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Sample records for academic hospital setting

  1. Academic Hospitality

    ERIC Educational Resources Information Center

    Phipps, Alison; Barnett, Ronald

    2007-01-01

    Academic hospitality is a feature of academic life. It takes many forms. It takes material form in the hosting of academics giving papers. It takes epistemological form in the welcome of new ideas. It takes linguistic form in the translation of academic work into other languages, and it takes touristic form through the welcome and generosity with…

  2. Conversational Competence in Academic Settings

    ERIC Educational Resources Information Center

    Bowman, Richard F.

    2014-01-01

    Conversational competence is a process, not a state. Ithaca does not exist, only the voyage to Ithaca. Vibrant campuses are a series of productive conversations. At its core, communicative competence in academic settings mirrors a collective search for meaning regarding the purpose and direction of a campus community. Communicative competence…

  3. A comparison of clinicians' access to online knowledge resources using two types of information retrieval applications in an academic hospital setting

    PubMed Central

    Hunt, Sevgin; Cimino, James J.; Koziol, Deloris E.

    2013-01-01

    Objective: The research studied whether a clinician's preference for online health knowledge resources varied with the use of two applications that were designed for information retrieval in an academic hospital setting. Methods: The researchers analyzed a year's worth of computer log files to study differences in the ways that four clinician groups (attending physicians, housestaff physicians, nurse practitioners, and nurses) sought information using two types of information retrieval applications (health resource links or Infobutton icons) across nine resources while they reviewed patients' laboratory results. Results: From a set of 14,979 observations, the authors found statistically significant differences among the 4 clinician groups for accessing resources using the health resources application (P<0.001) but not for the Infobuttons application (P = 0.31). For the health resources application, the preferences of the 4 clinical groups varied according to the specific resources examined (all P≤0.02). Conclusion: The information-seeking behavior of clinicians may vary in relation to their role and the way in which the information is presented. Studying these behaviors can provide valuable insights to those tasked with maintaining information retrieval systems' links to appropriate online knowledge resources. PMID:23405044

  4. Developing Socially Responsible Leaders in Academic Settings

    ERIC Educational Resources Information Center

    Cauthen, T. W., III

    2016-01-01

    This chapter begins the exploration of what leadership education is through examining the relationship between educational involvement and academic autonomy in the development of socially responsible leaders.

  5. Academic progress of students across inclusive and traditional settings.

    PubMed

    Cole, Cassandra M; Waldron, Nancy; Majd, Massoumeh

    2004-04-01

    Effects of inclusive school settings for students in six Indiana school corporations were investigated. Results reveal that students without disabilities educated in inclusive settings made significantly greater academic progress in mathematics and reading. For students with disabilities, there were no significant differences in reading and math achievement across the comparison groups. However, a review of group means and the percentage of students making comparable or greater than average academic progress when compared to students without disabilities indicates a pattern in favor of inclusive settings. The academic progress of students with specific disability labels, namely, learning disabilities and mild mental handicaps, also supported inclusive education.

  6. Relationships among Properties of College Students' Self-Set Academic Goals and Academic Achievement

    ERIC Educational Resources Information Center

    Acee, Taylor W.; Cho, Yoonjung; Kim, Jung-In; Weinstein, Claire Ellen

    2012-01-01

    The major purpose of this study was to investigate the relationships among properties of college students' self-set academic goals and academic achievement, using multiple theoretical perspectives. Using a personal goal-based research methodology, college students enrolled in a learning-to-learn course (N = 130) were asked to list 20 of their…

  7. Stress factors affecting academic physicians at a university hospital.

    PubMed

    Lindfors, Sara; Eintrei, Christina; Alexanderson, Kristina

    2009-01-01

    Research is limited regarding occupational stress in academic physicians; professionals whose work situation includes the three areas of clinical practice, research, and teaching. The aim of this study was to gain knowledge of factors experienced as stressful by academic physicians employed by a university hospital. A questionnaire assessing the frequency and intensity of 36 potentially stressful factors was sent to all 157 academic physicians who were employed at the Linköping University Hospital, Sweden. The response rate was 77%. Both a high frequency and intensity of stress was experienced by 66% of the academic physicians in relation to "time pressure" and by almost 50% in connection with both "find time for research" and having "conflict of interest between different work assignments". Moreover, physicians in the higher age group and those who had attained a higher academic position experienced less stress. The female participants experienced more stress than the males due to gender-related problems and to variables associated with relationships at work. More knowledge is needed to determine the consequences of this finding and to identify coping strategies used for handling such stress.

  8. Academic workforce trends in community hospitals

    PubMed Central

    Anderson, Britta L.; Schulkin, Jay; Lawrence, Hal C.

    2012-01-01

    Introduction Obstetrician-gynecologist faculty workforce studies have been limited to faculty at university training programs. Not much is known about the obstetrician-gynecologist faculty workforce at community programs. Method This study assessed the obstetrician-gynecologist faculty workforce in community training programs via administering surveys to the department chairs. The questionnaire assessed number of current faculty by degree, work status (part-time/full-time), rank, and sub-specialty. Out of 125 programs, 65 responded (52% response rate). Results The mean number of full-time faculty per department in community hospitals was 17 faculty. Two-thirds of community department chairs anticipated an increase in full-time faculty and 43% anticipated an increase in part-time faculty. Like university programs, sub-specialists and Professors (compared to generalists and assistant professors) were more likely to be male. Conclusion There are similarities between the community and university faculty workforce, many of the community program faculty are involved in research. Given the evolving clinical, educational, and research demands on community faculty, it is important to continue to monitor and study community program faculty. PMID:23882350

  9. [Approach to academic detailing as a hospital pharmacist].

    PubMed

    Nishikori, Atsumi

    2014-01-01

    In 2012, a new medical fee system was introduced for the clinical activities of hospital pharmacists responsible for in-patient pharmacotherapy monitoring in medical institutions in Japan. The new medical system demands greater efforts to provide the most suitable and safest medicine for each patient. By applying the concept of academic detailing to clinical pharmacists' roles in hospitals, I present drug use evaluation in three disease states (peptic ulcer, insomnia, and osteoporosis). To analyze these from multiple aspects, we not only need knowledge of drug monographs (clinical and adverse drug effects), but also the ability to evaluate a patient's adherence and cost-effectiveness. If we combine the idea of academic detailing with a clinical pharmacist's role, it is necessary to strengthen drug information skills, such as guideline or literature search skills and journal evaluation. Simultaneously, it is important to introduce new pharmaceutical education curriculums regarding evidence-based medicine (EBM), pharmacoeconomics, and professional communication in order to explore pharmacists' roles in the future.

  10. An Elder Abuse Assessment Team in an Acute Hospital Setting.

    ERIC Educational Resources Information Center

    The Beth Israel Hospital Elder Assessment Team

    1986-01-01

    Describes a hospital-based multidisciplinary team designed to assess and respond to cases of suspected abuse or neglect of elders from both institutional and community settings. Presence of the team has increased the hospital staff's awareness of elder abuse and neglect, as well as their willingness to refer suspected cases for further assessment.…

  11. Time of cochlear implant surgery in academic settings

    PubMed Central

    Majdani, Omid; Schuman, Theodore A.; Haynes, David S.; Dietrich, Mary S.; Leinung, Martin; Lenarz, Thomas

    2010-01-01

    OBJECTIVE Establish time required to perform cochlear implantation (CI) in academic settings. STUDY DESIGN Historical cohort study. SETTING German and American academic centers. PATIENTS 2,639 patients underwent CI (1997–2007), excluding patients receiving experimental device or technique with abnormal cochlear anatomy or incomplete charts, leaving 2,253 for analysis. INTERVENTION Unilateral, bilateral and revision CI with devices approved in USA and Europe. MAIN OUTCOME MEASURES Mean surgical time (ST) and total OR time (TORT). RESULTS Mixed model analysis was employed; estimated marginal means given in minutes after adjusting for random effect of individual surgeon. No differences between unilateral (ST=171, TORT=245) and revision CI (ST=160, TORT=232), but bilateral procedures were longer than (ST=295, TORT=377, p=0.000). Unilateral surgeries - Cochlear Limited (CL) devices were implanted faster (ST=165, TORT=225) than Advanced Bionics (ABC) (ST=183, p=0.001, TORT=240, p=0.023) or MedEl (ST=193, p=0.000, TORT=253, p=0.002). No differences for unilateral CI between ABC and MedEl. For revision CI, ABC (ST=141, TORT=219) was faster than CL (ST=181, p=0.001, TORT=266, p=0.000). No differences by age group or between Germany and the USA. ST and TORT were shorter for 575 CI performed in the final two years of the study (unilateral CI: ST=145, TORT=209; bilateral CI: ST=259, TORT=330; revision CI: ST=138, TORT=205). For unilateral CI, ST and TORT decreased yearly (linear regression, p<0.001) and inversely correlated with surgeon experience (linear regression, p<0.01). CONCLUSIONS We report time required to perform CI in academic settings, data vital for cost-benefit analyses and assessing new CI techniques. PMID:20115984

  12. Code R: Redesigning Hospital-wide Peer Review for Academic Hospitals.

    PubMed

    Kim, Daniel I; Au, Huy; Fargo, Ramiz; Garrison, Roger C; Thompson, Gary; Yu, Minho; Loo, Lawrence K

    2016-09-01

    In most health care institutions, physician peer review is the primary method for maintaining and measuring physician competency and quality of care issues. However, many teaching hospitals do not have a method of tracking resident trainees' involvement in adverse cases. At the study institution, Code R was introduced as a measure to capture resident trainee involvement in the hospital-wide peer review process. The authors conducted a retrospective review of all peer review cases from January 2008 to December 2011 in an academic medical center and determined the quantity and type of resident errors that occurred compared to attending faculty. The Accreditation Council for Graduate Medical Education's core competencies served as a framework to categorize quality of care errors. The addition of Code R to the peer review process can be readily adopted by other institutions to help improve resident education, facilitate faculty supervision, and potentially improve patient safety.

  13. Enteral Nutrition for Adults in the Hospital Setting.

    PubMed

    Kozeniecki, Michelle; Fritzshall, Rebecca

    2015-10-01

    In patients unable to tolerate oral intake, multiple options of nutrient delivery are available to the clinician. Administration of enteral nutrition (EN) has long been considered the standard of care for nutrition support among patients unable to meet energy and protein requirements orally. Healthcare practitioners must make careful decisions related to ordering, administering, and monitoring EN therapy. In the hospital setting, the registered dietitian is a key resource in enteral formula selection and method of administration, monitoring for and troubleshooting EN-related complications, and transitioning to oral feeding. The hospital setting also presents many unique challenges in providing optimal nutrition to the enterally fed patient.

  14. Clinical liaison nurse model in a community hospital: a unique academic-practice partnership that strengthens clinical nursing education.

    PubMed

    Lovecchio, Catherine P; DiMattio, Mary Jane K; Hudacek, Sharon

    2012-11-01

    The necessity to help baccalaureate nursing students transition to clinical practice in a health care environment governed by change has compelled nurse educators to investigate alternative clinical instruction models that nurture academic-practice partnerships and facilitate student clinical learning. This article describes an academic-practice partnership in a community hospital using the Clinical Liaison Nurse (CLN) model as a link between students and clinical faculty and reports results of a quasi-experimental study that compared perceptions of the clinical learning environment between students participating in the CLN model (experimental group) and those in a traditional, instructor-led clinical model (control group). Students assigned to the CLN model had statistically significantly higher individualization, satisfaction, and task orientation scores on the Clinical Learning Environment Inventory. The findings provide evidence that academic-practice partnerships can be successful in community hospital settings and enhance students' perceptions in the clinical learning environment.

  15. Management of pain in pre-hospital settings.

    PubMed

    Parker, Michael; Rodgers, Antony

    2015-06-01

    Assessment and management of pain in pre-hospital care settings are important aspects of paramedic and clinical team roles. As emergency department waiting times and delays in paramedic-to-nurse handover increase, it becomes more and more vital that patients receive adequate pre-hospital pain relief. However, administration of analgesia can be inadequate and can result in patients experiencing oligoanalgesia, or under-treated pain. This article examines these issues along with the aetiology of trauma and the related socioeconomic background of traumatic injury. It reviews validated pain-assessment tools, outlines physiological responses to traumatic pain and discusses some of the misconceptions about the provision of effective analgesia in pre-hospital settings.

  16. Impact of teaching intensity and academic status on medical resource utilization by teaching hospitals in Japan.

    PubMed

    Sato, Daisuke; Fushimi, Kiyohide

    2012-11-01

    Teaching hospitals require excess medical resources to maintain high-quality care and medical education. To evaluate the appropriateness of such surplus costs, we examined the impact of teaching intensity defined as activities for postgraduate training, and academic status as functions of medical research and undergraduate teaching on medical resource utilization. Administrative data for 47,397 discharges from 40 academic and 12 non-academic teaching hospitals in Japan were collected. Hospitals were classified into three groups according to intern/resident-to-bed (IRB) ratio. Resource utilization of medical services was estimated using fee-for-service charge schedules and normalized with case mix grouping. 15-24% more resource utilization for laboratory examinations, radiological imaging, and medications were observed in hospitals with higher IRB ratios. With multivariate adjustment for case mix and academic status, higher IRB ratios were associated with 10-15% more use of radiological imaging, injections, and medications; up to 5% shorter hospital stays; and not with total resource utilization. Conversely, academic status was associated with 21-33% more laboratory examinations, radiological imaging, and medications; 13% longer hospital stays; and 10% more total resource utilization. While differences in medical resource utilization by teaching intensity may not be associated with indirect educational costs, those by academic status may be. Therefore, academic hospitals may need efficiency improvement and financial compensation.

  17. Music in a Hospital Setting: A Multifaceted Experience

    ERIC Educational Resources Information Center

    Preti, Costanza; Welch, Graham F.

    2004-01-01

    The article offers an explanation of the effects of music on children within a hospital setting and points up the multifaceted nature of this experience. The nature of the client group allows the musical experience to work on many different levels, such as modifying the child's perception of pain and reducing stress, whilst at the same time having…

  18. PCL-R field validity in prison and hospital settings.

    PubMed

    Jeandarme, Inge; Edens, John F; Habets, Petra; Bruckers, Liesbeth; Oei, Karel; Bogaerts, Stefan

    2017-02-01

    Recent field studies have questioned the interrater reliability (IRR) and predictive validity regarding (violent) recidivism of the Psychopathy Checklist-Revised (PCL-R). Using a forensic psychiatric sample, the current study investigated discrepancies in scoring between hospital and prison settings, as well as differences in predictive validity across these two settings. PCL-R information was collected from prison and hospital files, resulting in 224 PCL-R total scores and 74 double scores. When examining repeated measurements, large individual differences were found together with an intraclass correlation coefficient (ICCA,1) of .42 for the total score. Discrepant results were found for Factor 2, with repeated scores within the same setting having an ICCA,1 of .28 versus an ICCA,1 of .57 for repeated scores between settings. However, areas under the curve (AUCs) from receiver operating characteristic (ROC) analyses for total, factor and facet scores did not differ between settings. For the whole sample, Factor 2 scores marginally predicted violent and general recidivism after 2 years (AUC = .62 and .63), whereas Factor 1 did not predict (violent) recidivism. Consistent with recent studies from other countries, these results suggest inadequate field reliability and validity in prison and hospital settings in Flanders (Belgium). (PsycINFO Database Record

  19. Effects of Goal-Setting Instruction on Academic Engagement for Students at Risk

    ERIC Educational Resources Information Center

    Rowe, Dawn A.; Mazzotti, Valerie L.; Ingram, Angela; Lee, Seunghee

    2017-01-01

    Research indicates teachers feel teaching goal-setting is an effective way to enhance academic engagement. However, teachers ultimately feel unprepared to embed goal-setting instruction into academic content to support active student engagement. Given the importance teachers place on goal-setting skills, there is a need to identify strategies to…

  20. Data management in academic settings: an intellectual property perspective.

    PubMed

    Geller, Lisa

    2010-12-01

    Intellectual property can be an important asset for academic institutions. Good data management practices are important for capture, development and protection of intellectual property assets. Selected issues focused on the relationship between data management and intellectual property are reviewed and a thesis that academic institutions and scientists should honor their obligations to responsibly manage data.

  1. Toward promoting generative cultures of intentional mentoring within academic settings.

    PubMed

    Ponce, Allison N; Williams, Michelle K; Allen, George J

    2005-09-01

    Mentoring promotes ongoing learning of clinical psychologists, regardless of their expertise and experience. Most academic programs, however, do not possess vigorous mentoring cultures in which mentors simultaneously are learners. Academic programs are largely based on "mastery" philosophies that tacitly aim mentoring at less-experienced peers. This orientation can make stigmatizing mentoring opportunities, especially for psychologists from underrepresented populations. Using concepts from experiential learning theory, we articulate interventions to invigorate mentoring cultures and make mentoring less stigmatizing.

  2. Hospitalizations of Adults with Intellectual Disability in Academic Medical Centers

    ERIC Educational Resources Information Center

    Ailey, Sarah H.; Johnson, Tricia; Fogg, Louis; Friese, Tanya R.

    2014-01-01

    Individuals with intellectual disability (ID) represent a small but important group of hospitalized patients who often have complex health care needs. Individuals with ID experience high rates of hospitalization for ambulatory-sensitive conditions and high rates of hospitalizations in general, even when in formal community care systems; however,…

  3. Entrepreneurial Academics: Developing Scientific Careers in Changing University Settings

    ERIC Educational Resources Information Center

    Duberley, Joanne; Cohen, Laurie; Leeson, Elspeth

    2007-01-01

    This paper examines the impact of entrepreneurial initiatives within universities on scientific careers. Based on the career accounts of university-based bioscientists involved in a government-sponsored entrepreneurship training initiative, the paper explores the concept of academic entrepreneurialism. Three groups were identified in the data.…

  4. Setting the Stage for Academic Success through Antecedent Intervention

    ERIC Educational Resources Information Center

    Kruger, Alicia M.; Strong, Whitney; Daly, Edward J., III; O'Connor, Maureen; Sommerhalder, Mackenzie S.; Holtz, Jill; Weis, Nicole; Kane, Elizabeth J.; Hoff, Natalie; Heifner, Allison

    2016-01-01

    Behavior-analytic academic intervention research has gained popularity among school psychologists because it offers a unique combination of robust principles of behavior and a degree of clarity and precision about functional relationships that is unparalleled in other learning paradigms. This article reviews the literature for a type of antecedent…

  5. The Prediction of College Student Academic Performance and Retention: Application of Expectancy and Goal Setting Theories

    ERIC Educational Resources Information Center

    Friedman, Barry A.; Mandel, Rhonda G.

    2010-01-01

    Student retention and performance in higher education are important issues for educators, students, and the nation facing critical professional labor shortages. Expectancy and goal setting theories were used to predict academic performance and college student retention. Students' academic expectancy motivation at the start of the college…

  6. Predictors of Situational Disengagement in the Academic Setting: The Contribution of Grades, Perceived Competence, and Academic Motivation

    ERIC Educational Resources Information Center

    Stephan, Yannick; Caudroit, Johan; Boiche, Julie; Sarrazin, Philippe

    2011-01-01

    Background: Although psychological disengagement is a well-documented phenomenon in the academic setting, the attempts to identify its predictors are scarce. In addition, existing research has mainly focused on chronic disengagement and less is known on the determinants of situational disengagement. Aims: The purpose of the present study was to…

  7. Repetitive Pediatric Anesthesia in a Non-Hospital Setting

    SciTech Connect

    Buchsbaum, Jeffrey C.; McMullen, Kevin P.; Douglas, James G.; Jackson, Jeffrey L.; Simoneaux, R. Victor; Hines, Matthew; Bratton, Jennifer; Kerstiens, John; Johnstone, Peter A.S.

    2013-04-01

    Purpose: Repetitive sedation/anesthesia (S/A) for children receiving fractionated radiation therapy requires induction and recovery daily for several weeks. In the vast majority of cases, this is accomplished in an academic center with direct access to pediatric faculty and facilities in case of an emergency. Proton radiation therapy centers are more frequently free-standing facilities at some distance from specialized pediatric care. This poses a potential dilemma in the case of children requiring anesthesia. Methods and Materials: The records of the Indiana University Health Proton Therapy Center were reviewed for patients requiring anesthesia during proton beam therapy (PBT) between June 1, 2008, and April 12, 2012. Results: A total of 138 children received daily anesthesia during this period. A median of 30 fractions (range, 1-49) was delivered over a median of 43 days (range, 1-74) for a total of 4045 sedation/anesthesia procedures. Three events (0.0074%) occurred, 1 fall from a gurney during anesthesia recovery and 2 aspiration events requiring emergency department evaluation. All 3 children did well. One aspiration patient needed admission to the hospital and mechanical ventilation support. The other patient returned the next day for treatment without issue. The patient who fell was not injured. No patient required cessation of therapy. Conclusions: This is the largest reported series of repetitive pediatric anesthesia in radiation therapy, and the only available data from the proton environment. Strict adherence to rigorous protocols and a well-trained team can safely deliver daily sedation/anesthesia in free-standing proton centers.

  8. Telemedicine for the care of children in the hospital setting.

    PubMed

    McSwain, S David; Marcin, James P

    2014-02-01

    Telemedicine is by no means a new technology, given that audio-video telecommunication links have been utilized for the provision of medical services since the 1950s. Nonetheless, telemedicine is currently in a phase of rapid growth and evolution. The combination of increasingly affordable and powerful networking, computing, and communication technology, along with the continued nationwide crisis in health care access and costs, has created a "tipping point," whereby telemedicine has progressed from a novel means of practicing medicine to practical tool to help address our nation's health care needs. Telemedicine has also evolved beyond a means of providing care to remote communities to becoming a versatile tool in the delivery of health care in a variety of non-rural settings. Although no one can be everywhere at once, telemedicine allows us to be in more places at once than we've ever been before. The problems of disparities and access to care are even more evident in pediatrics, where subspecialists are fewer in number and more regionalized than adult providers. Numerous successful telemedicine programs across the country have demonstrated the impact that these technologies can have in pediatrics, with many more programs in development. As a versatile means of delivering care, telemedicine can be used at any point during the course of a health care encounter as not only a means of expanding our reach, but also as a means of increasing efficiency. Using telemedicine to provide consultations to community hospitals has been shown to improve quality of care, strengthen the referral base for the consulting facilities, facilitate cost savings, and improve the financial bottom line for both referring and consulting facilities. This review highlights some of the ways in which telemedicine is being used to facilitate timely and effective pediatric care in a variety of hospital settings.

  9. Methods for Extracellular Vesicles Isolation in a Hospital Setting

    PubMed Central

    Sáenz-Cuesta, Matías; Arbelaiz, Ander; Oregi, Amaia; Irizar, Haritz; Osorio-Querejeta, Iñaki; Muñoz-Culla, Maider; Banales, Jesus M.; Falcón-Pérez, Juan M.; Olascoaga, Javier; Otaegui, David

    2015-01-01

    The research in extracellular vesicles (EVs) has been rising during the last decade. However, there is no clear consensus on the most accurate protocol to isolate and analyze them. Besides, most of the current protocols are difficult to implement in a hospital setting due to being very time-consuming or to requirements of specific infrastructure. Thus, our aim is to compare five different protocols (comprising two different medium-speed differential centrifugation protocols; commercially polymeric precipitation – exoquick – acid precipitation; and ultracentrifugation) for blood and urine samples to determine the most suitable one for the isolation of EVs. Nanoparticle tracking analysis, flow cytometry, western blot (WB), electronic microscopy, and spectrophotometry were used to characterize basic aspects of EVs such as concentration, size distribution, cell-origin and transmembrane markers, and RNA concentration. The highest EV concentrations were obtained using the exoquick protocol, followed by both differential centrifugation protocols, while the ultracentrifugation and acid-precipitation protocols yielded considerably lower EV concentrations. The five protocols isolated EVs of similar characteristics regarding markers and RNA concentration; however, standard protocol recovered only small EVs. EV isolated with exoquick presented difficult to be analyzed with WB. The RNA concentrations obtained from urine-derived EVs were similar to those obtained from blood-derived ones, despite the urine EV concentration being 10–20 times lower. We consider that a medium-speed differential centrifugation could be suitable to be applied in a hospital setting as it requires the simplest infrastructure and recovers higher concentration of EV than standard protocol. A workflow from sampling to characterization of EVs is proposed. PMID:25762995

  10. When a community hospital becomes an academic health centre.

    PubMed

    Topps, Maureen; Strasser, Roger

    2010-01-01

    With the burgeoning role of distributed medical education and the increasing use of community hospitals for training purposes, challenges arise for undergraduate and postgraduate programs expanding beyond traditional tertiary care models. It is of vital importance to encourage community hospitals and clinical faculty to embrace their roles in medical education for the 21st century. With no university hospitals in northern Ontario, the Northern Ontario School of Medicine and its educational partner hospitals identified questions of concern and collaborated to implement changes. Several themes emerged that are of relevance to any medical educational program expanding beyond its present location. Critical areas for attention include the institutional culture; human, physical and financial resources; and support for educational activities. It is important to establish and maintain the groundwork necessary for the development of thriving integrated community-engaged medical education. Done in tandem with advocacy for change in funding models, this will allow movement beyond the current educational environment. The ultimate goal is successful integration of university and accreditation ideals with practical hands-on medical care and education in new environments.

  11. Trends in Clinically Significant Pain Prevalence Among Hospitalized Cancer Patients at an Academic Hospital in Taiwan: A Retrospective Cohort Study.

    PubMed

    Wang, Wei-Yun; Ho, Shung-Tai; Wu, Shang-Liang; Chu, Chi-Ming; Sung, Chun-Sung; Wang, Kwua-Yun; Liang, Chun-Yu

    2016-01-01

    Clinically significant pain (CSP) is one of the most common complaints among cancer patients during repeated hospitalizations, and the prevalence ranges from 24% to 86%. This study aimed to characterize the trends in CSP among cancer patients and examine the differences in the prevalence of CSP across repeated hospitalizations. A hospital-based, retrospective cohort study was conducted at an academic hospital. Patient-reported pain intensity was assessed and recorded in a nursing information system. We examined the differences in the prevalence of worst pain intensity (WPI) and last evaluated pain intensity (LPI) of ≥ 4 or ≥ 7 points among cancer inpatients from the 1st to the 18th hospitalization. Linear mixed models were used to determine the significant difference in the WPI and LPI (≥ 4 or ≥ 7 points) at each hospitalization. We examined 88,133 pain scores from the 1st to the 18th hospitalization among cancer patients. The prevalence of the 4 CSP types showed a trend toward a reduction from the 1st to the 18th hospitalization. There was a robust reduction in the CSP prevalence from the 1st to the 5th hospitalization, except in the case of LPI ≥ 7 points. The prevalence of a WPI ≥ 4 points was significantly higher (0.240-fold increase) during the 1st hospitalization than during the 5th hospitalization. For the 2nd, 3rd, and 4th hospitalizations, there was a significantly higher prevalence of a WPI ≥ 4 points compared with the 5th hospitalization. We also observed significant reductions in the prevalence of a WPI ≥ 7 points during the 1st to the 4th hospitalizations, an LPI ≥ 4 points during the 1st to the 3rd hospitalizations, and an LPI ≥ 7 points during the 1st to the 2nd hospitalization. Although the prevalence of the 4 CSP types decreased gradually, it is impossible to state the causative factors on the basis of this observational and descriptive study. The next step will examine the factors that determine the CSP prevalence among cancer

  12. Hospitals as complex adaptive systems: A case study of factors influencing priority setting practices at the hospital level in Kenya.

    PubMed

    Barasa, Edwine W; Molyneux, Sassy; English, Mike; Cleary, Susan

    2017-02-01

    There is a dearth of literature on priority setting and resource allocation (PSRA) practices in hospitals, particularly in low and middle income countries (LMICs). Using a case study approach, we examined PSRA practices in 2 public hospitals in coastal Kenya. We collected data through a combination of in-depth interviews of national level policy makers, hospital managers, and frontline practitioners in the case study hospitals (n = 72), review of documents such as hospital plans and budgets, minutes of meetings and accounting records, and non-participant observations of PSRA practices in case study hospitals over a period of 7 months. In this paper, we apply complex adaptive system (CAS) theory to examine the factors that influence PSRA practices. We found that PSRA practices in the case hospitals were influenced by, 1) inadequate financing level and poorly designed financing arrangements, 2) limited hospital autonomy and decision space, and 3) inadequate management and leadership capacity in the hospital. The case study hospitals exhibited properties of complex adaptive systems (CASs) that exist in a dynamic state with multiple interacting agents. Weaknesses in system 'hardware' (resource scarcity) and 'software' (including PSRA guidelines that reduced hospitals decision space, and poor leadership skills) led to the emergence of undesired properties. The capacity of hospitals to set priorities should be improved across these interacting aspects of the hospital organizational system. Interventions should however recognize that hospitals are CAS. Rather than rectifying isolated aspects of the system, they should endeavor to create conditions for productive emergence.

  13. Using Latent Class Analysis To Set Academic Performance Standards.

    ERIC Educational Resources Information Center

    Brown, Richard S.

    The use of latent class analysis for establishing student performance standards was studied. Latent class analysis (LCA) is an established procedure for investigating the latent structure of a set of data. LCA presumes that groups, classes, or respondents differ qualitatively from one another, and that these differences account for all of the…

  14. Cultural Diversity in the Curriculum: Perceptions and Attitudes of Irish Hospitality and Tourism Academics

    ERIC Educational Resources Information Center

    Devine, Frances; Hearns, Niamh; Baum, Tom; Murray, Anna

    2008-01-01

    Academics are facing significant challenges in preparing indigenous students for employment in the multicultural working environment of hospitality and tourism organisations. In dealing with the impact of the new skills and flexibilities demanded by increasing globalisation, the indigenous workforce needs to possess a multicultural perspective and…

  15. Dual Enrollment Programs: A Comparative Study of High School Students' College Academic Achievement at Different Settings

    ERIC Educational Resources Information Center

    Flores, Agnes L. Acker

    2012-01-01

    The "ex post facto" causal-comparative study examined the academic achievement of high school students who took their dual credit English or mathematics college credit-bearing course in two different environments, namely, the college setting and the high school setting. Due to non-experimental nature of the study, no causal inferences…

  16. Evaluation of performance of the Medical Research Department in ‘Research naive’ non-academic hospital: An audit

    PubMed Central

    Kuyare, Mukta Sunil; Sarve, Parag Vijayrao; Dalal, Komal S.; Tripathi, Raakhi K.

    2016-01-01

    Introduction: Conducting medical research is not limited to academia and pharmaceutical industry but even multispeciality hospitals need to venture in this area along with patient care. To develop research culture among well-established non-acedemic hospital is always difficult and challenging task. This article attempts to evaluate the performance of the department in ‘Research naïve’ hospital in the last two years and review the strengths and challenges it faced at each step. Methods: This was a retrospective document analysis study evaluating the steps towards setting and sustaining of Medical Research Department of Bhaktivedanta Hospital during the period of January 2013 to June 2015 (30 Months). The authors developed a checklist (along with performance indicators) to assess the Preparatory phase and Activity phase of the research department which were evaluated by Institute Quality Management Team. Each step of both phases was also reviewed in terms of strengths and challenges as perceived by the authors. Results: During 2 year journey of research naïve Hospital, Institute had witnessed Hospital initiated (n=24, 59%) and sponsored projects (n=17, 41%) in all specialties. HRC reviewed (n=2.13) projects per meeting for administrative consideration while IEC reviewed (n=2.15) projects for scientific and ethical review. Challenges during preparatory phases were circumvent by immense cooperation of hospital management for initial investment, sensitization through research workshops for consultants, established procedures and trained support manpower and constant encouragement by research coordinator. Conclusion: Considering evaluation of 41 studies in very first 2 years in ‘Research naive non academic institute demonstrated successful implementation of trio model of Hospital Research Committee for administrative review, IEC for scientific-ethical review, centralized MRD for coordinating all research projects under one roof which may act as role model for

  17. Identifying and communicating the contributions of library and information services in hospitals and academic health sciences centers

    PubMed Central

    Abels, Eileen G.; Cogdill, Keith W.; Zach, Lisl

    2004-01-01

    Objective: This article introduces a systematic approach to identifying and communicating the value of library and information services (LIS) from the perspective of their contributions to achieving organizational goals. Methods: The contributions of library and information services (CLIS) approach for identifying and communicating the value of LIS draws on findings from a multimethod study of hospitals and academic health sciences centers. Results: The CLIS approach is based on the concept that an individual unit's value to an organization can be demonstrated by identifying and measuring its contributions to organizational goals. The CLIS approach involves seven steps: (1) selecting appropriate organizational goals that are meaningful in a specific setting; (2) linking LIS contributions to organizational goals; (3) obtaining data from users on the correspondence between LIS contributions and LIS services; (4) selecting measures for LIS services; (5) collecting and analyzing data for the selected measures; (6) planning and sustaining communication with administrators about LIS contributions; and (7) evaluating findings and revising selected goals, contributions, and services as necessary. Conclusions: The taxonomy of LIS contributions and the CLIS approach emerged from research conducted in hospitals and academic health sciences centers and reflect the mission and goals common in these organizations. However, both the taxonomy and the CLIS approach may be adapted for communicating the value of LIS in other settings. PMID:14762462

  18. Capturing Psychologists' Work in Academic Health Settings: The Role of the Educational Value Unit (EVU).

    PubMed

    D'Angelo, Eugene J; Gallagher, Katie

    2016-03-01

    This paper describes how psychology faculty positions in academic health centers (AHCs) have evolved to meet the changing needs in healthcare. In that context, the roles of psychologists have expanded significantly to include a wide array of clinical responsibilities, teaching and supervisory roles, administrative functions, research initiatives, and academic scholarship. Traditionally, faculty compensation plans have been calculated through the use of Relative Value Units which are primarily based on clinical service delivery, hence, incomplete when attempting to account for these growing academic responsibilities. This paper reviews the need to expand the ways in which the work provided by psychologists is appropriately identified and compensated for in AHCs. Drawing upon six models utilized in other areas of medical education, this paper describes the potential utility of incorporating Educational Value Units as a metric for capturing this expanding set of academic responsibilities and systematically incorporating them into a psychologist's job design. Recommendations for future considerations are provided.

  19. The Evolution of the Council of Academic Hospitals of Ontario Statement of Principles--A Successful Harmonization Initiative

    ERIC Educational Resources Information Center

    Porter, Katie; Lampson, Sarah

    2011-01-01

    To improve efficiency, consistency and transparency in clinical trial contract negotiations with industry sponsors, a Council of Academic Hospitals of Ontario (CAHO) committee facilitated the development of standard principles for member hospitals to follow during contract negotiation. Hospitals were encouraged to provide a link to the CAHO…

  20. Respirator Use in a Hospital Setting: Establishing Surveillance Metrics.

    PubMed

    Yarbrough, Mary I; Ficken, Meredith E; Lehmann, Christoph U; Talbot, Thomas R; Swift, Melanie D; McGown, Paula W; Wheaton, Robert F; Bruer, Michele; Little, Steven W; Oke, Charles A

    Information that details use and supply of respirators in acute care hospitals is vital to prevent disease transmission, assure the safety of health care personnel, and inform national guidelines and regulations.

  1. The Impact of Setting the Standards of Health Promoting Hospitals on Hospital Indicators in Iran

    PubMed Central

    Amiri, Mohammad; Khosravi, Ahmad; Riyahi, Leila

    2016-01-01

    Hospitals play a critical role in the health promotion of the society. This study aimed to determine the impact of establishing standards of health promoting hospitals on hospital indicators in Shahroud. This applied study was a quasi-experimental one which was conducted in 2013. Standards of health promoting hospitals were established as an intervention procedure in the Fatemiyeh hospital. Parameters of health promoting hospitals were compared in intervention and control hospitals before and after of intervention (6 months). The data were analyzed using chi-square and t-test. With the establishment of standards for health promotion hospitals, standard scores in intervention and control hospitals were found to be 72.26 ± 4.1 and 16.26 ± 7.5, respectively. T-test showed a significant difference between the mean scores of the hospitals under study (P = 0.001).The chi-square test also showed a significant relationship between patient satisfaction before and after the intervention so that patients’ satisfaction was higher after the intervention (P = 0.001). Commenting on the short-term or long-term positive impacts of establishing standards of health promoting hospitals on all hospital indicators is a bit difficult but preliminary results show the positive impact of the implementation of standards in case hospitals which has led to the improvement of many indicators in the hospital. PMID:27959930

  2. An Academic Approach to Stress Management for College Students in a Conventional Classroom Setting.

    ERIC Educational Resources Information Center

    Carnahan, Robert E.; And Others

    Since the identification of stress and the relationship of individual stress responses to physical and mental health, medical and behavioral professionals have been training individuals in coping strategies. To investigate the possibility of teaching cognitive coping skills to a nonclinical population in an academic setting, 41 college students…

  3. The Concept of Happiness and Moral Development of "Filipinas" in the Academic Setting

    ERIC Educational Resources Information Center

    Mallari, Shedy Dee C.; Ebreo, Edleen P.; Pelayo, Jose Maria G., III.

    2015-01-01

    This study determined salient themes of female individuals who are inside the academic setting on their concept of happiness and moral development. The idea of studying the Filipina Female Concept of Happiness came from two areas of study--Female Psychology and Positive Psychology. The researchers were intrigued by the idea that since the female…

  4. Strategic Planning for Information Systems: The Evidence from a Successful Implementation in an Academic Setting.

    ERIC Educational Resources Information Center

    Carter, Richard B.; And Others

    1991-01-01

    Demonstrates how an information systems plan can be successfully developed and implemented within an academic setting. Six guidelines for information systems planning are provided; problems are identified and recommendations to address the problems are suggested; and information systems objectives are discussed, including business communications,…

  5. Defining Success for Students with Autism Spectrum Disorder: Social Academic Behavior in Secondary General Education Settings

    ERIC Educational Resources Information Center

    McKenney, Elizabeth L. W.; Stachniak, Catherine; Albright, Jordan; Jewell, Jeremy D.; Dorencz, Julie M.

    2016-01-01

    An exploratory, observation-based study sought to strengthen understanding of the development of social communication skills that facilitate academic success, particularly within general education settings. Sixteen middle and high school students with Autism Spectrum Disorders (ASD), all of whom participated in at least one period per day of core…

  6. Analyzing Academic Achievement of Junior High School Students by an Improved Rough Set Model

    ERIC Educational Resources Information Center

    Pai, Ping-Feng; Lyu, Yi-Jia; Wang, Yu-Min

    2010-01-01

    Rough set theory (RST) is an emerging technique used to deal with problems in data mining and knowledge acquisition. However, the RST approach has not been widely explored in the field of academic achievement. This investigation developed an improved RST (IMRST) model, which employs linear discriminant analysis to determine a reduct of RST, and…

  7. The Relationship between Black Racial Identity and Academic Achievement in Urban Settings

    ERIC Educational Resources Information Center

    Harper, Brian E.

    2007-01-01

    This article examines the relationship between Black racial identity and academic achievement in urban settings. Using Mary Shelley's Frankenstein (1918) as a comparative framework, the author describes current practices and suggests practical applications of empirical findings for practicing classroom teachers of African American students.…

  8. Exploring Students' Perceptions of Academic Disengagement and Reengagement in a Dropout Recovery Charter School Setting

    ERIC Educational Resources Information Center

    Iachini, Aidyn L.; Buettner, Cynthia; Anderson-Butcher, Dawn; Reno, Rebecca

    2013-01-01

    The purpose of this exploratory case study was to understand the academic disengagement and reengagement process from the perspective of students enrolled in a dropout recovery charter school. Specifically, this study focused on students' perceptions of the factors that influenced their lack of success in the traditional school setting, the…

  9. Between Two Advisors: Interconnecting Academic and Workplace Settings in an Emerging Field

    ERIC Educational Resources Information Center

    Hytönen, Kaisa; Palonen, Tuire; Lehtinen, Erno; Hakkarainen, Kai

    2016-01-01

    This article examines a new training design for continuing professional development that aims to support the learning of the novel knowledge and skills needed in emerging professional fields by interconnecting academic and workplace settings. The training design is based on using two advisors, one from working life and the other from an academic…

  10. Student Affairs and Academic Affairs Collaborations in the Community College Setting

    ERIC Educational Resources Information Center

    Gulley, Needham Yancey; Mullendore, Richard H.

    2014-01-01

    The relationship between academic affairs and student affairs units in higher education settings has traditionally and historically been troubled by the divergent understandings of each other's institutional role and the systematic division of labor between the two. However, for a variety of reasons, not the least of which is a desire to…

  11. Hospital Epidemiology and Infection Control in Acute-Care Settings

    PubMed Central

    Sydnor, Emily R. M.; Perl, Trish M.

    2011-01-01

    Summary: Health care-associated infections (HAIs) have become more common as medical care has grown more complex and patients have become more complicated. HAIs are associated with significant morbidity, mortality, and cost. Growing rates of HAIs alongside evidence suggesting that active surveillance and infection control practices can prevent HAIs led to the development of hospital epidemiology and infection control programs. The role for infection control programs has grown and continues to grow as rates of antimicrobial resistance rise and HAIs lead to increasing risks to patients and expanding health care costs. In this review, we summarize the history of the development of hospital epidemiology and infection control, common HAIs and the pathogens causing them, and the structure and role of a hospital epidemiology and infection control program. PMID:21233510

  12. What is the role of general internists in the tertiary or academic setting?

    PubMed

    Tanriover, Mine Durusu; Rigby, Shirley; van Hulsteijn, L Harry; Ferreira, Faustino; Oliveira, Narcisso; Schumm-Draeger, Petra-Maria; Weidanz, Frauke; Kramer, Mark H H

    2015-01-01

    The changing demography of European populations mandates a vital role for internists in caring for patients in each level of healthcare. Internists in the tertiary or academic setting are highly ranked in terms of their responsibilities: they are clinicians, educators, researchers, role models, mentors and administrators. Contrary to the highly focused approach of sub-specialties, general internists working in academic settings can ensure that coordinated care is delivered in the most cost-conscious and efficient way. Moreover, internal medicine is one of the most appropriate specialties in which to teach clinical reasoning skills, decision-making and analytical thinking, as well as evidence based, patient oriented medicine. Internists deal with challenging patients of the new millennium with a high burden of chronic diseases and polypharmacy; practice personalised medicine with a wide scientific background and so they are the perfect fit to establish and implement new tools for scientific research. In conclusion, internal medicine is developing a new identity as a specialty in its own right. The European Federation of Internal Medicine supports the concept of academic internists and calls upon the member countries to construct academic (general) internal medicine departments in their respective countries. As 'internal medicine is the cornerstone of every national healthcare system', academic (general) internal medicine should strive to be the cornerstone of every integrated, patient-centred, modern medical care and training system.

  13. Environmental contaminants in hospital settings and progress in disinfecting techniques.

    PubMed

    Messina, Gabriele; Ceriale, Emma; Lenzi, Daniele; Burgassi, Sandra; Azzolini, Elena; Manzi, Pietro

    2013-01-01

    Medical devices, such as stethoscopes, and other objects found in hospital, such as computer keyboards and telephone handsets, may be reservoirs of bacteria for healthcare-associated infections. In this cross-over study involving an Italian teaching hospital we evaluated microbial contamination (total bacterial count (TBC) at 36°C/22°C, Staphylococcus spp., moulds, Enterococcus spp., Pseudomonas spp., E. coli, total coliform bacteria, Acinetobacter spp., and Clostridium difficile) of these devices before and after cleaning and differences in contamination between hospital units and between stethoscopes and keyboards plus handsets. We analysed 37 telephone handsets, 27 computer keyboards, and 35 stethoscopes, comparing their contamination in four hospital units. Wilcoxon signed-rank and Mann-Whitney tests were used. Before cleaning, many samples were positive for Staphylococcus spp. and coliforms. After cleaning, CFUs decreased to zero in most comparisons. The first aid unit had the highest and intensive care the lowest contamination (P < 0.01). Keyboards and handsets had higher TBC at 22°C (P = 0.046) and mould contamination (P = 0.002) than stethoscopes. Healthcare professionals should disinfect stethoscopes and other possible sources of bacterial healthcare-associated infections. The cleaning technique used was effective in reducing bacterial contamination. Units with high patient turnover, such as first aid, should practise stricter hygiene.

  14. Hospitalized but not Admitted: Characteristics of Patients with “Observation Status” at an Academic Medical Center

    PubMed Central

    Sheehy, Ann M.; Graf, Ben; Gangireddy, Sreedevi; Hoffman, Robert; Ehlenbach, Mary; Heidke, Cynthia; Fields, Sheilah; Liegel, Barbara; Jacobs, Elizabeth A.

    2014-01-01

    Importance The Centers for Medicare and Medicaid Services (CMS)defines observation status for hospitalized patients as a “well-defined set of specific, clinically appropriate services,” usually lasting <24 hours, and that in “only rare and exceptional cases” should last > 48 hours. Although an increasing proportion of observation care occurs on hospital wards, studies of patients with observation status have focused on the efficiency of dedicated units. Objective To describe inpatient and observation care. Design and Setting Descriptive study of all inpatient and observation stays between July 1, 2010 and December 31, 2011 at the University of Wisconsin Hospital and Clinics, a 566 bed tertiary academic medical center. Participants All patients with observation or inpatient stays during the study period. Main Outcome and Measures Patient demographics, length of stay, difference between cost and reimbursement per stay, and percent of patients discharged to skilled nursing facilities. Results Of 43,853 stays, 4,578 (10.4%) were observation, with 1,141 distinct diagnosis codes. Average observation length of stay was 33.3 hours, with 44.4% of stays <24 hours, and 16.5% >48 hours. Observation care had a negative margin per stay (-$331); the inpatient margin per stay was positive (+$2,163). Adult General Medicine patients accounted for 2,404 (52.5%) of all observation stays; 25.4% of the 9,453 Adult General Medicine stays were observation. The mean length of stay for general medicine observation patients was 41.1 hours, with 32.6% of stays < 24 hours, and 26.4% >48 hours. As compared to observation patients on other clinical services, Adult General Medicine had the highest percent >65 years (40.9%), highest percent female (57.9%), highest percent discharged to skilled nursing facilities (11.6%) and the most negative margin per stay (-$1,378). Conclusions and Relevance In an academic medical center, observation status for hospitalized patients differed markedly

  15. Predictors of situational disengagement in the academic setting: the contribution of grades, perceived competence, and academic motivation.

    PubMed

    Stephan, Yannick; Caudroit, Johan; Boiché, Julie; Sarrazin, Philippe

    2011-09-01

    BACKGROUND. Although psychological disengagement is a well-documented phenomenon in the academic setting, the attempts to identify its predictors are scarce. In addition, existing research has mainly focused on chronic disengagement and less is known on the determinants of situational disengagement. AIMS. The purpose of the present study was to identify the predictors of situational disengagement in a physical education (PE) setting. In line with the core postulate of psychological disengagement, it was hypothesized that grades contribute to discounting through a decrease in perceived competence. Drawing upon self-determination theory, it was also expected that devaluing reflects the motivational orientations of individuals. SAMPLE. A total of 120 students who were in seventh, eighth, and ninth grades. METHOD. Students were asked to report their motivation towards PE and their perceived competence at the beginning of a 10-week cycle. Perceived competence in PE and psychological disengagement were assessed at the end of cycle, after grades were communicated individually to each student. RESULTS. The results revealed that grades significantly predicted discounting, through perceived competence, but did not predict devaluing. Devaluing was negatively predicted by integrated and identified regulations, and positively predicted by amotivation, whereas no motivational variables were related to discounting. CONCLUSION. The present study extends the core postulate of psychological disengagement to situational disengagement. It revealed that students may temporarily disengage their self-esteem from performance feedback through discounting, but are less inclined to devalue the academic domain when faced with negative feedback in a particular situation because of their motivational orientations.

  16. Microbiological safety of food in hospitals and other healthcare settings.

    PubMed

    Lund, Barbara M; O'Brien, Sarah J

    2009-10-01

    Cases and outbreaks of foodborne infection in healthcare settings can result in serious illness, wastage of expensive medical treatments, spread of infection to other patients and staff and disruption of services. Providing nutritious meals for vulnerable people in healthcare settings involves a systematic approach to microbiological safety, as provided by hazard analysis and critical control point (HACCP) principles. The types of food served in healthcare settings should be selected to minimise the risk of foodborne infection.

  17. [Occupational exposure to glutaraldehyde in the hospital setting].

    PubMed

    d'Angelo, R; Russo, E; Lama, A

    2006-01-01

    Glutaraldehyde (GTA) solutions can be used for low-temperature endoscopes disinfection. The research aim was to evaluate the aldehyde air-contamination in Campania hospitals operating theatres produced by the use of two-percent glutaraldehyde alkaline solution. Air samples were analysed by HPLC-UV (Hight Performance Liquid Chromatography with UV detection). The final results show that some operating theatres have a significant GTA air-contamination with a substance concentration upper limit value (0,05 ppm), due to not-well ventilated workplaces and the presence of not-automatic washing units.

  18. Getting published in an academic-community hospital: the success of writing groups.

    PubMed

    Salas-Lopez, Debbie; Deitrick, Lynn; Mahady, Erica T; Moser, Kathleen; Gertner, Eric J; Sabino, Judith N

    2012-01-01

    Expressed barriers to writing for publication include lack of time, competing demands, anxiety about writing and a lack of knowledge about the submission process. These limitations can be magnified for practitioners in non-university environments in which there are fewer incentives or expectations regarding academic publication productivity. However, as members of professional disciplines, practitioners have both the responsibility and, oftentimes, the insights to make valuable contributions to the professional literature. Collaborative writing groups can be a useful intervention to overcome barriers, provide the necessary skills and encouragement as well as produce publications and conference presentations that make worthy additions to the professional body of knowledge. This article discusses the evolution and outcomes of writing groups at Lehigh Valley Health Network and describes how this strategy can be adopted by other academic community hospitals to promote professional development and publication.

  19. [Selection criteria of mobile lifters in the hospital setting].

    PubMed

    Ferriero, G; Ottonello, M; Franchignoni, F

    2002-01-01

    The manual handling of patients with limited mobility represents the major cause of musculoskeletal injury to the spine in paramedical health care workers. Within the hospital, the more complex procedures of patient transfer often require the use of mobile hoists. The aim of this paper is to describe the basic criteria for the selection of such hoists. The main characteristics of a hoist are its stability, the sling attachment, the speed of operation, range of movement of the spreader bar, safety of the operation being performed, patient comfort, the physical effort required on the part of the health care worker, manoeuvrability and simplicity of use. Important organizational-structural features to evaluate include: the type of patient normally present in the unit concerned, the specific movement to be performed, the structural characteristics of the environment, and the work organization of the personnel.

  20. Experience in Strategic Networking to Promote Palliative Care in a Clinical Academic Setting in India

    PubMed Central

    Nair, Shoba; Tarey, SD; Barathi, B; Mary, Thiophin Regina; Mathew, Lovely; Daniel, Sudha Pauline

    2016-01-01

    Background: Palliative care in low and middle-income countries is a new discipline, responding to a greater patient need, than in high-income countries. By its very nature, palliative as a specialty has to network with other specialties to provide quality care to patients. For any medical discipline to grow as a specialty, it should be well established in the teaching medical institutions of that country. Data show that palliative care is more likely to establish and grow in an academic health care institution. It is a necessity that multiple networking strategies are adopted to reach this goal. Objectives: (1) To describe a strategic approach to palliative care service development and integration into clinical academic setting. (2) To present the change in metrics to evaluate progress. Design and Setting: This is a descriptive study wherein, the different strategies that are adopted by the Department of Palliative Medicine for networking in an academic health care institution and outside the institution are scrutinized. Measurement: The impact of this networking was assessed, one, at the level of academics and the other, at the level of service. The number of people who attended various training programs conducted by the department and the number of patients who availed palliative care service over the years were assessed. Results: Ten different strategies were identified that helped with networking of palliative care in the institution. During this time, the referrals to the department increased both for malignant diseases (52–395) and nonmalignant diseases (5–353) from 2000 to 2013. The academic sessions conducted by the department for undergraduates also saw an increase in the number of hours from 6 to 12, apart from the increase in a number of courses conducted by the department for doctors and nurses. Conclusion: Networking is an essential strategy for the establishment of a relatively new medical discipline like palliative care in a developing and

  1. A small grant funding program to promote innovation at an academic research hospital.

    PubMed

    Orrell, Kelsey; Yankanah, Rosanna; Heon, Elise; Wright, James G

    2015-10-01

    Innovation is important for the improvement of health care. A small grant innovation funding program was implemented by the Hospital for Sick Children(SickKids) for the Perioperative Services group, awarding relatively small funds (approximately $10 000) in order to stimulate innovation. Of 48 applications,26 (54.2%) different innovation projects were funded for a total allocation of $227 870. This program demonstrated the ability of small grants to stimulate many applications with novel ideas, a wide range of innovations and reasonable academic productivity.

  2. [The Health Technology Assessment Engine of the Academic Hospital of Udine: first appraisal].

    PubMed

    Vidale, Claudia

    2014-01-01

    The Health Technology Assessment Engine (HTAE) of the Academic Hospital of Udine aggregates about one hundred of health technology assessment websites. It was born thanks to Google technology in 2008 and after about four years of testing it became public for everybody from the Homepage of the Italian Society of Health Technology Assessment (SIHTA). In this paper the first results obtained with this resource are reported. The role of the scientific librarian is examined not only as a support specialist in bibliographic search but also as a creative expert in managing new technologies for the community.

  3. Modifying the Toyota Production System for continuous performance improvement in an academic children's hospital.

    PubMed

    Stapleton, F Bruder; Hendricks, James; Hagan, Patrick; DelBeccaro, Mark

    2009-08-01

    The Toyota Production System (TPS) has become a successful model for improving efficiency and eliminating errors in manufacturing processes. In an effort to provide patients and families with the highest quality clinical care, our academic children's hospital has modified the techniques of the TPS for a program in continuous performance improvement (CPI) and has expanded its application to educational and research programs. Over a period of years, physicians, nurses, residents, administrators, and hospital staff have become actively engaged in a culture of continuous performance improvement. This article provides background into the methods of CPI and describes examples of how we have applied these methods for improvement in clinical care, resident teaching, and research administration.

  4. Microbial contamination of nonsterile pharmaceuticals in public hospital settings

    PubMed Central

    Mugoyela, Veronica; Mwambete, Kennedy D

    2010-01-01

    Purpose Contamination of pharmaceuticals with microorganisms irrespective whether they are harmful or nonpathogenic can bring about changes in physicochemical characteristics of the medicines. Although sterility is not a requirement in official compendia for nonsterile pharmaceuticals, bioburdens need to be within acceptable limits. Therefore, this study investigated microbial contamination of 10 nonsterile pharmaceuticals frequently delivered to outpatients by identifying and quantifying microbial contaminants and susceptibility pattern testing on the microbes isolated. Methods The study was carried out at Amana Municipal Hospital in Dar es Salaam, Tanzania. The protocol for the study involved structured selection of representative tablets, syrups, and capsules from the hospital’s outpatient pharmacy. Constitutive microorganisms were elaborated and enumerated using standard microbiologic procedures. Results Results showed that 50% of all tested products were heavily contaminated, and the predominant contaminants comprised Klebsiella, Bacillus, and Candida species. Furthermore, the results showed that the isolated Bacillus and Klebsiella species were resistant to Augmentin ® and cloxacillin. The differences in means for cfu/mL and zones of inhibition among the microorganisms isolated were considered significant at P < 0.05. Conclusion The nonsterile pharmaceuticals were presumably microbiologically contaminated due to poor handling during dispensing, repackaging, and/or nonadherence to good manufacturing practice. Therefore, training and educating the dispensers, as well as patients, on the proper handling and use of medicines cannot be overemphasized, because these are key aspects in controlling cross-contamination of medicines. PMID:20957135

  5. Collaboration: a Simple Recipe for Improving Research Productivity in the Community Teaching Hospital Setting.

    PubMed

    Friedman, Yelena; Sills, Meagan

    The Medical Library and the Department of Research of the Staten Island University Hospital developed a collaborative project aimed at improving research and scholarly productivity in the community teaching hospital setting to meet teaching program accreditation requirements. The project opens a new venue for hospital librarians seeking new and innovative roles within their institutions while helping to strengthen the library's position and demonstrate the value of library services to health professionals.

  6. Collaboration: a Simple Recipe for Improving Research Productivity in the Community Teaching Hospital Setting

    PubMed Central

    Friedman, Yelena; Sills, Meagan

    2016-01-01

    The Medical Library and the Department of Research of the Staten Island University Hospital developed a collaborative project aimed at improving research and scholarly productivity in the community teaching hospital setting to meet teaching program accreditation requirements. The project opens a new venue for hospital librarians seeking new and innovative roles within their institutions while helping to strengthen the library’s position and demonstrate the value of library services to health professionals. PMID:26848287

  7. Characteristics of methylphenidate dependence syndrome in psychiatric hospital settings.

    PubMed

    Ozaki, Shigeru; Wada, Kiyoshi

    2006-04-01

    The characteristics of methylphenidate (MPD) cases reported in a nationwide mental hospital survey on substance-related psychiatric disorders are studied compared to methamphetamine cases. Although the two groups did not differ in terms of age and sex, the MPD group revealed longer educational histories and lower antisocial traits. About half of the MPD group had a history of methamphetamine use and 30% had used the substance as the initial substance of abuse. They exhibited a general tendency toward multiple substance use. These results indicate that a significant number of MPD cases exist who used MPD as a substance alternative to methamphetamine and also suggest that they may potentially have a tendency to develop abuse or dependence. The MPD cases most likely had a psychiatric diagnosis of "Dependence syndrome (F15.2)," according to the ICD-10 guidelines. The SDS scores also indicated a more severe dependence syndrome, particularly psychological dependence, which they may possibly develop more quickly. An abundance of information for MPD abusers to utilize is available through the internet, including the pharmacological properties, such as increased sensation or elation through MPD intake and how and where to easily acquire the substance. They may even forge a prescription to obtain MPD. This behavior can be recognized as "substance-seeking behavior" in behavioral pharmacology terms, accompanied by craving based on psychological dependence on the substance, and can be very difficult to control. Little evidence exists regarding the effectiveness and necessity of MPD as a treatment for depression, and thus MPD prescriptions must be carefully considered by psychiatrists or physicians. The application of MPD as an antidepressant in the health insurance system must be re-examined as well.

  8. Roadmap to an effective quality improvement and patient safety program implementation in a rural hospital setting.

    PubMed

    Ingabire, Willy; Reine, Petera M; Hedt-Gauthier, Bethany L; Hirschhorn, Lisa R; Kirk, Catherine M; Nahimana, Evrard; Nepomscene Uwiringiyemungu, Jean; Ndayisaba, Aphrodis; Manzi, Anatole

    2015-12-01

    Implementation lessons: (1) implementation of an effective quality improvement and patient safety program in a rural hospital setting requires collaboration between hospital leadership, Ministry of Health and other stakeholders. (2) Building Quality Improvement (QI) capacity to develop engaged QI teams supported by mentoring can improve quality and patient safety.

  9. Toward Audience Involvement: Extending Audiences of Written Physician Notes in a Hospital Setting

    ERIC Educational Resources Information Center

    Breuch, Lee-Ann Kastman; Bakke, Abigail; Thomas-Pollei, Kimberly; Mackey, L. Elizabeth; Weinert, Craig

    2016-01-01

    This article explores rhetorical implications of extending the audience of written physician notes in hospital settings to include patients and/or family members (the OpenNotes program). Interviews of participating hospital patients and family members (n = 16) underscored the need for more complex understandings of audience beyond…

  10. The contributions of library and information services to hospitals and academic health sciences centers: a preliminary taxonomy

    PubMed Central

    Abels, Eileen G.; Cogdill, Keith W.; Zach, Lisl

    2002-01-01

    Objectives: This article presents a taxonomy of the contributions of library and information services (LIS) in hospitals and academic health sciences centers. The taxonomy emerges from a study with three objectives: to articulate the value of LIS for hospitals and academic health sciences centers in terms of contributions to organizational missions and goals, to identify measures and measurable surrogates associated with each LIS contribution, and to document best practices for communicating the value of LIS to institutional administrators. Methods: The preliminary taxonomy of LIS contributions in hospitals and academic health sciences centers is based on a review of the literature, twelve semi-structured interviews with LIS directors and institutional administrators, and a focus group of administrators from five academic, teaching, and nonteaching hospitals. Results: Derived from the balanced scorecard approach, the taxonomy of LIS contributions is organized on the basis of five mission-level concepts and fifteen organizational goals. LIS contributions are included only if they have measurable surrogates. Conclusions: The taxonomy of LIS contributions offers a framework for the collection of both quantitative and qualitative data in support of communicating the value of LIS in hospitals and academic health sciences centers. PMID:12113510

  11. A Successful US Academic Collaborative Supporting Medical Education in a Postconflict Setting.

    PubMed

    McQuilkin, Patricia; Marshall, Roseda E; Niescierenko, Michelle; Tubman, Venée N; Olson, Bradley G; Staton, Donna; Williams, Jackson H; Graham, Elinor A

    2014-01-01

    This article describes a model employed by the Academic Collaborative to Support Medical Education in Liberia to augment medical education in a postconflict setting where the health and educational structures and funding are very limited. We effectively utilized a cohort of visiting US pediatric faculty and trainees for short-term but recurrent clinical work and teaching. This model allows US academic medical centers, especially those with smaller residency programs, to provide global health experiences for faculty and trainees while contributing to the strengthening of medical education in the host country. Those involved can work toward a goal of sustainable training with a strengthened host country specialty education system. Partnerships such as ours evolve over time and succeed by meeting the needs of the host country, even during unanticipated challenges, such as the Ebola virus outbreak in West Africa.

  12. A Successful US Academic Collaborative Supporting Medical Education in a Postconflict Setting

    PubMed Central

    Marshall, Roseda E.; Niescierenko, Michelle; Tubman, Venée N.; Olson, Bradley G.; Staton, Donna; Williams, Jackson H.; Graham, Elinor A.

    2014-01-01

    This article describes a model employed by the Academic Collaborative to Support Medical Education in Liberia to augment medical education in a postconflict setting where the health and educational structures and funding are very limited. We effectively utilized a cohort of visiting US pediatric faculty and trainees for short-term but recurrent clinical work and teaching. This model allows US academic medical centers, especially those with smaller residency programs, to provide global health experiences for faculty and trainees while contributing to the strengthening of medical education in the host country. Those involved can work toward a goal of sustainable training with a strengthened host country specialty education system. Partnerships such as ours evolve over time and succeed by meeting the needs of the host country, even during unanticipated challenges, such as the Ebola virus outbreak in West Africa. PMID:27335926

  13. Pathways to Advancing Aging Policy-Relevant Research in Academic Settings

    PubMed Central

    KIETZMAN, KATHRYN G.; TROY, LISA M.; GREEN, CARMEN R.; WALLACE, STEVEN P.

    2016-01-01

    Policy-level changes have a significant influence on the health and well-being of aging populations. Yet there is often a gap between scientific knowledge and policy action. Although previous research has identified barriers and facilitators to effective knowledge translation, little attention has been given to the role of academic institutions in knowledge generation. This exploratory focus group study examines barriers and pathways to developing and maintaining an aging policy-relevant research agenda in academic settings, and additional challenges associated with minority group membership in this pursuit. Participants were personally committed to conducting policy-relevant research despite institutional barriers such as fewer funding opportunities and less value attributed to their research, particularly in the context of tenure and promotion. Although many viewed their research as an opportunity to make a difference, especially for underserved older adult populations, a number of minority group participants expressed that their policy research interests were marginalized. Participants offer individual and institutional-level strategies for addressing barriers, including collaborating with community members and colleagues and engaging mentors within and outside of their academic institutions. Reframing the valuation of policy research through the diversification of funding and publishing opportunities can better support scholars engaged in aging policy-relevant research. PMID:26849290

  14. Pathways to Advancing Aging Policy-Relevant Research in Academic Settings.

    PubMed

    Kietzman, Kathryn G; Troy, Lisa M; Green, Carmen R; Wallace, Steven P

    2016-01-01

    Policy-level changes have a significant influence on the health and well-being of aging populations. Yet there is often a gap between scientific knowledge and policy action. Although previous research has identified barriers and facilitators to effective knowledge translation, little attention has been given to the role of academic institutions in knowledge generation. This exploratory focus group study examines barriers and pathways to developing and maintaining an aging policy-relevant research agenda in academic settings, and additional challenges associated with minority group membership in this pursuit. Participants were personally committed to conducting policy-relevant research despite institutional barriers such as fewer funding opportunities and less value attributed to their research, particularly in the context of tenure and promotion. Although many viewed their research as an opportunity to make a difference, especially for underserved older adult populations, a number of minority group participants expressed that their policy research interests were marginalized. Participants offer individual and institutional-level strategies for addressing barriers, including collaborating with community members and colleagues and engaging mentors within and outside of their academic institutions. Reframing the valuation of policy research through the diversification of funding and publishing opportunities can better support scholars engaged in aging policy-relevant research.

