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Sample records for medication administration work

  1. Barcode medication administration work-arounds: a systematic review and implications for nurse executives.

    Science.gov (United States)

    Voshall, Barbara; Piscotty, Ronald; Lawrence, Jeanette; Targosz, Mary

    2013-10-01

    Safe medication administration is necessary to ensure quality healthcare. Barcode medication administration systems were developed to reduce drug administration errors and the related costs and improve patient safety. Work-arounds created by nurses in the execution of the required processes can lead to unintended consequences, including errors. This article provides a systematic review of the literature associated with barcoded medication administration and work-arounds and suggests interventions that should be adopted by nurse executives to ensure medication safety.

  2. Nurses' Perceptions of the Impact of Work Systems and Technology on Patient Safety during the Medication Administration Process

    Science.gov (United States)

    Gallagher Gordon, Mary

    2012-01-01

    This dissertation examines nurses' perceptions of the impacts of systems and technology utilized during the medication administration process on patient safety and the culture of medication error reporting. This exploratory research study was grounded in a model of patient safety based on Patricia Benner's Novice to Expert Skill Acquisition model,…

  3. Nurses' Perceptions of the Impact of Work Systems and Technology on Patient Safety during the Medication Administration Process

    Science.gov (United States)

    Gallagher Gordon, Mary

    2012-01-01

    This dissertation examines nurses' perceptions of the impacts of systems and technology utilized during the medication administration process on patient safety and the culture of medication error reporting. This exploratory research study was grounded in a model of patient safety based on Patricia Benner's Novice to Expert Skill…

  4. Nurses' Perceptions of the Impact of Work Systems and Technology on Patient Safety during the Medication Administration Process

    Science.gov (United States)

    Gallagher Gordon, Mary

    2012-01-01

    This dissertation examines nurses' perceptions of the impacts of systems and technology utilized during the medication administration process on patient safety and the culture of medication error reporting. This exploratory research study was grounded in a model of patient safety based on Patricia Benner's Novice to Expert Skill Acquisition model,…

  5. Interruptions during hospital nurses’ medication administration rounds

    Directory of Open Access Journals (Sweden)

    Marian Smeulers

    2013-05-01

    Full Text Available Medication administration errors are common, costly and the cause of adverse events in clinical practice. Interruptions during medication administration rounds are thought to be a prominent causative factor of these medication errors. In this observational study, data were collected on the number and duration of several different sources of verbal and non-verbal interruptions using unobtrusive structured observations on 32 medication administration rounds. Interruptions occurred very often (6.9 times per nurse each hour, differed in frequency among the medication administration rounds and were from a variety of sources. The most frequent interruptions were caused by nursing colleagues (43% and non-verbal interruptions from the ward environment (25%, such as noises from pagers, conversations in the vicinity of the nurse, the work of cleaners, or stock management by pharmacy staff. The longest durations of interruptions were from nursing colleagues’ verbal interrup- interruptions. When comparing the medication rounds, more and longer interruptions were observed during the morning rounds than those at noon. A comparison between surgical and non-surgical units showed that interruptions occurred more often and lasted longer in non-surgical units than those in surgical units. But the observed differences were not statistically significant. In conclusion, interruptions during medication administration rounds are frequent and originated from different human and environmental sources. Interventions should target not only interruptions by colleagues, but should also consider ways to reduce self-initiated interruptions and those arising from the immediate ward environment.

  6. SolidWorks Administration Bible

    CERN Document Server

    Lombard, Matt

    2009-01-01

    What you need to prepare, install, and maintain SolidWorks. It's not enough to know how to use SolidWorks, if your job also requires you to install or maintain it, train new users, and implement standards. This in-depth guide was written for those of you who have to actually manage your company's SolidWorks system. From hardware selection to helping users to licensing and more, this is the everyday, bread-and-butter SolidWorks administration resource that IT and CAD managers have been seeking.:; SolidWorks is a powerful 3D solid modeling system that is popular with CAD users everywhere, but of

  7. [Work-to-family influence and social supports: job satisfaction in a north-Italy public health organization --differences between medical and administrative staff].

    Science.gov (United States)

    Colombo, Lara; Zito, Margherita; Ghislieri, Chiara

    2012-01-01

    In recent years, the interest in the well-being at work has grown considerably, also considering the latest law directives. Several scholars have devoted particular attention to the topic of the work-to-family influence and of social supports, as elements able to affect the perceived well-being. The well-being in health care has to consider the particular nature of work and the relevant relational dimensions that require special attention for the emotional side. The research was promoted by the Committee for Equal Opportunities of a public health organization in the North-West Italy. Referring to the job demands-resources theoretical model, this study investigated the role of organizational and family supports, work-to-family spillover (positive and negative) and family workload as possible determinants of job satisfaction, intended as an indicator of psychological well-being at work. Respondents to the questionnaire are 541 (55% of the total employees), their average age is 43 and they are mostly women (80%). Data analysis showed the central role of supervisors supports, of the co-workers supports and, to a lesser extent, the role of the work-to-family spillover in influencing job satisfaction. Moreover, significant differences between medical and administrative staff were detected. The centrality of supports, especially those of supervisors in determining job satisfaction, is in line with studies indicating that a supportive leadership and a family-friendly culture can facilitate the arise of positive outcomes for both workers and organizations.

  8. Recognizing and preventing medication administration errors.

    Science.gov (United States)

    Martin, Caren McHenry; Bryan, Gianna

    2013-05-01

    Proper medication administration in the long-term care facility is vitally important, as many medications have specific administration parameters that are essential to their optimal efficacy. Pharmacists servicing long-term care facilities play an integral role in observing medication administration in the facility and educating facility staff on proper administration techniques. By being vigilant to potential problems, pharmacists can help ensure that facility residents receive their medications appropriately.

  9. Impact of an electronic medication administration record on medication administration efficiency and errors.

    Science.gov (United States)

    McComas, Jeffery; Riingen, Michelle; Chae Kim, Son

    2014-12-01

    The study aims were to evaluate the impact of electronic medication administration record implementation on medication administration efficiency and occurrence of medication errors as well as to identify the predictors of medication administration efficiency in an acute care setting. A prospective, observational study utilizing time-and-motion technique was conducted before and after electronic medication administration record implementation in November 2011. A total of 156 cases of medication administration activities (78 pre- and 78 post-electronic medication administration record) involving 38 nurses were observed at the point of care. A separate retrospective review of the hospital Midas+ medication error database was also performed to collect the rates and origin of medication errors for 6 months before and after electronic medication administration record implementation. The mean medication administration time actually increased from 11.3 to 14.4 minutes post-electronic medication administration record (P = .039). In a multivariate analysis, electronic medication administration record was not a predictor of medication administration time, but the distractions/interruptions during medication administration process were significant predictors. The mean hospital-wide medication errors significantly decreased from 11.0 to 5.3 events per month post-electronic medication administration record (P = .034). Although no improvement in medication administration efficiency was observed, electronic medication administration record improved the quality of care with a significant decrease in medication errors.

  10. Medication Administration Practices of School Nurses.

    Science.gov (United States)

    McCarthy, Ann Marie; Kelly, Michael W.; Reed, David

    2000-01-01

    Assessed medication administration practices among school nurses, surveying members of the National Association of School Nurses. Respondents were extremely concerned about medication administration. Errors in administering medications were reported by 48.5 percent of respondents, with missed doses the most common error. Most nurses followed…

  11. Improving medication administration safety in solid organ transplant patients through barcode-assisted medication administration.

    Science.gov (United States)

    Bonkowski, Josesph; Weber, Robert J; Melucci, Joseph; Pesavento, Todd; Henry, Mitchell; Moffatt-Bruce, Susan

    2014-01-01

    Solid organ transplant recipients are prescribed a high number of medications, increasing the potential for medication errors. Barcode-assisted medication administration (BCMA) is technology that reduces medication administration errors. An observational study was conducted at an academic medical center solid organ transplant unit before and after BMCA implementation. Medication accuracy was determined and administration errors were categorized by type and therapeutic class of medication. A baseline medication administration error rate of 4.8% was observed with wrong dose errors representing 78% of the errors. During the post-BCMA period the medication administration error rate was reduced by 68% to 1.5% (P = .0001). Wrong dose errors were reduced by 67% (P = .001), and unauthorized medication administrations were reduced by 73%. Steroids were associated with the highest error rate. The results of this study suggest that routinely adopting BCMA has the potential to reduce medication administration errors in transplant patients.

  12. Risk Propensity and Safe Medication Administration.

    Science.gov (United States)

    Gonzales, Kelly

    2015-09-01

    To examine the relationship between risk propensity and safe medication administration, while also providing additional evidence of validity and reliability on the Safe Administration of Medication (SAM) Scale. A convenience sample of nursing students from a private Midwest university in the United States was invited to participate in the study. Fourth-year nursing students completed 2 instruments: revised Domain-Specific Risk-Taking and Risk Perception (DOSPERT) Scale, which measures risk propensity, and the SAM Scale, which measures knowledge and performance of safe medication administration. Second-year nursing students completed the SAM Scale; their scores were used to provide evidence of construct validity. This study demonstrated a statistically significant relationship between personal risk taking in the area of health/safety and safe medication administration in nursing students. No statistically significant relationship was found between risk perception and safe medication administration. In addition, the study provided evidence of the validity and reliability of the SAM Scale. This study is among the first to demonstrate a relationship between risk propensity and safe medication administration. Further research into personal risk taking, risk perception and its impact on patient safety, specifically safe medication administration, is needed.

  13. Pediatric medication administration errors and workflow following implementation of a bar code medication administration system.

    Science.gov (United States)

    Hardmeier, Anna; Tsourounis, Candy; Moore, Mary; Abbott, Wendy E; Guglielmo, B Joseph

    2014-01-01

    Direct observation was used to detect medication errors and Bar Code Medication Administration (BCMA) workarounds on two pediatric units and one neonatal unit at UCSF Benioff Children's Hospital. The study (1) measured the frequency of nursing medication administration-related errors, (2) characterized the types of medication errors, (3) assessed compliance with the institution's six medication administration safety processes, and (4) identified observed workarounds following BCMA implementation. The results of the direct observation were compared to medication administration-related incident reports (IRs) for the same period. The frequency of medication errors was 5% for the three units. Compliance with the process measures was achieved 86% of the time (range 23-100%). Seven medication administration-related IRs were submitted during the same observation period. Three BCMA workarounds were identified; (1) failure to visually confirm patient's identification, (2) failure to compare the medication to the electronic medication administration record at least twice before administration, and (3) charting administration of medication before actual administration. The direct observation methodology identified a low frequency of medication administration errors (MAEs) consistent with post-BCMA implementation. The incident reporting system identified different MAEs than direct observation suggesting that both methods should be used to better characterize the scope of MAEs.

  14. Quantifying nursing workflow in medication administration.

    Science.gov (United States)

    Keohane, Carol A; Bane, Anne D; Featherstone, Erica; Hayes, Judy; Woolf, Seth; Hurley, Ann; Bates, David W; Gandhi, Tejal K; Poon, Eric G

    2008-01-01

    New medication administration systems are showing promise in improving patient safety at the point of care, but adoption of these systems requires significant changes in nursing workflow. To prepare for these changes, the authors report on a time-motion study that measured the proportion of time that nurses spend on various patient care activities, focusing on medication administration-related activities. Implications of their findings are discussed.

  15. The mat study: global insight into the medication administration process.

    Science.gov (United States)

    Elganzouri, Erika; Standish, Cynthia; Androwich, Ida

    2009-01-01

    An important aspect of global patient safety that has recently become a focal topic is preventing adverse drug events. As many as 7,000 patients die every year as a result of medication errors. (1) According to Bates, Spell, & Cullen, adverse drug events can cost up to an average of $8.4 million per year in a 700 bed hospital, not including injury to patient or malpractice costs. (2) Errors can occur throughout the process of ordering a medicine, dispensing, retrieving, and administrating process. Safety measures have been implemented for physicians prescribing medication and pharmacists dispensing medication through MARs and CPOE. However, there is no safety net for nursing. Bar coding can offer that safety net and allow the nurse to verify "the five rights" of medication administration electronically. However, prior to implementation of a bar coding medication system (BCMA), it is important for an institution to gain full understanding of its current nursing work flow during the medication administration process.

  16. Work Relations in Public Administration Institutiones

    OpenAIRE

    Anca Jarmila Guţă

    2007-01-01

    The paper presents the way work relations develop between public administration institution clerks, their relations with their superiors, the main subordination types of public administration clerks. The paper also dwells on the role played by the head of an institution belonging to public administration in establishing the most favorable work relations, the behaviour the subordinates should have with the institution head, the way a superior exerts his prerogative of making a decision and the...

  17. Dark chocolate administration improves working memory in students

    OpenAIRE

    Nawanto Agung Prastowo; Samuel Kristanto; Poppy Kristina Sasmita

    2016-01-01

    Background Flavonoids have positive effects on health, including the nervous system. High flavonoid content can be found in chocolate, especially dark chocolate. Verbal working memory is important for reasoning, language comprehension, planning, and spatial processing. The purpose of this study was to evaluate the effect of a single dose of dark and white chocolate administration on verbal working memory in medical students. Methods A study of experimental pre-post test design with...

  18. Dark chocolate administration improves working memory in students

    OpenAIRE

    Nawanto Agung Prastowo; Samuel Kristanto; Poppy Kristina Sasmita

    2016-01-01

    Background Flavonoids have positive effects on health, including the nervous system. High flavonoid content can be found in chocolate, especially dark chocolate. Verbal working memory is important for reasoning, language comprehension, planning, and spatial processing. The purpose of this study was to evaluate the effect of a single dose of dark and white chocolate administration on verbal working memory in medical students. Methods A study of experimental pre-post test design with...

  19. Application of Computer Simulation Modeling to Medication Administration Process Redesign

    Directory of Open Access Journals (Sweden)

    Nathan Huynh

    2012-01-01

    Full Text Available The medication administration process (MAP is one of the most high-risk processes in health care. MAP workflow redesign can precipitate both unanticipated and unintended consequences that can lead to new medication safety risks and workflow inefficiencies. Thus, it is necessary to have a tool to evaluate the impact of redesign approaches in advance of their clinical implementation. This paper discusses the development of an agent-based MAP computer simulation model that can be used to assess the impact of MAP workflow redesign on MAP performance. The agent-based approach is adopted in order to capture Registered Nurse medication administration performance. The process of designing, developing, validating, and testing such a model is explained. Work is underway to collect MAP data in a hospital setting to provide more complex MAP observations to extend development of the model to better represent the complexity of MAP.

  20. Provider risk factors for medication administration error alerts: analyses of a large-scale closed-loop medication administration system using RFID and barcode.

    Science.gov (United States)

    Hwang, Yeonsoo; Yoon, Dukyong; Ahn, Eun Kyoung; Hwang, Hee; Park, Rae Woong

    2016-12-01

    To determine the risk factors and rate of medication administration error (MAE) alerts by analyzing large-scale medication administration data and related error logs automatically recorded in a closed-loop medication administration system using radio-frequency identification and barcodes. The subject hospital adopted a closed-loop medication administration system. All medication administrations in the general wards were automatically recorded in real-time using radio-frequency identification, barcodes, and hand-held point-of-care devices. MAE alert logs recorded during a full 1 year of 2012. We evaluated risk factors for MAE alerts including administration time, order type, medication route, the number of medication doses administered, and factors associated with nurse practices by logistic regression analysis. A total of 2 874 539 medication dose records from 30 232 patients (882.6 patient-years) were included in 2012. We identified 35 082 MAE alerts (1.22% of total medication doses). The MAE alerts were significantly related to administration at non-standard time [odds ratio (OR) 1.559, 95% confidence interval (CI) 1.515-1.604], emergency order (OR 1.527, 95%CI 1.464-1.594), and the number of medication doses administered (OR 0.993, 95%CI 0.992-0.993). Medication route, nurse's employment duration, and working schedule were also significantly related. The MAE alert rate was 1.22% over the 1-year observation period in the hospital examined in this study. The MAE alerts were significantly related to administration time, order type, medication route, the number of medication doses administered, nurse's employment duration, and working schedule. The real-time closed-loop medication administration system contributed to improving patient safety by preventing potential MAEs. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  1. Administration Medication Errors in Emergency Department in Level III Hospital

    Directory of Open Access Journals (Sweden)

    Silvia González Gómez

    2012-09-01

    Full Text Available • Objective: To determine the prevalence of medication errors associated with the administration in the emergency room of University Hospital Marques de Valdecilla. • Introduction: Adverse events related to health care, are increasingly common, it is estimated that between 44000 and 98000 people served in U.S. hospitals die from adverse events related to health care. In 7000 these deaths are caused by medication errors. In Spain the studies speak of similar figures. The emergency services are excluded usually in these studies because of its particular characteristics, but also are well known that these are characteristics (speed of decision-making, not having systems in unit dose dispensing ... what is expected that mistakes can be produced in larger numbers in emergency services in the areas of Spain hospitalization. • Method: This is a descriptive study in which cross-examine a sample of 627 administrations made in different areas of attention of the Emergency Department Valdecilla Hospital, in different time slots, months of the year and days a week. Between the months of January and December 2009.• Results: Have detected 119 errors in 627 observations, the most common error is log.• Conclusions: We have found a lower incidence of error 2.7%, comparing with other work (10%. While most of the studies reviewed speak of medication errors in general, including prescription, transcription, and administration.

  2. Medication administration errors in an intensive care unit in Ethiopia

    OpenAIRE

    2012-01-01

    Background Medication administration errors in patient care have been shown to be frequent and serious. Such errors are particularly prevalent in highly technical specialties such as the intensive care unit (ICU). In Ethiopia, the prevalence of medication administration errors in the ICU is not studied. Objective To assess medication administration errors in the intensive care unit of Jimma University Specialized Hospital (JUSH), Southwest Ethiopia. Methods Prospective observation based cross...

  3. [Organisation of scientific and research work of Navy medical service].

    Science.gov (United States)

    Gavrilov, V V; Myznikov, I L; Kuz'minov, O V; Shmelev, S V; Oparin, M Iu

    2013-03-01

    The main issues of organization of scientific and research work of medical service in the North Fleet are considered in the present article. Analysis of some paragraphs of documents, regulating this work at army level is given. The authors give an example of successful experience of such work in the North Fleet, table some suggestions which allow to improve the administration of scientific and research work in the navy and also on the district scale.

  4. Medication wrong-route administrations in relation to medical prescriptions

    OpenAIRE

    GIMENES, Fernanda Raphael Escobar; Marques, Tatiane Cristina; Teixeira,Thalyta Cardoso Alux; MOTA, Maria Lurdemiler Sabóia; Silva,Ana Elisa Bauer de Camargo; Cassiani, Silvia Helena De Bortoli

    2011-01-01

    This study analyzes the influence of medical prescriptions' writing on the occurrence of medication errors in the medical wards of five Brazilian hospitals. This descriptive study used data obtained from a multicenter study conducted in 2005. The population was composed of 1,425 medication errors and the sample included 92 routes through which medication was wrongly administered. The pharmacological classes most frequently involved in errors were cardiovascular agents (31.5%), medication that...

  5. Work-Life Balance and Ideal Worker Expectations for Administrators

    Science.gov (United States)

    Wilk, Kelly E.

    2016-01-01

    This chapter explores the work-life experiences of administrators as well as whether and how the ideal worker model affects those experiences. Departmental and supervisory differences and technology complicate administrators' work-life experiences.

  6. Work-Life Balance and Ideal Worker Expectations for Administrators

    Science.gov (United States)

    Wilk, Kelly E.

    2016-01-01

    This chapter explores the work-life experiences of administrators as well as whether and how the ideal worker model affects those experiences. Departmental and supervisory differences and technology complicate administrators' work-life experiences.

  7. Medication Administration in the School Setting. Position Statement. Amended

    Science.gov (United States)

    Zacharski, Susan; Kain, Carole A.; Fleming, Robin; Pontius, Deborah

    2012-01-01

    It is the position of the National Association of School Nurses (NASN) that school districts develop written medication administration policies and procedures that focus on safe and efficient medication administration at school by a registered professional school nurse (hereinafter referred to as school nurse). Policies should include prescription…

  8. Medication administration in nursing homes: pharmacists' contribution to error prevention.

    Science.gov (United States)

    Verrue, Charlotte L; Mehuys, Els; Somers, Annemie; Van Maele, Georges; Remon, Jean Paul; Petrovic, Mirko

    2010-05-01

    The elderly use a large number of medications, which exposes them to an increased risk for medication-related errors, especially in nursing homes. The aim of this study was to investigate the impact of an educational session addressing good medication administration practices on the medication administration error rate in 2 nursing homes. A before-after study was performed, comparing outcome measurements 1 month before and 1 month after implementation of a formal training session on "good medication administration principles." Medication administration errors were detected using a direct observation method. Two experts (a geriatrician and a clinical pharmacist) scored the clinical relevance of these errors. The study was carried out between March 2007 and June 2007. In both nursing homes, the overall error rate (preparation errors and administration errors) decreased after the intervention. This decrease was significant both in nursing home 1 (P errors was rated highly likely to cause harm according to the experts. An educational session about good medication administration practices provided by a pharmacist is a very simple way to decrease medication administration error rates and to raise awareness on the possible clinical significance of the errors. Copyright (c) 2010 American Medical Directors Association. Published by Elsevier Inc. All rights reserved.

  9. Impacts of nurses’ circadian rhythm sleep disorders, fatigue, and depression on medication administration errors

    Directory of Open Access Journals (Sweden)

    Abdelbaset M. Saleh

    2014-01-01

    Conclusions: Medication administration errors, fatigue and depression were all significantly affected by circadian sleep disorders. An administration’s control of work flow to provide convenient sleep hours will help in improving sleep circadian rhythms and consequently minimize these problems.

  10. The afterlife for retiring deans and other senior medical administrators.

    Science.gov (United States)

    Tannen, Richard L

    2008-11-01

    Career options for individuals leaving the administrative role as dean of a school of medicine or other senior administrative positions are considered. Options discussed include retirement and a variety of other positions both within schools of medicines and in other venues. Many opportunities exist for a challenging and fulfilling career path after leaving the role as a senior administrator in an academic medical center.

  11. Medical social work positions: BSW or MSW?

    Science.gov (United States)

    Grant, Doris M; Toh, JoAnne S

    2017-04-01

    Acute care social work positions face budgetary scrutiny in the current climate of fiscal restraint in Canadian health care. Managers may be faced with the question of whether a new or vacant medical social work position should be filled by a BSW social worker or an MSW social worker. This question is further complicated when experienced and less costly BSW social workers are available while MSW social workers with medical or hospital experience may be limited in supply. This paper reviews the literature relevant to medical social work practice and hiring. A small scale survey was conducted with inter-professional managers responsible for the hiring of medical social workers. The purpose of this research was to examine the current hiring practices and considerations for hospital medical social workers.

  12. Administração de medicamentos injetáveis por via intramuscular: conhecimento dos ocupacionais de farmácias Administration of intramuscular injections medications: knowledge of occupationals working in pharmacies

    Directory of Open Access Journals (Sweden)

    Silvia Mara Rangel

    2000-06-01

    administration of diclofenac in pharmacies and it concluded that the lack of knowledge of this technique can be the causes of these complications. This current study objectives to identify and evaluate the level of knowledge of the professional that administer medications in pharmacies of Ribeirão Preto -SP. The study constituted in a survey, from a questionnaire with 20 open and closed questions, applied to a population constituted for occupational working in pharmacies, selected through the method of the sampling, resulting in a total of 41 pharmacies. It was concluded that the population is receiving medications from occupationals, without a specific formation and with deficit of knowledge regarding the technique. The subjects referred not to receive training to exercise that procedure, learning it with other employee or observing somebody that accomplishes it. It results knowledge gaps that can cause complications in the population that uses the services of those institutions.

  13. SWOT分析法在县级二甲医院医政管理工作中的应用%Application of SWOT analysis dimethy hospital in the county Medical Ad-ministration Management Work

    Institute of Scientific and Technical Information of China (English)

    郭红梅; 李中建

    2015-01-01

    目的:探讨SWOT分析法如何在县级二甲医院医政管理工作中的应用,为基层医院管理者更好地管理和发展医院提供有价值的参考。方法应用SWOT分析法对县级二甲医院自身的优势、劣势以及外界环境中可能存在的机会和威胁,进行仔细的分析,明确医院医政管理要求,以此为依据制定相应的发展战略。结果采用SWOT分析法对县级二甲医院进行了全面的分析和总结,以此为基础,制定出了有利于医院未来生存和发展的的医政管理策略,保证了医疗服务的可及性和公平性,尽可能达到卫生资源利用效率最大化,提高患者的健康水平。SWOT分析法是二甲医院医政管理中很实用的方法,值得借鉴和推广。结论该文应用SWOT分析法对医院的内部因素即自身的优势和劣势以及外部因素即外界环境中可能存在的机会和威胁进行全面的分析,依靠自身优势的同时利用外部存在的机会来弥补内部存在的劣势,规避外部的威胁。%Objective To explore how to apply the SWOT analysis dimethyl hospital in the county health administration and management work, provide a valuable reference for the primary hospital managers to better manage and develop hospital. Methods SWOT analysis of the opportunities and threats that may exist at the county level dimethyl hospital's own strengths, weaknesses and the external environment, careful analysis, clear Hospital Practice Management requirements, as a basis to develop appropriate development strategies, help hospitals better survival and development. Results SWOT analysis of the county dimethyl hospital conducted a comprehensive analysis and summary, as a basis to work out in favor of the fu-ture survival and development of the hospital's Medical Administrative management strategy to ensure the availability of medical services and fairness, as far as possible to maximize health resources utilization

  14. Nursing students and the supervision of medication administration.

    Science.gov (United States)

    Reid-Seari, Kerry; Happell, Brenda; Burke, Karena J; Gaskin, Cadeyrn J

    2013-01-01

    Up to one in five medication administrations in Australian hospitals involve an error. As registered nurses (RNs) are at the forefront of medication administration, they have been the focus of attempts to reduce errors. Given that nursing students have reported errors or experiences of near misses, their practices, as well as the supervision they receive from RNs, also deserves investigation. The aim of this study was to investigate student nurses' experiences of supervision while administering medications. Students (N= 45) completed a questionnaire on their supervision experiences while administering medications. The findings revealed that 88% of students agreed that they had been directly supervised during the entirety of administration procedures. Although 7% of students reported not receiving supervision throughout medication administration, higher percentages of students indicated that they received lower levels of supervision when wards were busy (66%), when they felt under pressure to comply with the wishes of RNs (40%), when students had been in clinical settings for extended periods of time (51%), and when the RNs trusted the student nurses (37%). Approximately one third (29%) of student nurses disagreed that RNs followed the six rights when administering medications. These findings suggest that student nurses are not always adequately supervised and are at times administering medications outside the parameters of the law. Healthcare organisations need to adapt their policies and practices to ensure that the legal requirements surrounding student nurse administration of medications are being met, as well as the educational and welfare needs of neophyte nurses.

  15. Two RFID-based solutions for secure inpatient medication administration.

    Science.gov (United States)

    Yen, Yi-Chung; Lo, Nai-Wei; Wu, Tzong-Chen

    2012-10-01

    Medication error can easily cause serious health damage to inpatients in hospital. Consequently, the whole society has to spend huge amount of extra resources for additional therapies and medication on those affected inpatients. In order to prevent medication errors, secure inpatient medication administration system is required in a hospital. Using RFID technology, such administration system provides automated medication verification for inpatient's medicine doses and generates corresponding medication evidence, which may be audited later for medical dispute. Recently, Peris-Lopez et al. (Int. J. Med. Inform., 2011) proposed an IS-RFID system to enhance inpatient medication safety. Nevertheless, IS-RFID system does not detect the denial of proof attack efficiently and the generated medication evidence cannot defend against counterfeit evidence generated from the hospital. That is, the hospital possesses enough privilege from the design of IS-RFID system to modify generated medication evidence whenever it is necessary. Hence, we design two lightweight RFID-based solutions for secure inpatient medication administration, one for online verification environment and the other for offline validation situation, to achieve system security on evidence generation and provide early detection on denial of proof attack.

  16. Use of administrative medical databases in population-based research.

    Science.gov (United States)

    Gavrielov-Yusim, Natalie; Friger, Michael

    2014-03-01

    Administrative medical databases are massive repositories of data collected in healthcare for various purposes. Such databases are maintained in hospitals, health maintenance organisations and health insurance organisations. Administrative databases may contain medical claims for reimbursement, records of health services, medical procedures, prescriptions, and diagnoses information. It is clear that such systems may provide a valuable variety of clinical and demographic information as well as an on-going process of data collection. In general, information gathering in these databases does not initially presume and is not planned for research purposes. Nonetheless, administrative databases may be used as a robust research tool. In this article, we address the subject of public health research that employs administrative data. We discuss the biases and the limitations of such research, as well as other important epidemiological and biostatistical key points specific to administrative database studies.

  17. Medication Administration: Measuring Associate Degree Nursing Student Knowledge

    Science.gov (United States)

    Crowell, Debra L.

    2016-01-01

    The American Nurse Association's (ANA) provisions outline the commitment expected of nurses to protect the community from harm. Medication administration coincides with patient safety as a compelling obligation in nursing practice. The study's purpose was to examine retention of medication safety knowledge among first year nursing students, after…

  18. Facilitators and Barriers to Safe Medication Administration to Hospital Inpatients: A Mixed Methods Study of Nurses' Medication Administration Processes and Systems (the MAPS Study.

    Directory of Open Access Journals (Sweden)

    Monsey McLeod

    Full Text Available Research has documented the problem of medication administration errors and their causes. However, little is known about how nurses administer medications safely or how existing systems facilitate or hinder medication administration; this represents a missed opportunity for implementation of practical, effective, and low-cost strategies to increase safety.To identify system factors that facilitate and/or hinder successful medication administration focused on three inter-related areas: nurse practices and workarounds, workflow, and interruptions and distractions.We used a mixed-methods ethnographic approach involving observational fieldwork, field notes, participant narratives, photographs, and spaghetti diagrams to identify system factors that facilitate and/or hinder successful medication administration in three inpatient wards, each from a different English NHS trust. We supplemented this with quantitative data on interruptions and distractions among other established medication safety measures.Overall, 43 nurses on 56 drug rounds were observed. We identified a median of 5.5 interruptions and 9.6 distractions per hour. We identified three interlinked themes that facilitated successful medication administration in some situations but which also acted as barriers in others: (1 system configurations and features, (2 behaviour types among nurses, and (3 patient interactions. Some system configurations and features acted as a physical constraint for parts of the drug round, however some system effects were partly dependent on nurses' inherent behaviour; we grouped these behaviours into 'task focused', and 'patient-interaction focused'. The former contributed to a more streamlined workflow with fewer interruptions while the latter seemed to empower patients to act as a defence barrier against medication errors by being: (1 an active resource of information, (2 a passive information resource, and/or (3 a 'double-checker'.We have identified practical

  19. "Arbeta som god man" - "Work as an administrator"

    OpenAIRE

    Carlsson, Lotta

    2006-01-01

    This study illustrates the task of the administrator where the main focus lies on getting understanding for the administrator’s work, showing how this is performed. The method I have used in the performance of the research is the qualitative method. This study was carried through by means of interviews. Theoretical starting points are exchange theories, friendship theories and part theories. I found that the administrator was pride over their work. Common for the administrator was they want t...

  20. Medication administration to the diabetic clients of the Helsinki Deaconess's institute nursing homes : Medication administration

    OpenAIRE

    2014-01-01

    Diabetic clients in nursing care homes are among the most vulnerable members of the society, as they depend on their care home staff for almost all of their entire needs. A combination of complex medical conditions may result in the need to take multiple medications with some taking up to eight medications on average. Medication system in nursing home passes through many steps before it actually reaches the client. This may result in an increase in medication error. The purpose of this st...

  1. [Administrative reform thinking on the regulations on the supervision and administration of medical devices].

    Science.gov (United States)

    Yue, Wei

    2014-09-01

    This paper learned and interpreted the regulations on the supervision and administration of medical devices, carded the thoughts of administrative reform, then put forward the "ten principles", including full supervision, classification supervision, risk classification, safety-effective-save, to encourage innovation, simplified license, scientific-standard, sincerity & self-discipline, clear responsibility, severe punishment, and discussed these priciples.

  2. The Impact of Bar Code Medication Administration Technology on Reported Medication Errors

    Science.gov (United States)

    Holecek, Andrea

    2011-01-01

    The use of bar-code medication administration technology is on the rise in acute care facilities in the United States. The technology is purported to decrease medication errors that occur at the point of administration. How significantly this technology affects actual rate and severity of error is unknown. This descriptive, longitudinal research…

  3. The Joy of Social Work Administration: An Exploratory Qualitative Study of Human Service Administrators' Positive Perceptions of Their Work

    Science.gov (United States)

    Watson, Larry D.; Hoefer, Richard A.

    2016-01-01

    Positive organizational psychology suggests that researchers should focus on the rewarding elements of work life, yet those in the fields of social work and nonprofit administration have not conducted research in line with this admonition. Indeed, the current focus on administrative challenges and problems may be part of the reason there is…

  4. The Joy of Social Work Administration: An Exploratory Qualitative Study of Human Service Administrators' Positive Perceptions of Their Work

    Science.gov (United States)

    Watson, Larry D.; Hoefer, Richard A.

    2016-01-01

    Positive organizational psychology suggests that researchers should focus on the rewarding elements of work life, yet those in the fields of social work and nonprofit administration have not conducted research in line with this admonition. Indeed, the current focus on administrative challenges and problems may be part of the reason there is…

  5. Administrative work consumes one-sixth of U.S. physicians' working hours and lowers their career satisfaction.

    Science.gov (United States)

    Woolhandler, Steffie; Himmelstein, David U

    2014-01-01

    Doctors often complain about the burden of administrative work, but few studies have quantified how much time clinicians devote to administrative tasks. We quantified the time U.S. physicians spent on administrative tasks, and its relationship to their career satisfaction, based on a nationally representative survey of 4,720 U.S. physicians working 20 or more hours per week in direct patient care. The average doctor spent 8.7 hours per week (16.6% of working hours) on administration. Psychiatrists spent the highest proportion of their time on administration (20.3%), followed by internists (17.3%) and family/general practitioners (17.3%). Pediatricians spent the least amount of time, 6.7 hours per week or 14.1 percent of professional time. Doctors in large practices, those in practices owned by a hospital, and those with financial incentives to reduce services spent more time on administration. More extensive use of electronic medical records was associated with a greater administrative burden. Doctors spending more time on administration had lower career satisfaction, even after controlling for income and other factors. Current trends in U.S. health policy--a shift to employment in large practices, the implementation of electronic medical records, and the increasing prevalence of financial risk sharing--are likely to increase doctors' paperwork burdens and may decrease their career satisfaction.

  6. Assessment of the Nurse Medication Administration Workflow Process

    Directory of Open Access Journals (Sweden)

    Nathan Huynh

    2016-01-01

    Full Text Available This paper presents findings of an observational study of the Registered Nurse (RN Medication Administration Process (MAP conducted on two comparable medical units in a large urban tertiary care medical center in Columbia, South Carolina. A total of 305 individual MAP observations were recorded over a 6-week period with an average of 5 MAP observations per RN participant for both clinical units. A key MAP variation was identified in terms of unbundled versus bundled MAP performance. In the unbundled workflow, an RN engages in the MAP by performing only MAP tasks during a care episode. In the bundled workflow, an RN completes medication administration along with other patient care responsibilities during the care episode. Using a discrete-event simulation model, this paper addresses the difference between unbundled and bundled workflow and their effects on simulated redesign interventions.

  7. Assessment of the Nurse Medication Administration Workflow Process

    Science.gov (United States)

    Snyder, Rita; Vidal, José M.; Sharif, Omor; Cai, Bo; Parsons, Bridgette; Bennett, Kevin

    2016-01-01

    This paper presents findings of an observational study of the Registered Nurse (RN) Medication Administration Process (MAP) conducted on two comparable medical units in a large urban tertiary care medical center in Columbia, South Carolina. A total of 305 individual MAP observations were recorded over a 6-week period with an average of 5 MAP observations per RN participant for both clinical units. A key MAP variation was identified in terms of unbundled versus bundled MAP performance. In the unbundled workflow, an RN engages in the MAP by performing only MAP tasks during a care episode. In the bundled workflow, an RN completes medication administration along with other patient care responsibilities during the care episode. Using a discrete-event simulation model, this paper addresses the difference between unbundled and bundled workflow and their effects on simulated redesign interventions.

  8. Frequency of pediatric medication administration errors and contributing factors.

    Science.gov (United States)

    Ozkan, Suzan; Kocaman, Gulseren; Ozturk, Candan; Seren, Seyda

    2011-01-01

    This study examined the frequency of pediatric medication administration errors and contributing factors. This research used the undisguised observation method and Critical Incident Technique. Errors and contributing factors were classified through the Organizational Accident Model. Errors were made in 36.5% of the 2344 doses that were observed. The most frequent errors were those associated with administration at the wrong time. According to the results of this study, errors arise from problems within the system.

  9. 20 CFR 404.1591 - If your medical recovery was expected and you returned to work.

    Science.gov (United States)

    2010-04-01

    ... returned to work. 404.1591 Section 404.1591 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD... Stopping Disability § 404.1591 If your medical recovery was expected and you returned to work. If your impairment was expected to improve and you returned to full-time work with no significant medical...

  10. Social Work Values in Human Services Administration: Implications for Social Work Education

    Science.gov (United States)

    Watson, Larry D.; Hoefer, Richard

    2014-01-01

    The perceived wisdom in the social work education community, based on empirical research from the 1990s and the early part of this century, says that the master of social work (MSW) degree is not competitive with the master of business administration or the master of public administration to obtain top-level administration jobs in nonprofit…

  11. A medical social work perspective on rehabilitation.

    Science.gov (United States)

    Fugl-Meyer, Kerstin Sjögren

    2016-10-12

    This paper introduces a biopsychosocial model for use as a tool by medical social workers and other rehabilitation professionals for the descriptive analysis of the case history and follow-up of patients needing rehabilitative support. The model is based on action theory and emphasizes the demands on evidence-based clarification of the interplay between a subject's contextual life situation, their ability to act in order to realize their goals, and their emotional adaptation. Using clinical experience and literature searches, a standard operations procedure to adequately document the case history in clinical practice is suggested, thus providing strategies through which the work of medical social workers can be based on evidence. Some specific areas of concern for the medical social worker within the rehabilitation of disabled people are highlighted.

  12. Factors influencing paediatric nurses' responses to medication administration

    NARCIS (Netherlands)

    Davis, Leigh; Ware, Robert S.; McCann, Damhnat; Keogh, Samantha; Watson, Karen

    2010-01-01

    Objective To evaluate the importance of contextual and policy factors on nurses' judgement about medication administration practice. Design A questionnaire survey of responses to a number of factorial vignettes in June 2004. These vignettes considered a combination of seven contextual and policy fac

  13. Medical safety in boxing: administrative, ethical, legislative, and legal considerations.

    Science.gov (United States)

    Schwartz, Michael B

    2009-10-01

    The roles and responsibilities of the ringside physician are complex and have evolved into a unique specialty in sport medicine. In addition to the medical aspects of ringside medicine, the doctor is now responsible for many administrative, ethical, and legal considerations. This article reviews and details the numerous roles the ringside physician plays in the sport of boxing.

  14. Appropriateness of administration of nasogastric medication and preliminary intervention

    Directory of Open Access Journals (Sweden)

    Zhou Q

    2012-11-01

    pharmacists with the entire responsibility for knowledge and decision-making concerning route of drug administration. After a 3-month preliminary intervention, irrational medical orders involving nasogastric administration of medications in group 1 were successfully abolished. The rate of answering correctly as to whether medications in group 1 could be crushed or opened increased to 100%. This utilization study indicates poor awareness concerning nasogastric administration of medication on the part of physicians and nurses, and preliminary intervention measures were efficient in improving knowledge through team cooperation and effort.Keywords: nasogastric tube, rational drug use, drug administration routes, drug absorption, pharmaceutical preparations, nursing

  15. Systematic literature review of hospital medication administration errors in children

    Directory of Open Access Journals (Sweden)

    Ameer A

    2015-11-01

    Full Text Available Ahmed Ameer,1 Soraya Dhillon,1 Mark J Peters,2 Maisoon Ghaleb11Department of Pharmacy, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK; 2Paediatric Intensive Care Unit, Great Ormond Street Hospital, London, UK Objective: Medication administration is the last step in the medication process. It can act as a safety net to prevent unintended harm to patients if detected. However, medication administration errors (MAEs during this process have been documented and thought to be preventable. In pediatric medicine, doses are usually administered based on the child's weight or body surface area. This in turn increases the risk of drug miscalculations and therefore MAEs. The aim of this review is to report MAEs occurring in pediatric inpatients. Methods: Twelve bibliographic databases were searched for studies published between January 2000 and February 2015 using “medication administration errors”, “hospital”, and “children” related terminologies. Handsearching of relevant publications was also carried out. A second reviewer screened articles for eligibility and quality in accordance with the inclusion/exclusion criteria. Key findings: A total of 44 studies were systematically reviewed. MAEs were generally defined as a deviation of dose given from that prescribed; this included omitted doses and administration at the wrong time. Hospital MAEs in children accounted for a mean of 50% of all reported medication error reports (n=12,588. It was also identified in a mean of 29% of doses observed (n=8,894. The most prevalent type of MAEs related to preparation, infusion rate, dose, and time. This review has identified five types of interventions to reduce hospital MAEs in children: barcode medicine administration, electronic prescribing, education, use of smart pumps, and standard concentration. Conclusion: This review has identified a wide variation in the prevalence of hospital MAEs in children. This is attributed to

  16. The Netherlands: Working conditions in central public administration

    NARCIS (Netherlands)

    Dhondt, S.

    2013-01-01

    This report deals with the development of working conditions for employees working in Central Public Administration in The Netherlands. Contrary to many countries, the distinction between public and private employees is very small. The main changes in the situation for public employees are a further

  17. Medication Administration and Knowledge Retention in Baccalaureate Nursing Students

    Directory of Open Access Journals (Sweden)

    Pamela Treister

    2016-12-01

    Full Text Available A quality improvement project was undertaken in order to assist the undergraduate baccalaureate nursing students in knowledge retention for medication administration during their senior semester in nursing school. Two specific changes in curriculum were implemented in order to assist these undergraduate baccalaureate nursing students at a suburban private university in New York. Simulation and the incorporation of competency by rubrics were implemented in the spring semester of junior year, which led to an increased knowledge retention during the fall semester of the senior year. This article discusses the advantages and challenges of using technology, how change occurred in the junior year semester and the effects it had on the senior nursing student's retention of medication administration knowledge.

  18. [Work environment assessment at a medical school].

    Science.gov (United States)

    Sánchez D, Ignacio; Airola G, Gregorio; Cayazzo A, Tatiana; Pedrals G, Nuria; Rodríguez M, Magdalena; Villarroel D, Luis

    2009-11-01

    The work environment of an organization has to do with a set of permanent qualities that are experienced by its members. To assess the work environment perception of faculty members of a Medical School in two different periods (2005 and 2007). A standardized survey was applied to faculty members and Department chairs of the academic units of our Medical School. The survey used the Likert scale from 1 to 5 and included 59 items, distributed in 8 factors. Additionally, there were two groups of statements, indicating the priorities for the School and for the academic departments. In the study performed in year 2005, the survey was answered by a total of 399 faculty members (68%) and in year 2007, it was answered by 408 members (68%). The global climate perceptions were 66% and 68% in 2005 and 2007, respectively (ns). Among the dimensions evaluated, communications (p =0,62) and physical conditions (p =0,008) improved in the two years period. The applied instrument was stable and useful to knowing the requirements of the faculty members and for improving the organizational climate.

  19. Development and assessment of learning objects about intramuscular medication administration

    OpenAIRE

    Lilian Mayumi Chinen Tamashiro; Heloisa Helena Ciqueto Peres

    2014-01-01

    OBJECTIVES: to develop and assess a learning object about intramuscular medication administration for nursing undergraduates and nurses. METHOD: a random, intentional and non-probabilistic sample was selected of nurses from a Brazilian social network of nursing and students from the Undergraduate Program at the University of São Paulo School of Nursing to serve as research subjects and assess the object. RESULTS: the participants, 8 nurses and 8 students, studied the object and answered an as...

  20. Early versus late misoprostol administration after mifepristone for medical abortion.

    Science.gov (United States)

    Tendler, Rene; Bornstein, Jacob; Kais, Mohamad; Masri, Irina; Odeh, Marwan

    2015-11-01

    To evaluate the successful medical termination of pregnancy comparing two regimens: misoprostol 2 or 48 h after mifepristone administration. Prospective randomized study. Department of Obstetrics and Gynecology. One hundred pregnant women admitted for medical termination of pregnancy were enrolled; no pregnancies were over 55 days gestational age. All subjects were randomly assigned for misoprostol administration either 2 or 48 h after mifepristone. All participants underwent transvaginal ultrasound examination for uterine contents 48 h and 3 weeks after mifepristone. Procedure failure, defined as the presence of fetal heart activity, presence of a gestational sac, or a need for uterine curettage after misoprostol administration. Each group consisted of 50 women. Fetal heart activity was significantly more frequent after 48 h in the 2-h interval group (10/50) than in the 48-h interval group (0/50) (p = 0.002). Three weeks after misoprostol administration, fetal heart activity was present in 4/50 (8 %) in the 2-h interval group (p = 0.118) and none of the 48-h interval group. At 48 h residual tissue was present in 13/50 (26 %) and 5/50 (10 %) in the 2 and 48-h interval groups, respectively (p = 0.031); this was reduced to 12/50 (24 %) compared to 5/50 (10 %) in the two groups, respectively (p = 0.054) after 3 weeks. Successful medical termination of pregnancy can be achieved using misoprostol administration 2 h after mifepristone in 76 % of cases. However, this regimen is not recommended as it is significantly inferior to the traditional 48-h interval regimen.

  1. Reflecting on the ethical administration of computerized medical records

    Science.gov (United States)

    Collmann, Jeff R.

    1995-05-01

    This presentation examines the ethical issues raised by computerized image management and communication systems (IMAC), the ethical principals that should guide development of policies, procedures and practices for IMACS systems, and who should be involved in developing a hospital's approach to these issues. The ready access of computerized records creates special hazards of which hospitals must beware. Hospitals must maintain confidentiality of patient's records while making records available to authorized users as efficiently as possible. The general conditions of contemporary health care undermine protecting the confidentiality of patient record. Patients may not provide health care institutions with information about themselves under conditions of informed consent. The field of information science must design sophisticated systems of computer security that stratify access, create audit trails on data changes and system use, safeguard patient data from corruption, and protect the databases from outside invasion. Radiology professionals must both work with information science experts in their own hospitals to create institutional safeguards and include the adequacy of security measures as a criterion for evaluating PACS systems. New policies and procedures on maintaining computerized patient records must be developed that obligate all members of the health care staff, not just care givers. Patients must be informed about the existence of computerized medical records, the rules and practices that govern their dissemination and given the opportunity to give or withhold consent for their use. Departmental and hospital policies on confidentiality should be reviewed to determine if revisions are necessary to manage computer-based records. Well developed discussions of the ethical principles and administrative policies on confidentiality and informed consent and of the risks posed by computer-based patient records systems should be included in initial and continuing

  2. Medication administration errors in nursing homes using an automated medication dispensing system.

    Science.gov (United States)

    van den Bemt, Patricia M L A; Idzinga, Jetske C; Robertz, Hans; Kormelink, Dennis Groot; Pels, Neske

    2009-01-01

    OBJECTIVE To identify the frequency of medication administration errors as well as their potential risk factors in nursing homes using a distribution robot. DESIGN The study was a prospective, observational study conducted within three nursing homes in the Netherlands caring for 180 individuals. MEASUREMENTS Medication errors were measured using the disguised observation technique. Types of medication errors were described. The correlation between several potential risk factors and the occurrence of medication errors was studied to identify potential causes for the errors. RESULTS In total 2,025 medication administrations to 127 clients were observed. In these administrations 428 errors were observed (21.2%). The most frequently occurring types of errors were use of wrong administration techniques (especially incorrect crushing of medication and not supervising the intake of medication) and wrong time errors (administering the medication at least 1 h early or late).The potential risk factors female gender (odds ratio (OR) 1.39; 95% confidence interval (CI) 1.05-1.83), ATC medication class antibiotics (OR 11.11; 95% CI 2.66-46.50), medication crushed (OR 7.83; 95% CI 5.40-11.36), number of dosages/day/client (OR 1.03; 95% CI 1.01-1.05), nursing home 2 (OR 3.97; 95% CI 2.86-5.50), medication not supplied by distribution robot (OR 2.92; 95% CI 2.04-4.18), time classes "7-10 am" (OR 2.28; 95% CI 1.50-3.47) and "10 am-2 pm" (OR 1.96; 1.18-3.27) and day of the week "Wednesday" (OR 1.46; 95% CI 1.03-2.07) are associated with a higher risk of administration errors. CONCLUSIONS Medication administration in nursing homes is prone to many errors. This study indicates that the handling of the medication after removing it from the robot packaging may contribute to this high error frequency, which may be reduced by training of nurse attendants, by automated clinical decision support and by measures to reduce workload.

  3. Medication error report: Intrathecal administration of labetalol during obstetric anesthesia

    Directory of Open Access Journals (Sweden)

    Baisakhi Laha

    2015-01-01

    Full Text Available Labetalol, a combined alfa and beta-adrenergic receptor antagonist, is used as an antihypertensive drug. We report a case of an acute rise in blood pressure and lower limb pain due to the inadvertent intrathecal administration of labetalol, mistaking it for bupivacaine, during obstetric anesthesia. The situation was rescued by converting to general anesthesia. The cesarean delivery was uneventful, and mother as well as newborn child showed no ill-effect. This particular medication error was attributable to a failure on the part of the doctors administering the injection to read and cross-check medication labels and the practice of keeping multiple injections together. In the absence of an organized medication error reporting system and action on that basis, such events may recur in future.

  4. PS-022 Complex automated medication systems reduce medication administration error rates in an acute medical ward

    DEFF Research Database (Denmark)

    Risør, Bettina Wulff; Lisby, Marianne; Sørensen, Jan

    2017-01-01

    Background Medication errors have received extensive attention in recent decades and are of significant concern to healthcare organisations globally. Medication errors occur frequently, and adverse events associated with medications are one of the largest causes of harm to hospitalised patients....... Reviews have suggested that up to 50% of the adverse events in the medication process may be preventable. Thus the medication process is an important means to improve safety. Purpose The objective of this study was to evaluate the effectiveness of two automated medication systems in reducing...... the medication administration error rate in comparison with current practice. Material and methods This was a controlled before and after study with follow-up after 7 and 14 months. The study was conducted in two acute medical hospital wards. Two automated medication systems were tested: (1) automated dispensing...

  5. Work stress in emergency medical technicians.

    Science.gov (United States)

    Neale, A V

    1991-09-01

    To better understand the dynamics underlying their high turnover rate, emergency medical technicians (EMTs) were asked to participate in a union-sponsored study. Fifty-two percent of 200 EMT union members returned the three mailed questionnaires: the Occupational Stress Index, which assesses stress, strain, and coping; the Staff Burnout Scale for Health Professionals; and a survey that probed areas of job satisfaction. The sample had high stress, strain, and burnout scores. Coping skills were within the normal range. Burnout, stress, strain, and coping (BSS&C) were significantly related to job satisfaction, worry about infectious diseases, and perceptions of being poorly treated by emergency room personnel and fire fighters. BSS&C also were related to being upset by "runs" related to injuries from violence, drug overdoses, and exposure. Job dissatisfaction was related to attitudes that the job adversely affects one's family, that the EMT quarters are uncomfortable, and that administrators are not knowledgeable of the job demands and skills of EMTs. Areas of great discontent were the low salary of the profession and the inadequacy of the equipment.

  6. Retrospective Analysis of Opioid Medication Incidents Requiring Administration of Naloxone

    Science.gov (United States)

    Neil, Katherine; Marcil, Allison; Kosar, Lynette; Dumont, Zack; Ruda, Lisa; McMillan, Kaitlyn

    2013-01-01

    Background: Opioid analgesics are high-alert medications known to cause adverse drug events. Objectives: The purpose of this study was to determine the cause of opioid incidents requiring administration of naloxone, an opioid reversal agent. The specific objectives were to determine the number of opioid incidents and the proportion of incidents documented through occurrence reporting and to characterize the incidents by phase in the medication-use process, by type of incident, and by drug responsible for toxic effects. Methods: A retrospective chart analysis was conducted using records from 2 acute care centres in the Regina Qu’Appelle Health Region. The study included inpatients who received naloxone for reversal of opioid toxicity resulting from licit, in-hospital opioid use. Cases were classified as preventable or nonpreventable. Preventable cases were analyzed to determine the phase of the medication-use process during which the incident occurred. These cases were also grouped thematically by the type of incident. The drug most likely responsible for opioid toxicity was determined for each case. The proportion of cases documented by occurrence reporting was also noted. Results: Thirty-six cases involving administration of naloxone were identified, of which 29 (81%) were deemed preventable. Of these 29 preventable cases, the primary medication incident occurred most frequently in the prescribing phase (23 [79%]), but multiple phases were often involved. The cases were grouped into 6 themes according to the type of incident. Morphine was the drug that most frequently resulted in toxic effects (18 cases [50%]). Only two of the cases (5.6%) were documented by occurrence reports. Conclusion: Preventable opioid incidents occurred in the acute care centres under study. A combination of medication safety initiatives involving multiple disciplines may be required to decrease the incidence of these events and to better document their occurrence. PMID:24159230

  7. Administrative Circular No. 23 (Rev. 4) - Special working hours

    CERN Multimedia

    Department Head Office - HR Department

    2016-01-01

    Administrative Circular No. 23 (Rev. 4) entitled "Special working hours", approved by the Director-General following discussion in the Standing Concertation Committee meeting on 22 March 2016, will be available on 1st September 2016 via the following link: https://cds.cern.ch/record/2208539.   This revised circular cancels and replaces Administrative Circular No. 23 (Rev. 3) also entitled "Special working hours" of January 2013. This document contains modifications to reflect the new career structure and ensuring the provision consistent with practice that compensation or remuneration of special working hours performed remotely is possible only in case of emergency.   This circular will enter into force on 1st September 2016.

  8. 20 CFR 416.991 - If your medical recovery was expected and you returned to work.

    Science.gov (United States)

    2010-04-01

    ... returned to work. 416.991 Section 416.991 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL... Stopping Disability Or Blindness § 416.991 If your medical recovery was expected and you returned to work. If your impairment was expected to improve and you returned to full-time work with no...

  9. Medication administration errors for older people in long-term residential care

    OpenAIRE

    2011-01-01

    Abstract Background Older people in long-term residential care are at increased risk of medication prescribing and administration errors. The main aim of this study was to measure the incidence of medication administration errors in nursing and residential homes using a barcode medication administration (BCMA) system. Methods A prospective study was conducted in 13 care homes (9 residential and 4 nursing). Data on all medication administrations for a cohort of 345 older residents were recorde...

  10. Challenges implementing bar-coded medication administration in the emergency room in comparison to medical surgical units.

    Science.gov (United States)

    Glover, Nancy

    2013-03-01

    Bar-coded medication administration has been successfully implemented and utilized to decrease medication errors at a number of hospitals in recent years. The purpose of this article was to discuss the varying success in utilization of bar-coded medication administration on medical-surgical units and in the emergency department. Utilization reports were analyzed to better understand the challenges between the units. Many factors negatively impacted utilization in the emergency department, including the inability to use bar-coded medication administration for verbal orders or to document medications distributed by the prescribing providers, unique aspects of emergency department nursing workflow, additional steps to chart when using bar-coded medication administration, and alert fatigue. Hardware problems affected all users. Bar-coded medication administration in its current form is more suitable for use on medical-surgical floors than in the emergency department. New solutions should be developed for bar-coded medication administration in the emergency department, keeping in mind requirements to chart medications when there is no order in the system, document medications distributed by prescribing providers, adapt to unpredictable nursing workflow, minimize steps to chart with bar-coded medication administration, limit alerts to those that are clinically meaningful, and choose reliable hardware with adequate bar-code scanning capability.

  11. Nursing delegation and medication administration in assisted living.

    Science.gov (United States)

    Mitty, Ethel; Resnick, Barbara; Allen, Josh; Bakerjian, Debra; Hertz, Judith; Gardner, Wendi; Rapp, Mary Pat; Reinhard, Susan; Young, Heather; Mezey, Mathy

    2010-01-01

    Assisted living (AL) residences are residential long-term care settings that provide housing, 24-hour oversight, personal care services, health-related services, or a combination of these on an as-needed basis. Most residents require some assistance with activities of daily living and instrumental activities of daily living, such as medication management. A resident plan of care (ie, service agreement) is developed to address the health and psychosocial needs of the resident. The amount and type of care provided, and the individual who provides that care, vary on the basis of state regulations and what services are provided within the facility. Some states require that an RN hold a leadership position to oversee medication management and other aspects of care within the facility. A licensed practical nurse/licensed vocational nurse can supervise the day-to-day direct care within the facility. The majority of direct care in AL settings is provided by direct care workers (DCWs), including certified nursing assistants or unlicensed providers. The scope of practice of a DCW varies by state and the legal structure within that state. In some states, the DCW is exempt from the nurse practice act, and in some states, the DCW may practice within a specific scope such as being a medication aide. In most states, however, the DCW scope of practice is conscribed, in part, by the delegation of responsibilities (such as medication administration) by a supervising RN. The issue of RN delegation has become the subject of ongoing discussion for AL residents, facilities, and regulators and for the nursing profession. The purpose of this article is to review delegation in AL and to provide recommendations for future practice and research in this area.

  12. [Ways to optimize working conditions of medical personnel servicing modern hi-tech medical equipment].

    Science.gov (United States)

    Kravchenko, O K

    2007-01-01

    The author analyzed health state of medical personnel through various parameters. Hygienic characteristics of work conditions for medical personnel subjected to physical factors when servicing modern hi-tech medical equipment are presented. Occupational groups at high risk are defined. The article covers main directions in improving work conditions and preserving health for medical personnel in these groups.

  13. The Impact of the work of Daniel KAHNEMAN in administration

    Directory of Open Access Journals (Sweden)

    Tomás Chahin

    2016-06-01

    Full Text Available The study of decision-making has expanded empirical knowledge on the subject through research and studies that have offered explanations to many of the questions that are usually made. One of those questions had to do with whether the decision of the executive was only arational type, or there was also some intuition and emotion when deciding.The aim of this work is to consider the contributions madeby Daniel Kahneman and several of his collaborators, especially those related to administration, in order to start findingpossible  answers to the above mentioned question.The development of the proposed topic is analysed through the available literature on Daniel Kahneman and colleagues’ thinking. Different pieces of work that integrate their ideas, highlighting those thatspecially impact on Administration are mentioned.As a result of this work we see the relationship thatnaturally exists between what Kahneman called System 1 (intuitive and System 2 (rational, exposing the errors and biases of quick thinking and influence of the intuitive on our thinking and behavior.Key Words: Daniel Kahneman, Decision-making, Biases of thought. 

  14. The use of narratives in medical work

    DEFF Research Database (Denmark)

    Mønsted, Troels; Reddy, Madhu; Bansler, Jørgen P.

    2011-01-01

    Medical reasoning involves more than just summarizing clinical data and guidelines. Illness trajectories of chronic patients are often long, complex and full of uncertain information that requires interpretation. Understanding the complex interrelations is an important aspect of medical reasoning...... that displays narrative rather than scientific characteristics. While the qualities of the medical record as a repository of information or as a coordinative tool are well known, the role it plays in the unfolding of narratives in medical reasoning is less discussed. This paper examines this issue through...... a case study of patient consultations that take place as part of a distributed treatment of chronic heart patients. We found that the record, even though fragmented and to some extent incomplete, enables the physician to construct an ad hoc narrative. During the actual consultation, physicians...

  15. Cooperative epistemic work in medical practice

    DEFF Research Database (Denmark)

    Bansler, Jørgen P.; Havn, Erling Carl; Schmidt, Kjeld;

    2016-01-01

    ’ clinical notes form the core of the medical record. They serve both as a ‘tool for thinking’ for the individual physician, enabling him or her to make sense of the patient’s past history and current condition, and as a coordinative artifact used by physicians, nurses, and other health care professionals......We examine an important part of the medical record that has not been studied extensively: physicians’ clinical notes. These notes constitute an explanatory medical narrative that documents the patient’s illness trajectory by combining each physician’s notes into a common text. Although several...... prior CSCW studies have addressed the role of the medical record in patient care, they have not dealt specifically with the role, structure, and content of these notes. In this article, we present a detailed analysis of a set of physicians’ clinical notes recording the acute hospitalization...

  16. Organizational culture, continuous quality improvement, and medication administration error reporting.

    Science.gov (United States)

    Wakefield, B J; Blegen, M A; Uden-Holman, T; Vaughn, T; Chrischilles, E; Wakefield, D S

    2001-01-01

    This study explores the relationships among measures of nurses' perceptions of organizational culture, continuous quality improvement (CQI) implementation, and medication administration error (MAE) reporting. Hospital-based nurses were surveyed using measures of organizational culture and CQI implementation. These data were combined with previously collected data on perceptions of MAE reporting. A group-oriented culture had a significant positive correlation with CQI implementation, whereas hierarchical and rational culture types were negatively correlated with CQI implementation. Higher barriers to reporting MAE were associated with lower perceived reporting rates. A group-oriented culture and a greater extent of CQI implementation were positively (but not significantly) associated with the estimated overall percentage of MAEs reported. We conclude that health care organizations have implemented CQI programs, yet barriers remain relative to MAE reporting. There is a need to assess the reliability, validity, and completeness of key quality assessment and risk management data.

  17. Workarounds to Barcode Medication Administration Systems: Their Occurrences, Causes, and Threats to Patient Safety

    OpenAIRE

    Koppel, Ross; Wetterneck, Tosha; Telles, Joel Leon; Karsh, Ben-Tzion

    2008-01-01

    The authors develop a typology of clinicians' workarounds when using barcoded medication administration (BCMA) systems. Authors then identify the causes and possible consequences of each workaround. The BCMAs usually consist of handheld devices for scanning machine-readable barcodes on patients and medications. They also interface with electronic medication administration records. Ideally, BCMAs help confirm the five “rights” of medication administration: right patient, drug, dose, route, and...

