Smell, Touch, Listen, Look--Kids Learn, Kids Cook: A Nutrition Education Workshop for Day Care Personnel.

ERIC Educational Resources Information Center

Herr, Judith; And Others

This collection of nutrition education materials is designed for use in inservice training workshops for day care personnel. The document includes a listing of good nutrition concepts, suggestions for cooking in the classroom, meal planning ideas, lesson plan forms and objectives, suggestions for involving parents in nutrition education, and…

Evaluating Home Day Care Mothers' Work with Young Children.

ERIC Educational Resources Information Center

Seattle Community Coll., Washington.

This checklist was developed to determine the skills of day care home mothers before and after training as observed by a day care home educator. Areas evaluated are: Professional Attitude; Parent Relationships; Nutrition; Health and Safety; Baby Care; Preparing the Teaching Environment; Guidance; Teaching Techniques, Language and Literature; Art;…

recycle, replenish, reSTORE

ERIC Educational Resources Information Center

Lansburgh, Therese

1976-01-01

Describes projects of the Maryland Committee for the Day Care of Children aimed at cutting day care costs: a recycling center for discarded industrial materials that can be put to educational uses, and workshops for teachers and volunteers in preschool and day care programs. (ED)

Early Education and Care, and Reconceptualizing Play. Advances in Early Education and Day Care.

ERIC Educational Resources Information Center

Reifel, Stuart, Ed.; Brown, Mac H., Ed.

Providing a forum for current thought about the field of early education and care, this book reviews efforts worldwide to educate young children. The book examines child care quality, presents a cultural feminist perspective on caregiving, discusses curricular issues, and considers the role of play in early childhood practice. The chapters are:…

Nutrition Inservice Education for Urban Day Care Providers: A Comparison of Three Models.

ERIC Educational Resources Information Center

Kaplan, Melissa G.

Three different models of inservice nutrition education implemented by Detroit's Nutrition Education Training (NET) Project are described and compared. The NET Project was funded first as a pilot project in 1978-79, and was refunded in 79-80 and 80-81. The original pilot project goal was to demonstrate the value of teaching urban day care staff…

The Cost and Quality of Full Day, Year-Round Early Care and Education in Massachusetts: Preschool Classrooms [with] Executive Summary.

ERIC Educational Resources Information Center

Marshall, Nancy L.; Creps, Cindy L.; Burstein, Nancy R.; Glantz, Frederic B.; Robeson, Wendy Wagner; Barnett, Steve

There are an estimated 167,000 children in early care and education programs in Massachusetts. In 2000, the state department of education commissioned a study of the cost and quality of early care and education in the state. This report and executive summary are the first from the study, addressing early care and education for preschool-aged…

Day care for pre-school children.

PubMed

Zoritch, B; Roberts, I; Oakley, A

2000-01-01

The debate about how, where and by whom young children should be looked after is one which has occupied much social policy and media attention in recent years. Mothers undertake most of the care of young children. Internationally, out-of-home day-care provision ranges widely. These different levels of provision are not simply a response to different levels of demand for day-care, but reflect cultural and economic interests concerning the welfare of children, the need to promote mothers' participation in paid work, and the importance of socialising children into society's values. At a time when a decline in family values is held responsible for a range of social problems, the day-care debate has a special prominence. To quantify the effects of out-of-home day-care for preschool children on educational, health and welfare outcomes for children and their families. Randomised controlled trials of day-care for pre-school children were identified using electronic databases, hand searches of relevant literature, and contact with authors. Studies were included in the review if the intervention involved the provision of non-parental day care for children under 5 years of age, and the evaluation design was that of a randomised or quasi-randomised controlled trial. A total of eight trials were identified after examining 920 abstracts and 19 books. The trials were assessed for methodological quality. Day-care increases children's IQ, and has beneficial effects on behavioural development and school achievement. Long-term follow up demonstrates increased employment, lower teenage pregnancy rates, higher socio-economic status and decreased criminal behaviour. There are positive effects on mothers' education, employment and interaction with children. Effects on fathers have not been examined. Few studies look at a range of outcomes spanning the health, education and welfare domains. Most of the trials combined non-parental day-care with some element of parent training or education (mostly targeted at mothers); they did not disentangle the possible effects of these two interventions. The trials had other significant methodological weaknesses, pointing to the importance of improving on study design in this field. All the trials were carried out in the USA. Day care has beneficial effect on children's development, school success and adult life patterns. To date, all randomised trials have been conducted among disadvantaged populations in the USA. The extent to which the results are generaliseable to other cultures and socioeconomic groups has yet to be evaluated.

The Role of the Educational Leader in Long Day Care--How Do They Perceive Their Role?

ERIC Educational Resources Information Center

Rouse, Elizabeth; Spradbury, Gail

2016-01-01

National reforms introduced into the early childhood education and care sector across Australia have created a requirement for each service to appoint an "educational" leader to provide curriculum direction to ensure that children achieve quality care and education to lead to positive outcomes. Leadership in the early childhood has often…

Enhancing Peer Interaction during Guided Play in Finnish Integrated Special Groups

ERIC Educational Resources Information Center

Syrjämäki, Marja; Pihlaja, Päivi; Sajaniemi, Nina

2018-01-01

This article focused on the pedagogy that enhances peer interaction in integrated special groups. In Finland, most children identified as having special educational needs (SEN) attend day-care in mainstream kindergarten groups; the rest are in integrated or segregated early childhood special education (ECSE) groups in public day-care centres…

Day Care in the USA, Russia and Finland: Views from Parents, Teachers and Directors.

ERIC Educational Resources Information Center

Hujala-Huttunen, Eeva

1996-01-01

Examined how family and day care are integrated in children's lives in the United States, Russia, and Finland. Found that congruence between parents' and teachers' views concerning upbringing and education was very high within societies, while opinions between societies differed greatly. Results suggest that implementation of early education in…

On the Home Front: Early Care and Education a Top Priority for Military Families

ERIC Educational Resources Information Center

Coleman, Alice

2011-01-01

Military parents with young children report that the need for early care and education services, including high-quality pre-kindergarten, tops their list of day-to-day needs. Frequent relocations and the cycle of deployment--preparation, separation and reunification--all cause disruptions that can have profound emotional and educational…

Dutch psychogeriatric day-care centers: a qualitative study of the needs and wishes of carers.

PubMed

de Jong, Jeltsje D; Boersma, F

2009-04-01

In the past day-care facilities for people with dementia were developed with little input from the users. As these facilities play an increasingly important role in the lives of the growing number of community-living persons with dementia and their caregivers, it now seems obvious to incorporate users' perspectives when establishing or optimizing day care. This study addresses the needs and wishes of informal caregivers when providing skilled psychogeriatric day-care in the Netherlands. This is a qualitative, exploratory study, based on interviews with family caregivers and professional focus groups as the primary data source. Using data from the interviews, the needs and wishes of carers were classed into three general domains: (1) approach to care - relating to shared and tailored care and confidence in professionals as well as the facility as important themes; (2) professional expertise - relating to the carers' need for education and information regarding dementia, available resources, as well as cooperation between professionals; and (3) the day program - concerning the content and structure of the day care. The interviews with the caregivers suggest that the relationship with day-care personnel is an important aspect of psychogeriatric day-care. Caregivers have high expectations regarding the expertise of professionals, but seem to be unaware of available resources and services. Professionals should play a more active role in providing education, advice and support. Above all, the attendees must have a positive experience of the day-care facilities and its activities.

Delivery Issues in the Day Care Debate. Occasional Papers in Education: Paper No. 2 - Policy Studies of the Early Childhood Planning Project.

ERIC Educational Resources Information Center

McGee, Maureen

The question of who should provide day care services is an unresolved issue in the current day care debate and a topic now on the national agenda because it is the common concern of a constellation of diverse, highly motivated interest groups. Motivation for extending day care in the United States stems from several factors: among these are the…

An interprofessional educational approach to oral health care in the geriatric population.

PubMed

Bonwell, Patricia Brown; Parsons, Pamela L; Best, Al M; Hise, Sabrina

2014-01-01

An interprofessional educational approach was used to provide five in-service training sessions for all direct health care providers in a long-term care facility, and one half-day seminar/live webinar for community-licensed health care professionals. Content included presentations by five disciplines: (a) periodontist: oral-systemic relationship, (b) oral pathologist: oral pathology, (c) pharmacist: oral health-pharmacological link, (d) dietitian: oral health-dietary link, and (e) occupational therapist: providing and practicing proper oral hygiene. Significant improvement in posttest scores for the five in-service training sessions and the half-day seminar/live webinar was revealed in t-test results, representing an increase in knowledge gained. Approximately 80% of the 145 participants indicated that they would make a change in patient care. Findings indicate that the in-service training sessions and half-day seminar/live webinar supported development of the geriatric work force by utilizing an interprofessional educational approach which will assist in meeting the oral health care needs of the geriatric population.

Educational video to improve CPAP use in patients with obstructive sleep apnoea at risk for poor adherence: a randomised controlled trial.

PubMed

Guralnick, Amy S; Balachandran, Jay S; Szutenbach, Shane; Adley, Kevin; Emami, Leila; Mohammadi, Meelad; Farnan, Jeanne M; Arora, Vineet M; Mokhlesi, Babak

2017-12-01

Suboptimal adherence to CPAP limits its clinical effectiveness in patients with obstructive sleep apnoea (OSA). Although rigorous behavioural interventions improve CPAP adherence, their labour-intensive nature has limited widespread implementation. Moreover, these interventions have not been tested in patients at risk of poor CPAP adherence. Our objective was to determine whether an educational video will improve CPAP adherence in patients at risk of poor CPAP adherence. Patients referred by clinicians without sleep medicine expertise to an urban sleep laboratory that serves predominantly minority population were randomised to view an educational video about OSA and CPAP therapy before the polysomnogram, or to usual care. The primary outcome was CPAP adherence during the first 30 days of therapy. Secondary outcomes were show rates to sleep clinic (attended appointment) and 30-day CPAP adherence after the sleep clinic visit date. A total of 212 patients met the eligibility criteria and were randomised to video education (n=99) or to usual care (n=113). There were no differences in CPAP adherence at 30 days (3.3, 95% CI 2.8 to 3.8 hours/day video education; vs 3.5, 95% CI 3.1 to 4.0 hours/day usual care; p=0.44) or during the 30 days after sleep clinic visit. Sleep clinic show rate was 54% in the video education group and 59% in the usual care group (p=0.41). CPAP adherence, however, significantly worsened in patients who did not show up to the sleep clinic. In patients at risk for poor CPAP adherence, an educational video did not improve CPAP adherence or show rates to sleep clinic compared with usual care. ClinicalTrials.gov Identifier: NCT02553694. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The Day Care Needs of the Indigent Children of West Virginia, with Recommendations for a Model Day Care Program and Delivery System. Volume 2.

ERIC Educational Resources Information Center

Hodges, Walter L.; And Others

This volume describes and discusses six major proposals for a complete model system of day care for indigent children in West Virginia. The recommendations include: (1) developing more specific objectives to be accomplished for children, parents, care providers, and the state; (2) developing a public education program designed to help parents…

45 CFR Appendix A to Part 96 - Uniform Definitions of Services

Code of Federal Regulations, 2011 CFR

2011-10-01

... transportation. 6. Day Care Services—Children Day care services for children (including infants, pre-schoolers... service counseling for parents, plan development, and licensing and monitoring of child care homes and...; obtaining legal services; and providing counseling, child care education, and training in and development of...

45 CFR Appendix A to Part 96 - Uniform Definitions of Services

Code of Federal Regulations, 2012 CFR

2012-10-01

... transportation. 6. Day Care Services—Children Day care services for children (including infants, pre-schoolers... service counseling for parents, plan development, and licensing and monitoring of child care homes and...; obtaining legal services; and providing counseling, child care education, and training in and development of...

45 CFR Appendix A to Part 96 - Uniform Definitions of Services

Code of Federal Regulations, 2014 CFR

2014-10-01

... transportation. 6. Day Care Services—Children Day care services for children (including infants, pre-schoolers... service counseling for parents, plan development, and licensing and monitoring of child care homes and...; obtaining legal services; and providing counseling, child care education, and training in and development of...

45 CFR Appendix A to Part 96 - Uniform Definitions of Services

Code of Federal Regulations, 2013 CFR

2013-10-01

... transportation. 6. Day Care Services—Children Day care services for children (including infants, pre-schoolers... service counseling for parents, plan development, and licensing and monitoring of child care homes and...; obtaining legal services; and providing counseling, child care education, and training in and development of...

WITHDRAWN: Day care for pre-school children.

PubMed

Zoritch, Bozhena; Roberts, Ian; Oakley, Ann

2016-10-11

The debate about how, where and by whom young children should be looked after is one which has occupied much social policy and media attention in recent years. Mothers undertake most of the care of young children. Internationally, out-of-home day-care provision ranges widely. These different levels of provision are not simply a response to different levels of demand for day-care, but reflect cultural and economic interests concerning the welfare of children, the need to promote mothers' participation in paid work, and the importance of socialising children into society's values. At a time when a decline in family values is held responsible for a range of social problems, the day-care debate has a special prominence. To quantify the effects of out-of-home day-care for preschool children on educational, health and welfare outcomes for children and their families. Randomised controlled trials of day-care for pre-school children were identified using electronic databases, hand searches of relevant literature, and contact with authors. Studies were included in the review if the intervention involved the provision of non-parental day care for children under 5 years of age, and the evaluation design was that of a randomised or quasi-randomised controlled trial. A total of eight trials were identified after examining 920 abstracts and 19 books. The trials were assessed for methodological quality. Day-care increases children's IQ, and has beneficial effects on behavioural development and school achievement. Long-term follow up demonstrates increased employment, lower teenage pregnancy rates, higher socio-economic status and decreased criminal behaviour. There are positive effects on mothers' education, employment and interaction with children. Effects on fathers have not been examined. Few studies look at a range of outcomes spanning the health, education and welfare domains. Most of the trials combined non-parental day-care with some element of parent training or education (mostly targeted at mothers); they did not disentangle the possible effects of these two interventions. The trials had other significant methodological weaknesses, pointing to the importance of improving on study design in this field. All the trials were carried out in the USA. Day care has beneficial effect on children's development, school success and adult life patterns. To date, all randomised trials have been conducted among disadvantaged populations in the USA. The extent to which the results are generaliseable to other cultures and socioeconomic groups has yet to be evaluated.

Creating an educationally minded schedule: one approach to minimize the impact of duty hour standards on intern continuity clinic experience.

PubMed

DeBlasio, Dominick; Kerrey, M Kathleen; Sucharew, Heidi; Klein, Melissa

2014-11-01

To determine if implementing an educationally minded schedule utilizing consecutive night shifts can moderate the impact of the 2011 duty hour standards on education and patient continuity of care in longitudinal primary care experience (continuity clinic). A 14-month pre-post study was performed in continuity clinic with one supervising physician group and two intern groups. Surveys to assess attitudes and education were distributed to the supervising physicians and interns before and after the changes in duty hour standards. Intern groups' schedules were reviewed for the number of regular and alternative day clinic (i.e. primary care experience on a different weekday) sessions and patient continuity of care. Fifteen supervising physicians and 51 interns participated (25 in 2011, 26 in 2012). Intern groups' comfort when discussing patient issues, educational needs and teamwork perception did not differ. Supervising physicians' understanding of learning needs and provision of feedback did not differ between groups. Supervising physicians indicated a greater ability to provide feedback and understand learning needs during regular continuity clinic sessions compared with alternative day clinics (all p < 0.05). No significant difference was detected between intern groups in the number of regularly scheduled continuity clinics, alternative day clinics or patient continuity of care. The 2011 duty hour standards required significant alterations to intern schedules, but educationally minded scheduling limited impact on education and patient continuity in care.

The Cost and Quality of Full-Day Year-Round Early Care and Education in Massachusetts: Infant and Toddler Classrooms

ERIC Educational Resources Information Center

Marshall, Nancy L.; Creps, Cindy L.; Burstein, Nancy R.; Roberts, Joanne; Glantz, Frederic B.; Robeson, Wendy Wagner

2004-01-01

The Massachusetts Cost and Quality Study assessed the quality and costs of early care and education services in Massachusetts, the relationship between quality and costs, and the relationship between the family income of children served and the quality of care provided by early care and education programs. This report presents the findings from…

Processes of Categorisation and the Politics of Belonging in Early Childhood Education and Care: An Infant's Experience in Multi-Age Family Day Care

ERIC Educational Resources Information Center

Stratigos, Tina

2015-01-01

Belonging is emerging as an important concept for early childhood education and care. However, it is one that requires further theorisation beyond everyday or romanticised understandings. The politics of belonging provides a potentially productive focus for thinking about belonging in early childhood education and care because of its attention to…

Training Programs for Family Child Care Providers: An Analysis of Ten Curricula. Second Edition.

ERIC Educational Resources Information Center

Modigliani, Kathy

This report analyzes the following 10 curricula for training programs for family child care providers: (1) Child Care, a family day home care provider program developed by Texas A&M's Agricultural Extension Service; (2) the Family Day Care Education Series, a coordinated resource manual and independent study course, the Active Learning Series,…

Impact of caregivers' education regarding respiratory infections on the health status of day-care children: a randomized trial.

PubMed

Alexandrino, Ana S; Santos, Rita; Melo, Cristina; Bastos, José M

2016-10-01

Acute respiratory infections are the most common illness in childhood, and caregivers often make an excessive use of medication and medical consultations. It is vital to design and implement educational interventions in order to minimize the burden of the disease. This study aimed to evaluate the impact of a health education session (HES) about respiratory infections on the indicators of individual health and health care utilization of day-care children. Randomized controlled trial in 10 day-care centres in Porto, including caregivers (parents or legal tutors) of children under 3 years of age. Children's caregivers were randomly distributed into an Intervention Group (IG), who attended a HES, and a Comparison Group (CG). Children's indicators of individual health and health care utilization were evaluated in both groups, during the month after HES. Children whose caregivers attended to the HES had fewer lower respiratory tract infections (IG = 5.8%; CG = 19.0%; P = 0.050) and fewer acute otitis media (IG = 9.5%; CG = 27.0%; P = 0.030), as well as fewer medical consultations (IG = 38.5% versus CG = 61.9%; P = 0.015) and less antibiotic consumption (IG = 11.5% versus CG = 29.5%; P = 0.022). They were also less absent from day care (IG = 21 days versus CG = 59 days; P = 0.037) and their caregivers were less absent from work (IG = 15 days versus CG = 44 days; P = 0.046). Caregivers who attended HES made more use of nasal irrigation (IG = 79.6% versus CG = 53.3%; P = 0.011). The HES about respiratory infections has positively influenced the indicators of individual health and health care utilization of children attending day-care centres in Porto. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

How Reflective are Teachers? A Study of Kindergarten Teachers' and Special Teachers' Levels of Reflection in Day Care

ERIC Educational Resources Information Center

Pihlaja, Paivi Marjo; Holst, Teija Kristiina

2013-01-01

The purpose of this study is to examine teachers' reflections of their early childhood special education work in Finnish day care. Work contents and work roles have faced many challenges in Early Childhood Special Education (ECSE), and therefore general reflection and research need to be developed. Teachers ("n"?=?218) evaluated, via an…

Improving Genetics Education in Graduate and Continuing Health Professional Education: Workshop Summary

ERIC Educational Resources Information Center

Berger, Adam C.; Johnson, Samuel G.; Beachy, Sarah H.; Olson, Steve

2015-01-01

Many health care providers do not have either the knowledge or the tools they need in order to apply genetic information in their day-to-day practices. This lack of support is contributing to a substantial delay in the translation of genetic research findings, when appropriate, into improvement in patient outcomes within the health care system.…

Diabetes Care as an Active Learning Model of Postgraduate Education and Training for Pharmaceutical Care.

ERIC Educational Resources Information Center

Koda-Kimble, Mary Anne; Batz, Forrest R.

1994-01-01

In a University of California continuing pharmacy education course in diabetes care, practicing pharmacists lived as patients with diabetes for two days and role-played in small groups. One year later, participants reported making changes in their diabetes care-related practice, suggesting its effectiveness in improving practitioners' skill…

[Achievement and Future Direction of the PEACE Project - A National Education Project for Palliative Care Education].

PubMed

Kizawa, Yoshiyuki; Yamamoto, Ryo

2017-07-01

Although palliative care is assuming an increasingly important role in patient care, most physicians did not learn to provide palliative care during their medical training. To address these serious deficiencies in physician training in palliative care, government decided to provide basic palliative education program for all practicing cancer doctors as a national policy namely Palliative care Emphasis program on symptom management and Assessment for Continuous medical Education(PEACE). The program was 2-days workshop based on adult learning theory and focusing on symptom management and communication. In this 9 years, 4,888 educational workshop has been held, and 93,250 physicians were trained. In prospective observational study, both knowledges and difficulties practicing palliative care were significantly improved. In 2017, the new palliative care education program will be launched including combined program of e-learning and workshop to provide tailor made education based on learner's readiness and educational needs in palliative care.

Relationships: The Fundamental R in Education

ERIC Educational Resources Information Center

Ellerbrock, Cheryl R.; Abbas, Bridget; DiCicco, Michael; Denmon, Jennifer M.; Sabella, Laura; Hart, Jennifer

2015-01-01

Through establishing caring relationships with adolescents, secondary teachers cultivate classroom communities that propagate care and promote academic success. Developing a caring classroom community begins on the first day of school and continues throughout the school year. In such communities, educators establish a safe and academic-focused…

Understanding Cortisol Reactivity across the Day at Child Care: The Potential Buffering Role of Secure Attachments to Caregivers

PubMed Central

Badanes, Lisa S.; Dmitrieva, Julia; Watamura, Sarah Enos

2011-01-01

Full-day center-based child care has been repeatedly associated with rising cortisol across the child care day. This study addressed the potential buffering role of attachment to mothers and lead teachers in 110 preschoolers while at child care. Using multi-level modeling and controlling for a number of child, family, and child care factors, children with more secure attachments to teachers were more likely to show falling cortisol across the child care day. Attachment to mothers interacted with child care quality, with buffering effects found for children with secure attachments attending higher quality child care. Implications for early childhood educators are discussed. PMID:22408288

A depression training session with consumer educators to reduce stigmatizing views and improve pharmacists' depression care attitudes and practices.

PubMed

Liekens, Sophie; Smits, Tim; Laekeman, Gert; Foulon, Veerle

2013-08-12

To measure the impact of a depression training day for pharmacists that included a 75-minute session with a consumer educator. The training day included interactive lectures on depression; the effects and side effects of and indications for the use of antidepressants; adherence issues; non-drug treatment options for depression; and basic skills in communication. Pharmacists also participated in a session with a consumer educator and in counseling exercises that included role playing. The study used a randomized, clustered, comparative design to measure pharmacists' stigma, attitudes, and current practice related to the provision of pharmaceutical care to people with depression. Mean scores for depression-care practice after the training session were significantly higher in the intervention group than in the control group. Analysis of the changes between baseline and postintervention measures in both the control and intervention groups confirmed a significant difference in the change in both social distance and practice but no significant difference in the change in attitude between the 2 groups of pharmacists. A continuing-education depression training day for pharmacists that involve consumer educators may improve the care delivered in the community pharmacy to people with depression.

Early Child Care and Education at Hull House: Voices from the Past, Challenges for the Future.

ERIC Educational Resources Information Center

Carlson, Helen L.

1993-01-01

Discussion of Chicago's Hull House centers on the physical and social environments, types of child care offered, learning experiences and environment in the day nursery and kindergarten, and professional education. Implications of Hull House for contemporary child care are described. (BG)

A one-day education in soft tissue massage: experiences and opinions as evaluated by nursing staff in palliative care.

PubMed

Cronfalk, Berit Seiger; Friedrichsen, Maria; Milberg, Anna; Strang, Peter

2008-06-01

Increasing awareness of well-being aspects of physical touch has spurred the appreciation for soft tissue massage (STM) as part of palliative care. Educational programs are available but with no specific focus on utilization for this kind of care. The aim was to study the feasibility of a 1-day course in STM in clarifying nursing staff's experiences and opinions, but also to shed light on their motivation and ability to employ STM in the care of dying cancer patients. In all, 135 nursing staff participated. The course consisted of theory and hands-on training (hand-foot-, back massage). Focus-groups with 30/135 randomly chosen participants were conducted 4 weeks after the intervention. This study engaged a qualitative approach using content analysis. The overall opinion of the 1-day course was positive. The majority experienced the contents of the course to be adequate and sufficient for clinical care. They emphasized the pedagogical expertise as valuable for the learning process. The majority of nurses shared the opinion that their extended knowledge clarified their attitudes on STM as a complement in palliative care. Still, a few found it to be too basic and/or intimate. Three categories emerged during the analysis: experiences of and attitudes toward the education, experiences of implementing the skills in every-day care situations, and attitudes to the physical body in nursing care. The approach to learning and the pedagogical skills of the teacher proved to be of importance for how new knowledge was perceived among nurses. The findings may encourage hospital organizations to introduce short courses in STM as an alternative to more extensive education.

Foundations, Adult Dynamics, Teacher Education and Play. Advances in Early Education and Day Care.

ERIC Educational Resources Information Center

Reifel, Stuart, Ed.

Providing a forum for current thinking related to early care and education, this book presents a wide range of views regarding research methodology, the nature of experience while teaching, teaching and program improvement, and conceptualizing play in the curriculum. The chapters are: (1) "Postmodern Research in Early Childhood Education" (Gaile…

[Day-care mother--a successful model of child rearing?].

PubMed

Schetelig, H

1977-02-17

The scientific reports published so far on the project "day care mothering" do not allow to draw scientific conclusions, whether this educational model can achieve nearly equal results as family education. The author critisises, that such a clame is made. It seems necessary, to pay more importance to the function of the mother for her children, to give the children a sound emotional basis for their future development.

Public/Private Partnership--A Cost Effective Model for Child Day Care Services.

ERIC Educational Resources Information Center

Alisberg, Helene R.

Trends suggest that 11 million children in the United States will need day care services by 1995. Presently, corporations provide child care support through subsidies to low income employees or through community facilities, parent education, and information and referral (I & R) services. Such support results in reduced rates of absenteeism and…

Parent Managed Day Care. Indian-Style.

ERIC Educational Resources Information Center

Taylor, Helen L. Sally

The efforts of a group of Quinault parents and the Early Childhood Education program of Edmonds College resulted in the establishment of a quality child care program which is parent managed, relevant to the community, and able to meet state requirements for day care. Funded by a Technical Assistance Contract and administered by Alaska Federated…

A Learning Center Approach to Infant Education.

ERIC Educational Resources Information Center

Adams, Polly K.; Taylor, Michaell K.

Following a prefatory description of infant development and high-quality infant day care centers, this paper focuses on the construction of learning centers for infants and toddlers in day care. Issues for consideration are specified, and 18 different care/learning centers and 6 work sstations for parents/staff are briefly described. In addition…

Students with Specialized Health Care Needs. ERIC Digest #458.

ERIC Educational Resources Information Center

Sirvis, Barbara

Students with specialized health care needs require specialized technological health care procedures for life support and/or health support during the school day. They may or may not require special education. These children were previously unserved in educational settings. Estimation of their numbers is difficult, but as many as 100,000 infants…

Geriatric Foot Care: A Model Educational Program for Mid-Level Practitioners.

ERIC Educational Resources Information Center

Suggs, Patricia K.; Krissak, Ruth; Caruso, Frank; Teasdall, Robert

2002-01-01

An educational program on geriatric foot care was completed by 59 nurse practitioners, 12 physicians' assistants, and 1 physician. The 3 1/2 day program included interactive sessions, observation, and hands-on patient care. Posttest results and 6-month follow-up showed significant knowledge increases and incorporation of learning into practice.…

Framing the Picture of the Child

ERIC Educational Resources Information Center

Alasuutari, Maarit; Karila, Kirsti

2010-01-01

The paper studies the forms that are used in planning for a child's early childhood education and care in Finnish day care from the perspectives of social constructionism and discourse analysis. It asks how childhood is conceptualised in these forms and what are the social functions of early childhood education and care as implied in the…

Interactive educational simulators in diabetes care.

PubMed

Lehmann, E D

1997-01-01

Since the Diabetes Control and Complications Trial demonstrated the substantial benefits of tight glycaemic control there has been renewed interest in the application of information technology (IT) based techniques for improving the day-to-day care of patients with diabetes mellitus. Computer-based educational approaches have a great deal of potential for patients use, and may offer a means of training more health-care professionals to deliver such improved care. In this article the potential role of IT in diabetes education is reviewed, focusing in particular on the application of compartmental models in both computer-based interactive simulators and educational video games. Close attention is devoted to practical applications-available today-for use by patients, their relatives, students and health-care professionals. The novel features and potential benefits of such methodologies are highlighted and some of the limitations of currently available software are discussed. The need for improved graphical user interfaces, and for further efforts to evaluate such programs and demonstrate an educational benefit from their use are identified as hurdles to their more widespread application. The review concludes with a look to the future and the type of modelling features which should be provided in the next generation of interactive diabetes simulators and educational video games.

Medical education and the ACGME duty hour requirements: assessing the effect of a day float system on educational activities.

PubMed

Roey, Steve

2006-01-01

In July 2003, the Accreditation Council for Graduate Medical Education (ACGME) instituted new resident work hour mandates, which are being shown to improve resident well-being and patient safety. However, there are limited data on the impact these new mandates may have on educational activities. To assess the impact on educational activities of a day float system created to meet ACGME work hour mandates. The inpatient ward coverage was changed by adding a day float team responsible for new patient admissions in the morning, with the on-call teams starting later and being responsible for new patient admissions thereafter. I surveyed the residents to assess the impact of this new system on educational activities-resident autonomy, attending teaching, conference attendance, resident teaching, self-directed learning, and ability to complete patient care responsibilities. There was no adverse effect of the day float system on educational activities. House staff reported increased autonomy, enhanced teaching from attending physicians, and improved ability to complete patient care responsibilities. Additionally, house staff demonstrated improved compliance with the ACGME mandates. The implementation of a novel day float system for the inpatient medicine ward service improved compliance with ACGME work duty requirements and did not adversely impact educational activities of the residency training program.

Statement by Marsden G. Wagner, M. D. Representing the American Public Health Association before the Select Subcommittee on Education, March 3, 1970.

ERIC Educational Resources Information Center

Wagner, Marsden G.

Critical issues in day care and early child education are outlined, and HR Bill 13520 is evaluated. The issues are: (1) the serious shortage of day care for children of working mothers, (2) rapidly increasing evidence that intervention must begin before the age of 3, if the poverty cycle is to be broken, (3) a need for comprehensive, continuous…

A Depression Training Session With Consumer Educators to Reduce Stigmatizing Views and Improve Pharmacists’ Depression Care Attitudes and Practices

PubMed Central

Smits, Tim; Laekeman, Gert; Foulon, Veerle

2013-01-01

Objective. To measure the impact of a depression training day for pharmacists that included a 75-minute session with a consumer educator. Design. The training day included interactive lectures on depression; the effects and side effects of and indications for the use of antidepressants; adherence issues; non-drug treatment options for depression; and basic skills in communication. Pharmacists also participated in a session with a consumer educator and in counseling exercises that included role playing. Assessment. The study used a randomized, clustered, comparative design to measure pharmacists' stigma, attitudes, and current practice related to the provision of pharmaceutical care to people with depression. Mean scores for depression-care practice after the training session were significantly higher in the intervention group than in the control group. Analysis of the changes between baseline and postintervention measures in both the control and intervention groups confirmed a significant difference in the change in both social distance and practice but no significant difference in the change in attitude between the 2 groups of pharmacists. Conclusion. A continuing-education depression training day for pharmacists that involve consumer educators may improve the care delivered in the community pharmacy to people with depression. PMID:23966723

On any Saturday--a practical model for diabetes education.

PubMed

Carter, Inge R; Nash, Creshelle; Ridgway, Andrea

2002-02-01

Patient self-management is an important part of treating chronic diseases. However, many primary care physicians face barriers in offering office-based diabetes education. This paper will discuss a practical program of community-based diabetes education that can be easily modified for a practitioner's office. Half-day diabetes education workshops geared toward local health care providers and patients with diabetes and their families were conducted in two rural communities in Arkansas. Participants were surveyed with respect to the effectiveness of the program and how they would use what they learned in the program. Thirty-one health care providers and 59 patients with diabetes and their families attended. Program evaluation scores were between 4.1 and 5 on a 5-point Likert scale. One third of the patients commented that they had a better understanding of diet and medication use. Feedback from community health care providers noted that attendance in local diabetes support groups increased after the workshops. Diabetes complications have a large impact on the health of the population and a growing economic impact on the health care industry. Although there are many barriers to diabetes education and control, a practical half-day diabetes workshop on any Saturday can be effectively developed and implemented.

Children's Well-Being in Day Care Centres: An Exploratory Empirical Study.

ERIC Educational Resources Information Center

Mayr, Toni; Ulich, Michaela

1999-01-01

Used educators' ratings to describe preschool children's well-being in day care centers. Identified 11 independent dimensions of well-being: empathic, prosocial behavior; social initiative and vitality; self-assertiveness, openness; pleasure in exploring; coping with stress; positive self-defense; pleasure in sensory experiences;…

Family Policy and Practice in Early Child Care. Advances in Early Education and Day Care.

ERIC Educational Resources Information Center

Reifel, Stuart, Ed.; Dunst, Carl J., Ed.; Wolery, Mark, Ed.

Family issues are an abiding concern for members of the profession of early education, and debate regarding government policies about families and child care continues to be timely. This volume provides a foundation for understanding programs, families, and the current social context, as well as particular areas of concern for families and child…

Lewy Body Dementia Glossary

MedlinePlus

... go during the day for activities, socializing, education, physical therapy and health care. These services can TIP: Definitions ... care services, such as disease management, nursing care, physical therapy, occupational therapy, and speech therapy. Assistance with every ...

Improving Tracheostomy Care Delivery: Instituting Clinical Care Pathways and Nursing Education to Improve Patient Outcomes.

PubMed

Colandrea, Maria; Eckardt, Patricia

2016-01-01

The complication rates for tracheostomy patients could be serious and life threatening. As a result, length of stay (LOS) increases and patient outcomes can be negatively impacted. Examples of complications include accidental decannulation, bleeding and total occlusion. Studies suggest there is an inconsistency in tracheostomy care among providers and institutions. Other studies suggest stronger patient outcomes can result from improved staff training and appropriate protocols. The purpose of this study was to develop and test a clinical care pathway (CCP) and nursing education program to improve tracheostomy patient outcomes. The use of a CCP and nursing education program at a tertiary VA Medical Center will: decrease length of stay (LOS). decrease 30 day tracheostomy readmissions. increase patient's readiness for discharge. increase nurses' comfort level with performing tracheostomy care. increase nurses' overall competence with performing tracheostomy care. A quasi-experimental pilot study examining the effect of a CCP compared LOS and complication rates of tracheostomy patients from admission to discharge. The population included veterans from a mid-Atlantic VA Medical Center. This study involved three phases. Phase 1: Administer the Readiness for Hospital Discharge Scale (RHDS) to tracheostomy patients' preintervention. Phase 2: Provide nurses with an educational program pre and post test assessment. Phase 3: Implement the CCP and evaluate patients' readiness for discharge. Comparing the pre-intervention sample of veterans (n = 10) to the post-intervention sample (n = 6), there was an increase in LOS by 1 day. There was a 15 point increase in RHDS from 165 (SD 25.8) to 180 (SD 14.42). This pilot was underpowered with an n = 6, so there was no significant difference in LOS and 30 day readmission rates. Bootstrapping of sample resulted in RHDS p = . 039 and readmission p = .007. A paired-samples t-test was conducted to assess nurses' competence in performing tracheostomy care and nursing comfort level in regards to providing tracheostomy care and discharge education. There was a significant increase in the post-test scores, nursing comfort level providing tracheostomy care and nurses' comfort level providing patient tracheostomy discharge education. The significance of this project improved overall tracheostomy care offered at a mid-Atlantic VA Medical Center. Standardizing tracheostomy care and properly educating nurses and patients, increased patients readiness for hospital discharge and decreased their readmission rates related to tracheostomies.

Physical activity levels among children attending family day care.

PubMed

Rice, Kelly R; Trost, Stewart G

2014-01-01

To objectively measure the physical activity (PA) levels of children attending family day care programs. A total of 114 children from 47 family day care centers wore an accelerometer for the duration of their time in care. Time in moderate-to-vigorous PA (MVPA) and total PA was calculated using previously validated cut points. Children accumulated 5.8 ± 3.2 minutes of MVPA and 10.4 ± 4.4 minutes of total PA per hour of attendance. Boys exhibited significantly higher levels of PA than girls. Among healthy weight children, 4- and 5-year-olds exhibited significantly higher levels of PA than 2- and 3-year-olds. Overweight and obese 4- and 5-year-olds exhibited significantly lower levels of PA than their healthy weight counterparts. Children attending family day care participate in low levels of PA during the child care day. The results highlight the need for effective programs to promote PA in family day care. Copyright © 2014 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

The Early Enrichment Project in Turkey = Le projet de renforcement precoce des potentialites de l'enfant en Turquie. Notes, Comments...No. 193.

ERIC Educational Resources Information Center

Kagiteibasi, Cigdem

This document provides a bilingual (English and French) report on the Turkish Early Enrichment Project, a four-year longitudinal study of the impact of educational day care combined with mother training on child development. This comprehensive approach was compared with custodial day care and home care, both with and without home intervention. The…

Development and Evaluation of a Staff Training Program on Palliative Care for Persons with Intellectual and Developmental Disabilities

ERIC Educational Resources Information Center

Hahn, Joan E.; Cadogan, Mary P.

2011-01-01

Persons with intellectual and developmental disabilities (I/DD) face barriers and disparities at end of life. Among these barriers are limited educational opportunities and a paucity of targeted training materials on palliative care for staff who provide their day-to-day care. This paper reports on a three-phase project undertaken to develop,…

Influence of the day care, home and neighbourhood environment on young children's physical activity and health: protocol for the PLAYCE observational study

PubMed Central

Christian, Hayley; Maitland, Clover; Enkel, Stephanie; Trapp, Georgina; Trost, Stewart G; Schipperijn, Jasper; Boruff, Bryan; Lester, Leanne; Rosenberg, Michael; Zubrick, Stephen R

2016-01-01

Introduction The early years are a critical period in a child's health and development, yet most preschool children fail to meet physical activity guidelines. Outside of the home and neighbourhood, children spend a large proportion of time within early childhood education and care (ECEC) services such as long day care. Research is required to determine how the design of day care outdoor (and indoor) spaces provides opportunities or constraints for physical activity. A significant evidence gap surrounds what objectively measured attributes of the home and neighbourhood environment influence preschoolers’ physical activity. The PLAY Spaces & Environments for Children's Physical Activity (PLAYCE) study will empirically investigate the relative and cumulative influence of the day care, home and neighbourhood environment on preschoolers’ physical activity. Methods and analysis The PLAYCE study is a cross-sectional observational study (April 2015 to April 2018) of 2400 children aged 2–5 years attending long day care in metropolitan Perth, Western Australia. Accelerometers will measure physical activity with indoor physical activity measured using radio frequency identification. Global positioning systems will be used to determine outdoor location of physical activity around the home and neighbourhood for a subsample (n=310). The day care environment will be objectively measured using a validated audit tool. Other potential individual, social and physical environmental influences on preschoolers’ physical activity will be collected by geographic information systems measures, parent and day care educator surveys. Ethics and dissemination Ethical approval has been granted by The University of Western Australia Human Ethics Research Committee, approval number RA/4/1/7417. Findings will be published in international peer-reviewed journals and presented at international conferences. Key findings will be disseminated to stakeholders, collaborators, policymakers and practitioners working in the ECEC sector. Day care centre directors and parents will be given a summary report of the key findings. PMID:27932343

The First Three Years: A Sourcebook on Early Childhood Care and Education. UNESCO-UNICEF Co-operative Programme Digest No. 31.

ERIC Educational Resources Information Center

Swaminathan, Mina

Providing guidelines on day care for children under 3 years of age in developing countries, this digest has been written out of a firm conviction that it is entirely possible for developing countries to provide a system of early childhood care and education that is affordable, humane, culturally appropriate, and supportive of child development.…

"Looking and Listening-In": A Methodological Approach to Generating Insights into Infants' Experiences of Early Childhood Education and Care Settings

ERIC Educational Resources Information Center

Sumsion, Jennifer; Goodfellow, Joy

2012-01-01

In this article, we describe an observational approach, "looking and listening-in," that we have used to try to understand the experience of an infant in an Australian family day-care home. The article is drawn from a larger study of infants' experiences of early childhood education and care settings. In keeping with the mosaic…

Collaboration with Other International Agencies in Community Development Programmes: The Nigerian Experience.

ERIC Educational Resources Information Center

Ajayi, Christie Ade

1993-01-01

Provides an overview of the activities of the World Organization for Early Childhood Education in Nigeria in the areas of the development of grass-roots day-care centers, Van Leer Nigerian Education Trust activities, the training of nursery school teachers, and the celebration of Children's Day. (AC)

Effects of a Geriatrics Interdisciplinary Experience on Learners' Knowledge and Attitudes

ERIC Educational Resources Information Center

Fitzgerald, James T.; Williams, Brent C.; Halter, Jeffrey B.; Remington, Tami L.; Foulk, Mariko A.; Persky, Neal W.; Shay, Barbara R.

2006-01-01

This study examines the impact of an interdisciplinary training program on knowledge and attitudes of learners from four health care programs: medicine, pharmacy, social work, and nursing. Sixty-two learners participated in a 4-day educational program (one day each week for 4 weeks) focusing on interdisciplinary geriatric care. After completing…

Growing Healthy Bodies: Nutrition Education for Day Care Providers.

ERIC Educational Resources Information Center

Viebrock, Margaret A.; Berry, Holly

This booklet discusses the important role that day care providers can play in ensuring that children eat healthy snacks and meals and learn good eating habits. Section one of the booklet examines snack foods, discusses the difference between nutritious and less-nutritious snacks, and recommends snack foods appropriate for different age groups.…

Practice versus Politics in Danish Day-Care Centres: How to Bridge the Gap in Early Learning?

ERIC Educational Resources Information Center

Clasen, Line Engel; Jensen de López, Kristine

2016-01-01

It is essential that early educators in day-care services possess adequate pedagogical tools for supporting children's communicative development. Early literacy programmes (ELPs) are potential tools. However, studies investigating the effects of ELPs seldom address implementation processes or the programme users' perspectives. This study sheds…

On any Saturday--a practical model for diabetes education.

PubMed Central

Carter, Inge R.; Nash, Creshelle; Ridgway, Andrea

2002-01-01

PURPOSE: Patient self-management is an important part of treating chronic diseases. However, many primary care physicians face barriers in offering office-based diabetes education. This paper will discuss a practical program of community-based diabetes education that can be easily modified for a practitioner's office. PROCEDURE: Half-day diabetes education workshops geared toward local health care providers and patients with diabetes and their families were conducted in two rural communities in Arkansas. Participants were surveyed with respect to the effectiveness of the program and how they would use what they learned in the program. FINDINGS: Thirty-one health care providers and 59 patients with diabetes and their families attended. Program evaluation scores were between 4.1 and 5 on a 5-point Likert scale. One third of the patients commented that they had a better understanding of diet and medication use. Feedback from community health care providers noted that attendance in local diabetes support groups increased after the workshops. CONCLUSIONS: Diabetes complications have a large impact on the health of the population and a growing economic impact on the health care industry. Although there are many barriers to diabetes education and control, a practical half-day diabetes workshop on any Saturday can be effectively developed and implemented. PMID:11853048

Development and Preliminary Evaluation of the Resident Coordinated-Transitional Care (RC-TraC) Program: A Sustainable Option for Transitional Care Education

PubMed Central

Chapman, E.; Eastman, A.; Gilmore-Bykovskyi, A.; Vogelman, B.; Kind, A. J.

2016-01-01

Older adults often face poor outcomes when transitioning from hospital to home. Although physicians play a key role in overseeing transitions, there is a lack of practice-based educational programs that prepare resident physicians to manage care transitions of older adults. An educational intervention to provide residents with real-life transitional care practice was therefore developed – Resident-coordinated Transitional Care (RC-TraC). RC-TraC adapted the evidence-based Coordinated-Transitional Care (C-TraC) nurse role for residents, providing opportunities to follow patients during the peri-hospital period without additional costs to the residency program. Between July 2010 and June 2013, thirty-one Internal Medicine residents participated in RC-TraC, caring for 721 patients. RC-TraC has been a sustainable, low-cost, practice-based education experience that is recognized as transitional care education by residents and continues in operation to this day. RC-TraC is a promising option for geriatric-based transitional care education of resident physicians and could also be adapted for non-physician learners. PMID:27749162

Rural Schools and Community Education.

ERIC Educational Resources Information Center

De Largy, Paul

1981-01-01

A community education project in Brooks County, Georgia, began in 1977 with five people, developed county-wide support, and now includes a community education county council, federal funding, volunteer programs, after-school programs, agricultural education (especially swine production), and a day-care center. (AN)

Effect of 16-hour duty periods on patient care and resident education.

PubMed

McCoy, Christopher P; Halvorsen, Andrew J; Loftus, Conor G; McDonald, Furman S; Oxentenko, Amy S

2011-03-01

To measure the effect of duty periods no longer than 16 hours on patient care and resident education. As part of our Educational Innovations Project, we piloted a novel resident schedule for an inpatient service that eliminated shifts longer than 16 hours without increased staffing or decreased patient admissions on 2 gastroenterology services from August 29 to November 27, 2009. Patient care variables were obtained through medical record review. Resident well-being and educational variables were collected by weekly surveys, end of rotation evaluations, and an electronic card-swipe system. Patient care metrics, including 30-day mortality, 30-day readmission rate, and length of stay, were unchanged for the 196 patient care episodes in the 5-week intervention month compared with the 274 episodes in the 8 weeks of control months. However, residents felt less prepared to manage cross-cover of patients (P = .006). There was a nonsignificant trend toward decreased perception of quality of education and balance of personal and professional life during the intervention month. Residents reported working fewer weekly hours overall during the intervention (64.3 vs 68.9 hours; P = .40), but they had significantly more episodes with fewer than 10 hours off between shifts (24 vs 2 episodes; P = .004). Inpatient hospital services can be staffed with residents working shifts less than 16 hours without additional residents. However, cross-cover of care, quality of education, and time off between shifts may be adversely affected.

Effect of 16-Hour Duty Periods on Patient Care and Resident Education

PubMed Central

McCoy, Christopher P.; Halvorsen, Andrew J.; Loftus, Conor G.; McDonald, Furman S.; Oxentenko, Amy S.

2011-01-01

OBJECTIVE: To measure the effect of duty periods no longer than 16 hours on patient care and resident education. PATIENTS AND METHODS: As part of our Educational Innovations Project, we piloted a novel resident schedule for an inpatient service that eliminated shifts longer than 16 hours without increased staffing or decreased patient admissions on 2 gastroenterology services from August 29 to November 27, 2009. Patient care variables were obtained through medical record review. Resident well-being and educational variables were collected by weekly surveys, end of rotation evaluations, and an electronic card-swipe system. RESULTS: Patient care metrics, including 30-day mortality, 30-day readmission rate, and length of stay, were unchanged for the 196 patient care episodes in the 5-week intervention month compared with the 274 episodes in the 8 weeks of control months. However, residents felt less prepared to manage cross-cover of patients (P=.006). There was a nonsignificant trend toward decreased perception of quality of education and balance of personal and professional life during the intervention month. Residents reported working fewer weekly hours overall during the intervention (64.3 vs 68.9 hours; P=.40), but they had significantly more episodes with fewer than 10 hours off between shifts (24 vs 2 episodes; P=.004). CONCLUSION: Inpatient hospital services can be staffed with residents working shifts less than 16 hours without additional residents. However, cross-cover of care, quality of education, and time off between shifts may be adversely affected. PMID:21307390

Short-term effectiveness of a culturally tailored educational intervention on foot self-care among type 2 diabetes patients in Morocco.

PubMed

Adarmouch, Latifa; Elyacoubi, Abdelhadi; Dahmash, Latifeh; El Ansari, Nawal; Sebbani, Majda; Amine, Mohamed

2017-03-01

Self-management education (SME) is an important yet unacknowledged aspect of diabetes care. Despite the raise of diabetes and its complications with significant burden in developing countries, research on SME interventions in Morocco is lacking. To assess the effectiveness of a culturally tailored SME intervention on foot-care self-management practices among type 2 diabetes patients and to identify factors associated with practices variation. We designed a pre-post prospective quasi-experimental study and recruited patients with type 2 diabetes aged 30 years old or above. The intervention consisted of an interactive group discussion using different materials: a narrative video, a PowerPoint presentation and a printed guide. Foot-care practices were assessed prior to the session and one month later using 2 items from the Summary of Diabetes Self-Care Activities (SDSCA). Binary logistic regression was performed to identify factors associated with a favorable variation, defined as an increase in the mean frequency score of foot-care by a minimum of 1 day/week. A total of 199 participants were recruited and 133 completed the second assessment. Mean age was 55.2 ± 11.2 years old. Women represented 67% and 72% of participants was illiterate. The foot-care score mean increased from 3.5 ± 2.9 days to 5.9 ± 1.8 days one month after the intervention (mean variation was 2.4 ± 3.1 days; p < 0.001). A favorable variation was found among 75 (37.7%) participants. In multivariate analysis, literacy was associated with higher likelihood of a favorable variation of foot-care practices (OR = 2.82; 95%CI: 1.09-7.31) while previous education about diabetic foot was associated with lower likelihood of a favorable variation (OR = 0.26; 95%CI: 0.08-0.78). There was a general improvement in foot-care practices after the intervention. Our findings suggest the role of literacy and previous patient education in shaping the observed variation. Culturally tailored interventions targeting other disease management domains are needed in our context.

Distributed Leadership as Administrative Practice in Finnish Early Childhood Education and Care

ERIC Educational Resources Information Center

Kangas, Jonna; Venninen, Tuulikki; Ojala, Mikko

2016-01-01

In this article, we describe the professional development towards distributed leadership among different organizational levels in Finnish day care centres within the Helsinki metropolitan area. The aim of the study was to monitor the progress of professional development between educational administration and practitioners. The data was based on…

The Funding of Early Care and Education Programmes in Sweden, 1845-1943

ERIC Educational Resources Information Center

Westberg, Johannes

2011-01-01

What significance did donations, bequests, tuition fees and fund-raising events have for early care and education programmes during the nineteenth and early twentieth century? Through an examination of 24 Swedish infant schools, day nurseries and free kindergartens, this article verifies that donations and bequests were essential for the economy…

Effect of Intensive Education and Training of Nurses on Ventilator-associated Pneumonia and Central Line-associated Bloodstream Infection Incidence in Intensive Care Unit at a Tertiary Care Center in North India.

PubMed

Sahni, Neeru; Biswal, Manisha; Gandhi, Komal; Kaur, Kulbeer; Saini, Vikas; Yaddanapudi, Lakshminarayana N

2017-11-01

The aim was to analyze the impact of education and training of nurses on the incidence of ventilator-associated pneumonia (VAP) and central line-associated bloodstream infection (CLABSI). A prospective observational study at a tertiary care hospital included adult patients with Intensive Care Unit stay >48 h. The study was done in three phases: in Phase 1, baseline VAP and CLABSI incidence was calculated; in Phase 2, education and training of nurses; and in Phase 3, data were recollected for the incidence of VAP and CLABSI. The baseline incidence of VAP in Phase 1 was 28.86/1000 ventilator days and that of CLABSI was 7.89/1000 central-line days. In Phase 3, the incidence of VAP increased to 35.06 and that of CLABSI decreased significantly, 1.73. Intensive education and training sessions with feedback from nurses over a period of 6 months led to significant reduction in the incidence of CLABSI; however, the incidence of VAP increased.

48 CFR 37.101 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

...), social services, health and mental health care, child (day) care, education (whether or not directly... on an individual or organizational basis. Some of the areas in which service contracts are found...

Burden of allergy diets in Finnish day care reduced by change in practices.

PubMed

Erkkola, M; Saloheimo, T; Hauta-Alus, H; Kukkonen, A K; Virta, S; Kronberg-Kippilä, C; Vaara, E; Pelkonen, A S; Fogelholm, M; Mäkelä, M J

2016-10-01

Nonessential allergy diets in children with mild symptoms may harm the development of immunological tolerance and impose a burden on families and day care. We aimed to reduce the high prevalence of allergy diets in day care by reforming the practices for inquiring about need of special diets from parents. We developed a new special diet form and an information leaflet based on the new allergy guidelines. The new form was implemented into 40 Finnish day care centres in the capital region in 2013-2015. The questionnaires on practices concerning special diets in day care centres and allergy knowledge were collected from the personnel. After 2 years, the new special diet form was used by 64% of families with food-allergic children, and the prevalence of allergy diets in day care centres decreased by 43% to 4.3% (IQ range 3.05-5.96). A significant decrease was found in the prevalence of all basic (milk, grains, egg) and most other allergy diets (P for trend < 0.01). The new practice was well accepted by day care and kitchen personnel. Lack of updated allergy knowledge was noted among day care personnel. The burden of allergy diets in day care settings could be decreased by simple pragmatic changes based on current allergy guidelines. Old allergy attitudes persisted among day care personnel, indicating the need for continuous education. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A Curriculum Guide for Inservice Education of Group Day Care and Nursery School Personnel.

ERIC Educational Resources Information Center

Thielges, Iva; Andersen, Rose

This curriculum guide outlines 10 inservice training courses for group day care and nursery school personnel. Each course outline presents a list of learning experiences and related resources from which the instructor can choose to meet the needs of his/her students. Materials are designed to meet the Minnesota Department of Public Welfare…

A Model Parental Involvement Program for Bilingual/Bicultural Developmental Day Care.

ERIC Educational Resources Information Center

de Avila, Marcia Freedman

Parental involvement in migrant education is now being mandated across the country. Parental involvement in bilingual/bicultural day care is just as, if not more, important than involvement at the public school level. This study was conducted to test whether or not parental involvement could become an active component in a bilingual/bicultural day…

Illinois: Child Care Collaboration Program

ERIC Educational Resources Information Center

Center for Law and Social Policy, Inc. (CLASP), 2012

2012-01-01

The Illinois Child Care Collaboration Program promotes collaboration between child care and other early care and education providers, including Early Head Start (EHS), by creating policies to ease blending of funds to extend the day or year of existing services. While no funding is provided through the initiative, participating programs may take…

45 CFR 605.38 - Preschool and adult education.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 3 2011-10-01 2011-10-01 false Preschool and adult education. 605.38 Section 605... Preschool, Elementary, and Secondary Education § 605.38 Preschool and adult education. A recipient to which this subpart applies that provides preschool education or day care or adult education may not, on the...

45 CFR 84.38 - Preschool and adult education.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Preschool and adult education. 84.38 Section 84.38..., and Secondary Education § 84.38 Preschool and adult education. A recipient to which this subpart applies that provides preschool education or day care or adult education may not, on the basis of handicap...

45 CFR 84.38 - Preschool and adult education.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Preschool and adult education. 84.38 Section 84.38..., and Secondary Education § 84.38 Preschool and adult education. A recipient to which this subpart applies that provides preschool education or day care or adult education may not, on the basis of handicap...

45 CFR 84.38 - Preschool and adult education.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false Preschool and adult education. 84.38 Section 84.38..., and Secondary Education § 84.38 Preschool and adult education. A recipient to which this subpart applies that provides preschool education or day care or adult education may not, on the basis of handicap...

45 CFR 84.38 - Preschool and adult education.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Preschool and adult education. 84.38 Section 84.38..., and Secondary Education § 84.38 Preschool and adult education. A recipient to which this subpart applies that provides preschool education or day care or adult education may not, on the basis of handicap...

45 CFR 605.38 - Preschool and adult education.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 3 2013-10-01 2013-10-01 false Preschool and adult education. 605.38 Section 605... Preschool, Elementary, and Secondary Education § 605.38 Preschool and adult education. A recipient to which this subpart applies that provides preschool education or day care or adult education may not, on the...

45 CFR 84.38 - Preschool and adult education.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Preschool and adult education. 84.38 Section 84.38..., and Secondary Education § 84.38 Preschool and adult education. A recipient to which this subpart applies that provides preschool education or day care or adult education may not, on the basis of handicap...

45 CFR 605.38 - Preschool and adult education.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Preschool and adult education. 605.38 Section 605... Preschool, Elementary, and Secondary Education § 605.38 Preschool and adult education. A recipient to which this subpart applies that provides preschool education or day care or adult education may not, on the...

Joining-up and Scaling-up: A Vision for Early Childhood Education and Care

ERIC Educational Resources Information Center

Friendly, Martha

2010-01-01

It has become commonplace for Canada to take last place in international comparisons of early childhood education and care (ECEC) arrangements or to be chastised and exhorted to do better. In 2007, Ontario Premier Dalton McGuinty, following on an election commitment to bring in "full-day early learning", appointed a Special Advisor on…

Comparative Benefit-Cost Analysis of the Abecedarian Program and Its Policy Implications

ERIC Educational Resources Information Center

Barnett, W. S.; Masse, Leonard N.

2007-01-01

Child care and education are to some extent joint products of preschool programs, but public policy and research frequently approach these two goals independently. We present a benefit-cost analysis of a preschool program that provided intensive education during full-day child care. Data were obtained from a randomized trial with longitudinal…

Challenges in the management of nutritional disorders and communicable diseases in child day care centers: a quantitative and qualitative approach.

PubMed

Konstantyner, Tulio; Konstantyner, Thais Cláudia Roma de Oliveira; Toloni, Maysa Helena Aguiar; Longo-Silva, Giovana; Taddei, José Augusto de Aguiar Carrazedo

2017-03-01

In Brazil, although many children from low income families attend day care centers with appropriate hygiene practices and food programs, they have nutritional disorders and communicable diseases. This quantitative and qualitative cross-sectional study identified staff challenges in child day care centers and suggested alternative activity management to prevent nutritional disorders and communicable diseases. The study included 71 nursery teachers and 270 children from public and philanthropic day care centers (teacher to child ratios of 1:2.57 and 1:6.40, respectively). Interviews and focus groups were conducted with teachers and parents, and anthropometry and blood samples were drawn from the children by digital puncture. Children in philanthropic child day care centers were more likely to be hospitalized due to communicable diseases. Teachers from philanthropic child day care centers had lower age, income and education and higher work responsibilities based on the number of children and working time. The focus groups characterized institutions with organized routines, standard food practices, difficulties with caretaking, and lack of training to provide healthcare to children. Strategies to improve children's health in day care settings should focus on training of teachers about healthcare and nutrition.

48 CFR 37.101 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... CONTRACTING SERVICE CONTRACTING Service Contracts-General 37.101 Definitions. As used in this part— Child care services means child protective services (including the investigation of child abuse and neglect reports), social services, health and mental health care, child (day) care, education (whether or not directly...

48 CFR 37.101 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... CONTRACTING SERVICE CONTRACTING Service Contracts-General 37.101 Definitions. As used in this part— Child care services means child protective services (including the investigation of child abuse and neglect reports), social services, health and mental health care, child (day) care, education (whether or not directly...

48 CFR 37.101 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... CONTRACTING SERVICE CONTRACTING Service Contracts-General 37.101 Definitions. As used in this part— Child care services means child protective services (including the investigation of child abuse and neglect reports), social services, health and mental health care, child (day) care, education (whether or not directly...

Does More Equal Better, and for Whom? Discourse and Practice in Parent Education.

ERIC Educational Resources Information Center

Loveridge, Judith

The ideas, practices, and day-to-day impact of parent education should be critically examined, and Michel Foucault's conception of discourse provides a useful model for doing so. Contemporary discourses about becoming a parent achieve their authority in different ways. In contrast to the child care literature by so-called experts earlier in this…

A Day in the Life of a Psychiatry Resident: A Pilot Qualitative Analysis

ERIC Educational Resources Information Center

Hilty, Donald M.; Maynes, Sonya M.; Kellner, Maria; Clark, Marilyn S.; Bourgeois, James A.; Servis, Mark E.

2005-01-01

Objective: The topic "A Day in the Life of a Psychiatry Resident" is an opportunity to explore residents' experiences to inform the delivery of education. Methods: An open-ended, qualitative approach was used in a pilot project to explore contemporary residents' experiences with education, similar to a patient-centered model of health care.…

Influence of the day care, home and neighbourhood environment on young children's physical activity and health: protocol for the PLAYCE observational study.