  15. Preparing an Academic Medical Center to Manage Patients Infected With Ebola: Experiences of a University Hospital.

    PubMed

    Schultz, Carl H; Koenig, Kristi L; Alassaf, Wajdan

    2015-10-01

    As Ebola has spread beyond West Africa, the challenges confronting health care systems with no experience in managing such patients are enormous. Not only is Ebola a significant threat to a population's health, it can infect the medical personnel trying to treat it. As such, it represents a major challenge to those in public health, emergency medical services (EMS), and acute care hospitals. Our academic medical center volunteered to become an Ebola Treatment Center as part of the US effort to manage the threat. We developed detailed policies and procedures for Ebola patient management at our university hospital. Both the EMS system and county public health made significant contributions during the development process. This article shares information about this process and the outcomes to inform other institutions facing similar challenges of preparing for an emerging threat with limited resources. The discussion includes information about management of (1) patients who arrive by ambulance with prior notification, (2) spontaneous walk-in patients, and (3) patients with confirmed Ebola who are interfacility transfers. Hospital management includes information about Ebola screening procedures, personal protective equipment selection and personnel training, erection of a tent outside the main facility, establishing an Ebola treatment unit inside the facility, and infectious waste and equipment management. Finally, several health policy considerations are presented.

  16. [GPs' self-perception of their own role compared with hospital, ambulatory, academic, and health organisation physicians].

    PubMed

    Daghio, Maria Monica; Gaglianò, Giuseppe; Bevini, Massimo; Cadioli, Tiziano; Delvecchio, Carlo; Guidetti, Patrizia; Lorenzetti, Manuela; Fattori, Giuseppe; Ciardullo, Anna Vittoria

    2005-05-01

    Aim of the present study was to explore how the 76 general practitioners (GPs) - serving Carpi district (90,000 residents) - value their own role compared with the hospital, ambulatory, academic, and health organisation physicians'. GPs had a positive self-image only in comparison with health organisation doctors (7 vs 7 grades). GPs disappointed with themselves when comparing their role with ambulatory (-1.6 grades), academic (-1.9 grades) and hospital doctors (-2.2 grades). Secondarily, GPs perceived patients' valuing their professional role mostly 'subordinate' to the other physicians', except health organisation colleagues'.

  17. Use of a national collaborative to improve hospital quality in a low-income setting

    PubMed Central

    Linnander, Erika; McNatt, Zahirah; Sipsma, Heather; Tatek, Dawit; Abebe, Yigeremu; Endeshaw, Abraham; Bradley, Elizabeth H.

    2016-01-01

    Background Quality improvement collaboratives are a widely used mechanism to improve hospital performance in high-income settings, but we lack evidence about their effectiveness in low-income settings. Methods We conducted cross-sectional and longitudinal analysis of data from the Ethiopian Hospital Alliance for Quality, a national collaborative sponsored by Ethiopia's Federal Ministry of Health. We identified hospital strategies associated with more positive patient satisfaction using linear regression and assessed changes in patient experience over a 3-year period (2012–2014) using matched t-tests. Results A total of 68 hospitals (response rate 68/120, 56.7%) were included in cross-sectional analysis. Four practices were significantly associated with more positive patient satisfaction (p<0.05): posting a record of cleaning activity in toilets and in patient wards, distributing leaflets in the local language with each prescription, and sharing ideas about patient experience across the hospital. Among hospitals that had complete data for longitudinal analysis (44/68, 65%), we found a 10% improvement in a 10-point measure of patient satisfaction (7.7 vs 8.4, p<0.01) from the start to the end of the study period. Conclusions Quality improvement collaboratives can be useful at scale in low-income settings in sub-Saharan Africa, particularly for hospitals that adopt strategies associated with patient satisfaction. PMID:26796023

  18. Misuse of antibiotics reserved for hospital settings in outpatients: a prospective clinical audit in a university hospital in Southern France.

    PubMed

    Roche, Manon; Bornet, Charléric; Monges, Philippe; Stein, Andreas; Gensollen, Sophie; Seng, Piseth

    2016-07-01

    Some antibiotics are reserved essentially for hospital settings owing to cost effectiveness and in order to fight the emerging antibiotic resistance crisis. In some cases, antibiotics reserved exclusively for use in hospitals may be prescribed in outpatients for serious infections or in the absence of a therapeutic alternative. A 30-day prospective audit of outpatient prescriptions of antibiotics reserved exclusively for use in hospitals was performed. The objective of this study was to evaluate the relevance of outpatient antibiotic prescriptions by measuring appropriateness according to guidelines. During the study period, 53 prescriptions were included, only 40% of which were appropriate. Among the 32 inappropriate prescriptions, 4 cases lacked microbial arguments, 1 case was not adequate for the infection type, 1 case involved an incorrect antibiotic dosage, 1 case involved an incorrect interval of dose administration, 3 cases had a therapeutic alternative and 22 cases were not recommended. Of the 53 prescriptions, 66% were started in hospital and 34% in outpatients. Only 25% of cases were prescribed with infectious diseases specialist (IDS) advice, 64% were based on microbiological documentation and 13% had a negative bacterial culture. Inappropriate prescriptions were usually observed in antibiotic lock therapy, skin infections, Clostridium difficile colitis, intra-abdominal infections and intravascular catheter-related infections. Outpatient prescriptions of antimicrobial drugs reserved exclusively for use in hospitals are frequently inappropriate. We recommend a real-time analysis algorithm with the involvement of an IDS for monitoring prescriptions to improve the quality of these prescriptions and possibly to prevent antibiotic resistance.

  19. Development of a Hospital-based Massage Therapy Course at an Academic Medical Center

    PubMed Central

    Dion, Liza J.; Cutshall, Susanne M.; Rodgers, Nancy J.; Hauschulz, Jennifer L.; Dreyer, Nikol E.; Thomley, Barbara S.; Bauer, Brent

    2015-01-01

    Background: Massage therapy is offered increasingly in US medical facilities. Although the United States has many massage schools, their education differs, along with licensure and standards. As massage therapy in hospitals expands and proves its value, massage therapists need increased training and skills in working with patients who have various complex medical concerns, to provide safe and effective treatment. These services for hospitalized patients can impact patient experience substantially and provide additional treatment options for pain and anxiety, among other symptoms. The present article summarizes the initial development and description of a hospital-based massage therapy course at a Midwest medical center. Methods: A hospital-based massage therapy course was developed on the basis of clinical experience and knowledge from massage therapists working in the complex medical environment. This massage therapy course had three components in its educational experience: online learning, classroom study, and a 25-hr shadowing experience. The in-classroom study portion included an entire day in the simulation center. Results: The hospital-based massage therapy course addressed the educational needs of therapists transitioning to work with interdisciplinary medical teams and with patients who have complicated medical conditions. Feedback from students in the course indicated key learning opportunities and additional content that are needed to address the knowledge and skills necessary when providing massage therapy in a complex medical environment. Conclusions: The complexity of care in medical settings is increasing while the length of hospital stay is decreasing. For this reason, massage provided in the hospital requires more specialized training to work in these environments. This course provides an example initial step in how to address some of the educational needs of therapists who are transitioning to working in the complex medical environment. PMID

  20. Academic Case Management: Promising Interventions for Closing Achievement Gaps in Multicultural Urban Settings

    ERIC Educational Resources Information Center

    Van Kannel-Ray, Nancy; Zeller, Pamela J.; Lacefield, Warren E.

    2009-01-01

    This article explains how individual academic case manager intervention programs were implemented in three urban middle schools. Academic case managers helped students integrate their personal lives with academic expectations by helping students learn to cope with their own personal challenges with the goal of improving their academic performance.…

  1. The efficacy of hydrogel dressings as a first aid measure for burn wound management in the pre-hospital setting: a systematic review of the literature.

    PubMed

    Goodwin, Nicholas S; Spinks, Anneliese; Wasiak, Jason

    2016-08-01

    The aim of this systematic review was to determine the supporting evidence for the clinical use of hydrogel dressings as a first aid measure for burn wound management in the pre-hospital setting. Two authors searched three databases (Ovid Medline, Ovid Embase and The Cochrane Library) for relevant English language articles published through September 2014. Reference lists, conference proceedings and non-indexed academic journals were manually searched. A separate search was conducted using the Internet search engine Google to source additional studies from burns advisory agencies, first aid bodies, military institutions, manufacturer and paramedic websites. Two authors independently assessed study eligibility and relevance of non-traditional data forms for inclusion. Studies were independently assessed and included if Hydrogel-based burn dressings (HBD) were examined in first aid practices in the pre-hospital setting. A total of 129 studies were considered for inclusion, of which no pre-hospital studies were identified. The review highlights that current use of HBD in the pre-hospital setting appears to be driven by sources of information that do not reflect the paramedic environment. We recommend researchers in the pre-hospital settings undertake clinical trials in this field. More so, the review supports the need for expert consensus to identify key demographic, clinical and injury outcomes for clinicians and researchers undertaking further research into the use of dressings as a first aid measure.

  2. [Nursing care management in hospital settings: the building of a construct].

    PubMed

    Christovam, Barbara Pompeu; Porto, Isaura Setenta; de Oliveira, Denise Cristina

    2012-06-01

    The objective of this study was to build and present a theoretical definition of the concept of nursing care management in hospital settings, based on specific literature. We chose to use Concept Analysis strategies for building concepts, the rules of Archeological Analysis for forming concepts, and Lexical Analysis as the theoretical-methodological framework. The operationalization of the strategies and rules for forming the concept permitted the construction of the concept of nursing care in hospital settings. The constructed concept presented, by its nature, the capacity to form a dialectic integration of the aspects relative to the knowing-doing of care and management. The theoretical definition of the concept of Nursing Care Management in Hospital Settings assigned meaning to the term, in the initial context of the construction of a theory of Nursing Care Management in Health Services.

  3. Utilization of Portable Radios to Improve Ophthalmology Clinic Efficiency in an Academic Setting.

    PubMed

    Davis, Alexander S; Elkeeb, Ahmed M; Vizzeri, Gianmarco; Godley, Bernard F

    2016-03-01

    Improvement in clinic efficiency in the ambulatory setting is often looked at as an area for development of lean management strategies to deliver a higher quality of healthcare while reducing errors, costs, and delays. To examine the benefits of improving team communication and its impact on clinic flow and efficiency, we describe a time-motion study performed in an academic outpatient Ophthalmology clinic and its objective and subjective results. Compared to clinic encounters without the use of the portable radios, objective data demonstrated an overall significant decreases in mean workup time (15.18 vs. 13.10), room wait (13.10 vs. 10.47), and decreased the total time needed with an MD per encounter (9.45 vs. 6.63). Subjectively, significant improvements were seen in careprovider scores for patient flow (60.78 vs. 84.29), getting assistance (61.89 vs. 88.57), moving patient charts (54.44 vs. 85.71), teamwork (69.56 vs. 91.0), communications (62.33 vs. 90.43), providing quality patient care (76.22 vs. 89.57), and receiving input on the ability to see walk-in patients (80.11 vs. 90.43). For academic purposes, an improvement in engagement in patient care and learning opportunities was noted by the clinic resident-in-training during the pilot study. Portable radios in our pilot study were preferred over the previous method of communication and demonstrates significant improvements in certain areas of clinical efficiency, subjective perception of teamwork and communications, and academic learning.

  4. An Evaluation of the Effects of Set Induction on the Academic Achievement and Academic Self-Concept of College Botany Students.

    ERIC Educational Resources Information Center

    Thomas, James Arthur

    In this study it was hypothesized that set induction teaching techniques (the experimental treatment) should have a direct effect on the students involved and would, in turn, improve the students' academic self-concept. The subjects in the study were college students from each of the four college grade levels. The instruments used were the Botany…

  5. Academic Success Groups for Middle-School Children with ADHD in the Outpatient Mental Health Setting – An Open Trial

    PubMed Central

    Ciesielski, Heather; Tamm, Leanne; Vaughn, Aaron; Cyran, Jessica; Epstein, Jeff

    2015-01-01

    Objective To conduct an open trial assessing the initial efficacy of an intervention focusing on increasing skills related to academic performance (planning, organization, studying, homework behaviors) for middle-school children diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD). The intervention is modeled on evidence-based interventions but designed for administration in the outpatient setting. Method Parents and their children diagnosed with ADHD attended 7 weekly group sessions targeting academic, organizational, and homework skills. Parents completed the Homework Problem Checklist and Impairment Rating Scale pre- and post-treatment. Results Following intervention, significant improvements in homework completion and management, as well as reductions in academic impairment and improvements in parent confidence and family relations were reported. Conclusion Despite limitations including small sample size and lack of a control group, our results demonstrate initial efficacy of an academic skills intervention designed for use in the outpatient setting with middle-school children diagnosed with ADHD on clinically relevant outcome measures. PMID:25926629

  6. Hyponatremia in patients hospitalized with heart failure: a condition often overlooked in low-income settings

    PubMed Central

    Ali, Khalid; Workicho, Abdulhalik; Gudina, Esayas Kebede

    2016-01-01

    Background Hyponatremia is a common electrolyte abnormality in patients with heart failure (HF). It is independently associated with increased short-term and long-term morbidity and mortality. The main objective of this study was to assess patterns of hyponatremia and its association with discharge outcomes in patients with HF admitted to a teaching hospital in Ethiopia. Patients and methods This is a descriptive, prospective, hospital-based cohort study of patients with HF admitted to Jimma University Hospital, Ethiopia, between November 1, 2013 and July 31, 2014. A structured questionnaire was used to collect information on sociodemographic characteristics, clinical profile at admission, and outcomes at discharge. Plasma sodium concentration was analyzed at admission for all patients. The relationship between hyponatremia at admission and in-hospital mortality, as well as length of hospital stay, was assessed using both bivariate analysis and multivariable logistic regressions. The level of statistical significance was set at P<0.05. Results Of 152 participants admitted with HF, 44 (28.9%) had hyponatremia, which is defined as serum sodium level <135 mmol/L. Patients on salt restriction, on chronic diuretic treatment (furosemide and spironolactone), and with impaired renal function at admission were found to be highly affected. Hyponatremia was found to be associated with increased in-hospital mortality (P=0.008) and longer hospital stay (16.6 vs 12 days, P<0.001). Patients with hyponatremia also had lower blood pressure and poor functional status at discharge. Conclusion This study demonstrates that hyponatremia is highly prevalent in patients hospitalized with HF and is associated with increased in-hospital mortality and longer hospital stay. Thus, great emphasis should be given to identify high-risk patients, and prevention and early detection of hyponatremia to prevent its deleterious effects. Large-scale national studies are also needed to complement our

  7. The Link between Basing Self-Worth on Academics and Student Performance Depends on Domain Identification and Academic Setting

    ERIC Educational Resources Information Center

    Lawrence, Jason S.; Charbonneau, Joseph

    2009-01-01

    Two studies showed that the link between how much students base their self-worth on academics and their math performance depends on whether their identification with math was statistically controlled and whether the task measured ability or not. Study 1 showed that, when math identification was uncontrolled and the task was ability-diagnostic,…

  8. Use of portable electronic devices in a hospital setting and their potential for bacterial colonization.

    PubMed

    Khan, Amber; Rao, Amitha; Reyes-Sacin, Carlos; Hayakawa, Kayoko; Szpunar, Susan; Riederer, Kathleen; Kaye, Keith; Fishbain, Joel T; Levine, Diane

    2015-03-01

    Portable electronic devices are increasingly being used in the hospital setting. As with other fomites, these devices represent a potential reservoir for the transmission of pathogens. We conducted a convenience sampling of devices in 2 large medical centers to identify bacterial colonization rates and potential risk factors.

  9. MICRO-CARES: An Information Management System for Psychosocial Services in Hospital Settings

    PubMed Central

    Hammer, Jeffrey S.; Lyons, John S.; Strain, James J.

    1984-01-01

    This paper presents a flexible software system that is adaptable to a variety of information management uses across different psychosocial service departments in hospital settings. Initially developed for Consultation Liaison Psychiatry, the present system has now been adapted for a Social Work department and is being adapted to Hospice, Home Care, Patient Representative, and Pastoral Care departmental uses.

  10. Efficacy Beliefs and the Learning Experiences of Children with Cancer in the Hospital Setting.

    ERIC Educational Resources Information Center

    Crossland, Andrea

    2002-01-01

    A study examined how self-efficacy beliefs influenced motivation, affect, and adjustment in five students aged 9-13 with cancer, receiving educational services in a hospital setting. Education was an effective vehicle through which children with cancer could experience control and autonomy and also achieve many necessary developmental outcomes for…

  11. Costs and process of in-patient tuberculosis management at a central academic hospital, Cape Town, South Africa

    PubMed Central

    Marais, F.; Mehtar, S.; Baltussen, R. M. P. M.

    2012-01-01

    Setting: South Africa reports more cases of tuberculosis (TB) than any other country, but an up-to-date, precise estimate of the costs associated with diagnosing, treating and preventing TB at the in-patient level is not available. Objective: To determine the costs associated with TB management among in-patients and to study the use of personal protective equipment (PPE) at a central academic hospital in Cape Town. Design: Retrospective and partly prospective cost analysis of TB cases diagnosed between May 2008 and October 2009. Results: The average daily in-patient costs were US$238; the average length of stay was 9.7 days. Mean laboratory and medication costs per stay were respectively US$26.82 and US$8.68. PPE use per day cost US$0.99. The average total TB management costs were US$2373 per patient. PPE was not always properly used. Discussion: The costs of in-patient TB management are high compared to community-based treatment; the main reason for the high costs is the high number of in-patient days. An efficiency assessment is needed to reduce costs. Cost reduction per TB case prevented was approximately US$2373 per case. PPE use accounted for the lowest costs. Training is needed to improve PPE use. PMID:26392953

  12. Defining the Role of Academic Advising in the Institutional Setting: The Next Phase.

    ERIC Educational Resources Information Center

    Trombley, Toni; Holmes, David

    1981-01-01

    Environmental factors that will affect academic advising in the 1980s, appropriate goals, and suggestions on how to affect change are discussed. Because evidence shows that academic advising, student retention, and institutional stability are strongly linked, the future of academic advising is seen as bright, with institutions elevating its…

  13. Process mapping evaluation of medication reconciliation in academic teaching hospitals: a critical step in quality improvement

    PubMed Central

    Holbrook, Anne; Bowen, James M; Patel, Harsit; O'Brien, Chris; You, John J; Tahavori, Roshan; Doleweerd, Jeff; Berezny, Tim; Perri, Dan; Nieuwstraten, Carmine; Troyan, Sue; Patel, Ameen

    2016-01-01

    Background Medication reconciliation (MedRec) has been a mandated or recommended activity in Canada, the USA and the UK for nearly 10 years. Accreditation bodies in North America will soon require MedRec for every admission, transfer and discharge of every patient. Studies of MedRec have revealed unintentional discrepancies in prescriptions but no clear evidence that clinically important outcomes are improved, leading to widely variable practices. Our objective was to apply process mapping methodology to MedRec to clarify current processes and resource usage, identify potential efficiencies and gaps in care, and make recommendations for improvement in the light of current literature evidence of effectiveness. Methods Process engineers observed and recorded all MedRec activities at 3 academic teaching hospitals, from initial emergency department triage to patient discharge, for general internal medicine patients. Process maps were validated with frontline staff, then with the study team, managers and patient safety leads to summarise current problems and discuss solutions. Results Across all of the 3 hospitals, 5 general problem themes were identified: lack of use of all available medication sources, duplication of effort creating inefficiency, lack of timeliness of completion of the Best Possible Medication History, lack of standardisation of the MedRec process, and suboptimal communication of MedRec issues between physicians, pharmacists and nurses. Discussion MedRec as practised in this environment requires improvements in quality, timeliness, consistency and dissemination. Further research exploring efficient use of resources, in terms of personnel and costs, is required. PMID:28039294

  14. Deconstructing myths, building alliances: a networking model to enhance tobacco control in hospital mental health settings.

    PubMed

    Ballbè, Montse; Gual, Antoni; Nieva, Gemma; Saltó, Esteve; Fernández, Esteve

    2016-01-01

    Life expectancy for people with severe mental disorders is up to 25 years less in comparison to the general population, mainly due to diseases caused or worsened by smoking. However, smoking is usually a neglected issue in mental healthcare settings. The aim of this article is to describe a strategy to improve tobacco control in the hospital mental healthcare services of Catalonia (Spain). To bridge this gap, the Catalan Network of Smoke-free Hospitals launched a nationwide bottom-up strategy in Catalonia in 2007. The strategy relied on the creation of a working group of key professionals from various hospitals -the early adopters- based on Rogers' theory of the Diffusion of Innovations. In 2016, the working group is composed of professionals from 17 hospitals (70.8% of all hospitals in the region with mental health inpatient units). Since 2007, tobacco control has improved in different areas such as increasing mental health professionals' awareness of smoking, training professionals on smoking cessation interventions and achieving good compliance with the national smoking ban. The working group has produced and disseminated various materials, including clinical practice and best practice guidelines, implemented smoking cessation programmes and organised seminars and training sessions on smoking cessation measures in patients with mental illnesses. The next challenge is to ensure effective follow-up for smoking cessation after discharge. While some areas of tobacco control within these services still require significant improvement, the aforementioned initiative promotes successful tobacco control in these settings.

  15. Delivering palliative care in an acute hospital setting: views of referrers and specialist providers.

    PubMed

    Ewing, Gail; Farquhar, Morag; Booth, Sara

    2009-09-01

    There has been a steady expansion of hospital-based palliative care in the United Kingdom but limited published research on health professionals' views of hospital multidisciplinary specialist palliative care services (SPCS). The aim of the study was to describe referrer (SPCS user) and provider (SPCS staff) perspectives on delivery of specialist palliative care in hospital. Interviews were conducted with referrers, including five junior doctors, 13 consultants, and six clinical nurse specialists, to investigate the reasons for referral, beneficial aspects, and barriers to use. Focus groups were conducted with providers, six medical and five nursing, to identify their perspective on delivering the specialist service in hospital. Discussions were tape recorded and transcribed verbatim. Data were analyzed thematically using a framework analysis approach. The study found large areas of agreement between referrers and providers on what hospital palliative care teams should be providing for patients, that is, expertise in managing difficult symptoms and complex psychosocial problems, and this was being achieved locally. Access to the specialist team was also important: visibility on the wards, informal routes of access to advice and a timely response by specialists. However, discordance in views of providing palliative care was also identified; in particular, whether specialists should be providing generalist palliative care (such as basic psychological support) neglected by ward teams and implementation of specialist advice by referrers. Such perspectives on the interface of generalist and specialist provision provide insights into improving care for palliative patients in the acute hospital setting.

  16. Palliative care need and management in the acute hospital setting: a census of one New Zealand Hospital

    PubMed Central

    2013-01-01

    Background Improving palliative care management in acute hospital settings has been identified as a priority internationally. The aim of this study was to establish the proportion of inpatients within one acute hospital in New Zealand who meet prognostic criteria for palliative care need and explore key aspects of their management. Methods A prospective survey of adult hospital inpatients (n = 501) was undertaken. Case notes were examined for evidence that the patient might be in their last year of life according to Gold Standards Framework (GSF) prognostic indicator criteria. For patients who met GSF criteria, clinical and socio-demographic information were recorded. Results Ninety-nine inpatients met GSF criteria, representing 19.8% of the total census population. The patients’ average age was 70 years; 47% had a primary diagnosis of cancer. Two thirds had died within 6 months of their admission. Seventy-eight of the 99 cases demonstrated evidence that a palliative approach to care had been adopted; however documentation of discussion about goals of care was very limited and only one patient had evidence of an advance care plan. Conclusion One fifth of hospital inpatients met criteria for palliative care need, the majority of whom were aged >70 years. Whilst over three quarters were concluded to be receiving care in line with a palliative care approach, very little documented evidence of discussion with patients and families regarding end of life issues was evident. Future research needs to explore how best to support ‘generalist’ palliative care providers in initiating, and appropriately recording, such discussions. PMID:23537092

  17. Exploratory Use of Microaerosol Decontamination Technology (PAEROSOL) in Enclosed, Unoccupied Hospital Setting

    SciTech Connect

    Rainina, Evguenia I.; McCune, D. E.; Luna, Maria L.; Cook, J. E.; Soltis, Michele A.; Demons, Samandra T.; Godoy-Kain, Patricia; Weston, J. H.

    2012-05-31

    The goal of this study was to validate the previously observed high biological kill performance of PAEROSOL, a semi-dry, micro-aerosol decontamination technology, against common HAI in a non-human subject trial within a hospital setting of Madigan Army Medical Center (MAMC) on Joint Base Lewis-McChord in Tacoma, Washington. In addition to validating the disinfecting efficacy of PAEROSOL, the objectives of the trial included a demonstration of PAEROSOL environmental safety, (i.e., impact to hospital interior materials and electronic equipment exposed during testing) and PAEROSOL parameters optimization for future deployment.

  18. Convergence and divergence: assessing criteria of consumer satisfaction across general practice, dental and hospital care settings.

    PubMed

    Williams, S J; Calnan, M

    1991-01-01

    This paper describes the results of the first-stage of a study carried out in the spring of 1988 in the South East of England. The study looked at general and specific aspects of consumer satisfaction with general practitioner services, general dental care services and hospital in-patients care. It also examined which specific consumer criteria were the key predictors of overall satisfaction within each of these particular medical care settings. A related aim was to assess the degree of congruence or divergence of consumer criteria across these differing medical care settings. The evidence suggests that whilst general levels of consumer satisfaction are high (i.e. 83-97%), questions of a more detailed and specific nature revealed greater levels of expressed dissatisfaction (e.g. 38% of the sample felt that they could not discuss personal problems with their GP, 51% felt their dentist was not easy to reach at weekends/holidays, whilst 35% felt hospital doctors did not give sufficient information). Whilst different areas of dissatisfaction were found in each specific medical care setting examined, what was particularly striking was the degree of convergence of the key predictors of overall consumer satisfaction across the medical care settings. That is to say, our findings clearly suggest that issues concerning 'professional competence', together with the nature and quality of the patient-professional relationship, are the key predictors of overall consumer satisfaction with general practice, dental and hospital care [e.g. GP giving sufficient information correlated 0.64 (P less than 0.001) with overall GP satisfaction scores; competent dentist 0.52 (P less than 0.001) with overall dental satisfaction scores; and full confidence in hospital doctors 0.49 (P less than 0.001) with overall hospital satisfaction scores]. The theoretical importance and policy implications of these findings, particularly in the light of the recent NHS reforms, are discussed.

  19. Learning science in a cooperative setting: Academic achievement and affective outcomes

    NASA Astrophysics Data System (ADS)

    Lazarowitz, Reuven; Hertz-Lazarowitz, Rachel; Baird, J. Hugh

    the overall social setting in the classroom as it relates to learning (Bruner, 1986, p. 86) and the central function of social interaction as learning occurs (Vygotsky, 1978, p. 106) seemed to have been ignored. Therefore, group mastery learning (GML), a cooperative learning tech- nique, was suggested as an antithesis to IML for teaching science over short periods. The cooperative mode of instruction considers learning as a cognitive as well as a social process, where students interact with each other as well as the teacher.To bring the social dimension back to science classrooms, the researchers chose to imple- ment GML in Grades 1 I and 12. The goal of the study was to investigate the GML's impact of the method on the individual student's academic achievement, creativity, self-esteem, and number of friends and on the overall learning environment of the classrooms. The researchers were also concerned with the students' attitudes toward earth science, the course being taught at the time of the experiment. Both cognitive and affective outcomes for students who participated in the cooperative GML approach were compared with outcomes for students who studied the same topic in an IML approach.The study addressed a number of questions related to academic and nonacademic outcomes of the two methods of study. First, it sought to determine whether academic achievement of the students taught in the cooperative GML mode would be different from the achievement of students who learned in an individualized method. Second, it sought to determine whether gains or losses would be seen in nonacademic outcomes, such as classroom learning environment, social relations, and students' self-esteem experienced by the students. The results of this study may support more use of cooperative learning in high school science.

  20. Tackling the climate targets set by the Paris Agreement (COP 21): Green leadership empowers public hospitals to overcome obstacles and challenges in a resource-constrained environment.

    PubMed

    Weimann, E; Patel, B

    2016-12-21

    The healthcare sector itself contributes to climate change, the creation of hazardous waste, use of toxic metals such as mercury, and water and air pollution. To mitigate the effect of healthcare provision on the deteriorating environment and avoid creating further challenges for already burdened health systems, Global Green Hospitals was formed as a global network. Groote Schuur Hospital (GSH), as the leading academic hospital in Africa, joined the network in 2014. Since then, several projects have been initiated to reduce the amount of general waste, energy consumption and food waste, and create an environmentally friendlier and more sustainable hospital in a resource-constrained public healthcare setting. We outline the various efforts made to reduce the carbon footprint of GSH and reduce waste and hazardous substances such as mercury and polystyrene, and elaborate how obstacles and resistance to change were overcome. The hospital was able to halve the amount of coal and water used, increase recycling by 50% over 6 months, replace polystyrene cups and packaging with Forest Stewardship Council recyclable paper-based products, reduce the effect of food wastage by making use of local farmers, and implement measures to reduce the amount of expired pharmaceutical drugs. To improve commitment from all involved roleplayers, political leadership, supportive government policies and financial funding is mandatory, or public hospitals will be unable to tackle the exponentially increasing costs related to climate change and its effects on healthcare.

  1. Impact of the Syrian Crisis on the Hospitalization of Syrians in a Psychiatric Setting.

    PubMed

    Lama, Souaiby; François, Kazour; Marwan, Zoghbi; Sami, Richa

    2016-01-01

    Determine the impact of the Syrian crisis on the hospitalization of Syrians in a psychiatric setting. All Syrians admitted to a psychiatric hospital in Lebanon between the 1st of January 2009 and the 31st of December 2013 were included. Number of admissions, psychiatric disorders and demographic and clinical data relative to patients were compared between those admitted before and after the crisis. 44 patients were admitted before the crisis and 106 after it. The distribution of diagnosis varied significantly after the crisis (p = 0.056) with the majority of patients being admitted for schizophrenia (37.7 %). The prevalence of suicidal ideation was higher after the crisis (p = 0.03) but suicidal attempts, need for electroconvulsive therapy and length of hospitalization did not differ significantly between both groups. Clinicians should be aware of the possible burden of mental illness in Syrians after the beginning of the Syrian crisis.

  2. Mobile Phones as a Potential Vehicle of Infection in a Hospital Setting.

    PubMed

    Chao Foong, Yi; Green, Mark; Zargari, Ahmad; Siddique, Romana; Tan, Vanessa; Brain, Terry; Ogden, Kathryn

    2015-01-01

    The objective of this article is to investigate the potential role of mobile phones as a reservoir for bacterial colonization and the risk factors for bacterial colonization in a hospital setting. We screened 226 staff members at a regional Australian hospital (146 doctors and 80 medical students) between January 2013 and March 2014. The main outcomes of interest were the types of microorganisms and the amount of contamination of the mobile phones. This study found a high level of bacterial contamination (n = 168/226, 74%) on the mobile phones of staff members in a tertiary hospital, with similar organisms isolated from the staff member's dominant hand and mobile phones. While most of the isolated organisms were normal skin flora, a small percentage were potentially pathogenic (n = 12/226, 5%). Being a junior medical staff was found to be a risk factor for heavy microbial growth (OR 4.00, 95% CI 1.54, 10.37). Only 31% (70/226) of our participants reported cleaning their phones routinely, and only 21% (47/226) reported using alcohol containing wipes on their phones. This study demonstrates that mobile phones are potentially vehicles for pathogenic bacteria in a hospital setting. Only a minority of our participants reported cleaning their phones routinely. Disinfection guidelines utilizing alcohol wipes should be developed and implemented.

  3. Pressure Ulcer Prevention in the Hospital Setting Using Silicone Foam Dressings

    PubMed Central

    Grigson, Eileen; Patel, Maulik; Liu, Xinwei

    2016-01-01

    Patient care is of the utmost importance in the hospital setting. Bedrest and immobility during hospitalization, especially in the surgical and intensive care setting, place the patient at high risk for pressure ulcers. It is very important to prevent or notice a pressure ulcer forming due to the significant health care costs involved and patient health associated with them. Various measures are in place to prevent patients from getting pressure ulcers, but a newer material, silicone foam dressings, has been introduced as an alternative solution for the prevention of these ulcers. We review the current literature to examine whether the standard protocol or silicone material is superior to the prevention of pressure ulcer formation. We conclude that silicone foam dressings, when used as prophylactic treatment, seems very promising and may even be superior to the standard care of prevention. However, there were limitations to some studies and further research is needed to confirm the role of silicone foam dressings. PMID:27630803

  4. Improving the reporting of adverse drug reactions in the hospital setting.

    PubMed

    Pushkin, Richard; Frassetto, Lynda; Tsourounis, Candy; Segal, Eleanor S; Kim, Stephanie

    2010-11-01

    The US Food and Drug Administration (FDA) is perceived by the public as having a substantial responsibility to ensure drug safety; however, the FDA has limited resources for active surveillance and relies on voluntary reporting of adverse events and potential adverse drug reactions. Studies have shown that underreporting of adverse events and adverse drug reactions is widespread. Furthermore, a review of several studies demonstrates that most adverse drug reactions are reported by pharmacists and nurses, with physicians reporting the fewest. The hospital setting, with its clearly defined patient population observed around the clock, is an ideal setting in which to identify potential adverse drug reaction signals and to report them to either the drug manufacturer or the FDA. In this article we describe the present system for addressing adverse events, obstacles to reporting them, and the important role any hospital physician could play in reporting adverse events and potential adverse drug reactions.

  5. A Physician's Practice Profile: Application for a Teaching Hospital Ambulatory Care Setting

    PubMed Central

    Retchin, Sheldon M.; Blish, Christine S.

    1984-01-01

    A computer generated report (Practice Profile) summarizing epidemiologic, demographic and utilization data from a general internal medicine practice, was developed and implemented in a teaching hospital setting. Using a computerized medical record system, the Profile displays individual and group practice data. It is used for enhancing the physicians' understanding of their ambulatory practices and for raising important quality assurance issues. The Practice Profile is also used for improving educational activities in the residency program and for stimulating research opportunities within the practice.

  6. Goal Setting, Decision-Making Skills and Academic Performance of Undergraduate Distance Learners: Implications for Retention and Support Services

    ERIC Educational Resources Information Center

    Tanglang, Nebath; Ibrahim, Aminu Kazeem

    2015-01-01

    The study adopted an ex-post facto research design. Randomization sampling technique was used to select 346 undergraduate distance learners and the learners were grouped into four, High and Low Goal setter learners and High and Low Decision-making skills learners. The instruments for data collection were Undergraduate Academic Goal Setting Scale…

  7. Evaluating a moving target: Using Practical Participatory Evaluation (P-PE) in hospital settings

    PubMed Central

    Wharton, Tracy; Alexander, Neil

    2014-01-01

    This article describes lessons learned about implementing evaluations in hospital settings. In order to overcome the methodological dilemmas inherent in this environment, we used a practical participatory evaluation strategy to engage as many stakeholders as possible in the process of evaluating a clinical demonstration project. Demonstration projects, in this context, push the envelope about what is known about effectiveness in novel settings, and turnover of staff and patient populations can present challenges to gathering optimal data. By using P-PE, we built capacity in the environment while expanding possibilities for data collection. Suggestions are made based on our experience. PMID:24860251

  8. An Analysis of Disability, Academic Performance, and Seeking Support in One University Setting

    ERIC Educational Resources Information Center

    Dong, Shengli; Lucas, Margaretha S.

    2016-01-01

    This study focused on the academic performance and use of disability support services (DSS) of students with different types of disabilities who attend a postsecondary education institution. Findings show different patterns of academic success over four semesters as well as different patterns of DSS usage. Students who requested support from DSS…

  9. The Study of the Optimal Parameter Settings in a Hospital Supply Chain System in Taiwan

    PubMed Central

    Liao, Hung-Chang; Chen, Meng-Hao; Wang, Ya-huei

    2014-01-01

    This study proposed the optimal parameter settings for the hospital supply chain system (HSCS) when either the total system cost (TSC) or patient safety level (PSL) (or both simultaneously) was considered as the measure of the HSCS's performance. Four parameters were considered in the HSCS: safety stock, maximum inventory level, transportation capacity, and the reliability of the HSCS. A full-factor experimental design was used to simulate an HSCS for the purpose of collecting data. The response surface method (RSM) was used to construct the regression model, and a genetic algorithm (GA) was applied to obtain the optimal parameter settings for the HSCS. The results show that the best method of obtaining the optimal parameter settings for the HSCS is the simultaneous consideration of both the TSC and the PSL to measure performance. Also, the results of sensitivity analysis based on the optimal parameter settings were used to derive adjustable strategies for the decision-makers. PMID:25250397

  10. The Effect of Availability of Manpower on Trauma Resuscitation Times in a Tertiary Academic Hospital

    PubMed Central

    Quek, Nathaniel Xin Ern; Koh, Zhi Xiong; Nadkarni, Nivedita; Singaram, Kanageswari; Ho, Andrew Fu Wah; Ong, Marcus Eng Hock

    2016-01-01

    Background For trauma patients, delays to assessment, resuscitation, and definitive care affect outcomes. We studied the effects of resuscitation area occupancy and trauma team size on trauma team resuscitation speed in an observational study at a tertiary academic institution in Singapore. Methods From January 2014 to January 2015, resuscitation videos of trauma team activated patients with an Injury Severity Score of 9 or more were extracted for review within 14 days by independent reviewers. Exclusion criteria were patients dead on arrival, inter-hospital transfers, and up-triaged patients. Data captured included manpower availability (trauma team size and resuscitation area occupancy), assessment (airway, breathing, circulation, logroll), interventions (vascular access, imaging), and process-of-care time intervals (time to assessment/intervention/adjuncts, time to imaging, and total time in the emergency department). Clinical data were obtained by chart review and from the trauma registry. Results Videos of 70 patients were reviewed over a 13-month period. The median time spent in the emergency department was 154.9 minutes (IQR 130.7–207.5) and the median resuscitation team size was 7, with larger team sizes correlating with faster process-of-care time intervals: time to airway assessment (p = 0.08) and time to disposition (p = 0.04). The mean resuscitation area occupancy rate (RAOR) was 1.89±2.49, and the RAOR was positively correlated with time spent in the emergency department (p = 0.009). Conclusion Our results suggest that adequate staffing for trauma teams and resuscitation room occupancy are correlated with faster trauma resuscitation and reduced time spent in the emergency department. PMID:27136299

  11. Invited Commentary on Wallace and Beange (2008): "On the Need for a Specialist Service within the Generic Hospital Setting"

    ERIC Educational Resources Information Center

    O'Hara, David

    2008-01-01

    In this article, the author comments on the paper "On the need for a specialist service within the generic hospital setting" (Wallace & Beange, 2008), which raises critical issues regarding effective models of healthcare delivery for individuals with intellectual disability (ID), particularly within a hospital setting (but not…

  12. Comparing Academic Library Spending with Public Libraries, Public K-12 Schools, Higher Education Public Institutions, and Public Hospitals between 1998-2008

    ERIC Educational Resources Information Center

    Regazzi, John J.

    2012-01-01

    This study compares the overall spending trends and patterns of growth of Academic Libraries with Public Libraries, K-12 schools, higher education institutions, and hospitals in the period of 1998 to 2008. Academic Libraries, while showing a growth of 13% over inflation for the period, far underperformed the growth of the other public institutions…

  13. Setting healthcare priorities: a description and evaluation of the budgeting and planning process in county hospitals in Kenya.

    PubMed

    Barasa, Edwine W; Cleary, Susan; Molyneux, Sassy; English, Mike

    2017-04-01

    This paper describes and evaluates the budgeting and planning processes in public hospitals in Kenya. We used a qualitative case study approach to examine these processes in two hospitals in Kenya. We collected data by in-depth interviews of national level policy makers, hospital managers, and frontline practitioners in the case study hospitals (n = 72), a review of documents, and non-participant observations within the hospitals over a 7 month period. We applied an evaluative framework that considers both consequentialist and proceduralist conditions as important to the quality of priority-setting processes. The budgeting and planning process in the case study hospitals was characterized by lack of alignment, inadequate role clarity and the use of informal priority-setting criteria. With regard to consequentialist conditions, the hospitals incorporated economic criteria by considering the affordability of alternatives, but rarely considered the equity of allocative decisions. In the first hospital, stakeholders were aware of - and somewhat satisfied with - the budgeting and planning process, while in the second hospital they were not. Decision making in both hospitals did not result in reallocation of resources. With regard to proceduralist conditions, the budgeting and planning process in the first hospital was more inclusive and transparent, with the stakeholders more empowered compared to the second hospital. In both hospitals, decisions were not based on evidence, implementation of decisions was poor and the community was not included. There were no mechanisms for appeals or to ensure that the proceduralist conditions were met in both hospitals. Public hospitals in Kenya could improve their budgeting and planning processes by harmonizing these processes, improving role clarity, using explicit priority-setting criteria, and by incorporating both consequentialist (efficiency, equity, stakeholder satisfaction and understanding, shifted priorities

  14. Setting healthcare priorities: a description and evaluation of the budgeting and planning process in county hospitals in Kenya

    PubMed Central

    Barasa, Edwine W.; Cleary, Susan; Molyneux, Sassy; English, Mike

    2016-01-01

    This paper describes and evaluates the budgeting and planning processes in public hospitals in Kenya. We used a qualitative case study approach to examine these processes in two hospitals in Kenya. We collected data by in-depth interviews of national level policy makers, hospital managers, and frontline practitioners in the case study hospitals (n = 72), a review of documents, and non-participant observations within the hospitals over a 7 month period. We applied an evaluative framework that considers both consequentialist and proceduralist conditions as important to the quality of priority-setting processes. The budgeting and planning process in the case study hospitals was characterized by lack of alignment, inadequate role clarity and the use of informal priority-setting criteria. With regard to consequentialist conditions, the hospitals incorporated economic criteria by considering the affordability of alternatives, but rarely considered the equity of allocative decisions. In the first hospital, stakeholders were aware of - and somewhat satisfied with - the budgeting and planning process, while in the second hospital they were not. Decision making in both hospitals did not result in reallocation of resources. With regard to proceduralist conditions, the budgeting and planning process in the first hospital was more inclusive and transparent, with the stakeholders more empowered compared to the second hospital. In both hospitals, decisions were not based on evidence, implementation of decisions was poor and the community was not included. There were no mechanisms for appeals or to ensure that the proceduralist conditions were met in both hospitals. Public hospitals in Kenya could improve their budgeting and planning processes by harmonizing these processes, improving role clarity, using explicit priority-setting criteria, and by incorporating both consequentialist (efficiency, equity, stakeholder satisfaction and understanding, shifted priorities, implementation

  15. Setting up robotic surgery in gynaecology: the experience of the Strasbourg teaching hospital.

    PubMed

    Sananès, N; Garbin, O; Hummel, M; Youssef, C; Vizitiu, R; Lemaho, D; Rottenberg, D; Diemunsch, P; Wattiez, A

    2011-06-01

    Teleoperated surgical robots could provide a genuine breakthrough in laparoscopy and it is for this reason that the development of robot-assisted laparoscopy is one of the priorities of the Strasbourg University Hospitals' strategic plan. The hospitals purchased a da Vinci S(®) robot in June 2006 and Strasbourg has, in IRCAD, one of the few robotic surgery training centres in the world. Our experience has, however, revealed the difficulties involved in setting up robotic surgery, the first of which are organizational issues. This prospective work was carried out between December 2007 and September 2008, primarily to examine the possibility of setting up robotic surgery on a regular basis for gynaecological surgical procedures at the Strasbourg University Hospitals. We maintained a "logbook" in which we prospectively noted all the resources implemented in setting up the robotic surgery service. The project was divided into two phases: the preparatory phase up until the first hysterectomy and then the second phase with the organization of subsequent hysterectomies. The first surgical procedure took 5 months to organize, and followed 25 interviews, 10 meetings, 53 telephone conversations and 48 e-mails with a total of 40 correspondents. The project was presented to seven separate groups, including the hospital medical commission, the gynaecology unit committee and the surgical staff. Fifteen members of the medical and paramedical team attended a two-day training course. Preparing the gynaecology department for robotic surgery required freeing up 8.5 days of "physician time" and 12.5 days of "nurse time". In the following five months, we performed five hysterectomies. Preparation for each procedure involved on average 5 interviews, 19 telephone conversations and 11 e-mails. The biggest obstacle was obtaining an operating slot, as on average it required 18 days, four telephone calls and four e-mails to be assigned a slot in the operating theatre schedule, which is

  16. Establishing a Personal Health Record System in an Academic Hospital: One Year's Experience

    PubMed Central

    Ro, Hyun Jung; Jung, Se Young; Hwang, Hee; Yoo, Sooyoung; Baek, Hyunyoung; Lee, Kiheon; Bae, Woo Kyung; Han, Jong-Soo; Kim, Sarah; Park, Hwayeon

    2015-01-01

    Background Personal health records (PHRs) are web based tools that help people to access and manage their personalized medical information. Although needs for PHR are increasing, current serviced PHRs are unsatisfactory and researches on them remain limited. The purpose of this study is to show the process of developing Seoul National University Bundang Hospital (SNUBH)'s own PHR system and to analyze consumer's use pattern after providing PHR service. Methods Task force team was organized to decide service range and set the program. They made the system available on both mobile application and internet web page. The study enrolled PHR consumers who assessed PHR system between June 2013 and June 2014. We analyzed the total number of users on a monthly basis and the using pattern according to each component. Results The PHR service named Health4U has been provided from June 2013. Every patient who visited SNUBH could register Health4U service and view their medical data. The PHR user has been increasing, especially they tend to approach via one way of either web page or mobile application. The most frequently used service is to check laboratory test result. Conclusion For paradigm shift toward patient-centered care, there is a growing interest in PHR. This study about experience of establishing and servicing the Health4U would contribute to development of interconnected PHR. PMID:26019761

  17. [Spiritual care in hospitals and other healthcare settings in Israel--a profession in the making].

    PubMed

    Bar-Sela, Gil; Bentur, Netta; Schultz, Michael; Corn, Benjamin W

    2014-05-01

    Faced with a serious, incurable illness, disability, and other symptoms, both physical and mental, some patients find themselves wondering about the meaning of their Lives. They need the help of a professional who can perceive their mental turmoil and identify their spiritual needs, and who knows how to help them find meaning in their uncertain state. Spiritual care providers are professionals whose role it is to provide patients with support in their hour of need, to help them preserve their identity in life-threatening situations, and to help them re-endow their world with meaning, employing a special language and set of tools that enable patients to get in touch with their spiritual resources and internal powers of healing. Spiritual care providers serve on the medical staff in Western countries. In the United States, some 2,600 are employed in general hospitals, psychiatric hospitals, long-term care facilities, and palliative care units. Approximately ten years ago, the profession began developing in Israel. Today, dozens of spiritual care providers are now working in the healthcare system. There is a spiritual care network with 21 member organizations. Although the profession is laying down roots in the healthcare system in this country, it is still in its infancy and has to contend with substantial barriers and challenges, including professional recognition, creating positions, and identifying sources of funding for positions. The profession still has much room to grow as it is further incorporated into the healthcare system and continues undergoing adaptation to the Israeli cultural setting.

  18. Asenapine augmentation and treatment-resistant schizophrenia in the high-secure hospital setting

    PubMed Central

    Durge, Vijay; Sengupta, Samrat; Das, Mrigendra

    2014-01-01

    Introduction: Asenapine is a novel, recently introduced antipsychotic drug. It has a unique receptor profile and it is licensed in the UK for the treatment of bipolar-affective disorder. However, there is some evidence for its effectiveness in schizophrenia and it is licensed for schizophrenia treatment in a number of countries. Significant numbers of patients within the high-secure hospital setting suffer from treatment-resistant schizophrenia. Many patients fail to respond to adequate antipsychotic trials, and require trials of augmentation with other medications. Methods: We report on our experience of using asenapine for augmentation of other antipsychotic medications in two male patients with treatment-resistant schizophrenia and histories of interpersonal violence. The patients provided informed consent to participate in this case series. Data were collected from the patients’ clinical records, incident reports and hospital medical centre records. These records were used to derive primary and secondary outcome measures. These included time spent in seclusion, verbal and physical aggression, numbers of incidents and metabolic parameters. Symptoms were rated pre- and postaugmentation using the Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression rating scales. Results: Both patients showed an improvement after the addition of asenapine. These improvements were characterized by a reduction in global PANSS scores, in the PANSS excitability component, a reduction in scores of violence, overall incidents and reduction in seclusion hours. Conclusions: We found asenapine to be an effective augmentation agent with other antipsychotics in both patients. Clinical improvement was noted within weeks. The case-series nature and small sample size limited our ability to draw firm conclusions from our data. However, retrospective analysis has allowed us to take a naturalistic approach that this augmentation strategy may be advantageous on an

  19. Building Community in Academic Settings: The Importance of Flexibility in a Structured Mentoring Program

    ERIC Educational Resources Information Center

    Ewing, Robyn; Freeman, Mark; Barrie, Simon; Bell, Amani; O'Connor, Donna; Waugh, Fran; Sykes, Chris

    2008-01-01

    Academic mentoring is increasingly being used by many universities as a tool to enhance the quality of research-led teaching, promote cross-faculty collaboration and encourage a mentoring culture and community. This article reports on a pilot project established to investigate the benefits of building flexibility into a structured academic…

  20. Ethical Issues of ICT Use by Teacher Trainers: Use of E-Books in Academic Settings

    ERIC Educational Resources Information Center

    Kilickaya, Ferit; Krajka, Jaroslaw

    2015-01-01

    In an attempt to address the issue of ethics in ICT use by university teacher trainers, the current study aimed to investigate academics' downloading and sharing e-books as well as the reasons that led them to be involved in this piracy. The participants included 140 teacher trainers working at faculties of education in Turkey, and a questionnaire…

  1. Collaborative Academic Training of Psychiatrists and Psychologists in VA and Medical School Settings

    ERIC Educational Resources Information Center

    Scaturo, Douglas J.; Huszonek, John J.

    2009-01-01

    Objective: The authors review the background and contemporary strengths of Dean's Committee Veterans Affairs Medical Centers in the collaborative academic training of psychiatrists and psychologists. Methods: The authors discuss the problems and prospects of the current health care environment as it impacts the behavioral health treatment of…

  2. Academic Learning Time (ALT-PE) in a Traditional Elementary Physical Education Setting: A Descriptive Analysis.

    ERIC Educational Resources Information Center

    Placek, Judith; And Others

    1982-01-01

    A study analyzed an elementary school physical educator's interactions with students, using the Academic Learning Time-Physical Education instrument. Data were collected to show differences in learning opportunities: (1) for girls and boys; (2) for high, medium, and low ability students; and (3) in different instructional units. (Author/PP)

  3. Using Student Health Data to Understand and Promote Academic Success in Higher Education Settings

    ERIC Educational Resources Information Center

    Larson, Mary; Orr, Megan; Warne, Donald

    2016-01-01

    The Problem: Institutions of higher education are interested in students' academic success as measured by GPA. Health is related to GPA and many institutions collect health data; however, this data is underutilized. This study used several health-related variables to examine relationships between health and GPA. Method: This study utilized a…

  4. Social Coping among Academically Gifted Adolescents in a Residential Setting: A Longitudinal Study

    ERIC Educational Resources Information Center

    Cross, Tracy L.; Swiatek, Mary Ann

    2009-01-01

    Much of the research on the social coping of students with gifts and talents has relied on a single administration of an instrument while the participants were attending a summer program. This study attempts to understand how attendance at a residential high school (academy) may affect academically gifted students over time. Students in two…

  5. An Evidence-Based Practice Model across the Academic and Clinical Settings

    ERIC Educational Resources Information Center

    Wolter, Julie A.; Corbin-Lewis, Kim; Self, Trisha; Elsweiler, Anne

    2011-01-01

    This tutorial is designed to provide academic communication sciences and disorders (CSD) programs, at both the undergraduate and graduate levels, with a comprehensive instructional model on evidence-based practice (EBP). The model was designed to help students view EBP as an ongoing process needed in all clinical decision making. The three facets…

  6. The Impact of Academic Accommodations on Final Grades in a Postsecondary Setting.

    ERIC Educational Resources Information Center

    Trammell, Jack K.

    2003-01-01

    Determines whether postsecondary students with learning disabilities (LD) and/or Attention Deficit Disorder (ADD) experienced a differential increase in end-of-term grades when they used academic accommodations required by the Americans with Disabilities Act, with verbal Scholastic Aptitude Test (SAT) scores serving as a baseline predictor.…

  7. Subject Liaisons in Academic Libraries: An Open Access Data Set from 2015

    ERIC Educational Resources Information Center

    Nero, Neil; Langley, Anne

    2017-01-01

    The work of subject liaison librarians in academic libraries has morphed to include a variety of roles that reach beyond the traditional. This study captures responses of 1,808 participants from land-grant, Oberlin Group, and Association of Research Libraries (ARL) institutions to a questionnaire about subject liaison librarians. The questionnaire…

  8. Changing Environment and the Academic Medical Center: The Johns Hopkins Hospital.

    ERIC Educational Resources Information Center

    Heyssel, Robert M.

    1989-01-01

    Johns Hopkins Hospital expanded its health care delivery capabilities and strengthened its position in the marketplace by acquisitions of and mergers with other hospitals and a health maintenance organization. The resulting conglomerate has achieved its goals of expanding patient care, broadening the patient base, and enlarging the asset base and…

  9. Clothing norms as markers of status in a hospital setting: A Bourdieusian analysis.

    PubMed

    Jenkins, Tania M

    2014-09-01

    This article uses a Bourdieusian framework to understand the importance of clothing norms for symbolizing and reproducing social, as well as professional, hierarchy in hospitals. Using data from participant observation, it examines how a complex yet informal dress code has emerged at a community hospital in the Northeastern United States, in a setting where very few formal guidelines exist on how to dress. By conceptualizing professionals as holders of various types of capital (economic, cultural, and symbolic), this article expands previous research which considered clothing only as a marker of professional identity. The findings demonstrate (1) how clothing norms are used in subtle, but purposeful, ways to reflect varying degrees of cultural and economic capital and (2) how these complex norms also reflect professional boundaries in medical authority (symbolic capital), which is important during critical moments where clothing can quickly signal who can take control. The discussion borrows Bourdieu's concepts of habitus and field to explain why subordinates subscribe to these clothing norms, in the absence of a formal organizational dress code.

  10. Use of sterile pre-fabricated antibiotic beads in the combat hospital setting.

    PubMed

    Gordon, Wade T; Petrides, Michael G; Gunn, Philip A; Howard, Michael

    2013-03-01

    Time and manpower constraints associated with acute combat casualty care can make antibiotic bead production at the point of care prohibitively difficult, if not impossible. The purpose of this study is to evaluate our technique for the sterile prefabrication of antibiotic-impregnated polymethylmethacrylate (PMMA) beads in the combat hospital environment by assessing their sterility at the time of use. This investigation is a prospective study of a consecutive series of specimens. Imipenem-impregnated antibiotic beads were sterilely prepared, threaded on a suture strand, and packaged. Over a 6-week period, 50 consecutive packages were evaluated for sterility with aerobic and anaerobic culture swabs performed at the time of opening. Culture results, as well as number of shelf days for each specimen, were then reviewed. Of the 50 packages of antibiotic-impregnated PMMA beads, the average number of days on the shelf before use was 9.3 (range: 2-17). None of the packages showed growth of organisms from the cultures, indicating that antibiotic-impregnated PMMA beads can be sterilely produced and maintained in their sterile state for future use in the combat hospital environment. This practice should be considered a safe adjunct in the management of contaminated, open traumatic injuries in this setting.

  11. [Nursing students' perception of the learning process in a hospital setting].

    PubMed

    Alves, Elcilene Andreíne Terra Durgante; Cogo, Ana Luísa Petersen

    2014-03-01

    The aim of this study was to identijf how nursing students perceive and experience the learning process during curricular practice in a hospital setting. A qualitative, retrospective, documentary study was developed in an undergraduate nursing course. Data were comprised of 162 posts made by 34 students in the online discussion forum of the Learning Management System Moodle, during the first half of 2011. The following themes emergedfrom t he thematic content analysis: "nursing students' understanding about the professional practice," and "the teaching and learning process in the perspective of nursing students." The study demonstrated that the forum was a place for reporting experiences such as the description of the physical area, performing procedures, perception of nursing care activities, conJlicts with peers, coping with death and learning evaluation. The online discussion forum needs to be used by professors as a space of interaction so as to contribute to professional training.

  12. POST DISCHARGE DROPOUT OF ALCOHOLICS - A NATURALISTIC STUDY IN A GENERAL HOSPITAL SETTING

    PubMed Central

    Sengupta, Somnath; Kar, N.; Sharma, P.S.V.N.; Rao, Gaunasagari

    2001-01-01

    In a naturalistic longitudinal design 133 consecutive inpatients with alcohol dependence syndrome were followed up for one year following discharge from the hospital. 59 patients (group 1) paid follow up visit at regular intervals whereas 28 subjects (group 2)never returned despite three consecutive postal intimations. Rest of the patient were irregular in follow up. The individuals in group 1 were compared with those in group 2 on various sociodemographic and clinical variables with the aim of delineating the characteristics that could define the alcoholics who dropped out following discharge. It was found that such patient were relatively younger with lower level of education, less frequently married, had earlier onset of problem drinking with poor social support and higher rates of mental problems. It was concluded that post discharge attrition of alcoholics could be a social as well as a clinical problem in any setting rendering long treatment for alcoholism. PMID:21407859

  13. Temporal trends for pregnancy length in a hospital setting of Southern Spain.

    PubMed

    González-Mesa, Ernesto; Villegas, Emilia

    2017-01-01

    For centuries it has been considered that the due date for delivery in our species is 280 days after the onset of the last menstruation. However, in most cases this statement is not accurate. The main objective of this study was to determine the mean duration of pregnancy in our setting and whether it has experienced changes in recent years. A retrospective, population-based descriptive study was made of 102,169 deliveries assisted in Malaga University Hospital (Malaga, Andalusia, Spain) during the period 1998-2015. The mean gestational age at delivery was 269 days (SD 16 days), with a modal gestational age of 273 days. The mean duration of the singleton and multiple pregnancies was 271 days (SD 17 days) and 242 days (SD 20 days), respectively. A significant shortening of the duration of pregnancy was observed in the course of the study period.

  14. Clinical Setting Influences Off-Label and Unlicensed Prescribing in a Paediatric Teaching Hospital

    PubMed Central

    Czarniak, Petra; Bint, Lewis; Favié, Laurent; Parsons, Richard; Hughes, Jeff; Sunderland, Bruce

    2015-01-01

    Purpose To estimate the prevalence of off-label and unlicensed prescribing during 2008 at a major paediatric teaching hospital in Western Australia. Methods A 12-month retrospective study was conducted at Princess Margaret Hospital using medication chart records randomly selected from 145,550 patient encounters from the Emergency Department, Inpatient Wards and Outpatient Clinics. Patient and prescribing data were collected. Drugs were classified as off-label or unlicensed based on Australian registration data. A hierarchical system of age, indication, route of administration and dosage was used. Drugs were classified according to the Anatomical Therapeutic Chemical Code. Results A total of 1,037 paediatric patients were selected where 2,654 prescriptions for 330 different drugs were prescribed to 699 patients (67.4%). Most off-label drugs (n = 295; 43.3%) were from the nervous system; a majority of unlicensed drugs were systemic hormonal preparations excluding sex hormones (n = 22, 32.4%). Inpatients were prescribed more off-label drugs than outpatients or Emergency Department patients (p < 0.0001). Most off-label prescribing occurred in infants and children (31.7% and 35.9% respectively) and the highest percentage of unlicensed prescribing (7.2%) occurred in infants (p < 0.0001). There were 25.7% of off-label and 2.6% of unlicensed medications prescribed across all three settings. Common reasons for off-label prescribing were dosage (47.4%) and age (43.2%). Conclusion This study confirmed off-label and unlicensed use of drugs remains common. Further, that prevalence of both is influenced by the clinical setting, which has implications in regards to medication misadventure, and the need to have systems in place to minimise medication errors. Further, there remains a need for changes in the regulatory system in Australia to ensure that manufacturers incorporate, as it becomes available, evidence regarding efficacy and safety of their drugs in children in the

  15. Effectiveness of an educational video in improving oral health knowledge in a hospital setting

    PubMed Central

    Shah, Naseem; Mathur, Vijay Prakash; Kathuria, Vartika; Gupta, Tanupriya

    2016-01-01

    Introduction: Prevention of oral diseases can be achieved by preventive measures. There is an educational component associated to the preventive aspect. Health education is a cornerstone to the success of a preventive programme. Health education has always been regarded as a primary tool in imparting awareness, bringing changes in healthy behaviors and improved life. Aim: To assess the effectiveness of an Educational Video in improving oral health knowledge of subjects in a hospital setting. Methodology: The study was conducted in Outpatient Department, CDER, AIIMS. This was a cross sectional interventional study. In the present study a total of 109 subjects were considered those who completed pre and post intervention questionnaire. In order to assess baseline oral health knowledge, a-14 itemed questionnaire was specially designed, based on the contents of video and was pre-tested on 10 patients. Pre-intervention knowledge was assessed and then the 30-minute video was shown. Following this, post-exposure knowledge was assessed using the same questionnaire. Change in the knowledge score amongst the subjects was assessed pre and post-intervention (showing the video film). Results: Paired t- test was used to analyze the data. Pre-intervention mean knowledge score was 9.49±2.09 which increased to 11.55±1.60 post-intervention; the difference was statistically significant (P < 0.001). Conclusions: It was found that increase in knowledge score was statistically significant after exposure to an educational video film in a hospital setting. Incorporation of video in imparting oral health education can be an effective tool in improving oral health knowledge, which can impact the oral health behavior of people and community. PMID:27433049

  16. Evaluation of Dabigatran for Appropriateness of Use and Bleeding Events in a Community Hospital Setting

    PubMed Central

    Armbruster, Anastasia L.; Buehler, Katie S.; Min, Sun H.; Riley, Margaret; Daly, Michael W.

    2014-01-01

    Background Warfarin has been the predominant anticoagulant for the prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation (NVAF). Its disadvantages are well-known and include a narrow therapeutic index, drug interactions, and the need for frequent monitoring. Dabigatran etexilate, a direct thrombin inhibitor, presents less complexity in prescribing and has emerged as an alternate therapy to warfarin. Although dabigatran does not require routine monitoring, concerns associated with its use include the lack of a reversal agent, complex dose adjustments, and limited guidance to the management of drug interactions. Objectives The goals of this study are to describe and to evaluate the use of dabigatran at a community hospital to identify areas for improvement in its prescribing. Methods This retrospective chart review of patients at a community hospital in St Louis, MO, included patients who received at least 1 dose of dabigatran between December 2010 and June 2012. The appropriateness of dabigatran was evaluated based on recommendations approved by the US Food and Drug Administration for stroke prophylaxis in the setting of NVAF. The composite end point of bleeding included hospital readmission within 1 year of receiving at least 1 dose of dabigatran at the study institution secondary to bleeding, bleeding associated with a decrease in hemoglobin level by ≥2 g/dL or transfusion of ≥2 units of blood, or a notation of bleeding in the patient's medical record. Results Of the 458 patients included in the evaluation, 76 (16.6%) patients receiving dabigatran were using an inappropriate regimen of this drug, based on dose and frequency on the first day of therapy of dabigatran or the presence of valvular disease. Many patients (42.3%) received at least 1 dose of a concomitant parenteral anticoagulant. The composite end point for bleeding was reported in 66 (14.4%) patients, including 23 (5%) with confirmed gastrointestinal bleeding

  17. A rural cancer outreach program lowers patient care costs and benefits both the rural hospitals and sponsoring academic medical center.

    PubMed

    Desch, C E; Grasso, M A; McCue, M J; Buonaiuto, D; Grasso, K; Johantgen, M K; Shaw, J E; Smith, T J

    1999-01-01

    The Rural Cancer Outreach Program (RCOP) between two rural hospitals and the Medical College of Virginia's Massey Cancer Center (MCC) was developed to bring state-of-the-art cancer care to medically underserved rural patients. The financial impact of the RCOP on both the rural hospitals and the MCC was analyzed. Pre- and post-RCOP financial data were collected on 1,745 cancer patients treated at the participating centers, two rural community hospitals and the MCC. The main outcome measures were costs (estimated reimbursement from all sources), revenues, contribution margins and profit (or loss) of the program. The RCOP may have enhanced access to cancer care for rural patients at less cost to society. The net annual cost per patient fell from $10,233 to $3,862 associated with more use of outpatient services, more efficient use of resources, and the shift to a less expensive locus of care. The cost for each rural patient admitted to the Medical College of Virginia fell by more than 40 percent compared with only an 8 percent decrease for all other cancer patients. The rural hospitals experienced rapid growth of their programs to more than 200 new patients yearly, and the RCOP generated significant profits for them. MCC benefited from increased referrals from RCOP service areas by 330 percent for cancer patients and by 9 percent for non-cancer patients during the same time period. While it did not generate a major profit for the MCC, the RCOP generated enough revenue to cover costs of the program. The RCOP had a positive financial impact on the rural and academic medical center hospitals, provided state-of-the-art care near home for rural patients and was associated with lower overall cancer treatment costs.

