WorldWideScience

Sample records for patient care technicians

  1. Job satisfaction and patient care practices of hemodialysis nurses and technicians.

    Science.gov (United States)

    Perumal, Seena; Sehgal, Ashwini R

    2003-10-01

    The quality of hemodialysis care has been the focus of intense scrutiny, yet little is known about the job satisfaction of the nurses and technicians providing this care. We identified 240 nurses and technicians from 307 randomly selected American facilities and asked them about (a) specific domains of job satisfaction, (b) overall job satisfaction, and (c) self-reported patient care practices. Fewer than half of nurses and technicians were satisfied with their pay or their opportunities for advancement. Almost all subjects were satisfied with their personal delivery of patient care, their chance to do things for others, and their job security. About three-fourths of nurses and technicians expressed overall satisfaction with their jobs. Higher job satisfaction was associated with increased attention to patient psychosocial and educational needs. We urge local and national associations of nurses and technicians to collaborate with dialysis facilities, chains, and regulatory agencies to address specific aspects of job satisfaction.

  2. Use of a pharmacy technician to facilitate postfracture care provided by clinical pharmacy specialists.

    Science.gov (United States)

    Irwin, Adriane N; Heilmann, Rachel M F; Gerrity, Theresa M; Kroner, Beverly A; Olson, Kari L

    2014-12-01

    The ability of a pharmacy technician to support the patient screening and documentation-related functions of a pharmacist-driven osteoporosis management service was evaluated. A two-phase prospective study was conducted within a large integrated health system to assess a pharmacy technician's performance in supporting a multisite team of clinical pharmacy specialists providing postfracture care. In phase I of the study, a specially trained pharmacy technician provided support to pharmacists at five participating medical offices, helping to identify patients requiring pharmacist intervention and, when applicable, collecting patient-specific clinical information from the electronic health record. In phase II of the study, the amount of pharmacist time saved through the use of technician support versus usual care was evaluated. The records of 127 patient cases were reviewed by the pharmacy technician during phase I of the study, and a pharmacist agreed with the technician's determination of the need for intervention in the majority of instances (92.9%). An additional 91 patient cases were reviewed by the technician in phase II of the research. With technician support, pharmacists spent less time reviewing cases subsequently determined as not requiring intervention (mean ± S.D., 5.0 ± 3.8 minutes per case compared with 5.2 ± 4.5 minutes under the usual care model; p = 0.78). In cases requiring intervention, technician support was associated with a reduction in the average pharmacist time spent on care plan development (13.5 ± 7.1 minutes versus 18.2 ± 16.6 minutes with usual care, p = 0.34). The study results suggest that a pharmacy technician can accurately determine if a patient is a candidate for pharmacist intervention and collect clinical information to facilitate care plan development. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  3. Clinical support role for a pharmacy technician within a primary care resource center.

    Science.gov (United States)

    Fera, Toni; Kanel, Keith T; Bolinger, Meghan L; Fink, Amber E; Iheasirim, Serah

    2018-02-01

    The creation of a clinical support role for a pharmacy technician within a primary care resource center is described. In the Primary Care Resource Center (PCRC) Project, hospital-based care transition coordination hubs staffed by nurses and pharmacist teams were created in 6 independent community hospitals. At the largest site, patient volume for targeted diseases challenged the ability of the PCRC pharmacist to provide expected elements of care to targeted patients. Creation of a new pharmacy technician clinical support role was implemented as a cost-effective option to increase the pharmacist's efficiency. The pharmacist's work processes were reviewed and technical functions identified that could be assigned to a specially trained pharmacy technician under the direction of the PCRC pharmacist. Daily tasks performed by the pharmacy technician included maintenance of the patient roster and pending discharges, retrieval and documentation of pertinent laboratory and diagnostic test information from the patient's medical record, assembly of patient medication education materials, and identification of discrepancies between disparate systems' medication records. In the 6 months after establishing the PCRC pharmacy technician role, the pharmacist's completion of comprehensive medication reviews (CMRs) for target patients increased by 40.5% ( p = 0.0223), driven largely by a 42.4% ( p technician to augment pharmacist care in a PCRC team extended the reach of the pharmacist and allowed more time for the pharmacist to engage patients. Technician support enabled the pharmacist to complete more CMRs and reduced the time required for chart reviews. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  4. Effects of Patient Care Unit Design and Technology on Nurse and Patient Care Technician Communication.

    Science.gov (United States)

    Beck, Mary S; Doscher, Mindy

    2018-04-01

    The current study described RN and patient care technician (PCT) communication in centralized and hybrid decentralized workstation designs using hands-free communication technology and infrared locator badge technology to facilitate communication. New construction of an oncology unit provided the opportunity to compare staff communication in two different workstation designs. Observations and questionnaires compared nurse and PCT communication in the two-unit designs. Descriptive statistics were used to analyze the differences. The hybrid decentralized unit had increased use of hands-free communication technology and hallway communication by nurses and PCTs, and increased patient room communication by nurses. Perceptions of communication between nurses and PCTs and congruency of priorities for care were similar for both units. The locator badge technology had limited adoption. Replacement of nurse workstations with new construction or remodeling impact staff communication patterns, necessitating that nurse leaders understand the impact of design and technology on communication. [Journal of Gerontological Nursing, 44(4), 17-22.]. Copyright 2018, SLACK Incorporated.

  5. The Iowa new practice model: Advancing technician roles to increase pharmacists' time to provide patient care services.

