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61.
Susan Hendricks Virginia Julie LaMothe Judith A. Halstead Jennifer Taylor Susan Ofner Linda Chase 《Journal of interprofessional care》2018,32(5):613-620
An interprofessional collaborative practice (IPCP) environment was implemented in four inpatient acute care unit accountable care teams (ACT) through an academic-practice partnership. An action research methodology was implemented to empower healthcare professionals and promote ownership and sustainment of the IPCP strategies. Healthcare professionals on the ACT units, students, and faculty engaged in the multi-year project. Interventions included staff engagement exercises and coaching and support of individual ACT unit IPCP strategies and education. Healthcare professional outcome data were collected in the form of participant surveys, measuring collaboration about care decisions and the extent to which professionals engaged in a culture of safety, collected at baseline and 6-month intervals. Healthcare outcome measures of the ACT units were also collected at baseline and 6-month intervals. Students had clinical learning experiences in the IPCP settings and completed post clinical surveys. Implementation of the interventions resulted in a positive trend in the healthcare professionals, although statistical significance was not observed. Student outcome data demonstrated statistically significant positive learning outcomes. Healthcare outcome measures demonstrated a significant decrease in readmissions and an overall decrease in catheter-associated urinary tract infections over time. Other measures were not significantly impacted. In conclusion, an academic – practice partnership can strengthen and support an IPCP environment by allowing healthcare clinicians to be directly involved in the selection and implementation of IPCP strategies and contribute to improved professional, healthcare and student outcomes. 相似文献
62.
David S. Thompson Jacques Abourbih Lorraine Carter Gayle Adams-Carpino Sue Berry Lisa E. Graves 《Journal of interprofessional care》2018,32(3):339-347
Exploring the perceived environment where students are educated, as well as where they practice, is particularly important for educators and practitioners working in situations of interprofessional rural and remote health. In this study, we explored the perceptions of undergraduate medical students regarding interprofessionalism across their four-year undergraduate program which focuses on rural health. A thematic content analysis of the text-data was conducted on a convenience sample of 47 student responses to essay questions across four cohorts of a four-year undergraduate medical program. The medical program has an explicit social accountability mandate for responsiveness to the needs of a rural population and thus students have multiple opportunities to experience interprofessional education and collaboration in rural contexts. Participants reported (a) blurring and flexibility of roles in a primarily positive manner, (b) participating in unstructured interprofessional learning and collaboration, (c) experiencing the importance of social connections to interprofessional collaboration and learning, and (d) realisations that interprofessional collaboration is a means of overcoming barriers in rural areas. We discuss our findings using the socio-material perspective of complexity theory. These findings may be used to inform undergraduate programs in re-defining, re-creating, developing, and fostering interprofessional learning opportunities for medical students in rural communities as well as to support clinical faculty through ongoing professional development. 相似文献
63.
In the United Kingdom, pharmacist and nurse independent prescribers are responsible for both the clinical assessment of and prescribing for patients. Prescribing is a complex skill that entails the application of knowledge, skills, and clinical reasoning to arrive at a clinically appropriate decision. Decision-making is influenced and informed by many factors. This study, the first of its kind, explores what factors influence pharmacist and nurse independent prescribers during the process of clinical reasoning. A think-aloud methodology immediately followed by a semi-structured interview was conducted with 11 active nurse and 10 pharmacist independent prescribers working in secondary care. Each participant was presented with validated clinical vignettes for the think-aloud stage. Participants chose the clinical therapeutic areas for the vignettes, based on their self-perceived competencies. Data were audio-recorded, transcribed verbatim, and a constant-comparative approach was used for analysis. Influences on clinical reasoning were broadly categorised into themes: social interaction, intrinsic, and contextual factors. These themes showed that intrinsic, sociocultural, and contextual aspects heavily influenced the clinical reasoning processes of prescribers. For example, prescribers were aware of treatment pathways, but chose to refer patient cases to avoid making the final prescribing decision. Exploration of this behaviour in the interviews revealed that previous experience and attitudes such as confidence and cautiousness associated with responsibility were strong influencers within the decision-making process. In addition, strengthening the professional identity of prescribers could be achieved through collaborative work with interprofessional healthcare teams to orient their professional practice from within the profession. Findings from this study can be used to inform the education, training, and practice of independent prescribers to improve healthcare services by improving their professional and interprofessional development. 相似文献
64.
