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Page, Steve, e Susan Hamer. "Specialities, sub-specialities and micro-specialities". Practice Development in Health Care 2, n.º 3 (outubro de 2003): 127. http://dx.doi.org/10.1002/pdh.103.
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Cobos Serrano, J. L. "Nursing specialities. The current fraud". Enfermería Intensiva (English ed.) 32, n.º 4 (outubro de 2021): 179–80. http://dx.doi.org/10.1016/j.enfie.2021.09.002.
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Hamlin, Jennifer. "The importance of veterinary nursing specialities". Veterinary Nurse 3, n.º 4 (maio de 2012): 205. http://dx.doi.org/10.12968/vetn.2012.3.4.205.
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&NA;. "‘ICU specialities’". Nursing 15, n.º 10 (outubro de 1985): 10. http://dx.doi.org/10.1097/00152193-198510000-00008.
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McAuliffe, M. S., e M. J. Edge. "A Systematic Approach for Nursing Specialities: Part 2". British Journal of Anaesthetic and Recovery Nursing 5, n.º 1 (fevereiro de 2004): 9–11. http://dx.doi.org/10.1017/s1742645600001212.
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ABSTRACTThis overview of the research process is for nurses who have either not had a formal course of study in the area, or have not thought about the process in some time. Using a systematic method of viewing the research process should improve understanding. By knowing how question type determines design, and ultimately how results are structured, nurses will be better able to engage in the process as knowledgeable participants. Using this framework should allow those, who wish to do so, to further study the numerous variations in designs and nuances within in each level.
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S, Maura. "Research – A Systematic Approach for Nursing Specialities Part I". British Journal of Anaesthetic and Recovery Nursing 4, n.º 4 (novembro de 2003): 6–9. http://dx.doi.org/10.1017/s174264560000111x.
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AbstractThis overview of the research process is for nurses who have either not had a formal course of study in the area, or have not thought about the process in some time. Using a systematic method of viewing the research process should improve understanding. By knowing how question type determines design, and ultimately how results are structured, nurses will be better able to engage in the process as knowledgeable participants. Using this framework should allow those, who wish to do so, to further study the numerous variations in designs and nuances within in each level
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Hua, May, Hannah Wunsch e Rebecca A. Aslakson. "Transformational Leaders Transcend Specialities". Journal of Pain and Symptom Management 63, n.º 6 (junho de 2022): e647-e648. http://dx.doi.org/10.1016/j.jpainsymman.2022.02.339.
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Spence, Emily. "Training to meet the pandemic's challenges in neuroscience nursing". British Journal of Neuroscience Nursing 17, n.º 4 (2 de agosto de 2021): 166–68. http://dx.doi.org/10.12968/bjnn.2021.17.4.166.
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All health services and specialities, including neuroscience, are facing an uncertain future as the pandemic's impact continues to be felt throughout 2021. Emily Spence highlights the importance of continuing professional development and education in meeting these challenges.
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Bawden, David, e Kay Robinson. "Information behaviour in nursing specialities: a case study of midwifery". Journal of Information Science 23, n.º 6 (dezembro de 1997): 407–21. http://dx.doi.org/10.1177/016555159702300602.
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Robinson, D. K. "Information Behaviour in Nursing Specialities: a case study of midwifery". Journal of Information Science 23, n.º 6 (1 de dezembro de 1997): 407–21. http://dx.doi.org/10.1177/0165551974231948.
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Cuevas-Santos, Cristina. "Nursing specialities and professional practice: Current situation and future perspectives". Enfermería Clínica (English Edition) 29, n.º 6 (novembro de 2019): 357–63. http://dx.doi.org/10.1016/j.enfcle.2019.10.001.
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Dill, Bobbie. "Integrated health careWorking together across specialities". Journal of Psychosocial Nursing and Mental Health Services 36, n.º 2 (fevereiro de 1998): 9. http://dx.doi.org/10.3928/0279-3695-19980201-04.
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Tingle, John. "COVID-19 safety in maternity care: lessons for the whole NHS". British Journal of Nursing 29, n.º 8 (23 de abril de 2020): 486–87. http://dx.doi.org/10.12968/bjon.2020.29.8.486.
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John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses some recent reports in maternity care, which can be seen to also to have general application across all clinical specialities
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Clark-Burg, Karen. "Future Perioperative Registered Nurses: An Insight into a Perioperative Programme for Undergraduate Nursing Students". Journal of Perioperative Practice 18, n.º 10 (outubro de 2008): 432–35. http://dx.doi.org/10.1177/175045890801801001.
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An Australian College of Operating Room Nurses (ACORN) submission (ACORN 2002–2008) recently stated that the specialities that suffered significantly from the transition of hospital-based nursing training to university training were the perioperative specialty, critical care and emergency. The main reason for this was that perioperative nursing was not included in the undergraduate nursing curriculum. Less than a handful of universities in Australia offer the subject as a compulsory unit. The University of Notre Dame Australia (UNDA) is one of these universities. This paper will provide an insight into the perioperative nursing care unit embedded within the Bachelor of Nursing (BN) undergraduate curriculum.
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Lelliott, Paul. "Mental health information systems: problems and opportunities". Advances in Psychiatric Treatment 1, n.º 8 (novembro de 1995): 216–22. http://dx.doi.org/10.1192/apt.1.8.216.
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Medical and nursing staff in acute specialities spend up to 25% of their working lives collecting, analysing, using and communicating information (Audit Commission, 1995). It is likely that staff delivering mental health care, which often involves services and staff based in a number of locations and inter-agency collaboration, spend just as much of their time on these activities.
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George, A. O. "Dermatology: A Useful Tool in a Depressed Economy". Tropical Doctor 27, n.º 3 (julho de 1997): 166–68. http://dx.doi.org/10.1177/004947559702700316.
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Dermatology is an aspect of medicine which can help produce a cheap and readily available tool for diagnosis, follow-up and epidemiologic study in a depressed economy such as in the developing countries of Africa and Asia. This would involve the provision of some dermatological training to students of medicine, nursing and other paramedical specialities, to allow maximum utilization of dermatology at the primary, secondary and even tertiary health institutions.
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Gupta, S., S. Milner e S. Shah. "50 Cognitive Assessment of Patients As Mandatory Part of MDT in A Community Rehabilitation Hospital". Age and Ageing 49, Supplement_1 (fevereiro de 2020): i14—i17. http://dx.doi.org/10.1093/ageing/afz186.04.
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Abstract Introduction Undiagnosed underlying cognitive issues have an impact on progression with rehabilitation. Early diagnosis of these is beneficial to the patient as it can offer them early treatment and advance planning for their future care. Methods Patients transferred to our rehabilitation wards from other specialities often do not have a routine cognitive assessment done. This has a negative impact on their rehabilitation goals and discharge planning. We hence routinely assessed cognition for all the patients transferred to our rehabilitation unit across two sites for 3 months. In the weekly MDT, we discussed in detail the cognition of each patient, taking into account not only the doctor’s view, but also nursing and therapists. Once a concern was raised, we investigated them fully with blood tests, imaging and MOCA or ACE-R. Results 56 patients were diagnosed as having cognitive issues. Average age was 81.67 years. Of them 32.14%were from surgical specialities and the rest from other sub-specialities of medicine. In the MDT cognitive concerns were raised 73.2% by therapists, 66.1%by nurses and 60.7% by doctors. Of the concerns raised, 87.4% of patients were diagnosed with some form of underlying dementia or cognitive impairment. 55.4% were started on treatment. Remaining was either palliative deemed unsuitable for treatment or needed more detailed input from community psychiatry team on discharge. 75% were for follow up with the mental health team on discharge, 7.14% by the Parkinson’s specialist and the rest by the own GP. All diagnosis was notified to the patient, next-of-kin and the GP Conclusions Routine multidisciplinary approach to cognitive assessment helps us in new and prompt diagnosis of dementia, offer appropriate treatment and plan ahead for the future.
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Agusthia, Mira, e Rachmawaty M. Noer. "Perception Student of Nursing Bachelor with Motivation Continuing Education in Professional Field in Nursing Program STIKES Awal Bros Batam". IJECA (International Journal of Education and Curriculum Application) 1, n.º 1 (30 de abril de 2018): 7. http://dx.doi.org/10.31764/ijeca.v1i1.2078.
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Preception is the one of factors influencing one’s motivation. A student who has negative preception could make them less motivate, otherwise a student who has positive preception make them more motivate, especially if they are motivated to continue their education on nursing professional development . This program is the program of graduate nursing student and professional in Nurse with attitude, behaviour, and professional abilities, and be able to carry out basic nursing care independently. Nursing Profesional Development Sepcialist is higher education level for nurse who has graduated from nursing education (nursing degree) to become profesion of nurse. the purpose of this program to prepare the nurses develop their knowledge and skills in adult learning principles and nursing career development in each specialities. This purpose of research to describe preception students of nursing with motivation to continue professional education in nursing science programs. types of research used on research in this qualitative research. By using method phenomenological research that is: using method (in depth interview). research participants it consists of 10 students. The results of this research is to identify 3 theme clusters according to the goals: according to the cluster theme perception participant is continue the nurses profession, goal of continuing nurses profession, interested in the nursing profession, motivation to continue the nurses profession, perception of nurses profession. The theme cluster hope is to accomplish grade point and program accomplishment nurse profession. The theme cluster support is family and lectures support. Based on the results of the research it is recommended for the undergraduate nursing student to continue the nurses profession, important to be improved because this matter will to increase quality of nursing services.