  18. How will restructuring work in your hospital? The helps and hinderances of a large academic environment.

    PubMed

    Galloway, M G

    1994-01-01

    In summary, academic medical centers face the same issues as their less complex brethren. Sure there are some "downs." The high expectations that the staff bring to their jobs can decrease flexibility in role design, and the increased need to keep professionals together can make the organizational matrix more complex. But there are also some "ups." In many ways their size and specialty focus can help with the difficult decisions in the areas of patient grouping and service delivery approach. Taking advantage of the positives and working to minimize the effect of the negatives can allow even the most complex organization to restructure successfully. Academic medical centers may not be "just right" for restructuring, but they are definitely not "too big."

  19. Nursing, Pharmacy, and Prescriber Knowledge and Perceptions of High-Alert Medications in a Large, Academic Medical Hospital

    PubMed Central

    Engels, Melanie J.

    2015-01-01

    Background: High-alert medications pose a greater risk of causing significant harm to patients if used in error. The Joint Commission requires that hospitals define institution-specific high-alert medications and implement processes to ensure safe medication use. Method: Nursing, pharmacy, and prescribers were asked to voluntarily complete a 34-question survey to assess their knowledge, experience, and perceptions regarding high-alert medications in an academic hospital. Results: The majority of respondents identified the organization’s high-alert medications, the consequences of an error involving a high-alert medication, and the reversal agent. Most of the risk-reduction strategies within the institution were viewed as being effective by respondents. Forty-five percent of the respondents utilized a high-alert medication in the previous 24 hours. Only 14.2% had experienced an error with a high-alert medication in the previous 12 months, with 46% being near misses. The survey found the 5 rights for medication administration were not being utilized consistently. Respondents indicated that work experience or hospital orientation is the preferred learning experience for high-alert medications. Conclusions: This study assessed all disciplines involved in the medication use process. Perceptions about high-alert medications differ between disciplines. Ongoing discipline-specific education is required to ensure that individuals accept accountability in the medication use process and to close knowledge gaps on high-alert medications and risk-reduction strategies. PMID:26446747

  20. Feasibility of Delivering a Dance Intervention for SubAcute Stroke in a Rehabilitation Hospital Setting

    PubMed Central

    Demers, Marika; McKinley, Patricia

    2015-01-01

    Dance can be a promising treatment intervention used in rehabilitation for individuals with disabilities to address physical, cognitive and psychological impairments. The aim of this pilot study was to determine the feasibility of a modified dance intervention as an adjunct therapy designed for people with subacute stroke, in a rehabilitation setting. Using a descriptive qualitative study design, a biweekly 45-min dance intervention was offered to individuals with a subacute stroke followed in a rehabilitation hospital, over 4 weeks. The dance intervention followed the structure of an usual dance class, but the exercises were modified and progressed to meet each individual’s needs. The dance intervention, delivered in a group format, was feasible in a rehabilitation setting. A 45-min dance class of moderate intensity was of appropriate duration and intensity for individuals with subacute stroke to avoid excessive fatigue and to deliver the appropriate level of challenge. The overall satisfaction of the participants towards the dance class, the availability of space and equipment, and the low level of risks contributed to the feasibility of a dance intervention designed for individuals in the subacute stage of post-stroke recovery. PMID:25785497

  1. Health care setting and severity, symptom burden, and complications in patients with Philadelphia-negative myeloproliferative neoplasms (MPN): a comparison between university hospitals, community hospitals, and office-based physicians.

    PubMed

    Kaifie, A; Isfort, S; Gattermann, N; Hollburg, W; Klausmann, M; Wolf, D; Maintz, C; Hänel, M; Goekkurt, E; Göthert, J R; Platzbecker, U; Geer, T; Parmentier, S; Jost, E; Serve, H; Ehninger, G; Berdel, W E; Brümmendorf, T H; Koschmieder, Steffen

    2016-09-01

    Philadelphia-negative myeloproliferative neoplasms (MPN) comprise a heterogeneous group of chronic hematological malignancies with significant variations in clinical characteristics. Due to the long survival and the feasibility of oral or subcutaneous therapy, these patients are frequently treated outside of larger academic centers. This analysis was performed to elucidate differences in MPN patients in three different health care settings: university hospitals (UH), community hospitals (CH), and office-based physicians (OBP). The MPN registry of the Study Alliance Leukemia is a non-interventional prospective study including adult patients with an MPN according to WHO criteria (2008). For statistical analysis, descriptive methods and tests for significant differences were used. Besides a different distribution of MPN subtypes between the settings, patients contributed by UH showed an impaired medical condition, a higher comorbidity burden, and more vascular complications. In the risk group analyses, the majority of polycythemia vera (PV) and essential thrombocythemia (ET) patients from UH were classified into the high-risk category due to previous vascular events, while for PV and ET patients in the CH and OBP settings, age was the major parameter for a high-risk categorization. Regarding MPN-directed therapy, PV patients from the UH setting were more likely to receive ruxolitinib within the framework of a clinical trial. In summary, the characteristics and management of patients differed significantly between the three health care settings with a higher burden of vascular events and comorbidities in patients contributed by UH. These differences need to be taken into account for further analyses and design of clinical trials.

  2. Efficacy of Infection Control Interventions in Reducing the Spread of Multidrug-Resistant Organisms in the Hospital Setting

    PubMed Central

    D'Agata, Erika M. C.; Horn, Mary Ann; Ruan, Shigui; Webb, Glenn F.; Wares, Joanna R.

    2012-01-01

    Multidrug-resistant organisms (MDRO) continue to spread in hospitals globally, but the population-level impact of recommended preventive strategies and the relative benefit of individual strategies targeting all MDRO in the hospital setting are unclear. To explore the dynamics of MDRO transmission in the hospital, we develop a model extending data from clinical individual-level studies to quantify the impact of hand hygiene, contact precautions, reducing antimicrobial exposure and screening surveillance cultures in decreasing the prevalence of MDRO colonization and infection. The effect of an ongoing increase in the influx of patients colonized with MDRO into the hospital setting is also quantified. We find that most recommended strategies have substantial effect in decreasing the prevalence of MDRO over time. However, screening for asymptomatic MDRO colonization among patients who are not receiving antimicrobials is of minimal value in reducing the spread of MDRO. PMID:22363420

  3. Adaption and validation of the Safety Attitudes Questionnaire for the Danish hospital setting

    PubMed Central

    Kristensen, Solvejg; Sabroe, Svend; Bartels, Paul; Mainz, Jan; Christensen, Karl Bang

    2015-01-01

    Purpose Measuring and developing a safe culture in health care is a focus point in creating highly reliable organizations being successful in avoiding patient safety incidents where these could normally be expected. Questionnaires can be used to capture a snapshot of an employee’s perceptions of patient safety culture. A commonly used instrument to measure safety climate is the Safety Attitudes Questionnaire (SAQ). The purpose of this study was to adapt the SAQ for use in Danish hospitals, assess its construct validity and reliability, and present benchmark data. Materials and methods The SAQ was translated and adapted for the Danish setting (SAQ-DK). The SAQ-DK was distributed to 1,263 staff members from 31 in- and outpatient units (clinical areas) across five somatic and one psychiatric hospitals through meeting administration, hand delivery, and mailing. Construct validity and reliability were tested in a cross-sectional study. Goodness-of-fit indices from confirmatory factor analysis were reported along with inter-item correlations, Cronbach’s alpha (α), and item and subscale scores. Results Participation was 73.2% (N=925) of invited health care workers. Goodness-of-fit indices from the confirmatory factor analysis showed: c2=1496.76, P<0.001, CFI 0.901, RMSEA (90% CI) 0.053 (0.050–0056), Probability RMSEA (p close)=0.057. Inter-scale correlations between the factors showed moderate-to-high correlations. The scale stress recognition had significant negative correlations with each of the other scales. Questionnaire reliability was high, (α=0.89), and scale reliability ranged from α=0.70 to α=0.86 for the six scales. Proportions of participants with a positive attitude to each of the six SAQ scales did not differ between the somatic and psychiatric health care staff. Substantial variability at the unit level in all six scale mean scores was found within the somatic and the psychiatric samples. Conclusion SAQ-DK showed good construct validity and

  4. Students' Individual and Collective Efficacy: Joining Together Two Sets of Beliefs for Understanding Academic Achievement

    ERIC Educational Resources Information Center

    Pina-Neves, Silvia; Faria, Luisa; Raty, Hannu

    2013-01-01

    In this paper, we assume that students' achievement is influenced not only by a set of individual appraisals such as beliefs about their personal efficacy but also by a set of more systemic factors related to beliefs about their class efficacy as a group. Literature and research review supports that students' beliefs about their efficacy, both as…

  5. Secondary school physics availability in an urban setting: Issues related to academic achievement and course offerings

    NASA Astrophysics Data System (ADS)

    Kelly, Angela M.; Sheppard, Keith

    2009-10-01

    High school physics is a gateway course for post-secondary study in science, and an essential component in the formation of students' scientific literacy. The opportunity to study physics is not universally available for children in U.S. schools, particularly in urban areas. Restricted science opportunities result in inequitable participation and a barrier to future participation in STEM-related fields. Although the national trend in physics enrollment has recently shown an increase, the percentage of participation is much lower for students in urban schools. We examined the availability of physics in New York City, and whether access was related to academic achievement measures, such as prior science performance, and graduation and college attendance percentages. High schools that offered physics were compared to those that did not, and patterns in types of available physics courses were examined. The findings substantiate the compelling need to explore the barriers to increased physics access and participation for urban youth.

  6. Assigning a team-based pager for on-call physicians reduces paging errors in a large academic hospital.

    PubMed

    Shieh, Lisa; Chi, Jeffrey; Kulik, Carol; Momeni, Arash; Shelton, Andrew; DePorte, Cynthia; Hopkins, Joseph

    2014-02-01

    As complexity of care of hospitalized patients has increased, the need for communication and collaboration among members of the team caring for the patient has become increasingly important. This often takes the form of a nurse's need to contact a patient's physician to discuss some aspect of care and modify treatment plans. Errors in communication delay care and can pose risk to patients. This report describes the successful implementation of a standardized team-based paging system at an academic center. Results showed a substantial improvement in nurses' perceptions of knowing how to contact the correct physician when discussion of the patient's care is needed. This improvement was found across multiple medical and surgical specialties and was particularly effective for services with the greatest communication problems.

  7. Triumph of hope over experience: learning from interventions to reduce avoidable hospital admissions identified through an Academic Health and Social Care Network

    PubMed Central

    2012-01-01

    Background Internationally health services are facing increasing demands due to new and more expensive health technologies and treatments, coupled with the needs of an ageing population. Reducing avoidable use of expensive secondary care services, especially high cost admissions where no procedure is carried out, has become a focus for the commissioners of healthcare. Method We set out to identify, evaluate and share learning about interventions to reduce avoidable hospital admission across a regional Academic Health and Social Care Network (AHSN). We conducted a service evaluation identifying initiatives that had taken place across the AHSN. This comprised a literature review, case studies, and two workshops. Results We identified three types of intervention: pre-hospital; within the emergency department (ED); and post-admission evaluation of appropriateness. Pre-hospital interventions included the use of predictive modelling tools (PARR – Patients at risk of readmission and ACG – Adjusted Clinical Groups) sometimes supported by community matrons or virtual wards. GP-advisers and outreach nurses were employed within the ED. The principal post-hoc interventions were the audit of records in primary care or the application of the Appropriateness Evaluation Protocol (AEP) within the admission ward. Overall there was a shortage of independent evaluation and limited evidence that each intervention had an impact on rates of admission. Conclusions Despite the frequency and cost of emergency admission there has been little independent evaluation of interventions to reduce avoidable admission. Commissioners of healthcare should consider interventions at all stages of the admission pathway, including regular audit, to ensure admission thresholds don’t change. PMID:22682525

  8. Adaptation and implementation of standardized order sets in a network of multi-hospital corporations in rural Ontario.

    PubMed

    Meleskie, Jessica; Eby, Don

    2009-01-01

    Standardized, preprinted or computer-generated physician orders are an attractive project for organizations that wish to improve the quality of patient care. The successful development and maintenance of order sets is a major undertaking. This article recounts the collaborative experience of the Grey Bruce Health Network in adapting and implementing an existing set of physician orders for use in its three hospital corporations. An Order Set Committee composed of primarily front-line staff was given authority over the order set development, approval and implementation processes. This arrangement bypassed the traditional approval process and facilitated the rapid implementation of a large number of order sets in a short time period.

  9. Prophylactic Antibiotic Management of Surgical Patients Noted as "Allergic" to Penicillin at Two Academic Hospitals.

    PubMed

    Epstein, Richard H; Jacques, Paul St; Wanderer, Jonathan P; Bombulie, Mark R; Agarwalla, Niraj

    2016-05-01

    We studied prophylactic antibiotics administered at 2 academic medical centers during a 6-year period where a cephalosporin was indicated but an "allergy" to penicillin was noted. Another drug (typically vancomycin or clindamycin) was substituted approximately 80% of the time; this occurred frequently even when symptoms unrelated to acute hypersensitivity were listed. In >50% of cases, the reaction was either omitted or vague (e.g., simply "rash"). Given the estimated 1% cross-reactivity between penicillins and cephalosporins with similar R1 side chains, many of these patients could have received either the prescribed cephalosporin or another cephalosporin with a different R1 side chain.

  10. Fecal Carriage of Staphylococcus aureus in the Hospital and Community Setting: A Systematic Review

    PubMed Central

    Claassen-Weitz, Shantelle; Shittu, Adebayo O.; Ngwarai, Michelle R.; Thabane, Lehana; Nicol, Mark P.; Kaba, Mamadou

    2016-01-01

    Background and rationale: Staphylococcus aureus fecal carriage has been identified as a potential source for nosocomial transmission and a risk factor for disease development. This systematic review determined the overall S. aureus [including methicillin susceptible and resistant S. aureus (MSSA and MRSA)] fecal carriage rates within the community and healthcare settings. Methodology: Peer-reviewed articles indexed in Medline, Scopus, Academic Search Premier, Africa-Wide Information, CINAHL, and Web of Science were identified using applicable and controlled vocabulary through to 11 November 2015. Eligible studies were ascertained by three independent reviewers. Random-effects meta-analyses of proportions were performed to determine S. aureus, MSSA and MRSA fecal carriage rates reported by eligible studies. Results: Twenty six studies were included in this review. The pooled estimates for S. aureus, MSSA and MRSA fecal carriage were 26% (95% confidence interval (CI): 16.8–36.3%), 86% (95% confidence interval (CI): 65.9–97.9%) and 10% (95% CI: 0.7–27.0%), respectively. Fecal S. aureus carriage rates increased on average from 10 to 65% during the first 8 weeks of life, followed by an average carriage rate of 64% at 6 months and 46% at 1 year of life. Genotyping techniques were employed mainly in studies conducted in developed countries and comprised largely of gel-based techniques. Six studies reported on the role of S. aureus fecal strains in diarrhea (n = 2) and the risk for acquiring infections (n = 4). Eight of the 26 studies included in this review performed antibiotic susceptibility testing of S. aureus fecal isolates. Conclusion: This study provides evidence that screening for S. aureus fecal carriage, at least in populations at high risk, could be an effective measure for the prevention of S. aureus transmission and infection in the healthcare and community setting. More well-structured studies need to be conducted and sequence-based genotyping

  11. Parental perceptions of giardiasis: a study in an outpatient paediatric hospital setting in havana, cuba.

    PubMed

    Almirall, Pedro; Escobedo, Angel A; Salazar, Yohana; Alfonso, Maydel; Avila, Ivonne; Cimerman, Sergio; Dawkins, Isabel V

    2013-01-01

    Background. Giardia lamblia is an important cause of diarrhoeal disease throughout the world. Giardiasis- a mild and self-limiting disease that this protozoan causes- is perceived as a harmful disease. Aim. To explore the general level of awareness about giardiasis, clinical features, mode of transmission, prevention, and consequences and describe the sources and channels of information caregivers would prefer using to be informed about this disease. Methods. A cross-sectional survey was conducted among caregivers attending to the outpatient paediatric hospital setting in Havana. Results. A total of 202 caregivers were interviewed. Nearly 73% considered giardiasis as a modern problem, and 39% considered that it could be a fatal disease. Although 76.7% were aware that small intestine is the organ affected, other localizations were cited. Abdominal pain and diarrhoea were recognized as the commonest symptoms. Around one-third could identify that giardiasis may spread through drinking unboiled water and unwashed vegetables other incorrect ways were mentioned; respondents with more than 12 years of formal education were more likely to have better knowledge. Discussion. Strategies to control giardiasis need to be through an integrated approach aiming at boosting caregivers' knowledge and encouraging healthcare workers to act as a readily available source for health information.

  12. Negotiating jurisdiction in the workplace: a multiple-case study of nurse prescribing in hospital settings.

    PubMed

    Kroezen, M; Mistiaen, P; van Dijk, L; Groenewegen, P P; Francke, A L

    2014-09-01

    This paper reports on a multiple-case study of prescribing by nurse specialists in Dutch hospital settings. Most analyses of interprofessional negotiations over professional boundaries take a macro sociological approach and ignore workplace jurisdictions. Yet boundary blurring takes place and healthcare professionals renegotiate formal policies in the workplace. This paper studies the division of jurisdictional control over prescribing between nurse specialists and medical specialists in the workplace, and examines the relationship between workplace jurisdiction and legal jurisdiction over prescribing. Data collection took place in the Netherlands during the first half of 2013. The study used in-depth interviews with fifteen nurse specialists and fourteen medical specialists, non-participant observation of nurse specialists' prescribing consultations and document analysis. Great variety was found in the extent to which and way in which nurse specialists' legal prescriptive authority had been implemented. These findings suggest that there is considerable discrepancy between the division of jurisdictional control over prescribing at the macro (legal) level and the division at the micro (workplace) level.

  13. Governance of professional nursing practice in a hospital setting: a mixed methods study1

    PubMed Central

    dos Santos, José Luís Guedes; Erdmann, Alacoque Lorenzini

    2015-01-01

    Objective: to elaborate an interpretative model for the governance of professional nursing practice in a hospital setting. Method: a mixed methods study with concurrent triangulation strategy, using data from a cross-sectional study with 106 nurses and a Grounded Theory study with 63 participants. The quantitative data were collected through the Brazilian Nursing Work Index - Revised and underwent descriptive statistical analysis. Qualitative data were obtained from interviews and analyzed through initial, selective and focused coding. Results: based on the results obtained with the Brazilian Nursing Work Index - Revised, it is possible to state that nurses perceived that they had autonomy, control over the environment, good relationships with physicians and organizational support for nursing governance. The governance of the professional nursing practice is based on the management of nursing care and services carried out by the nurses. To perform these tasks, nurses aim to get around the constraints of the organizational support and develop management knowledge and skills. Conclusion: it is important to reorganize the structures and processes of nursing governance, especially the support provided by the organization for the management practices of nurses. PMID:26625992

  14. Cancer patient experience with navigation service in an urban hospital setting: a qualitative study.

    PubMed

    Gotlib Conn, L; Hammond Mobilio, M; Rotstein, O D; Blacker, S

    2016-01-01

    Cancer patient navigators are increasingly present on the oncology health care team. The positive impact of navigation on cancer care is recognised, yet a clear understanding of what the patient navigator does and how he/she executes the role continues to emerge. This study aimed to understand cancer patients' perceptions of, and experiences with patient navigation, exploring how navigation may enhance the patient experience in an urban hospital setting where patients with varying needs are treated. A qualitative study using a constructionist approach was conducted. Fifteen colorectal cancer patients participated in semi-structured telephone interviews. Data were analyzed inductively and iteratively. Findings provide insight into two central aspects of cancer navigation: navigation as patient-centred coordination and explanation of clinical care, and navigation as individualised, holistic support. Within these themes, the key benefits of navigation from the patients' perspective were demystifying the system; ensuring comprehension, managing expectations; and, delivering patient-centred care. The navigator provided individualised and extended family support; a holistic approach; and, addressed emotional and psychological needs. These findings provide a means to operationalise and validate an emerging role description and competency framework for the cancer navigator who must identify and adapt to patients' varying needs throughout the cancer care continuum.

  15. Patient and organisational variables associated with pressure ulcer prevalence in hospital settings: a multilevel analysis

    PubMed Central

    Bredesen, Ida Marie; Bjøro, Karen; Gunningberg, Lena; Hofoss, Dag

    2015-01-01

    Objectives To investigate the association of ward-level differences in the odds of hospital-acquired pressure ulcers (HAPUs) with selected ward organisational variables and patient risk factors. Design Multilevel approach to data from 2 cross-sectional studies. Settings 4 hospitals in Norway were studied. Participants 1056 patients at 84 somatic wards. Primary outcome measure HAPU. Results Significant variance in the odds of HAPUs was found across wards. A regression model using only organisational variables left a significant variance in the odds of HAPUs across wards but patient variables eliminated the across-ward variance. In the model including organisational and patient variables, significant ward-level HAPU variables were ward type (rehabilitation vs surgery/internal medicine: OR 0.17 (95% CI 0.04 to 0.66)), use of preventive measures (yes vs no: OR 2.02 (95% CI 1.12 to 3.64)) and ward patient safety culture (OR 0.97 (95% CI 0.96 to 0.99)). Significant patient-level predictors were age >70 vs <70 (OR 2.70 (95% CI 1.54 to 4.74)), Braden scale total score (OR 0.73 (95% CI 0.67 to 0.80)) and overweight (body mass index 25–29.99 kg/m2) (OR 0.32 (95% CI 0.17 to 0.62)). Conclusions The fact that the odds of HAPU varied across wards, and that across-ward variance was reduced when the selected ward-level variables entered the explanatory model, indicates that the HAPU problem may be reduced by ward-level organisation of care improvements, that is, by improving the patient safety culture and implementation of preventive measures. Some wards may prevent pressure ulcers better than other wards. The fact that ward-level variation was eliminated when patient-level HAPU variables were included in the model indicates that even wards with the best HAPU prevention will be challenged by an influx of high-risk patients. PMID:26316647

  16. Classroom Social Capital: Development of a Measure of Instrumental Social Support within Academic Settings

    ERIC Educational Resources Information Center

    Shecter, Julie

    2009-01-01

    Many universities implement programs and interventions to increase students' perceived instrumental social support within the classroom setting, yet to date, no measures exist to adequately assess such perceptions. In response to this need, the current research developed an operational definition of instrumental classroom social support and also…

  17. Promote Academic Engagement and Communication of Students with Autism Spectrum Disorder in Inclusive Settings

    ERIC Educational Resources Information Center

    Hart, Juliet E.; Whalon, Kelly J.

    2008-01-01

    This article describes 20 strategies to facilitate the participation and learning of children with autism spectrum disorders (ASD) in inclusive settings. Note that although the majority of strategies and accommodations suggested are communication-building techniques geared specifically toward students with ASD, they also reflect sound principles…

  18. Employment in Non-Academic Setting. Report on 65th Annual Meeting Session.

    ERIC Educational Resources Information Center

    Tanaka, Keiko

    2002-01-01

    A panel at the Rural Sociological Society's (RSS) 65th annual meeting (2002) identified challenges to pursuing rural sociology careers in nonacademic settings: lack of career guidance and knowledge of nonacademic opportunities, limited graduate training in nonacademic areas, and devaluing of nonacademic work. Recommendations to universities and…

  19. Setting Academic Performance Standards: MCAS vs. PARCC. Technical Report. Policy Brief

    ERIC Educational Resources Information Center

    Phelps, Richard P.

    2015-01-01

    Political realities dictate that, as with any tests, passing scores on those developed by the Partnership for Assessment of Readiness for College and Careers (PARCC) will be set at a level that avoids having an unacceptable number of students fail. Since Massachusetts is by far the highest performing of the states that remain in the PARCC…

  20. Nurses' Comfort Level with Emergency Interventions in the Rural Hospital Setting

    ERIC Educational Resources Information Center

    Ross, Erin L.; Bell, Sue E.

    2009-01-01

    Context: One quarter of the persons living in the United States receive their emergency care in a rural hospital. Nurses employed in these hospitals see few emergencies but must be prepared to provide expert and efficient care when they do occur. Purpose: The purpose of this study was to determine the influence of registered nurses' certifications…

  1. Children and Young People in Hospitals: Doing Youth Work in Medical Settings

    ERIC Educational Resources Information Center

    Yates, Scott; Payne, Malcolm; Dyson, Simon

    2009-01-01

    Young people in hospitals face a range of challenging issues. Many have chronic conditions and experience stigmatisation, anxiety and family conflict. They may also experience social isolation in hospitals, separation from local peer groups and sources of support, and separation from trusted carers during transition to adult care. These issues can…

  2. Academic Success of At-Risk Students in an Alternative School Setting: An Examination of Students' Academic Success Out of the Mainstream School Environment.

    ERIC Educational Resources Information Center

    Turpin, Rodney; Hinton, Deborah

    This report examines whether students at risk for academic failure are achieving success in Kentucky's alternative schools. Alternative schools serve as a placement both for students who disrupt the mainstream classroom and for those who need academic remediation. Such mixed placements may not provide a quality education for students having only…

  3. Cognitive-Behavioural Therapy in a Hospital Setting for Children with Severe Emotional and/or Behaviour Disorders

    ERIC Educational Resources Information Center

    Yeo, Lay See; Wong, Margaret; Gerken, Kathryn; Ansley, Timothy

    2005-01-01

    This study examined the effectiveness of a cognitive-behavioural therapy programme for 13 children treated for severe emotional or behaviour disorders in a hospital setting. Data were obtained from multiple informants at pre-treatment, post-treatment, and three months follow-up. Results indicated statistically significant improvement in the…

  4. Exploring the Relationships between the Electronic Health Record System Components and Patient Outcomes in an Acute Hospital Setting

    ERIC Educational Resources Information Center

    Wiggley, Shirley L.

    2011-01-01

    Purpose: The purpose of this study was to examine the relationship between the electronic health record system components and patient outcomes in an acute hospital setting, given that the current presidential administration has earmarked nearly $50 billion to the implementation of the electronic health record. The relationship between the…

  5. Evaluating a Moving Target: Lessons Learned from Using Practical Participatory Evaluation (P-PE) in Hospital Settings

    ERIC Educational Resources Information Center

    Wharton, Tracy; Alexander, Neil

    2013-01-01

    This article describes lessons learned about implementing evaluations in hospital settings. In order to overcome the methodological dilemmas inherent in this environment, we used a practical participatory evaluation (P-PE) strategy to engage as many stakeholders as possible in the process of evaluating a clinical demonstration project.…

  6. Should the "in situ" simulation become the new way in Belgium? Experience of an academic hospital.

    PubMed

    Pospiech, A; Lois, F; Van Dyck, M; Kahn, D; De Kock, M

    2013-01-01

    The place of simulation in medical education, particularly in anesthesia, appears to be more and more evident. However, the history of simulation in Belgium showed that the associated costs remain a barrier. The use of 'in situ' simulation, defined as the practice of simulation in the usual workplace, could solve the problem of providing access to this educational tool. Indeed, it allows reducing equipment and manpower costs: the needed equipment comes from the hospital, and supervision and organization are provided by staff members. It also provides access to simulation for a larger number of individuals on site. The environment is more realistic because the participants operate in their usual workplace, with their customary equipment and team. Furthermore, 'in situ' simulation allows participation of the paramedical staff. This allows developing skills related to teamwork and communication. Despite those numerous advantages, several difficulties persist. The associated logistic and organizational constraints can be cumbersome.

  7. Accelerating Best Care in Pennsylvania: adapting a large academic system's quality improvement process to rural community hospitals.

    PubMed

    Haydar, Ziad; Gunderson, Julie; Ballard, David J; Skoufalos, Alexis; Berman, Bettina; Nash, David B

    2008-01-01

    Industrial quality improvement (QI) methods such as continuous quality improvement (CQI) may help bridge the gap between evidence-based "best care" and the quality of care provided. In 2006, Baylor Health Care System collaborated with Jefferson Medical College of Thomas Jefferson University to conduct a QI demonstration project in select Pennsylvania hospitals using CQI techniques developed by Baylor. The training was provided over a 6-month period and focused on methods for rapid-cycle improvement; data system design; data management; tools to improve patient outcomes, processes of care, and cost-effectiveness; use of clinical guidelines and protocols; leadership skills; and customer service skills. Participants successfully implemented a variety of QI projects. QI education programs developed and pioneered within large health care systems can be adapted and applied successfully to other settings, providing needed tools to smaller rural and community hospitals that lack the necessary resources to establish such programs independently.

  8. Why a successful task substitution in glaucoma care could not be transferred from a hospital setting to a primary care setting: a qualitative study

    PubMed Central

    2013-01-01

    Background Healthcare systems are challenged by a demand that exceeds available resources. One policy to meet this challenge is task substitution-transferring tasks to other professions and settings. Our study aimed to explore stakeholders’ perceived feasibility of transferring hospital-based monitoring of stable glaucoma patients to primary care optometrists. Methods A case study was undertaken in the Rotterdam Eye Hospital (REH) using semi-structured interviews and document reviews. They were inductively analysed using three implementation related theoretical perspectives: sociological theories on professionalism, management theories, and applied political analysis. Results Currently it is not feasible to use primary care optometrists as substitutes for optometrists and ophthalmic technicians working in a hospital-based glaucoma follow-up unit (GFU). Respondents’ narratives revealed that: the glaucoma specialists’ sense of urgency for task substitution outside the hospital diminished after establishing a GFU that satisfied their professionalization needs; the return on investments were unclear; and reluctant key stakeholders with strong power positions blocked implementation. The window of opportunity that existed for task substitution in person and setting in 1999 closed with the institutionalization of the GFU. Conclusions Transferring the monitoring of stable glaucoma patients to primary care optometrists in Rotterdam did not seem feasible. The main reasons were the lack of agreement on professional boundaries and work domains, the institutionalization of the GFU in the REH, and the absence of an appropriate reimbursement system. Policy makers considering substituting tasks to other professionals should carefully think about the implementation process, especially in a two-step implementation process (substitution in person and in setting) such as this case. Involving the substituting professionals early on to ensure all stakeholders see the change as a

  9. Acute Splenic Infarction at an Academic General Hospital Over 10 Years

    PubMed Central

    Ami, Schattner; Meital, Adi; Ella, Kitroser; Abraham, Klepfish

    2015-01-01

    Abstract Few case series provide a current, comprehensive, and detailed description of splenic infarction (SI), an uncommon condition. Retrospective chart review complemented by imaging evaluation and patient follow-up. All adult patients with a confirmed diagnosis of acute SI discharged over 10 years from a single academic center were studied. A systematic literature review was done to compile a complete list of SI etiologies. SI was found in 32 patients, 0.016% of admissions. Ages ranged from 18 to 86 (median 64) years. Cardiogenic emboli were the predominant etiology (20/32, 62.5%) and atrial fibrillation was frequent. Other patients had autoimmune disease (12.5%), associated infection (12.5%), or hematological malignancy (6%). Nine of the patients (28%) had been previously healthy or with no recognized morbidity predisposing to SI. In 5 of 9 hitherto silent antiphospholipid syndrome or mitral valve disease had been identified. Two remained cryptogenic. Most patients presented with abdominal pain (84%), often felt in the left upper quadrant or epigastrium. Associated symptoms, leukocytosis or increased serum lactate dehydrogenase occurred inconsistently (∼25% each). Chest X-ray showed suggestive Lt. supra-diaphragmatic findings in 22%. Thus, the typical predisposing factors and/or clinical presentation should suggest SI to the clinician and be followed by early imaging by computed tomography (CT), highly useful also in atypical presentations. Complications were rare and patients were discharged after 6.5 days (median) on anticoagulant treatment. The systematic literature review revealed an extensive list of conditions underlying SI. In some, SI may be the first and presenting manifestation. SI is a rare event but should be considered in predisposed patients or those with any combination of suggestive clinical features, especially abdominal pain CT evaluation is diagnostic and the outcome is good. PMID:26356690

  10. Anterior cervical discectomy and fusion in the outpatient ambulatory surgery setting compared with the inpatient hospital setting: analysis of 1000 consecutive cases.

    PubMed

    Adamson, Tim; Godil, Saniya S; Mehrlich, Melissa; Mendenhall, Stephen; Asher, Anthony L; McGirt, Matthew J

    2016-06-01

    OBJECTIVE In an era of escalating health care costs and pressure to improve efficiency and cost of care, ambulatory surgery centers (ASCs) have emerged as lower-cost options for many surgical therapies. Anterior cervical discectomy and fusion (ACDF) is one of the most prevalent spine surgeries performed, and the frequency of its performance is rapidly increasing as the aging population grows. Although ASCs offer significant cost advantages over hospital-based surgical centers, concern over the safety of outpatient ACDF has slowed its adoption. The authors intended to 1) determine the safety of the first 1000 consecutive ACDF surgeries performed in their outpatient ASC, and 2) compare the safety of these outpatient ACDFs with that of consecutive ACDFs performed during the same time period in the hospital setting. METHODS A total of 1000 consecutive patients who underwent ACDF in an ACS (outpatient ACDF) and 484 consecutive patients who underwent ACDF at Vanderbilt University Hospital (inpatient ACDF) from 2006 to 2013 were included in this retrospective study of patients' medical records. Data were collected on patient demographics, comorbidities, operative details, and perioperative and 90-day morbidity. Perioperative morbidity and hospital readmission were compared between the outpatient and inpatient ACDF groups. RESULTS Of the first 1000 outpatient ACDF cases performed in the authors' ASC, 629 (62.9%) were 1-level and 365 (36.5%) were 2-level ACDFs. Mean patient age was 49.5 ± 8.6, and 484 (48.4%) were males. All patients were observed postoperatively at the ASC postanesthesia care unit (PACU) for 4 hours before being discharged home. Eight patients (0.8%) were transferred from the surgery center to the hospital postoperatively (for pain control [n = 3], chest pain and electrocardiogram changes [n = 2], intraoperative CSF leak [n = 1], postoperative hematoma [n = 1], and profound postoperative weakness and surgical reexploration [n = 1]). No perioperative

  11. Setting the National Agenda: Academic Achievement and Transfer. A Policy Statement and Background Paper about Transfer Education.

    ERIC Educational Resources Information Center

    American Council on Education, Washington, DC. National Center for Academic Achievement and Transfer.

    Focusing on the academic dimensions of student transfer from two- to four-year institutions, this report seeks to provide a foundation for institutional and academic policy decisions affecting the transfer experience and student achievement. Part I presents a policy statement on academic achievement and transfer and a nine-point agenda for action.…

  12. Complementary and Integrative Healthcare for Patients with Mechanical Low Back Pain in a U.S. Hospital Setting

    PubMed Central

    Rhee, Taeho Greg; Leininger, Brent D.; Ghildayal, Neha; Evans, Roni L.; Dusek, Jeffery A.; Johnson, Pamela Jo

    2015-01-01

    Objectives Complementary and integrative healthcare (CIH) is commonly used to treat low back pain (LBP). While the use of CIH within hospitals is increasing, little is known regarding the delivery of these services within inpatient settings. We examine the patterns of CIH services among inpatients with mechanical LBP in a hospital setting. Methods This is a retrospective, practice-based study conducted at Abbot Northwestern hospital in Minnesota. Using electronic health record data from July 2009 to December 2012, 8,095 inpatients with mechanical LBP were identified using ICD-9 codes. We classified patients by reason for hospitalization. We examined demographic and clinical characteristics by receipt of CIH services. Then, we estimated the prevalence of types of CIH delivered and clinical foci for CIH visits among inpatients with mechanical LBP. Results Most inpatients with mechanical LBP (>90%) were hospitalized for surgical procedures. Overall, 14.2% received inpatient CIH services. All demographic and clinical characteristics differed by receipt of CIH (P<0.001), except race/ethnicity. CIH recipients were in poorer health than those who did not. Most commonly delivered CIH services were massage (62.1%), relaxation techniques (42.0%) and acupuncture (25.7%). Pain (45.1%), relaxation (17.5%), and comfort (8.2%) were the top three reasons for CIH visits. Conclusion There are important differences between CIH recipients and non-CIH recipients among patients with mechanical LBP within a hospital setting. The reasons documented for CIH visits included addressing physical, emotional and/or mental conditions of patients. Future studies are needed to determine the effectiveness of CIH services health and wellbeing outcomes in this population. PMID:26860795

  13. Pediatric emergency care capacity in a low-resource setting: An assessment of district hospitals in Rwanda

    PubMed Central

    Shoveller, Jean; Tuyisenge, Lisine; Kenyon, Cynthia; Cechetto, David F.; Lynd, Larry D.

    2017-01-01

    Background Health system strengthening is crucial to improving infant and child health outcomes in low-resource countries. While the knowledge related to improving newborn and child survival has advanced remarkably over the past few decades, many healthcare systems in such settings remain unable to effectively deliver pediatric advance life support management. With the introduction of the Emergency Triage, Assessment and Treatment plus Admission care (ETAT+)–a locally adapted pediatric advanced life support management program–in Rwandan district hospitals, we undertook this study to assess the extent to which these hospitals are prepared to provide this pediatric advanced life support management. The results of the study will shed light on the resources and support that are currently available to implement ETAT+, which aims to improve care for severely ill infants and children. Methods A cross-sectional survey was undertaken in eight district hospitals across Rwanda focusing on the availability of physical and human resources, as well as hospital services organizations to provide emergency triage, assessment and treatment plus admission care for severely ill infants and children. Results Many of essential resources deemed necessary for the provision of emergency care for severely ill infants and children were readily available (e.g. drugs and laboratory services). However, only 4/8 hospitals had BVM for newborns; while nebulizer and MDI were not available in 2/8 hospitals. Only 3/8 hospitals had F-75 and ReSoMal. Moreover, there was no adequate triage system across any of the hospitals evaluated. Further, guidelines for neonatal resuscitation and management of malaria were available in 5/8 and in 7/8 hospitals, respectively; while those for child resuscitation and management of sepsis, pneumonia, dehydration and severe malnutrition were available in less than half of the hospitals evaluated. Conclusions Our assessment provides evidence to inform new strategies

  14. Implementing the use of donor milk in the hospital setting: implications for nurses.

    PubMed

    Rosenbaum, Kimberly

    2012-01-01

    Breast milk is the ideal choice for neonates, particularly for the more vulnerable neonates in the neonatal intensive care unit (NICU). When milk from the mother is not available, pasteurized donor milk is an important option, because it maintains many of its health benefits after pasteurization. Yet there are barriers to implementing the use of donor milk at a hospital. This article discusses the implementation of a donor program for pasteurized donor breast milk in the NICUs of three hospitals.

  15. The bacterial contamination rate of glucose meter test strips in the hospital setting

    PubMed Central

    Al-Rubeaan, Khalid A.; Saeb, Amr T. M.; AlNaqeb, Dhekra M.; AlQumaidi, Hamed M.; AlMogbel, Turki A.

    2016-01-01

    Objectives: To assess the rate of bacterial contamination of the multi-use vial and single-use packed glucose meter strips, and to identify the type and frequency of various bacterial contamination in different hospital wards. Methods: This prospective observational study was conducted by a team from the Strategic Center for Diabetes Research in 7 general hospitals in the Central region of Saudi Arabia during the period from August to September 2014 to assess the bacterial contamination rate of the unused strips. A total of 10,447 strips were cultured using proper agar media and incubated both aerobically and anaerobically. Results: The total bacterial contamination rate for the multi-use vials glucose strips was 31.7%, while single-use packed strips were not contaminated at all. Ministry of Health hospitals had the highest contamination rates compared with other hospitals. Critical, obstetric, and surgical wards had the highest bacterial isolates number, where most were in the risk group 3 according to the National Institute of Health guidelines. Staphylococcus species were the most common bacteria found. Conclusion: Glucose meter strips should be recognized as a source of bacterial contamination that could be behind serious hospital acquired infections. The hospital infection control team should adopt proper measures to implement protocols for glucose meter cleaning and glucose strips handling. PMID:27570855

  16. A growing opportunity: Community gardens affiliated with US hospitals and academic health centers

    PubMed Central

    George, Daniel R.; Rovniak, Liza S.; Kraschnewski, Jennifer L.; Hanson, Ryan; Sciamanna, Christopher N.

    2014-01-01

    Background Community gardens can reduce public health disparities through promoting physical activity and healthy eating, growing food for underserved populations, and accelerating healing from injury or disease. Despite their potential to contribute to comprehensive patient care, no prior studies have investigated the prevalence of community gardens affiliated with US healthcare institutions, and the demographic characteristics of communities served by these gardens. Methods In 2013, national community garden databases, scientific abstracts, and public search engines (e.g., Google Scholar) were used to identify gardens. Outcomes included the prevalence of hospital-based community gardens by US regions, and demographic characteristics (age, race/ethnicity, education, household income, and obesity rates) of communities served by gardens. Results There were 110 healthcare-based gardens, with 39 in the Midwest, 25 in the South, 24 in the Northeast, and 22 in the West. Compared to US population averages, communities served by healthcare-based gardens had similar demographic characteristics, but significantly lower rates of obesity (27% versus 34%, P < .001). Conclusions Healthcare-based gardens are located in regions that are demographically representative of the US population, and are associated with lower rates of obesity in communities they serve. PMID:25599017

  17. Comparative analysis of acute toxic poisoning in 2003 and 2011: analysis of 3 academic hospitals.

    PubMed

    Jang, Hak-Soo; Kim, Jung-Youn; Choi, Sung-Hyuk; Yoon, Young-Hoon; Moon, Sung-Woo; Hong, Yun-Sik; Lee, Sung-Woo

    2013-10-01

    Social factors may affect the available sources of toxic substances and causes of poisoning; and these factors may change over time. Additionally, understanding the characteristics of patients with acute toxic poisoning is important for treating such patients. Therefore, this study investigated the characteristics of patients with toxic poisoning. Patients visiting one of 3 hospitals in 2003 and 2011 were included in this study. Data on all patients who were admitted to the emergency departments with acute toxic poisoning were retrospectively obtained from medical records. Total 939 patients were analyzed. The average age of patients was 40.0 ± 20 yr, and 335 (36.9%) patients were men. Among the elements that did not change over time were the facts that suicide was the most common cause, that alcohol consumption was involved in roughly 1 of 4 cases, and that there were more women than men. Furthermore, acetaminophen and doxylamine remained the most common poisoning agents. In conclusion, the average patient age and psychotic drug poisoning has increased over time, and the use of lavage treatment has decreased.

  18. ActiviTeen: A Protocol for Deployment of a Consumer Wearable Device in an Academic Setting

    PubMed Central

    Tueller, Stephen J; Cook, Sarah L; Furberg, Robert D

    2016-01-01

    Background Regular physical activity (PA) can be an important indicator of health across an individual’s life span. Consumer wearables, such as Fitbit or Jawbone, are becoming increasingly popular to track PA. With the increased adoption of activity trackers comes the increased generation of valuable individual-based data. Generated data has the potential to provide detailed insights into the user’s behavior and lifestyle. Objective The primary objective of the described study is to evaluate the feasibility of individual data collection from the selected consumer wearable device (the Fitbit Zip). The rate of user attrition and barriers preventing the use of consumer wearable devices will also be evaluated as secondary objectives. Methods The pilot study will occur in two stages and employs a long-term review and analysis with a convenience sample of 30 students attending Research Triangle High School. For the first stage, students will initially be asked to wear the Fitbit Zip over the course of 4 weeks. During which time, their activity data and step count will be collected. Students will also be asked to complete a self-administered survey at the beginning and conclusion of the first stage. The second stage will continue to collect students’ activity data and step count over an additional 3-month period. Results We are anticipating results for this study by the end of 2016. Conclusion This study will provide insight into the data collection procedures surrounding consumer wearable devices and could serve as the future foundation for other studies deploying consumer wearable devices in educational settings. PMID:27457824

  19. Novel microscale approaches for easy, rapid determination of protein stability in academic and commercial settings.

    PubMed

    Alexander, Crispin G; Wanner, Randy; Johnson, Christopher M; Breitsprecher, Dennis; Winter, Gerhard; Duhr, Stefan; Baaske, Philipp; Ferguson, Neil

    2014-12-01

    Chemical denaturant titrations can be used to accurately determine protein stability. However, data acquisition is typically labour intensive, has low throughput and is difficult to automate. These factors, combined with high protein consumption, have limited the adoption of chemical denaturant titrations in commercial settings. Thermal denaturation assays can be automated, sometimes with very high throughput. However, thermal denaturation assays are incompatible with proteins that aggregate at high temperatures and large extrapolation of stability parameters to physiological temperatures can introduce significant uncertainties. We used capillary-based instruments to measure chemical denaturant titrations by intrinsic fluorescence and microscale thermophoresis. This allowed higher throughput, consumed several hundred-fold less protein than conventional, cuvette-based methods yet maintained the high quality of the conventional approaches. We also established efficient strategies for automated, direct determination of protein stability at a range of temperatures via chemical denaturation, which has utility for characterising stability for proteins that are difficult to purify in high yield. This approach may also have merit for proteins that irreversibly denature or aggregate in classical thermal denaturation assays. We also developed procedures for affinity ranking of protein-ligand interactions from ligand-induced changes in chemical denaturation data, and proved the principle for this by correctly ranking the affinity of previously unreported peptide-PDZ domain interactions. The increased throughput, automation and low protein consumption of protein stability determinations afforded by using capillary-based methods to measure denaturant titrations, can help to revolutionise protein research. We believe that the strategies reported are likely to find wide applications in academia, biotherapeutic formulation and drug discovery programmes.

  20. [Means of communication for an early detection of diabetic nephropathy among the diabetics followed in the academic hospital of Cotonou].

    PubMed

    Vigan, Jacques; Adja, Éric; Zannou, Judith; Agboton, Bruno L; Kérékou, Célestine A; Amoussou-Guenou, Daniel; Zannou, Marcel D; Djrolo, François

    2014-06-01

    The purpose of this study is to determine the level of knowledge and the means of communication for early detection of diabetic nephropathy. This is a prospective study which took place from 6 February to 31 May 2012, in the Academic Clinics of Nephrology-Hemodialysis and the Endocrinology and Metabolic Diseases. Included all patients with diabetes mellitus in two sexes, older than fifteen years and hospitalized in one of these two clinicals or received in consultation during the study period. A questionnaire is used for data collection. Statistical analysis was performed by STATA 11(®) in its English version. One hundred and sixty patients were enrolled. More than 4 out of 5 patients had reported knowledge of diabetes mellitus while only 26.67% had acknowledged that manifests itself by high glycemia. More than half of the patients (57.50%) had said that diabetes mellitus can be complicated by renal impairment. Three out of four diabetics (75.63%) didn't know that it is possible to make an early diagnosis of diabetic nephropathy. The radio and television broadcasts, and sensitizations during medical consultations represented the best means of communication for early detection of diabetic nephropathy. The combination of several means of communication will raise awareness on early detection of diabetic nephropathy.

  1. [Nutritional support groups at a hospital setting. Size, composition, relationships and actions].

    PubMed

    Santana Porbén, S; Barreto Penié, J

    2007-01-01

    The hospital Nutricional Support Group (NSG) represents the ultimate step in the evolution of the forms of provision of nutritional and feeding care to hospitalized patients. The NSG outdoes other preceeding forms for its harmony and cohesion among its members, the multi-, inter- and transdisciplinarity, the dedication to the activity on a full time basis, and the capability to self-finance by means of the savings derived from the implementation of a nutritional policy consistent with the Good Practices of Feeding and Nutrition. It is to be expected that the inception and operation of a NSG in a hospital environment allows the realization of the benefits embedded into the Metabolic, Nutritional and Feeding Intervention Programs. Guidelines and recommendations for the definition of the size and composition of an hospital NSG are presented in this article, along with the responsabilities, functions and tasks to be assumed by its members, and a timetable for its implementation, always from the experiencies of the authors after conducting a NSG in a tertiary-care hospital in Havana (Cuba).

  2. An investigation and evaluation on species and characteristics of pathogenic microorganisms in Chinese local hospital settings.

    PubMed

    Chen, Liang; Lü, Xiaoli; Cao, Weiping; Zhang, Chunxia; Xu, Rongfa; Meng, Xu; Chen, Keping

    2015-12-01

    There are currently great concerns about the level of bacterial contamination in hospitals, as well as resistance to antimicrobial agents. The species and characteristics of microbes in Chinese hospitals are closely related to healthcare safety and the prevention and control of infections. However, data on the exposure of patients to microbes in Chinese hospitals are limited. The present study investigated the genera of microorganisms in Chinese hospitals. We evaluated their characteristics, such as antibiotic susceptibility, tolerance to disinfectants, and toxicity, using silkworms (Bombyx mori) as an animal model. Twenty-six distinct bacterial strains were isolated, and their genera were determined by sequencing their 16S rDNA regions. Twenty-five strains were resistant to one or more antibiotics, and six strains were resistant to multiple antibiotics. The results of minimal inhibitory concentration testing showed that eight strains were resistant to a chlorine-containing disinfectant, and 12 strains were resistant to Povidone-iodine. Following the injection of bacterial cultures into the silkworm hemolymph, 15 strains killed all of the silkworms within 5 d. Additionally, bacterial strain 14 killed all of silkworms within 12 h with a median lethal dose of 4 × 10(4) colony-forming units/larva. This study provides useful information for healthcare safety in Chinese hospitals.

  3. [Improvement of medical equipment setting for the hospital link of the medical service during wartime].

    PubMed

    Miroshnichenko, Yu V; Goryachev, A B; Popov, A A; Rodionov, E O

    2016-04-01

    One of the priorities of the military health care is to improve the system of rationing medical equipment for the hospital unit of the medical service of the Armed Forces in wartime. This is determined the fact that the effectiveness of measures to provide military field hospitals with medical supplies depends on the quality of medical care for the wounded and sick, as well as the level of their return to duty. The article presents the characteristics of modern standards medical supplies procurement of military field hospitals included in the new regulatory legal act of the Russian Federation Ministry of Defence--"Standards of supplies medical supplies medical and pharmaceutical organizations (units) of the Russian Federation on the wartime armed forces", approved and put into effect in 2015 by order of the Minister of Defence of the Russian Federation.

  4. Cooperation between Japanese and Cambodian Dietitians in Setting up a Hospital Diet Management System.

    PubMed

    Ly, Koung Ry; Saito, Shino; Kusama, Kaoru

    2015-01-01

    Cambodia faces a considerably high percentage of the stunted under 5 (Unicef, 2014). Despite the National Nutrition Strategy Launched by the Ministry of Health in cooperation with development partners, nutrition improvement projects have not always been effective. It is generally said these issues are addressed in many other developing nations, and the literature largely documented that successful nutrition programmes are community-based programmes because of their sustainability and the intensive communications between health workers and beneficiaries. Learning from the past experiences, the Foundation for International Development/Relief organized a project team with a Cambodian dietitian and an experienced Japanese dietitian to implement a hospital diet programme for children from April 2006 to March 2014 in the National Pediatric Hospital (NPH) in Cambodia. The project has two objectives: establishing a hospital diet management system, and developing the capacity of NPH staff. Hospital food menus were created paying particular attention to Cambodian culture, eating habits and accessibility to the ingredients for the purpose of continuous supply. We have also put emphasis on the communication between dietitians and family members of the children to let them understand the importance of a nutritious diet. After 8 y of project implementation, the hospital diet management system was established providing 7 types of menu with nutritious diets. The final evaluation of the project showed that NPH staff have the intention to continue hospital food supply with their acquired knowledge and capacity. In practice, a Cambodian dietitian currently takes the initiative for a continuous nutritional diet in NPH. The key to this success is the collaboration between Japanese dietitians with experience and Cambodian dietitians with knowledge of Cambodian eating habits. Taking our experience into account, it is highly recommended to educate Cambodian dietitians, as they are

  5. Quality improvement activity in radiology reading and reporting in a rural setting hospital in Indonesia.

    PubMed

    Frelita, Grace; Wongso, Christlyn; Pasaribu, Marganda Dapot Asi

    2012-01-01

    The Republic of Indonesia is an archipelago country, which is located between Asia and Australia. With a population of more than 200 million people, Indonesia only has about 600 Radiologists, whose majority resides in urban areas. In such a challenging situation, the Siloam Hospitals Group (SHG) established a strategy to improve its remote hospitals' Radiologists' quality care standard of patient safety. Although the strategy has produced a positive result, resistance towards cultural change was unavoidable throughout the strategy implementation. By learning from several resources and experiences, SHG's leaders tried to develop a strategy improvement towards better processes, particularly in recognizing and solving interpersonal conflicts.

  6. A practical method of predicting client revisit intention in a hospital setting.

    PubMed

    Lee, Kyun Jick

    2005-01-01

    Data mining (DM) models are an alternative to traditional statistical methods for examining whether higher customer satisfaction leads to higher revisit intention. This study used a total of 906 outpatients' satisfaction data collected from a nationwide survey interviews conducted by professional interviewers on a face-to-face basis in South Korea, 1998. Analyses showed that the relationship between overall satisfaction with hospital services and outpatients' revisit intention, along with word-of-mouth recommendation as intermediate variables, developed into a nonlinear relationship. The five strongest predictors of revisit intention were overall satisfaction, intention to recommend to others, awareness of hospital promotion, satisfaction with physician's kindness, and satisfaction with treatment level.

  7. Guide for Referral and Case Coordination for Young Children in Hospital Settings.

    ERIC Educational Resources Information Center

    Robinson, Cordelia C.; And Others

    The Early Referral and Follow-up Project of the University of Nebraska Medical Center was designed to facilitate developmental assessment and intervention with long-term or repeatedly hospitalized children from birth to 3 years of age. Developmentally delayed children, handicapped children, and children at risk for delays were eligible for…

  8. Development of Intentionality in the Vocalization of Handicapped Infants Reared in a Hospital Setting.

    ERIC Educational Resources Information Center

    Bochner, Sandra

    1986-01-01

    The 15-month study followed the vocal development of five handicapped (Down Syndrome, hydrocephalus, and spina bifida) hospital reared infants. Results suggested that only the two less handicapped infants demonstrated use of sounds for social interaction and that the other infants used vocalization primarily as protest or self-stimulation.…

  9. Evaluation of ATP bioluminescence assays for potential use in a hospital setting.

    PubMed

    Aiken, Zoie A; Wilson, Michael; Pratten, Jonathan

    2011-05-01

    ATP bioluminescence is being applied in hospitals to measure surface contamination. We compared commercial luminometers for detecting the number Staphylococcus aureus associated with surfaces. The data showed that the ATP bioluminescence methods tested were not robust enough to generate quantitative data on bacterial numbers, especially at low concentrations.

  10. Using lean methodology to improve efficiency of electronic order set maintenance in the hospital.

    PubMed

    Idemoto, Lori; Williams, Barbara; Blackmore, Craig

    2016-01-01

    Order sets, a series of orders focused around a diagnosis, condition, or treatment, can reinforce best practice, help eliminate outdated practice, and provide clinical guidance. However, order sets require regular updates as evidence and care processes change. We undertook a quality improvement intervention applying lean methodology to create a systematic process for order set review and maintenance. Root cause analysis revealed challenges with unclear prioritization of requests, lack of coordination between teams, and lack of communication between producers and requestors of order sets. In March of 2014, we implemented a systematic, cyclical order set review process, with a set schedule, defined responsibilities for various stakeholders, formal meetings and communication between stakeholders, and transparency of the process. We first identified and deactivated 89 order sets which were infrequently used. Between March and August 2014, 142 order sets went through the new review process. Processing time for the build duration of order sets decreased from a mean of 79.6 to 43.2 days (p<.001, CI=22.1, 50.7). Applying Lean production principles to the order set review process resulted in significant improvement in processing time and increased quality of orders. As use of order sets and other forms of clinical decision support increase, regular evidence and process updates become more critical.

  11. Insulin pump patient characteristics and glucose control in the hospitalized setting.

    PubMed

    Kannan, Subramanian; Satra, Ankita; Calogeras, Ellen; Lock, Patricia; Lansang, M Cecilia

    2014-05-01

    Patients' knowledge of their insulin pumps and glucose control during hospitalization has not been studied. The aim was to study the determinants of glycemic control in patients using continuous subcutaneous insulin infusion (CSII) in the hospital. Three groups of patients were identified: those who did not need any inpatient education and continued on CSII (gorup A), those who received education then continued on CSII (group B), and those for whom CSII was not appropriate and were treated with multiple daily insulin injections (gorup C). We compared the measures of glycemic control between the 3 groups and analyzed which variables impacted glucose control. There were 50 patients, with 51 hospital admissions, 57% males, mean age 48 ± 13 years, 86% had type 1 diabetes (T1DM). The mean DM duration was 26 ± 14 years, mean duration of CSII use was 8.7 ± 6 years, and mean HbA1c was 7.6 ± 1.4%. The mean duration of hospital stay was 5.6 ± 4.6 days. Mean blood glucose (BG) and frequency of hyperglycemia and hypoglycemic events among the 3 groups adjusted for their duration of hospital stay were not statistically different. None of the patients developed diabetic ketoacidosis while using their pump. Stepwise multivariate analysis revealed knowledge of hypoglycemia correction was the single most important predictor of mean BG (P < .001). Patients who received inpatient education performed similarly to patients who did not need inpatient education. Patients who receive inpatient education on CSII fare similar as patients who did not require inpatient education.

  12. Nursing Education Interventions for Managing Acute Pain in Hospital Settings: A Systematic Review of Clinical Outcomes and Teaching Methods.

    PubMed

    Drake, Gareth; de C Williams, Amanda C

    2017-02-01

    The objective of this review was to examine the effects of nursing education interventions on clinical outcomes for acute pain management in hospital settings, relating interventions to health care behavior change theory. Three databases were searched for nursing education interventions from 2002 to 2015 in acute hospital settings with clinical outcomes reported. Methodological quality was rated as strong, moderate, or weak using the Effective Public Health Practice Project Quality Assessment Tool for quantitative studies. The 12 eligible studies used varied didactic and interactive teaching methods. Several studies had weaknesses attributable to selection biases, uncontrolled confounders, and lack of blinding of outcome assessors. No studies made reference to behavior change theory in their design. Eight of the 12 studies investigated nursing documentation of pain assessment as the main outcome, with the majority reporting positive effects of education interventions on nursing pain assessment. Of the remaining studies, two reported mixed findings on patient self-report of pain scores as the key measure, one reported improvements in patient satisfaction with pain management after a nursing intervention, and one study found an increase in nurses' delivery of a relaxation treatment following an intervention. Improvements in design and evaluation of nursing education interventions are suggested, drawing on behavior change theory and emphasizing the relational, contextual, and emotionally demanding nature of nursing pain management in hospital settings.

  13. Bioterrorism preparedness--Part II. Smallpox vaccination in a hospital setting.

    PubMed

    Jacobs, Lenworth M; Emanuelsen, Kathy; McKay, Charles; Burns, Karyl

    2004-01-01

    The threat of using smallpox as an agent for bioterrorism resulted in a directive for the creation of smallpox response teams. In Connecticut, The Commissioner of the Department of Public Health convened public health and hospital leadership to plan for the vaccination of these teams. The purpose of this paper is to provide a description of the vaccination program at Hartford Hospital, a Center of Excellence for Bioterrorism Preparedness, and to report the results of a survey of the vaccinees regarding the vaccination experience. Ninety persons were vaccinated. Six individuals experienced low-grade fever and 10 had axillary node swelling. One individual experienced significant fatigue. A total of six persons lost time from work. Four lost one day and two persons lost between four to five days of work. There was no autoinoculation, transfer inoculation, vaccinia or any other significant complication. Survey results indicate that most vaccinees felt positive about the experience.

  14. Does Geographic Setting Alter the Roles of Academically Supportive Factors? African American Adolescents' Friendships, Math Self-Concept, and Math Performance

    ERIC Educational Resources Information Center

    Jones, Martin H.; Irvin, Matthew J.; Kibe, Grace W.

    2012-01-01

    The study is one of few to examine how living in rural, suburban, or urban settings may alter factors supporting African Americans adolescents' math performance. The study examines the relationship of math self-concept and perceptions of friends' academic behaviors to African American students' math performance. Participants (N = 1,049) are…

  15. Improving Medication Administration Safety in a Community Hospital Setting Using Lean Methodology.

    PubMed

    Critchley, Sandy

    2015-01-01

    Virtually all health care organizations have goals of improving patient safety, but despite clear goals and considerable investments, gains have been limited. This article explores a community hospital's resounding success using Lean methodology to improve medication administration safety with process changes designed by engaged employees and leaders with the knowledge and skill to effect improvements. This article inspires an interdisciplinary approach to quality improvement using reproducible strategies.

  16. The Habitat Factor in ELF(A)--English as a Lingua Franca (In Academic Settings)--And English for Plurilingual Academic Purposes

    ERIC Educational Resources Information Center

    Schaller-Schwaner, Iris

    2015-01-01

    This article considers a case of local language socialization and accommodation in a multilingual community of practice: the use of English as an additional academic language for specific purposes at a bilingual Swiss university and its implications for teaching. The acronym ELF(A) is used throughout as short for English as a Lingua Franca (in…

  17. Validation of dipslides as a tool for environmental sampling in a real-life hospital setting.

    PubMed

    Ibfelt, T; Foged, C; Andersen, L P

    2014-05-01

    Environmental sampling in hospitals is becoming increasingly important because of the rise in nosocomial infections. In order to monitor and track these infections and optimize cleaning and disinfection, we need to be able to locate the fomites with the highest amount of microorganisms, but the optimal method for this is not clear. The aim of this study was to evaluate which of four different dipslides or a standard TSA contact plate were best at recovering human bacteria from the environment. We tested four different dipslides with selective and non-selective agars versus a standard TSA contact plate in order to find the best sampling media. Two hundred sites in a children's medical ward in Copenhagen University hospital were sampled in autumn 2012. There was no difference in total bacteria count between the TSA contact plate and the dipslides. Faecal indicator bacteria recovery was the same for the dipslides and the TSA contact plate. Dipslides may be equally well suited for environmental sampling and hygiene assessment as TSA contact plates. Dipslides have some advantages, such as better sample security, easier sampling in confined spaces and longer shelf life that may speak in favour of choosing these for bacteria environmental sampling in hospitals, depending on the task.

  18. Genetic similarity between staphylococcus sp isolated from human and hospital settings, and susceptibility to different antimicrobials

    PubMed Central

    Fabiano, Telma Luciana Trovó; de Ávila, Bruna Helena Pinheiro; Dias, Cleusa Cascaes; Maluta, Renato Pariz; de Ávila, Fernando Antonio

    2008-01-01

    One hundred and forty-three samples from human hands and hospital beds were collected at a teaching hospital in the city of Ribeirão Preto/SP by swabs, and placed in BHI broth. Following a 24 h incubation period at 37°C, they were seeded on Petri dishes containing Agar “Staphylococcus Medium 110”. Colonies typical of the genus Staphylococcus were collected and stored at 4°C until tested for catalase, mannitol, hemolysis, DNAse and coagulase. Strains were analyzed by RAPD-PCR to verify their similarity, and tested for sensitivity to ten different antibiotics. From the ninety-two isolated strains, 67 (72,8%) were coagulase- negative and 25 (27,2%) coagulase-positive. Similarity analysis showed a great heterogeneity among strains, but some presented 100% similarity. Resistance to oxacilin was encountered in 39 (42%) of the strains. Two coagulase-negative strains were resistant to vancomycin, and eleven (12%) were considered multiresistant. Measures such as hand disinfection of the staff and hospital beds and rationalization of antibiotic use could contribute to decrease pathogen transmission and selection pressure, diminishing the frequency and lethality of nosocomial infections. PMID:24031283

  19. An Examination of the Relationship between Collegiate Student-Athlete's Leadership Role in the Athletic Setting and Their Academic Success

    ERIC Educational Resources Information Center

    Baumgarten, Darla K.

    2013-01-01

    Academic performance of collegiate student-athletes compared to non-athletes has been studied extensively. Results of these studies have been mixed in their findings of student-athletes academic performance in comparison to the nonstudent-athlete population. These conflicting results may be due to differences in level of competition or demographic…

  20. Metalinguistic Awareness and Academic Achievement in a Linguistically Diverse School Setting: A Study of Lower Secondary Pupils in Denmark

    ERIC Educational Resources Information Center

    Spellerberg, Stine Marie

    2016-01-01

    This study focuses on metalinguistic awareness (MLA) and its relation to academic achievement for mono-, bi- and multilingual adolescents in Denmark. While MLA is one of several cognitive measures positively related to bilingualism and bilingualism is associated with academic advantages, Danish bi-/multilingual pupils appear not to benefit from…

  1. Alcohol and tobacco use and cognitive-motivational variables in school settings: effects on academic performance in Spanish adolescents.

