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Immonen H, Raekallio M, Holmström AR. Promoting veterinary medication safety - Exploring the competencies of community pharmacy professionals in veterinary pharmacotherapy. Vet Anim Sci 2023; 21:100310. [PMID: 37664413 PMCID: PMC10468355 DOI: 10.1016/j.vas.2023.100310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023] Open
Abstract
The science of veterinary medicine is currently lacking studies on medication safety, although its importance in protecting animals from medication errors is central. Pharmacy professionals have an important role in ensuring medication safety of both prescription and over-the-counter medications of animals. However, this requires adequate competencies of pharmacy professionals in veterinary pharmacotherapy. The present study aimed to explore the competencies of pharmaceutical staff in community pharmacies in veterinary pharmacotherapy, which factors influence these competencies and what kind of information sources they typically use on veterinary pharmacotherapy. The study was conducted as a cross-sectional online survey targeted to pharmacy professionals in the Finnish community pharmacies, providing 596 responses. Less than half of the respondents (41%, n = 246) are considered to possess good competencies in veterinary pharmacotherapy. A third of the respondents (35%, n = 211) would dispense an anti-inflammatory drug for an animal off-label, whereas 24% (n = 145) would not interview the pet owner to discover the need for internal parasite medication before dispensing the drug. A small proportion (<1%, n = 5) would have dispensed a broad-spectrum internal parasite medication. Approximately a quarter of the respondents (27%, n = 159) stated that they acquired information on pharmacotherapy only from the material produced by the manufacturers of veterinary drugs. The competencies of pharmacy professionals in veterinary pharmacotherapy need to be strengthened in many areas to better promote veterinary medication safety. It should also be ensured that pharmacy professionals can access and use independent, high-quality information on veterinary pharmacotherapy.
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Affiliation(s)
- H. Immonen
- Faculty of Pharmacy, Division of pharmacology and pharmacotherapy, University of Helsinki, Viikinkaari 5 E, 00014, Finland
| | - M.R. Raekallio
- Faculty of Veterinary Medicine, Department of Equine and Small Animal Medicine, University of Helsinki, Koetilantie 2, 00014, Finland
| | - A-R. Holmström
- Faculty of Pharmacy, Division of pharmacology and pharmacotherapy, University of Helsinki, Viikinkaari 5 E, 00014, Finland
- Faculty of Veterinary Medicine, Department of Equine and Small Animal Medicine, University of Helsinki, Koetilantie 2, 00014, Finland
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2
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Hogg P, Cresswell J. Interprofessional research teams in radiography - where the magic happens. Radiography (Lond) 2021; 27 Suppl 1:S9-S13. [PMID: 34127374 DOI: 10.1016/j.radi.2021.05.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 05/13/2021] [Accepted: 05/17/2021] [Indexed: 10/21/2022]
Abstract
Based on publications and professional experiences, this article, intended for academic and clinical therapy/diagnostic radiographers, considers conducting research in interprofessional teams, including its values and how to go about achieving it. Whilst there is a growing number of journal papers published by interprofessional teams, almost nothing is published about how best to build interprofessional research relationships or harness the potential of the different professional experience to deliver novel research within the radiography literature. Thus, this article draws heavily on our experiences of creating, working within and leading interprofessional teams which have a specific focus on conducting radiography-related research. Suggestions are proposed about how to create an interprofessional research team and how to get the best out of it. Values of working within an interprofessional research team, to self, to research quality and to the end users of the research are considered.
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Affiliation(s)
- P Hogg
- University of Salford, UK.
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3
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Kanne GE, Sabol VK, Pierson D, Corcoran MW, Silva SG, White HK. On the Move clinic: A fall prevention nurse practitioner-driven model of care. Geriatr Nurs 2021; 42:850-4. [PMID: 34090230 DOI: 10.1016/j.gerinurse.2021.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 03/29/2021] [Accepted: 03/31/2021] [Indexed: 11/22/2022]
Abstract
Falls in older adults are common and interventions to reduce associated morbidity and mortality remain difficult to implement. This quality improvement project evaluated On the Move, a new clinic designed to provide tailored recommendations to reduce falls risk, based on an adaptation of CDC's STEADI: a falls risk screening, assessment and intervention guide. 89 participants were referred by primary care and emergency services. A nurse practitioner assessed modifiable physical, behavioral and environmental risk factors and utilized motivational interviewing and education to guide participants in developing an intervention plan. A physical therapist assessed gait/balance, the need for ongoing PT services and provided brief counseling. Participants received a 6-week phone call and 12-week follow up visit. Measurements, including 30-second chair stands, Timed Up and Go, 4-Item Dynamic Gait Index, and Activities-Specific Balance Confidence Scale all showed significant improvement. Participants made behavioral changes to reduce risk, and plans to continue exercise.