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Voznyuk, O., E. Malinovsky e V. Svyrydiuk. "THE APPLICATION OF THE THEORY OF FRACTALS FOR STUDYING THE REGULARITIES OF FORMING THE INFOSPHERE OF TRAINING APPLICANTS FOR NURSING SPECIALITIES". Zhytomyr Ivan Franko state university journal. Рedagogical sciences, n.º 1(108) (7 de junho de 2022): 240–50. http://dx.doi.org/10.35433/pedagogy.1(108).2022.240-250.
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The research stems from challenges which are characteristic of contemporary post-industrial, information and technological stage of development of human civilization. With respect to the initiation of training Masters of nursing in Ukraine a great importance is attributed to the research component of the professional competence of nurses with higher education, i.e. Masters of nursing. Taking into account the insufficient theoretical and methodical status of the problem, the researchers aim their study at developing a new approach to forming the infosphere of nursing as a research speciality on the basis of the theory of fractals. To achieve the goal the authors have used the content analysis of Master’s theses of 150 Masters in accordance with 112 indices, Hurst index calculation included. The calculated Hurst index values testify to a high level of structural organization of Master’s theses, as well as to certain regularities in using information sources in contrast with chaos and the absence of prevailing tendencies. The use of information sources which were referred to by the students of Master’s course for conducting research and writing Master’s theses, as well as the application of the techniques of content-analysis and scientific prognostication have made it possible to determine a number of tendencies in forming the infosphere of nursing as a research speciality. One can observe a pronounced tendency to decreasing the use of paper media as information sources, as well as the tendency to increasing the part of electronic media and the part of information sources in foreign languages. Among the information sources in foreign languages, in comparison with Russian English sources, prevail considerably. The study does not cover all aspects of the mentioned pedagogical problem since the further prospects for studying relates to the analysis of the quantity and quality of intellectual property objects created by the Masters enabling to formulate scientometric criteria for assessing the significance of scientific research of the Masters, thus revealing their ability to create the objects of intellectual property.
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Venkatesan, Latha, e Geethalakshmi. "Effectiveness of Statewide Training on Implementation of Objective Structured Clinical Examination (OSCE) in the Nursing Colleges of Tamilnadu". Nursing Journal of India CXII, n.º 06 (2021): 257–60. http://dx.doi.org/10.48029/nji.2021.cxii604.
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Objective Structured Clinical Examination (OSCE) is a powerful method of evaluating the clinical competencies of the nursing students. To build the capacity of nursing faculty of af'Agrave;liated colleges under the TN Dr MGR Medical University in OSCE and implement OSCE as part of University practical examination for nursing students' workshops were conducted by The TN Dr MGR Medical University, Chennai. The study was conducted in 2 phases using pre-experimental one group pre-test and post-test research design. Phase 1 included 78 post graduate faculty members from 13 selected nursing colleges representing 6 specialities in nursing from various zones of Tamil Nadu, who were trained in OSCE. The baseline data of faculty, existing practice of OSCE in the selected nursing colleges and the knowledge of faculty in OSCE before and after the capacity building programme were assessed using a Structured Questionnaire. In phase 2 the trained faculty of the 13 colleges conducted similar workshops in selected zones of Tamil Nadu by including the faculty members (N =1002) from the nursing colleges. Data collection was done in a similar manner in all the zones. Study 'Agrave;ndings revealed that 38.4 percent of the colleges were already practicing OSCE. In Phase 1 there was a signi'Agrave;cant improvement in the OSCE knowledge scores of the faculty in post-test (M= 17.6, SD = 2.35) in comparison with the mean pre-test (M=13.75, SD =3.04), out of 20, the total score (p 'lt; 0.001). In phase 2 the faculty from Vellore, Tiruvannamalai, Tirunelveli, and Madurai reported higher mean difference scores between pre- and post-test. OSCE can be effectively used as part of formative and summative evaluation in Nursing. Nursing faculty members need be periodically trained in OSCE to implement it uniformly and effectively.
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Kerstein, MB, e M. Hasler. "Introducing student nurses to critical care: shadow a critical care nurse". Critical Care Nurse 10, n.º 7 (1 de junho de 1990): 16–18. http://dx.doi.org/10.4037/ccn1990.10.7.16.
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The lack of student experience in critical care makes it difficult for graduate nurses to anticipate what expectations and demands might confront them in intensive care. Consequently, some new graduates discounted critical care as an opportunity available to them. Our institution believed that critical care had special qualities and if those qualities could be demonstrated to nurses, recruitment would improve. An unexpected benefit from the program was the positive staff nurse response to showcasing their skills and expertise. The success of the program was evidenced by the student evaluations and the hiring of students. To date, seven nursing students out of 20 who attended the program have been hired by the hospital. The long-term impact of the program on retention and recruitment is difficult to predict. The department will track these students, as they do all new hires; however, the initial success warranted continuation of the program. Student response to the program has resulted in plans to expand the "shadow a nurse" concept housewide to showcase the nursing specialities such as rehabilitation, maternal/child health, oncology, orthopedics, chemical dependency, and critical care. Current planning involves designing a program aimed toward high school students, with the goal of encouraging young people to consider nursing as a career.
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Anthony, James, Chethan Ram Kasargod Prabhakar, Paul Clift e Lucy Hudsmith. "COVID-19 and adult congenital heart disease services: impact on support and advice from nurse specialists". British Journal of Nursing 30, n.º 12 (24 de junho de 2021): 730–32. http://dx.doi.org/10.12968/bjon.2021.30.12.730.
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Although the focus on service provision in response to the COVID-19 pandemic has mainly been on acute and particularly intensive care, it is important to consider other services that are still needed. This is especially the case for vulnerable patients with long-term conditions, such as those under the care of an adult congenital heart disease (ACHD) service. The authors conducted a survey of ACHD nurse specialists in centres across the UK to acertain what they were planning in terms of the redeployment of nurse specialists. The results showed a range of plans with an average of half of nurses per centre being moved, but with 65% of the workforce planned to be redeployed to deal with the pandemic. The telephone advice service at the authors' own level 1 centre showed a significant increase in patients seeking advice when compared with the previous year, with large peaks following major Government announcements. Access to specialist advice for patients with complex conditions is of vital interest, for those in a wide range of specialities.
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Noonan, Claire, Dan Ryan, Tara Coughlan e Séan Kennelly. "210 Nursing Home Residents in Acute Hospital – a Targeted ANPc Program to Improve Care". Age and Ageing 48, Supplement_3 (setembro de 2019): iii17—iii65. http://dx.doi.org/10.1093/ageing/afz103.127.
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Abstract Background NHR are the frailest group of older people and require a gerontologically attuned approach to combat multiple challenges presented to the practitioner. The in-reach ANPc liaison service aims to confront such challenges, by providing comprehensive gerontological input to all nursing home residents admitted to hospital under all specialities medical, geriatric, and surgical. Methods This service commenced in September of 2018, working 9-5 Monday to Friday with limited leave cross-cover. All nursing home residents are reviewed by a Gerontology Advanced Nurse Practitioner candidate. Each patient received comprehensive geriatric assessment (CGA) with recommendations for care. All had follow up 2 weeks after discharge in telephone review clinic. Results 118 nursing home residents were admitted for acute care in the study period; 96/118 (82%) were reviewed by the ANPc. 16/118 (14%) were discharged prior to review and 6/118 (5%) died within 24 hours of admission. All other patients were reviewed within 72 hours. All assessed residents had >1 recommendation for intervention to enhance care following CGA: Interventions included 31% (30/96) undiagnosed delirium identified and management advice given. 21% (20/96) had recurrent falls work up and advice. 27% (26/96) had recommendations and changes to admission medications. 37% (36/96) referrals to other HSCP therapy disciplines for complete holistic care. 11% (11/ 96) had advanced care planning regarding future illnesses. 13% (13/96) had palliative care advice and referral to community palliative care. Follow up telephone review clinics have further resulted in reduced readmission rates through liaison with NH staff post-discharge. Conclusion The high complexity of this cohort of patients requires a timely, comprehensive gerontological approach in order to provide holistic care. They require a clearly defined approach to enhance care and minimise the need for unnecessary hospitalisations.
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Edwards-Jones, Val. "Antimicrobial stewardship in wound care". British Journal of Nursing 29, n.º 15 (13 de agosto de 2020): S10—S16. http://dx.doi.org/10.12968/bjon.2020.29.15.s10.