    Science.gov (United States)

    Andreski, Michael; Myers, Megan; Gainer, Kate; Pudlo, Anthony

    Determine the effects of an 18-month pilot project using tech-check-tech in 7 community pharmacies on 1) rate of dispensing errors not identified during refill prescription final product verification; 2) pharmacist workday task composition; and 3) amount of patient care services provided and the reimbursement status of those services. Pretest-posttest quasi-experimental study where baseline and study periods were compared. Pharmacists and pharmacy technicians in 7 community pharmacies in Iowa. The outcome measures were 1) percentage of technician verified refill prescriptions where dispensing errors were not identified on final product verification; 2) percentage of time spent by pharmacists in dispensing, management, patient care, practice development, and other activities; 3) the number of pharmacist patient care services provided per pharmacist hours worked; and 4) percentage of time that technician product verification was used. There was no significant difference in overall errors (0.2729% vs. 0.5124%, P = 0.513), patient safety errors (0.0525% vs. 0.0651%, P = 0.837), or administrative errors (0.2204% vs. 0.4784%, P = 0.411). Pharmacist's time in dispensing significantly decreased (67.3% vs. 49.06%, P = 0.005), and time in direct patient care (19.96% vs. 34.72%, P = 0.003), increased significantly. Time in other activities did not significantly change. Reimbursable services per pharmacist hour (0.11 vs. 0.30, P = 0.129), did not significantly change. Non-reimbursable services increased significantly (2.77 vs. 4.80, P = 0.042). Total services significantly increased (2.88 vs. 5.16, P = 0.044). Pharmacy technician product verification of refill prescriptions preserved dispensing safety while significantly increasing the time spent in delivery of pharmacist provided patient care services. The total number of pharmacist services provided per hour also increased significantly, driven primarily by a significant increase in the number of non

  6. Are further education opportunities for emergency care technicians ...

    African Journals Online (AJOL)

    Background. A recent review of emergency care education and training in South Africa resulted in the creation of a new 2-year, 240-credit National Qualifications Framework (NQF) level 6 Emergency Care Technician (ECT) qualification. The National Department of Health (NDoH) view ECTs as 'mid-level workers' in the ...

  7. Oral health technicians in Brazilian primary health care: potentials and constraints.

    Science.gov (United States)

    Aguiar, Dulce Maria Lucena de; Tomita, Nilce Emy; Machado, Maria de Fátima Antero Sousa; Martins, Cleide Lavieri; Frazão, Paulo

    2014-07-01

    Different perspectives on the role of mid-level workers in health care might represent a constraint to health policies. This study aimed to investigate how different agents view the participation of oral health technicians in direct activities of oral healthcare with the goal of understanding the related symbolic dispositions. Theoretical assumptions related to inter-professional collaboration and conflicts in the field of healthcare were used for this analysis. A researcher conducted 24 in-depth interviews with general dental practitioners, oral health technicians and local managers. The concepts of Pierre Bourdieu supported the data interpretation. The results indicated inter-professional relations marked by collaboration and conflict that reflect an action space related to different perspectives of primary care delivery. They also unveiled the symbolic devices related to the participation of oral health technicians that represent a constraint to the implementation of oral health policy, thus reducing the potential of primary health care in Brazil.

  8. From frustration to coping with caring for death by nurse technicians.

    Science.gov (United States)

    Beraldo, Lívia Maria; de Almeida, Débora Vieira; Bocchi, Silvia Cristina Mangini

    2015-01-01

    to understand nurse technicians' experience with caring for the death of terminal patients in ICUs and to configure a theoretical model. qualitative study with theoretical saturation when analyzing the 10th non-directive interview, having as reference Grounded Theory, Symbolic Interactionism and Bioethics. the core category - from frustration to coping with dignified nursing care for finitude: the acceptance of death as a therapeutic and intervenient component - emerged from the comparison of the sub-processes: when the nurse does not feel prepared for caring for death, accepting death as a therapeutic phenomenon and developing coping strategies. according to Symbolic Interactionism, a novice professional's frustration in caring for an individual for death is related to his/her interaction and interpretation of the situation as he/she feels prepared only to care for individuals for life.

  9. Best possible medication history for hemodialysis patients obtained by a pharmacy technician.

    Science.gov (United States)

    Leung, Marianna; Jung, Joanne; Lau, Wynnie; Kiaii, Mercedeh; Jung, Beverly

    2009-09-01

    Outpatients undergoing hemodialysis are at high risk for adverse drug events. Limited resources make it challenging for pharmacists to routinely obtain a best possible medication history (BPMH). The primary objective was to determine whether, for patients undergoing hemodialysis, a pharmacy technician has the skills to obtain a BPMH that would allow a pharmacist to identify drug-related problems. The secondary objectives were to determine the number and types of medication discrepancies and drug-related problems identified and the time required by the technician to complete the BPMH. All patients treated in the hemodialysis unit during the study period were included, except for those who required an interpreter or were unable to participate in an in-person interview. A single technician was taught how to interview patients according to a structured format. For each patient, the technician's BMPH was verified by a pharmacist. The agreement rate between technician and pharmacists was determined, along with the number and types of discrepancies and drug-related problems identified. The technician interviewed 99 patients. Of the 1334 medication orders reviewed, the technician and pharmacists agreed on all but 15 (agreement rate 98.9%). A total of 358 medication discrepancies were noted for 93 patients (3.8 discrepancies per patient). Of these, 210 (59%) were undocumented intentional discrepancies, and 148 (41%) were unintentional discrepancies (most commonly errors of commission). Of the 135 drug-related problems identified, the majority involved dosing problems or nonadherence. The technician required an average of 17 min for each interview. An adequately trained technician was capable of interviewing patients to create a BPMH. A variety of medication discrepancies and drug-related problems were identified. Generation of a BPMH by a technician is a useful approach allowing pharmacists to identify drug-related problems.