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4
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Gallagher E, Carter-Ramirez D, Boese K, Winemaker S, MacLennan A, Hansen N, Hafid A, Howard M. Frequency of providing a palliative approach to care in family practice: a chart review and perceptions of healthcare practitioners in Canada. BMC Fam Pract 2021; 22:58. [PMID: 33773579 PMCID: PMC8005234 DOI: 10.1186/s12875-021-01400-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 02/23/2021] [Indexed: 12/01/2022]
Abstract
Background Most patients nearing the end of life can benefit from a palliative approach in primary care. We currently do not know how to measure a palliative approach in family practice. The objective of this study was to describe the provision of a palliative approach and evaluate clinicians’ perceptions of the results. Methods We conducted a descriptive study of deceased patients in an interprofessional team family practice. We integrated conceptual models of a palliative approach to create a chart review tool to capture a palliative approach in the last year of life and assessed a global rating of whether a palliative approach was provided. Clinicians completed a questionnaire before learning the results and after, on perceptions of how often they believed a palliative approach was provided by the team. Results Among 79 patients (mean age at death 73 years, 54% female) cancer and cardiac diseases were the top conditions responsible for death. One-quarter of patients were assessed as having received a palliative approach. 53% of decedents had a documented discussion about goals of care, 41% had nurse involvement, and 15.2% had a discussion about caregiver well-being. These indicators had the greatest discrimination between a palliative approach or not. Agreement that elements of a palliative approach were provided decreased significantly on the clinician questionnaire from before to after viewing the results. Conclusions This study identified measurable indicators of a palliative approach in family practice, that can be used as the basis for quality improvement. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-021-01400-4.
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Affiliation(s)
- Erin Gallagher
- Department of Family Medicine, McMaster University, David Braley Health Sciences Centre 100 Main Street West, 5th Floor, Hamilton, ON, L8P 1H6, Canada.,Division of Palliative Care, McMaster University, David Braley Health Sciences Centre 100 Main Street West, 5th Floor, Hamilton, ON, L8P 1H6, Canada
| | - Daniel Carter-Ramirez
- Department of Family Medicine, McMaster University, David Braley Health Sciences Centre 100 Main Street West, 5th Floor, Hamilton, ON, L8P 1H6, Canada.,Division of Palliative Care, McMaster University, David Braley Health Sciences Centre 100 Main Street West, 5th Floor, Hamilton, ON, L8P 1H6, Canada
| | - Kaitlyn Boese
- Division of Palliative Care, Department of Medicine, University of Ottawa, 451 Smyth, Road Ottawa, Ottawa, ON, K1H 8M5, Canada.,Department of Palliative Care, Bruyere Continuing Care, 43 Bruyère St, Ottawa, ON, K1N 5C8, Canada
| | - Samantha Winemaker
- Department of Family Medicine, McMaster University, David Braley Health Sciences Centre 100 Main Street West, 5th Floor, Hamilton, ON, L8P 1H6, Canada.,Division of Palliative Care, McMaster University, David Braley Health Sciences Centre 100 Main Street West, 5th Floor, Hamilton, ON, L8P 1H6, Canada
| | - Amanda MacLennan
- Department of Family Medicine, McMaster University, David Braley Health Sciences Centre 100 Main Street West, 5th Floor, Hamilton, ON, L8P 1H6, Canada.,Division of Palliative Care, McMaster University, David Braley Health Sciences Centre 100 Main Street West, 5th Floor, Hamilton, ON, L8P 1H6, Canada
| | - Nicolle Hansen
- Department of Family Medicine, McMaster University, David Braley Health Sciences Centre 100 Main Street West, 5th Floor, Hamilton, ON, L8P 1H6, Canada
| | - Abe Hafid
- Department of Family Medicine, McMaster University, David Braley Health Sciences Centre 100 Main Street West, 5th Floor, Hamilton, ON, L8P 1H6, Canada
| | - Michelle Howard
- Department of Family Medicine, McMaster University, David Braley Health Sciences Centre 100 Main Street West, 5th Floor, Hamilton, ON, L8P 1H6, Canada.