PubMed

Christian, Hayley; Maitland, Clover; Enkel, Stephanie; Trapp, Georgina; Trost, Stewart G; Schipperijn, Jasper; Boruff, Bryan; Lester, Leanne; Rosenberg, Michael; Zubrick, Stephen R

2016-12-08

The early years are a critical period in a child's health and development, yet most preschool children fail to meet physical activity guidelines. Outside of the home and neighbourhood, children spend a large proportion of time within early childhood education and care (ECEC) services such as long day care. Research is required to determine how the design of day care outdoor (and indoor) spaces provides opportunities or constraints for physical activity. A significant evidence gap surrounds what objectively measured attributes of the home and neighbourhood environment influence preschoolers' physical activity. The PLAY Spaces & Environments for Children's Physical Activity (PLAYCE) study will empirically investigate the relative and cumulative influence of the day care, home and neighbourhood environment on preschoolers' physical activity. The PLAYCE study is a cross-sectional observational study (April 2015 to April 2018) of 2400 children aged 2-5 years attending long day care in metropolitan Perth, Western Australia. Accelerometers will measure physical activity with indoor physical activity measured using radio frequency identification. Global positioning systems will be used to determine outdoor location of physical activity around the home and neighbourhood for a subsample (n=310). The day care environment will be objectively measured using a validated audit tool. Other potential individual, social and physical environmental influences on preschoolers' physical activity will be collected by geographic information systems measures, parent and day care educator surveys. Ethical approval has been granted by The University of Western Australia Human Ethics Research Committee, approval number RA/4/1/7417. Findings will be published in international peer-reviewed journals and presented at international conferences. Key findings will be disseminated to stakeholders, collaborators, policymakers and practitioners working in the ECEC sector. Day care centre directors and parents will be given a summary report of the key findings. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

'I learn something new every day'.

PubMed

2017-05-24

Maggie Bennett qualified as a registered nurse in Birmingham in 1992, working initially in intensive care. Two years later she moved back to Northern Ireland, continuing in intensive care then community nursing and practice education.

Cost-effective wound management: a survey of 1717 nurses.

PubMed

Newton, Heather

2017-06-22

Delivering high-quality wound care requires a mix of knowledge and skills, which nurses aim to update by attending educational events such as conferences and study days. This article describes the data obtained from 30 educational study days, which took place across England, Scotland and Wales. It will explore nurses' knowledge in relation to the cost-effectiveness and clinical efficacy of current wound care practices, based on the answers of 1717 delegates that attended the events. It will also outline the results in relation to reducing expenditure on wound dressings and the importance of performing an accurate wound assessment.

Visiting nursery, kindergarten and after-school day care as astronomy for development

NASA Astrophysics Data System (ADS)

Tomita, Akihiko

2015-08-01

One of the frontiers of astronomy for development is astronomy education for young children. Note that it is not too-much-going-ahead education nor education for so-called gifted children. It is for all children in various situations. As an example, I present "Uchu no O-hanashi," a visiting activity which includeds slide show, story telling, and enjoying pictures on large sheets for children. Not only just for young children, but this activity also aims at intercultural understanding. Sometimes guest educator from abroad join the activity. Video letter exchange was successful even though there is a language barrier. For assessment of the activity, I have recorded the voice of children. I will present various examples of written records and their analysis of activites, at nursery, kindergarten, preschool, after-school day care for primary school children, and other sites. I hope exchanging the record will make a worldwide connection among educators for very young children.

Learning that leads to action: impact and characteristics of a professional education approach to improve the care of critically ill children and their families.

PubMed

Solomon, Mildred Z; Browning, David M; Dokken, Deborah L; Merriman, Melanie P; Rushton, Cynda H

2010-04-01

To determine the impact of an innovative professional educational approach on clinicians' confidence and ability to make institutional improvements in pediatric palliative care. Evaluation to assess impact of educational intervention on participants and participant institutions. Retreats lasting 2.5 days. Physicians, nurses, psychosocial staff, and bereaved parents. "Relational learning across boundaries" pedagogy. Analysis of participant questionnaires (n = 782, response rate of 84%), team leader surveys (n = 72, response rate of 71%), and follow-up interview with subsample (n = 21, response rate of 81%). Outcomes included confidence to act and institutional improvements achieved. Seventy-four percent of team leaders reported significant or moderate improvement in pediatric palliative care after the retreat; only 1% reported no improvement. Ninety-one percent credited the retreat experience as being somewhat or very instrumental to the improvements, which included the establishment of pediatric palliative care and bereavement programs, improvements in interdisciplinary communication, care coordination, clinician-family interaction at the bedside, and educational programs. Participants attributed the impact of the 2.5-day retreat to its key pedagogical features, involvement of family members as equal participants and participation of colleagues from other disciplines and care settings, as well as the ground rules used for the small group seminars. The intervention was successful in improving clinicians' confidence and catalyzed improvements in pediatric palliative care within participating institutions. Relational learning holds promise for professional learning, especially when the educational goal is tied to enabling a shift in social and ethical norms.

Thin Blue Lines and Red Crosses: Signposts to Quality in Family Day Care?

ERIC Educational Resources Information Center

White, Jayne

2005-01-01

This paper explores some of the findings of a study focussing on constructions of family day care from the perspectives of caregivers/educators and coordinators as they engaged in a quality review process using a recently developed resource--The Quality Journey/He haerenga whai hua (2000). The paper positions quality review as a part of a…

How To Start a Family Day Care = Como Iniciar una Guarderia en El Hogar. [Videotape and Viewer's Guide].

ERIC Educational Resources Information Center

Raphael, Doris; Weisman, Douglas

Being a family day care provider is work that requires professional responsibilities and attention to the physical, emotional, and educational well-being of children; listening and responding to parents; and running a business. This videotape, in English- and Spanish-language versions, explores the elements involved in starting up a family day…

Interprofessional care collaboration for patients with heart failure.

PubMed

Boykin, Amanda; Wright, Danielle; Stevens, Lydia; Gardner, Lauren

2018-01-01

An innovative collaborative care model to improve transitions of care (TOC) for patients with heart failure (HF) is described. As part of a broad effort by New Hanover Regional Medical Center (NHRMC) to reduce avoidable 30-day hospital readmissions and decrease associated healthcare costs through a team-centered, value-based approach to patient care, an interprofessional team was formed to help reduce hospital readmissions among discharged patients with HF. The team consists of 5 TOC pharmacists, 4 community paramedics, and 4 advanced care practitioners (ACPs) who collaborate to coordinate care and prevent 30-day readmissions among patients with HF transitioning from the hospital to the community setting. Each team member plays an integral role in providing high-quality postdischarge care. The TOC pharmacist ensures that patients have access to all needed medications, provides in-home medication reconciliation services, makes medication recommendations, and alerts the team of potential medication-related issues. Community paramedics conduct home visits consisting of physical and mental health assessments, diet and disease state education, reviews of medication bottles and education on proper medication use, and administration of i.v. diuretics to correct volume status under provider orders. The ACPs offer close clinic follow-up (typically initiated within 7 days of discharge) as well as long-term HF management and education. At NHRMC, collaboration among healthcare professionals, including a TOC pharmacist, community paramedics, and ACPs, has assisted in the growth and expansion of services provided to patients with HF. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

48 CFR 352.237-72 - Crime Control Act-requirement for background checks.

Code of Federal Regulations, 2010 CFR

2010-10-01

... of 1990 (Act), requires that all individuals involved with the provision of child care services to children under the age of 18 undergo a criminal background check. “Child care services” include, but are not limited to, social services, health and mental health care, child (day) care, education (whether...

48 CFR 352.237-72 - Crime Control Act-requirement for background checks.

Code of Federal Regulations, 2012 CFR

2012-10-01

... of 1990 (Act), requires that all individuals involved with the provision of child care services to children under the age of 18 undergo a criminal background check. “Child care services” include, but are not limited to, social services, health and mental health care, child (day) care, education (whether...

48 CFR 352.237-72 - Crime Control Act-requirement for background checks.

Code of Federal Regulations, 2013 CFR

2013-10-01

... of 1990 (Act), requires that all individuals involved with the provision of child care services to children under the age of 18 undergo a criminal background check. “Child care services” include, but are not limited to, social services, health and mental health care, child (day) care, education (whether...

48 CFR 352.237-72 - Crime Control Act-requirement for background checks.

Code of Federal Regulations, 2011 CFR

2011-10-01

... of 1990 (Act), requires that all individuals involved with the provision of child care services to children under the age of 18 undergo a criminal background check. “Child care services” include, but are not limited to, social services, health and mental health care, child (day) care, education (whether...

48 CFR 352.237-72 - Crime Control Act-requirement for background checks.

Code of Federal Regulations, 2014 CFR

2014-10-01

... of 1990 (Act), requires that all individuals involved with the provision of child care services to children under the age of 18 undergo a criminal background check. “Child care services” include, but are not limited to, social services, health and mental health care, child (day) care, education (whether...

A Report to the President of the United States [from the] Intergovernmental Advisory Council on Education, National Networking Conference [on] The Absent Parent (Washington, D.C. May 9-10, 1988).

ERIC Educational Resources Information Center

Intergovernmental Advisory Council on Education (ED), Washington, DC.

This report on child care and the Federal government's role in child care is based on the National Networking Conference on the Absent Parent which was held May 9-10, 1988 under the sponsorship of the President's Intergovernmental Advisory Council on Education (IACE). The report begins with 12 recommendations concerning day care and latchkey…

Nurse executives: new roles, new opportunities.

PubMed

Kleinman, C S

1999-01-01

As women have been nursing since the earliest days of recorded civilization, so nurses have been associated with health care since the earliest days of recorded medical history. Gender and function have been inextricably woven in ways that created a struggle for success within a male-dominated industry. Nurses, as women, have been undervalued as, until recently, their role in health care has been similarly undervalued. Changing realities in the health care environment have created an opportunity for women's unique skills and talents to be revalued in a way that offers new opportunities for nurses. Teamwork, global thinking, multitasking, creativity, and flexibility are characteristics that have assumed new importance in the marketplace. Nursing leaders possess these attributes, along with a strong clinical foundation that is integrated with knowledge of sound business principles. This combination now positions nurse executives to reach the highest levels of heath care administration. Critical to this achievement is the professional credibility obtained through education at the master's degree level in health care and nursing administration programs that provide the essential tools for professional success. New opportunities for nurse executives afford educators in health care and nursing administration similar opportunities to develop and market programs to this large group of health care professionals who are seeking graduate education in increasing numbers.

Educating nurse leaders in ethics and end-of-life care.

PubMed

Simpson, M

1999-01-01

The Midwest Bioethics Center's Nursing Leadership Institute 1999 focused on leadership in ethics and end-of-life care. Twenty-four nurses attended the four-day retreat, during which national speakers, community experts, and Center staff facilitated the continuing education of nurse leaders dedicated to improving end-of-life care in their communities. All participants in the Institute agreed to design and implement a community project for their constituency. Project reports will be made prior to the next nursing leadership institute. This article examines the role of nurses in providing end-of-life care.

Are We There Yet? Early Years Reform in Queensland: Stakeholder Perspectives on the Introduction of Funded Preschool Programs in Long Day Care Services

ERIC Educational Resources Information Center

Irvine, Susan; Farrell, Ann

2013-01-01

Australian educators are currently engaging with wide-ranging, national early childhood reform that is reshaping Early Childhood Education and Care (ECEC). The Australian reform agenda reflects many of the early childhood policy directions championed by bodies, such as the Organisation for Economic Cooperation and Development and the United…

Caregiver Education Reduces the Incidence of Community-Acquired CLABSIs in the Pediatric Patient With Intestinal Failure.

PubMed

Drews, Barbie; Macaluso, Michelle; Piper, Hannah; Channabasappa, Nandini

Pediatric patients with intestinal failure often require central venous catheters for extended periods of time for parenteral nutrition, blood sampling, and medication administration, increasing morbidity, mortality, and costs. In 2007, we reported a central line-associated bloodstream infection rate of 7.0 per 1,000 catheter line-days in our pediatric patients with intestinal failure. On the basis of this high rate of catheter-associated infections, we developed and implemented a central line care curriculum for patients/family caregivers and home health nurses. We aim to show with the implementation of patient/family caregiver and home health nurse standardized education, the central line-associated bloodstream infection rate can be significantly reduced and that this is sustainable. A retrospective review of 80 pediatric outpatients with intestinal failure and long-term central venous access was performed between January 1, 2009, and December 31, 2014. During this time period, the nursing department at Children's Medical Center of Dallas implemented a systematic central line care education program for patients and/or caregivers. The number of community-acquired central line-associated bloodstream infections during this time period was collected and compared with our previously reported data from 2005 to 2007 prior to the implementation of education program. With the implementation of standardized care guidelines and a central venous catheter care curriculum, the community-acquired rate decreased from 4.8 to 2.9 per 1,000 catheter-days in 80 patients with intestinal failure between January 1, 2009, and December 31, 2014 (p < .001). This was also a significant decrease compared with the initial central line-associated bloodstream infection rate of 7.0 per 1,000 central line days in 2007 (p < .001) prior to the development of the central venous catheter care curriculum. We have shown that the incidence of community-acquired central line-associated bloodstream infections in children with intestinal failure can be reduced through formal education of central venous catheter care to family members.

Psychological, Behavioral, and Educational Considerations for Children with Classified Disabilities and Diabetes within the School Setting

ERIC Educational Resources Information Center

Wyckoff, Leah; Hanchon, Timothy; Gregg, S. Renee

2015-01-01

School nurses are answering a call to action to provide day-to-day care for an increasing number of students diagnosed with chronic illnesses. Diabetes mellitus is one of the most prevalent chronic health conditions identified among school-age children and presents a host of complex challenges for the school nurse, educators, and other support…

Chronically ill rural women: self-identified management problems and solutions.

PubMed

Cudney, Shirley; Sullivan, Therese; Winters, Charlene A; Paul, Lynn; Oriet, Pat

2005-03-01

To add to the knowledge base of illness management of chronically ill, rural women by describing the self-identified problems and solutions reported by women participants in the online health-education segment of the Women to Women (WTW) computer outreach project. WTW is a research-based computer intervention providing health education and online peer support for rural women with chronic diseases. Messages posted to the online chat room were examined to determine the women's self-management problems and solutions. The self-identified problems were: (1) difficulties in carrying through on self-management programmes; (2) negative fears and feelings; (3) poor communication with care providers; and (4) disturbed relationships with family and friends. The self-identified solutions to these problems included problem-solving techniques that were tailored to the rural lifestyle. Although not all problems were 'solvable', they could be 'lived with' if the women's prescriptions for self-management were used. Glimpses into the women's day-to-day experiences of living with chronic illness gleaned from the interactive health-education discussions will give health professionals insights into the women's efforts to manage their illnesses. The data provide health professionals with information to heighten their sensitivity to their clients' day-to-day care and educational needs.

A Study Tour of India.

ERIC Educational Resources Information Center

French, Shirley

1992-01-01

Describes 1991 site visits by British educational administrators of early childhood educational institutions in Delhi and Bombay, India. Discusses philosophies and practices witnessed at a national center providing preschool education and meals, a mobile day-care center for children of migrant workers, a preschool teacher training institute, and…

Reflective Dialogues in Community Music Engagement: An Exploratory Experience in a Singapore Nursing Home and Day-Care Centre for Senior Citizens

ERIC Educational Resources Information Center

Lum, Chee-Hoo

2011-01-01

This study documents a reflective journey of a community music programme initiated by a university music education faculty member and an occupational therapist within the setting of a nursing home and day-care centre in Singapore. Weekly music interaction sessions in conjunction with reminiscence therapy were conducted over a period of five…

Evaluation of Street Projects for the Spanish Speaking. Findings, Conclusions, Recommendations. Volume II of a Two-Volume Report.

ERIC Educational Resources Information Center

Vasquez Associates Ltd., Milwaukee, WI.

Nine Street Projects designed for the Spanish speaking and funded by Region V of the Department of Health, Education and Welfare (HEW) are examined here. They were: the El Hogar del Nino Day Care Center, Spanish-American Day Care Center, United Migrant Opportunity Services' Bilingual/Bicultural Early Childhood Center, Youth Services at El Centro…

Evaluation of employees in public day care centers knowledge about breastfeeding and complementary feeding.

PubMed

Souza, Joelânia Pires de O; Prudente, Amanda Moura; Silva, Dyene Aparecida; Pereira, Leandro Alves; Rinaldi, Ana Elisa M

2013-12-01

To evaluate the knowledge of public day care centers employees about breastfeeding and complementary feeding. A cross-sectional study was conducted in 15 public day care centers randomly selected in the city of Uberlandia, Southeast Brazil. A questionnaire applied to school principals, teachers, educators and general services assistants (GSA) included demographic and socioeconomic variables and questions about knowledge on breastfeeding, complementary feeding besides employees' perceptions about these subjects. Kruskal-Wallis with multiple comparison and chi-square tests were used to compare variables by professional category. 304 employees participated in the study. The highest percentages of correct answers were noted for questions about exclusive breastfeeding: definition - 97% (n=296) and duration - 65% (n=199). Regarding complementary feeding, 61% (n=187) correctly answered about the appropriate age to introduce it, with a lower percentage for meat (56%; n=170) and sugar (16%; n=50). Concerning employees' perceptions, 9% (n=29) believed that there is weak breast milk, 79% (n=241) and 51% (n=157) reported the negative influence of bottle feeding and pacifier use on breastfeeding. Among the interviewed subjects, 77% (n=234) answered that they had a positive influence on the quality of the food given to the children. There were no differences in the answers according to professional category, except for the negative influence of pacifiers on breastfeeding. Employees of public day care centers knew more about breastfeeding than about complementary feeding. Educational activities about breastfeeding and complementary feeding are necessary for day care centers employees.

Evaluation of a Continuing Medical Education Program on Toxicologic Care.

ERIC Educational Resources Information Center

Fore, Robert C.; And Others

1993-01-01

Physicians and other health professionals attended either a two-day voluntary (n=27) or one-day mandatory (n=23) conference on toxicology. Groups did not differ in pretest/posttest scores; two-day participants were significantly more satisfied. Both groups demonstrated significant knowledge gains. (SK)

A Little Adventure Can Go a Long Way! Reintroducing Adventure Education into the Curriculum Conversation

ERIC Educational Resources Information Center

Heath, Jeffrey A.

2017-01-01

Although there has been a call for the reconceptualization of modern-day physical education, team sports continue to dominate the physical education curriculum landscape. With less time being devoted to physical education than ever before, physical educators must carefully choose which units of instruction they will present to their students. For…

An Educational Intervention to Evaluate Nurses' Knowledge of Heart Failure.

PubMed

Sundel, Siobhan; Ea, Emerson E

2018-07-01

Nurses are the main providers of patient education in inpatient and outpatient settings. Unfortunately, nurses may lack knowledge of chronic medical conditions, such as heart failure. The purpose of this one-group pretest-posttest intervention was to determine the effectiveness of teaching intervention on nurses' knowledge of heart failure self-care principles in an ambulatory care setting. The sample consisted of 40 staff nurses in ambulatory care. Nurse participants received a focused education intervention based on knowledge deficits revealed in the pretest and were then resurveyed within 30 days. Nurses were evaluated using the valid and reliable 20-item Nurses Knowledge of Heart Failure Education Principles Survey tool. The results of this project demonstrated that an education intervention on heart failure self-care principles improved nurses' knowledge of heart failure in an ambulatory care setting, which was statistically significant (p < .05). Results suggest that a teaching intervention could improve knowledge of heart failure, which could lead to better patient education and could reduce patient readmission for heart failure. J Contin Educ Nurs. 2018;49(7):315-321. Copyright 2018, SLACK Incorporated.

Knowledge Confidence and Desire for Further Diabetes-Management Education among Nurses and Personal Support Workers in Long-Term Care.

PubMed

Vincent, Corita; Hall, Peter; Ebsary, Sally; Hannay, Scott; Hayes-Cardinal, Lynn; Husein, Nadira

2016-06-01

Diabetes care in the long-term care (LTC) setting is complicated by increased prevalence of comorbidities, age-related changes in medication tolerance, frailty and limited resources. Registered nurses (RNs), registered practical nurses (RPNs) and personal support workers (PSWs) are responsible for front-line diabetes care; however, there is limited formal diabetes education in this setting. The current study aimed to assess the knowledge confidence and desire for additional diabetes education among nurses and PSWs in the LTC setting. We studied 89 RNs, RPNs and PSWs (Mage=43.6, 94.3% female) in 2 LTC facilities in the Kitchener-Waterloo area who participated in an online survey assessing knowledge and confidence in 6 key areas of diabetes care (nutrition, insulin, oral medications, hypoglycemia, hyperglycemia and sick-day management). Interest in further diabetes education was also explored. Self-rated knowledge and confidence were generally moderate to high, ranging from 46% to 79% being moderately to very knowledgeable and from 61% to 74% being moderately to very confident. Knowledge and confidence was highest for nutrition and management of hypo- and hyperglycemia and lower for sick-day management, oral medications and insulin. There were significant differences between clinicians such that PSWs reported less knowledge and confidence than RNs and RPNs on most parameters. Among the whole sample, 85% wanted education about diabetes, and this rate did not vary by occupation. The most commonly reported areas for additional education concerning diabetes were for management of hypo- and hyperglycemia (30% to 31%) and insulin (31%). Overall, the findings indicate moderate levels of self-rated knowledge across diabetes care areas; however, most clinicians feel there is room for more diabetes-care education, particularly regarding insulin and management of hypo- and hyperglycemia. Copyright © 2015 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

Music Education for Young Children in Scandinavia: Policy, Philosophy, or Wishful Thinking?

ERIC Educational Resources Information Center

Holgersen, Sven-Erik

2008-01-01

The author discusses current policies, philosophies, and educational practices of early childhood music education in Scandinavia (Denmark, Norway, and Sweden) and to what extent they meet the challenges of music education for young children. Nearly all children use day care provisions, and they are a governmental responsibility. The author reviews…

Outcomes of a diabetes education program for registered nurses caring for individuals with diabetes.

PubMed

Yacoub, Mohammed Ibrahim; Demeh, Waddah M; Barr, Jennifer L; Darawad, Muhammad W; Saleh, Ali M; Saleh, Mohammad Y N

2015-03-01

Nurses from various setting lack sufficient knowledge about diabetes and diabetes management. Better understand of evidence-based practices by nurses who are involved in caring for hospitalized individuals with diabetes can positively influence care outcomes. A pretest design was used to evaluate the effectiveness of a diabetes education program for RNs working voluntarily participated. A 1-day education program was developed and delivered to the participating nurses. Knowledge regarding diabetes was tested before and after the education program. a significant difference was noted in the modified diabetes basic knowledge mean test scores before and after implementation of the education program (t[128] = 17.95, P < 0.001). The diabetes education program had a positive on nurses' knowledge. This finding has implications for developing diabetes education content within nursing curricula, as well as continuing education courses for practicing nurses.

Clinical Nursing Leadership Education in Long-Term Care: Intervention Design and Evaluation.

PubMed

Fiset, Valerie; Luciani, Tracy; Hurtubise, Alyssa; Grant, Theresa L

2017-04-01

The main objective of the current case study was to investigate the perceived leadership learning needs and feasibility of delivering leadership education to registered staff involved in direct care in long-term care (LTC) homes. The study was conducted in Ontario, Canada, and participants included RNs, registered practical nurses, and nursing administrators. Phase 1 bilingual web-based survey and bilingual focus group needs assessment data supported a preference for external training along with in-house mentoring to support sustainability. An intervention designed using insights gained from Phase 1 data was delivered via a 2-day, in-person workshop. Phases 2 and 3 evaluation survey data identified aspects of leadership training for LTC that require ongoing refinement. Findings suggest that communication skills and managing day-to-day nursing demands in the context of regulatory frameworks were areas of particular interest for leadership training in the LTC setting. [Journal of Gerontological Nursing, 43(4), 49-56.]. Copyright 2017, SLACK Incorporated.

Special Programs for Individual Needs (SPIN). Handicapped Children Early Education Program: P.L. 91-230 Title VI, Part C. Final Report, July 1, 1974 to June 30, 1977.

ERIC Educational Resources Information Center

Wight, Byron W.

The document contains the final report of the Special Programs for Individualized Needs (SPIN) program designed to develop a demonstration model for training day care personnel to identify developmentally delayed or emotionally disturbed children and to program for them within the regular day care setting. Major objectives were to develop…

The Advocacy of Educators: Perspectives from Early Childhood

ERIC Educational Resources Information Center

Mevawalla, Zinnia; Hadley, Fay

2012-01-01

This article investigates early childhood educators' perceptions of advocacy in raising the professional status with multiple stakeholders in diverse contexts. The article reports on findings from a phenomenological study investigating the perceptions of 12 educators working full time in long-day-care settings across Sydney, New South Wales (NSW),…

The impact of education on caregiver burden on two inpatient oncology units.

PubMed

Creedle, Crista; Leak, Ashley; Deal, Allison M; Walton, Ann Marie; Talbert, Gayl; Riff, Barbara; Hornback, Ann

2012-06-01

Providing standardized education can alleviate the burden felt by the caregiver and improve health outcomes for both the patient and caregiver. Four disease groups were included in this study that represent a significantly longer hospital stay than other cancers: acute myelogenous leukemia, acute lymphoblastic leukemia, lymphoma, or those undergoing blood marrow transplant. The complexity of care is significantly higher, necessitating greater caregiver burden following hospitalization. Eligible patients and their caregivers received post-hospitalization care education through an Oncology CarePartner Program addressing the patient's physical and emotional needs. The impact of the CarePartners program on caregiver burden was evaluated by the Oberst Caregiving Burden Scale (OCBS) and Bakas Caregiving Outcomes Scale (BCOS) on two oncology units (medical/oncology (n = 17) and blood marrow transplant (n = 21)) at three times: within 5 days of admission (T1), patient discharge from the hospital (T2), and 30 days post-discharge (T3). There were significant increases seen from T1-T2 (median = 4, p = 0.0007) and T1-T3 (median = 5.5, p = 0.003) in the BCOS. No significant changes in OCBS (time or difficulty) were seen. Standardized patient education helped improve caregivers' overall well-being but lacked in impacting the time spent and difficulty with caregiving tasks. Educational changes to address these specific areas or evaluation by different scales are both worth further investigation.

The Heroic Beginnings of Child Care: Looking Back Two Centuries

ERIC Educational Resources Information Center

Neugebauer, Roger; Hartzell, Debra

2010-01-01

The field of early care and education has a long, proud history. In conducting research on the oldest child care centers in the United States, the authors discovered 75 organizations that have been in operation research more than 90 years; the oldest of which, Newark Day Care Center, has been in operation for 207 years! Rather than summarizing…

Professional Conversations: A Collaborative Approach to Support Policy Implementation, Professional Learning and Practice Change in ECEC

ERIC Educational Resources Information Center

Irvine, Susan; Price, Julie

2014-01-01

In 2012, Australia introduced a new "National Quality Framework" (NQF), comprising enhanced quality expectations for early childhood education and care services, two national learning frameworks and a new assessment and rating system spanning childcare centres, kindergartens and preschools, family day care and outside school hours care.…

Shaping the Corporate Response to Workers with Elder Care Commitments: Considerations for Gerontologists.

ERIC Educational Resources Information Center

Dellmann-Jenkins, Mary; And Others

1994-01-01

Initially designed in response to substance abuse, employee assistance programs are now recognizing needs of family caregivers of the elderly by providing such services as referral, education, information, flexible schedules/leaves, counseling, health promotion, financial assistance, and direct services--respite care and onsite adult day care. (SK)

Negotiating and Appropriating the "One Person, One Language" Policy within the Complex Reality of a Multilingual Crèche in Strasbourg

ERIC Educational Resources Information Center

Caporal-Ebersold, Eloise; Young, Andrea

2016-01-01

The aim of this article is to analyse the early childhood education and care (ECEC) language policy in the city of Strasbourg, focusing on an ethnographic case study of a newly established bilingual English-French crèche in the city. In France, establishing an early childhood education structure--more specifically, a day care centre catering to…

New Perspectives in Early Childhood Teacher Education: Bringing Practitioners into the Debate.

ERIC Educational Resources Information Center

Goffin, Stacie G., Ed.; Day, David E., Ed.

This book extends the discussion regarding effective early childhood teacher education in light of two contradictory public demands, day care and education. The sections of the book focus on what makes an effective beginning teacher, what is needed to move beyond initial competence, and what makes an effective early childhood teacher educator.…

Tending the Treasures of the Emerald Isle.

ERIC Educational Resources Information Center

Zeece, Pauline Davey

2000-01-01

Examines early childhood education and care in the Republic of Ireland. Highlights the work of two leaders in the field in Ireland through transcripts of an interview and a thumbnail sketch of national schools, preschools, nursery schools, and day care nurseries. (SD)

Developing Social Comptencies of Children in a Changing World. Proceedings of the Annual Conference on Early Childhood Education (7th, Duluth, Minnesota, September 25-26, 1987).

ERIC Educational Resources Information Center

Sword, Jeane, Ed.

Sponsored by the Advisory Council of the University of Minnesota, Duluth, the proceedings include the keynote address on the effects of day care on young children and associated guidelines for practice. Four sectional presentations provide discussions of discipline-based art education for early childhood, all-day programs for creative learning in…

Evaluation of employees in public day care centers knowledge about breastfeeding and complementary feeding

PubMed Central

Souza, Joelânia Pires de O.; Prudente, Amanda Moura; Silva, Dyene Aparecida; Pereira, Leandro Alves; Rinaldi, Ana Elisa M.

2013-01-01

OBJECTIVE: To evaluate the knowledge of public day care centers employees about breastfeeding and complementary feeding. METHODS: A cross-sectional study was conducted in 15 public day care centers randomly selected in the city of Uberlandia, Southeast Brazil. A questionnaire applied to school principals, teachers, educators and general services assistants (GSA) included demographic and socioeconomic variables and questions about knowledge on breastfeeding, complementary feeding besides employees' perceptions about these subjects. Kruskal-Wallis with multiple comparison and chi-square tests were used to compare variables by professional category. RESULTS: 304 employees participated in the study. The highest percentages of correct answers were noted for questions about exclusive breastfeeding: definition - 97% (n=296) and duration - 65% (n=199). Regarding complementary feeding, 61% (n=187) correctly answered about the appropriate age to introduce it, with a lower percentage for meat (56%; n=170) and sugar (16%; n=50). Concerning employees' perceptions, 9% (n=29) believed that there is weak breast milk, 79% (n=241) and 51% (n=157) reported the negative influence of bottle feeding and pacifier use on breastfeeding. Among the interviewed subjects, 77% (n=234) answered that they had a positive influence on the quality of the food given to the children. There were no differences in the answers according to professional category, except for the negative influence of pacifiers on breastfeeding. CONCLUSIONS: Employees of public day care centers knew more about breastfeeding than about complementary feeding. Educational activities about breastfeeding and complementary feeding are necessary for day care centers employees. PMID:24473953

Interprofessional education day - an evaluation of an introductory experience for first-year students.

PubMed

Singer, Zachary; Fung, Kevin; Lillie, Elaine; McLeod, Jennifer; Scott, Grace; You, Peng; Helleman, Krista

2018-05-01

Interprofessional health care teams have been shown to improve patient safety and reduce medical errors, among other benefits. Introducing interprofessional concepts to students in full day events is an established model that allows students to learn together. Our group developed an academic day for first-year students devoted to an introductory interprofessional education (IPE) experience, 'IPE Day'. In total, 438 students representing medicine, dentistry, pharmacy and optometry gathered together, along with 25 facilitators, for IPE Day. Following the day's program, students completed the evaluation consisting of the Interprofessional Collaborative Competencies Attainment Survey and open-ended questions. Narrative responses were analyzed for content and coded using the Canadian Interprofessional Health Collaborative competency domains. Three hundred and eight evaluations were completed. Students reported increased self-ratings of competency across all 20 items (p < 0.05). Their comments were organized into the six domains: interprofessional communication, collaborative leadership, role clarification, patient-centred care, conflict resolution, and team functioning. Based on these findings, we suggest that this IPE activity may be useful for improving learner perceptions about their interprofessional collaborative practice competence.

Simulated Disaster Day: Benefit From Lessons Learned Through Years of Transformation From Silos to Interprofessional Education.

PubMed

Livingston, Laura L; West, Courtney A; Livingston, Jerry L; Landry, Karen A; Watzak, Bree C; Graham, Lori L

2016-08-01

Disaster Day is a simulation event that began in the College of Nursing and has increased exponentially in size and popularity for the last 8 years. The evolution has been the direct result of reflective practice and dedicated leadership in the form of students, faculty, and administration. Its development and expansion into a robust interprofessional education activity are noteworthy because it gives health care professions students an opportunity to work in teams to provide care in a disaster setting. The "authentic" learning situation has enhanced student knowledge of roles and responsibilities and seems to increase collaborative efforts with other disciplines. The lessons learned and modifications made in our Disaster Day planning, implementation, and evaluation processes are shared in an effort to facilitate best practices for other institutions interested in a similar activity.

"I Have to Rest All the Time Because You Are Not Allowed to Play": Exploring Children's Perceptions of Autonomy during Sleep-Time in Long Day Care Services

ERIC Educational Resources Information Center

Nothard, Michaela; Irvine, Susan; Theobald, Maryanne; Staton, Sally; Pattinson, Cassandra; Thorpe, Karen

2015-01-01

Daytime sleep is a significant part of the daily routine for children attending early childhood education and care (ECEC) services in Australia and many other countries. The practice of sleep-time can account for a substantial portion of the day in ECEC and often involves a mandated sleep/rest period for all children, including older…

1 to 3-Year-Old Children in Day Care Centres in Finland: An Overview of Eight Doctoral Dissertations

ERIC Educational Resources Information Center

Hannikainen, Maritta

2010-01-01

This article gives a general picture of the policy and main structural features of early childhood education services for the younger children in Finland. It also provides an overview of the research on 1 to 3-year-old children in day care centres carried out in Finland during the last 15 years, the focus being on a review of all the eight…

Putting Early Childhood and Day Care Services into the Public Schools: The Position of the American Federation of Teachers and An Action Plan for Promoting It.

ERIC Educational Resources Information Center

American Federation of Teachers, Washington, DC.

The case for public school administration of federally-funded early childhood and day care services and an action plan for promoting it are presented in this manual prepared by the American Federation of Teachers (AFT) Task Force on Educational Issues. Arguments in support of an AFT-proposed amendment to the Child and Family Services Act under…

42 CFR 414.65 - Payment for telehealth services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... nursing facility care services (not including the Federally-mandated periodic visits under § 483.40(c) and with the limitation of one telehealth nursing facility care service every 30 days), professional... group medical nutrition therapy services, individual and group kidney disease education services...

An Educational Program for Psoriatics: An Evaluation.

ERIC Educational Resources Information Center

Rothman, A. I.; And Others

1980-01-01

Ambulatory day patients at the Psoriasis Education and Research Center developed self-care and coping skill and learned more about their skin disease than a control group of hospitalized patients. Comparisons were obtained by medical case history and skin photography. (CP)

Women and the Struggle for Daytime Adult Education in Ireland.

ERIC Educational Resources Information Center

Inglis, Tom

1994-01-01

Daytime adult education has emerged in Ireland in the form of voluntary, locally based groups of working class women providing education for themselves and others. A survey of 96 groups illuminated their struggles with finding suitable space, day care, and advertising. They thrive because of disenchantment with the content, scheduling, and form of…

Latch Key: Developing Child Care Programs Through Community Education.

ERIC Educational Resources Information Center

Cramer, James P.; And Others

This guide to the Latch Key program for after-school day care explores rationale and methods for developing Latch Key programs in the public schools to provide low cost after-school care for children (grades 1-6) of working or student parents. (Some programs have been provided for kindergarten children and some have been expanded to full time…

Day Care Deception: What the Child Care Establishment Isn't Telling Us.

ERIC Educational Resources Information Center

Robertson, Brian C.

Over the last generation, parents have felt more and more intimidated by child care "experts" and have increasingly surrendered their role as the primary educators of their children. On the premise that theories of development, often colored by ideological positions on the family and its function in society, should take a back seat to…

Facilitating Employee Recruitment and Retention through On-Site Child Day Care.

ERIC Educational Resources Information Center

Lombardo, Kathy A.

An early childhood educator at a 360-bed community general hospital implemented a licensed on-site child care program for children between 6 weeks and 10 years of age in order to improve employee recruitment and retention by assisting employees with appropriate child care arrangements. A parent questionnaire was used to assess the degree to which…

Special Day Class Teachers' Perceptions of the Role of the School Nurse

ERIC Educational Resources Information Center

Leier, Janice L.; Cureton, Virginia Young; Canham, Daryl L.

2003-01-01

School nurses are on the front lines of health care in public schools. The integration of students' health care needs as components of educational programs has become increasingly important as medically fragile children rely on school nurses to deliver or coordinate their health care services. The purpose of this descriptive study was to determine…

Parent Child Incorporated Provides 15 Years of Service to Children and Families.

ERIC Educational Resources Information Center

Saulter, Mae F.

1995-01-01

Provides an overview of the programs and activities of Parent Child Incorporated (PCI), a human services agency in San Antonio, Texas. PCI oversees or administers various Head Start, nutrition, family day-care, child-care, health, parenting, and adult education programs. (MDM)

42 CFR 414.65 - Payment for telehealth services.

Code of Federal Regulations, 2012 CFR

2012-10-01

...), subsequent nursing facility care services (not including the Federally-mandated periodic visits under § 483.40(c) and with the limitation of one telehealth nursing facility care service every 30 days...), individual and group medical nutrition therapy services, individual and group kidney disease education...

Factors Associated to Health Care Service Use among Latino Day Laborers

PubMed Central

Boyas, Javier Francisco; Negi, Nalini Junko; Valera, Pamela

2017-01-01

Latino day laborers (LDLs) are at elevated risks for disease and injury because of the environments in which they work. Despite this recognition, a comprehensive examination of factors related to LDLs’ health service use remains unexamined. Using the Andersen model, the current exploratory study examined predisposing (age, education level, location of educational training, legal status, and marital status), enabling (income, trust in medical personnel, whether the respondent has someone they consider their personal doctor, and whether their doctor speaks the same language, perceived barriers to care), and need (self-rated health, number of chronic conditions) variables to predict use of health services among a purposive sample of LDLs (N = 150). Cross-sectional data were collected in 2012 from 4 day laborer sites in Dallas and Arlington, Texas. Regression results suggest that the strongest predictor of health care use was trust in medical providers (β = .41). LDLs who were U.S legal residents (β = .21), reported multiple chronic conditions (β = .16), and had a doctor who spoke their language (β = .15) reported significantly higher levels of health care usage. In terms of barriers, not being able to pay for services (β = −.23), lacking health care insurance coverage (β = −.22), and being embarrassed or having a family member not approve of utilizing services (β = −.18) were significantly associated with lower health care usage among LDLs. These findings suggest that LDLs are faced with a number of predisposing, enabling, and need factors that comprise health care use. PMID:28625117

Lifelong Learning for Clinical Practice: How to Leverage Technology for Telebehavioral Health Care and Digital Continuing Medical Education.

PubMed

Hilty, Donald M; Turvey, Carolyn; Hwang, Tiffany

2018-03-12

Psychiatric practice continues to evolve and play an important role in patients' lives, the field of medicine, and health care delivery. Clinicians must learn a variety of clinical care systems and lifelong learning (LLL) is crucial to apply knowledge, develop skills, and adjust attitudes. Technology is rapidly becoming a key player-in delivery, lifelong learning, and education/training. The evidence base for telepsychiatry/telemental health via videoconferencing has been growing for three decades, but a greater array of technologies have emerged in the last decade (e.g., social media/networking, text, apps). Clinicians are combining telepsychiatry and these technologies frequently and they need to reflect on, learn more about, and develop skills for these technologies. The digital age has solidified the role of technology in continuing medical education and day-to-day practice. Other fields of medicine are also adapting to the digital age, as are graduate and undergraduate medical education and many allied mental health organizations. In the future, there will be more online training, simulation, and/or interactive electronic examinations, perhaps on a monthly cycle rather than a quasi-annual or 10-year cycle of recertification.

Associations of Nurse Staffing and Education With the Length of Stay of Surgical Patients.

PubMed

Cho, Eunhee; Park, Jeongyoung; Choi, Miyoung; Lee, Hye Sun; Kim, Eun-Young

2018-03-01

To examine the association of nurse staffing and education with the length of stay of surgical patients in acute care hospitals in South Korea. A cross-sectional survey design was used for a nurse survey in acute hospitals collected between 2008 and 2009. The survey data (N = 1,665) were linked with patient discharge data (N = 113,438) and hospital facility data from 58 hospitals with 100 or more beds in South Korea. The dependent variable was the length of stay, that is, the number of days a patient remained in the hospital. The independent variables were nurse staffing (number of patients per nurse) and nurses' education level (percentage of nurses with a bachelor of science in nursing [BSN] degree). A multilevel analysis was used to analyze the associations of nurse staffing and education level with the length of stay by controlling for both hospital and patient characteristics. The average proportion of nurses with a BSN in all the hospitals was 30.86%, while the average number of patients per nurse was 14.31. The median length of hospital stay for patients was about 7 days. The multilevel analysis showed that nurse staffing and nurse education level were significantly associated with the length of stay of surgical patients in acute care hospitals. A 10% increase in the average number of patients per nurse increased the length of stay by 0.284 days (p = .037). When the number of nurses with a BSN was increased by 1%, the length of stay decreased by 0.42 days (p = .025). Nurse staffing and nurses' education levels were significantly associated with the length of stay of surgical patients in South Korean hospitals. The findings from this study suggest that the South Korea healthcare system should develop appropriate strategies to improve the nurse staffing and education levels to ensure high-quality patient care in hospitals. Healthcare policymakers and nurse managers need to modify adequate nurse staffing and education levels in order to reduce the length of stay of patients. © 2017 Sigma Theta Tau International.

"Every Day He Has a Dream to Tell": Classroom Literacy Curriculum in a Full-Day Kindergarten

ERIC Educational Resources Information Center

Heydon, Rachel; Moffatt, Lyndsay; Iannacci, Luigi

2015-01-01

Within an era of change to early childhood education and care, this case study of kindergarten classroom literacy curricula sought to understand the production and effects of the curriculum within one urban, Canadian full-day kindergarten that included culturally and linguistically diverse children. Central was a concern for the place of…

Economic (gross cost) analysis of systematically implementing a programme of advance care planning in three Irish nursing homes.

PubMed

O'Sullivan, Ronan; Murphy, Aileen; O'Caoimh, Rónán; Cornally, Nicola; Svendrovski, Anton; Daly, Brian; Fizgerald, Carol; Twomey, Cillian; McGlade, Ciara; Molloy, D William

2016-04-26

Although advance care planning (ACP) and the use of advanced care directives (ACD) and end-of-life care plans are associated with a reduction in inappropriate hospitalisation, there is little evidence supporting the economic benefits of such programmes. We assessed the economic impact (gross savings) of the Let Me Decide (LMD) ACP programme in Ireland, specifically the impact on hospitalisations, bed days and location of resident deaths, before and after systematic implementation of the LMD-ACP combined with a palliative care education programme. The LMD-ACP was introduced into three long-term care (LTC) facilities in Southern Ireland and outcomes were compared pre and post implementation. In addition, 90 staff were trained in a palliative care educational programme. Economic analysis including probabilistic sensitivity analysis was performed. The uptake of an ACD or end-of-life care post-implementation rose from 25 to 76%. Post implementation, there were statistically significant decreases in hospitalisation rates from baseline (hospitalisation incidents declined from 27.8 to 14.6%, z = 3.96, p < 0.001; inpatient hospital days reduced from 0.54 to 0.36%, z = 8.85, p < 0.001). The percentage of hospital deaths also decreased from 22.9 to 8.4%, z = 3.22, p = 0.001. However, length of stay (LOS) increased marginally (7-9 days). Economic analysis suggested a cost-reduction related to reduced hospitalisations ranging between €10 and €17.8 million/annum and reduction in ambulance transfers, estimated at €0.4 million/annum if these results were extrapolated nationally. When unit costs and LOS estimates were varied in scenario analyses, the expected cost reduction owing to reduced hospitalisations, ranged from €17.7 to €42.4 million nationally. Implementation of the LMD-ACP (ACD/end-of-life care plans combined with palliative care education) programme resulted in reduced rates of hospitalisation. Despite an increase in LOS, likely reflecting more complex care needs of admitted residents, gross costs were reduced and scenario analysis projected large annual savings if these results were extrapolated to the wider LTC population in Ireland.

The Feasibility of Collecting School Nurse Data.

PubMed

Bergren, Martha Dewey

2016-10-01

School nurses cite barriers to collecting comprehensive data on the care they provide. This study evaluated the feasibility of collecting school nurse data on selected child health and education outcomes. Outcome variables included school health office visits; health provider, parent, and staff communication; early dismissal; and medications administered. On an average day, the school nurses cared for 43.5 students, administered 14 medications, and averaged of 17 daily communications. Day 1 data collection times averaged 15 min or less. By Day 5, 6.6 min was needed to complete the survey. Data collection was feasible for 76% of those who elected to participate. Feasibility is enhanced by limiting the number of data points and the number of days for data collection using a data collection web interface. Data collection across large numbers of nurses and a wide range of school nurse delivery models is necessary to measure the impact of school nurse presence and interventions on child health and education outcomes. © The Author(s) 2016.

Kangaroo Care Education Effects on Nurses' Knowledge and Skills Confidence.

PubMed

Almutairi, Wedad Matar; Ludington-Hoe, Susan M

2016-11-01

Less than 20% of the 996 NICUs in the United States routinely practice kangaroo care, due in part to the inadequate knowledge and skills confidence of nurses. Continuing education improves knowledge and skills acquisition, but the effects of a kangaroo care certification course on nurses' knowledge and skills confidence are unknown. A pretest-posttest quasi-experiment was conducted. The Kangaroo Care Knowledge and Skills Confidence Tool was administered to 68 RNs at a 2.5-day course about kangaroo care evidence and skills. Measures of central tendency, dispersion, and paired t tests were conducted on 57 questionnaires. The nurses' characteristics were varied. The mean posttest Knowledge score (M = 88.54, SD = 6.13) was significantly higher than the pretest score (M = 78.7, SD = 8.30), t [54] = -9.1, p = .000), as was the posttest Skills Confidence score (pretest M = 32.06, SD = 3.49; posttest M = 26.80, SD = 5.22), t [53] = -8.459, p = .000). The nurses' knowledge and skills confidence of kangaroo care improved following continuing education, suggesting a need for continuing education in this area. J Contin Educ Nurs. 2016;47(11):518-524. Copyright 2016, SLACK Incorporated.

The Persistent Gap between Education and Care: A "History of the Present" Research on Belgian Child Care Provision and Policy

ERIC Educational Resources Information Center

Vandenbroeck, Michel

2006-01-01

The first Belgian creches for children from birth to three years of age date from the nineteenth century. From 1919, formal legislation on child care was developed. In the early twentieth century, the origins of Belgian childcare and in its initial legislation some core aspects of present-day child care policy and practice can be found. This…

Patient safety competence for final-year health professional students: Perceptions of effectiveness of an interprofessional education course.

PubMed

Hwang, Jee-In; Yoon, Tai-Young; Jin, Hyeon-Jeong; Park, Yikyun; Park, Ju-Young; Lee, Beom-Joon

2016-11-01

As final-year medical and nursing students will soon play key roles in frontline patient care, their preparedness for safe, reliable care provision is of special importance. We assessed patient safety competencies of final-year health profession students, and the effect of a 1-day patient safety education programme on these competencies. A cross-sectional survey was conducted with 233 students in three colleges of medicine, nursing, and traditional medicine in Seoul. A before-and-after study followed to evaluate the effectiveness of the curriculum. Patient safety competency was measured using the Health-Professional Education for Patients Safety Survey (H-PEPSS) and an objective patient safety knowledge test. The mean scores were 3.4 and 1.7 out of 5.0, respectively. The communication domain was rated the highest and the teamwork domain was rated the lowest. H-PEPSS scores significantly differed between the students from three colleges. The 1-day patient safety education curriculum significantly improved H-PEPSS and knowledge test scores. These results indicated that strengthening patient safety competencies, especially teamwork, of students is required in undergraduate healthcare curricula. A 1-day interprofessional patient safety education programme may be a promising strategy. The findings suggest that interprofessional patient safety education needs to be implemented as a core undergraduate course to improve students' safety competence.

Where Does It Hurt?

ERIC Educational Resources Information Center

McNamee, Mike

2003-01-01

Offers insights on reigning in the costs of health care benefits from speakers at a two-day seminar for campus human resource professionals sponsored by TIAA-CREF Institute. Issues addressed include why chief financial officers must care, why higher education is different, drug costs, and changes in consumer behavior. (EV)

78 FR 49525 - Privacy Act of 1974; CMS Computer Match No. 2013-06; HHS Computer Match No. 1308

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-14

... Care Act of 2010 (Pub. L. 111-148), as amended by the Health Care and Education Reconciliation Act of..., 2009). INCLUSIVE DATES OF THE MATCH: The CMP will become effective no sooner than 40 days after the...

MIGRANT DAY CARE PROGRAM, 1961.

ERIC Educational Resources Information Center

NAYLOR, NAOMI L.

WITH THE COOPERATION OF VARIOUS COMMUNITY AGENCIES AND WITH FEDERAL AID FROM THE PUBLIC WELFARE DEPARTMENT, SEVERAL MIGRANT CHILD CARE CENTERS WERE ESTABLISHED BY PENNSYLVANIA STATE UNIVERSITY IN THE CENTRAL PART OF THE STATE OF PENNSYLVANIA. STAFFS WERE COMPOSED OF DIRECTORS AND EXPERIENCED TEACHERS FROM PRESCHOOL AND ELEMENTARY EDUCATION.…

Every Child, Every Classroom, Every Day: School Leaders Who Are Making Equity a Reality

ERIC Educational Resources Information Center

Peterkin, Robert; Jewell-Sherman, Deborah; Kelley, Laura; Boozer, Leslie

2011-01-01

This book demonstrates through case studies and expert analyses the impressive educational gains children can make when the best educational research, policy, and practice are aligned. This volume is a valuable resource to aspiring leaders, educational researchers, and current practitioners and a must-read for anyone who cares about the public…

Childcare and Education for Children between the Ages of Two and Seven in the Netherlands. Position Paper.

ERIC Educational Resources Information Center

Dutch Ministry of Education, Culture and Science, The Hague (Netherlands).

In the Netherlands, there is growing interest in the day care and education of young children, stemming from the increase in culturally different, multilingual pupils in recent years and the understanding that the first 2 years of primary education form the basis for a successful school career. This position paper of the Ministry of Education,…

Caregiver Behaviors and Adaptive Behavior Development of Very Young Children in Home Care and Daycare.

ERIC Educational Resources Information Center

Altman, Jennifer Schroer; Mills, Belen Collantes

The purpose of this study was to determine the effect of home-mother care and day care caregiver behaviors on the adaptive behavior development of infants between 18 and 24 months of age. Other variables under investigation included two indices of socioeconomic status: occupation and education of parents. The sample consisted of 72 children.…

41 CFR Appendix C to Part 102 - 37-Glossary of Terms for Determining Eligibility of Public Agencies and Nonprofit Organizations

Code of Federal Regulations, 2013 CFR

2013-07-01

.... Child care center means a public or nonprofit facility where educational, social, health, and nutritional services are provided to children through age 14 (or as prescribed by State law) and that is approved or licensed by the State or other appropriate authority as a child day care center or child care...

Misperceptions of medicaid ineligibility persist among African American caregivers of Alzheimer's dementia care recipients.

PubMed

Kingsberry, Sheridan Quarless; Mindler, Philinda

2012-06-01

African American caregivers of the elderly, including those who care for patients with Alzheimer's and other forms of dementia, remain underserved by Medicaid Assistance Programs. The purpose of this exploratory study was to ascertain to what degree participants in an Alzheimer's Association program that primarily targeted African Americans applied for and received Medicaid assistance, in particular for adult day care, in-home care, and respite care. Secondary data from the Delaware Regional Office of the Alzheimer's Association's 2006 Caregiver Survey of 38 caregivers were reviewed using descriptive, chi-square, and logistic regression analysis. Results indicate that 20 caregivers applied for Medicaid services, 12 of whom were approved. However, 18 caregivers did not apply for Medicaid mainly because they perceived that they would not qualify for benefits, without investigating their eligibility. Clearly more education is needed in African American communities about the eligibility requirements and benefits of Medicaid Assistance Programs because services such as adult day care, in-home care, and respite care have been shown to reduce some of the burden, stress, and strain associated with caring for elderly patients with Alzheimer's dementia. However, a multisystem approach should be used in the outreach and education processes. Finally, the Medicaid application process should be streamlined to make it less cumbersome. More financial and support services are needed by African American caregivers of Alzheimer's care recipients.

1972 Migrant Education State Evaluation Report [North Carolina].

ERIC Educational Resources Information Center

North Carolina State Dept. of Public Instruction, Raleigh.

Having identified the migratory agricultural workers in North Carolina, the State has increased its efforts towards providing them physical, dental, and mental health care; vocational and employment counseling; day care; food; and emergency assistance. The State has also established programs and projects designed to meet the special educational…

All in a Day's Work: Primary Teachers "Performing" and "Caring"

ERIC Educational Resources Information Center

Forrester, Gillian

2005-01-01

This article discusses the current nature of primary teachers' work, which is explored in terms of "performing" and "caring" activities. It considers how the education policies of successive Governments in the UK, particularly for England, have given rise to a "performance culture" in primary schools which emphasises…

Kansas Center for Research in Early Childhood Education. Annual Report (Part I) FY'73.

ERIC Educational Resources Information Center

Kansas Univ., Lawrence. Kansas Center for Research in Early Childhood Education.

This report includes five documents, three on child care research, and two concerning individual differences and discriminative abilities in newborn and young infants. "The Organization of Infant Day Care Environments: Feedback-Produced Improvements in Staff Job Performance" reports on the effectiveness of monitoring procedures as…

Nancy Kassebaum: Education's New Voice.

ERIC Educational Resources Information Center

Penning, Nick

1989-01-01

U.S. Senator Nancy Kassebaum has become the leading Republican advocate for education. She shares AASA's support for the Head Start program, but is skeptical about financing a federal day care program. She also supports latchkey, intergenerational, and vocational/technical programs, and favors community volunteering over a national youth service…

Integrating Depression Care Management into Medicare Home Health Reduces Risk of 30 and 60 Day Hospitalization: The Depression CAREPATH Cluster-Randomized Trial

PubMed Central

Bruce, Martha L.; Lohman, Matthew C.; Greenberg, Rebecca L.; Bao, Yuhua; Raue, Patrick J.

2016-01-01

OBJECTIVES To determine whether a depression care management intervention among Medicare home health recipients decreases risks of hospitalization. DESIGN Cluster-randomized trial. Nurse teams were randomized to Intervention (12 teams) or Enhanced Usual Care (EUC; 9 teams). SETTING Six home health agencies from distinct geographic regions. Patients were interviewed at home and by telephone. PARTICIPANTS Patients age>65 who screened positive for depression on nurse assessments (N=755), and a subset who consented to interviews (N=306). INTERVENTION The Depression CAREPATH (CARE for PATients at Home) guides nurses in managing depression during routine home visits. Clinical functions include weekly symptom assessment, medication management, care coordination, patient education, and goal setting. Researchers conducted biweekly telephone conferences with team supervisors. MEASUREMENTS The study examined acute-care hospitalization and days to hospitalization. H1 used data from the home health record to examine hospitalization over 30-day and 60-day periods while a home health patient. H2 used data from both home care record and research assessments to examine 30-day hospitalization from any setting. RESULTS The adjusted hazard ratio (HR) of being admitted to hospital directly from home health within 30 days of start of home health care was 0.65 (p=.013) for CAREPATH compared to EUC patients, and 0.72 (p=.027) within 60 days. In patients referred to home health directly from hospital, the relative hazard of being rehospitalized was approximately 55% lower (HR = 0.45, p=.001) among CAREPATH patients. CONCLUSION Integrating CAREPATH depression care management into routine nursing practice reduces hospitalization and rehospitalization risk among older adults receiving Medicare home health nursing services. PMID:27739067

Reduction in nosocomial infection with improved hand hygiene in intensive care units of a tertiary care hospital in Argentina.

PubMed

Rosenthal, Victor D; Guzman, Sandra; Safdar, Nasia

2005-09-01

Hand hygiene is a fundamental measure for the control of nosocomial infection. However, sustained compliance with hand hygiene in health care workers is poor. We attempted to enhance compliance with hand hygiene by implementing education, training, and performance feedback. We measured nosocomial infections in parallel. We monitored the overall compliance with hand hygiene during routine patient care in intensive care units (ICUs); 1 medical surgical ICU and 1 coronary ICU, of 1 hospital in Buenos Aires, Argentina, before and during implementation of a hand hygiene education, training, and performance feedback program. Observational surveys were done twice a week from September 2000 to May 2002. Nosocomial infections in the ICUs were identified using the National Nosocomial Infections Surveillance (NNIS) criteria, with prospective surveillance. We observed 4347 opportunities for hand hygiene in both ICUs. Compliance improved progressively (handwashing adherence, 23.1% (268/1160) to 64.5% (2056/3187) (RR, 2.79; 95% CI: 2.46-3.17; P < .0001). During the same period, overall nosocomial infection in both ICUs decreased from 47.55 per 1000 patient-days (104/2187) to 27.93 per 1000 patient days (207/7409) RR, 0.59; 95% CI: 0.46-0.74, P < .0001). A program consisting of focused education and frequent performance feedback produced a sustained improvement in compliance with hand hygiene, coinciding with a reduction in nosocomial infection rates in the ICUs.

Patient education and follow-up as an intervention for hypertensive patients discharged from an emergency department: a randomized control trial study protocol.

PubMed

Gleason-Comstock, Julie; Streater, Alicia; Ager, Joel; Goodman, Allen; Brody, Aaron; Kivell, Laura; Paranjpe, Aniruddha; Vickers, Jasmine; Mango, LynnMarie; Dawood, Rachelle; Levy, Phillip

2015-12-21

Persistently elevated blood pressure (BP) is a leading risk factor for cardiovascular disease development, making effective hypertension management an issue of considerable public health importance. Hypertension is particularly prominent among African Americans, who have higher disease prevalence and consistently lower BP control than Whites and Hispanics. Emergency departments (ED) have limited resources for chronic disease management, especially for under-served patients dependent upon the ED for primary care, and are not equipped to conduct follow-up. Kiosk-based patient education has been found to be effective in primary care settings, but little research has been done on the effectiveness of interactive patient education modules as ED enhanced discharge for an under-served urban minority population. Achieving Blood Pressure Control Through Enhanced Discharge (AchieveBP) is a behavioral RCT patient education intervention for patients with a history of hypertension who have uncontrolled BP at ED discharge. The project will recruit up to 200 eligible participants at the ED, primarily African-American, who will be asked to return to a nearby clinical research center for seven, thirty and ninety day visits, with a 180 day follow-up. Consenting participants will be randomized to either an attention-control or kiosk-based interactive patient education intervention. To control for potential medication effects, all participants will be prescribed similar, evidenced-based anti-hypertensive regimens and have their prescription filled onsite at the ED and during visits to the clinic. The primary target endpoint will be success in achieving BP control assessed at 180 days follow-up post-ED discharge. The secondary aim will be to assess the relationship between patient activation and self-care management. The AchieveBP trial will determine whether using interactive patient education delivered through health information technology as ED enhanced discharge with subsequent education sessions at a clinic is an effective strategy for achieving short-term patient management of BP. The project is innovative in that it uses the ED as an initial point of service for kiosk-based health education designed to increase BP self-management. It is anticipated findings from this translational research could also be used as a resource for patient education and follow-up with hypertensive patients in primary care settings. ClinicalTrials.gov. NCT02069015. Registered February 19, 2014.

Day Care in the Community. Action Research in Family and Early Childhood. UNESCO Education Sector Monograph = Accueil des jeunes enfants dans la communaute. Recherche-action sur la famille et la petite enfance. UNESCO Secteur de l'education monographie.

ERIC Educational Resources Information Center

Allen, John

Noting demographic pressures and increased poverty most countries experience, this report shows how parents and family members can work in their communities in developing countries to provide low-cost and efficient child care facilities for very young children and explains how such community-based early childhood programs benefit whole families.…

Formal support for informal caregivers to older persons with dementia through the course of the disease: an exploratory, cross-sectional study.

PubMed

Lethin, Connie; Leino-Kilpi, Helena; Roe, Brenda; Soto, Maria Martin; Saks, Kai; Stephan, Astrid; Zwakhalen, Sandra; Zabalegui, Adelaida; Karlsson, Staffan

2016-01-29

In European countries, knowledge about availability and utilization of support for informal caregivers caring for older persons (≥65 years) with dementia (PwD) is lacking. To be able to evaluate and develop the dementia support system for informal caregivers to PwD, a survey of European support systems and professionals involved is needed. The aim of this study was to explore support for informal caregivers to PwD in European countries. We investigated the availability and utilization of support in each of the participating countries, and the professional care providers involved, through the dementia disease. A mapping system was used in 2010-2011 to gather information about estimations of availability, utilization, and professional providers of support to informal caregivers caring for PwD. Data collected was representing each country as a whole. There was high availability of counselling, caregiver support, and education from the diagnosis to the intermediate stage, with a decrease in the late to end of life stage. Utilization was low, although there was a small increase in the intermediate stage. Day care and respite care were highly available in the diagnosis to the intermediate stage, with a decrease in the late to end of life stage, but both types of care were utilized by few or no caregivers through any of the disease stages. Professionals specialized in dementia (Bachelor to Master's degree) provided counselling and education, whereas caregiver support for informal caregivers and day care, respite care, and respite care at home were provided by professionals with education ranging from upper secondary schooling to a Master's degree. Counselling, caregiver support, and education were highly available in European countries from diagnosis to the intermediate stage of the dementia disease, decreasing in the late/end of life stages but were rarely utilized. Countries with care systems based on national guidelines for dementia care seem to be more aware of the importance of professionals specialized in dementia care when providing support to informal caregivers. Mapping the systems of support for informal caregivers of PwD is a valuable tool for evaluating existing systems, internationally, nationally and locally for policy making.