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Strategies to tackle the global crisis of antimicrobial resistance include implementing antimicrobial stewardship across the healthcare and agricultural sectors. Many clinical specialities have developed policies to advise practitioners on how to prescribe antibiotics more effectively, but there is still a lack of data on the impact of this change. Overuse and misuse of antibiotics have been commonplace since their introduction 70 years ago, and have contributed to the development of the resistance seen today. There is a dearth of new antibiotics and, if nothing is done to restrict the use of those that remain effective, there is a risk of returning to the pre-antibiotic era where simple infections could result in death. In wound care, it is essential that antibiotic treatment is appropriate to reduce infections. Many medical conditions predispose people to wounds that are difficult to heal and become chronic unless the underlying causes are addressed. Most wound infections are caused by bacteria, which are becoming increasingly resistant to commonly used antibiotics. This necessitates strict regimens for managing infection, which include prescribing antibiotics only when they are essential. Antimicrobial stewardship is undertaken in all UK healthcare facilities, and local advisory committees oversee the prudent use of antibiotics and other antimicrobial agents to try to prevent further increases in resistance. National guidance has been produced but whether full compliance has been followed has yet to be established and the impact of implementation needs to be analysed.
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Geyman, John. "Investor-owned Health Care: The Hidden Blight on America’s “System”". International Journal of Health Services 51, n.º 4 (14 de maio de 2021): 494–500. http://dx.doi.org/10.1177/00207314211015806.
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Investor ownership of US health care has grown exponentially in the past 50 years through ever closer ties with Wall Street corporate interests. More recently, private equity firms have accelerated this process, invariably with harmful impacts on access to affordable care, its quality, and profiteering, with little accountability. These impacts are fueled by several concurrent trends: (1) increasing privatization, (2) consolidation and mergers, (3) increasing bureaucracy and waste, and (4) profiteering that may bleed into outright fraud. This article traces the uncontrolled growth of health care costs and prices in recent decades, together with documented examples across the health care delivery system whereby profit-driven, investor-owned interests have compromised patient care. These include hospitals, emergency care, nursing homes, mental health, and practices of such specialities as obstetrics–gynecology and ophthalmology. These practices have compromised patient care in the midst of a pandemic and economic downturn, as reflected by markers of a system needing reform. A larger role of government is called for, together with the advantages of Medicare for All in establishing health care as a human right, not a privilege based on ability to pay.
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Patel, Sima, e Blanca Carioni. "IMPROVING ONGOING PATIENT CARE THROUGH GUIDING DOCUMENTATION OF WARD ROUNDS: A QUALITY IMPROVEMENT PROJECT IN A GENERAL SURGICAL UNIT WITHIN THE NATIONAL HEALTH SERVICE". International Journal of Advanced Research 10, n.º 12 (31 de dezembro de 2022): 126–34. http://dx.doi.org/10.21474/ijar01/15817.
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Aim: Increasing pressures within the National Health Service has led to busier ward rounds. Documentation of information can be sacrificed to accommodate the pace of (ward) rounds. This quality improvement project aims to implement a user-friendly proforma for surgical ward rounds, with the view both improving patient safety via directing documentation and supporting the junior doctor. Methods: Plan, Do, Study, Act (PDSA) method was used for this quality improvement project. Primary and secondary parameters were established, and baseline assessment undertaken 1 month prior to intervention with repeat data collection 1 month and 6 months after introduction of a pre-printed ward round proforma. Results: A total of 106 entries were reviewed within the 6-month study period. Pre-printed ward round proforma led to an improvement in all assessed parameters. 80% of junior doctors (n=10) and 75% nursing staff (n=8) found the pre- printed proforma standardised documentation, improving communication of plans to the wider team. Antibiotic stewardship improved from 0% (N=50) to 98% (N=30) over the 6-month period. 100% of junior doctors (n = 10) and nursing staff (n = 8) found coloured paper facilitated and bettered identification of last consultant review. Conclusion: The introduction of a pre-printed proforma allowed for standardisation of documented information for ongoing ward rounds, improved antibiotic stewardship and was received positively by junior doctors. Colour paper allowed for quicker identification of the last ward round entry which makes reviews of an unwell patient more efficient. Further work is needed to optimise and incorporate proforma within other surgical specialities.
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Leroy, J. P., F. Baudic, M. Douyère, J. Piot, B. Thirion e S. J. Darmoni. "CISMeF: A Structured Health Resource Guide". Methods of Information in Medicine 39, n.º 01 (2000): 30–35. http://dx.doi.org/10.1055/s-0038-1634259.
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Abstract:In 1999, the Internet has become a major source of health information. The objective of CISMeF is to catalogue and index the main French-speaking health resources. In September 1999, the number of indexed resources totaled over 7,100 with a mean of 75 new sites per week. CISMeF uses two standard tools for organizing information: the Medline bibliographic database MeSH thesaurus and the Dublin Core metadata format. Resources included in CISMeF are described by the following: title, author or creator, subject and keywords, description, publisher, date, resource type, format, identifier, and language. To index resources, CISMeF uses five levels of hierarchy: “meta-term”, category, keyword, subheading, and resource type. CISMeF contains a thematic index, including medical specialities and an alphabetic index. CISMeF respects the Net Scoring, criteria to assess the quality of health information on the Internet. The CISMeF project offers a valuable tool for the French-speaking health community: 2,500 computer users visit the Web site each working day.
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Penman, Joy, Eddie L Robinson e Wendy M Cross. "Remaining Connected with our Graduates: A Pilot Study". Interdisciplinary Journal of e-Skills and Lifelong Learning 15 (2019): 043–57. http://dx.doi.org/10.28945/4243.
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Aim/Purpose: This study aims to determine where nursing students from a metropolitan university subsequently work following graduation, identify the factors that influence decisions to pursue careers in particular locations, ascertain educational plans in the immediate future; and explore the factors that might attract students to pursue postgraduate study. Background: The global nursing shortage and high attrition of nursing students remain a challenge for the nursing profession. A recurrent pattern of maldistribution of nurses in clinical specialities and work locations has also occurred. It is imperative that institutions of learning examine their directions and priorities with the goal of meeting the mounting health needs of the wider community. Methodology: Qualitative and quantitative data were obtained through an online 21-item questionnaire. The questionnaire gathered data such as year of graduation, employment status, the location of main and secondary jobs, the principal area of nursing activity, and plans for postgraduate study. It sought graduates’ reasons for seeking employment in particular workplaces and the factors encouraging them to pursue postgraduate study. Contribution: This study is meaningful and relevant as it provided a window to see the gaps in higher education and nursing practice, and opportunities in research and collaboration. It conveys many insights that were informative, valuable and illuminating in the context of nurse shortage and nurse education. The partnership with hospitals and health services in providing education and support at the workplace is emphasized. Findings: Twenty-three students completed the online questionnaire. All respondents were employed, 22 were working in Australia on a permanent basis (96%), 19 in urban areas (83%) with three in regional/rural areas (13%), and one was working internationally (4%). This pilot study revealed that there were varied reasons for workplace decisions, but the most common answer was the opportunity provided to students to undertake their graduate year and subsequent employment offered. Moreover, the prevailing culture of the organization and high-quality clinical experiences afforded to students were significant contributory factors. Data analysis revealed their plans for postgraduate studies in the next five years (61%), with critical care nursing as the most popular specialty option. The majority of the respondents (78%) signified their interest in taking further courses, being familiar with the educational system and expressing high satisfaction with the university’s program delivery. Recommendations for Practitioners: The results of the pilot should be tested in a full study with validated instruments in the future. With a larger dataset, the conclusions about graduate destinations and postgraduate educational pursuits of graduates would be generalizable, valid and reliable. Recommendation for Researchers: Further research to explore how graduates might be encouraged to work in rural and regional areas, determine courses that meet the demand of the market, and how to better engage with clinical partners are recommended. Impact on Society: It is expected that the study will be extended in the future to benefit other academics, service managers, recruiters, and stakeholders to alert them of strategies that may be used to entice graduates to seek employment in various areas and plan for addressing the educational needs of postgraduate nursing students. The end goal is to help enhance the nursing workforce by focusing on leadership and retention. Future Research: Future directions for research will include canvassing a bigger sample of alumni students and continuously monitoring graduate destinations and educational aspirations. How graduates might be encouraged to work in rural and regional areas will be further explored. Further research will also be undertaken involving graduates from other universities and other countries in order to compare the work practice of graduates over the same time frame.
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Dancer, S., J. Raeside e M. Boothma. "Environmental organisms from different hospital wards". British Journal of Infection Control 3, n.º 4 (agosto de 2002): 10–14. http://dx.doi.org/10.1177/175717740200300405.