  10. Data analyst technician: an innovative role for the pharmacy technician.

    Science.gov (United States)

    Ervin, K C; Skledar, S; Hess, M M; Ryan, M

    2001-10-01

    The development of an innovative role for the pharmacy technician is described. The role of the pharmacy technician was based on a needs assessment and the expertise of the pharmacy technician selected. Initial responsibilities of the technician included chart reviews, benchmarking surveys, monthly financial impact analysis, initiative assessment, and quality improvement reporting. As the drug-use and disease-state management (DUDSM) program expanded, pharmacist activities increased, requiring the expansion of data analyst technician (DAT) duties. These new responsibilities included participation in patient assessment, data collection and interpretation, and formulary enforcement. Most recently, technicians' expanded duties include maintenance of a physician compliance profiling database, quality improvement reporting and graphing, active role in patient risk assessment and database management for adult vaccination, and support of financial impact monitoring for other institutions within the health system. This pharmacist-technician collaboration resulted a threefold increase in patient assessments completed per day. In addition, as the DUDSM program continues to expand across the health system, an increase in DAT resources from 0.5 to 1.0 full-time equivalent was obtained. The role of the DAT has increased the efficiency of the DUDSM program and has provided an innovative role for the pharmacy technician.

  11. Patient- and Technician-Oriented Attitudes Toward Transcranial Magnetic Stimulation Devices.

    Science.gov (United States)

    Lonergan, Brady; Nguyen, Eliza; Lembo, Cara; Hinchman, Carrie; Morales, Oscar G; Press, Daniel Z; Pascual-Leone, Alvaro; Stern, Adam P

    2018-01-25

    Four transcranial magnetic stimulation (TMS) devices are currently approved for use in treatment-resistant depression. The authors present the first data-driven study examining the patient- and technician-experience using three of these distinct devices. A retrospective survey design with both patient and technician arms was utilized. The study population included patients who received TMS for treatment-resistant depression at the Berenson Allen Center for Noninvasive Brain Stimulation for the first time between 2013 and 2016 and technicians who worked in the program from 2009 to 2017. Statistical analysis included t tests and analyses of variance to assess differences between and across the multiple groups, respectively. Patients treated with the NeuroStar device reported greater confidence that the treatment was being performed correctly compared with those treated with the Magstim device. Conversely, with regard to tolerability, patients treated with the Magstim device reported less pain in the last week and less pain on average compared with those treated with the NeuroStar device. On average, technicians reported feeling that both the Magstim and NeuroStar devices were significantly easier to use than the Brainsway Deep TMS H-Coil device. Additionally, they found the former two devices to be more reliable and better tolerated. Furthermore, the technicians reported greater confidence in the Magstim and NeuroStar devices compared with the Brainsway Deep TMS H-Coil device and indicated that they would be more likely to recommend the two former devices to other treatment centers.

  12. [Competencies in the education of nursing technicians to implement the nursing care systematization].

    Science.gov (United States)

    da Cruz, Andrea de Mello Pereira; Almeida, Miriam de Abreu

    2010-12-01

    This is a qualitative, exploratory and descriptive study whose general objective was to learn, considering the perspective of the nursing technician who works in school hospitals, the competencies developed during their educational process to implement the Nursing Care Systematization (NCS). Data collection and analysis were carried out through a focal group, with content analysis and nursing technicians. Two thematic categories emerged: The participation of the nursing technician in the NCS and The competencies in the education of the nursing technician. Each one received two subcategories: Conception of the NCS and (De)valuation of the NCS, Technical-scientific competency and Competency in the interpersonal relationship, respectively. It was observed that the NCS must be shared, discussed and made public among nursing professionals, so that they may acknowledge themselves as the leading actors of their methodology and be aware that their practices determine the results.

  13. Improving job satisfaction and enlarging the role of technicians.

    Science.gov (United States)

    Spooner, S H; Britton, M E; Erskine, L M; Verschoor, B A; Williams, P A

    1991-01-01

    The process used in preparing this administrative report provided the means of documenting departmental support of technician task expansion, cost benefits, increased availability of professional time, and the need for a dynamic department. Some of the benefits to St. Luke's Regional Medical Center and its Pharmacy Department were an increase in technician job satisfaction, improved quality of patient care attributable to the increased scope of pharmacy service, and up to 8554 hours per year of professional time available for more clinically oriented responsibilities. If technician turnover were decreased by half, technician pricing errors eliminated, and technicians assumed the identified technical tasks, potential monetary benefits could be as much as +116,900 per year. The departmental cost of implementing these recommendations would be an additional 4.16 technician FTEs, and the professional time for training, supervising, and coordinating technicians and functions. These recommendations were well received by pharmacy administration, and the committee was asked to develop a list of priorities and an implementation plan for administrative approval.

  14. [Role of the technician in a brachytherapy department].

    Science.gov (United States)

    Bélot-Cheval, V; Lemoine, L; Cuisinier, C; Gensse, M-C; Lasbareilles, O

    2013-04-01

    The role of the technician in a brachytherapy department is essential for the cohesion of the treatment team made up of the radiation oncologist, the physicist, and the technician. He/she collaborates in the different treatment steps such as taking care of the patients, training of the professionals and research studies in collaboration with the team. He participates in all steps of the treatment such as preparation, technician's consultation, catheters/templates and radioactives sources implant, dose distribution analysis and treatment. He looks after the management of planning, radioactive sources and chemist's equipments. He takes part in the training of the junior technician, and support doctors and physicists in different studies. The procedure writing and the presentation of professional practices are also part of the technician task. Copyright © 2013 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  15. Development and Evaluation of a Continuing Education Program for Nursing Technicians at a Pediatric Cardiac Intensive Care Unit in a Developing Country.

