预防为主遏制校园欺凌和暴力事件

当前社会各界密切关注校园欺凌和暴力事件,党中央、国务院也给予了高度重视.该文系统介绍了现行防控校园暴力的法律法规,阐明了“预防为主导、教育督导管理、及早发现制止、立法执法为本”的基本方法和教育、督导、管理等不同层面的运行体系与机制,提出“构建校园安全风险评估指标体系、建立起校园欺凌和暴力事件早期预警制度”的预防校园暴力的具体措施,重申了对校园欺凌行为“零容忍”态度和处置原则.     

Bar code technology and medication administration error

Medication administration error (MAE) remains a patient safety concern. Few studies have investigated the impact of bar-coded technology on medication error reduction during the medication administration process at the bedside in acute care settings. The purpose and focus of this systematic review is to determine whether implementation of the Bar Code Medication Administration System (BCMA) is associated with declines in MAE rate. Findings from this systematic review reveal varied findings between studies and among the 5 rights of medication administration (right drug, right time, right patient, right dose, and right route) in general. Although BCMA did not consistently decrease the overall incidence of MAE, the technology did identify categories of medication errors not previously detected with the traditional 5 rights approach. The opportunity to analyze the additional categories of MAE identified by BCMA has implications for patient safety and is perhaps the most significant contribution of this review.     

Tobacco control activities of Iowa dental hygienists

The purpose of this study was to determine the type and extent of tobacco control activities provided to dental patients by Iowa dental hygieniste. Surveys were mailed to 1056 dental hygienists who had active Iowa dental hygiene licenses. Forty-one were returned by the post office and 138 did not meet all of the criteria for the survey. Of the remaining pool of 877-340 were completed and returned for a response rate of 38.8%. Only 4.6% of the hygienists routinely asked their patients about their tobacco use. Thirty-five percent routinely advised smokers to stop and 57% routinely advised smokeless tobacco users to stop. Thirteen percent routinely assisted smokers to stop and 20% routinely assisted smokeless tobacco users in stopping. None of the hygienists routinely engaged in follow-up to tobacco cessation activities. Cessation practice activities and amounts varied by several categorical variables. The majority of Iowa dental hygienists who responded to this survey did not routinely ask, advise, assist or arrange for or about their patients' tobacco use or cessation. Recommendations are given on how to improve tobacco prevention and cessation programs in dental offices.     

Home care aides in the administration of medication.

OBJECTIVE: To assess to what extent home care aides (HCAs) within the social services are engaged in medication administration, including their knowledge of how to perform this work correctly, and also to assess their knowledge of pharmacology, adverse drug effects, diseases, and symptoms. Furthermore, we wanted to study if there were any changes to be seen in these areas since a previous study. DESIGN: A repeated survey, carried out in 1998, 5 years after a cross-sectional study. In a stratified sample of personnel within the social services in nine of Malm?'s (Sweden) 10 administrative districts, a questionnaire with multiple-choice and open-ended questions was answered individually and under supervision. Statistical analyses were carried out using the chi-square test, except for logistic regression where odds-ratios were presented. STUDY PARTICIPANTS: Employees (341) within the social services in the municipality of Malm?, of whom 313 were HCAs and 28 were supervisors, most of whom also were HCAs, at a total of 36 workplaces. The study 5 years earlier included 393 employees, of whom 39 were supervisors and 354 were HCAs. MAIN OUTCOME MEASURES: Where possible, the answers in the knowledge test were classified as 'correct', 'partially correct' or 'erroneous', or were assigned to the group 'do not know/have not answered'. RESULTS: Most (95%) of the HCAs were engaged in medication administration. On average, 53% managed to give a correct or partially correct answer on questions concerning medication administration. The result concerning indications for common drugs was 55%, contra-indications and adverse drug effects 25%, and symptoms 59%. Some general improvements in knowledge were seen from 1993 to 1998, mostly in the area of medication administration, but the results also indicated a change for the worse in the area of indications for common drugs. CONCLUSIONS: Although most HCAs are engaged in medication administration, to a great extent they lack knowledge in the area. There is a need for additional personnel with the appropriate professional background, i.e. registered nurses, and a need for further training of HCAs in order to ensure patient safety. With respect to this, issues of learning and quality improvement are discussed.     

Issues of accountability in mental health administration

The issue of accountability in state hospitals and state schools-hospitals can be expected to remain paramount in the future. Almost all areas of mental health services are being scrutinized by consumers who are demanding more for their money. From the Prespective of the mental administrator consumers will have to become a more meaningful part of the decision making process to produce productive changes in these human service fields. Thus, to this end, human service institutions must have the ability to function as open systems and must develop a sense of responsiveness to their consumers' needs. Sneed, Ralph J., Ph.D.—is a former Assistant Supt. of Treatment at St. Louis State School-Hospital and consultant in Stress Management at St. Louis University Hospitals, Department of Health Promotion. He currently is Superintendent at the North Jersey Developmental Center in Totowa, New Jersey, a 763 bed residential facility, Dr. Sneed earned his doctorate in Psychology from St. Louis University. Lee, James R., Jr. M.S.Ed.—is the former Vocational Rehabilitation Counselor and former Unit 19 Director at St. Lot.is State School and Hospital, currently the Unit 2 Director at St. Louis State Hospital. He received a masters in Vocational Rehabilitation Counseling and Administration from the University of Missouri at Columbia and received a second masters from Webster University in December 1983 in Marketing and Management.     

