Robert Liberman's Influence on Supported Employment

The authors have developed individual placement and support using many of the principles of psychiatric rehabilitation of Robert P. Liberman. These included respect for the individual, working in collaboration with the family, integrating skills and supports, using simple behavioral techniques to teach skills in a particular context, combining clinical and rehabilitative approaches, and insisting on rigorous research. As individual placement and support has become an evidence-based practice and has spread around the globe, Bob continues to be a tireless mentor, supporter, colleague, and friend.     

医院“院长代表门诊常设制”的实践与思考

医院门诊是面向社会的主要窗口,门诊工作的优劣、质量的高低,反映了医院整体服务水平和管理成效。"院长代表门诊常设制"是无锡市第二人民医院提升医院门诊服务水平的一项重要管理创新举措,2014年获亚洲医院管理奖。笔者结合医院门诊工作中存在的问题,从"院长代表门诊常设制"项目的背景、意义入手,介绍项目的主要做法和取得好成效,并就前置医院管理重心、架设患者与院长沟通桥梁、发挥院长代表现场解决作用、提高管理人员现场处置能力等方面提出了思考。     

上海市花木社区幼儿家长居家安全知-信-行调查

目的：了解幼儿家长居家安全知识、信念、行为（简称KAP）水平,为实施干预提供科学依据。方法在上海市浦东新区花木社区儿童保健门诊对满1周岁幼儿的父母或经常看护者进行问卷调查。结果共收集问卷219份。家长对于溺水、药物中毒、睡眠窒息的危险因素正确应答率较低,分别是32．42％、56．62％、79．00％,对于居家伤害中常见的烫伤、宠物伤和坠落伤的危险因素正确应答率分别是62．56％、83．56％、90．41％,在烫伤、睡眠窒息和坠落伤上,父母的正确应答率均高于（外）祖父母（χ2值分别为9．392、11．463和5．088,均P＜0．05）。72．6％的家长没有接受过有关预防儿童伤害的培训和指导;49．77％的家长愿意接受医务人员对其家庭环境进行安全评估和指导。父母中90．56％觉得在预防儿童伤害中“我能做很多事,作用会很大”,高于（外）祖父母的48．72％（χ2＝39．962,P＜0．001）。家长对于各类居家安全防护用品的知晓率可达79．00％～92．24％,但使用率仅为1．83％～6．39％。结论幼儿家长居家安全KAP水平不容乐观。预防幼儿居家伤害应当加强对监护人（尤其是祖父母/外祖父母）的教育和培训,建议推广使用居家安全防护用品。     

临床药师参与1例恶性外耳道炎伴糖尿病肾病患者诊疗的实践体会

目的 探讨临床药师参与肾功能不全严重感染患者的药学实践模式,保障患者抗感染治疗安全有效。方法 临床药师通过参与1例恶性外耳道炎伴糖尿病肾病患者的诊疗,结合细菌流行病学和药学特点调整抗菌药物,同时评估了患者的肾功能和药物相互作用,积极处理了治疗的矛盾。结果 临床药师实施的药学监护和对抗感染治疗方案的优化使患者得到了有效的抗感染治疗,病情得到有效控制。结论 临床药师通过对患者开展个体化药学监护,保障患者用药安全性,促进合理用药。     

The role of reflective practice in healthcare professions: Next steps for pharmacy education and practice

Reflective practice strategies can enable healthcare practitioners to draw on previous experiences to render more effective judgment in clinical situations. The central argument presented in this commentary is that education programs and structures for continuing professional development (CPD) and revalidation of professionals sharpen their focus regarding self-assessment to identify gaps in skills and attitudes rather than merely as a means of on-going monitoring. Pharmacy undergraduate and professional education need to promote reflective practice strategies that foster self-evaluation to promote pharmacists’ readiness for practice change and advance patient care within rapidly expanding roles and scope of practice.