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T hree clinical wards in the same hospital, High Dependency (HDU), Care of the Elderly (CE) and Acute Psychiatry (AP), were screened for environmental organisms. The screening programme ran for four weeks and targeted comparable sites from all three units. Floor areas were similar, as were staffing levels, cleaning schedules, infection control policies and patient numbers. Organisms such as coagulase-negative staphylococci, Bacillus spp., coliforms, oxidase-positive Gram-negative bacilli, Clostridium difficile, enterococci, various fungi and Staphylococcus aureus were isolated. Staphylococci and Gram-negative bacilli were tested against clinically appropriate antibiotics. There was little variation in diversity or density of organisms from any of the wards, except for significant differences in antibiotic susceptibilities of the organisms (P<0.0001 HDU v AP, P=0.0057 CE v AP and P=0.0365 HDU v CE). From HDU, 49% (of 43) isolates were resistant to four or more antibiotics and from CE, 37% (of 54) isolates were resistant to four or more. From AP, just 2% (of 52) were resistant to four or more antibiotics. 9% HDU organisms were fully susceptible, as compared with 20% of those from CE and 27% from AP. Antibiotic data (in Defined Daily Doses (g)/100 bed-days) showed that HDU consumed over 12 times more antibiotics than CE, which in turn consumed twice as much as AP; these were mostly intravenous broad-spectrum agents for HDU, as opposed to oral preparations for the other two wards (Chi-square for each ward for linear trends by level of antibiotic intake were all P<0.0001). It was concluded that the only significant difference between environmental bacteria from wards of varying specialities in this hospital is their resistance to antibiotics. Heavy use of antibiotics in a hospital unit, as demonstrated by antibiotic consumption data, may be associated with increased antibiotic resistance in environmental organisms originating from that unit.
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., Rudramani, Vineet Kumar, Neha Thakur, Vikas Singh, Shobhit Shakya, Neetu Singh, Soumya S. Nath, Richa Choudhary, Anamika Chandra e Amrita Lumbani. "Impact of a short-term training in emergency and trauma in a tertiary teaching institute". International Surgery Journal 8, n.º 7 (28 de junho de 2021): 2018. http://dx.doi.org/10.18203/2349-2902.isj20212370.
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Background: The health-workers working in emergency area need better training to handle emergency patients with sincerity and accurate clinical skills. So, it is imperative to train them on simulation models and prepare them to perform their duties with better skills and higher confidence.Methods: A structured course named as Dr. RMLIMS Emergency and Trauma-Basic Course (DrRMLIMS ET-BC), was designed to effectively train the resident doctors from different departments, nursing staff (pool A) and other health-workers, ancillary staff and security persons (pool B) posted in the casualty and emergency wards. Pool A underwent pretest to ascertain basic knowledge. Post-test questionnaire was taken after training. Predesigned google forms were used for feedback. Pool B underwent counselling and motivating sessions about the sense of team, role of leader and effective communication. Direct observation, officer in-charge’s feedback, buddy feedbacks, patient’s attendants’ feedbacks and self-appraisal were done for evaluation. Paired t test was applied on pool A pretest and post-test scores to evaluate the change in the knowledge.Results: Pool A shows a pre-test mean of 37.83±0.92 (approximately 39%) which improved significantly to 72.16±0.90 post training (p value=0.0000). Pool B revealed significant positive change in the attitude, behavior and sense of team and responsibility.Conclusions: This study shows that this training is an adequate training programme to teach the basics emergency and trauma skills and been successful in increasing knowledge, despite the variations in the vision of different subject specialities.
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Loughenbury, Peter R., e Athanasios I. Tsirikos. "Current concepts in the treatment of neuromuscular scoliosis: clinical assessment, treatment options, and surgical outcomes". Bone & Joint Open 3, n.º 1 (1 de janeiro de 2022): 85–92. http://dx.doi.org/10.1302/2633-1462.31.bjo-2021-0178.r1.
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The development of spinal deformity in children with underlying neurodisability can affect their ability to function and impact on their quality of life, as well as compromise provision of nursing care. Patients with neuromuscular spinal deformity are among the most challenging due to the number and complexity of medical comorbidities that increase the risk for severe intraoperative or postoperative complications. A multidisciplinary approach is mandatory at every stage to ensure that all nonoperative measures have been applied, and that the treatment goals have been clearly defined and agreed with the family. This will involve input from multiple specialities, including allied healthcare professionals, such as physiotherapists and wheelchair services. Surgery should be considered when there is significant impact on the patients’ quality of life, which is usually due to poor sitting balance, back or costo-pelvic pain, respiratory complications, or problems with self-care and feeding. Meticulous preoperative assessment is required, along with careful consideration of the nature of the deformity and the problems that it is causing. Surgery can achieve good curve correction and results in high levels of satisfaction from the patients and their caregivers. Modern modular posterior instrumentation systems allow an effective deformity correction. However, the risks of surgery remain high, and involvement of the family at all stages of decision-making is required in order to balance the risks and anticipated gains of the procedure, and to select those patients who can mostly benefit from spinal correction.
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Neilson, Sue, Faith Gibson, Stephen Jeffares e Sheila M. Greenfield. "GPs and paediatric oncology palliative care: a Q methodological study". BMJ Supportive & Palliative Care 10, n.º 2 (21 de abril de 2017): e11-e11. http://dx.doi.org/10.1136/bmjspcare-2015-000852.
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ObjectiveThis mixed-methods study set in the West Midlands region of the UK demonstrates the effectiveness of Q methodology in examining general practitioners' (GPs') perception of their role in children's oncology palliative care.MethodsUsing data obtained from the analysis of semistructured interviews with GPs who had cared for a child receiving palliative care at home and bereaved parents, 50 statements were identified as representative of the analysis findings. 32 GPs with a non-palliative child with cancer on their caseload were asked to rank the statements according to their level of agreement/disagreement on a grid. They were then asked to reflect and comment on the statements they most and least agreed with. The data were analysed using a dedicated statistical software package for Q analysis PQMethod V.2.20 (Schmolck 2012). A centroid factor analysis was undertaken initially with 7 factors then repeated for factors 1–6. Varimax and manual flagging was then completed.Results4 shared viewpoints were identified denoting different GP roles: the GP, the compassionate practitioner, the team player practitioner and the pragmatic practitioner. In addition consensus (time pressures, knowledge deficits, emotional toll) and disagreement (psychological support, role, experiential learning, prior relationships) between the viewpoints were identified and examined.ConclusionsQ methodology, used for the first time in this arena, identified 4 novel and distinct viewpoints reflecting a diverse range of GP perspectives. Appropriately timed and targeted GP education, training, support, in conjunction with collaborative multiprofessional working, have the potential to inform their role and practice across specialities.
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Panda, Smita Kumari, Sushree Priyadarsini Satapathy, Prakash Chandra Panda, Kulwant Lakra, Shilpa Karir e Jasmin Nilima Panda. "Determinants of Inpatient Satisfaction on Hospital Services in a Government Tertiary Care Center". Healthline 12, n.º 2 (7 de setembro de 2021): 5–12. http://dx.doi.org/10.51957/healthline_202_2021.
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Introduction: Patient satisfaction is a psychological concept which is considered as a judgment of individuals regarding any object or event after gathering some experiences over time. It is one of the established yardsticks to measure the success of the services. Objectives: 1. To assess the level of inpatient satisfaction on hospital services. 2. To find out the determinants of inpatient satisfaction on hospital services. Method: It was a cross-sectional study conducted over a period of four months at VIMSAR, a tertiary care hospital in Odisha in eastern India. A total of 164 patients were enrolled in the study from the five most occupied indoor departments who were administered a pre-tested semi-structured standardised questionnaire by face to face interview method. Results: Majority (77.44%) of respondents were in the age group of 21-60 years. The sample consisted of 65.24 % males and 43.9% were from lower socio-economic class. Patient satisfaction level was found to be relatively low (~80%) for the service domains like housekeeping, general services and ancillary services. Fields like front desk services, medical care, nursing care and laboratory services enjoyed a better satisfaction score (~90%). Binary logistic regression analysis reflected age and socio-economic class to be the negative determinants of the level of satisfaction. Conclusion: About two thirds of the inpatients were satisfied with the services availed at the tertiary care hospital in the five specialities. There is scope of improvement in the areas like housekeeping, ancillary care and general care. Socio-demographic characteristics like age and socioeconomic class inversely related to inpatient satisfaction on hospital services.
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Murphy, Caitriona, Eithne Mullen, Karrie Hogan, ronan O’toole e Seán Paul Teeling. "Streamlining an existing hip fracture patient pathway in an acute tertiary adult Irish hospital to improve patient experience and outcomes". International Journal for Quality in Health Care 31, Supplement_1 (dezembro de 2019): 45–51. http://dx.doi.org/10.1093/intqhc/mzz093.
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Abstract Objective To improve access for hip fracture patients to surgery within 48 h of presentation to the Emergency Department, and to increase the number of patients receiving pre-operative orthogeriatric review, through streamlining an existing hip fracture patient pathway. Design A pre–post design involving a multi-disciplinary team use of the Define, Measure, Analyse, Improve and Control framework integral to Lean Six Sigma (LSS) methodology, to assess and adapt the existing hip fracture pathway from presentation to Emergency Department to the initiation of surgery. Setting A 600-bed teaching hospital in Ireland. Participants Nursing, medical, administrative and physiotherapy staff working across Emergency Medicine, Orthogeriatrics and Orthopaedic Specialities and Project management. Interventions LSS methodology was used to redesign an existing pathway, improving patient access to ortho-geriatrician assessment, pain relief and surgery in line with the Irish Hip Fracture Data Base Key performance indicators. Main Outcome Measures Access to pain relief, access to surgery and volume of patients receiving ortho-geriatric assessment. Results The percentage of patients undergoing surgery within 48 h of presentation to Emergency Department increased from 55% to 79% at 3 months, and to 85% at 6 months. Improvements were also achieved in the secondary performance metrics relevant to quality of patient care. All care pathway changes were cost neutral. Conclusions Hip fracture surgery within 48 h of presentation to hospital is a recognized standard of hip fracture care associated with decreased length of stay and decreased mortality. With respect to this performance metric, this intervention has contributed to improved patient outcomes.