    PubMed

    Inglés, Cándido J; Torregrosa, María S; Rodríguez-Marín, Jesús; García del Castillo, José A; Gázquez, José J; García-Fernández, José M; Delgado, Beatriz

    2013-01-01

    The aim of the present study was to analyze: (a) the relationship between alcohol and tobacco use and academic performance, and (b) the predictive role of psycho-educational factors and alcohol and tobacco abuse on academic performance in a sample of 352 Spanish adolescents from grades 8 to 10 of Compulsory Secondary Education. The Self-Description Questionnaire-II, the Sydney Attribution Scale, and the Achievement Goal Tendencies Questionnaire were administered in order to analyze cognitive-motivational variables. Alcohol and tobacco abuse, sex, and grade retention were also measured using self-reported questions. Academic performance was measured by school records. Frequency analyses and logistic regression analyses were used. Frequency analyses revealed that students who abuse of tobacco and alcohol show a higher rate of poor academic performance. Logistic regression analyses showed that health behaviours, and educational and cognitive-motivational variables exert a different effect on academic performance depending on the academic area analyzed. These results point out that not only academic, but also health variables should be address to improve academic performance in adolescence.

  2. Prevalence of Depression and Anxiety amongst Cancer Patients in a Hospital Setting: A Cross-Sectional Study

    PubMed Central

    Faheem, Muhammad; Fahim, Ammad; Innocent, Haran; Mansoor, Zainab; Rizvi, Shehrbano; Farrukh, Hizra

    2016-01-01

    Background. The biomedical care for cancer has not been complemented by psychosocial progressions in cancer care. Objectives. To find the prevalence of anxiety and depression amongst cancer patients in a hospital setting. Design and Setting. This cross-sectional study was conducted at the tertiary care hospitals Shifa International Hospital Islamabad and Nuclear Medicine, Oncology, and Radiotherapy Institute [NORI]. Patients and Methods. 300 patients were interviewed from both the outpatient and inpatient department using The Aga Khan University Anxiety and Depression Scale (AKUADS). Main Outcome Measures. Using a score of 20 and above on the AKUADS, 146 (48.7%) patients were suffering from anxiety and depression. Results. When cross tabulation was done between different factors and the cancer patients with anxiety and depression, the following factors were found out to be significant with associated p value < 0.05: education of the patient, presence of cancer in the family, the severity of pain, and the patient's awareness of his anxiety and depression. Out of 143 (47.7%) uneducated patients, 85 (59.4%) were depressed, hence making it the highest educational category suffering from depression and anxiety. Conclusion. The prevalence of anxiety and depression amongst cancer patients was high showing that importance should be given to screening and counseling cancer patients for anxiety and depression, to help them cope with cancer as a disease and its impact on their mental wellbeing. Limitations. The frequency of female patients in our research was higher than those of male patients. PMID:27752508

  3. Systematic review of safety checklists for use by medical care teams in acute hospital settings - limited evidence of effectiveness

    PubMed Central

    2011-01-01

    Background Patient safety is a fundamental component of good quality health care. Checklists have been proposed as a method of improving patient safety. This systematic review, asked "In acute hospital settings, would the use of safety checklists applied by medical care teams, compared to not using checklists, improve patient safety?" Methods We searched the Cochrane Library, MEDLINE, CINAHL, and EMBASE for randomised controlled trials published in English before September 2009. Studies were selected and appraised by two reviewers independently in consultation with colleagues, using inclusion, exclusion and appraisal criteria established a priori. Results Nine cohort studies with historical controls studies from four hospital care settings were included-intensive care unit, emergency department, surgery, and acute care. The studies used a variety of designs of safety checklists, and implemented them in different ways, however most incorporated an educational component to teach the staff how to use the checklist. The studies assessed outcomes occurring a few weeks to a maximum of 12 months post-implementation, and these outcomes were diverse. The studies were generally of low to moderate quality and of low levels of evidence, with all but one of the studies containing a high risk of bias. The results of these studies suggest some improvements in patient safety arising from use of safety checklists, but these were not consistent across all studies or for all outcomes. Some studies showed no difference in outcomes between checklist use and standard care without a checklist. Due to the variations in setting, checklist design, educational training given, and outcomes measured, it was unfeasible to accurately summarise any trends across all studies. Conclusions The included studies suggest some benefits of using safety checklists to improve protocol adherence and patient safety, but due to the risk of bias in these studies, their results should be interpreted with

  4. Shared governance and empowerment in registered nurses working in a hospital setting.

    PubMed

    Barden, Agnes M; Griffin, Mary T Quinn; Donahue, Moreen; Fitzpatrick, Joyce J

    2011-01-01

    Empowerment of registered nurses through professional practice models inclusive of shared governance has been proposed as essential to improve quality patient care, contain costs, and retain nursing staff. The purpose of this study was to determine the relationship between perceptions of governance and empowerment among nurses working in acute care hospital units in which a shared governance model had been in place for 6 to 12 months. The 158 nurses who participated perceived themselves to be moderately empowered and in an early implementation stage of shared governance. There was a statistically significant positive relationship between perceptions of shared governance and empowerment. Recommendations for professional practice and future research are included.

  5. Evaluating the influence of perceived pain control on patient satisfaction in a hospital setting.

    PubMed

    Craig, Angela R; Otani, Koichiro; Herrmann, Patrick A

    2015-01-01

    The authors evaluated whether a patient's perceived pain control influenced the relationships between four attributes (nursing, physician, staff, and environment) and patient satisfaction. Multiple linear regression analyses were conducted to examine overall satisfaction and intention to recommend, controlling for race, gender, age, and education. The authors found that no matter the level of pain control, nursing was always the most influential attribute in patient satisfaction. The influence of the other attributes varied, depending on the patients' pain control. Hospital managers may improve patient satisfaction by focusing on pain management nursing care.

  6. Knowledge based functions for routine use at a German university hospital setting: the issue of fine tuning.

    PubMed Central

    Bürkle, T.; Prokosch, H. U.; Hussak, G.; Dudeck, J.

    1997-01-01

    In this paper we present the introduction of knowledge based functions into clinical routine at Giessen University Hospital. For this purpose a therapy planning module at the medical intensive care unit has been extensively redesigned in order to support the structured documentation of drug prescriptions. After introduction of this new HIS component in January 1996 research has been initiated to establish a basic drug therapy knowledge base. The main components of a knowledge based system have been fully incorporated into the hospital information system WING and are in routine use since December 1996. During a pre-production phase warnings of reminder functions were logged and reviewed by an interdisciplinary team in order to adapt the system to the actual clinical environment. The paper describes experiences during this fine tuning and adaptation process which was necessary to bring a small set of knowledge modules into clinical routine. PMID:9357589

  7. Characteristics of effective electronic mail messages distributed to healthcare professionals in a hospital setting.

    PubMed

    Kaltschmidt, Jens; Schmitt, Simon P W; Pruszydlo, Markus G; Haefeli, Walter E

    2008-01-01

    Electronic mailing systems (e-mail) are an important means to disseminate information within electronic networks. However, in large business communities including the hectic environment of hospitals it may be difficult to induce account holders to read the e-mail. In two mailings disseminated in a large university hospital we evaluated the impact of e-mail layout (three e-mail text versions, two e-mails with graphics) on the willingness of its approximately 6500 recipients to seek additional electronic information and open an integrated link. Overall access rates after 90 days were 21.1 and 23.5% with more than 70% of the respondents opening the link within 3 days. Differences between different layouts were large and artwork text, HTML text, animated GIF, and static image prompted 1.2, 1.7, 1.8, and 2.3 times more often access than the courier plain text message (p

  8. A metasynthesis of midwives' experience of hospital practice in publicly funded settings: compliance, resistance and authenticity.

    PubMed

    O'Connell, Rhona; Downe, Soo

    2009-11-01

    Worldwide, increasing percentages of women are giving birth in centralized hospitals in the belief that this maximizes safety for themselves and their babies. In parallel, there is international recognition that the number of birth interventions used in the routine care of labouring women is rising. This is fuelling concern about iatrogenesis, and, particularly, maternal and infant morbidity and mortality. It also has an adverse impact on the economics of health care. National and international policy characterizes midwives as the guardians of normal childbirth. This guardianship appears to be failing. The objective of this metasynthesis is to explore midwives' perceptions of hospital midwifery with a focus on labour ward practice to examine professional discourses around midwifery work in the current modernist, risk averse and consumerist childbirth context. Based on an iterative search strategy, 14 studies were selected for the metasynthesis. Three overarching themes were identified: 'power and control'; 'compliance with cultural norms'; and 'attempting to normalize birth'. Most midwives aimed to provide what they characterized as 'real midwifery' but this intention was often overwhelmed with heavy workloads and the normative pressure to provide equitable care to all women. This raises questions of authenticity, both in terms of midwives living out their beliefs, and in terms of acknowledgement of the power to resist. The theoretical insights generated by the metasynthesis could have resonance for other professional and occupational groups who wish to offer autonomous individualized services in an increasingly risk-averse target driven global society.

  9. What Influences Treatment Satisfaction in Patients with Personality Disorders? A Naturalistic Investigation in a Hospitalization Setting

    PubMed Central

    Gebhardt, Stefan; Huber, Martin Tobias

    2016-01-01

    Treatment satisfaction of different mental disorders is still poorly understood, but of high clinical interest. Inpatients of a general psychiatric care hospital were asked to fill out questionnaires on satisfaction and clinical variables at admission and discharge. On the basis of an exploratory approach, differences in treatment satisfaction among diagnostic groups were examined by means of one-way analysis of variance. Potential associated clinical and socio-demographic variables were studied using multi/univariate tests. Patients with personality disorders (n=18) showed a significantly lower treatment satisfaction (ZUF-8, Zurich Satisfaction Questionnaire) and a slightly lower improvement of symptoms (CGI, Clinical Global Impression) and global functioning (GAF, Global Assessment of Functioning scale) than that of other diagnostic groups (n=95). Satisfaction in patients with personality disorders correlated much stronger with the symptom improvement and slightly with the functioning level than in patients without personality disorders. Interestingly, in patients with personality disorders psychopharmacological treatment in general (present versus not present) was independent from satisfaction. This exploratory investigation suggests that a lower satisfaction of patients with personality disorders in a general psychiatric hospital is mainly based on a reduced improvement of the symptoms and of the global functioning level. PMID:28217274

  10. Evaluation of an intervention to increase screening colonoscopy in an urban public hospital setting.

    PubMed

    Nash, Denis; Azeez, Sulaiman; Vlahov, David; Schori, Melissa

    2006-03-01

    Only 50% of New Yorkers aged 50 and over reported ever being screened for colorectal cancer by any modality according to a recent household survey. The objective of this investigation was to assess the impact of a hospital-based intervention aimed at eliminating health care system barriers to timely colorectal cancer screening at Lincoln Medical Center, a large, urban public hospital in one of the nation's poorest census tracts. We conducted a retrospective analysis of all colonoscopies performed over an 11-month period, during which a multi-pronged intervention to increase the number of screening colonoscopies took place. Two "patient navigators" were hired during the study period to provide continuity for colonoscopy patients. A Direct Endoscopic Referral System (DERS) was also implemented. Enhancements to the gastrointestinal (GI) suite were also made to improve operational efficiency. Immediately following the introduction of the patient navigators, there was a dramatic and sustained decline in the broken appointment rates for both screening and diagnostic colonoscopy (from 67% in May of 2003 to 5% in June of 2003). The likelihood of keeping the appointment for colonoscopy after the patient navigator intervention increased by nearly 3-fold (relative risk = 2.6, 95% CI 2.2-3.0). The rate of screening colonoscopies increased from 56.8 per month to 119 per month. The screening colonoscopy coverage provided by this facility among persons aged 50 and over in surrounding Zip codes increased from 5.2 to 15.6% (RR 3.0, 95% CI 1.9-4.7). Efforts to increase the number of screening colonoscopies were highly successful, due in large part to the influence of patient navigators, a streamlined referral system, and GI suite enhancements. These findings suggest that there are significant health-care system barriers to colonoscopy that, when addressed, could have a significant impact on screening colonoscopy rates in the general population.

  11. Palliative and Curative Care Nurses' Attitudes Toward Dying and Death in the Hospital Setting.

    ERIC Educational Resources Information Center

    Thompson, Edward H.

    1986-01-01

    Examined sociodemographic background, nursing unit, amount of experience caring for dying patients, death anxiety, and attitudes toward working with dying patients among 56 nurses in palliative, surgical, and pediatric services. Work setting was found to be a more significant force in shaping attitudes toward caring for the dying than was…

  12. Hospitality and Collegial Community: An Essay.

    ERIC Educational Resources Information Center

    Bennett, John B.

    2000-01-01

    Explains a collegial ethic of hospitality as a cardinal academic virtue and suggests a way of building a "collegium," the covenantal community of academe. Discusses how academicians can develop hospitable teaching, hospitable scholarship, and hospitable service. (Author/SLD)

  13. The Dynamics of Visual Art Dialogues: Experiences to Be Used in Hospital Settings with Visual Art Enrichment

    PubMed Central

    Wikström, Britt-Maj

    2011-01-01

    Objectives. Given that hospitals have environmental enrichment with paintings and visual art arrangement, it would be meaningful to develop and document how hospital art could be used by health professionals. Methods. The study was undertaken at an art site in Sweden. During 1-hour sessions, participants (n = 20) get together in an art gallery every second week five times. Results. According to the participants a new value was perceived. From qualitative analyses, three themes appear: raise association, mentally present, and door-opener. In addition 72% of the participants reported makes me happy and gives energy and inspiration, and 52% reported that dialogues increase inspiration, make you involved, and stimulate curiosity. Conclusion. The present study supported the view that visual art dialogue could be used by health care professionals in a structured manner and that meaningful art stimulation, related to a person's experiences, could be of importance for the patients. Implementing art dialogues in hospital settings could be a fruitful working tool for nurses, a complementary manner of patient communication. PMID:22242200

  14. Hospital preparedness in community measles outbreaks-challenges and recommendations for low-resource settings.

    PubMed

    Shakoor, Sadia; Mir, Fatima; Zaidi, Anita K M; Zafar, Afia

    2015-01-01

    We have reviewed various strategies involved in containment of measles in healthcare facilities during community outbreaks. The strategies that are more applicable to resource-poor settings, such as natural ventilation, mechanical ventilation with heating and air-conditioning systems allowing unidirectional air-flow, and protection of un-infected patients and healthcare workers (HCWs), have been examined. Ventilation methods need innovative customization for resource-poor settings followed by validation and post-implementation analysis for impact. Mandatory vaccination of all HCWs with two doses of measles-containing vaccine, appropriate post-exposure prophylaxis of immunocompromised inpatients, and stringent admission criteria for measles cases can contribute toward reduction of nosocomial and secondary transmission within facilities.

  15. Hospital preparedness in community measles outbreaks—challenges and recommendations for low-resource settings

    PubMed Central

    Shakoor, Sadia; Mir, Fatima; Zaidi, Anita K. M.; Zafar, Afia

    2015-01-01

    We have reviewed various strategies involved in containment of measles in healthcare facilities during community outbreaks. The strategies that are more applicable to resource-poor settings, such as natural ventilation, mechanical ventilation with heating and air-conditioning systems allowing unidirectional air-flow, and protection of un-infected patients and healthcare workers (HCWs), have been examined. Ventilation methods need innovative customization for resource-poor settings followed by validation and post-implementation analysis for impact. Mandatory vaccination of all HCWs with two doses of measles-containing vaccine, appropriate post-exposure prophylaxis of immunocompromised inpatients, and stringent admission criteria for measles cases can contribute toward reduction of nosocomial and secondary transmission within facilities. PMID:25882388

  16. Estimation of exposure from spilled glutaraldehyde solutions in a hospital setting.

    PubMed

    Niven, K J; Cherrie, J W; Spencer, J

    1997-12-01

    Glutaraldehyde is commonly used in hospitals for cold disinfection of instruments which may be damaged by autoclaving. The increased use of automatic washer/disinfection machines has resulted in a greater risk of spills than with manual methods. A series of experiments was conducted to answer two related research questions: what was the likely range of airborne concentrations when glutaraldehyde is spilled, and are commonly used personal protective equipment ensembles effective and practicable in use? Objective measurements using three sampling methods (two pumped methods based on OSHA 64, one using treated filters and the other based on adsorbent tubes, and a Glutaraldemeter direct reading instrument) were conducted with spills of various surface areas of both 2 and 50% solutions of glutaraldehyde. Results ranged between < 0.01 and 1.4 ppm. Two personal protective equipment ensembles were tested. One was based on a half-facepiece respirator with gas-tight goggles, while the other comprised a full-facepiece cartridge respirator. Both ensembles gave adequate protection against irritation, although in use the half-facepiece respirator and goggles tended to interfere with each other. The direct reading instrument generally underestimated the glutaraldehyde concentrations, although there was a significant association with the results obtained using the method based on adsorbent tubes.

  17. Setting up a Tissue Bank in India: The Tata Memorial Hospital Experience.

    PubMed

    Gajiwala, A L

    2003-01-01

    In India, the procurement of tissues for transplantation is governed by the Transplantation of Human Organs Act, 1994. However, although this law exists, it is primarily applied to organ transplantation and rules and regulations that are specific to tissue banking have yet to be developed.The Tata Memorial Hospital (TMH) Tissue Bank was started in 1988 as part of an International Atomic Energy Agency (IAEA) programme to promote the use of ionising radiation for the sterilisation of biological tissues. It represents the Government of India within this project and was the first such facility in the country. It is registered with the Health Services Maharashtra State and provides lyophilised amnion, dura mater, skin and bone that have been terminally sterilised with exposure to 25 kGy of gamma radiation from a Cobalt 60 source. These are obtained either from cadavers or live donors.To date the TMH Tissue Bank has provided 6328 allografts for use as biological dressings or in various reconstructive procedures.The TMH Tissue Bank has helped initiate a Tissue Bank at the Defence Laboratory (DL), Jodhpur. At present these are the only two Banks in the country using radiation for terminal sterilisation of banked tissues.The availability of safe, clinically useful and cost effective grafts have resulted in changes in surgical treatment with a concomitant increase in demand for grafts and an interest in developing more tissue banks. The availability of donor tissue however, continues to be a major limitation.

  18. Management of euvolemic hyponatremia attributed to SIADH in the hospital setting.

    PubMed

    Peri, A; Giuliani, C

    2014-03-01

    Hyponatremia is the most frequent electrolyte disorder in hospitalized patients. Acute and severe hyponatremia can be a life-threatening condition, but recent evidence indicates that also mild and chronic hyponatremia is associated with neurological and extra-neurological signs, such as gait disturbances, attention deficits, falls and fracture occurrence, and bone loss. The syndrome of inappropriate ADH secretion (SIADH) is the most frequent cause of hyponatremia. Hyponatremia secondary to SIADH may result for instance from ectopic release of ADH in lung cancer, from diseases affecting the central nervous system, from pneumonia or other pneumopathies or as a side-effect of various drugs In SIADH, hyponatremia results from a pure disorder of water handling by the kidney, whereas external sodium balance is usually well regulated. Despite increased total body water, only minor changes of urine output and modest oedema are usually seen. Neurological impairment may range from subclinical to life-threatening, depending on the degree and mostly on the rate of serum sodium reduction. The management of hyponatremia secondary to SIADH is largely dependent on the symptomatology of the patient. This review briefly summarizes the main aspects related to hyponatremia and then discusses the available treatment options for the management of SIADH, including vaptans, which are vasopressin receptor antagonists targeted for the correction of euvolemic hyponatremia, such as that observed in SIADH.

  19. Exploring the impacts of personal factors on self-leadership in a hospital setting.

    PubMed

    Ugurluoglu, Ozgur; Saygılı, Meltem; Ozer, Ozlem; Santas, Fatih

    2015-01-01

    Self-leadership may be defined as a self-effecting process that individuals experience by maintaining the motivation they require for fulfilling their roles and duties. The self-leadership process comprises three key strategies: behaviour-oriented strategies, natural reward strategies and constructive thought pattern strategies. What is intended herein is to inquire about the implementation of self-leadership within organisations and to examine the effects of such variables as age, gender, total terms of employment, marital status and education on self-leadership strategies. The primary data collection instrument was a survey distributed to 450 personnel working at a state hospital in Kırıkkale, Turkey, and feedback thereto was received from 308 (68.4%) of those surveyed. As a result of the findings taken from the analyses, age, total terms of employment and receipt of education in leadership affect the use of self-leadership strategies. Although age and total terms of employment display a negative-directional correlation with the self-leadership strategies, female employees and those who receive education in leadership are more inclined towards self-leadership strategies.

  20. [Prevalence and risk factors for otomycosis treated in the hospital setting in Abidjan (Ivory Coast)].

    PubMed

    Yavo, W; Kassi, R R; Kiki-Barro, P C; Bamba, A; Kplé, T; Menan, E I; Ehouo, F; Koné, M

    2004-01-01

    Otomycosis is frequently encountered in tropical and subtropical zones. In Ivory Coast diagnosis of this disease is often based solely on the clinical symptoms. The objectives of this study were to determine the prevalence, predisposing factors, and etiologic agents associated with otomycosis at the Treichville University Hospital Center in Abidjan, Ivory Coast. Mycological examinations were performed on specimens obtained from 115 patients presenting with external otitis at the d'Oto-Rhino-Laryngology Department. Fungi-positive cultures were obtained in 49 patients for an overall otomycosis prevalence of 42.6 (95% Confidence Interval (CI), 34.4-52.2). Univariate analysis showed that the predisposing factors for otomycosis were frequent swimming in natural or artificial pools (Relative Risk (RR) 3.7; CI 1.7-8.1), daily ear cleaning (RR 3.5; CI 1.8-6.8) and excessive use of eardrops containing antibiotics and corticoids (RR = 9.3; IC95% = 4.3-20.1). The most common etiologic agents were Aspergillus flavus (20.4%), Candida albicans (16.3%), Candida parapsilosis (14.3%), and Aspergillus niger (12.2%). A combination of two agents was found in five cases. These data show that otomycosis is endemic in Ivory Coast. Management of otomycosis must include mycological examination for diagnosis as well as changing behavior patterns leading to infection.

  1. Scheduled cesarean delivery: maternal and neonatal risks in primiparous women in a community hospital setting.

    PubMed

    Quiroz, Lieschen H; Chang, Howard; Blomquist, Joan L; Okoh, Yvonne K; Handa, Victoria L

    2009-04-01

    We compared the short-term maternal and neonatal outcomes of women who deliver by cesarean without labor compared with women who deliver by cesarean after labor or by vaginal birth. This was a retrospective cohort study of women delivering a first baby from 1998 to 2002. Hospital discharge diagnostic coding identified unlabored cesarean deliveries (UCDs), labored cesarean deliveries (LCDs), and vaginal births (VBs). Medical records were abstracted and mode of delivery confirmed. The three outcomes of interest were maternal bleeding complications, maternal febrile morbidity, and neonatal respiratory complications. Using logistic regression for each outcome, we investigated whether mode of delivery was associated with the outcome, independent of other factors. The study groups included 513 UCDs, 261 LCDs, and 251 VBs. Compared with the UCD group, the adjusted odds of bleeding complications was higher in the LCD comparison group (odds ratio [OR] 2.3; 95% confidence interval [CI] 1.21, 4.53) and the VB comparison group (OR 1.96; 95% CI 0.95, 4.02). The incidence of febrile morbidity was similar for both cesarean groups but lower in the VB group. Both comparison groups had lower odds of neonatal complications than the UCD group (OR for LCD comparison group 0.52; 95% CI 0.27, 0.95 and OR for VB comparison group 0.26; 95% CI 0.098, 0.59). Scheduled cesarean is associated with increased odds of neonatal respiratory complications but decreased odds of maternal bleeding complications.

  2. Addressing parental smoking in pediatric settings of chinese hospitals: a qualitative study of parents.

    PubMed

    Abdullah, Abu S; Ma, Zhenyu; Liao, Jing; Huang, Kaiyong; Yang, Li; Zhang, Zhiyong; Winickoff, Jonathan P; Nong, Guang-Min

    2014-01-01

    This study explored factors associated with SHS exposure from parental smoking in Chinese families and assessed nature of antismoking discussions parents had with their children's pediatricians and how pediatricians might best engage with parents in an effort to reduce children's exposure to SHS. Six focus group discussions (FGDs) were conducted among 33 Chinese parents attending six major hospitals in Guangxi province, China. Most participants (32/33) had family members who smoke, and only 21% had strict restriction on smoking at home. Some parents did not know about health consequences of smoking and effects of SHS exposure on children. Situations that made it especially hard to avoid the child's SHS exposure were having an elderly smoker at home and having a visitor who smoked. Only few parents were asked by pediatricians about child's exposure to SHS at home, but only when child's illness was related to smoking. Parents believed that suggestions coming from pediatricians about smoke-free home and parental quitting would be acceptable to parents and other household members. The findings provide insight into SHS exposure reduction effort among Chinese parents and underscore the demand for pediatrician's engagement in addressing parental tobacco use.

  3. An investigation of the efficacy of electronic consenting interfaces of research permissions management system in a hospital setting

    PubMed Central

    Madathil, Kapil Chalil; Koikkara, Reshmi; Obeid, Jihad; Greenstein, Joel S.; Sanderson, Iain C.; Fryar, Katrina; Moskowitz, Jay; Gramopadhye, Anand K.

    2013-01-01

    Purpose Ethical and legal requirements for healthcare providers in the United States, stipulate that patients sign a consent form prior to undergoing medical treatment or participating in a research study. Currently, the majority of the hospitals obtain these consents using paper-based forms, which makes patient preference data cumbersome to store, search and retrieve. To address these issues, Health Sciences of South Carolina (HSSC), a collaborative of academic medical institutions and research universities in South Carolina, is developing an electronic consenting system, the Research Permissions Management System (RPMS). This article reports the findings of a study conducted to investigate the efficacy of the two proposed interfaces for this system – an iPad-based and touchscreen-based by comparing them to the paper-based and Topaz-based systems currently in use. Methods This study involved 50 participants: 10 hospital admission staff and 40 patients. The four systems were compared with respect to the time taken to complete the consenting process, the number of errors made by the patients, the workload experienced by the hospital staff and the subjective ratings of both patients and staff on post-test questionnaires. Results The results from the empirical study indicated no significant differences in the time taken to complete the tasks. More importantly, the participants found the new systems more usable than the conventional methods with the registration staff experiencing the least workload in the iPad and touchscreen-based conditions and the patients experiencing more privacy and control during the consenting process with the proposed electronic systems. In addition, they indicated better comprehension and awareness of what they were signing using the new interfaces. Discussion The results indicate the two methods proposed for capturing patient consents are at least as effective as the conventional methods, and superior in several important respects. While

  4. Challenges in contemporary academic neurosurgery.

    PubMed

    Black, Peter M

    2006-03-01

    Traditionally, the ideal academic neurosurgeon has been a "quadruple threat," with excellence in clinical work, teaching, research, and administration. This tradition was best exemplified in Harvey Cushing, who developed the field of neurosurgery 90 years ago. This paradigm will probably have to change as academic neurosurgeons face major challenges. In patient care, these include increasing regulatory control, increasing malpractice costs, consolidation of expensive care in academic centers, and decreasing reimbursement; in resident teaching, work hour limitations and a changing resident culture; in research, the increasing dominance of basic scientists in governmental funding decisions and decreased involvement of neurosurgeons in scientific review committees; and in administration, problems of relationships in the workplace, patient safety, and employment compliance in an increasingly bureaucratic system. To meet these challenges, the new academic neurosurgeon will probably not be a quadruple threat personally but will be part of a quadruple threat in a department and institution. Neurosurgeons in such a setting will have to work with hospital, medical school, and national and international groups to address malpractice, reimbursement, subspecialization, and training problems; find supplemental sources of income through grants, development funds, and hospital support; lead in the development of multidisciplinary centers for neuroscience, brain tumor, spine, and other initiatives; and focus on training leaders for hospital, regional, and national groups to reconfigure neurosurgery. Collaboration, flexibility, and leadership will be characteristic of the academic neurosurgeon in this new era.

  5. A machine learning framework for auto classification of imaging system exams in hospital setting for utilization optimization.

    PubMed

    Patil, Meru A; Patil, Ravindra B; Krishnamoorthy, P; John, Jacob

    2016-08-01

    In clinical environment, Interventional X-Ray (IXR) system is used on various anatomies and for various types of the procedures. It is important to classify correctly each exam of IXR system into respective procedures and/or assign to correct anatomy. This classification enhances productivity of the system in terms of better scheduling of the Cath lab, also provides means to perform device usage/revenue forecast of the system by hospital management and focus on targeted treatment planning for a disease/anatomy. Although it may appear classification of each exam into respective procedure/anatomy a simple task. However, in real-life hospital settings, it is well-known that same system settings are used to perform different types of procedures. Though, such usage leads to under-utilization of the system. In this work, a method is developed to classify exams into respective anatomical type by applying machine-learning techniques (SVM, KNN and decision trees) on log information of the systems. The classification result is promising with accuracy of greater than 90%.

  6. Everyone's business: developing an integrated model of care to respond to child abuse in a pediatric hospital setting.

    PubMed

    Connolly, Sarah

    2012-01-01

    In pediatric hospitals, social work plays a central role in the prevention, identification, and management of child abuse. Children who are suspected of having been abused or neglected require an evaluation of their psychosocial situation. As an integral member of the health care team, the social worker is well placed to undertake comprehensive psychosocial assessments including information on the child's development, parental capacity, family, and community supports. Current practice approaches have seen a shift away from a narrow, "expert" approach to child protection. This article describes the development of an integrated model of social work service delivery to better respond to vulnerable and at-risk children in a pediatric hospital setting. Developing a new model of service required strategic planning, consultation, and endorsement from senior hospital management. The new model aimed to ensure a high quality, responsive social work service to children at risk of physical abuse, neglect, or cumulative harm. The change necessitated understanding of current research evidence, development of best practice guidelines, and effective communication with staff and external stakeholders. Policy development, implementation of practice guidelines, staff training, data collection, and service evaluation are described. The role of social work management and leadership were central in creating change. Visionary leadership is widely regarded as key to successful organizational change. The management approach included consultation with staff, building commitment to the need for change, addressing staff concerns, and providing a vision of enhanced client outcomes as a result of the change process. This article provides a candid overview of challenges and barriers to change. Change strategies described are easily transferable to other social work settings.

  7. Peer pressure and public reporting within healthcare setting: improving accountability and health care quality in hospitals.

    PubMed

    Specchia, Maria Lucia; Veneziano, Maria Assunta; Cadeddu, Chiara; Ferriero, Anna Maria; Capizzi, Silvio; Ricciardi, Walter

    2012-01-01

    In the last few years, the need of public reporting of health outcomes has acquired a great importance. The public release of performance results could be a tool for improving health care quality and many attempts have been made in order to introduce public reporting programs within the health care context at different levels. It would be necessary to promote the introduction of a standardized set of outcome and performance measures in order to improve quality of health care services and to make health care providers aware of the importance of transparency and accountability.

  8. Proton-pump inhibitor therapy and vitamin B12 status in an inpatient hospital setting.

    PubMed

    Hartman, Brenda; Donnelly-VanderLoo, Mary; Watson, Tiffany; O'Connor, Colleen; Madill, Janet

    2016-06-23

    The risk for impaired vitamin B12 status increases with age, as does the use of proton pump inhibitors (PPI). Long-term use of PPIs is associated with several nutritional deficiencies including B12. Currently, there are no recommendations for B12 screening among patients taking PPIs. Data were abstracted on B12 concentrations, B12-containing supplement use, medications, and select hematological values from a retrospective chart review of 658 adults, 391 with serum B12 concentrations, admitted to 6 different medical units at 2 regional hospitals in Southwestern Ontario between 2010 and 2012. We found no difference between PPI users and nonusers and serum B12 concentrations (404 ± 224 vs 369 ± 213 pmol/L; P = 0.0690). This may be due to use of B12 containing multivitamins in 41% of PPI users. Regression modelling found that aging increases the odds of having an impaired B12 status (<220 pmol/L) by 1.4 times and those using B12 supplements are almost 4 times more likely to have an impaired status. Mean corpuscular volume was not related to B12 status. In this population, older PPI users are more likely to be using multivitamins, which may delay nutritional deficiencies. However, the lower B12 concentrations of PPI users taking only B12 supplements is a concern and requires further research. Finally, physicians need to be aware that mean corpuscular volume is no longer recommended as an effective biomarker for B12 screening and updated screening protocols need to be used to reduce the possibility of adverse neurological effects from impaired B12 status.

  9. Antibiogram of Medical Intensive Care Unit at Tertiary Care Hospital Setting of Pakistan

    PubMed Central

    Qadeer, Aayesha; Akhtar, Aftab; Ain, Qurat Ul; Saadat, Shoab; Mansoor, Salman; Ishtiaq, Wasib; Ilyas, Abid; Khan, Ali Y; Ajam, Yousaf

    2016-01-01

    Objective: To determine the frequency of micro-organisms causing sepsis as well as to determine the antibiotic susceptibility and resistance of microorganisms isolated in a medical intensive care unit. Materials and methods: This is a cross-sectional analysis of 802 patients from a medical intensive care unit (ICU) of Shifa International Hospital, Islamabad, Pakistan over a one-year period from August 2015 to August 2016. Specimens collected were from blood, urine, endotracheal secretions, catheter tips, tissue, pus swabs, cerebrospinal fluid, ascites, bronchoalveolar lavage (BAL), and pleural fluid. All bacteria were identified by standard microbiological methods, and antibiotic sensitivity/resistance was performed using the disk diffusion technique, according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Data was collected using a critical care unit electronic database and data analysis was done by using  the Statistical Package for Social Sciences (SPSS), version 20 (IBM SPSS Statistics, Armonk, NY). Results: Gram-negative bacteria were more frequent as compared to gram-positive bacteria. Most common bacterial isolates were Acinetobacter (15.3%), Escherichia coli (15.3%), Pseudomonas aeruginosa (13%), and Klebsiella pneumoniae (10.2%), whereas Enterococcus (7%) and methicillin-resistant staphylococcus aureus (MRSA) (6.2%) were the two most common gram-positive bacteria. For Acinetobacter, colistin was the most effective antibiotic (3% resistance). For E.coli, colistin (0%), tigecycline (0%), amikacin (7%), and carbapenems (10%) showed low resistance. Pseudomonas aeruginosa showed low resistance to colistin (7%). For Klebsiella pneumoniae, low resistance was seen for tigecycline (0%) and minocycline (16%). Overall, ICU mortality was 31.3%, including miscellaneous cases. Conclusion: Gram-negative infections, especially by multidrug-resistant organisms, are on the rise in ICUs. Empirical antibiotics should be used according to the local

  10. HIV rapid testing in a Veterans Affairs hospital ED setting: a 5-year sustainability evaluation.

    PubMed

    Knapp, Herschel; Hagedorn, Hildi; Anaya, Henry D

    2014-08-01

    Routine HIV testing in primary care settings is now recommended in the United States. The US Department of Veterans Affairs (VA) has increased the number of patients tested for HIV, but overall HIV testing rates in VA remain low. A proven strategy for increasing such testing involves nurse-initiated HIV rapid testing (HIV RT). The purpose of this work was to use a mixed methodology approach to evaluate the 5-year sustainability of an intervention that implemented HIV RT in a VA emergency department setting in a large, urban VA medical center to reduce missed diagnostic and treatment opportunities in this vulnerable patient population. In-person semistructured interviews were conducted with providers and stakeholders. Interview notes were qualitatively coded for emerging themes. Quarterly testing rates were evaluated for a 5-year time span starting from the launch in July 2008. Findings indicate that HIV RT was sustained by the enthusiasm of 2 clinical champions who oversaw the registered nurses responsible for conducting the testing. The departure of the clinical champions was correlated with a substantial drop-off in testing. Findings also indicate potential strategies for improving sustainability including engaging senior leadership in the project, engaging line staff in the implementation planning from the start to increase ownership over the innovation, incorporating information into initial training explaining the importance of the innovation to quality patient care, providing ongoing training to maintain skills, and providing routine progress reports to staff to demonstrate the ongoing impact of their efforts.

  11. Delirium Detection and Impact of Comorbid Health Conditions in a Post-Acute Rehabilitation Hospital Setting

    PubMed Central

    Stelmokas, Julija; Gabel, Nicolette; Flaherty, Jennifer M.; Rayson, Katherine; Tran, Kathileen; Anderson, Jason R.; Bieliauskas, Linas A.

    2016-01-01

    Misdiagnosis and under-detection of delirium may occur in many medical settings. This is important to address as delirium clearly increases risk of morbidity and mortality in such settings. This study assessed whether Veterans who screened positive on a delirium severity measure (Memorial Delirium Assessment Scale; MDAS) differed from those with and without corresponding medical documentation of delirium in terms of cognitive functioning, psychiatric/medical history, and medication use. A medical record review of 266 inpatients at a VA post-acute rehabilitation unit found that 10.9% were identified as delirious according to the MDAS and/or medical records. Of the Veterans who screened positive on the MDAS (N = 19), 68.4% went undetected by medical screening. Undetected cases had a higher number of comorbid medical conditions as measured by the Age-Adjusted Charlson Index (AACI) scores (median = 9, SD = 3.15; U = 5.5, p = .003) than medically documented cases. For Veterans with a score of 7 or greater on the AACI, the general relative risk for delirium was 4.46. Delirium is frequently under-detected in a post-acute rehabilitation unit, particularly for Veterans with high comorbid illness. The relative risk of delirium is up to 4.46 for those with high medical burden, suggesting the need for more comprehensive delirium screening in these patients. PMID:27902744

  12. THE MIXED EVIDENCE FOR BRIEF INTERVENTION IN EMERGENCY DEPARTMENTS, TRAUMA CARE CENTERS AND INPATIENT HOSPITAL SETTINGS: WHAT SHOULD WE DO?

    PubMed Central

    Field, Craig Andrew; Baird, Janette; Saitz, Richard; Caetano, Raul; Monti, Peter M.

    2010-01-01

    The purpose of this review is to provide a broad overview of the status of brief intervention in the emergency department, trauma center and inpatient hospital setting. This review is based on a symposia presented at the 2009 annual conference of the Research Society on Alcoholism (Baird et al., 2009; Field, et al., 2009; Monti et al., 2009; Saitz et al., 2009). While the general efficacy of brief alcohol interventions in these settings has been recognized, the evidence is increasingly mixed. Herein we discuss possible confounding factors; including the inconsistencies in interventions provided, differences in target population, study design and assessment procedures. Recent studies investigating potential moderators of treatment outcomes suggest that a more sophisticated approach to evaluating the effectiveness of brief interventions across varying patient populations is needed in order to further understand its effectiveness. Current dissemination efforts represent a significant advance in broadening the base of treatment for alcohol problems by providing an evidenced based intervention in health care settings and should not be curtailed. However, additional research is required to enhance treatment outcomes, refine current practice guidelines and continue to bridge the gap between science and practice. Given the current state of research, a multi-setting clinical trial is recommended to account for potential contextual differences while controlling for study design. PMID:20860610

  13. A feasibility test of a brief motivational interview intervention to reduce dating abuse perpetration in a hospital setting

    PubMed Central

    Rothman, Emily F.; Wang, Na

    2016-01-01

    Objective To describe the intervention development process and feasibility testing of a hospital-based brief intervention to reduce the perpetration of adolescent dating abuse (ADA). To our knowledge, this intervention is the first to focus exclusively on ADA perpetration reduction via a motivational interview-type intervention in this setting. Method The rationale for and the six Intervention Mapping steps used to generate the intervention are described. Feasibility is conceptualized as intervention acceptability, demand, implementation, practicality, integration, and limited-efficacy. Results The Real Talk intervention was integrated smoothly into the emergency department setting. Participants did not experience any negative impact, and the vast majority (86%) reported that they felt helped. Quantitative assessments suggest that the intervention reduced the number of participants in the pre-contemplation stage of change regarding their use of relationship violence, and may have moved them forward into the action stage. Real Talk participants were more likely than those in the control group to tell friends to help them stay calm around their partner after drinking alcohol, and to talk with their doctor to get help for their problems. Conclusions Real Talk was developed to meet an unmet need for tertiary ADA interventions in non-school settings. It was developed in accordance with a recommended framework, informed by theory, and subsequently tested for feasibility. Feasibility assessment results suggest that Real Talk can be implemented in health care settings and may influence attitudinal and behavioral outcomes in the desired directions. PMID:27525169

  14. The Council of Academic Hospitals of Ontario (CAHO) Adopting Research to Improve Care (ARTIC) Program: Reach, Sustainability, Spread and Lessons Learned from an Implementation Funding Model.

    PubMed

    Moore, Julia E; Grouchy, Michelle; Graham, Ian D; Shandling, Maureen; Doyle, Winnie; Straus, Sharon E

    2016-05-01

    Despite evidence on what works in healthcare, there is a significant gap in the time it takes to bring research into practice. The Council of Academic Hospitals of Ontario's Adopting Research to Improve Care program addresses this research-to-practice gap by incorporating the following components into its funding program: strategic selection of evidence for implementation, education and training for implementation, implementation supports, executive champions and governance, and evaluation. Funded projects have been sustained (76% reported full sustainability) and spread to over 200 new sites. Lessons learned include the following: assess readiness, develop tailored implementation materials, consider characteristics of implementation supports, protect champion time and consider evaluation feasibility.

  15. The Council of Academic Hospitals of Ontario (CAHO) Adopting Research to Improve Care (ARTIC) Program: Reach, Sustainability, Spread and Lessons Learned from an Implementation Funding Model

    PubMed Central

    Grouchy, Michelle; Graham, Ian D.; Shandling, Maureen; Doyle, Winnie; Straus, Sharon E.

    2016-01-01

    Despite evidence on what works in healthcare, there is a significant gap in the time it takes to bring research into practice. The Council of Academic Hospitals of Ontario's Adopting Research to Improve Care program addresses this research-to-practice gap by incorporating the following components into its funding program: strategic selection of evidence for implementation, education and training for implementation, implementation supports, executive champions and governance, and evaluation. Funded projects have been sustained (76% reported full sustainability) and spread to over 200 new sites. Lessons learned include the following: assess readiness, develop tailored implementation materials, consider characteristics of implementation supports, protect champion time and consider evaluation feasibility. PMID:27232234

  16. The acute hospital setting as a place of death and final care: a qualitative study on perspectives of family physicians, nurses and family carers.

    PubMed

    Reyniers, Thijs; Houttekier, Dirk; Cohen, Joachim; Pasman, H Roeline; Deliens, Luc

    2014-05-01

    While the focus of end-of-life care research and policy has predominantly been on 'death in a homelike environment', little is known about perceptions of the acute hospital setting as a place of final care or death. Using a qualitative design and constant comparative analysis, the perspectives of family physicians, nurses and family carers were explored. Participants generally perceived the acute hospital setting to be inadequate for terminally ill patients, although they indicated that in some circumstances it might be a 'safe haven'. This implies that a higher quality of end-of-life care provision in the acute hospital setting needs to be ensured, preferably by improving communication skills. At the same time alternatives to the acute hospital setting need to be developed or expanded.

  17. Recommendations on pre-hospital & early hospital management of acute heart failure: a consensus paper from the Heart Failure Association of the European Society of Cardiology, the European Society of Emergency Medicine and the Society of Academic Emergency Medicine.

    PubMed

    Mebazaa, Alexandre; Yilmaz, M Birhan; Levy, Phillip; Ponikowski, Piotr; Peacock, W Frank; Laribi, Said; Ristic, Arsen D; Lambrinou, Ekaterini; Masip, Josep; Riley, Jillian P; McDonagh, Theresa; Mueller, Christian; deFilippi, Christopher; Harjola, Veli-Pekka; Thiele, Holger; Piepoli, Massimo F; Metra, Marco; Maggioni, Aldo; McMurray, John; Dickstein, Kenneth; Damman, Kevin; Seferovic, Petar M; Ruschitzka, Frank; Leite-Moreira, Adelino F; Bellou, Abdelouahab; Anker, Stefan D; Filippatos, Gerasimos

    2015-06-01

    Acute heart failure is a fatal syndrome. Emergency physicians, cardiologists, intensivists, nurses and other health care providers have to cooperate to provide optimal benefit. However, many treatment decisions are opinion-based and few are evidenced-based. This consensus paper provides guidance to practicing physicians and nurses to manage acute heart failure in the pre-hospital and hospital setting. Criteria of hospitalization and of discharge are described. Gaps in knowledge and perspectives in the management of acute heart failure are also detailed. This consensus paper on acute heart failure might help enable contiguous practice.

  18. Informed consent practices for surgical care at university teaching hospitals: a case in a low resource setting

    PubMed Central

    2014-01-01

    Background Informed consent in medical practice is essential and a global standard that should be sought at all the times doctors interact with patients. Its intensity would vary depending on the invasiveness and risks associated with the anticipated treatment. To our knowledge there has not been any systematic review of consent practices to document best practices and identify areas that need improvement in our setting. The objective of the study was to evaluate the informed consent practices of surgeons at University teaching Hospitals in a low resource setting. Methods A cross-sectional study conducted at three university teaching hospitals in Uganda. Self-guided questionnaires were left at a central location in each of the surgical departments after verbally communicating to the surgeons of the intention of the study. Filled questionnaires were returned at the same location by the respondents for collection by the research team. In addition, 20 in-depth interviews were held with surgeons and a review of 384 patients’ record files for informed consent documentation was done. Results A total of 132 (62.1%) out of 214 questionnaires were completed and returned. Respondents were intern doctors, residents and specialists from General surgery, Orthopedic surgery, Ear, Nose and Throat, Ophthalmology, Dentistry, Obstetrics and Gynaecology departments. The average working experience of respondents was 4.8 years (SD 4.454, range 0–39 years). 48.8% of the respondents said they obtained consent all the time surgery is done while 51.2% did not obtain consent all the time. Many of the respondents indicated that informed consent was not obtained by the surgeon who operated the patient but was obtained either at admission or by nurses in the surgical units. The consent forms used in the hospitals were found to be inadequate and many times signed at admission before diagnosing the patient’s disease. Conclusions Informed consent administration and documentation for

  19. Athletes' Graduation Rates Set a Record, but Enrollment of Black Players Falls as NCAA Continues To Raise Academic Standards.

    ERIC Educational Resources Information Center

    Suggs, Welch

    2003-01-01

    A recent report shows that the National Collegiate Athletic Association is making progress on improving the academic performance of athletes, but it is doing so at a cost to black players who get athletic scholarships. More athletes graduate; fewer of them are black. (SLD)

  20. The Influence of Academic and Social Factors of School Principals on the Success of Middle School Students in Urban Settings

    ERIC Educational Resources Information Center

    Curtis, Tonya Yvette

    2012-01-01

    One thing is certain, accountability is here to stay; accountability exposes the good, the bad, and the ugly. The academic achievement gap between non-White and White students continues to exist in the disaggregated data in individual campuses, within school districts, and within comparison studies across the nation. Thus, school leadership is…

  1. The Attitude of Egyptian SET Academics towards Innovation: Universities and Innovation in a Factor-Driven Economy

    ERIC Educational Resources Information Center

    El Hadidi, Hala; Kirby, David A.

    2015-01-01

    In the modern knowledge economy universities are being required to operate more entrepreneurially, commercializing the results of their research and spinning out new ventures. The literature on the Triple Helix model (of academic-industry-government relations) is outlined, emphasizing--as does the model--the enhanced role that the modern…

  2. The Effect of Psychiatric Third-Year Rotation Setting on Academic Performance, Student Attitudes, and Specialty Choice

    ERIC Educational Resources Information Center

    Bobo, William V.; Nevin, Remington; Greene, Elizabeth; Lacy, Timothy J.

    2009-01-01

    Objective: Few studies have directly compared the effects of third-year clerkship rotation type on measures of academic performance, student attitudes about psychiatry and psychiatric patients, and level of interest in psychiatry as a career. The goal of this study was to assess the extent to which rotation type influenced these outcome variables…

  3. A Report on Using General-Case Programming to Teach Collateral Academic Skills to a Student in a Postsecondary Setting

    ERIC Educational Resources Information Center

    Chezan, Laura C.; Drasgow, Erik; Marshall, Kathleen J.

    2012-01-01

    The authors' purpose in this report is to examine the application of general-case programming to teach collateral academic skills to a student with pervasive developmental disorder-not otherwise specified (PDD-NOS) and with a mild intellectual disability who was attending college. The authors use data drawn from their work with Tom to explain and…

  4. Honor Codes and Other Contextual Influences on Academic Integrity: A Replication and Extension to Modified Honor Code Settings.

    ERIC Educational Resources Information Center

    McCabe, Donald L.; Trevino, Linda Klebe; Butterfield, Kenneth D.

    2002-01-01

    Investigated the influence of modified honor codes, an alternative to traditional codes that is gaining popularity on larger campuses. Also tested the model of student academic dishonesty previously suggested by McCabe and Trevino. Found that modified honor codes are associated with lower levels of student dishonesty and that the McCabe Trevino…

  5. Addressing the Social, Academic, and Behavioral Needs of Students with Challenging Behavior in Inclusive and Alternative Settings. Highlights from the Forum on Comprehensive Programming for a Diverse Population of Children and Youth with Challenging Behavior: Addressing Social, Academic, and Behavioral Needs within Inclusive and Alternative Settings (Las Vegas, Nevada, February 9-10, 2001).

    ERIC Educational Resources Information Center

    Bullock, Lyndal M., Ed.; Gable, Robert A., Ed.

    This document presents the texts of 11 major presentations and conference highlights from a February 2001 conference on the social, academic, and behavioral needs of students with challenging behavior in inclusive and alternative settings as required under the 1997 amendments to the Individuals with Disabilities Education Act. The presentations…

  6. Online Education for Improving Communication and Documentation of Dietary Supplements Among Health Professionals Practicing in a Hospital Setting

    PubMed Central

    Filippelli, Amanda C.; Kabbara, Karim; Lin, Steven C.; Sadikova, Ekaterina; Kaptchuk, Ted J.; Kemper, Kathi

    2015-01-01

    Abstract Background: Little is known about the feasibility of online education in improving communication and documentation of dietary supplements (DS) among clinicians. Methods: This prospective educational study included clinicians at an urban teaching hospital. The curriculum included video streams, didactics, and interactive case presentations to discuss (1) DS safety and effectiveness, (2) cultural competency, (3) managing DS in a hospital setting, and (4) DS adverse events. Participants were surveyed, at baseline and after training, about DS knowledge, confidence, communication, and documentation practices. Results: Thirty-nine of 61 (64%) recruited clinicians completed all four patient cases and post-tests. Most (82%) were women and 59% were physicians. The mean DS knowledge test score increased after the curriculum (p < 0.0001), and the clinician confidence score also increased (p < 0.0001). Most (82%) participants reported that curriculum changed their use of evidence-based resources (p = 0.01). There was a change in the indications for symptom management (p = 0.05) and gastrointestinal/digestive health issues (p = 0.03). There were statistically significant increases in the frequency of asking patients about DS use during discharge (p = 0.01), and 82% responded that the curriculum changed their DS documentation. Conclusion: An online curriculum is an effective tool for presenting DS education to clinicians with the goal of improving clinicians' knowledge, confidence, and documentation practices about DS. PMID:26270001

  7. Methodological aspects in the assessment of safety culture in the hospital setting: a review of the literature.

    PubMed

    Pumar-Méndez, María J; Attree, Moira; Wakefield, Ann

    2014-02-01

    A thematic literature review was undertaken to identify methodological aspects in the assessment of safety culture and critically examine how these have been addressed in hospital-based studies of safety culture, for the period 1999-2012. The literature search included an electronic database search (BNI, CINAHL, EMBASE, MEDLINE and PsycINFO), access to websites of organizations dedicated to the enhancement of patient safety, and a manual search of reference lists of the papers included. The analysis of the 43 records included in the review revealed that discussion regarding the measurement of safety culture in the hospital setting revolves around three methodological areas, namely: research approaches; survey tools for data collection; and levels of data aggregation. To advance these discussions, robust research is needed to clarify what dimensions belong to the core of safety culture and what the main sources of safety culture variability are. Studies using a mixed methods approach to assess safety culture would be useful, since they permit the in-depth research necessary to depict the multiple components of this construct.

  8. Workplace violence in different settings and among various health professionals in an Italian general hospital: a cross-sectional study

    PubMed Central

    Ferri, Paola; Silvestri, Monica; Artoni, Cecilia; Di Lorenzo, Rosaria

    2016-01-01

    Background Workplace violence (WPV) against health professionals is a global problem with an increasing incidence. The aims of this study were as follows: 1) to examine the frequency and characteristics of WPV in different settings and professionals of a general hospital and 2) to identify the clinical and organizational factors related to this phenomenon. Methods The study was cross-sectional. In a 1-month period, we administered the “Violent Incident Form” to 745 professionals (physicians, head nurses, nurses, nursing assistants), who worked in 15 wards of a general hospital in northern Italy. Results With a response rate of 56%, 45% of professionals reported WPV. The most frequently assaulted were nurses (67%), followed by nursing assistants (18%) and physicians (12%). The first two categories were correlated, in a statistically significant way, with the risk of WPV (P=0.005, P=0.004, multiple logistic regression). The violent incidents more frequently occurred in psychiatry department (86%), emergency department (71%), and in geriatric wards (57%). The assailants more frequently were males whereas assaulted professionals more often were females. Men committed physical violence more frequently than women, in a statistically significant way (P=0.034, chi-squared test). Verbal violence (51%) was often committed by people in a lucid and normal state of consciousness; physical violence (49%) was most often perpetrated by assailants affected by dementia, mental retardation, drug and substance abuse, or other psychiatric disorders. The variables positively related to WPV were “calling for help during the attack” and “physical injuries suffered in violent attack” (P=0.02, P=0.03, multiple logistic regression). Conclusion This study suggests that violence is a significant phenomenon and that all health workers, especially nurses, are at risk of suffering aggressive assaults. WPV presented specific characteristics related to the health care settings, where

  9. Structured sedation programs in the emergency department, hospital and other acute settings: protocol for systematic review of effects and events

    PubMed Central

    2013-01-01

    Background The use of procedural sedation outside the operating theatre has increased in hospital settings and has gained popularity among non-anesthesiologists. Sedative agents used for procedural pain, although effective, also pose significant risks to the patient if used incorrectly. There is currently no universally accepted program of education for practitioners using or introducing procedural sedation into their practice. There is emerging literature identifying structured procedural sedation programs (PSPs) as a method of ensuring a standardized level of competency among staff and reducing risks to the patient. We hypothesize that programs of education for healthcare professionals using procedural sedation outside the operating theatre are beneficial in improving patient care, safety, practitioner competence and reducing adverse event rates. Methods/Design Electronic databases will be systematically searched for studies (randomized and non-randomized) examining the effectiveness of structured PSPs from 1966 to present. Database searches will be supplemented by contact with experts, reference and citation checking, and a grey literature search. No language restriction will be imposed. Screening of titles and abstracts, and data extraction will be performed by two independent reviewers. All disagreements will be resolved by discussion with an independent third party. Data analysis will be completed adhering to procedures outlined in the Cochrane Handbook of Systematic Reviews of Interventions. If the data allows, a meta-analysis will be performed. Discussion This review will cohere evidence on the effectiveness of structured PSPs on sedation events and patient outcomes within the hospital and other acute care settings. In addition, it will examine key components identified within a PSP associated with patient safety and improved patient outcomes. Trial registration PROSPERO registration number: CRD42013003851 PMID:24083519

  10. [University professors in the Soviet Occupation Zone and the German Democratic Republic up to 1961: Academic alternation of generations at university psychiatric hospitals].

    PubMed

    Kumbier, E; Haack, K

    2015-05-01

    After WWII a politically guided staffing policy foresaw an exchange program for professors from the Soviet Occupation Zone and the German Democratic Republic (GDR). In the field of medicine this initiative was not successful. With respect to university psychiatric/neurological hospitals this experiment failed as a result of a shortage of personnel due to the consequences of war, denazification and people migrating into western occupation zones. Criteria for politically selecting promising young talent which had been propagated by the Socialist Unity Party of Germany (Sozialistische Einheitspartei Deutschlands, SED) were thus not relevant in academic medicine until 1961; however, the communist rulers had great interest in bringing professional and academic resources up to date. Politically implicated representatives in the field were also included in this process. At the forefront was the interest in functioning medical care and education in order to be able to train much needed health professionals. At the end of the 1950s a new generation of professors was established at the university hospitals. This generation rotation demonstrated the politically intended replacement of the "old" professor generation and the transition to a new GDR generation that had been trained after 1945. This second generation of professors inherited vacant professorships and defined and shaped research and academia until the end of the GDR much more than the previous generation had and also more than the one that followed. The generation of professors continued to feel a strong affiliation with their academic teachers and consequently continued their tradition in the sense of a school, for the most part independent of political circumstances.

  11. Adopting and sustaining a Virtual Fracture Clinic model in the District Hospital setting – a quality improvement approach

    PubMed Central

    Logishetty, Kartik; Subramanyam, Soosainathan

    2017-01-01

    Virtual Fracture Clinics (VFCs) are an alternative to the conventional fracture clinics, to manage certain musculoskeletal injuries. This has recently been reported as a safe, cost-effective and efficient care model. As demonstrated at vanguard sites in the United Kingdom, VFCs can enhance patient care by standardising treatment and reducing outpatient appointments. This project demonstrates how a Quality Improvement approach was applied to introduce VFCs in the District General Hospital setting. We demonstrate how undertaking Process Mapping, Driver Diagrams, and Stakeholder Analysis can assist implementation. We discuss Whole Systems Measures applicable to VFCs, to consider how robust and specific data collection can progress this care model. Three Plan-Do-Study-Act cycles led to a change in practice over a 21-month period. Our target for uptake of new patients seen in VFCs within 6 months of starting was set at 50%. It increased from 0% to 56.1% soon after introduction, and plateaued at an average of 56.4% in the six-months before the end of the study period. Careful planning, frequent monitoring, and gathering feedback from a multidisciplinary team of varying seniority, were the important factors in transitioning to, and sustaining, a successful VFC model. PMID:28243440

  12. Teaching social studies to high school students with academic handicaps in a mainstreamed setting: effects of a computerized study guide.

    PubMed

    Horton, S V; Lovitt, T C; Givens, A; Nelson, R

    1989-02-01

    This research investigated the effectiveness of a computerized study guide, in comparison to a notetaking condition, as a method to increase textbook comprehension among students with learning disabilities and remedial education pupils enrolled in a ninth-grade world geography class. Results indicated that the computerized study guide produced significantly higher performance than notetaking for both groups of students. There was no significant difference in the performance of the two groups within treatments. Several practical issues concerning the implementation of computerized study guides in secondary programs serving students with academic handicaps are discussed.

  13. Appropriateness of gram-negative agent use at a tertiary care hospital in the setting of significant antimicrobial resistance.

    PubMed

    Vora, Neil M; Kubin, Christine J; Furuya, E Yoko

    2015-01-01

    Background.  Practicing antimicrobial stewardship in the setting of widespread antimicrobial resistance among gram-negative bacilli, particularly in urban areas, is challenging. Methods.  We conducted a retrospective cross-sectional study at a tertiary care hospital with an established antimicrobial stewardship program in New York, New York to determine appropriateness of use of gram-negative antimicrobials and to identify factors associated with suboptimal antimicrobial use. Adult inpatients who received gram-negative agents on 2 dates, 1 June 2010 or 1 December 2010, were identified through pharmacy records. Clinical data were collected for each patient. Use of gram-negative agents was deemed optimal or suboptimal through chart review and according to hospital guidelines. Data were compared using χ(2) or Fischer's exact test for categorical variables and Student t test or Mann-Whitney U test for continuous variables. Results.  A total of 356 patients were included who received 422 gram-negative agents. Administration was deemed suboptimal in 26% of instances, with the most common reason being spectrum of activity too broad. In multivariable analysis, being in an intensive care unit (adjusted odds ratio [aOR], .49; 95% confidence interval [CI], .29-.84), having an infectious diseases consultation within the previous 7 days (aOR, .52; 95% CI, .28-.98), and having a history of multidrug-resistant gram-negative bacilli within the past year (aOR, .24; 95% CI, .09-.65) were associated with optimal gram-negative agent use. Beta-lactam/beta-lactamase inhibitor combination drug use (aOR, 2.6; 95% CI, 1.35-5.16) was associated with suboptimal use. Conclusions.  Gram-negative agents were used too broadly despite numerous antimicrobial stewardship program activities.

  14. Childhood intussusceptions at a tertiary care hospital in northwestern Tanzania: a diagnostic and therapeutic challenge in resource-limited setting

    PubMed Central

    2014-01-01

    Background Intussusception remains a common cause of bowel obstruction in children and results in significant morbidity and mortality if not promptly treated. There is a paucity of prospective studies regarding childhood intussusception in Tanzania and particularly the study area. This study describes the pattern, clinical presentations and management outcomes of childhood intussusception in our setting and highlights the challenging problems in the management of this disease. Methods This was a prospective descriptive study of patients aged < 10 years operated for intussusception at Bugando Medical Centre. Ethical approval to conduct the study was obtained from relevant authorities. Data was analyzed using SPSS version 17.0. Results A total of 56 patients were studied. The male to female ratio was 3.3: 1. The median age was 6 months. Three-quarter of patients were < 1 year. Etiology was mainly idiopathic in 91.1% of cases. The classic triad of bloody stool, vomiting and abdominal distention/abdominal pain was found in 24 (42.5%) patients. The diagnosis of intussusception was mainly clinically in 71.4% of cases. All patients were treated surgically. Ileo-colic was the most frequent type of intussusception (67.9%). Twenty-six (46.4%) patients required bowel resection. The rate of bowel resection was significantly associated with late presentation > 24 hour (p = 0.001). Complication rate was 32.1% and surgical site infection (37.5%) was the most frequent complication. The median length of hospital stay was 7 days. Patients who had bowel resection and those who developed complications stayed longer in the hospital and this was statistically significant (p < 0.001). Mortality rate was 14.3%. Age < 1 year, delayed presentation, associated peritonitis, bowel resection and surgical site infection were the main predictors of mortality (p < 0.001). The follow up of patients was generally poor Conclusion Intussusception in our setting is characterized by late presentation

  15. Instructor's Perceptions towards the Use of an Online Instructional Tool in an Academic English Setting in Kuwait

    ERIC Educational Resources Information Center

    Erguvan, Deniz

    2014-01-01

    This study sets out to explore the faculty members' perceptions of a specific web-based instruction tool (Achieve3000) in a private higher education institute in Kuwait. The online tool provides highly differentiated instruction, which is initiated with a level set at the beginning of the term. The program is used in two consecutive courses as…

  16. Field Note-Developing Suicide Risk Assessment Training for Hospital Social Workers: An Academic-Community Partnership

    ERIC Educational Resources Information Center

    Wharff, Elizabeth A.; Ross, Abigail M.; Lambert, Susan

    2014-01-01

    This article describes 1 large urban pediatric hospital's partnership with a university to provide suicide assessment and management training within its social work department. Social work administrators conducted a department-wide needs assessment and implemented a 2-session suicide assessment training program and evaluation. Respondents…

  17. Restructuring within an academic health center to support quality and safety: the development of the Center for Quality and Safety at the Massachusetts General Hospital.

    PubMed

    Bohmer, Richard M J; Bloom, Jonathan D; Mort, Elizabeth A; Demehin, Akinluwa A; Meyer, Gregg S

    2009-12-01

    Recent focus on the need to improve the quality and safety of health care has created new challenges for academic health centers (AHCs). Whereas previously quality was largely assumed, today it is increasingly quantifiable and requires organized systems for improvement. Traditional structures and cultures within AHCs, although well suited to the tripartite missions of teaching, research, and clinical care, are not easily adaptable to the tasks of measuring, reporting, and improving quality. Here, the authors use a case study of Massachusetts General Hospital's efforts to restructure quality and safety to illustrate the value of beginning with a focus on organizational culture, using a systematic process of engaging clinical leadership, developing an organizational framework dependent on proven business principles, leveraging focus events, and maintaining executive dedication to execution of the initiative. The case provides a generalizable example for AHCs of how applying explicit management design can foster robust organizational change with relatively modest incremental financial resources.