  18. Cooperative epistemic work in medical practice

    DEFF Research Database (Denmark)

    Bansler, Jørgen P.; Havn, Erling Carl; Schmidt, Kjeld

    2016-01-01

    prior CSCW studies have addressed the role of the medical record in patient care, they have not dealt specifically with the role, structure, and content of these notes. In this article, we present a detailed analysis of a set of physicians’ clinical notes recording the acute hospitalization......’ clinical notes form the core of the medical record. They serve both as a ‘tool for thinking’ for the individual physician, enabling him or her to make sense of the patient’s past history and current condition, and as a coordinative artifact used by physicians, nurses, and other health care professionals...

  19. Why are some medical specialists working part-time, while others work full-time?

    NARCIS (Netherlands)

    Jong, Judith D. de; Heiligers, Phil; Groenewegen, Peter P.; Hingstman, Lammert

    2006-01-01

    Although medical specialists primarily work full-time, part-time work is on the increase, a trend that can be found worldwide. This article seeks to answer the question why some medical specialists work part-time, while others do not although they are willing to work part-time. Two approaches are

  20. Medication administration errors for older people in long-term residential care

    Directory of Open Access Journals (Sweden)

    Szczepura Ala

    2011-12-01

    Full Text Available Abstract Background Older people in long-term residential care are at increased risk of medication prescribing and administration errors. The main aim of this study was to measure the incidence of medication administration errors in nursing and residential homes using a barcode medication administration (BCMA system. Methods A prospective study was conducted in 13 care homes (9 residential and 4 nursing. Data on all medication administrations for a cohort of 345 older residents were recorded in real-time using a disguised observation technique. Every attempt by social care and nursing staff to administer medication over a 3-month observation period was analysed using BCMA records to determine the incidence and types of potential medication administration errors (MAEs and whether errors were averted. Error classifications included attempts to administer medication at the wrong time, to the wrong person or discontinued medication. Further analysis compared data for residential and nursing homes. In addition, staff were surveyed prior to BCMA system implementation to assess their awareness of administration errors. Results A total of 188,249 medication administration attempts were analysed using BCMA data. Typically each resident was receiving nine different drugs and was exposed to 206 medication administration episodes every month. During the observation period, 2,289 potential MAEs were recorded for the 345 residents; 90% of residents were exposed to at least one error. The most common (n = 1,021, 45% of errors was attempting to give medication at the wrong time. Over the 3-month observation period, half (52% of residents were exposed to a serious error such as attempting to give medication to the wrong resident. Error incidence rates were 1.43 as high (95% CI 1.32-1.56 p Conclusions The incidence of medication administration errors is high in long-term residential care. A barcode medication administration system can capture medication

  1. Family Perceptions of Medication Administration at School: Errors, Risk Factors, and Consequences

    Science.gov (United States)

    Clay, Daniel; Farris, Karen; McCarthy, Ann Marie; Kelly, Michael W.; Howarth, Robyn

    2008-01-01

    Medications are administered every day in schools across the country. Researchers and clinicians have studied school nurses' and educators' experiences with medication administration, but not the experiences of children or their parents. This study examined medication administration from the child and parent perspectives to (a) determine problems…

  2. Development and assessment of learning objects about intramuscular medication administration

    Directory of Open Access Journals (Sweden)

    Lilian Mayumi Chinen Tamashiro

    2014-10-01

    Full Text Available OBJECTIVES: to develop and assess a learning object about intramuscular medication administration for nursing undergraduates and nurses.METHOD: a random, intentional and non-probabilistic sample was selected of nurses from a Brazilian social network of nursing and students from the Undergraduate Program at the University of São Paulo School of Nursing to serve as research subjects and assess the object.RESULTS: the participants, 8 nurses and 8 students, studied the object and answered an assessment instrument that included the following criteria: educational aspects (relevance of the theme, objectives and texts/hypertexts, interface of the environment (navigation, accessibility and screen design and didactic resources (interactivity and presentation of resources. In total, 128 significant answers were obtained, 124 (97% of which were positive, assessed as excellent and satisfactory, considered as a flexible, dynamic, objective resources that is appropriate to the nursing learning process.CONCLUSION: the educational technology shows a clear and easily understandable language and the teaching method could be applied in other themes, contributing to the education and training of nursing professionals, positively affecting nursing teaching, stimulating the knowledge, autonomous and independent learning, aligned with the new professional education requirements.

  3. 76 FR 43689 - Draft Guidance for Industry and Food and Drug Administration Staff; Mobile Medical Applications...

    Science.gov (United States)

    2011-07-21

    ... HUMAN SERVICES Food and Drug Administration Draft Guidance for Industry and Food and Drug Administration Staff; Mobile Medical Applications; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is announcing the availability of the...

  4. 78 FR 59038 - Mobile Medical Applications; Guidance for Industry and Food and Drug Administration Staff...

    Science.gov (United States)

    2013-09-25

    ... HUMAN SERVICES Food and Drug Administration Mobile Medical Applications; Guidance for Industry and Food and Drug Administration Staff; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is announcing the availability of the guidance...

  5. Discrete event simulation of administrative and medical processes: Diskretna dogodkovna simulacija administrativnih in medicinskih postopkov:

    OpenAIRE

    Accetto, Rok; Baggia, Alenka; Lazarevič, Zlatko; Leskovar, Robert; Požun, Peter; Vukovič, Goran

    2011-01-01

    Background: Medical processes are often obstructed by administrative ones. Themain issue in administrative processes is uneven workload resulting in an increased possibility of human errors. The system approach assures that medical and administrative processes are integrated. According to research reports and best practices, discrete event simulation is a proper method to implement the system approach. Methods: A detailed analysis of the administrative processes was performed using interviews...

  6. Physical working principles of medical radar.

    Science.gov (United States)

    Aardal, Øyvind; Paichard, Yoann; Brovoll, Sverre; Berger, Tor; Lande, Tor Sverre; Hamran, Svein-Erik

    2013-04-01

    There has been research interest in using radar for contactless measurements of the human heartbeat for several years. While many systems have been demonstrated, not much attention have been given to the actual physical causes of why this work. The consensus seems to be that the radar senses small body movements correlated with heartbeats, but whether only the movements of the body surface or reflections from internal organs are also monitored have not been answered definitely. There has recently been proposed another theory that blood perfusion in the skin could be the main reason radars are able to detect heartbeats. In this paper, an experimental approach is given to determine the physical causes. The measurement results show that it is the body surface reflections that dominate radar measurements of human heartbeats.

  7. Expanded Medical Home Model Works for Children in Foster Care

    Science.gov (United States)

    Jaudes, Paula Kienberger; Champagne, Vince; Harden, Allen; Masterson, James; Bilaver, Lucy A.

    2012-01-01

    The Illinois Child Welfare Department implemented a statewide health care system to ensure that children in foster care obtain quality health care by providing each child with a medical home. This study demonstrates that the Medical Home model works for children in foster care providing better health outcomes in higher immunization rates. These…

  8. Expanded Medical Home Model Works for Children in Foster Care

    Science.gov (United States)

    Jaudes, Paula Kienberger; Champagne, Vince; Harden, Allen; Masterson, James; Bilaver, Lucy A.

    2012-01-01

    The Illinois Child Welfare Department implemented a statewide health care system to ensure that children in foster care obtain quality health care by providing each child with a medical home. This study demonstrates that the Medical Home model works for children in foster care providing better health outcomes in higher immunization rates. These…

  9. Medical Marijuana's Pain Relief May Work Better for Men

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_160603.html Medical Marijuana's Pain Relief May Work Better for Men Study ... a new study indicates. Researchers asked 42 recreational marijuana smokers to place one hand in extremely cold ...

  10. NIOSH Mobile Emergency Medical Service (EMS) Work Environment Laboratory

    Data.gov (United States)

    Federal Laboratory Consortium — The NIOSH Mobile Emergency Medical Service (EMS) Work Environment Laboratory is a 2005 Wheeled Coach Type III ambulance mounted on a Ford E-450 cut-away van chassis....

  11. Using mobile devices to improve the safety of medication administration processes.

    Science.gov (United States)

    Navas, H; Graffi Moltrasio, L; Ares, F; Strumia, G; Dourado, E; Alvarez, M

    2015-01-01

    Within preventable medical errors, those related to medications are frequent in every stage of the prescribing cycle. Nursing is responsible for maintaining each patients safety and care quality. Moreover, nurses are the last people who can detect an error in medication before its administration. Medication administration is one of the riskiest tasks in nursing. The use of information and communication technologies is related to a decrease in these errors. Including mobile devices related to 2D code reading of patients and medication will decrease the possibility of error when preparing and administering medication by nurses. A cross-platform software (iOS and Android) was developed to ensure the five Rights of the medication administration process (patient, medication, dose, route and schedule). Deployment in November showed 39% use.

  12. Nurses' Attitudes Toward the Use of the Bar-coding Medication Administration System

    NARCIS (Netherlands)

    S.D. Marini; A. Hasman; H.A.S. Huijer; H. Dimassi

    2010-01-01

    This study determines nurses' attitudes toward bar-coding medication administration system use. Some of the factors underlying the successful use of bar-coding medication administration systems that are viewed as a connotative indicator of users' attitudes were used to gather data that describe the

  13. [work motivation -- assessment instruments and their relevance for medical care].

    Science.gov (United States)

    Fiedler, Rolf G; Ranft, Andreas; Greitemann, Bernhard; Heuft, Gereon

    2005-11-01

    The relevance of work motivation for medical research and healthcare, in particular rehabilitation, is described. Four diagnostic instruments in the German language are introduced which can assess work motivation using a scale system: AVEM, JDS, LMI and FBTM. Their possible application and potential usage for the clinical area are discussed. Apart from the FBTM, none of these instruments can be directly used as a general instrument in a normal medical clinical setting. Finally, a current model for work motivation (compensatory model of work motivation and volition) is presented that contains basis concepts, which are judged as important for future research questions concerning the development of motivation diagnostic instruments.

  14. Discrete event simulation of administrative and medical processes

    Directory of Open Access Journals (Sweden)

    Robert Leskovar

    2011-05-01

    Conclusions: Discrete event simulation provedthat joint administration would contribute to a more even workload distribution among administrative personnel, higher quality of service and easier human resource management. The presented approach can be efficiently applied to large-scale systems e.g. organizational changes of processes in Specialist Outpatient Clinics.

  15. Understanding the information dynamics of medication administration in residential aged care facilities (RACFs): a prerequisite for design of effective ICT systems.

    Science.gov (United States)

    Tariq, Amina; Georgiou, Andrew; Westbrook, Johanna

    2013-01-01

    Medication information is a critical part of the information required to ensure residents' safety in the highly collaborative care context of RACFs. Studies report poor medication information as a barrier to improve medication management in RACFs. Research exploring medication work practices in aged care settings remains limited. This study aimed to identify contextual and work practice factors contributing to breakdowns in medication information exchange in RACFs in relation to the medication administration process. We employed non-participant observations and semi-structured interviews to explore information practices in three Australian RACFs. Findings identified inefficiencies due to lack of information timeliness, manual stock management, multiple data transcriptions, inadequate design of essential documents such as administration sheets and a reliance on manual auditing procedures. Technological solutions such as electronic medication administration records offer opportunities to overcome some of the identified problems. However these interventions need to be designed to align with the collaborative team based processes they intend to support.

  16. Medication administration technologies and patient safety: a mixed-method systematic review.

    Science.gov (United States)

    Wulff, Kelly; Cummings, Greta G; Marck, Patricia; Yurtseven, Ozden

    2011-10-01

    Healthcare leaders need evidence-based information on nursing medication administration technologies to guide the design of improvements to patient safety. The aim of this study was to evaluate the research evidence on relationships between the use of medication administration technologies and incidence of medication administration incidents and preventable adverse drug events to inform decision-making about existing technology options. Thirteen electronic databases and seven relevant patient safety websites were searched for the years 1980-2009. A mixed-method systematic literature review of research on medication administration technologies and associated links to patient safety, operationalized as medication administration incidents and preventable adverse drug events, was conducted. Twelve studies (two qualitative, five pre- and postinterventions and five correlational) met the inclusion criteria. All were assessed as medium quality with low generalizability of study findings. Only two studies sampled more than one hospital and none of the studies was driven by an explicit theoretical framework. The studies included in this review are generally positive towards medication administration technologies and their potential benefits, yet the level of evidence overall is equivocal. The majority of studies pointed to the development of workarounds by nurses following medication administration technology implementation that could compromise patient safety. More theoretically driven research is needed to determine which medication administration technologies should be implemented in what ways to most effectively reduce medication administration incidents and preventable adverse drug events and minimize the development of potentially unsafe workarounds. Further evidence is required to accurately assess the actual contribution of medication administration technologies for improving patient safety. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell

  17. 77 FR 125 - Draft Guidance for Industry and Food and Drug Administration Staff; Medical Device Classification...

    Science.gov (United States)

    2012-01-03

    ... educate regulated industry and FDA Staff on how, when, and why to use classification product codes for... HUMAN SERVICES Food and Drug Administration Draft Guidance for Industry and Food and Drug Administration Staff; Medical Device Classification Product Codes; Availability AGENCY: Food and Drug Administration...

  18. Nursing medication administration and workflow using computerized physician order entry.

    Science.gov (United States)

    Tschannen, Dana; Talsma, Akkeneel; Reinemeyer, Nicholas; Belt, Christine; Schoville, Rhonda

    2011-07-01

    The benefits of computerized physician order entry systems have been described widely; however, the impact of computerized physician order entry on nursing workflow and its potential for error are unclear. The purpose of this study was to determine the impact of a computerized physician order entry system on nursing workflow. Using an exploratory design, nurses employed on an adult ICU (n = 36) and a general pediatric unit (n = 50) involved in computerized physician order entry-based medication delivery were observed. Nurses were also asked questions regarding the impact of computerized physician order entry on nursing workflow. Observations revealed total time required for administering medications averaged 8.45 minutes in the ICU and 9.93 minutes in the pediatric unit. Several additional steps were required in the process for pediatric patients, including preparing the medications and communicating with patients and family, which resulted in greater time associated with the delivery of medications. Frequent barriers to workflow were noted by nurses across settings, including system issues (ie, inefficient medication reconciliation processes, long order sets requiring more time to determine medication dosage), less frequent interaction between the healthcare team, and greater use of informal communication modes. Areas for nursing workflow improvement include (1) medication reconciliation/order duplication, (2) strategies to improve communication, and (3) evaluation of the impact of computerized physician order entry on practice standards.

  19. An Integrated Health Care Model in Medical Education: Interviews with Faculty and Administrators.

    Science.gov (United States)

    Tresolini, Carol P.; Shugars, Daniel A.

    1994-01-01

    Faculty and administrators of 22 medical schools were interviewed for their insights into development of an approach to health care and medical education that integrates psychosocial and biomedical perspectives. Results suggest medical curricula should address development of physicians' knowledge, attitudes, and skills in relationships with both…

  20. Establishing Compliance with Liquid Medication Administration in a Child with Autism

    Science.gov (United States)

    Schiff, Averil; Tarbox, Jonathan; Lanagan, Taira; Farag, Peter

    2011-01-01

    Children with autism often display difficulty with swallowing pills and liquid medications. In the current study, stimulus fading and positive reinforcement established compliance with liquid medication administration in a young boy with autism. The boy's mother eventually administered liquid medication on her own. (Contains 1 figure.)

  1. Work-life policies for Canadian medical faculty.

    Science.gov (United States)

    Gropper, Aaron; Gartke, Kathleen; MacLaren, Monika

    2010-09-01

    This study aims to catalogue and examine the following work-life flexibility policies at all 17 Canadian medical schools: maternity leave, paternity leave, adoption leave, extension of the probationary period for family responsibilities, part-time faculty appointments, job sharing, and child care. The seven work-life policies of Canadian medical schools were researched using a consistent and systematic method. This method involved an initial web search for policy information, followed by e-mail and telephone contact. The flexibility of the policies was scored 0 (least flexible) to 3 (most flexible). The majority of policies were easily accessible online. Work-life policies were scored out of 3, and average policy scores ranged from 0.47 for job sharing to 2.47 for part-time/work reduction. Across schools, total scores ranged from 7 to 16 out of 21. Variation in scores was noted for parenting leave and child care, whereas minimal variation was noted for other policies. Canadian medical schools are committed to helping medical faculty achieve work-life balance, but improvements can be made in the policies offered at all schools. Improving the quality of work flexibility policies will enhance working conditions and job satisfaction for faculty. This could potentially reduce Canada's loss of talented young academicians.

  2. Modelling medical care usage under medical insurance scheme for urban non-working residents.

    Science.gov (United States)

    Xiong, Linping; Tian, Wenhua; Tang, Weidong

    2013-06-01

    This research investigates and evaluates China's urban medical care usage for non-working residents using microsimulation techniques. It focuses on modelling medical services usage and simulating medical expenses on hospitalization treatments as well as clinic services for serious illness in an urban area for the period of 2008-2010. A static microsimulation model was created to project the impact of the medical insurance scheme. Four kinds of achievements have been made. For three different scenarios, the model predicted the hospitalization services costs and payments, as well as the balance of the social pool fund and the medical burden on families.

  3. Patient safety and technology-driven medication - A qualitative study on how graduate nursing students navigate through complex medication administration.

    Science.gov (United States)

    Orbæk, Janne; Gaard, Mette; Fabricius, Pia; Lefevre, Rikke S; Møller, Tom

    2015-05-01

    The technology-driven medication process is complex, involving advanced technologies, patient participation and increased safety measures. Medication administration errors are frequently reported, with nurses implicated in 26-38% of in-hospital cases. This points to the need for new ways of educating nursing students in today's medication administration. To explore nursing students' experiences and competences with the technology-driven medication administration process. 16 pre-graduate nursing students were included in two focus group interviews which were recorded, transcribed and analyzed using the systematic horizontal phenomenological-hermeneutic template methodology. The interviews uncovered that understanding the technologies; professionalism and patient safety are three crucial elements in the medication process. The students expressed positivity and confidence in using technology, but were fearful of committing serious medication errors. From the nursing students' perspective, experienced nurses deviate from existing guidelines, leaving them feeling isolated in practical learning situations. Having an unclear nursing role model for the technology-driven medication process, nursing students face difficulties in identifying and adopting best practices. The impact of using technology on the frequency, type and severity of medication errors; the technologies implications on nursing professionalism and the nurses ability to secure patient adherence to the medication process, still remains to be studied. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Queues and care: how medical residents organize their work in a busy clinic.

    Science.gov (United States)

    Finlay, W; Mutran, E J; Zeitler, R R; Randall, C S

    1990-09-01

    How do medical residents organize their work in settings where queue demands are heavy and resources are limited? Under such conditions, a queue theory would predict the delivery of care that is indifferent to clients' needs or that gets rid of clients as quickly as possible. In an exploratory case study of medical residents in a Veterans Administration outpatient clinic, we found instead that the medical residents' work was characterized by a high level of professional commitment: they provided thorough medical examinations and attempted to expedite patient care in other ways. We attribute the residents' professional ethos to opportunities provided in the VA hospital to learn the craft of routine medicine and to be directly responsible for patient care; such opportunities were not available in other settings.

  5. Collaborative Affordances of Hybrid Patient Record Technologies in Medical Work

    DEFF Research Database (Denmark)

    Houben, Steven; Frost, Mads; Bardram, Jakob E

    2015-01-01

    to digitally augment a paper medical record. We report on two studies: a field study in which we describe the benefits and challenges of using a combination of electronic and paper-based medical records in a large university hospital and a deployment study in which we analyze how 8 clinicians used the Hy......PR in a medical simulation. Based on these empirical studies, this paper introduces and discusses the concept of collaborative affordances, which describes a set of properties of the medical record that foster collaborative collocated work....... explored the integration of paper and digital technology, there are still a wide range of open issues in the design of technologies that integrate digital and paper-based medical records. This paper studies the use of one such novel technology, called the Hybrid Patient Record (HyPR), that is designed...

  6. Survey of nursing perceptions of medication administration practices, perceived sources of errors and reporting behaviours.

    Science.gov (United States)

    Armutlu, Markirit; Foley, Mary-Lou; Surette, Judy; Belzile, Eric; McCusker, Jane

    2008-01-01

    In January 2003, St. Mary's Hospital Center in Montreal, Quebec, established an interdisciplinary Committee on the Systematic Approach to Medication Error Control to review the whole process of medication administration within the hospital and to develop a systematic approach to medication error control. A cross-sectional survey on medication administration practices, perceived sources of errors and medication error reporting of nurses, adapted from a nursing practice survey and medication variance report (Sim and Joyner 2002), was conducted over a two-week period in February 2004. The results were analyzed by years of experience (greater or less than five years) and patient care unit of practice. The perceived source of error most often cited was transcription (processing), and the second most frequently cited source was the legibility of handwritten medication orders (prescribing). The results demonstrate no significant difference in medication safety practices or in perceptions of errors by years of experience. Nurses appear to adapt to the safety culture of the unit rather quickly, certainly within their first five years on the unit. Good medication error reporting behaviour was noted, with no differences between all comparative groups within both years of experience and unit of practice. Quality improvement initiatives to improve the safety of medication administration practices have included the development of a nursing medication administration handbook, the revision of policies and procedures related to medication administration safety, the standardization of solutions and limited variety of high-risk medication dosages and the reduction of handwritten reorders. The need for ongoing education and information sessions on policies and procedures specific to safe medication practices for all nurses, regardless of years of experience, was identified.

  7. EVA Physiology and Medical Considerations Working in the Suit

    Science.gov (United States)

    Parazynski, Scott

    2012-01-01

    This "EVA Physiology and Medical Considerations Working in the Suit" presentation covers several topics related to the medical implications and physiological effects of suited operations in space from the perspective of a physician with considerable first-hand Extravehicular Activity (EVA) experience. Key themes include EVA physiology working in a pressure suit in the vacuum of space, basic EVA life support and work support, Thermal Protection System (TPS) inspections and repairs, and discussions of the physical challenges of an EVA. Parazynski covers the common injuries and significant risks during EVAs, as well as physical training required to prepare for EVAs. He also shares overall suit physiological and medical knowledge with the next generation of Extravehicular Mobility Unit (EMU) system designers.

  8. Factors which affect the occurrence of nursing errors in medication administration and the errors' management

    Directory of Open Access Journals (Sweden)

    Theodore Kapadohos

    2012-04-01

    Full Text Available Nursing, as a humanitarian science, offers its services, on the comprehensive care of patients. Each nurse handling, involves the possibility of error. Meurier appointed nursing error as "any act, any decision or omission by a nurse, assessed as incorrect, by more experienced colleagues, and have adverse consequences for patients". Medication errors are the most common category of nursing errors. They affect health, patient safety and also have a high economic impact to health systems of each country. Aim: The present study investigated the causative factors of nursing errors, the frequency of medication errors and the ways of reporting, recording and managing these errors in the hospitals of Greece. Method: For the purpose of this study, a descriptive cross-sectional design was used. The sample consisted of 176 registered nurses, from eight public and three private hospitals, working in the ICU and their duties included the administration of drugs. Data collection was performed using an anonymous structured questionnaire that included demographic characteristics of the sample and closed questions about the factors implicated in the occurrence of errors and their management. To investigate the existence of correlation between demographics and various questions referred to the management of errors by nurses, the criterion of heterogeneity X2 of Pearson was used and to check for correlation between questions that reflect the participants' views on working conditions and management of errors, the non-parametric correlation coefficient of Spearman (Spearman rho was applied. The statistical analysis was performed using SPSS 17 software. Results: After statistical analysis of data, the most important causative factors for the occurrence of errors are the nursing workload (78.9%, the distraction of nurses (75.8% and the burnout (56.8%. More than 9 out of 10 nurses have made errors in drug administration (91.5%, especially with the wrong dose (34.7% and

  9. Searching for the Final Answer: Factors Contributing to Medication Administration Errors.

    Science.gov (United States)

    Pape, Tess M.

    2001-01-01

    Causal factors contributing to errors in medication administration should be thoroughly investigated, focusing on systems rather than individual nurses. Unless systemic causes are addressed, many errors will go unreported for fear of reprisal. (Contains 42 references.) (SK)

  10. Description of Medication Administration by Emergency Medical Services during Mass-casualty Incidents in the United States.

    Science.gov (United States)

    El Sayed, Mazen; Tamim, Hani; Mann, N Clay

    2016-04-01

    Emergency Medical Services (EMS) preparedness and availability of essential medications are important to reduce morbidity and mortality from mass-casualty incidents (MCIs). This study describes prehospital medication administration during MCIs by different EMS service levels. The US National EMS Public-Release Research Dataset maintained by the National Emergency Medical Services Information System (NEMSIS) was used to carry out the study. Emergency Medical Services activations coded as MCI at dispatch, or by EMS personnel, were included. The Center for Medicare and Medicaid Services (CMS) service level was used for the level of service provided. A descriptive analysis of medication administration by EMS service level was carried out. Among the 19,831,189 EMS activations, 53,334 activations had an MCI code, of which 26,110 activations were included. There were 8,179 (31.3%) Advanced Life Support (ALS), 5,811 (22.3%) Basic Life Support (BLS), 399 (1.5%) Air Medical Transport (AMT; fixed or rotary), and 38 (0.2%) Specialty Care Transport (SCT) activations. More than 80 different medications from 18 groups were reported. Seven thousand twenty-one activations (26.9%) had at least one medication administered. Oxygen was most common (16.3%), followed by crystalloids (6.9%), unknown (5.2%), analgesics (3.2%) mainly narcotics, antiemetics (1.5%), cardiac/vasopressors/inotropes (0.9%), bronchodilators (0.9%), sedatives (0.8%), and vasodilators/antihypertensives (0.7%). Overall, medication administration rates and frequencies of medications groups significantly varied between EMS service levels (Psystems can use the findings of this study to better prepare their stockpiles for MCIs.

  11. [A Program to Improve the Implementation Rate for the Barcode Medication Administration System].

    Science.gov (United States)

    Yen, Ying-Ting; Chang, Shih-Fen; Tsai, Kuei-Lan; Chen, Chen-Ju; Liu, Li-Ching; Fang, Yu-Chiung

    2015-12-01

    Fully implementing the barcode medication administration system has been shown to help improve medication safety. We have promoted the barcode medication administration system in our hospital since May of 2014. However, the rate of implementation reached only 32% initially. We identified the major obstacles to fully implementing the barcode system as: (1) the barcodes on patients' wristbands were smudged or broken; (2) the barcodes on transparent drug bags and infusion bags were difficult to scan; (3) nurses were not familiar with the scanner and lacked the skills necessary to conduct barcode scans; (4) poor wireless Internet access inhibited effective barcode scanning; and (5) the beep sound generated during barcode scanning disturbed patients' sleep. The present project was conducted to improve the implementation by nursing staff of the barcode medication administration system. The purpose was to increase the rate of implementation from 32% to 80%. The key members of the project were nurses, computer technicians, and pharmacists. The following procedures were conducted: (1) check the integrity of the wrist band and renew this band periodically; (2) print the barcode against a white background on transparent drug transfusion bags; (3) demonstration the skills of barcode scanning to nurses and inspect the function of scanners periodically; (4) increase the number of access points for the wireless network; (5) demonstrate the procedure for adjusting the sound volume on the scanner; and (6) provide rewards / incentives for using the barcode medication administration system. The rate of implementation of the barcode medication administration system increased from 32% to 85.2%. This project significantly increased the use of the barcode medication administration system by our nursing staff. The procedures used in this project may be referenced by administrators at other hospitals with low rates of barcode medication administration system usage.

  12. Collaborative Affordances of Hybrid Patient Record Technologies in Medical Work

    DEFF Research Database (Denmark)

    Houben, Steven; Frost, Mads; Bardram, Jakob E

    2015-01-01

    The medical record is a central artifact used to organize, communicate and coordinate information related to patient care. Despite recent deployments of electronic health records (EHR), paper medical records are still widely used because of the affordances of paper. Although a number of approache......PR in a medical simulation. Based on these empirical studies, this paper introduces and discusses the concept of collaborative affordances, which describes a set of properties of the medical record that foster collaborative collocated work.......The medical record is a central artifact used to organize, communicate and coordinate information related to patient care. Despite recent deployments of electronic health records (EHR), paper medical records are still widely used because of the affordances of paper. Although a number of approaches...... explored the integration of paper and digital technology, there are still a wide range of open issues in the design of technologies that integrate digital and paper-based medical records. This paper studies the use of one such novel technology, called the Hybrid Patient Record (HyPR), that is designed...

  13. Families, nurses and organisations contributing factors to medication administration error in paediatrics: a literature review

    Directory of Open Access Journals (Sweden)

    Albara Alomari

    2015-05-01

    Full Text Available Background: Medication error is the most common adverse event for hospitalised children and can lead to significant harm. Despite decades of research and implementation of a number of initiatives, the error rates continue to rise, particularly those associated with administration. Objectives: The objective of this literature review is to explore the factors involving nurses, families and healthcare systems that impact on medication administration errors in paediatric patients. Design: A review was undertaken of studies that reported on factors that contribute to a rise or fall in medication administration errors, from family, nurse and organisational perspectives. The following databases were searched: Medline, Embase, CINAHL and the Cochrane library. The title, abstract and full article were reviewed for relevance. Articles were excluded if they were not research studies, they related to medications and not medication administration errors or they referred to medical errors rather than medication errors. Results: A total of 15 studies met the inclusion criteria. The factors contributing to medication administration errors are communication failure between the parents and healthcare professionals, nurse workload, failure to adhere to policy and guidelines, interruptions, inexperience and insufficient nurse education from organisations. Strategies that were reported to reduce errors were doublechecking by two nurses, implementing educational sessions, use of computerised prescribing and barcoding administration systems. Yet despite such interventions, errors persist. The review highlighted families that have a central role in caring for the child and therefore are key to the administration process, but have largely been ignored in research studies relating to medication administration. Conclusions: While there is a consensus about the factors that contribute to errors, sustainable and effective solutions remain elusive. To date, families have not

  14. Personality, Vocational Interests, and Work Values of Medical Students

    Science.gov (United States)

    Duffy, Ryan D.; Borges, Nicole J.; Hartung, Paul J.

    2009-01-01

    Interests, personality, and values figure prominently in work motivation, yet little research has examined the combined influence of these factors on vocational behavior. The present study therefore examined relationships among these variables in a sample of 282 medical students (169 women, 113 men) who responded to the Strong Interest Inventory,…

  15. Personality, Vocational Interests, and Work Values of Medical Students

    Science.gov (United States)

    Duffy, Ryan D.; Borges, Nicole J.; Hartung, Paul J.

    2009-01-01

    Interests, personality, and values figure prominently in work motivation, yet little research has examined the combined influence of these factors on vocational behavior. The present study therefore examined relationships among these variables in a sample of 282 medical students (169 women, 113 men) who responded to the Strong Interest Inventory,…

  16. [Medication administration practices in elderly residential facilities in Ile de France Region in 2014: findings and room for improvement].

    Science.gov (United States)

    de Saunière, Anne; Bonneau, Laetitia; Donio, Valérie; Godinot, Valérie; Flouzat, Jean-Philippe; Bensasson, Géraldine; Code, Christelle; Galay, Guillaume; Pige, Dominique

    2016-11-25

    The institutions expressed great interest in medication administration systems and tools designed to monitor all stages of medication administration. A dozen simple and pragmatic improvement actions were identified and listed in the Ile-de-France Regional Health Agency action plan to improve medication administration management of in EHPAD..

  17. Workarounds to barcode medication administration systems: their occurrences, causes, and threats to patient safety.

    Science.gov (United States)

    Koppel, Ross; Wetterneck, Tosha; Telles, Joel Leon; Karsh, Ben-Tzion

    2008-01-01

    The authors develop a typology of clinicians' workarounds when using barcoded medication administration (BCMA) systems. Authors then identify the causes and possible consequences of each workaround. The BCMAs usually consist of handheld devices for scanning machine-readable barcodes on patients and medications. They also interface with electronic medication administration records. Ideally, BCMAs help confirm the five "rights" of medication administration: right patient, drug, dose, route, and time. While BCMAs are reported to reduce medication administration errors--the least likely medication error to be intercepted--these claims have not been clearly demonstrated. The authors studied BCMA use at five hospitals by: (1) observing and shadowing nurses using BCMAs at two hospitals, (2) interviewing staff and hospital leaders at five hospitals, (3) participating in BCMA staff meetings, (4) participating in one hospital's failure-mode-and-effects analyses, (5) analyzing BCMA override log data. The authors identified 15 types of workarounds, including, for example, affixing patient identification barcodes to computer carts, scanners, doorjambs, or nurses' belt rings; carrying several patients' prescanned medications on carts. The authors identified 31 types of causes of workarounds, such as unreadable medication barcodes (crinkled, smudged, torn, missing, covered by another label); malfunctioning scanners; unreadable or missing patient identification wristbands (chewed, soaked, missing); nonbarcoded medications; failing batteries; uncertain wireless connectivity; emergencies. The authors found nurses overrode BCMA alerts for 4.2% of patients charted and for 10.3% of medications charted. Possible consequences of the workarounds include wrong administration of medications, wrong doses, wrong times, and wrong formulations. Shortcomings in BCMAs' design, implementation, and workflow integration encourage workarounds. Integrating BCMAs within real-world clinical workflows

  18. Dark chocolate administration improves working memory in students

    Directory of Open Access Journals (Sweden)

    Nawanto Agung Prastowo

    2016-04-01

    Dark chocolate as a single dose is capable of improving verbal working memory in students, 3 hours after its consumption. Since cocoa contains multiple bioactive compounds, one approach might be to examine the neurocognitive effects of combinations of potential functional ingredients.

  19. [Educational game of medication administration: a validation study].

    Science.gov (United States)

    Moreira, Amanda Portugal de Andrade; Sabóia, Vera Maria; Camacho, Alessandra Conceição Leite Funchal; Daher, Donizete Vago; Teixeira, Elizabeth

    2014-01-01

    This is a methodological research, which aimed to determine the validity of an educational technology (ET) in the form of educational game of medicine administration, according to the judges and audience, using the theoretical stage of Pasquali model. Data were collected between September 2011 and May 2012 in two stages: 1) application and validation of TE by forty students of the 4th period of Nursing, at the Fluminense Federal University (target audience); 2) observation and validation of TE by 8 teachers (judges). The questionnaires were organized in Likert scale, with items distributed in blocks and analyzed quantitatively. The game was validated, since it has over 80% approval by the two groups, and may therefore be used as a TE in the discipline of Fundamentals of Nursing. The results were positive, demonstrating that students and teachers are more interested in content taught when most dynamic technologies are used in the classroom.

  20. Evaluation of Safe Medication Administration through the Use of Simulation in an Academic Setting

    Science.gov (United States)

    Dover, Cheryl D.

    2013-01-01

    Nursing educational programs are struggling with how to educate students to safely and efficiently administer medications. There is no doubt education programs need to find a way to assist students to acquire the skill of medication administration and to also transfer the skill into practice. Knowledge, skills, and abilities are requirements for…

  1. Inside Maine's Medicine Cabinet: Findings From the Drug Enforcement Administration's Medication Take-Back Events.

    Science.gov (United States)

    Stewart, Heather; Malinowski, Alexandra; Ochs, Leslie; Jaramillo, Jeanie; McCall, Kenneth; Sullivan, Meghan

    2015-01-01

    Objectives. We evaluated the quantity and type of medications obtained in unused-medications return programs and the proportion of medication waste. Methods. We analyzed data collected in 11 Maine cities in 2011 to 2013 during 6 Drug Enforcement Administration (DEA) national medication take-back events. Pharmacy doctoral student volunteers collected data under the supervision of law enforcement, independent of the DEA. Data entry into the Pharmaceutical Collection Monitoring System, through its interface with Micromedex, allowed for analysis of medication classification, controlled substance category, therapeutic class, and percentage of medication waste (units returned/units dispensed). Results. Medication take-back events resulted in return of 13 599 individual medications from 1049 participants. We cataloged 553 019 units (capsules, tablets, milliliters, patches, or grams), representing 69.7% medication waste. Noncontrolled prescription medications accounted for 56.4% of returns, followed by over-the-counter medications (31.4%) and controlled prescription medications (9.1%). Conclusions. The significant quantities of medications, including controlled substances, returned and high degree of medication waste emphasize the need for medication collection programs to further public health research and improve health in our communities.

  2. Medication Reconciliation: Work Domain Ontology, prototype development, and a predictive model.

    Science.gov (United States)

    Markowitz, Eliz; Bernstam, Elmer V; Herskovic, Jorge; Zhang, Jiajie; Shneiderman, Ben; Plaisant, Catherine; Johnson, Todd R

    2011-01-01

    Medication errors can result from administration inaccuracies at any point of care and are a major cause for concern. To develop a successful Medication Reconciliation (MR) tool, we believe it necessary to build a Work Domain Ontology (WDO) for the MR process. A WDO defines the explicit, abstract, implementation-independent description of the task by separating the task from work context, application technology, and cognitive architecture. We developed a prototype based upon the WDO and designed to adhere to standard principles of interface design. The prototype was compared to Legacy Health System's and Pre-Admission Medication List Builder MR tools via a Keystroke-Level Model analysis for three MR tasks. The analysis found the prototype requires the fewest mental operations, completes tasks in the fewest steps, and completes tasks in the least amount of time. Accordingly, we believe that developing a MR tool, based upon the WDO and user interface guidelines, improves user efficiency and reduces cognitive load.

  3. Is technology the best medicine? Three practice theoretical perspectives on medication administration technologies in nursing.

    Science.gov (United States)

    Boonen, Marcel Jmh; Vosman, Frans Jh; Niemeijer, Alistair R

    2016-06-01

    Even though it is often presumed that the use of technology like medication administration technology is both safer and more effective, the importance of nurses' know-how is not to be underestimated. In this article, we accordingly try to argue that nurses' labor, including their different forms of knowledge, must play a crucial role in the development, implementation and use of medication administration technology. Using three different theoretical perspectives ('heuristic lenses') and integrating this with our own ethnographic research, we will explore how nursing practices change through the use of medication technology. Ultimately, we will argue that ignoring (institutional) complexity and the various types of important knowledge that nurses have, will seriously complicate the implementation of medication administration technology. © 2015 John Wiley & Sons Ltd.

  4. Active Mycobacterium Infection Due to Intramuscular BCG Administration Following Multi-Steps Medication Errors

    Directory of Open Access Journals (Sweden)

    MohammadReza Rafati

    2015-10-01

    Full Text Available Bacillus Calmette-Guérin (BCG is indicated for treatment of primary or relapsing flat urothelial cell carcinoma in situ (CIS of the urinary bladder. Disseminated infectious complications occasionally occur due to BCG as a vaccine and intravesical therapy.  Intramuscular (IM or Intravenous (IV administrations of BCG are rare medication errors which are more probable to produce systemic infections. This report presents 13 years old case that several steps medication errors occurred consequently from physician handwriting, pharmacy dispensing, nursing administration and patient family. The physician wrote βHCG instead of HCG in the prescription. βHCG was read as BCG by the pharmacy staff and 6 vials of intravesical BCG were administered IM twice a week for 3 consecutive weeks. The patient experienced fever and chills after each injection, but he was admitted 2 months after first IM administration of BCG with fever and pancytopenia. Unfortunately four month after using drug, during second admission duo to cellulitis at the sites of BCG injection the physicians diagnosed the medication error. Using handwritten prescription and inappropriate abbreviations, spending inadequate time for taking a brief medical history in pharmacy, lack of verifying name, dose and wrote before medication administration and lack of considering medication error as an important differential diagnosis had roles to occur this multi-steps medication error.

  5. An overview of intravenous-related medication administration errors as reported to MEDMARX, a national medication error-reporting program.

    Science.gov (United States)

    Hicks, Rodney W; Becker, Shawn C

    2006-01-01

    Medication errors can be harmful, especially if they involve the intravenous (IV) route of administration. A mixed-methodology study using a 5-year review of 73,769 IV-related medication errors from a national medication error reporting program indicates that between 3% and 5% of these errors were harmful. The leading type of error was omission, and the leading cause of error involved clinician performance deficit. Using content analysis, three themes-product shortage, calculation errors, and tubing interconnectivity-emerge and appear to predispose patients to harm. Nurses often participate in IV therapy, and these findings have implications for practice and patient safety. Voluntary medication error-reporting programs afford an opportunity to improve patient care and to further understanding about the nature of IV-related medication errors.

  6. Administration of medication to use when needed and the care of psychiatric nursing

    Directory of Open Access Journals (Sweden)

    Kelly da Silva Rocha Estrela

    2014-07-01

    Full Text Available This qualitative study aimed to analyze the clinical criteria used for the administration of prescribed medications for use when needed (SOS; and discuss the implication of the findings in this research to clinical psychiatric nursing. The records of female patients admitted to a psychiatric institution in the city of Rio de Janeiro, in the time frame from May to June 2009, were analyzed. In the 38 patient records, 16 prescriptions for medications SOS were found. The mean age of patients was around 45-55 years with a clinical diagnosis of Bipolar Mood Disorder. The medication category most prescribed as SOS was of benzodiazepines, followed by antipsychotics. It was noticed a tendency to not valuing the administration of medication in SOS notes. The study points out the importance to establish clinical criteria to indicate the need, or not, to administer prescribed SOS medications.

  7. Pharmaceutical interventions in medications prescribed for administration via enteral tubes in a teaching hospital

    Directory of Open Access Journals (Sweden)

    Carolina Justus Buhrer Ferreira Neto

    2016-01-01

    Full Text Available Abstract Objective: to analyze the impact of guidelines regarding errors in medications prescribed for administration through enteral tubes. Method: quantitative study, in three phases, undertaken in internal medicine, neurology and an intensive care unit in a general teaching hospital. In Phase 1, the following was undertaken: a protocol for dilution and unit-dose repackaging and administration for 294 medications via enteral tubes; a decision flowchart; operational-standard procedures for dilution and unit-dose repackaging of oral pharmaceutical forms and for administration of medications through enteral tubes. In phase 2, errors in 872 medications prescribed through enteral tubes, in 293 prescriptions for patients receiving inpatient treatment between March and June, were investigated. This was followed by training of the teams in relation to the guidelines established. In Phase 3, pharmaceutical errors and interventions in 945 medications prescribed through enteral tubes, in 292 prescriptions of patients receiving inpatient treatment between August and September, were investigated prospectively. The data collected, in a structured questionnaire, were compiled in the Microsoft Office Excel(r program, and frequencies were calculated. Results: 786 errors were observed, 63.9% (502 in Phase 2, and 36.1% (284 in Phase 3. In Phase 3, a reduction was ascertained in the frequency of prescription of medications delivered via enteral tubes, medications which were contraindicated, and those for which information was not available. Conclusion: guidelines and pharmaceutical interventions were determined in the prevention of errors involving medications delivered through enteral tubes.

  8. Absence from work and the medical sickness certificate.

    Science.gov (United States)

    Massoni, F; Salesi, M; Sarra, M V; Ricci, S

    2013-03-01

    Internet and dematerialization have greatly facilitated the medical profession. Contractual physicians and national health service doctors now have efficient tools for the electronic management of their routine administrative workload. A recent innovation is the medical sickness certificate issued by primary care providers and national health service physicians. Following postponements and uncertainties, procedures for the electronic completion and online transmission of the sickness certificate are now complete. The changes introduced by the so-called "Brunetta decree", however, have made its application difficult and continuous improvement to the system is needed, considering also the severe penalties imposed for violations. In the light of serious legal repercussions for health care professionals, this article examines various critical issues, highlighting the pitfalls and the network's enormous potential for ascertaining evidence of irregularities. The overheated debate on absenteeism due to illness, the diverse roles of national health physicians and self-employed doctors responsible for issuing a sickness certificate, and problems related to circumstances in which a doctor operates, are the key topics in this discussion. Computerization is an effective tool for optimizing public resources; however, it also seeks to ferret out, through the traceability of certification, abuse of medical certification, with severe penalties applied if certificates are discovered to contain misleading or untrue information.

  9. Nursing administration of medication via enteral tubes in adults: a systematic review.

    Science.gov (United States)

    Phillips, Nicole M; Nay, Rhonda

    2007-09-01

    Background  Enteral tubes are frequently inserted as part of medical treatment in a wide range of patient situations. Patients with an enteral tube are cared for by nurses in a variety of settings, including general and specialised acute care areas, aged care facilities and at home. Regardless of the setting, nurses have the primary responsibility for administering medication through enteral tubes. Medication administration via an enteral tube is a reasonably common nursing intervention that entails a number of skills, including preparing the medication, verifying the tube position, flushing the tube and assessing for potential complications. If medications are not given effectively through an enteral tube, harmful consequences may result leading to increased morbidity, for example, tube occlusion, diarrhoea and aspiration pneumonia. There are resultant costs for the health-care system related to possible increased length of stay and increased use of equipment. Presently what is considered to be best practice to give medications through enteral tubes is unknown. Objectives  The objective of this systematic review was to determine the best available evidence on which nursing interventions are effective in minimising the complications associated with the administration of medications via enteral tubes in adults. Nursing interventions and considerations related to medication administration included form of medication, verifying tube placement before administration, methods used to give medication, methods used to flush tubes, maintenance of tube patency and specific practices to prevent possible complications related to the administration of enteral medications. Search strategy  The following databases were searched for literature reported in English only: CINAHL, MEDLINE, The Cochrane Library, Current Contents/All Editions, EMBASE, Australasian Medical Index and PsychINFO. There was no date restriction applied. In addition, the reference lists of all included

  10. The Food and Drug Administration and pragmatic clinical trials of marketed medical products.

    Science.gov (United States)

    Anderson, Monique L; Griffin, Joseph; Goldkind, Sara F; Zeitler, Emily P; Wing, Liz; Al-Khatib, Sana M; Sherman, Rachel E

    2015-10-01

    Pragmatic clinical trials can help answer questions of comparative effectiveness for interventions routinely used in medical practice. Pragmatic clinical trials may examine outcomes of one or more marketed medical products, and they are heterogeneous in design and risk. The Food and Drug Administration is charged with protecting the rights, safety, and welfare of individuals enrolled in clinical investigations, as well as assuring the integrity of the data upon which approval of medical products is made. The Food and Drug Administration has broad jurisdiction over drugs and medical devices (whether or not they are approved for marketing), and as such, clinical investigations of these products are subject to applicable Food and Drug Administration regulations. While many pragmatic clinical trials will meet the criteria for an exemption from the requirements for an investigational new drug application or investigational device exemption, in general, all clinical investigations of medical products that fall under Food and Drug Administration jurisdiction must adhere to regulations for informed consent and review by an institutional review board. We are concerned that current Food and Drug Administration requirements for obtaining individual informed consent may deter or delay the conduct of pragmatic clinical trials intended to develop reliable evidence of comparative safety and effectiveness of approved medical products that are regulated by the Food and Drug Administration. Under current regulations, there are no described mechanisms to alter or waive informed consent to make it less burdensome or more practicable for low-risk pragmatic clinical trials. We recommend that the Food and Drug Administration establish a risk-based approach to obtaining informed consent in pragmatic clinical trials that would facilitate the conduct of pragmatic clinical trials without compromising the protection of enrolled individuals or the integrity of the resulting data.

  11. Carers' Medication Administration Errors in the Domiciliary Setting: A Systematic Review

    Science.gov (United States)

    Garfield, Sara; Vincent, Charles; Franklin, Bryony Dean

    2016-01-01

    Purpose Medications are mostly taken in patients’ own homes, increasingly administered by carers, yet studies of medication safety have been largely conducted in the hospital setting. We aimed to review studies of how carers cause and/or prevent medication administration errors (MAEs) within the patient’s home; to identify types, prevalence and causes of these MAEs and any interventions to prevent them. Methods A narrative systematic review of literature published between 1 Jan 1946 and 23 Sep 2013 was carried out across the databases EMBASE, MEDLINE, PSYCHINFO, COCHRANE and CINAHL. Empirical studies were included where carers were responsible for preventing/causing MAEs in the home and standardised tools used for data extraction and quality assessment. Results Thirty-six papers met the criteria for narrative review, 33 of which included parents caring for children, two predominantly comprised adult children and spouses caring for older parents/partners, and one focused on paid carers mostly looking after older adults. The carer administration error rate ranged from 1.9 to 33% of medications administered and from 12 to 92.7% of carers administering medication. These included dosage errors, omitted administration, wrong medication and wrong time or route of administration. Contributory factors included individual carer factors (e.g. carer age), environmental factors (e.g. storage), medication factors (e.g. number of medicines), prescription communication factors (e.g. comprehensibility of instructions), psychosocial factors (e.g. carer-to-carer communication), and care-recipient factors (e.g. recipient age). The few interventions effective in preventing MAEs involved carer training and tailored equipment. Conclusion This review shows that home medication administration errors made by carers are a potentially serious patient safety issue. Carers made similar errors to those made by professionals in other contexts and a wide variety of contributory factors were

  12. Quality Indicators and Expected Outcomes for Social Work PhD Programs: Perceptions of Social Work Students, Faculty, and Administrators

    Science.gov (United States)

    Petr, Christopher G.; Harrington, Donna; Kim, Kyeongmo; Black, Beverly; Cunningham-Williams, Renee M.; Bentley, Kia J.

    2015-01-01

    This article presents and discusses the results of a national survey of social work PhD students, faculty, and administrators (n = 416), conducted by the Group for the Advancement of Doctoral Education in Social Work (GADE), in December 2012. The survey was undertaken to inform the updating of GADE's 2003 "Guidelines for Quality in Social…

  13. Same Story; Different Day: Greatest Challenges of Women Working in Intercollegiate Athletic Administration

    Directory of Open Access Journals (Sweden)

    Glenna G. Bower

    2015-09-01

    Full Text Available Women continue to be under-represented in administrative positions in intercollegiate athletics. Women in this study offered unique insights into challenges they face in the field. This study explored career profiles and challenges facing women working in intercollegiate athletic administration. The subjects were women working in intercollegiate athletic administration across National Collegiate Athletic Association (NCAA divisions I, II, III; National Association of Intercollegiate Athletics (NAIA; National Christian College Athletic Association (NCCAA; Junior Colleges; and Canadian Colleges. The study, which utilized the Female Sport Manager Career Survey, posed two research questions: (a what are the profiles of females working in athletic administration?, and (b what are the gender specific greatest challenges that women working in intercollegiate athletic administration face? This study included all 1834 women working in intercollegiate athletic administration listed by the National Directory of College Athletics in 2012, of which 28.0% (N=514 provided usable responses. Frequencies were calculated for the demographics using SPSS 20.0 and the qualitative data were analyzed using HyperResearch 2.8. Several practical implications for women wanting to work in intercollegiate athletic administration originated from this study including developing networks, being prepared to balance work and family, being aware of stereotyping, and gaining as much experience as possible.

  14. Prehospital Medication Administration: A Randomised Study Comparing Intranasal and Intravenous Routes

    Directory of Open Access Journals (Sweden)

    Cian McDermott

    2012-01-01

    Full Text Available Introduction. Opioid overdose is an ever-increasing problem globally. Recent studies have demonstrated that intranasal (IN naloxone is a safe and effective alternative to traditional routes of naloxone administration for reversal of opioid overdose. Aims. This randomised controlled trial aimed to compare the time taken to deliver intranasal medication with that of intravenous (IV medication by advanced paramedic trainees. Methods. 18 advanced paramedic trainees administered either an IN or IV medication to a mannequin model in a classroom-based setting. The time taken for medication delivery was compared. End-user satisfaction was assessed using a 5-point questionnaire regarding ease of use and safety for both routes. Results. The mean time taken for the IN and IV group was 87.1 seconds and 178.2 seconds respectively. The difference in mean time taken was 91.1 seconds (95% confidence interval 55.2 seconds to 126.9 seconds, P≤0.0001. 89% of advanced paramedic trainees reported that the IN route was easier and safer to use than the IV route. Conclusion. This study demonstrates that, amongst advanced paramedic trainees, the IN route of medication administration is significantly faster, better accepted and perceived to be safer than using the IV route. Thus, IN medication administration could be considered more frequently when administering emergency medications in a pre-hospital setting.

  15. Teaching successful medication administration today: more than just knowing your 'rights'.

    Science.gov (United States)

    Fothergill Bourbonnais, Frances; Caswell, Wenda

    2014-08-01

    Medication administration is an important skill taught in undergraduate nursing programs. Student learning for this activity includes not only how to prepare and administer medications, but also includes interventions such as patient and family teaching. Students also are taught a series of 'rights' in order to prevent medication errors. There are many factors, both personal and system related, which contribute to medication errors in the health care environment. The purpose of this article is to provide strategies for teaching students medication administration that encompass the multiple factors involved to ensure safe practice. This opinion paper is based on the authors' considerable years of teaching experience (35 years clinical setting and classroom teaching with senior students in final year of baccalaureate program for 1st author and 16 years total for co-author). Recommendations put forth by the authors are: a) leveling students' clinical experiences in administering medications to include understanding of system factors, b) structured scenarios and purposeful linking of theory to clinical courses to advance students' knowledge and skills related to medication administration as they progress through the program, 3) revisiting math skills.

  16. Professional competencies learned through working on a medication education project.

    Science.gov (United States)

    Hämeen-Anttila, Katri; Saano, Susanna; Vainio, Kirsti

    2010-08-10

    To implement a medication education project and assess the competencies students learned and implemented in professional practice after graduation. Fourth-year pharmacy students planned, carried out, and reported on a real-life project during 1 study year. Outside experts and 2 faculty members facilitated the work. The aim of the medication education project was to create material that schoolteachers could use to teach children about rational use of medicines. All students who had participated in the medication education program during its 3 years were contacted (n = 31). A questionnaire was sent to the 21 students who had graduated (18 responded), and a focus group was conducted with the 10 students completing their final year of pharmacy school (9 participants). The competencies that the students reported learning most were teamwork and social interaction skills. They considered the project motivating but also found it challenging and the deadlines frustrating. Through participation in a medication education project, students learned interpersonal skills, time management, conflict resolution, and other skills that many of them already were finding valuable in their professional practice.

  17. Health Hazard Evaluation Report HETA 91-395-2244, Veterans Administration Medical Center, Los Angeles, California

    Energy Technology Data Exchange (ETDEWEB)

    Kelly, J.E.; Miller, A.

    1992-08-01

    In response to a request from an employee of the Veterans Administration Medical Center (SIC-8062), Los Angeles, California, an investigation was undertaken of exposures to chemicals in the laboratory department, excessive heat and humidity in the kitchen area of the dietetics department, and carbon-monoxide (630080) exposures inside the building. In three of five personal breathing zone samples taken in the histopathology laboratory, formaldehyde (50000) was detected at concentrations up to 0.17 part per million (ppm) and it was also present in all four of the area air samples at concentrations up to 1.1ppm. The predominant symptoms associated with work in the laboratory included occasional headaches and nose/throat irritation. Mild episodes of dermal irritation and rash were also reported. All carbon-monoxide levels were less than 5ppm. In the kitchens, relative humidity levels were below the recommended range. Temperatures were above the range of temperatures recommended for a medium level of work. The authors conclude that a potential carcinogenic risk existed for workers in laboratories which use formaldehyde. The authors recommend specific measures to lower the risk of formaldehyde exposures in the laboratory.

  18. How do Interruptions Impact Nurses’ Visual Scanning Patterns When Using Barcode Medication Administration Systems?

    Science.gov (United States)

    He, Ze; Marquard, Jenna L.; Henneman, Philip L.

    2014-01-01

    While barcode medication administration (BCMA) systems have the potential to reduce medication errors, they may introduce errors, side effects, and hazards into the medication administration process. Studies of BCMA systems should therefore consider the interrelated nature of health information technology (IT) use and sociotechnical systems. We aimed to understand how the introduction of interruptions into the BCMA process impacts nurses’ visual scanning patterns, a proxy for one component of cognitive processing. We used an eye tracker to record nurses’ visual scanning patterns while administering a medication using BCMA. Nurses either performed the BCMA process in a controlled setting with no interruptions (n=25) or in a real clinical setting with interruptions (n=21). By comparing the visual scanning patterns between the two groups, we found that nurses in the interruptive environment identified less task-related information in a given period of time, and engaged in more information searching than information processing. PMID:25954449

  19. How do interruptions impact nurses' visual scanning patterns when using barcode medication administration systems?

    Science.gov (United States)

    He, Ze; Marquard, Jenna L; Henneman, Philip L

    2014-01-01

    While barcode medication administration (BCMA) systems have the potential to reduce medication errors, they may introduce errors, side effects, and hazards into the medication administration process. Studies of BCMA systems should therefore consider the interrelated nature of health information technology (IT) use and sociotechnical systems. We aimed to understand how the introduction of interruptions into the BCMA process impacts nurses' visual scanning patterns, a proxy for one component of cognitive processing. We used an eye tracker to record nurses' visual scanning patterns while administering a medication using BCMA. Nurses either performed the BCMA process in a controlled setting with no interruptions (n=25) or in a real clinical setting with interruptions (n=21). By comparing the visual scanning patterns between the two groups, we found that nurses in the interruptive environment identified less task-related information in a given period of time, and engaged in more information searching than information processing.

  20. A comparison of medication administration errors from original medication packaging and multi-compartment compliance aids in care homes: A prospective observational study.

    Science.gov (United States)

    Gilmartin-Thomas, Julia Fiona-Maree; Smith, Felicity; Wolfe, Rory; Jani, Yogini

    2017-07-01

    No published study has been specifically designed to compare medication administration errors between original medication packaging and multi-compartment compliance aids in care homes, using direct observation. Compare the effect of original medication packaging and multi-compartment compliance aids on medication administration accuracy. Prospective observational. Ten Greater London care homes. Nurses and carers administering medications. Between October 2014 and June 2015, a pharmacist researcher directly observed solid, orally administered medications in tablet or capsule form at ten purposively sampled care homes (five only used original medication packaging and five used both multi-compartment compliance aids and original medication packaging). The medication administration error rate was calculated as the number of observed doses administered (or omitted) in error according to medication administration records, compared to the opportunities for error (total number of observed doses plus omitted doses). Over 108.4h, 41 different staff (35 nurses, 6 carers) were observed to administer medications to 823 residents during 90 medication administration rounds. A total of 2452 medication doses were observed (1385 from original medication packaging, 1067 from multi-compartment compliance aids). One hundred and seventy eight medication administration errors were identified from 2493 opportunities for error (7.1% overall medication administration error rate). A greater medication administration error rate was seen for original medication packaging than multi-compartment compliance aids (9.3% and 3.1% respectively, risk ratio (RR)=3.9, 95% confidence interval (CI) 2.4 to 6.1, phomes) and multi-compartment compliance aids (RR=2.3, 95%CI 1.1 to 4.9, p=0.03), and between original medication packaging and multi-compartment compliance aids within care homes that used a combination of both medication administration systems (RR=4.3, 95%CI 2.7 to 6.8, phomes, as well as local

  1. Causes of medication administration errors in hospitals: a systematic review of quantitative and qualitative evidence.

    Science.gov (United States)

    Keers, Richard N; Williams, Steven D; Cooke, Jonathan; Ashcroft, Darren M

    2013-11-01

    Underlying systems factors have been seen to be crucial contributors to the occurrence of medication errors. By understanding the causes of these errors, the most appropriate interventions can be designed and implemented to minimise their occurrence. This study aimed to systematically review and appraise empirical evidence relating to the causes of medication administration errors (MAEs) in hospital settings. Nine electronic databases (MEDLINE, EMBASE, International Pharmaceutical Abstracts, ASSIA, PsycINFO, British Nursing Index, CINAHL, Health Management Information Consortium and Social Science Citations Index) were searched between 1985 and May 2013. Inclusion and exclusion criteria were applied to identify eligible publications through title analysis followed by abstract and then full text examination. English language publications reporting empirical data on causes of MAEs were included. Reference lists of included articles and relevant review papers were hand searched for additional studies. Studies were excluded if they did not report data on specific MAEs, used accounts from individuals not directly involved in the MAE concerned or were presented as conference abstracts with insufficient detail. A total of 54 unique studies were included. Causes of MAEs were categorised according to Reason's model of accident causation. Studies were assessed to determine relevance to the research question and how likely the results were to reflect the potential underlying causes of MAEs based on the method(s) used. Slips and lapses were the most commonly reported unsafe acts, followed by knowledge-based mistakes and deliberate violations. Error-provoking conditions influencing administration errors included inadequate written communication (prescriptions, documentation, transcription), problems with medicines supply and storage (pharmacy dispensing errors and ward stock management), high perceived workload, problems with ward-based equipment (access, functionality

  2. The Food and Drug Administration's initiative for safe design and effective use of home medical equipment.

    Science.gov (United States)

    Weick-Brady, Mary; Singh, Simran

    2014-06-01

    Although home-use medical devices provide significant benefits, including improved quality of life and cost savings, they are associated with unique risks. These risks result from interactions among the user, the use environment, and the device, and they can greatly impact user and patient safety. This article describes measures being taken by the Food and Drug Administration to address safe use of medical equipment by trained and untrained people outside of clinical facilities.

  3. Effects of the Leadership Roles of Administrators Who Work at Special Education Schools upon Organizational Climate

    Science.gov (United States)

    Üstün, Ahmet

    2017-01-01

    This research aims to determine the effects of the leadership roles of administrators who work at special education schools upon organizational climate. This research has been conducted using the case study technique, which is a kind of qualitative research approach. The study group of this research consists of four administrators including three…

  4. Examining the Mentoring Relationships of Women Working in Intercollegiate Athletic Administration

    Science.gov (United States)

    Bower, Glenna G.; Hums, Mary A.

    2014-01-01

    The purpose of this study was to examine mentoring relationships of women working within intercollegiate athletic administration. More specifically, the mentor characteristics and the career and psychosocial benefits of having a mentor in intercollegiate athletic administration were the focus of the study. The population for this study was all…

  5. Structured Observation of School Administrator Work Activities: Methodological Limitations and Recommendations for Research, Part II.

    Science.gov (United States)

    Pitner, Nancy J.; Russell, James S.