Effect of an education program on knowledge, self-care behavior and handwashing competence on prevention of febrile neutropenia among breast cancer patients receiving Doxorubicin and Cyclophosphamide in Chemotherapy Day Centre

PubMed Central

Mak, Wai Chi; Yin Ching, Shirley Siu

2015-01-01

Objective: To evaluate the efficacy of an education program on the prevention of febrile neutropenia (FN) among breast cancer patients receiving AC regimen. Methods: Randomized controlled trial with the repeated-measures design was conducted in a Chemotherapy Day Centre of an acute hospital in Hong Kong. Twenty-five subjects in the intervention group received an individual education session followed by three follow-up sessions and routine care. Twenty-four subjects in the control group received routine care. Primary outcomes included the incidence of admission due to FN, the self-care behavior adherence, the knowledge level on prevention of FN and the self-efficacy in self-management, handwashing competence were assessed by self-designed questionnaires, Chinese version of patient activation measure, and handwashing competence checklist. Results: No statistically significant difference between the intervention group and the control group on the incidence of admission due to FN, the self-efficacy in self-management, and the knowledge on prevention of FN. The self-care behavior adherence was significant at cycle 4 of AC regimen in favor of the intervention group (P = 0.036). Handwashing competence improved more significantly among subjects in the intervention group than the control group (P = 0.009). Conclusions: The education program on the prevention of FN had significantly favorable effects on self-care behavior adherence and handwashing competence across time. However, the intervention did not lead to statistically significant improvement on the incidence of admission due to FN, the self-efficacy in self-management and the knowledge level on prevention of FN. PMID:27981125

Programing for the Mentally Retarded. Report of a National Conference (Washington, D.C., October 31 - November 2, 1966).

ERIC Educational Resources Information Center

American Association for Health, Physical Education, and Recreation, Washington, DC. Project on Recreation and Fitness for the Mentally Retarded.

Papers and presentations on physical education and recreation for the mentally retarded consider programs in Norway, the importance of physical activity, the physical educator as a member of the special education team, and the team approach in programing. The following are also treated: recreation and day care for the severely retarded in a…

Outdoor Day-Care Centres--A Culturalization of Nature: How Do Children Relate to Nature as Educational Practice?

ERIC Educational Resources Information Center

Melhuus, E. Cathrine

2012-01-01

This article will discuss how children and adults experience a certain outdoor environment as part of an educational practice, through the activities the adults and children have. It will further discuss how these activities realize cultural values through the educators' and children's activities. In Norway the use of outdoor environments has…

Rethinking transitions of care: An interprofessional transfer triage protocol in post-acute care.

PubMed

Patel, Radha V; Wright, Lauri; Hay, Brittany

2017-09-01

Readmissions to hospitals from post-acute care (PAC) units within long-term care settings have been rapidly increasing over the past decade, and are drivers of increased healthcare costs. With an average of $11,000 per admission, there is a need for strategies to reduce 30-day preventable hospital readmission rates. In 2018, incentives and penalties will be instituted for long-term care facilities failing to meet all-cause, all-condition hospital readmission rate performance measures. An interprofessional team (IPT) developed and implemented a Transfer Triage Protocol used in conjunction with the INTERACT programme to enhance clinical decision-making and assess the potential to reduce the facility's 30-day preventable hospital readmission rates by 10% within 6 weeks of implementation. Results from quantitative analysis demonstrated an overall 35.2% reduction in the 30-day preventable hospital readmission rate. Qualitative analysis revealed the need for additional staff education, improved screening and communication upon admission and prior to hospital transfer, and the need for more IPT on-site availability. This pilot study demonstrates the benefits and implications for practice of an IPT to improve the quality of care within PAC and decrease 30-day preventable hospital readmissions.

Informing Transitions in the Early Years

ERIC Educational Resources Information Center

Dunlop, Aline-Wendy; Fabian, Hilary

2006-01-01

An increased emphasis on an early start in group day care and educational settings for young children means that by the time children enter statutory education, they may already have had several transitional experiences: each will have an impact. This book explores early transitions from a variety of international perspectives. Each chapter is…

Teaching in the Twilight Zone--A Child-Sensitive Approach to Politically Incorrect Activities.

ERIC Educational Resources Information Center

Corbett, Susan M.

1994-01-01

Argues that too much emphasis on developing a nonsexist, antibias, peace-centered, politically correct day-care center curriculum may overly restrict children's imagination, creativity, and desires, leading to an educator-imposed bias in the curriculum. Educators should encourage children to engage in developmentally appropriate play activities…

Flame Retardant Exposures in California Early Childhood Education Environments

EPA Science Inventory

Infants and young children spend as much as 50 hours per week in child care and preschool centers. Although approximately 13 million children, or 65% of all U.S. children, spend a portion of each day in early childhood education (ECE) facilities, little information is available a...

Ready, Set, Grow! Health Education for 3-5 Year Olds.

ERIC Educational Resources Information Center

Peterson, Paula J.

Intended for use in family day care, preschool centers, professional preparation institutions, and in homes, this comprehensive health education curriculum for 3- through 5-year-old children contains units designed to sequentially teach concepts about physical health, mental health, family living, and safety. Contents include the following…

Counselor Training Manual for Resident Environmental Education Camp.

ERIC Educational Resources Information Center

Fortman, Kathleen J.

Designed for use with junior and senior high school students, this manual outlines procedures for recruiting and training counselors to work with upper elementary students in a resident outdoor education setting. Counselors can provide the additional leadership necessary when caring for large groups of students 24 hours a day. However, their…

Diabetes education project: community networking in rural Utah.

PubMed

DeBry, S M; Smith, A; Wittenberg, M; Mortensen, V

1996-01-01

People in rural areas often lack the financial resources, workforce, and professional network needed to sustain a diabetes education pro gram in their own community. HealthInsight, a nonprofit organization that works to improve the quality of health care in its community, developed a 2-day seminar in an effort to facilitate the networking of rural health professionals who educate patients with diabetes and to help those educators better learn how to use existing resources. Participants included nurses, dietitians, diabetes educators, quality managers, and education directors from hospitals and home health agencies in both rural and metropolitan areas. Speakers presented information on a variety of topics related to program development, and a resource manual containing numerous materials was given to each participant. At the end of the seminar, the group turned in goals for their own programs. Too often, providers of health care compete rather than collaborate with one another. There is a great need for such networking opportunities among health care professionals working on common goals--especially in rural areas.

Perceptions of an educational programme for registered nurses who work at non-major trauma services in Victoria, Australia: The Nursing Emergency eXternal Trauma Programme.

PubMed

Ireland, Sharyn; Cross, Rachel; Decker, Kelly; Mitra, Biswadev

2017-08-01

Emergency nurses working in non-Major Trauma Service (non-MTS) facilities face the challenge of providing immediate care to seriously injured patients, despite infrequent presentations at their workplace. A one-day education programme endorsed by the Australian College of Nursing was developed to provide contemporary trauma education for nurses. The aim of this study was to report participants' perceptions of their experience of this programme. Peer reviewed lesson plans were developed to guide educational activities. Of 32 participants, 24 consented to and completed pre and post-programme surveys. Thematic analysis and descriptive statistics were used to report study findings. Most participants were nurses with greater than two years' experience in Emergency Nursing (92%). Trauma patient transfers each year from a non-MTS to a Major Trauma Service occurred infrequently; eight nurses (33.3%) reported greater than10 trauma transfers per year. Participant expectations of the programme included personal growth, knowledge acquisition, increased confidence and a focus on technical skills. Participants reported the day to be worthwhile and valuable; improved confidence, increased knowledge, and the opportunity to discuss current evidence based practice were highly regarded. Recommendations for future programmes included extending to two days and include burns and more complex pathophysiology. With centralisation of trauma care to major trauma services, frequent and continuing education of nurses is essential. Nurses from non-Major Trauma Service facilities in Victoria found this programme worthwhile as they gained knowledge and skills and increased confidence to care for trauma patients. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Two-Way Social Media Messaging in Postoperative Cataract Surgical Patients: Prospective Interventional Study

PubMed Central

Sanguansak, Thuss; Morley, Michael G; Thinkhamrop, Kavin; Thuanman, Jaruwan; Agarwal, Isha

2017-01-01

Background Social media offers a new way to provide education, reminders, and support for patients with a variety of health conditions. Most of these interventions use one-way, provider-patient communication. Incorporating social media tools to improve postoperative (postop) education and follow-up care has only been used in limited situations. Objective The aim of this study was to determine the feasibility and efficacy of two-way social media messaging to deliver reminders and educational information about postop care to cataract patients. Methods A total of 98 patients undergoing their first eye cataract surgery were divided into two groups: a no message group receiving usual pre- and postop care and a message group receiving usual care plus messages in a mobile social media format with standardized content and timing. Each patient in the message group received nine messages about hand and face hygiene, medication and postop visit adherence, and links to patient education videos about postop care. Patients could respond to messages as desired. Main outcome measures included medication adherence, postop visit adherence, clinical outcomes, and patients’ subjective assessments of two-way messaging. The number, types, content, and timing of responses by patients to messages were recorded. Results Medication adherence was better in the message group at postop day 7, with high adherence in 47 patients (96%, 47/49) versus 36 patients (73%, 36/49) in the no message group (P=.004), but no statistically significant differences in medication adherence between the groups were noted at preop and postop day 30. Visit adherence was higher at postop day 30 in the message group (100%, 49/49) versus the no message group (88%, 43/49; P=.03) but was 100% (49/49) in both groups at postop day 1 and 7. Final visual outcomes were similar between groups. A total of 441 standardized messages were sent to the message group. Out of 270 responses generated, 188 (70%) were simple acknowledgments or “thank you,” and 82 (30%) responses were questions that were divided into three general categories: administrative, postop care, and clinical issues. Out of the 82 question responses, 31 (11%) were about administrative issues, 28 (10%) about postop care, and 23 (9%) about clinical symptoms. All the messages about symptoms were triaged by nurses or ophthalmologists and only required reassurance or information. Patients expressed satisfaction with messaging. Conclusions Two-way social media messaging to deliver postop information to cataract patients is feasible and improves early medication compliance. Further design improvements can streamline work flow to optimize efficiency and patient satisfaction. PMID:29258973

An innovation in curriculum content and delivery of cancer education within undergraduate nurse training in the UK. What impact does this have on the knowledge, attitudes and confidence in delivering cancer care?

PubMed

Edwards, Deborah; Anstey, Sally; Kelly, Daniel; Hopkinson, Jane

2016-04-01

This was an evaluation of an innovation in curriculum content and delivery within undergraduate nursing education in the UK. Its purpose was to investigate the effect on knowledge, attitudes and confidence in delivering cancer care. The study design was a pre-test post-test survey design with a comparison group. Participants were two cohorts of undergraduate nursing students (n(intervention) = 84, n(comparison) = 91). The intervention cohort were exposed to a new 3.5 day programme of cancer education, coproduced with patients, carers and health professionals, which focused on cancer as a life changing long-term condition. The comparison cohort had been exposed to a 2 day programme produced by a lecturer. Following exposure to the new model for the delivery of undergraduate nurse cancer education, the intervention cohort demonstrated good overall knowledge of the impact of cancer, more positive attitudes towards cancer treatment and more confidence in their ability to deliver cancer care. Attitudes were more positive and confidence in ability to support cancer patients at all stages of the cancer journey were greater than in the comparison group. Insights gained into the cancer patient and carer perspectives were highly valued. This study has found that a new model for the delivery of cancer education focusing on survivorship and delivered in partnership with patients, carers and clinicians, may improve knowledge, attitudes and confidence in the delivery of cancer care. Further work is now needed, using a more robust experimental design, to investigate the generalisability of the results to other education programs. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Pilot testing of the effectiveness of nurse-guided, patient-centered heart failure education for older adults.

PubMed

Mathew, Shiny; Thukha, Henry

2017-12-13

Heart failure (HF) is the most common cause of hospitalization and rehospitalization among those 65 years and older. Effective HF self-management is recommended for reducing readmissions. This pilot study, through a one-group, pretest-posttest design, examines the effects of nurse-guided, patient-centered HF education on readmissions among older adults (n = 26) in a post-acute care unit. All selected participants received 3 sessions of tailored patient education. Their knowledge and self-care skills were measured pre- and post-intervention with the Atlanta Heart Failure Knowledge Test (A-HFKT) and the Self-Care of Heart Failure Index (SCHFI). Patients' HF-related knowledge and self-care skills showed statistically significant improvements, and only 1 patient was rehospitalized for any HF-related reason within 30 days post-discharge. These results suggest that HF rehabilitation teams could support better patient outcomes by assigning nursing staff to provide individualized patient education, as this can help ensure that patients understand discharge instructions for effective self-care. Copyright © 2017 Elsevier Inc. All rights reserved.

Cardiology Consultation in the Emergency Department Reduces Re-hospitalizations for Low-Socioeconomic Patients with Acute Decompensated Heart Failure.

PubMed

Tabit, Corey E; Coplan, Mitchell J; Spencer, Kirk T; Alcain, Charina F; Spiegel, Thomas; Vohra, Adam S; Adelman, Daniel; Liao, James K; Sanghani, Rupa Mehta

2017-09-01

Re-hospitalization after discharge for acute decompensated heart failure is a common problem. Low-socioeconomic urban patients suffer high rates of re-hospitalization and often over-utilize the emergency department (ED) for their care. We hypothesized that early consultation with a cardiologist in the ED can reduce re-hospitalization and health care costs for low-socioeconomic urban patients with acute decompensated heart failure. There were 392 patients treated at our center for acute decompensated heart failure who received standardized education and follow-up. Patients who returned to the ED received early consultation with a cardiologist; 392 patients who received usual care served as controls. Thirty- and 90-day re-hospitalization, ED re-visits, heart failure symptoms, mortality, and health care costs were recorded. Despite guideline-based education and follow-up, the rate of ED re-visits was not different between the groups. However, the rate of re-hospitalization was significantly lower in patients receiving the intervention compared with controls (odds ratio 0.592), driven by a reduction in the risk of readmission from the ED (0.56 vs 0.79, respectively). Patients receiving the intervention accumulated 14% fewer re-hospitalized days than controls and 57% lower 30-day total health care cost. Despite the reduction in health care resource consumption, mortality was unchanged. After accounting for the total cost of intervention delivery, the health care cost savings was substantially greater than the cost of intervention delivery. Early consultation with a cardiologist in the ED as an adjunct to guideline-based follow-up is associated with reduced re-hospitalization and health care cost for low-socioeconomic urban patients with acute decompensated heart failure. Copyright © 2017 Elsevier Inc. All rights reserved.

Recovering activity and illusion: the nephrology day care unit.

PubMed

Remón Rodríguez, C; Quirós Ganga, P L; González-Outón, J; del Castillo Gámez, R; García Herrera, A L; Sánchez Márquez, M G

2011-01-01

Day Care Units are an alternative to hospital care that improves more efficiency. The Nephrology, by its technical characteristics, would be benefit greatly from further development of this care modality. The objectives of this study are to present the process we have developed the Nephrology Day Care Unit in the Puerto Real University Hospital (Cádiz, Spain). For this project we followed the Deming Management Method of Quality improvement, selecting opportunities, analyzing causes, select interventions, implement and monitor results. The intervention plan includes the following points: 1) Define the place of the Day Care Unit in the organization of our Clinical Department of Nephrology, 2) Define the Manual of organization, 3) Define the structural and equipment resources, 4) Define the Catalogue of services and procedures, 5) Standards of Care Processes. Protocols and Clinical Pathways; and 6) Information and Registration System. In the first 8 months we have been performed nearly 2000 procedures, which corresponds to an average of about 10 procedures per day, and essentially related to Hemodialysis in critical or acute patients, the Interventional Nephrology, the Clinical Nephrology and Peritoneal Dialysis. The development of the Nephrology Day Care Units can help to increase our autonomy, our presence in Hospitals, recover the progressive loss of clinical activity (diagnostic and therapeutic skills) in the past to the benefit of other Specialties. It also contributes to: Promote and develop the Diagnostic and Interventional Nephrology; improve the clinical management of patients with Primary Health Level, promote the Health Education and Investigation, collaborate in the Resources Management, and finally, to make more attractive and exciting our Specialty, both for nephrologists to training specialists.

Use of 4MAT Learning Theory to Promote Better Skin Care During Radiation Therapy: An Evidence-Based Quality Improvement Project.

PubMed

Bauer, Carole; Magnan, Morris; Laszewski, Pamela

Radiation therapy is a key treatment modality for cancer patients, but it is associated with adverse side effects such as radiation dermatitis. To mitigate the adverse effects of radiation on the skin, patients must participate in skin-related self-care. However, even with self-care instruction, adherence can be poor. This quality improvement project used best available evidence for skin care in patients undergoing radiation therapy and a theoretical framework, 4MATing, to provide a structured approach to patient education designed to enhance adherence to skin care recommendations. Implementation of this approach resulted in increased adherence to a topical skin care protocol in our facility. Patients were highly satisfied with their education. While there was a 4-day delay in the onset of radiation dermatitis, this difference was not statistically significant.

Quality of care in reproductive health programmes: education for quality improvement.

PubMed

Kwast, B E

1998-09-01

The provision of high quality maternity care will make the difference between life and death or lifelong maiming for millions of pregnant women. Barriers preventing access to affordable, appropriate, acceptable and effective services, and lack of facilities providing high quality obstetric care result in about 1600 maternal deaths every day. Education in its broadest sense is required at all levels and sectors of society to enhance policy formulation that will strengthen programme commitment, improve services with a culturally sensitive approach and ensure appropriate delegation of responsibility to health staff at peripheral levels. This paper is the second in series of three which addresses quality of care. The first (Kwast 1998) contains an overview of concepts, assessments, barriers and improvements of quality of care. The third article will describe selected aspects of monitoring and evaluation of quality of care.

The Modification of Intelligence through Early Experience.

ERIC Educational Resources Information Center

Ramey, Craig T.; Haskins, Ron

Infants judged to be at risk for subnormal intellectual growth were randomly assigned to an experimental (N=27) or a control (N=25) group. Infants in both groups received medical care and dietary supplements; their families received social work services on a request basis. Experimental children participated in an educational day care program…

Feeding the Superintendent's Mind, Body, Spirit

ERIC Educational Resources Information Center

Palmer, Judith A.

2008-01-01

A superintendent's job requires taking care of people--children first, then faculty and staff, the board of education, parents and anyone else who strides through a superintendent's door. At the end of the day, no one really takes care of superintendents but themselves. Their well-being is directly linked to their state of minds, the health of…

Impact of a Brief Training on Medical Resident Screening for Alcohol Misuse and Illicit Drug Use

PubMed Central

Gunderson, Erik W.; Levin, Frances R.; Owen, Patricia

2011-01-01

Educational initiatives are needed to improve primary care substance use screening. This study assesses the impact on 24 medical residents of a 2.5-day curriculum combining experiential and manual-based training on screening for alcohol misuse and illicit drug use. A retrospective chart review of new primary care outpatients demonstrated that nearly all were asked about current alcohol use before and after curriculum participation. Adherence to national screening guidelines on quantification of alcohol consumption modestly improved (p < .05), as did inquiry about current illicit drug use (p < .05). Continued efforts are needed to enhance educational initiatives for primary care physicians. PMID:18393059

Impact of a brief training on medical resident screening for alcohol misuse and illicit drug use.

PubMed

Gunderson, Erik W; Levin, Frances R; Owen, Patricia

2008-01-01

Educational initiatives are needed to improve primary care substance use screening. This study assesses the impact on 24 medical residents of a 2.5-day curriculum combining experiential and manual-based training on screening for alcohol misuse and illicit drug use. A retrospective chart review of new primary care outpatients demonstrated that nearly all were asked about current alcohol use before and after curriculum participation. Adherence to national screening guidelines on quantification of alcohol consumption modestly improved (p < .05), as did inquiry about current illicit drug use (p < .05). Continued efforts are needed to enhance educational initiatives for primary care physicians.

Involvements of Parents in the Care of Preterm Infants: A Pilot Study Evaluating a Family-Centered Care Intervention in a Chinese Neonatal ICU.

PubMed

Zhang, Rong; Huang, Rui-Wena; Gao, Xi-Ronga; Peng, Xiao-Minga; Zhu, Li-Hui; Rangasamy, Ramanathan; Latour, Jos M

2018-05-17

To evaluate the effectiveness and safety of a family-centered care intervention in a Chinese neonatal ICU. Pilot study using a randomized controlled trial design to inform a main randomized controlled trial study. Stand-alone tertiary children's hospital in China with a 60-bed neonatal ICU serving as a regional neonatal ICU center. Premature infants (n = 61) and their parents (n = 110). Parent education program followed by parents' participation in care as primary caregiver until discharge for a minimum of 4 hours per day. Primary outcomes were infants' weight gain at discharge, length of stay, and readmission. Parental outcomes were stress, anxiety, satisfaction, and clinical knowledge. Infants in family-centered care group (n = 31) had higher weight gain (886g vs 542g; p = 0.013), less neonatal ICU length of stay in days (43 vs 46; p = 0.937), and decreased readmission rate at 1 week (41.9 vs 70.0; p = 0.045) and at 1 month (6.5% vs 50%; p < 0.001) compared with the control group (n = 30). Total Mean Parental Stress and Anxiety scores were lower in the family-centered care group (42 vs 59; p ≤ 0.007), mean satisfaction rates in family-centered care group were higher compared with control group (96 vs 90; p < 0.001), and parents in the family-centered care group had better educational outcomes related to neonatal specialized care skills (p < 0.05). Involving parents in the care of their infant improved clinical outcomes of infants. Family-centered care also contributed to a better understanding of parent's clinical education, decrease stress levels, and increased parental satisfaction. Our study suggests that involving parents in the daily care of their infants is feasible and should be promoted by neonatal ICU clinicians.

The All-Day Kindergarten and Pre-K Curriculum: A Dynamic-Themes Approach

ERIC Educational Resources Information Center

Fromberg, Doris Pronin

2011-01-01

Grounded in theory and research, "The All-Day Kindergarten and Pre-K Curriculum" provides an activity-based and classroom-proven curriculum for educators to consider as they plan and interact with pre-k and kindergarten children. Allowing young children the opportunities to become independent, caring, critical thinkers who feel comfortable asking…

Informal Nature Experience on the School Playground

ERIC Educational Resources Information Center

Raith, Andreas

2015-01-01

In Germany, all-day care and all-day schooling are currently increasing on a large-scale. The extended time children spend in educational institutions could potentially result in limited access to nature experience for children. On the other hand, it could equally create opportunities for informal nature experience if school playgrounds have a…

Charting the course for nurses' achievement of higher education levels.

PubMed

Kovner, Christine T; Brewer, Carol; Katigbak, Carina; Djukic, Maja; Fatehi, Farida

2012-01-01

To improve patient outcomes and meet the challenges of the U.S. health care system, the Institute of Medicine recommends higher educational attainment for the nursing workforce. Characteristics of registered nurses (RNs) who pursue additional education are poorly understood, and this information is critical to planning long-term strategies for U.S. nursing education. To identify factors predicting enrollment and completion of an additional degree among those with an associate or bachelor's as their pre-RN licensure degree, we performed logistic regression analysis on data from an ongoing nationally representative panel study following the career trajectories of newly licensed RNs. For associate degree RNs, predictors of obtaining a bachelor's degree are the following: being Black, living in a rural area, nonnursing work experience, higher positive affectivity, higher work motivation, working in the intensive care unit, and working the day shift. For bachelor's RNs, predictors of completing a master's degree are the following: being Black, nonnursing work experience, holding more than one job, working the day shift, working voluntary overtime, lower intent to stay at current employer, and higher work motivation. Mobilizing the nurse workforce toward higher education requires integrated efforts from policy makers, philanthropists, employers, and educators to mitigate the barriers to continuing education. Copyright © 2012 Elsevier Inc. All rights reserved.

The Diabetes Initiative of South Carolina Celebrates Over 20 Years of Professional Diabetes Education.

PubMed

Hermayer, Kathie L

2016-04-01

Diabetes is a major public health problem in South Carolina; however, the Diabetes Initiative of South Carolina (DSC) provides a realistic mechanism to address issues on a statewide basis. The Diabetes Center of Excellence in the DSC provides oversight for developing and supervising professional education programs for health care workers of all types in South Carolina to increase their knowledge and ability to care for people with diabetes. The DSC has developed many programs for the education of a variety of health professionals about diabetes and its complications. The DSC has sponsored 21 Annual Diabetes Fall Symposia for primary health care professionals featuring education regarding many aspects of diabetes mellitus. The intent of the program is to enhance the lifelong learning process of physicians, advanced practice providers, nurses, pharmacists, dietitians, laboratorians and other health care professionals, by providing educational opportunities and to advance the quality and safety of patient care. The symposium is an annual 2-day statewide program that supplies both a comprehensive diabetes management update to all primary care professionals and an opportunity for attendees to obtain continuing education credits at a low cost. The overarching goal of the DSC is that the programs it sponsors and the development of new targeted initiatives will lead to continuous improvements in the care of people at risk and with diabetes along with a decrease in morbidity, mortality and costs of diabetes and its complications in South Carolina and elsewhere. Published by Elsevier Inc.

What follows newborn screening? An evaluation of a residential education program for parents of infants with newly diagnosed cystic fibrosis.

PubMed

Sawyer, Susan M; Glazner, Judith A

2004-08-01

The diagnosis of a severe life-limiting condition, such as cystic fibrosis (CF), is generally followed by assessment and treatment of the child and education and counseling for parents. The introduction of newborn screening for CF provides an opportunity for standardized assessment and education. The aim of this study was to evaluate a 5-day residential assessment and education program for parents of infants who receive a diagnosis of CF after newborn screening. Eligible parents had a 6- to 30-month-old infant with CF diagnosed by newborn screening. Parents were interviewed by telephone using a structured questionnaire that addressed 3 main themes: 1) initial communication of the diagnosis of CF, 2) the perceived value of the 5-day assessment and education program, and 3) the perceived advantages and disadvantages of the residential component (Care-By-Parent unit) of the program. Fifteen of 17 eligible families took part in the 5-day assessment and education program, 12 of whom used the residential Care-By-Parent unit. At the end of the program, parents believed that they had the knowledge and skills required to manage their child's CF at home. One hundred percent endorsed the timing of the assessment and education program immediately after the child's diagnosis and would recommend it to other families in the same situation. Perceived advantages of the residential program were not having to travel (89%), being able to concentrate on CF (50%), and the benefit of a "home base" at the hospital (39%). Twenty-two percent reported that financial costs related to participation (paternal time off work) were a disadvantage, 17% reported additional strain on family members caring for siblings, and 17% mentioned lack of comfort within the unit. This time-intensive residential program was evaluated positively by parents of children with newly diagnosed CF. It provides a model for education programs after the diagnosis of CF by newborn screening, as well as for other pediatric conditions that require intensive parent education.

Utilization of maternal healthcare among adolescent mothers in urban India: evidence from DLHS-3.

PubMed

Singh, Aditya; Kumar, Abhishek; Pranjali, Pragya

2014-01-01

Background. Low use of maternal healthcare services is one of the reasons why maternal mortality is still considerably high among adolescents mothers in India. To increase the utilization of these services, it is necessary to identify factors that affect service utilization. To our knowledge, no national level study in India has yet examined the issue in the context urban adolescent mothers. The present study is an attempt to fill this gap. Data and Methods. Using information from the third wave of District Level Household Survey (2007-08), we have examined factors associated with the utilization of maternal healthcare services among urban Indian married adolescent women (aged 13-19 years) who have given live/still births during last three years preceding the survey. The three outcome variables included in the analyses are 'full antenatal care (ANC)', 'safe delivery' and 'postnatal care within 42 days of delivery'. We have used Chi-square test to determine the difference in proportion and the binary logistic regression to understand the net effect of predictor variables on the utilization of maternity care. Results. About 22.9% of mothers have received full ANC, 65.1% of mothers have had at least one postnatal check-up within 42 days of pregnancy. The proportion of mother having a safe delivery, i.e., assisted by skilled personnel, is about 70.5%. Findings indicate that there is considerable amount of variation in use of maternity care by educational attainment, household wealth, religion, parity and region of residence. Receiving full antenatal care is significantly associated with mother's education, religion, caste, household wealth, parity, exposure to healthcare messages and region of residence. Mother's education, full antenatal care, parity, household wealth, religion and region of residence are also statistically significant in case of safe delivery. The use of postnatal care is associated with household wealth, woman's education, full antenatal care, safe delivery care and region of residence. Conclusion. Several socioeconomic and demographic factors affect the utilization of maternal healthcare services among urban adolescent women in India. Promoting the use of family planning, female education and higher age at marriage, targeting vulnerable groups such as poor, illiterate, high parity women, involving media and grass root level workers and collaboration between community leaders and health care system could be some important policy level interventions to address the unmet need of maternity services among urban adolescents.

Ethical Behavior in Early Childhood Education.

ERIC Educational Resources Information Center

Katz, Lilian G.; Ward, Evangeline H.

This booklet contains two essays on ethics for early childhood educators. The first essay discusses the meaning of a code of ethics, the importance of a code of ethics for working with preschool children, ethical conflicts in day care and preschool work, and steps which may be taken to help early childhood workers resolve these conflicts. Ethical…

An Innovative Program in Social Work Education

ERIC Educational Resources Information Center

Peleg-Oren, Neta; Aran, Ofra; Even-Zahav, Ronit; Macgowan, Mark J.; Stanger, Varda

2007-01-01

This paper is a report of an innovative program in social work education to enrich field supervisors and students with the latest theories and practices related to social work practice in health care settings. This program consists of a study day organized jointly by academic faculty, field supervisors, and students, conducted once a year between…

Parental Involvement in Finnish Day Care--What Do Early Childhood Educators Say?

ERIC Educational Resources Information Center

Hakyemez-Paul, Sevcan; Pihlaja, Paivi; Silvennoinen, Heikki

2018-01-01

Research conducted in recent decades shows that parental involvement (PI) plays a significant role in the academic achievement and the healthy development of children. Gaining a better understanding of early childhood educators' views and the reasons for insufficient practices is important for improving PI. This mixed-method research investigates…

Education and empowerment of the nursing assistant: validating their important role in skin care and pressure ulcer prevention, and demonstrating productivity enhancement and cost savings.

PubMed

Howe, Lynn

2008-06-01

This article details an educational program designed to utilize nonlicensed personnel (certified nursing assistants [CNAs] and nursing assistants [NAs]) in the prevention of pressure ulcers and improved skin care in a 250-bed acute care facility in a suburban setting. The article is divided into 2 parts: A and B. Part A addresses the educational program, which was part of a major initiative for improving patient outcomes that included a review and standardization of skin care products and protocols. Part B addresses productivity enhancement and cost savings experienced because of changing bathing and incontinence care products and procedures. The educational program included instruction on time-saving methods for increasing productivity in bathing and incontinence care, and effectively promoted the importance of proper skin care and pressure ulcer prevention techniques. Methods incorporated into the educational training targeted different reading and comprehension levels, ranging from the use of PowerPoint slides, hands-on return demonstration, and group discussion related to pressure ulcer staging and wound treatment. These educational methods provided the participants with significant reinforcement of each day's learning objectives. Productivity enhancement and cost savings are addressed in part B, as well as the results of a time-motion study. Because of the program, CNAs/NAs were empowered in their integral caregiver roles. This program was part of a larger, major process improvement initiative, but the rate of acquired pressure ulcers declined from 2.17% in 2002 to 1.71% in 2003. This educational program was considered a contributor to the improved patient outcomes.

The Self-care Educational Intervention for Patients With Heart Failure: A Study Protocol.

PubMed

Boyde, Mary; Peters, Robyn; Hwang, Rita; Korczyk, Dariusz; Ha, Tina; New, Nicole

A variety of educational interventions have been implemented to assist patients with heart failure (HF) to maintain their own health, develop self-care behaviors, and decrease readmissions. The most effective approach to education has yet to be established. The aim of this study is to determine the effectiveness of a multimedia educational intervention for patients with HF in reducing hospital readmissions. Secondary outcomes include changes in knowledge and self-care behaviors. A randomized controlled trial in a large tertiary referral hospital in Australia has recruited 200 patients and will follow them for 12 months. Patients diagnosed with HF have been randomly allocated 1:1 to either usual education or a multimedia educational intervention. Framed by the principles of adult learning, this individualized intervention was delivered face to face by a specialized HF nurse, with a targeted educational assessment and subsequent development of an educational plan. The multimedia approach combined viewing a DVD and verbal discussion supported by a written manual. The teach-back strategy at the conclusion of the intervention evaluated the patient's learning through 5 key questions about self-management of HF. Readmissions are assessed at 28 days, 3 months, and 12 months. Knowledge and self-care behavior are assessed at baseline, 3 months, and 12 months. This study evaluates the effectiveness of a targeted multimedia educational intervention. Study results may inform the design of in-hospital education for HF patients.

Effects of implementation of an urgent surgical care service on subspecialty general surgery training

PubMed Central

Wood, Leanne; Buczkowski, Andrzej; Panton, Ormond M.N.; Sidhu, Ravi S.; Hameed, S. Morad

2010-01-01

Background In July 2007, a large Canadian teaching hospital realigned its general surgery services into elective general surgery subspecialty-based services (SUBS) and a new urgent surgical care (USC) service (also know in the literature as an acute care surgery service). The residents on SUBS had their number of on-call days reduced to enable them to focus on activities related to SUBS. Our aim was to examine the effect of the creation of the USC service on the educational experiences of SUBS residents. Methods We enrolled residents who were on SUBS for the 6 months before and after the introduction of the USC service. We collected data by use of a survey, WEB eVAL and recorded attendance at academic half days. Our 2 primary outcomes were residents’ attendance at ambulatory clinics and compliance with the reduction in the number of on-call days. Our secondary outcomes included residents’ time for independent study, attendance at academic half days, operative experience, attendance at multidisciplinary rounds and overall satisfaction with SUBS. Results Residents on SUBS had a decrease in the mean number of on-call days per resident per month from 6.28 to 1.84 (p = 0.006), an increase in mean attendance at academic half days from 65% to 87% (p = 0.028), at multidisciplinary rounds (p = 0.002) and at ambulatory clinics and an increase in independent reading time (p = 0.015), and they reported an improvement in their work environment. There was no change in the amount of time residents spent in the operating room or in their overall satisfaction with SUBS. Conclusion Residents’ education in the SUBS structure was positively affected by the creation of a USC service. Compliance with the readjustment of on-call duties was high and was identified as the single most significant factor in enabling residents to take full advantage of the unique educational opportunities available only while on SUBS. PMID:20334744

Patient subjective experience and satisfaction during the perioperative period in the day surgery setting: a systematic review.

PubMed

Rhodes, Lenore; Miles, Gail; Pearson, Alan

2006-08-01

This systematic review used the Joanna Briggs Institute Qualitative Assessment and Review Instrument to manage, appraise, analyse and synthesize textual data in order to present the best available information in relation to how patients experience nursing interventions and care during the perioperative period in the day surgery setting. Some of the significant findings that emerged from the systematic review include the importance of pre-admission contact, provision of relevant, specific education and information, improving communication skills and maintaining patient privacy throughout their continuum of care.

[The Impact of Demography, Migration, New Technologies and the Self-Actualization Movement on the Education System and on the Economic System.] Testimony of Jerry L. Fletcher, Prepared for The Joint Economic Committee Special Study on Economic Change, June 1, 1978.

ERIC Educational Resources Information Center

Fletcher, Jerry L.

Demography, urban to rural migration, new educational technologies, and the human potential movement all impact on education. With the decline in number of school-aged children, schools can try to expand the number of students downward (early childhood education/day care), outward (special education, dropouts), or upward (adults), expand service…

Educating residents for managed care: report on a multidisciplinary conference.

PubMed

Hewson, M G; Fishleder, A J; Halperin, A K; Henry, C A; Isaacson, J H; Kachur, E; Tresolini, C

1998-05-01

A growing number of residency programs are preparing their graduates for the realities of managed care practice. In 1996, The Cleveland Clinic Foundation, a private, nonprofit academic medical center, hosted a two-day conference on managed care education to develop innovative instructional and evaluative approaches that, where appropriate, would build on existing expertise. The conference was attended by invited national experts who had a stake in residents' education: clinical faculty, residents, medical educators, executives of managed care organizations, and representatives of other interested organizations. Participants spent much of their time in four small break out groups, each focusing on one of the following topics that were judged particularly relevant to managed care: preventive and population-based medicine, appropriate utilization of resources, clinician-patient communication, and interdisciplinary team practice. Participants shared existing materials, discussed teaching goals and objectives, and generated ideas for teaching methods, teaching materials, and evaluative methods for their respective topics. The authors summarize the recommendations from the four groups, with an overview of the issues that emerged during the conference concerning curriculum development, integration of managed care topics into existing curricula, staging of the curriculum, experiential teaching methods, negative attitudes and resistance, evaluation of trainees and profiling, program assessment, faculty development, and cooperation between academic medical centers and managed care organizations.

Surgical education and adult learning: Integrating theory into practice.

PubMed

Rashid, Prem

2017-01-01

Surgical education continues to evolve from the master-apprentice model. Newer methods of the process need to be used to manage the dual challenges of educating while providing safe surgical care. This requires integrating adult learning concepts into delivery of practical training and education in busy clinical environments. A narrative review aimed at outlining and integrating adult learning and surgical education theory was undertaken. Additionally, this information was used to relate the practical delivery of surgical training and education in day-to-day surgical practice. Concepts were sourced from reference material. Additional material was found using a PubMed search of the words: 'surgical education theory' and 'adult learning theory medical'. This yielded 1351 abstracts, of which 43 articles with a focus on key concepts in adult education theory were used. Key papers were used to formulate structure and additional cross-referenced papers were included where appropriate. Current concepts within adult learning have a lot to offer when considering how to better deliver surgical education and training. Better integration of adult learning theory can be fruitful. Individual teaching surgical units need to rethink their paradigms and consider how each individual can contribute to the education experience. Up skilling courses for trainers can do much to improve the delivery of surgical education. Understanding adult learning concepts and integrating these into day-to-day teaching can be valuable.

Surgical education and adult learning: Integrating theory into practice

PubMed Central

Rashid, Prem

2017-01-01

Surgical education continues to evolve from the master-apprentice model. Newer methods of the process need to be used to manage the dual challenges of educating while providing safe surgical care. This requires integrating adult learning concepts into delivery of practical training and education in busy clinical environments. A narrative review aimed at outlining and integrating adult learning and surgical education theory was undertaken. Additionally, this information was used to relate the practical delivery of surgical training and education in day-to-day surgical practice. Concepts were sourced from reference material. Additional material was found using a PubMed search of the words: ‘surgical education theory’ and ‘adult learning theory medical’. This yielded 1351 abstracts, of which 43 articles with a focus on key concepts in adult education theory were used. Key papers were used to formulate structure and additional cross-referenced papers were included where appropriate. Current concepts within adult learning have a lot to offer when considering how to better deliver surgical education and training. Better integration of adult learning theory can be fruitful. Individual teaching surgical units need to rethink their paradigms and consider how each individual can contribute to the education experience. Up skilling courses for trainers can do much to improve the delivery of surgical education. Understanding adult learning concepts and integrating these into day-to-day teaching can be valuable. PMID:28357046

Reduction of catheter-associated bloodstream infections through procedures in newborn babies admitted in a university hospital intensive care unit in Brazil.

PubMed

Resende, Daiane Silva; Ó, Jacqueline Moreira do; Brito, Denise von Dolinger de; Abdallah, Vânia Olivetti Steffen; Gontijo Filho, Paulo Pinto

2011-01-01

Catheter-associated bloodstream infection (CA-BSI) is the most common nosocomial infection in neonatal intensive care units. There is evidence that care bundles to reduce CA-BSI are effective in the adult literature. The aim of this study was to reduce CA-BSI in a Brazilian neonatal intensive care unit by means of a care bundle including few strategies or procedures of prevention and control of these infections. An intervention designed to reduce CA-BSI with five evidence-based procedures was conducted. A total of sixty-seven (26.7%) CA-BSIs were observed. There were 46 (32%) episodes of culture-proven sepsis in group preintervention (24.1 per 1,000 catheter days [CVC days]). Neonates in the group after implementation of the intervention had 21 (19.6%) episodes of CA-BSI (14.9 per 1,000 CVC days). The incidence of CA-BSI decreased significantly after the intervention from the group preintervention and postintervention (32% to 19.6%, 24.1 per 1,000 CVC days to 14.9 per 1,000 CVC days, p=0.04). In the multiple logistic regression analysis, the use of more than 3 antibiotics and length of stay >8 days were independent risk factors for BSI. A stepwise introduction of evidence-based intervention and intensive and continuous education of all healthcare workers are effective in reducing CA-BSI.

Investigating admitted patients’ satisfaction with nursing care at Debre Berhan Referral Hospital in Ethiopia: a cross-sectional study

PubMed Central

Assefa, Hilina Ketema

2018-01-01

Objectives The aims of the study were (1) to assess the level of patient satisfaction with nursing care and (2) to identify factors influencing patient satisfaction. Design A hospital-based, cross-sectional study was conducted with 252 admitted patients in the medical, surgical and paediatric wards. Setting Debre Berhan Referral Hospital, Debre Berhan, Ethiopia, with a catchment population of 2.8 million. Participants All patients admitted at least for 2 days and capable of independent communication were included. However, patients were excluded on any one of the following conditions: admitted for less than 2 days, cannot understand Amharic language, with critical illness or cognitive impairment that affects judgement, or inability to provide written informed consent. The mean age of the patients was 37.9 (SD=12.9) years, and half (50.4%) of them were male. Primary outcome measure Patient satisfaction with nursing care, measured by the Newcastle Satisfaction with Nursing Scale, was the outcome variable. Using a mean split approach, patient satisfaction scores were dichotomised into ‘satisfied’ and ‘unsatisfied’. Results 49.2% of patients were satisfied with nursing care. Educational status and history of admission were significant factors influencing patient satisfaction with nursing care. Patients who had high educational status were 80% less satisfied compared with those who had no formal education (p=0.01, OR=0.2, 95% CI 0.1 to 0.7). Patients who had a history of admission were 2.2 times more satisfied compared with those who had no history of admission (p=0.02, OR=2.2, 95% CI 1.2 to 4.2). Conclusions About half the admitted patients were satisfied with the nursing care. Satisfaction differed significantly by patients’ educational attainment and history of admission. This study provided evidence on patient satisfaction with nursing care in Ethiopia. This information may be useful in comparative studies of patient satisfaction and in identifying characteristics that may explain or predict patient satisfaction. PMID:29773703

Supporting ward staff in acute care areas: the past, the present and the future?

PubMed

Coad, Sharon; Haines, Susan; Lawrence, Barbara

2002-01-01

Clinical education for acute ward staff caring for critically ill patients has continued to be a strong focus for practice development. Adopting a work-based learning approach to empower ward staff has led to the development of a five-day competency-based high dependency skills course. Developing leadership potential and enhancing networking opportunities for nurses from within critical care and ward areas is essential for the realisation of the aims of Comprehensive Critical Care.

Partners in research: building academic-practice partnerships to educate and mentor advanced practice nurses.

PubMed

Harbman, Patricia; Bryant-Lukosius, Denise; Martin-Misener, Ruth; Carter, Nancy; Covell, Christine L; Donald, Faith; Gibbins, Sharyn; Kilpatrick, Kelley; McKinlay, James; Rawson, Krista; Sherifali, Diana; Tranmer, Joan; Valaitis, Ruta

2017-04-01

Clinical practice is the primary focus of advanced practice nursing (APN) roles. However, with unprecedented needs for health care reform and quality improvement (QI), health care administrators are seeking new ways to utilize all dimensions of APN expertise, especially related to research and evidence-based practice. International studies reveal research as the most underdeveloped and underutilized aspect of these roles. To improve patient care by strengthening the capacity of advanced practice nurses to integrate research and evidence-based practice activities into their day-to-day practice. An academic-practice partnership was created among hospital-based advanced practice nurses, nurse administrators, and APN researchers to create an innovative approach to educate and mentor advanced practice nurses in conducting point-of-care research, QI, or evidence-based practice projects to improve patient, provider, and/or system outcomes. A practice-based research course was delivered to 2 cohorts of advanced practice nurses using a range of teaching strategies including 1-to-1 academic mentorship. All participants completed self-report surveys before and after course delivery. Through participation in this initiative, advanced practice nurses enhanced their knowledge, skills, and confidence in the design, implementation, and/or evaluation of research, QI, and evidence-based practice activities. Evaluation of this initiative provides evidence of the acceptability and feasibility of academic-practice partnerships to educate and mentor point-of-care providers on how to lead, implement, and integrate research, QI and evidence-based activities into their practices. © 2016 John Wiley & Sons, Ltd.

Effects of Self-Management Support on Structure, Process, and Outcomes Among Vulnerable Patients With Diabetes

PubMed Central

Schillinger, Dean; Handley, Margaret; Wang, Frances; Hammer, Hali

2009-01-01

OBJECTIVE Despite the importance of self-management support (SMS), few studies have compared SMS interventions, involved diverse populations, or entailed implementation in safety net settings. We examined the effects of two SMS strategies across outcomes corresponding to the Chronic Care Model. RESEARCH DESIGN AND METHODS A total of 339 outpatients with poorly controlled diabetes from county-run clinics were enrolled in a three-arm trial. Participants, more than half of whom spoke limited English, were uninsured, and/or had less than a high school education, were randomly assigned to usual care, interactive weekly automated telephone self-management support with nurse follow-up (ATSM), or monthly group medical visits with physician and health educator facilitation (GMV). We measured 1-year changes in structure (Patient Assessment of Chronic Illness Care [PACIC]), communication processes (Interpersonal Processes of Care [IPC]), and outcomes (behavioral, functional, and metabolic). RESULTS Compared with the usual care group, the ATSM and GMV groups showed improvements in PACIC, with effect sizes of 0.48 and 0.50, respectively (P < 0.01). Only the ATSM group showed improvements in IPC (effect sizes 0.40 vs. usual care and 0.25 vs. GMV, P < 0.05). Both SMS arms showed improvements in self-management behavior versus the usual care arm (P < 0.05), with gains being greater for the ATSM group than for the GMV group (effect size 0.27, P = 0.02). The ATSM group had fewer bed days per month than the usual care group (−1.7 days, P = 0.05) and the GMV group (−2.3 days, P < 0.01) and less interference with daily activities than the usual care group (odds ratio 0.37, P = 0.02). We observed no differences in A1C change. CONCLUSIONS Patient-centered SMS improves certain aspects of diabetes care and positively influences self-management behavior. ATSM seems to be a more effective communication vehicle than GMV in improving behavior and quality of life. PMID:19131469

In the Child's Best Interest: A Primer on the U.N. Convention on the Rights of the Child. New Edition-Revised Text.

ERIC Educational Resources Information Center

Castelle, Kay

The purpose of this book is to explain the United Nations Convention on the Rights of the Child, which sets standards for the protection and care of children. No country protects the rights of all its children or provides them with an adequate standard of health care, education, day care, housing and nutrition, or properly protects them from…

The Journey: "Good Management Begins with Good People"

ERIC Educational Resources Information Center

Vicars, Dennis

2012-01-01

A day in the life of anyone who works in or around a center-based early care and education program is one of numerous duties, timelines, staffing issues, program concerns, parent meetings, training, budget analysis, and teaching. The list is endless. Their days are filled with multiple priorities, all demanding their time and energy. It's so easy…

Portraits of Whole Language Classrooms: Learning for All Ages.

ERIC Educational Resources Information Center

Mills, Heidi, Ed.; Clyde, Jean Anne, Ed.

Highlighting typical days in a variety of whole-language classrooms, this book describes learners of all ages, beginning with a home day-care setting through preschool programs and elementary classrooms to a junior high and high school. The book also describes a special education site and an English-as-a-Second Language classroom, and concludes in…

Research without billing data. Econometric estimation of patient-specific costs.

PubMed

Barnett, P G

1997-06-01

This article describes a method for computing the cost of care provided to individual patients in health care systems that do not routinely generate billing data, but gather information on patient utilization and total facility costs. Aggregate data on cost and utilization were used to estimate how costs vary with characteristics of patients and facilities of the US Department of Veterans Affairs. A set of cost functions was estimated, taking advantage of the department-level organization of the data. Casemix measures were used to determine the costs of acute hospital and long-term care. Hospitalization for medical conditions cost an average of $5,642 per US Health Care Financing Administration diagnosis-related group weight; surgical hospitalizations cost $11,836. Nursing home care cost $197.33 per day, intermediate care cost $280.66 per day, psychiatric care cost $307.33 per day, and domiciliary care cost $111.84 per day. Outpatient visits cost an average of $90.36. These estimates include the cost of physician services. The econometric method presented here accounts for variation in resource use caused by casemix that is not reflected in length of stay and for the effects of medical education, research, facility size, and wage rates. Data on non-Veteran's Affairs hospital stays suggest that the method accounts for 40% of the variation in acute hospital care costs and is superior to cost estimates based on length of stay or diagnosis-related group weight alone.

77 FR 70677 - National Child's Day, 2012

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-27

...! initiative, which aims to solve the problem of childhood obesity within a generation, and the Affordable Care... strengthened early childhood education to help prevent achievement gaps before they start. We have invested in...

Delivery strategies to optimize resource utilization and performance status for patients with advanced life-limiting illness: results from the "palliative care trial" [ISRCTN 81117481].

PubMed

Abernethy, Amy P; Currow, David C; Shelby-James, Tania; Rowett, Debra; May, Frank; Samsa, Gregory P; Hunt, Roger; Williams, Helena; Esterman, Adrian; Phillips, Paddy A

2013-03-01

Evidence-based approaches are needed to improve the delivery of specialized palliative care. The aim of this trial was to improve on current models of service provision. This 2×2×2 factorial cluster randomized controlled trial was conducted at an Australian community-based palliative care service, allowing three simultaneous comparative effectiveness studies. Participating patients were newly referred adults, experiencing pain, and who were expected to live >48 hours. Patients enrolled with their general practitioners (GPs) and were randomized three times: 1) individualized interdisciplinary case conference including their GP vs. control, 2) educational outreach visiting for GPs about pain management vs. control, and 3) structured educational visiting for patients/caregivers about pain management vs. control. The control condition was current palliative care. Outcomes included Australia-modified Karnofsky Performance Status (AKPS) and pain from 60 days after randomization and hospitalizations. There were 461 participants: mean age 71 years, 50% male, 91% with cancer, median survival 179 days, and median baseline AKPS 60. Only 47% of individuals randomized to the case conferencing intervention received it; based on a priori-defined analyses, 32% of participants were included in final analyses. Case conferencing reduced hospitalizations by 26% (least squares means hospitalizations per patient: case conference 1.26 [SE 0.10] vs. control 1.70 [SE 0.13], P=0.0069) and better maintained performance status (AKPS case conferences 57.3 [SE 1.5] vs. control 51.7 [SE 2.3], P=0.0368). Among patients with declining function (AKPS <70), case conferencing and patient/caregiver education better maintained performance status (AKPS case conferences 55.0 [SE 2.1] vs. control 46.5 [SE 2.9], P=0.0143; patient/caregiver education 54.7 [SE 2.8] vs. control 46.8 [SE 2.1], P=0.0206). Pain was unchanged. GP education did not change outcomes. A single case conference added to current specialized community-based palliative care reduced hospitalizations and better maintained performance status. Comparatively, patient/caregiver education was less effective; GP education was not effective. Copyright © 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

The Mississippi State University College of Veterinary Medicine Shelter Program

PubMed Central

Bushby, Philip; Woodruff, Kimberly; Shivley, Jake

2015-01-01

Simple Summary First initiated in 1995 to provide veterinary students with spay/neuter experience, the shelter program at the Mississippi State University College of Veterinary Medicine has grown to be comprehensive in nature incorporating spay/neuter, basic wellness care, diagnostics, medical management, disease control, shelter management and biosecurity. Junior veterinary students spend five days in shelters; senior veterinary students spend 2-weeks visiting shelters in mobile veterinary units. The program has three primary components: spay/neuter, shelter medical days and Animals in Focus. Student gain significant hands-on experience and evaluations of the program by students are overwhelmingly positive. Abstract The shelter program at the Mississippi State University College of Veterinary Medicine provides veterinary students with extensive experience in shelter animal care including spay/neuter, basic wellness care, diagnostics, medical management, disease control, shelter management and biosecurity. Students spend five days at shelters in the junior year of the curriculum and two weeks working on mobile veterinary units in their senior year. The program helps meet accreditation standards of the American Veterinary Medical Association’s Council on Education that require students to have hands-on experience and is in keeping with recommendations from the North American Veterinary Medical Education Consortium. The program responds, in part, to the challenge from the Pew Study on Future Directions for Veterinary Medicine that argued that veterinary students do not graduate with the level of knowledge and skills that is commensurate with the number of years of professional education. PMID:26479234

Education-related differences in case fatality among elderly with stroke.

PubMed

Löfmark, Ulrika; Hammarström, Anne

2008-01-01

There is strong evidence for the existence of a socioeconomic gradient in stroke incidence and mortality, but there seem to be contradictory findings concerning an association between socioeconomic status and case fatality after stroke. Moreover, there is still a lack of studies that include men and women as well as people over 75 years. Our aim was to investigate whether there were education-related differences in 28-day case fatality after stroke in different age groups. All patients who were diagnosed with a cerebral infarction at the Umeå University Hospital during a 2-year period were included in this study. In total, 610 stroke patients (331 men, 279 women) aged 20-85 were hospitalized, of whom 77% were first-ever strokes. Overall, there were few education-related differences between the patients in different age groups (20-74 and 75-85 years). The 28-day case fatality after stroke was shown to be associated with a low educational level in patients above 75 years, also after controlling for sex, risk factors and acute stroke care measures. In this population-based study on patients with cerebral infarction, we found an education-related difference in 28-day case fatality in patients aged 75-85 years. The socioeconomic gradient persisted when we adjusted for risk factors and acute care variables. There is a need for more community-based stroke studies including all ages, with good case ascertainment. (c) 2008 S. Karger AG, Basel.

Enhanced recovery clinical education programme improves quality of post-operative care.

PubMed

McDonald, Ruth

2015-01-01

Quality is the driving principle of Enhanced Recovery (ER). It improves the patient experience by getting patients better sooner and changes clinical practice to make care safer and more efficient. As a consequence of ER patients spend less time in hospital. A successful ER programme began to fail after organisational restructuring and staff changes. Patients did not meet their ER goals and length of stay (LOS) increased. An ER nurse was appointed to get the programme back on track. This involved a multidisciplinary approach to an ER clinical education programme. The programme aimed to develop knowledge of the physiology of post-operative recovery and the evidence underpinning the interventions required. This was considered crucial to secure longer term staff engagement while avoiding unthinking protocol driven compliance. Success of the education programme was measured by improved outcomes in patient LOS and readmission statistics. During the four months of the clinical education programme there were no significant changes in monthly LOS. At six months post implementation of the programme there was a reduction in LOS of 0.6 days compared to the previous six months. At 12 months there was a reduction in 1.1 days compared with previous 12 months. There was a mean reduction of 28 day readmissions for all elective gynaecology surgery of 1.1 patients per month in the 12 months post programme implementation compared to the 12 months before. Delivering a multidisciplinary participatory education programme improved overall understanding of ER, and achieved sustained improvement in ER for patient benefit.

Developing an Inclusive Approach to Preschool Education: A Discussion of Issues and Strategies, with Implications Focussing on Quebec.

ERIC Educational Resources Information Center

Potter, Annie; Jacques, Marie

1997-01-01

Examines cultural conditions necessary for children's development in day care settings, using Bronfenbrenner's Ecology of Human Development. Considers the parental role in this context; also the relationship between educators and parents, with a view to creating culturally appropriate conditions for the developing child. Discusses policies and…

Salud/Servicios Personales. Libro del Profesor. (Health/Personal Services. Teacher's Guide). B2. CHOICE (Challenging Options in Career Education).

ERIC Educational Resources Information Center

Mid-Hudson Migrant Education Center, New Paltz, NY.

Written in Spanish, the guide comprises the first grade unit of a career education curriculum developed for migrant students. The guide covers 12 health and personal service occupations--blacksmith, television repairer, hairdresser/barber, day care worker, waitress, gas station attendant, family doctor, ambulance driver/attendant, dietician,…

"Bad Days Don't Kill You; They Just Make You Stronger": A Case Study of an Early Childhood Educator's Resilience.

ERIC Educational Resources Information Center

Sumsion, Jennifer

This case study used in-depth conversational interviews and careful reading of a professional portfolio to explore the basis of one early childhood educator's resilience. The study uncovered influences contributing to her resilience and enabling her to thrive professionally despite difficult circumstances. These influences are: (1) personal…

Forgotten Children: A Program for the Multihandicapped.

ERIC Educational Resources Information Center

Frampton, Merle E.; And Others

In a cerebral palsy-blind experimental school unit for day and residential care, a staff of 13 served 30 children in 6 years with 12 to 17 children each year. All but six children who were found to be nontrainable progressed: eight became trainable, eight trainable and partly educable, and eight educable. Variable progress was found characteristic…

Better Outcomes for All: Promoting Partnerships Between Head Start and State Pre-K

ERIC Educational Resources Information Center

Stebbins, Helene; Scott, L. Carol

2007-01-01

Every day, millions of three- and four-year-old children attend early education programs. The range of early childhood education program models includes, among others, state-funded pre-k, Head Start, and child care programs. Children attend these programs in public schools, private schools, colleges, businesses, community-based centers, and homes.…

Advancing Public Health through Continuing Education of Health Care Professionals

ERIC Educational Resources Information Center

Hudmon, Karen Suchanek; Addleton, Robert L.; Vitale, Frank M.; Christiansen, Bruce A.; Mejicano, George C.

2011-01-01

This article describes how the CS2day (Cease Smoking Today) initiative positioned continuing education (CE) in the intersection between medicine and public health. The authors suggest that most CE activities address the medical challenges that clinicians confront, often to the neglect of the public health issues that are key risk factors for the…

A Guide to Cost Allocation Procedures: Implementing Strategies for Universal Pre-Kindergarten.

ERIC Educational Resources Information Center

Russell-Browne, Acquenetta; Lederman, Nancy

This guide is intended to assist community-based providers in New York City who intend to blend universal pre-kindergarten funds with public child care funds, Head Start, preschool special education, or other funds to provide full or extended day early education programs for children. The guide provides information on how to allocate a programs…

Teleradiology in southern Sweden--a tool for reorganization of health care and for education.

PubMed

Pettersson, H; Holmer, N G

1998-01-01

The county organization, including health care, is reorganized in the province of Scania in southern Sweden. As part of the restructuring of health care, a program for digitalization of the departments of diagnostic imaging, as well as for teleradiology, has been set up. Standards for network, radiology information systems, and workstations have been settled, and teleradiology links both for on-call consultations and for on-line consultations day-time have been implemented, mainly running at 10 Mb/s. Further digitalization and implementation of teleradiology is planned for the nearest years. Parallel to this, a video conference system including several disciplines, hospitals and health care levels in the whole of southern Sweden has been implemented. The links are now also used for education, both in the province and internationally.

Building skill in heart failure self-care among community dwelling older adults: results of a pilot study.

PubMed

Dickson, Victoria Vaughan; Melkus, Gail D'Eramo; Katz, Stuart; Levine-Wong, Alissa; Dillworth, Judy; Cleland, Charles M; Riegel, Barbara

2014-08-01

Most of the day-to-day care for heart failure (HF) is done by the patient at home and requires skill in self-care. In this randomized controlled trial (RCT) we tested the efficacy of a community-based skill-building intervention on HF self-care, knowledge and health-related quality of life (HRQL) at 1- and 3-months. An ethnically diverse sample (n=75) of patients with HF (53% female; 32% Hispanic, 27% Black; mean age 69.9±10 years) was randomized to the intervention group (IG) or a wait-list control group (CG). The protocol intervention focused on tactical and situational HF self-care skill development delivered by lay health educators in community senior centers. Data were analyzed using mixed (between-within subjects) ANOVA. There was a significant improvement in self-care maintenance [F(2,47)=3.42, p=.04, (Cohen's f=.38)], self-care management [F(2,41)=4.10, p=.02, (Cohen's f=.45) and HF knowledge [F(2,53)=8.00, p=.001 (Cohen's f=.54)] in the IG compared to the CG. The skill-building intervention improved self-care and knowledge but not HRQL in this community-dwelling sample. Delivering an intervention in a community setting using lay health educators provides an alternative to clinic- or home-based teaching that may be useful across diverse populations and geographically varied settings. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

[Health promotion in day-care centres in Reykjavík--intervention and result of actions].

