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https://www.readbyqxmd.com/read/29914440/ethical-competence-in-dnr-decisions-a-qualitative-study-of-swedish-physicians-and-nurses-working-in-hematology-and-oncology-care
#1
Mona Pettersson, Mariann Hedström, Anna T Höglund
BACKGROUND: DNR decisions are frequently made in oncology and hematology care and physicians and nurses may face related ethical dilemmas. Ethics is considered a basic competence in health care and can be understood as a capacity to handle a task that involves an ethical dilemma in an adequate, ethically responsible manner. One model of ethical competence for healthcare staff includes three main aspects: being, doing and knowing, suggesting that ethical competence requires abilities of character, action and knowledge...
June 19, 2018: BMC Medical Ethics
https://www.readbyqxmd.com/read/29914412/reintroducing-vacuum-extraction-in-primary-health-care-facilities-a-case-study-from-tanzania
#2
Sunday Dominico, Patricia E Bailey, Nguke Mwakatundu, Mkambu Kasanga, Jos van Roosmalen
BACKGROUND: In rural Tanzania access to emergency obstetric and newborn care is threatened by poor roads and understaffed facilities among other challenges. Districts in Kigoma, Pwani and Morogoro regions were targeted by a local non-governmental organization to assist local government to build capacity and improve access to clinical management of severe obstetric and newborn complications. The program upgraded ten primary health care centres to provide comprehensive emergency obstetric and newborn care...
June 19, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29908764/development-of-the-ripe-model-reflective-interprofessional-education-model-to-enhance-interprofessional-collaboration
#3
C Lucas, T Power, C Hayes, C Ferguson
This paper describes a novel model to providing interprofessional education (IPE) and interprofessional collaboration (IPC) within a simulated healthcare environment, in the higher education setting. The RIPE Model (Reflective Interprofessional Education Model) was developed for the purpose of enhancing IPE and IPC, clinical judgement, and decision-making between health professional students (pharmacy and nursing students) at the patient's simulated hospital bedside. A foundation 'unfolding' case utilizing the RIPE model was piloted with first year Master of pharmacy students and postgraduate nursing students at an Australian university and included a pharmacy practitioner acting as a resident medical officer (RMO) for the purpose of the teaching module...
June 2, 2018: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/29903784/designing-prep-and-early-hiv-treatment-interventions-for-implementation-among-female-sex-workers-in-south-africa-developing-and-learning-from-a-formative-research-process
#4
Robyn Eakle, Nyaradzo Mutanha, Judie Mbogua, Maria Sibanyoni, Adam Bourne, Gabriela Gomez, Francois Venter, Helen Rees
OBJECTIVES: The objective of this research was to design relevant, tailored oral pre-exposure prophylaxis (PrEP) and early antiretroviral (ART) interventions for female sex workers (FSWs) in South Africa. This paper examines the methods, process and outcomes of employing an inductive approach to formative research exploring intervention feasibility and acceptability. SETTING: Research was conducted in several sex work-related settings including five sites in and around clinics and stakeholder offices...
June 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29902741/clinical-learning-experiences-of-nursing-students-using-an-innovative-clinical-partnership-model-a-non-randomized-controlled-trial
#5
Aileen W K Chan, Fiona W K Tang, Kai Chow Choi, Ting Liu, Ruth E Taylor-Piliae
BACKGROUND: Clinical practicum is a major learning component for pre-registration nursing students. Various clinical practicum models have been used to facilitate students' clinical learning experiences, employing both university-based and hospital-based clinical teachers. Considering the strengths and limitations of these clinical practicum models, along with nursing workforce shortages, we developed and tested an innovative clinical partnership model (CPM) in Hong Kong. OBJECTIVE: To evaluate an innovative CPM among nursing students actual and preferred clinical learning environment, compared with a conventional facilitation model (CFM)...