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Matharoo, Manmeet, Adam Haycock, Nick Sevdalis e Siwan Thomas-Gibson. "A prospective study of patient safety incidents in gastrointestinal endoscopy". Endoscopy International Open 05, n.º 01 (17 de novembro de 2016): E83—E89. http://dx.doi.org/10.1055/s-0042-117219.
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Abstract Background and study aims Medical error occurs frequently with significant morbidity and mortality. This study aime to assess the frequency and type of endoscopy patient safety incidents (PSIs). Patients and methods A prospective observational study of PSIs in routine diagnostic and therapeutic endoscopy was undertaken in a secondary and tertiary care center. Observations were undertaken within the endoscopy suite across pre-procedure, intra-procedure and post-procedure phases of care. Experienced (Consultant-level) and trainee endoscopists from medical, surgical, and nursing specialities were included. PSIs were defined as any safety issue that had the potential to or directly adversely affected patient care: PSIs included near misses, complications, adverse events and “never events”. PSIs were reviewed by an expert panel and categorized for severity and nature via expert consensus. Results One hundred and forty procedures (92 diagnostic, 48 therapeutic) over 37 lists (experienced operators n = 25, trainees n = 12) were analyzed. One hundred forty PSIs were identified (median 1 per procedure, range 0 – 7). Eighty-six PSIs (61 %) occurred in 48 therapeutic procedures. Zero PSIs were detected in 13 diagnostic procedures. 21 (15 %) PSIs were categorized as severe and 12 (9 %) had the potential to be “never events,” including patient misidentification and wrong procedure. Forty PSIs (28 %) were of intermediate severity and 78 (56 %) were minor. Oxygen monitoring PSIs occurred most frequently. Conclusion This is the first study documenting the range and frequency of PSIs in endoscopy. Although many errors are minor without immediate consequence, further work should identify whether prevention of such recurrent errors affects the incidence of severe errors, thus improving safety and quality.
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Taylor, Richard. "The Tyranny of Size: challenges of health administration in Pacific Island States". Asia Pacific Journal of Health Management 11, n.º 3 (1 de outubro de 2016): 65–74. http://dx.doi.org/10.24083/apjhm.v11i3.159.
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There is great diversity among Pacific Island states (n=22) in geography, history, population size, political status, endemic disease, resources, economic and social development and positions in the demographic and health transitions and their variants. Excluding Papua New Guinea, all Pacific states are less than one million, and half of them (11) are less than 100,000.
Smallness also means fewer resources available for health, even if percentage allocations are similar to larger countries, and a disproportionate amount may derive from international aid.
Specialisation is not cost-effective or even possible in clinical, administrative or public health domains in small populations, even if resources or personnel were available, since such staff would lose their skills. In instances where only one to two staff are required, retirement or migration means decimation of the workforce.
Training doctors within the Pacific Island region provides appropriately trained personnel who are more likely to remain, including those trained in the major specialities. Nursing training should be in-country, although in very small entities, training in neighbouring states is necessary.
Outmigration is a significant issue, however, opportunities in Pacific Rim countries for medical doctors are contracting, and there is now a more fluid workforce among Pacific health personnel, including those resident in Pacific Rim countries.
International and regional agencies have a disproportionate influence in small states which can mean that global policies intended for larger polities are often promulgated inappropriately in small Pacific states.Smallness also leads to strong personal relationships between health staff, and contributes to teamwork, but can also create issues in supervision.
Small health services are not just scaled-down versions of large health services; they are qualitatively different. Smallness is usually intractable, and its effects require creative and particularistic solutions involving other more endowed Pacific states and Pacific Rim countries.
Abbreviations: NCD – Non-Communicable Disease; NGOs – Non Government Organisations; ODA – Overseas Development Assistance; TFR – Total Fertility Rate.
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López López, Carla, Ana Freijeiro Llorca e María Esther Arbesú Fernández. "Evolución del estigma hacia salud mental en especialistas sanitarios en formación en Asturias". Enfermería Global 22, n.º 1 (3 de janeiro de 2023): 105–33. http://dx.doi.org/10.6018/eglobal.525701.
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Introduction: Several studies have analysed social stigma among medical and nurse students or health care workers towards people with mental disorders. However, there is no evidence of social stigma training in residents during their specialised health training (FSE). Objective: This study aims to evaluate social stigma in residents in clinical specialities, the “anti-stigma” training during their residency, and its influence on the beliefs and attitudes they had in the first and last year of specialisation.Materials and Methods: A cross-sectional descriptive study in a sample of 250 residents of nursing, medicine, and clinical psychology: 141 in the first year of speciality and 109 in the last year, selected by random sampling proportional to the total number of residents in each year. The CAMI-S scale was used to measure social stigma, and a self-made questionnaire was used for sociodemographic variables. Both were created in the FORMS app and sent via email. The mean and standard deviation (SD) were obtained for “integration and contact”, “social distance”, “dangerousness and avoidance”, and overall stigma. Overall score for no stigma was between 80-100.Results: Response rate of 57.6%: 72.2% women, 64.6% 23-28 years old, 54.2% in the first year, 51.4% medical specialisation and 29.9% nursing. Only 20.1% had received “anti-stigma” training. Overall mean stigma of 86.7 (SD=8.5); 87.3 (SD=7.9) in the first year and 86.1 (SD=9.1) in the last year (P=0.398); 90.0 (SD=8.2) if they received training and 86.1 (SD=8.4) if they did not (p=0.027).Conclusions: Overall scores favourable to "anti-stigma" were obtained for people both in their first and last year of specialty. When there was "anti-stigma" training during residency, the results were even more favourable. It would therefore be beneficial to include content on "anti-stigma" in residency training programmes. Introducción: Diversos estudios analizaron el estigma en estudiantes o en profesionales sanitarios hacia personas con enfermedades mentales. Sin embargo, no hay evidencia que lo estudie en residentes en Formación Sanitaria Especializada (FSE). Objetivo: Este trabajo pretende evaluar el grado de estigma de residentes en especialidades clínicas, la formación recibida en materia «antiestigma» durante la residencia y su influencia sobre las creencias y actitudes que tenían en el primer y último año de la especialidad. Material y métodos: Diseño descriptivo transversal en una muestra de 250 residentes de enfermería, medicina y psicología clínica: 141 en el primer año de especialidad y 109 en el último, seleccionados por muestreo aleatorio proporcional al total de residentes en cada año. Para medir el estigma se utilizó la escala CAMI-S y para las variables sociodemográficas un cuestionario de elaboración propia. Ambos se crearon en la aplicación FORMS y se enviaron por correo electrónico. Se obtuvo la media y desviación estándar (DE) en «Integración y contacto», «Distancia social», «Peligrosidad y evitación», y Estigma global. Puntuación global sin estigma entre 80-100.Resultados: Tasa de respuesta del 57,6%: 72,2% mujeres, 23-28 años el 64,6%, 54,2% en primer año, 51,4% especialidad médica y de enfermería el 29,9%. El 20,1% había recibido formación «antiestigma». Media global de estigma de 86,7 (DE=8,5); de 87,3 (DE=7,9) en primer año y 86,1(DE=9,1) en último año (P=0,398); de 90,0 (DE=8,2) si recibieron formación y 86,1 (DE=8,4) si no la recibieron (p=0,027). Conclusiones: Se obtuvieron puntuaciones globales favorables al «antiestigma» hacia personas tanto en el primero como en el último año de especialidad. Cuando hubo formación «antiestigma» durante la residencia los resultados aún son más favorables. Resultaría por lo tanto beneficioso incluir contenidos en materia «antiestigma» en los programas formativos de FSE.
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Lee, Hyeongyeong. "A Study on the Spatiality of Choi Jinyoung’s “Where the Sun Goes” : Focusing On Specialities as Representative of Korean Post-Apocalypse Novel". Korean Society of Culture and Convergence 44, n.º 10 (31 de outubro de 2022): 909–18. http://dx.doi.org/10.33645/cnc.2022.10.44.10.909.
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This paper aims to deal with post-apocalypse materials that began the apocalyptic selfawareness that the world is an anthropocene, experienced the COVID-19 pandemic, and began to move from genre literature to pure literature. Among them, it will deal with the spatiality of Choi Jin -young's work “Where the Sun Goes,” which has been pointed out as a Korean-style post- apocalypse literature through various studies. Several studies have proven that studying the spatiality of literary works is a meaningful methodology that can reveal how the artist's thoughts are ideated and symbolized in the work, and how the artist's insights are structurally interacted with the characters. Therefore, this paper will analyze Choi Jin-young's “Where the Sun Goes” in this way, analyze how the author reveals his thoughts through spatiality in Korean-style post-apocalypse literature, examine how the metaphor of modern society is structured and used as spatiality, and furthermore, what alternative spaces are presented. This will be a meaningful study to confirm how Korean-style post-apocalypse novels use spatiality to escape from reproductive ethics and satirize the blatance of the violent system in modern society, and further present a new vision.