PubMed

Gudmarsdóttir, Agústa; Tómasson, Kristinn

2007-03-01

The purpose of the study was to compare wellbeing, health and work environment before and after intervention among employees of Reykjavík city day-care centre. The study is a prospective interventions study. In the year 2000 employees of 16 day-care centres responded to a questionnaire regarding work environment, health and wellbeing. Work environment evaluation was completed and the centre classified into four groups accordingly. Subsequently, the "equipment was renewed" noise protection improved and the employee received education concerning occupational health. Six months, after interventions, in the year 2002 the same questionnaire was readministered. Response rate in 2002 was 88% (n=267) but 90% in the year 2000. Work environment had improved. More employees had received instruction on good workposture and good work technique than 2 years earlier. Fewer employees used awkward posture than before. Better workspace resulted in reduced number of symptoms, also for the youngest employees. Symptoms were also fewer where unskilled employees were in majority and where the fewest of them had received proper education on work posture. In the year 2002, psychosocial wellbeing was better or equal than two years earlier. This was associated with better education and higher age even despite less workspace. Employees awareness towards noise was greatly improved. It is possible to improve work methods and work environment of employees with goal directed intervention, thus laying the ground for wellbeing at work. The interplay between the factors education and age is complex, though. Thus it is important, that all workplaces, adopt the process of "risk assessment", intervention, and then reassessment of the work environment. By doing so the goals of health promotion and good occupational health can be reached.

Two-Way Social Media Messaging in Postoperative Cataract Surgical Patients: Prospective Interventional Study.

PubMed

Sanguansak, Thuss; Morley, Katharine E; Morley, Michael G; Thinkhamrop, Kavin; Thuanman, Jaruwan; Agarwal, Isha

2017-12-19

Social media offers a new way to provide education, reminders, and support for patients with a variety of health conditions. Most of these interventions use one-way, provider-patient communication. Incorporating social media tools to improve postoperative (postop) education and follow-up care has only been used in limited situations. The aim of this study was to determine the feasibility and efficacy of two-way social media messaging to deliver reminders and educational information about postop care to cataract patients. A total of 98 patients undergoing their first eye cataract surgery were divided into two groups: a no message group receiving usual pre- and postop care and a message group receiving usual care plus messages in a mobile social media format with standardized content and timing. Each patient in the message group received nine messages about hand and face hygiene, medication and postop visit adherence, and links to patient education videos about postop care. Patients could respond to messages as desired. Main outcome measures included medication adherence, postop visit adherence, clinical outcomes, and patients' subjective assessments of two-way messaging. The number, types, content, and timing of responses by patients to messages were recorded. Medication adherence was better in the message group at postop day 7, with high adherence in 47 patients (96%, 47/49) versus 36 patients (73%, 36/49) in the no message group (P=.004), but no statistically significant differences in medication adherence between the groups were noted at preop and postop day 30. Visit adherence was higher at postop day 30 in the message group (100%, 49/49) versus the no message group (88%, 43/49; P=.03) but was 100% (49/49) in both groups at postop day 1 and 7. Final visual outcomes were similar between groups. A total of 441 standardized messages were sent to the message group. Out of 270 responses generated, 188 (70%) were simple acknowledgments or "thank you," and 82 (30%) responses were questions that were divided into three general categories: administrative, postop care, and clinical issues. Out of the 82 question responses, 31 (11%) were about administrative issues, 28 (10%) about postop care, and 23 (9%) about clinical symptoms. All the messages about symptoms were triaged by nurses or ophthalmologists and only required reassurance or information. Patients expressed satisfaction with messaging. Two-way social media messaging to deliver postop information to cataract patients is feasible and improves early medication compliance. Further design improvements can streamline work flow to optimize efficiency and patient satisfaction. ©Thuss Sanguansak, Katharine E Morley, Michael G Morley, Kavin Thinkhamrop, Jaruwan Thuanman, Isha Agarwal. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 19.12.2017.

Institution of a Preoperative Stoma Education Group Class Decreases Rate of Peristomal Complications in New Stoma Patients.

PubMed

Stokes, Audrey L; Tice, Shelly; Follett, Suzi; Paskey, Diane; Abraham, Lini; Bealer, Cheryl; Keister, Holly; Koltun, Walter; Puleo, Frances J

The purpose of this study was to compare selected postoperative complications (including stomal and peristomal complications), hospital length of stay, and readmission rates in a group of patients who attended a preoperative educational intervention to a retrospective group of patients who did not receive the intervention. Retrospective, comparison cohort study. The intervention group comprised 124 patients who attended an educational session for persons with fecal ostomies at a single tertiary care center in the Northeastern United States. They were compared to findings from a group of 94 individuals who underwent ostomy surgery during a 1-year period before initiation of the class. Patients undergoing emergent procedures or who had previous stomas were excluded. We found no significant differences between the 2 cohorts with respect to age, gender, comorbidities, open versus minimally invasive procedures, or colorectal diagnoses. A preoperative 2-hour stoma education class was led by certified WOC nurses for all patients undergoing colorectal surgeries in which the creation of a stoma was anticipated. This session included a didactic portion outlining postoperative expectations in the management of new ostomies (including dietary changes, prevention of dehydration, and an overview of ostomy supplies), as well as a hands-on portion to practice stoma care skills. We compared postoperative complications within 30 days (particularly stoma-related complications, including pouch leakage due to loss of seal, and peristomal skin irritation) between the group attending the education session and the control group. We also compared length of stay and 30-day readmission rates. Patients who participated in the educational intervention experienced significantly fewer peristomal complications than did patients in the historic control group (44.7% vs 20.2%, P = .002). Logistic regression analysis revealed that participation in the group was associated with a lower likelihood of peristomal skin complications (odds ratio = 0.35; 95% confidence interval, 0.18-0.67). Their length of stay (median 6 days vs 5 days, P = NS), and the proportion who experienced 30-day readmission (20.2% vs 15.3%, P = NS), did not significantly differ. A preoperative stoma education group class significantly reduced the likelihood of frequent leakage from the ostomy pouching system and peristomal skin irritation.

How Can Medical Students Add Value? Identifying Roles, Barriers, and Strategies to Advance the Value of Undergraduate Medical Education to Patient Care and the Health System.

PubMed

Gonzalo, Jed D; Dekhtyar, Michael; Hawkins, Richard E; Wolpaw, Daniel R

2017-09-01

As health systems evolve, the education community is seeking to reimagine student roles that combine learning with meaningful contributions to patient care. The authors sought to identify potential stakeholders regarding the value of student work, and roles and tasks students could perform to add value to the health system, including key barriers and associated strategies to promote value-added roles in undergraduate medical education. In 2016, 32 U.S. medical schools in the American Medical Association's (AMA's) Accelerating Change in Education Consortium met for a two-day national meeting to explore value-added medical education; 121 educators, systems leaders, clinical mentors, AMA staff leadership and advisory board members, and medical students were included. A thematic qualitative analysis of workshop discussions and written responses was performed, which extracted key themes. In current clinical roles, students can enhance value by performing detailed patient histories to identify social determinants of health and care barriers, providing evidence-based medicine contributions at the point-of-care, and undertaking health system research projects. Novel value-added roles include students serving as patient navigators/health coaches, care transition facilitators, population health managers, and quality improvement team extenders. Six priority areas for advancing value-added roles are student engagement, skills, and assessments; balance of service versus learning; resources, logistics, and supervision; productivity/billing pressures; current health systems design and culture; and faculty factors. These findings provide a starting point for collaborative work to positively impact clinical care and medical education through the enhanced integration of value-added medical student roles into care delivery systems.

Brazilian daycares: weighing the risks and benefits.

PubMed

Marchand, D

1994-10-01

The number of day care centers in Brazil has doubled over the last few years; with this increase has come a rise in the numbers of cases of communicable disease, particularly pneumonia (the main cause of child mortality in Brazil). A study by Dr. Walter V.C. da Fonseca states that a day care child is 5 times more likely to contact pneumonia. However, since the income earned by women in Brazil today is necessary to meet basic needs, children must be left at home with relatives or sent to day care. Most of the centers taking in children under 6 years of age are urban; they care for, on average, 125-200 children. These children are usually from low income families who live on the outskirts of cities; free day care is only provided to working mothers. There are 3 social factors involved: the greater number of single-parent families, more households supported solely by the mother, and an economic crisis that has hit the poor particularly hard. Financial and administrative responsibility for these centers varies. The centers provide meals, baths, rest, education (including some special education services), and health care (doctors, dentists, and nurses). Some accept abandoned children, who are cared for until they are adopted. However, new studies indicate that the centers represent the primary risk factor for respiratory illnesses and were, until recently, the principal causes of diarrhea and child mortality. An ongoing comparative study by da Fonseca is analyzing the incidence rates of respiratory and infectious diseases among 400 children attending a nursery in Fortaleza in comparison to those for 400 cared for at home by family. Doctor Aluiso Barros, in another study, is observing 1000 children in 40 nurseries in Campinas. For 8 weeks, data was collected on the health, socioeconomic situation, medical history, and family medical history of each child. The nurseries were examined and information was collected regarding the number of diseases reported each month, their causes, possible associations with services provided, and possibilities of transmission. Dr. Barros' research is supported by IDRC; Dr. da Fonseca's is supported by the British Overseas Development Agency.

Quality Disparities in Child Care for At-Risk Children: Comparing Head Start and Non-Head Start Settings

PubMed Central

Hillemeier, Marianne M.; Morgan, Paul L.; Farkas, George; Maczuga, Steven A.

2012-01-01

The study objectives are to describe child care type and quality experienced by developmentally at-risk children, examine quality differences between Head Start and non-Head Start settings, and identify factors associated with receiving higher-quality child care. Data are analyzed from the Early Childhood Longitudinal Survey, Birth Cohort, a prospective study of a nationally representative sample of US children born in 2001. The sample consisted of 7,500 children who were assessed at 48 months of age. The outcome of interest is child care quality, measured by the Early Childhood Environmental Rating Scale (center care) and the Family Day Care Rating Scale (family day care). Results of descriptive and multivariate regression analyses are presented. Less than one-third of poor children were in Head Start. Child care quality was higher in Head Start centers than other centers, particularly among poor children (4.75 vs. 4.28, p < 0.001), Hispanics (4.90 vs. 4.45, p < 0.001), and whites (4.89 vs. 4.51, p < 0.001). African Americans experienced the lowest quality care in both Head Start and non-Head Start centers. Quality disadvantage was associated with Head Start family care settings, especially for low birthweight children (2.04 in Head Start vs. 3.58 in non-Head Start, p < 0.001). Lower family day care quality was associated with less maternal education and African American and Hispanic ethnicity. Center-based Head Start provides higher quality child care for at-risk children, and expansion of these services will likely facilitate school readiness in these populations. Quality disadvantages in Head Start family day care settings are worrisome and warrant investigation. PMID:22392601

Assemblages of Desire: Infants, Bear Caves and Belonging in Early Childhood Education and Care

ERIC Educational Resources Information Center

Stratigos, Tina

2015-01-01

Belonging is emerging as an important concept in contemporary early childhood curricula, and calls have recently been made for belonging to be critically interrogated and further theorized. This article explores how belonging was operating for an infant in Australian family day care by looking at an episode that took place between the infant, a…

Adherence to the items in a bundle for the prevention of ventilator-associated pneumonia.

PubMed

Sachetti, Amanda; Rech, Viviane; Dias, Alexandre Simões; Fontana, Caroline; Barbosa, Gilberto da Luz; Schlichting, Dionara

2014-01-01

To assess adherence to a ventilator care bundle in an intensive care unit and to determine the impact of adherence on the rates of ventilator-associated pneumonia. A total of 198 beds were assessed for 60 days using a checklist that consisted of the following items: bed head elevation to 30 to 45º; position of the humidifier filter; lack of fluid in the ventilator circuit; oral hygiene; cuff pressure; and physical therapy. Next, an educational lecture was delivered, and 235 beds were assessed for the following 60 days. Data were also collected on the incidence of ventilator-acquired pneumonia. Adherence to the following ventilator care bundle items increased: bed head elevation from 18.7% to 34.5%; lack of fluid in the ventilator circuit from 55.6% to 72.8%; oral hygiene from 48.5% to 77.8%; and cuff pressure from 29.8% to 51.5%. The incidence of ventilator-associated pneumonia was statistically similar before and after intervention (p=0.389). The educational intervention performed in this study increased the adherence to the ventilator care bundle, but the incidence of ventilator-associated pneumonia did not decrease in the small sample that was assessed.

Drivers of Inpatient Hospital Experience Using the HCAHPS Survey in a Canadian Setting.

PubMed

Kemp, Kyle A; Chan, Nancy; McCormack, Brandi; Douglas-England, Kathleen

2015-08-01

To identify factors associated with patients' overall rating of inpatient hospital care. Two years of patient interview data (April 1, 2011 to March 31, 2013), linked to inpatient administrative records. Patients rated their overall health on a scale of 0 (worst care) to 10 (best care) using the HCAHPS instrument administered via telephone, up to 42 days postdischarge. Logistic regression was used to generate odds ratios for each independent predictor. HCAHPS data were linked to inpatient records based on health care numbers and dates of service. The outcome (overall health experience) was collapsed into two groups (10 vs. 0-9). Overall hospital experience of 0-9 was associated with younger age, male gender, higher level of education, being born in Canada, urgent admission, not having a family practitioner as the most responsible provider service, and not being discharged home. A length of stay of less than 3 days was protective. The c-statistic for the multivariate model was 0.635. Our results are novel in the Canadian population. Several questions for future research have been generated, in addition to opportunities for quality improvement within our own organization. © Health Research and Educational Trust.

Use of simulation-based education to reduce catheter-related bloodstream infections.

PubMed

Barsuk, Jeffrey H; Cohen, Elaine R; Feinglass, Joe; McGaghie, William C; Wayne, Diane B

2009-08-10

Simulation-based education improves procedural competence in central venous catheter (CVC) insertion. The effect of simulation-based education in CVC insertion on the incidence of catheter-related bloodstream infection (CRBSI) is unknown. The aim of this study was to determine if simulation-based training in CVC insertion reduces CRBSI. This was an observational education cohort study set in an adult intensive care unit (ICU) in an urban teaching hospital. Ninety-two internal medicine and emergency medicine residents completed a simulation-based mastery learning program in CVC insertion skills. Rates of CRBSI from CVCs inserted by residents in the ICU before and after the simulation-based educational intervention were compared over a 32-month period. There were fewer CRBSIs after the simulator-trained residents entered the intervention ICU (0.50 infections per 1000 catheter-days) compared with both the same unit prior to the intervention (3.20 per 1000 catheter-days) (P = .001) and with another ICU in the same hospital throughout the study period (5.03 per 1000 catheter-days) (P = .001). An educational intervention in CVC insertion significantly improved patient outcomes. Simulation-based education is a valuable adjunct in residency education.

Primary care nursing role and care coordination: an observational study of nursing work in a community health center.

PubMed

Anderson, Daren R; St Hilaire, Daniel; Flinter, Margaret

2012-05-31

Care coordination is a core element of the Patient-Centered Medical Home and requires an effective, well educated nursing staff. A greater understanding of roles and tasks currently being carried out by nurses in primary care is needed to help practices determine how best to implement care coordination and transform into PCMHs. We conducted an observational study of primary care nursing in a Community Health Center by creating a classification schema for nursing responsibilities, directly observing and tracking nurses' work, and categorizing their activities. Ten nurses in eight different practice sites were observed for a total of 61 hours. The vast majority of nursing time was spent in vaccine and medication administration; telephone work; and charting and paper work, while only 15% of their time was spent in activity that was classified broadly as care coordination. Care coordination work appeared to be subsumed by other daily tasks, many of which could have been accomplished by other, lesser trained members of the health care team. Practices looking to implement care coordination need a detailed look at work flow, task assignments, and a critical assessment of staffing, adhering to the principal of each team member working to the highest level of his or her education and license. Care coordination represents a distinct responsibility that requires dedicated nursing time, separate from the day to day tasks in a busy practice. To fully support these new functions, reimbursement models are needed that support such non visit-based work and provide incentives to coordinate and manage complex cases, achieve improved clinical outcomes and enhance efficiency of the health system. This article describes our study methods, data collection, and analysis, results, and discussion about reorganizing nursing roles to promote care coordination.

Changing practice in residential aged care using participatory methods.

PubMed

Lindeman, M A; Black, K; Smith, R; Gough, J; Bryce, A; Gilsenan, B; Hill, K; Stewart, A

2003-03-01

Residential aged care staff play a significant role in the day-to-day lives of residents yet are faced with many barriers to providing care that promotes resident wellbeing. Action research is a useful approach for clarifying issues, identifying education and training needs, and identifying, and in some cases overcoming, organizational barriers to change. The Well for Life project aimed to enhance the social and physical health and well being of residents of aged care settings by empowering the staff of facilities to make change. The project had a particular focus on nutrition and physical activity. This paper reports on the action research group process undertaken during Phase I of the Well for Life project. Five residential aged care settings participated in the action research process facilitated by project staff independent of the facilities. The action plan and outcomes from one of these settings is used to illustrate the process and outcomes. The main findings of the project indicate that using a process that encourages staff involvement in identification of issues and actions can facilitate change in the practice of resident care. The action research groups identified specific gaps in knowledge and skill leading to targeted education that addressed areas of need. The importance of presenting information and learning opportunities for staff in a variety of formats was also recognized, as was the importance of organizational context, management support and empowerment of staff to make change.

The awesome Asthma School Days Program: educating children, inspiring a community.

PubMed

Meurer, J R; McKenzie, S; Mischler, E; Subichin, S; Malloy, M; George, V

1999-02-01

Program planners developed an educational program to improve the health of children with asthma in grades three to five in Milwaukee (Wis.) Public Schools. During 1997-1998, 1,400 students from 74 elementary schools participated in the Awesome Asthma School Days education program. In a cross-sectional survey, about 40% of children reported play interrupted and sleep disturbed by asthma, more than 50% of children reported exposure to smoke in their home, most children lacked asthma self-care tools, and most children with persistent symptoms did not use an anti-inflammatory inhaler. The educational program improved students' expectations about normal play and sleep and improved their understanding of asthma. Leaders in Milwaukee used the survey results to develop a community action plan. The educational program, surveys, community partnerships, and strategic plans can be replicated in other schools.

Comparison among the efficacy of interventions for the return rate to receive the pap test report: randomized controlled clinical trial 1

PubMed Central

Vasconcelos, Camila Teixeira Moreira; Pinheiro, Ana Karina Bezerra; Nicolau, Ana Izabel Oliveira; Lima, Thaís Marques; Barbosa, Denise de Fátima Fernandes

2017-01-01

ABSTRACT Objective: to test the effects of a behavioral, an educative and a comparative intervention on women's adherence to the return appointment to receive the pap test report. Methods: randomized controlled clinical trial at a Primary Health Care Service, involving three groups: EG (educative session and test demonstration), BG (recall ribbon) and standard intervention (card containing the return appointment - graphical reminder), called comparative group here (CG). To select the sample, the following was established: having started sexual activity and undergoing the pap smear during the study, resulting in 775 women. Results: among the 775 women, 585 (75.5%) returned to receive the test result within 65 days. The educative group presented the highest return rate (EG=82%/CG=77%/BG=66%), statistically significant only when compared to the behavioral group (p=0.000). The educative group obtained the smallest interval (p<0.05) concerning the mean number of days of return to receive the test result (EG:M=43days/BG:M=47.5days/CG:M=44.8 days). Conclusion: the educative group reached higher return rates and the women returned earlier, but the behavioral intervention showed to be the least effective. Brazilian Clinical Trial Register: RBR-93ykhs. PMID:28301035

A Study on Health Seeking Behaviors of Patients of Post-Kala-Azar Dermal Leishmaniasis.

PubMed

Basher, Ariful; Nath, Proggananda; Nabi, Shah Golam; Selim, Shahjada; Rahman, Md Fashiur; Sutradhar, Satya Ranjan; Faiz, Abul; Bhuiyan, Matiur Rahman; Ahmed, Be-Nazir; Rahman, Ridwanur

2015-01-01

Post-Kala-Azar Dermal Leishmaniasis (PKDL) remains a major public health threat in Bangladesh. A cross-sectional study was carried out in Surya Kanta Kala azar Research Centre (SKKRC), Mymensingh, from January 2012 to July 2013 to evaluate the health seeking behaviour and the length of delay of PKDL management. The consecutive 200 diagnosed PKDL cases that got treatment in SKKRC hospital were subjected to evaluation. Most (98%) of the patients were not aware and had no knowledge about PKDL, though 87.5% had a history of history of Kala-azar treatment. Many patients reported first to village doctor (15.5%), the pharmacy shop (10%), or traditional health provider (7.5%) upon recognition of symptom. The time between the initial symptom recognition and first medical consultation (patient delay) ranged from 10 days to 4745 days (13 years) with a median of 373 days (mean: 696; IQR: 138 to 900 days). The time between first medical consultations to definite treatment (system delay) ranged from 0 days to 1971 days (5.4 years), with a median delay of 14 days (mean: 46.48; IQR: 7 to 44 days) that was reported in this study. Age, education, occupation, and residential status had significant association with patient delay (P < 0.05). Educational status, occupation, number of treatment providers, and first health care provider had a significant association with system delay (P < 0.05). Success in PKDL diagnosis and treatment requires specific behavior from patients and health care providers which facilitate those practices.

Closing The Gap “Disparity In Native Hawaiian Cardiac Care”

PubMed Central

Grothaus, Coraleen T; Gutierrez, Carol E; Kehoe, Kimberly A; Valentin, Mona R

2010-01-01

Purpose Queen's Heart, the cardiac service line at the Queens Medical Center (QMC), Honolulu, Hawai‘i, recognizes the importance of closing the health disparity gap that affects the Native Hawaiian population. The purpose of this study was to examine the process and outcomes of health care among Native Hawaiians with heart disease, and to evaluate the impact of a multidisciplinary, culturally sensitive effort to improve quality of care. An inpatient program was created by assembling a team of practitioners who have an affinity for Native Hawaiian culture to address the health care of the Native Hawaiian people. Methods All Native Hawaiian patients who were admitted to The Queen's Medical Center from January 2007 to December 2008 became participants of the program. Baseline outcomes data for cardiac core measures, length of stay, 30 day readmission rates, and adverse events were reviewed by the team before the study was initiated. Educational materials were developed to provide culturally specific disease management information to patients and family members. The patient educators and discharge counselors provided patients with the education and tools they needed to engage in self care management. Heart failure disease management ensured that all Native Hawaiian patients receive appropriate quality care, individualized heart failure education, and a definitive plan for out patient follow up. The Integrative Care Program provided a holistic perspective of healing. Results All quality indicators for Native Hawaiian patients with cardiac disease have improved. Patient satisfaction rates have remained at the 99th percentile. There has been a marked improvement in adverse events following percutaneous coronary interventions (PCI) for Native Hawaiian patients. Readmissions that occurred in less than 30 days for patients admitted with myocardial infarctions and heart failure have improved and are now essentially the same as all other patient populations. Conclusions Culturally sensitive and patient centered care, delivered by the team of specialists from Queen's Heart, has allowed patients to incorporate cultural preferences into their care and recovery. Readmission rates have decreased, mortality rates have improved, and patient and family satisfaction is enhanced. PMID:20544602

[The situation as regards diabetes mellitus type 1 in Andalusia. Care data, use of advanced therapies and human resources].

PubMed

López Siguero, Juan Pedro; Pérez González, Olga; Gómez Gila, Ana Lucía; Leiva Gea, Isabel

2017-11-14

The representation of Spain in European epidemiological studies on diabetes is limited, with only one centre in the Hvidoere study and another in the SWEET study. No Spanish studies have been published that combine epidemiological data and care resources. The aim of this study was to determine the epidemiological data, care resources, and use of new technologies in all Andalusian hospitals that care for children with Diabetes Mellitus type 1 (DM1) under 14 years. An electronic questionnaire of 18 questions was sent to all paediatric endocrinologists who treated children with diabetes in Andalusian hospitals. There was a mean of 3.12 (SD: 2.58) paediatric endocrinologist for every 100 patients, with a mean diabetes nurse educator ratio of 2.50 (SD: 3.94) per 100 patients and centre. Only 1 of the 29 centres had a psychologist, 9/29 had a day hospital, and 11/29 had a 24-hour telephone line. The mean of days of consultations exclusively for patients with DM1 was 1.56 days (SD: 1.21) per week. Continuous insulin infusion was used to treat 5% of patients, with a significant increase in centres with more than 150 patients. This study offers, for the first time, current data on the epidemiological situation related to health care data, comparing them with the recommendations of European standards, highlighting a low ratio of endocrinologists and educators in diabetes, absence of psychologists and low technology penetrance. Copyright © 2017. Publicado por Elsevier España, S.L.U.

Enhanced inpatient rounds, appointment reminders, and patient education improved HIV care engagement following hospital discharge.

PubMed

Khawcharoenporn, Thana; Damronglerd, Pansachee; Chunloy, Krongtip; Sha, Beverly E

2018-06-01

Human immunodeficiency virus (HIV) care engagement post hospital discharge is often suboptimal. Strategies to improve follow-up are needed. A quasi-experimental study was conducted among hospitalized HIV-infected patients between the period from 1 January 2013 to 30 June 2014 (preintervention period) and 1 July 2014 to 31 December 2015 (intervention period). During the intervention period, an HIV care team consisting of an Infectious Diseases physician, a nurse, a pharmacist, a social worker, and an HIV-infected volunteer made daily inpatient rounds. Prior to discharge, patients received a structured HIV education session and an outpatient appointment was scheduled for them with two telephone reminder calls following discharge. There were 240 HIV-infected patients enrolled (120 in each study period), of which the median age was 37 years (interquartile range [IQR] 28-44 years), 58% were male, 39% were newly diagnosed with HIV infection, 46% were hospitalized because of AIDS-related conditions, and the median CD4 cell count on admission was 158 cells/µl (IQR 72-382 cells/µl). The rate of HIV care engagement within 30 days after discharge was significantly higher in the intervention period compared to the preintervention period (95% versus 69%; P < 0.001). Independent factors associated with no care engagement within 30 days were patients in the preintervention period (adjusted odds ratio [aOR] 6.36; P < 0.001) and new diagnosis of HIV infection (aOR 2.77; P = 0.009). The study findings suggest that enhanced inpatient rounds, appointment reminders, and patient education were shown to be associated with improved HIV care engagement after hospital discharge. Patients with a new diagnosis of HIV infection benefit from more intense outreach. ClinicalTrials.gov Identifier: NCT02578654.

Assessing the effectiveness of Australian early childhood education and care experiences: study protocol.

PubMed

Tayler, Collette; Cloney, Daniel; Adams, Ray; Ishimine, Karin; Thorpe, Karen; Nguyen, Thi Kim Cuc

2016-04-21

In Australia, 61.5 % of children aged 3-4 attend Early Childhood Education and Care (ECEC) programs. Children's experiences within these programs vary widely and impact directly on educational wellbeing and social development. Research has shown that higher quality programs enhance children's learning and developmental outcomes, foster social participation and have long-lasting effects on their productivity as adults. Quality matters, yet we do not know what components of ECEC result in a quality program. Effective Early Educational Experiences (E4Kids) is a 5-year longitudinal study designed to identify and assess the impact of mainstream ECEC programs and program components on children's learning, development, social inclusion and well-being. E4Kids sets out to measure quality ECEC; identify components that add value and positively impact children's outcomes; evaluate the effects of child, family, community and environment characteristics on programs; and provide evidence on how best to invest in ECEC. E4Kids follows a sample of 2,494 children who have experienced a variety of approved care programs (long day care, kindergarten, family day care and occasional care), as well as 157 children who have not accessed such programs. Children are tracked to the first point of National Assessment Program - Literacy and Numeracy (NAPLAN) testing at Year 3. The study presents a multi-level design in which ECEC programs were sampled from two states - Queensland and Victoria - then randomly sampled from two greater metropolitan regions and two regional and remote locations. Parents, centre directors, educators and carers complete questionnaires to provide information on demographics and children's progress. Data collected also include the make-up and organisation of ECEC programs and schools children attended. The quality of adult-child interactions is directly assessed using the Classroom Assessment Scoring System (CLASS) and direct testing of children's cognitive abilities and achievements is undertaken over 3 years and linked with NAPLAN scores. Findings from the E4Kids study have the potential to influence the quality of ECEC available in Australia by providing up-to-date evidence on the impact of ECEC programs and program components to inform future policy decisions and research.

Male Teachers in Early Childhood Education: Self & Social Perceptions.

ERIC Educational Resources Information Center

Shaham, Dan

Noting that men make up only a small percentage of early childhood and day care educators, a study was conducted to assess male teachers' points of view and attitudes. The self- and social-perceptions of 5 male preschool teachers between the ages of 22 and 50 were determined through ethnographic interviews. It was found that, as a group, the male…

Sex-work harm reduction.

PubMed

Rekart, Michael L

2005-12-17

Sex work is an extremely dangerous profession. The use of harm-reduction principles can help to safeguard sex workers' lives in the same way that drug users have benefited from drug-use harm reduction. Sex workers are exposed to serious harms: drug use, disease, violence, discrimination, debt, criminalisation, and exploitation (child prostitution, trafficking for sex work, and exploitation of migrants). Successful and promising harm-reduction strategies are available: education, empowerment, prevention, care, occupational health and safety, decriminalisation of sex workers, and human-rights-based approaches. Successful interventions include peer education, training in condom-negotiating skills, safety tips for street-based sex workers, male and female condoms, the prevention-care synergy, occupational health and safety guidelines for brothels, self-help organisations, and community-based child protection networks. Straightforward and achievable steps are available to improve the day-to-day lives of sex workers while they continue to work. Conceptualising and debating sex-work harm reduction as a new paradigm can hasten this process.

Northwest Latinos' health promotion lifestyle profiles according to diabetes risk status.

PubMed

Sutherland, Leonie L; Weiler, Dawn M; Bond, Laura; Simonson, Shawn; Reis, Janet

2012-12-01

A sample of 225 low income and low education, middle aged Latinos with concern about diabetes and living in a mid-size Idaho city volunteered for a physical assessment for risk status for the disease. The health promoting lifestyles of Latino congregants were measured using the Health Promoting Lifestyle Profile II. Diabetes risk was measured by clinically standard glycated hemoglobin readings. From no risk for the disease to full blown diabetes as determined by glycated hemoglobin levels, the respondents reported engaging in basically the same levels of physical activity, monitoring of nutrition and use of health care services thus evidencing no apparent understanding of the role of lifestyle in disease management. The findings point to the imperative of a broad, comprehensive and especially culturally attuned educational campaign on basic disease pathophysiology, the value of prevention for individual health, and the necessity of day-to-day self-care should diabetes be diagnosed.

Autonomy, privacy and informed consent 3: elderly care perspective.

PubMed

Scott, P A; Välimäki, M; Leino-Kilpi, H; Dassen, T; Gasull, M; Lemonidou, C; Arndt, M

Despite the growing interest in clinical healthcare ethics, there is a dearth of empirical studies investigating the ethical elements of day-to-day clinical practice from the perspective of either patients or staff. This article, the third in a four-part series, reports the results of a Scottish Study that formed part of a multi-site comparative study funded by the European Commission. It explores patient autonomy, privacy and informed consent in the care of elderly people in long-stay care facilities (i.e. nursing homes and continuing care units). A convenience sample of 101 elderly residents and their nurses (n = 160) participated in the study. Data were collected by means of a self-completion questionnaire for staff and a structured interview schedule for elderly residents. Results indicate marked differences between staff's and residents' responses on three of the four dimensions explored: information-giving, and opportunity to participate in decision-making about care and consent. There was much closer agreement between staff's and residents' responses regarding protection of patient privacy. From the results of this study there is indication of a clear need for further empirical studies exploring issues of patient autonomy, privacy and informed consent in the day-to-day nursing care of older people. Findings to date suggest there is still a significant need to educate staff concerning ethical awareness and sensitivity to the dignity and rights of patients.

Cost-effectiveness of a program to prevent depression relapse in primary care.

PubMed

Simon, Gregory E; Von Korff, Michael; Ludman, Evette J; Katon, Wayne J; Rutter, Carolyn; Unützer, Jürgen; Lin, Elizabeth H B; Bush, Terry; Walker, Edward

2002-10-01

Evaluate the incremental cost-effectiveness of a depression relapse prevention program in primary care. Primary care patients initiating antidepressant treatment completed a standardized telephone assessment 6-8 weeks later. Those recovered from the current episode but at high risk for relapse (based on history of recurrent depression or dysthymia) were offered randomization to usual care or a relapse prevention intervention. The intervention included systematic patient education, two psychoeducational visits with a depression prevention specialist, shared decision-making regarding maintenance pharmacotherapy, and telephone and mail monitoring of medication adherence and depressive symptoms. Outcomes in both groups were assessed via blinded telephone assessments at 3, 6, 9, and 12 months and health plan claims and accounting data. Intervention patients experienced 13.9 additional depression-free days during a 12-month period (95% CI, -1.5 to 29.3). Incremental costs of the intervention were $273 (95% CI, $102 to $418) for depression treatment costs only and $160 (95% CI, -$173 to $512) for total outpatient costs. Incremental cost-effectiveness ratio was $24 per depression-free day (95% CI, -$59 to $496) for depression treatment costs only and $14 per depression-free day (95% CI, -$35 to $248) for total outpatient costs. A program to prevent depression relapse in primary care yields modest increases in days free of depression and modest increases in treatment costs. These modest differences reflect high rates of treatment in usual care. Along with other recent studies, these findings suggest that improved care of depression in primary care is a prudent investment of health care resources.

Home-based asthma education of young low-income children and their families.

PubMed

Brown, Josephine V; Bakeman, Roger; Celano, Marianne P; Demi, Alice S; Kobrynski, Lisa; Wilson, Sandra R

2002-12-01

To conduct a controlled trial of a home-based education program for low-income caregivers of young children with asthma. Participants were randomized to treatment-eight weekly asthma education sessions adapted from the Wee Wheezers program (n = 49)-or usual care (n = 46). Baseline and 3- and 12-month follow-up data were gathered from caregivers and from children's medical records. Treatment was associated with less bother from asthma symptoms, more symptom-free days, and better caregiver quality of life at follow-up for children 1-3, but not those 4-6, years of age. Treatment and control groups did not differ in caregiver asthma management behavior or children's acute care utilization. This home-based asthma education program was most effective with younger children; perhaps their caregivers were more motivated to learn about asthma management. Targeting psychosocial factors associated with asthma morbidity might also enhance the efficacy of asthma education for these families.

A Defined Esophagectomy Perioperative Clinical Care Process Can Improve Outcomes and Costs.

PubMed

Cooke, David T; Calhoun, Royce F; Kuderer, Valerie; David, Elizabeth A

2017-01-01

Esophagectomy (EG) is a high-risk therapy for esophageal cancer and end-stage benign disease. This study compares the results of EG before and after implementation of a perioperative clinical care process including a health provider education program (EP) and institutional uncomplicated postoperative clinical pathway (POP) for purpose quality improvement. This is a single institution retrospective cohort study. The EP was provided to critical care and telemetry unit nurses and the POP was imbedded in the electronic health record. Patients undergoing elective EG with reconstruction with the stomach for benign disease or cancer were included from 2005 to 2011. Cohorts were pre- and postimplementation (PreI and PostI) of an EP and 8-day POP (August 2008). Patient, tumor and peri/postoperative-specific variables were compared between cohorts, as well as resource utilization and hospital costs. We identified 33 PreI and 41 PostI patients. Both cohorts had similar patient demographics, preoperative comorbidities, majority cancer diagnosis, and for cancer patients, majority adenocarcinoma and IIB/III pathologic stage. Both groups had one death and similar rate of discharge to home. The PostI cohort demonstrated reduced 30-day readmission rate (2.4% vs 24.2%); P < 0.05. In regard to clinical outcomes, the PostI group exhibited reduced deep venous thrombosis/pulmonary emboli (2.4% vs 18.2%); P < 0.05. The PostI group demonstrated significantly reduced radiographic test utilization and costs, as well as total overall 30-day readmission costs. A defined perioperative clinical process involving educating the patient care team and implementing a widely disseminated POP can reduce complications, 30-day readmission rates, and hospital costs after EG.

The development of a community breast center.

PubMed

Edge, R M; Peterson, C; James Ward, S

1999-01-01

Maximum capacity for mammography services had been reached at the Kaweah Delta Health Care District, a 504-bed, multicampus hospital district in Visalia, Calif., so the community supported the idea of better and easier access to cancer care. Kaweah Delta Foundation, the hospital's development arm, helped raise funds for a new community breast center after hearing from local women that they disliked traveling to Los Angeles or San Francisco for state-of-the-art technology in diagnosis. They also requested better education and quicker exam results. The new Center was the result of a collaborative effort between imaging services and the cancer care program at Kaweah Delta. A nearby hospital, with more space for parking and room to offer an education program, became the site of the new Center. New equipment that met MQSA guidelines was purchased. An architectural firm designed a layout for patient comfort and privacy and efficient throughput for high volume work. The purchase of a second mammography unit allowed the Center to offer same-day and next-day appointments, which increased both physician and patient satisfaction. Consultation services with a radiologist are now offered. An education program that includes group support meetings and referrals to an oncology clinical nurse specialist are also offered. A new mobile mammography unit, housed at a newly acquired hospital 13 miles away, serves the needs of women in the two-county rural area who have no transportation. With careful planning and collaboration, the volume of mammography services has doubled in a year. Customer service ratings have soared.

The management of type 1 diabetes in primary school: review of the literature.

PubMed

Marks, Anne; Wilson, Valerie; Crisp, Jackie

2013-01-01

Type 1 diabetes is one of the most common chronic health conditions in childhood. The introduction of intensive insulin therapy and the rising prevalence of diabetes in younger children has increased the need for involvement of diabetes educators and school personnel in school diabetes care. School encompasses a significant proportion of a child's day, therefore diabetes treatment at school needs to be optimal or the child will have poor metabolic control. The aim of this literature review is to examine diabetes management in the early primary school setting. The main areas of diabetes management explored are: type, provision, and location of treatment, the impact on the child, and the role of the credentialed diabetes educator. The review identifies that the majority of children are not receiving intensive diabetes treatment at school. Younger children require more assistance with care and may be disadvantaged due to lack of appropriate school staff support. Most schools do not have nurses to assist with diabetes care, therefore teaching and administration staff are utilized. The use of insulin pump therapy may increase access to insulin at school, as children and teaching staff appear more confident with this method of delivery than injections. Treatment is frequently performed away from the classroom and can impact on class attendance, metabolic control, and emergencies. Diabetes educators need to work in collaboration with children, parents, and school personnel to ensure diabetes care is fully integrated into the school day.

An educational intervention to improve cost-effective care among medicine housestaff: a randomized controlled trial.

PubMed

Sommers, Benjamin D; Desai, Nihar; Fiskio, Julie; Licurse, Adam; Thorndike, Mary; Katz, Joel T; Bates, David W

2012-06-01

High medical costs create significant burdens. Research indicates that doctors have little awareness of costs. This study tested whether a brief educational intervention could increase residents' awareness of cost-effectiveness and reduce costs without negatively affecting patient outcomes. The authors conducted a clustered randomized controlled trial of 33 teams (96 residents) at an internal medicine residency program (2009-2010). The intervention was a 45-minute teaching session; residents reviewed the hospital bill of a patient for whom they had cared and discussed reducing unnecessary costs. Primary outcomes were laboratory, pharmacy, radiology, and total hospital costs per admission. Secondary measures were length of stay (LOS), intensive care unit (ICU) admission, 30-day readmission, and 30-day mortality. Multivariate adjustment controlled for patient demographics and health. A follow-up survey assessed resident attitudes three months later. Among 1,194 patients, there were no significant cost differences between intervention and control groups. In the intervention group, 30-day readmission was higher (adjusted odds ratio 1.51, P = .010). There was no effect on LOS or the composite outcome of readmission, mortality, and ICU transfer. In a subgroup analysis of 835 patients newly admitted during the study, the intervention group incurred $163 lower adjusted lab costs per admission (P = .046). The follow-up survey indicated persistent differences in residents' exposure to concepts of cost-effectiveness (P = .041). A brief intervention featuring a discussion of hospital bills can fill a gap in resident education and reduce laboratory costs for a subset of patients, but may increase readmission risk.

Parents are reluctant to use technological means of communication in pediatric day care.

PubMed

Murto, Kimmo; Bryson, Gregory L; Abushahwan, Ibrahim; King, Jim; Moher, David; El-Emam, Khaled; Splinter, William

2008-04-01

We hypothesized that advanced information and communication technology (ICT) would be acceptable to parents in a pediatric surgical, and diagnostic imaging day care setting. After Ethics Committee approval, we distributed surveys, over a one-month period, to parents of children arriving for day care surgery or diagnostic imaging. Parents indicated their acceptance of various proposed modes of postoperative discussion of healthcare i.e.; face-to-face, videophone, or telephone. Parents were also asked to describe their receptiveness to scheduling non-emergency hospital appointments online and to receiving electronic media describing their child's surgery and postoperative management. Parental education, income, and familiarity with the Internet were also assessed. A total of 451 surveys (84% response rate) were returned. Most parents (95%) had access to the Internet and 70% did their banking online. Forty-two percent of the parents had at least a university education and 63% had an annual family income > $50,000 Canadian. The majority of parents (98%) accepted face-to-face interaction, while only 35% and 37% of parents were receptive to videophone and telephone interviews, respectively. Computer availability (P = 0.001) and online banking (P = 0.011) were the only variables that predicted those parents who were in favour of using videophone technology. Parents were receptive to instruction electronic media (80%) and booking appointments online (61%). A well-educated and technologically sophisticated parent population does not favour advanced communication technologies over simple, face-to-face interaction in an in-hospital setting. These parents are prepared to receive technology-based information about their child's surgery and to schedule non-emergency hospital appointments online.

Women and Kidney Disease: Reflections on World Kidney Day 2018.

PubMed

Piccoli, Giorgina B; Alrukhaimi, Mona; Liu, Zhi-Hong; Zakharova, Elena; Levin, Adeera

2018-01-01

World Kidney Day and International Women's Day 2018 are commemorated on the same day (March 8), an opportunity to highlight the importance of women's health, and particularly, their kidney health. On its 13th anniversary, World Kidney Day promotes affordable and equitable access to health education, health care, and prevention for all women and girls in the world. In this article, we focus on what we do and do not know about women, kidney health, and kidney disease, and what we might learn in the future to improve outcomes worldwide. Copyright© by the American Nephrology Nurses Association.

Enhanced recovery clinical education programme improves quality of post-operative care

PubMed Central

McDonald, Ruth

2015-01-01

Quality is the driving principle of Enhanced Recovery (ER). It improves the patient experience by getting patients better sooner and changes clinical practice to make care safer and more efficient. As a consequence of ER patients spend less time in hospital. A successful ER programme began to fail after organisational restructuring and staff changes. Patients did not meet their ER goals and length of stay (LOS) increased. An ER nurse was appointed to get the programme back on track. This involved a multidisciplinary approach to an ER clinical education programme. The programme aimed to develop knowledge of the physiology of post-operative recovery and the evidence underpinning the interventions required. This was considered crucial to secure longer term staff engagement while avoiding unthinking protocol driven compliance. Success of the education programme was measured by improved outcomes in patient LOS and readmission statistics. During the four months of the clinical education programme there were no significant changes in monthly LOS. At six months post implementation of the programme there was a reduction in LOS of 0.6 days compared to the previous six months. At 12 months there was a reduction in 1.1 days compared with previous 12 months. There was a mean reduction of 28 day readmissions for all elective gynaecology surgery of 1.1 patients per month in the 12 months post programme implementation compared to the 12 months before. Delivering a multidisciplinary participatory education programme improved overall understanding of ER, and achieved sustained improvement in ER for patient benefit. PMID:26734343

Academia-industry collaboration in continuing medical education: description of two approaches.

PubMed

Katz, Harvey P; Goldfinger, Stephen E; Fletcher, Suzanne W

2002-01-01

Although concerns have been raised about industry support of continuing medical education (CME), there are few published reports of academia-industry collaboration in the field. We describe and evaluate Pri-Med, a CME experience for primary care clinicians developed jointly by the Harvard Medical School (HMS) and M/C Communications. Since 1995, 19 Pri-Med conferences have been held in four cities, drawing more than 100,000 primary care clinicians. The educational core of each Pri-Med conference is a 3-day Harvard course, "Current Clinical Issues in Primary Care." Course content is determined by a faculty committee independent of any commercial influence. Revenues from multiple industry sources flow through M/C Communications to the medical school as an educational grant to support primary care education. Pri-Med also offers separate pharmaceutical company-funded symposia. Comparing the two educational approaches during four conferences, 221 HMS talks and 103 symposia were presented. The HMS course covered a wide range with 133 topics; the symposia focused on 30 topics, most of which were linked to recently approved new therapeutic products manufactured by the funders. Both the course and the symposia were highly rated by attendees. When CME presentations for primary care physicians receive direct support from industry, the range of offered topics is narrower than when programs are developed independently of such support. There appear to be no differences in the perceived quality of presentations delivered with and without such support. Our experience suggests that a firewall between program planners and providers of financial support will result in a broader array of educational subjects relevant to the field of primary care.

Environmental education as part of compulsory education at school

NASA Astrophysics Data System (ADS)

Dimitrova, Boyanka

2013-04-01

Environmental education in schools is an element of civic education and skills, the students should learn in school. This is part of the state and public order in the school and as such lies in the mandatory training documentation for various objects from the natural and social sciences. With the idea to help teachers in this activity in recent years with teachers, students, and government and municipal authorities had organized a number of activities aimed at: 1. Targeted analysis of curricula for middle school and increase their knowledge and professional competence of teachers towards the standards set forth by the state educational requirements, analysis shows that knowledge is competencies aimed at environmental education of young people are out (to varying degrees) in significant part of the subjects taught in secondary schools - man and society, and man and nature (in early stages) Geography (including the risks associated with natural - causes and effects), Biology and Health Education, Chemistry and protection of the environment, physics and astronomy, history and civilization and interdisciplinary civic education field. 2. Seminar courses to acquire skills to conduct interactive activities with students and in conjunction with textbooks (Green Package, Natura 2000, WSP, Flupi for a better environment). 3. Visits interesting and protected areas and objects by exploring opportunities for outings with students. 4. Conducting workshops and classes using the provided tools, techniques and interesting games aimed at awareness of the need for care and attention to our surroundings. 5. Organizing and conducting competitions between students from schools in our city, usually associated with the most popular day - Earth Day, World Day for Environmental Protection, Day of Danube). 6. Participation in outdoor activities - studying the structure and features of parks hometown, Work shop for making objects from natural materials and waste materials; race making ikebana etc. It is important that the practical component of all these activities with the cooperation and participation of other important institutions (Regional Inspectorate of Environment and Water, municipalities) and NGOs. So in practice the idea of a total involvement and commitment to achieve socially important purposes. Pleasant form of fun activities for young people the opportunity to gain confidence in the necessity of careful attitude and actions towards nature.

Predictors of attrition for a sexual assault forensic examiner (SAFE) blended learning training program.

PubMed

Patterson, Debra; Resko, Stella

2015-01-01

Participant attrition is a major concern for online continuing education health care courses. The current study sought to understand what factors predicted health care professionals completing the online component of a sexual assault forensic examiner (SAFE) blended learning training program (12-week online course and 2-day in-person clinical skills workshop). The study used a Web-based survey to examine participant characteristics, motivation, and external barriers that may influence training completion. Hierarchical logistic regression was utilized to examine the predictors of training completion, while the Cox proportional hazards (Cox PH) regression model helped determine the factors associated with the timing of participant attrition. Results show that 79.3% of the enrolled professionals completed the online component. The study also found that clinicians who work in rural communities and those who were interested in a 2-day clinical skills workshop were more likely to complete the online course. In terms of when attrition occurred, we found that participants who were motivated by the 2-day clinical workshop, those who worked in a rural community, and participants interested in the training program because of its online nature were more likely to complete more of the online course. Blending an online course with a brief in-person clinical component may serve as a motivator for completing an online course because it provides the opportunity to develop clinical skills while receiving immediate feedback. Participant attrition appears to be less of a concern for rural clinicians because this modality can reduce their barriers to accessing continuing education. © 2015 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.

3 CFR 8907 - Proclamation 8907 of November 20, 2012. National Child's Day, 2012

Code of Federal Regulations, 2013 CFR

2013-01-01

...! initiative, which aims to solve the problem of childhood obesity within a generation, and the Affordable Care... early childhood education to help prevent achievement gaps before they start. We have invested in math...

Cost savings from reduced catheter-related bloodstream infection after simulation-based education for residents in a medical intensive care unit.

PubMed

Cohen, Elaine R; Feinglass, Joe; Barsuk, Jeffrey H; Barnard, Cynthia; O'Donnell, Anna; McGaghie, William C; Wayne, Diane B

2010-04-01

Interventions to reduce preventable complications such as catheter-related bloodstream infections (CRBSI) can also decrease hospital costs. However, little is known about the cost-effectiveness of simulation-based education. The aim of this study was to estimate hospital cost savings related to a reduction in CRBSI after simulation training for residents. This was an intervention evaluation study estimating cost savings related to a simulation-based intervention in central venous catheter (CVC) insertion in the Medical Intensive Care Unit (MICU) at an urban teaching hospital. After residents completed a simulation-based mastery learning program in CVC insertion, CRBSI rates declined sharply. Case-control and regression analysis methods were used to estimate savings by comparing CRBSI rates in the year before and after the intervention. Annual savings from reduced CRBSIs were compared with the annual cost of simulation training. Approximately 9.95 CRBSIs were prevented among MICU patients with CVCs in the year after the intervention. Incremental costs attributed to each CRBSI were approximately $82,000 in 2008 dollars and 14 additional hospital days (including 12 MICU days). The annual cost of the simulation-based education was approximately $112,000. Net annual savings were thus greater than $700,000, a 7 to 1 rate of return on the simulation training intervention. A simulation-based educational intervention in CVC insertion was highly cost-effective. These results suggest that investment in simulation training can produce significant medical care cost savings.

Effect of tailored educational intervention to improve self-care maintenance and quality of life in postmenopausal osteoporotic women after a fragility fracture: the Guardian Angel® study.

PubMed

Basilici Zannetti, Emanuela; D'Agostino, Fabio; Cittadini, Noemi; Feola, Maurizio; Pennini, Annalisa; Rao, Cecilia; Vellone, Ercole; Tarantino, Umberto; Alvaro, Rosaria

2017-01-01

Osteoporosis has a significant impact on affected patients. Healthcare providers should encourage postmenopausal women to improve self-care maintenance behaviors and quality of life following a fragility fracture. The aims of this study were to a) develop two new instruments for measuring, respectively, self-care maintenance and quality of life, in postmenopausal women with osteoporosis; b) evaluate the effectiveness of a tailored educational intervention to improve self-care maintenance and quality of life after a fragility fracture in postmenopausal women. For the first aim, a cross-sectional study will be performed; for the second aim, a multicenter, quasi-experimental, interventional design will be used. A convenience sample of postmenopausal women admitted to 44 hospitals in Italy with a diagnosis of bone fragility fracture will be enrolled and surveyed at 7, 30, 60 and 180 days after discharge. Trained nurses will conduct the educational intervention. The new instruments will allow the measurement of self-care and quality of life in postmenopausal women following a fragility fracture. Through tailored educational interventions, women can be helped to take their medications correctly, adopt a healthy lifestyle, reduce the occurrence of bone fractures, and have a better quality of life.

The Association Between Residential Care Facility Manager's Educational Attainment and the Presence of Structural and Service Innovations.

PubMed

Davis, Jullet A

For many service-oriented firms, knowledge is a key commodity, and the process by which knowledge is codified is critical for firm survival. The administrator or top manager acts as the repository and disseminator of organizational knowledge. The purpose of this project is to examine the association between the administrator's educational attainment and innovation in residential care facilities. The study hypothesized that administrator academic education and certification or licensure would be positively associated with facility innovation. Data for this project comes from the 2010 National Survey of Residential Care Facilities. There were 2277 facilities included in the sample (weighted 30 811). Innovation, the dependent variable, was operationalized using 5 dichotomized measures: clinical information systems, pharmaceutical information systems, electronic health records, providing adult day care, and providing respite care. The data were analyzed using logistic regression. Overall, the results reveal that college education or certification/licensure increased the likelihood of technology use. In addition, those with a high school diploma and certification/licensure were more likely to use technology than were individuals who had, at a minimum, some college. The services models were not significant. It may be that the resources necessary to implement information systems vary substantially from the resources necessary to provide services.

Therapeutic education and self-care: Results from the cross-sectional study Diabetes, Attitudes, Wishes and Needs 2 (DAWN2) in Spain.

PubMed

Galindo Rubio, Mercedes; Jansà Morató, Margarida; Menéndez Torre, Edelmiro

2015-10-01

Therapeutic education (TE) has been gradually introduced progressively into diabetes mellitus care programs with the aim of providing patients and their families or caregivers with the necessary skills for the self-management of the disease. The Diabetes Attitudes, Wishes and Needs 2 (DAWN2) study helps to clarify what are the unmet needs with regards to self-management and the TE offer available to patients and their families. The objective of this paper is to analyse the results of the DAWN2 study regarding self-care habits and participation in TE activities in Spain. The DAWN2 is an observational, cross-national study. In this paper, an analysis was performed on the Spanish sample of diabetic patients (502) and family members (123). Patients report taking their medications as recommended by their doctor an average of 6.4 days/week, and self-monitor their blood glucose an average of 3.4 days/week. The large majority (86%) of patients with diabetes mellitus type 1, 59% of patients with diabetes mellitus type 2, and 21% of family members state to have participated in education activities. Diabetes educators should reinforce the messages about the benefits of self-care, particularly for patients who are in the early stages of the disease. Likewise, access for family members and people with diabetes mellitus type 2 to TE programs should be improved, and these programs for diabetic patients and their families should be included in the services portfolio of health centres. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

Maximizing Technological Resources in Plastic Surgery Resident Education.

PubMed

Khansa, Ibrahim; Janis, Jeffrey E

2015-11-01

Modern plastic surgery resident education demands the acquisition of an ever-increasing fund of knowledge and familiarity with more surgical techniques than ever before. This all must take place within the context and boundaries of Accreditation Council for Graduate Medical Education-mandated restrictions on work hours as well as balance of education and service. Technological resources have been developed and can be used to complement the skills that residents acquire while performing their day-to-day activities such as taking care of patients, reading textbooks and journal articles, and assisting or performing surgical procedures. Those complementary resources provide the benefits of portability and accessibility, and can thus be conveniently incorporated into the hectic daily life of a resident. This article presents a summary of the most commonly used currently available advanced technologies in plastic surgery resident education, and suggestions for integration of those technologies into a curriculum.

Investigating admitted patients' satisfaction with nursing care at Debre Berhan Referral Hospital in Ethiopia: a cross-sectional study.

PubMed

Sharew, Nigussie Tadesse; Bizuneh, Hailegiorgis Teklegiorgis; Assefa, Hilina Ketema; Habtewold, Tesfa Dejenie

2018-05-17

The aims of the study were (1) to assess the level of patient satisfaction with nursing care and (2) to identify factors influencing patient satisfaction. A hospital-based, cross-sectional study was conducted with 252 admitted patients in the medical, surgical and paediatric wards. Debre Berhan Referral Hospital, Debre Berhan, Ethiopia, with a catchment population of 2.8 million. All patients admitted at least for 2 days and capable of independent communication were included. However, patients were excluded on any one of the following conditions: admitted for less than 2 days, cannot understand Amharic language, with critical illness or cognitive impairment that affects judgement, or inability to provide written informed consent. The mean age of the patients was 37.9 (SD=12.9) years, and half (50.4%) of them were male. Patient satisfaction with nursing care, measured by the Newcastle Satisfaction with Nursing Scale, was the outcome variable. Using a mean split approach, patient satisfaction scores were dichotomised into 'satisfied' and 'unsatisfied'. 49.2% of patients were satisfied with nursing care. Educational status and history of admission were significant factors influencing patient satisfaction with nursing care. Patients who had high educational status were 80% less satisfied compared with those who had no formal education (p=0.01, OR=0.2, 95% CI 0.1 to 0.7). Patients who had a history of admission were 2.2 times more satisfied compared with those who had no history of admission (p=0.02, OR=2.2, 95% CI 1.2 to 4.2). About half the admitted patients were satisfied with the nursing care. Satisfaction differed significantly by patients' educational attainment and history of admission. This study provided evidence on patient satisfaction with nursing care in Ethiopia. This information may be useful in comparative studies of patient satisfaction and in identifying characteristics that may explain or predict patient satisfaction. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Identifying the key elements of an education package to up-skill multidisciplinary adult specialist palliative care teams caring for young adults with life-limiting conditions: an online Delphi study

PubMed Central

Sivell, Stephanie; Lidstone, Victoria; Taubert, Mark; Thompson, Catherine; Nelson, Annmarie

2015-01-01

Objectives To collect the views of experts to inform the development of an education package for multidisciplinary adult specialist palliative care (SPC) teams caring for young people with life-limiting conditions. Methods A modified online Delphi process collated expert opinion on format, delivery and content of an education package to up-skill adult SPC teams. Round 1 participants (n=44) answered free-text questions, generating items for Round 2. In Round 2, 68 participants rated the extent to which they agreed/disagreed with the items on 5-point Likert-type scales. Median and mean scores assessed the importance of each item. IQR scores assessed level of consensus for each item; items lacking consensus were rerated by 35 participants in Round 3. Results In the Delphi, consensus was reached on a range of suggested formats, on who should deliver the training, and on several clinical, psychosocial and practical topics. Conclusions Development of a continuous/rolling programme of education, tailored for content and mode of delivery and incorporated into working practice is recommended. As a direct outcome of the results of this study, a series of six linked study days has been established, focusing specifically on the issues around caring for young adults with life-limiting conditions and palliative care needs. PMID:24670554

The Barefoot College...or Knowledge Demystified. Education for All, Making It Work, Innovations Series, 11.

ERIC Educational Resources Information Center

O'Brien, Catherine

Tilonia, a typical rural village of the State of Rajasthan (India), is home to the Social Work and Research Centre (SWRC). Since 1972, SWRC has brought educational services, safe drinking water, health care, and employment to villages in the area. It has started 150 night schools in 89 villages, where children who work during the day develop…

Observed Benefits to On-site Medical Services during an Annual 5-day Electronic Dance Music Event with Harm Reduction Services.

PubMed

Munn, Matthew Brendan; Lund, Adam; Golby, Riley; Turris, Sheila A

2016-04-01

With increasing attendance and media attention, large-scale electronic dance music events (EDMEs) are a subset of mass gatherings that have a unique risk profile for attendees and promoters. Shambhala Music Festival (Canada) is a multi-day event in a rural setting with a recognized history of providing harm reduction (HR) services alongside medical care. Study/Objective This manuscript describes the medical response at a multi-day electronic music festival where on-site HR interventions and dedicated medical care are delivered as parallel public health measures. This study was a descriptive case report. Medical encounters and event-related data were documented prospectively using an established event registry database. In 2014, Shambhala Music Festival had 67,120 cumulative attendees over a 7-day period, with a peak daily attendance of 15,380 people. There were 1,393 patient encounters and the patient presentation rate (PPR) was 20.8 per one thousand. The majority of these (90.9%) were for non-urgent complaints. The ambulance transfer rate (ATR) was 0.194 per one thousand and 0.93% of patient encounters were transferred by ambulance. No patients required intubation and there were no fatalities. Harm reduction services included mobile outreach teams, distribution of educational materials, pill checking facilities, a dedicated women's space, and a "Sanctuary" area that provided non-medical peer support for overwhelmed guests. More than 10,000 encounters were recorded by mobile and booth-based preventive and educational services, and 2,786 pills were checked on-site with a seven percent discard rate. Dedicated medical and HR services represent two complementary public health strategies to minimize risk at a multi-day electronic music festival. The specific extent to which HR strategies reduce the need for medical care is not well understood. Incorporation of HR practices when planning on-site medical care has the potential to inform patient management, reduce presentation rates and acuity, and decrease utilization and cost for local, community-based health services.