June 5, 2018: Nurse Education Today
https://www.readbyqxmd.com/read/29901662/how-theory-can-inform-our-understanding-of-experiential-learning-in-quality-improvement-education
#6
Joanne Goldman, Ayelet Kuper, Brian M Wong
It is widely accepted that quality improvement (QI) education should be experiential. Many training programs believe that making QI learning "hands-on" through project-based learning will translate into successful learning about QI. However, this pervasive and overly simplistic interpretation of experiential QI learning, and the general lack of empirical exploration of the factors that influence experiential learning processes, may limit the overall impact of project-based learning on educational outcomes...
June 12, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29901661/interprofessional-care-in-teaching-practices-lessons-from-bright-spots
#7
Thomas Bodenheimer, Margae Knox, Sara Syer
In this issue, Brandt and colleagues and Uhlig and colleagues highlight barriers faced by health professional schools implementing interprofessional education and describe how clinical learning environments can overcome those obstacles. Primary care residency teaching clinics provide an excellent opportunity for interprofessional education and patient care, with teachers and learners from various professions caring for patients together. This Invited Commentary offers three interprofessional education strategies used by five "bright spot" family medicine teaching clinics: (1) separate clinics for patients with complex healthcare needs during which learners from various professions see patients together; (2) interprofessional interactions in day-to-day patient care; and (3) case conferences across professions to discuss patients...
June 12, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29901656/untying-the-interprofessional-gordian-knot-the-national-collaborative-on-improving-the-clinical-learning-environment
#8
Barbara F Brandt, Simon Kitto, Ronald M Cervero
The National Collaborative for Improving the Clinical Learning Environment (NCICLE) is a growing group of over 40 organizations representing a variety of health professions. NCICLE is beginning a discussion of issues related to culture in health care, specifically how the current culture inhibits optimal outcomes, and the discordance between current early interprofessional education (IPE) curricula in health professions schools and traditional practice models in health care. In October 2017, the Accreditation Council for Graduate Medical Education and the Josiah Macy Jr...
June 12, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29897671/undergraduate-student-nurses-perspectives-of-an-integrated-clinical-learning-model-in-the-mental-health-environment
#9
Gayelene Boardman, Karen Lawrence, Meg Polacsek
Providing nursing students with appropriate clinical practice during their undergraduate programme is critical to ensuring that graduates meet the competency requirements to gain registration as a nurse. In response to the predicted nursing workforce shortage, universities have been significantly increasing the enrolment of undergraduate nurses into Bachelor of Nursing courses. This has placed a demand on the availability of clinical placements and often universities struggle to find appropriate places. In this study, a Bachelor of Nursing course incorporated an Integrated Clinical Learning Model (ICLM) for the first time during a mental health placement...
June 13, 2018: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/29897316/developing-a-professional-studies-curriculum-to-support-veterinary-professional-identity-formation
#10
Elizabeth Armitage-Chan, Stephen A May
Professional studies teaching in medical and veterinary education is undergoing a period of change. Traditional approaches, aiming to teach students professional values and behaviors, are being enhanced by curricula designed to support students' professional identity formation. This development offers the potential for improving student engagement and graduates' mental well-being. The veterinary professional identity associated with emotional resilience and success in practice incorporates complexity in professional decision making and the importance of context on behaviors and actions...
June 13, 2018: Journal of Veterinary Medical Education
https://www.readbyqxmd.com/read/29895178/ebovac-salone-lessons-learned-from-implementing-an-ebola-vaccine-trial-in-an-ebola-affected-country
#11
Thomas Mooney, Elizabeth Smout, Bailah Leigh, Brian Greenwood, Luisa Enria, David Ishola, Daniela Manno, Mohamed Samai, Macaya Douoguih, Deborah Watson-Jones
Background/aims During the 2014-2016 West African Ebola epidemic, clinical trials were fast-tracked in order to identify prophylactic vaccines and experimental treatments that might be useful in preventing or treating Ebola. These trials included the ongoing EBOVAC-Salone study, which was established and implemented in Sierra Leone to assess the safety and immunogenicity of the Ad26.ZEBOV/MVA-BN-Filo prime-boost Ebola vaccine regimen. Methods This article describes the experiences of the EBOVAC-Salone research team in setting up and implementing the trial, and provides recommendations for research teams aiming to conduct clinical trials in future outbreak situations...