    1986-01-01

    This paper critically reviews administrator work activity studies which follow the research of Henry Mintzberg. It discusses directions for future research using qualitative and quantitative methods and discourages research that relies solely on Mintzberg's structure. (Author/JAZ)

  6. Activities for education at work for Medical students

    Directory of Open Access Journals (Sweden)

    Mirna León Acebo

    2015-12-01

    Full Text Available Background: the growing demands of a health professional that combines study and work, school with life and teaching-learning in primary and secondary health care constitute a current social problem for the country.Objective: to design a set of activities for education at work for first year medical students, from the family doctor's office, to contribute to health promotion and disease prevention in the community, favoring the integral formation of future doctors.Methods: the program was designed in work areas for the integrated teaching of biomedical disciplines for contributing to health promotion and disease prevention in "Dr. Gustavo Aldereguía Lima” polyclinic in Las Tunas. It carried out the historic and graphical analysis of the problem; students’,  professors’ and community members’ behaviors were observed; interviews and surveys were applied to explore knowledge and experiences of students and health professionals on the promotion of health education at work; workshops on critical opinion and collective elaboration were carried out and permitted to  socialize with other teachers and health professionals the proposed program for its redesign based on collective criticism.Results: the shortcomings caused by the fragmentation of subject contents and biomedical disciplines in education at work were characterized and the plan to help to eliminate the inadequacies that occur in education at work was designed by work areas and determined by the general guidelines for its implementation, without specific indications.Conclusions: the clinical method was applied its pedagogical dimension, allowing the coordination between the traditional methods of teaching-learning and for diagnosing, to contribute to eliminate the spontaneous character in the development of education in the workplace. The program of activities was designed by work areas.

  7. Psychosocial work environment and antidepressant medication: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Westergaard-Nielsen Niels

    2009-07-01

    Full Text Available Abstract Background Adverse psychosocial work environments may lead to impaired mental health, but it is still a matter of conjecture if demonstrated associations are causal or biased. We aimed at verifying whether poor psychosocial working climate is related to increase of redeemed subscription of antidepressant medication. Methods Information on all antidepressant drugs (AD purchased at pharmacies from 1995 through 2006 was obtained for a cohort of 21,129 Danish public service workers that participated in work climate surveys carried out during the period 2002–2005. Individual self-reports of psychosocial factors at work including satisfaction with the work climate and dimensions of the job strain model were obtained by self-administered questionnaires (response rate 77,2%. Each employee was assigned the average score value for all employees at his/her managerial work unit [1094 units with an average of 18 employees (range 3–120]. The risk of first-time AD prescription during follow-up was examined according to level of satisfaction and psychosocial strain by Cox regression with adjustment for gender, age, marital status, occupational status and calendar year of the survey. Results The proportion of employees that received at least one prescription of ADs from 1995 through 2006 was 11.9% and prescriptions rose steadily from 1.50% in 1996 to the highest level 6.47% in 2006. ADs were prescribed more frequent among women, middle aged, employees with low occupational status and those living alone. None of the measured psychosocial work environment factors were consistently related to prescription of antidepressant drugs during the follow-up period. Conclusion The study does not indicate that a poor psychosocial work environment among public service employees is related to prescription of antidepressant pharmaceuticals. These findings need cautious interpretation because of lacking individual exposure assessments.

  8. The practice and effect of combined duty of administrative management, medical treatment and nursing

    Directory of Open Access Journals (Sweden)

    Min HU

    2014-09-01

    Full Text Available Objective: To explore the effect of combined duty mode on discovery and control of medical nursing hidden trouble. Method: In order to make sure that patients are in the first place, we should take the mode of combined duty of administrative management, medical treatment and nursing. Results:The incidence of nursing errors and defects reduced, and patients’ satisfaction improved. the differences were statistically significant (P<0.01 or P<0.05.Results: Combined duty can the reduce medical nursing defects, improve the efficiency of quality health care services and the management efficiency.

  9. Supervising nursing students in a technology-driven medication administration process in a hospital setting

    DEFF Research Database (Denmark)

    Gaard, Mette; Orbæk, Janne

    2016-01-01

    REVIEW QUESTION/OBJECTIVE: The objective of this review is to identify, describe and synthesize the experiences of nurse supervisors and the factors that influence the supervision of pre-graduate nursing students in undertaking technology-driven medication administration in hospital settings...

  10. Evolution of Medication Administration Workflow in Implementing Electronic Health Record System

    Science.gov (United States)

    Huang, Yuan-Han

    2013-01-01

    This study focused on the clinical workflow evolutions when implementing the health information technology (HIT). The study especially emphasized on administrating medication when the electronic health record (EHR) systems were adopted at rural healthcare facilities. Mixed-mode research methods, such as survey, observation, and focus group, were…

  11. A Tcl/Tk based graphical interface to medical and administrative information.

    Science.gov (United States)

    Webster, C; Pople, A; Silva, R; Wang, X; McLinden, S

    1994-01-01

    FELIX is an front-end application processor, with an open systems back-end, that provides a uniform and intuitive interface to clinical and administrative information. It consists of an information browser, three clinical applications, and three management applications. FELIX was developed in a community hospital environment, but has conceptual and technical roots in medical informatics and the Internet.

  12. 77 FR 70166 - Provisions of the Food and Drug Administration Safety and Innovation Act Related to Medical Gases...

    Science.gov (United States)

    2012-11-23

    ... HUMAN SERVICES Food and Drug Administration Provisions of the Food and Drug Administration Safety and Innovation Act Related to Medical Gases; Establishment of a Public Docket AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is establishing a...

  13. Administration of depot medroxyprogesterone acetate on the day of mifepristone for medical abortion: a pilot study.

    Science.gov (United States)

    Sonalkar, Sarita; McClusky, Jessica; Hou, Melody Y; Borgatta, Lynn

    2015-02-01

    We sought to evaluate satisfaction with timing of administration and continuation rates of depot medroxyprogesterone (DMPA) when given on the initial visit for first-trimester medical abortion. In this pilot study, we administered DMPA within 15 min of mifepristone administration. Participants were followed up in the clinic 7 days after enrollment and were contacted at 14 days, 28 days and 3, 6, 9 and 12 months by telephone. We assessed satisfaction with contraception timing, DMPA continuation, bleeding patterns and abortion completion. Twenty women were enrolled. At 7-day follow-up, 18 of 19 contacted participants (94.7%) were satisfied with timing of DMPA administration. Ten of 19 participants (52.6%) discontinued DMPA after the first injection. At 1 year, 3 participants out of 19 were continuing DMPA (15.7%). The median number of bleeding days after abortion was 19. Three participants had medical abortion failure. In the first year after abortion, there were four known repeat pregnancies. The timing of initiation of DMPA on the initial visit for medical abortion is satisfactory to women, but its influence on medical abortion efficacy requires further study. Continuation rates for DMPA were low in our sample. This pilot study provides groundwork for future larger studies to assess initiation of the injectable contraceptive DMPA on the day of mifepristone for medical abortion, but low continuation rates of DMPA in our sample emphasize the importance of access to intrauterine devices and implants after abortion. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. The Working Conditions of Elite Politicians and Administrators at the National and Local Level

    DEFF Research Database (Denmark)

    Hjelmar, Ulf; Holm Pedersen, Lene; Bhatti, Yosef

    of politicians, specifically between elite politicians working at different layers of government (ministers versus mayors). The results indicate that top politicians work longer hours compared to their top administrators, their work-life balance is more damaging to their families, and they are to a larger extent......This paper compares the working conditions of elite politicians and administrators. These groups allegedly have overlapping roles, which sometimes is characterized by politicians dominating managers, and in other cases as bureaucrats dominating the powerless politicians. But how do the working...... conditions of the political and administrative elites compare? This is a central question in order to understand not just the power balance between the two groups but also the attractiveness of recruitment into the respective professions. We take departure in a unique survey of all Danish ministers...

  15. Teamwork and delegation in medical homes: primary care staff perspectives in the Veterans Health Administration.

    Science.gov (United States)

    True, Gala; Stewart, Greg L; Lampman, Michelle; Pelak, Mary; Solimeo, Samantha L

    2014-07-01

    The patient-centered medical home (PCMH) relies on a team approach to patient care. For organizations engaged in transitioning to a PCMH model, identifying and providing the resources needed to promote team functioning is essential. To describe team-level resources required to support PCMH team functioning within the Veterans Health Administration (VHA), and provide insight into how the presence or absence of these resources facilitates or impedes within-team delegation. Semi-structured interviews with members of pilot teams engaged in PCMH implementation in 77 primary care clinics serving over 300,000 patients across two VHA regions covering the Mid-Atlantic and Midwest United States. A purposive sample of 101 core members of pilot teams, including 32 primary care providers, 42 registered nurse care managers, 15 clinical associates, and 12 clerical associates. Investigators from two evaluation sites interviewed frontline primary care staff separately, and then collaborated on joint analysis of parallel data to develop a broad, comprehensive understanding of global themes impacting team functioning and within-team delegation. We describe four themes key to understanding how resources at the team level supported ability of primary care staff to work as effective, engaged teams. Team-based task delegation was facilitated by demarcated boundaries and collective identity; shared goals and sense of purpose; mature and open communication characterized by psychological safety; and ongoing, intentional role negotiation. Our findings provide a framework for organizations to identify assets already in place to support team functioning, as well as areas in need of improvement. For teams struggling to make practice changes, our results indicate key areas where they may benefit from future support. In addition, this research sheds light on how variation in medical home implementation and outcomes may be associated with variation in team-based task delegation.

  16. A network collaboration implementing technology to improve medication dispensing and administration in critical access hospitals.

    Science.gov (United States)

    Wakefield, Douglas S; Ward, Marcia M; Loes, Jean L; O'Brien, John

    2010-01-01

    We report how seven independent critical access hospitals collaborated with a rural referral hospital to standardize workflow policies and procedures while jointly implementing the same health information technologies (HITs) to enhance medication care processes. The study hospitals implemented the same electronic health record, computerized provider order entry, pharmacy information systems, automated dispensing cabinets (ADC), and barcode medication administration systems. We conducted interviews and examined project documents to explore factors underlying the successful implementation of ADC and barcode medication administration across the network hospitals. These included a shared culture of collaboration; strategic sequencing of HIT component implementation; interface among HIT components; strategic placement of ADCs; disciplined use and sharing of workflow analyses linked with HIT applications; planning for workflow efficiencies; acquisition of adequate supply of HIT-related devices; and establishing metrics to monitor HIT use and outcomes.

  17. Structured Observation of School Administrator Work Activities: Methodological Limitations and Recommendations for Research, Part 1.

    Science.gov (United States)

    Pitner, Nancy J.; Russell, James S.

    1986-01-01

    This paper critically reviews studies of administrator work activities which follow the work of Henry Mintzberg (1973), concentrating on these shortcomings of the method: (1) procedural difficulties in coding; (2) design limitations of classifying activities; (3) inadequate testing of Mintzberg's hypotheses; and (4) failure to explore antecedents…

  18. The impact of type of manual medication cart filling method on the frequency of medication administration errors: A prospective before and after study

    OpenAIRE

    2011-01-01

    Background: The medication cart can be filled using an automated system or a manual method and when using a manual method the medication can be arranged either by round time or by medication name. For the manual methods, it is hypothesized that the latter method would result in a lower frequency of medication administration errors because nurses are forced to read the medication labels, but evidence for this hypothesis is lacking. Objectives: The aim of this study was to compare the frequency...

  19. [The role of chronic gastritis in past medical history with NSAID administration in patients with osteoarthrosis].

    Science.gov (United States)

    Zak, M Iu

    2014-11-01

    122 patients with osteoarthrosis, who have in the past medical history verified chronic gastritis (50 males and 72 females) at the age from 42 to 64 have been examined. Control group was comprised of 40 patients with osteoarthrosis without gastroduodenal zone pathology in the past medical history. For arthralgia relief patients were prescribed meloxicam (average dose--12.5 - 1.39 mg daily) or nimesulide (average dose--150 ± 14.91 mg daily). As a result of this research it was determined that administration of selective NSAID (meloxicam and nimesulide) in patients with chronic gastritis in the past medical history raised the risk of NSAID gastropathy/dyspepsia 2.9 times (P 0.05) of erosive gastropathy. Patients with chronic gastritis in the past medical history when taking NSAID with the purpose of gastropathy prevention are recommended to undergo gastroprotective therapy.

  20. Work Life Stress and Career Resilience of Licensed Nursing Facility Administrators.

    Science.gov (United States)

    Myers, Dennis R; Rogers, Rob; LeCrone, Harold H; Kelley, Katherine; Scott, Joel H

    2016-08-28

    Career resilience provided a frame for understanding how Licensed Nursing Facility Administrators (LNFAs) sustain role performance and even thrive in stressful skilled nursing facility work environments. Quantitative and qualitative analyses of in-depth interviews with18 LNFAs, averaging 24 years of experience were conducted by a five-member research team. Analysis was informed by evidence-based frameworks for career resilience in the health professions as well as the National Association of Long-Term Care Administrator Boards' (NAB) five domains of competent administrative practice. Findings included six sources of work stressors and six sources of professional satisfaction. Also, participants identified seven strategic principles and 10 administrative practices for addressing major sources of stress. Recommendations are provided for research and evidence-based application of the career resilience perspective to LNFA practice aimed at reducing role abandonment and energizing the delivery of the quality of care that each resident deserves.

  1. That's nice, but what does IT do? Evaluating the impact of bar coded medication administration by measuring changes in the process of care.

    Science.gov (United States)

    Holden, Richard J; Brown, Roger L; Alper, Samuel J; Scanlon, Matthew C; Patel, Neal R; Karsh, Ben-Tzion

    2011-07-01

    Health information technology (IT) is widely endorsed as a way to improve key health care outcomes, particularly patient safety. Applying a human factors approach, this paper models more explicitly how health IT might improve or worsen outcomes. The human factors model specifies that health IT transforms the work system, which transforms the process of care, which in turn transforms the outcome of care. This study reports on transformations of the medication administration process that resulted from the implementation of one type of IT: bar coded medication administration (BCMA). Registered nurses at two large pediatric hospitals in the US participated in a survey administered before and after one of the hospitals implemented BCMA. Nurses' perceptions of the administration process changed at the hospital that implemented BCMA, whereas perceptions of nurses at the control hospital did not. BCMA appeared to improve the safety of the processes of matching medications to the medication administration record and checking patient identification. The accuracy, usefulness, and consistency of checking patient identification improved as well. In contrast, nurses' perceptions of the usefulness, time efficiency, and ease of the documentation process decreased post-BCMA. Discussion of survey findings is supplemented by observations and interviews at the hospital that implemented BCMA. By considering the way that IT transforms the work system and the work process a practitioner can better predict the kind of outcomes that the IT might produce. More importantly, the practitioner can achieve or prevent outcomes of interest by using design and redesign aimed at controlling work system and process transformations.

  2. Medical library downsizing administrative, professional, and personal strategies for coping with change

    CERN Document Server

    Schott, Michael

    2005-01-01

    Learn how to stay ahead of the game when budgets and staff are cut Medical Library Downsizing: Administrative, Professional, and Personal Strategies for Coping with Change explores corporate downsizing and other company-wide events as they relate to medical librarians in their organization. This training manual is designed to help librarians prepare for a new era where shrinking budgets, inflated journal costs, and the increasing demand for new and expensive services now put salaries and jobs at risk. While focused on health care issues, this book will appeal to a general library audience and

  3. Building Community Pharmacy Work System Capacity for Medication Therapy Management

    Directory of Open Access Journals (Sweden)

    Jon C. Schommer, Ph.D.

    2012-01-01

    Full Text Available Questions within and outside of the pharmacy profession frequently arise about a community pharmacy’s capacity to provide patient-care services and maximize contributions to public health. It is surmised that community pharmacy locations must possess specific attributes and have identifiable resources within the location to effectively initiate and optimize their capacity to deliver patient care services in conjunction with medication distribution and other services. The purpose of this paper is to describe three research domains that can help pharmacies make the transition from “traditional” business models to “patient care centered” practices: (1 Work System Design, (2 Entrepreneurial Orientation, and (3 Organizational Flexibility. From these research domains, we identified 21 Work System Design themes, 4 dimensions of Entrepreneurial Orientation, and 4 types of Organizational Flexibility that can be used in combination to assist a practice location in transforming its business model to a “patient care centered” practice. The self-assessment tools we described in this paper could help realign an organization’s activities to initiate and optimize capacity for patient care.

  4. Systematic review and meta-analysis of educational interventions designed to improve medication administration skills and safety of registered nurses.

    Science.gov (United States)

    Härkänen, Marja; Voutilainen, Ari; Turunen, Elina; Vehviläinen-Julkunen, Katri

    2016-06-01

    The aim of this study is to evaluate the nature, quality and effectiveness of educational interventions designed to increase the medication administration skills and safety of registered nurses working in hospitals. A systematic review with meta-analysis. Intervention studies designed to increase the medication administration skills and safety of nurses, indexed in one or more databases (CINAHL, PubMed, Scopus, Cochrane, PsycInfo, or Medic), and published in peer-reviewed journals between January 2000 and April 2015. The nature of the interventions was evaluated by narrative analysis, the quality of studies was assessed using the Effective Public Health Practise Project Quality Assessment Tool and the effectiveness of the interventions was ascertained by calculating effect sizes and conducting a meta-analysis. A total of 755 studies were identified and 14 intervention studies were reviewed. Interventions differed by their nature, including traditional classroom training, simulation, e-learning, slide show presentations, interactive CD-ROM programme, and the use of posters and pamphlets. All interventions appeared to improve medication administration safety and skills based on original p-values. Only five studies reached strong (n=1) or moderate (n=4) quality ratings and one of them had to be omitted from the meta-analysis due unclear measures of dispersion. The meta-analysis favoured the interventions, the pooled effect size (Hedges' g) was large, 1.06. The most effective interventions were a blended learning programme including e-learning and a 60-min PowerPoint presentation. The least effective educational intervention, an interactive internet-based e-learning course, was reported in the study that achieved the only strong quality rating. It is challenging to recommend any specific intervention, because all educational interventions seem to have a positive effect, although the size of the effect greatly varies. In the future, studies sharing similar contents and

  5. Administration

    DEFF Research Database (Denmark)

    Bogen handler om den praksis, vi kalder administration. Vi er i den offentlige sektor i Danmark hos kontorfolkene med deres sagsmapper, computere, telefoner,, lovsamlinger,, retningslinier og regneark. I bogen udfoldes en mangfoldighed af konkrete historier om det administrative arbejde fra...... forskellige områder i den offentlige sektor. Hensigten er at forstå den praksis og faglighed der knytter sig til det administrative arbejde...

  6. The optimal choice of medication administration route regarding intravenous, intramuscular, and subcutaneous injection

    Science.gov (United States)

    Jin, Jing-fen; Zhu, Ling-ling; Chen, Meng; Xu, Hui-min; Wang, Hua-fen; Feng, Xiu-qin; Zhu, Xiu-ping; Zhou, Quan

    2015-01-01

    Background Intravenous (IV), intramuscular (IM), and subcutaneous (SC) are the three most frequently used injection routes in medication administration. Comparative studies of SC versus IV, IM versus IV, or IM versus SC have been sporadically conducted, and some new findings are completely different from the dosage recommendation as described in prescribing information. However, clinicians may still be ignorant of such new evidence-based findings when choosing treatment methods. Methods A literature search was performed using PubMed, MEDLINE, and Web of Sciences™ Core Collection to analyze the advantages and disadvantages of SC, IV, and IM administration in head-to-head comparative studies. Results “SC better than IV” involves trastuzumab, rituximab, antitumor necrosis factor medications, bortezomib, amifostine, recombinant human granulocyte-macrophage colony-stimulating factor, granulocyte colony-stimulating factor, recombinant interleukin-2, immunoglobulin, epoetin alfa, heparin, and opioids. “IV better than SC” involves ketamine, vitamin K1, and abatacept. With respect to insulin and ketamine, whether IV has advantages over SC is determined by specific clinical circumstances. “IM better than IV” involves epinephrine, hepatitis B immu-noglobulin, pegaspargase, and some antibiotics. “IV better than IM” involves ketamine, morphine, and antivenom. “IM better than SC” involves epinephrine. “SC better than IM” involves interferon-beta-1a, methotrexate, human chorionic gonadotropin, hepatitis B immunoglobulin, hydrocortisone, and morphine. Safety, efficacy, patient preference, and pharmacoeconomics are four principles governing the choice of injection route. Safety and efficacy must be the preferred principles to be considered (eg, epinephrine should be given intramuscularly during an episode of systemic anaphylaxis). If the safety and efficacy of two injection routes are equivalent, clinicians should consider more about patient preference and

  7. A randomized trial of hospital vs home self administration of vaginal misoprostol for medical abortion.

    Science.gov (United States)

    Shrestha, A; Sedhai, L B

    2014-01-01

    A combination of mifepristone followed after 24 hrs by misoprostol has proved a safe and effective abortifacient for termination of early pregnancy. Home use of misoprostol for medical abortion is still controversial in many countries including ours where women's literacy rate is low. Particularly in developing countries, this method markedly decreased the hospital visit which would be beneficial to patients and hospital staff. To see whether the home self administration of vaginal misoprostol was equally effective as administered by trained staff in terms of successful termination of early pregnancy. Secondary outcomes were bleeding and pain duration during medical abortion, side effects, reason for termination of pregnancy and women's acceptability of the procedure. One hundred and eighty eight women requesting medical abortion with pregnancy less than 63 days gestation were randomized into two groups either self administration of vaginal misoprostol (800 mcg) at home or hospital administration 24 hours after oral 200 mg mifepristone. Ultrasound was performed after 14 days to confirm complete abortion. The overall success rate was similar in two groups: 89.13% on home group Vs 86.9% in hospital group. Eleven out of 18 women (61.1%) having incomplete abortion had successful termination after 2nd dose misoprostol( 400 mcg). None of the women had continued pregnancy. Multigravida had slightly higher risk of failure (R.R: 1.04). Home self administration of vaginal misoprostol was safe and effective for early termination of medical abortion and was acceptable. Use of extra dose of misoprostol has advantage of higher completion rate of abortion.

  8. DRUG ADMINISTRATION: A SYSTEMIC VIEW FOR THE DEVELOPMENT OF MEDICATION ERROR PREVENTIVE ACTIONS

    Directory of Open Access Journals (Sweden)

    Silvia Helena De Bortoli Cassiani

    2004-08-01

    Full Text Available The drug administration is a very frequent activity of a hospital routine in general, as well as of itsnursing team. However studies have shown the need to implement strategies to prevent or to mitigate errors foundin this pratice. To look at the medication process thru a systemic view allows to identify its weak points and todevelop procedures to assure the safety of the customers and the professionals.

  9. Product-line administration: a framework for redefining medical record department services.

    Science.gov (United States)

    Postal, S N

    1990-06-01

    Product-line administration is a viable approach for managing medical records services in an environment that demands high quantity and quality service levels. Product-line administration directs medical record department team members to look outside of the department and seek input from the customers it is intended to serve. The feedback received may be alarming at first, as the current state of products usually reveals a true lack of customer input. As the planning, defining, managing, and marketing phases are implemented, the road will not be easy and rewards will be slow to come. Product-line administration does not provide quick fixes, but it does provide long-term problem resolution as products are refined and new products developed to meet customer needs and expectations. In addition to better meeting the needs of the department's external customers, the department's internal customers' needs and expectations will be addressed. The participative management approach will help nurture each team member's creativity. The team members will have the opportunity to reach their full potential while reaping the rewards and benefits of providing products and services that meet the needs and expectations of all department customers. The future of the health care industry promises more changes as the country moves toward some form of prospective payment in the ambulatory setting. Reactive management and the constant struggle to catch up can no longer be accepted as a management approach. It is imperative that the medical record department be viewed as a business with product lines composed of quality products. The planning, defining, managing, and marketing components of product-line administration afford responsiveness to the current situation and the development of quality products that will ensure that medical record departments are prepared for the future.

  10. Administrative Circular No. 22B (Rev. 2) - Compensation for hours of long-term shift work

    CERN Multimedia

    Department Head Office - HR Department

    2016-01-01

    Administrative Circular No. 22B (Rev. 2) entitled "Compensation for hours of long-term shift work",  approved by the Director-General following discussion in the Standing Concertation Committee meeting on 22 March 2016, will be available on 1st September 2016 via the following link: https://cds.cern.ch/record/2208538.   This revised circular cancels and replaces Administrative Circular No. 22B (Rev. 1) also entitled "Compensation for hours of long-term shift work" of March 2011. This document contains minor changes to reflect the new career structure. This circular will enter into force on 1st September 2016.

  11. Legal aspects of administrating antipsychotic medications to jail and prison inmates.

    Science.gov (United States)

    Dlugacz, Henry; Wimmer, Christopher

    2013-01-01

    The administration of antipsychotic medications to jail and prison inmates involves two related components: conducting the informed consent process in a coercive environment and, where consent is not obtained, forcible administration of medication if needed. In the United States, both involve common law, statutory, and constitutional principles. Obtaining informed consent in correctional institutions is complicated. Patients in correctional institutions lack access to alternate sources of information, and depend on the correctional system completely - a system which they may distrust. This may influence the patient's view of the administering physician. Where consent cannot be obtained, forcible administration may be legally permissible for two primary reasons: to restore a criminal defendant to competency in order to stand trial and to ameliorate severe symptoms of mental disability, particularly when they threaten the safety of self, others, or in some instances, property. The interests at stake for the individual and the government, and the legal standards developed to balance these interests, differ between the two situations. When considering challenges to forcible medication of inmates serving a prison sentence, the United States Supreme Court has treated the interest of the institution in maintaining security as paramount. By contrast, when considering challenges to forcible medication of pretrial detainees, the Court's concern for the fair trial rights guaranteed by the Sixth Amendment has seemingly led it to moderate its emphasis on security. However, this distinction is not stable and may in fact be breaking down, as the recent case of Jared Loughner demonstrates. This article discusses the various federal, state, and international legal standards applicable to both informed consent and forcible medication, and their implementation in the correctional setting, focusing on issues related to the United States. Copyright © 2013 Elsevier Ltd. All rights

  12. Status Quo and Future Development of Medical Social Work in China

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    LI Bing-shui, TONG Yu-lin, WU Wei (School of Humanities and Social Sciences, North China Electric Power University, Baoding 071003, China) Abstract:Medical social work is key to carrying out medical and health system reform in China, and to promoting universal access to medical and health services. In order to solve the problems with medical so- cial work in China, the paper first analyzes the necessity and present difficulties, then puts forward several countermeasures, such as promoting the publicity of medical social work, improving relevant legislation, enhancing the social identity and strengthening the education of qualified personnel with medical social work.

  13. The Relationship Between Nursing Experience and Education and the Occurrence of Reported Pediatric Medication Administration Errors.

    Science.gov (United States)

    Sears, Kim; O'Brien-Pallas, Linda; Stevens, Bonnie; Murphy, Gail Tomblin

    2016-01-01

    Medication errors are one of the most common incidents in the hospitals. They can be harmful, and they are even more detrimental for pediatric patients. This study explored the relationship between nursing experience, education, the frequency and severity of reported pediatric medication administration errors (PMAEs). The data for this study were collected from a larger pan Canadian study. A survey tool was developed to collect self-reported data from nurses. In addition to descriptive statistics, a Poisson regression or a multiple linear regression was completed to address the research questions, and a Boneferrai correction was conducted to adjust for the small sample size. Results demonstrated that on units with more nurses with a higher level of current experience, more PMAEs were reported (p=.001), however; the PMAEs reported by these nurses were not as severe (p=.003). Implications to advance both safe medication delivery in the pediatric setting and safe culture of reporting for both actual and potential errors are identified.

  14. Medical directors as partners in creating healthy work environments.

    Science.gov (United States)

    Disch, J; Beilman, G; Ingbar, D

    2001-08-01

    Relationships between nurses and physicians in the intensive care unit can range from collegial and supportive to dysfunctional and abusive. When there is trust, open communication, respect, and a sense of camaraderie, the work is still challenging but gets done: priorities are met and people feel good about what they are doing. When these key elements are missing, satisfaction on the part of staff and patients decreases and turnover and costs increase. More importantly, research findings suggest that improving collaboration and teamwork are more than "feel-good" exercises: patient outcomes of care can be jeopardized when nurses, physicians, and other members of the critical care team are not communicating or collaborating. The nurse manager and medical director of the unit, as leaders of this team, are responsible for ensuring not only that quality care is delivered to patients, but also that the environment is supportive to caregivers. Purposefully establishing a collaborative partnership and then modeling these behaviors to the rest of the team, and holding them accountable, are key steps in creating an environment that is healing to patients, families, and caregivers.

  15. Patient safety and technology-driven medication e A qualitative study on how graduate nursing students navigate through complex medication administration

    DEFF Research Database (Denmark)

    Orbæk, Janne; Gaard, Mette; Fabricius, Pia

    2014-01-01

    ways of educating nursing students in today's medication administration. Aim: To explore nursing students' experiences and competences with the technology-driven medication administration process. Methods: 16 pre-graduate nursing students were included in two focus group interviews which were recorded...... for the technology-driven medication process, nursing students face difficulties in identifying and adopting best practices. The impact of using technology on the frequency, type and severity of medication errors; the technologies implications on nursing professionalism and the nurses ability to secure patient......Background: The technology-driven medication process is complex, involving advanced technologies, patient participation and increased safety measures. Medication administration errors are frequently reported, with nurses implicated in 26e38% of in-hospital cases. This points to the need for new...

  16. The optimal choice of medication administration route regarding intravenous, intramuscular, and subcutaneous injection

    Directory of Open Access Journals (Sweden)

    Jin JF

    2015-07-01

    Full Text Available Jing-fen Jin,1 Ling-ling Zhu,2 Meng Chen,3 Hui-min Xu,3 Hua-fen Wang,1 Xiu-qin Feng,1 Xiu-ping Zhu,3 Quan Zhou31Division of Nursing, 2VIP Care Ward, Division of Nursing, 3Department of Pharmacy, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of ChinaBackground: Intravenous (IV, intramuscular (IM, and subcutaneous (SC are the three most frequently used injection routes in medication administration. Comparative studies of SC versus IV, IM versus IV, or IM versus SC have been sporadically conducted, and some new findings are completely different from the dosage recommendation as described in prescribing information. However, clinicians may still be ignorant of such new evidence-based findings when choosing treatment methods.Methods: A literature search was performed using PubMed, MEDLINE, and Web of Sciences™ Core Collection to analyze the advantages and disadvantages of SC, IV, and IM administration in head-to-head comparative studies.Results: “SC better than IV” involves trastuzumab, rituximab, antitumor necrosis factor medications, bortezomib, amifostine, recombinant human granulocyte-macrophage colony-stimulating factor, granulocyte colony-stimulating factor, recombinant interleukin-2, immunoglobulin, epoetin alfa, heparin, and opioids. “IV better than SC” involves ketamine, vitamin K1, and abatacept. With respect to insulin and ketamine, whether IV has advantages over SC is determined by specific clinical circumstances. “IM better than IV” involves epinephrine, hepatitis B immunoglobulin, pegaspargase, and some antibiotics. “IV better than IM” involves ketamine, morphine, and antivenom. “IM better than SC” involves epinephrine. “SC better than IM” involves interferon-beta-1a, methotrexate, human chorionic gonadotropin, hepatitis B immunoglobulin, hydrocortisone, and morphine. Safety, efficacy, patient preference, and pharmacoeconomics are four principles

  17. Field Practica in Social Work Administration: Tasks, Auspice, Selection Criteria and Outcomes.

    Science.gov (United States)

    Neugeboren, Bernard

    1988-01-01

    A study of the field practicum in one master's program in social work administration over 10 years looked at student performance and satisfaction and their relationship to tasks performed by students, the auspice of the field placement agency, and student prior experience. The study and its policy implications are discussed. (MSE)

  18. Attitudes towards Knowledge Management of School Administrators and Teachers Working in Turkish Schools

    Science.gov (United States)

    Dogan, Soner; Yigit, Yakup

    2014-01-01

    The aim of this study is to investigate attitudes of school administrators and teachers working in Turkish schools towards knowledge management. In this research, an explanatory design incorporating quantitative and qualitative methods was used. The quantitative strand of the study was designed as a survey model, and the data was collected from…

  19. Attitudes towards Knowledge Management of School Administrators and Teachers Working in Turkish Schools

    Science.gov (United States)

    Dogan, Soner; Yigit, Yakup

    2014-01-01

    The aim of this study is to investigate attitudes of school administrators and teachers working in Turkish schools towards knowledge management. In this research, an explanatory design incorporating quantitative and qualitative methods was used. The quantitative strand of the study was designed as a survey model, and the data was collected from…

  20. Collaborative Affordances of Hybrid Patient Record Technologies in Medical Work

    DEFF Research Database (Denmark)

    Houben, Steven; Frost, Mads; Bardram, Jakob E

    2015-01-01

    The medical record is a central artifact used to organize, communicate and coordinate information related to patient care. Despite recent deployments of electronic health records (EHR), paper medical records are still widely used because of the affordances of paper. Although a number of approaches...... to digitally augment a paper medical record. We report on two studies: a field study in which we describe the benefits and challenges of using a combination of electronic and paper-based medical records in a large university hospital and a deployment study in which we analyze how 8 clinicians used the Hy...

  1. TU-CD-213-00: Administrative Aspects of Medical Physics

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2015-06-15

    As part of the AAPM’s Scope of Practice, medical physicists are expected to collaborate effectively with practioners and allied health care providers. Interpersonal skills such as communication, negotiation and persuasion are vital for successful collaboration to achieve shared goals. This session will provide some theoretical background of these interpersonal skills as well as specific techniques and practical tools to influence others. Applications of these interpersonal skills for administrative and human resource management purposes vital to medical physicists will be shared. Session attendees will gain knowledge and tools to help them effectively collaborate with administrative and physician leaders in areas such as capital and human resource selection, prioritization, and implementation. Participants will hear methods of how to articulate their goals and to understand the goals of administration, helping ensure alignment of purpose. Session speakers will present one of the topics: equipment selection, budget creation, contracts, and program-related policy development. Specifics may include designing a business case in language that administrators understand, calculating the prioritization of budget requests, and influencing policies for safe and effective care. Human resource topics may include staffing justification, recruitment for fit, employment contracts, and benefits. Speakers will provide examples in both radiation therapy and diagnostic imaging departments and will share experiences and outcomes of their approaches for better results. Learning Objectives: After this course attendees will be better able to Understand the shared goal between administrative and physicist leadership. Articulate the “why” of the technical or human resource need. Utilize communication, negotiation and persuasion tools to improve collaboration.

  2. Analysis of the technology acceptance model in examining hospital nurses' behavioral intentions toward the use of bar code medication administration.

    Science.gov (United States)

    Song, Lunar; Park, Byeonghwa; Oh, Kyeung Mi

    2015-04-01

    Serious medication errors continue to exist in hospitals, even though there is technology that could potentially eliminate them such as bar code medication administration. Little is known about the degree to which the culture of patient safety is associated with behavioral intention to use bar code medication administration. Based on the Technology Acceptance Model, this study evaluated the relationships among patient safety culture and perceived usefulness and perceived ease of use, and behavioral intention to use bar code medication administration technology among nurses in hospitals. Cross-sectional surveys with a convenience sample of 163 nurses using bar code medication administration were conducted. Feedback and communication about errors had a positive impact in predicting perceived usefulness (β=.26, Pmodel predicting for behavioral intention, age had a negative impact (β=-.17, Pmodel explained 24% (Ptechnology.

  3. Galvanizing medical students in the administration of influenza vaccines: the Stanford Flu Crew

    Directory of Open Access Journals (Sweden)

    Rizal RE

    2015-07-01

    Full Text Available Rachel E Rizal,1,* Rishi P Mediratta,1,* James Xie,1 Swetha Kambhampati,1 Kelsey Hills-Evans,1 Tamara Montacute,1 Michael Zhang,1 Catherine Zaw,2 Jimmy He,2 Magali Sanchez,2 Lauren Pischel1 1Stanford University School of Medicine, Stanford, CA, USA; 2Stanford University, Stanford, CA, USA *These authors contributed equally to this work Abstract: Many national organizations call for medical students to receive more public health education in medical school. Nonetheless, limited evidence exists about successful service-learning programs that administer preventive health services in nonclinical settings. The Flu Crew program, started in 2001 at the Stanford University School of Medicine, provides preclinical medical students with opportunities to administer influenza immunizations in the local community. Medical students consider Flu Crew to be an important part of their medical education that cannot be learned in the classroom. Through delivering vaccines to where people live, eat, work, and pray, Flu Crew teaches medical students about patient care, preventive medicine, and population health needs. Additionally, Flu Crew allows students to work with several partners in the community in order to understand how various stakeholders improve the delivery of population health services. Flu Crew teaches students how to address common vaccination myths and provides insights into implementing public health interventions. This article describes the Stanford Flu Crew curriculum, outlines the planning needed to organize immunization events, shares findings from medical students' attitudes about population health, highlights the program’s outcomes, and summarizes the lessons learned. This article suggests that Flu Crew is an example of one viable service-learning modality that supports influenza vaccinations in nonclinical settings while simultaneously benefiting future clinicians. Keywords: immunizations, vaccine delivery, vaccinations 

  4. Administrative "health courts" for medical injury claims: the federal constitutional issues.

    Science.gov (United States)

    Elliott, E Donald; Narayan, Sanjay A; Nasmith, Moneen S

    2008-08-01

    Our article analyzes whether the federal government may constitutionally supplant a traditional system of common-law trials before state judges and juries with new federal institutions designed by statute for compensating victims of medical injuries. Specifically, this article examines the federal constitutional issues raised by various proposals to replace traditional medical malpractice litigation in state courts with a federal system of administrative "health courts." In doing so, we address the following constitutional issues: 1. Is there federal authority to preempt state law (the commerce clause and spending clause issues)? 2. May jurisdiction be created in non-article 3 tribunals, and may claims be decided without trial by jury (the separation of powers and Seventh Amendment issues)? 3. Would pilot programs that require some claims to be pursued in a federal administrative forum while other claimants are left to pursue traditional state tort law remedies be constitutional (the equal protection issue)? The article concludes that a federal compensation system through administrative health courts should be constitutional provided the statute is appropriately drafted and that appropriate factual findings are made concerning the benefits to patients and the public as well as to doctors and their insurers.

  5. Comparison of Burnout among Medical Residents before and after the Implementation of Work Hours Limits

    Science.gov (United States)

    Martini, Shahm; Arfken, Cynthia L.; Balon, Richard

    2006-01-01

    Objective: The authors assess whether implementation of work hour limits is associated with a lower prevalence of medical resident burnout. Method: A survey was mailed to medical residents in different medical specialties at one university. Results: Somewhat lower burnout prevalence was reported among residents after implementation of work hour…

  6. Re-inventing medical work and training: a view from generation X.

    Science.gov (United States)

    Skinner, Clare A

    2006-07-01

    Medical career preferences are changing, with doctors working fewer hours and seeking "work-life balance". There is an urgent need for creative workplace redesign if Australia is to have a sustainable health care system. Postgraduate medical education must adapt to changing medical roles. Curricula should be outcomes-based, should allow flexible delivery, and should consider future workforce needs.

  7. Comparison of Burnout among Medical Residents before and after the Implementation of Work Hours Limits

    Science.gov (United States)

    Martini, Shahm; Arfken, Cynthia L.; Balon, Richard

    2006-01-01

    Objective: The authors assess whether implementation of work hour limits is associated with a lower prevalence of medical resident burnout. Method: A survey was mailed to medical residents in different medical specialties at one university. Results: Somewhat lower burnout prevalence was reported among residents after implementation of work hour…

  8. Proposal for a European Public Health Research Infrastructure for Sharing of health and Medical administrative data (PHRIMA).

    Science.gov (United States)

    Burgun, Anita; Oksen, Dina V; Kuchinke, Wolfgang; Prokosch, Hans-Ulrich; Ganslandt, Thomas; Buchan, Iain; van Staa, Tjeerd; Cunningham, James; Gjerstorff, Marianne L; Dufour, Jean-Charles; Gibrat, Jean-Francois; Nikolski, Macha; Verger, Pierre; Cambon-Thomsen, Anne; Masella, Cristina; Lettieri, Emanuele; Bertele, Paolo; Salokannel, Marjut; Thiebaut, Rodolphe; Persoz, Charles; Chêne, Geneviève; Ohmann, Christian

    2015-01-01

    In Europe, health and medical administrative data is increasingly accumulating on a national level. Looking further than re-use of this data on a national level, sharing health and medical administrative data would enable large-scale analyses and European-level public health projects. There is currently no research infrastructure for this type of sharing. The PHRIMA consortium proposes to realise the Public Health Research Infrastructure for Sharing of health and Medical Administrative data (PHRIMA) which will enable and facilitate the efficient and secure sharing of healthcare data.

  9. 护理给药错误的调查分析及应对策略%Analysis and Countermeasure of Nursing Medication Administration Errors

    Institute of Scientific and Technical Information of China (English)

    郑惠芳; 谢丽萍; 董卫红; 孔月华

    2012-01-01

    Objective To analyze the causes of nursing medication administration errors and to seek certain countermeasures, so as to elevate the clinical medication administration safety. Methods The data of nursing medication administration errors from 2006 to 2010 in a Grade-Ⅲ Level B hospital were analyzed retrospectively. Results Of 98 cases of nursing medication administration errors,medication errors was the most common malpractice (30. 61%) ;medication error probability was highest in nurses with 1 to 2 years of working years (45. 94%); nursing medication administration errors were most frequently seen in day shift (71. 43%) ;the most common causes of medication errors was irregular operation process(29. 85%). Conclusion To ensure the medication administration safety of patients, the nursing administrators should enhance the connotations construction of nurse troop, strengthen drug administration rules and regulations, reform the existing nursing models, strengthen self-regulation of the nursing team, and promote the non-accountability reporting system of adverse events.%目的 探讨护理给药错误发生的原因及应对策略,以提高临床用药安全.方法 对某三级乙等医院2006-2010年护理系统上报的98例护理给药错误进行回顾性统计分析.结果 98例给药差错中,以药品错误最多,占30.61%;以白班发生错误的频次最多,占71.43%;以工作1~2年护士发生给药错误概率最高,占45.94%;给药错误的最常见原因为操作流程不规范,占29.85%.结论 应加强护士队伍业务素质建设,强化给药规章制度,改革现有的护理排班模式,加强护理队伍的自律监管,并提倡不良事件无责上报制度,以提高患者的用药安全.

  10. Distance to Veterans Administration Medical Centers as a Barrier to Specialty Care for Homeless Women Veterans.

    Science.gov (United States)

    Gawron, Lori M; Pettey, Warren B P; Redd, Andrew M; Suo, Ying; Gundlapalli, Adi V

    2017-01-01

    Homeless women Veterans have a high prevalence of chronic mental and physical conditions that necessitate frequent healthcare visits, but travel burdens to specialty services may be overwhelming to navigate for this population, especially for those in rural settings. Access to specialty care is a key priority in the Veterans Health Administration (VHA) and understanding the geographic distribution and rural designation of this population in relation to medical centers (VAMC) can assist in care coordination. We identified 41,747 women Veterans age 18-44y with administrative evidence of homelessness in the VHA anytime during 2002-2015. We found 7% live in rural settings and 29% live >40miles from a VAMC. The mean travel distance for homeless women Veterans with a rural designation to a VAMC specialty center was 107 miles. Developing interventions to overcome this travel burden and engage vulnerable Veterans in necessary care can improve overall health outcomes for this high-risk population.

  11. [Medical and administrative neglect of high blood glucose levels; comments on a decision by a medical disciplinary tribunal].

    Science.gov (United States)

    Erkelens, D W

    1997-04-26

    A 41-year-old man died in 1995 during ketoacidotic coma. He suffered from chronic manic depression, used lithium carbonate, and consulted the psychiatrist and the general practitioner (GP) frequently. Diabetes had not been diagnosed. Late in 1994 the situation worsened, the patient complaining of general illness, fatigue, nausea, vomiting, diarrhoea, thirst and excessive drinking of soft drinks. The GP referred the patient to a neurologist who found no neurological disorder but who asked for determination of blood glucose and lithium levels, and of thyroid function. The day afterwards the neurologist went on holiday. The blood glucose level proved to be elevated (16.9 mmol/1) but nobody took any action and the GP was not informed. Six days after returning from his holiday, the neurologist who had an administration backlog, found the laboratory findings only after he had been informed that the patient had just died. The court gave the neurologist a warning. Lessons are that somatic problems should be treated as such, even in a psychiatric patient, and that a good administrative signalling system is a prerequisite for quality in medical practice.

  12. Changes in Knowledge, Attitudes, and Work Preferences Following Courses in Gerontology among Medical, Nursing, and Social Work Students.

    Science.gov (United States)

    Carmel, Sara; And Others

    1992-01-01

    Completion of Palmore's Facts on Aging Quiz by 127 medical, 52 nursing, and 45 social work students in Israel revealed that nursing and social work students increased knowledge of aging and that no correlation was found among knowledge, attitudes, and work preferences among any group, implying that increased knowledge about aging does not…

  13. Administrative circular n°23 (Rev. 3) – Special working hours

    CERN Multimedia

    2013-01-01

    Administrative Circular No. 23 (Rev. 3) entitled “Special working hours”, approved by the Director-General following discussion at the Standing Concertation Committee meeting of 11 October 2012 and entering into force on 1 January 2013, is available on the intranet site of the Human Resources Department.   This circular is applicable to staff members and fellows. It cancels and replaces Administrative Circular No. 23 (Rev. 2) entitled “Special working hours” of December 2008. Paragraph 6 a) of Annex II of this circular was revised following the modification of Article III 1.04 of the Staff Regulations approved by Council on 14 December 2012. The modification serves to adapt the minimum rest time to the fact that, in case of rapidly alternating shifts, a maximum of seven consecutive shifts may be performed. Department Head Office HR Department

  14. The effect of a multifaceted educational intervention on medication preparation and administration errors in neonatal intensive care

    NARCIS (Netherlands)

    Chedoe, Indra; Molendijk, Harry; Hospes, Wobbe; Van den Heuvel, Edwin B.; Taxis, Katja

    2012-01-01

    Objective To examine the effect of a multifaceted educational intervention on the incidence of medication preparation and administration errors in a neonatal intensive care unit (NICU). Design Prospective study with a preintervention and postintervention measurement using direct observation. Setting

  15. The diffusion of innovation in nursing regulatory policy: removing a barrier to medication administration training for child care providers.

    Science.gov (United States)

    Torre, Carolyn T; Crowley, Angela A

    2011-08-01

    Safe medication administration is an essential component of high-quality child care. Its achievement in New Jersey was impeded by a controversy over whether teaching child care providers medication administration involves registered nurses in the process of nursing delegation. Through the theoretical framework of the Diffusion of Innovation, this paper examines how the interpretation of regulatory policy related to nursing practice in New Jersey was adjusted by the Board of Nursing following a similar interpretation of regulatory policy by the Board of Nursing in Connecticut. This adjustment enabled New Jersey nurses to continue medication administration training for child care providers. National data supporting the need for training child care providers in medication administration is presented, the Diffusion of Innovation paradigm is described; the Connecticut case and the New Jersey dilemma are discussed; the diffusion process between the two states is analyzed and an assessment of the need for further change is made.

  16. Situated Learning as a Model for the Design of an Interactive Multimedia Program on Medication Administration for Nurses.

    Science.gov (United States)

    Stillman, Gloria; Alison, Justine; Croker, Felicity; Tonkin, Carol

    1998-01-01

    This case study examines the use of a situated learning framework providing authentic contexts, authentic activities, access to expert performance, and opportunities for student reflection for the design of an interactive multimedia program on medication administration for nursing students. (PEN)

  17. Advancing Social Work Curriculum in Psychopharmacology and Medication Management

    Science.gov (United States)

    Farmer, Rosemary L.; Bentley, Kia J.; Walsh, Joseph

    2006-01-01

    The authors reviewed current literature and curriculum resources on psychopharmacology and social work. They argue that baccalaureate and master of social work courses need to routinely include more in-depth knowledge on psychopharmacology and provide a more critical social work-focused approach to this content due to the increasing complexity of…

  18. [Patients' preferences for nurses' nonverbal expressions of warmth during nursing rounds and administration of oral medication].

    Science.gov (United States)

    Kim, H S; Kim, M S

    1990-12-01

    Nursing involves deep human interpersonal relationships between nurses and patients. But in modern Korea, the nurse-patient relationship tends to be ritualistic and mechanestic. Patients usually express the hope that nurses be more tender and kind. Patients expect nurses to express their warmth especially through nonverbal behaviour. This study was conducted to identify patients' preferences for nurse's nonverbal expressions of warmth. Through the confirmation of these preferences, nurses may learn how to enhance their interpersonal relationships with patients. Subjects for the study were 73 patients who had been admitted to a university teaching hospital for at least three days and agreed to be interviewed by the investigator. The interactions were studied nonverbal expressions of warmth during nursing rounds and administration of oral medication. The interview schedule was especially designed by the investigator to measure the nurse's posture, the distance between the nurse and the patient, the nurse's eye contact, facial expression, hand motion and head nodding. Data analysis included frequencies, percentages and X2-test. The results of this study may be summerized as follows: 1. Patient's preferences for nurse's nonverbal expressions of warmth during nursing rounds. Preferred nurse's posture was sitting (50.7%) or standing (49.3%) opposite the patient. Preferred distance between the nurse and the patient was close to the bed (93.2%), less than 1m. Preferred eye contact was directed to the patient's eyes or their affected part (41.1%). Preferred facial expression was a smile (97.3%). Preferred hand motions were light gestures (41.1%). Patients preferred head nodding which approved their own opinions (69.9%). 2. Patient's preferences for nurse's nonverbal expressions of warmth during administration of oral medication. Preferred nurse's posture was standing and waiting to confirm that the medication had been taken (58.9%). Preferred distance from the patient was

  19. Healing the healer: stress and coping strategies in the field of temporary medical work.

    Science.gov (United States)

    Vorell, Matthew S; Carmack, Heather J

    2015-01-01

    Temporary medical workers provide a vital role for the medical profession. These individuals, however, occupy a unique work arrangement as professional-specific temporary workers. Temporary medical workers often find themselves bearing the burdens of both medical workers and temporary workers. In partnership with the largest medical temporary agency in the United States, we content analyzed the responses of 86 medical temporary workers, geared at uncovering the primary stressors and coping strategies this sample enacted. Our findings concluded that temporary medical workers experienced stressors associated with both their medical and temporary roles, although more stressors were associated with temporary work than with medical care. Participants also relied heavily on coping strategies that allowed them to avoid these stressors.

  20. 77 FR 41413 - Draft Guidance for Industry and Food and Drug Administration Staff; Medical Devices: The Pre...

    Science.gov (United States)

    2012-07-13

    ... HUMAN SERVICES Food and Drug Administration Draft Guidance for Industry and Food and Drug Administration... establishment in 1995, the pre-IDE program has been a successful resource for both medical device applicants and... clinical studies conducted outside of the United States to support future U.S. marketing applications (Ref...

  1. Health Economics Studies Information Exchange; Reports of Current Research in Health Economics, and Medical Care Administration. Publication No. 1719.

    Science.gov (United States)

    Public Health Service (DHEW), Arlington, VA. Home Economics Branch.

    The first volume of a continuing series reporting research in progress in health economics and medical care organization and administration was compiled by contacting (1) graduate schools offering degrees in the health professions, sociology, economics, public administration, and public health, (2) charitable foundations indicating an interest in…

  2. Medical outcomes associated with prescription opioid abuse via oral and non-oral routes of administration.

    Science.gov (United States)

    Green, Jody L; Bucher Bartelson, Becki; Le Lait, M Claire; Roland, Carl L; Masters, Elizabeth T; Mardekian, Jack; Bailey, J Elise; Dart, Richard C

    2017-06-01

    Prescription opioid abuse and misuse is a serious and growing public health issue. While the most common form of abuse is swallowing intact tablets/capsules, some abusers manipulate, or tamper with, these medications by altering the dosage form to allow for non-oral routes of administration (e.g., injection, inhalation) in order to achieve more rapid or enhanced psychoactive effects. Because administration of opioids via non-oral routes results in greater systemic availability and more rapid central nervous system penetration, we hypothesized that death and major medical outcomes occur more frequently with non-oral routes compared to oral route alone. This retrospective cohort study analyzed data from the Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS) System Poison Center Program to investigate relative risk of prescription opioid abuse via oral and non-oral routes. While the oral route was the most commonly reported route of abuse (64.0%), non-oral routes were reported in 14.6% exposures and unknown routes in 21.4% exposures. The relative risk of an exposure resulting in death or major effect was 2.43 (95% CI 1.97, 2.99) if non-oral routes were reported compared to exposures involving oral route only. Analysis of acute health events recorded by poison centers indicates that death or major effects are twice as likely to occur with intentional abuse of prescription opioids via non-oral routes of administration than ingestion alone. Effective interventions to prevent abuse via non-oral routes of solid dosage forms of prescription opioids, such as abuse-deterrent formulations could have a significant public health impact. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  3. METHOD OF THE EVALUATION OF THE MEDICAL EXPOSURE OF THE POPULATION IN THE RUSSIAN FEDERATION ADMINISTRATIVE TERRITORIES

    Directory of Open Access Journals (Sweden)

    V. G. Morozov

    2008-01-01

    Full Text Available The use of the comparable indexes in the given technique of the processing of the statistics of the population doses from medical allows to conduct a comparative analysis of the population medical exposure for administrative territories of Russian Federation.

  4. Internal conflict: undergraduate nursing students' response to inadequate supervision during the administration of medication.

    Science.gov (United States)

    Reid-Searl, Kerry; Moxham, Lorna; Walker, Sandra; Happell, Brenda

    2009-01-01

    Current legislation in Queensland requires that undergraduate nursing students are personally supervised when administering restricted medication in the clinical setting. Previous research suggests this is not always the case. Exploration of the experiences of undergraduate nursing students was undertaken using grounded theory as the methodological framework. In-depth, semi-structured interviews were conducted with 28 students during their final year clinical placements. Data were analysed using a constant comparative approach. The focus of this paper is to examine the emergent theme of internal conflict, which is experienced by the participants as a consequence of the theory-practice gap. This conflict is reflected by the divergent requirements and expectations between the university and the registered nurses providing supervision in light of the role both play in student assessment. In addition, the participants voiced concerns about patient safety due to the potential for medication error. Internal conflict was identified by participants as the cause of considerable fear and anxiety about passing the course, getting a job and avoiding harm to patients. These findings raise serious concerns about the adequacy of the supervision for nursing students and highlighted the need for a more concerted approach to the theoretical and clinical education of students in relation to medication administration.

  5. Reflections on health staff working with elderly people in the public administration. Case studies /

    Directory of Open Access Journals (Sweden)

    Concepción Nieto-Morales

    2013-10-01

    Full Text Available The speech of female health professionals who work in public residences is analyzed in this writing, a work which most of them choose as their vocation, from a perspective in public employment and personal cares. The crisis has destroyed positions, social rights, made precarious the employment done in all the environments and especially in the Administration, the outsourcing of work is started, the increasing of flexibility of the labor conditions, the instability… Everything worsens particularly the conditions of the public health professionals. The question arisen is: where are the labor stability, the vocation and working in a position each one has been trained for? The labor conditions worsen, making employment and positions more precarious. The statistics reflect there is less unemployment when there is more training; but there are many university people who work in a position different to the one they have been trained for. A group of discussion composed by six people with a university degree in Nursing and Auxiliary Nursing Care, who work in public residences for elderly people, has been created to focus on this work, out of the labor place.

  6. That’s nice, but what does IT do? Evaluating the impact of bar coded medication administration by measuring changes in the process of care

    Science.gov (United States)

    Holden, Richard J.; Brown, Roger L.; Alper, Samuel J.; Scanlon, Matthew C.; Patel, Neal R.; Karsh, Ben-Tzion

    2011-01-01

    Health information technology (IT) is widely endorsed as a way to improve key health care outcomes, particularly patient safety. Applying a human factors approach, this paper models more explicitly how health IT might improve or worsen outcomes. The human factors model specifies that health IT transforms the work system, which transforms the process of care, which in turn transforms the outcome of care. This study reports on transformations of the medication administration process that resulted from the implementation of one type of IT: bar coded medication administration (BCMA). Registered nurses at two large pediatric hospitals in the US participated in a survey administered before and after one of the hospitals implemented BCMA. Nurses’ perceptions of the administration process changed at the hospital that implemented BCMA, whereas perceptions of nurses at the control hospital did not. BCMA appeared to improve the safety of the processes of matching medications to the medication administration record and checking patient identification. The accuracy, usefulness, and consistency of checking patient identification improved as well. In contrast, nurses’ perceptions of the usefulness, time efficiency, and ease of the documentation process decreased post-BCMA. Discussion of survey findings is supplemented by observations and interviews at the hospital that implemented BCMA. By considering the way that IT transforms the work system and the work process a practitioner can better predict the kind of outcomes that the IT might produce. More importantly, the practitioner can achieve or prevent outcomes of interest by using design and redesign aimed at controlling work system and process transformations. PMID:21686318

  7. Medical Geography and Topography Works: the first environmental studies in a specific city

    National Research Council Canada - National Science Library

    Angela Lúcia de Araújo Ferreira; Anna Rachel Baracho Eduardo; Ana Caroline de Carvalho Lopes Dantes

    2012-01-01

    ... between the eighteenth and twentieth centuries. These ideas were systematically compiled in works known as Medical Geography and Topography Works which, when known throughout the world, ended up becoming precise descriptions of the cities...

  8. Medical graduates feel well-prepared for clinical work

    DEFF Research Database (Denmark)

    Mørcke, Anne Mette; Nielsen, Dorte Guldbrand; Kjeldsen, Inge Trads

    2011-01-01

    INTRODUCTION: The purpose of this study was to assess the coherence between the undergraduate medical program at Aarhus University and the foundation year. MATERIAL AND METHODS: This cross-sectional questionnaire survey included 503 doctors graduated from Aarhus University from the winter of 2007....../2008 to the summer of 2009. RESULTS: The response rate was 73%. Approximately 73% of the respondents were in their foundation year or their first year of specialist training and 83% generally felt well-prepared. Respondents found that most of the learning outcomes of the undergraduate medical curriculum at Aarhus...... University are important for junior doctors. More than 90% of the respondents estimated that they were sufficiently prepared when it came to core outcomes such as history taking and physical examination. Five issues diverged considerably in importance stated and preparedness experienced: suggestion...

  9. Collaboration between schools of social work and university medical centers.

    Science.gov (United States)

    Bracht, N F; Briar, S

    1979-05-01

    Although the interface involving social work, medicine, and the other health professions occurs primarily in the day-to-day world of practice in hospitals and other health agencies, an equally important opportunity exists for interaction at the university level between schools of social work and schools for health professionals. This artice analyzes one school's effort to build effective interdisciplinary linkages.

  10. Supervision of the work of executive and administrative bodies of units of local self government in Croatia

    OpenAIRE

    Dario ?erđa; Teodor Antić

    2016-01-01

    The specificity of supervision over the work of executive and administrative bodies of local self-government lies in the contradiction between administrative characteristics of units of local self-government and its self-administrative characteristics. Therefore, it should be organised in a way that respects the self-administration powers of local self-government, but at the same time, protects legality in the entire legal system. This paper investigates the supervision of executive and admin...

  11. Medical Team Training: Using Simulation as a Teaching Strategy for Group Work

    Science.gov (United States)

    Moyer, Michael R.; Brown, Rhonda Douglas

    2011-01-01

    Described is an innovative approach currently being used to inspire group work, specifically a medical team training model, referred to as The Simulation Model, which includes as its major components: (1) Prior Training in Group Work of Medical Team Members; (2) Simulation in Teams or Groups; (3) Multidisciplinary Teamwork; (4) Team Leader…

  12. Medical Team Training: Using Simulation as a Teaching Strategy for Group Work

    Science.gov (United States)

    Moyer, Michael R.; Brown, Rhonda Douglas

    2011-01-01

    Described is an innovative approach currently being used to inspire group work, specifically a medical team training model, referred to as The Simulation Model, which includes as its major components: (1) Prior Training in Group Work of Medical Team Members; (2) Simulation in Teams or Groups; (3) Multidisciplinary Teamwork; (4) Team Leader…

  13. Work-Stress Burnout in Emergency Medical Technicians and the Use of Early Recollections.

    Science.gov (United States)

    Vettor, Susan M.; Kosinski, Frederick A., Jr.

    2000-01-01

    Numerous studies have indicated a high work-stress burnout rate of emergency medical technicians, although none have used techniques predicting work-stress burnout. Discusses early memories that are representative of emergency medical technicians who may be susceptible to burnout, and memories that may indicate an individual's resistance to…

  14. Stress among medical doctors working in public hospitals of the ...

    African Journals Online (AJOL)

    situation to another.4 For the purpose of this study, work stress is ... and Primary Health Care, Faculty of Health Science, University of Limpopo (Medunsa Campus), Pretoria ... problems, which sometimes end in divorce,10,12 physical illness,.

  15. Working up autism: the practical role of medical genetics.

    Science.gov (United States)

    Gurrieri, Fiorella

    2012-05-15

    The autism spectrum disorders (ASD) comprise a group of neurobehavioral phenotypes of heterogeneous etiology. In spite of a worldwide extensive research effort to unravel the genetic mystery of autism, medical geneticists are still facing an embarrassing lack of knowledge in dealing with the diagnosis, and consequently prognosis, of a child with autism. However, some lessons can be learned from accumulating experience in the clinical and molecular genetic evaluation of children with this condition. Patient evaluation, indications for molecular testing and counseling are the three aspects that will be discussed in this review.

  16. [Niccolo Paganini: medical aspects of his life and work].

    Science.gov (United States)

    Miranda C, Marcelo; Navarrete T, Luz; Zúñiga N, Gonzalo

    2008-07-01

    Niccolo Paganini is the most virtuous violinist of the history of music. He even received the nick name of "the violinist of the evil" for his outstanding skills on stage performance. It has been suggested that he had syphilis and tuberculosis, the commonest diseases of that time, but this hypothesis remains speculative. There are suggestions that he was the victim of iatrogenic mercurial poisoning. Furthermore, his body build suggests the presence of Ehlers-Danlos syndrome which could give him special anatomical conditions allowing him to achieve an amazing level of vírtuousness in his art. We herein review the medical aspects of this brilliant musician's life.