A Study on Health Seeking Behaviors of Patients of Post-Kala-Azar Dermal Leishmaniasis

PubMed Central

Basher, Ariful; Nath, Proggananda; Nabi, Shah Golam; Selim, Shahjada; Rahman, Md Fashiur; Sutradhar, Satya Ranjan; Faiz, Abul; Bhuiyan, Matiur Rahman; Ahmed, Be-Nazir; Rahman, Ridwanur

2015-01-01

Post-Kala-Azar Dermal Leishmaniasis (PKDL) remains a major public health threat in Bangladesh. A cross-sectional study was carried out in Surya Kanta Kala azar Research Centre (SKKRC), Mymensingh, from January 2012 to July 2013 to evaluate the health seeking behaviour and the length of delay of PKDL management. The consecutive 200 diagnosed PKDL cases that got treatment in SKKRC hospital were subjected to evaluation. Most (98%) of the patients were not aware and had no knowledge about PKDL, though 87.5% had a history of history of Kala-azar treatment. Many patients reported first to village doctor (15.5%), the pharmacy shop (10%), or traditional health provider (7.5%) upon recognition of symptom. The time between the initial symptom recognition and first medical consultation (patient delay) ranged from 10 days to 4745 days (13 years) with a median of 373 days (mean: 696; IQR: 138 to 900 days). The time between first medical consultations to definite treatment (system delay) ranged from 0 days to 1971 days (5.4 years), with a median delay of 14 days (mean: 46.48; IQR: 7 to 44 days) that was reported in this study. Age, education, occupation, and residential status had significant association with patient delay (P < 0.05). Educational status, occupation, number of treatment providers, and first health care provider had a significant association with system delay (P < 0.05). Success in PKDL diagnosis and treatment requires specific behavior from patients and health care providers which facilitate those practices. PMID:26788500

Protecting the Rights of School Children with Diabetes

PubMed Central

Wood, James M.

2013-01-01

School children with diabetes are facing increasing difficulties in receiving care during the school day. Despite theexistence of federal statutes ensuring their rights to a free, appropriate public education, many school districts throughout the country do little, if anything, to ensure that their condition is treated throughout the school day. The chronic shortage of school nurses has resulted in hardships on families, relatives, and friends to ensure that care, including insulin, is timely and appropriately provided. While many states have taken measures to provide care by unlicensed trained volunteers, efforts to accomplish this in California have resulted in prolonged litigation. A variety of nursing organizations oppose all efforts to train unlicensed volunteers, arguing that such is not permitted by California law. The issue is unresolved and currently pending in the California Supreme Court. PMID:23566990

The declining demand for hospital care as a rationale for duty hour reform.

PubMed

Jena, Anupam B; DePasse, Jacqueline W; Prasad, Vinay

2014-10-01

The regulation of duty hours of physicians in training remains among the most hotly debated subjects in medical education. Although recent duty hour reforms have been chiefly motivated by concerns about resident well-being and medical errors attributable to resident fatigue, the debate surrounding duty hour reform has infrequently involved discussion of one of the most important secular changes in hospital care that has affected nearly all developed countries over the last 3 decades: the declining demand for hospital care. For example, in 1980, we show that resident physicians in US teaching hospitals provided, on average, 1,302 inpatient days of care per resident physician compared to 593 inpatient days in 2011, a decline of 54%. This decline in the demand for hospital care by residents provides an under-recognized economic rationale for reducing residency duty hours, a rationale based solely on supply and demand considerations. Work hour reductions and growing requirements for outpatient training can be seen as an appropriate response to the shrinking demand for hospital care across the health-care sector.

[Nutritional recovery of mild and moderately malnourished children under two different treatment approaches (ambulatory versus day-care)].

PubMed

Mariño, Mariana; Martínez, José; Azuaje, Arelis

2003-09-01

This retrospective analysis was conducted between May 1997 and May 2000 at the Centro de Atención Nutricional Infantil de Antímano, CANIA, in Caracas, Venezuela to assess the efficacy of two treatments (ambulatory versus day-care) of mild and moderate malnourished children. Inclusion criteria were: children under 10 years old with mild and moderate malnourishment, who attended a minimum of 3 control visits during a period of 12 months. One hundred fourteen malnourished children were included: fifty seven in ambulatory treatment and fifty seven in day-care treatment paired per nutritional diagnosis, gender and age (thirty nine mild and eighteen moderate malnourished children). The nutritional recovery criterion was weight for height above tenth percentile. No relation was found between treatment approaches and nutritional recovery at 3 and 6 months of treatment. In the group of mild malnourished children, the percentage of recovered patients at 3 months of treatment, that kept their recovered condition at 6 months was 83% (15/18) in the ambulatory treatment and 82% (18/22) in the day-care treatment Age of children, associated disease, acute morbidity, dietetic risk and mother's education and age were not associated with nutritional recovery at 6 months of treatment (p > 0.05). The day-care approach resulted as effective as ambulatory in mild malnourished children. In moderate malnourished new studies will need to be conducted with greater number of patients.

Impact of health education on drug adherence and self-care in people with epilepsy with low education.

PubMed

Dash, Deepa; Sebastian, Teenu Mary; Aggarwal, Meena; Tripathi, Manjari

2015-03-01

This study was conducted to observe the effect of a structured educational program on drug adherence and self-care management in people with epilepsy in a developing country. A total of 180 consecutive people with epilepsy were enrolled from the epilepsy clinic of a tertiary care hospital in North India. Out of these, 90 were randomized to the epilepsy health education group and received the educational program and 90 were in the control group and received the standard of care but did not receive any structured educational program. The modified Morisky Medication Adherence Scale (MMAS) and Epilepsy Self-Efficacy Scale (ESES) were administered to assess drug adherence and self-care, respectively, on the day of enrollment. The patients enrolled in the epilepsy health education group received 4 sessions of the structured educational program. The MMAS and ESES questionnaires were again administered to both groups after 6months. Continuous and categorical variables were compared between control and epilepsy health education groups using a chi-square test, with p value less than 0.05 considered significant. A comparison between pretest and posttest MMAS scores and ESES scores was done using a paired t-test. In the epilepsy health education group, the pretest mean MMAS score was 6.58 whereas the posttest mean MMAS score was 7.53; the difference was significant (p=0.001). The mean MMAS scores for the control group's pretest and posttest were 6.46 and 6.58, respectively, which were not significantly different (p=0.224). On comparing the ESES scores at the beginning of the study and after 6months, there was no significant change in both groups. The present study proves the efficacy of a structured educational program in improving drug adherence in a cohort of people with epilepsy with low educational background. Copyright © 2014 Elsevier Inc. All rights reserved.

Critical care nurses' experiences when technology malfunctions.

PubMed

Haghenbeck, Karen Toby

2005-01-01

When caring for critically ill patients, critical care nurses work with technology every day. Technology and equipment malfunctions can have a profound effect on nurses' practice and self-image. In this article, a descriptive phenomenological methodology was chosen to explicate the experience of seven critical care nurses. While participants realized that machines might malfunction, they experienced surprise, shock, and feelings of being "let down" and inadequate when malfunctions occurred. They questioned their competence and felt malfunctioning technology jeopardized their credibility and professional image. These findings are useful when structuring educational sessions on technology and in facilitating a supportive environment for critical care nurses when technology malfunctions.

Collaboration Around Research and Education (CARE) in Prostate Cancer

DTIC Science & Technology

2009-02-01

Nurse Licensure August 1972 - November 2009 Specialty certification( s ) and dates (Month/Day/Year): St. Margaret’s Hospital , Boston...Effectiveness of pediatric primary care. J. S . O’Shea & E.W. Collins, (Eds.), in Physical And Occupational Therapy in Pediatrics. 2. Price M.M...1986). Diagnosis and management of the hospitalized child. H.B. Levy, S.H. Sheldon, & R.F. Sulayman (Eds.), in Physical and Occupational Therapy in

Feasibility of Training Early Childhood Educators in a Community Child Care Setting Using a Caregiver-Mediated Intervention for Toddlers with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Brian, Jessica; Bernardi, Kate; Dowds, Erin; Easterbrook, Rachel; MacWilliam, Stacey; Bryson, Susan

2017-01-01

Parent-mediated intervention programs have demonstrated benefits for toddlers with autism spectrum disorder (ASD). Interest is emerging in other community-level models, such as those that can be integrated into child care settings. These programs have the potential to reach a wide range of high-risk toddlers who spend the majority of their day in…

Addressing the leadership gap in medicine: residents' need for systematic leadership development training.

PubMed

Blumenthal, Daniel M; Bernard, Ken; Bohnen, Jordan; Bohmer, Richard

2012-04-01

All clinicians take on leadership responsibilities when delivering care. Evidence suggests that effective clinical leadership yields superior clinical outcomes. However, few residency programs systematically teach all residents how to lead, and many clinicians are inadequately prepared to meet their day-to-day clinical leadership responsibilities. The purpose of this article is twofold: first, to make the case for the need to refocus residency education around the development of outstanding "frontline" clinical leaders and, second, to provide an evidence-based framework for designing formal leadership development programs for residents. The authors first present a definition of clinical leadership and highlight evidence that effective frontline clinical leadership improves both clinical outcomes and satisfaction for patients and providers. The authors then discuss the health care "leadership gap" and describe barriers to implementing leadership development training in health care. Next, they present evidence that leaders are not just "born" but, rather, can be "made," and offer a set of best practices to facilitate the design of leadership development programs. Finally, the authors suggest approaches to mitigating barriers to implementing leadership development programs and highlight the major reasons why health care delivery organizations, residency programs, and national accreditation bodies must make comprehensive leadership education an explicit goal of residency training.

Effects of Essential Newborn Care Training on Fresh Stillbirths and Early Neonatal Deaths by Maternal Education.

PubMed

Chomba, Elwyn; Carlo, Wally A; Goudar, Shivaprasad S; Jehan, Imtiaz; Tshefu, Antoinette; Garces, Ana; Parida, Sailajandan; Althabe, Fernando; McClure, Elizabeth M; Derman, Richard J; Goldenberg, Robert L; Bose, Carl; Krebs, Nancy F; Panigrahi, Pinaki; Buekens, Pierre; Wallace, Dennis; Moore, Janet; Koso-Thomas, Marion; Wright, Linda L

2017-01-01

Infants of women with lower education levels are at higher risk for perinatal mortality. We explored the impact of training birth attendants and pregnant women in the Essential Newborn Care (ENC) Program on fresh stillbirths (FSBs) and early (7-day) neonatal deaths (END) by maternal education level in developing countries. A train-the-trainer model was used with local instructors in rural communities in six countries (Argentina, Democratic Republic of the Congo, Guatemala, India, Pakistan, and Zambia). Data were collected using a pre-/post-active baseline controlled study design. A total of 57,643 infants/mothers were enrolled. The follow-up rate at 7 days of age was 99.2%. The risk for FSB and END was higher for mothers with 0-7 years of education than for those with ≥8 years of education during both the pre- and post-ENC periods in unadjusted models and in models adjusted for confounding. The effect of ENC differed as a function of maternal education for FSB (interaction p = 0.041) without evidence that the effect of ENC differed as a function of maternal education for END. The model-based estimate of FSB risk was reduced among mothers with 0-7 years of education (19.7/1,000 live births pre-ENC, CI: 16.3, 23.0 vs. 12.2/1,000 live births post-ENC, CI: 16.3, 23.0, p < 0.001), but was not significantly different for mothers with ≥8 years of education, respectively. A low level of maternal education was associated with higher risk for FSB and END. ENC training was more effective in reducing FSB among mothers with low education levels. © 2016 S. Karger AG, Basel.

A Cross-sectional, Descriptive, Quality Improvement Project to Assess Undergraduate Nursing Students' Clinical Exposure to Patients With Wounds in an Introductory Nursing Course.

PubMed

Pieper, Barbara; Keves-Foster, Mary Kathryn; Ashare, JoAnn; Zugcic, Mary; Albdour, Maha; Albdour, Dalia

2016-04-01

Because nurses frequently participate in decisions related to wound care, learning about wounds and their care during undergraduate education is critical. A cross-sectional, descriptive, quality improvement project was conducted in an introductory baccalaureate nursing course to identify: 1) the types of patients with wounds assigned to beginning students, 2) patient wound care procedures and dressings, and 3) student level of participation in wound care. Data were collected from the weekly notes recorded about students' (N = 49) patient care experiences in 3 acute care hospitals for 9 clinical days during 1 semester. Data were recorded on a paper-and-pencil form by instructors at the end of the clinical day and included type of wound, wound irrigation, dressing, technique of care, and student's participation. Descriptive statistics were used to examine the frequency and distribution of the wound characteristics and care assessed. Of the 284 patients assigned to students, 75 (26.4%) had a wound. The most common wound was a surgical incision (49, 65%) and was closed (36, 73.5%). Twenty-six (26) patients had a pressure ulcer, most commonly Stage II. The most common dressing was dry gauze (29). Damp gauze was used on 18 wounds. Wound irrigation was recorded for 24 wound protocols and performed with a bulb syringe or by pouring the solution from a container. Generally, nonsterile wound care was performed. Twenty-five (25) students performed wound care with the instructor, 16 watched the care performed by another clinician, and 10 participated with another nurse in the wound care. For 22 patients, the wound care was neither observed nor performed because either it was not time for the dressing to be changed or it was only to be changed by a medical team. From these data, it was concluded beginning nursing students had some, but limited, clinical experience with patients with wounds. Students' wound care experiences need further examination, especially across multiple educational courses.

Volume of hydration in terminal cancer patients.

PubMed

Bruera, E; Belzile, M; Watanabe, S; Fainsinger, R L

1996-03-01

In this retrospective study we reviewed the volume and modality of hydration of consecutive series of terminal cancer patients in two different settings. In a palliative care unit 203/290 admitted patients received subcutaneous hydration for 12 +/- 8 days at a daily volume of 1015 +/- 135 ml/day. At the cancer center, 30 consecutive similar patients received intravenous hydration for 11.5 +/- 5 days (P > 0.2) but at a daily volume of 2080 +/- 720 ml/day (P < 0.001). None of the palliative care unit patients required discontinuation of hydration because of complications. Hypodermoclysis was administered mainly as a continuous infusion, an overnight infusion, or in one to three 1-h boluses in 62 (31%), 98 (48%) and 43 (21%) patients, respectively. Our findings suggest that, in some settings, patients may be receiving excessive volumes of hydration by less comfortable routes such as the intravenous route. Increased education and research in this area are badly needed.

Social determinants of duration of last nursing home stay at the end of life in Switzerland: a retrospective cohort study.

PubMed

Hedinger, Damian; Hämmig, Oliver; Bopp, Matthias

2015-10-01

Due to demographic ageing and increasing life expectancy, a growing demand for long-term nursing home care can be expected. Stays in nursing homes appear to be more socially determined than hospital stays. We therefore looked at the impact of socio-demographic and health care variables on the length of the last nursing home stay. Nationwide individual data from nursing homes and hospitals in Switzerland were linked with census and mortality records. Gender-specific negative binomial regression models were used to analyze N = 35,739 individuals with an admission age of at least 65 years and deceased in 2007 or 2008 in a nursing home. Preceding death, men spent on average 790 days and women 1250 days in the respective nursing home. Adjusted for preceding hospitalizations, care level, cause of death and multimorbidity, a low educational level, living alone or being tenant as well as a low care level at the admission time increased the risk for longer terminal stays. Conversely, a high educational level, being homeowner, being married as well as a high care level at the admission time decreased the risk for longer stays. The length of the last nursing home stay before death was not only dependent on health-related factors alone, but also substantially depended on socio-demographic determinants such as educational level, homeownership or marital status. The support of elderly people at the admission time of a presumably following nursing home stay should be improved and better evaluated in order to reduce unnecessary and undesired long terminal nursing home stays. Health policy should aim at diminishing the role of situational, non-health-related factors in order to empower people to spend the last years before death according to individual needs and preferences.

Helping health and social care professionals to develop an 'inequalities imagination': a model for use in education and practice.

PubMed

Hart, Angie; Hall, Valerie; Henwood, Flis

2003-03-01

The 'inequalities imagination model' originated from our own research, and led to findings and recommendations regarding clinical and education issues. This article focuses on the creation of the model which, we suggest, could be used to facilitate the development of an 'inequalities imagination' in health and social care professionals. To describe and critically analyse the thinking that led to the concept of an 'inequalities imagination' and provide the framework for the theoretical model. Influencing concepts from the fields of social work, sociology, nursing and midwifery, and debates around antidiscriminatory and antioppressive practice, cultural safety, cultural competence and individualized care are analysed. INEQUALITIES IMAGINATION MODEL: Ideas generated from an analysis of the concepts of antidiscriminatory/anti-oppressive practice and from the research data led us to conceptualize a flexible model that incorporated issues of individual and structural agency and a broad definition of disadvantage. The literature review underpinning the theoretical framework means that the model has the potential to be truly interdisciplinary. Professional educators face a difficult task in preparing practitioners to work with clients in ways that take account of differences in background and lifestyle and which respect human rights and dignity. The model makes explicit a process that enables practitioners to think about their current practice and move towards a greater understanding and awareness of the way they work with disadvantaged clients, and ways in which they prepare others to do so. We suggest that professionals develop an 'inequalities imagination' in order to enhance equality of care. The development of an 'inequalities imagination' helps practitioners to bridge the gap between the challenges they face in day-to-day practice and what they need to achieve to aspire to provide equality of care to all.

[Puppet theatre as teaching strategy: a report of the experience].

PubMed

Rampaso, Débora Alves de Lima; Doria, Maria Aparecida Gonçalves; de Oliveira, Maria Cláudia Martins; da Silva, Gilberto Tadeu Reis

2011-01-01

The Didactics Applied to Care discipline is developed in the fifth semester of the nursing graduation course. It develops several theoretical-practical contents, among them, the teaching strategy. Our objective is to report the experience with the use of puppet theater to promote the oral health of children in a day nursery in the São Paulo East Zone. With this report we make it clear that the theoretical contents developed by the Didactics Applied to Care Discipline are essential to the practice of Health Education. The discipline allows us to develop multiple activities in the role of educator and in health promotion.

An evaluation of taster days to recruit untrained health care staff to pre-registration mental health nurse education within one UK university.

PubMed

Rhodes, Sheri; Bouic, Louise

2005-10-01

With a decrease in the amount of college leavers available to recruit to nurse training and a simultaneous increase in demand for nurses, achieving recruitment targets is becoming more difficult. The widening participation agenda has encouraged us to look wider and one very rich area for recruitment is untrained health and social care staff. Some of this group do eventually opt for professional education, but many could take up places sooner, but lack the confidence or the information they need to make informed decisions. The mental health directorate of an NHS Trust (Shropshire County PCT) agreed to fund 2 'Taster Days' for up to 40 untrained healthcare staff. The Trust was keen that this opportunity was offered to value the contribution, continued learning and skills development of their untrained staff. The Taster Days were to be delivered within the Faculty of Health & Sciences of Staffordshire University. The Trust gave permission for their name to be used on advertising materials and in subsequent publication. A literature review highlighted a dearth of material, consequently allowing freedom to develop and trial our own ideas. Current students and student nurse ambassadors (funded by Advantage West Midlands and Stoke Local Strategic Partnership through Full Circle) were involved in developing materials and the delivery of the day. An evaluation of the day and recommendations are included.

Designing a Care Pathway Model - A Case Study of the Outpatient Total Hip Arthroplasty Care Pathway.

PubMed

Oosterholt, Robin I; Simonse, Lianne Wl; Boess, Stella U; Vehmeijer, Stephan Bw

2017-03-09

Although the clinical attributes of total hip arthroplasty (THA) care pathways have been thoroughly researched, a detailed understanding of the equally important organisational attributes is still lacking. The aim of this article is to contribute with a model of the outpatient THA care pathway that depicts how the care team should be organised to enable patient discharge on the day of surgery. The outpatient THA care pathway enables patients to be discharged on the day of surgery, shortening the length of stay and intensifying the provision and organisation of care. We utilise visual care modelling to construct a visual design of the organisation of the care pathway. An embedded case study was conducted of the outpatient THA care pathway at a teaching hospital in the Netherlands. The data were collected using a visual care modelling toolkit in 16 semi-structured interviews. Problems and inefficiencies in the care pathway were identified and addressed in the iterative design process. The results are two visual models of the most critical phases of the outpatient THA care pathway: diagnosis & preparation (1) and mobilisation & discharge (4). The results show the care team composition, critical value exchanges, and sequence that enable patient discharge on the day of surgery. The design addressed existing problems and is an optimisation of the case hospital's pathway. The network of actors consists of the patient (1), radiologist (1), anaesthetist (1), nurse specialist (1), pharmacist (1), orthopaedic surgeon (1,4), physiotherapist (1,4), nurse (4), doctor (4) and patient application (1,4). The critical value exchanges include patient preparation (mental and practical), patient education, aligned care team, efficient sequence of value exchanges, early patient mobilisation, flexible availability of the physiotherapist, functional discharge criteria, joint decision making and availability of the care team.

Integrating Depression Care Management into Medicare Home Health Reduces Risk of 30- and 60-Day Hospitalization: The Depression Care for Patients at Home Cluster-Randomized Trial.

PubMed

Bruce, Martha L; Lohman, Matthew C; Greenberg, Rebecca L; Bao, Yuhua; Raue, Patrick J

2016-11-01

To determine whether a depression care management intervention in Medicare home health recipients decreases risk of hospitalization. Cluster-randomized trial. Nurse teams were randomized to intervention (12 teams) or enhanced usual care (EUC; 9 teams). Six home health agencies from distinct geographic regions. Home health recipients were interviewed at home and over the telephone. Individuals aged 65 and older who screened positive for depression on nurse assessments (N = 755) and a subset who consented to interviews (n = 306). The Depression CARE for PATients at Home (CAREPATH) guides nurses in managing depression during routine home visits. Clinical functions include weekly symptom assessment, medication management, care coordination, patient education, and goal setting. Researchers conducted telephone conferences with team supervisors every 2 weeks. Hospitalization while receiving home health services was assessed using data from the home health record. Hospitalization within 30 days of starting home health, regardless of how long recipients received home health services, was assessed using data from the home care record and research assessments. The relative hazard of being admitted to the hospital directly from home health was 35% lower within 30 days of starting home health care (hazard ratio (HR) = 0.65, P = .01) and 28% lower within 60 days (HR = 0.72, P = .03) for CAREPATH participants than for participants receiving EUC. In participants referred to home health directly from the hospital, the relative hazard of being rehospitalized was approximately 55% lower (HR = 0.45, P = .001) for CAREPATH participants. Integrating CAREPATH depression care management into routine nursing practice reduces hospitalization and rehospitalization risk in older adults receiving Medicare home health nursing services. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Sustained Reduction in Bloodstream Infections in Infants at a Large Tertiary Care Neonatal Intensive Care Unit

PubMed Central

Neill, Sara; Haithcock, Sarah; Smith, P. Brian; Goldberg, Ronald; Bidegain, Margarita; Tanaka, David; Carriker, Charlene; Ericson, Jessica E.

2015-01-01

Purpose Reduction of bloodstream infections (BSI) has emerged as an important patient safety goal. Implementation of central line insertion bundles, standardized line care protocols, and health care provider education programs have reduced BSI in neonatal intensive care units (NICUs) around the country. The ability of large tertiary care centers to decrease nosocomial infections, including BSI, has been demonstrated. However, long-term BSI reductions in infants are not well documented. We sought to demonstrate that a low incidence of BSI can be maintained over time in a tertiary care NICU. Subjects 6,790 infants admitted to a large, tertiary care NICU between 2005 and 2013. Design Retrospective intervention study. Methods A staged, multifaceted infection prevention plan was implemented beginning in October 2007 under nursing leadership. The incidence of BSI was determined annually for 2005-2013. Results Baseline BSI incidence for infants admitted to the NICU was 5.15 and 6.08 episodes per 1,000 infant-days in 2005 and 2006, respectively. After protocol implementation, the incidence of BSI decreased to 2.14/1,000 infant-days and 2.44/1,000 infant-days in 2008 and 2009, respectively. Yearly incidence remained low over the next 4 years and decreased even further to 0.20-0.45 infections/1,000 infant days. This represents a 92% decrease in BSI over a period of >5 years. Conclusions Implementation of a nursing-led comprehensive infection control initiative can effectively produce and maintain a reduction in the incidence of BSI in infants at a large tertiary care NICU. What this study adds Long term reductions in neonatal BSI are possible with implementation of a multidisciplinary team approach and strong nursing leadership. PMID:25915573

Increasing self-knowledge: Utilizing tele-coaching for patients with congestive heart failure.

PubMed

Rosen, Daniel; Berrios-Thomas, Saskia; Engel, Rafael J

2016-10-01

The objective was to assess self-care knowledge changes with dually eligible Medicare and Medicaid patients diagnosed with congestive heart failure (CHF), who received a telecoaching protocol integrating symptom monitoring with face-to-face video chat with a social worker. We recruited 45 patients with CHF from a regional managed care organization. Sessions via a Health Insurance Portability and Accountability Act-compliant tablet-based platform focused on educational information designed to improve patient self-care. Social workers administered the 13-item Member Confidence Measure (MCM) at baseline and at a 30-day follow-up period. Scores were recorded to measure differences in patients' understanding of CHF and related symptoms, their knowledge of the disease, and the behaviors necessary to prevent their symptoms from getting worse. Over the 30-day period, scores significantly (p < .01) increased on the total scale score and specific confidence measure subscales (symptom recognition, medication adherence, medical attention, healthy choices, and safety). Gender, race, and age were unrelated to these improvements. In addition, effect sizes for the sub-scales ranged from .54 to 1.08; the effect size of the intervention as expressed by the total scale score was 1.12. Overall, patients increased knowledge over a 30-day period. Tele-coaching by social workers holds promise as a feasible model for health education for high-risk populations.

Instituting parent education practices in the neonatal intensive care unit: an administrative case report of practice evaluation and statewide action.

PubMed

Dusing, Stacey C; Van Drew, Catherine M; Brown, Shaaron E

2012-07-01

Infants born preterm are at high risk of developmental disabilities and benefit from early developmental intervention programs. Physical therapists with neonatal expertise are ideally suited to educate parents about ways to support their infant's development in the first months of life. However, administrative policies are needed to support the therapist in providing adequate parent education in the neonatal intensive care unit (NICU). This administrative case report describes the process used by a team of neonatal therapists to evaluate clinical practice, determine the need for change, and develop and implement a new parent education program in the NICU. Physical therapy parent education practices were evaluated in an academic medical center with a 36-bed, level-3 NICU. Physical therapists with neonatal expertise covered multiple units within the hospital each day. A series of focus groups, a small descriptive study, and staff discussion were used to evaluate parent education practices in this academic medical center. A new parent education program was developed based on data collected and literature to improve clinical care. The new parent education model was implemented over the course of several months using overlapping initiatives. Administrative support for the change was developed through collaboration, open communication, and presentation of clinical data. In addition, this hospital-based program contributed to the development of a statewide initiative to educate parents of preterm infants about the importance of supporting development in the first months of life. A collaborative and data-driven approach to evaluating parent education practices supported the development of a new parent education practice while acknowledging the need to meet staff productivity standards and provide excellent care throughout the hospital.

Instituting Parent Education Practices in the Neonatal Intensive Care Unit: An Administrative Case Report of Practice Evaluation and Statewide Action

PubMed Central

Van Drew, Catherine M.; Brown, Shaaron E.

2012-01-01

Background and Purpose Infants born preterm are at high risk of developmental disabilities and benefit from early developmental intervention programs. Physical therapists with neonatal expertise are ideally suited to educate parents about ways to support their infant's development in the first months of life. However, administrative policies are needed to support the therapist in providing adequate parent education in the neonatal intensive care unit (NICU). This administrative case report describes the process used by a team of neonatal therapists to evaluate clinical practice, determine the need for change, and develop and implement a new parent education program in the NICU. Case Description Physical therapy parent education practices were evaluated in an academic medical center with a 36-bed, level-3 NICU. Physical therapists with neonatal expertise covered multiple units within the hospital each day. A series of focus groups, a small descriptive study, and staff discussion were used to evaluate parent education practices in this academic medical center. A new parent education program was developed based on data collected and literature to improve clinical care. Outcomes The new parent education model was implemented over the course of several months using overlapping initiatives. Administrative support for the change was developed through collaboration, open communication, and presentation of clinical data. In addition, this hospital-based program contributed to the development of a statewide initiative to educate parents of preterm infants about the importance of supporting development in the first months of life. Discussion A collaborative and data-driven approach to evaluating parent education practices supported the development of a new parent education practice while acknowledging the need to meet staff productivity standards and provide excellent care throughout the hospital. PMID:22466024

Core Competencies in Integrative Pain Care for Entry-Level Primary Care Physicians.

PubMed

Tick, Heather; Chauvin, Sheila W; Brown, Michael; Haramati, Aviad

2015-11-01

The objective was to develop a set of core competencies for graduating primary care physicians in integrative pain care (IPC), using the Accreditation Council for Graduate Medical Education (ACGME) domains. These competencies build on previous work in competencies for integrative medicine, interprofessional education, and pain medicine and are proposed for inclusion in residency training. A task force was formed to include representation from various professionals who are involved in education, research, and the practice of IPC and who represent broad areas of expertise. The task force convened during a 1.5-day face-to-face meeting, followed by a series of surveys and other vetting processes involving diverse interprofessional groups, which led to the consensus of a final set of competencies. The proposed competencies focus on interprofessional knowledge, skills, and attitudes (KSAs) and are in line with recommendations by the Institute of Medicine, military medicine, and professional pain societies advocating the need for coordination and integration of services for effective pain care with reduced risk and cost and improved outcomes. These ACGME domain compatible competencies for physicians reflect the contributions of several disciplines that will need to be included in evolving interprofessional settings and underscore the need for collaborative care. These core competencies can guide the incorporation of KSAs within curricula. The learning experiences should enable medical educators and graduating primary care physicians to focus more on integrative approaches, interprofessional team-based, patient-centered care that use evidence-based, traditional and complementary disciplines and therapeutics to provide safe and effective treatments for people in pain. Wiley Periodicals, Inc.

Impact of family integrated care on infants' clinical outcomes in two children's hospitals in China: a pre-post intervention study.

PubMed

He, Shi-Wen; Xiong, Yue-E; Zhu, Li-Hui; Lv, Bo; Gao, Xi-Rong; Xiong, Hua; Wang, Huan; Shi, Hua-Rong; Latour, Jos M

2018-06-05

Most Neonatal Intensive Care Units (NICUs) in China have restricted visiting policies for parents. This also implicates that parents are not involved in the care of their infant. Family Integrated Care (FIC), empowering parents in direct care delivery and decisions, is becoming the standard in NICUs in many countries and can improve quality-of-life and health outcomes of preterm infants. The aim of this study was to evaluate the impact of a FIC intervention on the clinical outcomes of preterm infants with Bronchopulmonary Dysplasia (BPD). A pre-post intervention study was conducted at NICUs in two Chinese children's hospitals. Infants with BPD were included: pre-intervention group (n = 134) from December 2015 to September 2016, post-intervention (FIC) group (n = 115) and their parents from October 2016 to June 2017. NICU nurses were trained between July and September 2016 to deliver the FIC intervention, including parent education and support. Parents had to be present and care for their infant minimal three hours a day. The infants' outcome measures were length-of-stay, breastfeeding, weight gain, respiratory and oxygen support, and parent hospital expenses. Compared with control group (n = 134), the FIC group (n = 115) had significantly increased breastfeeding rates (83% versus 71%, p = 0.030), breastfeeding time (31 days versus 19 days, p < 0.001), enteral nutrition time (50 days versus 34 days, p < 0.001), weight gain (29 g/day versus 23 g/day, p = 0.002), and significantly lower respiratory support time (16 days versus 25 days, p < 0.001). Oxygen Exposure Time decreased but not significant (39 days versus 41 days p = 0.393). Parents hospital expenses in local Chinese RMB currency was not significant (84 K versus 88 K, p = 0.391). The results of our study suggests that FIC is feasible in two Chinese NICUs and might improve clinical outcomes of preterm infants with BPD. Further research is needed to include all infants admitted to NICUs and should include parent reported outcome measures. Our study may help other NICUs with limited parental access to implement FIC to enhance parental empowerment and involvement in the care of their infant.

Characterizing emergency admissions of patients with sickle cell crisis in NHS brent: observational study

PubMed Central

Green, Stuart A; AlJuburi, Ghida; Majeed, Azeem; Okoye, Ogo; Amobi, Carole; Banarsee, Ricky; Phekoo, Karen J

2012-01-01

Objectives To characterize emergency admissions for patients with sickle cell crisis in NHS Brent and to determine which patients and practices may benefit most from primary care intervention. Design Observational study Setting Emergency departments attended by residents of the London borough of Brent Participants Patients with sickle cell disease registered with a general practitioner (GP) in the borough of Brent Main outcome measures Analysis of admissions between January 2008 and July 2010 that included length of stay (average and <2 days versus ≥2 days) by age group and registered GP practice. Results Thirty six percent of sickle cell disease admission spells resulted in a length of stay of less than two days. Seventy four percent of total bed days are associated with patients with more than one admission during the period of analysis, i.e. multiple admissions. Two general practices in Brent were identified as having the highest number of patients admitted to the emergency department for sickle cell crisis and may benefit most from primary care intervention. Discussion Patients with short length of stay and multiple admissions may be potentially amenable to primary care intervention. The practices which have the highest numbers of sickle cell disease patients who frequently seek emergency care will be earmarked for an education intervention designed to help further engage general practitioners in the care and management of their sickle cell patients. PMID:22768371

Characterizing emergency admissions of patients with sickle cell crisis in NHS brent: observational study.

PubMed

Green, Stuart A; Aljuburi, Ghida; Majeed, Azeem; Okoye, Ogo; Amobi, Carole; Banarsee, Ricky; Phekoo, Karen J

2012-06-01

To characterize emergency admissions for patients with sickle cell crisis in NHS Brent and to determine which patients and practices may benefit most from primary care intervention. Observational study Emergency departments attended by residents of the London borough of Brent Patients with sickle cell disease registered with a general practitioner (GP) in the borough of Brent Analysis of admissions between January 2008 and July 2010 that included length of stay (average and <2 days versus ≥2 days) by age group and registered GP practice. Thirty six percent of sickle cell disease admission spells resulted in a length of stay of less than two days. Seventy four percent of total bed days are associated with patients with more than one admission during the period of analysis, i.e. multiple admissions. Two general practices in Brent were identified as having the highest number of patients admitted to the emergency department for sickle cell crisis and may benefit most from primary care intervention. Patients with short length of stay and multiple admissions may be potentially amenable to primary care intervention. The practices which have the highest numbers of sickle cell disease patients who frequently seek emergency care will be earmarked for an education intervention designed to help further engage general practitioners in the care and management of their sickle cell patients.

Thirty-Day and 5-Year Readmissions following First Psychiatric Hospitalization: A System-Level Study of Ontario's Psychiatric Care.

PubMed

Chen, Sheng; Collins, April; Kidd, Sean A

2018-06-01

Analyses of representative, system-level data to examine trends in short- and longer-term readmission rates for psychiatric illnesses are largely absent. The objective of this article is to examine key trends and variables with implications for inpatient care as indicated by 30-day readmission and outpatient care as reflected by readmission within 5 years. Using OMHRS data from 2005 to 2015, patients who had their first inpatient admission were followed for 5 years to examine their subsequent 30-day and overall admission rates stratified by discharge time and diagnosis. The study cohort consisted of 42,280 patients. The 30-day and 5-year readmission rates for the entire cohort were 7.2% and 35.1%, respectively. Using a time course analysis of readmission for discharges in different years, both 30-day readmission and 5-year readmission rates decreased in a linear manner from 2005 to 2010, primarily because of readmission patterns for patients diagnosed with mood disorders and schizophrenia/other psychotic disorders. It was also evident that both demographic considerations such as age and gender and variables reflective of social determinants such as education level and employment were predictive of rehospitalization risk. The trends of decreasing readmission rates may be reflective of improvements in the quality of hospital and community-based outpatient care. Such system-level indicators warrant tracking and may inform more effective tertiary prevention.

Improved management of acute kidney injury in primary care using e-alerts and an educational outreach programme.

PubMed

Tollitt, James; Flanagan, Emma; McCorkindale, Sheila; Glynn-Atkins, Sam; Emmett, Lauren; Darby, Denise; Ritchie, James; Bennett, Brandon; Sinha, Smeeta; Poulikakos, Dimitrios

2018-04-28

Acute kidney injury (AKI) detected in primary care is associated with increased morbidity and mortality. AKI electronic alerts (e-alerts) and educational programmes have recently been implemented but their contribution to improve AKI care is unknown. This project aimed to improve response to AKI detected in primary care and used a factorial design to evaluate the impact of the UK National Health Service (NHS) AKI e-alert and AKI educational outreach sessions on time to response to primary care AKI stages 2 and 3 between April and August 2016. A total of 46 primary care practices were randomized into four groups. A 2 × 2 factorial design exposed each group to different combinations of two interventions. The primary outcome was 'time to repeat test' or hospitalization following AKI e-alert for stages 2 and 3. Yates algorithm was used to evaluate the impact of each intervention. Time to response and mortality pre- and post-intervention were analysed using Mann-Whitney U test and chi-square test respectively. The factorial design included two interventions: an AKI educational outreach programme and the NHS AKI e-alerts. 1807 (0.8%) primary care blood tests demonstrated AKI 1-3 (78.3% stage 1, 14.8% stage 2, 6.9% stage 3). There were 391 stage 2 and 3 events from 251 patients. E-alerts demonstrated a reduction in mean response time (-29 hours). Educational outreach had a smaller effect (-3 hours). Median response time to AKI 2 and 3 pre- and post-interventions was 27 hours versus 16 hours respectively (P = 0.037). Stage 2 and 3 event-related 30-day all-cause mortality decreased following the interventions (15.6% versus 3.9% P = 0.036). AKI e-alerts in primary care hasten response to AKI 2 and 3 and reduce all-cause mortality. Educational outreach sessions further improve response time.

Race, socioeconomic status, health-related quality of life, and self-care of type 2 diabetes mellitus among adults in North Carolina.

PubMed

Piper, Crystal N; Chalakalal, Shilpa; Sebastian, Neethu; Warren-Findlow, Jan; Thompson, Michael E

2015-04-01

The objective of this study was to examine the associations among race, education, income, and health-related quality of life (HRQoL) in self-care of type 2 diabetes mellitus among adults in North Carolina. A secondary analysis was conducted using data from the 2009 Behavioral Risk Factor Surveillance Survey (BRFSS), a large population-based survey (N = 432,607) conducted in the United States. The data were analyzed to account for the weighted complex multistage sampling design of the Behavioral Risk Factor Surveillance Survey. Parametric testing using univariate/bivariate/multivariate analysis was performed. The majority of participants reported taking a class/course on diabetes mellitus management and having checked their blood glucose levels at least once per day. The majority (61.26%) of the participants did not have good self-management skills, based on the education and blood glucose-monitoring criteria established for this study. Participants with poor HRQoL had significantly increased odds of good diabetes mellitus self-care practices. Individuals with poor HRQoL had significantly increased odds of good diabetes mellitus self-care practices. Although findings on race, education, and income were not statistically significant, they were consistent with previous research. In the future, individuals who are nonwhite, have less than a high school level of education, and have no health insurance should be targeted to improve diabetes mellitus self-care practices through educational and informational materials. Further investigation using more comprehensive measures of diabetes mellitus self-care is warranted.

End-of-Life Care Interventions: An Economic Analysis

PubMed Central

Pham, B; Krahn, M

2014-01-01

Background The annual cost of providing care for patients in their last year of life is estimated to account for approximately 9% of the Ontario health care budget. Access to integrated, comprehensive support and pain/symptom management appears to be inadequate and inequitable. Objective To evaluate the cost-effectiveness of end-of-life (EoL) care interventions included in the EoL care mega-analysis. Data Sources Multiple sources were used, including systematic reviews, linked health administration databases, survey data, planning documents, expert input, and additional literature searches. Review Methods We conducted a literature review of cost-effectiveness studies to inform the primary economic analysis. We conducted the primary economic analysis and budget impact analysis for an Ontario cohort of decedents and their families and included interventions pertaining to team-based models of care, patient care planning discussions, educational interventions for patients and caregivers, and supportive interventions for informal caregivers. The time horizon was the last year of life. Costs were in 2013 Canadian dollars. Effectiveness measures included days at home, percentage dying at home, and quality-adjusted life-days. We developed a Markov model; model inputs were obtained from a cohort of Ontario decedents assembled from Institute for Clinical Evaluative Sciences databases and published literature. Results In-home palliative team care was cost-effective; it increased the chance of dying at home by 10%, increased the average number of days at home (6 days) and quality-adjusted life-days (0.5 days), and it reduced costs by approximately $4,400 per patient. Expanding in-home palliative team care to those currently not receiving such services (approximately 45,000 per year, at an annual cost of $76–108 million) is likely to improve quality of life, reduce the use of acute care resources, and save $191–$385 million in health care costs. Results for the other interventions were uncertain. Limitations The cost-effectiveness analysis was based in part on the notion that resources allocated to EoL care interventions were designed to maximize quality-adjusted life-years (QALY) for patients and their family, but improving QALYs may not be the intended aim of EoL interventions. Conclusions In-home palliative team care was cost-effective, but firm conclusions about the cost-effectiveness of other interventions were not possible. PMID:26339303

End-of-Life Care Interventions: An Economic Analysis.

PubMed

Pham, B; Krahn, M

2014-01-01

The annual cost of providing care for patients in their last year of life is estimated to account for approximately 9% of the Ontario health care budget. Access to integrated, comprehensive support and pain/symptom management appears to be inadequate and inequitable. To evaluate the cost-effectiveness of end-of-life (EoL) care interventions included in the EoL care mega-analysis. Multiple sources were used, including systematic reviews, linked health administration databases, survey data, planning documents, expert input, and additional literature searches. We conducted a literature review of cost-effectiveness studies to inform the primary economic analysis. We conducted the primary economic analysis and budget impact analysis for an Ontario cohort of decedents and their families and included interventions pertaining to team-based models of care, patient care planning discussions, educational interventions for patients and caregivers, and supportive interventions for informal caregivers. The time horizon was the last year of life. Costs were in 2013 Canadian dollars. Effectiveness measures included days at home, percentage dying at home, and quality-adjusted life-days. We developed a Markov model; model inputs were obtained from a cohort of Ontario decedents assembled from Institute for Clinical Evaluative Sciences databases and published literature. In-home palliative team care was cost-effective; it increased the chance of dying at home by 10%, increased the average number of days at home (6 days) and quality-adjusted life-days (0.5 days), and it reduced costs by approximately $4,400 per patient. Expanding in-home palliative team care to those currently not receiving such services (approximately 45,000 per year, at an annual cost of $76-108 million) is likely to improve quality of life, reduce the use of acute care resources, and save $191-$385 million in health care costs. Results for the other interventions were uncertain. The cost-effectiveness analysis was based in part on the notion that resources allocated to EoL care interventions were designed to maximize quality-adjusted life-years (QALY) for patients and their family, but improving QALYs may not be the intended aim of EoL interventions. In-home palliative team care was cost-effective, but firm conclusions about the cost-effectiveness of other interventions were not possible.

Billing, coding, and documentation in the critical care environment.

PubMed

Fakhry, S M

2000-06-01

Optimal conduct of modern-day physician practices involves a thorough understanding and application of the principles of documentation, coding, and billing. Physicians' role in these activities can no longer be secondary. Surgeons practicing critical care must be well versed in these concepts and their effective application to ensure that they are competitive in an increasingly difficult and demanding environment. Health care policies and regulations continue to evolve, mandating constant education of practicing physicians and their staffs and surgical residents who also will have to function in this environment. Close, collaborative relationships between physicians and individuals well versed in the concepts of documentation, coding, and billing are indispensable. Similarly, ongoing educational and review processes (whether internal or consultative from outside sources) not only can decrease the possibility of unfavorable outcomes from audit but also will likely enhance practice efficiency and cash flow. A financially viable practice is certainly a prerequisite for a surgical critical care practice to achieve its primary goal of excellence in patient care.

Training South African Mental Health Care Providers to Talk About Sex in the Era of AIDS

PubMed Central

Collins, Pamela Y.; Mestry, Kezziah; Wainberg, Milton L.; Nzama, Thobile; Lindegger, Graham

2009-01-01

Objective Mental health care providers in South Africa often lack the skills to conduct effective prevention activities in psychiatric settings. This article describes the development and evaluation of an HIV education program for mental health care providers at three psychiatric institutions in South Africa. Methods The research team worked with a core group of 16 mental health care providers to assess HIV training needs and to develop a training intervention focused on identified issues. The training intervention was administered to three groups (42 total) during three 1.5-day workshops. Providers completed pre- and postintervention assessments that measured knowledge and attitudes about HIV and AIDS. Results Data analysis revealed a significant increase in reported levels of comfort with HIV care (d=.54), perceived knowledge of HIV (d=1.17), and factual knowledge (d=.74). Conclusions This contextually relevant HIV education curriculum changed providers’ attitudes and knowledge, demonstrated the feasibility of administering the training program, and provided a foundation for further prevention activities. PMID:17085615

2009 pandemic influenza A (H1N1) in pregnant women requiring intensive care - New York City, 2009.

PubMed

2010-03-26

Pregnant women are at increased risk for severe illness and complications from infection with seasonal influenza and 2009 pandemic influenza A (H1N1). To characterize the severity of 2009 H1N1 infection in pregnant women, the New York City Department of Health and Mental Hygiene (DOHMH) conducted active and passive surveillance for cases of 2009 H1N1 infection in pregnant women requiring intensive care. This report summarizes the results of that surveillance, which found that, during 2009, 16 pregnant women and one who was postpartum were admitted to New York City intensive-care units (ICUs). Two women died. Of the 17 women, 12 had no recognized risk factors for severe influenza complications other than pregnancy. All 17 women received antiviral treatment with oseltamivir; however, treatment was initiated or=5 days after symptom onset in four women. Because initiation of antiviral treatment 2 days after symptom onset. Health departments and health-care providers should educate pregnant and postpartum women regarding the risks posed by influenza and highlight the effectiveness and safety of influenza vaccination. Obstetricians and other health-care providers should offer influenza vaccination to their pregnant patients.

Educational intervention to improve adherence to the Mediterranean diet among parents and their children aged 1-2 years. EniM clinical trial.

PubMed

Roset-Salla, Margarita; Ramon-Cabot, Joana; Salabarnada-Torras, Jordi; Pera, Guillem; Dalmau, Albert

2016-04-01

The objective of the present study was to evaluate the effectiveness of an educational programme on healthy alimentation, carried out in day-care centres and aimed at the parents of children from 1 to 2 years of age, regarding the acquisition of healthy eating habits among themselves and their children. We performed a multicentre, multidisciplinary, randomized controlled study in a community setting. The EniM study (nutritional intervention study among children from Mataró) was performed in twelve day-care centres in Mataró (Spain). Centres were randomized into a control group (CG) and an intervention group (IG). IG received four or five educational workshops on diet, CG did not have workshops. Children, not exclusively breast-fed, from 1 to 2 years of age, in the participating day-care centres and the persons responsible for their alimentation (mother or father). Thirty-five per cent of the IG did not attend the minimum of three workshops and were excluded. The CG included seventy-four children and seventy-two parents and the IG seventy-five children and sixty-seven parents. Both groups were comparable at baseline. Basal adherence to the Mediterranean diet was 56·4 % in parents (Gerber index) and 7·7 points in children (Kidmed test). At 8 months, Mediterranean diet adherence had improved in the IG by 5·8 points in the Gerber index (P=0·01) and 0·6 points in the Kidmed test (P=0·02) compared with the CG. This educational intervention performed in parents at the key period of incorporation of a 1-2-year-old child to the family table showed significant increases in adherence of the parents to the Mediterranean diet, suggesting future improvement in different indicators of health and an expected influence on the diet of their children.

Nutritional practices in full-day-care pre-schools.

PubMed

Jennings, A; McEvoy, S; Corish, C

2011-06-01

Full-day-care pre-schools contribute significantly to the nutritional intake and acquisition of dietary habits of the pre-school child. The present study investigated nutritional practices in full-day-care pre-schools in Dublin, Ireland, aiming to determine the nutritional support that pre-school managers deem necessary, thereby facilitating the amelioration of existing pre-school nutritional training and practices. A telephone questionnaire completed by pre-school managers (n=54) examined pre-school dietary practices, food provision and the association between these and pre-school size, nutritional training attendance, possession of the Food and Nutrition Guidelines for Pre-school Services and having a healthy eating policy. Nutritional training needs were also investigated. Twenty-five pre-schools provided all food for attending children; parents were sole providers in six. Thirty-four pre-schools had a written healthy eating policy. Attendance at nutritional training was reported by 40. Possession of the Guidelines (n=40) did not consistently result in their use. Poor parental and staff involvement in policy and menu development was cited. Although the delayed introduction of iron-containing foods and a feeding beaker in infants was clearly evident, inappropriate beverages and snacks were served to children aged 1-5 years in 43 and 37 pre-schools, respectively. Training priorities cited by managers included parental education and the provision of information regarding menu planning and healthy food choices. Nutritional training should advocate whole staff familiarity with and use of current guidelines, in addition to encouraging nutritional policy development and enforcement. Parental education is warranted. Dietary education should focus specifically on appropriate weaning practices, healthy beverage and snack provision and menu planning. © 2011 The Authors. Journal of Human Nutrition and Dietetics © 2011 The British Dietetic Association Ltd.

Comparing the nutrition environment and practices of home- and centre-based child-care facilities.

PubMed

Martyniuk, Olivia J M; Vanderloo, Leigh M; Irwin, Jennifer D; Burke, Shauna M; Tucker, Patricia

2016-03-01

To assess and compare the nutrition environment and practices (as they relate to pre-schoolers) of centre- and home-based child-care facilities. Using a cross-sectional study design, nineteen child-care facilities (ten centre-based, nine home-based) were assessed for one full day using the Environment and Policy Assessment and Observation (EPAO) tool (consisting of a day-long observation/review of the nutrition environment, practices and related documents). Specifically, eight nutrition-related subscales were considered. Child-care facilities in London, Ontario, Canada. Child-care facilities were recruited through directors at centre-based programmes and the providers of home-based programmes. The mean total nutrition environment EPAO scores for centre- and home-based facilities were 12·3 (sd 1·94) and 10·8 (sd 0·78) out of 20 (where a higher score indicates a more supportive environment with regard to nutrition), respectively. The difference between the total nutrition environment EPAO score for centre- and home-based facilities was approaching significance (P=0·055). For both types of facilities, the highest nutrition subscale score (out of 20) was achieved in the staff behaviours domain (centre mean=17·4; home mean=17·0) and the lowest was in the nutrition training and education domain (centre mean=3·6; home mean=2·0). Additional research is needed to confirm these findings. In order to better support child-care staff and enhance the overall nutrition environment in child care, modifications to food practices could be adopted. Specifically, the nutritional quality of foods/beverages provided to pre-schoolers could be improved, nutrition-related training for child-care staff could be provided, and a nutrition curriculum could be created to educate pre-schoolers about healthy food choices.

Impact of a nursing education program about caring for patients in Japan with malignant pleural mesothelioma on nurses' knowledge, difficulties and attitude: a randomized control trial.

PubMed

Nagamatsu, Yasuko; Natori, Yuji; Yanai, Haruo; Horiuchi, Shigeko

2014-07-01

In Japan nursing care lags behind the growing population of patients with malignant pleural mesothelioma. This study evaluated an educational program for nurses about caring for patients with malignant pleural mesothelioma in Japan. In this randomized controlled study relative to care for malignant pleural mesothelioma, Knowledge, Difficulties and Attitude were measured at baseline, at post-test and at follow-up one month later. The two-day program with a half-day follow-up program included lectures, group work, role-playing and group discussion. 188 participants were randomly assigned to the intervention group (program, n=96) and control group (n=92; self-study by a similar content handbook). At baseline the groups showed no statistical differences in Knowledge (p=0.921), Difficulty (p=0.458) and Attitude (p=0.922). Completing the study were 177 participants yielding 88 in the intervention group and 89 in the control group. Human rights and privacy of participants were protected. The Knowledge score was significantly higher in the intervention post-test (t=14.03, p=0.000) and follow-up test (t=8.98, p=0.000). Difficulty score was significantly lower in the intervention at post-test (t=-3.41, p=0.001) and follow-up test (t=-3.70, p=0.000). The Attitude score was significantly higher in the intervention post-test (t=7.11, p=0.000) and follow-up test (t=4.54, p=0.000). The two-way analysis of variance with repeated measures on time showed an interaction between time and group; the subsequent simple main effect test found significant differences (p=0.000-0.001) between groups for after-program and at follow-up and a significant difference (p=0.000) in time only within the intervention group. The educational program was effective in improving the nurses' knowledge and attitude toward malignant pleural mesothelioma care and decreasing the difficulty in MPM care, therefore this program has potential for nurses' in-service education throughout Japan. Copyright © 2014. Published by Elsevier Ltd.

Impact of an educational intervention on hand hygiene compliance and infection rate in a developing country neonatal intensive care unit.

PubMed

Chhapola, Viswas; Brar, Rekha

2015-10-01

Nosocomial infections are a significant problem in neonatal intensive care units (NICUs) and hand hygiene (HH) has been stated as an effective mean to prevent spread of infections. The aim of study was to assess the baseline compliance HH practices and to evaluate the impact of hand washing educational programme on infection rate in a NICU. Continuous surveillance of nosocomial infections was done. A total of 15,797 and 12 ,29 opportunities for HH were observed in pre-intervention and postintervention phases, respectively. Compliance of health-care workers for all HH opportunities combined was 46% before intervention and improved significantly to 69% in postintervention (RR 1.49, CI 1.46-1.52, P < 0.0001). Compliance for nurses and doctors was similar. Nosocomial sepsis rate showed a significant decline from 96 per 1000 patient-days in pre-intervention to 47 per 1000 patient-days in postintervention phase (RR 0.44, CI 0.33-0.58, P < 0.0001). We conclude that effective HH practices can serve as an economical and effective nosocomial infection control approach especially important in developing nations. © 2014 Wiley Publishing Asia Pty Ltd.

Identifying the key elements of an education package to up-skill multidisciplinary adult specialist palliative care teams caring for young adults with life-limiting conditions: an online Delphi study.

PubMed

Sivell, Stephanie; Lidstone, Victoria; Taubert, Mark; Thompson, Catherine; Nelson, Annmarie

2015-09-01

To collect the views of experts to inform the development of an education package for multidisciplinary adult specialist palliative care (SPC) teams caring for young people with life-limiting conditions. A modified online Delphi process collated expert opinion on format, delivery and content of an education package to up-skill adult SPC teams. Round 1 participants (n=44) answered free-text questions, generating items for Round 2. In Round 2, 68 participants rated the extent to which they agreed/disagreed with the items on 5-point Likert-type scales. Median and mean scores assessed the importance of each item. IQR scores assessed level of consensus for each item; items lacking consensus were rerated by 35 participants in Round 3. In the Delphi, consensus was reached on a range of suggested formats, on who should deliver the training, and on several clinical, psychosocial and practical topics. Development of a continuous/rolling programme of education, tailored for content and mode of delivery and incorporated into working practice is recommended. As a direct outcome of the results of this study, a series of six linked study days has been established, focusing specifically on the issues around caring for young adults with life-limiting conditions and palliative care needs. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Views and experiences of using integrated care pathways (ICPs) for caring for people in the last days to hours of life: results from a cross-sectional survey of UK professionals.

PubMed

Collins, K A; Hughes, P M; Ibbotson, R; Foy, G; Brooks, D

2016-09-01

To determine the views and experiences of health and social care professionals on using integrated care pathways (ICPs)for caring for people in the last days to hours of life. Online cross-sectional questionnaire survey of UK professionals working in UK primary and secondary care settings. 1331 professionals returned completed questionnaires. Ninety-three per cent (1138/1228) of respondents used the Liverpool Care Pathway (LCP) or local variant. Eighty-eight (1089/1234) felt ICPs enabled professionals to provide better care for individuals and their families/carers. ICPs were viewed as promoting patient-centred holistic care, improving pain and symptom control, providing guidance and standards and improving communication with patients/families. Sixty-two per cent (770/1234) had no concerns regarding the use of ICPs. Areas of concern included incorrect use and implementation of the ICP, poor communication with families, junior level staff making decisions and insufficient education and support. There was strong support for using ICPs for caring for people in the last days to hours of life. ICPs were viewed as supporting high-quality patient-centred holistic care. Given the recommendations of the More Care Less Pathway report, those that develop the guidance and support that replace the LCP need to incorporate the aspects of this that have resulted in the benefits seen by professionals within this survey, but also learn from the instances where ICPs have failed to prevent poor care, or worse, have contributed to it. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Protecting the rights of school children with diabetes.

PubMed

Wood, James M

2013-03-01

School children with diabetes are facing increasing difficulties in receiving care during the school day. Despite theexistence of federal statutes ensuring their rights to a free, appropriate public education, many school districts throughout the country do little, if anything, to ensure that their condition is treated throughout the school day. The chronic shortage of school nurses has resulted in hardships on families, relatives, and friends to ensure that care, including insulin, is timely and appropriately provided. While many states have taken measures to provide care by unlicensed trained volunteers, efforts to accomplish this in California have resulted in prolonged litigation. A variety of nursing organizations oppose all efforts to train unlicensed volunteers, arguing that such is not permitted by California law. The issue is unresolved and currently pending in the California Supreme Court. © 2013 Diabetes Technology Society.

Non-technical skills training to enhance patient safety.

PubMed

Gordon, Morris

2013-06-01

  Patient safety is an increasingly recognised issue in health care. Systems-based and organisational methods of quality improvement, as well as education focusing on key clinical areas, are common, but there are few reports of educational interventions that focus on non-technical skills to address human factor sources of error. A flexible model for non-technical skills training for health care professionals has been designed based on the best available evidence, and with sound theoretical foundations.   Educational sessions to improve non-technical skills in health care have been described before. The descriptions lack the details to allow educators to replicate and innovate further.   A non-technical skills training course that can be delivered as either a half- or full-day intervention has been designed and delivered to a number of mixed groups of undergraduate medical students and doctors in postgraduate training. Participant satisfaction has been high and patient safety attitudes have improved post-intervention.   This non-technical skills educational intervention has been built on a sound evidence base, and is described so as to facilitate replication and dissemination. With the key themes laid out, clinical educators will be able to build interventions focused on numerous clinical issues that pay attention to human factor contributors to safety. © 2013 John Wiley & Sons Ltd.

Family partnership and education interventions to reduce dietary sodium by patients with heart failure differ by family functioning.

PubMed

Dunbar, Sandra B; Clark, Patricia C; Stamp, Kelly D; Reilly, Carolyn M; Gary, Rebecca A; Higgins, Melinda; Kaslow, Nadine

2016-01-01

Determine if family functioning influences response to family-focused interventions aimed at reducing dietary sodium by heart failure (HF) patients. Lowering dietary sodium by HF patients often occurs within the home and family context. Secondary analysis of 117 dyads randomized to patient and family education (PFE), family partnership intervention (FPI) or usual care (UC). Dietary sodium measures were obtained from 3-day food record and 24-h urine samples. In the poor family functioning groups, FPI and PFE had lower mean urine sodium than UC (p < .05) at 4 months, and FPI remained lower than UC at 8 months (p < .05). For good family functioning groups, FPI and PFE had lower mean sodium levels by 3-day food record at 4 and 8 months compared to the UC group. Optimizing family-focused interventions into HF clinical care maybe indicated. Copyright © 2016 Elsevier Inc. All rights reserved.

Improving dementia diagnosis and management in primary care: a cohort study of the impact of a training and support program on physician competency, practice patterns, and community linkages.

PubMed

Lathren, Christine R; Sloane, Philip D; Hoyle, Joseph D; Zimmerman, Sheryl; Kaufer, Daniel I

2013-12-10

Primary care physicians routinely provide dementia care, but may lack the clinical skills and awareness of available resources to provide optimal care. We conducted a community-based pilot dementia training intervention designed to both improve clinical competency and increase utilization of local dementia care services. Physicians (N = 29) and affiliated staff (N = 24) participated in a one-day training program on dementia screening, diagnosis and management that included direct engagement with local support service providers. Questionnaires about their dementia care competency and referral patterns were completed before and 6 months after the training intervention. Physicians reported significantly higher overall confidence in their dementia care competency 6 months post-training compared to pre-training. The largest reported improvements were in their ability to educate patients and caregivers about dementia and making appropriate referrals to community care services. Participants also reported markedly increased use of cognitive screening tools in providing care. Community service providers recorded approximately 160 physician-initiated referrals over a 2 year-period post-training, compared to few beforehand. Combining a targeted physician practice-based educational intervention with community service engagement improves dementia care competency in clinicians and promotes linkages between clinical and community dementia care providers.

A COMPARATIVE EVALUATION OF TWO INTERVENTIONS FOR EDUCATOR TRAINING IN HIV/AIDS IN SOUTH AFRICA

PubMed Central

CHAO, LI-WEI; GOW, JEFF; AKINTOLA, OLAGOKE; PAULY, MARK V.

2010-01-01

The purpose of this study was to compare two different methods to teach educators about HIV/AIDS. Sixty educators were selected from eight schools in KwaZulu-Natal Province, South Africa, to undergo HIV/AIDS training using an interactive CD-ROM intervention. Another sixty educators from other schools were selected to undergo a two-day Care & Support Training Programme provided by the Department of Education. The outcomes both before and after the interventions were measured by surveying the educators’ knowledge and attitudes related to HIV/AIDS, as well as their self-efficacy with respect to dealing with HIV/AIDS in the classroom setting. Both interventions resulted in significant changes in knowledge and attitudes as well as in the self-efficacy with respect to ability to teach about HIV/AIDS and to deal with classroom situations involving HIV and blood. The Care & Support Training Programme proved superior in enhancing basic knowledge about HIV, and the CD-ROM was superior in teaching about HIV transmission risks. PMID:20852677

Effect of end of life education on medical students' and health care workers' death attitude.