    Science.gov (United States)

    Borim, Bruna Cury; Croti, Ulisses A; Silveira, Patricia C; De Marchi, Carlos H; Moscardini, Airton C; Hickey, Patricia; Jenkins, Kathy

    2017-11-01

    The nursing profession faces continuous transformations demonstrating the importance of professional continuing education to extend knowledge following technological development without impairing quality of care. Nursing assistants and technicians account for nearly 80% of nursing professionals in Brazil and are responsible for uninterrupted patient care. Extensive knowledge improvement is needed to achieve excellence in nursing care. The objective was to develop and evaluate a continuing education program for nursing technicians at a pediatric cardiac intensive care unit (PCICU) using a virtual learning environment entitled EDUCATE. From July to September 2015, a total of 24 nursing technicians working at the PCICU at a children's hospital located in the northwestern region of São Paulo state (Brazil) fully participated in the continuing education program developed in a virtual learning environment using Wix platform, allowing access to video classes and pre- and post-training theoretical evaluation questionnaires outside the work environment. The evaluation tools recorded participants' knowledge evolution, technological difficulties, educational, and overall rating. Knowledge development was descriptively presented as positive in more than 66.7%. Content and training were considered "excellent" by most participants and 90% showed an interest in the use of technological resources. Technical difficulties were found and quickly resolved by 40% of participants including Internet access, login, and lack of technical expertise. The continuing education program using a virtual learning environment positively contributed to the improvement in theoretical knowledge of nursing technicians in PCICU.

  16. Intraoperative monitoring technician: a new member of the surgical team.

    Science.gov (United States)

    Brown, Molly S; Brown, Debra S

    2011-02-01

    As surgery needs have increased, the traditional surgical team has expanded to include personnel from radiology and perfusion services. A new surgical team member, the intraoperative monitoring technician, is needed to perform intraoperative monitoring during procedures that carry a higher risk of central and peripheral nerve injury. Including the intraoperative monitoring technician on the surgical team can create challenges, including surgical delays and anesthesia care considerations. When the surgical team members, including the surgeon, anesthesia care provider, and circulating nurse, understand and facilitate this new staff member's responsibilities, the technician is able to perform monitoring functions that promote the smooth flow of the surgical procedure and positive patient outcomes. Copyright © 2011 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  17. [Intersubjectivity in Mental Health care: narratives of nursing technicians at a Psychosocial Care Center].

    Science.gov (United States)

    Campos, Rosana Onocko; Baccari, Ivana Preto

    2011-04-01

    Psychosocial Care Centers (Caps) were established as a result of the demand for Mental Health care and were an attempt to update psychiatric treatment for those afflicted with severe mental disorders. This article seeks to analyze subjective repercussions of work conducted in Caps on mid-level professionals and to contribute to healthcare planning. Two focal groups were conducted with workers of a Caps III. The methodology applied to the analysis was based on the critical hermeneutical approach proposed by Ricoeur and espoused by Gadamerian philosophy. Lack of appreciation in the workplace was revealed as being the main cause of suffering. Several themes stood out including the difficulty of obtaining the cooperation of users'; relatives, the tenuous interconnection between Caps and the health network, the attribution of responsibility for the night shift, controversies regarding overnight-stay patients and an excessive workload. Adequate structural planning and institutional organization is proposed when opening new Caps in order to reduce the workload of technicians and improve the clinical performance of the team.

  18. Establishing a clinical pharmacy technician at a United States Army military treatment facility.

    Science.gov (United States)

    Evans, Jennifer L; Gladd, Ellen M; Gonzalez, Alicia C; Tranam, Salman; Larrabee, Joni M; Lipphardt, Sarah E; Chen, Tina T; Ronn, Michael D; Spain, John

    2016-01-01

    To describe the creation of a clinical pharmacy technician position within the U.S. Army and to identify the personal skills and characteristics required to meet the demands of this role. An outpatient military treatment facility located in Maryland. The clinical pharmacy technician position was designed to support clinical pharmacy services within a patient-centered medical home. Funding and a position description were established to hire a clinical pharmacy technician. Expected duties included administrative (45%), patient education (30%), and dispensing (25%). Local policy, in accordance with federal law and U.S. Army regulations, was developed to define the expanded technician responsibility to deliver patient medication education. In the initial 3 months, the clinical pharmacy technician spent 24 hours per week on clinical activities, affording an additional 10-15 hours per week for clinical pharmacists to provide patient care. Completed consults increased from 41% to 56%, and patient-pharmacist encounters increased from 240 to 290 per month. The technician, acting as a clinical pharmacist extender, also completed an average of 90 patient encounters independently each month. As a result of these improvements, the decision was made to hire a second technician. Currently, the technicians spend 28-40 hours per week on clinical activities, offsetting an average of 26 hours per week for the clinical pharmacists. A patient-centered medical home clinical pharmacy technician can reduce the administrative workload for clinical pharmacists, improve their efficiency, and enhance the use of clinical pharmacy services. Several characteristics, particularly medication knowledge, make pharmacy technicians particularly suited for this role. The results from the implementation of a clinical pharmacy technician at this military treatment facility resulted in an Army-wide expansion of the position and suggested applicability in other practice sites, particularly in federal

  19. Clinical Experience and Learning Style of Flight Nurse and Aeromedical Evacuation Technician Students.

    Science.gov (United States)

    De Jong, Marla J; Dukes, Susan F; Dufour, Karey M; Mortimer, Darcy L

    2017-01-01

    The clinical experience and preferred learning style of U.S. Air Force flight nurses and aeromedical evacuation technicians are unknown. Using a cross-sectional survey design, we gathered data regarding the clinical experience, level of comfort providing clinical care, and preferred learning style of 77 active duty (AD), Air Force Reserve (AFR), and Air National Guard (ANG) nurses enrolled in the U.S. Air Force School of Aerospace Medicine Flight Nurse course, and 121 AD, AFR, and ANG medical technicians enrolled in the Aeromedical Evacuation Technician course. Nurses and medical technicians reported 7.6 ± 5.5 and 3.9 ± 4.5 yr of experience, respectively. AD, AFR, and ANG nurses had comparable years of experience: 5.8 ± 3.2, 8.3 ± 6.6, and 7.9 ± 4.2 yr, respectively; however, AD medical technicians had more years of experience (5.6 ± 4.4 yr) than AFR (3.1 ± 4.8 yr) and ANG (1.9 ± 2.8 yr) medical technicians. Both nurses and medical technicians reported infrequently caring for patients with various disease processes and managing equipment or devices that they will routinely encounter when transporting patients as an aeromedical evacuation clinician. Nurses and medical technicians preferred a kinesthetic learning style or a multimodal learning style that included kinesthetic learning. Nearly all (99%) nurses and 97% of medical technicians identified simulation as their preferred teaching method. These findings confirm faculty concerns regarding the clinical experience of flight nurse and aerospace evacuation technician students.De Jong MJ, Dukes SF, Dufour KM, Mortimer DL. Clinical experience and learning style of flight nurse and aeromedical evacuation technician students. Aerosp Med Hum Perform. 2017; 88(1):23-29.