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5
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Fischer-Grönlund C, Brännström M, Zingmark K. The 'one to five' method - A tool for ethical communication in groups among healthcare professionals. Nurse Educ Pract 2021; 51:102998. [PMID: 33639607 DOI: 10.1016/j.nepr.2021.102998] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 02/10/2021] [Accepted: 02/14/2021] [Indexed: 11/24/2022]
Abstract
Healthcare professionals have expressed a wish for facilitated inter-professional communications about ethical difficulties experienced in clinical practice. The introduction of an easily accessible method for facilitating ethical communication in groups may promote its implementation in everyday clinical practice. The aim of this paper was to draw on previous studies and available knowledge in order to develop and describe a method that enables systematic implementation of inter-professional ethical communication in groups. The 'one-to-five method' for facilitated ethical communication in groups is theoretically inspired by Habermas's theory of communicative actions and base on previous studies that accords with the Helsinki Declaration (2013). The 'one to five method' supports guidance of ethical communication in five steps: telling the story about the situation; reflections and dialogue concerning the emotions involved; formulation of the problem/dilemma; analysis of the situation and the dilemma; and searching for a choice of action or approach. It offers an easily accessible method for teaching healthcare professionals how to facilitate ethics communication groups. Educating facilitators closely connected to clinical work may lead to ethical dialogue becoming a natural part of clinical practice for healthcare professionals.
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Affiliation(s)
| | | | - Karin Zingmark
- Department of Health Science, Division of Nursing, Luleå University of Technology, Sweden.
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6
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Bond R, Brown NS. Testing of a (Spiritual) Self-Assessment Tool ((S)SAT) in a Community Hospital Setting. J Pastoral Care Counsel 2020; 74:229-233. [PMID: 33228494 DOI: 10.1177/1542305020949443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The (Spiritual) Self-Assessment Tool Study was designed to test the novel engagement tool's effectiveness. Providing the (Spiritual) Self-Assessment Tool Study to newly admitted medical patients led to few instances where the tool was completed. Nevertheless, the (Spiritual) Self-Assessment Tool Study patient questionnaire generated significant secondary findings: a third of responding patients consider their hospital care incomplete without their care team having access to (Spiritual) Self-Assessment Tool data. Nursing staff also desire this data, but are unable to access it without the (Spiritual) Self-Assessment Tool or an equivalent source.
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Affiliation(s)
- Robert Bond
- Niagara Health, Canada; McMaster University, Canada
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7
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Liu HY. Inter-professional nursing education and the roles of swift trust, interaction behaviors, and creativity: A cross-sectional questionnaire survey. Nurse Educ Today 2020; 95:104598. [PMID: 32992270 DOI: 10.1016/j.nedt.2020.104598] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 08/14/2020] [Accepted: 09/08/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Technological advances in medicine have generated an increase in the complexity of delivering quality medical care, which is a challenge to the healthcare system. Improving interdisciplinary teamwork among all healthcare staff is one approach to meeting these new challenges. Interdisciplinary teamwork can be improved through inter-professional teaching in nursing education, which provides instruction from at least two professions to teams of students from different specialties. Behaviors that foster collaboration and creativity in temporary organizations, such as teams, include swift trust, interactive behaviors, and team creativity. A better understanding of the relationships between these behaviors could help educators improve inter-professional education courses for nursing students. METHOD A cross-sectional study was conducted with 210 nursing students enrolled in inter-professional education courses with interdisciplinary teams that included design students. Three self-report questionnaires assessed nursing students' perceptions about swift trust, interactive behaviors, and creativity: 1) swift trust measured cognitive-based and affective-based domains; 2) interactive behaviors measured domains of constructive controversy, helping behaviors, and spontaneous communication; and 3) team creativity measured collaborative abilities. Scale scores range from 1 to 5; higher scores indicate more swift trust, better interactive behaviors, and greater team creativity. Analysis with Pearson's correlation coefficient and SPSS PROCESS macro was employed to test the mediating effects. FINDINGS Cognitive-based swift trust was positively correlated with all three domains of interactive behaviors (p < .01); all domains of interactive behaviors were positively associated with team creativity (p < .01). Mediation models indicated that interactive behaviors mediated the relationship between cognitive-based swift trust and team creativity. DISCUSSION Enhancing cognitive-based swift trust and interactive behaviors in interdisciplinary education for nursing students could promote team creativity. Faculty involved in interdisciplinary education courses for nurses should encourage interactive behaviors, which could increase cognitive-based swift trust among nursing students and improve collaboration and creativity.
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Affiliation(s)
- Hsing-Yuan Liu
- Department of Nursing, Chang Gung University of Science and Technology, No. 261, Wenhua 1st Road, Guishan District, Taoyuan City 33303, Taiwan, ROC; Chang Gung Memorial Hospital, No.5, Fuxing St., Guishan Dist., Taoyuan City 333, Taiwan, ROC.
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8
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Abstract
The infectious diseases (ID) specialty continues to be in crisis due to a lack of interest by residents in the recruitment pool. It is possible that enhancing and innovating how microbiology is taught in medical school could increase the interest in ID. We need to improve teaching of preclinical medical microbiology and immunology by incorporating advancements in education and learning technologies to reignite the interest in the field. The shortage of ID specialists has important implications in our fight against ID threats such as the current COVID-19 global pandemic. In order to address this problem, we need to perform extensive research to identify the issues that medical learners and trainees are facing as they progress through their medical education towards the ID specialty.