  17. Relationship of work-family conflict, self-reported social support and job satisfaction to burnout syndrome among medical workers in southwest China: A cross-sectional study.

    Science.gov (United States)

    Yang, Shujuan; Liu, Danping; Liu, Hongbo; Zhang, Juying; Duan, Zhanqi

    2017-01-01

    Burnout is a psychosomatic syndrome widely observed in Chinese medical workers due to the increasing cost of medical treatment, excessive workload, and excessive prescribing behavior. No studies have evaluated the interrelationship among occupational burnout, work-family conflict, social support, and job satisfaction in medical workers. The aim of this study was to evaluate these relationships among medical workers in southwest China. This cross-sectional study was conducted between March 2013 and December 2013, and was based on the fifth National Health Service Survey (NHSS). A total of 1382 medical workers were enrolled in the study. Pearson correlation analysis and general linear model univariate analysis were used to evaluate the relationship of work-family conflict, self-reported social support, and job satisfaction with burnout syndrome in medical workers. We observed that five dimensions of job satisfaction and self-reported social support were negatively associated with burnout syndrome, whereas three dimensions of work-family conflict showed a positive correlation. In a four-stage general linear model analysis, we found that demographic factors accounted for 5.4% of individual variance in burnout syndrome (F = 4.720, Pburnout syndrome, and medical workers without administrative duties had more serious burnout syndrome than those with administrative duties. In conclusion, the present study suggests that work-family conflict and self-reported social support slightly affect the level of burnout syndrome, and that job satisfaction is a much stronger influence on burnout syndrome in medical workers of southwest China.

  18. Social work in the Veterans Health Administration (VA) System: rewards, challenges, roles and interventions.

    Science.gov (United States)

    Beder, Joan; Postiglione, Paul

    2013-01-01

    For the social worker in the Veterans Health Administration (VA) System, numerous challenges are faced and met while serving the nation's Veterans. As part of the multidisciplinary team, social workers perform a variety of tasks and function in diverse roles. The qualitative survey research reported in this article sought to detail what social workers identified about the impact and rewards of their work and what they saw as the challenges and frustrations. In addition the social workers were asked to clarify their role with the patient and the family. Intervention strategies used in the course of the social workers interaction with the Veterans was also ascertained.

  19. Descriptive study of stress and satisfaction at work in the Saragossa university services and administration staff

    Directory of Open Access Journals (Sweden)

    Lucha Lopez Ana

    2010-04-01

    Full Text Available Abstract Background The notion of stress in connection with the work environment became an important topic during the 1970's, when the first studies on the subject were published and the term of work stress was first coined. In 1974, Freudenberger proposed the term burnout to refer to the condition of physical and emotional exhaustion, as well as the associated negative attitudes, resulting from the intense interaction in working with people. The aim of our study is to examine burnout and job satisfaction in Saragossa University Services and Administration Staff (SAS and detect the main factors which could contribute to too much stress, because job stress has emerged as a major psychosocial influence on mental health, associated with burnout. Methods 24 people from the Services and Administration Staff in the University of Saragossa participated in the study. The research was carried out during the implementation of a module on Stress Management organised by the University of Saragossa and commissioned to the Unit for Research in Physical Therapy (University School of Health Sciences from that University. This research is an exploratory research to improve the stress management program. A personal interview was carried out and additionally, participants were given the Maslach Burnout Inventory and the Scale of Satisfaction at Work of Warr, Cook & Wall. Results However using small sample this is worth to state that participants present most of them low burnout levels in the burnout scale. Only in one person high exhaustion level was reflected, even though other seven showed mean levels; in the professional self-esteem section, most of them showed high self-esteem, with two cases of low self-esteem and five with mean level. With regard to satisfaction people participating in the study show mean levels in intrinsic as much as in extrinsic factors and general satisfaction. Conclusions Services and Administration Staff from the University of

  20. Accuracy of administratively-assigned ancestry for diverse populations in an electronic medical record-linked biobank.

    Directory of Open Access Journals (Sweden)

    Jacob B Hall

    Full Text Available Recently, the development of biobanks linked to electronic medical records has presented new opportunities for genetic and epidemiological research. Studies based on these resources, however, present unique challenges, including the accurate assignment of individual-level population ancestry. In this work we examine the accuracy of administratively-assigned race in diverse populations by comparing assigned races to genetically-defined ancestry estimates. Using 220 ancestry informative markers, we generated principal components for patients in our dataset, which were used to cluster patients into groups based on genetic ancestry. Consistent with other studies, we find a strong overall agreement (Kappa  = 0.872 between genetic ancestry and assigned race, with higher rates of agreement for African-descent and European-descent assignments, and reduced agreement for Hispanic, East Asian-descent, and South Asian-descent assignments. These results suggest caution when selecting study samples of non-African and non-European backgrounds when administratively-assigned race from biobanks is used.

  1. A case of delayed methotrexate clearance following administration of a complementary medication containing chlorophyll.

    Science.gov (United States)

    Brooks, Sally L; Sanders, Julie; Seymour, John F; Mellor, James D

    2014-06-01

    A 54-year-old male with relapsed primary cerebral lymphoma and normal renal function was treated with methotrexate (MTX) 3 g/m(2) monthly by intravenous infusion. Throughout treatment the patient self-administered a complementary medicine (Jason Winter's chlorophyll®), which he was advised to cease during methotrexate treatment due to the potential for unknown interactions. For the first four cycles, chlorophyll was ceased two days prior to commencement of methotrexate and withheld until clearance. These cycles were administered without complication, and the methotrexate level reduced to chlorophyll was not ceased and there were no changes to concomitant medications. A literature search found no documented interactions between methotrexate and chlorophyll and the chemotherapy was administered without a delay in treatment. The methotrexate level three days post-administration was 0.36 µmol/L and did not reduce to chlorophyll 48 h prior to methotrexate administration until clearance. There were no further episodes of delayed methotrexate clearance. No impurities were detected in a sample of Jason Winter's chlorophyll®. It is therefore likely that the patient's delayed methotrexate clearance was due to an interaction with chlorophyll. It is recommended that such chlorophyll containing preparations be avoided in patients treated with methotrexate.

  2. Effectiveness of a modified administration protocol for the medical treatment of canine pyometra.

    Science.gov (United States)

    Contri, Alberto; Gloria, Alessia; Carluccio, Augusto; Pantaleo, Stefania; Robbe, Domenico

    2015-03-01

    Pyometra is one of the most common diseases in intact bitches. The aim of this study was to evaluate the effectiveness of a modified aglepristone protocol for the medical treatment of pyometra in the bitch. Of these, 73 bitches affected by pyometra of different breeds and age (2-14 years old) were enrolled. They were randomly assigned to a control group (CTG - 26 bitches) treated with classical protocol (aglepristone at 0, 1 and 6 days - day 0 = day of the diagnosis) and a modified treated group (MTG - 47 bitches) treated with a different administration protocol (aglepristone at 0, 2, 5 and 8 days). The classical protocol with the anti-progestagen aglepristone was effective in 88.5 % (23/26) of CTG bitches while the modified protocol was effective in all (47/47) of MTG bitches. One of the 23 CTG bitches received a further administration on day 14, which resolved the pyometra, while in the three cases of CTG bitches, in which the treatment was ineffective, an ovariohysterectomy was carried out. The modified protocol showed a success rate of 100 %, compared with the classical protocol proposed in the literature, and no recurrence of the disease was recorded in the 24 months follow up. After treatment, the oestrus onset was earlier than expected (interoestrus of 128 ± 32 days). In this study, the modified treatment protocol showed high efficacy and lack of recurrence within 24 months, suggesting a complete recovery of reproductive function in the bitch, with a normal fertility.

  3. Psychosocial work environment and antidepressant medication: a prospective cohort study

    DEFF Research Database (Denmark)

    Bonde, Jens Peter; Munch-Hansen, T.; Wieclaw, J.;

    2009-01-01

    -reports of psychosocial factors at work including satisfaction with the work climate and dimensions of the job strain model were obtained by self-administered questionnaires (response rate 77,2%). Each employee was assigned the average score value for all employees at his/her managerial work unit [1094 units...... with an average of 18 employees (range 3-120)]. The risk of first-time AD prescription during follow-up was examined according to level of satisfaction and psychosocial strain by Cox regression with adjustment for gender, age, marital status, occupational status and calendar year of the survey. RESULTS......: The proportion of employees that received at least one prescription of ADs from 1995 through 2006 was 11.9% and prescriptions rose steadily from 1.50% in 1996 to the highest level 6.47% in 2006. ADs were prescribed more frequent among women, middle aged, employees with low occupational status and those living...

  4. Life cycle of medical product rules issued by the US Food and Drug Administration.

    Science.gov (United States)

    Hwang, Thomas J; Avorn, Jerry; Kesselheim, Aaron S

    2014-08-01

    The US Food and Drug Administration (FDA) uses rulemaking as one of its primary tools to protect the public health and implement laws enacted by Congress and the president. Because of the many effects that these rules have on social welfare and the economy, the FDA and other executive agencies receive input from the executive branch, the public, and in some cases, the courts, during the process of rulemaking. In this article, we examine the life cycle of FDA regulations concerning medical products and review notable features of the rulemaking process. The current system grants substantial opportunities for diverse stakeholders to participate in and influence how rules are written and implemented. However, the duration, complexity, and adversarial qualities of the rulemaking process can hinder the FDA's ability to achieve its policy and public health goals. There is considerable variation in the level of transparency at different stages in the process, ranging from freely accessible public comments to undisclosed internal agency deliberations. In addition, significant medical product rules are associated with lengthy times to finalization, in some cases for unclear reasons. We conclude by identifying potential areas for reform on the basis of transparency and efficiency. Copyright © 2014 by Duke University Press.

  5. Administration of over-the-counter medication to children at home--a survey of parents from community health centers.

    Science.gov (United States)

    Anderson, Colleen; Rolfe, Paula; Brennan-Hunter, Andrea

    2013-01-01

    Parents (n = 135) were surveyed in relation to administering antipyretic/analgesic medications to their children (2 months-6 years) at home. Parents usually chose acetaminophen, calculated dosages based on weight but did not always know the child's weight, administered medications with a dropper, and reported having a sick child was moderately stressful. Many children were medicated for pain and/or fever during the week prior to immunization and many weighed more than the age/weight recommended dosages on the label. Community health nurses can facilitate safe administration of medications by integrating knowledge of parents' pain and fever management practices into discussions and anticipatory planning during clinic visits.

  6. Experiences with Lean Six Sigma as improvement strategy to reduce parenteral medication administration errors and associated potential risk of harm.

    Science.gov (United States)

    van de Plas, Afke; Slikkerveer, Mariëlle; Hoen, Saskia; Schrijnemakers, Rick; Driessen, Johanna; de Vries, Frank; van den Bemt, Patricia

    2017-01-01

    In this controlled before-after study the effect of improvements, derived from Lean Six Sigma strategy, on parenteral medication administration errors and the potential risk of harm was determined. During baseline measurement, on control versus intervention ward, at least one administration error occurred in 14 (74%) and 6 (46%) administrations with potential risk of harm in 6 (32%) and 1 (8%) administrations. Most administration errors with high potential risk of harm occurred in bolus injections: 8 (57%) versus 2 (67%) bolus injections were injected too fast with a potential risk of harm in 6 (43%) and 1 (33%) bolus injections on control and intervention ward. Implemented improvement strategies, based on major causes of too fast administration of bolus injections, were: Substitution of bolus injections by infusions, education, availability of administration information and drug round tabards. Post intervention, on the control ward in 76 (76%) administrations at least one error was made (RR 1.03; CI95:0.77-1.38), with a potential risk of harm in 14 (14%) administrations (RR 0.45; CI95:0.20-1.02). In 40 (68%) administrations on the intervention ward at least one error occurred (RR 1.47; CI95:0.80-2.71) but no administrations were associated with a potential risk of harm. A shift in wrong duration administration errors from bolus injections to infusions, with a reduction of potential risk of harm, seems to have occurred on the intervention ward. Although data are insufficient to prove an effect, Lean Six Sigma was experienced as a suitable strategy to select tailored improvements. Further studies are required to prove the effect of the strategy on parenteral medication administration errors.

  7. Activity-based computing for medical work in hospitals

    DEFF Research Database (Denmark)

    Bardram, Jakob Eyvind

    2009-01-01

    Studies have revealed that people organize and think of their work in terms of activities that are carried out in pursuit of some overall objective, often in collaboration with others. Nevertheless, modern computer systems are typically single-user oriented, that is, designed to support individual...... tasks such as word processing while sitting at a desk. This article presents the concept of Activity-Based Computing (ABC), which seeks to create computational support for human activities. The ABC approach has been designed to address activity-based computing support for clinical work in hospitals....... In a hospital, the challenges arising from the management of parallel activities and interruptions are amplified because multitasking is now combined with a high degree of mobility, collaboration, and urgency. The article presents the empirical and theoretical background for activity-based computing, its...

  8. The work practice of medical secretaries and the implementation of electronic health records in Denmark

    DEFF Research Database (Denmark)

    Bertelsen, Pernille; Nøhr, Christian

    2005-01-01

    The introduction of electronic health records will entail substantial organisational changes to the clinical and administrative staff in hospitals. Hospital owners in Denmark have predicted that these changes will render up to half of medical secretaries redundant. The present study however shows...... that clinicians as well as nurses depend on medical secretaries, and therefore to reduce the number of secretaries because electronic health record systems are implemented needs very careful thinking, planning and discussion with the other professions involved....

  9. Pharmaceutical interventions in medications prescribed for administration via enteral tubes in a teaching hospital.

    Science.gov (United States)

    Ferreira, Carolina Justus Buhrer; Plodek, Caroline Koga; Soares, Franciny Kossemba; Andrade, Rayza Assis de; Teleginski, Fernanda; Rocha, Maria Dagmar da

    2016-01-01

    to analyze the impact of guidelines regarding errors in medications prescribed for administration through enteral tubes. quantitative study, in three phases, undertaken in internal medicine, neurology and an intensive care unit in a general teaching hospital. In Phase 1, the following was undertaken: a protocol for dilution and unit-dose repackaging and administration for 294 medications via enteral tubes; a decision flowchart; operational-standard procedures for dilution and unit-dose repackaging of oral pharmaceutical forms and for administration of medications through enteral tubes. In phase 2, errors in 872 medications prescribed through enteral tubes, in 293 prescriptions for patients receiving inpatient treatment between March and June, were investigated. This was followed by training of the teams in relation to the guidelines established. In Phase 3, pharmaceutical errors and interventions in 945 medications prescribed through enteral tubes, in 292 prescriptions of patients receiving inpatient treatment between August and September, were investigated prospectively. The data collected, in a structured questionnaire, were compiled in the Microsoft Office Excel(r) program, and frequencies were calculated. 786 errors were observed, 63.9% (502) in Phase 2, and 36.1% (284) in Phase 3. In Phase 3, a reduction was ascertained in the frequency of prescription of medications delivered via enteral tubes, medications which were contraindicated, and those for which information was not available. guidelines and pharmaceutical interventions were determined in the prevention of errors involving medications delivered through enteral tubes. analisar o impacto de diretrizes sobre erros em medicamentos prescritos para administração via sondas enterais. estudo quantitativo, em três fases, realizado em clínica médica, neurologia e unidade de terapia intensiva de hospital geral universitário. Na Fase 1 elaborou-se: protocolo de diluição, unitarização - transformação e

  10. Framing the fetus in medical work: rituals and practices.

    Science.gov (United States)

    Williams, Clare

    2005-05-01

    What does it mean to investigate the fetus, and what might be the potential consequences? Although a number of feminists have engaged with the debate around the status of the fetus in terms of the possible implications for women, discussion of fetuses has been avoided by many feminists, in response to the politics around the abortion debate. However, there has recently been a move to explore the ways in which the meanings and significance of the fetus can be socially constructed. Set within a United Kingdom context, this paper focuses on two areas which are arguably changing perceptions of the fetus: the recent 'discovery' of fetal 'pain'; and the growing recognition of the fetus as a patient. One of the key concerns of those who support the autonomy of women is that any increasing discourse around the concept of fetal patienthood may promote the notion of fetal personhood, which in turn may affect the status of pregnant women. In exploring perceptions of the fetus, this article firstly cites some of the key policy documents and medical articles which were published during the 1990s, looking at apparent shifts in the ways in which the fetus is discussed in terms of pain and patienthood. It then explores how practitioners from different disciplines talked about fetal pain and patienthood in relation to the clinical setting. Although this paper does not provide conclusive evidence of a wholesale shift in terms of how the fetus is perceived by practitioners, it does point to subtle shifts occurring, which may or may not be significant. It is important to track such shifts closely, primarily because of the potential impact on women, but also for others involved, including practitioners. Such tracking needs to be set within specific cultural and policy contexts.

  11. Building a local medical workforce in Tasmania: where are international fee-paying medical graduates likely to work?

    Science.gov (United States)

    Cheek, Colleen; Hays, Richard; Allen, Penny; Walker, Gary; Shires, Lizzi

    2017-01-01

    Much of regional Australia continues to face challenges in recruitment and retention of medical practitioners, despite the apparently successful rural medical education initiatives funded by the Commonwealth Government. International fee-paying (IFP) medical students are a significant component of Australian medical education, contributing additional income and more diverse learning environments for universities. Their contribution to the Australian medical workforce is harder to determine. After obtaining registration, IFP graduates may apply to remain in Australia as skilled migrants. Since 1999 there has been a 325% increase in the number of international medical students in Australia, with approximately 73% of IFP graduates remaining in Australia for at least some postgraduate training. Recognising the potential contribution of IFP students to the Tasmanian medical workforce, the authors sought better understanding of the career intentions and work locations of IFP graduates from the medical program in Tasmania, Australia, through two studies. Firstly, a quantitative study was conducted of the locations of all IFP graduates from the Tasmanian medical program, and then a qualitative study exploring graduating students' intentions and factors that contribute to their decisions about work location choices. This was a cohort study of IFP students who graduated from the University of Tasmania School of Medicine over the period 2000-2015. Work locations for 2016 were mapped to a Modified Monash rurality classification. Semi-structured interviews were held with 15 final year IFP medical students, exploring career intentions and location preferences. There were 261 IFP graduates, 54.4% male. The most common country of origin was Malaysia (55.2%). In 2016, 189 (72.4 %) were working in Australia, 42 (16.1%) in Tasmania and 126 (66.7%) in areas categorised as Modified Monash 1. Recent graduates in postgraduate year 1/2 (71.3%) were more likely to be working in Tasmania

  12. An alternative for rapid administration of medication and fluids in the emergency setting using a novel device.

    Science.gov (United States)

    Lyons, Neal; Nejak, Daniel; Lomotan, Nadine; Mokszycki, Robert; Jamieson, Stephen; McDowell, Marc; Kulstad, Erik

    2015-08-01

    Routes of administration for medications and fluids in the acute care setting have primarily focused on oral, intravenous, or intraosseous routes, but, in many patients, none of these routes is optimal. A novel device (Macy Catheter; Hospi Corp) that offers an easy route for administration of medications or fluids via rectal mucosal absorption (proctoclysis) has recently become available in the palliative care market; we describe here the first known uses of this device in the emergency setting. Three patients presenting to the hospital with conditions limiting more typical routes of medication or fluid administration were treated with this new device; patients were administered water for hydration, lorazepam for treatment of alcohol withdrawal, ondansetron for nausea, acetaminophen for fever, aspirin for antiplatelet effect, and methimazole for hyperthyroidism. Placement of the device was straightforward, absorption of administered medications (judged by immediacy of effects, where observable) was rapid, and use of the device was well tolerated by patients, suggesting that this device may be an appealing alternative route to medication and fluid administration for a variety of indications in acute and critical care settings.

  13. The corporate organization of hospital work: balancing professional and administrative responsibilities.

    Science.gov (United States)

    Stoeckle, J D; Reiser, S J

    1992-03-01

    The development of the hospital into a corporation has influenced the care of patients and the work of the professional staff. As a corporate enterprise, the modern hospital has a private agenda aimed at increasing growth and efficiency with an emphasis on technical services, professionals as employees, and patients as customers. These changes have resulted in a decrease in trustee and professional authority and an increase in administrative control. This shift in the control structure has continued in response to the need for accounting and regulation of services and in response to demands for increased growth and efficiency made by an increasingly competitive market environment. Strategies for the reorganization of hospital staff aimed at improving both inpatient and outpatient care are reviewed. The reorganization of the institution and staff, using either a staff group-practice corporation or an administrative staff model, is proposed. Clinicians have new responsibilities for developing collective arrangements for institutional governance, for allocating institutional resources, for providing public accountability regarding the use of these resources, and for defining the missions of care.

  14. Report on administrative work at radiation safety center in fiscal year 2000

    Energy Technology Data Exchange (ETDEWEB)

    Uda, Tatsuhiko; Sakuma, Yoichi; Kawano, Takao; Yamanishi, Hirokuni; Shinotsuka, Kazunori; Asakura, Yamato; Miyake, Hitoshi

    2002-05-01

    National Institute for Fusion Science constructed Large Helical Device (LHD) which is the largest magnetic confinement plasma experimental device using super conductive magnet coils. It took eight years to construct and the first plasma shot had been carried out on March 1998. Since then plasma confinement experiments have been improved. This is the report of administrative work at the radiation safety center considering radiation protection for workers at the LHD and related devices, and radiation monitoring in the site. Major scope is as follows. (1) Radiation measurement and dose monitoring in the radiation controlled area and in the site using particularly developed monitoring system named as Radiation Monitoring System Applicable to Fusion Experiments (RMSAFE). (2) Establishment of education and registration system for radiation workers and access control system for the LHD controlled area. I hope that as like the published report of fiscal year 1999, the present report will be helpful for management of future radiation protection in the research institute. (author)

  15. The work practice of medical secretaries and the implementation of electronic health records in Denmark

    DEFF Research Database (Denmark)

    Bertelsen, Pernille; Nøhr, Christian

    2005-01-01

    The introduction of electronic health records will entail substantial organisational changes to the clinical and administrative staff in hospitals. Hospital owners in Denmark have predicted that these changes will render up to half of medical secretaries redundant. The present study however shows...

  16. [Developing team reflexivity as a learning and working tool for medical teams].

    Science.gov (United States)

    Riskin, Arieh; Bamberger, Peter

    2014-01-01

    Team reflexivity is a collective activity in which team members review their previous work, and develop ideas on how to modify their work behavior in order to achieve better future results. It is an important learning tool and a key factor in explaining the varying effectiveness of teams. Team reflexivity encompasses both self-awareness and agency, and includes three main activities: reflection, planning, and adaptation. The model of briefing-debriefing cycles promotes team reflexivity. Its key elements include: Pre-action briefing--setting objectives, roles, and strategies the mission, as well as proposing adaptations based on what was previously learnt from similar procedures; Post-action debriefing--reflecting on the procedure performed and reviewing the extent to which objectives were met, and what can be learnt for future tasks. Given the widespread attention to team-based work systems and organizational learning, efforts should be made toward ntroducing team reflexivity in health administration systems. Implementation could be difficult because most teams in hospitals are short-lived action teams formed for a particular event, with limited time and opportunity to consciously reflect upon their actions. But it is precisely in these contexts that reflexive processes have the most to offer instead of the natural impulsive collective logics. Team reflexivity suggests a potential solution to the major problems of iatorgenesis--avoidable medical errors, as it forces all team members to participate in a reflexive process together. Briefing-debriefing technology was studied mainly in surgical teams and was shown to enhance team-based learning and to improve quality-related outcomes and safety.

  17. A JURIDICAL-ADMINISTRATIVE COMPARISON BETWEEN THE MILITARY AND THE MEDICAL OPERATION

    Directory of Open Access Journals (Sweden)

    Georgel RUSU

    2016-03-01

    Full Text Available To bring together the word operation and opera and/or accomplishing an opera is not at all improper. Defining a (military operation as ”the total amount of the military actions performed by large operative and strategic units, according to an unique plan, for attaining an operative or strategic objective....”[1], coldly and exhaustively developed along almost two pages, may provide sufficient arguments for correctly anchoring the action within the domain of military practice, in spite of the shortcoming of not having a more synthetic form, with valid landmarks for other disciplines, as well. Frequently, both the medical and the military operations exceed their routine, deserving artistic appreciations. It is not accidental that analysis and preparation of any military combat includes the field of military art, defined as ”a compounding part of the military science, a specialized domain of organization and management of armed conflicts. It includes both the principles, methods, procedures and rules for the preparation and development of military actions, and the personal endowments (talent, mastership, skill expected from the part of leaders and troops for attaining success in the battle...”[2] More than that, the operative art is defined as ”a component of military art ... created and developed as an intermediary domain between strategy and tactics...”[3]. Continuing to lay stress on the parallelism to which the study is devoted, the author considers that actions that may be related to or may be appreciated as possessing artistic characteristics occur even beyond the field of aesthetic or reparatory surgery. The definitions provided by medical dictionaries do not eliminate, yet encourage similarities. The operation is ”s.f./operation, (Lat. operatio, -onis = work, operation, derived from operari = to work, and opus, operis = labour, work, a medical act performed by the surgeon with his hands, by means of adequate instruments, for

  18. Book review:A heart for work; journeys through an African Medical ...

    African Journals Online (AJOL)

    PhD study. Her aim was ... work stems from a study for a doctoral thesis, the pace of the story never ... remain the bedrock of medical writing and clinical practice. “A Heart ... It should be required reading for anyone involved in training medical.

  19. Humor in the "Twilight Zone": My Work as a Medical Clown With Patients With Dementia.

    Science.gov (United States)

    Raviv, Amnon

    2014-09-01

    Medical clowning has been primarily identified with working with children in pediatrics wards in hospitals. Over the past decade, more and more medical clowns have been working with adults and with patients with dementia as part of holistic care. Along with traditional medical care by hospital staff, the medical clown treats the patient's emotional side. Furthermore, medical clowning has unique advantages in working with patients with dementia. Several studies have shown that humor assists in improving the quality of life of patients with dementia. The clown, as the ultimate comic figure, creates interactions with patients based on humor, which empowers, calms, and strengthens the patient while reinforcing the patient's connection with the surroundings. Medical clowning is an interdisciplinary therapeutic art, and the medical clown has a "kit" of multiple skills (including humor, drama, music, and dance), all of which have a beneficial, therapeutic impact on patients. The current article presents and analyzes case studies from my work as a medical clown with patients with dementia.

  20. Possible Link between Medical Students' Motivation for Academic Work and Time Engaged in Physical Exercise

    Science.gov (United States)

    Aung, Myo Nyein; Somboonwong, Juraiporn; Jaroonvanichkul, Vorapol; Wannakrairot, Pongsak

    2016-01-01

    Physical exercise results in an active well-being. It is likely that students' engagement in physical exercise keeps them motivated to perform academic endeavors. This study aimed to assess the relation of time engaged in physical exercise with medical students' motivation for academic work. Prospectively, 296 second-year medical students…

  1. Career preferences and the work-family balance in medicine: gender differences among medical specialists.

    NARCIS (Netherlands)

    Heiligers, P.J.M.; Hingstman, L.

    2000-01-01

    In this article career preferences of medical specialists in the Netherlands are analysed, based on a survey among the members of medical associations of five specialities. Four different career preferences were offered, each of which implied a possible variation in working hours. A questionnaire wa

  2. Career preferences and the work-family balance in medicine: gender differences among medical specialists.

    NARCIS (Netherlands)

    Heiligers, P.J.M.; Hingstman, L.

    2000-01-01

    In this article career preferences of medical specialists in the Netherlands are analysed, based on a survey among the members of medical associations of five specialities. Four different career preferences were offered, each of which implied a possible variation in working hours. A questionnaire wa

  3. The Contribution of Work Characteristics, Home Characteristics and Gender to Burnout in Medical Residents

    Science.gov (United States)

    Verweij, Hanne; van der Heijden, Frank M. M. A.; van Hooff, Madelon L. M.; Prins, Jelle T.; Lagro-Janssen, Antoine L. M.; van Ravesteijn, Hiske; Speckens, Anne E. M.

    2017-01-01

    Burnout is highly prevalent in medical residents. In order to prevent or reduce burnout in medical residents, we should gain a better understanding of contributing and protective factors of burnout. Therefore we examined the associations of job demands and resources, home demands and resources, and work-home interferences with burnout in male and…

  4. Simplified tilt table test protocol with continuous upright position during medication administration and no hydration.

    Science.gov (United States)

    Fisher, John D; Kim, Soo G; Ferrick, Kevin J; Gross, Jay N; Palma, Eugen C; Scavin, Gale M

    2003-01-01

    Recommendations for head-up tilt testing (HUT) often include the prolonged abstaining from food and water consumption (nothing by mouth [NPO]) and intravenous fluids administration before HUT. After the baseline test, supine equilibration periods are recommended before and between each dose of medication. The aim of this study was to determine if similar results are obtainable with a simpler protocol. After 2-3 hours NPO, 1,540 HUTs were performed at 70 degrees for 30 minutes unless predetermined endpoints were reached. Then, with the patient remaining in the tilted position, isoproterenol (ISO) (1 microgram/min), titrated every 3 minutes to a maximum of 5 micrograms/min (n = 803 patients), sublingual nitroglycerin (NTG) (300-400 micrograms) (n = 143 patients), or edrophonium (EDP) (5 mg) repeated once after 3 minutes (n = 46 patients) were administered. No aspiration or other adverse effects attributable to the abbreviated fasting period were observed. ISO was well tolerated as doses were increased. Vasovagal manifestations developed in 31% of ISO tests, in 11% with EDP, and in 50% with NTG (P postural changes during HUTs may be avoided when ISO is administered. With NTG the response may be excessive.

  5. Use of an Electronic Medication Administration Record (eMAR) for Surveillance of Medication Omissions: Results of a One Year Study of Antimicrobials in the Inpatient Setting

    Science.gov (United States)

    Dalton, Bruce R.; Sabuda, Deana M.; Bresee, Lauren C.; Conly, John M.

    2015-01-01

    Introduction Medication administration omissions (MAO) are usually considered medication errors but not all MAO are clinically relevant. We determined the frequency of clinically relevant MAO of antimicrobial drugs in adult hospitals in Calgary, Alberta, Canada based on electronic medication administration record (eMAR). Methods We examined 2011 data from eMAR records on medical wards and developed a reproducible assessment scheme to categorize and determine clinical relevance of MAO. We applied this scheme to records from 2012 in a retrospective cohort study to quantify clinically relevant MAO. Significant predictors of clinically relevant MAO were identified. Results A total of 294,718 dose records were assessed of which 10,282 (3.49%) were for doses not administered. Among these 4903 (1.66% of total); 47.68% of MAO were considered clinically relevant. Significant positive predictors of clinically relevant MAO included inhaled (OR 4.90, 95% CI 3.54-6.94) and liquid oral (OR 1.32, 95% CI 1.18-1.47) route of medication compared to solid oral and irregular dose schedules. Evening nursing shift compared to night shift (OR 0.77 95% CI 0.70-0.85) and parenteral (OR 0.50, 95% CI 0.46-0.54) were negative predictors, The commonest reasons for relevant MAO were patient preference, unspecified reason, administration access issues, drug not available or patient condition. Conclusion Assessment of MAO by review of computer records provides a greater scope and sample size than directly observed medication administration assessments without “observer” effect. We found that MAO of antimicrobials in inpatients were uncommon but were seen more frequently with orally administered antimicrobials which may have significance to antimicrobial stewardship initiatives. PMID:25856373

  6. Use of an electronic medication administration record (eMAR for surveillance of medication omissions: results of a one year study of antimicrobials in the inpatient setting.

    Directory of Open Access Journals (Sweden)

    Bruce R Dalton

    Full Text Available Medication administration omissions (MAO are usually considered medication errors but not all MAO are clinically relevant. We determined the frequency of clinically relevant MAO of antimicrobial drugs in adult hospitals in Calgary, Alberta, Canada based on electronic medication administration record (eMAR.We examined 2011 data from eMAR records on medical wards and developed a reproducible assessment scheme to categorize and determine clinical relevance of MAO. We applied this scheme to records from 2012 in a retrospective cohort study to quantify clinically relevant MAO. Significant predictors of clinically relevant MAO were identified.A total of 294,718 dose records were assessed of which 10,282 (3.49% were for doses not administered. Among these 4903 (1.66% of total; 47.68% of MAO were considered clinically relevant. Significant positive predictors of clinically relevant MAO included inhaled (OR 4.90, 95% CI 3.54-6.94 and liquid oral (OR 1.32, 95% CI 1.18-1.47 route of medication compared to solid oral and irregular dose schedules. Evening nursing shift compared to night shift (OR 0.77 95% CI 0.70-0.85 and parenteral (OR 0.50, 95% CI 0.46-0.54 were negative predictors, The commonest reasons for relevant MAO were patient preference, unspecified reason, administration access issues, drug not available or patient condition.Assessment of MAO by review of computer records provides a greater scope and sample size than directly observed medication administration assessments without "observer" effect. We found that MAO of antimicrobials in inpatients were uncommon but were seen more frequently with orally administered antimicrobials which may have significance to antimicrobial stewardship initiatives.

  7. Collaborative work and medical talk: opportunities for learning through knowledge sharing.

    Science.gov (United States)

    Nilsen, Line Lundvoll; Ludvigsen, Sten R

    2010-01-01

    Teleconsultations provide new opportunities for learning in medical settings. This study explores the conditions under which learning among physicians takes place. The empirical context is 47 real-time video conferences carried out to examine collaborative work and the medical talk involved. Sixteen of the observations were consultations wherein general practitioners (GPs) and specialists shared knowledge with the purpose of solving a medical problem related to a patient under treatment. In this exploratory study, the learning opportunities are seen as what medical practitioners with different types of expertise achieve through interaction while working with patients over periods of time. The analysis of medical talk in consultations shows that collaborative work among GPs and specialists creates a shared understanding of the patient's clinical history and treatment trajectory. As knowledge is demanded and attributed and gaps of knowledge become shared, consultations create a work tool that expands the medical work and talk. Collaborative work in and between different levels of the health care service expands knowledge, creates opportunities for learning in everyday settings, and improves the quality of knowledge distribution in the health care system.

  8. 77 FR 16036 - Guidance for Industry, Third Parties and Food and Drug Administration Staff; Medical Device ISO...

    Science.gov (United States)

    2012-03-19

    ... HUMAN SERVICES Food and Drug Administration Guidance for Industry, Third Parties and Food and Drug...--Requirements for regulatory purposes,'' (ISO 13485:2003) audit report provides FDA a degree of assurance of... GHTF founding members auditing systems include: The Canadian Medical Devices Conformity...

  9. 75 FR 28257 - Draft Guidance for Industry, Third Parties and Food and Drug Administration Staff; Medical Device...

    Science.gov (United States)

    2010-05-20

    ... concerning this draft guidance to the Division of Dockets Management (HFA-305), Food and Drug Administration... devices-- Quality management systems--Requirements for regulatory purposes,'' may voluntarily submit the... Japanese Medical Device Ministry of Health, Labour and Welfare system. This notice of availability...

  10. Analysis of data captured by barcode medication administration system using a PDA; aiming at reducing medication errors at point of care in Japanese Red Cross Kochi Hospital.

    Science.gov (United States)

    Akiyama, Masanori; Koshio, Atsushi; Kaihotsu, Nobuyuki

    2010-01-01

    Preventing medication errors by using a barcode administration system has become prevalent in patient safety. Analyses of data captured by bar code systems provide opportunities to understand the actual situation at the point of care. Our study aims at understanding issues of medication safety as well as investigating measures taken to prevent medication accidents, by analyzing data captured by a bar code system and a personal digital assistant (PDA). The barcode administration system named Point-of-Act-System implemented in Japanese Red Cross Kochi Hospital was designed to capture every activity at the bedside. Complete activity data captured by the system, which included injections, treatment and other nursing activity, as well as injection warning data, were used for our analyses. We describe the data and analyze them statistically to find potentially times of risk and to ascertain the relation between busyness and error. The injection warning rate as a whole was 6.1% on average. The results showed there was a negative correlation between the number of injections given and the injection warning rate (-0.48, pmedication safety. A bar code administration system is quite an effective way not only to prevent medication error at point of care, but also to improve patient safety through analyses of data captured by such a system.

  11. [THE MOTIVATION OF MEDICAL PERSONNEL OF MULTIFIELD HOSPITAL TO WORKING OVER STANDARDS OF SINGLE JOB POSITION].

    Science.gov (United States)

    Khazov, M V; Romanov, S V; Abaeva, O P; Murigina, M M

    2015-01-01

    The article considers results of study concerning prevalence of physicians working over standards of single job position in multifield hospital, including factors motivating to extra job. The research purpose was to analyze impact of gender age structure of medical personnel of multfield public medical organization on motivation of physicians to work over standards of single job position. The objectives consisted of analyzing prevalence of over standard work of medical personnel of multifield public medical organization with consideration of social structure and studying factors motivating physicians to work over standards of single job position. The study was carried out on the basis of questionnaire survey of physicians. The results of study testify higher degree of prevalence of working over standards of single job position in modern health care. So, 64.8 ± 3.6% of respondents work subject to conditions of internal and/or external moonlighting. Moreover; one third of physicians enlisted to extra job. Among physicians males more often than females work subject to conditions of moonlighting, perform extra job, enlist to working during days off. The specialists of age group from 35 to 54 years work subject to conditions of external and internal moonlighting more often than younger physicians. Among physicians, the most significant cause of working subject to conditions of moonlighting is additional earnings. At that, every fifth physician works over standards of job position with purpose to increase one's professional competence. The study results permit concluding that aspects of social structure of modern medical staff significantly impact motivation and hence possibility of enlisting workers to work over standards of single job position.

  12. Tradeoffs of Using Administrative Claims and Medical Records to Identify the Use of Personalized Medicine for Patients with Breast Cancer

    Science.gov (United States)

    Liang, Su-Ying; Phillips, Kathryn A.; Wang, Grace; Keohane, Carol; Armstrong, Joanne; Morris, William M.; Haas, Jennifer S.

    2012-01-01

    Background Administrative claims and medical records are important data sources to examine healthcare utilization and outcomes. Little is known about identifying personalized medicine technologies in these sources. Objectives To describe agreement, sensitivity, and specificity of administrative claims compared to medical records for two pairs of targeted tests and treatments for breast cancer. Research Design Retrospective analysis of medical records linked to administrative claims from a large health plan. We examined whether agreement varied by factors that facilitate tracking in claims (coding and cost) and that enhance medical record completeness (records from multiple providers). Subjects Women (35 – 65 years) with incident breast cancer diagnosed in 2006–2007 (n=775). Measures Use of human epidermal growth factor receptor 2 (HER2) and gene expression profiling (GEP) testing, trastuzumab and adjuvant chemotherapy in claims and medical records. Results Agreement between claims and records was substantial for GEP, trastuzumab, and chemotherapy, and lowest for HER2 tests. GEP, an expensive test with unique billing codes, had higher agreement (91.6% vs. 75.2%), sensitivity (94.9% vs. 76.7%), and specificity (90.1% vs. 29.2%) than HER2, a test without unique billing codes. Trastuzumab, a treatment with unique billing codes, had slightly higher agreement (95.1% vs. 90%) and sensitivity (98.1% vs. 87.9%) than adjuvant chemotherapy. Conclusions Higher agreement and specificity were associated with services that had unique billing codes and high cost. Administrative claims may be sufficient for examining services with unique billing codes. Medical records provide better data for identifying tests lacking specific codes and for research requiring detailed clinical information. PMID:21422962

  13. Radiation therapists' and radiation oncology medical physicists' perceptions of work and the working environment in Australia: a qualitative study.

    Science.gov (United States)

    Halkett, G K B; McKay, J; Hegney, D G; Breen, Lauren J; Berg, M; Ebert, M A; Davis, M; Kearvell, R

    2016-05-05

    Workforce recruitment and retention are issues in radiation oncology. The working environment is likely to have an impact on retention; however, there is a lack of research in this area. The objectives of this study were to: investigate radiation therapists' (RTs) and radiation oncology medical physicists' (ROMPs) perceptions of work and the working environment; and determine the factors that influence the ability of RTs and ROMPs to undertake their work and how these factors affect recruitment and retention. Semi-structured interviews were conducted and thematic analysis was used. Twenty-eight RTs and 21 ROMPs participated. The overarching themes were delivering care, support in work, working conditions and lifestyle. The overarching themes were mostly consistent across both groups; however, the exemplars reflected the different roles and perspectives of RTs and ROMPs. Participants described the importance they placed on treating patients and improving their lives. Working conditions were sometimes difficult with participants reporting pressure at work, large workloads and longer hours and overtime. Insufficient staff numbers impacted on the effectiveness of staff, the working environment and intentions to stay. Staff satisfaction is likely to be improved if changes are made to the working environment. We make recommendations that may assist departments to support RTs and ROMPs.

  14. Evaluation of an interactive web-based nursing course with streaming videos for medication administration skills.

    Science.gov (United States)

    Sowan, Azizeh K; Idhail, Jamila Abu

    2014-08-01

    Nursing students should exhibit competence in nursing skills in order to provide safe and quality patient care. This study describes the design and students' response to an interactive web-based course using streaming video technology tailored to students' needs and the course objectives of the fundamentals of nursing skills clinical course. A mixed-methodology design was used to describe the experience of 102 first-year undergraduate nursing students at a school of nursing in Jordan who were enrolled in the course. A virtual course with streaming videos was designed to demonstrate medication administration fundamental skills. The videos recorded the ideal lab demonstration of the skills, and real-world practice performed by registered nurses for patients in a hospital setting. After course completion, students completed a 30-item satisfaction questionnaire, 8 self-efficacy scales, and a 4-item scale solicited their preferences of using the virtual course as a substitute or a replacement of the lab demonstration. Students' grades in the skill examination of the procedures were measured. Relationships between the main variables and predictors of satisfaction and self-efficacy were examined. Students were satisfied with the virtual course (3.9 ± 0.56, out of a 5-point scale) with a high-perceived overall self-efficacy (4.38 ± 0.42, out of a 5-point scale). Data showed a significant correlation between student satisfaction, self-efficacy and achievement in the virtual course (r = 0.45-0.49, p streaming videos for clinical courses is a complex process that should be carefully designed to positively influence the learning experience. However, the learning benefits gained from such pedagogical approach are worth faculty, institution and students' efforts. Published by Elsevier Ireland Ltd.

  15. The contribution of work characteristics, home characteristics and gender to burnout in medical residents.

    Science.gov (United States)

    Verweij, Hanne; van der Heijden, Frank M M A; van Hooff, Madelon L M; Prins, Jelle T; Lagro-Janssen, Antoine L M; van Ravesteijn, Hiske; Speckens, Anne E M

    2016-09-20

    Burnout is highly prevalent in medical residents. In order to prevent or reduce burnout in medical residents, we should gain a better understanding of contributing and protective factors of burnout. Therefore we examined the associations of job demands and resources, home demands and resources, and work-home interferences with burnout in male and female medical residents. This study was conducted on a nation-wide sample of medical residents. In 2005, all Dutch medical residents (n = 5245) received a self-report questionnaire on burnout, job and home demands and resources and work-home interference. Path analysis was used to examine the associations between job and home characteristics and work-home interference and burnout in both males and females. In total, 2115 (41.1 %) residents completed the questionnaire. In both sexes emotional demands at work and the interference between work and home were important contributors to burnout, especially when work interferes with home life. Opportunities for job development appeared to be an important protective factor. Other contributing and protective factors were different for male and female residents. In females, social support from family or partner seemed protective against burnout. In males, social support from colleagues and participation in decision-making at work seemed important. Effectively handling emotional demands at work, dealing with the interference between work and home, and having opportunities for job development are the most essential factors which should be addressed. However it is important to take gender differences into consideration when implementing preventive or therapeutic interventions for burnout in medical residents.

  16. Is networking different with part-time working colleagues? A study of medical teams.

    NARCIS (Netherlands)

    Heiligers, P.; Jong, J. de; Groenewegen, P.; Hingstman, L.

    2007-01-01

    Changes in work arrangements like the introduction of part-time work can affect both formal and informal organization. This study will focus on informal networks amongst teams of medical specialists, some but not all of which include part-time workers. Are there notable differences in the structure

  17. Hospitals of the Future - Ubiquitous Computing support for Medical Work in Hospitals

    DEFF Research Database (Denmark)

    Bardram, Jakob Eyvind

    2003-01-01

    This paper describes the visions and on-going research within creating ubiquitous computing support for medical work in the hospitals of the future. Today, clinical computer systems seldom play any role in the execution of clinical work as such. Electronic Patient Records (EPR) are more often...

  18. US Food and Drug Administration Regulation of Medical Devices and Radiation Oncology: Can Reform Improve Safety?

    OpenAIRE

    Hattangadi, Jona A.; O'Reilly, James T.; Recht, Abram

    2011-01-01

    A review of the issues involved in medical device regulation in radiation oncology, including a general review of federal medical device regulation and explanations of the legal and regulatory framework.

  19. Medical social work practice in child protection in China: A multiple case study in Shanghai hospitals.

    Science.gov (United States)

    Zhao, Fang; Hämäläinen, Juha; Chen, Yu-Ting

    2017-01-24

    With the rapid development of the child welfare system in China over recent years, medical social work has been increasingly involved in providing child protection services in several hospitals in Shanghai. Focusing on five cases in this paper, the exploratory study aims to present a critical overview of current practices and effects of medical social work for child protection, based on a critical analysis of the multidimensional role of social work practitioners engaged in the provision of child protection services as well as potential challenges. Implications and suggestions for future improvements of China's child protection system are also discussed.

  20. Medical educators working abroad: a pilot study of educators' experiences in the Middle East.

    Science.gov (United States)

    McLean, Michelle; McKimm, Judy; Major, Stella

    2014-09-01

    Medical education is now a global enterprise, with many medical educators working internationally, either for short or longer periods or even permanently. In parallel, many medical schools are now involved in collaborations and partnerships with schools in other countries. With this in mind, we set out to explore what motivates, supports and inhibits medical educators who wish to or might work outside their "home country". This article reports on the pilot stage (in specific organizational contexts in Middle East) of a longitudinal project aimed at canvassing medical educators on a broader global scale, using reflective accounts and a questionnaire survey. The findings from this pilot study raise interesting issues about the lived experience of medical educators who have chosen to work in a different culture from their own. Respondents identify many advantages around skills, personal and professional development. Three main issues emerged in terms of educators' experiences: the academic environment, medical practice in a different cultural context and personal matters. Adapting to the local culture, gender segregation and the impact on learning and teaching was an overarching factor. We introduce an explanatory framework to explain the development of international educator identity, a cyclical process in which, through experiences and reflection, individual world views and perspectives are continually modified and developed. This pilot study tested the methodologies and developed a new conceptual model that will be used in a wider study across different cultures.

  1. A randomized trial to compare two dosing intervals of misoprostol following mifepristone administration in second trimester medical abortion.

    Science.gov (United States)

    Chai, J; Tang, O S; Hong, Q Q; Chen, Q F; Cheng, L N; Ng, E; Ho, P C

    2009-02-01

    The conventional timing of misoprostol administration after mifepristone for second trimester medical abortion is 36-48 h, but simultaneous administration, which may make the regimen more convenient, has not been studied. The objective of this randomized comparison study is to compare two intervals of administration of misoprostol after pretreatment with mifepristone for second trimester medical abortion. Eligible women with gestational age between 12 and 20 weeks were randomized to receive mifepristone 200 mg orally followed by 600 microg misoprostol vaginally either immediately or 36-38 h later, followed by 400 microg vaginal misoprostol every 3 h for a maximum of four doses. The primary outcome measure was the success rate at 24 h after the start of misoprostol treatment and the secondary outcome measures were the induction-to-abortion interval and the frequency of side effects. There was a significant difference in the success rate at 24 h (36-38 h: 100%; immediate: 91.5%). The median induction-to-abortion interval was significantly shorter in the 36-38 h regimen (4.9 h) compared with the immediate regimen (10 h). Side effects in terms of febrile episodes and chills/rigors were significantly higher in the immediate administration group. Simultaneous use of mifepristone and misoprostol for second trimester medical abortion is not as effective as the regimen using a 36-38 h dosing interval.

  2. An example of US Food and Drug Administration device regulation: medical devices indicated for use in acute ischemic stroke.

    Science.gov (United States)

    Peña, Carlos; Li, Khan; Felten, Richard; Ogden, Neil; Melkerson, Mark

    2007-06-01

    The Food and Drug Administration has established requirements for protecting the public health by assuring the safety and effectiveness of a variety of medical products including drugs, devices, and biological products, and for promoting public health by expediting the approval of treatments that are safe and effective. The Center for Devices and Radiological Health is the center within the agency that is responsible for pre- and postmarket regulation of medical devices. In this article, we review current regulation of medical devices, research and development programs, pre- and postmarket perspectives, and future considerations of medical devices, particularly as they relate to devices targeting acute ischemic stroke as an example of the process. We also review the Center for Devices and Radiological Health's historical perspective of acute ischemic stroke trials and clinical trial design considerations used in prior studies that have led to US market clearance as they are related to currently marketed devices indicated for acute ischemic stroke.

  3. A Study on Quality of Work Life among Nurses in a Medical College Hospital in Bangalore

    OpenAIRE

    Naveen Ramesh, Catherine Nisha, Andre Mary Josephine, Seena Thomas, Bobby Joseph

    2013-01-01

    Introduction: Quality of Work Life (QWL) is defined as the extent to which an employee is satisfied with personal and working needs through participating in the workplace while achieving the goals of the organization. Objectives: To assess the quality of life of nurses working in a medical college hospital in Bangalore and the factors associated with it. Methods: Ethical approval from the institution and informed consent from the study participants was obtained and quality of life que...

  4. Multiprofessional teamwork in work-related medical rehabilitation for patients with chronic musculoskeletal disorders.

    Science.gov (United States)

    Schwarz, Betje; Neuderth, Silke; Gutenbrunner, Christoph; Bethge, Matthias

    2015-01-01

    Systematic reviews indicate the effectiveness of multimodal rehabilitation. In Germany this has been shown, in particular, for work-related medical rehabilitation. A recently published guideline on work-related medical rehabilitation supports the dissemination of these programmes. The feasibility of this guideline was examined in a multicentre study. This paper presents findings on the relevance of multiprofessional teamwork for the implementation of successful work-related medical rehabilitation. Focus groups were conducted with 7 inpatient orthopaedic rehabilitation teams and examined using qualitative content analysis. Multiprofessional teamwork emerged inductively as a meaningful theme. All teams described multiprofessional teamwork as a work-related medical rehabilitation success factor, referring to its relevance for holistic treatment of multifactorially impaired patients. Although similar indicators of successful multiprofessional teamwork were named, the teams realized multiprofessional teamwork differently. We found 3 team types, corresponding to multidisciplinary, interdisciplinary and transdisciplinary team models. These types and models constitute a continuum of collaborative practice, which seems to be affected by context-related factors. The significance of multiprofessional teamwork for successful multimodal rehabilitation was underlined. Indicators of ideal multiprofessional teamwork and contextual facilitators were specified. The contingency approach to teamwork, as well as the assumption of multiprofessional teamwork as a continuum of collaborative practice, is supported. Stronger consideration of multiprofessional teamwork in the work-related medical rehabilitation guideline is indicated.

  5. Comparing shingles incidence and complication rates from medical record review and administrative database estimates: how close are they?

    Science.gov (United States)

    Yawn, Barbara P; Wollan, Peter; St Sauver, Jennifer

    2011-11-01

    Accurate rates of herpes zoster incidence and complication have become of greater interest as studies have suggested an increasing temporal trend in incidence rates across all age groups and long-term follow-up studies of vaccine effectiveness are required by the Food and Drug Administration. This study compares the results obtained from the most commonly used method to obtain herpes zoster data (rates obtained from administrative data) with results obtained when administrative data are supplemented by medical record review. Administrative billing code data identified 1,959 cases of herpes zoster in Olmsted County, Minnesota, adults between January 1, 1996, and December 31, 2001. Of those 1,959 cases, 1,669 (85.2%) could be confirmed by medical record review, a decrease in incidence rate of 14.8%, resulting in a decrease of 0.61/1,000 person-years when adjusted to the US adult population. Complication rates were also significantly different between the 2 methods. It is not clear if the 15% decrease in incidence rates would be seen in every administrative data set or if the lack of confirmation of cases may be variable in both validity and reproducibility between data sets, making estimations in temporal trends and pre/post-vaccine rates difficult to compare across data resources.

  6. Training residents and nurses to work as a patient-centered care team on a medical ward.

    Science.gov (United States)

    Laird-Fick, Heather S; Solomon, David; Jodoin, Christine; Dwamena, Francesca C; Alexander, Kim; Rawsthorne, Larry; Banker, Tammy; Gourineni, Nandu; Aloka, Feras; Frankel, Richard M; Smith, Robert C

    2011-07-01

    To train medical residents and nurses to work together as a patient-centered care (PCC) team on a medical ward and test its feasibility, nurses' learning, and patient outcomes. Working with administrative leadership, we consolidated residents' patients on one 32-bed ward. Already training residents in an evidence-based patient-centered method, we now trained 5 nurse leaders similarly, and they then trained all staff nurses. A national consultant visited twice. Specific team-building activities for nurses and residents fostered ward interactions. We used a retrospective pre/post/6-month post-design to evaluate nurses' knowledge and self-efficacy of patient-centered skills. Patients were assigned non-randomly to our unit or comparison units from our emergency room; using a post-test only design, the primary endpoint was patient satisfaction. 28 trained nurses showed improvement in knowledge (p=0.02) and self-efficacy (p=0.001). 81 treatment patients showed no improvement in satisfaction (p=0.44). Training nurses in patient-centered practices were effective. Unique in this country, we also trained nurses and residents together as a PCC team on a medical ward and showed it was feasible and well accepted. We provide a template for team training and urge that others explore this important new area and contribute to its further development. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  7. Moderating role of interior amenities on hospital medical directors' patient-related work stresses.

    Science.gov (United States)

    Lin, Blossom Yen-Ju; Lin, Yung-Kai; Juan, Chi Wen; Lee, Suhsing; Lin, Cheng-Chieh

    2013-01-01

    Considering hospital medical directors' work stress, this study aims to examine how interior amenities might moderate the effect of work stress on their health. Previous studies have revealed that hospital medical directors-senior physicians in the management positions with high-demand jobs in clinical practices and management-had a lower self-rated health. This was a cross-sectional survey study and 737 hospital medical directors in Taiwan were included. A developed and structured questionnaire covered the dimensions of patient-related work stress (i.e., physician-patient relationship stress and patient condition stress), hospital interior amenities (i.e., indoor plants, aquarium, music, art and exhibitions, and private or personalized spaces that are common or surround the workplace of healthcare professionals), and self-rated health status and health complaints. Hierarchical regressions were performed. Hospital medical directors' physician-patient relationship stresses were found to have more negative effects on their self-reported health status and complaints than do their patient condition stresses; however, only indoor plants were found to have moderating effects on their short-term health complaints (p interior amenities can produce buffering effects on work stress to some extent. Future studies could focus on finding alternatives to relieve hospital medical directors' physician-patient relationship work stresses. Evidence-based design, physicians, privacy and security, satisfaction, work environmentPreferred Citation: Lin, B. Y.-J., Lin, Y.-K., Juan, C.W., Lee, S., Lin, C.-C. (2013). Moderating role of interior amenities on hospital medical directors' patient-related work stresses. Health Environments Research & Design Journal 6(2), pp 77-92.

  8. WE-G-19A-01: Radiologists and Medical Physicists: Working Together to Achieve Common Goals

    Energy Technology Data Exchange (ETDEWEB)

    Jones, A; Ma, J; Steele, J; Choi, H [UT MD Anderson Cancer Center, Houston, TX (United States)

    2014-06-15

    It is vitally important that medical physicists understand the clinical questions that radiologists are trying to answer with patient images. Knowledge of the types of information the radiologist needs helps medical physicists configure imaging protocols that appropriately balance radiation dose, time, and image quality. The ability to communicate with radiologists and understand medical terminology, anatomy, and physiology is key to creating such imaging protocols. In this session, radiologists will present clinical cases and describe the information they are seeking in the clinical images. Medical physicists will then discuss how imaging protocols are configured. Learning Objectives: Understand the types of information that radiologists seek in medical images. Apply this understanding in configuring the imaging equipment to deliver this information. Develop strategies for working with physician colleagues.

  9. [Statistical analysis of existing ancient medical works in Japan and Korea and the development value].

    Science.gov (United States)

    Xiao, Yong-Zhi; Zhang, Li-Jun; Li, Chun-Mei; Quan, Shi-Yu; Zhou, Min

    2011-03-01

    The category, number, date of writing, circulated copies and library collection situation of 12275 Japanese medical works before 1912 and 416 Korean medical works before 1910 were analyzed. Most of these medical books are clinical books, which reflected the emphasis on clinical practice and conclusions in the two countries. Japanese medical books were mainly completed between the 17 - 19th century and nearly all of them are conserved as copies, while in Korea the number is 39.6% and we don't know the time that more than half of Korean medical books were completed. The existing books in Japan are collected in more than 500 libraries, especially in 19 public and private libraries., such as Kyoto University Library, Tokyo University Library, Japan Library of Congress. In Korea, most of the books are conserved in Kyujanggak Institute for Korean Studies in Seoul National University. It is necessary for scholars of China, Japan and Korea to work together to study and utilize the ancient medical books of the three countries and to make them play a more important role in the development of Eastern traditional medicine.

  10. English for University Administrative Work: English Officialization Policy and Foreign Language Learning Motivation

    Science.gov (United States)

    Kim, Jeongyeon; Choi, Jinsook

    2014-01-01

    This study examines how the English officialization policy of higher education in an EFL context interplays with administrative workers' motivational orientations towards English learning. The data consisted of questionnaire responses of 117 administrative members with undergraduate degrees and qualitative interviews with 9 who answered the…

  11. Hostile Work Environment: What Communication Administrators and Educators Can Learn from Communication-based Law.

    Science.gov (United States)

    Newburger, Craig

    2001-01-01

    Presents a consideration of sexual harassment laws that are intended to underscore the variety of heuristic possibilities offered by inquiry into communication-based laws, for both communication administrators and educators. Concludes that communication administration, communication education, and evolving communication-based legal standards and…

  12. The Effective Use of Management Science in University Administration. Working Paper No. 9.

    Science.gov (United States)

    Schroeder, Roger G.; Adams, Carl R.

    Most college administrators are anxious to make use of management science techniques to assist them in operating their organizations. Despite their positive attitude, however, these administrators seem to lack a systematic method of approaching their specific organizations to decide which areas of application and what techniques should be…

  13. Relationship of work-family conflict, self-reported social support and job satisfaction to burnout syndrome among medical workers in southwest China: A cross-sectional study

    Science.gov (United States)

    Yang, Shujuan; Liu, Danping; Liu, Hongbo; Zhang, Juying; Duan, Zhanqi

    2017-01-01

    Background Burnout is a psychosomatic syndrome widely observed in Chinese medical workers due to the increasing cost of medical treatment, excessive workload, and excessive prescribing behavior. No studies have evaluated the interrelationship among occupational burnout, work-family conflict, social support, and job satisfaction in medical workers. The aim of this study was to evaluate these relationships among medical workers in southwest China. Methods This cross-sectional study was conducted between March 2013 and December 2013, and was based on the fifth National Health Service Survey (NHSS). A total of 1382 medical workers were enrolled in the study. Pearson correlation analysis and general linear model univariate analysis were used to evaluate the relationship of work-family conflict, self-reported social support, and job satisfaction with burnout syndrome in medical workers. Results We observed that five dimensions of job satisfaction and self-reported social support were negatively associated with burnout syndrome, whereas three dimensions of work-family conflict showed a positive correlation. In a four-stage general linear model analysis, we found that demographic factors accounted for 5.4% of individual variance in burnout syndrome (F = 4.720, Pburnout syndrome, and medical workers without administrative duties had more serious burnout syndrome than those with administrative duties. Conclusions In conclusion, the present study suggests that work-family conflict and self-reported social support slightly affect the level of burnout syndrome, and that job satisfaction is a much stronger influence on burnout syndrome in medical workers of southwest China. PMID:28207821

  14. Capturing Psychologists' Work in Integrated Care: Measuring and Documenting Administrative Outcomes.

    Science.gov (United States)

    Kearney, Lisa K; Smith, Clifford A; Pomerantz, Andrew S

    2015-12-01

    With the expansion of integrated primary care and the increased focus on fiscal sustainability, it is critical for clinical managers of these innovative systems to have practical methods for measuring administrative outcomes. Administrative outcomes will assist leadership in the development of efficient, streamlined clinics to provide services to the primary care population. Additionally, administrative measures can be utilized to provide information to assist in guiding resource utilization and management decisions. Several administrative outcomes are suggested for integrated primary care managers to consider for application, including: clinic utilization measures, integrated care administrative measures, wait time and access metrics, and productivity monitors. Effective utilization of these measures can help office managers and clinic leadership not only to maximize patient care, but also to enhance essential business operations, which increase the long-term sustainability of integrated primary care programs.

  15. Views of Japanese medical students on the work-life balance of female physicians.

    Science.gov (United States)

    Takahashi, Keiko; Nin, Tomoni; Akano, Megumi; Hasuike, Yukiko; Iijima, Hiroko; Suzuki, Keiichirou

    2017-05-11

    To survey medical students on their ideas of future work-life balance and discuss topics for next-generation medical education. First-year (n=372, 34.9% female) and sixth-year medical students (n=311, 44.1% female) responded to a questionnaire on future self, marriage and childcare, and gender differences at the workplace. Responses were compared between academic years and gender. Responses were evaluated by gender and academic year using the Mann-Whitney U test.  Significance was set at pwork part-time. Also among first-year students, greater percentages of female students expected to work part-time or leave their jobs temporarily while raising their children. Compared with first-year male students, first-year female students expected to undertake larger portions of the childcare and housework burden than their partners. However, gender differences in work-life balance and childcare leave vanished in the sixth-year students. Female medical students accepted childcare and housework burdens as inevitable; the work environment they choose might affect their career development. While support from male partners and institutions must be increased, voluntary actions and change in mentality of female students need to be promoted through medical education to prevent them from waiting passively for the situation to change.