June 1, 2018: Clinical Trials: Journal of the Society for Clinical Trials
https://www.readbyqxmd.com/read/29889035/-malpractice-in-urology-lessons-of-clinical-and-legal-safety
#12
César Vargas-Blasco, Esperanza L Gómez-Durán, Carles Martin-Fumadó, Josep Arimany-Manso
OBJECTIVES: Data about urology malpractice claims in our environment are scarce and should be considered a potential opportunity to "learn from errors". METHODS: We analyzed every claim for alleged malpractice in Urology managed by the Council of Medical Colleges of Catalonia between 1990 and 2012, and specifically evaluated the clinical and medicolegal features of those cases with medical professional responsibility. RESULTS: We identified 182 cases in 22 years, but only the 25,74%showed professional liability...
June 2018: Archivos Españoles de Urología
https://www.readbyqxmd.com/read/29888953/examples-of-dramatic-failures-and-their-effectiveness-in-modern-surgical-disciplines-can-we-learn-from-our-mistakes
#13
Chad G Ball, Sean C Grondin, Janice L Pasieka, Andrew W Kirkpatrick, Anthony R MacLean, Paul Cantle, Elijah Dixon, Prism Schneider, Mark Hamilton
Innovation can be variably defined, but when applied to healthcare is often considered to be the introduction of something new, whether an idea, method or device, into an unfilled void or needy environment. Despite the introduction of many positive surgical subspecialty altering concepts/devices however, epic failures are not uncommon. These failures can be dramatic in regards to both their human and economic costs. They can also be very public or more quiet in nature. As surgical leaders in our communities and advocates for patient safety and outcomes, it remains crucial that we meet new introductions in technology and patient care with a measured level of curiosity, skepticism and science-based conclusions...
June 11, 2018: Journal of Comparative Effectiveness Research
https://www.readbyqxmd.com/read/29886777/-i-ve-learned-to-just-go-with-the-flow-family-caregivers-strategies-for-managing-behavioral-and-psychological-symptoms-of-dementia
#14
Courtney A Polenick, Laura M Struble, Barbara Stanislawski, Molly Turnwald, Brianna Broderick, Laura N Gitlin, Helen C Kales
Background and objectives Behavioral and psychological symptoms of dementia are highly prevalent, stressful, and challenging to manage. Caregivers' approaches for handling these behaviors have implications for both care partners' well-being. Yet the specific strategies that caregivers use in their daily management of behavioral and psychological symptoms of dementia are relatively unknown. This study used in-depth focus group data to examine family caregivers' strategies for managing behavioral and psychological symptoms of dementia...
January 1, 2018: Dementia
https://www.readbyqxmd.com/read/29886121/utilization-of-quality-improvement-methodology-to-standardize-communication-of-outside-hospital-transfers-in-a-general-surgery-program
#15
Xiaoxi Feng, Jennifer Colvin, Judith French, Jane Wey
OBJECTIVE: There is no standardized method of communication regarding the arrival of outside hospital (OSH) transfers at our institution. We utilized quality improvement methodologies to enhance sign-out, benefiting both resident workflow and patient care. DESIGN: A dynamic census log of pending OSH transfers was created. Total number of OSH transfers (with or without prior notification), time to admission orders, and resident self-reported preparedness in receiving/triaging OSH admissions were measured before and after implementation of the census log tool...