  20. Expectations and final evaluation of complete dentures by patients, dentist and dental technician.

    Science.gov (United States)

    Marachlioglou, C R M Z; Dos Santos, J F F; Cunha, V P P; Marchini, Leonardo

    2010-07-01

    There is a poor association between the dentist's evaluation of denture quality and patients' satisfaction with their dentures. Possible differences between dental professionals and patients' expectations might help explain differences in outcome evaluations. This study compared scores given by a dentist, a dental technician and patients for their expectations before and their final evaluation after complete dentures treatment. Twenty completely edentulous patients, a prosthodontist and a dental technician provided scores for the expected aesthetic and functional results of their dentures based on a visual analogue scale at baseline. Post-treatment completion ratings were given after adjustments, by dentist and patients. The dental technician provided post-treatment completion ratings after completing the dentures. The patients had higher expectations than the dental technician and the dentist perceived for both aesthetic and function (P < 0.001). The patients also presented higher post-treatment completion ratings than the dental professionals perceived for final aesthetics (P = 0.016, Kendall's W = 0.207) and function (P = 0.002, Kendall's W = 0.303). Only the dentist presented a statistically significant difference between expectations (lower) and final (higher) outcomes for aesthetics (P = 0.017) and function (P = 0.003). There was no correlation between expectations and post-treatment completion ratings according to the patients' age. There was also no correlation between the patients' gender and expectation scores. Patients presented higher expectations regarding their dentures than dental professionals. The dentist believed that dentures would bring fewer benefits than patients did, but his perception of denture benefits post-treatment was significantly higher than his expectations.

  1. [The speech therapist in geriatrics: caregiver, technician-researcher, or both?].

    Science.gov (United States)

    Orellana, Blandine

    2015-01-01

    Geriatric care mostly consists not in curingthe patient, but supportingthem to the end of their life, giving meaning to care procedures and actions through speech, touch or look and maintaining a connection.The helping relationship is omnipresent and the role of the speech therapist is therefore essential in helping to maintain or re-establish elderly patients' abilityto communicate. However, todaythis role is struggling to define itself between that of the technician-researcher and that of caregiver.

  2. Human resource management in patient-centered pharmaceutical care.

    Science.gov (United States)

    White, S J

    1994-04-01

    Patient-centered care may have the pharmacists and technicians reporting either directly or in a matrix to other than pharmacy administration. The pharmacy administrative people will need to be both effective leaders and managers utilizing excellent human resource management skills. Significant creativity and innovation will be needed for transition from departmental-based services to patient care team services. Changes in the traditional methods of recruiting, interviewing, hiring, training, developing, inspiring, evaluating, and disciplining are required in this new environment.

  3. Emergency Victim Care. A Training Manual for Emergency Medical Technicians. Module 14. Appendix I: Communicating with Deaf and Hearing Impaired Patients. Appendix II: Medical Terminology. Appendix III: EMS Organizations. Appendix IV: Legislation (Ohio). Glossary of Terms. Index. Revised.

    Science.gov (United States)

    Ohio State Dept. of Education, Columbus. Div. of Vocational Education.

    This training manual for emergency medical technicians, one of 14 modules that comprise the Emergency Victim Care textbook, contains appendixes, a glossary, and an index. The first appendix is an article on communicating with deaf and hearing-impaired patients. Appendix 2, the largest section in this manual, is an introduction to medical…

  4. Outbreak of hepatitis C virus infection associated with narcotics diversion by an hepatitis C virus-infected surgical technician.

    Science.gov (United States)

    Warner, Amy E; Schaefer, Melissa K; Patel, Priti R; Drobeniuc, Jan; Xia, Guoliang; Lin, Yulin; Khudyakov, Yury; Vonderwahl, Candace W; Miller, Lisa; Thompson, Nicola D

    2015-01-01

    Drug diversion by health care personnel poses a risk for serious patient harm. Public health identified 2 patients diagnosed with acute hepatitis C virus (HCV) infection who shared a common link with a hospital. Further investigation implicated a drug-diverting, HCV-infected surgical technician who was subsequently employed at an ambulatory surgical center. Patients at the 2 facilities were offered testing for HCV infection if they were potentially exposed. Serum from the surgical technician and patients testing positive for HCV but without evidence of infection before their surgical procedure was further tested to determine HCV genotype and quasi-species sequences. Parenteral medication handling practices at the 2 facilities were evaluated. The 2 facilities notified 5970 patients of their possible exposure to HCV, 88% of whom were tested and had results reported to the state public health departments. Eighteen patients had HCV highly related to the surgical technician's virus. The surgical technician gained unauthorized access to fentanyl owing to limitations in procedures for securing controlled substances. Public health surveillance identified an outbreak of HCV infection due to an infected health care provider engaged in diversion of injectable narcotics. The investigation highlights the value of public health surveillance in identifying HCV outbreaks and uncovering a method of drug diversion and its impacts on patients. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

  5. Pharmacy technician-to-pharmacist ratios: a state-driven safety and quality decision.

    Science.gov (United States)