  16. ADMINISTRATIVE CIRCULAR No. 25 (REV. 3) - Special provisions for the fire and rescue service governing working and rest time

    CERN Document Server

    2012-01-01

    Administrative Circular No. 25 (Rev. 3) entitled “Special provisions for the Fire and Rescue Service governing working and rest time”, approved by the Director-General following discussion at the Standing Concertation Committee meeting of 28 September 2012 and entering into force in October 2012, is available on the intranet site of the Human Resources Department: http://cern.ch/hr-docs/admincirc/admincirc.asp This Circular is applicable to staff members of the Fire and Rescue Service It cancels and replaces Administrative Circular No. 25 (Rev. 2) entitled “Shift work – Special provisions for the Fire and Rescue Service” of April 2003. This new version takes into account the new organisation of the Fire and Rescue Service, members of which will henceforth not exclusively perform their functions in the context of shift work, but also during reference working hours and during stand-by duty. Additionally, applicable limits regarding working and rest times an...

  17. A Markov Model for Forecasting Inventory Levels for U.S Navy Medical Service Corps Healthcare Administrators

    Science.gov (United States)

    2014-03-01

    Exper Psych 30 4% Clinical Dietetics 26 3% Financial Mgt 78 8% Research Psych 17 3% Optometry 109 11% MPT&E 31 3% Entomology 39 6% Pharmacy , General 136...NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA THESIS Approved for public release; distribution is unlimited A MARKOV MODEL FOR...FORECASTING INVENTORY LEVELS FOR U.S NAVY MEDICAL SERVICE CORPS HEALTHCARE ADMINISTRATORS by Sobondo Josiah March 2014 Thesis Co

  18. The Impact of Word Processing on Office Administration in the Medical and Allied Health Professions.

    Science.gov (United States)

    Platt, Naomi Dornfeld

    The effect of word processing equipment on the future medical secretarial science curriculum was studied. A literature search focused on word processing and the medical and allied health professions, word processing and business education, and futuring of and changes in the secretarial science curriculum. Questionnaires to identify various aspects…

  19. A Quantitative Analysis of the Effect of Simulation on Medication Administration in Nursing Students

    Science.gov (United States)

    Scudmore, Casey

    2013-01-01

    Medication errors are a leading cause of injury and death in health care, and nurses are the last line of defense for patient safety. Nursing educators must develop curriculum to effectively teach nursing students to prevent medication errors and protect the public. The purpose of this quantitative, quasi-experimental study was to determine if…

  20. Bachelors of Science in Nursing Students and a Qualitative Analysis of Their Medication Administration Experiences

    Science.gov (United States)

    Betts, Kelly J.

    2016-01-01

    Lack of medication knowledge and skills is detrimental to the safety and welfare of patients. Lack of pharmacology knowledge and skills is detrimental to the safety and welfare of patients. In a southern baccalaureate nursing program, students demonstrated deficiencies in their medication knowledge and skill proficiency. This qualitative study…

  1. Medical yoga in the workplace setting-perceived stress and work ability-a feasibility study.

    Science.gov (United States)

    Axén, Iben; Follin, Gabriella

    2017-02-01

    This study examined the feasibility of using an intervention of Medical Yoga in the workplace and investigated its effects on perceived stress and work ability. This was a quasi-experimental pilot study comparing a group who received Medical Yoga (intervention group, N=17), with a group waiting to receive Medical Yoga (control group, N=15). Medical Yoga in nine weekly sessions led by a certified instructor, as well as an instruction film to be followed at home twice weekly. Feasibility was assessed through recruitment, eligibility, willingness to participate, response to questionnaires and adherence to the intervention plan. Stress was measured with the Perceived Stress Scale, work ability with the Work Ability Index. Convincing unit managers to let their employees participate in this intervention was difficult. Eligibility was perfect, but only 40% of workers were willing to participate. The subjects adhered to a great extent to the intervention and answered the questionnaires satisfactorily. Reaching target individuals requires careful attention to informing participants. The intervention showed no significant effects on stress and work ability, though the two measures correlated significantly over time. Factors limiting feasibility of this workplace intervention were identified. Work place interventions may need to be sanctioned at a higher managerial level. The optimal time, length and availability of the workplace intervention should be explored further. Knowledge from this study could be used as a foundation when planning a larger scale study. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Work-Related Quality of Life among Medical Residents at a University Hospital in Northeastern Thailand.

    Science.gov (United States)

    Somsila, Nattamon; Chaiear, Naesinee; Boonjaraspinyo, Sirintip; Tiamkao, Somsak

    2015-12-01

    1) To assess work-related quality of life (WRQOL) among medical residents at a university hospital in northeast Thailand. 2) To determine the strength of the association between personal and working condition components and WRQOL among medical residents. A descriptive study was used to describe the WRQOL among medical residents. The study population comprised of all 375 residents affiliated with the university hospital. The Thai version of a self-administered work-related quality of life scale-2 was used for data collection. Testing the reliability revealed a Cronbach's alpha of 0.908. Questionnaires were completed by 259 of 375 (68.3%). The study found that the mean rating by residents for overall WRQOL was 113.8 out of 170 (SD 14.8). Most rated WRQOL as moderate (76.6%). The seven sub-factors were rated as moderate to high for employee engagement and control at work, moderate for home/work interface, general well-being and working conditions, high-moderate for job career satisfaction, and low-moderate for stress at work. Relationships between the personal and working condition components and WRQOL were analyzed using binary logistic regression. Residents in minor specialties had a higher WRQOL than those in major specialties (OR 2.522, 95% CI: 1.37, 4.63). Residents who had less than eight duty shifts/week had a higher WRQOL than those with more than eight duty shifts/week (OR 2.263, 95% CI: 1.16, 4.41). Similarly, residents working with less than 80 hours/week had a higher WRQOL than those working more than 80 hours/week (OR 2.344, 95% CI: 1.17, 4.72). A subgroup analyzes of those working in minor specialties showed the trend that working less than eight shifts/month and working less than 80 hours/week had the potential association with good quality of work-life (QWL). This phenomenon is presented in the subgroup analyses of those working in major specialties. Therefore, working hours and number of shifts might have played important role in contributing good QWL

  3. Assessment of workplace air concentrations of formaldehyde during and before working hours in medical facilities.

    Science.gov (United States)

    Higashikubo, Ichiro; Miyauchi, Hiroyuki; Yoshida, Satoru; Tanaka, Shinsuke; Matsuoka, Mitsunori; Arito, Heihachiro; Araki, Akihiro; Shimizu, Hidesuke; Sakurai, Haruhiko

    2017-04-07

    Workplace air concentrations of formaldehyde (FA) in medical facilities where FA and FA-treated organs were stored and handled were measured before and during working hours and assessed by the official method specified by Work Environment Measurement Law. Sixty-percent of the total facilities examined were judged as inappropriately controlled work environment. The concentrations of FA before working hours by spot sampling were found to exceed 0.1 ppm in some facilities, and tended to increase with increasing volume of containers storing FA and FA-treated materials. Regression analysis revealed that logarithmic concentrations of FA during working hours by the Law-specified analytical method were highly correlated with those before working hours by spot sampling, suggesting the importance for appropriate storing methods of FA and FA-treated materials. The concentrations of FA during working hours are considered to be lowered by effective ventilation of FA-contaminated workplace air and appropriate storage of FA and FA-treated materials in plastic containers in the medical facilities. In particular, such improvement by a local exhaust ventilation system and tightly-sealed containment of FA-treated material were urgently needed for the dissecting room where FA-treated cadavers were prepared and handled for a gross anatomy course in a medical school.

  4. Hospitals of the Future - Ubiquitous Computing support for Medical Work in Hospitals

    DEFF Research Database (Denmark)

    Bardram, Jakob Eyvind

    2003-01-01

    This paper describes the visions and on-going research within creating ubiquitous computing support for medical work in the hospitals of the future. Today, clinical computer systems seldom play any role in the execution of clinical work as such. Electronic Patient Records (EPR) are more often...... while operating a patient. Research within UbiComp provides a range of new conceptual and technological possibilities, which enable us to move clinical computer support closer to the clinical work setting. An important barnce of the research at the Danish Center for Pervasive Healthcare is to design...... and develop such new ubicomp computer technologies for clinical work....

  5. [Effects of Training Students through a Program Simulating Medication Administration and Patient Instructions in Pre-training for Practical Training].

    Science.gov (United States)

    Kikuchi, Chigusa; Matsunaga, Tamihide; Suzuki, Tadashi

    2015-01-01

    Pharmacy school students were trained in a program simulating medication administration and giving adherence instructions. Following the training, the educational effects were evaluated. Students were separated into two groups. One group of students played the role of pharmacists and instructed simulated patients on medication adherence. Another group of students played the role of patients receiving simulated drug therapy; they were instructed on medication adherence by the students playing the role of pharmacists. The educational effects were evaluated using a questionnaire. The scores for "recognition of factors that influence medication adherence" tended to increase after the simulation, and they increased significantly after practical training. The scores for "self-evaluation of technique for instructing patients on medication adherence" increased significantly after the simulation, and they increased even more after practical training. The students' understanding of the effects on patients who were being instructed also increased significantly after the simulation, and these changes were maintained after practical training. In particular, students became more aware of the influence of pharmacists' attitudes. In practical training, the simulation training was helpful for bedside practice at hospital pharmacies and over-the-counter service at community pharmacies. Thus, the use of role play and simulated patients was an effective method for training pharmacy students to instruct patients on medication adherence.

  6. Influence of parental education on Honduran medical students' labour perspectives: rural work and emigration.

    Science.gov (United States)

    Zambrano, Lysien I; Pereyra-Elías, Reneé; Reyes-García, Selvin Z; Fuentes, Itzel; Mayta-Tristán, Percy

    2015-01-01

    We sought to evaluate the intentions of Honduran medical students to emigrate or to work in a rural setting, and their association with parental education. We performed a cross-sectional, analytic study at a Honduran medical school. Student participants completed a structured questionnaire, which assessed their intentions to emigrate or work in a rural setting after finishing medical school and the highest level of education achieved by their parents. We calculated crude and adjusted prevalence ratios with their respective 95% confidence intervals. Of 868 surveys distributed, 564 were completed. The mean age of the participants was 21 (standard deviation 3) years, and 62.2% were female. Of the respondents, 16.6% intended to emigrate to work and 11.2% intended to work in a rural setting. Higher paternal education (i.e., technical, university and postgraduate training) was associated with a higher rate of intention to emigrate. Students whose fathers underwent postgraduate education were less likely to intend to work in a rural setting. For maternal education, only the postgraduate level was associated with the outcomes in some of the tested models. The frequency of students intending to emigrate was relatively low. However, the frequency of students being willing to work in rural settings was also low. Students whose parents had higher levels of education were more likely to intend to work abroad and less likely to intend to work in a rural area. These factors should be considered in medical schools' selection processes to improve retention and ensure adequate distribution of physicians.

  7. The Effectiveness of a Working Memory Training Regimen for Iranian University Students: Implications for Medical Students

    OpenAIRE

    Gholam Reza Kiany; Bahman Mehraban; Reza Ghafar Samar

    2016-01-01

    Introduction: Working memory is thought to serve as a part of memory structure where functions like temporary storage and manipulation of information take place. This study investigates the effectiveness of working memory training regimens with Iranian university students, while considering the implications for medical students. Methods: Thirty university students studying at different universities in Kermanshah took part in the study. They were divided into two groups as the experimental...

  8. Interventions to reduce nurses' medication administration errors in inpatient settings: A systematic review and meta-analysis.

    Science.gov (United States)

    Berdot, Sarah; Roudot, Marjorie; Schramm, Catherine; Katsahian, Sandrine; Durieux, Pierre; Sabatier, Brigitte

    2016-01-01

    Serious medication administration errors are common in hospitals. Various interventions, including barcode-based technologies, have been developed to help prevent such errors. This systematic review and this meta-analysis focus on the efficacy of interventions for reducing medication administration errors. The types of error and their gravity were also studied. MEDLINE, EMBASE, the Cochrane Library and reference lists of relevant articles published between January 1975 and August 2014 were searched, without language restriction. Randomized controlled trials, interrupted time-series studies, non-randomized controlled trials and controlled before-and-after studies were included. Studies evaluating interventions for decreasing administration errors based on total opportunity for error method were included. Nurses administering medications to adult or child inpatients were considered eligible as participants. Two reviewers independently assessed studies for eligibility, extracted data and assessed the risk of bias. The main outcome was the error rate without wrong-time errors measured at study level. A random effects model was used to evaluate the effects of interventions on administration errors. 5312 records from electronic database searches were identified. Seven studies were included: five were randomized controlled trials (including one crossover trial) and two were non-randomized controlled trials. Interventions were training-related (n=4; dedicated medication nurses, interactive CD-ROM program, simulation-based learning, pharmacist-led training program), and technology-related (n=3; computerized prescribing and automated medication dispensing systems). All studies were subject to a high risk of bias, mostly due to a lack of blinding to outcome assessment and a risk of contamination. No difference between the control group and the intervention group was found (OR=0.72 [0.39; 1.34], p=0.3). No fatal error was observed in the three studies evaluating the gravity of

  9. Review on the administration and effectiveness of team-based learning in medical education.

    Science.gov (United States)

    Hur, Yera; Cho, A Ra; Kim, Sun

    2013-12-01

    Team-based learning (TBL) is an active learning approach. In recent years, medical educators have been increasingly using TBL in their classes. We reviewed the concepts of TBL and discuss examples of international cases. Two types of TBL are administered: classic TBL and adapted TBL. Combining TBL and problem-based learning (PBL) might be a useful strategy for medical schools. TBL is an attainable and efficient educational approach in preparing large classes with regard to PBL. TBL improves student performance, team communication skills, leadership skills, problem solving skills, and cognitive conceptual structures and increases student engagement and satisfaction. This study suggests recommendations for administering TBL effectively in medical education.

  10. Working with anxious or fearful patients: a training tool for the medical practice staff.

    Science.gov (United States)

    Hills, Laura Sachs

    2007-01-01

    Every medical practice must work with at least some patients who are fearful or anxious. This article explores the seven most common root causes of patient fear and anxiety and offers practical suggestions for avoiding or minimizing these fears. It addresses, in particular, the patient's fear of the unknown, of being humiliated, of reenacting a medical legend or horror story, and of being vulnerable and helpless. It also explores the patient's fear of high medical fees or being unable to pay, a poor or disappointing clinical outcome, and being in a hospital-like environment. The author suggests that the medica lpractice staff may wish to seek training in fear control and includes practical how-to strategies for minimizing fear when working with children.

  11. Medical Residents' Beliefs and Actions: Implications for Clinical Teaching during Work Rounds.

    Science.gov (United States)

    Valerio, Nina Morena L.

    A study was done to examine the relationships between medical residents' beliefs about their clinical teaching roles and their teaching behaviors within the context of work rounds. The research was conceptually based on theories of symbolic interactionism and reasoned action. Fourteen residents in general internal medicine, representing four…

  12. Quality of Work-Life Programs in U.S. Medical Schools: Review and Case Studies

    Science.gov (United States)

    Otto, Ann; Bourguet, Claire

    2006-01-01

    Quality of work life is being recognized more and more as a driving factor in the recruitment and retention of highly qualified employees. Before Northeastern Ohio Universities College of Medicine began development of its QWL initiative, it surveyed other medical schools across the U.S. to determine benchmarks of best practices in these programs.…

  13. Quality of Work-Life Programs in U.S. Medical Schools: Review and Case Studies

    Science.gov (United States)

    Otto, Ann; Bourguet, Claire

    2006-01-01

    Quality of work life is being recognized more and more as a driving factor in the recruitment and retention of highly qualified employees. Before Northeastern Ohio Universities College of Medicine began development of its QWL initiative, it surveyed other medical schools across the U.S. to determine benchmarks of best practices in these programs.…

  14. Work-family conflicts and subsequent sleep medication among women and men: a longitudinal registry linkage study.

    Science.gov (United States)

    Lallukka, T; Arber, S; Laaksonen, M; Lahelma, E; Partonen, T; Rahkonen, O

    2013-02-01

    Work and family are two key domains of life among working populations. Conflicts between paid work and family life can be detrimental to sleep and other health-related outcomes. This study examined longitudinally the influence of work-family conflicts on subsequent sleep medication. Questionnaire data were derived from the Helsinki Health Study mail surveys in 2001-2002 (2929 women, 793 men) of employees aged 40-60 years. Data concerning sleep medication were derived from the Finnish Social Insurance Institution's registers covering all prescribed medication from 1995 to 2007. Four items measured whether job responsibilities interfered with family life (work to family conflicts), and four items measured whether family responsibilities interfered with work (family to work conflicts). Cox proportional hazard models were fitted, adjusting for age, sleep medication five years before baseline, as well as various family- and work-related covariates. During a five-year follow-up, 17% of women and 10% of men had at least one purchase of prescribed sleep medication. Among women, family to work conflicts were associated with sleep medication over the following 5 years after adjustment for age and prior medication. The association remained largely unaffected after adjusting for family-related and work-related covariates. Work to family conflicts were also associated with subsequent sleep medication after adjustment for age and prior medication. The association attenuated after adjustment for work-related factors. No associations could be confirmed among men. Thus reasons for men's sleep medication likely emerge outside their work and family lives. Concerning individual items, strain-based ones showed stronger associations with sleep medication than more concrete time-based items. In conclusion, in particular family to work conflicts, but also work to family conflicts, are clear determinants of women's sleep medication.

  15. 75 FR 17143 - Draft Guidance for Industry and Food and Drug Administration Staff; Medical Devices; Neurological...

    Science.gov (United States)

    2010-04-05

    ... Staff; Medical Devices; Neurological and Physical Medicine Device Guidance Documents; Availability... physical medicine devices. FDA has developed a draft special controls guidance document for each of the 11... Guidance Document: Transcutaneous Electrical Stimulator for Aesthetic Purposes; Draft Guidance for...

  16. 76 FR 15986 - Food and Drug Administration/Xavier University Global Medical Device Conference

    Science.gov (United States)

    2011-03-22

    ... accommodations. The conference headquarter hotel is the Downtown Cincinnati Hilton Netherlands Plaza, 35 West 5th... Activities. Inspection Readiness. Training. International Regulatory Update. FDCA, Anti Kickback and False.... Using Electronic Medical Records. Cooperative Research Activities Between Academia and Industry. FDA...

  17. Effects of Work Environment on Transfer of Training: Empirical Evidence from Master of Business Administration Programs in Vietnam

    Science.gov (United States)

    Pham, Nga T. P.; Segers, Mien S. R.; Gijselaers, Wim H.

    2013-01-01

    Practical application of newly gained knowledge and skills, also referred to as transfer of training, is an issue of great concern in training issues generally and in Master of Business Administration (MBA) programs particularly. This empirical study examined the influence of the trainees' work environment on their transfer of training, taking…

  18. Using a Comprehensive Case-Based Examination to Evaluate and Integrate Student Learning in Social Work Administration

    Science.gov (United States)

    Packard, Thomas; Austin, Michael J.

    2009-01-01

    While the case method has been used in teaching social work practice for many years, its use as an evaluation tool is less common. This analysis describes the use of the case method in a comprehensive examination for MSW students in an Administration concentration. After a brief review of the issues related to student outcome assessment and the…

  19. Loneliness at the Top: Ten Ways Medical Practice Administrators Can Manage the Isolation of Leadership.

    Science.gov (United States)

    Hills, Laura

    2016-01-01

    Medical practice.managers spend their days surrounded by people, so the last thing they may expect to feel is lonely. Yet for many, being the manager of a medical practice can lead to feelings of isolation from the rest of the staff, and loneliness. This article explores the many reasons that managing a medical practice can be a lonely business. It considers the risks when a practice manager's loneliness goes unchecked, both to the individual and to the practice. It suggests 10 effective and healthy strategies for preventing and managing the leadership loneliness that medical practice managers sometimes experience. Next, this article argues that acceptance is the first step in overcoming loneliness in the workplace. It offers guidance for medical practice managers who wish to help lonely members of their teams. It describes the benefits of having a confidant to help support the medical practice manager, and the characteristics of an ideal confidant. Finally, this article suggests a strategy for combatting loneliness by interacting with the staff more frequently.

  20. Attitudes of Polish physicians and medical students toward breaking bad news, euthanasia and morphine administration in cancer patients.

    Science.gov (United States)

    Leppert, Wojciech; Majkowicz, Mikolaj; Forycka, Maria

    2013-12-01

    Medical students and physicians should possess basic knowledge concerning medical ethics and palliative care. The aim of the study was to explore the knowledge on the end-of-life ethics and palliative care in third-year medical students and physicians during internal medicine specialty training and their attitude towards breaking bad news and euthanasia. A voluntary and anonymous questionnaire survey with the participation of 401 students and 217 physicians filled after lectures concerning ethics for medical students and after palliative medicine course for physicians during internal medicine specialty training. A total of 28 % students and 24 % physicians (p = 0.282) were ready to reveal full information to advanced cancer patients. A total of 82 % of students and 90 % of physicians (p = 0.008) would not practice euthanasia; 67 % of students and 75 % of physicians (p = 0.039) were opponents of euthanasia legalisation. A total of 70 % doctors and 23 % students indicated oral as the most preferable route of morphine administration. A total of 74 % physicians and 43 % students stated that there is no maximal dose of morphine; 64 % of doctors and 6 % of students indicated constipation as a constant adverse effect of morphine. Breaking bad news is a significant difficulty for both students and physicians. There is a small percentage of those tending to practice euthanasia and bigger accepting its legalisation with fewer physicians than students. In contrast to medical students, the majority of physicians have knowledge concerning chronic morphine use in the treatment of cancer patients.

  1. Administrative Leadership in Three Small, Private Tennessee Colleges: Working Groups, Real Teams, or Both?

    Science.gov (United States)

    Nichols, Michael E.

    2010-01-01

    Diversity of knowledge and multiple perspectives are characteristic advantages of group leadership as compared to transactional or bureaucratic forms of leadership. When groups are engaged in administrative functions, they are more likely to realize a higher level of performance and more relevant and innovative solutions than may be achieved by a…

  2. The Social Security Administration's Youth Transition Demonstration Projects: Interim Report on Transition WORKS

    Science.gov (United States)

    Fraker, Thomas; Black, Alison; Mamun, Arif; Manno, Michelle; Martinez, John; O'Day, Bonnie; O'Toole, Meghan; Rangarajan, Anu; Reed, Debbie

    2011-01-01

    The Social Security Administration is funding a random assignment evaluation of six demonstration projects to improve employment and other outcomes for youth ages 14 to 25 who are either receiving disability benefits or are at high risk of receiving them in the future. This report reviews the Youth Transition Demonstration (YTD) projects, located…

  3. Analysis of Work Assignments After Medical Ethics Workshop for First-Year Residents at Siriraj Hospital

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    Sakda Sathirareuangchai

    2016-11-01

    Full Text Available Background: Upon entering the residency training program, all 1st year residents at Siriraj Hospital must join medical ethics workshop held by the Division of Postgraduate Studies. At the end of the workshop, the residents were given a work assignment to write a clinical ethics situation they have encountered in their past practice. Methods: This study is an analysis of content described in the work assignments in order to gain the information regarding common medical ethics dilemmas, which the physicians faced in the early days of practice. Results: 740 work assignments were reviewed. The 4 most common ethical principle mentioned in these assign- ments were autonomy (144, 19.5%, palliative care (133, 18.0%, beneficence (121, 16.4%, and confidentiality (110, 14.9%. More than half of the situations described were during their internship (474, 64.1% and tended to distributed equally among community hospital (39.1%, university hospital (28.0%, and general hospital (24.3%. Conclusion: This study should raise the awareness of the medical educator towards these medical ethics issues during curriculum planning.

  4. [Life-style of medical personnel dwelling and working in agroindustrial area].

    Science.gov (United States)

    Sorokina, M G; Kamaev, I A

    2005-01-01

    Results of sociological survey of medical personnel of typical agroindustrial area of Novgorod Oblast are presented. Data of self-registration of acute and chronic diseases and self-appraisal of one's health testify higher morbidity and health deterioration during last 3 years. Analysis of demographic characteristics, life-styles and labor conditions revealed complex of major factors impacting individual health and flow-out of professional medical personnel. Both amount of average monthly wage of physicians and paramedics, levels of their family income and welfare and as well degree of their inconsistence with cost of living of able-bodied population are established. Conditions of living and social maintenance, labor and off-labor activity, attitude to one's own health and spread of risk factors were analyzed. Management weaknesses of district and rural patient care institutions were established, including considerable exceeding of hygienic regulations established for medical personnel working load and higher spread of physical, chemical and biological risk factors of working environment harmful for health. Need in further enhancement of management of working process, occupational safety, labor remuneration and in increasing social safety, hygienic and curative activity of medical personnel is justified.

  5. Residents′ perceptions of work environment during their postgraduate medical training in Pakistan

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    Avan B

    2006-01-01

    Full Text Available Background: In Pakistan, there is a lack of information about the work environment of residency programs. This lack is a major impediment in their improvement. One of the approaches for improvement in these programs can be directed through the residents′ own perception of their working conditions. Therefore, we collected data which would reflect working conditions of residents. Aim: To assess the perceived status of "work environment" in different specialities Materials and Methods: A cross-sectional survey was conducted in four teaching hospitals of Karachi from July 1999 to January 2000. Residents from selected programs were grouped into four broad groups: specialist, medical, surgical, and multidisciplinary. Responses of residents were obtained on a Likert scale of 0 to 4. Indices were formed for two components of work environment: academic and mistreatment. Statistical Analysis: Differences between residents′ groups were assessed through analysis of variance (ANOVA at 5% significance. Results: A total of 341 registered residents responded (response rate: 75%. Surgical residents were working more than 80 h/week and this was more than the other three groups. Medical residents were spending the highest actual time on research and teaching activities (10% and 14%, respectively. Academic index score was highest for surgical group (15.81, SD = 4.69 and lowest for multidisciplinary group (11.82, SD = 4.80. Medical group had the highest perceived mistreatment index score (5.56, SD = 4.57. Conclusions: In a study of work environment of residency programs, differential impact was found for the four groups on work environment perceptions. Most of the residents recognized undergraduate teaching, grand rounds, patient rounds, and seminars or workshops as contributing to their academic learning. Reporting of sexual harassment was low, indicating either underreporting or cultural dynamics of our setting.

  6. Insulin Administration in Catholic Schools: A New Look at Legal and Medical Issues

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    Huggins, Mike

    2015-01-01

    Anecdotal evidence indicates that more students with type 1 diabetes are enrolling in Catholic schools across the United States. Meeting the medical needs of these students appears to be a significant challenge--legally and logistically--for many Catholic schools. District officials, school leaders, and school staff need support to understand the…

  7. Development and evaluation of a computer-based medical work assessment programme

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    Spallek Michael

    2008-12-01

    Full Text Available Abstract Background There are several ways to conduct a job task analysis in medical work environments including pencil-paper observations, interviews and questionnaires. However these methods implicate bias problems such as high inter-individual deviations and risks of misjudgement. Computer-based observation helps to reduce these problems. The aim of this paper is to give an overview of the development process of a computer-based job task analysis instrument for real-time observations to quantify the job tasks performed by physicians working in different medical settings. In addition reliability and validity data of this instrument will be demonstrated. Methods This instrument was developed in consequential steps. First, lists comprising tasks performed by physicians in different care settings were classified. Afterwards content validity of task lists was proved. After establishing the final task categories, computer software was programmed and implemented in a mobile personal computer. At least inter-observer reliability was evaluated. Two trained observers recorded simultaneously tasks of the same physician. Results Content validity of the task lists was confirmed by observations and experienced specialists of each medical area. Development process of the job task analysis instrument was completed successfully. Simultaneous records showed adequate interrater reliability. Conclusion Initial results of this analysis supported the validity and reliability of this developed method for assessing physicians' working routines as well as organizational context factors. Based on results using this method, possible improvements for health professionals' work organisation can be identified.

  8. Development and evaluation of a computer-based medical work assessment programme

    Science.gov (United States)

    Mache, Stefanie; Scutaru, Cristian; Vitzthum, Karin; Gerber, Alexander; Quarcoo, David; Welte, Tobias; Bauer, Torsten T; Spallek, Michael; Seidler, Andreas; Nienhaus, Albert; Klapp, Burghard F; Groneberg, David A

    2008-01-01

    Background There are several ways to conduct a job task analysis in medical work environments including pencil-paper observations, interviews and questionnaires. However these methods implicate bias problems such as high inter-individual deviations and risks of misjudgement. Computer-based observation helps to reduce these problems. The aim of this paper is to give an overview of the development process of a computer-based job task analysis instrument for real-time observations to quantify the job tasks performed by physicians working in different medical settings. In addition reliability and validity data of this instrument will be demonstrated. Methods This instrument was developed in consequential steps. First, lists comprising tasks performed by physicians in different care settings were classified. Afterwards content validity of task lists was proved. After establishing the final task categories, computer software was programmed and implemented in a mobile personal computer. At least inter-observer reliability was evaluated. Two trained observers recorded simultaneously tasks of the same physician. Results Content validity of the task lists was confirmed by observations and experienced specialists of each medical area. Development process of the job task analysis instrument was completed successfully. Simultaneous records showed adequate interrater reliability. Conclusion Initial results of this analysis supported the validity and reliability of this developed method for assessing physicians' working routines as well as organizational context factors. Based on results using this method, possible improvements for health professionals' work organisation can be identified. PMID:19094213

  9. The effect of additional topical cyclosporine or vitamin A on the ocular surface during antiglaucoma medication administration.

    Science.gov (United States)

    Cho, Hyun Kyung; Park, Myoung Hee; Moon, Jung Il

    2012-01-01

    To investigate the effects of topical application of cyclosporine or vitamin A on the ocular surface during the concurrent administration of antiglaucoma drugs. Thirty rabbits were randomized into 5 groups. Group 1 was administered timolol, group 2 received travoprost, group 3 received a travoprost/timolol fixed combination solution, group 4 received timolol and travoprost, and group 5 received timolol, travoprost, and dorzolamide. Each group was divided into a subgroup that received only the antiglaucoma medication (subgroup A), a subgroup that received topical cyclosporine in addition to the antiglaucoma medication (subgroup B), and a subgroup that received topical vitamin A in addition to the antiglaucoma medication (subgroup C). Conjunctival impression cytology specimens were collected at baseline and at weeks 1, 3, and 6. Conjunctival biopsy specimens were collected at week 6. The impression cytologic study results are as follows: statistically significant differences were found between groups 4A and 4B and between groups 4A and 4C at week 6 (p = 0.004, p = 0.006, respectively) and between groups 5A and 5B and between groups 5A and 5C at weeks 3 and 6 (p = 0.006, p = 0.008 at week 3, p = 0.003, p = 0.004 at week 6, respectively). No statistically significant differences were found between subgroup B and subgroup C in any of the groups at any of the times evaluated (p > 0.05). The conjunctival biopsy specimens from groups 1, 2, and 3 showed no distortion, but groups 4A and 5A showed distortion of the conjunctival epithelial structures. Groups 4B, 4C, 5B, and 5C showed less distortion of the conjunctival epithelial structures. Administration of cyclosporine or vitamin A may reduce the adverse ocular surface changes caused by long-term administration of antiglaucoma drugs. Copyright © 2012 S. Karger AG, Basel.

  10. Views of junior doctors about whether their medical school prepared them well for work: questionnaire surveys

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    Taylor Kathryn

    2010-11-01

    Full Text Available Abstract Background The transition from medical student to junior doctor in postgraduate training is a critical stage in career progression. We report junior doctors' views about the extent to which their medical school prepared them for their work in clinical practice. Methods Postal questionnaires were used to survey the medical graduates of 1999, 2000, 2002 and 2005, from all UK medical schools, one year after graduation, and graduates of 2000, 2002 and 2005 three years after graduation. Summary statistics, chi-squared tests, and binary logistic regression were used to analyse the results. The main outcome measure was the level of agreement that medical school had prepared the responder well for work. Results Response rate was 63.7% (11610/18216 in year one and 60.2% (8427/13997 in year three. One year after graduation, 36.3% (95% CI: 34.6, 38.0 of 1999/2000 graduates, 50.3% (48.5, 52.2 of 2002 graduates, and 58.2% (56.5, 59.9 of 2005 graduates agreed their medical school had prepared them well. Conversely, in year three agreement fell from 48.9% (47.1, 50.7 to 38.0% (36.0, 40.0 to 28.0% (26.2, 29.7. Combining cohorts at year one, percentages who agreed that they had been well prepared ranged from 82% (95% CI: 79-87 at the medical school with the highest level of agreement to 30% (25-35 at the lowest. At year three the range was 70% to 27%. Ethnicity and sex were partial predictors of doctors' level of agreement; following adjustment for them, substantial differences between schools remained. In years one and three, 30% and 34% of doctors specified that feeling unprepared had been a serious or medium-sized problem for them (only 3% in each year regarded it as serious. Conclusions The vast knowledge base of clinical practice makes full preparation impossible. Our statement about feeling prepared is simple yet discriminating and identified some substantial differences between medical schools. Medical schools need feedback from graduates about

  11. Temperature variations around medication cassette and carry bag in routine use of epoprostenol administration in healthy volunteers.

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    Yuichi Tamura

    Full Text Available BACKGROUND: According to several treatment guidelines, epoprostenol is an important treatment option for pulmonary arterial hypertension. However, the pharmacokinetic characteristics and poor stability of epoprostenol at room temperature make its administration challenging. We therefore studied temperature fluctuations between the drug administration cassette and atmosphere to promote the safe use of epoprostenol. METHODS AND FINDINGS: Five healthy volunteers carried a portable intravenous infusion pump attached to a medication cassette containing saline in a bag during their ordinary activities over 16 days during which the mean atmospheric temperature was 29.6 ± 1.5°C. The temperature around the medication cassette was not less than 25°C on any occasion, and the mean period over 24 h during which the temperature around the cassette exceeded 35°C and 40°C was 96.9 ± 156.4 min and 24.4 ± 77.3 min, respectively. Significant correlations were observed between the temperatures outside the bag and around the cassette, as well as between temperatures around the cassette and of the saline solution in the cassette (r = 0.9258 and 0.8276, respectively. There were no differences in the temperatures outside the bag or around the cassette with respect to the bag material. CONCLUSIONS: Temperatures around a medication cassette and outside the bag containing the medication increase with sunlight exposure. The temperature around cassettes used for administering epoprostenol must therefore be kept low for as long as possible during hot summer conditions to maintain the drug stability.

  12. Difficulties in administration of oral medication formulations to pet cats: an e-survey of cat owners.

    Science.gov (United States)

    Sivén, M; Savolainen, S; Räntilä, S; Männikkö, S; Vainionpää, M; Airaksinen, S; Raekallio, M; Vainio, O; Juppo, A M

    2017-03-11

    The purpose here was to determine the problems cat owners encounter in medicating their cats with orally administered drugs at home. The study was carried out as an open e-questionnaire survey addressed to cat owners in which the authors focused on the oral administration route. A total of 46 completed questionnaires were included in the survey. In the study, 46 cats received 67 orally administered drugs. Approximately half of the drugs were registered for use in cats by the European Medicines Agency (54 per cent), and there were also off-label drugs registered for human (36 per cent) and canine medication (7.4 per cent) and an ex tempore drug (3.0 per cent). The owners were unable to give the doses as prescribed for their cats for one-fourth of the medications (16/67). Drugs that were registered for feline medication were significantly more palatable than drugs registered for other species (odds ratio (OR) 4.9), and liquid formulations were significantly more palatable than solid formulations (OR 4.8). However, most of the owners (22/38) preferred a solid dosage form, while few (4/38) chose a liquid formulation. The results indicate that there is still a need for more palatable and easily administered oral drugs for cats.

  13. Introduction and Administration of the Clinical Skill Test of the Medical Licensing Examination, Republic of Korea (2009

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    Kun Sang Kim

    2010-12-01

    Full Text Available The first trial of the clinical skill test as part of the Korean Medical Licensing Examination was done from September 23 to December 1, 2009, in the clinical skill test center located in the National Health Personnel Licensing Examination Board (NHPLEB building, Seoul. Korea is the first country to introduce the clinical skill test as part of the medical licensing examination in Asia. It is a report on the introduction and administration of the test. The NHPLEB launched researches on the validity of introducing the clinical skill test and on the best implementation methods in 2000. Since 2006, lists of subjects of test items for the clinical skill test has been developed. The test consisted of two types of evaluation, i.e., a clinical performance examination (CPX with a standardized patient (SP and objective structured clinical examination (OSCE. The proctor (medical faculty member and SP rate the examinees??proficiency for the OSCE and CPX respectively. Out of 3,456 applicants, 3,289 examinees (95.2% passed the test. Out of 167 examinees who failed the clinical skill test, 142 passed the written test. This means that the clinical skill test showed characteristics independent from the written test. This successful implementation of the clinical skill test is going to improve the medical graduates??performance of clinical skills.

  14. Making short-term international medical volunteer placements work: a qualitative study

    Science.gov (United States)

    Elnawawy, Omnia; Lee, Andrew CK; Pohl, Gerda

    2014-01-01

    Background International medical volunteering has grown in recent decades. It has the potential to benefit and harm the volunteer and host countries; but there is a paucity of literature on the impacts of international medical volunteering and a need to find ways to optimise the benefits of such placements. Aim In this study, one example of international medical volunteering was examined involving British GPs on short-term placements in Nepal. The intention was to explore the expectations and experiences of the local health workers, volunteers, and host organisation to try and understand what makes volunteer placements work. Design Qualitative study of key informant interviews. Setting Stakeholders of a short-term international medical volunteer (IMV) placement programme in Nepal. Method Key informant interviews were carried out via face-to-face or telephone/internet interviews with five previous volunteers, three representatives from a non-governmental organisation providing placements, and five local health workers in Nepal who had had contact with the IMVs. Interviews were recorded, transcribed, and analysed using standard thematic framework approaches. Results All the stakeholders had their own specific motives for participating in the IMV programme. The relationship between volunteers and the Nepalese health workers was complex and characterised by discrepant and occasionally unrealistic expectations. Managing these different expectations was challenging. Conclusion Contextual issues and cultural differences are important considerations in medical volunteer programmes, and this study highlights the importance of robust preparation pre-placement for the volunteer and host to ensure positive outcomes. PMID:24868070

  15. Working alliance and its relationship to outcomes in a randomized controlled trial (RCT of antipsychotic medication

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    Wykes Til

    2013-01-01

    Full Text Available Abstract Background Long acting injections (LAI have been associated with perceptions of coercion in cross sectional studies but there have been no longitudinal studies of the effects on clinical relationships with newer depot medications. Method Randomized controlled trial with (50 participants with a diagnosis of schizophrenia randomized to risperidone LAI or oral atypical antipsychotic medication. The main outcome was the Working Alliance Inventory (WAI with background variables (symptoms, side effect, social functioning, quality of life measured before randomization and at two years. Results At follow-up (14 risperidone LAI and 16 oral medication analyses including predictors of missing data and baseline score showed a trend for those on risperidone LAI to reduce WAI score and those on oral medication showing no change. Sensitivity analyses showed (i a significant detrimental effect of LAI on WAI and (ii the pattern of results was not affected by change in symptoms over the study. Conclusion This is the first study to show that the prescription of depot atypical depot medication is associated with detrimental effects on clinical relationships after 2 years of continual treatment.

  16. Aromatherapy alleviates endothelial dysfunction of medical staff after night-shift work: preliminary observations.

    Science.gov (United States)

    Shimada, Kenei; Fukuda, Shota; Maeda, Kumiko; Kawasaki, Toshihiro; Kono, Yasushi; Jissho, Satoshi; Taguchi, Haruyuki; Yoshiyama, Minoru; Yoshikawa, Junichi

    2011-02-01

    Night-shift work causes mental stress and lifestyle changes, and is recognized as a risk of cardiovascular diseases associated with impaired endothelial function. Aromatherapy is becoming popular as a complementary therapy that is beneficial for mental relaxation. The purpose of this study was to investigate the effect of aromatherapy on the endothelial function of medical staff after night-shift work. This study consisted of 19 healthy medical personnel (19 men, mean age 32 ± 7 years), including 11 physicians and 8 technicians. Aromatherapy was performed for 30 min by inhalation of the essential oil of lavender. Flow-mediated dilation (FMD) of the brachial artery was measured three times in each subject: on a regular workday, and after night-shift work before and immediately after aromatherapy. A control study was performed to assess the effect of a 30-min rest without aromatherapy. The mean value of sleep time during night-shift work was 3.3 ± 1.3 h. FMD after night-shift work was lower than on a regular workday (10.4 ± 1.8 vs. 12.5 ± 1.7%, Paromatherapy (11.8 ± 2.5%, P=0.02 vs. before aromatherapy). FMD was stable in the control study (10.1 ± 1.9 vs. 10.1 ± 2.2%, P=0.9). This study demonstrated that night-shift work impaired endothelial function in medical staff, an effect that was alleviated by short-term aromatherapy.

  17. STRESSFUL SITUATIONS IN THE WORK OF A MULTIPROFILE PEDIATRIC MEDICAL FACILITY'S CALL CENTER

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    I. M. Spivak

    2015-01-01

    Full Text Available Stressful situations in the work of a pediatric medical facility's call center are associated with patients' violation of social communication norms and aggressive behavior, as well as the operator's professional/maternal conflict. The following psychological resources facilitate better stress resistance of operators: self-confidence, mature and rational attitude, personal activity, inner satisfaction, optimism, emotional breadth and emotional colleague support. 

  18. The Study of Administrative Personnel Awareness about Patients’ Rights in the Hospitals of Tabriz University of Medical Sciences in 2009

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    Massumeh gholizadeh

    2015-07-01

    Full Text Available ​Background and objectives : Nowadays, respecting patients’ rights is the principal concern of hospital administrators to improve quality and patient satisfaction. It is also one of the most important competitive advantages for hospitals. Since administrative personnel are at the top of the healthcare team, their awareness of patients’ rights is essential for better implementation of these rights. This study was conducted to determine the extent of administrative personnel awareness of patients’ rights in Tabriz educational hospitals in 2009. Material and Methods : This descriptive-analytical study was conducted as cross-sectional by census method with the contribution of 55 participants (including hospital administrators, supervisors and matrons of Tabriz University of Medical Sciences. A valid and reliable questionnaire was used for data collecting. Descriptive and inferential statistical methods were applied for data analysis. Chi-square and Fisher tests were used to compare the relationship between variables. SPSS 10 was used for data analysis. Results : In total, 1.8% of the managers had poor awareness, 76.2% average and 22% of the managers had good awareness. The findings of the awareness divided by administrators, supervisors and matrons are as follows: poor, average and good awareness of managers were (0%, 10%, 7.2% respectively. Also, poor, average and good awareness of supervisors were (1.8 %, 47.3%, 14.8 % respectively. The awareness of all matrons was on average in patients’ rights. The rate of good awarenessamong hospital managers had the highest rank compared with other groups. By investigating the relationship between individual variables and awareness of patients’ rights, there was a significant and inverse relationship between job experience and knowledge about the patient’s rights. The findings indicated that 63.3% of studied subjects had no training course about patient’s rights. Conclusion : The moderate

  19. A psychiatric medication decision support guide for social work practice with pregnant and postpartum women.

    Science.gov (United States)

    Bentley, Kia J; Price, Sarah Kye; Cummings, Cory R

    2014-10-01

    In their work in human services organizations and community agencies across service sectors, social workers encounter pregnant and postpartum women experiencing mental health challenges. This article offers an evidence-informed Decision Support Guide designed for use by social workers working with pregnant and postpartum women who are struggling with complicated decisions about psychiatric medication use. The guide is built on contemporary notions of health literacy and shared decision making and is informed by three areas: (1) research into the lived experiences of pregnant and postpartum women and health care providers around psychiatric medication decision making, (2) a critical review of existing decision aids, and (3) feedback on the strategy from social work practitioners who work with pregnant and postpartum women. Emphasizing the relational nature of social work in supporting effective health-related decision making, the guide relies on maintaining a collaborative practice milieu and using a decision aid that engages clients in discussions about mental health during and around the time of pregnancy. The guide offers social workers a practice tool to support responsive and compassionate care by embracing their roles in problem solving and decision making, providing emotional and psychosocial support, and making appropriate referrals to prescribers.

  20. Factors that influence the choice to work in rural township health centers among 4,669 clinical medical students from five medical universities in Guangxi, China.

    Science.gov (United States)

    Qing, Yunbo; Hu, Guijie; Chen, Qingyun; Peng, Hailun; Li, Kailan; Wei, Jinling; Yi, Yanhua

    2015-01-01

    To produce competent undergraduate-level medical doctors for rural township health centers (THCs), the Chinese government mandated that medical colleges in Central and Western China recruit rural-oriented, tuition-waived medical students (RTMSs) starting in 2010. This study aimed to identify and assess factors that influence the choice to work in rural township health centers among both RTMSs and other students from five medical universities in Guangxi, China. An internet-based self-administered questionnaire survey was conducted with medical students in Guangxi province. Multinomial logistic regression was used to identify factors related to the attitudes toward work in a rural township health center. Among 4,669 medical students, 1,523 (33%) had a positive attitude and 2,574 (55%) had a neutral attitude toward working in THCs. Demographic characteristics, personal job concerns, and knowledge of THCs were associated with the choice of a career in THCs. The factors related to a positive attitude included the following: three-year program, a rural-oriented medical program, being male, an expectation of working in a county or township, a focus on medical career development, some perceived difficulty of getting a job, having family support, sufficient knowledge of THCs, optimism toward THC development, seeking lower working pressure, and a lower expected monthly salary. Male students in a three-year program or a rural-oriented tuition-waived medical education program were more likely to work in THCs. Selecting medical students through interviews to identify their family support and intentions to work in THCs would increase recruitment and retention. Establishing favorable policies and financial incentives to improve living conditions and the social status of rural physicians is necessary.

  1. Factors that influence the choice to work in rural township health centers among 4,669 clinical medical students from five medical universities in Guangxi, China

    Directory of Open Access Journals (Sweden)

    Yunbo Qing

    2015-07-01

    Full Text Available Purpose: To produce competent undergraduate-level medical doctors for rural township health centers (THCs, the Chinese government mandated that medical colleges in Central and Western China recruit rural-oriented, tuition-waived medical students (RTMSs starting in 2010. This study aimed to identify and assess factors that influence the choice to work in rural township health centers among both RTMSs and other students from five medical universities in Guangxi, China. Methods: An internet-based self-administered questionnaire survey was conducted with medical students in Guangxi province. Multinomial logistic regression was used to identify factors related to the attitudes toward work in a rural township health center. Results: Among 4,669 medical students, 1,523 (33% had a positive attitude and 2,574 (55% had a neutral attitude toward working in THCs. Demographic characteristics, personal job concerns, and knowledge of THCs were associated with the choice of a career in THCs. The factors related to a positive attitude included the following: three-year program, a rural-oriented medical program, being male, an expectation of working in a county or township, a focus on medical career development, some perceived difficulty of getting a job, having family support, sufficient knowledge of THCs, optimism toward THC development, seeking lower working pressure, and a lower expected monthly salary. Conclusion: Male students in a three-year program or a rural-oriented tuition-waived medical education program were more likely to work in THCs. Selecting medical students through interviews to identify their family support and intentions to work in THCs would increase recruitment and retention. Establishing favorable policies and financial incentives to improve living conditions and the social status of rural physicians is necessary.

  2. Work Stress and Alcohol Use: Developing and Testing a Biphasic Self-Medication Model.

    Science.gov (United States)

    Frone, Michael R

    2016-01-01

    This study developed and tested a moderated-mediation model of work stress and alcohol use, based on the biphasic (stimulant and sedative) effects of alcohol and the self-medication and stress-vulnerability models of alcohol use. The model proposes that exposure to work stressors can increase both negative affect and work fatigue, and that these two sources of strain can subsequently motivate the use of alcohol. However, the relations of negative affect and work fatigue to alcohol use are conditional on the joint moderating effects of alcohol outcome expectancies and gender. Data were collected from a national probability sample of 2,808 U.S. workers. Supporting the model, the results indicated that work stressor exposure was conditionally related via negative affect to heavy alcohol use among both men and women holding strong tension reduction alcohol expectancies and to after work alcohol use among men holding strong tension reduction alcohol expectancies. Also, work stressor exposure was conditionally related via work fatigue to both heavy alcohol use and workday alcohol use among men holding strong fatigue reduction alcohol expectancies. The results have application in the identification of individuals at higher risk of problematic alcohol use and are relevant to workplace safety and to the design of appropriate interventions.

  3. Organizational Climate and Work Addiction in Shahid Sadoughi University of Medical Sciences, 2014: a Case Study.

    Science.gov (United States)

    Rafiee, Noora; Bahrami, Mohammad Amin; Zare, Vahid; Mohammadi, Mahan

    2015-12-01

    The occupational nature of employees in headquarters units of the University requires them to deal with support issues. Thus, there is some pressure on these employees to complete their assignments on time so that employees in the line units can accurately and expeditiously perform their duties. As a result, work addiction behaviors are sometimes observed among the headquarters personnel. Considering the importance of work addiction and recognizing the factors that intensify it, this study investigated the relationship between organizational climate and the work addiction of headquarters personnel at the Shahid Sadoughi University of Medical Sciences. This descriptive-analytic study was conducted using stratified random sampling of 151 University employees in 2014. The data collection tool was an organizational climate questionnaire, which was supplemented by the Work Addiction Risk Test (WART). The data were analyzed using the Pearson test, Spearman test, independent t-test, Mann-Whitney test, one-way analysis of variance (ANOVA), and the Kruskal-Wallis test using IBM-SPSS version 20. The findings of this study showed that the organizational climate was at a moderate level, and employees were in the danger level in terms of work addiction. In addition, among the dimensions of organizational climate, the risk dimension had a significant relationship with work addiction (porganizational climate score was low and the work addiction score was at the high-risk level, this issue demands more attention of senior managers and human resource officers of organizations to improve the organizational climate and increase employees' awareness of work addiction.

  4. Investigating concordance in diabetes diagnosis between primary care charts (electronic medical records and health administrative data: a retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Chevendra Vijaya

    2010-12-01

    Full Text Available Abstract Background Electronic medical records contain valuable clinical information not readily available elsewhere. Accordingly, they hold important potential for contributing to and enhancing chronic disease registries with the goal of improving chronic disease management; however a standard for diagnoses of conditions such as diabetes remains to be developed. The purpose of this study was to establish a validated electronic medical record definition for diabetes. Methods We constructed a retrospective cohort using health administrative data from the Institute for Clinical Evaluative Sciences Ontario Diabetes Database linked with electronic medical records from the Deliver Primary Healthcare Information Project using data from 1 April 2006 - 31 March 2008 (N = 19,443. We systematically examined eight definitions for diabetes diagnosis, both established and proposed. Results The definition that identified the highest number of patients with diabetes (N = 2,180 while limiting to those with the highest probability of having diabetes was: individuals with ≥2 abnormal plasma glucose tests, or diabetes on the problem list, or insulin prescription, or ≥2 oral anti-diabetic agents, or HbA1c ≥6.5%. Compared to the Ontario Diabetes Database, this definition identified 13% more patients while maintaining good sensitivity (75% and specificity (98%. Conclusions This study establishes the feasibility of developing an electronic medical record standard definition of diabetes and validates an algorithm for use in this context. While the algorithm may need to be tailored to fit available data in different electronic medical records, it contributes to the establishment of validated disease registries with the goal of enhancing research, and enabling quality improvement in clinical care and patient self-management.

  5. Investigating concordance in diabetes diagnosis between primary care charts (electronic medical records) and health administrative data: a retrospective cohort study.

    Science.gov (United States)

    Harris, Stewart B; Glazier, Richard H; Tompkins, Jordan W; Wilton, Andrew S; Chevendra, Vijaya; Stewart, Moira A; Thind, Amardeep

    2010-12-23

    Electronic medical records contain valuable clinical information not readily available elsewhere. Accordingly, they hold important potential for contributing to and enhancing chronic disease registries with the goal of improving chronic disease management; however a standard for diagnoses of conditions such as diabetes remains to be developed. The purpose of this study was to establish a validated electronic medical record definition for diabetes. We constructed a retrospective cohort using health administrative data from the Institute for Clinical Evaluative Sciences Ontario Diabetes Database linked with electronic medical records from the Deliver Primary Healthcare Information Project using data from 1 April 2006-31 March 2008 (N = 19,443). We systematically examined eight definitions for diabetes diagnosis, both established and proposed. The definition that identified the highest number of patients with diabetes (N = 2,180) while limiting to those with the highest probability of having diabetes was: individuals with ≥2 abnormal plasma glucose tests, or diabetes on the problem list, or insulin prescription, or ≥2 oral anti-diabetic agents, or HbA1c ≥6.5%. Compared to the Ontario Diabetes Database, this definition identified 13% more patients while maintaining good sensitivity (75%) and specificity (98%). This study establishes the feasibility of developing an electronic medical record standard definition of diabetes and validates an algorithm for use in this context. While the algorithm may need to be tailored to fit available data in different electronic medical records, it contributes to the establishment of validated disease registries with the goal of enhancing research, and enabling quality improvement in clinical care and patient self-management.

  6. Maternity protection for working women in Argentina: legal and administrative aspects in the first half of the twentieth century.

    Science.gov (United States)

    Biernat, Carolina; Ramacciotti, Karina

    2011-12-01

    This article discusses the construction of social policies aimed at working women as mothers in Argentina. Thus, we examine the legal corpus, the scope of legislation, and the criticisms of its implementation coming from civil society and from medical, legal and political circles. We focus on the debate about the creation of the Caja de Maternidad (1934) and the shifts in the discussions regarding welfare policy for working women during Perón's first term in office. The methodology is based on a qualitative analysis of parliamentary debates, proposals for legislative reform and reactions in the press.

  7. Ten Years’Progress of Administration Work for Registered Urban Planners

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    The urban planner qualification system of China was established in the year of 2000.After ten years’ progress,a team of 15,000 registered urban planners has been set up,which has become the backbone of China’s urban planning industry and has played an important role.The enhancement of the administration of registered urban planners is needed for standardizing urban planning education,accelerating the fostering of planning professionals,and keeping pace with the market economy system and the urban-rural planning in the new era.Meanwhile,it is also an important task for China’s urban planning industry to open up to the outside world and catch up with international standards.

  8. Online video in clinical skills education of oral medication administration for undergraduate student nurses: a mixed methods, prospective cohort study.

    Science.gov (United States)

    Holland, Agi; Smith, Fiona; McCrossan, Gill; Adamson, Elizabeth; Watt, Susan; Penny, Kay

    2013-06-01

    Improvements in the safety of the prescribing, dispensing and administration of medicines are identified as a priority across international healthcare systems. It is therefore essential that higher education institutions play their part in helping to meet this patient safety objective. New developments in clinical skills education which are aligned to emerging educational theory are available, but evaluations and supportive evidence are limited. To evaluate the use of an online best practice exemplar as an adjunct to the clinical skills teaching of oral medication administration to undergraduate student nurses. Mixed-methods prospective cohort design. Two intakes of undergraduate nursing students (n=168, n=154) undertaking a first year clinical skills based module at a British university. The Control group received standard teaching using lectures and skills classes facilitated by experienced clinical skills lecturers. The Intervention group received the standard teaching and unlimited access to an online video clip of medication administration. Performance and satisfaction were measured using module assessment results and a satisfaction questionnaire. Qualitative data were gathered using focus groups (n=16, n=20). The Intervention group was significantly (p=0.021) more likely to pass the assessment and rate their satisfaction with the teaching significantly higher (p<0.05) on more than half of the items from the Student Satisfaction Survey. Two Categories were identified from focus group data; Classroom Learning and Transfer to Practice. Classroom Learning included four themes of Peers, Self, Teaching and Time and when Classroom Learning was positive, the Transfer to Practice of the clinical skill was enhanced. An online video of a best practice exemplar as an adjunct to taught clinical skills sessions improves student assessment results and satisfaction ratings. The video was also reported to positively influence all themes identified in Classroom Learning and

  9. Comparison of Three Supply Distribution Systems for Medical and Surgical Supplies in the Veterans Administration Sierra Pacific Network

    Science.gov (United States)

    2011-12-01

    rehabilitation , women’s health, surgery and social work services. Northern California has two divisions, each with an associate director. The Sacramento Valley...24 medical- surgical beds, 16 TCU beds, 10 ICU beds, 10 PICU, and a four-room operating suite, also houses a cardiac catheterization lab, a...medicine, surgery, psychiatry, 21 rehabilitation , neurology, oncology, dentistry, geriatrics, and extended care. With nearly 900 beds, including

  10. Business process improvement: an electronic system to monitor compliance with medical resident work hours.

    Science.gov (United States)

    Landesman, Linda Young; Markowitz, Forest; Conde, Nelson

    2010-01-01

    The limitation of medical intern and resident work hours, known as the Bell 405 regulations, was initiated in New York State in 1989 with a modification to the state hospital code. The Bell 405 regulations were strengthened in 2000, and facilities would now be fined for noncompliance. Monitoring systems in place at that time were insufficient to provide an adequate level of review for the New York City Health and Hospitals Corporation (HHC) with more than 7,000 medical residents whose training is based at or who rotate through these public hospitals. A "simple to use," yet comprehensive, method of monitoring compliance needed to be developed to ensure that residents and interns complied with laws regulating working hours. The subsequent development of national accreditation standards increased the stakes for reliable scrutiny. HHC developed and implemented a Web-based Structured Query Language (SQL) application that facilitated easy access to work hour surveys captured through electronic time sheets. The time sheet data automatically entered a database that provided instant analysis of conformance to state law. The development of an electronic on-line application accessible from anywhere allowed HHC to efficiently identify nonconformance and pinpoint corrective action. Since the inception of the application and its expansion allowing access through the intranet, 26,000 individual time sheets have been submitted for evaluation. With the national movement regulating work hours, other hospitals still at the pencil and manual computation stage would greatly benefit by developing a similar application.

  11. Emergency medical services and "psych calls": Examining the work of urban EMS providers.

    Science.gov (United States)

    Prener, Christopher; Lincoln, Alisa K

    2015-11-01

    Emergency medical technicians and paramedics form the backbone of the United States' Emergency Medical Service (EMS) system. Despite the frequent involvement of EMS with people with mental health and substance abuse problems, the nature and content of this work, as well as how EMS providers think about this work, have not been fully explored. Using data obtained through observations and interviews with providers at an urban American EMS agency, this paper provides an analysis of the ways in which EMS providers interact with people with mental illness and substance abuse problems, as well as providers' experiences with the mental health care system. Results demonstrate that EMS providers share common beliefs and frustrations about "psych calls" and the types of calls that involve people with behavioral health problems. In addition, providers described their understandings of the ways in which people with mental health and substance use problems "abuse the system" and the consequences of this abuse. Finally, EMS providers discuss the system-level factors that impact their work and specific barriers and challenges to care. These results suggest that additional work is needed to expand our understanding of the role of EMS providers in the care of people with behavioral health problems and that mental health practitioners and policy makers should include consideration of the important role of EMS and prehospital care in providing community-based supports for people with behavioral health needs. (PsycINFO Database Record

  12. Effects of health insurance on non-working married women’s medical care use and bed days at home

    Science.gov (United States)

    2013-01-01

    Background This study examines whether bed days are alternative methods to medical care use for treating a particular illness. If bed days at home are considered as an alternative to medical treatment, then medical care use and bed days at home should be influenced by an individual’s health insurance status. Method This study uses data from the 2003 Medical Expenditure Panel Survey (MEPS) on medical care use and bed days at home for each contracted illness of non-working married women. Results The results suggest that the health insurance status of non-working married women has considerable influence on their choice between medical care use and bed days at home. In addition, those with health insurance are more likely to use medical care and less likely to use bed days at home, but they tend to avoid the simultaneous use of medical care and bed days at home. Conclusions In contrast to previous studies’ findings indicating that absences from work and medical care use among working males may be complements, this study’s results for non-working married women without health insurance suggest that they use rest and medical treatment as substitutes, not complements. PMID:23816313

  13. A Computer-Assisted Instructional Software Program in Mathematical Problem-Solving Skills for Medication Administration for Beginning Baccalaureate Nursing Students at San Jose State University.

    Science.gov (United States)

    Wahl, Sharon C.

    Nursing educators and administrators are concerned about medication errors made by students which jeopardize patient safety. The inability to conceptualize and calculate medication dosages, often related to math anxiety, is implicated in such errors. A computer-assisted instruction (CAI) program is seen as a viable method of allowing students to…

  14. Time Spent With Children and Working Parents’ Willingness to Medicate ADHD-Like Behaviors

    Directory of Open Access Journals (Sweden)

    Bora Pajo

    2013-11-01

    Full Text Available How much time parents spend with their children is likely to influence their judgments of children’s behaviors and the behaviors themselves. In the diagnosis of children with attention-deficit/hyperactivity disorder (ADHD, parents are key informants and decide whether their children should receive medication. This exploratory study investigates the relationship between working parents’ willingness to medicate ADHD-like behaviors and the time they can spend with their children during a regular workday. The participants (409 parents of 5- to 17- year-old children reporting having no child with emotional or behavioral problems and 87 reporting having such a child were drawn from a population-based telephone survey of parents stratified by race and ethnicity in two urban Florida counties. Path analysis models, controlling for selected sociodemographic and household variables, showed that spending more time with one’s children during a regular workday and self-identifying as African American were negatively related to willingness to medicate among parents of children with problems. Among parents reporting no children with problems, only the number of children in the household and the parent-type household showed relationships to willingness to medicate, while mothers were more likely than fathers to spend more time with children. These observed relationships were of moderate effect but underscore the importance to initiate studies using valid measures of quantity and quality of parental time spent with ADHD children, and to query parents on these points when assessing the information they provide to clinicians.

  15. 25 tips for working through language and cultural barriers in your medical practice.

