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《Research in social & administrative pharmacy》2019,15(7):895-901
BackgroundWhen patient safety information is communicated across a regulatory jurisdiction or country, the potential to enhance the safety of community pharmacy practice is significant. While there currently exists a number of sources for patient safety information (e.g., websites, safety bulletins, online tools), knowledge of the barriers that may inhibit the use of such information sources within community pharmacies is limited.ObjectiveThis research explores community pharmacy manager use of Canadian patient safety information sources and the barriers that may limit the use of such sources.MethodsA qualitative research study design using semi-structured interviews was conducted with 15 community pharmacy managers in the Halifax Regional Municipality of Nova Scotia, Canada. The study explored how pharmacists access and engage a variety of information sources, including corporate intranets, websites, and tools provided by third party data base repositories. Interview data were analyzed using thematic analysis.ResultsFive general barriers were identified: lack of time to access information sources and its contents; too many sources of available information; too much information not relevant to community pharmacy practice; complexity navigating online information sources; and lack of community pharmacy involvement in source design.ConclusionWhile pharmacies do use safety information sources to enhance practice safety, their ability to incorporate this information is inhibited by their general lack of time available to access and read safety information, lack of knowledge about where to get this information, and lack of tailored information for the community pharmacy context. Future initiatives should address increasing information awareness of available sources, consolidating and reducing information overload of such sources, and packaging information to better fit with pharmacists’ needs. 相似文献
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Dawn S. Hui Richard Lee Marc R. Moon Melanie A. Edwards Mina L. Boutrous Jessica G.Y. Luc Richard L. Prager Keith S. Naunheim 《The Journal of thoracic and cardiovascular surgery》2019,157(5):1925-1932
Background
In cardiothoracic surgery, little data exist on the transition to operative independence. We aimed to compare current perceptions of operative autonomy of junior cardiothoracic surgeons and senior colleagues who oversee transitional years.Methods
An anonymous online survey was sent to currently practicing North American board-certified/eligible cardiothoracic surgeons to assess reported time to operative independence and comfort with cardiothoracic operations. The χ2 test, Fisher exact test, and Mann-Whitney U test were used to compare junior surgeons’ self-reported experience to the junior experience as reported by the midcareer and senior surgeons with whom they practiced. Logistic regression was performed to assess factors associated with operative independence.Results
Responses from 436 completed surveys were analyzed (82 juniors and 354 midcareer/seniors). Two hundred fifty-four midcareer/senior surgeons reported on the experience of 531 junior partners. Juniors reported high immediate posttraining comfort with basic cardiac cases and moderate comfort with all other categories. Time to operative independence was significantly different between juniors' self-report and midcareer/senior reports of junior partners except for complex thoracic cases. In multivariable logistic regression analysis, senior, and not midcareer, surgeon status was independently associated with junior operative independence status for cardiac cases and for basic thoracic cases.Conclusions
Most junior surgeons perceived operative independence with basic thoracic, basic cardiac, and complex cardiac operations earlier in their surgical career than that reported by senior colleagues. Objective measures of operative independence may clarify this discrepancy. This study establishes a baseline by which to compare the effects of integrated 6-year programs on operative independence. The discrepant perceptions may have implications for how training programs prepare graduates for the transition to independent practice. 相似文献68.
Meghan Peterson Kathryn Nowotny Emily Dauria Trisha Arnold Lauren Brinkley-Rubinstein 《AIDS care》2019,31(3):364-369
Populations at highest risk for acquiring HIV are more likely to pass through criminal justice (CJ) settings, and CJ-involved individuals are often at the intersection of multiple overlapping risk factors. The present study explored interest in, knowledge of, and barriers to PrEP uptake among gay, bisexual, and other men who have sex with men involved in the criminal justice system. Using semi-structured interviews, 26 participants who identified as MSM were asked about PrEP knowledge and interest, HIV risk, and incarceration experience. One theme that emerged across interviews was how institutional distrust in CJ settings may instill lack of trust in medical care after perceived mistreatment. Participants explained how lack of privacy fostered feelings that medical care was not confidential, care received was tied to status as an incarcerated person, and feelings of dehumanization led to distrust. Findings explore how distrust may hinder PrEP uptake and other HIV prevention efforts in CJ settings as well as after release. They highlight the need for greater privacy efforts and cultural humility, and explore how medical settings may function as spaces for people who are incarcerated to disclose HIV risk status. Few studies to our knowledge have examined the role of institutional distrust on men who have sex with men (MSM) in the context of pre-exposure prophylaxis (PrEP) interventions. The present study has implications for creating best practices to structure HIV prevention interventions in CJ settings. 相似文献
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Marta Benet Ramon Escuriet Manuela Alcaraz-Quevedo Sandra Ezquerra Margarida Pla 《Gaceta sanitaria / S.E.S.P.A.S》2019,33(5):472-479
ObjectiveWe analyse how reproductive health strategies have been incorporated into the everyday activities of the services and the resulting transformation of professional and user practices.MethodCartographic research taking a multi-sited ethnographic approach that seeks to reveal the processes of transformation. Data generation techniques featuring participant observation and situated interviews. Discourse analysis of the text corpus using three analytical axes based on three main lines of action promoted by the strategies.ResultsWe identified transformations in: 1) demedicalisation: an increase in midwives’ know-how and autonomy, changes in episiotomy practice and the facilitation of bonding practices; 2) warmth of care: incorporation of women's needs and expectations and improvements in the comfortableness of birth settings, especially in assistance at physiological birth; and 3) participation: actions that foster shared decision-making and the involvement of the persons accompanying women in labour.ConclusionsAbove all, transformation is visible in the incorporation of new attitudes, sensibilities and practices that have developed around the old structures, especially during physiological childbirth. The more technological areas have been less permeable to change. Risk management in decision-making and addressing diversity are identified as areas where transformation is less evident. 相似文献
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