Collective worship in primary schools: Issues for practice

This paper begins with a brief summary of the history of collective worship in schools and then outlines the terms of the 1988 Act, reflecting on the interpretations which have been placed on it. There follows some examples of responses from members of various faith perspectives and life stances.     

Beating the system--pitfalls of bar code medication administration

Beating the system to maximize efficiency will yield no positive return on a bar code investment, in terms of reducing medical errors. The critical success factor in the bar coding scenario is that of operational effectiveness. By shifting the nurses' focus from that of efficiency to that of operational effectiveness, the use of bar coding medication technology will reduce medication errors. CIOs looking for a quick fix to reducing medication errors through the use of bar coding technology need to understand that the technology alone won't solve their problem. Rather, it's the balance between operational efficiency and effectiveness among multiple departments working together, both vertically and horizontally, which will yield the greatest ROI.     

Issues with medication supply and management in a rural community in Queensland

Objective: To identify the key issues reported by rural health‐care providers in their provision of medication supply and related cognitive services, and in order to advise health workforce and role development and thus improve the quality use of medicines in rural communities. Design: Exploratory semistructured interview research. Setting: A rural community comprising four towns in a rural health service district in Queensland, Australia. Participants: Forty‐nine health‐care providers (medical practitioners, pharmacists, nurses and others) with medication‐related roles who serviced the study community, identified through databases and local contacts. Main outcome measures: Medication‐related roles undertaken by the health‐care providers, focusing on medication supply and cognitive services; challenges in undertaking these roles. Results: Medical and nursing providers reported challenges in ensuring continuity in supply of medications due to their existing medical workload demands. Local pharmacists were largely involved in medication supply, with limited capacity for extended cognitive roles. Participants identified a lack of support for their medication roles and the potential value of clinically focused pharmacists in medication management services. Conclusions: Medication supply may become more efficient with extended roles for certain health‐care providers. The need for cognitive medication management services suggests potential for clinical pharmacists' role development in rural areas.     

The medication preparation and administration process: problem identification in order to propose improvements and prevent medication errors

This exploratory study analyzed the medication preparation and administration process in medical-clinical units at four Brazilian hospitals located in the Southeast, Central-West and Northeast, identified problems that can contribute to the occurrence of medication errors and proposed improvement measures. Data were collected through non-participant and direct observation of nursing professionals' activities during one week. The results revealed the following main problems: the environment in Hospital B; preparation errors related to technique and anticipated medication preparation in C and D; technical, communication and patient identification mistakes in Hospital A. Suggestions to achieve greater quality and safety in patient care include the constitution of a multidisciplinary commission to evaluate the system, nursing discussion groups, environmental improvements, permanent courses and training and actual presence of a nurse during the process.     

Nurses' willingness to report medication administration errors in Saudi Arabia

Reporting of medication administration errors (MAEs) is one means by which health care facilities monitor their practice in an attempt to maintain the safest patient environment. This study examined the likelihood of registered nurses (RNs) reporting MAEs when working in Saudi Arabia. It also attempted to identify potential barriers in the reporting of MAE. This study found that 63% of RNs raised concerns about reporting of MAEs in Saudi Arabia-nursing administration was the largest impediment affecting nurses' willingness to report MAEs. Changing attitude to a non-blame system and implementation of anonymous reporting systems may encourage a greater reporting of MAEs.     

Chronic disease medication administration rates in a public school system

Anecdotal reports suggest school nurses and staff treat increasing numbers of public school students with chronic diseases. However, professionals know little about actual disease burden in schools. This study measured prevalence of chronic disease medication administration rates in a large, urban midwestern school district. Data from daily medication logs were recorded by school nurses during a single week. Medications and administrations were sorted by disease type. Prevalence rates were calculated for six chronic diseases: asthma, diabetes, seizures, attention deficit/hyperactivity disorder, other mental/behavioral disorders, and other diseases/conditions. Separate rates stratified by school grade, poverty level, and type of school were calculated. Overall, 3.12% of students received medication for chronic diseases, including 2.13% for psychiatric/mental disorders and 1.91% for attention deficit/hyperactivity disorder alone. These rates were lower than estimates from other states. Factors that contributed to this finding are reviewed.     

Errors prevented by and associated with bar-code medication administration systems

As expected, bar-code medication administration systems can prevent medication errors. However, health care organizations must be aware of identified failure points in bar coding that may contribute to errors.