    Science.gov (United States)

    Hills, Laura Sachs

    2009-01-01

    The language and cultural barriers facing medical patients with limited English language proficiency pose tremendous challenges and risks. Moreover, medical practices today are more likely than ever to employ individuals whose first language is not English or who do not possess native-like knowledge of American culture. Knowing how to work through the language and cultural barriers you are likely to encounter in your medical practice has become increasingly more important. This article is written by a practice management consultant who has graduate-level linguistics training and second-language teaching credentials and experience. It offers 25 practical tips to help you communicate more effectively with individuals who are outside of your native culture and language. These include easy-to-implement tips about English language pronunciation, grammar, and word choice. This article also suggests what you can do personally to bridge the cultural divide with your patients and co-workers. Finally, this article includes a case study of one Virginia practice in which cultural differences interfered with the practice's smooth operation. It explains how the practice eventually worked through and overcame this cultural obstacle.

  16. Mental health in medical residents: relationship with personal, work-related, and sociodemographic variables

    Directory of Open Access Journals (Sweden)

    Karina Pereira-Lima

    2016-01-01

    Full Text Available Objective: To examine association of sociodemographic characteristics, personality traits, social skills, and work variables with anxiety, depression, and alcohol dependence in medical residents. Methods: A total of 270 medical residents completed the following self-report instruments: sociodemographic and work questionnaire, Patient Health Questionnaire-4 (PHQ-4, Alcohol Use Disorders Identification Test-3 (AUDIT-3, Revised NEO-Five Factor Inventory (NEO-FFI-R, and Social Skills Inventory (SSI-Del-Prette. Data were analyzed using descriptive statistics and univariate and multivariate logistic regression analyses. Results: Multivariate analysis showed an association of neuroticism (odds ratio [OR] 2.60, p < 0.001, social skills (OR 0.41, p < 0.01, and number of shifts (OR 1.91, p = 0.03 with anxiety or depression, and of male sex (OR 3.14, p = 0.01, surgical residency (OR 4.40, p = 0.001, extraversion (OR 1.80, p < 0.01, and number of shifts (OR 2.32, p = 0.04 with alcohol dependence. Conclusion: The findings support a multidetermined nature of mental health problems in medical residents, in addition to providing data that may assist in the design of preventive measures to protect the mental health of this group.

  17. Professional identity formation in the transition from medical school to working life

    DEFF Research Database (Denmark)

    De Lasson, Lydia; Just, Eva; Stegeager, Nikolaj W.M.

    2016-01-01

    Background The transition from student to medical doctor is challenging and stressful to many junior doctors. To practice with confidence and professionalism the junior doctors have to develop a strong professional identity. Various suggestions on how to facilitate formation of professional ident...... and acting as a doctor), adoption to medical culture, career planning and managing a healthy work/life-balance. Further studies in different contexts are recommended as well as studies using other methods to test the results of this qualitative study.......: Adoption to medical culture, career planning, and work/life-balance. The junior doctors found the coaching intervention highly useful in order to cope with these challenges. Furthermore, the group was a forum where the junior doctors could share thoughts and feelings with colleagues without being afraid...... identity have been offered including the possible positive effect of group-coaching courses. The purpose of this study was to explore how group-coaching might facilitate professional identity formation among junior doctors in the transition period. Methods Group-coaching courses comprising three whole...

  18. Governmental oversight of prescribing medications: history of the US Food and Drug Administration and prescriptive authority.

    Science.gov (United States)

    Plank, Linda S

    2011-01-01

    The evolution of drug regulation and awarding of prescriptive authority is a complex and sometimes convoluted process that can be confusing for health care providers. A review of the history of how drugs have been manufactured and dispensed helps explain why this process has been so laborious and complicated. Because the federal and state governments have the responsibility for protecting the public, most regulations have been passed with the intentions of ensuring consumer safety. The current system of laws and regulations is the result of many years of using the legal system to correct drug marketing that had adverse health consequences. Government oversight will continue as prescribing medications transitions to an electronic form and as health care professionals in addition to physicians seek to gain prescriptive authority.

  19. Clinical Informatics: Recursive Concurrence Intravenous Medication Administration Systems Protocols for Addressing the Potential Problem of Recessive Lethal Autonomy in Smart Infusion Systems

    OpenAIRE

    Nyagudi, Nyagudi Musandu

    2016-01-01

    Smart Infusion Pumps are vital tools for use in administering a broad range of parenteral/intravenous medications. Safe and effective use of smart infusion pumps depends upon their integration with Pump Servers, Computerized Physician Order Entry Systems, Pharmacy Information Systems, DERS/MERS Dose/Medication Error Reduction Systems( and the digital Drug Libraries that they use), eMARS/electronic Medication Administration Records Systems, etc. More computer systems result in more computer ne...

  20. The City Image and the Local Public Administration: a Working Tool in Urban Planning

    Directory of Open Access Journals (Sweden)

    Marius Cristian NEACȘU

    2009-10-01

    Full Text Available  The goal of this study consist of identifyingand testing in operational terms the concept of cityimage in the decision-making processes, both asfar as the urban planning and the future policies oflocal and regional development are concerned or inthe management of public spaces. It is well-knownthe fact that the simple series of statistical dataand the models based upon them do not sketchout a complete image regarding the urban reality,the perception of habitants at a micro-scale levelabout habituation conditions, illustrated by thecity image, presenting itself as a barometer of thedysfunctionalities encountered in the city. Thus, thepractical implications of this concept based on anew vision in the philosophy of the managementof urban spaces are likely to be interestingenough. Using this tool in the policies and in theactivity of public administration, in urbanism etc.,complementarily to statistical analyses, shouldaccompany any type of local development policyin order to enhance life quality and to transmit acertain life style, well appreciated by the residentswhich should bestow the city distinctiveness anda particular status in the regional and nationalhierarchy. The conceptual scheme of this studyis based on three elements: theory (what doesthe city image represent?, method (how could wemap at a micro-scale level?, case study (whichare the results and the tests of the applicability inthe city of Ploieşti.

  1. Abū Bakr Muhammad al-Rāzī's (Rhazes) medical works.

    Science.gov (United States)

    Richter-Bernburg, L

    1994-01-01

    A-Rāzī (Rhazes, with variants, in Medieval Latin), Abū Bakr Muhammad ibn Zakariyyā' (al-Rayy, close to modern Teherān, Irān, A.D. 865-925), is rightly considered one of the greatest medical practitioners and writers in the period between Galen and the renaissance reemergence of medicine as an empirical discipline (apart from his ranking as one of the most original and independent-minded philosophers of Islām). The following biobibliographical survey - in the format of an encyclopaedia article - will focus on those of his medical works which either had the greatest impact on posterity and/or attest most solidly to al-Rāzī's outstanding combination of textual scholarship and clinical observation, outstanding at least with reference to the horizon of his culture.

  2. Pentobarbital Toxicity after Self-Administration of Euthasol Veterinary Euthanasia Medication

    Directory of Open Access Journals (Sweden)

    Steven Jason Crellin

    2016-01-01

    Full Text Available Suicide attempt via sodium pentobarbital is uncommon. A 48-year-old woman with a history of depression and prior suicide attempt was found unresponsive by her veterinarian spouse near a syringe containing pink solution. Upon EMS’ arrival, the patient was experiencing apnea, hypoxemia, and miotic pupils; her blood glucose level measured 73 mg/dL. She was bradycardic and administered atropine with transient improvement in heart rate and transported to an emergency department; 2 mg of intravenous naloxone was administered without effect. She was endotracheally intubated via rapid sequence intubation. Rapid urine drug screening detected both benzodiazepines and barbiturates. The patient was transferred to an intensive care unit where she demonstrated a nearly absent radial pulse. Emergent fasciotomy to the left forearm and carpal tunnel was performed for acute compartment syndrome; “Euthasol” had been self-administered into the antecubital fossa. Expanded toxicological analysis via liquid chromatography/mass spectroscopy detected caffeine, atropine, 7-aminoclonazepam, phenytoin, citalopram, and naproxen. The patient’s coma resolved over 48 hours and she was successfully extubated without complication. Emergency physicians must closely monitor patients exposed to veterinary euthanasia agents who develop central nervous system and respiratory depression, hypothermia, bradycardia, hypotension, or skin injury. Consultation with a regional poison center and medical toxicologist is recommended.

  3. The Effect of Student Working Group Establishment on Teaching General Embryology Course to Medical Students

    Directory of Open Access Journals (Sweden)

    Mozafar Khazaei

    2012-11-01

    Full Text Available Introduction: Quantitative and qualitative enhancement of educational activities is an essential issue. Learners’ cooperation in the teaching process in order to increase teaching effectiveness and promotion is considered significant. The aim of the present study was to determine the effect of establishment of student working group on the teaching general embryology course to medical students.Methods: Ten students (1% of medical embryology course were selected to analyze the topics to be taught before each session according to lesson plan, and observe the whole teaching process during lesson presentation. Then, having asked the other students’ viewpoints and discussing with one another, they provided the teacher with a written report on the strengths and weaknesses of the teaching and its problems. The teacher analyzed the problems proposed by the working group to improve teaching process in the next session. At the end of the semester, a questionnaire was administered to all the participants. Data were analyzed using descriptive statistics.Results: The mean of students’ scores was 74.26%. The most important findings obtained in this study included positive role of film projection in teaching the materials (95.34%, significance of presentation of various pictures from different books (88.4%, changing students’ attitude toward application of embryology in different diseases (86%, and repetition of previous session’s pictures (83.75%. The weak points mentioned, however, were physical problems of the classroom and deficiency of audio visual equipment.Conclusion: Student working group has a positive impact on the teaching medical general embryology.

  4. Continuing education in ethical decision making using case studies from medical social work.

    Science.gov (United States)

    McCormick, Andrew J; Stowell-Weiss, Patti; Carson, Jennifer; Tebo, Gerald; Hanson, Inga; Quesada, Bianca

    2014-01-01

    Medical social workers have needs for training in ethics that is specific to dilemmas that arise while providing service to patients who are very ill, mentally compromised, or in a terminal condition. A social work department developed a continuing education training to educate social workers in bioethics related to determining decisional capacity and understanding standards of ethical decision making. Case studies are used to illustrate ethical conflicts and the role of social workers in resolving them. The benefits of case study training are discussed.

  5. Risk mitigation of shared electronic records system in campus institutions: medical social work practice in singapore.

    Science.gov (United States)

    Ow Yong, Lai Meng; Tan, Amanda Wei Li; Loo, Cecilia Lay Keng; Lim, Esther Li Ping

    2014-10-01

    In 2013, the Singapore General Hospital (SGH) Campus initiated a shared electronic system where patient records and documentations were standardized and shared across institutions within the Campus. The project was initiated to enhance quality of health care, improve accessibility, and ensure integrated (as opposed to fragmented) care for best outcomes in our patients. In mitigating the risks of ICT, it was found that familiarity with guiding ethical principles, and ensuring adherence to regulatory and technical competencies in medical social work were important. The need to negotiate and maneuver in a large environment within the Campus to ensure proactive integrative process helped.

  6. The Effect of Programmed Physical Exercise to Attention and Working Memory Score in Medical Students

    Directory of Open Access Journals (Sweden)

    Kevin Fachri Muhammad

    2015-06-01

    Full Text Available Background: Attention and working memory are two cognitive domain crucial for activities of daily living. Physical exercise increases the level of BDNF, IGF-1, and VEGF which contributes in attention and working memory processes.This study was conducted to analyze improvement of attention and working memory after programmed physical exercise of Pendidikan Dasar XXI Atlas Medical Pioneer (Pendas XXI AMP. Methods: An analytic observational study was conducted on 47 students from Faculty of Medicine, Universitas Padjadjaran during September-November 2012. Attention was assessed using digit span backward test, stroop test, visual search task, and trail making test. Working memory was assessed using digit span forward test and digit symbol test. Assessment was done on the 11th and 19th week of Pendas XXI AMP. Data distribution was tested first using a test of normality, and then analyzed using T-Dependent Test and Wilcoxon Test Results: Significant improvement was noted for attention in males based on working time for stroop test (26.50±5.66 to 22.03±3.78 seconds, working memory in males based on digit symbol test score (43.96±6.14 to 53.36±5.26 points, attention in females based on reaction time of visual search task for target absent (0.92±0.07 to 0.87±0.07 seconds, and working memory in females based on digit span forward score (5.42±1.30 to 6.63±1.07 points and digit symbol test score (42.47±5.95 to 53.84±5.33 points. Conclusions: Exercise in Pendas XXI AMP improves attention and working memory for college students in Faculty of Medicine Universitas Padjadjaran.

  7. Organizational Climate and Work Addiction in Shahid Sadoughi University of Medical Sciences, 2014: a Case Study

    Science.gov (United States)

    Rafiee, Noora; Bahrami, Mohammad Amin; Zare, Vahid; Mohammadi, Mahan

    2015-01-01

    Introduction The occupational nature of employees in headquarters units of the University requires them to deal with support issues. Thus, there is some pressure on these employees to complete their assignments on time so that employees in the line units can accurately and expeditiously perform their duties. As a result, work addiction behaviors are sometimes observed among the headquarters personnel. Considering the importance of work addiction and recognizing the factors that intensify it, this study investigated the relationship between organizational climate and the work addiction of headquarters personnel at the Shahid Sadoughi University of Medical Sciences. Methods This descriptive-analytic study was conducted using stratified random sampling of 151 University employees in 2014. The data collection tool was an organizational climate questionnaire, which was supplemented by the Work Addiction Risk Test (WART). The data were analyzed using the Pearson test, Spearman test, independent t-test, Mann-Whitney test, one-way analysis of variance (ANOVA), and the Kruskal-Wallis test using IBM-SPSS version 20. Results The findings of this study showed that the organizational climate was at a moderate level, and employees were in the danger level in terms of work addiction. In addition, among the dimensions of organizational climate, the risk dimension had a significant relationship with work addiction (porganizational climate score was low and the work addiction score was at the high-risk level, this issue demands more attention of senior managers and human resource officers of organizations to improve the organizational climate and increase employees’ awareness of work addiction. PMID:26816586

  8. National utilization of antihypertensive medications from 2000 to 2006 in the Veterans Health Administration: focus on thiazide diuretics.

    Science.gov (United States)

    Furmaga, Elaine M; Cunningham, Francesca E; Cushman, William C; Dong, Diane; Jiang, Rong; Basile, Jan; Katz, Lois A; Rutan, Gale H; Berlowitz, Dan R; Papademetriou, Vasilios; Glassman, Peter A

    2008-10-01

    The authors sought to determine the prescribing practices of clinicians treating veterans with hypertension. A descriptive analysis was performed using a national pharmacy database of patients with a diagnosis of hypertension receiving antihypertensive medication in the fiscal years 2000 to 2006. Angiotensin-converting enzyme inhibitors were the most frequently prescribed antihypertensive class, with utilization increasing from 56.0% in fiscal year 2000 to 63.2% of patients in 2006. Utilization of thiazide-type diuretics increased from 31.9% of patients in fiscal year 2000 to 42.0% in 2006. When patient comorbidities were taken into consideration, 48.1% of patients defined as having uncomplicated hypertension had at least one prescription for a thiazide diuretic in fiscal year 2006. Utilization by monotherapy and combination therapy were also evaluated. The trends in utilization allowed for identification of areas in which a change in prescribing practices may improve blood pressure control and health outcomes in the Veterans Health Administration.

  9. Key factors in work engagement and job motivation of teaching faculty at a university medical centre.

    Science.gov (United States)

    van den Berg, B A M; Bakker, Arnold B; Ten Cate, Th J

    2013-11-01

    This study reports about teacher motivation and work engagement in a Dutch University Medical Centre (UMC). We examined factors affecting the motivation for teaching in a UMC, the engagement of UMC Utrecht teaching faculty in their work, and their engagement in teaching compared with engagement in patient care and research. Based on a pilot study within various departments at the UMCU, a survey on teaching motivation and work engagement was developed and sent to over 600 UMCU teachers. About 50 % responded. Work engagement was measured by the Utrecht Work Engagement Scale, included in this survey. From a list of 22 pre-defined items, 5 were marked as most motivating: teaching about my own speciality, noticeable appreciation for teaching by my direct superior, teaching small groups, feedback on my teaching performance, and freedom to determine what I teach. Feedback on my teaching performance showed the strongest predictive value for teaching engagement. Engagement scores were relatively favourable, but engagement with patient care was higher than with research and teaching. Task combinations appear to decrease teaching engagement. Our results match with self-determination theory and the job demands-resources model, and challenge the policy to combine teaching with research and patient care.

  10. The effects of standardized trauma training on prehospital pain control: have pain medication administration rates increased on the battlefield?

    Science.gov (United States)

    Bowman, W Joseph; Nesbitt, Michael E; Therien, Sean P

    2012-08-01

    The US Military has served in some of the most austere locations in the world. In this ever-changing environment, units are organized into smaller elements operating in very remote areas. This often results in longer evacuation times, which can lead to a delay in pain management if treatment is not initiated in the prehospital setting. Early pain control has become an increasingly crucial military prehospital task and must be controlled from the pain-initiating event. The individual services developed their standardized trauma training based on the recommendations by Frank Butler and the Defense Health Board Committee on Tactical Combat Casualty Care. This training stresses evidence-based treatment modalities, including pain control, derived from casualty injury analysis. Inadequate early pain control may lead to multiple acute and potentially chronic effects. These effects encompass a wide range from changes in blood pressure to delayed wound healing and posttraumatic stress disorder. Therefore, it is essential that pain be addressed in the prehospital environment. Institutional Review Board approval was obtained to conduct a retrospective Joint Theater Trauma Registry comparative study evaluating whether standardized trauma training increased prehospital pain medication administration between 2007 and 2009. These years were selected on the basis of mandatory training initiation dates and available Joint Theater Trauma Registry records. Records were analyzed for all US prehospital trauma cases with documented pain medication administration from Operations Enduring Freedom and Iraqi Freedom for the specified years. Data analysis revealed 232 patients available for review (102 for 2007 and 130 for 2009). A statistically significant prehospital pain treatment increase was noted, from 3.1% in 2007 to 6.7% in 2009 (p importance of early pain control.

  11. Severity of COPD at initial spirometry-confirmed diagnosis: data from medical charts and administrative claims

    Directory of Open Access Journals (Sweden)

    Mapel DW

    2011-11-01

    Full Text Available Douglas W Mapel1, Anand A Dalal2, Christopher M Blanchette3,4, Hans Petersen3, Gary T Ferguson5 1Lovelace Clinic Foundation, Albuquerque, NM, USA; 2US Health Outcomes, GlaxoSmithKline, Research Triangle Park, NC, USA; 3Lovelace Respiratory Research Institute, Kannapolis, NC, USA; 4University of North Carolina Eshelmen School of Pharmacy, Chapel Hill, NC, USA; 5Pulmonary Research Institute of Southeast Michigan, Livonia, MI, USA Purpose: This study was conducted to determine COPD severity at the time of diagnosis as confirmed by spirometry in patients treated in a US managed care setting. Patients and methods: All patients with one or more inpatient stays, one or more emergency department visits, or two or more outpatient visits with diagnosis codes for COPD during 1994–2006 were identified from the Lovelace Patient Database. From this group, a subset of continuously enrolled patients with evidence in claims of a first available pulmonary function test or pulmonary clinic visit and a confirmatory claim for a COPD diagnosis was selected. Medical chart abstraction was undertaken for this subset to gather information for diagnosis and severity staging of each patient based on the Global Initiative for Chronic Obstructive Lung Disease (GOLD criteria for COPD. Results: Of the 12,491 patients with a primary or secondary COPD diagnosis between 1994 and 2006, there were 1520 continuously enrolled patients who comprised the study cohort. Among the 648 eligible records from patients with evidence of a pulmonary function test, 366 were identified by spirometry as having COPD of GOLD stage I or higher (average percentage of predicted forced expiratory volume in 1 second: 60%: 19% were diagnosed at the stage of mild disease (GOLD stage I; 50% at moderate disease (GOLD stage II; and 31% at severe or very severe disease (GOLD stage III or IV, respectively. The majority of patients in these groups were not receiving maintenance treatment. Conclusion: The

  12. State-Level Lifetime Medical and Work-Loss Costs of Fatal Injuries - United States, 2014.

    Science.gov (United States)

    Luo, Feijun; Florence, Curtis

    2017-01-13

    Injury-associated deaths have substantial economic consequences in the United States. The total estimated lifetime medical and work-loss costs associated with fatal injuries in 2013 were $214 billion (1). In 2014, unintentional injury, suicide, and homicide (the fourth, tenth, and seventeenth leading causes of death, respectively) accounted for 194,635 deaths in the United States (2). In 2014, a total of 199,756 fatal injuries occurred in the United States, and the associated lifetime medical and work-loss costs were $227 billion (3). This report examines the state-level economic burdens of fatal injuries by extending a previous national-level study (1). Numbers and rates of fatal injuries, lifetime costs, and lifetime costs per capita were calculated for each of the 50 states and the District of Columbia (DC) and for four injury intent categories (all intents, unintentional, suicide, and homicide). During 2014, injury mortality rates and economic burdens varied widely among the states and DC. Among fatal injuries of all intents, the mortality rate and lifetime costs per capita ranged from 101.9 per 100,000 and $1,233, respectively (New Mexico) to 40.2 per 100,000 and $491 (New York). States can engage more effectively and efficiently in injury prevention if they are aware of the economic burden of injuries, identify areas for immediate improvement, and devote necessary resources to those areas.

  13. Chronic smoking, but not acute nicotine administration, modulates neural correlates of working memory.

    Science.gov (United States)

    Sutherland, Matthew T; Ross, Thomas J; Shakleya, Diaá M; Huestis, Marilyn A; Stein, Elliot A

    2011-01-01

    Beyond the amelioration of deprivation-induced impairments, and in contrast to effects on attentional processes, the cognitive-enhancing properties of nicotine on working memory (WM) operations remain unclear. In an effort to elucidate potential enhancing effects, we explored the impact of transdermal nicotine on neural functioning in minimally deprived smokers and, in addition, assessed differences between smokers and non-smokers using a mixed block/event-related fMRI design that attempted to isolate specific central executive operations (attentional switch events) within general WM function (task blocks). In task blocks, participants performed a continuous counting paradigm that required the simultaneous maintenance of, and frequent switching of attentional focus between, two running tallies in WM on some trials. Cigarette smokers (n = 30) were scanned twice, once each with a nicotine and placebo patch, while non-smokers (n = 27) were scanned twice with no patch. Across both groups, task blocks were associated with bilateral activation, notably in medial and lateral prefrontal cortex (PFC), anterior insula, and parietal regions, whereas individual attentional switch trials were associated with activation in a similar, but predominantly left-lateralized network. Within the smoker group, although nicotine increased heart rate, altered performance and mood, and reduced tobacco cravings, no acute drug (state-like) effect on brain activity was detected for either the task or switch effects. However, relative to non-smokers, smokers showed greater tonic activation in medial superior frontal cortex, right anterior insula, and bilateral anterior PFC throughout task blocks (trait-like effect). These data suggest smokers require recruitment of additional WM and supervisory control operations during task performance.

  14. Exploring Rural Disparities in Medical Diagnoses Among Veterans With Transgender-related Diagnoses Utilizing Veterans Health Administration Care.

    Science.gov (United States)

    Bukowski, Leigh A; Blosnich, John; Shipherd, Jillian C; Kauth, Michael R; Brown, George R; Gordon, Adam J

    2017-09-01

    Research shows transgender individuals experience pronounced health disparities compared with their nontransgender peers. Yet, there remains insufficient research about health differences within transgender populations. This study seeks to fill this gap by exploring how current urban/rural status is associated with lifetime diagnosis of mood disorder, alcohol dependence disorder, illicit drug abuse disorder, tobacco use, posttraumatic stress disorder, human immunodeficiency virus, and suicidal ideation or attempt among veterans with transgender-related diagnoses. This study used a retrospective review of The Department of Veterans Affairs (VA) administrative data for transgender patients who received VA care from 1997 through 2014. Transgender patients were defined as individuals that had a lifetime diagnosis of any of 4 International Classification of Diseases-9 diagnosis codes associated with transgender status. Independent multivariable logistic regression models were used to explore associations of rural status with medical conditions. Veterans with transgender-related diagnoses residing in small/isolated rural towns had increased odds of tobacco use disorder (adjusted odds ratio=1.39; 95% confidence intervals, 1.09-1.78) and posttraumatic stress disorder (adjusted odds ratio=1.33; 95% confidence intervals, 1.03-1.71) compared with their urban transgender peers. Urban/rural status was not significantly associated with other medical conditions of interest. This study contributes the first empirical investigations of how place of residence is associated with medical diagnoses among veterans with transgender-related diagnoses. The importance of place as a determinant of health is increasingly clear, but for veterans with transgender-related diagnoses this line of research is currently limited. The addition of self-reported sex identity data within VA electronic health records is one way to advance this line of research.

  15. The importance of job characteristics in determining medical care-seeking in the Dutch working population, a longitudinal survey study

    Directory of Open Access Journals (Sweden)

    Steenbeek Romy

    2012-08-01

    Full Text Available Abstract Background The working population is ageing, which will increase the number of workers with chronic health complaints, and, as a consequence, the number of workers seeking health care. It is very important to understand factors that influence medical care-seeking in order to control the costs. I will investigate which work characteristics independently attribute to later care-seeking in order to find possibilities to prevent unnecessary or inefficient care-seeking. Methods Data were collected in a longitudinal two-wave study (n = 2305 workers. The outcome measures were visits (yes/no and frequency to a general practitioner (GP, a physical therapist, a medical specialist and/or a mental health professional. Multivariate regression analyses were carried out separately for men and women for workers with health complaints. Results In the Dutch working population, personal, health, and work characteristics, but not sickness absence, were associated with later care-seeking. Work characteristics independently attributed to medical care-seeking but only for men and only for the frequency of visits to the GP. Women experience more health complaints and seek health care more often than men. For women, experiencing a work handicap (health complaints that impede work performance was the only work characteristic associated with more care-seeking (GP. For men, work characteristics that led to less care-seeking were social support by colleagues (GP frequency, high levels of decision latitude (GP frequency and high levels of social support by the supervisor (medical specialist. Other work characteristics led to more care-seeking: high levels of engagement (GP, full time work (GP frequency and experiencing a work handicap (physical therapist. Conclusions We can conclude that personal and health characteristics are most important when explaining medical care-seeking in the Dutch working population. Work characteristics independently attributed to

  16. The importance of job characteristics in determining medical care-seeking in the Dutch working population, a longitudinal survey study.

    Science.gov (United States)

    Steenbeek, Romy

    2012-08-31

    The working population is ageing, which will increase the number of workers with chronic health complaints, and, as a consequence, the number of workers seeking health care. It is very important to understand factors that influence medical care-seeking in order to control the costs. I will investigate which work characteristics independently attribute to later care-seeking in order to find possibilities to prevent unnecessary or inefficient care-seeking. Data were collected in a longitudinal two-wave study (n = 2305 workers). The outcome measures were visits (yes/no and frequency) to a general practitioner (GP), a physical therapist, a medical specialist and/or a mental health professional. Multivariate regression analyses were carried out separately for men and women for workers with health complaints. In the Dutch working population, personal, health, and work characteristics, but not sickness absence, were associated with later care-seeking. Work characteristics independently attributed to medical care-seeking but only for men and only for the frequency of visits to the GP. Women experience more health complaints and seek health care more often than men. For women, experiencing a work handicap (health complaints that impede work performance) was the only work characteristic associated with more care-seeking (GP). For men, work characteristics that led to less care-seeking were social support by colleagues (GP frequency), high levels of decision latitude (GP frequency) and high levels of social support by the supervisor (medical specialist). Other work characteristics led to more care-seeking: high levels of engagement (GP), full time work (GP frequency) and experiencing a work handicap (physical therapist). We can conclude that personal and health characteristics are most important when explaining medical care-seeking in the Dutch working population. Work characteristics independently attributed to medical care-seeking but only for men and only for the

  17. 20 CFR 220.187 - If the annuitant's medical recovery was expected and the annuitant returned to work.

    Science.gov (United States)

    2010-04-01

    ... expected and the annuitant returned to work. 220.187 Section 220.187 Employees' Benefits RAILROAD... recovery was expected and the annuitant returned to work. If the annuitant's impairment was expected to improve and the annuitant returned to full-time work with no significant medical limitations...

  18. [Work organization and mobbing: application of cognitive methodology in medical circle].

    Science.gov (United States)

    Martire, M R; Lo Cascio, G; Picciotto, D; Lo Cascio, N

    2006-01-01

    Mobbing is a phenomenon produced for the most part by factors related to work organization. During the medical control of workers in Universitary Policlinico Hospital of Palermo, we used a methodology (in advance applied with effectiveness by ISPESL in other institutions) that is able to evidence factors of work organization causing Mobbing. 338 out 2060 workers (total staff) with different professional figures were recruited. We evidenced the working classes that had more troubles about communications of business information, about interpersonal relationships at work with top manager, with other members of team and with colleagues. Particularly doctors and OTA, in worrying percentage, stated that they suffered psychological molestations. Aim of our study was to assay a procedure that, even if it doesn't identify proclaimed mobbing phenomenon, enables us to acquire information about relationships between business management and workers and organizational aspects perceiving by subordinates. A I level study about a phenomenon in expansion is very useful to recognize preventively intentionally made mobbing actions.

  19. The association between work ethics and attitudes towards organizational changes among the administrative, financial and support employees of general teaching hospitals.

    Science.gov (United States)

    Ravangard, Ramin; Sajjadnia, Zahra; Jafari, Abdosaleh; Shahsavan, Najme; Bahmaie, Jamshid; Bahadori, Mohammadkarim

    2014-01-01

    In order to achieve success in today's competitive world, organizations should adapt to environmental changes. On the other hand, managers should have a set of values and ethical guidelines for their administrative and organizational functions. This study aimed to investigate the association between work ethics and attitudes towards organizational changes among the administrative, financial and support employees of general teaching hospitals affiliated to Shiraz University of Medical Sciences. This was an applied, cross-sectional and descriptive-analytic study conducted in 2013. A sample of 124 employees was selected using stratified sampling proportional to size and simple random sampling methods. Data were collected using 2 questionnaires measuring the dimensions of employees' work ethics (four dimensions) and attitudes towards organizational changes (three dimensions). The collected data were analyzed using SPSS 18.0 and statistical tests, including ANOVA, independent samples t-test, and Pearson's correlation coefficient. A P ethic dimensions were related to being cooperative (4.60 ± 0.38) and dependable (4.29 ± 0.39) respectively. On the other hand, the maximum and minimum score of attitudes towards the various dimensions of organizational changes were related to the behavioral (3.83 ± 0.70) and the affective (3.55 ± 0.88) dimensions respectively. Furthermore, there was a significant relationship between the work ethics and education levels of the employees in this study (P = 0.003). Also, among work s dimensions, only being considerate had a significant association with attitudes towards organizational changes (P = 0.014) and their cognitive dimension (P = 0.005). To improve employees' work ethics and attitudes towards organizational changes, the following suggestions can be offered: training hospitals managers in participative management style and its application, as well as the importance of meeting the employees' needs and expectations based on their

  20. Medication adherence, work performance and self-esteem among psychiatric patients attending psychosocial rehabilitation services at Bangalore, India

    Directory of Open Access Journals (Sweden)

    Sailaxmi Gandhi

    2014-01-01

    Full Text Available Context: Work benefits mental health in innumerable ways. Vocational rehabilitation can enhance self-esteem. Medication adherence can improve work performance and thereby the individuals′ self-esteem. Aim: To test the hypothesis that there would be a significant correlation between medication adherence, work performance and self-esteem. Setting and Design: A quantitative, descriptive correlational research design was adopted to invite patients attending psychiatric rehabilitation services to participate in the research. Material and Methods: Data was collected from a convenience sample of 60 subjects using the ′Medication Adherence Rating scale′, ′Griffiths work behaviour scale′ and the ′Rosenberg′s Self-esteem scale′. Statistical analysis used: Analysis was done using spss18 with descriptive statistics, Pearsons correlation coefficient and multiple regression analysis. Results: There were 36 males and 24 females who participated in this study. The subjects had good mean medication adherence of 8.4 ± 1.5 with median of 9.00, high mean self-esteem of 17.65 ± 2.97 with median of 18.0 and good mean work performance of 88.62 ± 22.56 with median of 93.0. Although weak and not significant, there was a positive correlation (r = 0.22, P = 0.103 between medication adherence and work performance; positive correlation between (r = 0.25, P = 0.067 medication adherence and self-esteem; positive correlation between (r = 0.136, P = 0.299 work performance and self-esteem. Multiple regression analysis showed no significant predictors for medication adherence, work performance and self-esteem among patients with psychiatric illness. Conclusions: Medication monitoring and strengthening of work habit can improve self-esteem thereby, strengthening hope of recovery from illness.

  1. Ideas on Faculty Administrative Work in University%高校院系行政工作之我见

    Institute of Scientific and Technical Information of China (English)

    闫黎丽

    2012-01-01

    The faculty administrative work is a strong bond of contact between schools and colleges bear transmit, compre-hensive and coordinated role in the two management system of colleges and universities play an important role. We should continue to learn at work to have excellent professional skills, good working attitude into the work, good at using the coor- dination and communication, good leadership aides and staff.%院系行政工作是联系学校与学院的有力纽带,承担着上传下达、综合协调的作用,在高校两级管理体系中发挥着重要的作用。我们应当在工作中不断学习以具备过硬的专业技能,以良好的工作态度投入到工作中去,善于运用协调沟通,做好领导的助手和参谋。

  2. A professional development model for medical laboratory scientists working in the microbiology laboratory.

    Science.gov (United States)

    Amerson, Megan H; Pulido, Lila; Garza, Melinda N; Ali, Faheem A; Greenhill, Brandy; Einspahr, Christopher L; Yarsa, Joseph; Sood, Pramilla K; Hu, Peter C

    2012-01-01

    The University of Texas M.D. Anderson Cancer Center, Division of Pathology and Laboratory Medicine is committed to providing the best pathology and medicine through: state-of-the art techniques, progressive ground-breaking research, education and training for the clinical diagnosis and research of cancer and related diseases. After surveying the laboratory staff and other hospital professionals, the Department administrators and Human Resource generalists developed a professional development model for Microbiology to support laboratory skills, behavior, certification, and continual education within its staff. This model sets high standards for the laboratory professionals to allow the labs to work at their fullest potential; it provides organization to training technologists based on complete laboratory needs instead of training technologists in individual areas in which more training is required if the laboratory needs them to work in other areas. This model is a working example for all microbiology based laboratories who want to set high standards and want their staff to be acknowledged for demonstrated excellence and professional development in the laboratory. The PDM model is designed to focus on the needs of the laboratory as well as the laboratory professionals.

  3. Working memory-related functional brain patterns in never medicated children with ADHD.

    Directory of Open Access Journals (Sweden)

    Isabelle Massat

    Full Text Available Attention Deficit/Hyperactivity Disorder (ADHD is a pervasive neurodevelopmental disorder characterized by 3 clusters of age-inappropriate cardinal symptoms: inattention, hyperactivity and impulsivity. These clinical/behavioural symptoms are assumed to result from disturbances within brain systems supporting executive functions including working memory (WM, which refers to the ability to transiently store and flexibly manipulate task-relevant information. Ongoing or past medications, co-morbidity and differences in task performance are potential, independent confounds in assessing the integrity of cerebral patterns in ADHD. In the present study, we recorded WM-related cerebral activity during a memory updating N-back task using functional Magnetic Resonance Imaging (fMRI in control children and never medicated, prepubescent children with ADHD but without comorbid symptoms. Despite similar updating performance than controls, children with ADHD exhibited decreased, below baseline WM-related activation levels in a widespread cortico-subcortical network encompassing bilateral occipital and inferior parietal areas, caudate nucleus, cerebellum and functionally connected brainstem nuclei. Distinctive functional connectivity patterns were also found in the ADHD in these regions, with a tighter coupling in the updating than in the control condition with a distributed WM-related cerebral network. Especially, cerebellum showed tighter coupling with activity in an area compatible with the brainstem red nucleus. These results in children with clinical core symptoms of ADHD but without comorbid affections and never treated with medication yield evidence for a core functional neuroanatomical network subtending WM-related processes in ADHD, which may participate to the pathophysiology and expression of clinical symptoms.

  4. Navy Public Works Administration.

    Science.gov (United States)

    1980-06-01

    as a unit, to process any reduction-in-force that may become necessary and to operate outplacement programs. (c) Supervisor development programs...undergoing RIF are urged to make this pamphlet available to all employees. (c) Outplacement programs should be tailored to the locality, the size of

  5. Living alone and antidepressant medication use: a prospective study in a working-age population

    Directory of Open Access Journals (Sweden)

    Pulkki-Råback Laura

    2012-03-01

    Full Text Available Abstract Background An increasing proportion of the population lives in one-person households. The authors examined whether living alone predicts the use of antidepressant medication and whether socioeconomic, psychosocial, or behavioral factors explain this association. Methods The participants were a nationally representative sample of working-age Finns from the Health 2000 Study, totaling 1695 men and 1776 women with a mean age of 44.6 years. In the baseline survey in 2000, living arrangements (living alone vs. not and potential explanatory factors, including psychosocial factors (social support, work climate, hostility, sociodemographic factors (occupational grade, education, income, unemployment, urbanicity, rental living, housing conditions, and health behaviors (smoking, alcohol use, physical activity, obesity, were measured. Antidepressant medication use was followed up from 2000 to 2008 through linkage to national prescription registers. Results Participants living alone had a 1.81-fold (CI = 1.46-2.23 higher purchase rate of antidepressants during the follow-up period than those who did not live alone. Adjustment for sociodemographic factors attenuated this association by 21% (adjusted OR = 1.64, CI = 1.32-2.05. The corresponding attenuation was 12% after adjustment for psychosocial factors (adjusted OR = 1.71, CI = 1.38-2.11 and 9% after adjustment for health behaviors (adjusted OR = 1.74, CI = 1.41-2.14. Gender-stratified analyses showed that in women the greatest attenuation was related to sociodemographic factors and in men to psychosocial factors. Conclusions These data suggest that people living alone may be at increased risk of developing mental health problems. The public health value is in recognizing that people who live alone are more likely to have material and psychosocial problems that may contribute to excess mental health problems in this population group.

  6. An Observational Study to Evaluate the Medication Errors by Nursing Staff Working in Bushehr Medical Centers during one Year Interval (1385-1386

    Directory of Open Access Journals (Sweden)

    Nasrin Zahmatkeshan

    2010-09-01

    Full Text Available Background: Medication errors refer to inappropriate use of drugs, can lead to harmful and serious consequent. Many factors contribute to incidence of these errors. To investigate this factors a descriptive analytic study was done that assess clinical staff medication errors in Bushehr medical centers. Methods: The participants were 400 clinical staff, including nurses, midwives and nurse assistances to complete designed medication errors questionnaire. This questionnaire include 2 parts, part one was demographic data and part two, assess influencing factors of medication errors in six domain. Results: Results showed that the half of participants (49.9% had medication errors in acquaintance and the most error in dosage (37.7% and then type of drugs(27.7%. 73.3% of participants reported their errors and in unreported cases the most cause was fear of managers. According to participants attitude factors that interfering to medication errors were physicians factor, including illegible order in patient file (24.94%, nurses factors including, incorrect documentation (24.38%, interpersonal relationship (19.45%, inappropriate environment (15.3%, knowledge deficit and lack of experience (11.23% and stressful events (4.66%. No statistical significant correlation between situation of job and shift work. Conclusion: Results show that medication errors are common and human factors are the most factors in these errors.

  7. Towards a learning organization: the introduction of a client-centered team-based organization in administrative surveying work.

    Science.gov (United States)

    Gard, G; Lindström, K; Dallner, M

    2003-03-01

    Within administrative surveying work in Sweden, a transition to a client-centered team-based organization was made during 1998. The aim of this study was to describe the employees' perceptions and expectations of job and organizational practices when working as a generalist in a client-centered team-based organization; job and organizational practices and well-being and effectiveness measures were examined when introducing a team-based organization. Interventions such as courses in how to cope with the role of a generalist, how to increase service to clients, education in technology, law and economics, as well as computer information support, were ongoing at the time of the study. The Team Work Profile and QPS Nordic questionnaires were used. All the surveyors in five regions in Sweden participated, in total 640 surveyors. The transition to a client-centered team-based organization was expected to improve job control and job content but at the same time lead to impairments in job climate and group cohesion. Distress was associated with negative future expectations of the organization. High job control and group cohesion were the central contributors towards growth in personal competence and social effectiveness of teamwork. Both internal and external client-related activities of team and organization were in focus during the transition.

  8. Medical Services: Patient Administration

    Science.gov (United States)

    2007-11-02

    Family planning services a. Family planning services (for example, counseling, prescription of oral contraceptive pills , and prescription of other methods...of contraception ) may be furnished to eligible persons requesting such care at Army MTFs. They will be provided to the extent that professional...table 2–2, table 2–3 Comfort items for patients, 4–3 Commercial transportation or travel, 2–6, 9–9 Consent by nonmilitary patient, 2–12 Contraception , 2

  9. Poorer verbal working memory for a second language selectively impacts academic achievement in university medical students.

    Science.gov (United States)

    Mann, Collette; Canny, Benedict J; Reser, David H; Rajan, Ramesh

    2013-01-01

    Working memory (WM) is often poorer for a second language (L2). In low noise conditions, people listening to a language other than their first language (L1) may have similar auditory perception skills for that L2 as native listeners, but do worse in high noise conditions, and this has been attributed to the poorer WM for L2. Given that WM is critical for academic success in children and young adults, these speech in noise effects have implications for academic performance where the language of instruction is L2 for a student. We used a well-established Speech-in-Noise task as a verbal WM (vWM) test, and developed a model correlating vWM and measures of English proficiency and/or usage to scholastic outcomes in a multi-faceted assessment medical education program. Significant differences in Speech-Noise Ratio (SNR50) values were observed between medical undergraduates who had learned English before or after five years of age, with the latter group doing worse in the ability to extract whole connected speech in the presence of background multi-talker babble (Student-t tests, p students previously. The remaining two variables, Perceived Stress Scale (PSS) and the Age of Acquisition of English (AoAoE) were significantly positively correlated with the SNR50, showing that those with a poorer capacity to discriminate simple English sentences from noise had learnt English later in life and had higher levels of stress - all characteristics of the international students. Local students exhibited significantly lower SNR50 scores and were significantly younger when they first learnt English. No significant correlation was detected between the SNR50 and the students' Visual/Verbal Learning Style (r = -0.023). Standard multiple regression was carried out to assess the relationship between language proficiency and verbal working memory (SNR50) using 5 variables of L2 proficiency, with the results showing that the variance in SNR50 was significantly predicted by this model (r

  10. Effectiveness of two distinct web-based education tools for bedside nurses on medication administration practice for venous thromboembolism prevention: A randomized clinical trial.

    Science.gov (United States)

    Lau, Brandyn D; Shaffer, Dauryne L; Hobson, Deborah B; Yenokyan, Gayane; Wang, Jiangxia; Sugar, Elizabeth A; Canner, Joseph K; Bongiovanni, David; Kraus, Peggy S; Popoola, Victor O; Shihab, Hasan M; Farrow, Norma E; Aboagye, Jonathan K; Pronovost, Peter J; Streiff, Michael B; Haut, Elliott R

    2017-01-01

    Venous thromboembolism (VTE) is a common cause of preventable harm in hospitalized patients. While numerous successful interventions have been implemented to improve prescription of VTE prophylaxis, a substantial proportion of doses of prescribed preventive medications are not administered to hospitalized patients. The purpose of this trial was to evaluate the effectiveness of nurse education on medication administration practice. This was a double-blinded, cluster randomized trial in 21 medical or surgical floors of 933 nurses at The Johns Hopkins Hospital, an academic medical center, from April 1, 2014 -March 31, 2015. Nurses were cluster-randomized by hospital floor to receive either a linear static education (Static) module with voiceover or an interactive learner-centric dynamic scenario-based education (Dynamic) module. The primary and secondary outcomes were non-administration of prescribed VTE prophylaxis medication and nurse-reported satisfaction with education modules, respectively. Overall, non-administration improved significantly following education (12.4% vs. 11.1%, conditional OR: 0.87, 95% CI: 0.80-0.95, p = 0.002) achieving our primary objective. The reduction in non-administration was greater for those randomized to the Dynamic arm (10.8% vs. 9.2%, conditional OR: 0.83, 95% CI: 0.72-0.95) versus the Static arm (14.5% vs. 13.5%, conditional OR: 0.92, 95% CI: 0.81-1.03), although the difference between arms was not statistically significant (p = 0.26). Satisfaction scores were significantly higher (p<0.05) for all survey items for nurses in the Dynamic arm. Education for nurses significantly improves medication administration practice. Dynamic learner-centered education is more effective at engaging nurses. These findings suggest that education should be tailored to the learner. ClinicalTrials.gov NCT02301793.

  11. Work-related psychosocial hazards among emergency medical responders (EMRS in Mansoura city

    Directory of Open Access Journals (Sweden)

    Eman Omar Khashaba

    2014-01-01

    Full Text Available Purpose: This research was done to assess levels of psychosocial stress and related hazards [(burnout, depression, and posttraumatic stress disorder (PTSD] among emergency medical responders (EMRs. Materials and Methods: A comparative cross-sectional study was conducted upon (140 EMRs and a comparative group composed of (140 nonemergency workers. The groups studied were subjected to semistructured questionnaire including demographic data, survey for job stressors, Maslach burn out inventory (MBI, Beck depression inventory (BDI, and Davidson Trauma scale for PTSD. Results: The most severe acute stressors among EMRs were dealing with traumatic events (88.57%, followed by dealing with serious accidents (87.8% and young victims (87.14%. Chronic stressors were more commonly reported among EMRs with statistically significant differences (P 0.05. There was increased risk of PTSD for those who had higher stress levels from death of colleagues [odds ratio (OR [95% confidence interval (CI] = 2.2 (0.7-7.6, exposure to verbal or physical assault OR (95% CI = 1.6 (0.5-4.4 and dealing with psychiatric OR (95% CI 1.4 (0.53.7 (P > 0.05 Conclusion: EMRs group had more frequent exposure to both acute and chronic work-related stressors than comparative group. Also, EMRs had higher levels of EE, DP, and PTSD compared with comparative group. EMRs are in need for stress management program for prevention these of stress related hazards on health and work performance.

  12. Advancing regulatory science to bring novel medical devices for use in emergency care to market: the role of the Food and Drug Administration.

    Science.gov (United States)

    Scully, Christopher G; Forrest, Shawn; Galeotti, Loriano; Schwartz, Suzanne B; Strauss, David G

    2015-04-01

    The Food and Drug Administration (FDA) performs regulatory science to provide science-based medical product regulatory decisions. This article describes the types of scientific research the FDA's Center for Devices and Radiological Health performs and highlights specific projects related to medical devices for emergency medicine. In addition, this article discusses how results from regulatory science are used by the FDA to support the regulatory process as well as how the results are communicated to the public. Regulatory science supports the FDA's mission to assure safe, effective, and high-quality medical products are available to patients.

  13. Medical Students and Patient-Centred Clinical Practice: The Case for More Critical Work in Medical Schools

    Science.gov (United States)

    Donetto, Sara

    2012-01-01

    In the last two decades, undergraduate medical education in the United Kingdom has undergone several important changes. Many of these have revolved around a paradigmatic shift from "paternalistic" to "patient-centred" approaches to healthcare. Adopting a Foucauldian understanding of power and borrowing from Freire's critical…

  14. Medical Students and Patient-Centred Clinical Practice: The Case for More Critical Work in Medical Schools

    Science.gov (United States)

    Donetto, Sara

    2012-01-01

    In the last two decades, undergraduate medical education in the United Kingdom has undergone several important changes. Many of these have revolved around a paradigmatic shift from "paternalistic" to "patient-centred" approaches to healthcare. Adopting a Foucauldian understanding of power and borrowing from Freire's critical…

  15. Medical Students and Patient-Centred Clinical Practice: The Case for More Critical Work in Medical Schools

    Science.gov (United States)

    Donetto, Sara

    2012-01-01

    In the last two decades, undergraduate medical education in the United Kingdom has undergone several important changes. Many of these have revolved around a paradigmatic shift from "paternalistic" to "patient-centred" approaches to healthcare. Adopting a Foucauldian understanding of power and borrowing from Freire's critical pedagogy, in this…

  16. Effects of organizational and professional identification on the relationship between administrators' social influence and professional employees' adoption of new work behavior.

    Science.gov (United States)

    Hekman, David R; Steensma, H Kevin; Bigley, Gregory A; Hereford, James F

    2009-09-01

    Administrative social influence is a principal tool for motivating employee behavior. The authors argue that the compliance of professional employees (e.g., doctors) with administrative social influence will depend on the degree to which these employees identify with their profession and organization. Professional employees were found to be most receptive to administrator social influence to adopt new work behavior when they strongly identified with the organization and weakly identified with the profession. In contrast, administrator social influence was counterproductive when professional employees strongly identified with the profession and weakly identified with the organization.

  17. Mifepristone followed by home administration of buccal misoprostol for medical abortion up to 70 days of amenorrhoea in a general practice in Curacao

    NARCIS (Netherlands)

    Boersma, Adriana A.; Jong, Betty Meyboom-de; Kleiverda, Gunilla

    2011-01-01

    Objective To evaluate the efficacy and safety of home administration of buccal misoprostol after mifepristone for medical abortion up to 70 days' gestation in a general practice in Curacao, where induced abortion is severely restricted by law. Methods In a prospective study 330 women received 200 mg

  18. Mifepristone followed by home administration of buccal misoprostol for medical abortion up to 70 days of amenorrhoea in a general practice in Curacao

    NARCIS (Netherlands)

    Boersma, Adriana A.; Jong, Betty Meyboom-de; Kleiverda, Gunilla

    2011-01-01

    Objective To evaluate the efficacy and safety of home administration of buccal misoprostol after mifepristone for medical abortion up to 70 days' gestation in a general practice in Curacao, where induced abortion is severely restricted by law. Methods In a prospective study 330 women received 200 mg

  19. [Perinatal health and medical administrative data: What uses, which stakeholders, what the issues for birth data? - Special REDSIAM].

    Science.gov (United States)

    Serfaty, A; Baron, S; Crenn-Hebert, C; Barry, Y; Tala, S

    2017-10-01

    The uses of medical administrative data (MAD/BDMA) emerged in perinatal health following the work on regionalization of very pre-term birth. They have become more numerous since the late 2000s. The objective of this article is to take stock of the existing work carried out within the REDSIAM-perinatality group, on MAD/BDMA and their uses for the period of "birth". The studied MADs are the Hospital Discharge Data (PMSI) and the French national health database (SNIIRAM). The material includes knowledge shared by the members of the REDSIAM-perinatality group, scientific references and gray literature. Our exploratory study shows that the uses of MAD in perinatal health are diversified at the local, regional and national levels. The works and publications, increasing, take the form of public access of processed data. Collective thinking makes it possible to move from a localized use to an institution, a network or several, to a national use and an inscription in public authorities' responses. In 2015/2016, two institutional sites provide access to data on maternal and child health: Data.Drees and ATIH ScanSanté. MAD/BDMA uses are multiple: epidemiological use (count of births by gestational age, weight in particular; perinatal indicators), quality of care, planning (maternity activities, regionalization of care). There is an increasing interest among stakeholders, producers and/or operators of MAD/BDMA (decision-makers, professionals or researchers). The BDMA, including the PMSI and the SNIIRAM, are used and relevant in Perinatal health with the rise of health networks, the territorialisation of health, in an increased demand for quality of care. Their use will increase the reliability of the data collected and an inscription in the validation studies, more and more numerous in the field of BDMA. The algorithms need to be more finely compiled, validated and enhanced. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  20. Continuing Medical Education Needs Assessment of General Physicians Working at Tabriz Health Centers in 2014

    Directory of Open Access Journals (Sweden)

    Parisa Golanbar

    2014-12-01

    Full Text Available Introduction: The aim of this study was to identify the educational needs of General Physicians working in the health centers of Tabriz in 2014. Methods: The study method was descriptive. The statistical population was 2,024. Of the population of the study, 322 physicians were randomly selected. In order to gather the data, the Delphi method and a researcher-made questionnaire were used in 14 domains of medicine, including: Communicable and Infectious Diseases, Non-communicable Diseases, Health Education, Mental and Social Health, Dental and Oral Health, Medical Procedures, Population and Family, Nutritional Health, Occupational Health, Environmental Health, Complementary Procedures, Health Crisis and Disasters, Laboratory and Drugs, and Alternative Medicine. The validity of the study was confirmed with the viewpoint of the Delphi team and the reliability was confirmed with the Alpha Cronbach (r = 0.84. For data analysis, we used descriptive statistic methods like frequency, percentage and mean, and the Friedman ranking test (calculated using SPSS v. 21. Results: The results showed that the first-ranked educational needs of every domain were the following (in order of domain listed above: respiratory infection, hypertension, healthy lifestyle, stress management, dental growth and care in children, raising hope and pleasure, weight and nutritional control, occupational health and safety, water hygiene, cardiopulmonary resuscitation, therapeutic exercises, natural disasters’ primary cares, rational use of drugs and traditional medicine.Conclusion: The first domain receiving the first rank of educational needs was non-communicable diseases, and the conformity range of implemented plans in continuing medical education with need assessment results was 53.84%.

  1. The impact of type of manual medication cart filling method on the frequency of medication administration errors : A prospective before and after study

    NARCIS (Netherlands)

    Schimmel, Anneliene M.; Becker, Matthijs L.; van den Bout, Tilly; Taxis, Katja; van den Bemt, Patricia M. L. A.

    2011-01-01

    Background: The medication cart can be filled using an automated system or a manual method and when using a manual method the medication can be arranged either by round time or by medication name. For the manual methods, it is hypothesized that the latter method would result in a lower frequency of

  2. Medical image computing and computer-aided medical interventions applied to soft tissues. Work in progress in urology

    CERN Document Server

    Troccaz, Jocelyne; Berkelman, Peter; Cinquin, Philippe; Daanen, Vincent; Leroy, Antoine; Marchal, Maud; Payan, Yohan; Promayon, Emmanuel; Voros, Sandrine; Bart, Stéphane; Bolla, Michel; Chartier-Kastler, Emmanuel; Descotes, Jean-Luc; Dusserre, Andrée; Giraud, Jean-Yves; Long, Jean-Alexandre; Moalic, Ronan; Mozer, Pierre

    2006-01-01

    Until recently, Computer-Aided Medical Interventions (CAMI) and Medical Robotics have focused on rigid and non deformable anatomical structures. Nowadays, special attention is paid to soft tissues, raising complex issues due to their mobility and deformation. Mini-invasive digestive surgery was probably one of the first fields where soft tissues were handled through the development of simulators, tracking of anatomical structures and specific assistance robots. However, other clinical domains, for instance urology, are concerned. Indeed, laparoscopic surgery, new tumour destruction techniques (e.g. HIFU, radiofrequency, or cryoablation), increasingly early detection of cancer, and use of interventional and diagnostic imaging modalities, recently opened new challenges to the urologist and scientists involved in CAMI. This resulted in the last five years in a very significant increase of research and developments of computer-aided urology systems. In this paper, we propose a description of the main problems rel...

  3. The Profile and Work of Officials in Central and Regional Administration Compared: The Case of the Czech Republic

    Directory of Open Access Journals (Sweden)

    Veselý Arnošt

    2014-06-01

    Full Text Available This paper examines the profiles and work tasks of officials in central and regional administration in the Czech Republic. It analyzes data from surveys among the officials of eleven ministries in 2013 (N = 1351 and fourteen regional offices in 2012 (N = 783. First, the profile of ministerial officials (MOs is compared with that of regional-level officials (ROs. In accordance with our hypotheses, on average it is found that MOs are, when compared to ROs, older, more educated and have spent more time in civil service. Th ere is also a higher proportion of men in ministries than in regional offices. On the other hand, ministerial work seems to be affected by higher levels of fluctuation than jobs in the regional offices. Second, we compare work tasks of MOs and ROs. As expected, MOs are more involved in analytical tasks and research than ROs. In contrast, ROs are more likely to implement policies or programs, direct and monitor programs or lower-level bodies, provide advice for political bodies of the region, negotiate with elected politicians, communicate with citizens and provide methodological guidance, train or lecture. Contrary to our theoretical expectations, we found a strong positive correlation between analytical and brokering tasks (communication and negotiation. We thus reject the hypothesis that analytical tasks are at odds with negotiating and communication. Instead, it is concluded that most officials are multitaskers, and it is especially so in regional offices. It is hypothesized that this might be caused by the fact that regional offices are smaller and have a lower capacity to specialize

  4. Learning Medical Microbiology and Infectious Diseases by Means of a Board Game: Can It Work?

    Science.gov (United States)

    Struwig, Magdalena C.; Beylefeld, Adriana A.; Joubert, Georgina

    2014-01-01

    Innovative teaching and learning is increasingly becoming part of medical education. We report the evaluation of a medical microbiology board game, Med Micro Fun With Facts (MMFWF), based on Trivial Pursuit™ principles. The game was developed to stimulate medical students' interest in microbiology and expose students to the subject content of an…

  5. Learning Medical Microbiology and Infectious Diseases by Means of a Board Game: Can It Work?

    Science.gov (United States)

    Struwig, Magdalena C.; Beylefeld, Adriana A.; Joubert, Georgina

    2014-01-01

    Innovative teaching and learning is increasingly becoming part of medical education. We report the evaluation of a medical microbiology board game, Med Micro Fun With Facts (MMFWF), based on Trivial Pursuit™ principles. The game was developed to stimulate medical students' interest in microbiology and expose students to the subject content of an…

  6. Learning Medical Microbiology and Infectious Diseases by Means of a Board Game: Can It Work?

    Science.gov (United States)

    Struwig, Magdalena C.; Beylefeld, Adriana A.; Joubert, Georgina

    2014-01-01

    Innovative teaching and learning is increasingly becoming part of medical education. We report the evaluation of a medical microbiology board game, Med Micro Fun With Facts (MMFWF), based on Trivial Pursuit™ principles. The game was developed to stimulate medical students' interest in microbiology and expose students to the subject content of…

  7. Legal and medical aspects of the ethics committee’s work relating to abortion

    Directory of Open Access Journals (Sweden)

    Ponjavić Zoran

    2011-01-01

    Full Text Available This paper analyses the legal and medical aspects of the work of ethics committees on abortion. According to the legislation of the Republic of Serbia, these committees are competent to determine justifiable terms for abortion after the twentieth week of the fetus. It is well known that abortion is not only a medical but a legal, ethic, social and demographic problem as well. A liberal solution in view of abortion in the first trimester has been accepted in most European countries, as by the legislature of the Republic of Serbia. Since prenatal diagnosis cannot always determine the fetus state with certainty but at times may do so at a later stage, abortion is then required when the child is already capable of extrauterine life. The necessity for performing abortion in the third trimester is thus a result of good knowledge of techno-medicine but also from the limited information it provides. In such situations, the physician needs confirmation and justification of his standpoint with respect to abortion through a legal formulation which should contain "minimum moral". Society has found a way to protect and help him through moral and ethic forms of prevention without anybody’s emotions being affected. Ethics committees should thus help the physician in view of determining the terms for performing late abortion, since the rules of doctor’s ethics are not sufficient in this case. The article especially analyses the work of the Ethics Committee of the Clinical Center in Kragujevac in the period 2000-2010. It is stated that the largest number of cases referred to determined diseases or fetus anomalies while only a negligible number (11.29% to the illness of the mother. There were no requests for abortions due to legal reasons (pregnancies from criminal offences. A significant number (40.28% of requests submitted to the Ethics Committee related to pregnancies under the 24th week of pregnancy. Since a pregnancy of 24 weeks represents a boundary

  8. Administrating Solr

    CERN Document Server

    Mohan, Surendra

    2013-01-01

    A fast-paced, example-based guide to learning how to administrate, monitor, and optimize Apache Solr.""Administrating Solr"" is for developers and Solr administrators who have a basic knowledge of Solr and who are looking for ways to keep their Solr server healthy and well maintained. A basic working knowledge of Apache Lucene is recommended, but this is not mandatory.

  9. 医院管理人员与医护人员对医患关系评价的差异性分析%Analysis of Evaluation Difference between Hospital Administrator and Medical Personnel on Doctor-patient Relationship

    Institute of Scientific and Technical Information of China (English)

    汉业旭; 王晓燕; 张建; 梁立智; 关丽征; 宋晓霞; 焦峰

    2012-01-01

    Objective To know about evaluation difference and the cause of it between hospital administrator and medical personnel on doctor-patient relationship. Methods Questionnaire survey was used to investigate 114 hospital administrators and 378 medical personnel, and the result was analyzed by statistical techniques. Results There are statistical significance between hospital administrator and medical personnel in terms of their evaluation difference on doctor-patient relationship, and the evaluation difference is relevant to their life satisfaction and work experience. Conclusion The difference in working principle between hospital administrator and medical personnel is the key issue in the evaluation difference on doctor-patient relationship; hospital administrator needs to strengthen the management theory of humanism, manage the hospitar scientifically , as well as pursue high medical quality, and build up a strong foundation for hospital, construct a harmonious relationship between doctors and patients.%目的 了解医院行政管理人员与医护人员对医患关系的总体评价,探究其差异产生的原因.方法 对北京市5家三级甲等医院114名医院行政管理人员和378名医护人员进行问卷调查,运用秩和检验、Logistic回归等方法对其结果进行统计学分析.结果 医院行政管理人员与医务人员对医患关系的评价存在差异,具有统计学意义;差异产生的原因与他们的生活满意度和工作总体感受相关.结论 医院行政管理人员与医护人员对医患关系评价的差异与其各自的岗位特点有直接关系;医院行政管理需加强人本管理理念,科学管理医院,同时追求更高的医疗质量,打造坚实的医院品牌,构建和谐的医患关系.