PubMed

Hegedus, K; Zana, A; Szabó, G

2008-04-01

One of the goals of education in end of life care is to make communication more open by exploring critical issues related to fear of dying and death in order to reduce anxiety and improve an individual's attitude to dying patients. The aim of our research was to evaluate the effects of courses for health care workers and medical students in care at the end of life. One hundred and twenty-seven health care professionals and 41 undergraduate medical students completed the Multidimensional Fear of Death Scale (MFODS) on the first and last day of the course. The most significant factors of fear of death are: Fear for Significant Others, Fear of the Dying Process and Fear of the Unknown. Overall fear of death scores were reduced as an effect of the courses. Changes in the components and level of fear of death are influenced by the participants' gender, age and profession. Improvement was evident in the attitudes to dying patients in both groups, which was related to an increase in knowledge of high-quality care of dying patients.

[Introduction of Shimane University's outside funded support project for female researchers and healthcare staff].

PubMed

Tsumori, Toshiko

2013-09-01

Shimane University has started to provide facilities and services to female researchers and healthcare staff who have worked for the university or its hospital after 2007. This initiative had been supported by grants from the Japanese Ministry of Education, Culture, Sports, Science and Technology until 2010. Over time, it has become clear that these efforts, including a day-and-night nursery, day-care for sick children, temporary day-care, after-school programs, and research support system have effectively sustained female researchers and staff in maintaining a balance between private life and work. It is essential that the university devote part of its budget along with outside funding for continued childcare, which has so motivated these female employees. Moreover, it is expected that these efforts will become an effective recruitment tool for excellent young teachers and researchers.

Caring and competency.

PubMed

Mustard, Lewis W

2002-06-01

The long-term crisis in nursing, particularly in acute care hospitals, is demonstrated in studies on negligence by the Institute of Medicine in To Err is Human: Building a Safer Health System1 and Crossing the Quality Chasm: A New Health System for the 21st Century.2 A review of the nursing literature reflects unclear definitions of competency and its component caring, and no single theory of competency has been adopted from the literature and used in the education of nurses. The American Nurses 2001 Code of Ethics does not resolve this confusion, because it does not correct the individual acts of nursing incompetencies in acute care hospitals. The author defines caring and competency by providing examples of what they are not in examining 200 actual cases of hospital nursing acts of incompetence by nursing discipline. None of these examples of imputed negligence was reported to the National Practitioner Data Bank because the "corporate shield" protected the nurses by not being named in the complaint nor named as part of the settlement against the hospital.A new model of the hospitalist, the nurse hospitalist, is presented to act as a daily teacher and facilitator for hospital nurses based on a curriculum of day-to-day examples of substandard patient care. This nurse specialist is an inpatient generalist advanced practice nurse who is employed by the hospital and reports to the chief nurse executive. The author proposes that this new model of the nurse hospitalist be devoted entirely to collaborating with nurse leaders, educators, charge nurses, and floor nurses throughout disciplines in advancing the competency of nursing. This daily proactive and prospective model of improving nursing performance in a facultative manner offers strategies to mitigate the limitations of the retrospective model of quality control. Total quality improvement practiced retroactively is ineffective. The author recommends no structural change in the institution but an educational agenda by the nurse hospitalist, with hospital administration to assist nurses in a new learning environment.

Teaching End-of-Life Communication in Intensive Care Medicine: Review of the Existing Literature and Implications for Future Curricula.

PubMed

Zante, Bjoern; Schefold, Joerg C

2017-01-01

End-of-life (EOL) situations are common in the intensive care unit (ICU). Poor communication in respective situations may result in conflict and/or post-traumatic stress disorder in patients' next of kin. Thus, training for EOL communication seems pivotal. Primary objective of the current report was to identify approaches for educational programs in the ICU with regard to EOL communication as well as to conclude on implications for future curricula. A literature review in MEDLINE, EMBASE, and PsychINFO was performed. A total of 3484 articles published between 2000 until 2016 were assessed for eligibility. Nine articles reporting on education in EOL communication in the ICU were identified and analyzed further. The duration of EOL workshops ranged from 3 hours to 3 days, with several different educational methods being applied. Mounting data suggest improved comfort, preparedness, and communication performance in EOL providers following specific EOL training. Due to missing data, the effect of EOL training programs on respective patients' next of kin remains unclear. Few scientific investigations focus on EOL communication in intensive care medicine. The available evidence points to increased comfort and EOL communication performance following specific individual EOL training. Given the general importance of EOL communication, we suggest implementation of educational EOL programs. When developing future educational programs, educators should consider previous experience of participants, clearly defined objectives based on institutional needs, and critical care society recommendations to ensure best benefit of all involved parties.

Centre-based day care for children younger than five years of age in high-income countries.

PubMed

van Urk, Felix C; Brown, Taylor W; Waller, Rebecca; Mayo-Wilson, Evan

2014-09-23

A large proportion of children younger than five years of age in high-income countries experience significant non-parental care. Centre-based day care services may influence the development of children and the economic situation of parents. To assess the effects of centre-based day care without additional interventions (e.g. psychological or medical services, parent training) on the development and well-being of children and families in high-income countries (as defined by the World Bank 2011). In April 2014, we searched CENTRAL, Ovid MEDLINE, EMBASE, PsycINFO, the Education Resources Information Center (ERIC) and eight other databases. We also searched two trials registers and the reference lists of relevant studies. We included randomised and quasi-randomised controlled trials of centre-based day care for children younger than five years of age. We excluded studies that involved co-interventions not directed toward children (e.g. parent programmes, home visits, teacher training). We included the following outcomes: child cognitive development (primary outcome), child psychosocial development, maternal and family outcomes and child long-term outcomes. Two review authors independently assessed the risk of bias and extracted data from the single included study. We contacted investigators to obtain missing information. We included in the review one trial, involving 120 families and 143 children. Risk of bias was high because of contamination between groups, as 63% of control group participants accessed day care services separate from those offered within the intervention. No evidence suggested that centre-based day care, rather than no treatment (care at home), improved or worsened children's cognitive ability (Griffiths Mental Development Scale, standardised mean difference (SMD) 0.34, 95% confidence interval (CI) -0.01 to 0.69, 127 participants, 1 study, very low-quality evidence) or psychosocial development (parental report of abnormal development, risk ratio (RR) 1.21, 95% CI 0.25 to 5.78, 137 participants, 1 study, very low-quality evidence). No other measures of child intellectual or psychosocial development were reported in the included study. Moreover, no evidence indicated that centre-based day care, rather than no treatment (care at home), improved or worsened employment of parents, as measured by the number of mothers in full-time or part-time employment (RR 1.12, 95% CI 0.85 to 1.48, 114 participants, 1 study, very low-quality evidence) and maternal hours per week in paid employment (SMD 0.20, 95% -0.15 to 0.55, 127 participants, 1 study, very low-quality evidence) or household income above £200 per week (RR 0.86, 95% CI 0.57 to 1.29, 113 participants, 1 study, very low-quality evidence). This study did not report on long-term outcomes for children (high-school completion or income). This review includes one trial that provides inconclusive evidence as regards the effects of centre-based day care for children younger than five years of age and their families in high-income countries. Robust guidance for parents, policymakers and other stakeholders on the effects of day care cannot currently be offered on the basis of evidence from randomised controlled trials. Some trials included co-interventions that are unlikely to be found in normal day care centres. Effectiveness studies of centre-based day care without these co-interventions are few, and the need for such studies is significant. Comparisons might include home visits or alternative day care arrangements that provide special attention to children from low-income families while exploring possible mechanisms of effect.

Palliative care in Japan: a review focusing on care delivery system.

PubMed

Morita, Tatsuya; Kizawa, Yoshiyuki

2013-06-01

Providing palliative care in Japan is one of the most important health issues. Understanding palliative care delivery systems of other countries is useful when developing and modifying palliative care systems worldwide. This review summarizes the current status of palliative care in Japan, focusing on the structure and process development. Palliative care units and hospital palliative care consultation teams are the two main specialized palliative care services in Japan. The number of palliative care units is 215 (involved in 8.4% of all cancer deaths), and there are approximately 500 hospital palliative care teams. Conversely, specialized home care services are one of the most undeveloped areas in Japan. However, the government has been trying to develop more efficient home care services through modifying laws, healthcare systems, and multiple educational and cooperative projects. The numbers of palliative care specialists are increasing across all disciplines: cancer pain nurses (1365), palliative care nurses (1100), palliative care physicians (646), and palliative care pharmacists (238). Postgraduate education for physicians is performed via the special nationwide efforts of the Palliative care Emphasis program on symptom management and Assessment for Continuous medical Education (PEACE) project - a 2-day program adopting a trainer-trainee strategy. Over 30,000 physicians have participated in the PEACE program. A total of 1298 and 544 physicians have completed a trainer course for palliative medicine and psycho-oncology, respectively. Multiple structure and process evaluation, bereaved family surveys in palliative care units, and patient and family evaluation in the regional palliative care program indicate many improvements. Palliative care in Japan has progressed rapidly, and the Cancer Control Act has played a very important role in developing palliative medicine. Challenges include developing a structure for palliative care in the community or regional palliative care programs, establishing a method to measure and improve the quality of palliative care at a national level, developing evidence-based medicine and policy making, and palliative care for the noncancerous population.

Does community health care require different competencies from physicians and nurses?

PubMed Central

2014-01-01

Background Recently competency approach in Health Professionals’ Education (HPE) has become quite popular and for an effective competency based HPE, it is important to design the curriculum around the health care needs of the population to be served and on the expected roles of the health care providers. Unfortunately, in community settings roles of health providers tend to be described less clearly, particularly at the Primary Health Care (PHC) level where a multidisciplinary and appropriately prepared health team is generally lacking. Moreover, to tailor the education on community needs there is no substantial evidence on what specific requirements the providers must be prepared for. Methods This study has explored specific tasks of physicians and nurses employed to work in primary or secondary health care units in a context where there is a structural scarcity of community health care providers. In-depth Interviews of 11 physicians and 06 nurses working in community settings of Pakistan were conducted along with review of their job descriptions. Results At all levels of health settings, physicians’ were mostly engaged with diagnosing and prescribing medical illness of patients coming to health center and nurses depending on their employer were either providing preventive health care activities, assisting physicians or occupied in day to day management of health center. Geographical location or level of health facility did not have major effect on the roles being expected or performed, however the factors that determined the roles performed by health providers were employer expectations, preparation of health providers for providing community based care, role clarity and availability of resources including health team at health facilities. Conclusions Exploration of specific tasks of physicians and nurses working in community settings provide a useful framework to map competencies, and can help educators revisit the curricula and instructional designs accordingly. Furthermore, in community settings there are many synergies between the roles of physicians and nurses which could be simulated as learning activities; at the same time these two groups of health providers offer distinct sets of services, which must be harnessed to build effective, non-hierarchal, collaborative health teams. PMID:24387322

Effect of the 2011 vs 2003 duty hour regulation-compliant models on sleep duration, trainee education, and continuity of patient care among internal medicine house staff: a randomized trial.

PubMed

Desai, Sanjay V; Feldman, Leonard; Brown, Lorrel; Dezube, Rebecca; Yeh, Hsin-Chieh; Punjabi, Naresh; Afshar, Kia; Grunwald, Michael R; Harrington, Colleen; Naik, Rakhi; Cofrancesco, Joseph

2013-04-22

On July 1, 2011, the Accreditation Council for Graduate Medical Education implemented further restrictions of its 2003 regulations on duty hours and supervision. It remains unclear if the 2003 regulations improved trainee well-being or patient safety. To determine the effects of the 2011 Accreditation Council for Graduate Medical Education duty hour regulations compared with the 2003 regulations concerning sleep duration, trainee education, continuity of patient care, and perceived quality of care among internal medicine trainees. Crossover study design in an academic research setting. Medical house staff. General medical teams were randomly assigned using a sealed-envelope draw to an experimental model or a control model. We randomly assigned 4 medical house staff teams (43 interns) using a 3-month crossover design to a 2003-compliant model of every fourth night overnight call (control) with 30-hour duty limits or to one of two 2011-compliant models of every fifth night overnight call (Q5) or a night float schedule (NF), both with 16-hour duty limits. We measured sleep duration using actigraphy and used admission volumes, educational opportunities, the number of handoffs, and satisfaction surveys to assess trainee education, continuity of patient care, and perceived quality of care. RESULTS The study included 560 control, 420 Q5, and 140 NF days that interns worked and 834 hospital admissions. Compared with controls, interns on NF slept longer during the on call period (mean, 5.1 vs 8.3 hours; P = .003), and interns on Q5 slept longer during the postcall period (mean, 7.5 vs 10.2 hours; P = .05). However, both the Q5 and NF models increased handoffs, decreased availability for teaching conferences, and reduced intern presence during daytime work hours. Residents and nurses in both experimental models perceived reduced quality of care, so much so with NF that it was terminated early. Compared with a 2003-compliant model, two 2011 duty hour regulation-compliant models were associated with increased sleep duration during the on-call period and with deteriorations in educational opportunities, continuity of patient care, and perceived quality of care.

Impact of General Practitioner Transient Ischemic Attack Training on 90-Day Stroke Outcomes: Secondary Analysis of a Cluster Randomized Controlled Trial.

PubMed

Ranta, Annemarei; Dovey, Susan; Gommans, John; Tilyard, Murray; Weatherall, Mark

2018-07-01

Many patients with transient ischemic attack (TIA) receive initial assessments by general practitioners (GPs) who may lack TIA management experience. In a randomized controlled trial (RCT), we showed that electronic decision support for GPs improves patient outcomes and guideline adherence. Some stroke services prefer to improve referrer expertise through TIA/stroke education sessions instead of promoting TIA decision aids or triaging tools. This is a secondary analysis of whether a GP education session influenced TIA management and outcomes. Post hoc analysis of a multicenter, single blind, parallel group, cluster RCT comparing TIA/stroke electronic decision support guided GP management with usual care to assess whether a pretrial TIA/stroke education session also affected RCT outcomes. Of 181 participating GPs, 79 (43.7%) attended an education session and 140 of 291 (48.1%) trial patients were managed by these GPs. There were fewer 90-day stroke events and 90-day vascular events or deaths in patients treated by GPs who attended education; 2 of 140 (1.4%) and 10 of 140 (7.1%) respectively, compared with those who did not; 5 of 151 (3.3%), and 14 of 151 (9.3%), respectively. Logistic regression for association between 90-day stroke and 90-day vascular events or death and education, however, was nonsignificant (odds ratio [OR] .42 (.08 to 2.22), P = .29 and .59 (95% confidence interval [CI] .27 to 1.29), P = .18 respectively. Guideline adherence was not improved by the education session: OR .84 (95% CI .49 to 1.45), P = .54. In the described setting, a GP TIA/stroke education session did not significantly enhance guideline adherence or reduce 90-day stroke or vascular events following TIA. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

A Prospective, Descriptive, Quality Improvement Study to Decrease Incontinence-Associated Dermatitis and Hospital-Acquired Pressure Ulcers.

PubMed

Hall, Kimberly D; Clark, Rebecca C

2015-07-01

Incontinence is a common problem among hospitalized patients and has been associated with multiple health complications, including incontinence-associated dermatitis (IAD) and hospital-acquired pressure ulcers (HAPUs). A prospective, descriptive study was conducted in 2 acute care neurology units to 1) assess the prevalence of incontinence and incidence of IAD and HAPUs among incontinent patients, and 2) evaluate the effect of caregiver education and use of a 1-step cleanser, moisturizer, barrier product on the development of IAD and HAPUs among patients with incontinence. During a period of 1 month, the incontinence status of admitted patients was recorded and skin was assessed for the presence/absence of IAD and HAPUs twice per day. After the 1-month data collection, all clinicians on the study units completed a facility-based online education program about IAD, HAPUs, and skin care followed by the implementation of a 1-step cleanser/barrier product for skin care of all patients with incontinence. Data collection procedures remained the same. Data were collected using a paper/pencil instrument and entered into a spreadsheet for analysis. Descriptive statistics were calculated and prevalence and incidence rates were compared between the pre-intervention and post-intervention phase using Fisher's exact analysis. During the first phase of the study, 17 of 40 admitted patients (42.5%) were incontinent. Of those, 5 (29.4%) developed IAD and all of these patients developed HAPUs (5 of 40 admitted, 29.4%) during an average length of stay of 7.3 (range: 2-14) days. In the intervention phase of the study, 25 of 46 (54.3%) patients were incontinent and none developed IAD or a HAPU during an average length of stay of 7.4 (range: 2-14) days. The average Braden scale score was 14.14 in the pre-intervention group of patients with incontinence and 12.74 in the intervention group. The prevalence of incontinence among patients admitted to acute care neurology units and the rate of IAD in these populations is high. After educating clinicians and implementing incontinence care procedures with a 1-step product, the rate of HAPUs decreased significantly but the rate of IADs remained the same. Clinicians should consider the results of this and other studies when developing incontinence-care protocols. Controlled clinical studies utilizing more detailed IAD assessments will help elucidate these observations.

Aiming for zero: decreasing central line associated bacteraemia in the intensive care unit.

PubMed

Seddon, Mary E; Hocking, Catherine J; Mead, Pat; Simpson, Catherine

2011-07-29

To eliminate Central Line Associated Bacteraemia (CLAB) in the Critical Care Complex (CCC)-Intensive Care Unit (ICU) and High Dependency Unit (HDU)-Middlemore Hospital. Multifaceted quality improvement programme that included: engagement with ICU leadership and education of ICU staff; the introduction of a CLAB prevention bundle of care through standardised checklists for central line insertion (December 2008) and line maintenance (July 2009); the development of a central line pack; and rapid, visual feedback of results. Absolute numbers of CLAB in the CCC decreased from 14 in 2008, to 4 in 2009 and 1 in the first 6 months of 2010 (despite increase in bed census and a doubling of admissions). The CLAB rate per 1,000 line days decreased from 6.6 to 0.9. The days between CLAB increased from a median of 30 to >100 days, with zero CLAB for 5 of the last 6 months. Mortality for patients with CLAB was 37%, compared with mortality of 13% for all other ICU patients. The conservative cost savings were $200,000 in 2009 and $260,000 in 2010. Using an evidenced-based quality improvement approach, it is possible to significantly decrease Central Line Associated Bacteraemia in the Critical Care Complex. In doing so patient morbidity and mortality are reduced and money is saved for other healthcare needs.

Unplanned admissions in day-case surgery as a clinical indicator for quality assurance.

PubMed

Margovsky, A

2000-03-01

Day surgery is a modern, effective and economical way to treat patients while maintaining the same level of quality of patient care. Quality improvement in day surgery units, however, continues to be an issue due to high rates of unplanned admissions. The aim of the present retrospective study was to investigate reasons for and methods of preventing unplanned postoperative admissions in a day surgical unit over a 12-month period in respect to different surgical specialties. The study was based on an audit from the Endoscopy and Day Surgery Unit (EDSU) at Launceston General Hospital, which provides health care to a population of more than 120000. For the accounted period 920 outpatients had elective day surgical procedures. Overall the unplanned admission rate was 4.7%, and surgical, anaesthetic and social reasons accounted for 58.2, 37.2 and 4.6% of the unplanned admissions, respectively. The highest rate of unplanned admissions was for plastic and reconstructive surgery (12.8%) and orthopaedic surgery (7.5%) despite the relatively small number of patients who underwent such procedures in the day surgery unit. The results also showed a correlation between age group, pre-operative medical status of the patients found suitable for the day surgical procedure and unplanned admissions. Strategies to reduce the unplanned admission rate which include patient selection and pre-operative assessment, patient waiting time and education, pre-operative anaesthesia, follow-up with nursing care and postoperative analgesia are discussed.

Palliative Care Professional Development for Critical Care Nurses: A Multicenter Program.

PubMed

Anderson, Wendy G; Puntillo, Kathleen; Cimino, Jenica; Noort, Janice; Pearson, Diana; Boyle, Deborah; Grywalski, Michelle; Meyer, Jeannette; O'Neil-Page, Edith; Cain, Julia; Herman, Heather; Barbour, Susan; Turner, Kathleen; Moore, Eric; Liao, Solomon; Ferrell, Bruce; Mitchell, William; Edmonds, Kyle; Fairman, Nathan; Joseph, Denah; MacMillan, John; Milic, Michelle M; Miller, Monica; Nakagawa, Laura; O'Riordan, David L; Pietras, Christopher; Thornberry, Kathryn; Pantilat, Steven Z

2017-09-01

Integrating palliative care into intensive care units (ICUs) requires involvement of bedside nurses, who report inadequate education in palliative care. To implement and evaluate a palliative care professional development program for ICU bedside nurses. From May 2013 to January 2015, palliative care advanced practice nurses and nurse educators in 5 academic medical centers completed a 3-day train-the-trainer program followed by 2 years of mentoring to implement the initiative. The program consisted of 8-hour communication workshops for bedside nurses and structured rounds in ICUs, where nurse leaders coached bedside nurses in identifying and addressing palliative care needs. Primary outcomes were nurses' ratings of their palliative care communication skills in surveys, and nurses' identification of palliative care needs during coaching rounds. Each center held at least 6 workshops, training 428 bedside nurses. Nurses rated their skill level higher after the workshop for 15 tasks (eg, responding to family distress, ensuring families understand information in family meetings, all P < .01 vs preworkshop). Coaching rounds in each ICU took a mean of 3 hours per month. For 82% of 1110 patients discussed in rounds, bedside nurses identified palliative care needs and created plans to address them. Communication skills training workshops increased nurses' ratings of their palliative care communication skills. Coaching rounds supported nurses in identifying and addressing palliative care needs. ©2017 American Association of Critical-Care Nurses.

Tomorrow Is Today at Silver Ridge.

ERIC Educational Resources Information Center

Wise, B. J.

1994-01-01

Describes a Washington State school's efforts to forego factory-model education for a boldly restructured curriculum dependent on new technologies, such as computer networks, two-year classrooms, ongoing staff development and planning sessions, and an innovative onsite day-care program for staff and students. The school has succeeded in…

Factors Influencing the Decision to Receive an Influenza Vaccination Among Manufacturing Plant and Day Care Center Employees.

PubMed

McKeirnan, Kimberly C

2016-05-01

To improve influenza immunization rates, it is essential to understand why adults are not immunized and the factors that influence their decisions. This information can be used to tailor educational materials and outreach. © 2016 The Author(s).

Innovative solutions: my heart is a what?! Creativity in critical care education.

PubMed

Smith, Lynn W

2007-01-01

Nurses teach patients, families, and other healthcare providers. All of us teach our neighbors and communities. Choosing strategies for teaching essential content is the challenge we face every day. This article describes some innovative ways to share knowledge using creativity and imagination.

The Emergence of Civil Rights in Wyoming.

ERIC Educational Resources Information Center

Wyoming State Advisory Committee to the U.S. Commission on Civil Rights, Cheyenne.

Local, state, and federal government representatives and private citizens participated in a two-day consultation on civil rights in Wyoming. Panel discussions focused on the difficulties of civil rights enforcement in the areas of housing and economic opportunity, medical care, education, the handicapped, employment discrimination, and women's…

Employers' Responsibility for Social Services: Public Perceptions.

ERIC Educational Resources Information Center

Roff, Lucinda Lee; Klemmack, David L.

1985-01-01

Surveyed 2,207 Alabama residents to determine public perceptions about employer responsibility for social services. Results indicated that the majority of respondents believe employers have some responsibility for drug and alcohol counseling, family problem counseling, and day care. Race, sex, family, and educational differences are discussed. (BL)

78 FR 49524 - Privacy Act of 1974; CMS Computer Match No. 2013-08; HHS Computer Match No. 1309

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-14

... by the Health Care and Education Reconciliation Act of 2010 (Pub. L. 111-152) (collectively, the ACA...). INCLUSIVE DATES OF THE MATCH: The CMP will become effective no sooner than 40 days after the report of the...

Supporting Young Learners: Ideas for Preschool and Day Care Providers.

ERIC Educational Resources Information Center

Brickman, Nancy Altman, Ed.; Taylor, Lynn Spencer, Ed.

The High/Scope Curriculum is a developmentally based approach to early childhood education. The curriculum's "Extensions" newsletter, in which the articles in this collection first appeared, informs curriculum users about new developments relating to the High/Scope "open framework" curriculum. The articles are presented in…

Women's Studies Sourcebook: A Comprehensive, Classified Bibliography of Books.

ERIC Educational Resources Information Center

King, Judith D., Comp.

Over 1,000 entries are presented in this bibliography of resources about women. Subject categories include the following: abortion; academia; art; biography; black women; business, banking, and economics; crime; day care; education; employment; health; history; Jewish women; lesbianism; literary works; medicine; music; national studies; police…

Characteristics, Outcomes, and Predictability of Critically Ill Obstetric Patients: A Multicenter Prospective Cohort Study.

PubMed

Vasquez, Daniela N; Das Neves, Andrea V; Vidal, Laura; Moseinco, Miriam; Lapadula, Jorge; Zakalik, Graciela; Santa-Maria, Analía; Gomez, Raúl A; Capalbo, Mónica; Fernandez, Claudia; Agüero-Villareal, Enrique; Vommaro, Santiago; Moretti, Marcelo; Soli, Silvana B; Ballestero, Florencia; Sottile, Juan P; Chapier, Viviana; Lovesio, Carlos; Santos, José; Bertoletti, Fernando; Intile, Alfredo D; Desmery, Pablo M; Estenssoro, Elisa

2015-09-01

To evaluate pregnant/postpartum patients requiring ICUs admission in Argentina, describe characteristics of mothers and outcomes for mothers/babies, evaluate risk factors for maternal-fetal-neonatal mortality; and compare outcomes between patients admitted to public and private health sectors. Multicenter, prospective, national cohort study. Twenty ICUs in Argentina (public, 8 and private, 12). Pregnant/postpartum (< 42 d) patients admitted to ICU. None. Three hundred sixty-two patients were recruited, 51% from the public health sector and 49% from the private. Acute Physiology and Chronic Health Evaluation II was 8 (4-12); predicted/observed mortality, 7.6%/3.6%; hospital length of stay, 7 days (5-13 d); and fetal-neonatal losses, 17%. Public versus private health sector patients: years of education, 9 ± 3 versus 15 ± 3; transferred from another hospital, 43% versus 12%; Acute Physiology and Chronic Health Evaluation II, 9 (5-13.75) versus 7 (4-9); hospital length of stay, 10 days (6-17 d) versus 6 days (4-9 d); prenatal care, 75% versus 99.4%; fetal-neonatal losses, 25% versus 9% (p = 0.000 for all); and mortality, 5.4% versus 1.7% (p = 0.09). Complications in ICU were multiple-organ dysfunction syndrome (34%), shock (28%), renal dysfunction (25%), and acute respiratory distress syndrome (20%); all predominated in the public sector. Sequential Organ Failure Assessment (during first 24 hr of admission) score of at least 6.5 presented the best discriminative power for maternal mortality. Independent predictors of maternal-fetal-neonatal mortality were Acute Physiology and Chronic Health Evaluation II, education level, prenatal care, and admission to tertiary hospitals. Patients spent a median of 7 days in hospital; 3.6% died. Maternal-fetal-neonatal mortality was determined not only by acuteness of illness but to social and healthcare aspects like education, prenatal control, and being cared in specialized hospitals. Sequential Organ Failure Assessment (during first 24 hr of admission), easier to calculate than Acute Physiology and Chronic Health Evaluation II, was a better predictor of maternal outcome. Evident health disparities existed between patients admitted to public versus private hospitals: the former received less prenatal care, were less educated, were more frequently transferred from other hospitals, were sicker at admission, and developed more complications; maternal and fetal-neonatal mortality were higher. These findings point to the need of redesigning healthcare services to account for these inequities.

Preliminary Investigation of Workplace-Provided Compressed Mindfulness-Based Stress Reduction with Pediatric Medical Social Workers.

PubMed

Trowbridge, Kelly; Mische Lawson, Lisa; Andrews, Stephanie; Pecora, Jodi; Boyd, Sabra

2017-11-01

Mindfulness practices, including mindfulness meditation, show promise for decreasing stress among health care providers. This exploratory study investigates the feasibility of a two-day compressed mindfulness-based stress reduction (cMBSR) course provided in the hospital workplace with pediatric health care social workers. The standard course of Jon Kabat-Zinn's MBSR requires a participant commitment to eight weeks of instruction consisting of one 2.5-hour-per-week class, a single day retreat, and 45 minutes of practice for six of seven days each week. Commitments to family, work, caregiving, education, and so on, as well as limitations such as distance, may prevent health care providers from participating in a standard MBSR course. Using t tests, researchers measured the effect of cMBSR on (a) positive and negative experiences in pediatric social work, (b) perceived stress, (c) mindfulness, and (d) caring self-efficacy (as a component of patient- and family-centered care). Results included significant differences between the pre- and post-intervention outcome variables on the Professional Quality of Life Secondary Traumatic Stress subscale, the Mindful Attention and Awareness Scale, and the Caring Efficacy Scale. Findings found adequate evidence for the feasibility of cMBSR design and for a need of a more rigorous study of the effects of the cMBSR intervention. © 2017 National Association of Social Workers.

Perspective: the revolution is upon us.

PubMed

Sierles, Frederick S

2010-05-01

Profound socioeconomic pressures on medical student education have been catalogued extensively. These pressures include teaching patient shortages, teacher shortages, conflicting systems, and financial problems. Many of these problems have been caused by an unregulated free market affecting medicine overall, with market values sometimes overshadowing the academic values of education, research, and patient care. This has caused profound changes in the conduct of medical student education. Particularly important has been a reduction in the "gold standard" of teaching: direct student-teacher and supervised student-patient interaction, replaced by a potpourri of online and simulated modules. The aggregate of these changes constitutes a revolution that challenges whether medical schools, school buildings, classes, and dedicated faculty are even necessary. The author posits several recommendations in response to this revolution: (1) recognize the revolution as such, and carefully guide or abort it, lest its outcome be inadequate, inauthentic, or corrupt, (2) prioritize academic rather than business values, (3) ensure that funds allotted for education are used for education, (4) insist that medical schools, not industry, teach students, (5) value authentic education more than simulation, (6) adopt learner-centered teaching without misusing it, (7) maintain acceptable class attendance without requiring it, (8) provide, from the first school day, authentic, patient-centered medical education characterized by vertical integration, humanism, early patient exposure, biopsychosocial orientation, and physician role modeling, (9) ensure that third- and fourth-year students have rich patient-care responsibility, and 10) keep tenure. These actions would permit the preservation of an educational gold standard that justifies medical education's cost.

Utilization of maternal health care services among married adolescent women: insights from the Nigeria Demographic and Health Survey, 2008.

PubMed

Rai, Rajesh Kumar; Singh, Prashant Kumar; Singh, Lucky

2012-01-01

An ongoing social catastrophe of very poor performance in maternal health coupled with an unacceptably high number of maternal deaths is evident in Nigeria, especially among adolescent women. This study examines the factors associated with selected maternity services-married adolescent women who have had at least four antenatal care (ANC) visits, those who have undergone safe delivery care, and those who received postnatal care within 42 days of delivery. Data from Nigeria Demographic and Health Survey, 2008, were used. An eligible sample of 2,434 married adolescent (aged 15-19 years) women was included in the analysis. Pearson chi-square test and binary logistic regression were performed to fulfill the study objective. It was found that about 35% of adolescent women had at least four ANC visits, a little over 25% had undergone safe delivery care, and nearly 32% received postnatal care within 42 days of delivery. Women's education, husband's education, wealth quintile, and region of residence were documented as the most important factors associated with maternal healthcare service utilization. The ANC visit was found to be vital in the utilization of safe delivery and postnatal care. Findings indicate that programs to improve maternal healthcare have not succeeded in overcoming the socioeconomic obstacles in the way of adolescents' utilizing maternity services. In the long run, the content and service delivery strategy of maternity programs must be designed in keeping with the socioeconomic context with special attention to adolescent women who are uneducated, poor, and residing in rural areas. Copyright © 2012 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Effectiveness of Simulation-Based Education on Childhood Fever Management by Taiwanese Parents.

PubMed

Chang, Li-Chuan; Lee, Ping-Ing; Guo, Nai-Wen; Huang, Mei-Chih

2016-12-01

Childhood fever is a common symptom managed by parents at home. Most parents do not know the definition of fever, its effect, or its management. To establish simulation-based education for parents and evaluate its effectiveness for fever management at home are essential for nursing care. This study assesses the long-term effects of simulation-based education on information, motivation, behavioral skills, and behaviors related to parental fever management in Taiwan. Cluster random sampling was used to recruit parents having children aged from 3 months to 5 years who were attending kindergartens in Kaohsiung, Taiwan. A total of 160 parents were randomly assigned into experimental (EP) and control (CP) groups equally. Parents in the EP group received simulation-based education with fever education brochures, while the CP group received only the brochure. Data on parental fever information, motivation, behavioral skills, and management behaviors were collected before the 1 st day, on the 1 st day (except management behaviors), at the 6-month, and at the 12-month marks post-training with a self-developed instrument based on the information-motivation-behavioral skills model. The results of a generalized estimating equation analysis indicated that the information, motivation, behavioral skills, and management behaviors of all participants had improved at the post-test assessment, with the EP group showing significantly better improvement than the CP group. This study supports that simulation-based education effectively enhances fever management of parents for a long period of time. Simulation-based education, compared to using the brochure, was a better strategy for improving parental information, motivation, behavioral skills, and behaviors regarding fever management. We suggest that providing community-based education on fever with scenario simulation is needed to increase parental competence for child care. Copyright © 2016. Published by Elsevier B.V.

Teaching and learning in an 80-hour work week: a novel day-float rotation for medical residents.

PubMed

Wong, Jeffrey G; Holmboe, Eric S; Huot, Stephen J

2004-05-01

The 80-hour workweek limit for residents provides an opportunity for residency directors to creatively innovate their programs. Our novel day-float rotation augmented both the educational structure within the inpatient team setting and the ability for house staff to complete their work within the mandated limits. Descriptive evaluation of the rotation was performed through an end-of-rotation questionnaire. The average length of the ward residents' work week was quantified before and after the rotation's implementation. Educational portfolios and mentored peer-teaching opportunities enriched the rotation. As measured by our evaluation, this new rotation enhanced learning and patient care while reducing work hours for inpatient ward residents.

12th International CHARGE syndrome conference proceedings.

PubMed

Martin, Donna M; Salem-Hartshorne, Nancy; Hartshorne, Timothy S; Scacheri, Peter C; Hefner, Margaret A

2016-04-01

The CHARGE Syndrome Foundation holds an International conference for families and professionals every other summer. In July, 2015, the 12th meeting was held in Schaumburg, Illinois, at the Renaissance Schaumburg Hotel. Day one of the 4-day conference was dedicated to professionals caring for and researching various aspects of CHARGE, including education, medical management, animal models, and stem cell-based approaches to understanding and treating individuals with CHARGE. Here, we summarize presentations from the meeting, including a synopsis of each of the three different breakout sessions (Medical/Clinical, Basic Science/CHD7, and Education), followed by a list of abstracts and authors for both platform and poster presentations. © 2016 Wiley Periodicals, Inc.

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

The Albuquerque Operations Office through the Pinellas Plant Area Office is involved in a joint venture to establish a Partnership School and a Day Care Facility at the Plant. The venture is unique in that it is based on a partnership with the local county school system. The county school system will provide the teachers, supplies and classroom furnishings for the operation of the school for pre-kindergarten, kindergarten, first and second grade during regular school hours. The Government will provide the facility and its normal operating and maintenance costs. A Day Care Facility will also be available for children frommore » infancy through the second grade for outside school hours. The day care will be operated as a non-profit corporation. Fees paid by parents with children in the day care center will cove the cost of staff, food, supplies and liability insurance. Again, the government will provide the facility and its normal operating and maintenance costs. Between 75 and 90 children are expected in the first year of operation. The Partnership School will consist of one class each for pre-kindergarten, kindergarten and first grade. Second grade will be added in 1990. The total estimated number of children for both the Child Care and Partnership School should not exceed 200 children. Expected benefits include reduced absenteeism, tardiness and turnover and thus increased productivity. The program will be an asset in recruiting and retaining the best workforce. Other benefits include improved education for the children.« less

Estimation of Need for Palliative Care among Noncancer Patients Attending a Tertiary Care Hospital.

PubMed

Prasad, Parvathy; Sarkar, Sonali; Dubashi, Biswajit; Adinarayanan, S

2017-01-01

Palliative care services, until recently, were mainly restricted to cancer patients with incurable diseases. Hence, evaluative studies of palliative care are sparse in areas other than oncology. To estimate what proportion of patients attending the Departments of Neurology, Cardiology, and Nephrology of Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, required palliative care and to identify the palliative care needs of those patients. This was an exploratory descriptive study conducted in the three departments of JIPMER. There was no predetermined sample size for the study. The participants were all adult inpatients and outpatients who were in need of palliative care in the departments of Cardiology, Nephrology, and Neurology on the day of study. Percentage distribution was used to analyze the categorical variables such as education, gender, age, patients in need of palliative care, and their needs. The study showed that one in ten non-cancer patients in tertiary care hospitals may require palliative care services. Apart from issues in physical domain, a substantial proportion of participants also had issues in the psychological, emotional, and financial domains. This study highlights the need for incorporation and initiation of palliative care services in other non-cancer specialties in tertiary care hospitals to ensure holistic management of such cases. Counseling service has also to be rendered as part of palliative care since a good share of the patients had psychological and emotional issues.

Satisfaction and perceived quality of life results in patients operated on for primary hernia of the abdominal wall.

PubMed

de Miguel-Ibáñez, Ricardo; Nahban-Al Saied, Saif Adeen; Alonso-Vallejo, Javier; Escribano Sotos, Francisco

2015-12-01

Outpatient surgery is currently the standard procedure in 60-70% of the most prevalent surgical procedures. Minimally invasive models in health care have improved basic aspects such as postoperative pain and hospital stay, but there are few publications related to perceived quality shown by patients, such as the need for informal care at home or delay before surgery. The aim of the study was to determine the global satisfaction perceived by patients undergoing abdominal wall hernia repair. An ad hoc split questionnaire has been completed on satisfaction after a week and postoperative quality a month after intervention by 203 patients operated on for abdominal hernia in a year. Variables included postoperative pain, need for informal care, surgical delay, information supplied, professional management and overall satisfaction. A total of 48.28% of patients needed informal care at home. They were largely attended by women, wives or daughters, for a few days. In 45.81% they were discharged on the same day, and 53.2% in less than 72 h. Overall satisfaction in the program of day surgery and short hospital stay was 94.6%. The overall process of satisfaction was not related to age, sex or educational level of patients, while there was an inverse relationship between satisfaction and days of hospitalization and days of pain that required analgesia at home. Copyright © 2014 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

Community based kangaroo mother care for low birth weight babies: A pilot study

PubMed Central

Rasaily, Reeta; Ganguly, K. K.; Roy, M.; Vani, S. N.; Kharood, N.; Kulkarni, R.; Chauhan, S.; Swain, S.; Kanugo, L.

2017-01-01

Background & objectives: Kangaroo mother care (KMC - early continuous skin-to-skin contact between mother and infants) has been recommended as an alternative care for low birth weight infants. There is limited evidence in our country on KMC initiated at home. The present study was undertaken to study acceptability of KMC in different community settings. Methods: A community-based pilot study was carried out at three sites in the States of Odisha, Gujarat and Maharashtra covering rural, urban and rural tribal population, respectively. Trained health workers provided IEC (information, education and communication) on KMC during antenatal period along with essential newborn care messages. These messages were reinforced during the postnatal period. Outcome measures were the proportion of women accepting KMC, duration of KMC/day and total number of days continuing KMC. Focus group discussions and in-depth interviews were also carried out. Results: KMC was provided to 101 infants weighing 1500-2000 g; 57.4 per cent were preterm. Overall, 80.2 per cent mothers received health education on KMC during antenatal period, family members (68.3%) also attended KMC sessions along with pregnant women and 55.4 per cent of the women initiated KMC within 72 h of birth. KMC was provided on an average for five hours per day. Qualitative survey data indicated that the method was acceptable to mothers and family members; living in nuclear family, household work, twin pregnancy, hot weather, etc., were cited as reasons for not being able to practice KMC for a longer duration. Interpretation & conclusions: It was feasible to provide KMC using existing infrastructure, and the method was acceptable to most mothers of low birth infants. PMID:28574014

Community based kangaroo mother care for low birth weight babies: A pilot study.

PubMed

Rasaily, Reeta; Ganguly, K K; Roy, M; Vani, S N; Kharood, N; Kulkarni, R; Chauhan, S; Swain, S; Kanugo, L

2017-01-01

Kangaroo mother care (KMC - early continuous skin-to-skin contact between mother and infants) has been recommended as an alternative care for low birth weight infants. There is limited evidence in our country on KMC initiated at home. The present study was undertaken to study acceptability of KMC in different community settings. A community-based pilot study was carried out at three sites in the States of Odisha, Gujarat and Maharashtra covering rural, urban and rural tribal population, respectively. Trained health workers provided IEC (information, education and communication) on KMC during antenatal period along with essential newborn care messages. These messages were reinforced during the postnatal period. Outcome measures were the proportion of women accepting KMC, duration of KMC/day and total number of days continuing KMC. Focus group discussions and in-depth interviews were also carried out. KMC was provided to 101 infants weighing 1500-2000 g; 57.4 per cent were preterm. Overall, 80.2 per cent mothers received health education on KMC during antenatal period, family members (68.3%) also attended KMC sessions along with pregnant women and 55.4 per cent of the women initiated KMC within 72 h of birth. KMC was provided on an average for five hours per day. Qualitative survey data indicated that the method was acceptable to mothers and family members; living in nuclear family, household work, twin pregnancy, hot weather, etc., were cited as reasons for not being able to practice KMC for a longer duration. It was feasible to provide KMC using existing infrastructure, and the method was acceptable to most mothers of low birth infants.

The impact of an education program on hand hygiene compliance and nosocomial infection incidence in an urban neonatal intensive care unit: an intervention study with before and after comparison.

PubMed

Helder, Onno K; Brug, Johannes; Looman, Caspar W N; van Goudoever, Johannes B; Kornelisse, René F

2010-10-01

Nosocomial bloodstream infections are a major cause of morbidity and mortality in neonatal intensive care units. Appropriate hand hygiene is singled out as the most important measure in preventing these infections. However, hand hygiene compliance among healthcare professionals remains low despite the well-known effect on infection reduction. We studied the effectiveness of a hand hygiene education program on the incidence of nosocomial bloodstream infections. Observational study with two pretests and two posttest measurements and interrupted time series analysis. A 27 bed level IIID neonatal intensive care unit in a teaching hospital in the Netherlands. Healthcare professionals who had physical contact with very low birth weight (VLBW) infants. The study was conducted during a period of 4 years. Medical and nursing staff followed a problem-based education program on hand hygiene. Hand hygiene practices before and after the education program were compared by guided observations. The incidence of nosocomial infections in VLBW infants was compared. In addition, numbers of nosocomial bloodstream infections per day-at-risk in very low birth weight infants were analyzed by a segmented loglinear regression analysis. During 1201 observations hand hygiene compliance before patient contact increased from 65% to 88% (p<0.001). Median (interquartile range) drying time increased from 4s (4-10) to 10s (7-14) (p<0.001). The proportion of very low birth weight infants with one or more bloodstream infections and the infection rate per 1000 patient days (relative risk reduction) before and after the education program on hand hygiene intervention decreased from 44.5% to 36.1% (18.9%, p=0.03) and from 17.3% to 13.5% (22.0%, p=0.03), respectively. At the baseline the nosocomial bloodstream infections per day-at-risk decreased by +0.07% (95% CI -1.41 to +1.60) per month and decreased with -1.25% (95% CI -4.67 to +2.44) after the intervention (p=0.51). The level of instant change was -14.8% (p=0.48). The results are consistent with relevant improvement of hand hygiene practices among healthcare professionals due to an education program. Improved hand hygiene resulted in a reduction in nosocomial bloodstream infections. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

Cost-effectiveness of reducing glycaemic episodes through community pharmacy management of patients with type 2 diabetes mellitus.

PubMed

Hendrie, Delia; Miller, Ted R; Woodman, Richard J; Hoti, Kreshnik; Hughes, Jeff

2014-12-01

Accessibility, availability and frequent public contact place community pharmacists in an ideal position to provide medically necessary, intensive health education and preventive health services to diabetes patients, thus reducing physician burden. We assessed the cost-effectiveness of reducing glycaemic episodes in patients with type 2 diabetes mellitus through a pharmacist-led Diabetes Management Education Program (DMEP) compared to standard care. We recruited eight metropolitan community pharmacies in Perth, Western Australia for the study. We paired them based on geographical location and the socioeconomic status of the population served, and then randomly selected one pharmacy in each pair to be in the intervention group, with the other assigned to the control group. We conducted an incremental cost-effectiveness analysis to compare the costs and effectiveness of DMEP with standard pharmacy care. Cost per patient of implementing DMEP was AU$394 (US$356) for the 6-month intervention period. Significantly greater reductions in number of hyperglycaemic and hypoglycaemic episodes occurred in the intervention relative to the control group [OR 0.34 (95 % CI 0.22, 0.52), p = 0.001; OR 0.54 (95 % CI 0.34, 0.86), p = 0.009], respectively, with a net reduction of 1.86 days with glycaemic episodes per patient per month. The cost-effectiveness of DMEP relative to standard pharmacy care was AU$43 (US$39) per day of glycaemic symptoms avoided. Patients with type 2 diabetes in three surveys were willing to pay an average of 1.9 times that amount to avoid a hypoglycaemic day. We conclude that DMEP decreased days with glycaemic symptoms at a reasonable cost. If a larger-scale replication study confirms these findings, widespread adoption of this approach would improve diabetes health without burdening general practitioners.

Report of a Health Screening Project in Pre-School Programs.

ERIC Educational Resources Information Center

Grever, Elizabeth

This paper describes a preschool health screening service in which nurses, contracted through the Visiting Nurse Association, are assigned to day care centers receiving Title XX funds. The program focuses on health, safety and nutrition education. Screening includes history and physical assessment, developmental assessment, assessment or updating…

Air Structures. Educational Facilities Review Series Number 23.

ERIC Educational Resources Information Center

Finne, Mary Lou

Air structures can be erected quickly, cover large areas, cost substantially less than conventional buildings, and use less natural resources. Air structures are economically utilized for many facilities, such as athletic fields, swimming pools, high schools, day care centers, and college campuses. The literature on air structures covered in this…

The Texas Plan to Combat Mental Retardation.

ERIC Educational Resources Information Center

Governor's Advisory Committee on Mental Retardation Planning, Austin, TX.

The Texas state plan of action against mental retardation is presented. Aspects considered include the evolution of the plan, the role of the health services, medical aspects of retardation, education and training, vocational rehabilitation and employment, and social welfare. Also surveyed are the following: residential and day care, manpower,…

5 CFR 6301.102 - Prior approval for certain outside activities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... activities. 6301.102 Section 6301.102 Administrative Personnel DEPARTMENT OF EDUCATION SUPPLEMENTAL STANDARDS...: (i) To participate in the activities of a: (A) Social, fraternal, civic, or political entity; (B... organization at the employee's child's school or day care center, other than as a member of a board of...

Miniconsultation on the Mental and Physical Health Problems of Black Women.

ERIC Educational Resources Information Center

Black Women's Community Development Foundation, Inc., Washington, DC.

The Black Women's Community Development Foundation (BWCDF) examined the mental and physical health issues confronting black women. BWCDF chose to examine these issues through a "miniconsultation," a gathering of some 60 health care professionals, sociologists, educators and others who for two days comprehensively shared their…

Policy and Advocacy

ERIC Educational Resources Information Center

Fletcher, Geoffrey H.

2013-01-01

The names of operating systems and devices have been on the lips of unlikely people lately. In this day and age, superintendents, state commissioners of education, and even state legislators certainly should understand and care about technical details, but the author is just not used to hearing such things from them. The reason for the…

Polydrug-Using Adolescent Mothers and Their Infants Receiving Early Intervention.

ERIC Educational Resources Information Center

Field, Tiffany N.; Scafidi, Frank; Pickens, Jeffrey; Prodromidis, Margarita; Pelaez-Nogueras, Martha; Torquati, Julia; Wilcox, Holly; Malphurs, Julie; Schanberg, Saul; Kuhn, Cynthia

1998-01-01

Investigates the effects of an intervention program involving educational, vocational, and parenting classes; social and drug rehabilitation; and infant day care on polydrug-using adolescent mothers. Results show that mothers' and infants' interactions improved, mothers demonstrated a lower incidence of drug use and pregnancy, and a greater number…

Attitude of Palestinian Nursing Students Toward Caring for Dying Patients: A Call for Change in Health Education Policy.

PubMed

Abu-El-Noor, Nasser Ibrahim; Abu-El-Noor, Mysoon Khalikl

2016-06-01

Death is a natural process that occurs each day. Some nursing students may encounter the experience of taking care of a dying patient while others do not. Therefore, their attitude toward death and caring for dying patients may vary. The purpose of this study was to assess Palestinian student nurses' attitudes toward death and caring for dying patients and their families. In a cross-sectional, descriptive study, all fourth-year students at the College of Nursing, Islamic University of Gaza, Palestine, were invited to participate in this study. A total of 141 students completed the Frommelt Attitude Toward Care of the Dying Scale Form B (FATCOD-B). Results revealed that the mean score on the FATCOD-B was (96.96 ± 8.30). Overall, nursing students in the sample demonstrated a relatively low attitude toward caring for dying patients and their families. No statistically significant differences of students' attitudes toward caring for dying patients were found between male and female students nor between students who attended death cases and those who did not. The results suggest that theoretical nursing education should place more emphasis on palliative care to improve the quality of care at the end of life. © The Author(s) 2015.

A remote monitoring and telephone nurse coaching intervention to reduce readmissions among patients with heart failure: study protocol for the Better Effectiveness After Transition - Heart Failure (BEAT-HF) randomized controlled trial.

PubMed

Black, Jeanne T; Romano, Patrick S; Sadeghi, Banafsheh; Auerbach, Andrew D; Ganiats, Theodore G; Greenfield, Sheldon; Kaplan, Sherrie H; Ong, Michael K

2014-04-13

Heart failure is a prevalent health problem associated with costly hospital readmissions. Transitional care programs have been shown to reduce readmissions but are costly to implement. Evidence regarding the effectiveness of telemonitoring in managing the care of this chronic condition is mixed. The objective of this randomized controlled comparative effectiveness study is to evaluate the effectiveness of a care transition intervention that includes pre-discharge education about heart failure and post-discharge telephone nurse coaching combined with home telemonitoring of weight, blood pressure, heart rate, and symptoms in reducing all-cause 180-day hospital readmissions for older adults hospitalized with heart failure. A multi-center, randomized controlled trial is being conducted at six academic health systems in California. A total of 1,500 patients aged 50 years and older will be enrolled during a hospitalization for treatment of heart failure. Patients in the intervention group will receive intensive patient education using the 'teach-back' method and receive instruction in using the telemonitoring equipment. Following hospital discharge, they will receive a series of nine scheduled health coaching telephone calls over 6 months from nurses located in a centralized call center. The nurses also will call patients and patients' physicians in response to alerts generated by the telemonitoring system, based on predetermined parameters. The primary outcome is readmission for any cause within 180 days. Secondary outcomes include 30-day readmission, mortality, hospital days, emergency department (ED) visits, hospital cost, and health-related quality of life. BEAT-HF is one of the largest randomized controlled trials of telemonitoring in patients with heart failure, and the first explicitly to adapt the care transition approach and combine it with remote telemonitoring. The study population also includes patients with a wide range of demographic and socioeconomic characteristics. Once completed, the study will be a rich resource of information on how best to use remote technology in the care management of patients with chronic heart failure. ClinicalTrials.gov # NCT01360203.

Reduction of Insulin Related Preventable Severe Hypoglycemic Events in Hospitalized Children

PubMed Central

Poppy, Amy; Retamal-Munoz, Claudia; Cree-Green, Melanie; Wood, Colleen; Davis, Shanlee; Clements, Scott A.; Majidi, Shideh; Steck, Andrea K.; Alonso, G. Todd; Chambers, Christina; Rewers, Arleta

2018-01-01

OBJECTIVE Insulin is a commonly used, high-risk medication in the inpatient setting. Incorrect insulin administration can lead to preventable hypoglycemic events, which are a significant morbidity in inpatient diabetes care. The goal of this intervention was to decrease preventable insulin-related hypoglycemic events in an inpatient setting in a tertiary care pediatric hospital. METHODS Methods included the institution of several interventions such as nursing and physician education, electronic medical record order sets, electronic communication note templates, and the development of new care guidelines. RESULTS After the institution of multiple interventions, the rate of preventable hypoglycemic events decreased from 1.4 preventable events per 100 insulin days to 0.4 preventable events per 100 insulin days. CONCLUSIONS Through the use of a multi-interventional approach with oversight of a multidisciplinary insulin safety committee, a sustained decreased rate of severe preventable hypoglycemic events in hospitalized pediatric patients receiving insulin was achieved. PMID:27317577

Reduction of Insulin Related Preventable Severe Hypoglycemic Events in Hospitalized Children.

PubMed

Poppy, Amy; Retamal-Munoz, Claudia; Cree-Green, Melanie; Wood, Colleen; Davis, Shanlee; Clements, Scott A; Majidi, Shideh; Steck, Andrea K; Alonso, G Todd; Chambers, Christina; Rewers, Arleta

2016-07-01

Insulin is a commonly used, high-risk medication in the inpatient setting. Incorrect insulin administration can lead to preventable hypoglycemic events, which are a significant morbidity in inpatient diabetes care. The goal of this intervention was to decrease preventable insulin-related hypoglycemic events in an inpatient setting in a tertiary care pediatric hospital. Methods included the institution of several interventions such as nursing and physician education, electronic medical record order sets, electronic communication note templates, and the development of new care guidelines. After the institution of multiple interventions, the rate of preventable hypoglycemic events decreased from 1.4 preventable events per 100 insulin days to 0.4 preventable events per 100 insulin days. Through the use of a multi-interventional approach with oversight of a multidisciplinary insulin safety committee, a sustained decreased rate of severe preventable hypoglycemic events in hospitalized pediatric patients receiving insulin was achieved. Copyright © 2016 by the American Academy of Pediatrics.

Differences in effectiveness of the active living every day program for older adults with arthritis.

PubMed

Sperber, Nina R; Allen, Kelli D; Devellis, Brenda M; Devellis, Robert F; Lewis, Megan A; Callahan, Leigh F

2013-10-01

The authors explored whether demographic and psychosocial variables predicted differences in physical activity for participants with arthritis in a trial of Active Living Every Day (ALED). Participants (N = 280) from 17 community sites were randomized into ALED or usual care. The authors assessed participant demographic characteristics, self-efficacy, outcome expectations, pain, fatigue, and depressive symptoms at baseline and physical activity frequency at 20-wk follow-up. They conducted linear regression with interaction terms (Baseline Characteristic × Randomization Group). Being female (p ≤ .05), less depressed (p ≤ .05), or younger (p ≤ .10) was associated with more frequent posttest physical activity for ALED participants than for those with usual care. Higher education was associated with more physical activity for both ALED and usual-care groups. ALED was particularly effective for female, younger, and less depressed participants. Further research should determine whether modifications could produce better outcomes in other subgroups.

Health-related quality of life and behaviors risky to health among adults aged 18-24 years in secondary or higher education--United States, 2003-2005.

PubMed

Zahran, Hatice S; Zack, Matthew M; Vernon-Smiley, Mary E; Hertz, Marci F

2007-10-01

To identify the demographic characteristics and behaviors risky to health contributing to health-related quality of life (HRQOL), defined as the perceived physical or mental health over time. Information on students aged 18-24 years from the aggregated Behavioral Risk Factor Surveillance System survey (BRFSS) 2003, 2004, and 2005 data for the 50 states and District of Columbia was studied. Selected HRQOL measures, health care access, behaviors risky to health (i.e., leisure-time physical activity or exercise, cigarette smoking, binge drinking, and indicators of risky sex behaviors), and selected health conditions were analyzed. Overall, students aged 18-24 years reported more mentally unhealthy days than physically unhealthy days. Compared with students in secondary education, younger graduate students reported better mental health, self-rated health, and fewer behaviors risky to health. Regardless of educational level, reported physically or mentally unhealthy days differed by selected demographic characteristics, health care access, behaviors risky to health, and health conditions. Behaviors risky to health and their associations with mental health should be recognized and addressed in any health prevention or intervention program for student populations. Public health professionals should promote evidence-based health promotion programs to prevent young adults from initiating risky behaviors, continue to promote risk-reduction and cessation skills to those engaged in these behaviors, and incorporate mental health promotion into risk-reduction intervention programs.

Supporting Australian Defence Force Peacekeepers and Their Families: The Case of East Timor

DTIC Science & Technology

2003-10-01

found further education of families regarding the impact of relief leave be provided in information packs and day care centres, pre-schools and... environmental exposures. The present research will examine in-depth participants’ perceptions of the impact of the East Timor deployment on personnel and...would be valuable to have more education about the impact of relief leave in briefings and information packs as well as flexibility in the timing of

Evaluating the Impact of Six Supplemental Nutrition Assistance Program Education Interventions on Children's At-Home Diets.

PubMed

Williams, Pamela A; Cates, Sheryl C; Blitstein, Jonathan L; Hersey, James C; Kosa, Katherine M; Long, Valerie A; Singh, Anita; Berman, Danielle

2015-06-01

Nutrition education in the Supplemental Nutrition Assistance Program Education (SNAP-Ed) is designed to promote healthy eating behaviors in a low-income target population. To evaluate the effectiveness of six SNAP-Ed interventions delivered in child care centers or elementary school settings in increasing participating children's at-home fruit and vegetable (F/V) consumption by 0.3 cups per day and use of fat-free or low-fat milk instead of whole or reduced-fat milk during the prior week. Clustered randomized or quasi-experimental clustered trials took place in child care centers or elementary schools between 2010 and 2012. Parents of children at intervention and control sites completed baseline and follow-up surveys about their child's at home F/V consumption and other dietary behaviors. One of the six interventions was successful in meeting the objective of increasing children's F/V consumption by 0.3 cups per day. For three of the six interventions, there was a small but statistically significant increase in F/V consumption and/or use of low-fat or fat-free milk. Although not all interventions were effective, these findings suggest that it is possible for some SNAP-Ed interventions to improve dietary habits among low-income children among some families. The effective interventions appear to have benefited from implementation experience and sustained efforts at intervention refinement and improvement. © 2014 Society for Public Health Education.

Designing a Care Pathway Model – A Case Study of the Outpatient Total Hip Arthroplasty Care Pathway

PubMed Central

Oosterholt, Robin I; Boess, Stella U; Vehmeijer, Stephan BW

2017-01-01

Introduction: Although the clinical attributes of total hip arthroplasty (THA) care pathways have been thoroughly researched, a detailed understanding of the equally important organisational attributes is still lacking. The aim of this article is to contribute with a model of the outpatient THA care pathway that depicts how the care team should be organised to enable patient discharge on the day of surgery. Theory: The outpatient THA care pathway enables patients to be discharged on the day of surgery, shortening the length of stay and intensifying the provision and organisation of care. We utilise visual care modelling to construct a visual design of the organisation of the care pathway. Methods: An embedded case study was conducted of the outpatient THA care pathway at a teaching hospital in the Netherlands. The data were collected using a visual care modelling toolkit in 16 semi-structured interviews. Problems and inefficiencies in the care pathway were identified and addressed in the iterative design process. Results: The results are two visual models of the most critical phases of the outpatient THA care pathway: diagnosis & preparation (1) and mobilisation & discharge (4). The results show the care team composition, critical value exchanges, and sequence that enable patient discharge on the day of surgery. Conclusion: The design addressed existing problems and is an optimisation of the case hospital’s pathway. The network of actors consists of the patient (1), radiologist (1), anaesthetist (1), nurse specialist (1), pharmacist (1), orthopaedic surgeon (1,4), physiotherapist (1,4), nurse (4), doctor (4) and patient application (1,4). The critical value exchanges include patient preparation (mental and practical), patient education, aligned care team, efficient sequence of value exchanges, early patient mobilisation, flexible availability of the physiotherapist, functional discharge criteria, joint decision making and availability of the care team. PMID:29042844

Poor Linkage to Care Despite Significant Improvement in Access to Early cART in Central Poland - Data from Test and Keep in Care (TAK) Project.