    Bess, D Todd; Carter, Jason; DeLoach, Lindsey; White, Carol L

    2014-01-01

    To discuss the policy of pharmacy technician-to-pharmacist ratios by comparing Florida as an example of legislative-led authority versus Tennessee as an example of board of pharmacy-led ruling. Over the past 2 years, the Florida legislature has debated the issue of pharmacy staffing ratios, initially leaving the Florida Board of Pharmacy with little authority to advocate for and enact safe technician staffing ratios. Anticipating this situation, the Tennessee Board of Pharmacy created rules to meet pharmacy staffing needs while protecting the authority of the pharmacist-in-charge and promoting patient safety. Before enacting rules, members of the board toured the state and talked about proposed rule changes with pharmacists. The final rule sets the pharmacy technician-to-pharmacist ratio at 2:1 but permits a 4:1 ratio based on public safety considerations and availability of at least two Certified Pharmacy Technicians. Pharmacists and leaders within the profession should conduct further research on appropriate and safe ratios of pharmacy technicians to pharmacists, with a focus on safety and quality of care.

  6. Introducing a checking technician allows pharmacists to spend more time on patient-focused activities.

    Science.gov (United States)

    Napier, Patti; Norris, Pauline; Braund, Rhiannon

    2018-04-01

    Internationally there is an increasing focus on the clinical and cognitive services that pharmacists can provide. Lack of time has been identified as a barrier to pharmacists increasing their clinical activities. Within the pharmacy workplace there are many tasks that can only be performed by a pharmacist. The final accuracy check of a dispensed prescription is currently the sole responsibility of pharmacists in New Zealand. This takes up a significant amount of time during a pharmacist's work day. The introduction of a checking technician role has been suggested to allow pharmacists more time to do more patient focused work. To investigate the amount of time pharmacy staff spend on specific activities and to establish whether the introduction of a checking technician into twelve pilot sites increased the amount of time that the pharmacists could spend on patient focused activities. This study utilised a self-reported work sampling technique in twelve pilot sites, selected from both the hospital and community settings. Work sampling using an electronic device was conducted at two time-points (before the implementation of a Pharmacy Accuracy Checking Technician (PACT) role and when the PACT was in place). Data was collected at 10 min intervals for the period of five days, a working week. Tasks were grouped into patient focused, dispensing and personal activities. The introduction of the PACT into the pilot sites saw a mean increase of 19% in pharmacists' patient focused activities and a mean 20% decrease in dispensing activities. The introduction of a checking technician role into New Zealand pharmacies demonstrated the potential to provide pharmacists with more time to spend on patient focused activities. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Medication reconciliation by a pharmacy technician in a mental health assessment unit.

    Science.gov (United States)

    Brownlie, Kay; Schneider, Carl; Culliford, Roger; Fox, Chris; Boukouvalas, Alexis; Willan, Cathy; Maidment, Ian D

    2014-04-01

    Medication discrepancies are common when patients cross organisational boundaries. However, little is known about the frequency of discrepancies within mental health and the efficacy of interventions to reduce discrepancies. To evaluate the impact of a pharmacy-led reconciliation service on medication discrepancies on admissions to a secondary care mental health trust. In-patient mental health services. Prospective evaluation of pharmacy technician led medication reconciliation for admissions to a UK Mental Health NHS Trust. From March to June 2012 information on any unintentional discrepancies (dose, frequency and name of medication); patient demographics;and type and cause of the discrepancy was collected. The potential for harm was assessed based on two scenarios; the discrepancy was continued into primary care, and the discrepancy was corrected during admission. Logistic regression identified factors associated with discrepancies. Mean number of discrepancies per admission corrected by the pharmacy technician. Unintentional medication discrepancies occurred in 212 of 377 admissions (56.2 %). Discrepancies involving 569 medicines (mean 1.5 medicines per admission) were corrected.The most common discrepancy was omission(n = 464). Severity was assessed for 114 discrepancies. If the discrepancy was corrected within 16 days the potential harm was minor in 71 (62.3 %) cases and moderate in 43(37.7 %) cases whereas if the discrepancy was not corrected the potential harm was minor in 27 (23.7 %) cases and moderate in 87 (76.3 %) cases. Discrepancies were associated with both age and number of medications; the stronger association was age. Medication discrepancies are common within mental health services with potentially significant consequences for patients.Trained pharmacy technicians are able to reduce the frequency of discrepancies, improving safety.

  8. Deriving a Framework for a Systems Approach to Agitated Patient Care in the Emergency Department.

    Science.gov (United States)

    Wong, Ambrose H; Ruppel, Halley; Crispino, Lauren J; Rosenberg, Alana; Iennaco, Joanne D; Vaca, Federico E

    2018-05-01

    The rising agitated patient population presenting to the emergency department (ED) has caused increasing safety threats for health care workers and patients. Development of evidence-based strategies has been limited by the lack of a structured framework to examine agitated patient care in the ED. In this study, a systems approach from the patient safety literature was used to derive a comprehensive theoretical framework for addressing ED patient agitation. A mixed-methods approach was used with ED staff members at an academic site and a community site of a regional health care network. Participants consisted of resident and attending physicians, physician assistants/nurse practitioners, nurses, technicians, and security officers. After a simulated agitated patient encounter to prime participants, uniprofessional and interprofessional focus groups were conducted, followed by a structured thematic analysis using a grounded theory approach. Quantitative data consisted of surveys of violence exposure and attitudes toward patient aggression and management. Data saturation was reached with 57 participants. Violence exposure was higher for technicians, nurses, and officers. Conflicting priorities and management challenges occurred due to four main interconnected elements: perceived complex patient motivations; a patient care paradox between professional duty and personal safety; discordant interprofessional dynamics mitigated by respect and trust; and logistical challenges impeding care delivery and long-term outcomes. Using a systems approach, five interconnected levels of ED agitated patient care delivery were identified: patient, staff, team, ED microsystem, and health care macrosystem. These care dimensions were synthesized to form a novel patient safety-based framework that can help guide future research, practice, and policy. Copyright © 2018 The Joint Commission. Published by Elsevier Inc. All rights reserved.