  18. Time and Cost Analysis: Pediatric Dental Rehabilitation with General Anesthesia in the Office and the Hospital Settings

    PubMed Central

    Rashewsky, Stephanie; Parameswaran, Ashish; Sloane, Carole; Ferguson, Fred; Epstein, Ralph

    2012-01-01

    Pediatric dental patients who cannot receive dental care in the clinic due to uncooperative behavior are often referred to receive dental care under general anesthesia (GA). At Stony Brook Medicine, dental patients requiring treatment with GA receive dental care in our outpatient facility at the Stony Brook School of Dental Medicine (SDM) or in the Stony Brook University Hospital ambulatory setting (SBUH). This study investigates the time and cost for ambulatory American Society of Anesthesiologists (ASA) Class I pediatric patients receiving full-mouth dental rehabilitation using GA in these 2 locations, along with a descriptive analysis of the patients and dental services provided. In this institutional review board–approved cross-sectional retrospective study, ICD-9 codes for dental caries (521.00) were used to collect patient records between July 2009 and May 2011. Participants were limited to ASA I patients aged 36–60 months. Complete records from 96 patients were reviewed. There were significant differences in cost, total anesthesia time, and recovery room time (P < .001). The average total time (anesthesia end time minus anesthesia start time) to treat a child at SBUH under GA was 222 ± 62.7 minutes, and recovery time (time of discharge minus anesthesia end time) was 157 ± 97.2 minutes; the average total cost was $7,303. At the SDM, the average total time was 175 ± 36.8 minutes, and recovery time was 25 ± 12.7 minutes; the average total cost was $414. After controlling for anesthesia time and procedures, we found that SBUH cost 13.2 times more than SDM. This study provides evidence that ASA I pediatric patients can receive full-mouth dental rehabilitation utilizing GA under the direction of dentist anesthesiologists in an office-based dental setting more quickly and at a lower cost. This is very promising for patients with the least access to care, including patients with special needs and lack of insurance. PMID:23241037

  19. Time and cost analysis: pediatric dental rehabilitation with general anesthesia in the office and the hospital settings.

    PubMed

    Rashewsky, Stephanie; Parameswaran, Ashish; Sloane, Carole; Ferguson, Fred; Epstein, Ralph

    2012-01-01

    Pediatric dental patients who cannot receive dental care in the clinic due to uncooperative behavior are often referred to receive dental care under general anesthesia (GA). At Stony Brook Medicine, dental patients requiring treatment with GA receive dental care in our outpatient facility at the Stony Brook School of Dental Medicine (SDM) or in the Stony Brook University Hospital ambulatory setting (SBUH). This study investigates the time and cost for ambulatory American Society of Anesthesiologists (ASA) Class I pediatric patients receiving full-mouth dental rehabilitation using GA in these 2 locations, along with a descriptive analysis of the patients and dental services provided. In this institutional review board-approved cross-sectional retrospective study, ICD-9 codes for dental caries (521.00) were used to collect patient records between July 2009 and May 2011. Participants were limited to ASA I patients aged 36-60 months. Complete records from 96 patients were reviewed. There were significant differences in cost, total anesthesia time, and recovery room time (P < .001). The average total time (anesthesia end time minus anesthesia start time) to treat a child at SBUH under GA was 222 ± 62.7 minutes, and recovery time (time of discharge minus anesthesia end time) was 157 ± 97.2 minutes; the average total cost was $7,303. At the SDM, the average total time was 175 ± 36.8 minutes, and recovery time was 25 ± 12.7 minutes; the average total cost was $414. After controlling for anesthesia time and procedures, we found that SBUH cost 13.2 times more than SDM. This study provides evidence that ASA I pediatric patients can receive full-mouth dental rehabilitation utilizing GA under the direction of dentist anesthesiologists in an office-based dental setting more quickly and at a lower cost. This is very promising for patients with the least access to care, including patients with special needs and lack of insurance.

  20. Human resource management strategies for the retention of nurses in acute care settings in hospitals in Australia.

    PubMed

    Hogan, Pamela; Moxham, Lorna; Dwyer, Trudy

    2007-04-01

    It is paramount that there is an adequate nursing workforce supply for now and in the future, to achieve equitable and quality health outcomes and consumer access to healthcare, regardless of geographic location. Nursing forms the largest body of employees in the health care system, spanning all segments of care. A shortage of nurses, particularly in the acute care settings in hospitals, jeopardizes the provision of quality health care to consumers. This article provides a literature review of Australian State and Federal Government reports into nurse retention. All reports discuss staff turnover rates; the average age of nurses; enrolment numbers in nursing courses; workloads; nursing workforce shortfalls and the effect on the work environment; leadership and management styles; organizational culture; change management; the mobility of nursing qualifications both locally and internationally and the critical need to value nurses. Then why has the situation of nurse retention not improved? Possible reasons for the continued nurse shortage and the promise of strategic HRM in addressing nurse retention are discussed.

  1. Entry into Nursing: An Ethnographic Study of Newly Qualified Nurses Taking on the Nursing Role in a Hospital Setting

    PubMed Central

    Bjerknes, Mari Skancke; Bjørk, Ida Torunn

    2012-01-01

    The transition from student to working nurse has long been recognized as challenging. This paper presents the findings of research into the opportunities and limitations encountered by newly qualified nurses when taking on the nursing role. The study had an ethnographic design. Observation, interviews, and document analysis were used to gain insight into nurses' daily work from the perspective of recently graduated nurses. Thirteen nurses were monitored closely during their first year in a hospital setting in Norway. These new nurses generally entered the field with empathy for their patients, enthusiasm for the profession, and readiness to learn more about being a good nurse. However, their more experienced colleagues seemed to neither respect nor nurture this attitude. The new nurses experienced heavier responsibilities than expected, fragmentation of patient care, and stressful interactions with colleagues. The lack of a supportive work environment and role models increased the new nurses' experience of overwhelming responsibility in their daily work situations. The nurses learned to cope the hard way, despite the organizational culture, not because of it. Adjusting the profession's expectations of new nurses, and offering good role models and more comprehensive support programmes, would markedly ease the transition for new nurses. PMID:23050136

  2. Urban Rural Comparisons of Polycystic Ovary Syndrome Burden among Adolescent Girls in a Hospital Setting in India

    PubMed Central

    Balaji, Swetha; Prasad, Satish; Bala Kasav, Jyoti; Upadhyay, Vandana; Singh, Awnish K.; Joshi, Ashish

    2015-01-01

    Background. Polycystic ovarian syndrome (PCOS) is a multifaceted disorder characterized by varying clinical presentations. Objective. The aim of this study was to determine urban and rural differences in the burden of polycystic ovarian syndrome among Indian adolescent females aged 12 to 19 years. Methods. A pilot cross-sectional study was conducted for a period of one month (August-September 2013) at Balaji Hospital, Vellore, Tamil Nadu, India. The final sample included 126 study participants located in various urban (50%, n = 63) and rural (50%, n = 63) settings. Information was gathered on sociodemographic and anthropometric characteristics, clinical history, occurrence of acne and hirsutism, serum testosterone levels, obstetric history, family history of chronic diseases, menstrual history, physical activity, and dietary intake. Results. Eighteen percent of the participants were confirmed of having PCOS by recent guidelines of Rotterdam Consensus for adolescent diagnosis of PCOS (presence of all three elements). Majority of the individuals with PCOS had an average age of 16 (SD = 2) (P = .02) years with an average age of menarche 12 years (SD = 1). Conclusion. The proportion of participants diagnosed with PCOS was higher among urban participants in comparison to rural participants. PMID:25629036

  3. Is Survival After Out-of-Hospital Cardiac Arrests Worse During Days of National Academic Meetings in Japan? A Population-Based Study

    PubMed Central

    Kitamura, Tetsuhisa; Kiyohara, Kosuke; Matsuyama, Tasuku; Hatakeyama, Toshihiro; Shimamoto, Tomonari; Izawa, Junichi; Nishiyama, Chika; Iwami, Taku

    2016-01-01

    Background Outcomes after out-of-hospital cardiac arrests (OHCAs) might be worse during academic meetings because many medical professionals attend them. Methods This nationwide population-based observation of all consecutively enrolled Japanese adult OHCA patients with resuscitation attempts from 2005 to 2012. The primary outcome was 1-month survival with a neurologically favorable outcome. Calendar days at three national meetings (Japanese Society of Intensive Care Medicine, Japanese Association for Acute Medicine, and Japanese Circulation Society) were obtained for each year during the study period, because medical professionals who belong to these academic societies play an important role in treating OHCA patients after hospital admission, and we identified two groups: the exposure group included OHCAs that occurred on meeting days, and the control group included OHCAs that occurred on the same days of the week 1 week before and after meetings. Multiple logistic regression analysis was used to adjust for confounding variables. Results A total of 20 143 OHCAs that occurred during meeting days and 38 860 OHCAs that occurred during non-meeting days were eligible for our analyses. The proportion of patients with favorable neurologic outcomes after whole arrests did not differ during meeting and non-meeting days (1.6% [324/20 143] vs 1.5% [596/38 855]; adjusted odds ratio 1.02; 95% confidence interval, 0.88–1.19). Regarding bystander-witnessed ventricular fibrillation arrests of cardiac origin, the proportion of patients with favorable neurologic outcomes also did not differ between the groups. Conclusions In this population, there were no significant differences in outcomes after OHCAs that occurred during national meetings of professional organizations related to OHCA care and those that occurred during non-meeting days. PMID:26639754

  4. Bacterial and viral pathogen spectra of acute respiratory infections in under-5 children in hospital settings in Dhaka city

    PubMed Central

    Bhuyan, Golam Sarower; Hossain, Mohammad Amir; Sarker, Suprovath Kumar; Rahat, Asifuzzaman; Islam, Md Tarikul; Haque, Tanjina Noor; Begum, Noorjahan; Qadri, Syeda Kashfi; Muraduzzaman, A. K. M.; Islam, Nafisa Nawal; Islam, Mohammad Sazzadul; Sultana, Nusrat; Jony, Manjur Hossain Khan; Khanam, Farhana; Mowla, Golam; Matin, Abdul; Begum, Firoza; Shirin, Tahmina; Ahmed, Dilruba; Saha, Narayan; Qadri, Firdausi

    2017-01-01

    The study aimed to examine for the first time the spectra of viral and bacterial pathogens along with the antibiotic susceptibility of the isolated bacteria in under-5 children with acute respiratory infections (ARIs) in hospital settings of Dhaka, Bangladesh. Nasal swabs were collected from 200 under-five children hospitalized with clinical signs of ARIs. Nasal swabs from 30 asymptomatic children were also collected. Screening of viral pathogens targeted ten respiratory viruses using RT-qPCR. Bacterial pathogens were identified by bacteriological culture methods and antimicrobial susceptibility of the isolates was determined following CLSI guidelines. About 82.5% (n = 165) of specimens were positive for pathogens. Of 165 infected cases, 3% (n = 6) had only single bacterial pathogens, whereas 43.5% (n = 87) cases had only single viral pathogens. The remaining 36% (n = 72) cases had coinfections. In symptomatic cases, human rhinovirus was detected as the predominant virus (31.5%), followed by RSV (31%), HMPV (13%), HBoV (11%), HPIV-3 (10.5%), and adenovirus (7%). Streptococcus pneumoniae was the most frequently isolated bacterial pathogen (9%), whereas Klebsiella pneumaniae, Streptococcus spp., Enterobacter agglomerans, and Haemophilus influenzae were 5.5%, 5%, 2%, and 1.5%, respectively. Of 15 multidrug-resistant bacteria, a Klebsiella pneumoniae isolate and an Enterobacter agglomerans isolate exhibited resistance against more than 10 different antibiotics. Both ARI incidence and predominant pathogen detection rates were higher during post-monsoon and winter, peaking in September. Pathogen detection rates and coinfection incidence in less than 1-year group were significantly higher (P = 0.0034 and 0.049, respectively) than in 1–5 years age group. Pathogen detection rate (43%) in asymptomatic cases was significantly lower compared to symptomatic group (P<0.0001). Human rhinovirus, HPIV-3, adenovirus, Streptococcus pneumonia, and Klebsiella pneumaniae had

  5. Whose responsibility is medication reconciliation: Physicians, pharmacists or nurses? A survey in an academic tertiary care hospital.

    PubMed

    Al-Hashar, Amna; Al-Zakwani, Ibrahim; Eriksson, Tommy; Al Za'abi, Mohammed

    2017-01-01

    Background: Medication errors occur frequently at transitions in care and can result in morbidity and mortality. Medication reconciliation is a recognized hospital accreditation requirement and designed to limit errors in transitions in care. Objectives: To identify beliefs, perceived roles and responsibilities of physicians, pharmacists and nurses prior to the implementation of a standardized medication reconciliation process. Methods: A survey was distributed to the three professions: pharmacists in the pharmacy and physicians and nurses in hospital in-patient units. It contained questions about the current level of medication reconciliation practices, as well as perceived roles and responsibilities of each profession when a standardized process is implemented. Value, barriers to implementing medication reconciliation and the role of information technology were also assessed. Analyses were performed using univariate statistics. Results: There was a lack of clarity of current medication reconciliation practices as well as lack of agreement between the three professions. Physicians and pharmacists considered their professions as the main providers while nurses considered physicians followed by themselves as the main providers with limited roles for pharmacists. The three professions recognize the values and benefits of medication reconciliation yet pharmacists, more than others, stated limited time to implement reconciliation is a major barrier. Obstacles such as unreliable sources of medication history, patient knowledge and lack of coordination and communication between the three professions were expressed. Conclusions: The three health care professions recognize the value of medication reconciliation and want to see it implemented in the hospital, yet there is a lack of agreement with regard to roles and responsibilities of each profession within the process. This needs to be addressed by the hospital administration to design clear procedures and defined roles

  6. The parents', hospitalized child's, and health care providers' perceptions and experiences of family centered care within a pediatric critical care setting: a metasynthesis of qualitative research.

    PubMed

    Foster, Mandie Jane; Whitehead, Lisa; Maybee, Patricia; Cullens, Victoria

    2013-11-01

    The delivery of family centered care (FCC) occurs within varied pediatric care settings with a belief that this model of care meets the psychosocial, emotional, and physical needs of the hospitalized child and family. The aim of this review was to explore the attitudes, experiences, and implementation of FCC from many studies and to facilitate a wider and more thorough understanding of this practice from a diverse sample of parents, hospitalized children, and their health care providers within a pediatric critical care setting. A metasynthesis is an integration of qualitative research findings based on a systematic review of the literature. Thirty original research articles focusing on family-centered care experiences from the hospitalized child's, parents', and health care providers' perception published between 1998 and 2011 met the criteria for the review. Nine syntheses from 17 themes emerged from the synthesis of the literature: Prehospital, Entry into the Hospital, Journeying Through Unknown Waters, Information, Relationships, The hospital Environment, The Possibility of Death, Religion and Spirituality, and The Journey Home. The individual cultures of the critical care units helped create and reinforce the context of parental needs where satisfaction with communication, information, and relationships were interconnecting factors that helped maintain the positive or negative experiences for the parent, hospitalized child, and/or health care providers.

  7. Diagnostic virology practices for respiratory syncytial virus and influenza virus among children in the hospital setting: a national survey.

    PubMed

    Jafri, Hasan S; Ramilo, Octavio; Makari, Doris; Charsha-May, Deborah; Romero, José R

    2007-10-01

    A survey was sent to the emergency room and laboratory directors of 400 randomly selected US hospitals to assess the diagnostic testing practices for respiratory syncytial virus and influenza virus in children. The results demonstrate that the majority of hospitals routinely perform viral testing for both viruses and use virology testing practices appropriate for the reasons reported for testing.

  8. AMTA Monograph Series. Effective Clinical Practice in Music Therapy Medical Music Therapy for Pediatrics in Hospital Settings

    ERIC Educational Resources Information Center

    American Music Therapy Association, 2008

    2008-01-01

    The impact of hospitalization on children and their families is becoming more clearly understood in today's changing healthcare environment. Pediatric inpatient services are focused on children with more critical illnesses, shorter hospital stays, and a culture of family-centered care. This publication clearly exemplifies the role of music…

  9. Vancomycin-resistant enterococci in intensive-care hospital settings: Transmission dynamics, persistence, and the impact of infection control programs

    PubMed Central

    Austin, Daren J.; Bonten, Marc J. M.; Weinstein, Robert A.; Slaughter, Sarah; Anderson, Roy M.

    1999-01-01

    Vancomycin-resistant enterococci (VRE) recently have emerged as a nosocomial pathogen especially in intensive-care units (ICUs) worldwide. Transmission via the hands of health-care workers is an important determinant of spread and persistence in a VRE-endemic ICU. We describe the transmission of nosocomial pathogens by using a micro-epidemiological framework based on the transmission dynamics of vector-borne diseases. By using the concept of a basic reproductive number, R0, defined as the average number of secondary cases generated by one primary case, we show quantitatively how infection control measures such as hand washing, cohorting, and antibiotic restriction affect nosocomial cross-transmission. By using detailed molecular epidemiological surveillance and compliance monitoring, we found that the estimated basic reproductive number for VRE during a study at the Cook County Hospital, Chicago, was approximately 3–4 without infection control and 0.7 when infection control measures were included. The impact of infection control was to reduce the prevalence from a predicted 79% to an observed 36%. Hand washing and staff cohorting are the most powerful control measures although their efficacy depends on the magnitude of R0. Under the circumstances tested, endemicity of VRE was stabilized despite infection control measures, by the constant introduction of colonized patients. Multiple stochastic simulations of the model revealed excellent agreement with observed pattern. In conjunction with detailed microbiological surveillance, a mathematical framework provides a precise template to describe the colonization dynamics of VRE in ICUs and impact of infection control measures. Our analyses suggest that compliance for hand washing significantly in excess of reported levels, or the cohorting of nursing staff, are needed to prevent nosocomial transmission of VRE in endemic settings. PMID:10359812

  10. Incidence of vitamin deficiency after laparoscopic Roux-en-Y gastric bypass in a university hospital setting.

    PubMed

    Clements, Ronald H; Katasani, Venkata G; Palepu, Rajendra; Leeth, Ruth R; Leath, Teresa D; Roy, Brandon P; Vickers, Selwyn M

    2006-12-01

    Vitamin deficiency after gastric bypass surgery is a known complication. The purpose of this study was to measure the incidence of vitamin deficiency after laparoscopic Roux-en-Y gastric bypass in a university hospital setting. All patients who underwent laparoscopic Roux-en-Y gastric bypass from January 2002 to December 2004 and completed a 1- and 2-year follow-up after surgery were selected. Of the total 493 patients, 318 (65%) had vitamin results at 1-year follow-up. Of the 366 eligible for the 2-year follow-up, 141 (39%) had vitamin results. Patients were further grouped based on gender, race, and Roux limb length, and incidence of vitamin deficiencies were studied. The incidence of vitamin A (retinol) deficiency was 11 per cent, vitamin C was 34.6 per cent, vitamin D25OH was 7 per cent, vitamin B1 was 18.3 per cent, vitamin B2 was 13.6 per cent, vitamin B6 was 17.6 per cent, and vitamin B12 was 3.6 per cent 12 months after surgery. There was no statistical difference in the incidence of vitamin deficiencies between 1 and 2 years. In univariate and multivariate logistic regression of 1- and 2-year follow up, black patients (vitamins A, D, and B1 for 1 year and B1 and B6 for 2 years) and women (vitamin C at 1 year) were more likely to have vitamin deficiencies. Vitamin deficiencies after laparoscopic Roux-en-Y gastric bypass are more common and involve more vitamins, even those that are water soluble, than previously appreciated. Black patients tend to have more deficiencies than other groups. The bariatric surgeon should be committed to the long-term follow-up and care of these patients. Further prospective and randomized studies are necessary to provide appropriate guidelines for supplementation.

  11. Using Goal Setting, Task Clarification, and Feedback to Increase the Use of the Hands-Free Technique by Hospital Operating Room Staff

    ERIC Educational Resources Information Center

    Cunningham, Thomas R.; Austin, John

    2007-01-01

    We evaluated the effects of a behavioral treatment on the safe passing of sharp instruments using the hands-free technique among hospital operating room personnel during surgical procedures. Treatment consisted of participative goal setting, task clarification, and feedback. The average percentage of sharp instruments passed safely increased from…

  12. Therapeutic Intervention in the Treatment of Substance Abuser's Unresolved Grief Reactions in an Inpatient Hospital Setting: A Study of Two Group Approaches.

    ERIC Educational Resources Information Center

    Forrest, Alan; Geoffroy, Kevin

    This study examined the differential effects of a higher level inpatient therapy group as compared with a structured didactic group on adult substance abusers' unresolved grief reactions in an inpatient hospital setting. It was hypothesized that, compared to control group subjects, subjects participating in the two treatment groups would…

  13. Standard Setting for Next Generation TOEFL Academic Speaking Test (TAST): Reflections on the ETS Panel of International Teaching Assistant Developers

    ERIC Educational Resources Information Center

    Papajohn, Dean

    2006-01-01

    While many institutions have utilized TOEFL scores for international admissions for many years, a speaking section has never before been a required part of TOEFL until the development of the iBT/Next Generation TOEFL. So institutions will need to determine how to set standards for the speaking section of TOEFL, also known as TOEFL Academic…

  14. Use of Bevacizumab in Community Settings: Toxicity Profile and Risk of Hospitalization in Patients With Advanced Non–Small-Cell Lung Cancer

    PubMed Central

    Carroll, Nikki M.; Delate, Thomas; Menter, Alex; Hornbrook, Mark C.; Kushi, Lawrence; Aiello Bowles, Erin J.; Loggers, Elizabeth T.; Ritzwoller, Debra P.

    2015-01-01

    Purpose: Little is known regarding toxicities and hospitalizations in community-based settings for patients with advanced non–small-cell lung cancer (NSCLC) who received commonly prescribed carboplatin-paclitaxel (CP) or carboplatin-paclitaxel-bevacizumab (CPB) chemotherapy. Methods: Patients with stages IIIB-IV NSCLC age ≥ 21 years diagnosed between 2005 and 2010 who received first-line CP or CPB were identified at four health maintenance organizations (N = 1,109). Using patient and tumor characteristics and hospital and ambulatory encounters from automated data in the 180 days after chemotherapy initiation, the association between CP and CPB and toxicities and hospitalizations were evaluated with χ2 tests and propensity score–adjusted regression models. Results: Patients who received CPB were significantly younger and had significantly more bleeding, proteinuria, and GI perforation events (all P < .05). For these patients, the unadjusted odds ratio associated with the likelihood of having a hospitalization was 0.46 (95% CI, 0.32 to 0.67). As shown by multivariable and propensity score–adjusted models, patients who received CPB were less likely to have been hospitalized (odds ratio, 0.48; 95% CI, 0.32 to 0.71) and had fewer total hospitalizations (rate ratio, 0.62; 95% CI, 0.47 to 0.82) and hospital days (rate ratio, 0.53; 95% CI, 0.47 to 0.60) than patients who received CP. Conclusion: Consistent with earlier randomized clinical trials, significantly more toxicity events were identified in patients treated with CPB. However, both unadjusted and adjusted models showed that patients who received CPB were less likely than patients who received CP to experience a hospital-related event after the initiation of chemotherapy. Findings here confirm the need for adherence to clinical recommendations for judicious use of CPB, but provide reassurance regarding the relative risk for hospitalizations. PMID:26060223

  15. Development and Evaluation of the Barriers to Nurses' Participation in Research Questionnaire at a Large Academic Pediatric Hospital.

    PubMed

    Hagan, Joseph; Walden, Marlene

    2017-04-01

    The purposes of this study were to survey nurses at a large pediatric hospital to examine barriers to nursing research and to develop the Barriers to Nurses' Participation in Research Questionnaire (BNPRQ) in preparation for its use at other institutions. The BNPRQ was created and refined through iterative pilot testing. Exploratory factor analysis was applied, and composite scores were computed for the identified factors. The two latent factors "Research Resources" and "Personal Relevance of Research" were extracted. The independent item "lack of time to do research" represented the largest barrier to research. Factor and item scores differed according to subject characteristics. Findings from this study will be used to create targeted interventions to reduce barriers to research participation prevalent in specific groups of nurses. By using the BNPRQ developed in this study, researchers and administrators at other institutions can identify and address barriers to research among their nurses.

  16. Care-seeking behaviour and diagnostic processes for symptomatic giardiasis in children attending an academic paediatric hospital.

    PubMed

    Escobedo, Angel A; Almirall, Pedro; Ávila, Ivonne; Salazar, Yohana; Alfonso, Maydel

    2014-09-01

    Giardiasis is one of the commonest intestinal parasitic infections in Cuba. In order to determine care-seeking behaviour and diagnostic processes in paediatric in-patients with giardiasis, structured questionnaires were administered by interview mothers of children with giardiasis during January to December 2010. During the study period, 97 children were diagnosed with giardiasis, of whom 86 (88·6%) caregivers were interviewed. The median number of days from symptoms onset to the first presentation in a health unit was 2 days (range: 0-15 days). The pattern of care-seeking behaviour was variable; 41 (47·7%) of children initially visited the emergency unit in a paediatric hospital. Sixty-six children had, at least, one further contact for help before diagnosis of giardiasis was made (range: 1-5 contacts) and of the 128 contact visits, 94 (73·4%) were also targeted more to hospitals. There was a median time of 6 days between the first presentation to a health unit until diagnosis, which was mainly made by microscopic examination of duodenal aspiration. Among factors investigated in mothers, only knowing other person with giardiasis had significant association with their ability to suspect giardiasis [odds ratio (OR): 29·8, 95% confidence interval (CI): 3·71-239·4, P = 0·001]. Requesting a faecal specimen or ordering duodenal aspiration for microscopic examination during the first visit appeared associated with correct diagnosis (OR: 3·84, 95% CI: 1·57-9·40, P = 0·003). Efforts should be made to increase doctors' awareness of- and diagnostic skills for childhood giardiasis. At the same time, it is necessary to improve caregivers' awareness about giardiasis.

  17. Academic dentistry.

    PubMed

    Rushton, Vivian E; Horner, Keith

    2008-07-01

    Since 1988, thirteen dental schools have provided dental undergraduate programmes within the United Kingdom (UK). In 2006, two new dental schools were created supporting dental education in the community. A further new dental school in Scotland will be accepting students in autumn 2008. In the past 25 years, extensive reorganisation of the NHS has resulted in long-term implications for the training of medical and dental academic staff. The number of academic clinicians is below the minimum viable level and external constraints, combined with a lack of suitable applicants, have led to a moratorium on academic recruitment within some Dental Schools. A detailed review of the historical and associated factors which have led to the problems presently besetting academic dentistry are discussed along with the initiatives introduced in the last 10 years to revitalise the speciality. Also, the present and future outlook for academic dentistry in other countries are discussed. Opinion is divided as to the appropriate setting for the training of undergraduate students between those who support community-based dental education and those who believe dental education should remain within research led dental establishments. External factors are moulding an unsatisfactory situation that is proving increasingly unattractive to the potential dental academic and the case for reform is obvious.

  18. Pain Management Following Major Intracranial Surgery in Pediatric Patients: A Prospective Cohort Study in Three Academic Children’s Hospitals

    PubMed Central

    Maxwell, Lynne G.; Buckley, George M.; Kudchadkar, Sapna R.; Ely, Elizabeth; Stebbins, Emily L.; Dube, Christine; Morad, Athir; Jastaniah, Ebaa A.; Sethna, Navil F.; Yaster, Myron

    2014-01-01

    Introduction Pain management following major intracranial surgery is often limited by a presumed lack of need and a concern that opioids will adversely affect postoperative outcome and interfere with the neurologic examination. Nevertheless, evidence in adults is accumulating that these patients suffer moderate to severe pain and this pain is often under-treated. The purpose of this prospective, clinical observational cohort study was to assess the incidence of pain, prescribed analgesics, methods of analgesic delivery, and patient/parent satisfaction in pediatric patients undergoing cranial surgery at 3 major university children’s hospitals. Methods After obtaining IRB and parental consent (and when applicable, patient assent), children who underwent cranial surgery for cancer, epilepsy, vascular malformations, and craniofacial reconstruction were studied. Neither intraoperative anesthetic management nor postoperative pain management was standardized, but were based on institutional routine. Patients were evaluated daily by a study investigator and by chart review for pain scores using age appropriate, validated tools (FLACC, Faces Pain Scale-Revised, Wong Baker Faces Scale or Self-Report on a 0–10 scale), for patient/parent satisfaction using a subset of the NRC Picker satisfaction tool and in adolescents a modified QoR-40, and for the frequency, mode of administration, and type of analgesic provided. Finally, the incidence of opioid-induced side effects, specifically nausea, vomiting, pruritus, altered level of consciousness, and need for emergency diagnostic radiologic studies for altered neurologic examination were recorded. Data are provided as mean ± SD. Results Two hundred children (98:102 M:F), averaging 7.8 ± 5.8 years old (range 2 mos to 18.5 yr) and 32.2 ± 23.0 kg (range 4.5 to 111.6 kg) undergoing craniectomy (51), craniotomy (96), and craniofacial reconstruction (53) were studied. Despite considerable variation in mode and route of analgesic

  19. Characterization of breast cancers with PI3K mutations in an academic practice setting using SNaPshot profiling.

    PubMed

    Abramson, Vandana G; Cooper Lloyd, M; Ballinger, Tarah; Sanders, Melinda E; Du, Liping; Lai, Darson; Su, Zengliu; Mayer, Ingrid; Levy, Mia; LaFrance, Delecia R; Vnencak-Jones, Cindy L; Shyr, Yu; Dahlman, Kimberly B; Pao, William; Arteaga, Carlos L

    2014-06-01

    Mutations in the PIK3CA gene are common in breast cancer and represent a clinically useful therapeutic target. Several larger, population-based studies have shown a positive prognostic significance associated with these mutations. This study aims to further identify characteristics of patients harboring PIK3CA mutations while evaluating the clinical impact of genomic testing for these mutations. Tumors from 312 patients at Vanderbilt-Ingram Cancer Center were analyzed for PIK3CA mutations using a multiplex screening assay (SNaPshot). Mutation rates, receptor status, histopathologic characteristics, and time to recurrence were assessed. The number of patients participating in clinical trials, specifically trials relating to the PIK3CA mutation, was examined. Statistically significant differences between wild-type and mutated tumors were determined using the Wilcoxon, Pearson, and Fischer exact tests. The PIK3CA mutation was found in 25 % of tumors tested. Patients with PIK3CA mutations were significantly more likely to express hormone receptors, be of lower combined histological grade, and have a reduced time to recurrence. Patients found to have a PIK3CA mutation were significantly more likely to enter a PIK3CA-specific clinical trial. In addition to confirming previously established positive prognostic characteristics of tumors harboring PIK3CA mutations, this study demonstrates the feasibility and utility of mutation profiling in a clinical setting. PIK3CA mutation testing impacted treatment and resulted in more patients entering mutation-specific clinical trials.

  20. A Prospective Study for Introducing Insulin Pens and Safety Needles in a Hospital Setting. The SANITHY Study.

    PubMed Central

    Bossi, Antonio C.; Veronesi, Giovanni; Poerio, Carmine S.; Braus, Alessandra; Madaschi, Sara; Destro, Maurizio; Ferraro, Bruno; Gilberti, Lavinia; Sganzerla, Paolo; Davis, Estella M.

    2016-01-01

    Abstract: Background To assess costs and safety of insulin pen devices and safety needles as compared to vial/syringes in hospitalized patients requiring insulin therapy in a General Hospital in Northern Italy. Materials and Methods In a prospective 9-month study, consecutive patients admitted to three Hospital Units received insulin therapy through either a traditional disposable syringe method, or pen/safety needles with dual-ended protection, or disposable safety syringes. We compared the median direct (insulin and devices) and indirect (insulin supply at discharge, insulin wastage) costs of a 10-day in-hospital insulin treatment in the 3 study groups, additionally accounting for the costs related to the observed needlestick injury rate. Patients’ safety during in-hospital stay (hypo- and hyperglycemia episodes) and satisfaction were also assessed. Results N=360 patients (55% men, mean age 75.6 years, 57% with DM since ≥10 years) were recruited in the study. Insulin pens had higher median direct cost than both traditional syringes (43 vs. 18 €/patient, p<.0001) and safety syringes (21.5 €/patient, p<.0001). However, when also indirect and injuries costs were taken into account, the estimated savings for using pens over traditional syringes were as high as 32 €/patient (45.8 vs. 77.6 €/patient, p-value <.0001). No differences in patients’ safety were observed. 74% and 12% of patients using pens and syringes would like to continue the method at home, respectively (p<0.0001). Discussion A selective use of individual pre-filled pens/safety needles for patients who are likely to continue insulin therapy at home may strongly reduce hospital diabetes treatment related costs. PMID:26245310

  1. High Nasal Carriage Rate of Staphylococcus aureus Containing Panton-Valentine leukocidin- and EDIN-Encoding Genes in Community and Hospital Settings in Burkina Faso

    PubMed Central

    Ouedraogo, Abdoul-Salam; Dunyach-Remy, Catherine; Kissou, Aimée; Sanou, Soufiane; Poda, Armel; Kyelem, Carole G.; Solassol, Jérôme; Bañuls, Anne-Laure; Van De Perre, Philippe; Ouédraogo, Rasmata; Jean-Pierre, Hélène; Lavigne, Jean-Philippe; Godreuil, Sylvain

    2016-01-01

    The objectives of the present study were to investigate the rate of S.aureus nasal carriage and molecular characteristics in hospital and community settings in Bobo Dioulasso, Burkina Faso. Nasal samples (n = 219) were collected from 116 healthy volunteers and 103 hospitalized patients in July and August 2014. Samples were first screened using CHROMagar Staph aureus chromogenic agar plates, and S. aureus strains were identified by mass spectrometry. Antibiotic susceptibility was tested using the disk diffusion method on Müller-Hinton agar. All S. aureus isolates were genotyped using DNA microarray. Overall, the rate of S. aureus nasal carriage was 32.9% (72/219) with 29% in healthy volunteers and 37% in hospital patients. Among the S. aureus isolates, only four methicillin-resistant S. aureus (MRSA) strains were identified and all in hospital patients (3.9%). The 72 S. aureus isolates from nasal samples belonged to 16 different clonal complexes, particularly to CC 152-MSSA (22 clones) and CC1-MSSA (nine clones). Two clones were significantly associated with community settings: CC1-MSSA and CC45-MSSA. The MRSA strains belonged to the ST88-MRSA-IV or the CC8-MRSA-V complex. A very high prevalence of toxinogenic strains 52.2% (36/69), containing Panton-Valentine leucocidin- and EDIN-encoding genes, was identified among the S. aureus isolates in community and hospital settings. This study provides the first characterization of S. aureus clones and their genetic characteristics in Burkina Faso. Altogether, it highlights the low prevalence of antimicrobial resistance, high diversity of methicillin-sensitive S. aureus clones and high frequency of toxinogenic S. aureus strains. PMID:27679613

  2. High Nasal Carriage Rate of Staphylococcus aureus Containing Panton-Valentine leukocidin- and EDIN-Encoding Genes in Community and Hospital Settings in Burkina Faso.

    PubMed

    Ouedraogo, Abdoul-Salam; Dunyach-Remy, Catherine; Kissou, Aimée; Sanou, Soufiane; Poda, Armel; Kyelem, Carole G; Solassol, Jérôme; Bañuls, Anne-Laure; Van De Perre, Philippe; Ouédraogo, Rasmata; Jean-Pierre, Hélène; Lavigne, Jean-Philippe; Godreuil, Sylvain

    2016-01-01

    The objectives of the present study were to investigate the rate of S.aureus nasal carriage and molecular characteristics in hospital and community settings in Bobo Dioulasso, Burkina Faso. Nasal samples (n = 219) were collected from 116 healthy volunteers and 103 hospitalized patients in July and August 2014. Samples were first screened using CHROMagar Staph aureus chromogenic agar plates, and S. aureus strains were identified by mass spectrometry. Antibiotic susceptibility was tested using the disk diffusion method on Müller-Hinton agar. All S. aureus isolates were genotyped using DNA microarray. Overall, the rate of S. aureus nasal carriage was 32.9% (72/219) with 29% in healthy volunteers and 37% in hospital patients. Among the S. aureus isolates, only four methicillin-resistant S. aureus (MRSA) strains were identified and all in hospital patients (3.9%). The 72 S. aureus isolates from nasal samples belonged to 16 different clonal complexes, particularly to CC 152-MSSA (22 clones) and CC1-MSSA (nine clones). Two clones were significantly associated with community settings: CC1-MSSA and CC45-MSSA. The MRSA strains belonged to the ST88-MRSA-IV or the CC8-MRSA-V complex. A very high prevalence of toxinogenic strains 52.2% (36/69), containing Panton-Valentine leucocidin- and EDIN-encoding genes, was identified among the S. aureus isolates in community and hospital settings. This study provides the first characterization of S. aureus clones and their genetic characteristics in Burkina Faso. Altogether, it highlights the low prevalence of antimicrobial resistance, high diversity of methicillin-sensitive S. aureus clones and high frequency of toxinogenic S. aureus strains.

  3. Organizational development trajectory of a large academic radiotherapy department set up similarly to a prospective clinical trial: the MAASTRO experience

    PubMed Central

    Boersma, L; Dekker, A; Hermanns, E; Houben, R; Govers, M; van Merode, F; Lambin, P

    2015-01-01

    Objective: To simultaneously improve patient care processes and clinical research activities by starting a hypothesis-driven reorganization trajectory mimicking the rigorous methodology of a prospective clinical trial. Methods: The design of this reorganization trajectory was based on the model of a prospective trial. It consisted of (1) listing problems and analysing their potential causes, (2) defining interventions, (3) defining end points and (4) measuring the effect of the interventions (i.e. at baseline and after 1 and 2 years). The primary end point for patient care was the number of organizational root causes of incidents/near incidents; for clinical research, it was the number of patients in trials. There were several secondary end points. We analysed the data using two sample z-tests, χ2 test, a Mann–Whitney U test and the one-way analysis of variance with Bonferroni correction. Results: The number of organizational root causes was reduced by 27% (p < 0.001). There was no effect on the percentage of patients included in trials. Conclusion: The reorganizational trajectory was successful for the primary end point of patient care and had no effect on clinical research. Some confounding events hampered our ability to draw strong conclusions. Nevertheless, the transparency of this approach can give medical professionals more confidence in moving forward with other organizational changes in the same way. Advances in knowledge: This article is novel because managerial interventions were set up similarly to a prospective clinical trial. This study is the first of its kind in radiotherapy, and this approach can contribute to discussions about the effectiveness of managerial interventions. PMID:25679320

  4. Hospital marketing.

    PubMed

    Carter, Tony

    2003-01-01

    This article looks at a prescribed academic framework for various criteria that serve as a checklist for marketing performance that can be applied to hospital marketing organizations. These guidelines are drawn from some of Dr. Noel Capon of Columbia University's book Marketing Management in the 21st Century and applied to actual practices of hospital marketing organizations. In many ways this checklist can act as a "marketing" balanced scorecard to verify performance effectiveness and develop opportunities for innovation.

  5. Using an evidence-based approach for system selection at a large academic medical center: lessons learned in selecting an ambulatory EMR at Mount Sinai Hospital.

    PubMed

    Kannry, Joseph; Mukani, Sonia; Myers, Kristin

    2006-01-01

    The experience of Mount Sinai Hospital is representative of the challenges and problems facing large academic medical centers in selecting an ambulatory EMR. The facility successfully revived a stalled process in a challenging financial climate, using a framework of science and rigorous investigation. The process incorporated several innovations: 1) There was a thorough review of medical informatics literature to develop a mission statement, determine practical objectives and guide the demonstration process; 2) The process involved rigorous investigation of vendor statements, industry statements and other institution's views of vendors; 3) The initiative focused on user-centric selection, and the survey instrument was scientifically and specifically designed to assess user feedback; 4) There was scientific analysis of validated findings and survey results at all steering meetings; 5) The process included an assessment of vendors' ability to support research by identifying funded and published research; 6) Selection involved meticulous total cost of ownership analysis to assess and compare real costs of implementing a vendor solution; and finally, 7) There were iterative meetings with stakeholders, executives and users to understand needs, address concerns and communicate the vision.

  6. Complete-genome sequencing elucidates outbreak dynamics of CA-MRSA USA300 (ST8-spa t008) in an academic hospital of Paramaribo, Republic of Suriname

    PubMed Central

    Sabat, Artur J.; Hermelijn, Sandra M.; Akkerboom, Viktoria; Juliana, Amadu; Degener, John E.; Grundmann, Hajo; Friedrich, Alexander W.

    2017-01-01

    We report the investigation of an outbreak situation of methicillin-resistant Staphylococcus aureus (MRSA) that occurred at the Academic Hospital Paramaribo (AZP) in the Republic of Suriname from April to May 2013. We performed whole genome sequencing with complete gap closure for chromosomes and plasmids on all isolates. The outbreak involved 12 patients and 1 healthcare worker/nurse at the AZP. In total 24 isolates were investigated. spa typing, genome-wide single nucleotide polymorphism (SNP) analysis, ad hoc whole genome multilocus sequence typing (wgMLST), stable core genome MLST (cgMLST) and in silico PFGE were used to determine phylogenetic relatedness and to identify transmission. Whole-genome sequencing (WGS) showed that all isolates were members of genomic variants of the North American USA300 clone. However, WGS revealed a heterogeneous population structure of USA300 circulating at the AZP. We observed up to 8 SNPs or up to 5 alleles of difference by wgMLST when the isolates were recovered from different body sites of the same patient or if direct transmission between patients was most likely. This work describes the usefulness of complete genome sequencing of bacterial chromosomes and plasmids providing an unprecedented level of detail during outbreak investigations not being visible by using conventional typing methods. PMID:28106148

  7. Complete-genome sequencing elucidates outbreak dynamics of CA-MRSA USA300 (ST8-spa t008) in an academic hospital of Paramaribo, Republic of Suriname.

    PubMed

    Sabat, Artur J; Hermelijn, Sandra M; Akkerboom, Viktoria; Juliana, Amadu; Degener, John E; Grundmann, Hajo; Friedrich, Alexander W

    2017-01-20

    We report the investigation of an outbreak situation of methicillin-resistant Staphylococcus aureus (MRSA) that occurred at the Academic Hospital Paramaribo (AZP) in the Republic of Suriname from April to May 2013. We performed whole genome sequencing with complete gap closure for chromosomes and plasmids on all isolates. The outbreak involved 12 patients and 1 healthcare worker/nurse at the AZP. In total 24 isolates were investigated. spa typing, genome-wide single nucleotide polymorphism (SNP) analysis, ad hoc whole genome multilocus sequence typing (wgMLST), stable core genome MLST (cgMLST) and in silico PFGE were used to determine phylogenetic relatedness and to identify transmission. Whole-genome sequencing (WGS) showed that all isolates were members of genomic variants of the North American USA300 clone. However, WGS revealed a heterogeneous population structure of USA300 circulating at the AZP. We observed up to 8 SNPs or up to 5 alleles of difference by wgMLST when the isolates were recovered from different body sites of the same patient or if direct transmission between patients was most likely. This work describes the usefulness of complete genome sequencing of bacterial chromosomes and plasmids providing an unprecedented level of detail during outbreak investigations not being visible by using conventional typing methods.

  8. Oxygen supplies for hospitals in Papua New Guinea: a comparison of the feasibility and cost-effectiveness of methods for different settings.

    PubMed

    Duke, Trevor; Peel, David; Wandi, Francis; Subhi, Rami; Sa'avu Martin; Matai, Sens

    2010-01-01

    Oxygen therapy is essential in all wards, emergency departments and operating theatres of hospitals at all levels, and oxygen is life-saving. In Papua New Guinea (PNG), an effective oxygen system that improved the detection and treatment of hypoxaemia in provincial and district hospitals reduced death rates from pneumonia in children by as much as 35%. The methods for providing oxygen in PNG are reviewed. A busy provincial hospital will use on average about 38,000 l of oxygen each day. Over 2 years the cost of this amount of oxygen being provided by cylinders (at least K555,000) or an oxygen generator (about K1 million) is significantly more than the cost of setting up and maintaining a comprehensive system of bedside oxygen concentrators (K223,000). A district hospital will use 17,000 l per day. The full costs of this over 2 years are K33,000 if supplied by bedside concentrators, or K333,000 plus transport costs if the oxygen source is cylinders. In provincial and district hospitals bedside oxygen concentrators will be the most cost-effective, simple and reliable sources of oxygen. In large hospitals where there are existing oxygen pipelines, or in newly designed hospitals, an oxygen generator will be effective but currently much more expensive than bedside concentrators that provide the same volume of oxygen generation. There are options for oxygen concentrator use in hospitals and health centres that do not have reliable power. These include battery storage of power or solar power. While these considerably add to the establishment cost when changing from cylinders to concentrators, a battery-powered system should repay its capital costs in less than one year, though this has not yet been proven in the field. Bedside oxygen concentrators are currently the 'best-buy' in supplying oxygen in most hospitals in PNG, where cylinder oxygen is the largest single item in their drug budget. Oxygen concentrators should not be seen as an expensive intervention that has to

  9. Safe medication management and use of narcotics in a Joint Commission International-accredited academic medical center hospital in the People's Republic of China.

    PubMed

    Fang, Xu; Zhu, Ling-Ling; Pan, Sheng-Dong; Xia, Ping; Chen, Meng; Zhou, Quan

    2016-01-01

    Safe medication management and use of high-alert narcotics should arouse concern. Risk management experiences in this respect in a large-scale Joint Commission International (JCI)-accredited academic medical center hospital in the People's Republic of China during 2011-2015, focusing on organizational, educational, motivational, and information technological measures in storage, prescribing, preparing, dispensing, administration, and monitoring of medication are summarized. The intensity of use of meperidine in hospitalized patients in 2015 was one-fourth that in 2011. A 100% implementation rate of standard storage of narcotics has been achieved in the hospital since December 2012. A "Plan, Do, Check, Act" cycle was efficient because the ratio of number of inappropriate narcotics prescriptions to total number of narcotics prescriptions for inpatients decreased from August 2014 to December 2014 (28.22% versus 2.96%, P=0.0000), and it was controlled below 6% from then on. During the journey to good pain management ward accreditation by the Ministry of Health, People's Republic of China, (April 2012-October 2012), the medical oncology ward successfully demonstrated an increase in the pain screening rate at admission from 43.5% to 100%, cancer pain control rate from 85% to 96%, and degree of satisfaction toward pain nursing from 95.4% to 100% (all P-values <0.05). Oral morphine equivalent dosage in the good pain management ward increased from 2.3 mg/patient before June 2012 to 54.74 mg/patient in 2014. From 2011 to 2015, the oral morphine equivalent dose per discharged patient increased from 8.52 mg/person to 20.36 mg/person. A 100% implementation rate of independent double-check prior to narcotics dosing has been achieved since January 2013. From 2014 to 2015, the ratio of number of narcotics-related medication errors to number of discharged patients significantly decreased (6.95% versus 0.99%, P=0.0000). Taken together, continuous quality improvements have been

  10. Safe medication management and use of narcotics in a Joint Commission International-accredited academic medical center hospital in the People’s Republic of China

    PubMed Central

    Fang, Xu; Zhu, Ling-ling; Pan, Sheng-dong; Xia, Ping; Chen, Meng; Zhou, Quan

    2016-01-01

    Safe medication management and use of high-alert narcotics should arouse concern. Risk management experiences in this respect in a large-scale Joint Commission International (JCI)-accredited academic medical center hospital in the People’s Republic of China during 2011–2015, focusing on organizational, educational, motivational, and information technological measures in storage, prescribing, preparing, dispensing, administration, and monitoring of medication are summarized. The intensity of use of meperidine in hospitalized patients in 2015 was one-fourth that in 2011. A 100% implementation rate of standard storage of narcotics has been achieved in the hospital since December 2012. A “Plan, Do, Check, Act” cycle was efficient because the ratio of number of inappropriate narcotics prescriptions to total number of narcotics prescriptions for inpatients decreased from August 2014 to December 2014 (28.22% versus 2.96%, P=0.0000), and it was controlled below 6% from then on. During the journey to good pain management ward accreditation by the Ministry of Health, People’s Republic of China, (April 2012–October 2012), the medical oncology ward successfully demonstrated an increase in the pain screening rate at admission from 43.5% to 100%, cancer pain control rate from 85% to 96%, and degree of satisfaction toward pain nursing from 95.4% to 100% (all P-values <0.05). Oral morphine equivalent dosage in the good pain management ward increased from 2.3 mg/patient before June 2012 to 54.74 mg/patient in 2014. From 2011 to 2015, the oral morphine equivalent dose per discharged patient increased from 8.52 mg/person to 20.36 mg/person. A 100% implementation rate of independent double-check prior to narcotics dosing has been achieved since January 2013. From 2014 to 2015, the ratio of number of narcotics-related medication errors to number of discharged patients significantly decreased (6.95% versus 0.99%, P=0.0000). Taken together, continuous quality improvements

  11. An Investigation of Nursing Staff Attitudes and Emotional Reactions towards Patients with Intellectual Disability in a General Hospital Setting

    ERIC Educational Resources Information Center

    Lewis, Sharna; Stenfert-Kroese, Biza

    2010-01-01

    Background: It has been suggested that inequalities in health care for people with intellectual disabilities may be partly explained by negative attitudes of health professionals. This study aimed to investigate the attitudes and emotional reactions reported by nursing staff working in general hospitals towards caring for patients with…

  12. Organizational Impact of the Introduction of a New Portable Syringe Pump for Iloprost Therapy in Italian Hospital Settings

    PubMed Central

    Restelli, Umberto; Faggioli, Paola; Scolari, Francesca; Gussoni, Gualberto; Valerio, Antonella; Sciascera, Alba; Croce, Davide; Mazzone, Antonino

    2015-01-01

    Purpose: The study aims at assessing the organizational and economic impact related to the use of a new portable syringe pump (Pompa Infonde®, Italfarmaco S.p.A., Cinisello Balsamo, Italy) at a hospital level. Methodology: Based on the HTA approach, the analysis assessed the organizational and economic impact of the new device at hospital level, using the traditional methods of Iloprost infusion as comparator. After a pilot evaluation, the organizational impact was assessed within 24 Italian hospitals. Structured interviews were conducted with clinicians and nurses. According to the Hospital-Based HTA approach, a questionnaire assessed the impact on human resources, training activities, internal meetings, spaces needed, facilities, clinical practice implications. Using Activity Based Costing approach, the economic evaluation was performed within the pilot center “Ospedale Civile” of Legnano, Italy. Findings: The new device leads to a positive managerial impact, with a substantial reduction of time to monitor patients by nurses. This resulted in a better management of human resources and in a reduction in nursing cost. Although a mild negative impact on training time for personnel, the structured interviews allowed the identification of three main areas of positive impact: (i) efficiency of internal processes, (ii) clinical pathways, (iii) synergies between wards. Originality: The organizational impact of Pompa Infonde®, showed that it is an efficient alternative to traditional methods, with benefits in the management of patients administered with Iloprost.

  13. Cost Effectiveness of Alcoholism Treatment in Partial Hospital versus Inpatient Settings After Brief Inpatient Treatment: 12-Month Outcomes.

    ERIC Educational Resources Information Center

    McCrady, Barbara; And Others

    1986-01-01

    Alcoholics (N=174) were randomly assigned to partial hospital treatment (PHT) or extended inpatient (EIP) rehabilitation after inpatient evaluation and/or detoxification. There were few differences in clinical outcomes between the PHT and EIP groups. Subjects showed significant improvements in psychological well-being and social behavior.…

  14. Methicillin-Resistant Staphylococcus aureus in the Community in Luanda, Angola: Blurred Boundaries with the Hospital Setting.

    PubMed

    Conceição, Teresa; Coelho, Céline; Santos Silva, Isabel; de Lencastre, Hermínia; Aires-de-Sousa, Marta

    2016-01-01

    Although the nosocomial prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in Angola is over 60% and one of the highest in Africa, the extent of MRSA in the community is unknown. To fill this gap, we conducted a hospital-based study in which 158 children attending the emergency ward and ambulatory services of a pediatric hospital in Luanda, the capital of Angola, were screened for S. aureus nasal colonization. Overall, 70 (44.3%) individuals were colonized with S. aureus, of which 20 (28.6%) carried MRSA, resulting in a prevalence of 12.7% (20/158) of MRSA in the population screened. Molecular characterization by pulsed-field gel electrophoresis (PFGE), spa typing, multilocus sequence typing, and SCCmec typing distributed the isolates into two major MRSA clones and one dominant methicillin-susceptible S. aureus (MSSA) lineage, corresponding to the main clones circulating in hospitals in Luanda. The MRSA isolates mainly belonged to clones A (PFGE type A, spa type t105, ST5-IVa-65%) and B (PFGE B, t3869, ST88-IVa-30%), while MSSA isolates mainly belonged to clone L (PFGE type L, t861, ST508-42%). S. aureus isolates showed resistance to penicillin (96%), rifampin (87%), and trimethoprim-sulfamethoxazole (21%). In conclusion, the prevalence of MRSA among children in the community in Luanda is high and seems to originate from hospitals, warranting continuous monitoring and implementation of additional infection control measures.

  15. Costs of providing infusion therapy for patients with inflammatory bowel disease in a hospital-based infusion center setting.

    PubMed

    Afzali, Anita; Ogden, Kristine; Friedman, Michael L; Chao, Jingdong; Wang, Anthony

    2017-01-23

    Aims Inflammatory bowel disease (IBD) (e.g., ulcerative colitis [UC] and Crohn's disease [CD]) severely impacts patient quality of life. Moderate to severe disease is often treated with biologics requiring infusion therapy, adding incremental costs beyond drug costs. This study evaluates US hospital-based infusion services costs for treatment of UC or CD patients receiving infliximab or vedolizumab therapy. Materials and methods A model was developed, estimating annual costs of providing monitored infusions using activity-based costing framework approach. Multiple sources (published literature, treatment product inserts) informed base-case model input estimates. Results The total modeled per patient infusion therapy costs in Year 1 with infliximab and vedolizumab was $38,782 and $41,320, respectively, and Year 2+, $49,897 and $36,197, respectively. Drug acquisition cost was the largest total costs driver (90-93%), followed by costs associated with hospital-based infusion provision: labor (53-56%, non-drug costs), allocated overhead (23%, non-drug costs), non-labor (23%, non-drug costs), and laboratory (7-10%, non-drug costs). Limitations Limitations included reliance on published estimates, base-case cost estimates infusion drug and supplies not accounting for volume pricing, assumption of a small hospital infusion center, and that given the model adopts the hospital perspective, costs to the patient were not included in infusion administration cost base-case estimates. Conclusions This model is an early step towards a framework to fully analyze infusion therapies' associated costs. Given the lack of published data, it would be beneficial for hospital administrators to assess total costs and trade-offs with alternative means of providing biologic therapies. This analysis highlights the value to hospital administrators of assessing cost associated with infusion patient mix to make more informed resource allocation decisions. As the landscape for reimbursement

  16. Use of Risk Assessment Tool for Inpatient Traumatic Intracranial Hemorrhage after Falls in Acute Care Hospital Setting

    PubMed Central

    Toyabe, Shin-ichi

    2012-01-01

    Severe injuries such as intracranial hemorrhage (ICH) are the most serious problem after falls in hospital, but they have not been considered in risk assessment scores for falls. We tried to determine the risk factors for ICH after falls in 20,320 inpatients (696,364 patient-days) aged from 40 to 90 years who were admitted to a tertiary-care university hospital. Possible risk factors including STRATIFY risk score for falls and FRAX™ risk score for fractures were analyzed by univariate and multivariate analyses. Fallers accounted for 3.2% of the patients, and 5.0% of the fallers suffered major injuries, including peripheral bone fracture (59.6%) and ICH (23.4%). In addition to STRATIFY, FRAX™ was significantly associated not only with bone fractures but also ICH. Concomitant use of risk score for falls and risk score for fractures might be useful for the prediction of major injuries such as ICH after falls. PMID:22980233

  17. Barriers to the use of the library service amongst clinical staff in an acute hospital setting: an evaluation.

    PubMed

    Thomas, Gaynor; Preston, Hugh

    2016-06-01

    This article reports on research into the reasons why clinical staff in an acute hospital may be reluctant to use library services. The research was conducted by Gaynor Thomas at the Prince Philip Hospital in Llanelli in Wales as part of the dissertation she completed for an MSc in Economics. She graduated in July 2014 from Aberystwyth University and has co-written the article with Hugh Preston, her dissertation supervisor. The article summarises the key findings from the interviews undertaken as part of the research process and lists the resulting recommendations. Gaynor also highlights the initiatives which have been put in place with the express aim of removing barriers to use and encouraging clinical staff to make the most of the library which is, she argues, a time-saving resource. AM.

  18. Radial forearm flaps as durable soft tissue coverage for local nationals being treated in the field hospital setting.

    PubMed

    Hanna, Kh; Jeffery, Sla

    2013-03-01

    The current conflict in Afghanistan has seen the increasing use of Improvised Explosive Devices (IED) in insurgency attacks. In addition to the coalition forces killed and injured from these devices, local national civilians are also injured. Injuries often include amputations, open fractures and large areas of skin affected by fragmentation. Local national access to long-term care after an IED injury is limited, and often when the patient leaves a coalition hospital this concludes the care the patient will receive. Definitive, durable treatment options are needed for these patients. In the IED-injured patient with open extremity wounds and open metacarpal fractures, pedicled radial forearm flaps offer a suitable soft tissue coverage option. Four cases are reported on IED- injured Afghan patients treated at a Role 3 hospital facility.

  19. Outbreak of a Cluster with Epidemic Behavior Due to Serratia marcescens after Colistin Administration in a Hospital Setting

    PubMed Central

    Merkier, Andrea Karina; Rodríguez, María Cecilia; Togneri, Ana; Brengi, Silvina; Osuna, Carolina; Pichel, Mariana; Cassini, Marcelo H.

    2013-01-01

    Serratia marcescens causes health care-associated infections with important morbidity and mortality. Particularly, outbreaks produced by multidrug-resistant isolates of this species, which is already naturally resistant to several antibiotics, including colistin, are usually described with high rates of fatal outcomes throughout the world. Thus, it is important to survey factors associated with increasing frequency and/or emergence of multidrug-resistant S. marcescens nosocomial infections. We report the investigation and control of an outbreak with 40% mortality due to multidrug-resistant S. marcescens infections that happened from November 2007 to April 2008 after treatment with colistin for Acinetobacter baumannii meningitis was started at hospital H1 in 2005. Since that year, the epidemiological pattern of frequently recovered species has changed, with an increase of S. marcescens and Proteus mirabilis infections in 2006 in concordance with a significant decrease of the numbers of P. aeruginosa and A. baumannii isolates. A single pulsed-field gel electrophoresis (PFGE) cluster of S. marcescens isolates was identified during the outbreak. When this cluster was compared with S. marcescens strains (n = 21) from 10 other hospitals (1997 to 2010), it was also identified in both sporadic and outbreak isolates circulating in 4 hospitals in Argentina. In132::ISCR1::blaCTX-M-2 was associated with the multidrug-resistant cluster with epidemic behavior when isolated from outbreaks. Standard infection control interventions interrupted transmission of this cluster even when treatment with colistin continued in several wards of hospital H1 until now. Optimizing use of colistin should be achieved simultaneously with improved infection control to prevent the emergence of species naturally resistant to colistin, such as S. marcescens and P. mirabilis. PMID:23698525

  20. Mobile Display of Information about Aggregated Antibiotic Resistance in the Hospital Setting Supported by Near Field Communication.

    PubMed

    Meng, Philipp; Fehre, Karsten; Rappelsberger, Andrea; Adlassnig, Klaus-Peter

    2014-01-01

    Antibiotic resistance is a heterogeneous phenomenon. It does not only differ between countries or states, but also between wards of hospitals, where different resistance patterns have been found. To support clinicians in administering empiric antibiotic therapy, we developed software to present information about antibiotic resistance using a mobile concept. A pre-existing infrastructure was deployed as the server component. The systems analyze and aggregate data from laboratory information systems, generating statistical data on antibiotic resistance. The information is presented to the Android client using a Representational State Transfer (REST) interface. Geographical localization is performed using near field communication (NFC) tags. The prototype provides tabulated data concerning antibiotic resistance patterns in the wards of a hospital. Using Android, NFC, and data caching, the usability of the system is estimated to be high. We hypothesize that antibiotic stewardship in hospitals can be supported by this software, thus improving medical monitoring of antibiotic resistance. Future studies in a productive environment are needed to measure the impact of the system on the outcome of patient care.

  1. A Mobile App Development Guideline for Hospital Settings: Maximizing the Use of and Minimizing the Security Risks of "Bring Your Own Devices" Policies

    PubMed Central

    Pelletier, Alexandra; Sunthara, Gajen; Gujral, Nitin; Mittal, Vandna; Bourgeois, Fabienne C

    2016-01-01

    understanding what features should be built into the app. Phase 3 involved deployment of TaskList on a clinical floor at BCH. Lastly, Phase 4 gathered the lessons learned from the pilot to refine the guideline. Results Fourteen practical recommendations were identified to create the BCH Mobile Application Development Guideline to safeguard custom applications in hospital BYOD settings. The recommendations were grouped into four categories: (1) authentication and authorization, (2) data management, (3) safeguarding app environment, and (4) remote enforcement. Following the guideline, the TaskList app was developed and then was piloted with an inpatient ward team. Conclusions The Mobile Application Development guideline was created and used in the development of TaskList. The guideline is intended for use by developers when addressing integration with hospital information systems, deploying apps in BYOD health care settings, and meeting compliance standards, such as Health Insurance Portability and Accountability Act (HIPAA) regulations. PMID:27169345

  2. Implementing FAIRMODEL: The Academic Setting.

    ERIC Educational Resources Information Center

    Breece, James H.; Polak, Ruth Getter

    1988-01-01

    Based on interviews with instructors Breece and Polak who state that the benefits of implementing FAIRMODEL in the classroom (usually intermediate macroeconomics and the first course in graduate macroeconomics) greatly outweigh the costs. Concludes that students benefit from the use of FAIRMODEL by gaining marketable skills currently in demand by…

  3. Assessing Classism in Academic Settings

    ERIC Educational Resources Information Center

    Langhout, Regina Day; Rosselli, Francine; Feinstein, Jonathan

    2007-01-01

    The research described in this paper creates a behaviorally based measure that defines theoretically distinct domains of classism, assesses base rates within a college context, and examines how social class, race, and gender are related to classism. Participants of the study were college students at Hilltop University. A web-based survey was used…

  4. Which patient characteristics influence length of hospital stay after primary total hip arthroplasty in a 'fast-track' setting?

    PubMed

    den Hartog, Y M; Mathijssen, N M C; Hannink, G; Vehmeijer, S B W

    2015-01-01

    After implementation of a 'fast-track' rehabilitation protocol in our hospital, mean length of hospital stay for primary total hip arthroplasty decreased from 4.6 to 2.9 nights for unselected patients. However, despite this reduction there was still a wide range across the patients' hospital duration. The purpose of this study was to identify which specific patient characteristics influence length of stay after successful implementation of a 'fast-track' rehabilitation protocol. A total of 477 patients (317 female and 160 male, mean age 71.0 years; 39.3 to 92.6, mean BMI 27.0 kg/m(2);18.8 to 45.2) who underwent primary total hip arthroplasty between 1 February 2011 and 31 January 2013, were included in this retrospective cohort study. A length of stay greater than the median was considered as an increased duration. Logistic regression analyses were performed to identify potential factors associated with increased durations. Median length of stay was two nights (interquartile range 1), and the mean length of stay 2.9 nights (1 to 75). In all, 266 patients had a length of stay ≤ two nights. Age (odds ratio (OR) 2.46; 95% confidence intervals (CI) 1.72 to 3.51; p < 0.001), living situation (alone vs living together with cohabitants, OR 2.09; 95% CI 1.33 to 3.30; p = 0.002) and approach (anterior approach vs lateral, OR 0.29; 95% CI 0.19 to 0.46; p < 0.001) (posterolateral approach vs lateral, OR 0.24; 95% CI 0.10 to 0.55; p < 0.001) were factors that were significantly associated with increased length of stay in the multivariable logistic regression model.

  5. Multi-View Interaction Modelling of human collaboration processes: a business process study of head and neck cancer care in a Dutch academic hospital.

    PubMed

    Stuit, Marco; Wortmann, Hans; Szirbik, Nick; Roodenburg, Jan

    2011-12-01

    In the healthcare domain, human collaboration processes (HCPs), which consist of interactions between healthcare workers from different (para)medical disciplines and departments, are of growing importance as healthcare delivery becomes increasingly integrated. Existing workflow-based process modelling tools for healthcare process management, which are the most commonly applied, are not suited for healthcare HCPs mainly due to their focus on the definition of task sequences instead of the graphical description of human interactions. This paper uses a case study of a healthcare HCP at a Dutch academic hospital to evaluate a novel interaction-centric process modelling method. The HCP under study is the care pathway performed by the head and neck oncology team. The evaluation results show that the method brings innovative, effective, and useful features. First, it collects and formalizes the tacit domain knowledge of the interviewed healthcare workers in individual interaction diagrams. Second, the method automatically integrates these local diagrams into a single global interaction diagram that reflects the consolidated domain knowledge. Third, the case study illustrates how the method utilizes a graphical modelling language for effective tree-based description of interactions, their composition and routing relations, and their roles. A process analysis of the global interaction diagram is shown to identify HCP improvement opportunities. The proposed interaction-centric method has wider applicability since interactions are the core of most multidisciplinary patient-care processes. A discussion argues that, although (multidisciplinary) collaboration is in many cases not optimal in the healthcare domain, it is increasingly considered a necessity to improve integration, continuity, and quality of care. The proposed method is helpful to describe, analyze, and improve the functioning of healthcare collaboration.

