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91.
目的探讨临床药师在老年患者多学科诊疗模式中的作用。方法总结分析北京老年医院老年患者多学科诊疗模式中临床药师所做的工作。结果在老年患者的多学科诊疗模式中,临床药师的参与具有重要意义。结论通过参与老年患者多学科诊疗,充分发挥了临床药师在促进老年患者合理用药中的作用。 相似文献
92.
93.
目的:探讨以护士为核心的新型疼痛管理模式,为术后患者疼痛的管理提供科学的经验。方法:选择2016年5月至2017年4月在我院行胸、腹微创手术的患者,共212名。随机分为干预组106例,对照组106例。对照组按常规方式进行术后疼痛管理;干预组由护士进行常规疼痛管理外,同时参与患者自控式镇痛(PCA)泵的管理。结果:各研究组中没有明显药物不良反应发生。干预组停泵率明显低于对照组。在胸部手术后行静脉镇痛的患者中干预组的镇痛效果优于对照组;其他治疗组间的镇痛效果比较虽无差异,但干预组的额外用药量却显著降低。研究证明通过以护士为核心,多学科协作的疼痛管理,使自控式镇痛泵得到了充分应用,额外镇痛药物的用药量明显减少。结论:以护士为核心的多学科协作管理模式在术后镇痛管理中具有很大的优势,起到了重要的作用。 相似文献
94.
Background
Improving the timely recognition and response to clinical deterioration is a critical challenge for clinicians, educators, administrators and researchers. Clinical deterioration leading to Rapid Response Team review is associated with poor patient outcomes. A range of factors associated with clinical deterioration and its outcomes have been identified, and may help with early identification of deteriorating patients. However, the relative importance of each factor on the development of clinical deterioration is unknown.Objective
To identify the relative importance of factors contributing to the development of clinical deterioration in ward patients, as perceived by health professionals who have experience in recognising or responding to clinical deterioration, or in the management, administration or governance of RRSs.Methods
A written questionnaire containing 12 pre-determined factors was provided to participants. Participants were asked to rank the items from most to least important contributors to ward patient deterioration. The study took place during a session of the Australia and New Zealand Intensive Care Society Rapid Response Team conference.Results
A final sample of 233 (83% response rate), returned the questionnaire. The sample comprised specialist ICU registered nurses with direct patient contact (64%), ICU consultant doctors (17%), ICU nurse managers (7%), hospital administrators (2%), ICU registrars (2%), quality coordinators (2%) and non-hospital staff (4%). The patient’s presenting illness/main diagnosis was the highest ranked factor, followed by pre-existing co-morbidities, seniority of nursing ward staff, medical documentation, senior medical staff, and interdisciplinary communication. Almost two-thirds of participants ranked patient characteristics as the most important contributor to clinical deterioration.Conclusion
Health professionals who have experience in recognising or responding to clinical deterioration, or in the management, administration or governance of RRSs perceive that patient characteristics such as the patient’s primary diagnosis and comorbidities to be the most important contributors to clinical deterioration. 相似文献95.
在过去相当长的一段时期内,中医学界仅把大肠视为排泄器官。但大肠与神经传导、神经系统病变之间存在紧密联系,以"大肠主神志传导"补释"大肠者传道之官",而不使用"肠脑相通"新理论主要是因为以下2点:①中医学的发展要以经典为主线,凡是能够在原有理念下依附存在的学说,没有必要也不应该作为新的理论提出。②尚有很多周围神经病变的病位并不在中枢神经系统,无法用"肠脑相通"理论解释。"大肠主神志传导"一说旨在提出"神经系统病变从肠论治",更符合中医学整体、互联、恒动的观念。 相似文献
96.
Hummy Song Alyna T Chien Josephine Fisher Julia Martin Antoinette S Peters Karen Hacker Meredith B Rosenthal Sara J Singer 《Health services research》2015,50(3):897-921
ObjectiveTo develop and validate a survey instrument designed to measure team dynamics in primary care.ConclusionsIt is possible to measure primary care team dynamics reliably using a 29-item survey. This survey may be used in ambulatory settings to study teamwork and explore the effect of efforts to improve team-based care. Future studies should demonstrate the importance of team dynamics for markers of team effectiveness (e.g., work satisfaction, care quality, clinical outcomes). 相似文献
97.
Objectives
The aim of the study is to assess the weight loss programme with regards to the long-term effectiveness of weight reduction and weight maintenance, using completion rate and BMI, blood sugar, cholesterol and blood pressure levels as outcomes. The aim of the study also includes identifying the factors associated with adherence to the programme.Methods
The programme was developed by a multidisciplinary team. It included 6 months of introduction and another 18 months of maintenance. The data for 397 participants was collected after 24 months.Results
346 participants have completed the introduction and 123 have completed the programme. In the introduction, the average weight loss was 12% of the initial weight. The participants, who completed the full programme, lost 9.4% of their initial weight. The participants also significantly (p<0.05) reduced their blood sugar and cholesterol levels, as well as their blood pressure. The factors associated with adherence to the programme are: age over 50, lower educational levels, lower initial weight and higher weight loss in the introduction.Conclusions
The multi-disciplinary approach to obesity treatment was effective for a selected group of people. The proportion of dropouts was relatively high, but still low compared to similar programmes. Group treatment and mutual support are of a great importance in bringing about and maintaining the changes. 相似文献98.
Latarsha Chisholm Sheryl Zimmerman Cherie Rosemond Eleanor McConnell Bryan J. Weiner Feng-Chang Lin Laura Hanson 《Geriatric nursing (New York, N.Y.)》2018,39(2):157-161
Nursing homes (NH) are important settings for end-of-life care, but limited implementation may impede goals of care discussions. The purpose of this study was to understand NH staff perceptions of adoption and sustainability of the Goals of Care video decision aid for families of residents with advanced dementia. Study design was a cross-sectional survey of staff at 11 NHs in North Carolina who participated in the Goals of Care (GOC) cluster randomized clinical trial. Staff perceived the GOC decision aid intervention as a positive innovation; it was perceived as more compatible with current practices by male staff, nurses, and more experienced NH staff. Perceptions were correlated with experience, implying that experience with an innovative approach may help to promote improved GOC communication in nursing homes. Nurses and social work staff could be effective champions for implementing a communication technique, like the GOC intervention. 相似文献
99.
María Elena Pileño Javier Morillo Andrea Morillo Marta Losa-Iglesias 《Archives of Psychiatric Nursing》2018,32(2):206-214
Background
Health care institutions include workers who must operate in accordance with the requirements of the position, even though there are psychosocial influences that can affect the stability of the worker.Aims
To analyze the organizational culture of the team of professionals who work in the mental health network.Method
A qualitative methodology was used to assess a sample of 55 mental health professionals who have been practicing for at least 5 years.Results
“Team” was the overall topic. The subtopics within “Team” were: getting along in the unit, getting along with the patient, personal resources for dealing with patients, adaptive resources of team members and, resources that the team uses in their group activities.Conclusion
It was observed that the team does not work with a common objective and needs an accepted leader to manage the group. The definition and acceptance of roles can result in conflict. By increasing the skill level of each worker, the multidisciplinary team would be more collaborative. 相似文献100.
Multidisciplinary diabetes team care: the experiences of young adults with Type 1 diabetes
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Janice Wiley MB BS MPH MHM Mary Westbrook PhD Janet Long RN Jerry R. Greenfield PhD Richard O. Day MD Jeffrey Braithwaite PhD 《Health expectations》2015,18(5):1783-1796