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Smith, Rachel. "P28 Implementation of clinical pharmacy services at weekends within a tertiary children’s hospital". Archives of Disease in Childhood 103, n.º 2 (19 de janeiro de 2018): e2.31-e2. http://dx.doi.org/10.1136/archdischild-2017-314585.37.
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AimThe need to improve the provision of Pharmacy services across seven days was highlighted in the initial findings of a report commissioned by the Medical Director of NHS England.1 The authors commented that Pharmacy services should be regarded as a priority in the first stages of transformational project work.The aim of this study was to evaluate the impact of specialist paediatric pharmacists working directly within the children’s wards of a tertiary paediatric centre within a large teaching hospital at weekends.MethodClinical pharmacists within our organisation have not routinely provided ward based services at weekends. Pharmacists were based within the inpatient dispensary or aseptic preparative service managing supply requests for medicines from a range of adult and paediatric specialities. Information queries were managed by the dispensary teams, or referred to the duty Medicines Information pharmacist.Changes were made to the weekend service specification to ensure a paediatric specialist pharmacist was available to provide ward based clinical pharmacy service to paediatric areas at the weekend.Requests for medicines for children’s areas were referred to a specialist paediatric pharmacist. The service specification included requests for supply of non-stock medicines, medicines for discharge and orders for aseptically prepared items. All orders for medicines supply were managed within the ward environment. The pharmacist was available to patients and carers, had access to medical and nursing teams, patient information and could assess patients own drugs for discharge.The duty paediatric pharmacist was available to answer clinical pharmacy related enquiries from ward staff. Details of complex patients who may need weekend review were transferred from weekday teams to the weekend duty pharmacist. Records were kept of the weekend workloadResultsA median of 7 clinical queries per weekend were managed by the weekend paediatric pharmacist. On average, 20 patients per weekend required discharge prescription management, including clinical validation, patient counselling and assessment of patients own medicines suitable for use on discharge. Twelve requests for non-stock medicines were made on a typical weekend. Staff feedback was sought following the initiation of the new weekend service. Pharmacists reported increased satisfaction in the service they provided and felt it was a more appropriate use of their skill set.Details of enquiries from children’s wards were recorded. One patient story involved a patient with haemophagocytic lymphohistiocytosis who required multiple drug dose adjustments due to haemodialysis. The paediatric pharmacist was able to review the patient’s medicines and advise appropriate dose adjustments. A patient with newly diagnosed acute leukaemia required urgent chemotherapy. The request was managed by the paediatric pharmacist enabling treatment to be commenced without delay.ConclusionThe presence of a paediatric pharmacist on children’s wards at the weekend enables medicines supply issues to be managed effectively. Requests for information on the use of medicines occur in a timely manner.ReferenceNHS England. NHS services, 7 days a week forum: Summary of initial findingsDecember 2013. https://www.england.nhs.uk/wp-content/uploads/2013/12/forum-summary-report.pdf accessed 29th July 2016.
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Yung, Ka Yu, Ruchi Sinha e Susan Giles. "P033 Improving paediatric practice through multidisciplinary safety huddles". Archives of Disease in Childhood 104, n.º 7 (19 de junho de 2019): e2.38-e2. http://dx.doi.org/10.1136/archdischild-2019-nppc.43.
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BackgroundMedication is the most prevalent therapeutic intervention in patient management.1 Medication errors are incidents that have occurred in the medication cycle of prescribing, dispensing, administering, monitoring, or providing medicines advice, regardless of whether they caused harm.1 In a hospital setting, medication error rates are similar amongst adults and children but there is three times the potential to cause harm in the latter. Due to the complexities that are associated with prescribing for children and the potential for the lack of necessary metabolic reserves to buffer any consequences,2 ensuring high quality prescribing in paediatrics is paramount and this requires multidisciplinary team (MDT) collaboration. Pharmacy contributions: The introduction of weekly Safety Huddles was started on the Paediatric Intensive Care Unit (PICU) in March 2017 – led by the PICU consultant, paediatric risk nurse and pharmacist. Safety Huddles are short MDT briefings, involving the ward-based medical, nursing & pharmacy teams, providing a platform for all staff to understand things that are happening within the ward and anticipate further risks to improve patient safety and care. The aim is to create an open environment where staff regularly communicate and feel safe to raise concerns about patient safety. The Safety Huddle comprises of three main aspects: pharmacy updates as ‘top tips’; Datix incident reports and issues/concerns of the week. Pharmacy interventions are collected on a daily basis and fed back to the individual prescriber immediately where possible as the exchange of information must be rapid to optimise engagement. These then form the weekly ‘top tips’ which are shared with the whole MDT, along with Datix reports and any particular concerns where learning and action points are developed and agreed through contribution by all.OutcomeThe concept of Safety Huddles has been adapted and fully established throughout all paediatric and neonatal specialities at the Trust. There has been an increase in the number of incidents reported since the implementation of the Safety Huddles. Error themes and their impact are looked at so the team learn from improvement and harm occurrence or near misses. The measurement of interventions provides a weekly update to the individual team to see if these are being carried out effectively and to improve where necessary. It allows identification of triggers and incorporates problem solving through the involvement of all members of the team, improving staff, patient and family experience and communication in addition to reducing harm, allowing Trust values to be met. Lessons learned: Safety Huddles are held in the spirit of learning and improvement. It allows integration with the wider team, empowering the team to work unanimously towards the ultimate goal of delivering the best patient care.ReferencesDepartment of Health and Social Care. The Report of the Short Life Working Group on reducing medication- related harm. February 2018.Department of Health. Medicines Standard: National Service Framework for Children, Young People and Maternity Services. October 2004. Department of Health. Building a Safer NHS or Patients: Improving Medication Safety. January 2004.
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Prata, Juliana Amaral, Jane Márcia Progianti e Helena Scherlowski Leal David. "Productive restructuring in the area of health and obstetric nursing". Texto & Contexto - Enfermagem 23, n.º 4 (dezembro de 2014): 1123–29. http://dx.doi.org/10.1590/0104-07072014002040013.
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This reflection aimed to show the productive restructuring dimensions achieved in Brazilian healthcare, discussing the nexuses between this phenomenon and the work in obstetrical nursing. Its construction was based on articles about productive restructuring and health available in the Virtual Health Library, reflecting the consequences on this speciality's caregiving process. We observed that the productive restructuring in health care may be seen under the health system management and work organization viewpoints. Despite the negative impacts in the field of work, there has been an appreciation of living labor in obstetrics in a context favorable to changes in labor care, through the introduction of obstetrical nursing and implementation of health care technologies. We conclude that, besides the focus on living labor and soft technologies, such concepts comprise technological innovation, as they have changed and resignified the way of providing care, thus beginning the process of the inversion of the technological core in obstetrics.
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Yusuf, Asif, e Choudhury Camrul. "P24 Developing a paediatric electronic prescribing system". Archives of Disease in Childhood 103, n.º 2 (19 de janeiro de 2018): e1.29-e1. http://dx.doi.org/10.1136/archdischild-2017-314584.35.
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AimTo develop an electronic prescribing system (EPS), in a tertiary care paediatric hospital.MethodOne of the many benefits of electronic prescribing (EP) in secondary care, is the reduction in prescribing error rates.1 However, implementing EP in paediatrics, presents many challenges such as the increased complexity of medication dosing2 and varying doses of drugs depending on indication.2 An EPS was acquired from a local adult secondary care hospital and developed to include a specialist paediatric drug library with clinical decision support. The pharmacy department used a dispensing patient medication record system that was incompatible with the EPS, so the latter had to work side-by- side with the former, as the drug chart. A smaller training team was deployed with external trainers, from the hospital where the system was acquired from and they were enlisted for the pilot.ResultsThe pilot was launched in April 2017, on the hepatology ward, consisting of 14 beds. All patients that were treated under the hepatology medical and surgical teams were placed on the e-prescribing system and this accounted for 95 patients, from the launch over a period of 3 months. Although the benefits of an EPS became a reality, which included a reduction in medication and administration errors, many drawbacks still existed that hindered a more complete EPS. Certain drugs were found to be missing from the drug library and drug monographs lacked the appropriate clinical decision support for prescribers and administrators alike. This was observed by the sharp rise in incident reporting from 20 reports, in the 3 months prior to the launch, to 55 reports, in the 3 months post-launch. Pharmacy processes, that proved effortless on drug charts and discharge prescriptions, became complex for pharmacists and technicians, as the EPS lacked the necessary features including insufficient message functionality to document patient’s own medicines and supply from pharmacy, discharge prescription alerting and modification of prescriptions once printed. The absence of sufficient and relevant clinical support staff became apparent soon after external trainers returned to their respective bases; with only one support member remaining that had held a clinical position previously. Difficulties quickly became apparent when attempting to explain specific clinical EP functions to non-clinical support staff.ConclusionIn preparation for rollout across the trust, many areas could be improved upon to ensure substantial progress could be made, from the pilot. Developing a more robust system to build and review drug monographs to include both medical and nursing input, from their respective clinical specialities and ensuring that all drugs whether supplied with or without pharmacy involvement are included in the paediatric drug library. Observing the work of pharmacists and other healthcare professionals, to ensure their day-today tasks, on drug charts or discharge prescriptions, are replicated successfully on the EPS. Increased pharmacy involvement in training and support, would benefit the EPS greatly, from a clinical perspective.ReferencesFranklin G, O’Grady K, Donyai P, Jacklin A, Barber N. The impact of a closed-loop electronic prescribing and administration system on prescribing errors, administration errors and staff time: A before-and-after study. QualSaf Health Care2007;16:279–84.Johnson KB, Lehmann CU. Council on clinical information technology. Technical report: Electronic prescribing in paediatrics: Toward safer and more effective medication management. Paediatrics2013;131(4):e1350–e1356.