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Affiliation(s)
- Jorge Cervantes
- Department of Medical Education, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center at El Paso, El Paso, TX USA
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9
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Reumerman MO, Richir MC, Domela Nieuwenhuis PM, Sultan R, Daelmans HEM, Springer H, Muller M, van Agtmael MA, Tichelaar J. The clinical and educational outcomes of an inter-professional student-led medication review team, a pilot study. Eur J Clin Pharmacol 2020; 77:117-123. [PMID: 32770387 PMCID: PMC7782385 DOI: 10.1007/s00228-020-02972-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 07/27/2020] [Indexed: 12/04/2022]
Abstract
Aims The involvement of an inter-professional healthcare student team in the review of medications used by geriatric patients could not only provide patients with optimized therapy but also provide students with a valuable inter-professional learning experience. We describe and evaluate the clinical and learning outcomes of an inter-professional student-run mediation review program (ISP). Subject and method A variable team consisting of students in medicine, pharmacy, master advanced nursing practice, and master physician assistant reviewed the medication lists of patients attending a specialized geriatric outpatient clinic. Results During 32 outpatient visits, 188 medications were reviewed. The students identified 14 medication-related problems, of which 4 were not recognized by healthcare professionals. The ISP team advised 95 medication changes, of which 68 (71.6%) were directly implemented. Students evaluated this pilot program positively and considered it educational (median score 4 out of 5) and thought it would contribute to their future inter-professional relationships. Conclusion An inter-professional team of healthcare students is an innovative healthcare improvement for (academic) hospitals to increase medication safety. Most formulated advices were directly incorporated in daily practice and could prevent future medication-related harm. The ISP also offers students a first opportunity to work in an inter-professional manner and get insight into the perspectives and qualities of their future colleagues. Electronic supplementary material The online version of this article (10.1007/s00228-020-02972-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Michael O Reumerman
- Department of Internal Medicine, Section Pharmacotherapy, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands. .,Research & Expertise Center In Pharmacotherapy Education (RECIPE), Amsterdam, Netherlands.
| | - Milan C Richir
- Department of Internal Medicine, Section Pharmacotherapy, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands.,Research & Expertise Center In Pharmacotherapy Education (RECIPE), Amsterdam, Netherlands
| | - Philippe M Domela Nieuwenhuis
- Department of Internal Medicine, Section Pharmacotherapy, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands.,Research & Expertise Center In Pharmacotherapy Education (RECIPE), Amsterdam, Netherlands
| | - Rowan Sultan
- Department of Internal Medicine, Section Pharmacotherapy, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands.,Research & Expertise Center In Pharmacotherapy Education (RECIPE), Amsterdam, Netherlands
| | - Hester E M Daelmans
- VUmc School of Medical Sciences, Institute of Education and Training, Amsterdam, Netherlands
| | | | - Majon Muller
- Department of Internal Medicine and Geriatrics, Amsterdam UMC, location VUmc, Amsterdam, Netherlands
| | - Michiel A van Agtmael
- Department of Internal Medicine, Section Pharmacotherapy, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands.,Research & Expertise Center In Pharmacotherapy Education (RECIPE), Amsterdam, Netherlands
| | - Jelle Tichelaar
- Department of Internal Medicine, Section Pharmacotherapy, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands.,Research & Expertise Center In Pharmacotherapy Education (RECIPE), Amsterdam, Netherlands
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10
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Bissett SM, Preshaw PM, Presseau J, Rapley T. A qualitative study exploring strategies to improve the inter-professional management of diabetes and periodontitis. Prim Care Diabetes 2020; 14:126-132. [PMID: 31831377 PMCID: PMC7059110 DOI: 10.1016/j.pcd.2019.11.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 11/05/2019] [Accepted: 11/20/2019] [Indexed: 12/31/2022]
Abstract
AIMS To explore inter-professional communication and collaboration in guideline-concordant diabetes and periodontitis care. METHODS Qualitative design using iterations of workshops to identify ways to improve multidisciplinary working attended by staff from medical and dental primary care practices, and people with diabetes (n=43). Workshops were semi-structured around a topic guide. Recruitment was via the UK Clinical Research Network, and a patient and public involvement group in the North of England. RESULTS Medical practice participants were unaware of the bidirectional evidence linking diabetes and periodontitis and stated that they had never received a referral from a dental professional in this context. The patient participants with diabetes reported never having been informed about the links between diabetes and periodontitis from either their family physician or dentist. Medical and dental practice participants gave negative accounts of inter-professional communication, with claims of inappropriate requests and defensive or non-responses that stymied future interaction. Indirect communication through the patient was suggested as an alternative to direct communication. CONCLUSIONS Indirect referral, whereby the patient is signposted to a healthcare professional, was suggested by medical and dental professionals as a useful alternative to the traditional (and time consuming) letter or telephone call, particularly in the case of suspected diabetes or periodontitis.