  10. Thermosensitive hydrogel based on chitosan and its derivatives containing medicated nanoparticles for transcorneal administration of 5-fluorouracil

    Directory of Open Access Journals (Sweden)

    Fabiano A

    2017-01-01

    Full Text Available Angela Fabiano,1 Ranieri Bizzarri,2 Ylenia Zambito1 1Department of Pharmacy, University of Pisa, 2NEST, Istituto Nanoscienze CNR (CNR-NANO and Scuola Normale Superiore, Pisa, Italy Abstract: A thermosensitive ophthalmic hydrogel (TSOH – fluid at 4°C (instillation temperature, semisolid at 35°C (eye temperature, which coupled the dosing accuracy and administration ease of eyedrops with the increased ocular bioavailability of a hydrogel – was prepared by gelling a chitosan hydrochloride (ChHCl solution (27.8 mg/mL medicated with 1.25 mg/mL 5-fluorouracil (5-FU with β-glycerophosphate 0.8 mg/mL. Polymer mixtures, where Ch was partially (10%, 15%, or 20% replaced by quaternary ammonium–chitosan conjugates (QA-Ch or thiolated derivatives thereof, were also used to modulate 5-FU-release properties of TSOH. Also, Ch-based nanoparticles (NPs; size after lyophilization and redispersion 341.5±15.2 nm, polydispersity 0.315±0.45, ζ-potential 10.21 mV medicated with 1.25 mg/mL 5-FU prepared by ionotropic cross-linking of Ch with hyaluronan were introduced into TSOH. The 5-FU binding by TSOH polymers in the sol state was maximum with plain Ch (31.4% and tended to decrease with increasing QA presence in polymer mixture. 5-FU release from TSOH with or without NPs was diffusion-controlled and linear in √t. The different TSOH polymers were compared on a diffusivity basis by comparing the slopes of √t plots. These showed a general decrease with NP-containing TSOH, which was the most marked with the TSOH, where Ch was 20% replaced by the derivative QA-Ch50. This formulation and that not containing NP were instilled in rabbits and the 5-FU transcorneal penetration was measured by analyzing the aqueous humor. Both TSOH solutions increased the area under the curve (0–8 hours 3.5 times compared with the plain eyedrops, but maximum concentration for the NP-free TSOH was about 0.65 µg/mL, followed by a slow decline, while the NP-containing one showed a

  11. Thermosensitive hydrogel based on chitosan and its derivatives containing medicated nanoparticles for transcorneal administration of 5-fluorouracil

    Science.gov (United States)

    Fabiano, Angela; Bizzarri, Ranieri; Zambito, Ylenia

    2017-01-01

    A thermosensitive ophthalmic hydrogel (TSOH) – fluid at 4°C (instillation temperature), semisolid at 35°C (eye temperature), which coupled the dosing accuracy and administration ease of eyedrops with the increased ocular bioavailability of a hydrogel – was prepared by gelling a chitosan hydrochloride (ChHCl) solution (27.8 mg/mL) medicated with 1.25 mg/mL 5-fluorouracil (5-FU) with β-glycerophosphate 0.8 mg/mL. Polymer mixtures, where Ch was partially (10%, 15%, or 20%) replaced by quaternary ammonium–chitosan conjugates (QA-Ch) or thiolated derivatives thereof, were also used to modulate 5-FU-release properties of TSOH. Also, Ch-based nanoparticles (NPs; size after lyophilization and redispersion 341.5±15.2 nm, polydispersity 0.315±0.45, ζ-potential 10.21 mV) medicated with 1.25 mg/mL 5-FU prepared by ionotropic cross-linking of Ch with hyaluronan were introduced into TSOH. The 5-FU binding by TSOH polymers in the sol state was maximum with plain Ch (31.4%) and tended to decrease with increasing QA presence in polymer mixture. 5-FU release from TSOH with or without NPs was diffusion-controlled and linear in √t. The different TSOH polymers were compared on a diffusivity basis by comparing the slopes of √t plots. These showed a general decrease with NP-containing TSOH, which was the most marked with the TSOH, where Ch was 20% replaced by the derivative QA-Ch50. This formulation and that not containing NP were instilled in rabbits and the 5-FU transcorneal penetration was measured by analyzing the aqueous humor. Both TSOH solutions increased the area under the curve (0–8 hours) 3.5 times compared with the plain eyedrops, but maximum concentration for the NP-free TSOH was about 0.65 µg/mL, followed by a slow decline, while the NP-containing one showed a plateau (0.25–0.3 µg/mL) in a time interval of 0.5–7 hours. This is ascribed to the ability of this TSOH to control drug release to a zero order and that of NPs to be internalized by corneal

  12. Linking primary study data with administrative and claims data in a German cohort study on work, age, health and work participation: is there a consent bias?

    Science.gov (United States)

    Stallmann, C; Swart, E; Robra, B-P; March, S

    2017-09-01

    We analysed the degree and impact of consent bias in the prospective study 'leben in der Arbeit (lidA)' after linking primary interview data with claims data from German statutory health insurance funds as well as with administrative data provided by the German Federal Employment Agency. Prospective cohort study. Within two study waves (2011, 2014) primary data were collected based on computer-assisted personal interviews. During interview informed consent to data linkage was obtained. We used binary logistic regression analyses with participants' consent for record linkage as the dependent variable calculating odds ratios (ORs) and 95% confidence intervals (95% CIs) for independent variables. Several sociodemographic, socio-economic and work-related factors were modelled as potential determinants of consent. A total of 4244 participants took part in both waves. After excluding invalid consent, 4178 participants were included in the analysis. About 3918 (93.8%) of these participants gave their consent to link their primary data with data from at least one source. Within regression analyses only moderate bias was found due to region of residence, apprenticeship, professional affiliations, income and number of diseases. Participants from former West Germany were less likely to have their study data linked with both data sources (OR 0.63 [95% CI 0.42-0.96]) than those from the former East Germany. Participants with no information on income were more likely to refuse consent to both data sources compared to the reference group (net income: under EUR 1000; OR 0.15 [95% CI 0.08-0.30]). Respondents with two (OR 1.37 [95% CI 1.06-1.77]) or three and more diseases (OR 1.30 [95% CI 1.02-1.66]) diagnosed by a doctor agreed more frequently to linking both data sources than participants without disease. There is just a small proportion of variance in consenting explained by the models (R(2): 0.063-0.085). Also, only small changes of factors' prevalence were observed in

  13. Differences in medication knowledge and risk of errors between graduating nursing students and working registered nurses: comparative study

    OpenAIRE

    2014-01-01

    Background: Nurses experience insufficient medication knowledge; particularly in drug dose calculations, but also in drug management and pharmacology. The weak knowledge could be a result of deficiencies in the basic nursing education, or lack of continuing maintenance training during working years. The aim of this study was to compare the medication knowledge, certainty and risk of error between graduating bachelor students in nursing and experienced registered nurses. Methods: Bac...

  14. Poorer verbal working memory for a second language selectively impacts academic achievement in university medical students

    Directory of Open Access Journals (Sweden)

    Collette Mann

    2013-02-01

    Full Text Available Working memory (WM is often poorer for a second language (L2. In low noise conditions, people listening to a language other than their first language (L1 may have similar auditory perception skills for that L2 as native listeners, but do worse in high noise conditions, and this has been attributed to the poorer WM for L2. Given that WM is critical for academic success in children and young adults, these speech in noise effects have implications for academic performance where the language of instruction is L2 for a student. We used a well-established Speech-in-Noise task as a verbal WM (vWM test, and developed a model correlating vWM and measures of English proficiency and/or usage to scholastic outcomes in a multi-faceted assessment medical education program. Significant differences in Speech-Noise Ratio (SNR50 values were observed between medical undergraduates who had learned English before or after five years of age, with the latter group doing worse in the ability to extract whole connected speech in the presence of background multi-talker babble (Student-t tests, p < 0.001. Significant negative correlations were observed between the SNR50 and seven of the nine variables of English usage, learning styles, stress, and musical abilities in a questionnaire administered to the students previously. The remaining two variables, Perceived Stress Scale (PSS and the Age of Acquisition of English (AoAoE were significantly positively correlated with the SNR50 , showing that those with a poorer capacity to discriminate simple English sentences from noise had learnt English later in life and had higher levels of stress – all characteristics of the international students. Local students exhibited significantly lower SNR50 scores and were significantly younger when they first learnt English. No significant correlation was detected between the SNR50 and the students’ Visual/Verbal Learning Style (r = −0.023. Standard multiple regression was

  15. Poorer verbal working memory for a second language selectively impacts academic achievement in university medical students

    Science.gov (United States)

    Canny, Benedict J.; Reser, David H.; Rajan, Ramesh

    2013-01-01

    Working memory (WM) is often poorer for a second language (L2). In low noise conditions, people listening to a language other than their first language (L1) may have similar auditory perception skills for that L2 as native listeners, but do worse in high noise conditions, and this has been attributed to the poorer WM for L2. Given that WM is critical for academic success in children and young adults, these speech in noise effects have implications for academic performance where the language of instruction is L2 for a student. We used a well-established Speech-in-Noise task as a verbal WM (vWM) test, and developed a model correlating vWM and measures of English proficiency and/or usage to scholastic outcomes in a multi-faceted assessment medical education program. Significant differences in Speech-Noise Ratio (SNR50 ) values were observed between medical undergraduates who had learned English before or after five years of age, with the latter group doing worse in the ability to extract whole connected speech in the presence of background multi-talker babble (Student-t tests, p musical abilities in a questionnaire administered to the students previously. The remaining two variables, Perceived Stress Scale (PSS) and the Age of Acquisition of English (AoAoE) were significantly positively correlated with the SNR50 , showing that those with a poorer capacity to discriminate simple English sentences from noise had learnt English later in life and had higher levels of stress – all characteristics of the international students. Local students exhibited significantly lower SNR50 scores and were significantly younger when they first learnt English. No significant correlation was detected between the SNR50 and the students’ Visual/Verbal Learning Style (r = −0.023). Standard multiple regression was carried out to assess the relationship between language proficiency and verbal working memory (SNR50 ) using 5 variables of L2 proficiency, with the results showing that

  16. Making sense: duty hours, work flow, and waste in graduate medical education.

    Science.gov (United States)

    Bush, Roger W; Philibert, Ingrid

    2009-12-01

    Parsimony, and not industry, is the immediate cause of the increase of capital. Industry, indeed, provides the subject which parsimony accumulates. But whatever industry might acquire, if parsimony did not save and store up, the capital would never be the greater.Adam Smith, The Wealth of Nations, book 2, chapter 31In 2003, the Accreditation Council for Graduate Medical Education implemented resident duty hour limits that included a weekly limit and limits on continuous hours. Recent recommendations for added reductions in resident duty hours have produced concern about concomitant reductions in future graduates' preparedness for independent practice. The current debate about resident hours largely does not consider whether all hours residents spend in the educational and clinical-care environment contribute meaningfully either to residents' learning or to effective patient care. This may distract the community from waste in the current clinical-education model. We propose that use of "lean production" and quality improvement methods may assist teaching institutions in attaining a deeper understanding of work flow and waste. These methods can be used to assign value to patient- and learner-centered activities and outputs and to optimize the competing and synergistic aspects of all desired outcomes to produce the care the Institute of Medicine recommends: safe, effective, efficient, patient-centered, timely, and equitable. Finally, engagement of senior clinical faculty in determining the culture of the care and education system will contribute to an advanced social-learning and care network.

  17. SATISFACTION LEVEL OF MEDICAL EDUCATORS WORKING IN TEACHING INSTITUTIONS : A QUESTIONNAIRE BASED CROSS-SECTIONAL STUDY

    Directory of Open Access Journals (Sweden)

    Sudeshna Chatterjee

    2016-12-01

    Full Text Available In a resource-limited and high-burden disease setting, satisfied health professional is an asset in terms of maximized productivity, efficiency and quality health care. Job Satisfaction Index is a validated measure to identify the components that influence those issues. A multi-faceted structured questionnaire study was conducted upon a cross-section of medical educators (n=160 serving two tertiary care teaching institutions under different management set-up. Multiple demographic features were independent variables whereas three (3 critical areas of satisfaction index (SI were outcome variables. All participants were interviewed using 15 item Likert response-based, modified job satisfaction scale. It was observed that total SI scores among doctors representing the private group remained marginally higher (P<0.05 while compared to the other group. The comparative analysis of SI scores in critical areas like availability of academic supports and job security remained higher among the private doctors than that of the government ones though not significant. However the private doctors remained marginally satisfied in terms of working environment. The study outcome necessitates appropriate intervention measures at the organizational levels.

  18. Residents' perceived barriers to communication skills learning: comparing two medical working contexts in postgraduate training.

    Science.gov (United States)

    van den Eertwegh, Valerie; van Dalen, Jan; van Dulmen, Sandra; van der Vleuten, Cees; Scherpbier, Albert

    2014-04-01

    Contextual factors are known to influence the acquisition and application of communication skills in clinical settings. Little is known about residents' perceptions of these factors. This article aims to explore residents' perceptions of contextual factors affecting the acquisition and application of communication skills in the medical workplace. We conducted an exploratory study comprising seven focus groups with residents in two different specialities: general practice (n=23) and surgery (n=18). Residents perceive the use of summative assessment checklists that reduce communication skills to behavioural components as impeding the learning of their communication skills. Residents perceive encouragement to deliberately practise in an environment in which the value of communication skills is recognised and support is institutionalised with appropriate feedback from role models as the most important enhancing factors in communication skills learning. To gradually realise a clinical working environment in which the above results are incorporated, we propose to use transformative learning theory to guide further studies. Provided it is used continuously, an approach that combines self-directed learning with observation and discussion of resident-patient consultations seems an effective method for transformative learning of communication skills. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  19. Quality improvements in decreasing medication administration errors made by nursing staff in an academic medical center hospital: a trend analysis during the journey to Joint Commission International accreditation and in the post-accreditation era.

    Science.gov (United States)

    Wang, Hua-Fen; Jin, Jing-Fen; Feng, Xiu-Qin; Huang, Xin; Zhu, Ling-Ling; Zhao, Xiao-Ying; Zhou, Quan

    2015-01-01

    Medication errors may occur during prescribing, transcribing, prescription auditing, preparing, dispensing, administration, and monitoring. Medication administration errors (MAEs) are those that actually reach patients and remain a threat to patient safety. The Joint Commission International (JCI) advocates medication error prevention, but experience in reducing MAEs during the period of before and after JCI accreditation has not been reported. An intervention study, aimed at reducing MAEs in hospitalized patients, was performed in the Second Affiliated Hospital of Zhejiang University, Hangzhou, People's Republic of China, during the journey to JCI accreditation and in the post-JCI accreditation era (first half-year of 2011 to first half-year of 2014). Comprehensive interventions included organizational, information technology, educational, and process optimization-based measures. Data mining was performed on MAEs derived from a compulsory electronic reporting system. The number of MAEs continuously decreased from 143 (first half-year of 2012) to 64 (first half-year of 2014), with a decrease in occurrence rate by 60.9% (0.338% versus 0.132%, Pefficiency of multidiscipline collaboration among physicians, pharmacists, nurses, information engineers, and hospital administrators are pivotal to safety in medication administration. JCI accreditation may help health systems enhance the awareness and ability to prevent MAEs and achieve successful quality improvements.

  20. Individual and work-unit measures of psychological demands and decision latitude and the use of antihypertensive medication

    DEFF Research Database (Denmark)

    Daugaard, S; Andersen, JH; Grynderup, M B

    2014-01-01

    PURPOSE: To analyse whether psychological demands and decision latitude measured on individual and work-unit level were related to prescription of antihypertensive medication. METHODS: A total of 3,421 women and 897 men within 388 small work units completed a questionnaire concerning psychological...... working conditions according to the job strain model. Mean levels of psychological demands and decision latitude were computed for each work unit to obtain exposure measures that were less influenced by reporting bias. Dispensed antihypertensive medication prescriptions were identified in The Danish...... National Prescription Registry. Odds ratios (OR) comparing the highest and lowest third of the population at individual and work-unit level, respectively, were estimated by multilevel logistic regression adjusted for confounders. Psychological demands and decision latitude were tested for interaction...

  1. Work.

    Science.gov (United States)

    Haines, Annette M.

    2003-01-01

    Draws upon Maria Montessori's writings to examine work as a universal human tendency throughout life. Discusses the work of adaptation of the infant, work of "psycho-muscular organism" for the preschooler, work of the imagination for the elementary child, community work of the adolescent, and work of the adult. Asserts that…

  2. Shift Work and Related Health Problems among Medical and Diagnostic Staff of the General Teaching Hospitals Affiliated to Shiraz University of Medical Sciences, 2012

    Directory of Open Access Journals (Sweden)

    Zahra Sajjadnia

    2015-07-01

    Full Text Available Introduction:Today, shift work is considered as a necessity in many jobs and for some 24-hour services the use of shift-work is growing. However, shift work can lead to physiological and psycho-social problems for shift workers. This study aimed to determine the effects of shift work on the associated health problems, together with the demographic and job characteristics underlying the problems, among the medical and diagnostic staff of the general teaching hospitals affiliated to Shiraz University of Medical Sciences in 2012. Method:This study was an applied, cross-sectional and descriptive-analytical one. The study employed a sample of 205 employees from the medical and diagnostic staff using stratified sampling proportional to the size and simple random sampling methods. Data were collected using the Survey of Shift workers (SOS questionnaire, validity and reliability of which have already been confirmed. Finally, the collected data were analyzed using SPSS 16.0 software through ANOVA, Chi-square, Independent-Samples T-Test, as well as Pearson Correlation Coefficient. A P<0.05 was considered statistically significant. Results: The results showed that among the demographic and job characteristics studied, the individual, family and social problems had significant associations with work schedules, shift work and job satisfaction. In addition, there were significant associations between musculoskeletal disorders and the satisfaction of shift work; cardiovascular disorders and marital status and occupation; digestive disorders and the work schedules; sleep disorders and the satisfaction of shift work; musculoskeletal disorders, cardiovascular disorders and sleep disorders and age, job experience and shift work experience. And finally, there were significant associations among sleep disorders and age, job experience and the shift work experience. Conclusion: Based on the findings of this study, demographic characteristics such as age, marital

  3. Assessment of Predictable Productivity of Nurses Working in Kerman University of Medical Sciences' Teaching Hospitals via the Dimensions of Quality of Work Life.

    Science.gov (United States)

    Borhani, Fariba; Arbabisarjou, Azizollah; Kianian, Toktam; Saber, Saman

    2016-10-01

    Despite the existence of a large community of nurses, specific mechanisms have not been developed yet to consider their needs and the quality of their work life. Moreover, few studies have been conducted to analyze the nature of nursing, nursing places or nurses' quality of work life. In this regard, the present study aimed to assess predictable productivity of nurses working in Kerman University of Medical Sciences' teaching hospitals via the dimensions of Quality of Work Life. The present descriptive-correlational study was conducted to assess predictable productivity of nurses via the dimensions of Quality of Work Life. The study's population consisted of all nurses working in different wards of teaching hospitals associated with Kerman University of Medical Sciences. Out of the whole population, 266 nurses were selected based on the simple random sampling method. To collect data, the questionnaires of 'Quality of Nursing Work Life' and 'Productivity' were used after confirming their reliability (test-retest) and content validity. Finally, the collected data were analyzed through the SPSS software (version 16). Although the quality of work life for nurses was average and their productivity was low but the results showed that quality of life is directly related to nurses' productivity. Quality of life and its dimensions are predictive factors in the in the nurses' productivity. It can conclude that by recognizing the nurses' quality of work life situation, it can realize this group productivity and their values to the efficiency of the health system. For the quality of working life improvement and increasing nurses' productivity more efforts are needed by authorities. The findings can be applied by managers of hospitals and nursing services along with head nurses to enhance the quality of health services and nursing profession in general.

  4. 医疗设备档案管理中创新思维的运用%Exploration of creative thinking application in medical equipment archive administration

    Institute of Scientific and Technical Information of China (English)

    王春鹤

    2012-01-01

    Objective: To explore the active role of creative thinking application in medical equipment archive administration. Methods: The application of creative thinking and ability was scientifically explored through literature review and practice summary. Results: The application of creative thinking in medical equipment archives administration makes an attempt in effective medical archives usage. Conclusion: The exploration of creative thinking and ability may change the delay status quo of medical equipment archive administration.%目的:探讨创新思维在医疗设备档案管理中的积极作用.方法:通过查阅文献和实践经验总结,对创新思维和创新能力的实施进行科学探讨.结果:将创新内容应用于医疗设备档案管理中,为高效率利用医疗设备档案资源进行有益尝试.结论:通过对创新思维、创新能力的探讨,有望改变医疗设备档案管理滞后的现状和局面.

  5. Regulatory organizations for physicians' status and administrative sanctions on physicians: - examining the framework of government administrative systems for physicians in Japan based on a questionnaire survey conducted on 13 national medical associations.

    Science.gov (United States)

    Morioka, Yasuhiko; Higuchi, Norio; Kuroyanagi, Tatsuo; Nudeshima, Jiro

    2014-05-01

    Society bestows professional privilege on physicians. At the same time, it expects physicians to strive constantly to improve their ethics and quality in medical expertise. In every nation, some level of government is responsible for certifying or licensing physicians and imposes strict management, including revoking licenses from inappropriate physicians or providing severe sanctions for misconduct or conduct unbecoming of a physician. In reality, however, it is difficult to reduce the number of inappropriate or indiscreet physicians, and each nation faces its own challenges. We conducted a questionnaire survey of 13 national medical associations, including some major Western countries, regarding the licensing of physicians, the organizations managing their medical practice status, and the data and grounds for administrative sanctioning of physicians. We then examined the circumstances in Japan based on the survey results and pointed out the domestic issues.

  6. A structural equation model relating work stress, coping resource, and quality of life among Chinese medical professionals.

    Science.gov (United States)

    Wu, Siying; Li, Huangyuan; Zhu, Wei; Li, Jian; Wang, Xiaorong

    2010-11-01

    Work stress and coping resource may contribute to the quality of life in medical professionals. This study is to determine the relationships among work stressor, personal strain, coping resource and the quality of life (QOL) and its two dimensions in medical professionals. The Chinese version of Short Form-36 Health Survey was used to measure QOL, the modified edition of the Occupational Stress Inventory was applied to evaluate the work stressor, personal strain and coping resources among 2,721 medical professionals. The structural equation model was established to assess the relationships among these variables. Work stressor and coping resources had both direct and indirect effects on QOL and its two dimensions, the indirect effects were mediated by personal strain. Personal strain had a negative direct effect on QOL and its two dimensions. This study confirmed a complex relationship among these variables. Countermeasures targeting work stressor, reducing personal strain and strengthening coping resources are necessary in order to improve the QOL among medical professionals. © 2010 Wiley-Liss, Inc.

  7. [A profile of requirements for the performance of work related medical rehabilitation from the perspective of the statutory pension insurance].

    Science.gov (United States)

    Streibelt, M; Buschmann-Steinhage, R

    2011-06-01

    Work-related medical rehabilitation (Work MR) is a specific part of medical rehabilitation, which is well-established and broadly investigated. In almost all indications there is evidence of benefit of Work MR in patients with distinctive work-related problems due to chronic disease or disability. Nevertheless, there is a lack of implementation in clinical practice. This is due to a variety of reasons, mainly a missing definition of the appropriate Work MR interventions. The development of a Profile of Requirements (PoR) for defining contents and patterns of Work MR on behalf of the Statutory Pension Insurance (SPI) therefore is a fundamental step towards evidence-based, needs-focused rehabilitation management. The article introduces such a PoR - for the present focused on somatic indications. The PoR was developed by an SPI expert group and revised in an extensive discourse within the SPI. A strategy involved in this context was the dissemination of work-related therapeutical concepts in medical rehabilitation. In the PoR, Work MR is defined as a concrete work-related designing of therapeutical interventions as well as an integrated "philosophy" in thinking and practicing of the actors involved. Work MR is differentiated in 3 intervention levels: While work-related basic interventions (Level A) are provided in all facilities for all patients, core interventions (Level B) as well as specific interventions (Level C) are explicitly concentrated on patient subgroups with distinct work-related problems. In the PoR the relevant diagnostic and therapeutic work-related interventions are attributed to the different intervention levels and described concerning the concrete arrangement. The 3 central core interventions "Work-related psychological group interventions", "Work-related internal load test" and "Work conditioning" are presented. The decisive benefit of the PoR is to substantiate the requirements of Work MR on behalf of the SPI often worded in a rather unspecific

  8. Veterans Health Administration

    Science.gov (United States)

    ... code here VA » Veterans Health Administration Veterans Health Administration Robotic Brace for Veterans of Spinal Cord Injury ... Read more » VA Medical Centers The Veterans Health Administration is home to the United States’ largest integrated ...

  9. 20 CFR 416.962 - Medical-vocational profiles showing an inability to make an adjustment to other work.

    Science.gov (United States)

    2010-04-01

    ... inability to make an adjustment to other work. 416.962 Section 416.962 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Determining Disability and... shows that you meet this profile, we will not need to assess your residual functional capacity...

  10. The empowerment paradox as a central challenge to patient centered medical home implementation in the veteran's health administration.

    Science.gov (United States)

    Solimeo, Samantha L; Ono, Sarah S; Lampman, Michelle A M; Paez, Monica B W; Stewart, Gregory L

    2015-01-01

    In this paper we present results of a mixed methods study conducted to identify barriers to team function among staff implementing patient aligned care teams - the Department of Veterans Affairs' patient centered medical home (PCMH) model. Using a convergent mixed methods design, we administered a standardized survey measure (Team and Individual Role Perception Survey) to assess work role challenge and engagement; and conducted discussion groups to gather context pertaining to role change. We found that the role of primary care providers is highly challenging and did not become less difficult over the initial year of implementation. Unexpectedly over the course of the first year nurse care managers reported a decrease in their perceptions of empowerment and clerical associates reported less skill variety. Qualitative data suggest that more skilled team members fail to delegate and share tasks within their teams. We characterize this interprofessional knowledge factor as an empowerment paradox where team members find it difficult to share tasks in ways that are counter to traditionally structured hierarchical roles. Health care systems seeking to implement PCMH should dedicate resources to facilitating within-team role knowledge and negotiation.

  11. Injection device-related risk management toward safe administration of medications: experience in a university teaching hospital in The People's Republic of China

    Directory of Open Access Journals (Sweden)

    Zhu LL

    2014-03-01

    Full Text Available Ling-ling Zhu,1 Wei Li,2 Ping Song,3 Quan Zhou3 1Geriatric VIP Ward, Division of Nursing, 2Division of Medical Administration, 3Department of Pharmacy, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China Abstract: The use of injection devices to administer intravenous or subcutaneous medications is common practice throughout a variety of health care settings. Studies suggest that one-half of all harmful medication errors originate during drug administration; of those errors, about two-thirds involve injectables. Therefore, injection device management is pivotal to safe administration of medications. In this article, the authors summarize the relevant experiences by retrospective analysis of injection device-related near misses and adverse events in the Second Affiliated Hospital of Zhejiang University, School of Medicine, Zhejiang University, People's Republic of China. Injection device-related near misses and adverse events comprised the following: 1 improper selection of needle diameter for subcutaneous injection, material of infusion sets, and pore size of in-line filter; 2 complications associated with vascular access; 3 incidents induced by absence of efficient electronic pump management and infusion tube management; and 4 liquid leakage of chemotherapeutic infusion around the syringe needle. Safe injection drug use was enhanced by multidisciplinary collaboration, especially among pharmacists and nurses; drafting of clinical pathways in selection of vascular access; application of approaches such as root cause analysis using a fishbone diagram; plan–do–check–act and quality control circle; and construction of a culture of spontaneous reporting of near misses and adverse events. Pharmacists must be professional in regards to medication management and use. The depth, breadth, and efficiency of cooperation between nurses and pharmacists are pivotal to injection safety. Keywords

  12. Challenges and solutions in medically managed ACS in the Asia-Pacific region: expert recommendations from the Asia-Pacific ACS Medical Management Working Group.

    Science.gov (United States)

    Huo, Yong; Thompson, Peter; Buddhari, Wacin; Ge, Junbo; Harding, Scott; Ramanathan, Letchuman; Reyes, Eugenio; Santoso, Anwar; Tam, Li-Wah; Vijayaraghavan, Govindan; Yeh, Hung-I

    2015-03-15

    Acute coronary syndromes (ACS) remain a leading cause of mortality and morbidity in the Asia-Pacific (APAC) region. International guidelines advocate invasive procedures in all but low-risk ACS patients; however, a high proportion of ACS patients in the APAC region receive solely medical management due to a combination of unique geographical, socioeconomic, and population-specific barriers. The APAC ACS Medical Management Working Group recently convened to discuss the ACS medical management landscape in the APAC region. Local and international ACS guidelines and the global and APAC clinical evidence-base for medical management of ACS were reviewed. Challenges in the provision of optimal care for these patients were identified and broadly categorized into issues related to (1) accessibility/systems of care, (2) risk stratification, (3) education, (4) optimization of pharmacotherapy, and (5) cost/affordability. While ACS guidelines clearly represent a valuable standard of care, the group concluded that these challenges can be best met by establishing cardiac networks and individual hospital models/clinical pathways taking into account local risk factors (including socioeconomic status), affordability and availability of pharmacotherapies/invasive facilities, and the nature of local healthcare systems. Potential solutions central to the optimization of ACS medical management in the APAC region are outlined with specific recommendations.

  13. Medical students' participation in the 2009 Novel H1N1 influenza vaccination administration: policy alternatives for effective student utilization to enhance surge capacity in disasters.

    Science.gov (United States)

    Kaiser, Heather E; Barnett, Daniel J; Hayanga, Awori J; Brown, Meghan E; Filak, Andrew T

    2011-06-01

    As cases of 2009 novel H1N1 influenza became prevalent in Cincinnati, Ohio, Hamilton County Public Health called upon the University of Cincinnati College of Medicine to enhance its surge capacity in vaccination administration. Although the collaboration was well organized, it became evident that a system should exist for medical students' involvement in disaster response and recovery efforts in advance of a disaster. Therefore, 5 policy alternatives for effective utilization of medical students in disaster-response efforts have been examined: maintaining the status quo, enhancing the Medical Reserve Corps, creating medical school-based disaster-response units, using students within another selected disaster-response organization, or devising an entirely new plan for medical students' utilization. The intent of presenting these policy alternatives is to foster a policy dialogue around creating a more formalized approach for integrating medical students into disaster surge capacity-enhancement strategies. Using medical students to supplement the current and future workforce may help substantially in achieving goals related to workforce requirements. Discussions will be necessary to translate policy into practice.

  14. [German-Hungarian medical relationships during the Enlightenment; including an 18th century work on inoculation against plague].

    Science.gov (United States)

    Schultheisz, E

    2001-09-01

    The influence of German science and medicine on the development of Hungarian medicine in the age of Enlightenment has been extraordinary strong. Many Hungarian medical students stayed in German medical faculties. The medical interrelationships between Germany and Hungary in the 18th century are discussed in an overview according to the following dimensions: education of protestant Hungarian medical students at German >Aufklaerungs-Universitaeten<, practical and theoretical resonance, membership of scientific societies, personal contacts and correspondence. Outstanding personalities of this area were Daniel Fischer, István Weszprémi, Abraham Vater. Special attention is given to a new idea: inoculation against plague was first described by A. Vater in his work Blattern-Beltzen (1721). Thirty years later I. Weszprémi published his original conception - independently from Vater - in the Tentamen de inoculanda peste (1755).

  15. The Impact of a Health IT Changeover on Medical Imaging Department Work Processes and Turnaround Times: A mixed method study.

    Science.gov (United States)

    Georgiou, A; Prgomet, M; Lymer, S; Hordern, A; Ridley, L; Westbrook, J

    2015-01-01

    To assess the impact of introducing a new Picture Archiving and Communication System (PACS) and Radiology Information System (RIS) on: (i) Medical Imaging work processes; and (ii) turnaround times (TATs) for x-ray and CT scan orders initiated in the Emergency Department (ED). We employed a mixed method study design comprising: (i) semi-structured interviews with Medical Imaging Department staff; and (ii) retrospectively extracted ED data before (March/April 2010) and after (March/April 2011 and 2012) the introduction of a new PACS/RIS. TATs were calculated as: processing TAT (median time from image ordering to examination) and reporting TAT (median time from examination to final report). Reporting TAT for x-rays decreased significantly after introduction of the new PACS/RIS; from a median of 76 hours to 38 hours per order (pMedical Imaging staff reported that the changeover to the new PACS/RIS led to gains in efficiency, particularly regarding the accessibility of images and patient-related information. Nevertheless, assimilation of the new PACS/RIS with existing Departmental work processes was considered inadequate and in some instances unsafe. Issues highlighted related to the synchronization of work tasks (e.g., porter arrangements) and the material set up of the work place (e.g., the number and location of computers). The introduction of new health IT can be a "double-edged sword" providing improved efficiency but at the same time introducing potential hazards affecting the effectiveness of the Medical Imaging Department.

  16. Discrediting the Notion "Working with 'Crazies' Will Make You"Crazy"": Addressing Stigma and Enhancing Empathy in Medical Student Education

    Science.gov (United States)

    Cutler, Janis L.; Harding, Kelli J.; Mozian, Sharon A.; Wright, Leslie L.; Pica, Adrienne G.; Masters, Scott R.; Graham, Mark J.

    2009-01-01

    People with mental illness around the world continue to suffer from stigmatization and limited care. Previous studies utilizing self-report questionnaires indicate that many medical students regard clinical work with psychiatric patients as unappealing, while the professionalism literature has documented a general decline in students' capacity for…

  17. Effects of acute nicotine administration on behavioral and neural (EEG) correlates of working memory in non-smokers.

    Science.gov (United States)

    Fisher, Derek J; Daniels, Richelle; Jaworska, Natalia; Knobelsdorf, Amy; Knott, Verner J

    2012-01-06

    Enhancements in working memory (WM) performance have been previously reported following acute smoking/nicotine. Neuroimaging and behavioral assessments of nicotine's effects on WM have yielded inconsistent findings. Few studies, however, have examined the effects of nicotine on WM-related neural activity in non-smokers. The present study examined the effect of acute nicotine gum administration (6 mg) on electroencephalographic (EEG) activity (alpha(1), alpha(2) and theta bands) and performance on the parametrically manipulated N-back task of WM in 20 non-smoking adults. EEG activity varied with WM load (e.g. alpha(1) decreasing and theta increasing). Performance on the N-back was also load-sensitive, with slower reaction times and decreased accuracy associated with increasing memory load. Neither response speed nor accuracy measures were affected by nicotine but EEG was, with the effects varying by load and brain region. Nicotine-induced increases in alpha(2) and theta were observed under lower (0-, 1-back) memory load conditions Additionally, nicotine significantly reduced signal detection sensitivity values and altered response bias toward being more conservative at all levels of the N-back. Taken together, these findings suggest that while nicotine may boost WM neural processes at lower levels of WM load in non-smokers, it also may activate concurrent behavioral inhibition networks that negate any effects on behavioral performance. Additionally, nicotine appears to have no impact, or perhaps a negative impact, on these processes under more demanding (2-back, 3-back) conditions in non-smokers.

  18. Medication adherence in patients with hypertension: Does satisfaction with doctor-patient relationship work?

    Directory of Open Access Journals (Sweden)

    Ahmad Mahmoudian

    2017-01-01

    Full Text Available Background: It is assumed that doctor-patient relationship plays an effective role in patients' satisfaction, medication adherence, and health outcomes since exploring different aspects of this relationship, such as addressing medication adherence, has rarely been investigated. Therefore, the main aim of the present study was to assess the impact of patients' satisfaction derived from communicating with doctors on medication adherence in hypertensive patients. Materials and Methods: This cross-sectional survey was conducted on three hundred patients with hypertension, using multistage sampling technique in health care centers in Isfahan, Iran. Data were collected by two questionnaires comprised (1 patients' satisfaction derived from the relationship with doctors and (2 medication adherence named “Morisky Medication Adherence Scale” with 8 items. Multivariate logistic regression model was applied to test the odds ratio (OR of patients' satisfaction resulting from the relationship with physicians in numerous aspects in two groups: appropriate and inappropriate medication adherence. Results: A lower level of satisfaction derived from building the relationship (confidence interval [CI] =0.95, 0.06–0.71 and OR = 0.20 and empathy subscales (CI = 0.95, 13–0.80 and OR = 0.33 was associated with nonadherence to treatment after controlling the physicians' gender and patients' age, gender, education, and duration of disease. Conclusion: Patients' satisfaction resulting from building the relationship and empathy with physicians appeared to be associated with medication adherence among hypertensive patients.

  19. Medication adherence in patients with hypertension: Does satisfaction with doctor-patient relationship work?

    Science.gov (United States)

    Mahmoudian, Ahmad; Zamani, Ahmadreza; Tavakoli, Neda; Farajzadegan, Ziba; Fathollahi-Dehkordi, Fariba

    2017-01-01

    It is assumed that doctor-patient relationship plays an effective role in patients' satisfaction, medication adherence, and health outcomes since exploring different aspects of this relationship, such as addressing medication adherence, has rarely been investigated. Therefore, the main aim of the present study was to assess the impact of patients' satisfaction derived from communicating with doctors on medication adherence in hypertensive patients. This cross-sectional survey was conducted on three hundred patients with hypertension, using multistage sampling technique in health care centers in Isfahan, Iran. Data were collected by two questionnaires comprised (1) patients' satisfaction derived from the relationship with doctors and (2) medication adherence named "Morisky Medication Adherence Scale" with 8 items. Multivariate logistic regression model was applied to test the odds ratio (OR) of patients' satisfaction resulting from the relationship with physicians in numerous aspects in two groups: appropriate and inappropriate medication adherence. A lower level of satisfaction derived from building the relationship (confidence interval [CI] =0.95, 0.06-0.71 and OR = 0.20) and empathy subscales (CI = 0.95, 13-0.80 and OR = 0.33) was associated with nonadherence to treatment after controlling the physicians' gender and patients' age, gender, education, and duration of disease. Patients' satisfaction resulting from building the relationship and empathy with physicians appeared to be associated with medication adherence among hypertensive patients.

  20. 我院护理给药差错管理办法的实施与效果%The management of nursing errors in medication administration

    Institute of Scientific and Technical Information of China (English)

    霍世英; 黄叶莉; 朱荔

    2009-01-01

    Objective To control the underreport rate of nursing errors in medication administration and enhance patient safety. Methods A team for the man-agement of nursing errors in medication administration was set up to strengthen nurses' safety awareness, broaden the ways to report nursing errors, specify the re-wards and punishment regulations and evaluation criteria. Result This practice significantly increased the report rate of nursing errors in medication administra-tion (P<0.01). Conclusion Rational management regulations of nursing errors in medication administration can encourage the nurses and head nurses to re-port the errors voluntarily and promote the good circle of error management.%目的 有效控制护理给药差错的漏报率,提高住院病人的安全.方法 成立护理给药差错评定小组,强化护理人员的安全意识,扩充有效的给药差错报告渠道,细化奖惩细则及评价标准.结果 实施护理给药差错管理办法后,给药差错漏报率有明显降低,差异具有统计学意义(P<0.01).结论 合理的护理给药差错管理办法能激励当事人和科室管理者主动上报差错的发生情况,使护理给药差错管理纳入良性循环.

  1. Report from the Committee for Improving the Work Environment of Japanese Surgeons: survey on effects of the fee revision for medical services provided by surgeons.

    Science.gov (United States)

    Hanazaki, Kazuhiro; Tominaga, Ryuji; Nio, Masaki; Iwanaka, Tadashi; Okoshi, Kae; Kaneko, Koichi; Nagano, Hiroaki; Nishida, Takahiro; Nishida, Hiroshi; Hoshino, Ken; Maehara, Tadaaki; Masuda, Munetaka; Matsufuji, Hiroshi; Yanaga, Katsuhiko; Tabayashi, Koichi; Satomi, Susumu; Kokudo, Norihiro

    2013-11-01

    The aim of this study was to achieve improvements in the work environment of Japanese surgeons and shortage of surgeons. Questionnaires were distributed to selected Japanese surgical Society (JSS) members. Retrospective analysis was conducted comparing the current 2011 survey with previous 2007 survey. To examine the influence of 2010 revision of the fee for medical services performed by surgeons, we distributed a second questionnaire to directors of hospitals and administrators of clerks belonging to official institutes in JSS. Collective data were analyzed retrospectively. The main potential causes for the shortage of surgeons in Japan were long hours (72.8 %), excessive emergency surgeries (69.4 %), and high risk of lawsuit (67.7 %). Mean weekly working hours of surgeons in national or public university hospitals and private university hospitals were 96.2 and 85.6, respectively. Approximately 70 % of surgeons were forced to do hardworking tasks, possibly leading to death from overwork. Of note, approximately 25 % of surgeons had over time of more than 100 h a week, coinciding to the number of hours that might lead to death from fatigue, described in the Japanese labor law. Although the total medical service fee in hospitals, especially in large-scale hospitals with more than 500 beds, increased markedly after 2010 revision of the fee for medical services performed by surgeons, few hospitals gave perquisites and/or incentives to surgeons. To prevent and avoid collapse of the surgical specialty in Japan, an improvement in the work environment of surgeons by initiation of the JSS would be required as soon as possible.

  2. Medical work Assessment in German hospitals: a Real-time Observation study (MAGRO – the study protocol

    Directory of Open Access Journals (Sweden)

    Mache Stefanie

    2009-06-01

    Full Text Available Abstract Background The increasing economic pressure characterizes the current situation in health care and the need to justify medical decisions and organizational processes due to limited financial resources is omnipresent. Physicians tend to interpret this development as a decimation of their own medical influence. This becomes even more obvious after a change in hospital ownership i.e. from a public to a private profit oriented organization. In this case each work procedure is revised. To date, most research studies have focused mainly on differences between hospitals of different ownership regarding financial outcomes and quality of care, leaving important organizational issues unexplored. Little attention has been devoted to the effects of hospital ownership on physicians' working routines. The aim of this observational real time study is to deliver exact data about physicians' work at hospitals of different ownership. Methods The consequences of different management types on the organizational structures of the physicians' work situation and on job satisfaction in the ward situation are monitored by objective real time studies and multi-level psycho diagnostic measurements. Discussion This study is unique in its focus. To date no results have been found for computer-based real time studies on work activity in the clinical field in order to objectively evaluate a physician's work-related stress. After a complete documentation of the physicians' work processes the daily work flow can be estimated and systematically optimized. This can stimulate an overall improvement of health care services in Germany.

  3. The relationship between quality of work life and job satisfaction of faculty members in Zahedan University of Medical Sciences.

    Science.gov (United States)

    Kermansaravi, Fatihe; Navidian, Ali; Navabi Rigi, Shahindokht; Yaghoubinia, Fariba

    2014-10-29

    Quality of work life is one of the most important factors for human motivating and improving of job satisfaction. The current study was carried out aimed to determine the relationship between quality of work life and job satisfaction in faculty members of Zahedan University of Medical Sciences. In this descriptive-analytic study, 202 faculty members of Zahedan University of Medical Sciences in 2012 were entered the study through census. The job satisfaction questionnaire of Smith and Kendall and Walton Quality of Work Life questionnaire were used for data collection. Validity and reliability of questionnaires were confirmed in previous studies. Data analysis was done using SPSS 18. The Pearson correlation coefficient and multiple regression tests were used for data analysis. The mean score of quality of work life was 121/30±37/08 and job satisfaction was 135/98 ±33/78. There was a significant and positive correlation between job satisfaction of faculty members and their quality of work life (P=0.003). In addition, two components of quality of work life "adequate and fair compensation" (β=0.3) and "Social Integration" (β=0.4) can predict job satisfaction of faculty members. According to correlation between job satisfaction and quality of work life in faculty members, job satisfaction can be improved through the changing and manipulating the components of quality of work life and in this way; the suitable environment for organization development should be provided.

  4. Association of post-traumatic stress disorder and work performance: A survey from an emergency medical service, Karachi, Pakistan.

    Science.gov (United States)

    Kerai, Salima; Pasha, Omrana; Khan, Uzma; Islam, Muhammad; Asad, Nargis; Razzak, Junaid

    2017-01-01

    The purpose of the study was to explore the association between post-traumatic stress disorder (PTSD) and work performance of emergency medical services personnel in Karachi, Pakistan. Emergency medical service personnel were screened for potential PTSD using Impact of Event Scale-Revised (IES-R). Work performance was assessed on the basis of five variables: number of late arrivals to work, number of days absent, number of days sick, adherence to protocol, and patient satisfaction over a period of 3 months. In order to model outcomes like the number of late arrivals to work, days absent and days late, negative binomial regression was applied, whereas logistic regression was applied for adherence to protocol and linear for patient satisfaction scores. Mean scores of PTSD were 24.0±12.2. No association was found between PTSD and work performance measures: number of late arrivals to work (RRadj 0.99; 0.98-1.00), days absent (RRadj 0.98; 0.96-0.99), days sick (RRadj 0.99; 0.98-1.00), adherence to protocol (ORadj 1.01; 0.99-1.04) and patient satisfaction (β 0.001%-0.03%) after adjusting for years of formal schooling, living status, coping mechanism, social support, working hours, years of experience and anxiety or depression. No statistically significant association was found between PTSD and work performance amongst EMS personnel in Karachi, Pakistan.

  5. Student perception about working in rural Nepal after graduation: a study among first- and second-year medical students

    Directory of Open Access Journals (Sweden)

    Shankar P

    2012-08-01

    Full Text Available Abstract Background The Federal Democratic Republic of Nepal is a developing country in South Asia with a population of 29.8 million. In September 2011, there were 18 medical schools with 14 being in the private sector. KIST Medical College is a private school in Lalitpur district. The present study was conducted to obtain information on student perceptions about working in rural Nepal after graduation. Methods The study was conducted among first- and second-year undergraduate medical students using a semi-structured questionnaire developed by the authors using inputs from the literature and their experiences of teaching medical students. Year of study, gender, method of financing of medical education, place of family residence and occupation of parents were noted. Participant responses were analysed, grouped together and the number of respondents stating a particular response was noted. Results Of the 200 students, 185 (92.5% participated with 95 being from the first year and 90 from the second. Most students were self-financing and from urban areas. Regarding the question of working in rural Nepal after graduation, 134 (72.4% said they will work after their undergraduate course. Students preferred to work in the government or nongovernmental sector. Student felt doctors are reluctant to serve in rural Nepal due to inadequate facilities, low salary, less security, problems with their professional development, less equipment in health centres, decreased contact with family and difficulties in communicating with an illiterate, rural population. About 43% of respondents felt medical education does not adequately prepare them for rural service. Repeated rural exposure, postings in rural hospitals and health centres, and training students to diagnose and treat illness with less technology were suggested. The median monthly salary expected was 60 000 Nepalese rupees (US$ 820 and was significantly higher among first-year students. Conclusions The

  6. [The work of Moscow communities of Sisters of Charity in own medical institutions].

    Science.gov (United States)

    Zorin, K V

    2011-01-01

    The article analyses the medical activities of Moscow communities of Sisters of Charity in curative and educational institutions organized by the communities themselves. The social ministration of communities on the territory of Moscow is considered.

  7. Working on reform. How workers' compensation medical care is affected by health care reform.

    OpenAIRE

    Himmelstein, J; Rest, K

    1996-01-01

    The medical component of workers' compensation programs-now costing over $24 billion annually-and the rest of the nation's medical care system are linked. They share the same patients and providers. They provide similar benefits and services. And they struggle over who should pay for what. Clearly, health care reform and restructuring will have a major impact on the operation and expenditures of the workers' compensation system. For a brief period, during the 1994 national health care reform ...

  8. Design and evaluation of a multimodal mHealth based medication management system for patient self administration.

    Science.gov (United States)

    Schreier, Gunter; Schwarz, Mark; Modre-Osprian, Robert; Kastner, Peter; Scherr, Daniel; Fruhwald, Friedrich

    2013-01-01

    The intake of prescribed medication presents a challenge, in particular for elderly people and in cases where a variety of medications have to be taken in accordance to a complex schedule. To support patients with this task, an mHealth-concept was developed and evaluated in the course of a clinical trial. The system used a multimodal user interface concept, i.e. both RFID tags and barcodes to identify and document the intake of medications. Results of the clinical study with 20 patients indicate that the multimodal mHealth concept utilizing barcode and RFID tags enabled easy-to-use medication management. Although further clinical evaluation is needed to assess whether such a tool can also enhance adherence, the system shows the potential for targeting the problem of medication management with mHealth methods.

  9. 三级综合医院医学装备质量与安全管理指标探讨%Study on Indicators for Quality and Security Administration of Medical Devices in Grade III General Hospitals

    Institute of Scientific and Technical Information of China (English)

    郑理华; 何兴华; 陈宇珂; 丁效军

    2013-01-01

    按照三级综合医院医学装备管理要求,提出质量与安全管理6项指标:大型医疗设备配置许可证以及操作人员上岗证;医学装备管理信息档案完备性及设备标识唯一性;列入国家强检目录的医疗器械定期进行计量检测及计量检定证书有效性;用于急救、生命支持系统的医学装备完好率;医用耗材和试剂的管理指标;医疗器械不良事件监测指标。为顺利通过等级医院评审提供参考。%Six quality and security administration indicators were raised in this paper in accordance with requirements of medical devices management in Grade III general hospitals, which made a distinct deifnition of corresponding requirements and was of great reference value in classiifcation of hospitals in China. These indicators involved the permissions for large medical devices and the licenses for their operators;completeness of the medical devices history record and unique identiifcation for every device;regular calibration and inspection of medical devices listed in the national catalog of mandatory inspection and the certiifcates of calibrations and inspections;the work condition of the ifrst-aid and life supporting medical devices;management indicators of medical consumables and reagents;indicators for adverse event reports of medical devices.

  10. Injection device-related risk management toward safe administration of medications: experience in a university teaching hospital in The People's Republic of China.

    Science.gov (United States)

    Zhu, Ling-Ling; Li, Wei; Song, Ping; Zhou, Quan

    2014-01-01

    The use of injection devices to administer intravenous or subcutaneous medications is common practice throughout a variety of health care settings. Studies suggest that one-half of all harmful medication errors originate during drug administration; of those errors, about two-thirds involve injectables. Therefore, injection device management is pivotal to safe administration of medications. In this article, the authors summarize the relevant experiences by retrospective analysis of injection device-related near misses and adverse events in the Second Affiliated Hospital of Zhejiang University, School of Medicine, Zhejiang University, People's Republic of China. Injection device-related near misses and adverse events comprised the following: 1) improper selection of needle diameter for subcutaneous injection, material of infusion sets, and pore size of in-line filter; 2) complications associated with vascular access; 3) incidents induced by absence of efficient electronic pump management and infusion tube management; and 4) liquid leakage of chemotherapeutic infusion around the syringe needle. Safe injection drug use was enhanced by multidisciplinary collaboration, especially among pharmacists and nurses; drafting of clinical pathways in selection of vascular access; application of approaches such as root cause analysis using a fishbone diagram; plan-do-check-act and quality control circle; and construction of a culture of spontaneous reporting of near misses and adverse events. Pharmacists must be professional in regards to medication management and use. The depth, breadth, and efficiency of cooperation between nurses and pharmacists are pivotal to injection safety.

  11. Injection device-related risk management toward safe administration of medications: experience in a university teaching hospital in The People’s Republic of China

    Science.gov (United States)

    Zhu, Ling-ling; Li, Wei; Song, Ping; Zhou, Quan

    2014-01-01

    The use of injection devices to administer intravenous or subcutaneous medications is common practice throughout a variety of health care settings. Studies suggest that one-half of all harmful medication errors originate during drug administration; of those errors, about two-thirds involve injectables. Therefore, injection device management is pivotal to safe administration of medications. In this article, the authors summarize the relevant experiences by retrospective analysis of injection device-related near misses and adverse events in the Second Affiliated Hospital of Zhejiang University, School of Medicine, Zhejiang University, People’s Republic of China. Injection device-related near misses and adverse events comprised the following: 1) improper selection of needle diameter for subcutaneous injection, material of infusion sets, and pore size of in-line filter; 2) complications associated with vascular access; 3) incidents induced by absence of efficient electronic pump management and infusion tube management; and 4) liquid leakage of chemotherapeutic infusion around the syringe needle. Safe injection drug use was enhanced by multidisciplinary collaboration, especially among pharmacists and nurses; drafting of clinical pathways in selection of vascular access; application of approaches such as root cause analysis using a fishbone diagram; plan–do–check–act and quality control circle; and construction of a culture of spontaneous reporting of near misses and adverse events. Pharmacists must be professional in regards to medication management and use. The depth, breadth, and efficiency of cooperation between nurses and pharmacists are pivotal to injection safety. PMID:24669192

  12. [An a priori risk analysis study. Securisation of transfusion of blood product in a hospital: from the reception in the medical unit to its administration].

    Science.gov (United States)

    Bertrand, E; Lévy, R; Boyeldieu, D

    2013-12-01

    Following an ABO accident after transfusion of red blood cells, an a priori risk analysis study is being performed in a hospital. The scope of this analysis covers from the reception of the blood product in the medical unit to its administration. The risk analysis enables to identify the potentially dangerous situations and the evaluation of the risks in order to propose corrective measures (precautionary or protective) and bring the system back to an acceptable risk level. The innovative concept of an a priori risk analysis in the medical field allows the extension of the analysis of this transfusion risk to other hospitals. In addition, it allows the extension of the use of this approach to other medical fields.

  13. Occupationally Oriented Medical Rehabilitation and Hairdressers' Work Techniques--A one-and-a-half-year follow-up.

    Science.gov (United States)

    Arokoski; Nevala-Puranen; Danner; Halonen; Tikkanen

    1998-01-01

    This study examined changes in work techniques and musculoskeletal symptoms after occupationally oriented medical rehabilitation arranged for 21 hairdressers who were experiencing neck-shoulder or back pain but were still able to work. OWAS (Ovako Working Posture Analysing System) analyses of working postures and questionnaire data were obtained at the beginning of the courses and one and a half years later. The participants worked with their back bent and twisted or their arms at or over shoulder level more seldom (p <.0001) at the end of the follow-up than at the beginning of the rehabilitation. Subjective work-related physical and mental strain had decreased by 45.4% (p <.001) and 27.1% (p <.05), respectively, and subjective neck and back pain by 40.0% (p <.01) and 45.3% (p <.01), respectively. This study suggests that occupationally oriented medical rehabilitation can have significant and long-lasting effects on the rehabilitee's work techniques and subjective well-being.

  14. [Protective action figurations for superoxide dismutase - chondroitin sulfate - catalase bienzyme conjugate after its medicative administration in endotoxin shock].

    Science.gov (United States)

    Maksimenko, A V; Vavaeva, A V; Zvyagintseva, M A; Abramov, A A; Timoshin, A A; Vavaev, A V; Lakomkin, V L

    2016-03-01

    Previously it found that the bienzymatic conjugate superoxide dismutase-chondroitin sulfate, catalase (SOD-CHS-CAT) increased the survival rate of rats with endotoxic shock caused by the administration of lipopolysaccharide (LPS). This effect was observed both in preventive (before LPS) and therapeutic conjugate administration (after the administration of LPS). This study shows that the development of endotoxic shock is accompanied by increased levels of NO in the liver, lungs, kidneys, heart; administration of the SOD-CHS-CAT conjugate insignificantly influenced this parameter. At the same time, the changes in blood urea and creatinine suggest the protective effect of the conjugate on renal function, while diverse changes in biochemical parameters studied complicate the formation of the agreed conclusions on the state of other organs.

  15. Evaluating the Effect of a Policy Change to Hospital Productivity: 80 Hours Work Restriction on Medical Residents

    OpenAIRE

    Fernandez, Jose

    2006-01-01

    This paper uses a two-year panel dataset on hospitals from the American Hospital Association (AHA) to evaluate the effect a policy change has on the marginal product of medical residents. A weighted 2SLS approach is used to estimate a semi-parametric production function. A policy restricting medical residents to work no more than 80 hours a week is found to result in a net loss of 14 inpatient days per resident annually, which is not statistically different from zero. In addition, the mode...

  16. Evaluating the Effect of a Policy Change to Hospital Productivity: 80 Hours Work Restriction on Medical Residents

    OpenAIRE

    Fernandez, Jose

    2006-01-01

    This paper uses a two-year panel dataset on hospitals from the American Hospital Association (AHA) to evaluate the effect a policy change has on the marginal product of medical residents. A weighted 2SLS approach is used to estimate a semi-parametric production function. A policy restricting medical residents to work no more than 80 hours a week is found to result in a net loss of 14 inpatient days per resident annually, which is not statistically different from zero. In addition, the model p...

  17. Quality improvements in decreasing medication administration errors made by nursing staff in an academic medical center hospital: a trend analysis during the journey to Joint Commission International accreditation and in the post-accreditation era

    Directory of Open Access Journals (Sweden)

    Wang HF

    2015-03-01

    Full Text Available Hua-fen Wang,1 Jing-fen Jin,1 Xiu-qin Feng,1 Xin Huang,1 Ling-ling Zhu,2 Xiao-ying Zhao,3 Quan Zhou4 1Division of Nursing, 2Geriatric VIP Ward, Division of Nursing, 3Office of Quality Administration, 4Department of Pharmacy, the Second Affiliated Hospital of Zhejiang University, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People’s Republic of China Background: Medication errors may occur during prescribing, transcribing, prescription auditing, preparing, dispensing, administration, and monitoring. Medication administration errors (MAEs are those that actually reach patients and remain a threat to patient safety. The Joint Commission International (JCI advocates medication error prevention, but experience in reducing MAEs during the period of before and after JCI accreditation has not been reported. Methods: An intervention study, aimed at reducing MAEs in hospitalized patients, was performed in the Second Affiliated Hospital of Zhejiang University, Hangzhou, People’s Republic of China, during the journey to JCI accreditation and in the post-JCI accreditation era (first half-year of 2011 to first half-year of 2014. Comprehensive interventions included organizational, information technology, educational, and process optimization-based measures. Data mining was performed on MAEs derived from a compulsory electronic reporting system. Results: The number of MAEs continuously decreased from 143 (first half-year of 2012 to 64 (first half-year of 2014, with a decrease in occurrence rate by 60.9% (0.338% versus 0.132%, P<0.05. The number of MAEs related to high-alert medications decreased from 32 (the second half-year of 2011 to 16 (the first half-year of 2014, with a decrease in occurrence rate by 57.9% (0.0787% versus 0.0331%, P<0.05. Omission was the top type of MAE during the first half-year of 2011 to the first half-year of 2014, with a decrease by 50% (40 cases versus 20 cases. Intravenous administration error was the

  18. Determination of the Relationship between the Quality of Working Life and Tendency for Continuing Education in the Nurses working in Selected Hospitals of Isfahan Medical University

    Directory of Open Access Journals (Sweden)

    Maryam Javidmoghadam

    2016-07-01

    Full Text Available In the past, the main role of nurses was providing care and comfort during nursing duties. However, today due to the changes in the health-related systems, more emphasis is put on the health promotion, disease prevention, and paying attention to the patient as a whole and considering all of his aspects (holistic care. Therefore, in the current societies, the nurses play a more varied roles and professional responsibilities which are expanding in line with the changes in society. The working life quality is among the important and effective factors on the nurses' productivity. Also, regarding the high sensitivity of the health-care fields which are directly related to the human life, their education, knowledge, and working ability for better performing the duties is vital. The current study aimed at evaluation and investigation of the working life quality on the tendency to continue education in the nurses working in Isfahan Medical University. the current study is of descriptive - cross sectional bivariate correlation type conducted on 123 nurses working in four departments as internal medicine, surgery, emergency and intensive care in five hospitals as Al-Zahra, Amin, Ayatollah Kashani, Noor, and Ali Asghar (pbuh, which were under supervision of Isfahan Medical University. The data collection instrument was a questionnaire including the demographic information, working life quality, job satisfaction, and tendency to continue education. For data analysis, In addition to the descriptive statistical indicators (mean and standard deviation, the Chi Square test was also used for qualitative variables as well as paired sample t-test for comparison between the means of the two groups. All the analysis were performed in SPSS with the significance level 0.05.there is significant relationship between the nurses' education and their working life quality however there were no relationships between the years in service and marital status with people working

  19. Exploration of Teaching Work of Medical Colleges and Hospitals under the New Medical Reform%新医改形势下高等医学院校及附属医院教学工作探讨

    Institute of Scientific and Technical Information of China (English)

    孟晶莹

    2013-01-01

    新医改形势下,医院如何确保自身的发展,理顺教学工作任务,切实保证教学质量,在人才培养上顺应国家新医改政策要求,培养出具有创新精神的实用型、复合型的医学人才是摆在医院面前的重要问题.在对新形势下医院教学工作的现状和存在的问题予以分析和探讨的基础上,从健全教学管理机构、增强教学意识、构建教学质量管理体系、加强医院师资队伍建设、提高教学管理部门的管理水平和建立科学化、规范化的临床医学技能培训体系等方面提出合理建议.%With the new situation of medical reform, the vital issue we faced is that how to definite education task.guarantee for the teaching quality, cultivate practical and compound medical talents who should have initiative spirit,according to our country new medical reform policy, it is based on hospital developments to explore and analysis the current situation and problem of teaching works in the hospital with the new situation of medical reform. We give some reasonable suggestions such as perfecting teaching management organization,enhancing teaching consciousness, constructing the system of teaching quality management, strengthening construction teaching staff,improving management level in the teaching administrative department and establishing clinical medicine technique training system which should be in the scientification and standardization.

  20. Expanding Women's Rural Medical Work in Early Modern Brittany: The Daughters of the Holy Spirit

    Science.gov (United States)

    McHugh, Tim

    2012-01-01

    During the eighteenth century, orders of nursing sisters took on an expanded role in the rural areas of Brittany. This article explores the impact of religious change on the medical activities of these women. While limits were placed on the medical practice of unlicensed individuals, areas of new opportunity for nuns as charitable practitioners were created by devout nobles throughout the eighteenth century. These nuns provided comprehensive care for the sick poor on their patrons' estates, acting not only as nurses, but also in lieu of physicians, surgeons, and apothecaries. This article argues that the medical knowledge and expertise of these sisters from the nursing orders were highly valued by the elites of early modern Brittany. PMID:21724643

  1. Making multipayer reform work: what can be learned from medical home initiatives.

    Science.gov (United States)

    Takach, Mary; Townley, Charles; Yalowich, Rachel; Kinsler, Sarah

    2015-04-01

    Multipayer collaboratives of all types will encounter legal, logistical, and often political obstacles that multipayer medical home initiatives have already overcome. The seventeen multipayer medical home initiatives launched between 2008 and 2014 all navigated four critical decision-making points: convening stakeholders; establishing provider participation criteria; determining payment; and measuring performance. Although we observed trends toward voluntary payer participation and more flexible participation criteria for both payers and providers, initiatives continue to vary widely, each shaped largely by its insurance market and policy environment. Medical home initiatives across the United States are demonstrating that multipayer reform, although complex and difficult to implement, is feasible when committed stakeholders negotiate strategies that are responsive to the local context. Their experiences can inform, and perhaps expedite, negotiations in current and future multipayer collaborations.