  6. A Comparison of the Academic Achievement and Perceptions of Leadership Skills and Citizenship Traits of JROTC, Student Athletes, and Other Students in an Urban High School Setting

    ERIC Educational Resources Information Center

    Williams-Bonds, Carmen

    2013-01-01

    The purpose of this study was to compare three groups: JROTC students, student athletes, and other students, to determine if there were differences in academic achievement. Gaining an understanding of the necessary skills required to become academically successful and make healthy life choices, could provide educators working within an urban…

  7. A set of four simple performance measures reflecting adherence to guidelines predicts hospitalization: a claims-based cohort study of patients with diabetes

    PubMed Central

    Huber, Carola A; Brändle, Michael; Rapold, Roland; Reich, Oliver; Rosemann, Thomas

    2016-01-01

    Background The link between guideline adherence and outcomes is a highly demanded issue in diabetes care. We aimed to assess the adherence to guidelines and its impact on hospitalization using a simple set of performance measures among patients with diabetes. Methods We performed a retrospective cohort study, using health care claims data for adult patients with treated diabetes (2011–2013). Patients were categorized into three drug treatment groups (with oral antidiabetic agents [OAs] only, in combination with insulin, and insulin only). Performance measures were based on international established guidelines for diabetes care. Multivariate logistic regression models predicted the probability of hospitalization (2013) by adherence level (2011) among all treatment groups. Results A total of 40,285 patients with diabetes were enrolled in 2011. Guideline adherence was quite low: about 70% of all patients received a biannual hemoglobin A1c measurement and 19.8% had undergone an annual low-density lipoprotein cholesterol test. Only 4.8% were exposed to full adherence including all performance measures (OAs: 3.7%; insulin: 7.7%; and in combination: 7.2%). Increased guideline adherence was associated with decreased probability of hospitalization. This effect was strongest in patients using OAs and insulin in combination. Conclusion Our study showed that measures to reflect physicians’ guideline adherence in diabetes care can easily be calculated based on already available datasets. Furthermore, these measures are clearly linked with the probability of hospitalization suggesting that a better guideline adherence by physicians could help to prevent a large number of hospitalizations. PMID:27042016

  8. Exercise therapy for low back pain: a small-scale exploratory survey of current physiotherapy practice in the Republic of Ireland acute hospital setting.

    PubMed

    Byrne, Karol; Doody, Catherine; Hurley, Deirdre A

    2006-11-01

    A small-scale exploratory cross-sectional survey investigated the current use of a range of exercise therapy approaches for low back pain (LBP) by outpatient physiotherapists in the acute hospital setting in the Republic of Ireland, where the majority of publicly funded treatment is delivered. Of the 120 postal questionnaires distributed to 24 physiotherapy departments, 87 were returned (72.5% response rate). The results showed specific spinal stabilization exercises were the most popular exercise therapy for acute (39%; n = 35) and chronic (51%; n = 48) LBP, followed by the McKenzie approach (acute LBP (ALBP) 35.6%; n = 32: chronic LBP (CLBP) 17%; n = 16), and abdominal exercise (ALBP 11.1%; n = 10: CLBP 9.6%; n = 9). The most popular forms of exercise therapy used by outpatient physiotherapists in acute hospital settings in Ireland lack support from evidence-based clinical guidelines, and further large-scale high quality randomized controlled trials of these approaches are warranted. Further research should also establish the use of exercise therapy and attitudes to clinical guidelines of physiotherapists in other countries and healthcare settings.

  9. External Validation of an Instructional Design Model for High Fidelity Simulation: Model Application in a Hospital Setting

    ERIC Educational Resources Information Center

    Wilson, Rebecca D.

    2011-01-01

    The purpose of this study was to investigate the use of the design characteristics component of the Jeffries/National League for Nursing Framework for Designing, Implementing, and Evaluating Simulations when developing a simulation-based approach to teaching structured communication to new graduate nurses. The setting for the study was a medium…

  10. Experiences of the Implementation of a Learning Disability Nursing Liaison Service within an Acute Hospital Setting: A Service Evaluation

    ERIC Educational Resources Information Center

    Castles, Amy; Bailey, Carol; Gates, Bob; Sooben, Roja

    2014-01-01

    It has been well documented that people with learning disabilities receive poor care in acute settings. Over the last few years, a number of learning disability liaison nurse services have developed in the United Kingdom as a response to this, but there has been a failure to systematically gather evidence as to their effectiveness. This article…

  11. The effectiveness of computerized order entry at reducing preventable adverse drug events and medication errors in hospital settings: a systematic review and meta-analysis

    PubMed Central

    2014-01-01

    Background The Health Information Technology for Economic and Clinical Health (HITECH) Act subsidizes implementation by hospitals of electronic health records with computerized provider order entry (CPOE), which may reduce patient injuries caused by medication errors (preventable adverse drug events, pADEs). Effects on pADEs have not been rigorously quantified, and effects on medication errors have been variable. The objectives of this analysis were to assess the effectiveness of CPOE at reducing pADEs in hospital-related settings, and examine reasons for heterogeneous effects on medication errors. Methods Articles were identified using MEDLINE, Cochrane Library, Econlit, web-based databases, and bibliographies of previous systematic reviews (September 2013). Eligible studies compared CPOE with paper-order entry in acute care hospitals, and examined diverse pADEs or medication errors. Studies on children or with limited event-detection methods were excluded. Two investigators extracted data on events and factors potentially associated with effectiveness. We used random effects models to pool data. Results Sixteen studies addressing medication errors met pooling criteria; six also addressed pADEs. Thirteen studies used pre-post designs. Compared with paper-order entry, CPOE was associated with half as many pADEs (pooled risk ratio (RR) = 0.47, 95% CI 0.31 to 0.71) and medication errors (RR = 0.46, 95% CI 0.35 to 0.60). Regarding reasons for heterogeneous effects on medication errors, five intervention factors and two contextual factors were sufficiently reported to support subgroup analyses or meta-regression. Differences between commercial versus homegrown systems, presence and sophistication of clinical decision support, hospital-wide versus limited implementation, and US versus non-US studies were not significant, nor was timing of publication. Higher baseline rates of medication errors predicted greater reductions (P < 0.001). Other context and

  12. Mortality in cancer patients previously diagnosed with herpes zoster in the hospital setting: a nationwide cohort study

    PubMed Central

    Schmidt, S A J; Sørensen, G V; Horváth-Puhó, E; Pedersen, L; Obel, N; Petersen, K L; Schønheyder, H C; Sørensen, H T

    2015-01-01

    Background: Herpes zoster (HZ) is associated with underlying immunodeficiency and may thereby predict mortality of subsequent cancer. Methods: By using Danish nationwide medical databases, we identified all cancer patients with a prior hospital-based HZ diagnosis during 1982–2011 (n=2754) and a matched cancer cohort without prior HZ (n=26 243). We computed adjusted mortality rate ratios (aMRRs) associating prior HZ with mortality following cancer. Results: Prior HZ was associated with decreased mortality within the year after cancer diagnosis (aMRR 0.87; 95% confidence interval (CI): 0.81–0.93), but not thereafter (aMRR 1.07; 95% CI: 0.99–1.15). However, prior HZ predicted increased mortality throughout the entire follow-up among patients aged <60 years (aMRR 1.39; 95% CI: 1.15–1.68) and those with disseminated HZ (aMRR 1.18; 95% CI: 1.01–1.37). The increased mortality rates were observed primarily for haematological and immune-related cancers. Conclusions: Overall, HZ was not a predictor of increased mortality following subsequent cancer. PMID:25880013

  13. Incontinence-associated dermatitis: a cross-sectional prevalence study in the Australian acute care hospital setting.

    PubMed

    Campbell, Jill L; Coyer, Fiona M; Osborne, Sonya R

    2016-06-01

    The purpose of this cross-sectional study was to identify the prevalence of incontinence and incontinence-associated dermatitis (IAD) in Australian acute care patients and to describe the products worn to manage incontinence, and those provided at the bedside for perineal skin care. Data on 376 inpatients were collected over 2 days at a major Australian teaching hospital. The mean age of the sample group was 62 years and 52% of the patients were male. The prevalence rate of incontinence was 24% (91/376). Urinary incontinence was significantly more prevalent in females (10%) than males (6%) (χ(2)  = 4·458, df = 1, P = 0·035). IAD occurred in 10% (38/376) of the sample group, with 42% (38/91) of incontinent patients having IAD. Semi-formed and liquid stool were associated with IAD (χ(2)  = 5·520, df = 1, P = 0·027). Clinical indication of fungal infection was present in 32% (12/38) of patients with IAD. Absorbent disposable briefs were the most common incontinence aids used (80%, 70/91), with soap/water and disposable washcloths being the clean-up products most commonly available (60%, 55/91) at the bedside. Further data are needed to validate this high prevalence. Studies that address prevention of IAD and the effectiveness of management strategies are also needed.

  14. Device-associated infection rates and bacterial resistance in six academic teaching hospitals of Iran: Findings from the International Nocosomial Infection Control Consortium (INICC).

    PubMed

    Jahani-Sherafat, Somayeh; Razaghi, Maryam; Rosenthal, Victor D; Tajeddin, Elahe; Seyedjavadi, Simasadat; Rashidan, Marjan; Alebouyeh, Masoud; Rostampour, Maryam; Haghi, Arezo; Sayarbayat, Masoumeh; Farazmandian, Somayeh; Yarmohammadi, Tahere; Arshadi, Fardokht K; Mansouri, Nahid; Sarbazi, Mohammad R; Vilar, Mariano; Zali, Mohammad R

    2015-01-01

    Device-associated health care-acquired infections (DA-HAIs) pose a threat to patient safety, particularly in the intensive care unit (ICU). However, few data regarding DA-HAI rates and their associated bacterial resistance in ICUs from Iran are available. A DA-HAI surveillance study was conducted in six adult and pediatric ICUs in academic teaching hospitals in Tehran using CDC/NHSN definitions. We collected prospective data regarding device use, DA-HAI rates, and lengths of stay from 2584 patients, 16,796 bed-days from one adult ICU, and bacterial profiles and bacterial resistance from six ICUs. Among the DA-HAIs, there were 5.84 central line-associated bloodstream infections (CLABs) per 1000 central line-days, 7.88 ventilator-associated pneumonias (VAPs) per 1000 mechanical ventilator-days and 8.99 catheter-associated urinary tract infections (CAUTIs) per 1000 urinary catheter-days. The device utilization ratios were 0.44 for central lines, 0.42 for mechanical ventilators and 1.0 for urinary catheters. The device utilization ratios of mechanical ventilators and urinary catheters were higher than those reported in the ICUs of the INICC and the CDC's NHSN reports, but central line use was lower. The DA-HAI rates in this study were higher than the CDC's NHSN report. However, compared with the INICC report, the VAP rate in our study was lower, while the CLAB rate was similar and the CAUTI rate was higher. Nearly 83% of the samples showed a mixed-type infection. The most frequent pathogens were Acinetobacter baumannii, Staphylococcus aureus and Pseudomonas aeruginosa, followed by Klebsiella pneumoniae and Enterococcus spp. In the S. aureus isolates, 100% were resistant to oxacillin. Overall resistances of A. baumannii and K. pneumonia to imipenem were 70.5% and 76.7%, respectively. A multiple drug resistance phenotype was detected in 68.15% of the isolates. The DA-HAI rates in Iran were shown to be higher than the CDC-NHSN rates and similar to the INICC rates

  15. The design and evaluation of a system for improved surveillance and prevention programmes in resource-limited settings using a hospital-based burn injury questionnaire

    PubMed Central

    Peck, Michael; Falk, Henry; Meddings, David; Sugerman, David; Mehta, Sumi; Sage, Michael

    2016-01-01

    Background Limited and fragmented data collection systems exist for burn injury. A global registry may lead to better injury estimates and identify risk factors. A collaborative effort involving the WHO, the Global Alliance for Clean Cookstoves, the CDC and the International Society for Burn Injuries was undertaken to simplify and standardise inpatient burn data collection. An expert panel of epidemiologists and burn care practitioners advised on the development of a new Global Burn Registry (GBR) form and online data entry system that can be expected to be used in resource-abundant or resource-limited settings. Methods International burn organisations, the CDC and the WHO solicited burn centre participation to pilot test the GBR system. The WHO and the CDC led a webinar tutorial for system implementation. Results During an 8-month period, 52 hospitals in 30 countries enrolled in the pilot and were provided the GBR instrument, guidance and a data visualisation tool. Evaluations were received from 29 hospitals (56%). Key findings Median time to upload completed forms was <10 min; physicians most commonly entered data (64%), followed by nurses (25%); layout, clarity, accuracy and relevance were all rated high; and a vast majority (85%) considered the GBR ‘highly valuable’ for prioritising, developing and monitoring burn prevention programmes. Conclusions The GBR was shown to be simple, flexible and acceptable to users. Enhanced regional and global understanding of burn epidemiology may help prioritise the selection, development and testing of primary prevention interventions for burns in resource-limited settings. PMID:27044496

  16. Multiplex molecular testing for management of infectious gastroenteritis in a hospital setting: a comparative diagnostic and clinical utility study.

    PubMed

    Halligan, E; Edgeworth, J; Bisnauthsing, K; Bible, J; Cliff, P; Aarons, E; Klein, J; Patel, A; Goldenberg, S

    2014-08-01

    Laboratory diagnosis and clinical management of inpatients with diarrhoea is complex and time consuming. Tests are often requested sequentially and undertaken in different laboratories. This causes prolonged unnecessary presumptive isolation of patients, because most cases are non-infectious. A molecular multiplex test (Luminex(®) Gastrointestinal Pathogen Panel (GPP)) was compared with conventional testing over 8 months to determine diagnostic accuracy, turnaround times, laboratory costs, use of isolation facilities and user acceptability. A total of 262 (12%) patients had a pathogen detected by conventional methods compared with 483 (22.1%) by GPP. Most additional cases were detected in patients developing symptoms in the first 4 days of admission. Additional cases were detected because of presumed improved diagnostic sensitivity but also because clinicians had not requested the correct pathogen. Turnaround time (41.8 h) was faster than bacterial culture (66.5 h) and parasite investigation (66.5 h) but slower than conventional testing for Clostridium difficile (17.3 h) and viruses (27 h). The test could allow simplified requesting by clinicians and a consolidated laboratory workflow, reducing the overall number of specimens received by the laboratory. A total of 154 isolation days were saved at an estimated cost of £30 800. Consumables and labour were estimated at £150 641 compared with £63 431 for conventional testing. Multiplex molecular testing using a panel of targets allowed enhanced detection and a consolidated laboratory workflow. This is likely to be of greater benefit to cases that present within the first 4 days of hospital admission.

  17. Understanding the barriers to setting up a healthcare quality improvement process in resource-limited settings: a situational analysis at the Medical Department of Kamuzu Central Hospital in Lilongwe, Malawi

    PubMed Central

    2014-01-01

    Background Knowledge regarding the best approaches to improving the quality of healthcare and their implementation is lacking in many resource-limited settings. The Medical Department of Kamuzu Central Hospital in Malawi set out to improve the quality of care provided to its patients and establish itself as a recognized centre in teaching, operations research and supervision of district hospitals. Efforts in the past to achieve these objectives were short-lived, and largely unsuccessful. Against this background, a situational analysis was performed to aid the Medical Department to define and prioritize its quality improvement activities. Methods A mix of quantitative and qualitative methods was applied using checklists for observed practice, review of registers, key informant interviews and structured patient interviews. The mixed methods comprised triangulation by including the perspectives of the clients, healthcare providers from within and outside the department, and the field researcher’s perspectives by means of document review and participatory observation. Results Human resource shortages, staff attitudes and shortage of equipment were identified as major constraints to patient care, and the running of the Medical Department. Processes, including documentation in registers and files and communication within and across cadres of staff were also found to be insufficient and thus undermining the effort of staff and management in establishing a sustained high quality culture. Depending on their past experience and knowledge, the stakeholder interviewees revealed different perspectives and expectations of quality healthcare and the intended quality improvement process. Conclusions Establishing a quality improvement process in resource-limited settings is an enormous task, considering the host of challenges that these facilities face. The steps towards changing the status quo for improved quality care require critical self-assessment, the willingness to change

  18. A recent case of periorbital necrotizing fasciitis--presentation to definitive reconstruction within an in-theater combat hospital setting.

    PubMed

    Casey, Kevin; Cudjoe, Peter; Green, J Marshall; Valerio, Ian L

    2014-07-01

    . Delayed reconstruction of the eyelids with skin grafts and/or facial flaps is often required to avoid late complications such as cicatricial lid retraction, lid malposition, exposure keratopathy, and potential loss of vision. We describe a patient who presented to a military combat hospital with a virulent periorbital soft tissue infection. We have outlined his treatment course from the initial presentation through definitive reconstruction.

  19. A hospital-based child and adolescent overweight and obesity treatment protocol transferred into a community healthcare setting

    PubMed Central

    Mollerup, Pernille Maria; Gamborg, Michael; Trier, Cæcilie; Bøjsøe, Christine; Nielsen, Tenna Ruest Haarmark; Baker, Jennifer Lyn; Holm, Jens-Christian

    2017-01-01

    Background Due to the pandemic of child and adolescent overweight and obesity, improvements in overweight and obesity treatment availability and accessibility are needed. Methods In this prospective study, we investigated if reductions in body mass index (BMI) standard deviation scores (SDS) and waist circumference (WC) would occur during 1.5 years of community-based overweight and obesity treatment based upon an effective hospital-based overweight and obesity treatment protocol, The Children’s Obesity Clinics’ Treatment protocol. Height, weight, and WC were measured at all consultations. Changes in BMI SDS and WC were analyzed using linear mixed models based upon the repeated measures in each child. Results From June 2012 to January 2015, 1,001 children (455 boys) were consecutively enrolled in the community-based treatment program. Upon entry, the median age was 11 years (range: 3−18), and the median BMI SDS was 2.85 (range: 1.26−8.96) in boys and 2.48 (range: 1.08−4.41) in girls. After 1.5 years of treatment BMI SDS was reduced in 74% of the children. BMI SDS was reduced by a mean of 0.38 (95% confidence interval (CI): 0.30−0.45, p<0.0001) in boys and 0.18 (95% CI: 0.12−0.25, p<0.0001) in girls after 1.5 years of treatment, independently of baseline age, BMI SDS, and Tanner stage (all p>0.08). WC was reduced by a mean of 3.8 cm (95% CI: 2.7−4.9, p>0.0001) in boys and 5.1 cm (95% CI: 4.0−6.2, p>0.0001) in girls. The dropout rate was 31% after 1.5 years. A median of 4.5 consultation hours was invested per child per year. Conclusion BMI SDS and WC were reduced after 1.5 years of treatment. Hence, this community-based overweight and obesity treatment program may help accommodate the need for improvements in treatment availability and accessibility. PMID:28264043

  20. Limited efficacy of a nonrestricted intervention on antimicrobial prescription of commonly used antibiotics in the hospital setting: results of a randomized controlled trial.

    PubMed

    Masiá, M; Matoses, C; Padilla, S; Murcia, A; Sánchez, V; Romero, I; Navarro, A; Hernández, I; Gutiérrez, F

    2008-07-01

    Most interventions aimed at diminishing the use of antimicrobials in hospitals have focussed on newly introduced antibiotics and very few have been randomly controlled. We evaluated the impact on antibiotic consumption of an intervention without restrictions in antibiotic use, focussed on commonly used antibiotics with a controlled randomized trial. All new prescriptions of levofloxacin, carbapenems, or vancomycin in hospitalized patients were randomized to an intervention or a control group. Intervention consisted of an antibiotic regimen counselling targeted to match local antibiotic guidelines, performed using only patients' charts. Clinical charts of patients assigned to the control group were reviewed daily by a pharmacist. The primary endpoint was a reduction in consumption of the targeted antibiotics. Two hundred seventy-eight prescriptions corresponding to 253 patients were included: 146 were assigned to the intervention and 132 to the control group. Total consumption of the targeted antibiotics (median [IQR]) was slightly lower in the intervention (8 [4-12] defined daily doses [DDDs] per patient) than in the control group (10 [6-16] DDDs per patient; p = 0.04). No differences in number of DDDs were observed when antibiotics of substitution were included (11.05 [6-18.2] vs 10 [6-16.5] in the intervention and control groups, respectively, p = 0.13). The total number of days on treatment with the targeted antibiotics was lower in the intervention (4 [3-7] days per patient) than in the control group (6 [4-10] days per patient; p = 0.002). Differences in number of days on treatment only reached statistical significance in the prescriptions of carbapenems. There were no differences between intervention and control groups in terms of number of deaths, hospital readmissions, length of hospital stay, or antibiotic costs. In this trial, an intervention without restrictions focussed on antimicrobial prescriptions of commonly used antibiotics in the hospital setting

  1. A New Model for Providing Cell-Free DNA and Risk Assessment for Chromosome Abnormalities in a Public Hospital Setting

    PubMed Central

    Wallerstein, Robert; Jelks, Andrea; Garabedian, Matthew J.

    2014-01-01

    Objective. Cell-free DNA (cfDNA) offers highly accurate noninvasive screening for Down syndrome. Incorporating it into routine care is complicated. We present our experience implementing a novel program for cfDNA screening, emphasizing patient education, genetic counseling, and resource management. Study Design. Beginning in January 2013, we initiated a new patient care model in which high-risk patients for aneuploidy received genetic counseling at 12 weeks of gestation. Patients were presented with four pathways for aneuploidy risk assessment and diagnosis: (1) cfDNA; (2) integrated screening; (3) direct-to-invasive testing (chorionic villus sampling or amniocentesis); or (4) no first trimester diagnostic testing/screening. Patients underwent follow-up genetic counseling and detailed ultrasound at 18–20 weeks to review first trimester testing and finalize decision for amniocentesis. Results. Counseling and second trimester detailed ultrasound were provided to 163 women. Most selected cfDNA screening (69%) over integrated screening (0.6%), direct-to-invasive testing (14.1%), or no screening (16.6%). Amniocentesis rates decreased following implementation of cfDNA screening (19.0% versus 13.0%, P < 0.05). Conclusion. When counseled about screening options, women often chose cfDNA over integrated screening. This program is a model for patient-directed, efficient delivery of a newly available high-level technology in a public health setting. Genetic counseling is an integral part of patient education and determination of plan of care. PMID:25101177

  2. Pediatric Heart Failure, Lagging, and Sagging of Care in Low Income Settings: A Hospital Based Review of Cases in Ethiopia.

    PubMed

    Gebremariam, Solmon; Moges, Tamirat

    2016-01-01

    Introduction. Causes of acute heart failure in children range from simple myocarditis complicating chest infection to complex structural heart diseases. Objective. To describe patterns, predictors of mortality, and management outcomes of acute heart failure in children. Methods. In retrospective review, between February 2012 and October 2015 at a tertiary center, 106 admitted cases were selected consecutively from discharge records. Data were extracted from patients chart and analyzed using SPSS software package. t-test and statistical significance at P value < 0.05 with 95% CI were used. Result. Acute heart failure accounted for 2.9% of the total pediatric admissions. The age ranged from 2 months up to 14 years with mean age of 8 years. Male to female ratio is 1 : 2.1. Rheumatic heart disease accounted for 53.7%; pneumonia, anemia, infective endocarditis, and recurrence of acute rheumatic fever were the main precipitating causes. Death occurred in 19% of cases. Younger age at presentation, low hemoglobin concentration, and undernutrition were associated with death with P value of 0.00, 0.01, and 0.02, respectively. Conclusions and Recommendation. Pediatric heart failure in our settings is diagnosed mainly in older age groups and mostly precipitated due to preventable causes. Significant mortality is observed in relation to factors that can be preventable in children with underlying structural heart disease. Early suspicion and diagnosis of cases may reduce the observed high mortality.

  3. Pediatric Heart Failure, Lagging, and Sagging of Care in Low Income Settings: A Hospital Based Review of Cases in Ethiopia

    PubMed Central

    Gebremariam, Solmon

    2016-01-01

    Introduction. Causes of acute heart failure in children range from simple myocarditis complicating chest infection to complex structural heart diseases. Objective. To describe patterns, predictors of mortality, and management outcomes of acute heart failure in children. Methods. In retrospective review, between February 2012 and October 2015 at a tertiary center, 106 admitted cases were selected consecutively from discharge records. Data were extracted from patients chart and analyzed using SPSS software package. t-test and statistical significance at P value < 0.05 with 95% CI were used. Result. Acute heart failure accounted for 2.9% of the total pediatric admissions. The age ranged from 2 months up to 14 years with mean age of 8 years. Male to female ratio is 1 : 2.1. Rheumatic heart disease accounted for 53.7%; pneumonia, anemia, infective endocarditis, and recurrence of acute rheumatic fever were the main precipitating causes. Death occurred in 19% of cases. Younger age at presentation, low hemoglobin concentration, and undernutrition were associated with death with P value of 0.00, 0.01, and 0.02, respectively. Conclusions and Recommendation. Pediatric heart failure in our settings is diagnosed mainly in older age groups and mostly precipitated due to preventable causes. Significant mortality is observed in relation to factors that can be preventable in children with underlying structural heart disease. Early suspicion and diagnosis of cases may reduce the observed high mortality. PMID:27974990

  4. The effect of health care reform on academic medicine in Canada. Editorial Committee of the Canadian Institute for Academic Medicine.

    PubMed Central

    Hollenberg, C H

    1996-01-01

    Although Canadian health care reform has constrained costs and improved efficiency, it has had a profound and mixed effect on Canadian academic medicine. Teaching hospitals have been reduced in number and size, and in patient programs have shifted to ambulatory and community settings. Specialized care programs are now multi-institutional and multidisciplinary. Furthermore, the influence of regional planning bodies has grown markedly. Although these changes have likely improved clinical service, their impact on the quality of clinical education is uncertain. Within the academic clinical department, recruitment of young faculty has been greatly complicated by constraints on licensing, billing numbers, fee-for-service income and research funding. The departmental practice plan based on university funds and fee-for-service income is being replaced by less favourable funding arrangements. However, emphasis on multidisciplinary programs has rendered these departments more flexible in structure. The future of Canadian academic medicine depends on an effective alliance with government. Academia and government must agree, particularly on human-resource requirements, research objectives and the delivery of clinical and academic programs in regional and community settings. The establishment of focal points for academic health sciences planning within academic health sciences centres and within governments would assist in these developments. Finally, government and the academic health sciences sector must work together to remove the current impediments to the recruitment of highly qualified young faculty. PMID:8624998

  5. Setting up a Prospective Thyroid Biobank for Translational Research: Practical Approach of a Single Institution (2004-2009, Pasteur Hospital, Nice, France).

    PubMed

    Lassalle, Sandra; Hofman, Véronique; Ilie, Marius; Butori, Catherine; Bonnetaud, Christelle; Gaziello, Marie Clotilde; Selva, Eric; Gavric-Tanga, Virginie; Guevara, Nicolas; Castillo, Laurent; Santini, José; Chabannon, Christian; Hofman, Paul

    2011-03-01

    In the last few years, conditions for setting up a human biobank in France have been upgraded by taking into account (1) the new laws and regulations that integrate the ethical and societal dimension of biobanking and delineate the risks for patients associated with the procurement of human cells and tissues, (2) the increasing request by scientists for human samples with proven biological quality and sophisticated sets of annotations, including information produced through the evergrowing use of molecular biology in pathology, and (3) establishment of procedures concerning the safety of the personnel working with biological products. For this purpose, health authorities and national research institutes in France have provided significant support for the set up of biobanks. The present work was conducted to describe how we set up a biobank targeting diseases of a specific organ (thyroid gland), with the aim of rapidly developing translational research projects. The prospective experience of a single institution (Pasteur Hospital, Nice, France) over a 6-year period (2004-2009) is presented from the practical point of view of a surgical pathology laboratory. We describe different procedures required to obtain high-quality thyroid biological resources and clinical annotations. The procedures were established for the management of biological products obtained from 1454 patients who underwent thyroid surgery. The preanalytical steps leading to the storage of frozen specimens were carried out in parallel with diagnostic procedures. As the number of international networks for research programs using biological products is steadily increasing, it is crucial to harmonize the procedures used by biobanks. In this regard, the described thyroid biobank has been set up using criteria established by the French National Cancer Institute (Institut National du Cancer) to guarantee the quality of different collections stored in biobanks.

  6. Observed Handwashing with Soap Practices Among Cholera Patients and Accompanying Household Members in a Hospital Setting (CHoBI7 Trial).

    PubMed

    Zohura, Fatema; Bhuyian, Sazzadul Islam; Monira, Shirajum; Begum, Farzana; Biswas, Shwapon K; Parvin, Tahmina; Sack, David; Sack, R Bradley; Leontsini, Elli; Saif-Ur-Rahman, K M; Rashid, Mahamud-Ur; Sharmin, Rumana; Zhang, Xiaotong; Alam, Munirul; George, Christine Marie

    2016-12-07

    Household members of cholera patients are at a 100 times higher risk of cholera than the general population. Despite this risk, there are only a handful of studies that have investigated the handwashing practices among hospitalized diarrhea patients and their accompanying household members. To investigate handwashing practices in a hospital setting among this high-risk population, 444 hours of structured observation was conducted in a hospital in Dhaka, Bangladesh, among 148 cholera patients and their household members. Handwashing with soap practices were observed at the following key events: after toileting, after cleaning the anus of a child, after removing child feces, during food preparation, before eating, and before feeding. Spot-checks were also conducted to observe the presence of soap at bathroom areas. Overall, 4% (4/103) of key events involved handwashing with soap among cholera patients and household members during the structured observation period. This was 3% (1/37) among cholera patients and 5% (3/66) for household members. For toileting events, observed handwashing with soap was 7% (3/46) overall, 7% (1/14) for cholera patients, and 6% (2/32) for household members. For food-related events, overall observed handwashing with soap was 2% (2/93 overall), and 0% (0/34) and 3% (2/59) for cholera patients and household members, respectively. Soap was observed at only 7% (4/55) of handwashing stations used by patients and household members during spot-checks. Observed handwashing with soap at key times among patients and accompanying household members was very low. These findings highlight the urgent need for interventions to target this high-risk population.

  7. Evaluation of a primary-care setting at a veterinary teaching hospital by a student business group: implementing business training within the curriculum.

    PubMed

    Louisa Poon, W Y; Covington, Jennifer P; Dempsey, Lauren S; Goetgeluck, Scott L; Marscher, William F; Morelli, Sierra C; Powell, Jana E; Rivers, Elizabeth M; Roth, Ira G

    2014-01-01

    This article provides an introduction to the use of students' business skills in optimizing teaching opportunities, student learning, and client satisfaction in a primary health care setting at a veterinary teaching hospital. Seven veterinary-student members of the local chapter of the Veterinary Business Management Association (VBMA) evaluated the primary-care service at the University of Georgia (UGA) veterinary teaching hospital and assessed six areas of focus: (1) branding and marketing, (2) client experience, (3) staff and staffing, (4) student experience, (5) time management, and (6) standard operating procedures and protocols. For each area of focus, strengths, weaknesses, opportunities, and threats were identified. Of the six areas, two were identified as areas in need of immediate improvement, the first being the updating of standard operating protocols and the second being time management and the flow of appointments. Recommendations made for these two areas were implemented. Overall, the staff and students provided positive feedback on the recommended changes. Through such a student-centered approach to improving the quality of their education, students are empowered and are held accountable for their learning environment. The fact that the VBMA functions without a parent organization and that the primary-care service at UGA functions primarily as a separate entity from the specialty services at the College of Veterinary Medicine allowed students to have a direct impact on their learning environment. We hope that this model for advancing business education will be studied and promoted to benefit both veterinary education and business practice within academia.

  8. Goal-Setting, Self-Monitoring, and Teacher-Student Conferences and the Relationship with Overall School Climate and Student Academic Achievement

    ERIC Educational Resources Information Center

    Godwin, Paul Thomas

    2013-01-01

    Programs and reforms have come and gone in the educational arena with little impact on student performance. The problem at the school of study was the students' perception of their sense of belonging and the sense of the school as a community and the students' academic performance did not show adequate growth. The study took place in a mid-western…

  9. Creating a School Context of Success: The Role of Enabling School Structure & Academic Optimism in an Urban Elementary & Middle School Setting

    ERIC Educational Resources Information Center

    Mitchell, Roxanne M.; Mendiola, Brenda J.; Schumacker, Randall; Lowery, Xaviera

    2016-01-01

    Purpose: The purpose of this paper is to use SEM to explore the effects of enabling school structure (ESS) and academic optimism (AO) on school achievement (SA). Design/methodology/approach: A sample of 58 urban schools, including 42 elementary schools and 16 middle schools in a southeastern district in the USA were included in this study.…

  10. Remedial Learners in a Community College Setting Contribute to Their Own Academic Success: Identifying Effective Teaching and Learning Strategies, Delivery Methods and Instructional Technologies for Remedial Learners

    ERIC Educational Resources Information Center

    Bollash, Mary C.

    2013-01-01

    The purpose of this research was to expand on previous research surrounding remedial education at the college level. This research was conducted in four phases and identified common traits for a population of remedial learners and then determined how these common elements, when implemented, positively impacted the academic success for learners in…

  11. Perceptions and experiences of the implementation, management, use and optimisation of electronic prescribing systems in hospital settings: protocol for a systematic review of qualitative studies

    PubMed Central

    Farre, Albert; Bem, Danai; Heath, Gemma; Shaw, Karen; Cummins, Carole

    2016-01-01

    Introduction There is increasing evidence that electronic prescribing (ePrescribing) or computerised provider/physician order entry (CPOE) systems can improve the quality and safety of healthcare services. However, it has also become clear that their implementation is not straightforward and may create unintended or undesired consequences once in use. In this context, qualitative approaches have been particularly useful and their interpretative synthesis could make an important and timely contribution to the field. This review will aim to identify, appraise and synthesise qualitative studies on ePrescribing/CPOE in hospital settings, with or without clinical decision support. Methods and analysis Data sources will include the following bibliographic databases: MEDLINE, MEDLINE In Process, EMBASE, PsycINFO, Social Policy and Practice via Ovid, CINAHL via EBSCO, The Cochrane Library (CDSR, DARE and CENTRAL databases), Nursing and Allied Health Sources, Applied Social Sciences Index and Abstracts via ProQuest and SCOPUS. In addition, other sources will be searched for ongoing studies (ClinicalTrials.gov) and grey literature: Healthcare Management Information Consortium, Conference Proceedings Citation Index (Web of Science) and Sociological abstracts. Studies will be independently screened for eligibility by 2 reviewers. Qualitative studies, either standalone or in the context of mixed-methods designs, reporting the perspectives of any actors involved in the implementation, management and use of ePrescribing/CPOE systems in hospital-based care settings will be included. Data extraction will be conducted by 2 reviewers using a piloted form. Quality appraisal will be based on criteria from the Critical Appraisal Skills Programme checklist and Standards for Reporting Qualitative Research. Studies will not be excluded based on quality assessment. A postsynthesis sensitivity analysis will be undertaken. Data analysis will follow the thematic synthesis method. Ethics and

  12. The Scholarship of Academic Development.

    ERIC Educational Resources Information Center

    Eggins, Heather, Ed.; Macdonald, Ranald, Ed.

    The selections in this book address the concept and nature of academic development and examine research into and within the field. Following an introduction, "Developing a Scholarship of Academic Development: Setting the Context," by Ranald Macdonald, the chapters of part 1, "Conceptualizing Academic Development," are: (2)…

  13. Academic Blogging: Academic Practice and Academic Identity

    ERIC Educational Resources Information Center

    Kirkup, Gill

    2010-01-01

    This paper describes a small-scale study which investigates the role of blogging in professional academic practice in higher education. It draws on interviews with a sample of academics (scholars, researchers and teachers) who have blogs and on the author's own reflections on blogging to investigate the function of blogging in academic practice…

  14. Increased prevalence of carbapenem resistant Enterobacteriaceae in hospital setting due to cross-species transmission of the bla NDM-1 element and clonal spread of progenitor resistant strains.

    PubMed

    Wang, Xuan; Chen, Gongxiang; Wu, Xiaoyan; Wang, Liangping; Cai, Jiachang; Chan, Edward W; Chen, Sheng; Zhang, Rong

    2015-01-01

    This study investigated the transmission characteristics of carbapenem-resistant Enterobacteriaceae (CRE) strains collected from a hospital setting in China, in which consistent emergence of CRE strains were observable during the period of May 2013 to February 2014. Among the 45 CRE isolates tested, 21 (47%) strains were found to harbor the bla NDM-1 element, and the rest of 24 CRE strains were all positive for bla KPC-2. The 21 bla NDM-1-borne strains were found to comprise multiple Enterobacteriaceae species including nine Enterobacter cloacae, three Escherichia coli, three Citrobacter freundii, two Klebsiella pneumoniae, two Klebsiella oxytoca, and two Morganella morganii strains, indicating that cross-species transmission of bla NDM-1 is a common event. Genetic analyses by PFGE and MLST showed that, with the exception of E. coli and E. cloacae, strains belonging to the same species were often genetically unrelated. In addition to bla NDM-1, several CRE strains were also found to harbor the bla KPC-2, bla VIM-1, and bla IMP-4 elements. Conjugations experiments confirmed that the majority of carbapenem resistance determinants were transferable. Taken together, our findings suggest that transmission of mobile resistance elements among members of Enterobacteriaceae and clonal spread of CRE strains may contribute synergistically to a rapid increase in the population of CRE in clinical settings, prompting a need to implement more rigorous infection control measures to arrest such vicious transmission cycle in CRE-prevalent areas.

  15. Genome Sequencing of an Extended Series of NDM-Producing Klebsiella pneumoniae Isolates from Neonatal Infections in a Nepali Hospital Characterizes the Extent of Community- versus Hospital-Associated Transmission in an Endemic Setting

    PubMed Central

    Batty, E. M.; Sheppard, A. E.; Walker, A. S.; Wilson, D. J.; Didelot, X.; Bashir, A.; Sebra, R.; Kasarskis, A.; Sthapit, B.; Shakya, M.; Kelly, D.; Pollard, A. J.; Peto, T. E. A.; Crook, D. W.; Donnelly, P.; Thorson, S.; Amatya, P.; Joshi, S.

    2014-01-01

    NDM-producing Klebsiella pneumoniae strains represent major clinical and infection control challenges, particularly in resource-limited settings with high rates of antimicrobial resistance. Determining whether transmission occurs at a gene, plasmid, or bacterial strain level and within hospital and/or the community has implications for monitoring and controlling spread. Whole-genome sequencing (WGS) is the highest-resolution typing method available for transmission epidemiology. We sequenced carbapenem-resistant K. pneumoniae isolates from 26 individuals involved in several infection case clusters in a Nepali neonatal unit and 68 other clinical Gram-negative isolates from a similar time frame, using Illumina and PacBio technologies. Within-outbreak chromosomal and closed-plasmid structures were generated and used as data set-specific references. Three temporally separated case clusters were caused by a single NDM K. pneumoniae strain with a conserved set of four plasmids, one being a 304,526-bp plasmid carrying blaNDM-1. The plasmids contained a large number of antimicrobial/heavy metal resistance and plasmid maintenance genes, which may have explained their persistence. No obvious environmental/human reservoir was found. There was no evidence of transmission of outbreak plasmids to other Gram-negative clinical isolates, although blaNDM variants were present in other isolates in different genetic contexts. WGS can effectively define complex antimicrobial resistance epidemiology. Wider sampling frames are required to contextualize outbreaks. Infection control may be effective in terminating outbreaks caused by particular strains, even in areas with widespread resistance, although this study could not demonstrate evidence supporting specific interventions. Larger, detailed studies are needed to characterize resistance genes, vectors, and host strains involved in disease, to enable effective intervention. PMID:25267672

  16. Gender Inequalities in Remote Settings: Analysis of 105,025 Medical Records of a Rural Hospital in Ethiopia (2005-2015).

    PubMed

    Accorsi, Sandro; Somigliana, Edgardo; Farese, Pasquale; Ademe, Tsegaye; Desta, Yonas; Putoto, Giovanni; Manenti, Fabio

    2017-03-16

    Gender inequalities in Sub-Saharan Africa are deemed relevant but data to support this view are scanty. Retrospective analysis of a large dataset of 105,025 patients admitted to an Ethiopian rural private, non-for-profit hospital over a 11 years period (2005-2015). Since 2001, the hospital and the local community are involved in a long-term, comprehensive and externally-supported health care intervention. The total number of admissions was higher for females (61.9% of the total) mainly because of the high frequency of admissions for obstetrics conditions. The total male-to-female ratio (M:F) was 0.6. Except for malaria, men had more admissions for the other leading causes, with the highest M:F being found for injuries (2.7) and musculoskeletal diseases (1.7). Overall, excluding admissions for pregnancy-related issues, the M:F was 1.4. The frequency of admissions changed with age and gender. Female admissions prevailed in the reproductive age period (from 15 to 44 years of age) while males admissions prevailed in the younger and older age groups. The case fatality rate was higher for men (M:F = 2.0). The total M:F and the M:F excluding pregnancy-related admissions did not change during the study period. Gender inequalities do exist in rural remote setting but tend to affect women differently during their lifespan. Even if gender inequalities generally favor males, the substantial proportion of admissions for pregnancy-related situations is encouraging.

  17. Population Analysis and Epidemiological Features of Inhibitor-Resistant-TEM-β-Lactamase-Producing Escherichia coli Isolates from both Community and Hospital Settings in Madrid, Spain▿

    PubMed Central

    Martín, Oihane; Valverde, Aránzazu; Morosini, María I.; Rodríguez-Domínguez, Mario; Rodríguez-Baños, Mercedes; Coque, Teresa M.; Cantón, Rafael; del Campo, Rosa

    2010-01-01

    Punctual mutations in the TEM-1 or TEM-2 gene may lead to inhibitor-resistant-TEM (IRT) β-lactamases with resistance to β-lactam-β-lactamase inhibitor combinations and susceptibility to cephalosporins. The aim of this work was to analyze the current epidemiology of IRT β-lactamases in contemporary clinical Escherichia coli. Isolates were prospectively collected in our hospital (2007 and 2008) from both outpatients (59.8%) and hospitalized patients (40.2%). The genetic relationships of the isolates were determined by XbaI pulsed-field gel electrophoresis, multilocus sequence typing, and phylogenetic group analysis. IRT genes were sequenced and located by hybridization, and the incompatibility group of the plasmids was determined. From a total of 3,556 E. coli isolates recovered during the study period, 152 (4.3%) showed reduced susceptibility to amoxicillin-clavulanate, with 18 of them producing IRT enzymes (0.5%). These were mostly recovered from urine (77.8%). A high degree of IRT diversity was detected (TEM-30, -32, -33, -34, -36, -37, -40, and -54), and the isolates were clonally unrelated but were mostly associated with phylogenetic group B2 (55.5%). In 12 out of 16 (75%) isolates, the blaIRT gene was plasmid located and transferred by conjugation in 9 of them, whereas chromosomal localization was demonstrated in 4 isolates (25%). The sizes of the plasmids ranged from 40 kb (IncN) to 100 kb (IncFII, IncFI/FIIA), and they showed different restriction patterns by restriction fragment length polymorphism analysis. Unlike extended-spectrum β-lactamase producers, the frequency of IRT producers remains low in both community and hospital settings, with most of them causing urinary tract infections. Although blaIRT genes are mainly associated with plasmids, they can be also located in the chromosome. Despite this situation, clonal expansion and/or gene dispersion was not observed, denoting the independent emergence of these enzymes. PMID:20444963

  18. Impact of dose rate on accuracy of intensity modulated radiation therapy plan delivery using the pretreatment portal dosimetry quality assurance and setting up the workflow at hospital levels

    PubMed Central

    Kaviarasu, Karunakaran; Raj, N. Arunai Nambi; Murthy, K. Krishna; Babu, A. Ananda Giri; Prasad, Bhaskar Laxman Durga

    2015-01-01

    The aim of this study was to examine the impact of dose rate on accuracy of intensity modulated radiation therapy (IMRT) plan delivery by comparing the gamma agreement between the calculated and measured portal doses by pretreatment quality assurance (QA) using electronic portal imaging device dosimetry and creating a workflow for the pretreatment IMRT QA at hospital levels. As the improvement in gamma agreement leads to increase in the quality of IMRT treatment delivery, gamma evaluation was carried out for the calculated and the measured portal images for the criteria of 3% dose difference and 3 mm distance-to-agreement (DTA). Three gamma parameters: Maximum gamma, average gamma, and percentage of the field area with a gamma value>1.0 were analyzed. Three gamma index parameters were evaluated for 40 IMRT plans (315 IMRT fields) which were calculated for 400 monitor units (MU)/min dose rate and maximum multileaf collimator (MLC) speed of 2.5 cm/s. Gamma parameters for all 315 fields are within acceptable limits set at our center. Further, to improve the gamma results, we set an action level for this study using the mean and standard deviation (SD) values from the 315 fields studied. Forty out of 315 IMRT fields showed low gamma agreement (gamma parameters>2 SD as per action level of the study). The parameters were recalculated and reanalyzed for the dose rates of 300, 400 and 500 MU/min. Lowering the dose rate helped in getting an enhanced gamma agreement between the calculated and measured portal doses of complicated fields. This may be attributed to the less complex motion of MLC over time and the MU of the field/segment. An IMRT QA work flow was prepared which will help in improving the quality of IMRT delivery. PMID:26865759

  19. A review of the use of human factors classification frameworks that identify causal factors for adverse events in the hospital setting.

    PubMed

    Mitchell, R J; Williamson, A M; Molesworth, B; Chung, A Z Q

    2014-01-01

    Various human factors classification frameworks have been used to identified causal factors for clinical adverse events. A systematic review was conducted to identify human factors classification frameworks that identified the causal factors (including human error) of adverse events in a hospital setting. Six electronic databases were searched, identifying 1997 articles and 38 of these met inclusion criteria. Most studies included causal contributing factors as well as error and error type, but the nature of coding varied considerably between studies. The ability of human factors classification frameworks to provide information on specific causal factors for an adverse event enables the focus of preventive attention on areas where improvements are most needed. This review highlighted some areas needing considerable improvement in order to meet this need, including better definition of terms, more emphasis on assessing reliability of coding and greater sophistication in analysis of results of the classification. Practitioner Summary: Human factors classification frameworks can be used to identify causal factors of clinical adverse events. However, this review suggests that existing frameworks are diverse, limited in their identification of the context of human error and have poor reliability when used by different individuals.

  20. Getting evidence-based pressure ulcer prevention into practice: a multi-faceted unit-tailored intervention in a hospital setting.

    PubMed

    Sving, Eva; Högman, Marieann; Mamhidir, Anna-Greta; Gunningberg, Lena

    2016-10-01

    The aim of the study was to evaluate whether a multi-faceted, unit-tailored intervention using evidenced-based pressure ulcer prevention affects (i) the performance of pressure ulcer prevention, (ii) the prevalence of pressure ulcers and (iii) knowledge and attitudes concerning pressure ulcer prevention among registered and assistant nurses. A quasi-experimental, clustered pre- and post-test design was used. Five units at a hospital setting were included. The intervention was based on the PARIHS framework and included a multi-professional team, training and repeated quality measurements. An established methodology was used to evaluate the prevalence and prevention of pressure ulcers. Nurses' knowledge and attitudes were evaluated using a validated questionnaire. A total of 506 patients were included, of whom 105 patients had a risk to develop pressure ulcer. More patients were provided pressure ulcer prevention care (P = 0·001) and more prevention care was given to each patient (P = 0·021) after the intervention. Corresponding results were shown in the group of patients assessed as being at risk for developing pressure ulcers. Nurses' knowledge about pressure ulcer prevention increased (P < 0·001). Positive attitudes towards pressure ulcer prevention remained high between pre- and post-test surveys. This multi-faceted unit-tailored intervention affected pressure ulcer prevention. Facilitation and repeated quality measurement together with constructed feedback of results seemed to be the most important factor for pressure ulcer prevention.

  1. Evaluating the Effectiveness of Self-Administration of Medication (SAM) Schemes in the Hospital Setting: A Systematic Review of the Literature

    PubMed Central

    Richardson, Suzanna J.; Brooks, Hannah L.; Bramley, George; Coleman, Jamie J.

    2014-01-01

    Background Self-administration of medicines is believed to increase patients' understanding about their medication and to promote their independence and autonomy in the hospital setting. The effect of inpatient self-administration of medication (SAM) schemes on patients, staff and institutions is currently unclear. Objective To systematically review the literature relating to the effect of SAM schemes on the following outcomes: patient knowledge, patient compliance/medication errors, success in self-administration, patient satisfaction, staff satisfaction, staff workload, and costs. Design Keyword and text word searches of online databases were performed between January and March 2013. Included articles described and evaluated inpatient SAM schemes. Case studies and anecdotal studies were excluded. Results 43 papers were included for final analysis. Due to the heterogeneity of results and unclear findings it was not possible to perform a quantitative synthesis of results. Participation in SAM schemes often led to increased knowledge about drugs and drug regimens, but not side effects. However, the effect of SAM schemes on patient compliance/medication errors was inconclusive. Patients and staff were highly satisfied with their involvement in SAM schemes. Conclusions SAM schemes appear to provide some benefits (e.g. increased patient knowledge), but their effect on other outcomes (e.g. compliance) is unclear. Few studies of high methodological quality using validated outcome measures exist. Inconsistencies in both measuring and reporting outcomes across studies make it challenging to compare results and draw substantive conclusions about the effectiveness of SAM schemes. PMID:25463269

  2. Reflections on the practice of facilitating group-based antenatal education: should a midwife wear a uniform in the hospital setting?

    PubMed

    Wisanskoonwong, Peeranan; Fahy, Kathleen; Hastie, Carolyn

    2011-12-01

    The first author of this paper, a Thai midwife, conducted a feminist action research project aimed at collaboratively developing a model for group-based antenatal education in Thailand. Should a midwife wear a uniform when facilitating midwife-led group-based antenatal education sessions in the hospital setting? This paper reports on a single example of reflection in and on midwifery practice that aimed to answer the guiding question. The practice and reflection occurred over a number of months at the beginning of the feminist action research project. The midwife should wear normal clothes when facilitating group-based antenatal education as a symbol of equality in power relationships within the group. When power relationships between women and the midwife are equalized, women are more able to take responsibility for their health as they are less likely to defer to the 'expert'. Reflection in and on practice is a powerful tool to allow the midwife to understand and change her own practice as required to meet those goals. Self-change is a critical first step because there can be no change in the way maternity care is provided without each midwife being willing to be self-aware and open to appropriate self-change.

  3. Prevalence of supporting limb laminitis in a UK equine practice and referral hospital setting between 2005 and 2013: implications for future epidemiological studies.

    PubMed

    Wylie, C E; Newton, J R; Bathe, A P; Payne, R J

    2015-01-17

    The electronic patient records of all equine patients of Rossdales Equine Practice between January 1, 2005 and November 1, 2013 were reviewed to determine the number of cases of supporting limb laminitis (SLL) in a large equine practice and referral hospital setting in the UK and to discuss the implications for future epidemiological studies. The clinical notes were searched electronically for a combination of 'laminitis AND (contralateral OR supporting OR overload OR weight bearing)'. The prevalence of SLL within each identified denominator population and the corresponding 95% CI were calculated. SLL developed in nine horses, one donkey and one pony. Thoroughbreds were the most commonly affected breed (72.7 per cent, CI 46.4 to 99.1 per cent), aged 2-14 years (median six years), and only mares (n=9) and stallions (n=2) were represented. SLL was not restricted to horses that were non-weightbearing lame, it developed within 4-100 days after injury (median 14.5 days) and occurred most commonly in a forelimb (54.6 per cent, CI 25.1 to 84.0 per cent). During the same time frame, a total of 65,327 horses were registered with Rossdales Equine Practice, resulting in an overall practice prevalence of SLL of 0.02 per cent (CI 0.01 to 0.03 per cent). Future epidemiological studies to investigate risk factors for SLL prevention will, therefore, be a logistical challenge.

  4. "I Am Who I Am Because of Here!": School Settings as a Mechanism of Change in Establishing High-Risk Adolescents' Academic Identities

    ERIC Educational Resources Information Center

    Brown, Elizabeth Levine; Kanny, M. Allison; Johnson, Blake

    2014-01-01

    A growing body of research considers the role of school settings in supporting adolescents' social-emotional and behavioral development through instructional, social, and organizational practices (Eccles & Roeser, 2009). Recent lines of inquiry have begun to investigate individual aspects of the school setting and their influence in promoting…

  5. Measuring Rural Hospital Quality

    ERIC Educational Resources Information Center

    Moscovice, Ira; Wholey, Douglas R.; Klingner, Jill; Knott, Astrid

    2004-01-01

    Increased interest in the measurement of hospital quality has been stimulated by accrediting bodies, purchaser coalitions, government agencies, and other entities. This paper examines quality measurement for hospitals in rural settings. We seek to identify rural hospital quality measures that reflect quality in all hospitals and that are sensitive…

  6. Academic writing

    NASA Astrophysics Data System (ADS)

    Eremina, Svetlana V.

    2003-10-01

    The series of workshops on academic writing have been developed by academic writing instructors from Language Teaching Centre, Central European University and presented at the Samara Academic Writing Workshops in November 2001. This paper presents only the part dealing with strucutre of an argumentative essay.

  7. Development of an evidence-based practice and research collaborative among urban hospitals.

    PubMed

    Weeks, Susan Mace; Marshall, June; Burns, Paulette

    2009-03-01

    This article describes the development of an evidence-based practice and research collaborative among urban hospitals. The collaborative began as a mechanism to support the incorporation of evidence-based practice and research in the acute care practice setting. This article discusses the development of the collaborative, as well as the challenges, success, and future goals from both the academic and practice perspectives.

  8. The Effects of a Self-Management Procedure on the On-Task Behavior, Academic Productivity, and Academic Accuracy of Female Students with Disabilities in a Juvenile Correctional High School Setting

    ERIC Educational Resources Information Center

    Caldwell, Stacy Lynette

    2010-01-01

    Students served in juvenile correctional school settings often arrive with histories of trauma, aversive educational experiences, low achievement, and other severe risk factors that impeded psychosocial development, educational progress, and occupational outcomes. Schools serving adjudicated youth must address a higher percentage of severe…

  9. Lessons learned: mobile device encryption in the academic medical center.

    PubMed

    Kusche, Kristopher P

    2009-01-01

    The academic medical center is faced with the unique challenge of meeting the multi-faceted needs of both a modern healthcare organization and an academic institution, The need for security to protect patient information must be balanced by the academic freedoms expected in the college setting. The Albany Medical Center, consisting of the Albany Medical College and the Albany Medical Center Hospital, was challenged with implementing a solution that would preserve the availability, integrity and confidentiality of business, patient and research data stored on mobile devices. To solve this problem, Albany Medical Center implemented a mobile encryption suite across the enterprise. Such an implementation comes with complexities, from performance across multiple generations of computers and operating systems, to diversity of application use mode and end user adoption, all of which requires thoughtful policy and standards creation, understanding of regulations, and a willingness and ability to work through such diverse needs.

  10. The Effect of Care Setting in the Delivery of High-Value Colon Cancer Care

    PubMed Central

    Veenstra, Christine M.; Epstein, Andrew J.; Liao, Kaijun; Morris, Arden M.; Pollack, Craig E.; Armstrong, Katrina A.

    2015-01-01

    BACKGROUND The effect of care setting on value of colon cancer care is unknown. METHODS A Surveillance, Epidemiology, and End Results (SEER)-Medicare cohort study of 6544 patients aged ≥66 years with stage IV colon cancer (based on the American Joint Committee on Cancer staging system) who were diagnosed between 1996 and 2005 was performed. All patients were followed through December 31, 2007. Using outpatient and carrier claims, patients were assigned to a treating hospital based on the hospital affiliation of the primary oncologist. Hospitals were classified academic or nonacademic using the SEER-Medicare National Cancer Institute Hospital File. RESULTS Of the 6544 patients, 1605 (25%) received care from providers affiliated with academic medical centers. The unadjusted median cancer-specific survival was 16.0 months at academic medical centers versus 13.9 months at nonacademic medical centers (P<.001). After adjustment, treatment at academic hospitals remained significantly associated with a reduced risk of death from cancer (hazard ratio, 0.87; 95% confidence interval [95% CI], 0.82–0.93 [P<.001]). Adjusted mean 12-month Medicare spending was $8571 higher at academic medical centers (95% CI, $2340–$14,802; P =.007). The adjusted median cost was $1559 higher at academic medical centers; this difference was not found to be statistically significant (95% CI, −$5239 to $2122; P =.41). A small percentage of patients who received very expensive care skewed the difference in mean cost; the only statistically significant difference in adjusted costs in quantile regressions was at the 99.9th percentile of costs (P<.001). CONCLUSIONS Among Medicare beneficiaries with stage IV colon cancer, treatment by a provider affiliated with an academic medical center was associated with a 2 month improvement in overall survival. Except for patients in the 99.9th percentile of the cost distribution, costs at academic medical centers were not found to be significantly

  11. Occurrence and molecular characteristics of methicillin-resistant Staphylococcus aureus and methicillin-resistant Staphylococcus pseudintermedius in an academic veterinary hospital.

    PubMed

    Ishihara, Kanako; Shimokubo, Natsumi; Sakagami, Akie; Ueno, Hiroshi; Muramatsu, Yasukazu; Kadosawa, Tsuyoshi; Yanagisawa, Chie; Hanaki, Hideaki; Nakajima, Chie; Suzuki, Yasuhiko; Tamura, Yutaka

    2010-08-01

    Recently, methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant Staphylococcus pseudintermedius (MRSP) have been increasingly isolated from veterinarians and companion animals. With a view to preventing the spread of MRSA and MRSP, we evaluated the occurrence and molecular characteristics of each in a veterinary college. MRSA and MRSP were isolated from nasal samples from veterinarians, staff members, and veterinary students affiliated with a veterinary hospital. Using stepwise logistic regression, we identified two factors associated with MRSA carriage: (i) contact with an identified animal MRSA case (odds ratio [OR], 6.9; 95% confidence interval [95% CI], 2.2 to 21.6) and (ii) being an employee (OR, 6.2; 95% CI, 2.0 to 19.4). The majority of MRSA isolates obtained from individuals affiliated with the veterinary hospital and dog patients harbored spa type t002 and a type II staphylococcal cassette chromosome mec (SCCmec), similar to the hospital-acquired MRSA isolates in Japan. MRSA isolates harboring spa type t008 and a type IV SCCmec were obtained from one veterinarian on three different sampling occasions and also from dog patients. MRSA carriers can also be a source of MRSA infection in animals. The majority of MRSP isolates (85.2%) carried hybrid SCCmec type II-III, and almost all the remaining MRSP isolates (11.1%) carried SCCmec type V. MRSA and MRSP were also isolated from environmental samples collected from the veterinary hospital (5.1% and 6.4%, respectively). The application of certain disinfection procedures is important for the prevention of nosocomial infection, and MRSA and MRSP infection control strategies should be adopted in veterinary medical practice.

  12. Antimicrobial Stewardship in the Microbiology Laboratory: Impact of Selective Susceptibility Reporting on Ciprofloxacin Utilization and Susceptibility of Gram-Negative Isolates to Ciprofloxacin in a Hospital Setting

    PubMed Central

    Seah, J.; Chan, A.; Downing, M.; Johnstone, J.; Matukas, L. M.

    2016-01-01

    The objective of this study was to determine the impact of selective susceptibility reporting on ciprofloxacin utilization and Gram-negative susceptibility to ciprofloxacin in a hospital setting. Historically at our institution, the microbiology laboratory practice was to report ciprofloxacin susceptibility for all Enterobacteriaceae regardless of susceptibility to other agents. A selective reporting policy was implemented which involved the suppression of ciprofloxacin susceptibility to Enterobacteriaceae when there was lack of resistance to the antibiotics on the Gram-negative panel. Ciprofloxacin utilization (measured in defined daily doses [DDD] per 1,000 patient days) was collected before and after the intervention and compared to moxifloxacin, trimethoprim-sulfamethoxazole, nitrofurantoin, and amoxicillin-clavulanate. Monthly susceptibility of Pseudomonas aeruginosa and Escherichia coli to ciprofloxacin was tabulated. An interrupted time series analysis using segmented regression was performed. The mean monthly ciprofloxacin utilization decreased from 87 (95% CI, 83.7 to 91.2) to 39 (95% CI, 35.0 to 44.0) DDD per 1,000 patient days before and after the implementation of selective reporting, respectively. There was an immediate and sustained reduction in ciprofloxacin usage at 1, 3, 6, 12, and 24 months postintervention (P < 0.001). A compensatory increase in amoxicillin-clavulanate use was noted starting at 6 months postintervention and persisted for the study period (P < 0.027). Susceptibility of E. coli, but not that of P. aeruginosa, to ciprofloxacin was higher than predicted starting 12 months after the intervention (P < 0.05). In conclusion, selective reporting of ciprofloxacin susceptibly may be a useful intervention to reduce targeted antimicrobial utilization and improve Gram-negative susceptibility to ciprofloxacin. This approach should be considered as part of a broader multimodal antimicrobial stewardship program. PMID:27385708

  13. Academic buoyancy: Towards an understanding of students' everyday academic resilience.

    PubMed

    Martin, Andrew J; Marsh, Herbert W

    2008-02-01

    Academic buoyancy is developed as a construct reflecting everyday academic resilience within a positive psychology context and is defined as students' ability to successfully deal with academic setbacks and challenges that are typical of the ordinary course of school life (e.g., poor grades, competing deadlines, exam pressure, difficult schoolwork). Data were collected from 598 students in Years 8 and 10 at five Australian high schools. Half-way through the school year and then again at the end of the year, students were asked to rate their academic buoyancy as well as a set of hypothesized predictors (self-efficacy, control, academic engagement, anxiety, teacher-student relationship) in the area of mathematics. Multilevel modeling found that the bulk of variance in academic buoyancy was explained at the student level. Confirmatory factor analysis and structural equation modeling showed that (a) Time 1 anxiety (negatively), self-efficacy, and academic engagement significantly predict Time 1 academic buoyancy; (b) Time 2 anxiety (negatively), self-efficacy, academic engagement, and teacher-student relationships explain variance in Time 2 academic buoyancy over and above that explained by academic buoyancy at Time 1; and (c) of the significant predictors, anxiety explains the bulk of variance in academic buoyancy.

  14. How Academic Is Academic Development?

    ERIC Educational Resources Information Center

    Fraser, Kym; Ling, Peter

    2014-01-01

    University provision for academic development is well established in the USA, UK and many other countries. However, arrangements for its provision and staffing vary. In Australia, there has been a trend towards professional rather than academic staff appointments. Is this appropriate? In this paper, the domains of academic development work are…

  15. Surface Microbiology of the iPad Tablet Computer and the Potential to Serve as a Fomite in Both Inpatient Practice Settings as Well as Outside of the Hospital Environment

    PubMed Central

    Hirsch, Elizabeth B.; Raux, Brian R.; Lancaster, Jason W.; Mann, Rachael L.; Leonard, Steven N.