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Roseveare, Chris. "Editorial". Acute Medicine Journal 9, n.º 2 (1 de abril de 2010): 54. http://dx.doi.org/10.52964/amja.0270.
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‘So why do you want to do Acute Medicine?’ – it’s a common interview question, and one for which most prospective trainees will have a well-prepared answer. Sometimes the candidate will focus on the opportunities for multi-professional working and teamwork, as well as interactions with critical care and other specialities; however almost all will mention the wide variety of conditions with which acute physicians are faced in their daily practice. What may appear a simple problem at the time of presentation may have a twist in the tail which will catch out the unwary. The need to maintain a broad differential diagnosis is a key skill for the acute physician: I frequently need to remind trainees that ‘Query ACS – measure 12 hour troponin’ is not an acceptable management plan. It is crucial to remember that even when a condition like acute coronary syndrome has been ‘excluded’, a serious cause may still be lurking. Several of the articles in this edition illustrate such caveats. In the review of the diagnosis and management of aortic dissection, the variability of presentation is illustrated with a case where the onset of symptoms preceded the hospital admission by several weeks and was initially labelled as ‘musculoskeletal’. In this case it was the chest x-ray which raised the clinical suspicion when a change in the mediastinal contour was identified. However, serious spinal causes of chest pain, such as the spontaneous extradural haematoma on p76, will only be diagnosed by more complex imaging; this will be hard to arrange without a clear clinical indication. The rarity of this condition means that most will not have come across a case and will therefore be unaware of the need to consider this diagnosis. The importance of a careful history, refreshingly emphasised in the recent NICE guidance on chest pain of possible cardiac origin as summarised by Charlotte Cannon in this edition, cannot be understated. Many readers will have come across patients with erythema nodosum, referred as ‘unresolving cellulitis’ – often these turn out to have sarcoidosis as described in Dr Chakraborty’s case series, although other underlying causes need also to be considered. Cellulitis may also be a manifestation of a subcutaneous source of infection, particularly when it appears in an unusual site; Denzil May’s case illustrates the need to image the abdomen when presented with abdominal wall cellulites – on this occasion an underlying psoas abscess was the cause although appendix abscesses, inflammatory bowel disease, diverticular abscesses and pelvic collections also need to be considered. The opportunity to learn a practical procedure has been a subject of considerable debate amongst acute medical trainees over recent years, and has been highlighted in this journal in the past. Much of the focus in previous editions has been on echocardiography. Ultrasound is another practical procedure which is listed in the training curriculum for Acute Medicine, although the feasibility of training acute medical trainees in this area has not been fully evaluated. Dr Ismaeel’s study comparing the outcome of ultrasound undertaken at the bedside by an acute medical trainee and that undertaken in the radiology department may stimulate some debate on the value of this. This study looked specifically at diagnostic ultrasound of the abdomen and demonstrated that some conditions could be identified at the bedside, though probably not with enough reliability to prevent the need for a subsequent departmental ultrasound. The key is whether the specific questions can be answered by the ‘occasional’ sonographer using portable equipment: ‘are the bile ducts dilated?’, ‘are the kidneys obstructed?’, ‘are there metastases in the liver?’, ‘is there ascites or is it just fat?’ – knowing the answers to such questions can inf luence management out of hours, although currently most patients will have to wait until the morning for a scan. A formal training programme in acute medical ultrasound will need to focus clearly on these specific areas, rather than generic diagnostic ultrasound skills. Many readers will be familiar with the rapid turnover of AMU nursing staff, particularly at a junior level, which can undermine the ability to develop a stable workforce. In a questionnaire study in Birmingham and Dundee, consultant nurses Liz Lees and Liz Myers have produced some interesting data which may help to improve recruitment and retention of nurses on Acute Medical Units. It seems that, as with junior doctors, it is the variety which is the main attraction, as well as the being the main factor which keeps nurses interested in working on the AMU. Correspondence relating to this and any other issues relating to articles in this journal would be most welcome.
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Honey, Carly, Victoria Smyth, Lisa Wee, David Ellis, Stella Smith e Anthony Chan. "EP.TU.1068Developing a Major Trauma Nursing Education Framework in Manchester". British Journal of Surgery 108, Supplement_7 (1 de outubro de 2021). http://dx.doi.org/10.1093/bjs/znab311.118.
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Abstract Aims The opening of the Major Trauma Ward (MTW) at Manchester University Hospitals NHS Trust represents a key milestone for managing major adult trauma within the Greater Manchester conurbation. We present an overview of the development of a novel Major Trauma Nursing Education Framework incorporating both the induction and continuing professional development of trauma nurses. Methods The MTW nursing skillset combines elements from acute surgical specialities and rehabilitation medicine. A framework for education was constructed from the Adult Nursing Competencies for the Major Trauma Patient (National Major Trauma Nursing Group) and the Trauma Intermediate Life Support curriculum. An induction programme was developed with a Competencies Workbook for an interim period including external courses for band 5 (Nurse Trauma and Critical Care course) and senior nurses (ALS and Neonatal, Adult and Paediatric Safe Transfer and Retrieval Course). An annual training programme will renew these competencies. Results Feedback from the first cohort for the induction programme has been positive, particularly with the third of nurses who did not feel confident managing trauma patients prior to induction (Wilcoxin-signed rank test, p = 0.00116). Free text comments ranged from the completeness of the topics covered to the delivery methods of the curriculum and how to work effectively within the wider multidisciplinary team. Conclusions The development of a formal Major Trauma Nursing Education Framework is necessary for a modern trauma workforce. Feedback has so far been positive. Continual audit of the framework will be necessary to ensure and improve the quality of delivery of education.
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Hassan, Nor Haty, Syed Mohamed Aljunid e Amrizal Muhammad Nur. "The development of inpatient cost and nursing service weights in a tertiary hospital in Malaysia". BMC Health Services Research 20, n.º 1 (14 de outubro de 2020). http://dx.doi.org/10.1186/s12913-020-05776-4.
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Abstract Background The current healthcare sector consists of diverse services to accommodate the high demands and expectations of the users. Nursing plays a major role in catering to these demands and expectations, but nursing costs and service weights are underestimated. Therefore, this study aimed to estimate the nursing costs and service weights as well as identify the factors that influence these costs. Methods A retrospective cross-sectional descriptive study was conducted at Universiti Kebangsaan Malaysia Medical Centre (UKMMC) using 85,042 hospital discharges from 2009 to 2012. A casemix costing method using the step-down approach was used to derive the nursing costs and service weights. The cost analysis was performed using the hospital data obtained from five departments of the UKMMC: Finance, Human Resource, Nursing Management, Maintenance and Medical Information. The costing data were trimmed using a low trim point and high trim point (L3H3) method. Results The highest nursing cost and service weights for medical cases were from F-4-13-II (bipolar disorders including mania - moderate, RM6,129; 4.9871). The highest nursing cost and service weights for surgical cases were from G-1-11-III (ventricular shunt - major, RM9,694; 7.8880). In obstetrics and gynaecology (O&G), the highest nursing cost and service weights were from O-6-10-III (caesarean section - major, RM2,515; 2.0467). Finally, the highest nursing cost and service weights for paediatric were from P-8-08-II (neonate birthweight > 2499 g with respiratory distress syndrome congenital pneumonia - moderate, RM1,300; 1.0582). Multiple linear regression analysis showed that nursing hours were significantly related to the following factors: length of stay (β = 7.6, p < 0.05), adult (β = − 6.0, p < 0.05), severity level I (β = − 3.2, p < 0.05), severity level III (β = 7.3, p < 0.05), male gender (β = − 4.2, p < 0.05), and the elderly (β = − 0.5, p < 0.05). Conclusions The results showed that nursing cost and service weights were higher in surgical cases compared to other disciplines such as medical, O&G and paediatric. This is possible as there are significant differences in the nursing activities and work processes between wards and specialities.
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Sherwood, Rebecca. "Supporting eLearners by increasing Digital Literacy Skills in Healthcare Educators". Compass: Journal of Learning and Teaching 10, n.º 1 (26 de abril de 2017). http://dx.doi.org/10.21100/compass.v10i1.375.