PubMed

Kowalska, Justyna D; Shepherd, Leah; Ankiersztejn-Bartczak, Magdalena; Cybula, Aneta; Czeszko-Paprocka, Hanna; Firląg-Burkacka, Ewa; Mocroft, Amanda; Horban, Andrzej

2016-01-01

The main objective of the TAK project is investigating barriers in accessing HIV care after HIV-diagnosis at the CBVCTs of central Poland. Here we describe factors associated with and changes over time in linkage to care and access to cART. Data collected in 2010-2013 in CBVCTs were linked with HIV clinics records using unique identifiers. Individuals were followed from the day of CBVCTs visit until first clinical visit or 4/06/2014. Cox-proportional hazard models were used to identify factors associated with being linked to care and starting cART. In total 232 persons were diagnosed HIV-positive and 144 (62.1% 95%CI: 55.5-68.3) persons were linked to care. There was no change over time in linkage to care (p = 0.48), while time to starting cART decreased (p = 0.02). Multivariate factors associated with a lower rate of linkage to care were hetero/bisexual sexual orientation, lower education, not having an HIV-positive partner and not using condoms in a stable relationship. Multivariate factors associated with starting cART were lower education, recent year of linked to care, and first HIV RNA and CD4 cell count. Benefits of linkage to care, measured by access to early treatment, steadily improved in recent years. However at least 1 in 3 persons aware of their HIV status in central Poland remained outside professional healthcare. Persons at higher risk of remaining outside care, thus target population for future interventions, are bi/heterosexuals and those with lower levels of education.

Impact of an educational program on antibiotic use in a tertiary care hospital in a developing country.

PubMed

Thamlikitkul, V; Danchaivijitr, S; Kongpattanakul, S; Ckokloikaew, S

1998-09-01

A multi-cross-sectional study was conducted in a 2000-bed tertiary care university hospital in Bangkok, Thailand, from September 1993 to May 1994 to assess the effectiveness of an educational program on the use of antibiotics. Data on the study covered antibiotic usage both in-patients and out-patients. Data were collected for a 24-hour period every 2 weeks for 7 days for each 3-month period. The target population were residents, general practitioners, and sixth-year medical students. The educational program provided information derived from the data of inappropriate use of antibiotics during the pre-intervention period and guidelines on the use of antibiotics which were agreed to by a consensus among the faculty in all clinical departments. The study revealed: (1) the prevalence of antibiotic use and the cost of antibiotics during post-intervention period was significantly decreased by 20%; (2) the use of antibiotic prophylaxis for obstetrics patients and patients undergoing cataract surgery decreased significantly; (3) there was a shift from second or third generation cephalosporins to cefazolin for surgical prophylaxis; (4) the duration of perioperative antibiotic prophylaxis was reduced to under 2 days; (5) there was a shift from netilmicin or amikacin to gentamicin for the treatment of community acquired infection; and (6) the mortality, median length of hospital stay, and nosocomial infection rate among the patients who received antibiotics during the post-intervention period were not significantly different from those during the pre-intervention period. These results suggest that this educational program comprising information feedback and antibiotic usage guidelines was effective in improving antibiotic use at this tertiary care university hospital in Thailand.

Evaluation of a tele-education programme in Brazil.

PubMed

Joshi, Ashish; Novaes, Magdala A; Iyengar, Sriram; Machiavelli, Josiane L; Zhang, Jiajie; Vogler, Robert; Hsu, Chiehwen E

2011-01-01

We evaluated a tele-education programme for primary care staff in Pernambuco State, Brazil. During 2008 and 2009, tele-education sessions occurred four times each week for one hour per day. The topics included public health, child and adolescent health, mental health and nursing. After each session, participants completed an evaluation questionnaire. A total of 73 municipalities and 141 health centres participated in the programme. There were 254 tele-education sessions scheduled during the 20-month study period; of these, 224 sessions were successfully performed and 30 were cancelled. We collected 3504 responses from the satisfaction survey. There was high acceptance of the programme: 97% rated it as excellent or good.

Impact of Tele-nursing on adherence to treatment plan in discharged patients after coronary artery bypass graft surgery: A quasi-experimental study in Iran.

PubMed

Bikmoradi, Ali; Masmouei, Behnam; Ghomeisi, Mohammad; Roshanaei, Ghodratollah

2016-02-01

Coronary artery bypass graft is a major surgery and has complications that require professional and long term follow-up and nursing care that if do not properly handled, could reduce the quality of life and increase post-operative complications. On the other hand Tele-nursing is a cost-effective way to educate and follow-up of patients. This study aimed to assess the impact of Tele-nursing on adherence to treatment plan in discharged patients after coronary artery bypass graft. A quasi-experimental study was carried out at Ekbatan Therapeutic and Educational Center of Hamadan University of Medical Sciences at Hamadan, Iran, in 2013. In this study, 71 patients who had undergone coronary artery bypass graft surgery and had inclusion criteria were randomly divided into two experimental group (n=36), and control group (n=35). They completed questionnaire before discharging from Therapeutic and Educational Center. In the experimental group on days 2, 4, 7, second week (day 11), third week (day 18) and fourth week (day 25) after discharge, follow-up interventions and nursing education with Tele-nursing was done, but in the in the control groups, patients received only routine interventions. After completion of the intervention period, both groups completed the questionnaire and the results were compared. Adherence of treatment plan in both groups did not have significant difference before intervention (P=0.696), but had a significant difference with regard to baseline after intervention in aromatherapy group (P< 0.01) and with control group after intervention (P<0.01). Adherence to treatment plan in the aromatherapy group was better in compared to control group (P<0.01). Tele-nursing is a convenient way, cost effective training and follow-up care for patients after coronary artery bypass surgery, which can improve patients' adherence to treatment plan in developing countries such as Iran. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Medical education in China for the 21st century: the context for change.

PubMed

Kaufman, A; Hamilton, J D; Peabody, J W

1988-07-01

A national conference on Medical Education in China for the 21st Century was convened in Beijing in November 1986. Over 6 days, leading medical educators and Ministry of Public Health officials from across China presented China's future health service needs and debated opportunities and constraints in meeting those needs by various innovations in medical education. Recent political upheavals have left many educators wary of innovation. There are major, conflicting demands between the needs of rural primary care service and the needs of medical schools to replenish medical school professional ranks depleted by the Cultural Revolution. Multiple and varied experiments in medical education will be encouraged among China's medical schools. China will probably amalgamate indigenous and foreign education experiments, offering the world community new and important innovations in medical education.

Evaluation of a family camp intervention for children with a heart transplant and their families.

PubMed

Nicholas, David B; Dodd, Bernadette; Urschel, Simon; Young, Amber; West, Lori J

2016-10-01

Given the arduous course of heart transplantation and follow-up care, recipients and their families face complex challenges and stressors warranting supportive interventions. This study explored the impact of a family camp as an intervention of education and social support for pediatric transplant recipients and their families. A total of 49 individuals participated in this evaluation, including eight children and nine youth with heart transplants, five siblings, 19 parents, and 13 health care providers. Participants ranked and described the 3-day family camp experience. Analysis of pre/post intervention measures on knowledge, social support, and coping revealed statistically significant improvements in knowledge, social support, self-esteem, and psychological stability. Satisfaction surveys revealed the camp to be an important resource for education, family fun, and peer support among transplant recipients, their families, and the health care team. Implications and recommendations are offered for clinical and community practice.

Family practice in Turkey.

PubMed

Ozsahin, Akatli Kursad

2014-03-01

The national project 'Transformation in Health' was started in 2005 to provide expert primary care by family physicians, and decrease expenses in Turkey. The number of family physicians was far below the need, so public physicians were promoted to family physician status after a 10-day intensive course. The government declared some satisfactory results, but privately paid family physicians were not accepted into the system. Furthermore, the government stopped paying for their services from private settings. Some family physicians became unemployed as the major payer for all forms of medical care in Turkey denied their services. The process showed it's value in time. Nevertheless, family physicians should be the core of this transformation as family medicine is an academic and a scientific discipline and a primary care-oriented specialty with its own specific educational content, research and base of evidence, which cannot be achieved through standard medical education.

Prevalence, correlates, and outcomes of multimorbidity among patients attending primary care in Odisha, India.

PubMed

Pati, Sanghamitra; Swain, Subhashisa; Hussain, Mohammad Akhtar; Kadam, Shridhar; Salisbury, Chris

2015-09-01

Little information is available on multimorbidity in primary care in India. Because primary care is the first contact of health care for most of the population and important for coordinating chronic care, we wanted to examine the prevalence and correlates of multimorbidity in India and its association with health care utilization. Using a structured multimorbidity assessment protocol, we conducted a cross-sectional study, collecting information on 22 self-reported chronic conditions in a representative sample of 1,649 adult primary care patients in Odisha, India. The overall age- and sex-adjusted prevalence of multimorbidity was 28.3% (95% CI, 24.3-28.6) ranging from 5.8% in patients aged 18 to 29 years to 45% in those aged older than 70 years. Older age, female sex, higher education, and high income were associated with significantly higher odds of multimorbidity. After adjusting for age, sex, socioeconomic status (SES), education, and ethnicity, the addition of each chronic condition, as well as consultation at private hospitals, was associated with significant increase in the number of medicines intake per person per day. Increasing age and higher education status significantly raised the number of hospital visits per person per year for patients with multiple chronic conditions. Our findings of higher prevalence of multimorbidity and hospitalizations in higher SES individuals contrast with findings in Western countries, where lower SES is associated with a greater morbidity burden. © 2015 Annals of Family Medicine, Inc.

Santa Monica Children's Centers, Santa Monica, California: Low-Cost Day Care Facilities for Children of Working Mothers Made Available Through the Cooperation of the California State Government and Local School District. Model Programs--Childhood Education.

ERIC Educational Resources Information Center

American Institutes for Research in the Behavioral Sciences, Palo Alto, CA.

Two of the four Santa Monica Children's Centers are nursery schools for children aged 3 to 5; the other two centers serve as extended care facilities for children of school age. All centers are concerned with meeting the physical, intellectual, and emotional needs of children on a long-term basis and stress a program offering a variety of play…

Video-based educational intervention associated with improved stroke literacy, self-efficacy, and patient satisfaction.

PubMed

Denny, Mary Carter; Vahidy, Farhaan; Vu, Kim Y T; Sharrief, Anjail Z; Savitz, Sean I

2017-01-01

Interventions are needed to improve stroke literacy among recent stroke survivors. We developed an educational video for patients hospitalized with acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH). A 5-minute stroke education video was shown to our AIS and ICH patients admitted from March to June 2015. Demographics and a 5-minute protocol Montreal Cognitive Assessment were also collected. Questions related to stroke knowledge, self-efficacy, and patient satisfaction were answered before, immediately after, and 30 days after the video. Among 250 screened, 102 patients consented, and 93 completed the video intervention. There was a significant difference between pre-video median knowledge score of 6 (IQR 4-7) and the post-video score of 7 (IQR 6-8; p<0.001) and between pre-video and the 30 day score of 7 (IQR 5-8; p = 0.04). There was a significant difference between the proportion of patients who were very certain in recognizing symptoms of a stroke pre- and post-video, which was maintained at 30-days (35.5% vs. 53.5%, p = 0.01; 35.5% vs. 54.4%, p = 0.02). The proportion who were "very satisfied" with their education post-video (74.2%) was significantly higher than pre-video (49.5%, p<0.01), and this was maintained at 30 days (75.4%, p<0.01). There was no association between MoCA scores and stroke knowledge acquisition or retention. There was no association between stroke knowledge acquisition and rates of home blood pressure monitoring or primary care provider follow-up. An educational video was associated with improved stroke knowledge, self-efficacy in recognizing stroke symptoms, and satisfaction with education in hospitalized stroke patients, which was maintained at 30 days after discharge.

Factors that influence quality of life in rural children with asthma and their parents.

PubMed

Walker, Jennifer; Winkelstein, Marilyn; Land, Cassia; Lewis-Boyer, Lapricia; Quartey, Ruth; Pham, Luu; Butz, Arlene

2008-01-01

Among rural children with asthma and their parents, this study examined the relationship between parental and child reports of quality of life and described the relationship of several factors such as asthma severity, missed days of work, and asthma education on their quality of life. Two hundred one rural families with asthma were enrolled in a school-based educational program. Intervention parents and children participated in interactive asthma workshop(s) and received asthma devices and literature. Parent and child quality of life measurements were obtained before and after the intervention using Juniper's Paediatric Caregivers Quality of Life and Juniper's Paediatric Quality of Life Questionnaires. Asthma severity was measured using criteria from the National Asthma Education and Prevention Program guidelines. There was no association between parent and child total quality of life scores, and mean parental total quality of life scores were higher at baseline and follow-up than those of the children. All the parents' quality of life scores were correlated with parental reports of missed days of work. For all children, emotional quality of life (EQOL) was significantly associated with parental reports of school days missed (P = .03) and marginally associated with parental reports of hospitalizations due to asthma (P = .08). Parent's EQOL and activity quality of life (AQOL) were significantly associated with children's asthma severity (EQOL, P = .009; AQOL, P = .03), but not the asthma educational intervention. None of the child quality of life measurements was associated with asthma severity. Asthma interventions for rural families should help families focus on gaining and maintaining low asthma severity levels to enjoy an optimal quality of life. Health care providers should try to assess the child's quality of life at each asthma care visit independently of the parents.

Impact of shift work on critical care nurses.

PubMed

Pryce, Cheryl

2016-01-01

Shift work is a common practice in the health care field to maintain 24-hour patient care. The purpose of this article is to recognize the negative impact of shift work on critical care nurses, and identify strategies to mitigate these effects. A review of the literature was completed, using the search terms: 'shift work, 'critical care', impact, and health. The literature revealed that shift work has an adverse effect on the health of a nurse. Some of the health implications include stress, sleep deprivation, cardiovascular disease, gastrointestinal symptoms, and mental health illnesses. Furthermore, shift work impacts a nurse's social life and may result in patient harm. Strategies to reduce the negative impact of shift work will be focused on educating critical care nurses and managers. These strategies include frontline staff maintaining a moderate amount of exercise, sustaining a well-balanced diet, using relaxation techniques, reducing the use of cigarettes, working an eight-hour work day, and napping during scheduled breaks. Recommendations for managers include implementing quiet time at the workplace, providing a safe space for staff to nap during breaks, facilitating an eight-hour work day, and encouraging a multidisciplinary team approach when managing workload.

Caregiver's education level, not income, as determining factor of dietary intake and nutritional status of individuals cared for at home.

PubMed

Correa, B; Leandro Merhi, V A; Pagotto Fogaca, K; Marques de Oliveira, M R

2009-08-01

Home care should intervene in the nutritional status of the elderly. To analyze the nutritional status of the elderly assisted by a Home Care Program (PAD) and associate it with income and education level of the caregiver. Thirty-four individuals of both genders who received home care from PAD. The MNA (Mini Nutritional Assessment) was used along with arm circumference. Dietary intake assessment was done with three 24-hour recalls in non-consecutive days. We collected data on income, education level of the caregiver and user in years of formal education and autonomy of user. The differences between the proportions of the nominal variables were tested by the chi-square test. The continuous variables were tested for normality and if normal, the Student's t-test or ANOVA was applied. The adopted significance level was P < 0.05. The studied sample represented individuals older than 65 years, assisted by PAD and 100% dependent on the caregiver. MNA revealed that 38.2% of the users were malnourished and 61.8% were at risk for malnourishment. Energy, fiber, vitamin E, calcium and zinc intakes were inadequate. Education level of the caregivers was a determining factor (P=0.01) for the nutritional status of the elderly while no association was found with respect to income. These findings allows us to conclude that the nutritional status of this population is worrisome and that it may be associated with low quality of life influenced by the education level of the caregiver, but also by age, economic conditions and limited autonomy of this population.

Effects of a gerotranscendence educational program on gerotranscendence recognition, attitude towards aging and behavioral intention towards the elderly in long-term care facilities: A quasi-experimental study.

PubMed

Lin, Yen-Chun; Wang, Chi-Jane; Wang, Jing-Jy

2016-01-01

Caregivers in long-term care (LTC) facilities have to uphold a positive attitude toward the elderly, so they will be more willing to provide the elderly with care of higher quality. Theory of Gerotranscendence is a theory which can assist the elderly in developing more mature and intellectual state of mind. It is hoped that the caregivers who receive gerotranscendence education may apply its concept to the care for the elderly. To evaluate the effects of the gerotranscendence educational program on caregivers' gerotranscendence recognition, attitude towards aging, and behavioral intention towards caring for the elderly. A quasi-experimental design with repeated measures was conducted. A total of 41 caregivers in LTC facilities participated and completed the study. Participants were invited to participate in a 2-day gerotranscendence educational program, and measurement took place at baseline, the end of the program (post-test) and three months after the program (follow-up test). The research tools included Gerotranscendence Recognition Scale-Chinese version, Aging Attitude scale, and Caregivers' Behavioral Intention Scale. This study used GLM repeated measures to perform analysis. There was a statistically significant difference in three repeated measures of participants' gerotranscendence recognition and behavior intention toward caring for the elderly (p=.002, .002, respectively) but not in the aging attitude score (p=.21). The post hoc comparison showed that the scores of these two outcomes in the post-test were significantly higher than those in the pre-test (p=.000; .024). However, the scores in the follow-up test were almost the same as those in the pre-test. The gerotranscendence educational program had timely effects on caregivers' gerotranscendence recognition and behavioral intention towards aging, and so caregivers working in LTC facilities may require ongoing training in the gerotranscendence educational program to ensure that these positive effects remain strong. Copyright © 2015 Elsevier Ltd. All rights reserved.

The burden of inappropriate emergency department pediatric visits: why Italy needs an urgent reform.

PubMed

Vedovetto, Alessio; Soriani, Nicola; Merlo, Emanuela; Gregori, Dario

2014-08-01

To better understand the issue of inappropriate pediatric Emergency Department (ED) visits in Italy, including the impact of the last National Health System reform. A retrospective cohort study was conducted with five health care providers in the Veneto region (Italy) in a 2-year period (2010-2011). ED visits were considered "inappropriate" by evaluating both nursing triage and resource utilization, as addressed by the Italian Ministry of Health in 2007. Factors associated with inappropriate ED visits were identified. The cost of each visit was calculated. In total, 134,358 ED visits with 455,650 performed procedures were recorded in the 2-year period; of these, 76,680 (57.1 percent) were considered inappropriate ED visits. Patients likely to make inappropriate ED visits were younger, female, visiting the ED during night or holiday, when the primary care provider (PCP) is not available. The National Health System reform aims to improve efficiency, effectiveness, and costs by opening PCP offices 24 hours a day and 7 days a week. This study highlights the need for a deep reorganization of the Italian Primary Care System not only providing a larger time availability but also treating the parents' lack of education on children's health. © Health Research and Educational Trust.

Impact of an activities-based adult dementia care program

PubMed Central

Higgins, Margaret; Koch, Kathleen; Hynan, Linda S; Carr, Sandra; Byrnes, Kathleen; Weiner, Myron F

2005-01-01

The investigators studied over one year the impact of a newly established once-a-week activity-based day care program for dementia patients combined with 17 educational sessions for caregivers held at the same facility. Outcome measures were patient and caregiver quality of life (QOL), patient behavioral disturbance, and use of community-based resources. Of the 37 enrollees, 3 chose not to start the program and 13 dropped out before the end of one year, largely due to health-related issues. Of the initial group, 21 attended for the entire year. The average patient Mini-Mental State Exam (MMSE) score at entry was 16, indicating a moderate level of dementia. Average score on the CERAD Behavior Rating Scale for Dementia (BRSD) was 30.1, indicating a mild level of behavioral disturbance. Attendance at day care was 91%; at the caregiver educational sessions, 74%. Patient and caregiver enthusiasm for the program was high and all wanted to continue attendance beyond the study period despite the fact that patients reported no change in QOL. Caregivers rated patients as having significantly less QOL, and rated their own QOL as unchanged. Symptomatic patient behaviors, as measured by the BRSD, increased significantly over the period of study. Caregivers reported greater use of community resources. PMID:18568062

A heart failure initiative to reduce the length of stay and readmission rates.

PubMed

White, Sabrina Marie; Hill, Alethea

2014-01-01

The purpose of this pilot was to improve multidisciplinary coordination of care and patient education and foster self-management behaviors. The primary and secondary outcomes achieved from this pilot were to decrease the 30-day readmission rate and heart failure length of stay. The primary practice site was an inpatient medical-surgical nursing unit. The length of stay decreased from 6.05% to 4.42% for heart failure diagnostic-related group 291 as a result of utilizing the model. The length of stay decreased from 3.9% to 3.09%, which was also less than the national rate of 3.8036% for diagnostic-related group 292. In addition, the readmission rate decreased from 23.1% prior to January 2013 to 12.9%. Implementation of standards of care coordination can decrease length of stay, readmission rate, and improve self-management. Implementation of evidence-based heart failure guidelines, improved interdisciplinary coordination of care, patient education, self-management skills, and transitional care at the time of discharge improved overall heart failure outcome measures. Utilizing the longitudinal model of care to transition patients to home aided in evaluating social support, resource allocation and utilization, access to care postdischarge, and interdisciplinary coordination of care. The collaboration between disciplines improved continuity of care, patient compliance to their discharge regimen, and adequate discharge follow-up.

Development of Electronic Medical Record-Based "Rounds Report" Results in Improved Resident Efficiency, More Time for Direct Patient Care and Education, and Less Resident Duty Hour Violations.

PubMed

Ham, Phillip B; Anderton, Toby; Gallaher, Ryan; Hyrman, Mike; Simmerman, Erika; Ramanathan, Annamalai; Fallaw, David; Holsten, Steven; Howell, Charles Gordon

2016-09-01

Surgeons frequently report frustration and loss of efficiency with electronic medical record (EMR) systems. Together, surgery residents and a programmer at Augusta University created a rounds report (RR) summarizing 24 hours of vitals, intake/output, labs, and other values for each inpatient that were previously transcribed by hand. The objective of this study was to evaluate the RR's effect on surgery residents. Surgery residents were queried to assess the RR's impact. Outcome measures were time spent preparing for rounds, direct patient care time, educational activity time, rates of incorrect/incomplete data on rounds, and rate of duty hour violations. Hospital wide, 17,200 RRs were generated in the 1-month study. Twenty-three surgery residents participated. Time spent preparing for rounds decreased per floor patient (15.6 ± 3.0 vs 6.0 ± 1.2, P < 0.0001) and per intensive care unit patient (19.9 ± 2.9 vs 7.5 ± 1.2 P < 0.0001). The work day spent in direct patient care increased from 45.1 ± 5.6 to 54.0 ± 5.7 per cent (P = 0.0044). Educational activity time increased from 35.2 ± 5.4 to 54.7 ± 7.1 minutes per resident per day (P = 0.0004). Reported duty hour violations decreased 58 per cent (P < 0.0001). American Board of Surgery in Training exam scores trended up, and estimates of departmental annual financial savings range from $66,598 to $273,141 per year. Significant improvements occur with surgeon designed EMR tools like the RR. Hospitals and EMR companies should pair interested surgeons with health information technology developers to facilitate EMR enhancements. Improvements like RRs can have broad ranging, multidisciplinary impact and should be standard in all EMRs used for inpatient care at academic medical centers.

Nurse education regarding agitated patients and its effects on clinical practice.

PubMed

Ozdemir, Leyla; Karabulut, Erdem

This study identified the impact of an education program on nurses' practices for agitated patients and documented the changes in practice after completion of the training. Eighteen cardiac intensive care nurses were included to the study. Prior to nurses' participation in an education program, a pre-test indicating nurses' current practices for 40 agitated patients was evaluated with the 'Nurse Practice Form'. After the pre-test data collection period was completed, the 2-day training program on caring for agitated patients was conducted. The last step of the study was evaluation of post-test nurses' practices for 40 agitated patients using the 'Nurse Practice Form'. The findings indicated that instead of pre-test nurses' use of physical restraints for controlling agitated patients without a physician order, none of post-test nurses applied them. The training program provided nurses the knowledge and skills needed to evaluate and to manage the causes of agitation.

House subcommittee rejects effort to remove abortion coverage.

PubMed

1994-05-27

On May 12, (1994) a subcommittee of the House Education and Labor Committee voted 16-11 in support of retaining abortion coverage in the President's proposed health care plan. With its vote, the Labor/Management Relations subcommittee rejected an amendment by Representative Ron Klink (D-PA), which would have allowed insurers to cover abortions only in cases of forcible rape or incest, or life endangerment. Two Republican Representatives joined 14 Democrats voting against the amendment, while 3 Democratic Representatives were among the 11 people supporting the Klink amendment. The subcommittee also defeated an amendment introduced by Representative Dick Armey (R-TX), which would have prohibited any language in a health care reform bill from overruling constitutional state laws restricting abortion. 14 subcommittee members voted against the Armey amendment; 11 voted in favor. The subcommittee is not expected to act on a final health care measure before the Memorial Day recess. In related news, a Veterans' Affairs House subcommittee voted 11-8 on May 11 to prohibit the performance of abortions at Department of Veterans' Affairs Hospitals or the coverage of abortion services by VA funds. The amendment was introduced in the Hospitals and Health Care subcommittee by Representative Chris Smith (R-NJ). Neither subcommittee action represents a final decision on abortion coverage in health care reform and none of the 5 Congressional committees considering health reform is expected to finalize their proposals before the Memorial Day recess. The Senate Labor and Human Resources Committee and the House Ways and Means Committee started work on health care reform on May 18. The Senate Finance Committee has only been meeting privately thus far, while neither the full House Education and Labor Committee nor the House Energy and Commerce Committee has met. full text

Population-based assessment of diabetes care and self-management among Puerto Rican adults in New York City.

PubMed

Hosler, Akiko S; Melnik, Thomas A

2005-01-01

The purpose of this study was to assess the status of diabetes medical care and self-management among adult Puerto Ricans in New York City. A random-digit-dialing telephone survey with a dual-frame sampling design was employed to obtain a probability sample of adult Puerto Ricans with diagnosed diabetes (n = 606). Demographic characteristics, health status, and indicators of diabetes medical care and self-management were collected using the standard Behavioral Risk Factor Surveillance System (BRFSS) questionnaire. A statewide sample of adults with diagnosed diabetes (n = 232) was obtained from the BRFSS for comparison. Compared to New York State adults, Puerto Ricans were significantly less likely to receive annual A1C testing (72.7% vs 84.9%), cholesterol testing (67.5% vs 87.2%), blood-pressure-lowering medication (82.4% vs 91.9%), and pneumococcal vaccination (19.3% vs 28.5%, among those aged 18 to 64 years). Puerto Ricans were also less likely to take aspirin every day or every other day to prevent cardiovascular complications (30.6% vs 40.7%). Puerto Ricans were younger and more likely to have lower educational attainment and lower income than New York State adults, but they were not significantly disadvantaged in access to health care indicated by rates of health insurance coverage, having a particular place for medical care, and frequencies of seeing a provider for diabetes. These findings support the need to introduce culturally sensitive and linguistically appropriate diabetes education programs for Puerto Ricans and continue system-based diabetes care quality improvement efforts in the areas of prevention and control of cardiovascular complications, adult immunization, and A1C testing.

Aviation's Normal Operations Safety Audit: a safety management and educational tool for health care? Results of a small-scale trial.

PubMed

Bennett, Simon A

2017-01-01

A National Health Service (NHS) contingent liability for medical error claims of over £26 billion. To evaluate the safety management and educational benefits of adapting aviation's Normal Operations Safety Audit (NOSA) to health care. In vivo research, a NOSA was performed by medical students at an English NHS Trust. After receiving training from the author, the students spent 6 days gathering data under his supervision. The data revealed a threat-rich environment, where errors - some consequential - were made (359 threats and 86 errors were recorded over 2 weeks). The students claimed that the exercise improved their observational, investigative, communication, teamworking and other nontechnical skills. NOSA is potentially an effective safety management and educational tool for health care. It is suggested that 1) the UK General Medical Council mandates that all medical students perform a NOSA in fulfillment of their degree; 2) the participating NHS Trusts be encouraged to act on students' findings; and 3) the UK Department of Health adopts NOSA as a cornerstone risk assessment and management tool.

Meeting the educational needs of general practitioners for epilepsy.

PubMed

Chappell, B; Smithson, H

1999-05-01

Epilepsy care in general practice has been criticized, but what do GPs feel they deal with most and complete satisfactorily? If criticism is justified, education should be useful in improving epilepsy care, but what do general practitioners want to learn and how do they want to learn it? Questionnaires about these issues were sent to randomly chosen general practitioners throughout the United Kingdom. One hundred and twenty-four out of 200 (62%) responded. They were not biased by age, sex, type of practice or previous interest in epilepsy. Drug treatment and regular review were the two areas of care GPs said they dealt with most, but only half felt they dealt with them well. Sixty-six percent wanted to learn more about drug treatment, 46% about lifestyle advice, 45% about non-drug treatment, 44% about diagnosis and only 16% did not want to learn more about any aspect of care. Weekdays and evenings were the preferred times for study. Courses up to one full day away from practices were popular, distance learning and personal education plans were not, except for a group of younger GPs. When attending courses multi-disciplinary lectures rated highly and nearly three-quarters preferred to attend courses where epilepsy was covered in conjunction with other conditions. Future epilepsy education for GPs should recognize these findings if attendance and positive outcomes are to be maximized. Copyright 1999 BEA Trading Ltd.

Improving population management through pharmacist-primary care integration: a pilot study.

PubMed

Kennedy, Amanda G; Chen, Harry; Corriveau, Michele; MacLean, Charles D

2015-02-01

Pharmacists have unique skills that may benefit primary care practices. The objective of this demonstration project was to determine the impact of integrating pharmacists into patient-centered medical homes, with a focus on population management. Pharmacists were partnered into 5 primary care practices in Vermont 1 day per week to provide direct patient care, population-based medication management, and prescriber education. The main measures included a description of drug therapy problems identified and cost avoidance models. The pharmacists identified 708 drug therapy problems through direct patient care (336/708; 47.5%), population-based strategies (276/708; 38.9%), and education (96/708; 13.6%). Common population-based strategies included adjusting doses and discontinuing unnecessary medications. Pharmacists' recommendations to correct drug therapy problems were accepted by prescribers 86% of the time, when data about acceptance were known. Of the 49 recommendations not accepted, 47/49 (96%) were population-based and 2/49 (4%) were related to direct patient care. The cost avoidance model suggests $2.11 in cost was avoided for every $1.00 spent on a pharmacist ($373,092/$176,690). There was clear value in integrating pharmacists into primary care teams. Their inclusion prevented adverse drug events, avoided costs, and improved patient outcomes. Primary care providers should consider pharmacists well suited to offer direct patient care, population-based management, and prescriber education to their practices. To be successful, pharmacists must have full permission to document findings in the primary care practices' electronic health records. Given that many pharmacist services do not involve billable activities, sustainability requires identifying alternative funding mechanisms that do not rely on a traditional fee-for-service approach.

Evaluation of a community-based inner-city disease management program for postmyocardial infarction patients: a randomized controlled trial

PubMed Central

Young, Wendy; Rewa, George; Goodman, Shaun G.; Jaglal, Susan Brenda; Cash, Linda; Lefkowitz, Charles; Coyte, Peter C.

2003-01-01

Background Disease management programs (DMPs) that use multidisciplinary teams and specialized clinics reduce hospital admissions and improve quality of life and functional status. Evaluations of cardiac DMPs delivered by home health nurses are required. Methods Between August 1999 and August 2000 we identified consecutive patients admitted to hospital with elevated cardiac enzymes. Patients who agreed were randomly assigned to participate in a DMP or to receive usual care. The DMP included 6 home visits by a cardiac-trained nurse, a standardized nurses' checklist, referral criteria for specialty care, communication with the family physician and patient education. We measured readmission days per 1000 follow-up days for angina, congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD); all-cause readmission days; and provincial claims for emergency department visits, physician visits, diagnostic or therapeutic services and laboratory services. Results We screened 715 consecutive patients admitted with elevated cardiac markers between August 1999 and August 2000. Of those screened 71 DMP and 75 usual care patients met the diagnostic criteria for myocardial infarction, were eligible for visits from a home health nurse and consented to participate in the study. Readmission days for angina, CHF and COPD per 1000 follow-up days were significantly higher for usual care patients than for DMP patients (incidence density ratio [IDR] = 1.59, 95% confidence interval [CI] 1.27–2.00, p < 0.001). All-cause readmission days per 1000 follow-up days were significantly higher for usual care patients than for DMP patients (IDR = 1.53, 95% CI 1.37–1.71, p < 0.001). The difference in emergency department encounters per 1000 follow-up days was significant (IDR = 2.08, 95% CI 1.56–2.77, p < 0.001). During the first 25 days after discharge, there were significantly fewer provincial claims submitted for DMP patients than for usual care patients for emergency department visits (p = 0.007), diagnostic or therapeutic services (p = 0.012) and laboratory services (p = 0.007). Interpretation The results provide evidence that an appropriately developed and implemented community-based inner-city DMP delivered by home health nurses has a positive impact on patient outcomes. PMID:14581307

The development of resident "report cards" in the context of managed care education.

PubMed

Farquhar, L; Keefe, C; Priester, F; Colenda, C; Wadland, W

2001-11-01

This article describes the development of residents' report cards as one component of a curriculum on physician profiling for primary care residents. Thirty-two first-year residents matriculating into family practice, internal medicine, pediatrics, and obstetrics-gynecology residency programs in 1998 were profiled. The patient information in the report cards was limited to data on a panel of Medicaid patients initially seen in the resident ambulatory care clinics. All subsequent patient care for that population was also included. The method was multi-step and complex, involving hospital billing personnel and cooperation with a managed care partner. A three-session educational program was developed to introduce the concept of physician profiling. The first session consisted of a panel discussion on managed care. The second session was devoted to a discussion of hypothetical physician profiles with inappropriate length of stays, days/1,000, low numbers of office visits combined with high urgent-care use, and high outpatient services utilization. Small groups of residents participated in a problem-identification process as if they were members of a group practice. Residents identified problems in the reports and made suggestions for behavioral changes. A final session presented residents with their own personal report cards. Residents were surveyed both at the beginning of their first year and before and after the educational intervention on profiling. Resident attitudes, which were negative toward managed care at the outset, became generally more positive. Comparisons of pre-test and post-test means on the five-point Likert scale, using a paired-samples t-test, revealed significant changes in the residents' attitudes overall.

Telemedicine delivery of patient education in remote Ontario communities: feasibility of an Advanced Clinician Practitioner in Arthritis Care (ACPAC)-led inflammatory arthritis education program.

PubMed

Warmington, Kelly; Flewelling, Carol; Kennedy, Carol A; Shupak, Rachel; Papachristos, Angelo; Jones, Caroline; Linton, Denise; Beaton, Dorcas E; Lineker, Sydney

2017-01-01

Telemedicine-based approaches to health care service delivery improve access to care. It was recognized that adults with inflammatory arthritis (IA) living in remote areas had limited access to patient education and could benefit from the 1-day Prescription for Education (RxEd) program. The program was delivered by extended role practitioners with advanced training in arthritis care. Normally offered at one urban center, RxEd was adapted for videoconference delivery through two educator development workshops that addressed telemedicine and adult education best practices. This study explores the feasibility of and participant satisfaction with telemedicine delivery of the RxEd program in remote communities. Participants included adults with IA attending the RxEd program at one of six rural sites. They completed post-course program evaluations and follow-up interviews. Educators provided post-course feedback to identify program improvements that were later implemented. In total, 123 people (36 in-person and 87 remote, across 6 sites) participated, attending one of three RxEd sessions. Remote participants were satisfied with the quality of the video-conference (% agree/strongly agree): could hear the presenter (92.9%) and discussion between sites (82.4%); could see who was speaking at other remote sites (85.7%); could see the slides (95.3%); and interaction between sites adequately facilitated (94.0%). Educator and participant feedback were consistent. Suggested improvements included: use of two screens (speaker and slides); frontal camera angles; equal interaction with remote sites; and slide modifications to improve the readability on screen. Interview data included similar constructive feedback but highlighted the educational and social benefits of the program, which participants noted would have been inaccessible if not offered via telemedicine. Study findings confirm the feasibility of delivering the RxEd program to remote communities by using telemedicine. Future research with a focus on the sustainability of this and other models of technology-supported patient education for adults with IA across Ontario is warranted.

Preventive Ethics Through Expanding Education.

PubMed

Ho, Anita; MacDonald, Lisa Mei-Hwa; Unger, David

2016-03-01

Healthcare institutions have been making increasing efforts to standardize consultation methodology and to accredit both bioethics training programs and the consultants accordingly. The focus has traditionally been on the ethics consultation as the relevant unit of ethics intervention. Outcome measures are studied in relation to consultations, and the hidden assumption is that consultations are the preferred or best way to address day-to-day ethical dilemmas. Reflecting on the data from an internal quality improvement survey and the literature, we argue that having general ethics education as a key function of ethics services may be more important in meeting the contemporaneous needs of acute care settings. An expanded and varied ethics education, with attention to the time constraints of healthcare workers' schedules, was a key recommendation brought forward by survey respondents. Promoting ethical reflection and creating a culture of ethics may serve to prevent ethical dilemmas or mitigate their effects.

Use of simulation-based medical training in Swiss pediatric hospitals: a national survey.

PubMed

Stocker, Martin; Laine, Kathryn; Ulmer, Francis

2017-06-17

Simulation-based medical training (SBMT) is a powerful tool for continuing medical education. In contrast to the Anglo-Saxon medical education community, up until recently, SBMT was scarce in continental Europe's pediatric health care education: In 2009, only 3 Swiss pediatric health care institutions used SBMT. The Swiss catalogue of objectives in Pediatrics does not acknowledge SBMT. The aim of this survey is to describe and analyze the current state of SBMT in Swiss pediatric hospitals and health care departments. A survey was carried out with medical education representatives of every institution. SBMT was defined as any kind of training with a mannequin excluding national and/or international standardized courses. The survey reference day was May 31st 2015. Thirty Swiss pediatric hospitals and health care departments answered our survey (response rate 96.8%) with 66.6% (20 out of 30) offering SBMT. Four of the 20 hospitals offering SMBT had two independently operating training simulation units, resulting in 24 educational units as the basis for our SBMT analysis. More than 90% of the educational units offering SBMT (22 out of 24 units) were conducting in-situ training and 62.5% (15 out of 24) were using high-technology mannequins. Technical skills, communication and leadership ranked among the top training priorities. All institutions catered to inter-professional participants. The vast majority conducted training that was neither embedded within a larger educational curriculum (19 out of 24: 79.2%) nor evaluated (16 out of 24: 66.6%) by its participants. Only 5 institutions (20.8%) extended their training to at least two thirds of their hospital staff. Two thirds of the Swiss pediatric hospitals and health care departments are offering SBMT. Swiss pediatric SBMT is inter-professional, mainly in-situ based, covering technical as well as non-technical skills, and often employing high-technology mannequins. The absence of a systematic approach and reaching only a small number of healthcare employees were identified as shortcomings that need to be addressed.

Daycare and Preschool Handbook for Churches.

ERIC Educational Resources Information Center

McMurphy, John R.

Designed to guide church groups interested in opening and operating day care and preschool centers, this book offers a view of such centers as extensions of the church. Contents of the volume are divided into four parts devoted to (1) getting a church early childhood education program started, (2) administering the center, (3) operating the new…

A Case for Community-Run Pre-Schools and Daycare Centres.

ERIC Educational Resources Information Center

Renard, Rosamunde

This booklet advocates and describes the establishment of community run preschool and day care centers. The type described is based on the Laborie Community Education Centre in Saint Lucia, West Indies. Chapter 1 advocates establishing small, local institutions that are community managed, community owned, concerned with quality, and sustainable.…

Negotiating Ethics as Relational Knowing--A Pedagogical Space between "Right" and "Wrong."

ERIC Educational Resources Information Center

Husu, Jukka

This study investigated the process and the products of negotiation in the ethical conflicts of teaching, focusing on the ethical conflicts experienced by early education teachers. Participants included urban kindergarten and elementary school teachers from several Finnish public day care centers and schools. The study examined various categories…

Modeling and Verbalizations of Lower-Class, Black, Preschool Children: Educational Implications.

ERIC Educational Resources Information Center

Gottfried, Adele E.

Two purposes guided this study: (1) to investigate the effects of modeling on the verbalizations of lower-class, black, preschool children; and (2) to investigate the relationships between the dialect employed by the model and children's language production. As subjects, 72 black, preschool children in lower-class neighborhood day care centers of…

"Observation-Projet": A Professional Tool for Caregivers. Two Experiences in Italian Day-Care Settings

ERIC Educational Resources Information Center

Molina, Paola; Marotta, Monica; Bulgarelli, Daniela

2016-01-01

Ability to reflect on practice is a key element of early childhood professionalism and is positively associated with the quality of educational services. "Observation-Projet" (Fontaine 2008, 2011b) is a method designed to support practitioners' reflection through the observational process. The method adapts the required scientific…

You Are a Storyteller!

ERIC Educational Resources Information Center

Wilcox, Susan

The aim of this presentation is to persuade early childhood educators that they can and should tell stories to children in their preschool classes, day care homes, or centers. The story of Scheherezade is retold in order to illuminate the points that: (1) traditional stories share a basic, satisfying structure which, regardless of the details of…

Preschool Inclusion: Navigating through Alphabet Soup

ERIC Educational Resources Information Center

Lytle, Rebecca; Bordin, Judith

2005-01-01

The number of preschool-aged children with disabilities who spend some part of their day in an inclusive school or child care setting has grown tremendously in the past ten years. Meeting the needs of these children is always challenging. However, Public Law 105-17 the Individuals with Disabilities Education Act (IDEA'97) mandates that children…

Encore: A Selction of Articles from ERIC/ECE Newsletters (Jan. 1971-Dec. 1972).

ERIC Educational Resources Information Center

ERIC Clearinghouse on Early Childhood Education, Champaign, IL.

This compilation of articles from newsletters issued by the ERIC Clearinghouse on Early Childhood Education, (January 1971 - December 1972) includes a wide variety of topics such as: teachers' developmental stages, family day care in Pasadena, television violence, children's altruistic lying, and the Home Start program. Also included is a complete…

[Outcome of the 6-year curriculum for pharmacy education: "Contribution to medical care and society: how will I act as a pharmacist in the future?"--A report on the 3rd National Student Workshop].

PubMed

Kamei, Miwako; Imoto, Yumi; Otowa, Ryo; Shida, Miharu; Hirai, Yumi; Nakamura, Akihiro

2015-01-01

In August 2013, the Pharmaceutical Society of Japan held the Third National Student Workshop in Tokyo. A total of 88 people-70 sixth-year undergraduate students from 70 universities, and 18 alumni who had participated in the First and the Second Workshops-attended this Workshop. The theme of this Workshop was "Contribution to medical care and society: How will I act as a pharmacist in the future?" The first day took the form of a World Café, with participants exchanging information on such topics as, "The purpose for choosing a pharmacy major, and my achievement status", "My favorite aspects of my college", and "My dreams and paths: Painting my future image". Later that day, participants discussed and gave presentations on the ways they would be contributing as pharmacists to society and medical care. On the second day, participants discussed and gave presentations on the efforts they would like to make as pharmacists to contribute to society and medical care. The final session was a general assembly for discussion on the ways they would be contributing as pharmacists to society and medical care. Throughout the two days, attendees participated in discussions with an awareness of their common ground, in that they all had national qualification in spite of different intended paths. In this article, 4 sixth-year students (their status at the time of the symposium) from the Workshop introduce outlines of the discussions and products from each group.

eHealth Technology Competencies for Health Professionals Working in Home Care to Support Older Adults to Age in Place: Outcomes of a Two-Day Collaborative Workshop

PubMed Central

Barakat, Ansam; Woolrych, Ryan D; Sixsmith, Andrew; Kearns, William D

2013-01-01

Background The demand for care is increasing, whereas in the near future the number of people working in professional care will not match with the demand for care. eHealth technology can help to meet the growing demand for care. Despite the apparent positive effects of eHealth technology, there are still barriers to technology adoption related to the absence of a composite set of knowledge and skills among health care professionals regarding the use of eHealth technology. Objective The objective of this paper is to discuss the competencies required by health care professionals working in home care, with eHealth technologies such as remote telecare and ambient assisted living (AAL), mobile health, and fall detection systems. Methods A two-day collaborative workshop was undertaken with academics across multiple disciplines with experience in working on funded research regarding the application and development of technologies to support older people. Results The findings revealed that health care professionals working in home care require a subset of composite skills as well as technology-specific competencies to develop the necessary aptitude in eHealth care. This paper argues that eHealth care technology skills must be instilled in health care professionals to ensure that technologies become integral components of future care delivery, especially to support older adults to age in place. Educating health care professionals with the necessary skill training in eHealth care will improve service delivery and optimise the eHealth care potential to reduce costs by improving efficiency. Moreover, embedding eHealth care competencies within training and education for health care professionals ensures that the benefits of new technologies are realized by casting them in the context of the larger system of care. These care improvements will potentially support the independent living of older persons at home. Conclusions This paper describes the health care professionals’ competencies and requirements needed for the use of eHealth technologies to support elderly adults to age in place. In addition, this paper underscores the need for further discussion of the changing role of health care professionals working in home care within the context of emerging eHealth care technologies. The findings are of value to local and central government, health care professionals, service delivery organizations, and commissioners of care to use this paper as a framework to conduct and develop competencies for health care professionals working with eHealth technologies. PMID:25075233

eHealth Technology Competencies for Health Professionals Working in Home Care to Support Older Adults to Age in Place: Outcomes of a Two-Day Collaborative Workshop.

PubMed

Barakat, Ansam; Woolrych, Ryan D; Sixsmith, Andrew; Kearns, William D; Kort, Helianthe S M

2013-01-01

The demand for care is increasing, whereas in the near future the number of people working in professional care will not match with the demand for care. eHealth technology can help to meet the growing demand for care. Despite the apparent positive effects of eHealth technology, there are still barriers to technology adoption related to the absence of a composite set of knowledge and skills among health care professionals regarding the use of eHealth technology. The objective of this paper is to discuss the competencies required by health care professionals working in home care, with eHealth technologies such as remote telecare and ambient assisted living (AAL), mobile health, and fall detection systems. A two-day collaborative workshop was undertaken with academics across multiple disciplines with experience in working on funded research regarding the application and development of technologies to support older people. The findings revealed that health care professionals working in home care require a subset of composite skills as well as technology-specific competencies to develop the necessary aptitude in eHealth care. This paper argues that eHealth care technology skills must be instilled in health care professionals to ensure that technologies become integral components of future care delivery, especially to support older adults to age in place. Educating health care professionals with the necessary skill training in eHealth care will improve service delivery and optimise the eHealth care potential to reduce costs by improving efficiency. Moreover, embedding eHealth care competencies within training and education for health care professionals ensures that the benefits of new technologies are realized by casting them in the context of the larger system of care. These care improvements will potentially support the independent living of older persons at home. This paper describes the health care professionals' competencies and requirements needed for the use of eHealth technologies to support elderly adults to age in place. In addition, this paper underscores the need for further discussion of the changing role of health care professionals working in home care within the context of emerging eHealth care technologies. The findings are of value to local and central government, health care professionals, service delivery organizations, and commissioners of care to use this paper as a framework to conduct and develop competencies for health care professionals working with eHealth technologies.

[Fatigue symptoms and workplace related factors of long-term care workers employed in facilities].

PubMed

Kawamura, Sachiyo; Yamada, Kazuko; Morioka, Ikuharu

2015-01-01

"Regular visiting/on-demand response type long-term care" has recently been established. This will lead to a decrease in the burden on the family, but an increase in the burden of the care personnel who provide this kind of long-term care. The objectives of this study were to clarify the fatigue symptoms of long-term care workers in facilities that provide this kind of long-term care, and examine the related factors in the workplace. An anonymous questionnaire survey was conducted with 96 workers engaged in long-term care in facilities. The questionnaire was composed of cumulative fatigue symptoms index, work situation, supports in the workplace, and the attributes. The subjects were divided into two groups: those who had night shift between PM 6 to AM 8 with or without day shift (night shift group), and those who had only day shift (day shift group). The relationships between the fatigue symptom levels and work situation etc. were compared between the two groups. The night shift group consisted of 47 workers, whose mean age was 42.3 years and whose mean working experience was 6.0 years. The median number of persons they had visited in the previous month was 9. The day shift group consisted of 49 workers, whose mean age was 44.6 years and whose mean working experience was 5.9 years. The median number of persons they visited in the previous month was 9.5. Age and sex distributions showed no difference between the two groups. There was no difference in the work situations and the supports in the workplace, except for working time and the details of care the subjects were providing. The fatigue symptom levels were high in both groups, but in the night shift group the level of physical disorders was higher than in the day shift group. Satisfaction with work, education and training for mental health and consideration for traffic safety when making home visits were negatively related to fatigue symptom levels in both groups. Learning care during the previous year, and the ease of receiving paid holiday were not related to the fatigue symptom levels in the night shift group. This was different in the day shift group. Measures of fatigue symptoms should be performed for both groups. It is desirable that supports, additional to that given in the workplace to the day shift group, be given to the night shift group, and its efficacy be researched.

Simulation training for improving the quality of care for older people: an independent evaluation of an innovative programme for inter-professional education.

PubMed

Ross, Alastair J; Anderson, Janet E; Kodate, Naonori; Thomas, Libby; Thompson, Kellie; Thomas, Beth; Key, Suzie; Jensen, Heidi; Schiff, Rebekah; Jaye, Peter

2013-06-01

This paper describes the evaluation of a 2-day simulation training programme for staff designed to improve teamwork and inpatient care and compassion in an older persons' unit. The programme was designed to improve inpatient care for older people by using mixed modality simulation exercises to enhance teamwork and empathetic and compassionate care. Healthcare professionals took part in: (a) a 1-day human patient simulation course with six scenarios and (b) a 1-day ward-based simulation course involving five 1-h exercises with integrated debriefing. A mixed methods evaluation included observations of the programme, precourse and postcourse confidence rating scales and follow-up interviews with staff at 7-9 weeks post-training. Observations showed enjoyment of the course but some anxiety and apprehension about the simulation environment. Staff self-confidence improved after human patient simulation (t=9; df=56; p<0.001) and ward-based exercises (t=9.3; df=76; p<0.001). Thematic analysis of interview data showed learning in teamwork and patient care. Participants thought that simulation had been beneficial for team practices such as calling for help and verbalising concerns and for improved interaction with patients. Areas to address in future include widening participation across multi-disciplinary teams, enhancing post-training support and exploring further which aspects of the programme enhance compassion and care of older persons. The study demonstrated that simulation is an effective method for encouraging dignified care and compassion for older persons by teaching team skills and empathetic and sensitive communication with patients and relatives.

National Impact of the EPEC-Pediatrics Enhanced Train-the-Trainer Model for Delivering Education on Pediatric Palliative Care.

PubMed

Widger, Kimberley; Wolfe, Joanne; Friedrichsdorf, Stefan; Pole, Jason D; Brennenstuhl, Sarah; Liben, Stephen; Greenberg, Mark; Bouffet, Eric; Siden, Harold; Husain, Amna; Whitlock, James A; Leyden, Myra; Rapoport, Adam

2018-05-21

Lack of pediatric palliative care (PPC) training impedes successful integration of PPC principles into pediatric oncology. We examined the impact of an enhanced implementation of the Education in Palliative and End-of-Life Care for Pediatrics (EPEC ® -Pediatrics) curriculum on the following: (1) knowledge dissemination; (2) health professionals' knowledge; (3) practice change; and (4) quality of PPC. An integrated knowledge translation approach was used with pre-/posttest evaluation of care quality. Setting/Subjects/Measurements: Regional Teams of 3-6 health professionals based at 15 pediatric oncology programs in Canada became EPEC-Pediatrics Trainers who taught the curriculum to health professionals (learners) and implemented quality improvement (QI) projects. Trainers recorded the number of learners at each education session and progress on QI goals. Learners completed knowledge surveys. Care quality was assessed through surveys with a cross-sectional sample of children with cancer and their parents about symptoms, quality of life, and care quality plus reviews of deceased patients' health records. Seventy-two Trainers taught 3475 learners; the majority (96.7%) agreed that their PPC knowledge improved. In addition, 10/15 sites achieved practice change QI goals. The only improvements in care quality were an increased number of days from referral to PPC teams until death by a factor of 1.54 (95% confidence interval [CI] = 1.17-2.03) and from first documentation of advance care planning until death by a factor of 1.50 (95% CI = 1.06-2.11), after adjusting for background variables. While improvements in care quality were only seen in two areas, our approach was highly effective in achieving knowledge dissemination, knowledge improvement, and practice change goals.

Intergenerational care: an exploration of consumer preferences and willingness to pay for care.

PubMed

Vecchio, N; Radford, K; Fitzgerald, J A; Comans, T; Harris, P; Harris, N

2017-05-25

To identify feasible models of intergenerational care programmes, that is, care of children and older people in a shared setting, to determine consumer preferences and willingness to pay. Feasible models were constructed in extensive consultations with a panel of experts using a Delphi technique (n = 23) and were considered based on their practical implementation within an Australian setting. This informed a survey tool that captured the preferences and willingness to pay for these models by potential consumers, when compared to the status quo. Information collected from the surveys (n = 816) was analysed using regression analysis to identify fundamental drivers of preferences and the prices consumers were willing to pay for intergenerational care programmes. The shared campus and visiting models were identified as feasible intergenerational care models. Key attributes of these models included respite day care; a common educational pedagogy across generations; screening; monitoring; and evaluation of participant outcomes. Although parents were more likely to take up intergenerational care compared to the status quo, adult carers reported a higher willingness to pay for these services. Educational attainment also influenced the likely uptake of intergenerational care. The results of this study show that there is demand for the shared campus and the visiting campus models among the Australian community. The findings support moves towards consumer-centric models of care, in line with national and international best practice. This consumer-centric approach is encapsulated in the intergenerational care model and enables greater choice of care to match different consumer demands.

[Continuing training plan in a clinical management unit].

PubMed

Gamboa Antiñolo, Fernando Miguel; Bayol Serradilla, Elia; Gómez Camacho, Eduardo

2011-01-01

Continuing Care Unit (UCA) focused the attention of frail patients, polypathological patients and palliative care. UCA attend patients at home, consulting, day unit, telephone consulting and in two hospitals of the health area. From 2002 UCA began as a management unit, training has been a priority for development. Key elements include: providing education to the workplace, including key aspects of the most prevalent health care problems in daily work, directing training to all staff including organizational aspects of patient safety and the environment, improved working environment, development of new skills and knowledge supported by the evidence-based care for the development of different skills. The unit can be the ideal setting to undertake the reforms necessary conceptual training of professionals to improve the quality of care. 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

Access barriers to and unmet needs for home- and community-based services among older Korean Americans.

PubMed

Casado, Banghwa Lee; Lee, Sang E

2012-01-01

This cross-sectional survey study of 146 caregivers of older Korean Americans explored access barriers to and unmet needs for home- and community-based services (HCBS) programs (respite care, adult day care, personal care, home health, housekeeping, and transportation). Most often reported access barriers were lack of awareness and care recipient refusal. Predictors of unmet needs varied depending on the type of service, but included caregiver gender, relationship, education, caregiving duration, Medicaid coverage, English proficiency, caregiver self-efficacy, care recipient functional dependency, cognitive impairment, and caregiving hours. This study highlighted unmet needs for HCBS in Korean American communities, pointing to the pressing need for a collaborative effort to develop plans that modify and expand HCBS programs for older Korean Americans.

Improving transition of care for veterans after total joint replacement.

PubMed

Green, Uthona R; Dearmon, Valorie; Taggart, Helen

2015-01-01

Patients transitioning from hospital to home are at risk for readmission to the hospital. Readmissions are costly and occur too often. Standardized discharge education processes have shown to decrease readmissions. The purpose of this quality improvement project was to utilize evidence-based practice changes to decrease 30-day all-cause readmissions after total joint replacement. Review of literature revealed that improved discharge education can decrease unnecessary readmissions after discharge. A quality improvement project was developed including standardized total joint replacement discharge education, teach-back education methodology, and improved postdischarge telephone follow-up. The quality improvement project was initiated and outcomes were evaluated. Improving coordination of the discharge process, enhanced education for patients/caregivers, and postdischarge follow-up decreased total joint replacement readmissions.

Food Insecurity and Health Care Expenditures in the United States, 2011-2013.

PubMed

Berkowitz, Seth A; Basu, Sanjay; Meigs, James B; Seligman, Hilary K

2018-06-01

To determine whether food insecurity, limited or uncertain food access owing to cost, is associated with greater health care expenditures. Nationally representative sample of the civilian noninstitutionalized population of the United States (2011 National Health Interview Survey [NHIS] linked to 2012-2013 Medication Expenditure Panel Survey [MEPS]). Longitudinal retrospective cohort. A total of 16,663 individuals underwent assessment of food insecurity, using the 10-item adult 30-day food security module, in the 2011 NHIS. Their total health care expenditures in 2012 and 2013 were recorded in MEPS. Expenditure data were analyzed using zero-inflated negative binomial regression and adjusted for age, gender, race/ethnicity, education, income, insurance, and residence area. Fourteen percent of individuals reported food insecurity, representing 41,616,255 Americans. Mean annualized total expenditures were $4,113 (standard error $115); 9.2 percent of all individuals had no health care expenditures. In multivariable analyses, those with food insecurity had significantly greater estimated mean annualized health care expenditures ($6,072 vs. $4,208, p < .0001), an extra $1,863 in health care expenditure per year, or $77.5 billion in additional health care expenditure annually. Food insecurity was associated with greater subsequent health care expenditures. Future studies should determine whether food insecurity interventions can improve health and reduce health care costs. © Health Research and Educational Trust.

The Second Annual Primary Care Conference--Programming to eliminate health disparities among ethnic minority populations: an introduction to proceedings.

PubMed

Heisler, Michael; Blumenthal, Daniel S; Rust, George; Dubois, Anne M

2003-01-01

From October 31, 2002 through November 2, 2002, the Second Annual Primary Care Conference was held, sponsored by the Morehouse School of Medicine's National Center for Primary Care and its Prevention Research Center. The conference was designed as a collaborative activity with the Atlanta Regional Health Forum; The Carter Center; Emory University's School of Medicine, Nell Hodgson Woodruff School of Nursing, and Rollins School of Public Health; Georgia Chapter of the American College of Physicians/American Society of Internal Medicine; Georgia Nurses Foundation; Southeastern Primary Care Consortium, Inc./Atlanta Area Health Education Center; St. Joseph's Mercy Care Services; United States Department of Health and Human Services: Agency for Healthcare Research and Quality; Centers for Disease Control and Prevention; Health and Human Services (Region IV); Health Resources and Services Administration; Office of Minority Health (Region IV); and Office on Women's Health (Region IV). The 2 and a half-day conference featured 5 plenary sessions and 3 tracks of medical education for primary care physicians and other healthcare providers. The tracks were categorized as: Track A: Adult Health; Track B: Public Health and Prevention; and Track C: Maternal/Child/Youth Health. Within each track, 6 working sessions were presented on topic areas including diabetes, obesity, cardiovascular disease, cancer, mental health, infectious disease, behavioral and social health, women's health, stroke, and asthma. A total of 18 working sessions took place and each working session included 3 presentations. Continuing medical education credits or continuing education units were granted to participants. In all, 485 individuals participated in the conference, with the majority of the participants from the southeastern United States. Of the attendees, 35% were physicians (MD); 13% were nurses (RN); 12% held master-level degrees; and 12% held other doctorate-level degrees.

Mobile Health Technology for Atrial Fibrillation Management Integrating Decision Support, Education, and Patient Involvement: mAF App Trial.

PubMed

Guo, Yutao; Chen, Yundai; Lane, Deirdre A; Liu, Lihong; Wang, Yutang; Lip, Gregory Y H

2017-12-01

Mobile Health technology for the management of patients with atrial fibrillation is unknown. The simple mobile AF (mAF) App was designed to incorporate clinical decision-support tools (CHA 2 DS 2 -VASc [Congestive heart failure, Hypertension, Age ≥75 years, Diabetes Mellitus, Prior Stroke or TIA, Vascular disease, Age 65-74 years, Sex category], HAS-BLED [Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile INR, Elderly, Drugs/alcohol concomitantly], SAMe-TT 2 R 2 [Sex, Age <60 years, Medical history, Treatment, Tobacco use, Race] scores), educational materials, and patient involvement strategies with self-care protocols and structured follow-up. Patients with atrial fibrillation were randomized into 2 groups (mAF App vs usual care) in a cluster randomized design pilot study. Patients' knowledge, quality of life, drug adherence, and anticoagulation satisfaction were evaluated at baseline, 1 month, and 3 months. Usability, feasibility, and acceptability of the mAF App were assessed at 1 month. A total of 113 patients were randomized to mAF App intervention (mean age, 67.4 years; 57.5% were male; mean follow-up, 69 days), and 96 patients were randomized to usual care (mean age, 70.9 years; 55.2% were male; mean follow-up, 95 days). More than 90% of patients reported that the mAF App was easy, user-friendly, helpful, and associated with significant improvements in knowledge compared with the usual care arm (P values for trend <.05). Drug adherence and anticoagulant satisfaction were significantly better with the mAF App versus usual care (all P < .05). Quality of life scores were significantly increased in the mAF App arm versus usual care, with anxiety and depression reduced (all P < .05). The pilot mAFA Trial is the first prospective randomized trial of Mobile Health technology in patients with atrial fibrillation, demonstrating that the mAF App, integrating clinical decision support, education, and patient-involvement strategies, significantly improved knowledge, drug adherence, quality of life, and anticoagulation satisfaction. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Interdisciplinary treatment of diabetes mellitus in a military treatment facility.