    2014-01-01

    Background The use of tablet computers and other touch screen technology within the healthcare system has rapidly expanded. It has been reported that these devices can harbor pathogens in hospitals; however, much less is known about what pathogens they can harbor when used outside the hospital environment compared to hospital practice. Methods Thirty iPads belonging to faculty with a variety of practice settings were sampled to determine the presence and quantity of clinically-relevant organisms. Flocked nylon swabs and neutralizer solution were used to sample the surface of each iPad. Samples were then plated on a variety of selective agars for presence and quantity of selected pathogens. In addition, faculty members were surveyed to classify the physical location of their practice settings and usage patterns. Continuous variables were compared via an unpaired Student's t test with two-tailed distribution; categorical variables were compared with the Fisher's exact test. Results Of the iPads sampled, 16 belonged to faculty practicing within a hospital and 14 belonged to a faculty member practicing outside a hospital. More faculty within the hospital group used their iPads at their practice sites (78.6% vs. 31.3%; p = 0.014) and within patient care areas (71.4% vs. 18.8%; p = 0.009) than the non-hospital group. There were no differences in the presence, absence, or quantity of, any of the pathogens selectively isolated between groups. Problematic nosocomial pathogens such as methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and P. aeruginosa were isolated from both hospital and non-hospital faculty iPads. Conclusions Gram positive and Gram negative organisms were recovered from the surfaces of iPads regardless of practice setting; these included problematic multidrug-resistant pathogens like MRSA, VRE, and Pseudomonas aeruginosa. Healthcare personnel in all settings should be aware of the potential for tablet

  16. Learning behaviour and preferences of family medicine residents under a flexible academic curriculum

    PubMed Central

    Sy, Alice; Wong, Eric; Boisvert, Leslie

    2014-01-01

    Abstract Objective To determine family medicine residents’ learning behaviour and preferences outside of clinical settings in order to help guide the development of an effective academic program that can maximize their learning. Design Retrospective descriptive analysis of academic learning logs submitted by residents as part of their academic training requirements between 2008 and 2011. Setting London, Ont. Participants All family medicine residents at Western University who had completed their academic program requirements (N = 72) by submitting 300 or more credits (1 credit = 1 hour). Main outcome measures Amount of time spent on various learning modalities, location where the learning took place, resources used for self-study, and the objective of the learning activity. Results A total of 72 residents completed their academic requirements during the study period and logged a total of 25 068 hours of academic learning. Residents chose to spend most of their academic time engaging in self-study (44%), attending staff physicians’ teaching sessions (20%), and participating in conferences, courses, or workshops (12%) and in postgraduate medical education sessions (12%). Textbooks (26%), medical journals (20%), and point-of-care resources (12%) were the 3 most common resources used for self-study. The hospital (32%), residents’ homes (32%), and family medicine clinics (14%) were the most frequently cited locations where academic learning occurred. While all physicians used a variety of educational activities, most residents (67%) chose self-study as their primary method of learning. The topic for academic learning appeared to have some influence on the learning modalities used by residents. Conclusion Residents used a variety of learning modalities and chose self-study over other more traditional modalities (eg, lectures) for most of their academic learning. A successful academic program must take into account residents’ various learning preferences and

  17. Cost-Minimization Model of a Multidisciplinary Antibiotic Stewardship Team Based on a Successful Implementation on a Urology Ward of an Academic Hospital

    PubMed Central

    Dik, Jan-Willem H.; Hendrix, Ron; Friedrich, Alex W.; Luttjeboer, Jos; Nannan Panday, Prashant; Wilting, Kasper R.; Lo-Ten-Foe, Jerome R.; Postma, Maarten J.; Sinha, Bhanu

    2015-01-01

    Background In order to stimulate appropriate antimicrobial use and thereby lower the chances of resistance development, an Antibiotic Stewardship Team (A-Team) has been implemented at the University Medical Center Groningen, the Netherlands. Focus of the A-Team was a pro-active day 2 case-audit, which was financially evaluated here to calculate the return on investment from a hospital perspective. Methods Effects were evaluated by comparing audited patients with a historic cohort with the same diagnosis-related groups. Based upon this evaluation a cost-minimization model was created that can be used to predict the financial effects of a day 2 case-audit. Sensitivity analyses were performed to deal with uncertainties. Finally, the model was used to financially evaluate the A-Team. Results One whole year including 114 patients was evaluated. Implementation costs were calculated to be €17,732, which represent total costs spent to implement this A-Team. For this specific patient group admitted to a urology ward and consulted on day 2 by the A-Team, the model estimated total savings of €60,306 after one year for this single department, leading to a return on investment of 5.9. Conclusions The implemented multi-disciplinary A-Team performing a day 2 case-audit in the hospital had a positive return on investment caused by a reduced length of stay due to a more appropriate antibiotic therapy. Based on the extensive data analysis, a model of this intervention could be constructed. This model could be used by other institutions, using their own data to estimate the effects of a day 2 case-audit in their hospital. PMID:25955494

  18. Using Needs Assessment to Develop Curricula for Screening, Brief Intervention, and Referral to Treatment (SBIRT) in Academic and Community Health Settings

    ERIC Educational Resources Information Center

    Satre, Derek D.; McCance-Katz, Elinore F.; Moreno-John, Gina; Julian, Katherine A.; O'Sullivan, Patricia S.; Satterfield, Jason M.

    2012-01-01

    This article describes the use of a brief needs assessment survey in the development of alcohol and drug screening, brief intervention, and referral to treatment (SBIRT) curricula in 2 health care settings in the San Francisco Bay Area. The samples included university medical center faculty (n = 27) and nonphysician community health and social…

  19. Academic and Family Conditions Associated with Intrinsic Academic Motivation in Japanese Medical Students: A Pilot Study

    ERIC Educational Resources Information Center

    Tanaka, Masaaki; Watanabea, Yasuyoshi

    2012-01-01

    Objective: Intrinsic academic motivation is one of the most important psychological concepts in education, and it is related to academic outcomes in medical students. This study examined the relationships between academic and family conditions and intrinsic academic motivation. Design: Cross-sectional design. Setting: The study group consisted of…

  20. Improving obstetric care in low-resource settings: implementation of facility-based maternal death reviews in five pilot hospitals in Senegal

    PubMed Central

    Dumont, Alexandre; Tourigny, Caroline; Fournier, Pierre

    2009-01-01

    Background In sub-Saharan Africa, maternal and perinatal mortality and morbidity are major problems. Service availability and quality of care in health facilities are heterogeneous and most often inadequate. In resource-poor settings, the facility-based maternal death review or audit is one of the most promising strategies to improve health service performance. We aim to explore and describe health workers' perceptions of facility-based maternal death reviews and to identify barriers to and facilitators of the implementation of this approach in pilot health facilities of Senegal. Methods This study was conducted in five reference hospitals in Senegal with different characteristics. Data were collected from focus group discussions, participant observations of audit meetings, audit documents and interviews with the staff of the maternity unit. Data were analysed by means of both quantitative and qualitative approaches. Results Health professionals and service administrators were receptive and adhered relatively well to the process and the results of the audits, although some considered the situation destabilizing or even threatening. The main barriers to the implementation of maternal deaths reviews were: (1) bad quality of information in medical files; (2) non-participation of the head of department in the audit meetings; (3) lack of feedback to the staff who did not attend the audit meetings. The main facilitators were: (1) high level of professional qualifications or experience of the data collector; (2) involvement of the head of the maternity unit, acting as a moderator during the audit meetings; (3) participation of managers in the audit session to plan appropriate and realistic actions to prevent other maternal deaths. Conclusion The identification of the barriers to and the facilitators of the implementation of maternal death reviews is an essential step for the future adaptation of this method in countries with few resources. We recommend for future

  1. Comparative cost-efficiency of the EVOTECH endoscope cleaner and reprocessor versus manual cleaning plus automated endoscope reprocessing in a real-world Canadian hospital endoscopy setting

    PubMed Central

    2011-01-01

    Background Reprocessing of endoscopes generally requires labour-intensive manual cleaning followed by high-level disinfection in an automated endoscope reprocessor (AER). EVOTECH Endoscope Cleaner and Reprocessor (ECR) is approved for fully automated cleaning and disinfection whereas AERs require manual cleaning prior to the high-level disinfection procedure. The purpose of this economic evaluation was to determine the cost-efficiency of the ECR versus AER methods of endoscopy reprocessing in an actual practice setting. Methods A time and motion study was conducted at a Canadian hospital to collect data on the personnel resources and consumable supplies costs associated with the use of EVOTECH ECR versus manual cleaning followed by AER with Medivators DSD-201. Reprocessing of all endoscopes was observed and timed for both reprocessor types over three days. Laboratory staff members were interviewed regarding the consumption and cost of all disposable supplies and equipment. Exact Wilcoxon rank sum test was used for assessing differences in total cycle reprocessing time. Results Endoscope reprocessing was significantly shorter with the ECR than with manual cleaning followed by AER. The differences in median time were 12.46 minutes per colonoscope (p < 0.0001), 6.31 minutes per gastroscope (p < 0.0001), and 5.66 minutes per bronchoscope (p = 0.0040). Almost 2 hours of direct labour time was saved daily with the ECR. The total per cycle cost of consumables and labour for maintenance was slightly higher for EVOTECH ECR versus manual cleaning followed by AER ($8.91 versus $8.31, respectively). Including the cost of direct labour time consumed in reprocessing scopes, the per cycle and annual costs of using the EVOTECH ECR was less than the cost of manual cleaning followed by AER disinfection ($11.50 versus $11.88). Conclusions The EVOTECH ECR was more efficient and less costly to use for the reprocessing of endoscopes than manual cleaning followed by AER disinfection

  2. Rate of spontaneous voiding recovery after acute urinary retention due to bed rest in the hospital setting in a non-urological population clinical study of the relationship between lower limbs and bladder function

    PubMed Central

    Rodrigues, Paulo; Hering, Flávio; Cieli, Eli; Campagnari, João Carlos

    2016-01-01

    Abstract Objectives To understand the clinical relationship between lower limbs functions and the recovery of spontaneous voiding after an acute urinary retention (AUR) in older patients admitted to hospitals for non-urological causes using clinical parameters. Materials and Methods 56 adult patients (32 men; mean age: 77.9 ± 8.3 and 24 women; mean age 82.1 ± 4.6) with AUR were prospectively followed with validated Physical Performance Mobility Exam (PPME) instrument to evaluate the relationship between the recovery of mobility capacity and spontaneous voiding. After a short period of permanent bladder drainage patients started CIC along evaluation by PPME during hospitalization and at 7, 15, 30 60, 90, and 180 days of discharge. Mann-Whitney U, chi-square test and ANOVA tests were used. Results All patients were hospitalized for at least 15 days (Median 26.3 ± 4.1 days). Progressive improvement on mobility scale measured by PPME was observed after leaving ICU and along the initial 7 days of hospitalization but with a deterioration if hospitalization extends beyond 15 days (p<0.03). Prolonged hospital stay impairs mobility in all domains (p<0.05) except step-up and transfer skills (p<0.02) although a recovery rate on spontaneous voiding persistented. Restoration of spontaneous voiding was accompanied by improvement on mobility scale (p<0.02). Recovery of spontaneous voiding was markedly observed after discharging the hospital. All patients recovered spontaneous voiding until 6 months of follow-up. Conclusions Recovery to spontaneous voiding after acute urinary retention in the hospital setting may be anticipated by evaluation of lower limbs function measured by validated instruments. PMID:27532117

  3. Community-Academic Partnership to Investigate Low Birth Weight Deliveries and Improve Maternal and Infant Outcomes at a Baltimore City Hospital.

    PubMed

    Harvey, Elizabeth M; Strobino, Donna; Sherrod, Leslie; Webb, Mary Catherine; Anderson, Caroline; White, Jennifer Arice; Atlas, Robert

    2017-02-01

    Purpose Mercy Medical Center (MMC), a community hospital in Baltimore Maryland, has undertaken a community initiative to reduce low birth weight (LBW) deliveries by 10 % in 3 years. MMC partnered with a School of Public Health to evaluate characteristics associated with LBW deliveries and formulate collaborations with obstetricians and community services to improve birth outcomes. Description As part of the initiative, a case control study of LBW was undertaken of all newborns weighing <2500 grams during June 2010-June 2011 matched 2:1 with newborns ≥2500 grams (n = 862). Assessment Logistic regression models including maternal characteristics prior to and during pregnancy showed an increased odds of LBW among women with a previous preterm birth (aOR 2.48; 95 % CI: 1.49-4.13), chronic hypertension (aOR: 2.53; 95 % CI: 1.25-5.10), hospitalization during pregnancy (aOR: 2.27; 95 % CI:1.52-3.40), multiple gestation (aOR:12.33; 95 % CI:5.49-27.73) and gestational hypertension (aOR: 2.81; 95 % CI: 1.79-4.41). Given that both maternal pre-existing conditions and those occurring during pregnancy were found to be associated with LBW, one strategy to address pregnant women at risk of LBW infants is to improve the intake and referral system to better triage women to appropriate services in the community. Meetings were held with community organizations and feedback was operationalized into collaboration strategies which can be jointly implemented. Conclusion Education sessions with providers about the referral system are one ongoing strategy to improve birth outcomes in Baltimore City, as well as provision of timely home visits by nurses to high-risk women.

  4. Academic Bullies

    ERIC Educational Resources Information Center

    Fogg, Piper

    2008-01-01

    Many professors have been traumatized by academic bullies. Unlike bullies at school, the academic bully plays a more subtle game. Bullies may spread rumors to undermine a colleague's credibility or shut their target out of social conversations. The more aggressive of the species cuss out co-workers, even threatening to get physical. There is…

  5. Commentary on: "On the Need for a Specialist Service within the Generic Hospital Setting" by Robyn A. Wallace and Helen Beange (2008)

    ERIC Educational Resources Information Center

    Kerr, Michael

    2008-01-01

    This commentary discusses whether a sufficient case has been made for specialism in hospital services as a viable alternative to existing generic services. The impact of developments in specialist care such as those outlined by Robyn A. Wallace and Helen Beange should be assessed as a means of reducing inequality. In particular, model services…

  6. A novel organizational model to face the challenge of multimorbid elderly patients in an internal medicine setting: a case study from Parma Hospital, Italy.

    PubMed

    Meschi, Tiziana; Ticinesi, Andrea; Prati, Beatrice; Montali, Arianna; Ventura, Antonio; Nouvenne, Antonio; Borghi, Loris

    2016-08-01

    Continuous increase of elderly patients with multimorbidity and Emergency Department (ED) overcrowding are great challenges for modern medicine. Traditional hospital organizations are often too rigid to solve them without consistently rising healthcare costs. In this paper we present a new organizational model achieved at Internal Medicine and Critical Subacute Care Unit of Parma University Hospital, Italy, a 106-bed internal medicine area organized by intensity of care and specifically dedicated to such patients. The unit is partitioned into smaller wards, each with a specific intensity level of care, including a rapid-turnover ward (mean length of stay <4 days) admitting acutely ill patients from the ED, a subacute care ward for chronic critically ill subjects and a nurse-managed ward for stable patients who have socio-economic trouble preventing discharge. A very-rapid-turnover ("come'n'go") ward has also been instituted to manage sudden ED overflows. Continuity, effectiveness, safety and appropriateness of care are guaranteed by an innovative figure called "flow manager," with skilled clinical experience and managerial attitude, and by elaboration of an early personalized discharge plan anticipating every patient's needs according to lean methodology principles. In 2012-2014, this organizational model, compared with other peer units of the hospital and of other teaching hospitals of the region, showed a better performance, efficacy and effectiveness indexes calculated on Regional Hospital Discharge Records database system, allowing a capacity to face a massive (+22 %) rise in medical admissions from the ED. Further studies are needed to validate this model from a patient outcome point of view.

  7. Hospital outpatient perceptions of the physical environment of waiting areas: the role of patient characteristics on atmospherics in one academic medical center

    PubMed Central

    Tsai, Chun-Yen; Wang, Mu-Chia; Liao, Wei-Tsen; Lu, Jui-Heng; Sun, Pi-hung; Lin, Blossom Yen-Ju; Breen, Gerald-Mark

    2007-01-01

    Background This study examines hospital outpatient perceptions of the physical environment of the outpatient waiting areas in one medical center. The relationship of patient characteristics and their perceptions and needs for the outpatient waiting areas are also examined. Method The examined medical center consists of five main buildings which house seventeen primary waiting areas for the outpatient clinics of nine medical specialties: 1) Internal Medicine; 2) Surgery; 3) Ophthalmology; 4) Obstetrics-Gynecology and Pediatrics; 5) Chinese Medicine; 6) Otolaryngology; 7) Orthopedics; 8) Family Medicine; and 9) Dermatology. A 15-item structured questionnaire was developed to rate patient satisfaction covering the four dimensions of the physical environments of the outpatient waiting areas: 1) visual environment; 2) hearing environment; 3) body contact environment; and 4) cleanliness. The survey was conducted between November 28, 2005 and December 8, 2005. A total of 680 outpatients responded. Descriptive, univariate, and multiple regression analyses were applied in this study. Results All of the 15 items were ranked as relatively high with a range from 3.362 to 4.010, with a neutral score of 3. Using a principal component analysis' summated scores of four constructed dimensions of patient satisfaction with the physical environments (i.e. visual environment, hearing environment, body contact environment, and cleanliness), multiple regression analyses revealed that patient satisfaction with the physical environment of outpatient waiting areas was associated with gender, age, visiting frequency, and visiting time. Conclusion Patients' socio-demographics and context backgrounds demonstrated to have effects on their satisfaction with the physical environment of outpatient waiting areas. In addition to noticing the overall rankings for less satisfactory items, what should receive further attention is the consideration of the patients' personal characteristics when

  8. Hospital Dermatology, Introduction.

    PubMed

    Fox, Lindy P

    2017-03-01

    Inpatient dermatology is emerging as a distinct dermatology subspecialty where dermatologists specialize in caring for patients hospitalized with skin disease. While the main focus of inpatient dermatology is the delivery of top-quality and timely dermatologic care to patients in the hospital setting, the practice of hospital-based dermatology has many additional components that are critical to its success.

  9. Academic Freedom and Academic Tenure.

    ERIC Educational Resources Information Center

    De George, Richard T.

    2001-01-01

    Asserts that Martin Michaelson's proposal in "Should Untenured as Well as Tenured Faculty Be Guaranteed Academic Freedom? A Few Observations," despite its good intentions, is seriously flawed and if adopted in preference to existing standards will weaken rather than strengthen academic freedom. (EV)

  10. Is laboratory medicine ready for the era of personalized medicine? A survey addressed to laboratory directors of hospitals/academic schools of medicine in Europe.

    PubMed

    Malentacchi, Francesca; Mancini, Irene; Brandslund, Ivan; Vermeersch, Pieter; Schwab, Matthias; Marc, Janja; van Schaik, Ron H N; Siest, Gerard; Theodorsson, Elvar; Pazzagli, Mario; Di Resta, Chiara

    2015-06-01

    Developments in "-omics" are creating a paradigm shift in laboratory medicine leading to personalized medicine. This allows the increase in diagnostics and therapeutics focused on individuals rather than populations. In order to investigate whether laboratory medicine is ready to play a key role in the integration of personalized medicine in routine health care and set the state-of-the-art knowledge about personalized medicine and laboratory medicine in Europe, a questionnaire was constructed under the auspices of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) and the European Society of Pharmacogenomics and Personalised Therapy (ESPT). The answers of the participating laboratory medicine professionals indicate that they are aware that personalized medicine can represent a new and promising health model, and that laboratory medicine should play a key role in supporting the implementation of personalized medicine in the clinical setting. Participants think that the current organization of laboratory medicine needs additional/relevant implementations such as (i) new technological facilities in -omics; (ii) additional training for the current personnel focused on the new methodologies; (iii) incorporation in the laboratory of new competencies in data interpretation and counseling; and (iv) cooperation and collaboration among professionals of different disciplines to integrate information according to a personalized medicine approach.

  11. Implementation and performance of the BioFire FilmArray® Blood Culture Identification panel with antimicrobial treatment recommendations for bloodstream infections at a midwestern academic tertiary hospital.

    PubMed

    Southern, Timothy R; VanSchooneveld, Trevor C; Bannister, Dianna L; Brown, TeAnne L; Crismon, Amy S; Buss, Sarah N; Iwen, Peter C; Fey, Paul D

    2015-02-01

    The FilmArray® Blood Culture Identification (BCID) panel was recently implemented at a midwestern academic tertiary care hospital to provide rapid identification (ID) of common pathogens from positive blood cultures. This study evaluated the clinical performance of the BCID panel compared to culture-based ID methods. One hundred thirty-eight monomicrobial and 8 polymicrobial blood cultures were evaluated during the 30-day study resulting in the ID of 152 total organisms by culture with 115 organisms correctly identified using the BCID panel. The BCID panel had sensitivities of 80.4% (115/152) for all organisms identified during the study and 94.6% (115/122) when considering only on-panel organisms. BCID panel specificity was 100%. Implementation of the BCID panel was coupled with the development of empiric therapy recommendations for bloodstream infections by the antimicrobial stewardship team. Based on this study, the FilmArray® BCID panel is a rapid and reliable test for the detection of common bloodstream pathogens, and therapeutic decisions can be based upon panel results.

  12. Setting Goals for Achievement in Physical Education Settings

    ERIC Educational Resources Information Center

    Baghurst, Timothy; Tapps, Tyler; Kensinger, Weston

    2015-01-01

    Goal setting has been shown to improve student performance, motivation, and task completion in academic settings. Although goal setting is utilized by many education professionals to help students set realistic and proper goals, physical educators may not be using goal setting effectively. Without incorporating all three types of goals and…

  13. The Third Language of Academic English

    ERIC Educational Resources Information Center

    Zwiers, Jeff

    2005-01-01

    Academic language is the linguistic glue that holds the tasks, texts, and tests of school together. If students can't use this glue well, their academic work is likely to fall apart. According to the author of this article, "academic language" is defined as the set of words and phrases that (1) describe content-area knowledge and procedures; (2)…

  14. Autopsy of Adult Patients Deceased in an Academic Hospital: Considerations of Doctors and Next-of-Kin in the Consent Process

    PubMed Central

    Weustink, Annick C.; Hunink, M. G. Myriam; Oosterhuis, J. Wolter

    2016-01-01

    Introduction Hospital autopsies, vanishing worldwide, need to be requested by clinicians and consented to by next-of-kin. The aim of this prospective observational study was to examine how often and why clinicians do not request an autopsy, and for what reasons next-of-kin allow, or refuse it. Methods Clinicians at the Erasmus University Medical Centre were asked to complete a questionnaire when an adult patient had died. Questionnaires on 1000 consecutive naturally deceased adults were collected. If possible, missing data in the questionnaires were retrieved from the electronic patient record. Results Data from 958 (96%) questionnaires was available for analysis. In 167/958 (17·4%) cases clinicians did not request an autopsy, and in 641/791 (81·0%) cases next-of-kin did not give consent. The most important reason for both clinicians (51·5%) and next-of-kin (51·0%) to not request or consent to an autopsy was an assumed known cause of death. Their second reason was that the deceased had gone through a long illness (9·6% and 29·5%). The third reason for next-of-kin was mutilation of the deceased’s body by the autopsy procedure (16·1%). Autopsy rates were highest among patients aged 30–39 years, Europeans, suddenly and/or unexpectedly deceased patients, and tissue and/or organ donors. The intensive care and emergency units achieved the highest autopsy rates, and surgical wards the lowest. Conclusion The main reason for not requesting or allowing an autopsy is the assumption that the cause of death is known. This is a dangerous premise, because it is a self-fulfilling prophecy. Clinicians should be aware, and communicate with the next of kin, that autopsies not infrequently disclose unexpected findings, which might have changed patient management. Mutilation of the deceased’s body seems a minor consideration of next-of-kin, though how it really affects autopsy rates, should be studied by offering minimally or non-invasive autopsy methods. PMID:27736974

  15. Identifying research priorities in anaesthesia and perioperative care: final report of the joint National Institute of Academic Anaesthesia/James Lind Alliance Research Priority Setting Partnership

    PubMed Central

    Boney, Oliver; Bell, Madeline; Bell, Natalie; Conquest, Ann; Cumbers, Marion; Drake, Sharon; Galsworthy, Mike; Gath, Jacqui; Grocott, Michael P W; Harris, Emma; Howell, Simon; Ingold, Anthony; Nathanson, Michael H; Pinkney, Thomas; Metcalf, Leanne

    2015-01-01

    Objective To identify research priorities for Anaesthesia and Perioperative Medicine. Design Prospective surveys and consensus meetings guided by an independent adviser. Setting UK. Participants 45 stakeholder organisations (25 professional, 20 patient/carer) affiliated as James Lind Alliance partners. Outcomes First ‘ideas-gathering’ survey: Free text research ideas and suggestions. Second ‘prioritisation’ survey: Shortlist of ‘summary’ research questions (derived from the first survey) ranked by respondents in order of priority. Final ‘top ten’: Agreed by consensus at a final prioritisation workshop. Results First survey: 1420 suggestions received from 623 respondents (49% patients/public) were refined into a shortlist of 92 ‘summary’ questions. Second survey: 1718 respondents each nominated up to 10 questions as research priorities. Top ten: The 25 highest-ranked questions advanced to the final workshop, where 23 stakeholders (13 professional, 10 patient/carer) agreed the 10 most important questions: ▸ What can we do to stop patients developing chronic pain after surgery? ▸ How can patient care around the time of emergency surgery be improved? ▸ What long-term harm may result from anaesthesia, particularly following repeated anaesthetics? ▸ What outcomes should we use to measure the ‘success’ of anaesthesia and perioperative care? ▸ How can we improve recovery from surgery for elderly patients? ▸ For which patients does regional anaesthesia give better outcomes than general anaesthesia? ▸ What are the effects of anaesthesia on the developing brain? ▸ Do enhanced recovery programmes improve short and long-term outcomes? ▸ How can preoperative exercise or fitness training, including physiotherapy, improve outcomes after surgery? ▸ How can we improve communication between the teams looking after patients throughout their surgical journey? Conclusions Almost 2000 stakeholders contributed their views

  16. Community-Academic Partnerships: Developing a Service-Learning Framework.

    PubMed

    Voss, Heather C; Mathews, Launa Rae; Fossen, Traci; Scott, Ginger; Schaefer, Michele

    2015-01-01

    Academic partnerships with hospitals and health care agencies for authentic clinical learning have become a major focus of schools of nursing and professional nursing organizations. Formal academic partnerships in community settings are less common despite evolving models of care delivery outside of inpatient settings. Community-Academic partnerships are commonly developed as a means to engage nursing students in service-learning experiences with an emphasis on student outcomes. The benefit of service-learning projects on community partners and populations receiving the service is largely unknown primarily due to the lack of structure for identifying and measuring outcomes specific to service-learning. Nursing students and their faculty engaged in service-learning have a unique opportunity to collaborate with community partners to evaluate benefits of service-learning projects on those receiving the service. This article describes the development of a service-learning framework as a first step toward successful measurement of the benefits of undergraduate nursing students' service-learning projects on community agencies and the people they serve through a collaborative community-academic partnership.

  17. Population Structure of Enterococcus faecium Causing Bacteremia in a Spanish University Hospital: Setting the Scene for a Future Increase in Vancomycin Resistance?

    PubMed Central

    Coque, Teresa M.; Willems, Rob J. L.; Fortún, Jesús; Top, Janetta; Diz, Sergio; Loza, Elena; Cantón, Rafael; Baquero, Fernando

    2005-01-01

    Over an 8-year period (1995 to 2002), 86 Enterococcus faecium blood isolates from 84 patients, of which 54 were ampicillin resistant (AREF) and 32 were ampicillin susceptible (ASEF), were studied in a university hospital (1,200 beds; serving a population of 600,000) in Spain, a country characterized by a near-absence of resistance to vancomycin and very high rates of ampicillin resistance among enterococci. Clonal relatedness by pulsed-field gel electrophoresis (PFGE), antibiotic susceptibility, presence of the virulence/epidemicity genes espEfm and hylEfm, and identification of purK alleles were studied. A group of isolates was also analyzed by amplified fragment length polymorphism (AFLP) and multilocus sequence typing. Medical charts (30 variables collected) were reviewed for 60/84 patients. ASEF showed high clonal diversity (32 PFGE types, 11 purK alleles, 4 AFLP genogroups), did not harbor putative virulence genes, and had no specific association with hospital acquisition. AREF isolates belonged to a clonal complex (CC) of genetically related strains (purK-1, AFLP genogroup C), occasionally harboring putative virulence traits, and were from patients with particular risk factors. Within this CC, previously associated with vancomycin-resistant E. faecium isolates causing outbreaks worldwide (W. L. Homan et al., J. Clin. Microbiol. 40:1963-1971, 2002), a great genetic diversity of antibiotic resistance and virulence/epidemicity profiles was found. Associations between esp and a >7-day hospital stay and between purK-1, hospital location, and nosocomial acquisition were noted (P < 0.001). These findings reflect the importance of local environmental differences in the evolution of this CC, suggesting that the emergence of vancomycin resistance among AREF strains in Spain may be a question of time. PMID:15980338

  18. Exclusive contracts in the hospital setting: a two-edged sword: part 2: pros and cons, avoidance strategies, and negotiating tips.

    PubMed

    Portman, Robert M

    2007-06-01

    Hospitals routinely enter into contracts with radiology groups for the right to be the exclusive providers of radiologic services at the facilities in exchange for the groups' agreeing to provide and manage all aspects of those services within the hospitals. These exclusive contracts generally result in radiology departments and associated equipment being closed off to physicians who are not part of the contracting groups. Although exclusive contracts offer obvious benefits to the physicians who receive them and obvious disadvantages for those who are excluded, they also present pitfalls for physicians in the chosen group. Part 1 of this article discussed the legal issues raised by exclusive contracts. Part 2 weighs the practical advantages and disadvantages of exclusive contracts for physicians covered and not covered by such contracts and strategies for avoiding them, as well as provisions that can be included in medical staff bylaws to protect physicians from the automatic termination of privileges when a hospital enters into or terminates an exclusive contract. The remainder of the article provides tips on specific provisions of exclusive contracts that should be included or avoided.

  19. Management of the Hospital Environment

    ERIC Educational Resources Information Center

    Turner, Alvis G.

    1976-01-01

    Hospital studies indicate the need for an environmental/sanitarian specialist for control of nosocomial infection and maintenance of a quality environment. The author recommends these requirements for certification as a hospital environmentalist: academic studies including toxicology, epidemiology, hygiene, management, and an internship in…

  20. Academic Village.

    ERIC Educational Resources Information Center

    Boles, Rebecca

    2001-01-01

    Presents design features of the Renner Middle School (Plano, Texas) where the sprawling suburbs have been kept at bay while creating the atmosphere of an academic village. Photos and a floor plan are provided. (GR)

  1. Academic Libraries

    ERIC Educational Resources Information Center

    Library Journal, 1970

    1970-01-01

    Building data is given for the following academic libraries: (1) Rosary College, River Forest, Illinois; (2) Abilene Christian College, Abilene, Texas; (3) University of California, San Diego, La Jolla, California. (MF)

  2. Measurement of academic entitlement.

    PubMed

    Miller, Brian K

    2013-10-01

    Members of Generation Y, or Millennials, have been accused of being lazy, whiny, pampered, and entitled, particularly in the college classroom. Using an equity theory framework, eight items from a measure of work entitlement were adapted to measure academic entitlement in a university setting in three independent samples. In Study 1 (n = 229), confirmatory factor analyses indicated good model fit to a unidimensional structure for the data. In Study 2 (n = 200), the questionnaire predicted unique variance in university satisfaction beyond two more general measures of dispositional entitlement. In Study 3 (n = 161), the measure predicted unique variance in perceptions of grade fairness beyond that which was predicted by another measure of academic entitlement. This analysis provides evidence of discriminant, convergent, incremental, concurrent criterion-related, and construct validity for the Academic Equity Preference Questionnaire.

  3. Infection in Health Personnel with High and Low Levels of Exposure in a Hospital Setting during the H1N1 2009 Influenza A Pandemic.

    PubMed

    Sandoval, Carmen; Barrera, Aldo; Ferrés, Marcela; Cerda, Jaime; Retamal, Javiera; García-Sastre, Adolfo; Medina, Rafael A; Hirsch, Tamara

    2016-01-01

    A novel H1N1 influenza A virus caused the first pandemic of the 21st century in 2009. Hospitals had an increased demand of health consultations, that made it difficult to estimate the incidence of infection in hospital personnel due to asymptomatic presentations and the under notification of cases. To estimate and compare the rate of exposure of high versus low risk health personnel to 2009 pandemic H1N1 (H1N1pdm2009) influenza A virus in a University Hospital in Chile, we performed a comparative and prospective study. Serum samples were obtained from 117 individuals that worked in the emergency room (ER) and the operating room (OR) during the peak of the pandemic. Antibody titers were determined by the hemagglutination inhibition (HI) assay. Of the samples analyzed, 65% were workers at the ER and 35% at the OR. Of the total number of the subjects tested, 29.1% were seropositive. One out of 3 (36.8%) workers at the ER had positive HI titers, meanwhile only 1 out of 7 (14.6%) workers from the OR was seropositive to the virus. The possibility of being infected in the ER as compared to the OR was 3.4 times greater (OR 3.4; CI 95%, 1.27-9.1), and the individuals of the ER had almost twice as much antibody titers against H1N1pdm2009 than the personnel in the OR, suggesting the potential of more than one exposure to the virus. Of the 34 seropositive subjects, 12 (35.3%) did not develop influenza like illness, including 2 non-clinical personnel involved in direct contact with patients at the ER. Considering the estimated population attack rate in Chile of 13%, both groups presented a higher exposure and seropositive rate than the general population, with ER personnel showing greater risk of infection and a significantly higher level of antibodies. This data provide a strong rationale to design improved control measures aimed at all the hospital personnel, including those coming into contact with the patients prior to triage, to prevent the propagation and transmission of

  4. A Systemic Capillary Leak Syndrome (Clarkson Syndrome) in a Patient with Chronic Lymphocytic Leukemia: A Case Report in an Out-of-Hospital Setting

    PubMed Central

    Durand Bechu, Manon; Rouget, Antoine; Recher, Christian; Azoulay, Elie; Bounes, Vincent

    2016-01-01

    Systemic Capillary Leak Syndrome (SCLS) is a rare disease with poor prognosis, characterized by the occurrence of mucocutaneous and visceral edema with hypotension, hemoconcentration, and unexpected hypoalbuminemia. The disease can be idiopathic (Clarkson syndrome) or secondary to other diseases and treatments. We describe this syndrome in a prehospitalized, 63-year-old patient with chronic lymphocytic leukemia and an idiopathic form of SCLS manifesting as hypovolemic shock. Initial care is hospitalization in intensive care. In addition to etiological treatment if fluid replacement is necessary, treatment must be closely monitored for secondary overload complications. Catecholamine rather than arrhythmogenic support may be associated. PMID:27069700

  5. Infection in Health Personnel with High and Low Levels of Exposure in a Hospital Setting during the H1N1 2009 Influenza A Pandemic

    PubMed Central

    Sandoval, Carmen; Barrera, Aldo; Ferrés, Marcela; Cerda, Jaime; Retamal, Javiera; García-Sastre, Adolfo; Medina, Rafael A.; Hirsch, Tamara

    2016-01-01

    A novel H1N1 influenza A virus caused the first pandemic of the 21st century in 2009. Hospitals had an increased demand of health consultations, that made it difficult to estimate the incidence of infection in hospital personnel due to asymptomatic presentations and the under notification of cases. To estimate and compare the rate of exposure of high versus low risk health personnel to 2009 pandemic H1N1 (H1N1pdm2009) influenza A virus in a University Hospital in Chile, we performed a comparative and prospective study. Serum samples were obtained from 117 individuals that worked in the emergency room (ER) and the operating room (OR) during the peak of the pandemic. Antibody titers were determined by the hemagglutination inhibition (HI) assay. Of the samples analyzed, 65% were workers at the ER and 35% at the OR. Of the total number of the subjects tested, 29.1% were seropositive. One out of 3 (36.8%) workers at the ER had positive HI titers, meanwhile only 1 out of 7 (14.6%) workers from the OR was seropositive to the virus. The possibility of being infected in the ER as compared to the OR was 3.4 times greater (OR 3.4; CI 95%, 1.27–9.1), and the individuals of the ER had almost twice as much antibody titers against H1N1pdm2009 than the personnel in the OR, suggesting the potential of more than one exposure to the virus. Of the 34 seropositive subjects, 12 (35.3%) did not develop influenza like illness, including 2 non-clinical personnel involved in direct contact with patients at the ER. Considering the estimated population attack rate in Chile of 13%, both groups presented a higher exposure and seropositive rate than the general population, with ER personnel showing greater risk of infection and a significantly higher level of antibodies. This data provide a strong rationale to design improved control measures aimed at all the hospital personnel, including those coming into contact with the patients prior to triage, to prevent the propagation and transmission

  6. Audit. Operations in an academic setting.

    PubMed

    Shaw, D V; Soronson, B M; Holderle, F W

    1995-01-01

    A-U-D-I-T...the very word instills fear in the hearts of many. We recently received a letter from the director of the University of Rochester's Internal Audit Department, notifying us that they had scheduled a routine operational audit of our department. What is an "operational audit"? What is meant by "routine"? Who are these internal auditors and what do they want from us? This article illustrates two actual experiences: an operational audit and the process used to develop and implement standards and practices consistent with an auditor's recommendations. Additionally, it provides information on what an auditor looks for during an audit, and lastly, provides tips on how to prepare for a "painless" audit.

  7. Learning Paths in Academic Setting: Research Synthesis

    ERIC Educational Resources Information Center

    Mirkov, Snežana

    2013-01-01

    The paper represents a synthesis of results obtained in empirical studies of variables related to learning process. A number of studies were carried out within the Students Approaches to Learning perspective. According to the 3P model of learning, the complex of learning process comprises three learning approaches--Deep, Surface and Achievement…

  8. Establishing a practice climate in academic settings.

    PubMed

    Peloquin, Suzanne M; Osborne, Karen A

    2003-01-01

    This article describes an innovative educational approach that was introduced and developed in one occupational therapy program, favorably assessed by students, and promoted within the occupational therapy literature. A review of educational literature from other disciplines suggests that the approach characterized as creating a practice climate, may be useful to most allied health educators. We discuss (1) the meaning of the term practice climate, (2) the rationale for creating such a climate in larger classroom sessions, (3) nine process strategies that can establish this climate, and (4) an assessment of the approach by two groups of undergraduate students. Although introduced in a senior-level undergraduate course, the approach has merit for implementation in less advanced courses and in graduate education.

  9. Development of a medical academic degree system in China

    PubMed Central

    Wu, Lijuan; Wang, Youxin; Peng, Xiaoxia; Song, Manshu; Guo, Xiuhua; Nelson, Hugh; Wang, Wei

    2014-01-01

    Context The Chinese government launched a comprehensive healthcare reform to tackle challenges to health equities. Medical education will become the key for successful healthcare reform. Purpose We describe the current status of the Chinese medical degree system and its evolution over the last 80 years. Content Progress has been uneven, historically punctuated most dramatically by the Cultural Revolution. There is a great regional disparity. Doctors with limited tertiary education may be licensed to practice, whereas medical graduates with advanced doctorates may have limited clinical skills. There are undefined relationships between competing tertiary training streams, the academic professional degree, and the clinical residency training programme (RTP). The perceived quality of training in both streams varies widely across China. As the degrees of master or doctor of academic medicine is seen as instrumental in career advancement, including employability in urban hospitals, attainment of this degree is sought after, yet is often unrelated to a role in health care, or is seen as superior to clinical experience. Meanwhile, the practical experience gained in some prestigious academic institutions is deprecated by the RTP and must be repeated before accreditation for clinical practice. This complexity is confusing both for students seeking the most appropriate training, and also for clinics, hospitals and universities seeking to recruit the most appropriate applicants. Conclusion The future education reforms might include: 1) a domestic system of ‘credits’ that gives weight to quality clinical experience vs. academic publications in career advancement, enhanced harmonisation between the competing streams of the professional degree and the RTP, and promotion of mobility of staff between areas of excellence and areas of need; 2) International – a mutual professional and academic recognition between China and other countries by reference to the Bologna Accord

  10. The application of hospitality elements in hospitals.

    PubMed

    Wu, Ziqi; Robson, Stephani; Hollis, Brooke

    2013-01-01

    In the last decade, many hospital designs have taken inspiration from hotels, spurred by factors such as increased patient and family expectations and regulatory or financial incentives. Increasingly, research evidence suggests the value of enhancing the physical environment to foster healing and drive consumer decisions and perceptions of service quality. Although interest is increasing in the broader applicability of numerous hospitality concepts to the healthcare field, the focus of this article is design innovations, and the services that such innovations support, from the hospitality industry. To identify physical hotel design elements and associated operational features that have been used in the healthcare arena, a series of interviews with hospital and hotel design experts were conducted. Current examples and suggestions for future hospitality elements were also sought from the experts, academic journals, and news articles. Hospitality elements applied in existing hospitals that are addressed in this article include hotel-like rooms and decor; actual hotels incorporated into medical centers; hotel-quality food, room service, and dining facilities for families; welcoming lobbies and common spaces; hospitality-oriented customer service training; enhanced service offerings, including concierges; spas or therapy centers; hotel-style signage and way-finding tools; and entertainment features. Selected elements that have potential for future incorporation include executive lounges and/or communal lobbies with complimentary wireless Internet and refreshments, centralized controls for patients, and flexible furniture. Although the findings from this study underscore the need for more hospitality-like environments in hospitals, the investment decisions made by healthcare executives must be balanced with cost-effectiveness and the assurance that clinical excellence remains the top priority.

  11. Developing a Research Skill Set

    PubMed Central

    You, Y. Nancy; Bednarski, Brian

    2014-01-01

    The recent decades have witnessed a significant expansion in the diversity of career paths within academic surgery. Although the skills for providing exemplary surgical care and for maintaining a strong work ethic are the foundations of an academic surgeon, deliberate career planning and organized acquisition of research skills contribute to the success of an academic career. In this article, we identify a set of core academic skills and propose a framework for acquiring them. We also describe specific career paths within academic surgery and provide an overview of the opportunities for acquiring specific skill sets. The development of an academic career is challenging, and firm knowledge of the personal motivations will sustain and endure the time needed for acquiring the needed skills. PMID:25067917

  12. Developing a research skill set.

    PubMed

    You, Y Nancy; Bednarski, Brian

    2014-06-01

    The recent decades have witnessed a significant expansion in the diversity of career paths within academic surgery. Although the skills for providing exemplary surgical care and for maintaining a strong work ethic are the foundations of an academic surgeon, deliberate career planning and organized acquisition of research skills contribute to the success of an academic career. In this article, we identify a set of core academic skills and propose a framework for acquiring them. We also describe specific career paths within academic surgery and provide an overview of the opportunities for acquiring specific skill sets. The development of an academic career is challenging, and firm knowledge of the personal motivations will sustain and endure the time needed for acquiring the needed skills.

  13. An exploratory study to assess the computer knowledge, attitude and skill among nurses in health care setting of a selected hospital in Ludhiana, Punjab, India.

    PubMed

    Raja, Emans Evangel Joel; Mahal, Rajinder; Masih, Veena Barkat

    2004-01-01

    Explorative study conducted to assess and identify deficit areas of computer knowledge, attitudes and skills among nurses working in the hospital and to examine the relationship among these factors. 120 staff nurses were surveyed by systematic random sampling. Computer knowledge, attitudes and skills were measured by a self-structured computer knowledge questionnaire, computer attitude and skill scale respectively. Data analysis showed that the majority 75% staff nurses had good computer knowledge. 100% of nurses had positive attitudes towards computer utilization. 50.8% and 30.8% had average and fair computer skills respectively. No significant correlation was found between nurses' computer knowledge, attitude and skills. The relationships of computer knowledge, attitude and skill were analyzed among nurses with the selected variables like age, sex, designation, years of nursing service, professional qualification, area of nursing service, type of computer training received, frequency of computer usage and monthly family income. Strategies to enhance nurses' computer knowledge, attitudes and skills were proposed.

  14. [HYGEA (Hygiene in gastroenterology--endoscope reprocessing): Study on quality of reprocessing flexible endoscopes in hospitals and in the practice setting].

    PubMed

    Bader, L; Blumenstock, G; Birkner, B; Leiss, O; Heesemann, J; Riemann, J F; Selbmann, H-K

    2002-03-01

    The quality of reprocessing gastroscopes, colonoscopes and duodenoscopes in daily routine of 25 endoscopy departments in hospitals and 30 doctors with their own practices was evaluated by microbiological testing in the HYGEA interventional study. In 2 test periods, endoscopes ready for use in patients were found contaminated at high rates (period 1: 49 % of 152 endoscopes; period 2: 39 % of 154 endoscopes). Culture of bacterial fecal flora (E. coli, coliform enterobacteriaceae, enterococci) was interpreted indicating failure of cleaning procedure and disinfection of endoscopes. Detection of Pseudomonas spp. (especially P. aeruginosa) and other non-fermenting rods - indicating microbially insufficient final rinsing and incomplete drying of the endoscope or a contaminated flushing equipment for the air/water-channel - pointed out endoscope recontamination during reprocessing or afterwards. Cause for complaint was found in more than 50 % of endoscopy facilities tested (period 2: 5 in hospitals, 25 practices). Reprocessing endoscopes in fully automatic chemo-thermally decontaminating washer-disinfectors with disinfection of final rinsing water led to much better results than manual or semi-automatic procedures (failure rate of endoscopy facilities in period 2 : 3 of 28 with fully automatic, 8 of 12 with manual, 9 of 15 with semi-automatic reprocessing). The study results give evidence for the following recommendations: 1. Manual brushing of all accessible endoscope channels has to be performed even before further automatic reprocessing; 2. For final endoscope rinsing, water or aqua dest. should only be used disinfected or sterile-filtered; 3. Endoscopes have to be dried thoroughly using compressed air prior to storage; 4. Bottle and tube for air/water-channel flushing have to be reprocessed daily by disinfection or sterilization, and in use, the bottle have to be filled exclusively with sterile water. The HYGEA study shows that microbiological testing of endoscopes is

  15. What should be the patient’s preference regarding the choice of hospital in the case of radical cystectomy? Evaluation of early complications after open radical cystectomy in a medium and high volume setting in one hospital

    PubMed Central

    Mani, Jens; Vallo, Stefan; Brandt, Maximilian P; Gust, Kilian M; Bartsch, Claudia; Daechert, Johannes; Tsaur, Igor; Bartsch, Georg; Haferkamp, Axel

    2016-01-01

    Purpose This study compares early complications after cystectomy and urinary diversion (UD) stratified by the surgical focus and case load of two different department chairpersons in a single institution in two time periods. Creating clear data about complications that can affect the quality of life is an important tool for patients to decide whether and where to perform this extensive surgery. Hypothesis A team of surgeons with a clear focus on pelvic surgery leads to lower complication rates in radical cystectomy. Materials and methods Radical cystectomy was performed in two separate time periods under the patronage of two different chairmen in the same university hospital. The patient data were analyzed retrospectively and the complications 30 days after surgery were assessed using the Clavien–Dindo classification. Results Statistical analysis showed a significant difference in the severity of complications between the two time periods, A and B, in total (P<0.001). When placing patients into subgroups, significantly more complications in period A were also seen concerning sex (male, P<0.001; female, P=0.003), age (<70 years, P<0.001; >70 years, P≤50.001) tumor grade (low grade, P<0.001; high grade, P≤0.001), and UD (ileal conduit, P<0.001; neobladder, P<0.001). In a multivariable analysis, age (P=0.031) and type of UD (P=0.028) were determined as independent predictors for complications in period A. When joining the two periods together, the type of UD (P=0.0417), age (P=0.041), and the time periods (A/B) (P<0.001) show a significant association with the presence of complications. Conclusion This study compares for the first time surgical complications in two time periods with different case load and surgical focus in one department. Categorization shows that patients should prefer radical cystectomy in centers of excellence or a high-volume hospital in order to keep complications at the lowest possible level and thus have the highest benefit for oncologic

  16. Leading Academics.

    ERIC Educational Resources Information Center

    Middlehurst, Robin

    This book aims to increase the level of interest and understanding of leadership within the academic context and to demonstrate the relevance of leadership for contemporary United Kingdom universities. The book considers the concept of leadership and its appropriateness and usefulness for nonprofit professional organizations such as universities,…

  17. Academic Aspirations

    ERIC Educational Resources Information Center

    Durant, Linda

    2013-01-01

    As colleges and universities become even more complex organizations, advancement professionals need to have the skills, experience, and academic credentials to succeed in this ever-changing environment. Advancement leaders need competencies that extend beyond fundraising, alumni relations, and communications and marketing. The author encourages…

  18. Academic Cloning.

    ERIC Educational Resources Information Center

    Sikula, John P.; Sikula, Andrew F.

    1980-01-01

    The authors define "cloning" as an integral feature of all educational systems, citing teaching practices which reward students for closely reproducing the teacher's thoughts and/or behaviors and administrative systems which tend to promote like-minded subordinates. They insist, however, that "academic cloning" is not a totally…

  19. Personality traits, gender differences and symptoms of anhedonia: What does the Hospital Anxiety and Depression Scale (HADS) measure in nonclinical settings?

    PubMed

    Langvik, Eva; Hjemdal, Odin; Nordahl, Hans M

    2016-04-01

    In healthy populations men report more depressive symptoms than women when depression is measured by the Hospital Anxiety and Depression Scale (HADS). This study aims to investigate the role of neuroticism and extroversion in symptom reporting by men and women and whether anhedonia can explain these reversed gender differences in depression observed when using HADS. HADS, Positive and Negative Affect Schedule (PANAS) and NEO Five Factor Inventory (NEO FFI) were administered twice to a sample of university students. Number of subjects at T1 was 372 and 160 at T2, measured two months apart. Men had a higher average score on depressive symptoms measured by HADS-D compared to women (p = 0.029). Women scored higher than men on HADS-A (p = 0.012), neuroticism (p < 0.001) and PANAS-negative affect (p < 0.029). No significant gender differences were observed in extroversion and positive affect. Test-retest stabilities on HADS-A and HADS-D were high. Neuroticism predicted HADS-A at Time 2. Gender, extroversion, and neuroticism predicted HADS-D at Time 2. The anhedonic content in HADS may be a plausible explanation of reversed gender differences in the HADS depression scale. HADS-D represents a specific anhedonic subtype of depression where symptom reporting reflects dispositional tendencies related specifically to extroversion.

  20. Comparison of seclusion and restraint prevalence between hearing patients and deaf or hard of hearing patients in a state hospital setting.

    PubMed

    Hartman, Brian; Blalock, Ann

    2011-01-01

    The present study is an effort to obtain preliminary data to assess the validity of the long-standing claim that the rate of seclusion and restraint is higher among deaf and hard of hearing individuals than among hearing individuals. This difference has been claimed repeatedly despite there being no research to support it. The sample was comprised of 22 deaf or hard of hearing individuals who had been committed to a large state hospital, all but three of whom had been discharged prior to data collection. The deaf and hard of hearing subjects were matched to subjects with no hearing loss on factors believed to be associated with behaviors that can result in seclusion or restraint. Archived clinical records of both groups of subjects were reviewed to determine the rates of seclusion and restraint for the two groups, as well as to assess the length of time each group was in seclusion or restraint. The results indicate a significantly higher frequency of seclusion and restraint for the deaf and hard of hearing group than for the hearing group. Of note is that the hearing individuals spent longer in seclusion and restraint than did the deaf and hard of hearing. The hypothesis of a higher rate of restrictive events among deaf and hard of hearing individuals is supported. The results of this study suggest that further research be undertaken to determine the generalizability of these results as well as possible sources of the differences between these two groups.

  1. Minimizing the Risk of Disease Transmission in Emergency Settings: Novel In Situ Physico-Chemical Disinfection of Pathogen-Laden Hospital Wastewaters

    PubMed Central

    Sozzi, Emanuele; Fabre, Kerline; Fesselet, Jean-François; Ebdon, James E.; Taylor, Huw

    2015-01-01

    The operation of a health care facility, such as a cholera or Ebola treatment center in an emergency setting, results in the production of pathogen-laden wastewaters that may potentially lead to onward transmission of the disease. The research presented here evaluated the design and operation of a novel treatment system, successfully used by Médecins Sans Frontières in Haiti to disinfect CTC wastewaters in situ, eliminating the need for road haulage and disposal of the waste to a poorly-managed hazardous waste facility, thereby providing an effective barrier to disease transmission through a novel but simple sanitary intervention. The physico-chemical protocols eventually successfully treated over 600 m3 of wastewater, achieving coagulation/flocculation and disinfection by exposure to high pH (Protocol A) and low pH (Protocol B) environments, using thermotolerant coliforms as a disinfection efficacy index. In Protocol A, the addition of hydrated lime resulted in wastewater disinfection and coagulation/flocculation of suspended solids. In Protocol B, disinfection was achieved by the addition of hydrochloric acid, followed by pH neutralization and coagulation/flocculation of suspended solids using aluminum sulfate. Removal rates achieved were: COD >99%; suspended solids >90%; turbidity >90% and thermotolerant coliforms >99.9%. The proposed approach is the first known successful attempt to disinfect wastewater in a disease outbreak setting without resorting to the alternative, untested, approach of ‘super chlorination’ which, it has been suggested, may not consistently achieve adequate disinfection. A basic analysis of costs demonstrated a significant saving in reagent costs compared with the less reliable approach of super-chlorination. The proposed approach to in situ sanitation in cholera treatment centers and other disease outbreak settings represents a timely response to a UN call for onsite disinfection of wastewaters generated in such emergencies, and the

  2. The Joint Commission: hospitals make strides on core measures with more achieving "top performer" status.

    PubMed

    2015-01-01

    Performance on key quality measures continues to improve at more than 3,300 accredited hospitals, according to new data from The Joint Commission (TJC). In its 2014 annual report, the Oakbrook Terrace, IL, accrediting agency, said that more than a third of the country's accredited hospitals are now top performers in TJC's core measures program. This is a marked increase from 2002 when the top performer program was first initiated and just 7% of hospitals achieved top performer status on a much smaller range of quality metrics. To be recognized as a top performer, TJC stipulates that hospitals must achieve a cumulative performance of 95% or greater on all reported accountability measures, achieve a performance of 95% or greater on every accountability measure where there are at least 30 denominator cases, and have at least one core measure set that has a composite rate of at least 95%--and all metrics within that measure set must rank at 95% or above as well. The number of academic medical centers recognized as top performers grew from 24, recognized in last year's annual report, to 35 in the 2014 report, now representing 29% of all accredited academic medical centers. Only 11% of the top performing hospitals were public hospitals, designated as "government owned" in the annual report. The TJC suggests that this indicates that performance improvement needs to be prioritized at these hospitals. TJC is providing special recognition to 44 top performing hospitals that went beyond the minimum requirements, reporting on five or more sets of measures, and achieved top performer recognition on that expanded set of measures.

  3. [Success factors in hospital management].

    PubMed

    Heberer, M

    1998-12-01

    The hospital environment of most Western countries is currently undergoing dramatic changes. Competition among hospitals is increasing, and economic issues have become decisive factors for the allocation of medical care. Hospitals therefore require management tools to respond to these changes adequately. The balanced scorecard is a method of enabling development and implementation of a business strategy that equally respects the financial requirements, the needs of the customers, process development, and organizational learning. This method was used to derive generally valid success factors for hospital management based on an analysis of an academic hospital in Switzerland. Strategic management, the focus of medical services, customer orientation, and integration of professional groups across the hospital value chain were identified as success factors for hospital management.

  4. Improving Standards of Care in Obstructed Labour: A Criteria-Based Audit at a Referral Hospital in a Low-Resource Setting in Tanzania

    PubMed Central

    2016-01-01

    Objective In low-resource settings, obstructed labour is strongly associated with severe maternal morbidity and intrapartum asphyxia, and consequently maternal and perinatal deaths. This study evaluated the impact of a criteria-based audit of the diagnosis and management of obstructed labour in a low-resource setting. Methods A baseline criteria-based audit was conducted from October 2013 to March 2014, followed by a workshop in which stakeholders gave feedback on interventions agreed upon to improve obstetric care. The implemented interventions included but were not limited to introducing standard guidelines for diagnosis and management of obstructed labour, agreeing on mandatory review by specialist for cases that are assigned caesarean section, re-training and supervision on use and interpretation of partograph and, strengthening team work between doctors, mid-wives and theatre staff. After implementing these interventions in March, a re-audit was performed from July 2015 to November, 2015, and the results were compared to those of the baseline audit. Results Two hundred and sixty deliveries in the baseline survey and 250 deliveries in the follow-up survey were audited. Implementing the new criteria improved the diagnosis from 74% to 81% (p = 0.049) and also the management of obstructed labour from 4.2% at baseline audit to 9.2% at re-audit (p = 0.025). Improved detection of prolonged labour through heightened observation of regular contractions, protracted cervical dilatation, protracted descent of presenting part, arrested cervical dilation, and severe moulding contributed to improved standards of diagnosis (all p < 0.04). Patient reviews by senior obstetricians increased from 34% to 43% (p = 0.045) and reduced time for caesarean section intervention from the median time of 120 to 90 minutes (p = 0.001) improved management (all p < 0.05). Perinatal outcomes, neonatal distress and fresh stillbirths, were reduced from 16% to. 8.8% (p = 0.01). Conclusion A

  5. The PRESLO study: evaluation of a global secondary low back pain prevention program for health care personnel in a hospital setting. Multicenter, randomized intervention trial

    PubMed Central

    2012-01-01

    Background Common low back pain represents a major public health problem in terms of its direct cost to health care and its socio-economic repercussions. Ten percent of individuals who suffer from low back pain evolve toward a chronic case and as such are responsible for 75 to 80% of the direct cost of low back pain. It is therefore imperative to highlight the predictive factors of low back pain chronification in order to lighten the economic burden of low back pain-related invalidity. Despite being particularly affected by low back pain, Hospices Civils de Lyon (HCL) personnel have never been offered a specific, tailor-made treatment plan. The PRESLO study (with PRESLO referring to Secondary Low Back Pain Prevention, or in French, PREvention Secondaire de la LOmbalgie), proposed by HCL occupational health services and the Centre Médico-Chirurgical et de Réadaptation des Massues – Croix Rouge Française, is a randomized trial that aims to evaluate the feasibility and efficiency of a global secondary low back pain prevention program for the low back pain sufferers among HCL hospital personnel, a population at risk for recurrence and chronification. This program, which is based on the concept of physical retraining, employs a multidisciplinary approach uniting physical activity, cognitive education about low back pain and lumbopelvic morphotype analysis. No study targeting populations at risk for low back pain chronification has as yet evaluated the efficiency of lighter secondary prevention programs. Methods/Design This study is a two-arm parallel randomized controlled trial proposed to all low back pain sufferers among HCL workers, included between October 2008 and July 2011 and followed over two years. The personnel following their usual treatment (control group) and those following the global prevention program in addition to their usual treatment (intervention group) are compared in terms of low back pain recurrence and the impairments measured at the

  6. [How to Understand "Clinical Ethics" and "Research Ethics" in Clinical Settings--Incorporation of IRB, REC, and CEC in Hospital Organizations].

    PubMed

    Ita, Koichiro

    2016-02-01

    As the traditional definition of "medical ethics" has recently changed markedly with advances in medical knowledge and technology, medical doctors and researchers in Japan are required to understand and apply both research and clinical ethics. Quite frequently, ethical problems in clinical settings cannot be addressed by the simple application of good will, hard work, and perseverance by medical personnel. The Ministry of Health, Labour and Welfare (MHLW) and the Ministry of Education, Culture, Sports, Science and Technology (MEXT) have jointly published "Ethical Guidelines for Clinical Studies;" however, clear guidelines (legal, ministerial, or governmental) outlining the expectations regarding clinical ethics do not exist. All medical personnel face deep ethical dilemmas. In these instances, if the fulfillment of 'ethics' relies solely on the capacity of personnel to apply their own individual moral efforts, the result will be burn-out among these workers who have a strong sense of responsibility. In order to avoid this, a system which comprises multiple physicians, nurses, and other personnel must be established, allowing collaboration when an appropriate response is required. A major factor supporting this approach is the offering of Clinical Ethics Consultations.

  7. Massachusetts General Hospital starts own degree programs.

    PubMed

    1979-01-01

    Massachusetts General Hospital has established a new Education Division that administers various degree programs in seven professional fields. Major emphasis is on interdisciplinary study and integration of the academic and the clinical components of training.

  8. Prevalence and risk factors of early fecal carriage of Enterococcus faecalis and Staphylococcus spp and their antimicrobial resistant patterns among healthy neonates born in a hospital setting in central Saudi Arabia

    PubMed Central

    El-Kersh, Talat A.; Marie, Mohammed A.; Al-Sheikh, Yazeed A.; Al-Agamy, Mohamed H.; Al-Bloushy, Ahmad A.

    2016-01-01

    Objectives: To investigate the prevalence, antibiotic resistant profiles, and risk factors of early fecal carriage of Enterococcus faecalis (E. faecalis) and staphylococci among 150 healthy Saudi neonates born in a hospital setting in central Saudi Arabia. Methods: This prospective study was conducted in Al-Bukayriyah General Hospital, Qassim, Saudi Arabia, between June 2012 and January 2013. The E. faecalis and Staphylococcus spp. isolates were identified manually, and Vitek2 system was used for identity confirmation at the species level and minimum inhibitory concentration-susceptibility testing. Results: Enterococcus faecalis (n=73) and Staphylococcus spp. (n=18) were recovered. Unlike staphylococci, E. faecalis colonization did not significantly vary from day one up to 7 days of life, regardless of the type of feeding, but it was relatively higher among vaginally versus cesarean delivery. Both Staphylococcus epidermidis (S. epidermidis) and Staphylococcus aureus carriage increase as the body weight increases, and this difference was significant (p=0.025) for S. epidermidis. High-level resistance in Gentamycin among E. faecalis isolates was 25% and 11% to Streptomycin. Thirty percent of S. epidermidis were resistant to oxacillin and exhibited multidrug-resistant (MDR) patterns of 5 resistant markers, which were also observed among 2/5 (40%) of Methicillin-resistant Staphylococcus aureus isolates. Conclusion: Enterococcus faecalis did not significantly vary in relation to type of delivery, age up to 7 days, and type of feeding. The neonatal fecal carriage of MDR isolates should be considered as a crucial reservoir to the further spread of antimicrobial resistance genes among hospitals, cross infections, and the community. PMID:26905350

  9. Between a Rock and a Hard Place: Academic Institutional Change and the Problem of Collective Action

    ERIC Educational Resources Information Center

    Hellstrom, Tomas

    2004-01-01

    This paper argues that some of the current trends affecting academe impede on key institutional structures, or sets of interrelated norms for academic conduct, which are necessary for sustaining collective action among academics. In this sense academics and academic units may find themselves "between a rock and a hard place'', that is with new…

  10. Norovirus - hospital

    MedlinePlus

    Gastroenteritis - norovirus; Colitis - norovirus; Hospital acquired infection - norovirus ... fluids ( dehydration ). Anyone can become infected with norovirus. Hospital patients who are very old, very young, or ...

  11. Thyroid function and prevalence of anti-thyroperoxidase (TPO) and anti-thyroglobulin (Tg) antibodies in outpatients hospital setting in an area with sufficient iodine intake: influences of age and sex.

    PubMed

    Legakis, Ioannis; Manousaki, Mina; Detsi, Stela; Nikita, Dimitra

    2013-01-01

    In order to examine the prevalence of thyroid disease in a hospital outpatient setting, in an area of sufficient iodine intake, serum levels of TSH, T4, T3, anti-Tg and anti-TPO antibodies were examined in 909 individuals with an age range of 12.4 to 88.5 years, participating in a checkup outpatient setting. The study was conducted in Henry Dynant Hospital located in the metropolitan area of Athens, Greece, during a 2 year period. Hormonal parameters were determined by chemiluminescence immunoassay. Overt thyrotoxicosis was found in 4.95% of the total population and subclinical thyrotoxicosis in 5.5%. Overt hypothyroidism was found in 1.43% and subclinical hypothyroidism in 4.51%. In male population, overt thyrotoxicosis was found in 4.4 % and subclinical thyrotoxicosis was also found in 4.4%. On the other hand, overt hypothyroidism was found in 1.4% and subclinical hypothyroidism was found in 3.7% in males. In female population, overt thyrotoxicosis was found in 5.2% whereas subclinical thyrotoxicosis was found in 6.0%. Overt hypothyroidism was found in 1.5% and subclinical hypothyroidism was found in 4,9% in females. Positive anti-TPO antibodies were detected more often (30.4%) than anti-Tg (15.4%) in the tested population. The positivity in both anti-TPO and anti-Tg antibodies was correlated with abnormally high TSH concentrations after the age of 50 years, especially in female population. In conclusion distinct profile of thyroid hormonal parameters was observed in inhabitants in the metropolitan area of Athens, with overt thyrotoxicosis strikingly overcome overt hypothyroidism while subclinical forms of each dysfunction also exhibit analogous results.

  12. Student Academic Optimism: A Confirmatory Factor Analysis

    ERIC Educational Resources Information Center

    Tschannen-Moran, Megan; Bankole, Regina A.; Mitchell, Roxanne M.; Moore, Dennis M., Jr.

    2013-01-01

    Purpose: This research aims to add to the literature on Academic Optimism, a composite measure composed of teacher perceptions of trust in students, academic press, and collective efficacy by exploring a similar set of constructs from the student perceptive. The relationships between student trust in teachers, student perceptions of academic…

  13. Women and Teaching in Academic Psychiatry

    ERIC Educational Resources Information Center

    Hirshbein, Laura D.; Fitzgerald, Kate; Riba, Michelle

    2004-01-01

    Objective: This article explores past, present, and future issues for women and teaching in academic psychiatry. A small study of didactic teaching responsibilities along faculty groups in one academic psychiatry department helps to illustrate challenges and opportunities for women in psychiatric teaching settings. Background: Although women have…

  14. Unpredictable Feelings: Academic Women under Research Audit

    ERIC Educational Resources Information Center

    Grant, Barbara M.; Elizabeth, Vivienne

    2015-01-01

    Academic research is subject to audit in many national settings. In Aotearoa/New Zealand, the government regulates the flow of publicly funded research income into tertiary institutions through the Performance-Based Research Fund (PBRF). This article enquires into the effects of the PBRF by exploring data collected from 16 academic women of…

  15. Academic Achievements of Children in Immigrant Families

    ERIC Educational Resources Information Center

    Han, Wen-Jui

    2006-01-01

    Utilizing data on approximately 16,000 children from the Early Childhood Longitudinal Survey-Kindergarten Cohort and a rich set of mediating factors on 16 immigrant groups, this paper examined the associations between children's immigrant generation status and their academic performance. The changes in academic achievements during kindergarten and…

  16. Academic Integrity in Web Based Distance Education

    ERIC Educational Resources Information Center

    Baron, Julie; Crooks, Steven M.

