practice vital to the success of the Joint Replacement Program and facilitate care of these patients through the continuum.

Kinship care for the safety, permanency, and well-being of children removed from the home for maltreatment.

BACKGROUND: Every year a large number of children around the world are removed from their homes because they are maltreated. Child welfare agencies are responsible for placing these children in out-of-home settings that will facilitate their safety, permanency, and well-being. However, children in out-of-home placements typically display more educational, behavioral, and psychological problems than do their peers, although it is unclear whether this results from the placement itself, the maltreatment that precipitated it, or inadequacies in the child welfare system. OBJECTIVES: To evaluate the effect of kinship care placement on the safety, permanency, and well-being of children removed from the home for maltreatment. SEARCH STRATEGY: The following databases were searched to Februrary 2007: CENTRAL, MEDLINE, C2- Specter, Sociological Abstracts, Social Work Abstracts, SSCI, Family and Society Studies Worldwide, ERIC, PsycINFO, ISI Proceedings, CINAHL, ASSIA, and Dissertation Abstracts International. Relevant social work journals and reference lists of published literature reviews were handsearched, and authors contacted. SELECTION CRITERIA: Randomized experimental and quasi-experimental studies, in which children removed from the home for maltreatment and subsequently placed in kinship foster care, were compared with children placed in non-kinship foster care on child welfare outcomes in the domains of well-being, permanency, or safety. DATA COLLECTION AND ANALYSIS: Reviewers independently read the titles and abstracts identified in the search and selected appropriate studies. Reviewers assessed the eligibility of each study for the evidence base and then evaluated the methodological quality of the included studies. Lastly, outcome data were extracted and entered into REVMAN for meta-analysis with the results presented in written and graphical forms. MAIN RESULTS: Sixty two quasi-experimental studies were included in this review. Data suggest that children in kinship foster care experience better behavioral development, mental health functioning, and placement stability than do children in non-kinship foster care. Although there was no difference on reunification rates, children in non-kinship foster care were more likely to be adopted while children in kinship foster care were more likely to be in guardianship. Lastly, children in non-kinship foster care were more likely to utilize mental health services. AUTHORS' CONCLUSIONS: This review supports the practice of treating kinship care as a viable out-of-home placement option for children removed from the home for maltreatment. However, this conclusion is tempered by the pronounced methodological and design weaknesses of the included studies.

Through the eyes of Hollywood: images of social workers in film.

This article reports on research that investigated the images of social workers as portrayed in movies as a major medium of popular culture. Findings from an analysis of 44 movies spanning the period from 1938 to 1998 are presented with particular attention to the themes of gender, race, and class. Using the concept of motivated representations in popular culture, we suggest that these popular constructions of social workers are perhaps motivated by efforts to maintain the status quo of the dominant society, rather than to promote social change and social justice.