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Affiliation(s)
- Susan M Bissett
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK.
| | - Philip M Preshaw
- National University Centre for Oral Health, National University of Singapore, Singapore
| | - Justin Presseau
- Centre for Implementation Research, Ottawa Hospital Research Institute, Ottawa, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Tim Rapley
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
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11
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Waring J, Bishop S, Marshall F, Tyler N, Vickers R. An ethnographic study comparing approaches to inter-professional knowledge sharing and learning in discharge planning and care transitions. J Health Organ Manag 2019; 33:677-694. [PMID: 31625820 DOI: 10.1108/jhom-10-2018-0302] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this paper is to investigate how three communication interventions commonly used during discharge planning and care transitions enable inter-professional knowledge sharing and learning as a foundation for more integrated working. These interventions include information communication systems, dedicated discharge planning roles and group-based planning activities. DESIGN/METHODOLOGY/APPROACH A two-year ethnographic study was carried out across two regional health and care systems in the English National Health Service, focussing on the discharge of stroke and hip fracture patients. Data collection involved in-depth observations and 213 semi-structured interviews. FINDINGS Information systems (e.g. e-records) represent a relatively stable conduit for routine and standardised forms of syntactic information exchange that can "bridge" time-space knowledge boundaries. Specialist discharge roles (e.g. discharge coordinators) support personalised and dynamic forms of "semantic" knowledge sharing that can "broker" epistemic and cultural boundaries. Group-based activities (e.g. team meetings) provide a basis for more direct "pragmatic" knowledge translation that can support inter-professional "bonding" at the cultural and organisational level, but where inclusion factors complicate exchange. RESEARCH LIMITATIONS/IMPLICATIONS The study offers analysis of how professional boundaries complicate discharge planning and care transition, and the potential for different communication interventions to support knowledge sharing and learning. ORIGINALITY/VALUE The paper builds upon existing research on inter-professional collaboration and patient safety by focussing on the problems of communication and coordination in the context of discharge planning and care transitions. It suggests that care systems should look to develop multiple complementary approaches to inter-professional communication that offer opportunities for dynamic knowledge sharing and learning.
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Affiliation(s)
- Justin Waring
- Health Services Management Centre, University of Birmingham , Birmingham, UK
| | - Simon Bishop
- Business School, University of Nottingham , Nottingham, UK
| | - Fiona Marshall
- Business School, University of Nottingham , Nottingham, UK
| | - Natasha Tyler
- Business School, University of Nottingham , Nottingham, UK
| | - Robert Vickers
- Business School, University of Nottingham , Nottingham, UK
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12
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Kilpatrick K, Tchouaket É, Paquette L, Guillemette C, Jabbour M, Desmeules F, Landry V, Fernandez N. Measuring patient and family perceptions of team processes and outcomes in healthcare teams: questionnaire development and psychometric evaluation. BMC Health Serv Res 2019; 19:9. [PMID: 30612571 PMCID: PMC6322340 DOI: 10.1186/s12913-018-3808-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 12/11/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND There is a lack of validated instruments examining dimensions of team functioning from the perspective of patients and families consistent with a conceptual framework. The study aimed to develop and assess the psychometric properties of the Patient-Perceptions of Team Effectiveness (PTE) questionnaire. METHODS A cross-sectional survey was undertaken in three studies. Data were collected from May-October 2016 for Study 1, April 2018-ongoing for Study 2, and October 2016 to June 2017 for Study 3. Online and paper versions of the self-administered questionnaire were available in English and in French. The initial questionnaire included 41 items. Study 1 included 320 respondents. Reliability was assessed using Cronbach alpha. Face validity (n = 250) was assessed using a structured questionnaire. Content validity was examined using subject matter experts and Spearman's item-total correlations. Construct validity was examined using known group comparisons (i.e., clinical specialty, education, length of follow-up, reason of consultation). Content analysis was used for open-ended questions. RESULTS The questionnaire took 10 to 15 min to complete. Positive assessments were noted for instructions, formatting, font size and logical ordering of questions. In Study 1, reliability indices for the PTE-Overall, Team Processes and Outcomes subscales ranged from 0.72 to 0.84. Item-total correlations ranged from 0.551 to 0.794 (p < 0.001). Differences were noted between clinical specialties, education, length of follow-up, reason of consultation, low and high functioning teams. No differences were noted between English and French language respondents. Psychometric properties were re-assessed in Study 2 and 3 after unclear questions were reworked. Reliability indices for the subscales ranged from 0.76 to 0.94 and differences remained significant between low and high functioning teams. CONCLUSION The final 43-item instrument is easy to administer to patients and families. The studies provide evidence of validity to support the propositions in the conceptual framework. The patient-level measures can be aggregated to the team, organizational or system level. The information can be used to assess healthcare team functioning in acute and primary care and determine the role patients and families are playing in teams. Further testing is needed with patients and families who are hospitalized or receiving care from teams in rural areas.