  9. Outbreak of hepatitis C virus infection associated with narcotics diversion by an hepatitis C virus–infected surgical technician

    Science.gov (United States)

    Warner, Amy E.; Schaefer, Melissa K.; Patel, Priti R.; Drobeniuc, Jan; Xia, Guoliang; Lin, Yulin; Khudyakov, Yury; Vonderwahl, Candace W.; Miller, Lisa; Thompson, Nicola D.

    2015-01-01

    Background Drug diversion by health care personnel poses a risk for serious patient harm. Public health identified 2 patients diagnosed with acute hepatitis C virus (HCV) infection who shared a common link with a hospital. Further investigation implicated a drug-diverting, HCV-infected surgical technician who was subsequently employed at an ambulatory surgical center. Methods Patients at the 2 facilities were offered testing for HCV infection if they were potentially exposed. Serum from the surgical technician and patients testing positive for HCV but without evidence of infection before their surgical procedure was further tested to determine HCV genotype and quasi-species sequences. Parenteral medication handling practices at the 2 facilities were evaluated. Results The 2 facilities notified 5970 patients of their possible exposure to HCV, 88% of whom were tested and had results reported to the state public health departments. Eighteen patients had HCV highly related to the surgical technician’s virus. The surgical technician gained unauthorized access to fentanyl owing to limitations in procedures for securing controlled substances. Conclusions Public health surveillance identified an outbreak of HCV infection due to an infected health care provider engaged in diversion of injectable narcotics. The investigation highlights the value of public health surveillance in identifying HCV outbreaks and uncovering a method of drug diversion and its impacts on patients. PMID:25442395

  10. Patient identification errors are common in a simulated setting.

    Science.gov (United States)

    Henneman, Philip L; Fisher, Donald L; Henneman, Elizabeth A; Pham, Tuan A; Campbell, Megan M; Nathanson, Brian H

    2010-06-01

    We evaluate the frequency and accuracy of health care workers verifying patient identity before performing common tasks. The study included prospective, simulated patient scenarios with an eye-tracking device that showed where the health care workers looked. Simulations involved nurses administering an intravenous medication, technicians labeling a blood specimen, and clerks applying an identity band. Participants were asked to perform their assigned task on 3 simulated patients, and the third patient had a different date of birth and medical record number than the identity information on the artifact label specific to the health care workers' task. Health care workers were unaware that the focus of the study was patient identity. Sixty-one emergency health care workers participated--28 nurses, 16 technicians, and 17 emergency service associates--in 183 patient scenarios. Sixty-one percent of health care workers (37/61) caught the identity error (61% nurses, 94% technicians, 29% emergency service associates). Thirty-nine percent of health care workers (24/61) performed their assigned task on the wrong patient (39% nurses, 6% technicians, 71% emergency service associates). Eye-tracking data were available for 73% of the patient scenarios (133/183). Seventy-four percent of health care workers (74/100) failed to match the patient to the identity band (87% nurses, 49% technicians). Twenty-seven percent of health care workers (36/133) failed to match the artifact to the patient or the identity band before performing their task (33% nurses, 9% technicians, 33% emergency service associates). Fifteen percent (5/33) of health care workers who completed the steps to verify patient identity on the patient with the identification error still failed to recognize the error. Wide variation exists among health care workers verifying patient identity before performing everyday tasks. Education, process changes, and technology are needed to improve the frequency and accuracy of

  11. Medication reconciliation in pediatric cardiology performed by a pharmacy technician: a prospective cohort comparison study.

    Science.gov (United States)

    Chan, Carol; Woo, Renée; Seto, Winnie; Pong, Sandra; Gilhooly, Tessie; Russell, Jennifer

    2015-01-01

    Medication reconciliation reduces potential medication discrepancies and adverse drug events. The role of pharmacy technicians in obtaining best possible medication histories (BPMHs) and performing reconciliation at the admission and transfer interfaces of care for pediatric patients has not been described. To compare the completeness and accuracy of BPMHs and reconciliation conducted by a pharmacy technician (pilot study) and by nurses and/or pharmacists (baseline). The severity of identified unintentional discrepancies was rated to determine their clinical importance. This prospective cohort comparison study involved patients up to 18 years of age admitted to and/or transferred between the Cardiology ward and the Cardiac Critical Care Unit of a pediatric tertiary care teaching hospital. A pharmacy resident conducted two 3-week audits: the first to assess the completeness and accuracy of BPMHs and reconciliation performed by nurses and/or pharmacists and the second to assess the completeness and accuracy of BPMHs and reconciliation performed by a pharmacy technician. The total number of patients was 38 in the baseline phase and 46 in the pilot period. There were no statistically significant differences between the baseline and pilot audits in terms of completion of BPMH (82% [28/34] versus 78% [21/27], p = 0.75) or completion of reconciliation (70% [23/33] versus 75% [15/20], p = 0.76) within 24 h of admission. Completeness of transfer reconciliation was significantly higher during the pilot study than at baseline (91% [31/34] versus 61% [11/18], p = 0.022). No significant differences between the baseline and pilot audits were found in the proportions of patients with at least one BPMH discrepancy (38% [13/34] versus 22% [6/27], p = 0.27), at least one unintentional discrepancy upon admission (21% [7/33] versus 10% [2/20], p = 0.46), or at least one unintentional discrepancy at the transfer interface (6% [1/18] versus 3% [1/34], p = 0.58). None of the 16

  12. Forensic Science Technician

    Science.gov (United States)

    Tech Directions, 2010

    2010-01-01

    Forensic science technicians, also called crime laboratory technicians or police science technicians, help solve crimes. They examine and identify physical evidence to reconstruct a crime scene. This article discusses everything students need to know about careers for forensic science technicians--wages, responsibilities, skills needed, career…