June 7, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29884169/pregnant-women-s-views-on-how-to-promote-the-use-of-a-decision-aid-for-down-syndrome-prenatal-screening-a-theory-informed-qualitative-study
#16
Titilayo Tatiana Agbadjé, Matthew Menear, Michèle Dugas, Marie-Pierre Gagnon, Samira Abbasgholizadeh Rahimi, Hubert Robitaille, Anik M C Giguère, François Rousseau, Brenda J Wilson, France Légaré
BACKGROUND: For pregnant women and their partners, the decision to undergo Down syndrome prenatal screening is difficult. Patient decision aids (PtDA) can help them make an informed decision. We aimed to identify behaviour change techniques (BCTs) that would be useful in an intervention to promote the use of a PtDA for Down syndrome prenatal screening, and to identify which of these BCTs pregnant women found relevant and acceptable. METHODS: Using the Behaviour Change Wheel and the Theoretical Domains Framework, we conducted a qualitative descriptive study...
June 8, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29883198/bridging-the-expertise-gap-developing-and-utilizing-a-radiological-advisory-committee-for-new-york-city
#17
Mark L Maiello, Jessica Cole, Elaine Vernetti
From the Field is a semi-regular column that explores what it means to be a local health professional on the front lines of an emergency. Typically, National Association of County and City Health Officials (NACCHO) members share their stories of preparing for and responding to disasters, epidemics, and other major health issues. This month's column features a submission from the New York City health department that describes their experience in setting up a radiological advisory committee. Through exploring the analysis of the challenges faced and the solutions developed, readers can learn how these public health champions keep their communities safe even in extreme situations...
June 8, 2018: Health Security
https://www.readbyqxmd.com/read/29879847/the-sano-study-justification-and-detailed-description-of-a-multidisciplinary-biopsychosocial-rehabilitation-programme-in-patients-with-chronic-low-back-pain
#18
Anne Mette Schmidt, Helle Terkildsen Maindal, Trine Bay Laurberg, Berit Schiøttz-Christensen, Charlotte Ibsen, Kirstine Bak Gulstad, Thomas Maribo
OBJECTIVE: To justify and describe an integrated rehabilitation programme for patients with chronic low back pain prior to evaluation in a randomized controlled trial. METHOD: The Template for Intervention Description and Replication (TIDieR) checklist was used as a structural framework for the description of the integrated rehabilitation programme. As a part of the description, the Medical Research Council guidance, 'Developing and evaluating complex interventions', was used as a framework to justify the integrated rehabilitation programme...
June 1, 2018: Clinical Rehabilitation
https://www.readbyqxmd.com/read/29878838/ecologically-relevant-episodic-memory-assessment-indicates-an-attenuated-age-related-memory-loss-a-virtual-reality-study
#19
Marlon O Pflueger, Rolf-Dieter Stieglitz, Patrick Lemoine, Thomas Leyhe
OBJECTIVES: Since the advent of imaging techniques, the role of the neuropsychological assessment has changed. Questions concerning everyday functionality became primarily important and, thus, ecologically valid neuropsychological assessments are mandatory. Virtual reality (VR) environments might provide a way of implementing immersive cognitive assessments with a higher degree of everyday-life-related cognitive demands. METHOD: We report on a VR-based episodic memory examination in N = 30 young and N = 18 healthy older adults (HOA) using a kitchen scene...
June 7, 2018: Neuropsychology
https://www.readbyqxmd.com/read/29873645/-knowledge-retain-of-bls-and-bls-d-theoretical-contents-in-a-long-term-follow-up
#20
Enrico Paolini, Elettra Conti, Federico Guerra, Alessandro Capucci
BACKGROUND: Despite the many recent improvements in basic life support (BLS) and the widespread training to a great number of lay rescuers, out-of-hospital cardiac arrest (OHCA) is still a major cause of death. Nowadays, BLS teaching protocols ask for many concepts to be learned and specific algorithms to be applied, without any available data on how much all these inputs are retained by the students. The present survey aims to evaluate how BLS is really retained by those rescuers (laypersons and nurses) who do not often put it into practice...
March 2018: Giornale Italiano di Cardiologia
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