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Affiliation(s)
- Kelley Kilpatrick
- Susan E. French Chair in Nursing Research and Innovative Practice, Ingram School of Nursing, McGill University, Montréal, Canada. .,Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal-Hôpital Maisonneuve-Rosemont (CIUSSS-EMTL), Montréal, Canada.
| | | | - Lysane Paquette
- Faculty of Nursing, Université de Montréal, Montréal, Canada
| | - Claudel Guillemette
- Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal-Hôpital Maisonneuve-Rosemont (CIUSSS-EMTL), Montréal, Canada
| | - Mira Jabbour
- Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal-Hôpital Maisonneuve-Rosemont (CIUSSS-EMTL), Montréal, Canada
| | - François Desmeules
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, Canada
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13
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Southerland LT, Porter BL, Newman NW, Payne K, Hoyt C, Rodis JL. The feasibility of an inter-professional transitions of care service in an older adult population. Am J Emerg Med 2018; 37:553-556. [PMID: 30131205 DOI: 10.1016/j.ajem.2018.07.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 07/24/2018] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Older adults discharged from the Emergency Department (ED) are at high risk for medication interactions and side effects; examples of practice models addressing this transition of care are lacking. METHODS This was a prospective cohort study for adults in one of two urban community EDs. Patients ≥50 years of age discharged with at least one new, non-schedule II prescription medication were included. Patients had the option of three transitions of care services: 1) pharmacist-only with home delivery of discharge medications and full medication reconciliation, 2) pharmacist and home health care, including home delivery, medication reconciliation, and a visit from a home health nurse, or 3) either of the above without home delivery. RESULTS Over seven months, 440 ED patients were screened. Of those, 43 patients were eligible, and three patients elected to join the study. All three patients selected pharmacy-only. Identified barriers to enrollment include the rate of schedule II prescriptions from the ED (53% of potential patients) and high patient loyalty to their community pharmacist. CONCLUSIONS A pharmacy and home health care transitions of care program was not feasible at an urban community ED. While the pharmacist team identified and managed multiple medication issues, most patients did not qualify due to prescriptions ineligible for delivery. Patients did not want pharmacist or home health nurse involvement in their post ED visit care, many due to loyalty to their community pharmacy. Multiple barriers must be addressed to create a successful inter-professional transition of care model.
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Affiliation(s)
- Lauren T Southerland
- Department of Emergency Medicine, The Ohio State Wexner Medical Center, Columbus, OH, United States of America.
| | - Brianne L Porter
- Division of Pharmacy Practice and Science, The Ohio State University, College of Pharmacy, United States of America
| | - Nicholas W Newman
- The Ohio State University, College of Pharmacy, United States of America
| | - Kimberly Payne
- Home Care by BlackStone, Columbus, OH, United States of America.
| | - Cara Hoyt
- Uptown Pharmacy, Westerville, OH, United States of America
| | - Jennifer L Rodis
- Division of Pharmacy Practice and Science, The Ohio State University, College of Pharmacy, United States of America.