PubMed

Earles, J E; Hartung, G H; Dickert, J M; Moriyama, H H; Coll, K J; Aiello, L M; Jackson, R; Polonsky, W

2001-10-01

The American Diabetes Association emphasizes interdisciplinary management as the standard of care for patients with diabetes. Many times, however, interdisciplinary means various health care professionals treating a patient but not necessarily interacting with each other regarding the patient's care. Recently, Tripler Army Medical Center replicated the Joslin Diabetes Center's diabetes outpatient intensive treatment program as part of a Joslin Diabetes Center/Department of Defense/Veteran's Administration research collaboration. Tripler Army Medical Center named this interdisciplinary program Holopono, which is Hawaiian for success. Holopono is a team of health care professionals providing integrated care and education to a group of diabetes patients over 3.5 days. Individual care management, aided by an Internet-based telemedicine system, then continues for 1 year after entry into the program. This article describes the Holopono program, the role of each team member, and how the team functions together to provide comprehensive diabetes care.

Welcoming Home the Patient with a New Ostomy.

PubMed

Walker, Cynthia A; Rau, Lou Ann; Green, Mary Phyllis

2015-01-01

The 5-day average inpatient hospital length-of-stay postostomy limits opportunities for patients and family members to master self-care of the new ostomy prior to discharge. The literature suggests premature discharge, poor care coordination, lack of symptom reporting and follow-up as the primary factors supporting causes of readmissions. Home care nurses are faced with failed handoffs, limited resources, poor care coordination, payor restrictions, and knowledge and skill deficits that negatively impact safe and effective discharge practices of patients with a new ostomy. This article describes an evolving community standard related to nursing care of the patient with a new ostomy as identified by the Baltimore Wound, Ostomy, Continence (WOC) Nursing Affiliate. Case managers, discharge planners, intake team members, and home care nurses benefit from ongoing education from WOC nurse experts to master the skills needed to care for patients with ostomies.

Effectiveness of a multidisciplinary disease management program on outcomes in patients with heart failure in China: A randomized controlled single center study.

PubMed

Chen, Yiyin; Funk, Marjorie; Wen, Jia; Tang, Xianghua; He, Guixiang; Liu, Hong

Multidisciplinary disease management programs (MDMP) for patients with heart failure (HF) have been delivered, but evidence of their effectiveness in China is limited. To determine if a MDMP improves quality of life (QoL), physical performance, depressive symptoms, self-care behaviors and mortality or rehospitalization in patients with HF in China. This is a randomized controlled single center trial in which patients with HF received either MDMP with discharge education, physical training, follow-up visits and telephone calls for 180 days (n = 31) or standard care (SC, n = 31). Compared with SC, QoL, depressive symptoms, and self-care behaviors were significantly improved by MDMP from baseline to 180 days (37% vs 66%, 20% vs 61%, and 8% vs 33%, respectively, all p < 0.001). There were no differences in physical performance and mortality or rehospitalization during follow-up. A HF MDMP can improve QoL, depressive symptoms and self-care behaviors in China. Copyright © 2017 Elsevier Inc. All rights reserved.

The influence of health literacy level on an educational intervention to improve glaucoma medication adherence.

PubMed

Muir, Kelly W; Ventura, Alice; Stinnett, Sandra S; Enfiedjian, Abraham; Allingham, R Rand; Lee, Paul P

2012-05-01

To test an educational intervention targeted to health literacy level with the goal of improving glaucoma medication adherence. One hundred and twenty-seven veterans with glaucoma were randomized to glaucoma education or standard care. The intervention included a video scripted at a 4th, 7th, or 10th grade level, depending on the subject's literacy level. After six months, the number of days without glaucoma medicine (DWM) according to pharmacy records for the intervention and control groups was compared. The number of DWM in the six months following enrollment was similar for control and intervention groups (intervention, n=67, DWM=63 ± 198; standard care, n=60, DWM=65 ± 198; p=0.708). For each subgroup of literacy (adequate, marginal, inadequate), subjects in the intervention group experienced less mean DWM than subjects in the control group and the effect size (ES) increased as literacy decreased: adequate literacy, ES 0.069; marginal, ES 0.183, inadequate, ES 0.363. Decreasing health literacy skills were associated with decreasing self-reported satisfaction with care (slope=0.017, SE=0.005, p=0.002). Patients with decreased health literacy skills may benefit from educational efforts tailored to address their health literacy level and learning style. Providers should consider health literacy skills when engaging in glaucoma education. Published by Elsevier Ireland Ltd.

What is left unsaid: an interpretive description of the information needs of parents of children with asthma.

PubMed

Archibald, Mandy M; Caine, Vera; Ali, Samina; Hartling, Lisa; Scott, Shannon D

2015-02-01

Parents of children with asthma provide the vast majority of day-to-day asthma care. Understanding their information needs is an essential step to provide meaningful and effective family-centered asthma education. To gain insight into the information needs and information deficits of parents of children with asthma, we conducted an interpretive descriptive study to capture the perspectives of 21 parents from diverse backgrounds whose 23 children with asthma had a range of illness trajectories and management scenarios. Parents were purposively sampled from two asthma clinics and one pediatric emergency department in a large urban center in North America. Semi-structured interviews were conducted in 2011-2012. In data analysis, parents' self-identified information needs were distinguished from analysts' interpretations of information deficits. Participants' knowledge did not always reflect time since diagnosis, and information needs and deficits persisted for years. Parents often reported receiving little or no little or no education about asthma and its management. An asthma management information hierarchy was identified, starting with the most foundational, recognizing severity; followed by acute management; prevention versus crisis orientation; and knowing "about" asthma. In the absence of adequate and accurate education, parents' beliefs about the nature of asthma as an acute rather than chronic condition shaped their asthma management decisions and information-seeking behaviors. Information deficits were affected by interactions with health care providers. These parents' pervasive unmet information needs and deficits highlight the need for comprehensive, problem-oriented asthma education. © 2015 Wiley Periodicals, Inc.

Mental health care for the elderly in low-income countries: a health systems approach

PubMed Central

PRINCE, MARTIN; LIVINGSTON, GILL; KATONA, CORNELIUS

2007-01-01

Future development of services for older people needs to be tailored to suit the health systems context. Low-income countries lack the economic and human capital to contemplate widespread introduction of specialist services. The most cost-effective way to manage people with dementia will be through supporting, educating and advising family caregivers. The next level of care to be prioritized would be respite care, both in day centres and in residential or nursing homes. An important prerequisite to improving care for older persons is to create a climate that fosters such advances. Better awareness is a necessary precondition for appropriate help-seeking, and lack of awareness is a public health problem for which population level interventions are needed. PMID:17342213

Palliative Care Office Hours for Patients with Hematologic Malignancies: An Innovative Model for Symptom Management and Education.

PubMed

Foxwell, Anessa M; Moyer, Mary E; Casarett, David J; O'Connor, Nina R

2017-10-01

Palliative care programs are experiencing rapid growth, with demand for consults surpassing staffing. Innovative models are needed to equip nonpalliative care providers to manage basic palliative care issues. To develop a novel program of palliative care office hours for hematologic oncology advanced practice providers, and to evaluate its impact on palliative care consult volume and composition. A palliative care nurse practitioner or pharmacist was available for weekday office hours to all inpatient hematologic oncology advanced practice providers at an academic medical center to offer advice on pain, nonpain symptoms, and psychosocial distress. A retrospective study looking at outcome measures after six months of office hour utilization and palliative care consults from the hematologic oncology services. Palliative care office hours had a mean duration of 16 minutes per day (range 5 to 55). A mean of 11 patients were discussed per week (range 4 to 20). Pain, nausea, and anxiety were the issues most frequently raised. Of 299 patients discussed during office hours, 44 (14.7%) subsequently required a full palliative care consult. Overall, palliative care consults from the hematologic oncology services decreased from 19.6% to 10.2% of admissions (87/445 vs. 61/594, p < 0.001) with an increase in consults for goals of care. Office hours are an efficient way to address palliative care needs when demand for palliative care consults exceeds capacity. Office hours may serve an educational function as well, enabling primary teams to manage basic palliative care issues with increasing independence over time.

Effectiveness of the Certificate Course in Essentials of Palliative Care Program on the Knowledge in Palliative Care among the Participants: A Cross-sectional Interventional Study.

PubMed

Bhatnagar, Sushma; Patel, Anuradha

2018-01-01

Palliative medicine is an upcoming new specialty aimed at relieving suffering, improving quality of life and comfort care. There are many challenges and barriers in providing palliative care to our patients. The major challenge is lack of knowledge, attitude and skills among health-care providers. Evaluate the effectiveness of the certificate course in essentials of palliative care (CCEPC) program on the knowledge in palliative care among the participants. All participants ( n = 29) of the CCEPC at All India Institute of Medical Sciences, Delhi, giving consent for pretest and posttest were recruited in the study. This educational lecture of 15 h was presented to all the participants following pretest and participants were given same set of questionnaire to be filled as postintervention test. In pretest, 7/29 (24.1%) had good knowledge which improved to 24/29 (82.8%) after the program. In pretest, 62.1% had average knowledge and only 13.8% had poor knowledge. There was also improvement in communication skills, symptom management, breaking bad news, and pain assessment after completion of the program. The CCEPC is an effective program and improving the knowledge level about palliative care among the participants. The participants should implement this knowledge and the skills in their day-to-day practice to improve the quality of life of patients.

Antenatal and postnatal care practices among mothers in rural Bangladesh: A community based cross-sectional study.

PubMed

Shahjahan, Md; Chowdhury, Hasina Akhter; Al-Hadhrami, Ahmed Y; Harun, Golam Dostogir

2017-09-01

appropriate utilization of antenatal and postnatal care can prevent complications and ensures better maternal and child health care. Although under-five mortality in South Asia, including Bangladesh, has reduced substantially, the rate of neonatal mortality is still high. The study aims to identify factors associated with the practice of antenatal and/or postnatal care amongst mothers of newborns from a healthcare facility in a selected area of rural Bangladesh. RESEARCH DESIGN/SETTING: a community-based cross-sectional study was conducted among 360 postnatal mothers, who were within 42 days of delivery. The study was conducted at Madhupur Upazila (sub-district) in Tangail district of Bangladesh from January 2012 to June 2012. A structured questionnaire was used to collect relevant information from the study subjects. only one in seven (14.2%) of the mothers visited health care facility for 4 or more times to receive antenatal care. A higher proportion of mothers delivered at home, thirty-five percent of the respondents experienced post-delivery complications. About 18% of mothers received postnatal care from the health care facility. Several variables revealed significant associations in bivariate analyses; few variables remained significant for antenatal care and post-natal care categories in the multinomial logistic regression analysis. The likelihood of receiving either antenatal care or post-natal care (OR =0.30, 95% CI =0.10-0.96) was significantly lower among mothers who had either no education or less education (1-5 years of schooling); and was found significantly higher for women who watched TV (OR = 2.79; 95% CI = 1.45-5.37); family income showed significant association for receiving both antenatal care and postnatal care services as well. mother's education appears to have a strong and significant association with antenatal care and postnatal care practices in rural Bangladesh. Community based intervention and regular home visits by health care providers could enhance care for women and newborns including delivery of specific health messages. Counseling could be integrated during antenatal care visits to increase the postnatal care service further. Copyright © 2017 Elsevier Ltd. All rights reserved.

A Pilot Program: Using Text Messaging to Improve Timely Communication to Tonsillectomy Patients.

PubMed

Newton, Laurie; Sulman, Cecille

2016-01-01

Approximately 1,500 tonsillectomies are performed annually at a large pediatric academic medical center each year. Families need to be educated on how to care for their child after this surgery. Most tonsillectomy patients are discharged home either the same day as surgery or after one night of observation, resulting in post-operative tonsillectomy recovery and care falling upon the patient's family. Multiple quality improvement efforts to improve family education post tonsillectomy surgery have been performed over the last several years at a large pediatric academic medical center. None of these efforts, however, have focused on the use of technology to provide innovative patient education. The purpose of this project is to provide information to parents via text messages and videos to improve patient experience and outcomes following tonsillectomy. Families provided positive feedback, including that the texts were helpful, easy to understand, and reduced pre-operative and recovery anxiety. Also, none of these families needed to call the ENT clinic for any other questions or concerns. The recovery from tonsillectomy is not easy and this pediatric otolaryngology practice is always searching for new ways to improve care and education. Use of technology is an innovative approach and likely one that will be used more often in the future.

The Internet: friend or foe when providing patient education?

PubMed

Anderson, Amy Shelton; Klemm, Paula

2008-02-01

The Internet has changed how patients with cancer learn about and cope with their disease. Newly diagnosed patients with cancer often have complex educational and informational needs related to diagnosis and treatment. Nurses frequently encounter time and work-related constraints that can interfere with the provision of patient education. They are challenged to educate patients in an environment of rapidly expanding and innovative computer technology. Barriers that hinder nurses in integrating educational Internet resources into patient care include lack of training, time constraints, and inadequate administrative support. Advantages of Internet use for patient education and support include wide-ranging and current information, a variety of teaching formats, patient empowerment, new communication options, and support 24 hours a day, seven days a week. Pitfalls associated with Internet use for patients with cancer include inaccurate information, lack of access, poor quality of online resources, and security and privacy issues. Nurses routinely use computer technology in the workplace and follow rigorous security and privacy standards to protect patient information. Those skills can provide the foundation for the use of online sources for patient teaching. Nurses play an important role in helping patients evaluate the veracity of online information and introducing them to reliable Internet resources.

Availability and Primary Health Care Orientation of Dementia-Related Services in Rural Saskatchewan, Canada.

PubMed

Morgan, Debra G; Kosteniuk, Julie G; Stewart, Norma J; O'Connell, Megan E; Kirk, Andrew; Crossley, Margaret; Dal Bello-Haas, Vanina; Forbes, Dorothy; Innes, Anthea

2015-01-01

Community-based services are important for improving outcomes for individuals with dementia and their caregivers. This study examined: (a) availability of rural dementia-related services in the Canadian province of Saskatchewan, and (b) orientation of services toward six key attributes of primary health care (i.e., information/education, accessibility, population orientation, coordinated care, comprehensiveness, quality of care). Data were collected from 71 rural Home Care Assessors via cross-sectional survey. Basic health services were available in most communities (e.g., pharmacists, family physicians, palliative care, adult day programs, home care, long-term care facilities). Dementia-specific services typically were unavailable (e.g., health promotion, counseling, caregiver support groups, transportation, week-end/night respite). Mean scores on the primary health care orientation scales were low (range 12.4 to 17.5/25). Specific services to address needs of rural individuals with dementia and their caregivers are limited in availability and fit with primary health care attributes.

The impact of diabetes self-management education on glucose management and empowerment in ethnic Armenians with type 2 diabetes.

PubMed

Naccashian, Zarmine

2014-01-01

The purpose of this study was to investigate the impact of diabetes self-management education on glycemic control and perceptions of empowerment in Armenian American immigrants diagnosed with type 2 diabetes. A quasi-experimental pre and post design was used to investigate the impact of using education on self-management as measured by A1C levels and empowerment scores. Nine hours of diabetes self-management education classes were offered in the Armenian language to 75 clients at 2 adult health day care centers over 6 weeks. The participants were mostly first-generation Armenian immigrants aged 65 years and older. A1C results, the 8-item Diabetes Empowerment Scale (DES), and the 15-item Armenian Ethnic Orientation Questionnaire-Revised (AEOQ-R) were used to determine the impact of education on self-care management. After institutional review board approval was obtained, 75 participants completed the study. A paired t test indicated that the postintervention mean A1C level was significantly lower than the preintervention mean A1C level. The postintervention mean DES score was significantly greater than the preintervention mean DES score. No mediating effects of age, gender, acculturation, and number of years with the disease were identified for either A1C or DES score. The findings demonstrate the efficacy of the diabetes self-management education classes in improving diabetes self-care management skills. © 2014 The Author(s).

Impact of new duty-hour rules on residency training.

PubMed

Duran-Nelson, Alisa; Van Camp, Joan; Ling, Louis

2010-11-01

On the surface, changing the rules related to the number of hours residents work per day and per week sounds like a good idea. Theoretically, residents who work fewer hours would be less tired and provide better patient care. But even small changes in residency training programs have implications for the quality of the educational experience and the cost of training, as well as patient care. This article highlights the challenges that two Minnesota residency programs are facing as they adapt to the new rules around residents' work hours.

The democratization of medicine.

PubMed

Cellini, Gary L

2015-11-01

We can give patients the data, devices, education, and point of care access they need to 1) determine their genomic risk, 2) to manage their co-morbid conditions to delay CKD progression, 3) to manage the first 100 days of dialysis, 4) to differentiate the stress on the body with home versus in center dialysis, 5) to manage their 8-15 medications better, 6) to virtually access their health care professionals 24/7, and 7) to empower them to improve their clinical and financial outcomes. All of this is possible with technology and through the democratization of medicine.

Are we prepared for Affordable Care Act provisions of care coordination? Case managers' self-assessments and views on physicians' roles.

PubMed

Moreo, Kathleen; Moreo, Natalie; Urbano, Frank L; Weeks, Matthew; Greene, Laurence

2014-01-01

Care coordination, traditionally the purview of the case management field, is recognized as a national priority for improving health care delivery and patient outcomes. With reforms of the Affordable Care Act (ACA) of 2010, case managers face new challenges and opportunities in providing care coordination services. The evolving roles of case managers as members of interprofessional care teams will be influenced by new policies that enable physicians to be reimbursed for care coordination. This qualitative study aimed to evaluate case managers' self-assessed readiness for ACA reforms of care coordination and their perceptions of physicians' understanding of case management and ability to lead care coordination efforts in evolving models. Provisions of care coordination in the ACA affect case managers in all practice settings. The majority of this study's participants represented hospital and managed care settings. An invitation to complete an 11-item online survey was sent by e-mail to 8,110 case managers in an opt-in database maintained by a health care continuing education company. Survey questions were designed to assess respondents' (1) self-reported levels of knowledge and preparation for ACA care coordination provisions and (2) beliefs about the readiness and abilities of physicians to administer care coordination services. In addition, demographic data and open-ended comments regarding physicians' roles in conducting care coordination were collected. Over a restricted 9-day period, 834 case managers representing various health care settings responded to the survey. The majority of respondents (63%) indicated that more than 50% of their day is dedicated to performing care coordination activities. However, 80% of all respondents reported being "not at all knowledgeable" or only "somewhat knowledgeable" about the new care coordination provisions in the ACA. Only 8% admitted to being "very prepared" to implement ACA changes. The majority of respondents (68%) perceive their case management departments to be at least "somewhat prepared" to implement necessary changes. Whereas 67% of respondents expect physicians to have at least a "moderate role" in implementing care coordination services, only 12% believe that physicians have more than "some" understanding of the processes of care coordination and case managers' roles. These qualitative study findings suggest that case managers from multiple practice settings perceive a lack of preparedness, knowledge, and understanding among themselves and physicians regarding ACA reforms that may significantly affect the delivery of care coordination services. The findings call for new initiatives in interprofessional education to address the knowledge gaps and enhance understanding of the collaborative roles among case managers and physicians.

Self-care behaviors of adults with type 2 diabetes mellitus in Greece.

PubMed

Chourdakis, Michael; Kontogiannis, Vasileios; Malachas, Konstantinos; Pliakas, Triantafyllos; Kritis, Aristidis

2014-10-01

The purpose of this study was to examine self-care behaviors of adults with type 2 diabetes mellitus living in the Metropolitan Area of Thessaloniki in Northern Greece. The Summary of Diabetes Self-Care behaviors measurement was administered to 215 patients, out of which 177 were eligible to participate (87 males). Patients, aged 30 years or more, were recruited through a university hospital day-clinic. Older patients (>65 years), as well as those with "higher educational level" did not distribute their daily carbohydrate intake equally. Nevertheless, they were more likely to adapt to their physician's recommendations regarding medication and to regularly perform suggested blood glucose checking. Exercise patterns were more often found for higher educated, earlier diagnosed males. Younger patients were less likely to follow their healthcare professional's recommendations, regarding diet, medication intake, blood glucose checking, foot care and exercise compared to older patients. These results pose a higher risk for complications and morbidity in younger patients with type 2 diabetes mellitus, who most possibly will require intensive treatment in the future.

Study of Programs To Meet the Developmental Needs of Young Children. Report to the Legislature.

ERIC Educational Resources Information Center

Minnesota State Dept. of Education, St. Paul. Div. of Development and Partnership.

Committees discussed six educational program options for 4- and 5-year-old children, in terms of curriculum, staff and licensure, cost and school facilities, coordination with existing resources, public opinion, and school-age day care. The curriculum committee developed a set of goals, outlined a program design, and considered the possible…

Intervening with High-Risk Families via Infant Daycare.

ERIC Educational Resources Information Center

Ramey, Craig T.; Farran, Dale C.

A longitudinal study was conducted at the Frank Porter Graham Center NC to explore the use of educational day care and related services as a mechanism for preparing socially disadvantaged children for success in later public schooling. Infant children of mothers who met a criterion score on a high risk index were randomly assigned to either an…

Children's Play Behaviour and Social Communication in Integrated Special Day-Care Groups

ERIC Educational Resources Information Center

Suhonen, Eira; Nislin, Mari A.; Alijoki, Alisa; Sajaniemi, Nina K.

2015-01-01

The aim of this study was to investigate children's social communication abilities and play to reveal possible changes during a one year period in the context of Finnish early childhood special education. The data we collected during 2012-2013 consisted of assessments of play behaviour (Preschool Play Behavior Scale) and social communication…

Day Care and Maternal Employment in 1990's Introductory Psychology Textbooks.

ERIC Educational Resources Information Center

Etaugh, Claire; Cohen, Joseph; Hill, Myra

One of the most striking societal changes in recent years is the increasing participation of mothers in the labor force. Since college-educated mothers are especially likely to work, a potentially important source of information about the effects of maternal employment is the introductory psychology course. To study the features of mothers in the…

School-Age Parents: Federal Programs and Policies Relevant to Pregnant or Parenting Secondary Students.

ERIC Educational Resources Information Center

Moore, Kristin A.

Federal programs and policies that affect pregnant and parenting teenagers, particularly those programs that are of relevance to schools, are briefly described. The main categories of programs and legislation described are: (1) those bearing on teenage parents and education; (2) pre-school programs; (3) day care; (4) welfare; (5) social services;…

Comparison of Motor Development in Preschool Children.

ERIC Educational Resources Information Center

Bohren, Judy M.; Vlahov, Eric

This study investigated the gross motor development of children at two day care centers, one with a movement-oriented physical education program and the other with an unstructured free play period. Also studied were the biological factors of age and sex. A total of 146 children were tested during a 3-year period. During the last two years,…

Money and Politics: Who Owns Democracy? NIF Report on the Issues, 2001.

ERIC Educational Resources Information Center

National Issues Forums, Dayton, OH.

National Issues Forums (NIF) bring together citizens to deliberate and make choices about challenging social and political issues of the day. These forums have addressed issues such as the economy, education, health care, foreign affairs, and crime. This report is an analysis of what happened in a forum on "Money and Politics" that took…

Komatsudani Then and Now: Continuity and Change in a Japanese Preschool

ERIC Educational Resources Information Center

Tobin, Joseph; Karasawa, Mayumi; Hsueh, Yeh

2004-01-01

In this article the reflections of the teachers and directors of Komatsudani Hoikuen ("day-care center") on a video the authors recently made at their preschool are used to explore processes of continuity and change in Japanese preschool education over the course of a generation. The social changes that are associated with changing…

A Review of Research on Problematic Internet Use and Well-Being: With Recommendations for the U.S. Air Force

DTIC Science & Technology

2015-01-01

monitoring; educational, prevention, and treatment services; and self-monitoring support. They should carefully weigh the pros and cons of more onerous...triggers related to thoughts (“I cannot make it through the day without a drink”), feelings (feeling anxious in public and using marijuana to numb out

A study on delay in treatment of kala-azar patients in Bangladesh.

PubMed

Arif, Syed M; Basher, Ariful; Rahman, Mohammad R; Faiz, Mohammad A

2012-01-01

Visceral leishmaniasis (kala-azar) continues to be a major rural public health problem in Bangladesh. A cross-sectional study was carried out in two subdistricts of Mymensingh district from January 2006 to June 2007 to evaluate the delay kala-azar treatment. Suspected patients who attended to out patient department (OPD) were subjected to a dipstick test (RK39) for kala-azar. Sixty five from Bhaluka and 60 positive patients from Gafargaon subdistrict were enrolled. Most of the patients (80%) first visited nonqualified private practitioners, while only 15.2% consulted registered doctors. Fifty per cent were referred to the Upazilla health complex (UZHC) by the family members or relatives. About 49% and 43% patients required third and second health-care providers for kala-azar treatment, respectively. Patient delay ranged from 2 to 30 days; median 4 (IQR 3 to 7 days), the system delay ranged from 0 days to 225 days; median 54 (IQR 40-66 days). Residential status (p value <0.05) had impact on patient delay. Educational status and number of treatment providers had impact on system delay (p<0.05). System delay rather than patient delay is the important weakness of the kala-azar control programme in Bangladesh. Residence in rural areas, low educational background and treatment providers are associated with these delays. A proper educational programme may reduce the delay.

The frequency of outdoor play for preschool age children cared for at home-based child care settings.

PubMed

Tandon, Pooja S; Zhou, Chuan; Christakis, Dimitri A

2012-01-01

Given that more than 34% of U.S. children are cared for in home-based child care settings and outdoor play is associated with physical activity and other health benefits, we sought to characterize the outdoor play frequency of preschoolers cared for at home-based child care settings and factors associated with outdoor play. Cross-sectional study of 1900 preschoolers (representing approximately 862,800 children) cared for in home-based child care settings (including relative and nonrelative care) using the nationally representative Early Childhood Longitudinal Study, Birth Cohort. Only 50% of home-based child care providers reported taking the child outside to walk or play at least once/day. More than one-third of all children did not go outside to play daily with either their parent(s) or home-based child care provider. There were increased odds of going outside daily for children cared for by nonrelatives in the child's home compared with care from a relative. Children with ≥3 regular playmates had greater odds of being taken outdoors by either the parents or child care provider. We did not find statistically significant associations between other child level (age, sex, screen-time), family level (highest education in household, mother's race, employment, exercise frequency), and child care level (hours in care, provider's educational attainment, perception of neighborhood safety) factors and frequency of outdoor play. At a national level, the frequency of outdoor play for preschoolers cared for in home-based child care settings is suboptimal. Further study and efforts to increase outdoor playtime for children in home-based child care settings are needed. Copyright © 2012 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Is a family-centred initiative a family-centred service? A case of a Conductive Education setting for children with cerebral palsy.

PubMed

Schenker, R; Parush, S; Rosenbaum, P; Rigbi, A; Yochman, A

2016-11-01

From the moment a child is diagnosed as having cerebral palsy, families have to cope on a daily basis with the multifaceted challenges of life-long disability management. Family-centred service is embraced as a 'best practice' model because of accumulating evidence supporting its positive influence on parents and children's outcomes. Nevertheless, research comparing parent and provider perspectives on family-centred practices of educational service providers in education settings is scarce. The aims of this study were to compare the extent to which parents and conductors experience the service delivery in Tsad Kadima, the Association for Conductive Education in Israel, as being family-centred, as well as comparing parents' perception of different educational settings as being family-centred. Measurements of family-centeredness, the Israeli Measure of Processes of Care for families (MPOC-20) and for service providers (MPOC-SP), were administrated to 38 teacher conductors and 83 families of children with cerebral palsy (aged 1-14), from different conductive educational settings. Parents and conductors perceive Conductive Education service as being highly family centred in most domains, rating respectful and supportive care the highest and providing general information the lowest, thus indicating an area where improvements should be made. Parents perceived the service they receive to be more family-centred than conductor's perception about their own activities. In addition, educational setting (day care, pre-school and school) was found to be associated with parent's scores. The current study, which is the first to examine family-centred service provision in a conductive special education setting, from the perspectives of both parents and conductors, provides significant evidence for high-quality services in these settings. © 2016 John Wiley & Sons Ltd.

Driving standards in tracheostomy care: a preliminary communication of the St Mary's ENT-led multi disciplinary team approach.

PubMed

Arora, A; Hettige, R; Ifeacho, S; Narula, A

2008-12-01

To assess tracheostomy care and improve standards following the introduction of an ENT-led multidisciplinary tracheostomy ward round service. Prospective third cycle audit. Tertiary academic London hospital serving an inner city population of multi-ethnic background (St Mary's Hospital, Paddington, London). Patients with a tracheostomy discharged from ITU to general wards. IMPLEMENTED ACTIONS: Establishment of an ENT-led Tracheostomy Multidisciplinary Team (TMDT). Weekly TMDT ward round to manage patients with a tracheostomy. ENT-led educational and training sessions for allied healthcare professionals. Compliance with local tracheostomy care guidelines (St Mary's tracheostomy care bundle) and time to tracheostomy tube decannulation. Preliminary results of 10 patients show improved compliance with tracheostomy care guidelines, established in 2004, rising to 94%. Average time to decannulation was significantly reduced from 21 to 5 days (P-value = 0.0005, Mann Whitney Wilcoxon Test). The mean total tracheostomy time was reduced from 34 to 24 days although this was not statistically significant (P-value = 0.13, Mann Whitney Wilcoxon Test). The introduction of regular ENT-led multidisciplinary input for patients with a tracheostomy significantly improved compliance with nursing care standards. There was also a reduction in the total length of time tracheostomy tubes remain in situ, with time to decannulation significantly reduced.

A pilot programme of clinical practice improvement for future consultant doctors.

PubMed

Oates, Kim; Vinters, Cathy; Cass-Verco, John; Fletcher, Mandy; Kaur, Narinder; Mherekumombe, Martha; Tang, Alice

2017-04-01

To provide junior doctors with tools to improve patient care in their workplace, a partnership was developed between the Clinical Excellence Commission (CEC) and the Royal Australasian College of Physicians (RACP) to help trainee consultants carry out clinical practice improvement (CPI) projects during clinical work. Based on a patient-care problem they wished to resolve, trainee consultants attended a 2-day face-to-face workshop to learn quality-improvement methods, describe their proposals and refine them using CPI methodology. They were provided with continuing supervision, participated in a mid-point review and were responsible for driving their projects. Trainee consultants attended a 2-day face-to-face workshop to learn quality-improvement methods RESULTS: Examples of five projects are: reducing mislabelled specimens leaving an emergency department, from 82 in the baseline period to 18 following the intervention; creating a multidisciplinary team to reduce hypoglycaemic episodes on a diabetic ward, from 23 episodes at baseline to three episodes over the same time period after the intervention; establishing an acute paediatric review clinic that reduced avoidable admissions of pneumonia by 74 per cent; providing 100 per cent of patients in a palliative care unit with an effective pain-management plan; developing an education package to increase staff confidence in recognising and responding to anaphylaxis in children, producing an increase in confidence from 51 per cent at baseline to 100 per cent after the intervention. Involving a learned college such as the RACP in patient-care improvement, with educational input from a partner organisation, shows how junior staff can become effective leaders in improving patient care. © 2016 John Wiley & Sons Ltd.

Randomized Face-to-Face vs. Home Exercise Interventions in Pregnant Women with Gestational Diabetes

PubMed Central

DOWNS, Danielle Symons; DINALLO, Jennifer M.; BIRCH, Leann L.; PAUL, Ian M.; ULBRECHT, Jan S.

2017-01-01

Objectives Evaluate effects of a theoretically-based, semi-intensive (Face-to-Face; F2F) exercise intervention and minimum-contact (Home) exercise intervention to the standard care (Control) on exercise, its motivational determinants, blood glucose levels, and insulin use of pregnant women with gestational diabetes mellitus (GDM). Design Randomized control trial with two intervention arms and control (standard care). Method Participants (N=65) were randomized to a Control (standard prenatal care/GDM dietary counseling), Home (standard care + phone education/support + home exercise), or F2F (standard care + on-site education/support + guided exercise with instructor on 2 days/week) group from ~20 weeks gestation to delivery. Assessments of exercise and motivational determinants were obtained at baseline (20-weeks gestation) and follow-up (32-weeks gestation). Blood glucose levels (fasting/postprandial mg/dL) and insulin use were extrapolated from medical records. Results At the 32-week follow-up, the F2F group had significantly higher exercise min, pedometer steps/day, and motivational determinants (attitude, subjective norm, perceived control, intention) than controls (p’s < .05) and significantly higher exercise min and subjective norm than the Home group (p’s < .05); these effect sizes were medium-large (η2 = .11–.23). There was a medium effect (η2 = .13) on postprandial blood glucose at 36-weeks gestation with the F2F group having lower values than controls. Although not significant, the F2F group started insulin later (33 weeks gestation) than the Home (27 weeks) and Control (31 weeks) groups. Conclusion A theoretically-based, F2F exercise intervention has multiple health benefits and may be the necessary approach for promoting exercise motivation and behavior among GDM women. PMID:28428728

Randomized Face-to-Face vs. Home Exercise Interventions in Pregnant Women with Gestational Diabetes.

PubMed

Downs, Danielle Symons; Dinallo, Jennifer M; Birch, Leann L; Paul, Ian M; Ulbrecht, Jan S

2017-05-01

Evaluate effects of a theoretically-based, semi-intensive (Face-to-Face; F2F) exercise intervention and minimum-contact (Home) exercise intervention to the standard care (Control) on exercise, its motivational determinants, blood glucose levels, and insulin use of pregnant women with gestational diabetes mellitus (GDM). Randomized control trial with two intervention arms and control (standard care). Participants ( N =65) were randomized to a Control (standard prenatal care/GDM dietary counseling), Home (standard care + phone education/support + home exercise), or F2F (standard care + on-site education/support + guided exercise with instructor on 2 days/week) group from ~20 weeks gestation to delivery. Assessments of exercise and motivational determinants were obtained at baseline (20-weeks gestation) and follow-up (32-weeks gestation). Blood glucose levels (fasting/postprandial mg/dL) and insulin use were extrapolated from medical records. At the 32-week follow-up, the F2F group had significantly higher exercise min, pedometer steps/day, and motivational determinants (attitude, subjective norm, perceived control, intention) than controls ( p 's < .05) and significantly higher exercise min and subjective norm than the Home group ( p 's < .05); these effect sizes were medium-large (η 2 = .11-.23). There was a medium effect (η 2 = .13) on postprandial blood glucose at 36-weeks gestation with the F2F group having lower values than controls. Although not significant, the F2F group started insulin later (33 weeks gestation) than the Home (27 weeks) and Control (31 weeks) groups. A theoretically-based, F2F exercise intervention has multiple health benefits and may be the necessary approach for promoting exercise motivation and behavior among GDM women.

Fall rates in hospital rehabilitation units after individualised patient and staff education programmes: a pragmatic, stepped-wedge, cluster-randomised controlled trial.

PubMed

Hill, Anne-Marie; McPhail, Steven M; Waldron, Nicholas; Etherton-Beer, Christopher; Ingram, Katharine; Flicker, Leon; Bulsara, Max; Haines, Terry P

2015-06-27

Falls are the most frequent adverse events that are reported in hospitals. We examined the effectiveness of individualised falls-prevention education for patients, supported by training and feedback for staff, delivered as a ward-level programme. Eight rehabilitation units in general hospitals in Australia participated in this stepped-wedge, cluster-randomised study, undertaken during a 50 week period. Units were randomly assigned to intervention or control groups by use of computer-generated, random allocation sequences. We included patients admitted to the unit during the study with a Mini-Mental State Examination (MMSE) score of more than 23/30 to receive individualised education that was based on principles of changes in health behaviour from a trained health professional, in addition to usual care. We provided information about patients' goals, feedback about the ward environment, and perceived barriers to engagement in falls-prevention strategies to staff who were trained to support the uptake of strategies by patients. The coprimary outcome measures were patient rate of falls per 1000 patient-days and the proportion of patients who were fallers. All analyses were by intention to treat. This trial is registered with the Australian New Zealand Clinical Trials registry, number ACTRN12612000877886). Between Jan 13, and Dec 27, 2013, 3606 patients were admitted to the eight units (n=1983 control period; n=1623 intervention period). There were fewer falls (n=196, 7·80/1000 patient-days vs n=380, 13·78/1000 patient-days, adjusted rate ratio 0·60 [robust 95% CI 0·42-0·94], p=0·003), injurious falls (n=66, 2·63/1000 patient-days vs 131, 4·75/1000 patient-days, 0·65 [robust 95% CI 0·42-0·88], p=0·006), and fallers (n=136 [8·38%] vs n=248 [12·51%] adjusted odds ratio 0·55 [robust 95% CI 0·38 to 0·81], p=0·003) in the intervention compared with the control group. There was no significant difference in length of stay (intervention median 11 days [IQR 7-19], control 10 days [6-18]). Individualised patient education programmes combined with training and feedback to staff added to usual care reduces the rates of falls and injurious falls in older patients in rehabilitation hospital-units. State Health Research Advisory Council, Department of Health, Government of Western Australia. Copyright © 2015 Elsevier Ltd. All rights reserved.

Impact of educational outreach intervention on enhancing health care providers' knowledge about statin therapy prescribing in Malaysian patients with type 2 diabetes mellitus.

PubMed

Elnaem, Mohamed Hassan; Nik Mohamed, Mohamad Haniki; Zaman Huri, Hasniza; Azarisman, Shah M

2018-03-06

Previous research reported underutilization of statin therapy among patients with type 2 diabetes mellitus. Improving health care providers' awareness and understanding of the benefits and risks of statin treatment could be of assistance in optimizing the statin prescribing process. This study aimed to assess health care providers' knowledge related to statin therapy and the impact of educational outreach intervention based on the perceived knowledge. This was a cross-sectional study based on educational outreach intervention targeting physicians and pharmacists in 1 major tertiary hospital in the state of Pahang, Malaysia. Participants responded to a 12-item, validated questionnaire both prior to and after the outreach educational program. Two sessions were conducted separately for 2 cohorts of pharmacists and physicians. The knowledge scores prior to and after the educational intervention were calculated and compared using a paired-samples t-test. The response rate to both pre-and post-educational outreach questionnaires was 91% (40/44). Prior to the intervention, around 84% (n37) of the participants decided to initiate statin therapy for both pre-assessment clinical case scenarios; however, only 27% (n12) could state the clinical benefits of statin therapy. Forty-five percent (n20) could state the drug to drug interactions, and 52.3% (n23) could identify the statin therapy that can be given at any time day/evening. The educational outreach program increased participants' knowledge scores of 1.450 (95% CI, 0.918 to 1.982) point, P < .0005, which is statistically significant. Forty respondents (91%) were of the opinion that statin side effects are the most common cause of treatment discontinuation. This work demonstrated the impact of an educational outreach intervention on improving health care providers' knowledge and beliefs about statin therapy. This type of intervention is considered effective for short-term knowledge enhancement. Further research is needed to test the long-term efficacy of such intervention. © 2018 John Wiley & Sons, Ltd.

Heart failure education in the emergency department markedly reduces readmissions in un- and under-insured patients.

PubMed

Asthana, Vishwaratn; Sundararajan, Miel; Ackah, Ruth Linda; Karun, Vivek; Misra, Arunima; Pritchett, Allison; Bugga, Pallavi; Siler-Fisher, Angela; Peacock, William Frank

2018-03-21

Heart failure (HF) readmissions are a longstanding national healthcare issue for both hospitals and patients. Our purpose was to evaluate the efficacy of a structured, educational intervention targeted towards un- and under-insured emergency department (ED) HF patients. HF patients presenting to the ED for care were enrolled between July and December 2015 as part of an open label, interventional study, using a parallel observational control group. Eligible patients provided informed consent, had an established HF diagnosis, and were hemodynamically stable. Intervention patients received a standardized educational intervention in the ED waiting room before seeing the emergency physician, and a 30-day telephone follow-up. Primary and secondary endpoints were 30- and 90-day ED and hospital readmission rates, as well as days alive and out of hospital (DAOH) respectively. Of the 94 patients enrolled, median age was 58.4 years; 40.4% were female, and 54.3% were African American. Intervention patients (n = 45) experienced a 47.8% and 45.3% decrease in ED revisits (P = 0.02 &P < 0.001), and 60.0% and 47.4% decrease in hospital readmissions (P = 0.049 &P = 0.007) in the 30 and 90 days pre- versus post-intervention respectively. Control patients (n = 49) had no change in hospital readmissions or 30-day ED revisits, but experienced a 36.6% increase in 90-day ED revisits (P = 0.03). Intervention patients also saw a 59.2% improvement in DAOH versus control patients (P = 0.03). An ED educational intervention markedly decreases ED and hospital readmissions in un- and under-insured HF patients. Copyright © 2018 Elsevier Inc. All rights reserved.

The effects of in-service education to promote emergent literacy in child care centers: a feasibility study.

PubMed

Girolametto, Luigi; Weitzman, Elaine; Lefebvre, Pascal; Greenberg, Janice

2007-01-01

The purpose of this study was to determine the feasibility of a 2-day in-service education program for (a) promoting the use of two emergent literacy strategies by early childhood educators and (b) increasing children's responses to these strategies. Sixteen early childhood educators were randomly assigned to an experimental and a control group. The experimental in-service program sought to increase educators' use of abstract utterances and print references. Educators were videotaped with small groups of preschoolers during storybook reading and a post-story craft activity. Pretest and posttest videotapes were coded to yield rates of abstract language, verbal print references, and children's responses. In comparison to the control group, educators in the experimental program used more abstract utterances that elicited talk about emotions and children's past experiences during storybook reading. They also used significantly more print references during a post-story craft activity. In addition, children in the experimental group responded more often with appropriate responses to abstract utterances and print references in comparison to children in the control group. A 2-day in-service education program resulted in short-term behavioral changes in educators' use of abstract language and print references. Suggestions for improving instruction include providing opportunities for classroom practice with feedback, modeling the use of strategies in classroom routines, and long-term mentoring of educators to promote retention of gains.

Nurses Urged to Prepare for Sex Education.

PubMed

2017-01-01

Editors' note: From its first issue in 1900 through to the present day, AJN has unparalleled archives detailing nurses' work and lives over more than a century. These articles not only chronicle nursing's growth as a profession within the context of the events of the day, but they also reveal prevailing societal attitudes about women, health care, and human rights. Today's nursing school curricula rarely include nursing's history, but it's a history worth knowing. To this end, From the AJN Archives highlights articles selected to fit today's topics and times.This month we reprint a brief "Professional Practice" note from the June 1969 issue about what was described as the first family planning conference for nurse educators. Speakers emphasized the need to make this subject a routine part of nursing school curricula (despite debates over the nurse's role in family planning), "so that nurses can counsel out of wisdom and not from piety or ignorance." Speakers included James Lieberman, MD, who years later coauthored with his daughter a teen sex guide, and Alan Guttmacher, MD, then president of Planned Parenthood, whose Center for Family Planning Program Development within that organization was later renamed the Guttmacher Institute in his honor.Nurses today are deeply involved in sexual and reproductive health care. In this issue, public health specialist Diane Santa Maria and colleagues offer ways to advance sexual and reproductive health care for adolescents by devising more friendly, youth-oriented clinical settings.

Reducing Readmissions among Heart Failure Patients Discharged to Home Health Care: Effectiveness of Early and Intensive Nursing Services and Early Physician Follow-Up.

PubMed

Murtaugh, Christopher M; Deb, Partha; Zhu, Carolyn; Peng, Timothy R; Barrón, Yolanda; Shah, Shivani; Moore, Stanley M; Bowles, Kathryn H; Kalman, Jill; Feldman, Penny H; Siu, Albert L

2017-08-01

To compare the effectiveness of two "treatments"-early, intensive home health nursing and physician follow-up within a week-versus less intense and later postacute care in reducing readmissions among heart failure (HF) patients discharged to home health care. National Medicare administrative, claims, and patient assessment data. Patients with a full week of potential exposure to the treatments were followed for 30 days to determine exposure status, 30-day all-cause hospital readmission, other health care use, and mortality. An extension of instrumental variables methods for nonlinear statistical models corrects for nonrandom selection of patients into treatment categories. Our instruments are the index hospital's rate of early aftercare for non-HF patients and hospital discharge day of the week. All hospitalizations for a HF principal diagnosis with discharge to home health care between July 2009 and June 2010 were identified from source files. Neither treatment by itself has a statistically significant effect on hospital readmission. In combination, however, they reduce the probability of readmission by roughly 8 percentage points (p < .001; confidence interval = -12.3, -4.1). Results are robust to changes in implementation of the nonlinear IV estimator, sample, outcome measure, and length of follow-up. Our results call for closer coordination between home health and medical providers in the clinical management of HF patients immediately after hospital discharge. © Health Research and Educational Trust.

Family Day Care in the United States: Family Day Care Systems. Final Report of the National Day Care Home Study. Volume 5.

ERIC Educational Resources Information Center

Grasso, Janet; Fosburg, Steven

Fifth in a series of seven volumes reporting the design, methodology, and findings of the 4-year National Day Care Home Study (NDCHS), this volume presents a descriptive and statistical analysis of the day care institutions that administer day care systems. These systems, such as Learning Unlimited in Los Angeles and the family day care program of…

Impact of preoperative patient education on the prevention of postoperative complications after major visceral surgery: the cluster randomized controlled PEDUCAT trial.

PubMed

Klaiber, Ulla; Stephan-Paulsen, Lisa M; Bruckner, Thomas; Müller, Gisela; Auer, Silke; Farrenkopf, Ingrid; Fink, Christine; Dörr-Harim, Colette; Diener, Markus K; Büchler, Markus W; Knebel, Phillip

2018-05-24

The prevention of postoperative complications is of prime importance after complex elective abdominal operations. Preoperative patient education may prevent postoperative complications and improve patients' wellbeing, but evidence for its efficacy is poor. The aims of the PEDUCAT trial were (a) to assess the impact of preoperative patient education on postoperative complications and patient-reported outcomes in patients scheduled for elective complex visceral surgery and (b) to evaluate the feasibility of cluster randomization in this setting. Adult patients (age ≥ 18 years) scheduled for elective major visceral surgery were randomly assigned in clusters to attend a preoperative education seminar or to the control group receiving the department's standard care. Outcome measures were the postoperative complications pneumonia, deep vein thrombosis (DVT), pulmonary embolism, burst abdomen, and in-hospital fall, together with patient-reported outcomes (postoperative pain, anxiety and depression, patient satisfaction, quality of life), length of hospital stay (LOS), and postoperative mortality within 30 days after the index operation. Statistical analysis was primarily by intention to treat. In total 244 patients (60 clusters) were finally included (intervention group 138 patients; control group 106 patients). Allocation of hospital wards instead of individual patients facilitated study conduct and reduced confusion about group assignment. In the intervention and control groups respectively, pneumonia occurred in 7.4% versus 8.3% (p = 0.807), pulmonary embolism in 1.6% versus 1.0% (p = 0.707), burst abdomen in 4.2% versus 1.0% (p = 0.165), and in-hospital falls in 0.0% versus 4.2% of patients (p = 0.024). DVT did not occur in any of the patients. Mortality rates (1.4% versus 1.9%, p = 0.790) and LOS (14.2 (+/- 12.0) days versus 16.1 (+/- 15.0) days, p = 0.285) were also similar in the intervention and control groups. Cluster randomization was feasible in the setting of preoperative patient education and reduced the risk of contamination effects. The results of this trial indicate good postoperative outcomes in patients undergoing major visceral surgery without superiority of preoperative patient education compared to standard patient care at a high-volume center. However, preoperative patient education is a helpful instrument not only for teaching patients but also for training the nursing staff. German Clinical Trials Registry, DRKS00004226 . Registered on 23 October 2012. Registered 8 days after the first enrollment.

An assessment of lower back pain in young adults: implications for college health education.

PubMed

Reis, J; Flegel, M; Kennedy, C

1996-05-01

A convenience sample of 243 undergraduates completed a 36-item questionnaire on their knowledge about back care and exercise patterns before they attended lectures and a workshop on back mechanics. At the workshop, the students were individually evaluated for posture, hamstring flexibility, hip flexor flexibility, back and abdominal strength, and lifting technique. Twenty-nine percent of the students reported that they experienced no back pain; 71% experienced lower back pain 1 to 5 days a week. The majority were neglectful of their posture, lifting and carrying techniques, and scored fair-to-poor on the hamstring flexibility test, possibly foreshadowing back problems in later life. The majority of respondents were unsure of what exercises to do for back care. Within the subgroup of students who claimed they were knowledgeable about exercise, more than 50% were performing ineffective and potentially harmful exercises. The results underscored the potential worth of health education on back care offered through didactic instruction and experiential workshops.

Environmentally sustainable health care: using an educational intervention to engage the public health medical workforce in Australia.

PubMed

Charlesworth, Kate E; Madden, D Lynne; Capon, Anthony G

2013-11-01

Awareness of the benefits of environmentally sustainable health care is growing. In the United Kingdom in 2010, an educational intervention on sustainable health care was successfully delivered to public health registrars. We conducted a feasibility study to test the intervention in Australia. The intervention consisted of a 1-day workshop delivered face-to-face covering climate change, sustainability and health. The workshop was modified, piloted and then delivered to 33 health professionals. Modifications included using Australian resources, introducing active learning exercises and including guest speakers. Delivery by videoconference was trialled. Outcomes were assessed in three areas - awareness, advocacy and action - using questionnaires and follow-up telephone interviews. There were improvements in participants' mean awareness and advocacy scores. All participants rated sustainability as 'important' for health professionals and many looked to their professional organisation to take a lead advocacy role on this issue. This study demonstrated that the workshop is feasible for use in Australia; the modifications and delivery by videoconference were well received.

Day Care: A Program in Search of a Policy.

ERIC Educational Resources Information Center

Bikales, Gerda

This report examines current issues relating to day care and challenges many of the policy assumptions that underlie a major public program of subsidized day care for children. A historical perspective of day care is presented and various types of day care are described. The costs and benefits of day care are examined and the relation of day care…

Effect of chlorhexidine/silver sulfadiazine-impregnated central venous catheters in an intensive care unit with a low blood stream infection rate after implementation of an educational program: a before-after trial.

PubMed

Schuerer, Douglas J E; Zack, Jeanne E; Thomas, James; Borecki, Ingrid B; Sona, Carrie S; Schallom, Marilyn E; Venker, Melissa; Nemeth, Jennifer L; Ward, Myrna R; Verjan, Linda; Warren, David K; Fraser, Victoria J; Mazuski, John E; Boyle, Walter A; Buchman, Timothy G; Coopersmith, Craig M

2007-08-01

Current guidelines recommend using antiseptic- or antibiotic-impregnated central venous catheters (CVCs) if, following a comprehensive strategy to prevent catheter-related blood stream infection (CR-BSI), infection rates remain above institutional goals based on benchmark values. The purpose of this study was to determine if chlorhexidine/silver sulfadiazine-impregnated CVCs could decrease the CR-BSI rate in an intensive care unit (ICU) with a low baseline infection rate. Pre-intervention and post-intervention observational study in a 24-bed surgical/trauma/burn ICU from October, 2002 to August, 2005. All patients requiring CVC placement after March, 2004 had a chlorhexidine/silver sulfadiazine-impregnated catheter inserted (post-intervention period). Twenty-three CR-BSIs occurred in 6,960 catheter days (3.3 per 1,000 catheter days)during the 17-month control period. After introduction of chlorhexidine/silver sulfadiazine-impregnated catheters, 16 CR-BSIs occurred in 7,732 catheter days (2.1 per 1,000 catheter days; p = 0.16). The average length of time required for an infection to become established after catheterization was similar in the two groups (8.4 vs. 8.6 days; p = 0.85). Chlorhexidine/silver sulfadiazine-impregnated catheters did not result in a statistically significant change in the microbiological profile of CR-BSIs, nor did they increase the incidence of resistant organisms. Although chlorhexidine/silver sulfadiazine-impregnated catheters are useful in specific patient populations, they did not result in a statistically significant decrease in the CR-BSI rate in this study, beyond what was achieved with education alone.

Aviation’s Normal Operations Safety Audit: a safety management and educational tool for health care? Results of a small-scale trial

PubMed Central

Bennett, Simon A

2017-01-01

Background A National Health Service (NHS) contingent liability for medical error claims of over £26 billion. Objectives To evaluate the safety management and educational benefits of adapting aviation’s Normal Operations Safety Audit (NOSA) to health care. Methods In vivo research, a NOSA was performed by medical students at an English NHS Trust. After receiving training from the author, the students spent 6 days gathering data under his supervision. Results The data revealed a threat-rich environment, where errors – some consequential – were made (359 threats and 86 errors were recorded over 2 weeks). The students claimed that the exercise improved their observational, investigative, communication, teamworking and other nontechnical skills. Conclusion NOSA is potentially an effective safety management and educational tool for health care. It is suggested that 1) the UK General Medical Council mandates that all medical students perform a NOSA in fulfillment of their degree; 2) the participating NHS Trusts be encouraged to act on students’ findings; and 3) the UK Department of Health adopts NOSA as a cornerstone risk assessment and management tool. PMID:28860881

International telepharmacy education: another venue to improve cancer care in the developing world.

PubMed

Alfaar, Ahmad S; Kamal, Sherif; Abouelnaga, Sherif; Greene, William L; Quintana, Yuri; Ribeiro, Raul C; Qaddoumi, Ibrahim A

2012-01-01

In developed countries, pharmacists play a crucial role in designing and implementing cancer treatments as part of a multidisciplinary oncology team. However, developing countries have a shortage of pharmacists, and their role is generally limited to dispensing and selling drugs. The aim of this study was to investigate the feasibility of providing clinical pharmacy educational activities via international teleconferencing to improve cancer care in developing countries. Meticulous preparation and intense promotion of the workshop were done in Egypt before the telepharmacy conferences began. Multiple connectivity tests were performed to resolve technical problems. Nine telepharmacy conferences were delivered during 3-h sessions that were held on three consecutive days. Talks were subsequently made available via Web streaming. Attendees were requested to complete a survey to measure their satisfaction with the sessions. The teleconference was attended by a total of 345 persons, and it was subsequently reviewed online via 456 log-in sessions from 10 countries. Technical issues (e.g., poor auditory quality) were resolved on the first day of the event. The rate of attendees' responses on the survey was 30.1%, and satisfaction with the event was generally good. Telecommunication is a relatively inexpensive approach that may improve pharmacy practices, especially those used to treat patients with cancer in developing countries. Special attention to patient-based telepharmacy education, including the use of cost-effective technology, should be considered.

Nutrition and physical activity in child care centers: the impact of a wellness policy initiative on environment and policy assessment and observation outcomes, 2011.

PubMed

Lyn, Rodney; Maalouf, Joyce; Evers, Sarah; Davis, Justin; Griffin, Monica

2013-05-23

The child care environment has emerged as an ideal setting in which to implement policies that promote healthy body weight of children. The purpose of this study was to assess the effect of a wellness policy and training program on the physical activity and nutrition environment in 24 child care centers in Georgia. We used the Environment and Policy Assessment and Observation instrument to identify changes to foods served, staff behaviors, and physical activity opportunities. Observations were performed over 1 day, beginning with breakfast and concluding when the program ended for the day. Observations were conducted from February 2010 through April 2011 for a total of 2 observations in each center. Changes to nutrition and physical activity in centers were assessed on the basis of changes in scores related to the physical activity and nutrition environment documented in the observations. Paired t test analyses were performed to determine significance of changes. Significant improvements to total nutrition (P < .001) and physical activity scores (P < .001) were observed. Results indicate that centers significantly improved the physical activity environments of centers by enhancing active play (P = .02), the sedentary environment (P = .005), the portable environment (P = .002), staff behavior (P = .004), and physical activity training and education (P < .001). Significant improvements were found for the nutrition environment (P < .001), and nutrition training and education (P < .001). Findings from this study suggest that implementing wellness policies and training caregivers in best practices for physical activity and nutrition can promote healthy weight for young children in child care settings.

Helping mothers survive bleeding after birth: an evaluation of simulation-based training in a low-resource setting.

PubMed

Nelissen, Ellen; Ersdal, Hege; Ostergaard, Doris; Mduma, Estomih; Broerse, Jacqueline; Evjen-Olsen, Bjørg; van Roosmalen, Jos; Stekelenburg, Jelle

2014-03-01

To evaluate "Helping Mothers Survive Bleeding After Birth" (HMS BAB) simulation-based training in a low-resource setting. Educational intervention study. Rural referral hospital in Northern Tanzania. Clinicians, nurse-midwives, medical attendants, and ambulance drivers involved in maternity care. In March 2012, health care workers were trained in HMS BAB, a half-day simulation-based training, using a train-the-trainer model. The training focused on basic delivery care, active management of third stage of labor, and treatment of postpartum hemorrhage, including bimanual uterine compression. Evaluation questionnaires provided information on course perception. Knowledge, skills, and confidence of facilitators and learners were tested before and after training. Four master trainers trained eight local facilitators, who subsequently trained 89 learners. After training, all facilitators passed the knowledge test, but pass rates for the skills test were low (29% pass rate for basic delivery and 0% pass rate for management of postpartum hemorrhage). Evaluation revealed that HMS BAB training was considered acceptable and feasible, although more time should be allocated for training, and teaching materials should be translated into the local language. Knowledge, skills, and confidence of learners increased significantly immediately after training. However, overall pass rates for skills tests of learners after training were low (3% pass rate for basic delivery and management of postpartum hemorrhage). The HMS BAB simulation-based training has potential to contribute to education of health care providers. We recommend a full day of training and validation of the facilitators to improve the training. © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

Reduction of seasonal influenza transmission among healthcare workers in an intensive care unit: a 4-year intervention study in Thailand.

PubMed

Apisarnthanarak, Anucha; Uyeki, Timothy M; Puthavathana, Pilaipan; Kitphati, Rungrueng; Mundy, Linda M

2010-10-01

To evaluate the feasibility and effectiveness of an influenza control bundle to minimize healthcare-associated seasonal influenza transmission among healthcare workers (HCWs) in an intensive care unit (ICU) equipped with central air conditioning. A quasi-experimental study was conducted in a 500-bed tertiary care center in Thailand from July 1, 2005, through June 30,2009. The medical ICU (MICU) implemented an influenza control bundle including healthcare worker (HCW) education, influenza screening of adult community-acquired pneumonia patients, antiviral treatment of patients and ill HCWs who tested positive for influenza, promotion of influenza vaccination among HCWs, and reinforcement of standard infection control policies. The surgical ICU (SICU) and coronary care unit (CCU) received no intervention. The numbers of influenza infections among HCWs during the pre- and postintervention periods were 18 cases in 5,294 HCW days and 0 cases in 5,336 HCW-days in the MICU (3.4 vs 0 cases per 1,000 HCW-days; P ! .001), 19 cases in 4,318 HCW-days and 20 cases in 4,348 HCW-days in the SICU (4.4 vs 4.6 cases per 1,000 HCW-days; Pp.80), and 18 cases in 5,000 HCW-days and 18 cases in 5,143 HCW-days in the CCU (3.6 vs 3.5 cases per 1,000 HCW-days; Pp.92), respectively. Outbreak-related influenza occurred in 7 MICUHCWs, 6 SICU HCWs, and 4 CCU HCWs before intervention and 0 MICU HCWs, 9 SICU HCWs, and 8 CCU HCWs after intervention.Before and after intervention, 25 (71%) and 35 (100%) of 35 MICU HCWs were vaccinated, respectively (P ! .001); HCW vaccination coverage did not change significantly in the SICU (21 [70%] of 30 vs 24 [80%] of 30; Pp.89) and CCU (19 [68%] of 28 vs 21 [75%]of 28; Pp.83). The estimated costs of US $6,471 per unit for postintervention outbreak investigations exceeded the intervention costs of US $4,969. A sustained influenza intervention bundle was associated with clinical and economic benefits to a Thai hospital.

"Do not resuscitate" orders among deceased patients who received acute neurological care: an observation analysis.

PubMed

Chao, Tzu-Hao; Hsieh, Tien-Jen; Wang, Vinchi

2014-12-01

There were many reports about the "do not resuscitate" (DNR) order while practicing in the critical care units and conducting hospice affairs but limited in the neurological issues. This study investigated the possible flaws in the execution of the DNR order among patients who received acute neurological care in Taiwan. Over a 3-year period, we retrospectively reviewed the medical records of 77 deceased patients with neurological conditions for DNR orders. Registry and analysis works included demography, hospital courses, DNR data, and clinical usefulness of the lab and image examinations. Sixty-seven DNR orders were requested by the patients' families, and more than half were signed by the patients' children or grandchildren. The main DNR items were chest compression, cardiac defibrillation, and pacemaker use, although several DNR patients received resuscitation. The mean duration from the coding date to death was 7.6 days. Two-thirds of the patients with DNR requests remained in the intensive care unit, with a mean stay of 6.9 days. Several patients underwent regular roentgenography and blood tests on the day of their death, despite their DNR orders. Hospital courses and DNR items may be valuable information on dealing with the patients with DNR orders. The results of this study also suggest the public education about the DNR orders implemented for neurological illnesses.