    2005-01-01

    This paper reviews the literature relative to academic dishonesty in WBDE settings assuming the average class size to be 30-50 students with the instructor filling the role of facilitator, concept expert, grader and mentor when necessary. It shows that some common stereotypes about academic integrity and WBDE are unsubstantiated. In addition, it…

  17. Development of Cities Mentor Project: An Intervention to Improve Academic Outcomes for Low-Income Urban Youth through Instruction in Effective Coping Supported by Mentoring Relationships and Protective Settings

    ERIC Educational Resources Information Center

    Grant, Kathryn E.; Farahmand, Farahnaz; Meyerson, David A.; Dubois, David L.; Tolan, Patrick H.; Gaylord-Harden, Noni K.; Barnett, Alexandra; Horwath, Jordan; Doxie, Jackie; Tyler, Donald; Harrison, Aubrey; Johnson, Sarah; Duffy, Sophia

    2014-01-01

    This manuscript summarizes an iterative process used to develop a new intervention for low-income urban youth at risk for negative academic outcomes (e.g., disengagement, failure, drop-out). A series of seven steps, building incrementally one upon the other, are described: 1) identify targets of the intervention; 2) develop logic model; 3)…

  18. Educational Intervention/Case Study: Implementing an Elementary-Level, Classroom-Based Media Literacy Education Program for Academically At-Risk Middle-School Students in the Non-Classroom Setting

    ERIC Educational Resources Information Center

    Draper, Michele; Appregilio, Seymour; Kramer, Alaina; Ketcherside, Miranda; Campbell, Summer; Stewart, Brandon; Rhodes, Darson; Cox, Carol

    2015-01-01

    Media literacy education teaches youth to critically examine the influence of media messages on health and substance use behavior. A small group of low-achieving middle school students at high risk for substance abuse attending an afterschool academic remediation program received a media literacy intervention intended for elementary students in a…

  19. A Reengineered Hospital Discharge Program to Decrease Rehospitalization

    PubMed Central

    Jack, Brian W.; Chetty, Veerappa K.; Anthony, David; Greenwald, Jeffrey L.; Sanchez, Gail M.; Johnson, Anna E.; Forsythe, Shaula R.; O'Donnell, Julie K.; Paasche-Orlow, Michael K.; Manasseh, Christopher; Martin, Stephen; Culpepper, Larry

    2009-01-01

    Background: Emergency department visits and rehospitalization are common after hospital discharge. Objective: To test the effects of an intervention designed to minimize hospital utilization after discharge. Design: Randomized trial using block randomization of 6 and 8. Randomly arranged index cards were placed in opaque envelopes labeled consecutively with study numbers, and participants were assigned a study group by revealing the index card. Setting: General medical service at an urban, academic, safety-net hospital. Patients: 749 English-speaking hospitalized adults (mean age, 49.9 years). Intervention: A nurse discharge advocate worked with patients during their hospital stay to arrange follow-up appointments, confirm medication reconciliation, and conduct patient education with an individualized instruction booklet that was sent to their primary care provider. A clinical pharmacist called patients 2 to 4 days after discharge to reinforce the discharge plan and review medications. Participants and providers were not blinded to treatment assignment. Measurements: Primary outcomes were emergency department visits and hospitalizations within 30 days of discharge. Secondary outcomes were self-reported preparedness for discharge and frequency of primary care providers′ follow-up within 30 days of discharge. Research staff doing follow-up were blinded to study group assignment. Results: Participants in the intervention group (n = 370) had a lower rate of hospital utilization than those receiving usual care (n = 368) (0.314 vs. 0.451 visit per person per month; incidence rate ratio, 0.695 [95% CI, 0.515 to 0.937]; P = 0.009). The intervention was most effective among participants with hospital utilization in the 6 months before index admission (P = 0.014). Adverse events were not assessed; these data were collected but are still being analyzed. Limitation: This was a single-center study in which not all potentially eligible patients could be enrolled, and outcome

  20. Associations of Mild Cognitive Impairment with Hospitalization and Readmission

    PubMed Central

    Callahan, Kathryn E.; Lovato, James F.; Miller, Michael E.; Easterling, Doug; Snitz, Beth; Williamson, Jeff D.

    2016-01-01

    OBJECTIVES To determine whether older adults with mild cognitive impairment (MCI), a condition not previously explored as a risk factor, experience increased hospitalizations and 30-day readmission compared to those with normal cognition. Frequent hospitalizations and unplanned readmissions are recognized as markers of poor quality care for older adults. DESIGN Post-hoc analysis of prospectively gathered data on incident hospitalization and readmission from the Ginkgo Evaluation of Memory Study (GEMS), a randomized double-blind placebo-controlled trial designed to assess the impact of Ginkgo biloba on incidence of dementia. SETTING GEMS was conducted in 5 academic medical centers in the United States. PARTICIPANTS 2742 community-dwelling adults age 75 or older with normal cognition (n=2314) or MCI (n=428) at baseline cognitive testing. MEASUREMENTS Index hospitalization and 30-day hospital readmission, adjusted for age, sex, race, education, clinic site, trial assignment status, comorbidities, number of prescription medications, and living with an identified proxy. RESULTS MCI was associated with a 17% increase in the hazard of index hospitalization as compared with normal cognition (adjusted Hazard Ratio (HR)=1.17 (1.02 – 1.34)). In participants who lived with their proxy, MCI was associated with a 39% increased hazard of index hospitalization (adjusted HR=1.392 (1.169 – 1.657)). Baseline MCI was not associated with increased odds of 30-day hospital readmission (adjusted Odds Ratio=0.90 (0.60 – 1.36)). CONCLUSION MCI may represent a target condition for healthcare providers to coordinate support services in an effort to reduce hospitalization and subsequent disability. PMID:26313420

  1. Establishing the SouthWestern Academic Health Network (SWAHN): A Survey Exploring the Needs of Academic and Community Networks in SouthWestern Ontario.

    PubMed

    Nicholson, Kathryn; Randhawa, Jasmine; Steele, Margaret

    2015-10-01

    With the evolving fields of health research, health professional education and advanced clinical care comes a need to bring researchers, educators and health care providers together to enhance communication, knowledge-sharing and interdisciplinary collaboration. There is also a need for active collaboration between academic institutions and community organizations to improve health care delivery and health outcomes in the community setting. In Canada, an Academic Health Sciences Network model has been proposed to achieve such activities. The SouthWestern Academic Health Network (SWAHN) has been established among three universities, three community colleges, community hospitals, community-based organizations and health care providers and two Local Health Integrated Networks (LHINs) in Southwestern Ontario. A survey was conducted to understand the characteristics, activities, existing partnerships, short- and long-term goals of the academic and community health networks in SouthWestern Ontario to inform the development of SWAHN moving forward. A total of 114 health networks were identified from the two participating LHINs, 103 community health networks and 11 academic health networks. A mailed survey was sent to all networks and responses were analyzed using both quantitative and qualitative approaches. The short- and long-term goals of these networks were categorized into five main themes: Public Health, Education, Research, System Delivery and Special Populations. Overall, this study helped to elicit important information from the academic and community based networks, which will inform the future work of SWAHN. This research has also demonstrated the significance of collecting information from both academic and community partners during the formation of other interdisciplinary health networks.

  2. Bibliography for the Hospitality Industry.

    ERIC Educational Resources Information Center

    Nelson, Elizabeth A.

    This annotated bibliography is a sample collection of reference materials in the hospitality industry suitable for a small academic library. It is assumed that the library has a general reference collection. Publication dates range from 1992-96, with two publication dates in the 1980s. No periodicals are included. The 41 reference materials are…

  3. Identifying potential academic leaders

    PubMed Central

    White, David; Krueger, Paul; Meaney, Christopher; Antao, Viola; Kim, Florence; Kwong, Jeffrey C.

    2016-01-01

    Objective To identify variables associated with willingness to undertake leadership roles among academic family medicine faculty. Design Web-based survey. Bivariate and multivariable analyses (logistic regression) were used to identify variables associated with willingness to undertake leadership roles. Setting Department of Family and Community Medicine at the University of Toronto in Ontario. Participants A total of 687 faculty members. Main outcome measures Variables related to respondents’ willingness to take on various academic leadership roles. Results Of all 1029 faculty members invited to participate in the survey, 687 (66.8%) members responded. Of the respondents, 596 (86.8%) indicated their level of willingness to take on various academic leadership roles. Multivariable analysis revealed that the predictors associated with willingness to take on leadership roles were as follows: pursuit of professional development opportunities (odds ratio [OR] 3.79, 95% CI 2.29 to 6.27); currently holding at least 1 leadership role (OR 5.37, 95% CI 3.38 to 8.53); a history of leadership training (OR 1.86, 95% CI 1.25 to 2.78); the perception that mentorship is important for one’s current role (OR 2.25, 95% CI 1.40 to 3.60); and younger age (OR 0.97, 95% CI 0.95 to 0.99). Conclusion Willingness to undertake new or additional leadership roles was associated with 2 variables related to leadership experiences, 2 variables related to perceptions of mentorship and professional development, and 1 demographic variable (younger age). Interventions that support opportunities in these areas might expand the pool and strengthen the academic leadership potential of faculty members. PMID:27331226

  4. Universal Design for Academic Facilities

    ERIC Educational Resources Information Center

    Salmen, John P. S.

    2011-01-01

    Universal design (UD) can play a role in many aspects of academic life and is often thought of in the context of learning. However, this chapter focuses on the impact of UD on the design of facilities in a university or campus setting. Universal design has the potential for transforming universities into truly egalitarian institutions that…

  5. Academics in the Persian Gulf

    ERIC Educational Resources Information Center

    Mills, Andrew

    2009-01-01

    The job market on North American campuses may be heading for the deep freeze, but hundreds of positions are opening up in the Persian Gulf as American universities scramble to set down roots in those petrodollar-rich states. The combination of money and opportunity on offer may seem hard to resist. But academics who trade the rich intellectual…

  6. Cardinal Virtues of Academic Administration

    ERIC Educational Resources Information Center

    Curren, Randall

    2008-01-01

    The aim of this article is to articulate the basic elements of a comprehensive ethic of academic administration, organized around a set of three cardinal virtues: "commitment" to the good of the institution; good administrative "judgment"; and "conscientiousness" in discharging the duties of the office. In addition to explaining this framework and…

  7. Moving beyond the Academic Doors

    ERIC Educational Resources Information Center

    Beals, Fiona M.

    2012-01-01

    Using contemporary research methodologies with young people can, and does, pose many ethical challenges for researchers keen to fully incorporate principles of participation and voice into their research endeavours. Adding to the challenge, when the project is grounded outside of an academic context in a not-for-profit community setting, ethical…

  8. Simulated Cardiopulmonary Arrests in a Hospital Setting.

    ERIC Educational Resources Information Center

    Mishkin, Barbara H.; And Others

    1982-01-01

    Describes a simulated interdisciplinary role rehearsal for cardiopulmonary arrest to prepare nurses to function effectively. Includes needs analysis, program components, and responses of program participants. (Author)

  9. [Internal medicine in the hospital setting].

    PubMed

    Moret, M; Darbellay, P; Lebowitz, D; Alves, C; Sabeh, N; Carballo, S

    2015-01-21

    Management of all pathologies, and in particular that of the most frequent ones, should whenever possible be based on robust evidence and arguments. New studies published this year enable rationalizing of screening in certain clinical situations, more adequate treatment of others, and open the way for novel and apparently very effective treatments. Whether it be the screening of carotid stenosis, the treatment of pericarditis, of heart failure, of chronic obstructive lung disease or spontaneous bacterial peritonitis, paradigm changes are conceivable. This selective review of the literature summarizes certain studies published this year.

  10. Teenage pregnancy in an urban hospital setting.

    PubMed

    Davis, J K; Fink, R; Yesupria, A; Rajegowda, B; Lala, R

    1986-01-01

    Recent research suggests that adverse consequences of teenage pregnancy are largely a function of social background factors and adequacy of prenatal care. This study examines the situation of young mothers with new babies in a low income, urban environment. The study explores the relationship between age and ethnicity and various life circumstance and life style differences which might effect long term developmental outcome. 475 Hispanic and black mothers were interviewed using a structured questionnaire. The majority are poorly educated, single parents. Educational attainment is higher for blacks than for Hispanics and for older mothers than for younger. Older mothers are more likely to be living with the father, to be married, and to have received adequate prenatal care. Hispanic parents are more likely than Blacks to be planning to live together. Hispanic mothers are more likely than blacks to be planning to be the primary caretaker for their babies. Adequacy of prenatal care is related to both prematurity and low birth weight. The implications of these findings are discussed in relation to pregnancy prevention and parenting education programs.

  11. Implementing medical teaching policy in university hospitals.

    PubMed

    Engbers, Rik; Fluit, Cornelia R M G; Bolhuis, Sanneke; de Visser, Marieke; Laan, Roland F J M

    2016-11-16

    Within the unique and complex settings of university hospitals, it is difficult to implement policy initiatives aimed at developing careers in and improving the quality of academic medical teaching because of the competing domains of medical research and patient care. Factors that influence faculty in making use of teaching policy incentives have remained underexplored. Knowledge of these factors is needed to develop theory on the successful implementation of medical teaching policy in university hospitals. To explore factors that influence faculty in making use of teaching policy incentives and to develop a conceptual model for implementation of medical teaching policy in university hospitals. We used the grounded theory methodology. We applied constant comparative analysis to qualitative data obtained from 12 semi-structured interviews conducted at the Radboud University Medical Center. We used a constructivist approach, in which data and theories are co-created through interaction between the researcher and the field and its participants. We constructed a model for the implementation of medical teaching policy in university hospitals, including five factors that were perceived to promote or inhibit faculty in a university hospital to make use of teaching policy incentives: Executive Board Strategy, Departmental Strategy, Departmental Structure, Departmental Culture, and Individual Strategy. Most factors we found to affect individual teachers' strategies and their use of medical teaching policy lie at the departmental level. If an individual teacher's strategy is focused on medical teaching and a medical teaching career, and the departmental context offers support and opportunity for his/her development, this promotes faculty's use of teaching policy incentives.

  12. The Hathaway Scholarship and Academic Preparation: A Study of Perceptions of Academic Preparation and Academic Success

    ERIC Educational Resources Information Center

    Aagard, Tammy Lindsay

    2010-01-01

    With the implementation of the Hathaway scholarship in the state of Wyoming, questions arose regarding the effectiveness of a prescribed set of high school courses (the Success Curriculum) in preparing students for success in college. This research sought to determine the perceptions of academic preparation of students who earned the Hathaway…

  13. Defining and Monitoring Academic Standards in Australian Higher Education

    ERIC Educational Resources Information Center

    Coates, Hamish

    2010-01-01

    This paper outlines the need for adopting a more scientific approach to specifying and assessing academic standards in higher education. Drawing together insights from large-scale studies in Australia, it advances a definition of academic standards, explores potential indicators of academic quality and looks at approaches for setting standards. As…

  14. Biomedical innovation in academic institutions: mitigating conflict of interest.

    PubMed

    Nelsen, Lita L; Bierer, Barbara E

    2011-09-14

    As universities and research hospitals move increasingly toward translational research and encouragement of entrepreneurship, more attention must be paid to management of conflicts of interest (COIs) if the public trust is to be maintained. Here, we describe COI policies at two institutions that aim to structure an academic environment that encourages innovation while protecting academic values.

  15. Painting the Bigger Picture: Academic Literacy in Postgraduate Vocational Education

    ERIC Educational Resources Information Center

    Strauss, Pat; Mooney, Shelagh

    2011-01-01

    Currently postgraduate hospitality courses are attracting large numbers of international students, many of whom do not speak English as a first language. In addition, these programmes are also popular with first language students drawn from non-traditional academic backgrounds. Both cohorts experience difficulties with the academic genre…

  16. The use of blogging in tertiary healthcare educational settings to enhance reflective learning in nursing leadership.

    PubMed

    Levine, Theodora C

    2014-01-01

    Web 2.0 technologies such as blogs are increasingly used in academic settings; however, they are not widely used in hospital settings. This project explored the effectiveness of using a blog to enhance reflective learning in a nurse manager leadership development course of a tertiary care hospital setting. Differences in reflective learning between the blog group and traditional learning group were measured post training using a Reflective Learning and Interaction Questionnaire. Although the groups did not differ significantly on any reflective learning dimension (p < .05, n = 11), the mean scores showed that both groups identified a reflective learning experience. Findings from this study inform the practice of other nurse educators contemplating to incorporate blogs into their learning strategies to enhance reflective learning.

  17. Academic detailing.

    PubMed

    Shankar, P R; Jha, N; Piryani, R M; Bajracharya, O; Shrestha, R; Thapa, H S

    2010-01-01

    There are a number of sources available to prescribers to stay up to date about medicines. Prescribers in rural areas in developing countries however, may not able to access some of them. Interventions to improve prescribing can be educational, managerial, and regulatory or use a mix of strategies. Detailing by the pharmaceutical industry is widespread. Academic detailing (AD) has been classically seen as a form of continuing medical education in which a trained health professional such as a physician or pharmacist visits physicians in their offices to provide evidence-based information. Face-to-face sessions, preferably on an individual basis, clear educational and behavioural objectives, establishing credibility with respect to objectivity, stimulating physician interaction, use of concise graphic educational materials, highlighting key messages, and when possible, providing positive reinforcement of improved practices in follow-up visits can increase success of AD initiatives. AD is common in developed countries and certain examples have been cited in this review. In developing countries the authors have come across reports of AD in Pakistan, Sudan, Argentina and Uruguay, Bihar state in India, Zambia, Cuba, Indonesia and Mexico. AD had a consistent, small but potentially significant impact on prescribing practices. AD has much less resources at its command compared to the efforts by the industry. Steps have to be taken to formally start AD in Nepal and there may be specific hindering factors similar to those in other developing nations.

  18. Understanding hospitality.

    PubMed

    Patten, C S

    1994-03-01

    Bridging patient/"customer" issues and business aspects can be aided through developing a specific nursing basis for hospitality. The ancient practice of hospitality has evolved into three distinct levels: public, personal and therapeutic. Understanding these levels is helpful in integrating various dimensions of guest relations programs in hospitals into a more comprehensive vision. Hospitality issues must become a greater part of today's nursing management.

  19. Hospital-acquired infections - when are hospitals legally liable?

    PubMed

    McQuoid-Mason, David

    2012-04-12

    Hospital-acquired infections (nosocomial infections) are acquired in healthcare settings by patients admitted for reasons unrelated to the infection or not previously infected when admitted to the facility. Liability for hospital-acquired infections depends on whether the hospital: (i) has introduced best practice infection control measures; (ii) has implemented best practice infection control measures; or (iii) will be vicariously liable for negligent or intentional failures by staff to comply with the infection control measures implemented. A hospital and hospital administrators may be held directly liable for not introducing or implementing best practice infection control measures, resulting in harm to patients. The hospital may also be held vicariously liable where patients have been harmed because hospital staff negligently or intentionally failed to comply with the infection control measures that have been implemented by the hospital, during the course and scope of their employment.

  20. A Preliminary Investigation of Academic Disidentification, Racial Identity, and Academic Achievement among African American Adolescents

    ERIC Educational Resources Information Center

    Cokley, Kevin; McClain, Shannon; Jones, Martinique; Johnson, Samoan

    2012-01-01

    The purpose of this study was to examine academic disidentification along with demographic and psychological factors related to the academic achievement of African American adolescents. Participants included 96 African American students (41 males, 55 females) in an urban high school setting located in the Southwest. Consistent with previous…

  1. Erector set.

    PubMed

    Saphir, A

    1999-12-06

    It was an untold story in Washington this year: while hospital associations were clamoring for Medicare givebacks from Congress, a miniboom in construction was under way, as some profitable hospitals built new facilities or additions to meet growing patient demand in their markets.

  2. Hospital mergers and market overlap.

    PubMed Central

    Brooks, G R; Jones, V G

    1997-01-01

    OBJECTIVE: To address two questions: What are the characteristics of hospitals that affect the likelihood of their being involved in a merger? What characteristics of particular pairs of hospitals affect the likelihood of the pair engaging in a merger? DATA SOURCES/STUDY SETTING: Hospitals in the 12 county region surrounding the San Francisco Bay during the period 1983 to 1992 were the focus of the study. Data were drawn from secondary sources, including the Lexis/Nexis database, the American Hospital Association, and the Office of Statewide Health Planning and Development of the State of California. STUDY DESIGN: Seventeen hospital mergers during the study period were identified. A random sample of pairs of hospitals that did not merge was drawn to establish a statistically efficient control set. Models constructed from hypotheses regarding hospital and market characteristics believed to be related to merger likelihood were tested using logistic regression analysis. DATA COLLECTION: See Data Sources/Study Setting. PRINCIPAL FINDINGS: The analysis shows that the likelihood of a merger between a particular pair of hospitals is positively related to the degree of market overlap that exists between them. Furthermore, market overlap and performance difference interact in their effect on merger likelihood. In an analysis of individual hospitals, conditions of rivalry, hospital market share, and hospital size were not found to influence the likelihood that a hospital will engage in a merger. CONCLUSIONS: Mergers between hospitals are not driven directly by considerations of market power or efficiency as much as by the existence of specific merger opportunities in the hospitals' local markets. Market overlap is a condition that enables a merger to occur, but other factors, such as the relative performance levels of the hospitals in question and their ownership and teaching status, also play a role in influencing the likelihood that a merger will in fact take place. PMID

  3. 45 CFR 84.34 - Educational setting.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Educational setting. 84.34 Section 84.34 Public... Secondary Education § 84.34 Educational setting. (a) Academic setting. A recipient to which this subpart... satisfactorily. Whenever a recipient places a person in a setting other than the regular educational...

  4. 7 CFR 15b.23 - Educational setting.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 1 2010-01-01 2010-01-01 false Educational setting. 15b.23 Section 15b.23 Agriculture... Education § 15b.23 Educational setting. (a) Academic setting. A recipient to which this subpart applies... satisfactorily. Whenever a recipient places a person in a setting other than the regular educational...

  5. 45 CFR 605.34 - Educational setting.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Educational setting. 605.34 Section 605.34 Public..., Elementary, and Secondary Education § 605.34 Educational setting. (a) Academic setting. A recipient to which... satisfactorily. Whenever a recipient places a person in a setting other than the regular educational...

  6. Strategic Planning as a Tool for Achieving Alignment in Academic Health Centers

    PubMed Central

    Higginbotham, Eve J.; Church, Kathryn C.

    2012-01-01

    After the passage of the Patient Protection and Affordable Care Act in March 2010, there is an urgent need for medical schools, teaching hospitals, and practice plans to work together seamlessly across a common mission. Although there is agreement that there should be greater coordination of initiatives and resources, there is little guidance in the literature to address the method to achieve the necessary transformation. Traditional approaches to strategic planning often engage a few leaders and produce a set of immeasurable initiatives. A nontraditional approach, consisting of a Whole-Scale (Dannemiller Tyson Associates, Ann Arbor, MI) engagement, appreciative inquiry, and a balanced scorecard can, more rapidly transform an academic health center. Using this nontraditional approach to strategic planning, increased organizational awareness was achieved in a single academic health center. Strategic planning can be an effective tool to achieve alignment, enhance accountability, and a first step in meeting the demands of the new landscape of healthcare. PMID:23303997

  7. Strategic planning as a tool for achieving alignment in academic health centers.

    PubMed

    Higginbotham, Eve J; Church, Kathryn C

    2012-01-01

    After the passage of the Patient Protection and Affordable Care Act in March 2010, there is an urgent need for medical schools, teaching hospitals, and practice plans to work together seamlessly across a common mission. Although there is agreement that there should be greater coordination of initiatives and resources, there is little guidance in the literature to address the method to achieve the necessary transformation. Traditional approaches to strategic planning often engage a few leaders and produce a set of immeasurable initiatives. A nontraditional approach, consisting of a Whole-Scale (Dannemiller Tyson Associates, Ann Arbor, MI) engagement, appreciative inquiry, and a balanced scorecard can, more rapidly transform an academic health center. Using this nontraditional approach to strategic planning, increased organizational awareness was achieved in a single academic health center. Strategic planning can be an effective tool to achieve alignment, enhance accountability, and a first step in meeting the demands of the new landscape of healthcare.

  8. Alternative funding plans: is there a place in academic medicine?

    PubMed Central

    Haslam, R H; Walker, N E

    1993-01-01

    Because of shrinking resources and the resulting threat to its academic vitality the Department of Paediatrics, Hospital for Sick Children, University of Toronto, entered into an agreement on alternative funding with the Ontario Ministry of Health in 1990. The department developed a set of principles that guided the negotiations, which ultimately led to a budget that formed the basis of the agreement. The contract with the ministry provides a global budget to the department; this budget funds faculty members, administrative staff and the educational and research programs formerly supported by fee-for-service billing to the Ontario Health Insurance Plan. The alternative funding plan has provided financial stability to the department and affords an opportunity to develop innovative and cost-effective models of pediatric care. PMID:8457954

  9. Medical psychology services in dutch general hospitals: state of the art developments and recommendations for the future.

    PubMed

    Soons, Paul; Denollet, Johan

    2009-06-01

    In this article an overview is presented of the emergence of medical psychology in the care of somatically ill patients. The situation in the Netherlands can be considered as prototypical. For 60 years, clinical psychologists have been working in general, teaching and academic hospitals. Nowadays, they are an integrated non-medical specialism working in the medical setting of hospitals in the Netherlands, and are a full-member of the medical board. This paper discusses several topics: the position of the general hospital in the health care system in the Netherlands, the emergence of medical psychology in Dutch hospitals, the role of the professional association of medical psychologists, and the characteristics of patients seen by clinical psychologists. Following the discussion about the situation of medical psychology in other countries, recommendations are formulated for the further development of medical psychology in the Netherlands as well as in other countries.

  10. The Construction of Academic Identity in the Changes of Finnish Higher Education

    ERIC Educational Resources Information Center

    Ylijoki, Oili-Helena; Ursin, Jani

    2013-01-01

    This article sets out to explore how academics make sense of the current transformations of higher education and what kinds of academic identities are thereby constructed. Based on a narrative analysis of 42 interviews with Finnish academics, nine narratives are discerned, each providing a different answer as to what it means to be an academic in…

  11. Hospital Costs Associated With Laparoscopic and Open Inguinal Herniorrhaphy

    PubMed Central

    Quereshy, Fayez; Camilotti, Bruna G.; Pitzul, Kristen; Kwong, Josephine; Jackson, Timothy; Penner, Todd; Okrainec, Allan

    2014-01-01

    Purpose: The purpose of this study was to compare the total hospital costs associated with elective laparoscopic and open inguinal herniorrhaphy. Methods: A prospectively maintained database was used to identify patients who underwent elective inguinal herniorrhaphy from April 2009 to March 2011. A retrospective review of electronic patient records was performed along with a standardized case-costing analysis using data from the Ontario Case Costing Initiative. The main outcomes were operating room (OR) and total hospital costs. Results: Two hundred eleven patients underwent elective unilateral inguinal herniorrhaphy (117 open and 94 laparoscopic), and 33 patients underwent elective bilateral inguinal herniorrhaphy (9 open and 24 laparoscopic). OR and total hospital costs for open unilateral inguinal hernia repair were significantly lower than for the laparoscopic approach (median total cost, $3207.15 vs $3723.66; P < .001). OR and total hospital costs for repair of elective bilateral inguinal hernias were similar between the open and laparoscopic approaches (median total cost, $4574.02 vs $4662.89; P = .827). Conclusions: In the setting of a Canadian academic hospital, when considering the repair of an elective unilateral inguinal hernia, the OR and total hospital costs of open surgery were significantly lower than for the laparoscopic techniques. There was no statistical difference between OR and total hospital costs when comparing open surgery and laparoscopic techniques for the repair of bilateral inguinal hernias. Given the perioperative benefits of laparoscopy, further studies incorporating hernia-specific outcomes are necessary to determine the cost-effectiveness of each approach and to define the optimal treatment strategy. PMID:25392677

  12. Predictors of job satisfaction among academic family medicine faculty

    PubMed Central

    Krueger, Paul; White, David; Meaney, Christopher; Kwong, Jeffrey; Antao, Viola; Kim, Florence

    2017-01-01

    Abstract Objective To identify predictors of job satisfaction among academic family medicine faculty members. Design A comprehensive Web-based survey of all faculty members in an academic department of family medicine. Bivariate and multivariable analyses (logistic regression) were used to identify variables associated with job satisfaction. Setting The Department of Family and Community Medicine at the University of Toronto in Ontario and its 15 affiliated community teaching hospitals and community-based teaching practices. Participants All 1029 faculty members in the Department of Family and Community Medicine were invited to complete the survey. Main outcome measures Faculty members’ demographic and practice information; teaching, clinical, administration, and research activities; leadership roles; training needs and preferences; mentorship experiences; health status; stress levels; burnout levels; and job satisfaction. Faculty members’ perceptions about supports provided, recognition, communication, retention, workload, teamwork, respect, resource distribution, remuneration, and infrastructure support. Faculty members’ job satisfaction, which was the main outcome variable, was obtained from the question, “Overall, how satisfied are you with your job?” Results Of the 1029 faculty members, 687 (66.8%) responded to the survey. Bivariate analyses revealed 26 predictors as being statistically significantly associated with job satisfaction, including faculty members’ ratings of their local department and main practice setting, their ratings of leadership and mentorship experiences, health status variables, and demographic variables. The multivariable analyses identified the following 5 predictors of job satisfaction: the Maslach Burnout Inventory subscales of emotional exhaustion and personal accomplishment; being born in Canada; the overall quality of mentorship that was received being rated as very good or excellent; and teamwork being rated as very

  13. Development of cities mentor project: an intervention to improve academic outcomes for low-income urban youth through instruction in effective coping supported by mentoring relationships and protective settings.

    PubMed

    Grant, Kathryn E; Farahmand, Farahnaz; Meyerson, David A; Dubois, David L; Tolan, Patrick H; Gaylord-Harden, Noni K; Barnett, Alexandra; Horwath, Jordan; Doxie, Jackie; Tyler, Donald; Harrison, Aubrey; Johnson, Sarah; Duffy, Sophia

    2014-01-01

    This manuscript summarizes an iterative process used to develop a new intervention for low-income urban youth at risk for negative academic outcomes (e.g., disengagement, failure, drop-out). A series of seven steps, building incrementally one upon the other, are described: 1) identify targets of the intervention; 2) develop logic model; 3) identify effective elements of targets; 4) vet intervention with stakeholders; 5) develop models for sustaining the intervention; 6) develop measures of relevant constructs currently missing from the literature; 7) assess feasibility and usability of the intervention. Methods used to accomplish these steps include basic research studies, literature reviews, meta-analyses, focus groups, community advisory meetings, consultations with scholarly consultants, and piloting. The resulting intervention provides early adolescents in low-income urban communities with a) training in contextually relevant coping, b) connection to mentors who support youth's developing coping strategies, and c) connection to youth-serving community organizations, where youth receive additional support.

  14. Getting your home ready - after the hospital

    MedlinePlus

    ... 000432.htm Getting your home ready - after the hospital To use the sharing features on this page, ... home ready after you have been in the hospital often requires much preparation. Set up your home ...

  15. Leasing capital assets and durable goods: opinions and practices in Florida hospitals.

    PubMed

    Gapenski, L C; Langland-Orban, B

    1991-01-01

    Although leasing is a major source of financing for hospital capital acquisitions, the rationale for choosing leasing over conventional financing is not clear. This article examines academic and leasing company views, and then surveys hospital executives to obtain their views.

  16. Hospital free cash flow.

    PubMed

    Kauer, R T; Silvers, J B

    1991-01-01

    Hospital managers may find it difficult to admit their investments have been suboptimal, but such investments often lead to poor returns and less future cash. Inappropriate use of free cash flow produces large transaction costs of exit. The relative efficiency of investor-owned and tax-exempt hospitals in the product market for hospital services is examined as the free cash flow theory is used to explore capital-market conditions of hospitals. Hypotheses concerning the current competitive conditions in the industry are set forth, and the implications of free cash flow for risk, capital-market efficiency, and the cost of capital to tax-exempt institution is compared to capital-market norms.

  17. Academic Probation Intervention through Academic Assistance Advising

    ERIC Educational Resources Information Center

    Preuss, Michael; Switalski, Rachael

    2008-01-01

    Retaining and aiding students on academic probation is a concern for all institutions of higher education. Students placed on academic probation by Rockingham Community College (RCC) have been encouraged to participate in an intervention program since the summer of 2006. When treated as an aggregate, the data regarding the program indicates that…

  18. Association of Academic Physiatrists

    MedlinePlus

    Donate Member Portal Search Search » Donate | Member Portal | Sign In | Join Membership Join the AAP Coming Home Member Benefits Top 5 Reasons to Join Categories & Dues Academic Partnership Program Current Academic ...

  19. Relationships between in-hospital and 30-day standardized hospital mortality: implications for profiling hospitals.

    PubMed Central

    Rosenthal, G. E.; Baker, D. W.; Norris, D. G.; Way, L. E.; Harper, D. L.; Snow, R. J.

    2000-01-01

    OBJECTIVE: To examine the relationship of in-hospital and 30-day mortality rates and the association between in-hospital mortality and hospital discharge practices. DATA SOURCES/STUDY SETTING: A secondary analysis of data for 13,834 patients with congestive heart failure who were admitted to 30 hospitals in northeast Ohio in 1992-1994. DESIGN: A retrospective cohort study was conducted. DATA COLLECTION: Demographic and clinical data were collected from patients' medical records and were used to develop multivariable models that estimated the risk of in-hospital and 30-day (post-admission) mortality. Standardized mortality ratios (SMRs) for in-hospital and 30-day mortality were determined by dividing observed death rates by predicted death rates. PRINCIPAL FINDINGS: In-hospital SMRs ranged from 0.54 to 1.42, and six hospitals were classified as statistical outliers (p <.05); 30-day SMRs ranged from 0.63 to 1.73, and seven hospitals were outliers. Although the correlation between in-hospital SMRs and 30-day SMRs was substantial (R = 0.78, p < .001), outlier status changed for seven of the 30 hospitals. Nonetheless, changes in outlier status reflected relatively small differences between in-hospital and 30-day SMRs. Rates of discharge to nursing homes or other inpatient facilities varied from 5.4 percent to 34.2 percent across hospitals. However, relationships between discharge rates to such facilities and in-hospital SMRs (R = 0.08; p = .65) and early post-discharge mortality rates (R = 0.23; p = .21) were not significant. CONCLUSIONS: SMRs based on in-hospital and 30-day mortality were relatively similar, although classification of hospitals as statistical outliers often differed. However, there was no evidence that in-hospital SMRs were biased by differences in post-discharge mortality or discharge practices. PMID:10737447

  20. Academic Inbreeding in Nursing

    ERIC Educational Resources Information Center

    Miller, Michael H.

    1977-01-01

    Academic inbreeding, the employment for faculty positions of persons who receive their graduate training at the same academic institution, is considered detrimental to an institution's academic environment. Results of a study conducted at 54 universities revealed that almost half the faculty (48 percent) in collegiate nursing programs are drawn…

  1. The Academic Adviser

    ERIC Educational Resources Information Center

    Darling, Ruth

    2015-01-01

    In this essay, I explore the idea that "academic" advisers are "academics" who play a major role in connecting the general education curriculum to the students' experience as well as connecting the faculty to the students' holistic experience of the curriculum. The National Academic Advising Association Concept of Academic…

  2. What Is Academic Vocabulary?

    ERIC Educational Resources Information Center

    Baumann, James F.; Graves, Michael F.

    2010-01-01

    In this article, the authors address the construct of "academic vocabulary." First, they attempt to bring some clarity to a constellation of terms surrounding academic vocabulary. Second, they compare and contrast definitions of academic vocabulary. Third, they review typologies that researchers and writers have proposed to organize academic…

  3. A comparison of embedded total task instruction in teaching behavioral chains to massed one-on-one instruction for students with intellectual disabilities: accessing general education settings and core academic content.

    PubMed

    Jameson, J Matt; Walker, Ryan; Utley, Kristen; Maughan, Ryan

    2012-05-01

    This study is a comparison of the embedded instruction of behavioral chains with more traditional (one-on-one massed trials in special education setting) instructional procedures for teaching behavioral chains to students with significant cognitive disabilities. Although embedded instruction has emerged as a promising potential instructional procedure, no literature has examined the efficacy of embedded instructional procedures to teach more complex chained behaviors. To date, all research on embedding instruction in general education settings has focused on teaching discrete skills. This study compares instruction of embedded total task chains with more traditional (one-on-one massed trials in special education setting) instructional procedures for teaching behavioral chains. The chains targeted for instruction were selected by state core educational needs and functional skill development.

  4. Academic medicine amenities unit: developing a model to integrate academic medical care with luxury hotel services.

    PubMed

    Kennedy, David W; Kagan, Sarah H; Abramson, Kelly Brennen; Boberick, Cheryl; Kaiser, Larry R

    2009-02-01

    The interface between established values of academic medicine and the trend toward inpatient amenities units requires close examination. Opinions of such units can be polarized, reflecting traditional reservations about the ethical dilemma of offering exclusive services only to an elite patient group. An amenities unit was developed at the University of Pennsylvania Health System in 2007, using an approach that integrated academic medicine values with the benefits of philanthropy and service excellence to make amenities unit services available to all patients. Given inherent internal political concerns, a broadly based steering committee of academic and hospital leadership was developed. An academically appropriate model was conceived, anchored by four principles: (1) integration of academic values, (2) interdisciplinary senior leadership, (3) service excellence, and (4) recalibrated occupancy expectations based on multiple revenue streams. Foremost is ensuring the same health care is afforded all patients throughout the hospital, thereby overcoming ethical challenges and optimizing teaching experiences. Service excellence frames the service ethic for all staff, and this, in addition to luxury hotel-style amenities, differentiates the style and feel of the unit from others in the hospital. Recalibrated occupancy creates program viability given revenue streams redefined to encompass gifts and patient revenue, including both reimbursement and self-pay. The medical-surgical amenities patient-care unit has enjoyed a successful first year and a growing stream of returning patients and admitting physicians. Implications for other academic medical centers include opportunities to extrapolate service excellence throughout the hospital and to cultivate philanthropy to benefit services throughout the medical center.

  5. The Profile of Academic Offenders: Features of Students Who Admit to Academic Dishonesty

    PubMed Central

    Korn, Liat; Davidovitch, Nitza

    2016-01-01

    Dishonesty in academic settings is a reckless behavior that is unique to students and is associated with cheat ing and plagiarism of academic tasks. Incidents involving dishonesty in higher education have increased considerably in the past decade, with regard to the extent of these practices, the types of dishonesty employed, and their prevalence. The current study examines the profile of “academic offenders”. Which types are more prone to commit academic offenses? To what degree are they “normative” and do they represent the average student with regard to personal traits, personal perceptions, features of their academic studies, risk behaviors, and health risks. The study is based on a structured anonymous questionnaire. The sample consisted of 1,432 students, of whom 899 were female (63%) and 533 male (37%). The research findings indicate a common tendency among more than one quarter of the sample reported cheating on homework and 12.5% reported cheating on tests. Strong associations were found between academic dishonesty and various personal perceptions, the academic study experience, and involvement in other risky and deviant behaviors. Significant predictors of academic dishonesty were found, i.e., self-image, ethics, grades, time devoted to homework, and deviant and daring behaviors. The research findings might help indicate policies for optimally dealing with dishonesty, maybe even before the offense is committed, by means of cooperation between academic forces. PMID:27569198

  6. The Profile of Academic Offenders: Features of Students Who Admit to Academic Dishonesty.

    PubMed

    Korn, Liat; Davidovitch, Nitza

    2016-08-29

    Dishonesty in academic settings is a reckless behavior that is unique to students and is associated with cheat    ing and plagiarism of academic tasks. Incidents involving dishonesty in higher education have increased considerably in the past decade, with regard to the extent of these practices, the types of dishonesty employed, and their prevalence. The current study examines the profile of "academic offenders". Which types are more prone to commit academic offenses? To what degree are they "normative" and do they represent the average student with regard to personal traits, personal perceptions, features of their academic studies, risk behaviors, and health risks. The study is based on a structured anonymous questionnaire. The sample consisted of 1,432 students, of whom 899 were female (63%) and 533 male (37%). The research findings indicate a common tendency among more than one quarter of the sample reported cheating on homework and 12.5% reported cheating on tests. Strong associations were found between academic dishonesty and various personal perceptions, the academic study experience, and involvement in other risky and deviant behaviors. Significant predictors of academic dishonesty were found, i.e., self-image, ethics, grades, time devoted to homework, and deviant and daring behaviors. The research findings might help indicate policies for optimally dealing with dishonesty, maybe even before the offense is committed, by means of cooperation between academic forces.

  7. Rationale for a Study of the Relevance of Academic Learning Time and Active Teaching Behaviors to Secondary Science Teacher Education. Part of a Paper Set: Applying Teacher Effectiveness Findings to Preservice and Inservice Science Teacher Education.

    ERIC Educational Resources Information Center

    Ponzio, Richard; Russell, Thomas L.

    This report is part of a paper set which focuses on a project designated as "Applying Research to Teacher Education (ARTE)." It reviews application possibilities of teacher effectiveness research in elementary classrooms to science teaching at the secondary level. Mills College (Oakland, California) was one of the sites involved in the…

  8. A Comparison of Embedded Total Task Instruction in Teaching Behavioral Chains to Massed One-on-One Instruction for Students with Intellectual Disabilities: Accessing General Education Settings and Core Academic Content

    ERIC Educational Resources Information Center

    Jameson, J. Matt; Walker, Ryan; Utley, Kristen; Maughan, Ryan

    2012-01-01

    This study is a comparison of the embedded instruction of behavioral chains with more traditional (one-on-one massed trials in special education setting) instructional procedures for teaching behavioral chains to students with significant cognitive disabilities. Although embedded instruction has emerged as a promising potential instructional…

  9. Managing Neonatal and Early Childhood Syndromic Sepsis in Sub-District Hospitals in Resource Poor Settings: Improvement in Quality of Care through Introduction of a Package of Interventions in Rural Bangladesh

    PubMed Central

    Iqbal, Afrin; Hoque, D. M. Emdadul; Moinuddin, Md.; Zaman, Sojib Bin; Rahman, Qazi Sadeq-ur; Begum, Tahmina; Chowdhury, Atique Iqbal; Haider, Rafiqul; Arifeen, Shams El; Kissoon, Niranjan; Larson, Charles P.

    2017-01-01

    Introduction Sepsis is dysregulated systemic inflammatory response which can lead to tissue damage, organ failure, and death. With an estimated 30 million cases per year, it is a global public health concern. Severe infections leading to sepsis account for more than half of all under five deaths and around one quarter of all neonatal deaths annually. Most of these deaths occur in low and middle income countries and could be averted by rapid assessment and appropriate treatment. Evidence suggests that service provision and quality of care pertaining to sepsis management in resource poor settings can be improved significantly with minimum resource allocation and investments. Cognizant of the stark realities, a project titled ‘Interrupting Pathways to Sepsis Initiative’ (IPSI) introduced a package of interventions for improving quality of care pertaining to sepsis management at 2 sub-district level public hospitals in rural Bangladesh. We present here the quality improvement process and achievements regarding some fundamental steps of sepsis management which include rapid identification and admission, followed by assessment for hypoxemia, hypoglycaemia and hypothermia, immediate resuscitation when required and early administration of parenteral broad spectrum antibiotics. Materials and Method Key components of the intervention package include identification of structural and functional gaps through a baseline environmental scan, capacity development on protocolized management through training and supportive supervision by onsite ‘Program Coaches’, facilitating triage and rapid transfer of patients through ‘Welcoming Persons’ and enabling rapid treatment through ‘Task Shifting’ from on-call physicians to on-duty paramedics in the emergency department and on-call physicians to on-duty nurses in the inpatient department. Results From August, 2013 to March, 2015, 1,262 under-5 children were identified as syndromic sepsis in the emergency departments; of

  10. 34 CFR 104.34 - Educational setting.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 1 2013-07-01 2013-07-01 false Educational setting. 104.34 Section 104.34 Education Regulations of the Offices of the Department of Education OFFICE FOR CIVIL RIGHTS, DEPARTMENT OF EDUCATION... Preschool, Elementary, and Secondary Education § 104.34 Educational setting. (a) Academic setting....

  11. 34 CFR 104.34 - Educational setting.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 1 2011-07-01 2011-07-01 false Educational setting. 104.34 Section 104.34 Education Regulations of the Offices of the Department of Education OFFICE FOR CIVIL RIGHTS, DEPARTMENT OF EDUCATION... Preschool, Elementary, and Secondary Education § 104.34 Educational setting. (a) Academic setting....

  12. 34 CFR 104.34 - Educational setting.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Educational setting. 104.34 Section 104.34 Education Regulations of the Offices of the Department of Education OFFICE FOR CIVIL RIGHTS, DEPARTMENT OF EDUCATION... Preschool, Elementary, and Secondary Education § 104.34 Educational setting. (a) Academic setting....

  13. 34 CFR 104.34 - Educational setting.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 1 2014-07-01 2014-07-01 false Educational setting. 104.34 Section 104.34 Education Regulations of the Offices of the Department of Education OFFICE FOR CIVIL RIGHTS, DEPARTMENT OF EDUCATION... Preschool, Elementary, and Secondary Education § 104.34 Educational setting. (a) Academic setting....

  14. 34 CFR 104.34 - Educational setting.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 1 2012-07-01 2012-07-01 false Educational setting. 104.34 Section 104.34 Education Regulations of the Offices of the Department of Education OFFICE FOR CIVIL RIGHTS, DEPARTMENT OF EDUCATION... Preschool, Elementary, and Secondary Education § 104.34 Educational setting. (a) Academic setting....

  15. 38 CFR 18.434 - Education setting.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Education setting. 18.434... Adult Education § 18.434 Education setting. (a) Academic setting. A recipient shall educate, or shall provide for the education of, each qualified handicapped person in its jurisdiction with persons who...

  16. 38 CFR 18.434 - Education setting.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Education setting. 18.434... Adult Education § 18.434 Education setting. (a) Academic setting. A recipient shall educate, or shall provide for the education of, each qualified handicapped person in its jurisdiction with persons who...

  17. 38 CFR 18.434 - Education setting.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Education setting. 18.434... Adult Education § 18.434 Education setting. (a) Academic setting. A recipient shall educate, or shall provide for the education of, each qualified handicapped person in its jurisdiction with persons who...

  18. 38 CFR 18.434 - Education setting.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Education setting. 18.434... Adult Education § 18.434 Education setting. (a) Academic setting. A recipient shall educate, or shall provide for the education of, each qualified handicapped person in its jurisdiction with persons who...

  19. 38 CFR 18.434 - Education setting.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Education setting. 18.434... Adult Education § 18.434 Education setting. (a) Academic setting. A recipient shall educate, or shall provide for the education of, each qualified handicapped person in its jurisdiction with persons who...

  20. Impacts of Campus Involvement on Hospitality Student Achievement and Satisfaction

    ERIC Educational Resources Information Center

    Yin, Dean; Lei, Simon A.

    2007-01-01

    Campus involvement affecting satisfaction and academic achievement (overall grade point average) of hospitality undergraduate students at a state university in the Midwest (University X) was investigated through a survey research. A four-part survey instrument was developed to facilitate this study. There were a number of academic, professional,…

  1. Academic Self-Concept, Autonomous Academic Motivation, and Academic Achievement: Mediating and Additive Effects

    ERIC Educational Resources Information Center

    Guay, Frederic; Ratelle, Catherine F.; Roy, Amelie; Litalien, David

    2010-01-01

    Three conceptual models were tested to examine the relationships among academic self-concept, autonomous academic motivation, and academic achievement. This allowed us to determine whether 1) autonomous academic motivation mediates the relation between academic self-concept and achievement, 2) academic self-concept mediates the relation between…

  2. Hospital philanthropy.

    PubMed

    Smith, Dean G; Clement, Jan P

    2013-01-01

    It remains an open question whether hospital spending on fundraising efforts to garner philanthropy is a good use of funds. Research and industry reports provide conflicting results. We describe the accounting and data challenges in analysis of hospital philanthropy, which include measurement of donations, measurement of fundraising expenses, and finding the relationships among organizations where these cash flows occur. With these challenges, finding conflicting results is not a surprise.

  3. Building cancer nursing skills in a resource-constrained government hospital.

    PubMed

    Strother, R M; Fitch, Margaret; Kamau, Peter; Beattie, Kathy; Boudreau, Angela; Busakhalla, N; Loehrer, P J

    2012-09-01

    Cancer is a rising cause of morbidity and mortality in resource-constrained settings. Few places in the developing world have cancer care experts and infrastructure for caring for cancer patients; therefore, it is imperative to develop this infrastructure and expertise. A critical component of cancer care, rarely addressed in the published literature, is cancer nursing. This report describes an effort to develop cancer nursing subspecialty knowledge and skills in support of a growing resource-constrained comprehensive cancer care program in Western Kenya. This report highlights the context of cancer care delivery in a resource-constrained setting, and describes one targeted intervention to further develop the skill set and knowledge of cancer care providers, as part of collaboration between developed world academic institutions and a medical school and governmental hospital in Western Kenya. Based on observations of current practice, practice setting, and resource limitations, a pragmatic curriculum for cancer care nursing was developed and implemented.

  4. Quality improvements in decreasing medication administration errors made by nursing staff in an academic medical center hospital: a trend analysis during the journey to Joint Commission International accreditation and in the post-accreditation era

    PubMed Central

    Wang, Hua-fen; Jin, Jing-fen; Feng, Xiu-qin; Huang, Xin; Zhu, Ling-ling; Zhao, Xiao-ying; Zhou, Quan

    2015-01-01

    Background Medication errors may occur during prescribing, transcribing, prescription auditing, preparing, dispensing, administration, and monitoring. Medication administration errors (MAEs) are those that actually reach patients and remain a threat to patient safety. The Joint Commission International (JCI) advocates medication error prevention, but experience in reducing MAEs during the period of before and after JCI accreditation has not been reported. Methods An intervention study, aimed at reducing MAEs in hospitalized patients, was performed in the Second Affiliated Hospital of Zhejiang University, Hangzhou, People’s Republic of China, during the journey to JCI accreditation and in the post-JCI accreditation era (first half-year of 2011 to first half-year of 2014). Comprehensive interventions included organizational, information technology, educational, and process optimization-based measures. Data mining was performed on MAEs derived from a compulsory electronic reporting system. Results The number of MAEs continuously decreased from 143 (first half-year of 2012) to 64 (first half-year of 2014), with a decrease in occurrence rate by 60.9% (0.338% versus 0.132%, P<0.05). The number of MAEs related to high-alert medications decreased from 32 (the second half-year of 2011) to 16 (the first half-year of 2014), with a decrease in occurrence rate by 57.9% (0.0787% versus 0.0331%, P<0.05). Omission was the top type of MAE during the first half-year of 2011 to the first half-year of 2014, with a decrease by 50% (40 cases versus 20 cases). Intravenous administration error was the top type of error regarding administration route, but it continuously decreased from 64 (first half-year of 2012) to 27 (first half-year of 2014). More experienced registered nurses made fewer medication errors. The number of MAEs in surgical wards was twice that in medicinal wards. Compared with non-intensive care units, the intensive care units exhibited higher occurrence rates of MAEs

  5. Study Drugs and Academic Integrity: The Role of Beliefs about an Academic Honor Code in the Prediction of Nonmedical Prescription Drug Use for Academic Enhancement

    ERIC Educational Resources Information Center

    Reisinger, Kelsy B.; Rutledge, Patricia C.; Conklin, Sarah M.

    2016-01-01

    The role of beliefs about academic integrity in college students' decisions to use nonmedical prescription drugs (NMPDs) in academic settings was examined. In Spring 2012 the authors obtained survey data from 645 participants at a small, undergraduate, private liberal arts institution in the Northeastern United States. A broadcast e-mail message…

  6. A detailed description and assessment of outcomes of patients with hospital recorded QTc prolongation.

    PubMed

    Laksman, Zachary; Momciu, Bogdan; Seong, You Won; Burrows, Patricia; Conacher, Susan; Manlucu, Jaimie; Leong-Sit, Peter; Gula, Lorne J; Skanes, Allan C; Yee, Raymond; Klein, George J; Krahn, Andrew D

    2015-04-01

    Corrected QT (QTc) interval prolongation has been shown to be an independent predictor of mortality in many clinical settings and is a common finding in hospitalized patients. The causes and outcomes of patients with extreme QTc interval prolongation during a hospital admission are poorly described. The aim of this study was to prospectively identify patients with automated readings of QTc intervals >550 ms at 1 academic tertiary hospital. One hundred seventy-two patients with dramatic QTc interval prolongation (574 ± 53 ms) were identified (mean age 67.6 ± 15.1 years, 48% women). Most patients had underlying heart disease (60%), predominantly ischemic cardiomyopathy (43%). At lease 1 credible and presumed reversible cause associated with QTc interval prolongation was identified in 98% of patients. The most common culprits were QTc interval-prolonging medications, which were deemed most responsible in 48% of patients, with 25% of these patients taking ≥2 offending drugs. Two patients were diagnosed with congenital long-QT syndrome. Patients with electrocardiograms available before and after hospital admission demonstrated significantly lower preadmission and postdischarge QTc intervals compared with the QTc intervals recorded in the hospital. In conclusion, in-hospital mortality was high in the study population (29%), with only 4% of patients experiencing arrhythmic deaths, all of which were attributed to secondary causes.

  7. Bacterial contamination of clothes and environmental items in a third-level hospital in Colombia.

    PubMed

    Cataño, J C; Echeverri, L M; Szela, C

    2012-01-01

    Objective. This study evaluates the bacterial contamination rate of items in the hospital setting that are in frequent contact with patients and/or physicians. By determining the bacterial species and the associated antibiotic resistance that patients are exposed to. Methods. Hospital-based cross-sectional surveillance study of potential bacterial reservoirs. Cultures from 30 computer keyboards, 32 curtains, 40 cell phones, 35 white coats, and 22 ties were obtained. Setting. The study was conducted an urban academic 650-bed teaching hospital providing tertiary care to the city of Medellin, Colombia. Results. In total, 235 bacterial isolates were obtained from 159 surfaces sampled. 98.7% of the surfaces grew positive bacterial cultures with some interesting resistance profiles. Conclusion. There are significant opportunities to reduce patient exposure to frequently pathogenic bacteria in the hospital setting; patients are likely exposed to many bacteria through direct contact with white coats, curtains, and ties. They may be exposed to additional bacterial reservoirs indirectly through the hands of clinicians, using computer keyboards and cell phones.

  8. Bacterial Contamination of Clothes and Environmental Items in a Third-Level Hospital in Colombia

    PubMed Central

    Cataño, J. C.; Echeverri, L. M.; Szela, C.

    2012-01-01

    Objective. This study evaluates the bacterial contamination rate of items in the hospital setting that are in frequent contact with patients and/or physicians. By determining the bacterial species and the associated antibiotic resistance that patients are exposed to. Methods. Hospital-based cross-sectional surveillance study of potential bacterial reservoirs. Cultures from 30 computer keyboards, 32 curtains, 40 cell phones, 35 white coats, and 22 ties were obtained. Setting. The study was conducted an urban academic 650-bed teaching hospital providing tertiary care to the city of Medellin, Colombia. Results. In total, 235 bacterial isolates were obtained from 159 surfaces sampled. 98.7% of the surfaces grew positive bacterial cultures with some interesting resistance profiles. Conclusion. There are significant opportunities to reduce patient exposure to frequently pathogenic bacteria in the hospital setting; patients are likely exposed to many bacteria through direct contact with white coats, curtains, and ties. They may be exposed to additional bacterial reservoirs indirectly through the hands of clinicians, using computer keyboards and cell phones. PMID:22536231

  9. Exploring improvements in patient logistics in Dutch hospitals with a survey

    PubMed Central

    2012-01-01

    Background Research showed that promising approaches such as benchmarking, operations research, lean management and six sigma, could be adopted to improve patient logistics in healthcare. To our knowledge, little research has been conducted to obtain an overview on the use, combination and effects of approaches to improve patient logistics in hospitals. We therefore examined the approaches and tools used to improve patient logistics in Dutch hospitals, the reported effects of these approaches on performance, the applied support structure and the methods used to evaluate the effects. Methods A survey among experts on patient logistics in 94 Dutch hospitals. The survey data were analysed using cross tables. Results Forty-eight percent of all hospitals participated. Ninety-eight percent reported to have used multiple approaches, 39% of them used five or more approaches. Care pathways were the preferred approach by 43% of the hospitals, followed by business process re-engineering and lean six sigma (both 13%). Flowcharts were the most commonly used tool, they were used on a regular basis by 94% of the hospitals. Less than 10% of the hospitals used data envelopment analysis and critical path analysis on a regular basis. Most hospitals (68%) relied on external support for process analyses and education on patient logistics, only 24% had permanent internal training programs on patient logistics. Approximately 50% of the hospitals that evaluated the effects of approaches on efficiency, throughput times and financial results, reported that they had accomplished their goals. Goal accomplishment in general hospitals ranged from 63% to 67%, in academic teaching hospitals from 0% to 50%, and in teaching hospitals from 25% to 44%. More than 86% performed an evaluation, 53% performed a post-intervention measurement. Conclusions Patient logistics appeared to be a rather new subject as most hospitals had not selected a single approach, they relied on external support and they did

  10. Establishing a multidisciplinary academic cosmetic center.

    PubMed

    Rao, Venkat K; Schmid, Daniel B; Hanson, Summer E; Bentz, Michael L

    2011-12-01

    The demand for cosmetic services has risen rapidly in recent years, but has slowed down with the current economic downturn. Managed care organizations and Medicare have been steadily reducing their reimbursements for physician services. The payment for reconstructive surgical procedures has been decreasing and is likely to worsen with healthcare reform, and many plastic surgery residency programs are facing fiscal challenges. An adequate volume of patients needing cosmetic services is necessary to recruit and train the best candidates to the residency programs. Self-pay patients will help ensure the fiscal viability of plastic surgery residency programs. Attracting patients to an academic healthcare center will become more difficult in a recession without the appropriate facilities, programs, and pricing strategies. Setting up a modern cosmetic services program at an academic center has some unique challenges, including funding, academic politics, and turf. The authors opened a free-standing academic multidisciplinary center at their medical school 3 years ago. The center is an off-site, 13,000-sq ft facility that includes faculty from plastic surgery, ear, nose, and throat, dermatology, and vascular surgery. In this article, the authors discuss the process of developing and executing a plan for starting an aesthetic services center in an academic setting. The financing of the center and factors in pricing services are discussed. The authors show the impact of the center on their cosmetic surgery patient volumes, resident education, and finances. They expect that their experience will be helpful to other plastic surgery programs at academic medical centers.

  11. Automatic sets and Delone sets

    NASA Astrophysics Data System (ADS)

    Barbé, A.; von Haeseler, F.

    2004-04-01

    Automatic sets D\\subset{\\bb Z}^m are characterized by having a finite number of decimations. They are equivalently generated by fixed points of certain substitution systems, or by certain finite automata. As examples, two-dimensional versions of the Thue-Morse, Baum-Sweet, Rudin-Shapiro and paperfolding sequences are presented. We give a necessary and sufficient condition for an automatic set D\\subset{\\bb Z}^m to be a Delone set in {\\bb R}^m . The result is then extended to automatic sets that are defined as fixed points of certain substitutions. The morphology of automatic sets is discussed by means of examples.

  12. All-Round Marketing Increases Hospital Popularity.

    PubMed

    Ziqi, Tao

    2015-06-01

    Xuzhou Center Hospital is in a competing medical market in Xuzhou city. This hospital has been dedicating to improve the medical skills and provide professional and individualized service to the patients in order to improve the patient's experience and increase the patient's satisfaction. On the other side, this hospital has provided an all-round marketing campaign to build up the social influence and public reputation through public-praise marketing, web marketing, media marketing, and scholar marketing. Besides, this hospital has been cooperating with foreign medical institutions and inviting foreign medical specialists to academic communication. With the combined effects of improving medical service and all-round marketing, the hospital's economic performance has been enhanced significantly and laid a solid foundation for its ambition to become the first-class hospital in Huaihai Economic Zone.

  13. The Academic Structure in Japan: Institutional Hierarchy and Academic Mobility.

    ERIC Educational Resources Information Center

    Arimoto, Akira

    The characteristics of the Japanese academic structure are examined with attention to the evolution of institutional hierarchy, the closed academic structure, and the effects of the academic structure upon academic research. The evolution of Japan's institutional hierarchy in academics has been tightly related to factors of nationalism,…

  14. Publishing and academic promotion.

    PubMed

    Dixon, A K

    2009-09-01

    Clearly, academic endeavour has to be the single most important criterion for appointment to an academic position and for subsequent promotion. It is rare for excellence either in teaching or clinical practice to offset a poor publication record. However, the pressure to publish and gain related grant income can lead to problems in the normal academic pursuits of a department or institution. These and other related issues will be explored in this editorial.

  15. Academic career development in geriatric fellowship training.

    PubMed

    Medina-Walpole, Annette; Fonzi, Judith; Katz, Paul R

    2007-12-01

    Career development is rarely formalized in the curricula of geriatric fellowship programs, and the training of new generations of academic leaders is challenging in the 1 year of fellowship training. To effectively prepare fellows for academic leadership, the University of Rochester's Division of Geriatrics, in collaboration with the Warner School of Graduate Education, created a yearlong course to achieve excellence in teaching and career development during the 1-year geriatric fellowship. Nine interdisciplinary geriatric medicine, dentistry, and psychiatry fellows completed the course in its initial year (2005/06). As participants, fellows gained the knowledge and experience to successfully develop and implement educational initiatives in various formats. Fellows acquired teaching and leadership skills necessary to succeed as clinician-educators in an academic setting and to communicate effectively with patients, families, and colleagues. Fellows completed a series of individual and group education projects, including academic portfolio development, curriculum vitae revision, abstract submission and poster presentation at national meetings, lay lecture series development, and geriatric grand rounds presentation. One hundred percent of fellows reported that the course positively affected their career development, with six of nine fellows choosing academic careers. The course provided opportunities to teach and assess all six of the Accreditation Council of Graduate Medical Education core competencies. This academic career development course was intended to prepare geriatric fellows as the next generation of academic leaders as clinician-teacher-scholars. It could set a new standard for academic development during fellowship training and provide a model for national dissemination in other geriatric and subspecialty fellowship programs.

  16. Text Sets.

    ERIC Educational Resources Information Center

    Giorgis, Cyndi; Johnson, Nancy J.

    2002-01-01

    Presents annotations of approximately 30 titles grouped in text sets. Defines a text set as five to ten books on a particular topic or theme. Discusses books on the following topics: living creatures; pirates; physical appearance; natural disasters; and the Irish potato famine. (SG)

  17. Partnerships with Academic Departments

    ERIC Educational Resources Information Center

    English, Anthony M.

    2013-01-01

    This chapter describes how professional and continuing higher education units can develop and sustain successful partnerships with academic departments in order to deliver educational programs effectively to students.

  18. The Relationship between Academic Writing Experience and Academic Publishing for Graduate Physics Students

    ERIC Educational Resources Information Center

    Hess, Steven Timothy Michael

    2012-01-01

    Writing for scientific publication represents an opportunity to interact with colleagues and make a positive contribution to the academic community. However, there is a growing concern regarding the ability of graduate students' to transfer writing skill sets learned at the graduate and undergraduate levels into professional settings. The main…

  19. The role of the VA in academic radiology: a report of the ACR's Committee on Governmental and Regulatory Affairs in Academic Radiology.

    PubMed

    Sherrier, Robert H; Chang, Barbara K; Rawson, James V; Romanelli, Gloria

    2012-08-01

    Academic radiology departments have benefited from their relationships with US Department of Veterans Affairs hospitals. Review of the history of the care of veterans shows a unique relationship with academic medical centers. Opportunities for future collaborations include clinical care, teaching, and research.

  20. Multifaceted impact of self-efficacy beliefs on academic functioning.

    PubMed

    Bandura, A; Barbaranelli, C; Caprara, G V; Pastorelli, C

    1996-06-01

    This research analyzed the network of psychosocial influences through which efficacy beliefs affect academic achievement. Parents' sense of academic efficacy and aspirations for their children were linked to their children's scholastic achievement through their perceived academic capabilities and aspirations. Children's beliefs in their efficacy to regulate their own learning and academic attainments, in turn, contributed to scholastic achievement both independently and by promoting high academic aspirations and prosocial behavior and reducing vulnerability to feelings of futility and depression. Children's perceived social efficacy and efficacy to manage peer pressure for detrimental conduct also contributed to academic attainments but through partially different paths of affective and self-regulatory influence. The impact of perceived social efficacy was mediated through academic aspirations and a low level of depression. Perceived self-regulatory efficacy was related to academic achievement both directly and through adherence to moral self-sanctions for detrimental conduct and problem behavior that can subvert academic pursuits. Familial socioeconomic status was linked to children's academic achievement only indirectly through its effects on parental aspirations and children's prosocialness. The full set of self-efficacy, aspirational, and psychosocial factors accounted for a sizable share of the variance in academic achievement.