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Matthys E, Remmen R, Van Bogaert P. An overview of systematic reviews on the collaboration between physicians and nurses and the impact on patient outcomes: what can we learn in primary care? BMC Fam Pract 2017; 18:110. [PMID: 29273023 PMCID: PMC5741858 DOI: 10.1186/s12875-017-0698-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 12/12/2017] [Indexed: 01/08/2023]
Abstract
Background Primary care needs to be strengthened in order to address the many societal challenges. Group practices in primary care foster collaboration with other health care providers, which encourages care co-ordination and leads to a higher quality of primary care. Nursing roles and responsibilities expanded over time and nurses have been found to often provide equal high-quality chronic patient care compared to physicians, even with higher patient satisfaction. Inter-professional collaboration between primary care physicians and nurses is a possible strategy to achieve the desired quality outcomes in a strengthened primary care system. The objective of this research is to synthesize the evidence presented in literature on the impact of collaboration between physicians and nurses on patient outcomes in primary care or in comparable care settings. Methods A systematic review of peer-reviewed reviews was performed in four databases: COCHRANE, MEDLINE, EMBASE and CINAHL. All studies from 1970 until May 22 2016 were included in the search strategy. Titles, abstracts and full texts were respectively reviewed. At least two of the three authors independently reviewed each of the 277 abstracts and 58 full texts retrieved in the searches to identify those which contained all the inclusion criteria. Two authors independently appraised the methodological quality of the reviews, using the AMSTAR quality appraisal tool. Results A total of eleven systematic reviews met all the inclusion criteria and almost fifty different patient outcomes were described. In most reviews, it was concluded that nurses do have added value. Blood pressure, patient satisfaction and hospitalization are patient outcomes where three or more systematic reviews concluded better results when physicians and nurses collaborated, compared to usual care. Colorectal screening, hospital length of stay and health-related quality of life are outcomes where collaboration appeared not to be effective. Conclusions Collaboration between physicians and nurses may have a positive impact on a number of patient outcomes and on a variety of pathologies. To address future challenges of primary care, there is a need for more integrated inter-professional collaboration care models with sufficiently educated nurses. Electronic supplementary material The online version of this article (10.1186/s12875-017-0698-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Evi Matthys
- University of Antwerp, Campus Drie Eiken DR334, Universiteitsplein 1, 2610, Wilrijk, Belgium.
| | - Roy Remmen
- University of Antwerp, Campus Drie Eiken DR334, Universiteitsplein 1, 2610, Wilrijk, Belgium
| | - Peter Van Bogaert
- University of Antwerp, Campus Drie Eiken DR334, Universiteitsplein 1, 2610, Wilrijk, Belgium
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15
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Sørensen JL, Østergaard D, LeBlanc V, Ottesen B, Konge L, Dieckmann P, Van der Vleuten C. Design of simulation-based medical education and advantages and disadvantages of in situ simulation versus off-site simulation. BMC Med Educ 2017; 17:20. [PMID: 28109296 PMCID: PMC5251301 DOI: 10.1186/s12909-016-0838-3] [Citation(s) in RCA: 102] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 12/05/2016] [Indexed: 05/21/2023]
Abstract
BACKGROUND Simulation-based medical education (SBME) has traditionally been conducted as off-site simulation in simulation centres. Some hospital departments also provide off-site simulation using in-house training room(s) set up for simulation away from the clinical setting, and these activities are called in-house training. In-house training facilities can be part of hospital departments and resemble to some extent simulation centres but often have less technical equipment. In situ simulation, introduced over the past decade, mainly comprises of team-based activities and occurs in patient care units with healthcare professionals in their own working environment. Thus, this intentional blend of simulation and real working environments means that in situ simulation brings simulation to the real working environment and provides training where people work. In situ simulation can be either announced or unannounced, the latter also known as a drill. This article presents and discusses the design of SBME and the advantage and disadvantage of the different simulation settings, such as training in simulation-centres, in-house simulations in hospital departments, announced or unannounced in situ simulations. DISCUSSION Non-randomised studies argue that in situ simulation is more effective for educational purposes than other types of simulation settings. Conversely, the few comparison studies that exist, either randomised or retrospective, show that choice of setting does not seem to influence individual or team learning. However, hospital department-based simulations, such as in-house simulation and in situ simulation, lead to a gain in organisational learning. To our knowledge no studies have compared announced and unannounced in situ simulation. The literature suggests some improved organisational learning from unannounced in situ simulation; however, unannounced in situ simulation was also found to be challenging to plan and conduct, and more stressful among participants. The importance of setting, context and fidelity are discussed. Based on the current limited research we suggest that choice of setting for simulations does not seem to influence individual and team learning. Department-based local simulation, such as simulation in-house and especially in situ simulation, leads to gains in organisational learning. The overall objectives of simulation-based education and factors such as feasibility can help determine choice of simulation setting.
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Affiliation(s)
- Jette Led Sørensen
- Juliane Marie Centre for Children, Women and Reproduction, Rigshospitalet, University of Copenhagen, 2100 Copenhagen, Denmark
| | - Doris Østergaard
- Copenhagen Academy for Medical Education and Simulation, Herlev Hospital, Capital Region of Denmark and University of Copenhagen, 2730 Herlev, Denmark
| | - Vicki LeBlanc
- Department of Innovation in Medical Education, University of Ottawa, Ottawa, Canada
- University of Ottawa Skills and Simulation Centre, The Ottawa Hospital, & University of Ottawa, K1Y 4E9 Ottawa, Canada
| | - Bent Ottesen
- Juliane Marie Centre for Children, Women and Reproduction, Rigshospitalet, University of Copenhagen, 2100 Copenhagen, Denmark
| | - Lars Konge
- Copenhagen Academy for Medical Education and Simulation, Rigshospitalet, Capital Region of Denmark and University of Copenhagen, 2100 Copenhagen, Denmark
| | - Peter Dieckmann
- Copenhagen Academy for Medical Education and Simulation, Herlev Hospital, Capital Region of Denmark and University of Copenhagen, 2730 Herlev, Denmark
| | - Cees Van der Vleuten
- Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6200 Maastricht, Netherlands
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Clarke D. OC38 - Beyond boundaries: inter-professional simulation in children and young people's nursing - three pilot projects. Nurs Child Young People 2016; 28:80-81. [PMID: 27214452 DOI: 10.7748/ncyp.28.4.80.s69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Theme: Nursing education, management and leadership.