Fabio Vittadello Maria Mischo-Kelling Heike Wieser Luisa Cavada Lukas Lochner Carla Naletto 《Journal of interprofessional care》2018,32(3):266-273
This article presents a study that aimed to validate a translation of a multiple-group measurement scale for interprofessional collaboration (IPC). We used survey data gathered over a three month period as part of a mixed methods study that explored the nature of IPC in Northern Italy. Following a translation from English into Italian and German the survey was distributed online to over 5,000 health professionals (dieticians, nurses, occupational therapists, physicians, physiotherapists, speech therapists and psychologists) based in one regional health trust. In total, 2,238 different health professions completed the survey. Based on the original scale, three principal components were extracted and confirmed as relevant factors for IPC (communication, accommodation and isolation). A confirmatory analysis (3-factor model) was applied to the data of physicians and nurses by language group. In conclusion, the validation of the German and Italian IPC scale has provided an instrument of acceptable reliability and validity for the assessment of IPC involving physicians and nurses. 相似文献
65.
Erin L. Hickey Erika K. Dumke Rollin L. Ballentine Brooke L. Brown 《Journal of interprofessional care》2018,32(2):250-253
Negative perceptions or underdeveloped understanding of healthcare team member roles can impact the functionality of the team and stunt innovations in interprofessional practice and education. Therefore, the intent of this study was to explore the perception of pharmacists’ role on the healthcare team by future team members: prospective health professional students. The study utilised a survey to examine these perceptions in prospective health professional students (n = 34) nearing the application process to health professional school. A coding process was used to explore open-ended text responses through a line-by-line analysis and identify emerging themes regarding perception of pharmacists’ roles, responsibilities, and practice settings. Quantitative data examined perception of pharmacists by intended prospective profession, healthcare experience, and pharmacy experience. Results indicate that while prospective health professional students find pharmacists to be an important part of the healthcare team, they lack a developed understanding of pharmacists’ roles, responsibilities, and practice settings. Identifying and addressing prospective health professional students’ misperceptions surrounding pharmacists’ roles and responsibilities may encourage them to make informed career decisions and shape them into more knowledgeable future professionals with the ability to better impact patient care on interprofessional teams. 相似文献
66.
67.
Lucas Calais-Ferreira Vinicius C. Oliveira Jeffrey M. Craig Louisa B. Flander John L. Hopper Luci F. Teixeira-Salmela Paulo H. Ferreira 《Revista brasileira de fisioterapia (S?o Carlos (S?o Paulo, Brazil))》2018,22(3):184-189
Background
Musculoskeletal conditions are highly prevalent in our ageing society and are therefore incurring substantial increases in population levels of years lived with disability (YLD). An evidence-based approach to the prognosis, prevention, and treatment of those disorders can allow an overall improvement in the quality of life of patients, while also softening the burden on national health care systems.Methods
In this Masterclass article, we provide an overview of the most relevant twin study designs, their advantages, limitations and major contributions to the investigation of traits related to the domain of musculoskeletal physical therapy.Conclusions
Twin studies can be an important scientific tool to address issues related to musculoskeletal conditions. They allow researchers to understand how genes and environment combine to influence human health and disease. Twin registries and international collaboration through existing networks can provide resources for achieving large sample sizes and access to expertise in study design and analysis of twin data. 相似文献68.
Jessica Peters Rebecca Aslakson Marisa Wilson 《The Journal for Nurse Practitioners》2018,14(6):e121-e125
The purpose of this pilot study was to implement care collaboration measures into a critical care advanced practice. The intervention included an outreach algorithm and a standardized handoff tool during care transition. One hundred eight patients were enrolled; 5 (4%) experienced unplanned readmission. There was no significant association with transition time and the ability to complete the algorithm. Comorbidities of chronic obstructive pulmonary disease (P < .005), a PaO2 ratio < 200 (P < .003), and pulmonary disease (P < .027) showed increased unplanned readmission within 48 hours of transition. Implementing critical care collaborating measures was not affected by transition time and unit care flow. 相似文献
69.
Exploring Educational Disparities in Risk of Preterm Delivery: A Comparative Study of 12 European Birth Cohorts 下载免费PDF全文
Gry Poulsen Katrine Strandberg‐Larsen Laust Mortensen Henrique Barros Sylvaine Cordier Sofia Correia Asta Danileviciute Manon van Eijsden Ana Fernández‐Somoano Ulrike Gehring Regina Grazuleviciene Esther Hafkamp‐de Groen Tine Brink Henriksen Morten Søndergaard Jensen Isabel Larrañaga Per Magnus Kate Pickett Hein Raat Lorenzo Richiardi Florence Rouget Franca Rusconi Camilla Stoltenberg Eleonora P. Uphoff Tanja G. M. Vrijkotte Alet H. Wijga Martine Vrijheid Merete Osler Anne‐Marie Nybo Andersen 《Paediatric and perinatal epidemiology》2015,29(3):172-183
70.