  2. Expanding women's rural medical work in early modern Brittany: the Daughters of the Holy Spirit.

    Science.gov (United States)

    McHugh, Tim

    2012-07-01

    During the eighteenth century, orders of nursing sisters took on an expanded role in the rural areas of Brittany. This article explores the impact of religious change on the medical activities of these women. While limits were placed on the medical practice of unlicensed individuals, areas of new opportunity for nuns as charitable practitioners were created by devout nobles throughout the eighteenth century. These nuns provided comprehensive care for the sick poor on their patrons' estates, acting not only as nurses, but also in lieu of physicians, surgeons, and apothecaries. This article argues that the medical knowledge and expertise of these sisters from the nursing orders were highly valued by the elites of early modern Brittany.

  3. The effects of arts-in-medicine programming on the medical-surgical work environment

    Science.gov (United States)

    Sonke, Jill; Pesata, Virginia; Arce, Lauren; Carytsas, Ferol P.; Zemina, Kristen; Jokisch, Christine

    2015-01-01

    Background: Arts in medicine programs have significant impacts on patients and staff in long-term care environments, but the literature lacks evidence of effectiveness on hospital units with shorter average lengths of stay. Methods: The qualitative study used individual structured interviews to assess the impacts of arts programming on job satisfaction, stress, unit culture, support, quality of care, and patient outcomes on a short-term medical-surgical unit, and used a qualitative cross comparison grounded theory methodology to analyze data. Results: The study confirmed that arts programming can positively affect unit culture, nursing practice, and quality of care on short-stay medical-surgical units. Significant insights related to nursing practice and the art program were found, including that music can cause negative distraction for staff. Conclusions: While positive impacts of arts programming on the medical-surgical environment are clear, potential negative effects also need to be considered in the development of practice protocols for artists. PMID:25544861

  4. Frontline learning of medical teaching: "you pick up as you go through work and practice".

    Science.gov (United States)

    Hartford, W; Nimmon, L; Stenfors, T

    2017-09-19

    Few medical teachers have received formal teaching education. Along with individual and organizational barriers to participation in teacher training programs, increasing numbers and altered distribution of physicians away from major teaching centers have increased the difficulty of attendance. Furthermore, it is not known if traditional faculty development formats are the optimal learning options given findings from existing studies document both positive and negative outcomes. There is a gap in research that explores how medical teachers learn to teach and also limited research regarding how medical teachers actually teach. The purpose of this study was to provide insight into how physicians describe their teaching of trainees, and the nature of their teaching development and improvement to inform faculty development programs. Semi-structured interviews were conducted with 36 physicians, with a broad range of teaching experience, purposefully selected from five disciplines: Internal Medicine, Pediatrics, Psychiatry, Surgery, and Family Medicine. A qualitative, inductive approach was used to analyse the data. Teaching was described as being centered on the needs of individual trainees, but was dependent on patient presentation and environmental context. For this group of physicians learning to teach was perceived as a dynamic and evolving process influenced by multiple life experiences. The physicians had not learnt to teach through formal education and then put that learning into practice, but had learnt to teach and improve their teaching through their trial and errors teaching. Life experiences unconnected with the medical environment contributed to their knowledge of teaching along with limited formal learning to teach experiences. Teaching practice was influenced by peers and trainees, feedback, and observation. The findings suggest these medical teachers learn to teach along a continuum largely through their teaching practice. The findings suggested that the

  5. Administrative Circulars

    CERN Multimedia

    Département des Ressources humaines

    2004-01-01

    Administrative Circular N° 2 (Rev. 2) - May 2004 Guidelines and procedures concerning recruitment and probation period of staff members This circular has been revised. It cancels and replaces Administrative Circular N° 2 (Rev. 1) - March 2000. Administrative Circular N° 9 (Rev. 3) - May 2004 Staff members contracts This circular has been revised. It cancels and replaces Administrative Circular N° 9 (Rev. 2) - March 2000. Administrative Circular N° 26 (Rev. 4) - May 2004 Procedure governing the career evolution of staff members This circular has also been revised. It Administrative Circulars Administrative Circular N° 26 (Rev. 3) - December 2001 and brings up to date the French version (Rev. 4) published on the HR Department Web site in January 2004. Operational Circular N° 7 - May 2004 Work from home This circular has been drawn up. Operational Circular N° 8 - May 2004 Dealing with alcohol-related problems...

  6. Comparing the Effects of Yoga & Oral Calcium Administration in Alleviating Symptoms of Premenstrual Syndrome in Medical Undergraduates

    OpenAIRE

    Mehta Bharati

    2016-01-01

    Introduction: Medical undergraduates are heavily burdened by their curriculum. The females, in addition, suffer from vivid affective or somatic premenstrual syndrome (PMS) symptoms such as bloating, mastalgia, insomnia, fatigue, mood swings, irritability, and depression. The present study was proposed to attenuate the symptoms of PMS by simple lifestyle measures like yoga and/or oral calcium. Methods: 65 medical female students (18-22 years) with a...

  7. Comparison of Dental Caries Experience in Children Suffering From Epilepsy with and without Administration of Long Term Liquid Oral Medication.

    Science.gov (United States)

    Goyal, Ankita; Bhadravathi, Manjunath Chaluvaiah; Kumar, Adarsh; Narang, Ridhi; Gupta, Ambika; Singh, Harneet

    2016-06-01

    Sucrose is added as sweetening agent in liquid oral medication (LOM) to mask the acrid taste of medicines which may be potentially cariogenic. Many children under long term LOM therapy for treatment of epilepsy may be susceptible to dental caries. To assess and compare dental caries experience in children under long term liquid oral medication with those not under such medication among 2-12 years old children suffering from epilepsy. A cross-sectional study was undertaken on a total of 84 children aged 2-12 years, who were suffering from epilepsy receiving liquid oral medication for more than 3 months were selected (study group) and for comparison 106 children of similar age group and disease but on other forms of medication were included as control group. Dental caries was assessed using DMFT/DMFS (Decayed, Missing, Fillled Teeth / Surfaces), dmft/dft and dmfs/dfs indices. One-way ANOVA and t-test were used with p-value fixed at 0.05. Univariate logistic regression was applied. Children on LOM were at increased risk of dental caries than those with other forms of medications (OR: 2.55, 95% CI (2.37-4.15) p=0.000, HS). Caries prevalence was high in the study group (76.1%) when compared to control group (55.6%). Long term use of liquid medicines containing sucrose is a risk factor for dental caries among children with epilepsy.

  8. Comparison of Dental Caries Experience in Children Suffering From Epilepsy with and without Administration of Long Term Liquid Oral Medication

    Science.gov (United States)

    Bhadravathi, Manjunath Chaluvaiah; Kumar, Adarsh; Narang, Ridhi; Gupta, Ambika; Singh, Harneet

    2016-01-01

    Introduction Sucrose is added as sweetening agent in liquid oral medication (LOM) to mask the acrid taste of medicines which may be potentially cariogenic. Many children under long term LOM therapy for treatment of epilepsy may be susceptible to dental caries. Aim To assess and compare dental caries experience in children under long term liquid oral medication with those not under such medication among 2-12 years old children suffering from epilepsy. Materials and Methods A cross-sectional study was undertaken on a total of 84 children aged 2–12 years, who were suffering from epilepsy receiving liquid oral medication for more than 3 months were selected (study group) and for comparison 106 children of similar age group and disease but on other forms of medication were included as control group. Dental caries was assessed using DMFT/DMFS (Decayed, Missing, Fillled Teeth / Surfaces), dmft/dft and dmfs/dfs indices. One-way ANOVA and t-test were used with p-value fixed at 0.05. Univariate logistic regression was applied. Results Children on LOM were at increased risk of dental caries than those with other forms of medications (OR: 2.55, 95% CI (2.37-4.15) p=0.000, HS). Caries prevalence was high in the study group (76.1%) when compared to control group (55.6%). Conclusion Long term use of liquid medicines containing sucrose is a risk factor for dental caries among children with epilepsy. PMID:27504416

  9. Evaluating the Frequency of Errors in Preparation and Administration of Intravenous Medications in the Intensive Care Unit of Shahid-Sadoughi Hospital in Yazd

    Directory of Open Access Journals (Sweden)

    SeyedMojtaba Sohrevardi

    2015-10-01

    Full Text Available Background: In most Iranian hospitals, the nurses in the wards prepare intravenous (IV drugs and unfortunately pharmacists are not involved in this process. The severity of the patients in Intensive Care Unit (ICU heightens the risk of errors. More over the frequency of using IV drugs in this unit is high, so we decided to determine the frequency and types of errors, which occur in the preparation and administration of commonly, used IV medications in an ICU.Method: A prospective cross sectional study was performed from November 2013 to August 2014, in the intensive care unit in Shahid-Sadoughi hospital in Yazd. Medication errors occurred in the process of preparation and administration of IV drugs, were recorded by a pharmacy student and were evaluated by direct observation, according to the method established by Barker and McConnell.Results: A total number of 843 intravenous doses were evaluated. The most common type of error (34.26% was the injection of IV doses faster than the recommended rate followed by preparation (15.69%, administration (9.23% and compatibility with doctor’s order (6.24%. Amikacin was the most common drug involved in errors (41.67%. Most of errors were occurred at afternoon (8 p.m, 28.36%.Conclusion: According to our study the rate of errors in preparation and administration of IV drugs was high in this ICU. Employing more nurses, using developed medical instruments and clinical pharmacists can help to decrease these errors and improve the quality of patient care.

  10. Work Practice and Problem Discussion on Transferring High Quality Medical Resources to Grass-roots Medical Institutions%优质医疗资源下沉工作实践与问题探讨

    Institute of Scientific and Technical Information of China (English)

    陈扬波

    2015-01-01

    Objective To review the achievements and shortcomings of transferring high quality medical resources to grass-roots medical institutions for one year in Zhejiang Province and explore promotion methods.Methods Management and technical team from tertiary hospitals at the provincial and municipal level was regularly dispatched to county hospitals to execute administrative duties and provided support in terms of hospital management, medical quality, medical technology for six months or one year, which gives an all-round guidance by combining medical network service platform construction and information construction etc..Results Transferring high quality medical resources to grass-roots medical institutions has achieved remarkable economic and social benefits after one year's practice, but it also appeared some problems like difficulty in transferring funds and materials, passive attitude of mandated hospitals, employees' worry about interests and medical resource allocation imbalance etc..Conclusion Transferring high quality medical resources to grass-roots medical institutions is a bold innovation and the beneficial attempt for targeted aid work between urban and rural hospitals. To further promote the work, we must deepen the health care reform and accelerate the comprehensive reform of public hospitals.%目的回顾浙江省优质医疗资源下沉一年的成效和不足,探讨推进方法。方法由省市三级医院定期派遣管理技术团队并担任县级医院的行政职务,从医院管理、医疗质量、医疗技术等进行半年至一年的连续扶持,结合医疗网络服务平台构建、信息化建设等给予全方位的帮扶指导。结果优质医疗资源下沉工作一年,取得了显著的经济和社会效益,但也出现了财物下沉困难、被托管医院的被动性、职工对利益的担心、医疗资源配置新的不平衡等问题。结论优质医疗资源下沉是城乡医院对口支援工作的大胆创新和

  11. Working on reform. How workers' compensation medical care is affected by health care reform.

    Science.gov (United States)

    Himmelstein, J; Rest, K

    1996-01-01

    The medical component of workers' compensation programs-now costing over $24 billion annually-and the rest of the nation's medical care system are linked. They share the same patients and providers. They provide similar benefits and services. And they struggle over who should pay for what. Clearly, health care reform and restructuring will have a major impact on the operation and expenditures of the workers' compensation system. For a brief period, during the 1994 national health care reform debate, these two systems were part of the same federal policy development and legislative process. With comprehensive health care reform no longer on the horizon, states now are tackling both workers' compensation and medical system reforms on their own. This paper reviews the major issues federal and state policy makers face as they consider reforms affecting the relationship between workers' compensation and traditional health insurance. What is the relationship of the workers' compensation cost crisis to that in general health care? What strategies are being considered by states involved in reforming the medical component of workers compensation? What are the major policy implications of these strategies?

  12. Medical Secretaries and Electronic Patient Records: Invisible work and its future?

    DEFF Research Database (Denmark)

    Bossen, Claus

    2012-01-01

    SUMMARY: The upgrade plan for the new electronic patient record (EPR) was changed by the ITdepartment a few weeks after taking it into use. It was the first time for the Regional Hospital to implement a comprehensive EPR and unexpectedly medical secretaries, not performance, IT-bugs, or resistanc...

  13. Antecedents and consequences of work-home interference among medical residents

    NARCIS (Netherlands)

    Geurts, S.A.E.; Rutte, C.G.; Peeters, M.C.W.

    1999-01-01

    A cross-sectional field study is reported in which a comprehensive model of work–home interference (WHI) was developed and tested among 166 medical residents of an academic hospital in the Netherlands. It was hypothesized that WHI functions as a critical mediating pathway in the relationship between

  14. Mutual Recognition of the Food and Drug Administration and European Community Member State Conformity Assessment Procedures; pharmaceutical GMP inspection reports, medical device quality system evaluation reports, and certain medical device premarket evaluation reports--FDA. Proposed rule.

    Science.gov (United States)

    1998-04-10

    The Food and Drug Administration (FDA) is proposing to amend its regulations pursuant to an international agreement that is expected to be concluded between the United States and the European Community (EC) (Ref. 1). Under the terms of that agreement, FDA may normally endorse good manufacturing practice (GMP) inspection reports for pharmaceuticals provided by equivalent EC Member State regulatory authorities and medical device quality system evaluation reports and certain medical device premarket evaluation reports provided by equivalent conformity assessment bodies. FDA is taking this action to enhance its ability to ensure the safety and efficacy of pharmaceuticals and medical devices through more efficient and effective utilization of its regulatory resources. The agency is requesting comments on the proposed rule.

  15. Relationship between work - family conflict and marital satisfaction among nurses and midwives in hospitals of Zabol university of medical sciences

    Directory of Open Access Journals (Sweden)

    A. Mansouri

    2016-08-01

    Full Text Available Background: Work-family conflicts described as incompatibility between work and family roles. There is mutual relationship between marital satisfaction and job so that the tension in one of two areas of career and family are affected. Objective: To examine the relationship between marital satisfaction and work-family conflict among nurses and midwives. Methods: All of 289 employees of married nursing and midwifery of Zabol University of Medical Sciences hospitals participated in the study in 2014. The data were collected with questionnaires of Enrich marital satisfaction and Carlson work-family conflict and were analyzed with statistical tests including Pearson correlation coefficient, t-test and linear regression analysis. Findings: Marital satisfaction score of the staff was 168.52 which indicates the relative satisfaction of spouses from each other. The mean score of work-family conflict among employees was 3.26; it can be said that employees in terms of work-family conflict, the conflict a moderate experience. There is a significant negative correlation among marital satisfaction and work-family conflict of employees. In fact, marital satisfaction decreases when the conflict between work and family is decreased. Nursing staffs have a higher marital satisfaction and in terms of work-family conflict they experience less conflict. Conclusion: According to the findings, the managers should create conditions that minimize the role conflicts and consequently increase the level of marital satisfaction.

  16. Nurturing educational research at Dartmouth Medical School: the synergy among innovative ideas, support faculty, and administrative structures.

    Science.gov (United States)

    Nierenberg, David W; Carney, Patricia A

    2004-10-01

    In recent years, Dartmouth Medical School has increased its commitment to educational research within the school, and in collaboration with other schools across the country. Passionate faculty members with ideas and expertise in particular curricular areas are one critical component needed for a successful educational research program. Other components include an atmosphere that fosters research collaborations and mentoring, and various types of institutional support structures. This same model has effectively supported basic science and clinical research for decades. Because of the complexities involved in studying medical education, Dartmouth Medical School has invested in support structures for educational grant and manuscript development, financial support for pilot projects and partial salary support for investigators and key staff members, and other support targeted toward specific research projects. Ultimately, the goal is to use the results of the school's educational research projects to improve the curriculum through cycles of hypothesis development and testing, providing evidence for subsequent curricular change. When some research findings are relevant and applicable for use in other medical schools, that is an additional benefit of the educational research process. In this report, the authors describe the development of Dartmouth Medical School's infrastructure for supporting educational research, which has helped to accelerate the educational research productivity teaching faculty now enjoy. The authors also address some of the challenges that they anticipate in the near future.

  17. Using the Substance Abuse and Mental Health Services Administration (SAMHSA) Evidence-Based Practice Kits in Social Work Education

    Science.gov (United States)

    Myers, Laura L.; Wodarski, John S.

    2014-01-01

    In today's climate, it is becoming increasingly important to provide social work students with practice knowledge on research-supported social work interventions. CSWE has placed greater emphasis on using research-based knowledge to inform and guide social work practice, and the field has recognized the value of adhering to the evidence-based…

  18. Short-term glucocorticoid administration in patients with protracted and chronic gout arthritis. Part 2 — comparison of different medication forms efficacy

    Directory of Open Access Journals (Sweden)

    A A Fedorova

    2008-01-01

    Full Text Available Objective. To compare efficacy of different glucocorticoid (GC medication forms in protracted and chronic gout arthritis. Material and methods. 59 pts with tophaceous gout (crystal-verified diagnosis and arthritis of three and more joints lasting more than a months in spite of treatment with sufficient doses of nonsteroidal anti-inflammatory drugs were included. Median age of pts was 56 [48;63], median disease duration — 15,2 years [7,4;20], median swollen joint count at the examination — 8 [5; 11]. The patients were randomized into 2 groups. Methylprednisolone (MP 500 mg/day iv during 2 days and placebo im once was administered in one of them, betamethasone (BM 7 mg im once and placebo iv twice — in the other. Results. Number of pts with full resolution of arthritis, recurrent exacerbation, insufficient arthritis resolution or clinically insignificant response was comparable in both groups. More rapid decrease of pain at moving was achieved during the first 2-3 days after GC administration in pts with full resolution of arthritis (p=0,03 in group receiving MP in comparison with BM. At day 14 joint damage measures did not differ between groups. Conclusion. Efficacy of short-term glucocorticoid administration does not depend on mode of administration and GC medication form (methylprednisolone 500 mg/day iv during 2 days or betamethasone 7 mg im once.

  19. Descriptive Analysis of Medication Administration During Inpatient Cardiopulmonary Arrest Resuscitation (from the Mayo Registry for Telemetry Efficacy in Arrest Study).

    Science.gov (United States)

    Snipelisky, David; Ray, Jordan; Matcha, Gautam; Roy, Archana; Dumitrascu, Adrian; Harris, Dana; Bosworth, Veronica; Clark, Brooke; Thomas, Colleen S; Heckman, Michael G; Vadeboncoeur, Tyler; Kusumoto, Fred; Burton, M Caroline

    2016-05-15

    Advanced cardiovascular life support guidelines exist, yet there are variations in clinical practice. Our study aims to describe the utilization of medications during resuscitation from in-hospital cardiopulmonary arrest. A retrospective review of patients who suffered a cardiopulmonary arrest from May 2008 to June 2014 was performed. Clinical and resuscitation data, including timing and dose of medications used, were extracted from the electronic medical record and comparisons made. A total of 94 patients were included in the study. Patients were divided into different groups based on the medication combination used during resuscitation: (1) epinephrine; (2) epinephrine and bicarbonate; (3) epinephrine, bicarbonate, and calcium; (4) epinephrine, bicarbonate, and epinephrine drip; and (5) epinephrine, bicarbonate, calcium, and epinephrine drip. No difference in baseline demographics or clinical data was present, apart from history of dementia and the use of calcium channel blockers. The number of medications given was correlated with resuscitation duration (Spearman's rank correlation = 0.50, p <0.001). The proportion of patients who died during the arrest was 12.5% in those who received epinephrine alone, 30.0% in those who received only epinephrine and bicarbonate, and 46.7% to 57.9% in the remaining groups. Patients receiving only epinephrine had shorter resuscitation durations compared to that of the other groups (p <0.001) and improved survival (p = 0.003). In conclusion, providers frequently use nonguideline medications in resuscitation efforts for in-hospital cardiopulmonary arrests. Increased duration and mortality rates were found in those resuscitations compared with epinephrine alone, likely due to the longer resuscitation duration in the former groups. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Investigation of the Relationship Between Mental Health and Organizational Employees’ work Fatigue and Deputyships of Yasouj Medical Science University

    Directory of Open Access Journals (Sweden)

    A Mahmoodi

    2015-08-01

    Full Text Available Background & aim: Peoples’ mental health in improvement of society’s national and ideal aims have the main and most importance such as thriftiness in material and spiritual costs. Work fatigue is the result of severe decrease of person’s capabilities sources that counter with long –time stress, especially work stress. This study was designed with the aim of investigating the relationship between mental health and work fatigue at Yasuj University of Medical Sciences. Method of investigation: The present co-operation – descriptive study was conducted on 274 participants from 961 organization employees and deputyships of Yasuj University of Medical Sciences in 2013-2014 who were chosen randomly. In order to collect data, Maslach questionnaire of mental health condition and work fatigue was used. Data were analysed with statistical tests of the interconnection index Pearson and Friedman’s test. Findings: There was no significant relationship between mental health and work fatigue dimensions (p<0/05. A meaningful relationship was observed between studied models after usage. High attention and metamorphosis of personality had the least importance. Conclusion: When employees have full mental health and job satisfaction, the ability to achieve maximum efficiency in the organization is reachable.

  1. Knowledge of Staff Members of Residential Care Facilities for Individuals with Intellectual Disability on Medication Administration via Enteral Feeding Tube

    Science.gov (United States)

    Joos, E.; Mehuys, E.; Van Bocxlaer, J.; Remon, J. P.; Van Winckel, M.; Boussery, K.

    2016-01-01

    Background: Guidelines for the safe administration of drugs through enteral feeding tube (EFT) are an important tool to minimise the risk of errors. This study aimed to investigate knowledge of these guidelines among staff of residential care facilities (RCF) for people with ID. Method: Knowledge was assessed using a 13-item self-administered…

  2. Research on Standardization Work of Administration Examination and Approval%行政审批标准化工作初探

    Institute of Scientific and Technical Information of China (English)

    陈丽君; 黄娟; 陈思嘉

    2014-01-01

    Based on the standard work on administration examination and approval in Guangdong, this paper discusses the construction thinking and structure of standards system for administration examination and approval, the development of the standards and several considerations during standards implementation.%本文以广东省行政审批标准工作实践为基础,探讨了行政审批标准体系构建的思路、体系结构框架,行政审批标准研制及实施过程中的几点考虑。

  3. THE INFLUENCE OF STRESS CONNECTED WITH PROFESSIONAL WORK ON THE OCCURRENCE OF BURNOUT SYNDROME IN NURSES WORKING IN SURGICAL AND MEDICAL TREATMENT WARDS

    Directory of Open Access Journals (Sweden)

    Grażyna Nowak-Starz

    2013-11-01

    Full Text Available Nursing is one of the professions where chronic stress is an inseparable characteristic and stems from the very nature of the profession itself. The job of a nurse involves particular mental burdens. The source of these is another person, one who has most often found themselves in an extreme situation. A nurse carries out her/his duties in a state of strong and long-lasting emotional strain. Inappropriate coping with stress and a lack of support from others in difficult situations leads to the development of burnout syndrome. This syndrome not only lowers, to a great extent, the quality of performed work but also prevents nurses from further professional development. Aims : The aim of the following paper is to evaluate the influence of stress connected with the professional work of a nurse on the occurrence of burnout syndrome. Material and methodology : Research was conducted on a group of 103 nurses working at eight hospital wards (surgical and medical treatment at the District Hospital in Lipsko. The research tool was a questionnaire of the author’s own devise, which contained 34 questions. Results : Among the examined nurses, 90% concluded that their professional work has a negative impact on their family life and they pointed to their own occupational burnout. Nurses who carried negative emotions over from work to their homes significantly more often showed a lack of satisfaction from their job and signs of occupational burnout. A substantial percentage of the participants considered shift-work and the professional position held to be a detrimental factor in the process of occupational burnout. Conclusion : The nurses were to a large extent exposed to mental burdens having a negative impact on their work. The vast majority of the respondents felt satisfaction from their job but a significant percentage of the respondents admitted to suffering from symptoms of chronic stress and exhaustion, which may indicate a lack of any support from co

  4. Predicting medical specialists' working (long) hours: Testing a contemporary career model

    NARCIS (Netherlands)

    Pas, B.R.; Eisinga, R.N.; Doorewaard, J.A.C.M.

    2016-01-01

    With the feminization (in numbers) of several professions, changing gender role prescriptions regarding parenthood and an increased attention for work-life balance, career theorists recently addressed the need for a more contemporary career model taking a work-home perspective. In this study, we tes

  5. Predicting medical specialists' working (long) hours: Testing a contemporary career model

    NARCIS (Netherlands)

    Pas, B.R.; Eisinga, R.N.; Doorewaard, J.A.C.M.

    2016-01-01

    With the feminization (in numbers) of several professions, changing gender role prescriptions regarding parenthood and an increased attention for work-life balance, career theorists recently addressed the need for a more contemporary career model taking a work-home perspective. In this study, we

  6. Working toward decreasing infant mortality in developing countries through change in the medical curriculum

    Directory of Open Access Journals (Sweden)

    Zaman Iffat F

    2011-08-01

    Full Text Available Abstract Background High infant and maternal mortality rates are one of the biggest health issues in Pakistan. Although these rates are given high priority at the national level (Millennium Development Goals 4 and 5, respectively, there has been no significant decrease in them so far. We hypothesize that this lack of success is because the undergraduate curriculum in Pakistan does not match local needs. Currently, the Pakistani medical curriculum deals with issues in maternal and child morbidity and mortality according to Western textbooks. Moreover, these are taught disjointedly through various departments. We undertook curriculum revision to sensitize medical students to maternal and infant mortality issues important in the Pakistani context and educate them about ways to reduce the same through an integrated teaching approach. Methods The major determinants of infant mortality in underdeveloped countries were identified through a literature review covering international research produced over the last 10 years and the Pakistan Demographic Health Survey 2006-07. An interdisciplinary maternal and child health module team was created by the Medical Education Department at Shifa College of Medicine. The curriculum was developed based on the role of identified determinants in infant and maternal mortality. It was delivered by an integrated team without any subject boundaries. Students' knowledge, skills, and attitudes were assessed by multiple modalities and the module itself by student feedback using questionnaires and focus group discussions. Results Assessment and feedback demonstrated that the students had developed a thorough understanding of the complexity of factors that contribute to infant mortality. Students also demonstrated knowledge and skill in counseling, antenatal care, and care of newborns and infants. Conclusions A carefully designed integrated curriculum can help sensitize undergraduate medical students and equip them to

  7. A professional development model for medical laboratory scientists working in the immunohematology laboratory.

    Science.gov (United States)

    Garza, Melinda N; Pulido, Lila A; Amerson, Megan; Ali, Faheem A; Greenhill, Brandy A; Griffin, Gary; Alvarez, Enrique; Whatley, Marsha; Hu, Peter C

    2012-01-01

    Transfusion medicine, a section of the Department of Laboratory Medicine at The University of Texas MD Anderson Cancer Center is committed to the education and advancement of its health care professionals. It is our belief that giving medical laboratory professionals a path for advancement leads to excellence and increases overall professionalism in the Immunohematology Laboratory. As a result of this strong commitment to excellence and professionalism, the Immunohematology laboratory has instituted a Professional Development Model (PDM) that aims to create Medical Laboratory Scientists (MLS) that are not only more knowledgeable, but are continually striving for excellence. In addition, these MLS are poised for advancement in their careers. The professional development model consists of four levels: Discovery, Application, Maturation, and Expert. The model was formulated to serve as a detailed path to the mastery of all process and methods in the Immunohematology Laboratory. Each level in the professional development model consists of tasks that optimize the laboratory workflow and allow for concurrent training. Completion of a level in the PDM is rewarded with financial incentive and further advancement in the field. The PDM for Medical Laboratory Scientists in the Immunohematology Laboratory fosters personal development, rewards growth and competency, and sets high standards for all services and skills provided. This model is a vital component of the Immunohematology Laboratory and aims to ensure the highest quality of care and standards in their testing. It is because of the success of this model and the robustness of its content that we hope other medical laboratories aim to reach the same level of excellence and professionalism, and adapt this model into their own environment.

  8. The influence of factors of work environment and burnout syndrome on self-efficacy of medical staff.

    Science.gov (United States)

    Nowakowska, Iwona; Rasińska, Renata; Głowacka, Maria Danuta

    2016-06-02

    Conditions of a healthy, friendly and safe work environment and proper work organisation increase self-efficacy and decrease or eliminate the factors causing the occurrence of burnout symptoms, all of which have a decisive impact on increasing the quality of work. The aim of the study was to analyse and assess the influence of factors of work environment and burnout syndrome on the self-efficacy of medical staff. The study comprised randomly selected professionally-active nurses working on hospital wards (N=405) on the area of two provinces in Poland. The study used the Generalized Self-Efficacy Scale, Copenhagen Burnout Inventory and a questionnaire concerning the factors that influence the process of work organisation at nursing positions in hospitals. Lower scores for self-efficacy resulted in a worse assessment of development opportunities and promotion prospects (r=-0.11), participation in the decision-making process (r=-0.11) and teamwork (r=-0.10). Lower self-efficacy contributed to the occurrence of burnout symptoms r∈[-0.19 - -0.17]. Properly shaped and used organisational factors are stimulating for professional efficiency and effectiveness, and consequently, for the quality of nursing work. Negative assessment of the factors in the work environment contributes to the occurrence of burnout symptoms and decrease in self-efficacy. Nurses with lower self-efficacy more often experienced symptoms of burnout.

  9. Medical marijuana

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000899.htm Medical marijuana To use the sharing features on this ... have legalized marijuana for medical use. How Does Medical Marijuana Work? Medical marijuana may be: Smoked Vaporized ...

  10. Determinants of General Health, Work-Related Strain, and Burnout in Public Versus Private Emergency Medical Technicians in Istanbul.

    Science.gov (United States)

    Tunaligil, Verda; Dokucu, Ali Ihsan; Erdogan, Mehmet Sarper

    2016-07-01

    This study investigated the impact of working for public versus private ambulance services in Turkey and elaborated on predictors of mental, physical, and emotional well-being in emergency medical technicians (EMT-Bs). In this observational cross-sectional study, an 81-question self-report survey was used to gather data about employee demographics, socioeconomic status, educational background, working conditions, and occupational health and workplace safety (OHS), followed by the 12-item General Health Questionnaire (GHQ-12), the Work-Related Strain Inventory (WRSI), and the Maslach Burnout Inventory (MBI) with three subscales: Emotional Exhaustion (MBI-EE), Depersonalization (MBI-DP), and Diminished Personal Accomplishment (MBI-PA). In 2011, 1,038 EMT-Bs worked for publicly operated and 483 EMT-Bs worked for privately owned ambulance services in Istanbul, Turkey, of which 606 (58.4%) and 236 (48.9%) participated in the study (overall participation rate = 55.4%), respectively. On all scales, differences between total mean scores in both sectors were statistically insignificant (p > .05). In the public sector, work locations, false accusations, occupational injuries and diseases, work-related permanent disabilities, and organizational support were found to significantly influence self-reported perceptions of well-being (p work (p work-related permanent disabilities (p working lives that need improvement; priority expectations in the public and private sectors were higher earnings (17.5%; 16.7%) and better social opportunities (17.4%; 16.8%). Working conditions, vocational training, and OHS emerged as topics that merit priority attention.

  11. Medical procedures and outcomes of Japanese patients with trisomy 18 or trisomy 13: analysis of a nationwide administrative database of hospitalized patients.

    Science.gov (United States)

    Ishitsuka, Kazue; Matsui, Hiroki; Michihata, Nobuaki; Fushimi, Kiyohide; Nakamura, Tomoo; Yasunaga, Hideo

    2015-08-01

    The choices of aggressive treatment for trisomy 18 (T18) and trisomy 13 (T13) remain controversial. Here, we describe the current medical procedures and outcomes of patients with T18 and T13 from a nationwide administrative database of hospitalized patients in Japan. We used the database to identify eligible patients with T18 (n = 438) and T13 (n = 133) who were first admitted to one of 200 hospitals between July 2010 and March 2013. Patients were divided into admission at day trisomy received surgery and were then discharged home, but, of these, a considerable number required home medical care. This included home oxygen therapy, home mechanical ventilation, and tube feeding. These findings will be useful to clinicians or families who care for patients with T18 and T13.

  12. The ABCs of the FDA: A Primer on the Role of the United States Food and Drug Administration in Medical Device Approvals and IR Research.

    Science.gov (United States)

    Adamovich, Ashley; Park, Susie; Siskin, Gary P; Englander, Meridith J; Mandato, Kenneth D; Herr, Allen; Keating, Lawrence J

    2015-09-01

    The role of the US Food and Drug Administration (FDA) in medical device regulation is important to device-driven specialties such as interventional radiology. Whether it is through industry-sponsored trials during the approval process for new devices or investigator-initiated research prospectively evaluating the role of existing devices for new or established procedures, interaction with the FDA is an integral part of performing significant research in interventional radiology. This article reviews the potential areas of interface between the FDA and interventional radiology, as understanding these areas is necessary to continue the innovation that is the hallmark of this specialty.

  13. Learning from lives together: medical and social work students' experiences of learning from people with disabilities in the community.

    Science.gov (United States)

    Anderson, E S; Smith, R; Thorpe, L N

    2010-05-01

    The study aims to evaluate an interprofessional community-based learning event, focussing on disability. The learning opportunity was based on the Leicester Model of Interprofessional Education, organised around the experiences and perceptions of service users and their carers. Programme participants were drawn from medicine and social work education in Leicester, UK, bringing together diverse traditions in the care of people with disabilities. Small student groups (3-4 students) worked from one of the eight community rehabilitation hospitals through a programme of contact with people with disabilities in hospital, at home or in other community settings. The evaluation, in March 2005, used a mixed methods approach, incorporating questionnaire surveys, focus group interviews with students and feedback from service users. Responses were collated and analysed using quantitative and qualitative measures. Fifty social work and 100 medical students completed the first combined delivery of the module. The findings indicated that the merging of social work and medical perspectives appear to create some tensions, although overall the student experience was found to be beneficial. Service users (16 responses) valued the process. They were not concerned at the prospect of meeting a number of students at home or elsewhere and were pleased to think of themselves as educators. Problems and obstacles still anticipated include changing the mindset of clinicians and practising social workers to enable them to support students from each other's disciplines in practice learning. The generally positive outcomes highlight that disability focussed joint learning offers a meaningful platform for interprofessional education in a practice environment.

  14. Prescribing of psychotropic medications to the elderly population of a Canadian province: a retrospective study using administrative databases

    Directory of Open Access Journals (Sweden)

    Silvia Alessi-Severini

    2013-09-01

    Full Text Available Background. Psychotropic medications, in particular second-generation antipsychotics (SGAs and benzodiazepines, have been associated with harm in elderly populations. Health agencies around the world have issued warnings about the risks of prescribing such medications to frail individuals affected by dementia and current guidelines recommend their use only in cases where the benefits clearly outweigh the risks. This study documents the use of psychotropic medications in the entire elderly population of a Canadian province in the context of current clinical guidelines for the treatment of behavioural disturbances. Methods. Prevalent and incident utilization of antipsychotics, benzodiazepines and related medications (zopiclone and zaleplon were determined in the population of Manitobans over age 65 in the time period 1997/98 to 2008/09 fiscal years. Comparisons between patients living in the community and those living in personal care (nursing homes (PCH were conducted. Influence of sociodemographic characteristics on prescribing was assessed by generalized estimating equations. Non-optimal use was defined as the prescribing of high dose of antipsychotic medications and the use of combination therapy of a benzodiazepine (or zopiclone/zaleplon with an antipsychotic. A decrease in intensity of use over time and lower proportions of patients treated with antipsychotics at high dose or in combination with benzodiazepines (or zopiclone/zaleplon was considered a trend toward better prescribing. Multiple regression analysis determined predictors of non-optimal use in the elderly population. Results. A 20-fold greater prevalent utilization of SGAs was observed in PCH-dwelling elderly persons compared to those living in the community. In 2008/09, 27% of PCH-dwelling individuals received a prescription for an SGA. Patient characteristics, such as younger age, male gender, diagnoses of dementia (or use of an acetylcholinesterase inhibitor or psychosis in the

  15. Transformational leadership in medical practice: capturing and influencing principles-driven work.

    Science.gov (United States)

    Gabel, Stewart

    2012-01-01

    The importance of leadership in medicine is well recognized. Transformational leadership is a well-defined model that provides an empirically supported approach to foster organizational and personal change. It has been applied in health care settings with favorable outcomes. Transformational leadership is intended to help subordinates and followers transcend usual expectations of their own capabilities to reach higher levels of performance and personal meaning. The application of transformational leadership is appropriate to physicians in many roles, including to those who are supervisors in medical education or practice as team members in outpatient settings. Illustrations exemplify these points.

  16. Implementing medical information systems in developing countries, what works and what doesn't.

    Science.gov (United States)

    Fraser, Hamish Sf; Blaya, Joaquin

    2010-11-13

    Global Health Informatics is an emerging field, as demonstrated by several substantial and widely used electronic medical record (EMR) systems along with the emergence of mobile based or"mhealth" systems. We describe here many of the practical lessons we have learned from implementing systems in a wide range of challenging environments over the last decade. Some requirements, like data backups, skilled staff and local leadership are universally important. Others, such as limited power, poor network access and distributed populations, require different designs and strategies in resource poor environments.

  17. Implementing medical information systems in developing countries, what works and what doesn’t

    Science.gov (United States)

    Fraser, Hamish SF; Blaya, Joaquin

    2010-01-01

    Global Health Informatics is an emerging field, as demonstrated by several substantial and widely used electronic medical record (EMR) systems along with the emergence of mobile based or“mhealth” systems. We describe here many of the practical lessons we have learned from implementing systems in a wide range of challenging environments over the last decade. Some requirements, like data backups, skilled staff and local leadership are universally important. Others, such as limited power, poor network access and distributed populations, require different designs and strategies in resource poor environments. PMID:21346975

  18. Carbon dioxide as a potential danger to medical rescue teams at work - A case study.

    Science.gov (United States)

    Podlewski, Roland; Płotek, Włodzimierz; Grześkowiak, Małgorzata; Małkiewicz, Tomasz; Frydrysiak, Krystyna; Żaba, Zbigniew

    2017-02-28

    Medical rescue teams might be exposed to the risk of accidental poisoning while performing rescue procedures. Exposure to the risk of lethal carbon dioxide (CO2) concentrations is a rare situation. This case study describes rescuing a patient who suffered from sudden cardiac arrest due to accidental CO2 poisoning. The victim was finally evacuated and resuscitated, but the circumstances of the rescue operation point to the need to equip ambulances with carbon dioxide detectors and hermetic oxygen masks. Med Pr 2017;68(1):135-138.

  19. Many Can Work Better than the Best: Diagnosing with Medical Images via Crowdsourcing

    Directory of Open Access Journals (Sweden)

    Xian-Hong Xiang

    2014-07-01

    Full Text Available We study a crowdsourcing-based diagnosis algorithm, which is against the fact that currently we do not lack medical staff, but high level experts. Our approach is to make use of the general practitioners’ efforts: For every patient whose illness cannot be judged definitely, we arrange for them to be diagnosed multiple times by different doctors, and we collect the all diagnosis results to derive the final judgement. Our inference model is based on the statistical consistency of the diagnosis data. To evaluate the proposed model, we conduct experiments on both the synthetic and real data; the results show that it outperforms the benchmarks.

  20. Administrative circulars No. 22A (rev. 1) – Award of additional periods of membership in the Pensions Fund for long-term shift work and No. 22B (rev. 1) – Compensation for long-term shift work hours

    CERN Multimedia

    HR Department

    2011-01-01

    Administrative Circulars No. 22A (Rev. 1) entitled "Award of additional periods of membership in the Pension Fund for long-term shift work" and No. 22B (Rev.1) entitled “Compensation for long-term shift work hours”, adopted following discussion in the Standing Concertation Committee meeting of 21 September 2010 and entering into force on 1 March 2011, are available on the intranet site of the Human Resources Department: http://cern.ch/hr-docs/admincirc/admincirc.asp They cancel and replace Administrative Circulars No. 22A and 22B entitled "Award of additional periods of membership in the Pension Fund to shift workers (Early Departure)” and “Duration and special compensation for shift work” of January 2000. This new version clarifies, in particular, the compensation of effective long-term shift work hours. Department Head Office  

  1. A Study of the Effects of Educational and Administrative-Organizational Factors on the Students' Work Commitment

    Science.gov (United States)

    Liaghatdar, Mohammad Javad; Samiee, Fatemeh; Sadeghian, Alireza; Shafaie, Shokouh; Alikhani, Madineh; Hashemi, Bibi Vajiheh

    2012-01-01

    Work commitment in the organizations is a factor which leads to the development of discipline, sense of duty, morality, and improvement of human relationships at work. The existence of ethics in the organization, having commitment to the tasks and playing professional roles and behaviors in the best way and with no external control, cause inner…

  2. Perceptions of newly admitted undergraduate medical students on experiential training on community placements and working in rural areas of Uganda.

    Science.gov (United States)

    Kaye, Dan K; Mwanika, Andrew; Sekimpi, Patrick; Tugumisirize, Joshua; Sewankambo, Nelson

    2010-06-23

    Uganda has an acute problem of inadequate human resources partly due to health professionals' unwillingness to work in a rural environment. One strategy to address this problem is to arrange health professional training in rural environments through community placements. Makerere University College of Health Sciences changed training of medical students from the traditional curriculum to a problem-based learning (PBL) curriculum in 2003. This curriculum is based on the SPICES model (student-centered, problem-based, integrated, community-based and services oriented). During their first academic year, students undergo orientation on key areas of community-based education, after which they are sent in interdisciplinary teams for community placements. The objective was to assess first year students' perceptions on experiential training through community placements and factors that might influence their willingness to work in rural health facilities after completion of their training. The survey was conducted among 107 newly admitted first year students on the medical, nursing, pharmacy and medical radiography program students, using in-depth interview and open-ended self-administered questionnaires on their first day at the college, from October 28-30, 2008. Data was collected on socio-demographic characteristics, motivation for choosing a medical career, prior exposure to rural health facilities, willingness to have part of their training in rural areas and factors that would influence the decision to work in rural areas. Over 75% completed their high school from urban areas. The majority had minimal exposure to rural health facilities, yet this is where most of them will eventually have to work. Over 75% of the newly admitted students were willing to have their training from a rural area. Perceived factors that might influence retention in rural areas include the local context of work environment, support from family and friends, availability of continuing

  3. Perceptions of newly admitted undergraduate medical students on experiential training on community placements and working in rural areas of Uganda

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    Tugumisirize Joshua

    2010-06-01

    Full Text Available Abstract Background Uganda has an acute problem of inadequate human resources partly due to health professionals' unwillingness to work in a rural environment. One strategy to address this problem is to arrange health professional training in rural environments through community placements. Makerere University College of Health Sciences changed training of medical students from the traditional curriculum to a problem-based learning (PBL curriculum in 2003. This curriculum is based on the SPICES model (student-centered, problem-based, integrated, community-based and services oriented. During their first academic year, students undergo orientation on key areas of community-based education, after which they are sent in interdisciplinary teams for community placements. The objective was to assess first year students' perceptions on experiential training through community placements and factors that might influence their willingness to work in rural health facilities after completion of their training. Methods The survey was conducted among 107 newly admitted first year students on the medical, nursing, pharmacy and medical radiography program students, using in-depth interview and open-ended self-administered questionnaires on their first day at the college, from October 28-30, 2008. Data was collected on socio-demographic characteristics, motivation for choosing a medical career, prior exposure to rural health facilities, willingness to have part of their training in rural areas and factors that would influence the decision to work in rural areas. Results Over 75% completed their high school from urban areas. The majority had minimal exposure to rural health facilities, yet this is where most of them will eventually have to work. Over 75% of the newly admitted students were willing to have their training from a rural area. Perceived factors that might influence retention in rural areas include the local context of work environment, support from

  4. Willingness and professional motivations of medical students to work in rural areas: a study in Alexandria, Egypt

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    Aida M. Mohamed

    2013-03-01

    Full Text Available Retaining health workers in rural areas is challenging for a number of reasons, e.g. personal preferences, difficult work conditions and low remuneration. Our aim was to determine the effect of motivational factors on willingness to accept postings to rural underserved areas in Alexandria, Egypt and to identify perceived attributes of rural service.,A cross-sectional survey involving 302 4th-year medical students was conducted in March-July 2012. Logistic regression analysis was used to assess the association between students’ willingness to accept rural postings and their professional motivations, rural exposure and family parental professional and educational status (PPES. Perceived attributes to rural service were also assessed. Over 85% students were born in urban areas and 41.4% came from affluent backgrounds. More than half students reported strong intrinsic motivation to study medicine. After controlling for demographic characteristics and rural exposure, motivational factors significantly influenced willingness to practice in rural areas. High-family PPES was consistently associated with lower willingness to work in rural areas. A sizable portion of medical students are motivated to study and practice medicine in rural areas. Efforts should be made to build on motivation during medical training and designing rural postings, as well as favor lower PPES students for admission and improving organizational and contextual issues of rural service.

  5. Using an eye tracker during medication administration to identify gaps in nursing students' contextual knowledge: an observational study.

    Science.gov (United States)

    Amster, Brian; Marquard, Jenna; Henneman, Elizabeth; Fisher, Donald

    2015-01-01

    In this clinical simulation study using an eye-tracking device, 40% of senior nursing students administered a contraindicated medication to a patient. Our findings suggest that the participants who did not identify the error did not know that amoxicillin is a type of penicillin. Eye-tracking devices may be valuable for determining whether nursing students are making rule- or knowledge-based errors, a distinction not easily captured via observations and interviews.

  6. Perceptions of academic administrators of the effect of involvement in doctoral programs on faculty members' research and work-life balance.

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    Smeltzer, Suzanne C; Sharts-Hopko, Nancy C; Cantrell, Mary Ann; Heverly, Mary Ann; Wise, Nancy; Jenkinson, Amanda

    2017-05-10

    Support for research strongly predicts doctoral program faculty members' research productivity. Although academic administrators affect such support, their views of faculty members' use of support are unknown. We examined academic administrators' perceptions of institutional support and their perceptions of the effects of teaching doctoral students on faculty members' scholarship productivity and work-life balance. An online survey was completed by a random sample of 180 deans/directors of schools of nursing and doctoral programs directors. Data were analyzed with descriptive statistics, chi-square analysis, and analysis of variance. Deans and doctoral program directors viewed the level of productivity of program faculty as high to moderately high and unchanged since faculty started teaching doctoral students. Deans perceived better administrative research supports, productivity, and work-life balance of doctoral program faculty than did program directors. Findings indicate the need for greater administrative support for scholarship and mentoring given the changes in the composition of doctoral program faculty. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Comparing the Effects of Yoga & Oral Calcium Administration in Alleviating Symptoms of Premenstrual Syndrome in Medical Undergraduates

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    Mehta Bharati

    2016-09-01

    Full Text Available Introduction: Medical undergraduates are heavily burdened by their curriculum. The females, in addition, suffer from vivid affective or somatic premenstrual syndrome (PMS symptoms such as bloating, mastalgia, insomnia, fatigue, mood swings, irritability, and depression. The present study was proposed to attenuate the symptoms of PMS by simple lifestyle measures like yoga and/or oral calcium. Methods: 65 medical female students (18-22 years with a regular menstrual cycle were asked to self-rate their symptoms, along with their severity, in a validated questionnaire for two consecutive menstrual cycles. Fifty-eight students were found to have PMS. Twenty girls were given yoga training (45 minutes daily, five days a week, for three months. Another group of 20 was given oral tablets of calcium carbonate daily (500 mg, for three months and rest 18 girl served as control group. Data were analyzed by SPSS ver.13 software. Results: The yoga and calcium groups showed a significant decrease in number and severity of premenstrual symptoms whereas in the control group there was not the significant difference. Conclusion: Encouraging a regular practice of yoga or taking a tablet of calcium daily in the medical schools can decrease the symptoms of premenstrual syndrome.

  8. Comparing the Effects of Yoga & Oral Calcium Administration in Alleviating Symptoms of Premenstrual Syndrome in Medical Undergraduates.

    Science.gov (United States)

    Bharati, Mehta

    2016-09-01

    Introduction: Medical undergraduates are heavily burdened by their curriculum. The females, in addition, suffer from vivid affective or somatic premenstrual syndrome (PMS) symptoms such as bloating, mastalgia, insomnia, fatigue, mood swings, irritability, and depression. The present study was proposed to attenuate the symptoms of PMS by simple lifestyle measures like yoga and/or oral calcium. Methods: 65 medical female students (18-22 years) with a regular menstrual cycle were asked to self-rate their symptoms, along with their severity, in a validated questionnaire for two consecutive menstrual cycles. Fifty-eight students were found to have PMS. Twenty girls were given yoga training (45 minutes daily, five days a week, for three months). Another group of 20 was given oral tablets of calcium carbonate daily (500 mg, for three months) and rest 18 girl served as control group. Data were analyzed by SPSS ver.13 software. Results: The yoga and calcium groups showed a significant decrease in number and severity of premenstrual symptoms whereas in the control group there was not the significant difference. Conclusion: Encouraging a regular practice of yoga or taking a tablet of calcium daily in the medical schools can decrease the symptoms of premenstrual syndrome.

  9. Our medical work experience in a foreign country%国外医疗工作初体验

    Institute of Scientific and Technical Information of China (English)

    朱敏敏; 黄伟; 任国琴; 徐建国; 易利华

    2012-01-01

    通过在加拿大蒙特利尔犹太总医院访问、工作的实际感受,以重症监护室为例,详细介绍了国外医院重症监护室从人员配置、资源共享、医疗活动、医院管理等方面的所见所闻,以期对我们的工作有所借鉴和启示.%Based on our visit to Jewish General Hospital of Montreal, Canada, and experience of working there, as well as taking ICU for example, this paper makes a detailed introduction of ICU medical staff allocation, resources sharing, medical activities and hospital management so as to provide some reference for China.

  10. A transitional curriculum for preparing medical students for internship, does it work?

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    Mostafa Dehghani

    2013-01-01

    Full Text Available Background: In a formative evaluation, we were supposed to find whether an innovative program has some merits to be continued or not. We also determined the critical points of the program. The evaluated program was a clinical pre-clerkship curriculum launched for departing to a less stressful medical clerkship. Materials and Methods: We analyzed the information contained in the students′ logbooks. Using Dundee Ready Education Environment Measure standardized questionnaire, we also assessed the students′ perception of learning environment within six clinical departments. Results: Totally, 64% of expected patient contacts, and teaching of more than 71% of required skills at 4 departments were carried out and students had more positive than negative perspective of their learning environments. Conclusion: The evaluand is a worthwhile program to be continued, though it needs some considerations for improvement.

  11. Predicting medical specialists’ working (long) hours: testing a contemporary career model

    NARCIS (Netherlands)

    Pas, B.R.; Eisinga, R.; Doorewaard, J.A.C.M.

    2016-01-01

    With the feminization (in numbers) of several professions, changing gender role prescriptions regarding parenthood and an increased attention for work-life balance, career theorists recently addressed the need for a more contemporary career model taking a work–home perspective. In this study, we tes

  12. Predicting medical specialists’ working (long) hours: Testing a contemporary career model

    NARCIS (Netherlands)

    Pas, B.R.; Eisinga, R.; Doorewaard, J.A.C.M.

    2016-01-01

    With the feminization (in numbers) of several professions, changing gender role prescriptions regarding parenthood and an increased attention for work-life balance, career theorists recently addressed the need for a more contemporary career model taking a work–home perspective. In this study, we

  13. Life Works: Explore Health and Medical Science Careers | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... My favorite subjects in school were always science, sociology, and math. My interest in science was so well known that in high school, I was voted most likely to become a scientist. “What I like best about my work is that almost every day is different and ...

  14. Work-home interface stress: an important predictor of emotional exhaustion 15 years into a medical career.

    Science.gov (United States)

    Hertzberg, Tuva Kolstad; Rø, Karin Isaksson; Vaglum, Per Jørgen Wiggen; Moum, Torbjørn; Røvik, Jan Ole; Gude, Tore; Ekeberg, Øivind; Tyssen, Reidar

    2016-01-01

    The importance of work-home interface stress can vary throughout a medical career and between genders. We studied changes in work-home interface stress over 5 yr, and their prediction of emotional exhaustion (main dimension of burn-out), controlled for other variables. A nationwide doctor cohort (NORDOC; n=293) completed questionnaires at 10 and 15 yr after graduation. Changes over the period were examined and predictors of emotional exhaustion analyzed using linear regression. Levels of work-home interface stress declined, whereas emotional exhaustion stayed on the same level. Lack of reduction in work-home interface stress was an independent predictor of emotional exhaustion in year 15 (β=-0.21, p=0.001). Additional independent predictors were reduction in support from colleagues (β=0.11, p=0.04) and emotional exhaustion at baseline (β=0.62, pwork-home interface stress among women, and reduction of collegial support and lack of reduction in working hours among men. Thus, change in work-home interface stress is a key independent predictor of emotional exhaustion among doctors 15 yr after graduation. Some gender differences in predictors of emotional exhaustion were found.

  15. [The mad and the demented in the literary works of Cervantes: on Cervantes' sources of medical information about neuropsychiatry].

    Science.gov (United States)

    López-Muñoz, F; Alamo, C; García-García, P

    Throughout the writings of Cervantes, the lunatic or the madman (which allows for certain neurological pathologies, such as epilepsy) is a figure that appears over and over again, as a literary strategy that the author uses to express his own particular social criticism. This literary characterisation of insanity is endowed with a number of clinical connotations that suggest that Cervantes was quite familiar with certain elements of medicine; although such knowledge may well have come from relatives and friends, he also showed a personal interest in the mentally ill (there is evidence that he visited the Hospital de Inocentes--a mental asylum--in Seville). Likewise, it seems obvious that Cervantes was also familiar with several medical treatises concerning the neurosciences, which were very much in vogue in Spain in the late Renaissance period. In fact, his personal library included two works that, in addition to serving to inspire the Alcalá-born author on some points, are cited almost literally in some of his novels. These references are The Examination of Men's Wits, written by Juan Huarte de San Juan in 1575, and the annotated Spanish version of Dioscorides (On medical matters and mortal poisons) by Andrés Laguna, from 1555. Similarly, the clinical description of the main character in the novela ejemplar Vidriera, the Lawyer seems to have been taken from the medical tract Dignotio et cura affectuum melancholicorum (1569) by Alfonso de Santa Cruz. Lastly, it has also been suggested that, in the construction of his literature, Cervantes drew on the humanistic approaches advocated by Erasmus of Rotterdam in his In Praise of Folly (1509). These four works may have served as a source of medical information that allowed Cervantes to develop some of his characters and to write his accurate comments on therapeutic matters.

  16. Undergraduate Prosthodontics Students’ Knowledge of Working With Methyl Methacrylate at Shahid Sadoughi Medical University in 2014

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    Lotfikamran

    2016-06-01

    Full Text Available Background The toxicity of the methyl methacrylate monomer is an ongoing concern in dentistry. Therefore, those who are involved with this substance need to be cognizant of how to work with it. Objectives This study aimed to evaluate the level of working knowledge about methyl methacrylate among undergraduate prosthodontics students at Shahid Sadoughi university in 2014. Materials and Methods In this descriptive cross-sectional study, the knowledge level of 54 undergraduate prosthodontics students, who had passed the last 2 years of their education, was assessed via a 13-question survey related to methyl methacrylate. Each correct answer was assigned 2 points, and the total sum of right answers was used to measure the knowledge level of each participant. In order to analyze the study data, SPSS16 was used to apply an ANOVA test, t-test, and Pearson correlation coefficient. Results The mean level of individuals’ knowledge in regard to working with methyl methacrylate was 14.74 ± 5.03, with a domain variance of 0 to 22. A significant relationship was observed between age-related knowledge level mean and education level (P = 0.001, though no relationship was confirmed in regard to knowledge mean and gender (P < 0.286. Moreover, there was a reverse insignificant relationship between the students’ total average and their knowledge level (P = 0.715. Conclusions The study results demonstrated that undergraduate prosthodontics students in their last two years of study had an average knowledge of working with methyl methacrylate. Therefore, health education should focus more on working with dentistry substances, in order to enhance the knowledge level of the targeted students.

  17. Mifepristone followed by home administration of buccal misoprostol for medical abortion up to 70 days of amenorrhoea in a general practice in Curaçao.

    Science.gov (United States)

    Boersma, Adriana A; Meyboom-de Jong, Betty; Kleiverda, Gunilla

    2011-04-01

    To evaluate the efficacy and safety of home administration of buccal misoprostol after mifepristone for medical abortion up to 70 days' gestation in a general practice in Curaçao, where induced abortion is severely restricted by law. In a prospective study 330 women received 200 mg mifepristone and were instructed to take four tablets (800 μg) of misoprostol via the buccal route 24-36 h later, at home. One week later, follow-up took place. The outcome could be evaluated in 307 of the 330 women. The efficacy of the mifepristone-buccal misoprostol procedure was 97.7% (300/307). In seven women vacuum aspirations for continuing pregnancy or incomplete abortion following treatment were required. Success rates at 64-70 days' gestation were the same as for gestations of less than 64 days duration. The main adverse effects were nausea and diarrhoea. Home administration of buccal misoprostol 24-36 h after mifepristone is a safe and effective method of medical abortion up to 70 days. It could be applied in a general practice in Curaçao, where induced abortion is legally restricted.

  18. Validity of the days supply field in pharmacy administrative claims data for the identification of blister packaging of medications.

    Science.gov (United States)

    Leong, Christine; Sareen, Jitender; Leslie, William D; Enns, Murray W; Bolton, James; Alessi-Severini, Silvia; Katz, Laurence Y; Logsetty, Sarvesh; Snider, Carolyn; Berry, Jason; Prior, Heather J; Chateau, Dan

    2017-08-30

    Pharmacy claims data is often used in pharmacoepidemiology studies, but no studies to date have examined whether it was possible to identify the use of blister packs in these databases. We aimed to determine whether medications dispensed in days divisible by 7 are more likely to be blister packed than medications dispensed in other quantities. Community pharmacies in Manitoba were invited to participate in a mail-out survey to identify the use of blister packaging for up to 25 patients who had a solid oral medication dispensed from April 1, 2012 to March 31, 2014. Eligible medications were identified using the population-based province-wide retail pharmacy network. Algorithms for identifying the use of blister packaging were determined by comparing the proportion of fills that confirmed blister pack use between different days supply quantities. Twenty-seven out of 32 pharmacies that agreed to participate completed the survey. The total number of prescriptions in the analysis was 2045 of which 131 (6.4%) were dispensed in blister packaging. Overall, prescriptions dispensed in days divisible by 7 yielded a 72.5% sensitivity, 86.6% specificity, 30.3% PPV, and 97.9% NPV compared with prescriptions dispensed in other quantities. A 28-day to 30-day comparison yielded an 87.9% sensitivity, 96.1% specificity, 64.6% PPV, and 99.0% NPV. While the NPV was high, the PPV for identifying blister packaging using the days supply field in pharmacy claims data was modest given the low prevalence in blister pack use. The best predictor occurred when 28 days was compared with 30 days. KEY POINTS Blister packs are arranged in 4 × 7 compartments and are often used to improve adherence, but no studies have examined whether it was possible to identify the use of blister packs using the days supply field in pharmacy claims data. Findings show that a 28-day supply yielded a high sensitivity and specificity for identifying the use of blister packaging compared with a 30-day supply, but

  19. Estimated Lifetime Medical and Work-Loss Costs of Emergency Department-Treated Nonfatal Injuries--United States, 2013.

    Science.gov (United States)

    Florence, Curtis; Haegerich, Tamara; Simon, Thomas; Zhou, Chao; Luo, Feijun

    2015-10-02

    A large number of nonfatal injuries are treated in U.S. emergency departments (EDs) every year. CDC's National Center for Health Statistics estimates that approximately 29% of all ED visits in 2010 were for injuries. To assess the economic impact of ED-treated injuries, CDC examined injury data from the National Electronic Injury Surveillance System--All Injury Program (NEISS-AIP) for 2013, as well as injury-related lifetime medical and work-loss costs from the Web-Based Injury Statistics Query and Reporting System (WISQARS). NEISS-AIP collects data from a nationally representative sample of EDs, using specific guidelines for recording the primary diagnosis and mechanism of injury. Number of injuries, crude- and age-specific injury rates, and total lifetime work-loss costs and medical costs were calculated for ED-treated injuries, stratified by sex, age groups, and intent and mechanism of injury. ED-treated injuries were further classified as those that were subsequently hospitalized or treated and released. The rate of hospitalized injuries was 950.8 per 100,000, and the rate of treated and released injuries was 8,549.8 per 100,000. Combined medical and work-loss costs for all ED-treated injuries (both hospitalized and treated and released) were $456.9 billion, or approximately 68% of the total costs of $671 billion associated with all fatal and ED-treated injuries. The substantial economic burden associated with nonfatal injuries underscores the need for effective prevention strategies.

  20. Effect of Joint Commission International Accreditation on the Nursing Work Environment in a Tertiary Medical Center.

    Science.gov (United States)

    Kagan, Ilya; Farkash-Fink, Naomi; Fish, Miri

    2016-01-01

    How might a tertiary hospital's nursing staff respond to the huge improvement effort required for external accreditation if they are encouraged to lead the change process themselves? This article reports the results of a concurrent evaluation of the nursing work climate at ward level, before and after accreditation by the Joint Commission International. Physician-nurse relations improved; the involvement of social workers, dieticians, and physiotherapists increased; support services responded more quickly to requests; and management-line staff relations became closer.