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This paper presents a case study detailing the author’s involvement in a teacher training module designed to improve healthcare educators’ scope for delivering e-learning elements within their curricula. The best method for enhancing teacher understanding of how students experience learning in the online environment is by first allowing teachers to experience the process themselves from a student perspective. It is proposed that such exposure will allow teachers to gain greater insight into the potential benefits and pitfalls of online delivery and apply the knowledge gained to their own practice. Teachers from a wide range of healthcare specialities engaged in discussion forums and gained practice in new and varied methods of e-learning, discovering how they could be blended with traditional classroom based delivery to achieve a diverse range of learning outcomes. It was found that the inter-disciplinary representation on the module created a potent mix of experience and viewpoints that greatly contributed to the overall learning environment. The cohort of 12 included adult and children branch nursing (hospital and community based), midwifery, allied health, and a member of the e-learning support team.
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Khan, Siraj DAA, Musleh Al-Garni, Abdullrahman Saeed Hadi Alalharith, Mohammad Dafer Alalharith, Obaid Saleh Obaid, Saleh Saeed AL Baaltahin e Mohammad Abdulkareem Alnaji. "Knowledge and Practice of Personal Protective Equipment among Students of Different Healthcare Specialties during COVID-19 Pandemic". JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2021. http://dx.doi.org/10.7860/jcdr/2021/51216.15764.
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Introduction: Healthcare professionals who are constantly working to treat the patients of Coronavirus Disease-2019 (COVID-19) are at great risk. So the only method they can prevent themselves while working is the use of Personal Protective Equipment (PPE). The use of PPE has increased with the spread of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Aim: To evaluate the knowledge and practice of students of different healthcare specialties regarding the use of PPE. Materials and Methods: The present cross-sectional study was conducted from October 2020 to December 2020 on healthcare students of different healthcare specialties of Najran University, Saudi Arabia. Participants were asked questions about the practice and knowledge of PPE via an electronic link of a questionnaire. Collected data were statistically analysed for frequency and association of responses by using Statistical Package for the Social Sciences (SPSS) version 23.0. Results: Total of 606 students (females were 122, males were 484) from different health specialities i.e., Medical (25.4%), Dental (42.1%), Pharmacy (11.2%), Nursing (13.4%) and Physiotherapy (7.9%) participated in this survey. Most of the participants (110 from the medical field, 142 from dental, 42 from pharmacy and 63 from nursing and 28 from physiotherapy) were familiar with the word PPE before this pandemic. There was a significant relationship (p-value <0.0001) between the specialty and practice of PPE. The majority of the participants (52%) did not know the Occupational Safety and Health Administration (OSHA) guideline and 55.9% were not aware of donning and doffing. Only 44.7% of professionals used N95 before the pandemic and 41.9% did not use N95 before COVID-19. While using the N95 mask 58.2% felt comfortable and 11.4% didn’t feel comfortable and the remaining participants were not sure. Conclusion: Although most participants practiced and had knowledge about the use and handling of PPE, but still there is a need to improve their knowledge and train them about its importance during COVID-19. Their knowledge can be improved by different training programs and health education.
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Glennie, Deborah, e Cara Swain. "26 Mixed Realities Chest Drain Workshop: Integrating Hands-On and VR Learning". International Journal of Healthcare Simulation, 23 de dezembro de 2021. http://dx.doi.org/10.54531/djob5086.
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During the pandemic, several wards in our surgical wing became re-purposed for COVID patients. This resulted in patients who would usually be nursed in those wards being placed elsewhere. There were also many nurses and medical staff being redeployed to wards in unfamiliar specialities which required caring for patients outside their usual clinical areas. This resulted in some patients with chest drains being nursed outside the usual areas, and incidents being reported regarding their management.The hour-long workshop was designed to simulate the management and understanding of the terminology around chest drains. The hands-on aspect was achieved by modifying a manikin to be able to demonstrate these actions and troubleshoot when things go wrong.What is meant by a swinging chest drain?How much bubbling is expected?Followed by the procedure of inserting a large-bore chest drain using immersive virtual realityWard nursing staff, operating theatre staff and junior doctors were invited to attend the workshop. Six sessions each with five participants ran over the course of a month. The first part of the workshop was a hands-on session with a modified defunct manikin. We had the locally available kit for people to be able to interact with and understand the mechanics of chest drains Introducing people to the Royal Marsden manual of clinical nursing procedures Questionnaires were completed before and after the workshop for attendees to evaluate their confidence to independently manage a chest drain. Every attendee reported an increase in confidence because of the session (As a result of this session, the ward areas created a ‘chest drain box’ which had everything needed to manage and replace a chest drain included as locating where kit was kept was identified as an issue. This box will be at the side of the patient being managed with the chest drain and will be checked for completeness regularly. This workshop would be useful to repeat because 50% of junior doctors have now rotated placements and many of the ward staff have been re-deployed to other areas.
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Woodward, Sue, Maureen Coggrave, Lesley Dibley, Doreen McClurg e Christine Norton. "A Qualitative Study of Health Care Professionals’ Views on Bowel Care in Multiple Sclerosis: Whose Job Is It Anyway?" International Journal of MS Care, 15 de junho de 2021. http://dx.doi.org/10.7224/1537-2073.2020-087.
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Abstract Background: Bowel dysfunction, including constipation and fecal incontinence, is prevalent in people with multiple sclerosis (MS), adversely affecting quality of life and increasing caregiver burden. How health care professionals (HCPs) identify, assess, and manage people with MS with bowel dysfunction is understudied. This study explored how HCPs think about, assess, and manage bowel dysfunction in people with MS. Methods: Semistructured interviews were conducted with 18 HCPs from different professional disciplines and clinical specialities recruited from UK National Health Service primary, secondary, and tertiary care services using purposive and chain referral sampling through professional networks. One participant worked for a bladder and bowel charity. Data were analyzed using thematic analysis. Results: Views differed regarding responsibilities for providing bowel care. Participants thought people with MS should notify HCPs of bowel symptoms and take responsibility for self-management where possible, with family caregivers required to help with bowel care. Although people with MS were often referred to bladder and bowel specialists when a crisis point was reached, earlier referral was called for by these HCPs. There were variations in assessment processes, treatment options offered, and service provision. Participants thought HCPs needed more education on bowel dysfunction, bowel care should take a high priority, and evidence-based clinical guidelines and referral pathways would improve service delivery. Conclusions: The HCPs caring for people with MS see many with bowel dysfunction, and there is variation in care and service provision; HCPs require more education, evidence-based clinical guidelines, and referral pathways to improve case finding, assessment, and management of these symptoms for people with MS.
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Wragg, Ashley, Fiona Coia, Emma Jones, Sam Williamson, Hayley Boal e Joe Gleeson. "How to introduce interprofessional education (IPE) to cardiac arrest simulations for final year undergraduate medical and nursing students". International Journal of Healthcare Simulation, 15 de novembro de 2022. http://dx.doi.org/10.54531/brre2637.
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Healthcare professionals work in a diverse community of different specialities and skills. However, most healthcare professional courses are insular and isolating in their training methods. This results in highly trained individuals, who are unfamiliar with the true multidisciplinary team (MDT) approach in health services [1], leaving them unprepared for working in the NHS. One specific area where teamwork, good communication and appreciation of others’ skills sets are crucial is during medical emergencies and cardiac arrests, where multiple professions (including: Doctors, Nurses, Resuscitation officers, Operating Department Practitioners) work together to achieve the best outcome patients. We aimed to introduce Interprofessional Education (IPE) to cardiac arrest simulations for final year undergraduate medical and nursing students to improve their understanding of working as part of a MDT, to enhance their confidence in dealing with cardiac arrests and prepare them for work in the NHS. Reviewing the literature, there are several key components required to successfully instil IPE including: commitment to IPE, expert facilitation, understanding of roles in different professions, and positive role modelling [2]. When designing the course, we obtained each profession’s learning outcomes for cardiac arrest and planned them into the course; paying particular attention to equal weighting of learning outcomes for both professions and mutual learning outcomes. Furthermore, we identified key skills which we wanted students to demonstrate and designed simulations to incorporate these. For example, nursing students using the defibrillator in manual mode independently and medical students to independently use the defibrillator in automatic mode. To add value to the course we wanted high quality role modelling and profession specific feedback. To do this, we ensured both qualified nurses and doctors with experience in delivering feedback and real-life cardiac arrest cases were present for all sessions. Feedback collated from students and faculty positively supported the introduction of IPE in cardiac arrest simulation, with students specifically commenting on the benefits of teamwork, understanding each other’s competencies, and benefits of workings as an MDT. Due to these simple changes and keeping IPE at the centre of our design and implementation of the cardiac arrest simulation course, we were able to successfully introduce IPE to final year undergraduate medical and nursing students. 1. Choudhury RI, Mathur J, Choudhury SR. How interprofessional education could benefit the future of healthcare–medical students’ perspective. BMC Medical Education. 2020;20(1):1–4. 2. Buring SM, Bhushan A, Broeseker A, Conway S, Duncan-Hewitt W, Hansen L, Westberg S. Interprofessional education: definitions, student competencies, and guidelines for implementation. American journal of pharmaceutical education. 2009;73(4).