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17
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Senior E, Telford M. Using an integrated teaching and learning approach to deliver inter-professional practice in Public Health. Nurse Educ Today 2015; 35:1013-1015. [PMID: 26235202 DOI: 10.1016/j.nedt.2015.07.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 07/09/2015] [Accepted: 07/17/2015] [Indexed: 06/04/2023]
Abstract
In order to address health inequalities an interprofessional approach is required. To recreate this experience for pre-registration healthcare students an innovative model utilising integrated approaches to teaching and learning was developed. This incorporated interprofessional education, threshold concepts, virtual learning and narrative pedagogy.
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18
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Weglicki RS, Reynolds J, Rivers PH. Continuing professional development needs of nursing and allied health professionals with responsibility for prescribing. Nurse Educ Today 2015; 35:227-231. [PMID: 25240679 DOI: 10.1016/j.nedt.2014.08.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 08/15/2014] [Accepted: 08/19/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND Continuing professional development (CPD) for non-medical prescribers is recognised as being pivotal in maintaining up -to -date knowledge and skills influencing prescribing competence. This study was, therefore, designed to ascertain the aspirations, priorities and preferred mode of CPD for non-medical prescribers. METHOD Qualitative data were derived from semi-structured in-depth interviews and a focus group given by 16 allied health professionals working in primary and secondary care settings. A topic guide was used to cover clinical decision-making (including difficult decisions), legal aspects of prescribing and diagnostic issues. A content analysis of the verbatim transcripts enabled four key emerging themes to be identified, thus offering a basis for developing a greater understanding of the CPD needs of non-medical prescribers. RESULTS The four key emerging themes identified are the following: Theme 1: "Personal anxiety undermining confidence to prescribe", Theme 2: "External barriers and other factors that exacerbate anxiety", Theme 3: "Need for support identified through coping strategies", and Theme 4: "Preferred mode or style of learning". DISCUSSION The findings suggest that anxiety and lack of confidence in non-medical prescribing pose a significant challenge for CPD. Strategies that are most likely to improve prescribing confidence are through a blended learning approach. Local higher education and workplace employer collaboration is an appropriate step forward to achieve this.
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Evans AM, Ellis G, Norman S, Luke K. Patient safety education - a description and evaluation of an international, interdisciplinary e-learning programme. Nurse Educ Today 2014; 34:248-51. [PMID: 23597656 DOI: 10.1016/j.nedt.2013.03.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Revised: 02/27/2013] [Accepted: 03/15/2013] [Indexed: 05/11/2023]
Abstract
Patient safety is a priority within healthcare across the globe. Delivering safer healthcare demands a system wide approach and educators have a responsibility to play a full role. This article describes how e-learning can be a means of engaging and educating an international group of critical care professionals studying at Masters level. Using online tools such as blogs, wikis and discussion boards students are introduced to quality and safety subjects and tools to help them improve care at a local level. Working together as a collaborative of different professionals has engaged the student group helping them understand their role in reducing harm and has resulted in improvements to care.
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Affiliation(s)
- Alison M Evans
- Cardiff University Department of Anaesthetics, Intensive Care and Pain Management, University Hospital of Wales, B Block 3rd Floor, Heath Park, Cardiff, CF14 4XN, United Kingdom.
| | - Gemma Ellis
- Cardiff University Department of Anaesthetics, Intensive Care and Pain Management, University Hospital of Wales, B Block 3rd Floor, Heath Park, Cardiff, CF14 4XN, United Kingdom
| | - Sharon Norman
- Cardiff University Department of Anaesthetics, Intensive Care and Pain Management, University Hospital of Wales, B Block 3rd Floor, Heath Park, Cardiff, CF14 4XN, United Kingdom
| | - Karl Luke
- Cardiff University Department of Anaesthetics, Intensive Care and Pain Management, University Hospital of Wales, B Block 3rd Floor, Heath Park, Cardiff, CF14 4XN, United Kingdom
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