  13. Reduction in respiratory motion artefacts on gadoxetate-enhanced MRI after training technicians to apply a simple and more patient-adapted breathing command

    International Nuclear Information System (INIS)

    Gutzeit, Andreas; Matoori, Simon; Weymarn, Constantin von; Reischauer, Carolin; Goyen, Matthias; Hergan, Klaus; Meissnitzer, Matthias; Forstner, Rosemarie; Froehlich, Johannes M.; Kolokythas, Orpheus; Soyka, Jan D.; Doert, Aleksis; Koh, Dow-Mu

    2016-01-01

    To investigate whether a trained group of technicians using a modified breathing command during gadoxetate-enhanced liver MRI reduces respiratory motion artefacts compared to non-trained technicians using a traditional breathing command. The gadoxetate-enhanced liver MR images of 30 patients acquired using the traditional breathing command and the subsequent 30 patients after training the technicians to use a modified breathing command were analyzed. A subgroup of patients (n = 8) underwent scans both by trained and untrained technicians. Images obtained using the traditional and modified breathing command were compared for the presence of breathing artefacts [respiratory artefact-based image quality scores from 1 (best) to 5 (non-diagnostic)]. There was a highly significant improvement in the arterial phase image quality scores in patients using the modified breathing command compared to the traditional one (P < 0.001). The percentage of patients with severe and extensive breathing artefacts in the arterial phase decreased from 33.3 % to 6.7 % after introducing the modified breathing command (P = 0.021). In the subgroup that underwent MRI using both breathing commands, arterial phase image quality improved significantly (P = 0.008) using the modified breathing command. Training technicians to use a modified breathing command significantly improved arterial phase image quality of gadoxetate-enhanced liver MRI. (orig.)

  14. Defining the Role of the Pharmacy Technician and Identifying Their Future Role in Medicines Optimisation.

    Science.gov (United States)

    Boughen, Melanie; Sutton, Jane; Fenn, Tess; Wright, David

    2017-07-15

    Traditionally, pharmacy technicians have worked alongside pharmacists in community and hospital pharmacy. Changes within pharmacy provide opportunity for role expansion and with no apparent career pathway, there is a need to define the current pharmacy technician role and role in medicines optimisation. To capture the current roles of pharmacy technicians and identify how their future role will contribute to medicines optimisation. Following ethical approval and piloting, an online survey to ascertain pharmacy technicians' views about their roles was undertaken. Recruitment took place in collaboration with the Association of Pharmacy Technicians UK. Data were exported to SPSS, data screened and descriptive statistics produced. Free text responses were analysed and tasks collated into categories reflecting the type of work involved in each task. Responses received were 393 (28%, n = 1380). Results were organised into five groups: i.e., hospital, community, primary care, General Practitioner (GP) practice and other (which included HM Prison Service). Thirty tasks were reported as commonly undertaken in three or more settings and 206 (84.7%, n = 243) pharmacy technicians reported they would like to expand their role. Tasks core to hospital and community pharmacy should be considered for inclusion to initial education standards to reflect current practice. Post qualification, pharmacy technicians indicate a significant desire to expand clinically and managerially allowing pharmacists more time in patient-facing/clinical roles.

  15. The Influence of Skill Development Training Program for Spiritual Care of Elderly Individual on Elderly Care Technician Students' Perception of Spiritual Support.

    Science.gov (United States)

    Bulduk, Serap; Usta, Esra; Dinçer, Yeliz

    2017-06-01

    Spiritual care means helping an individual protect, maintain and gain all the dimensions of his/her existence. Elderly care technicians face numerous cases or crisis situations in which elderly individuals from different backgrounds question the meaning and value of life. Elderly care technicians must acknowledge that the spirituality is an important element in the way an elderly individual receives healthcare and they must be equipped for this matter. This study was conducted in order to examine the influence of "Skill Development Training Program for Spiritual Care of Elderly Individual," which was carried out with students from elderly care program, on the perception of spirituality support in a pretest-posttest quasi-experimental study design with control group. As the data collection form, "Spiritual Support Perception" (SSP) scale was used. The mean scores of the intervention group after the training and after one month are 50.39 ± 5.34 and 51.13 ± 4.98, respectively, and those of the control group are 43.16 ± 4.83 and 42.72 ± 4.48. A statistically significant difference was found between the mean scores of the intervention group from the pretest and the posttests immediately after the training and one month after the training (f = 94.247, p = 0.001). In the control group, however, there was no significant change in the SSP mean scores (f = 0.269, p = 0.77). As a result, this study pointed out the necessity of such training programs for healthcare professionals to make a distinction between their professional duties and their own personalities in order to offer spiritual care to the elderly individual.

  16. Defining the Role of the Pharmacy Technician and Identifying Their Future Role in Medicines Optimisation

    Science.gov (United States)

    Boughen, Melanie; Sutton, Jane; Fenn, Tess

    2017-01-01

    Background: Traditionally, pharmacy technicians have worked alongside pharmacists in community and hospital pharmacy. Changes within pharmacy provide opportunity for role expansion and with no apparent career pathway, there is a need to define the current pharmacy technician role and role in medicines optimisation. Aim: To capture the current roles of pharmacy technicians and identify how their future role will contribute to medicines optimisation. Methods: Following ethical approval and piloting, an online survey to ascertain pharmacy technicians’ views about their roles was undertaken. Recruitment took place in collaboration with the Association of Pharmacy Technicians UK. Data were exported to SPSS, data screened and descriptive statistics produced. Free text responses were analysed and tasks collated into categories reflecting the type of work involved in each task. Results: Responses received were 393 (28%, n = 1380). Results were organised into five groups: i.e., hospital, community, primary care, General Practitioner (GP) practice and other (which included HM Prison Service). Thirty tasks were reported as commonly undertaken in three or more settings and 206 (84.7%, n = 243) pharmacy technicians reported they would like to expand their role. Conclusions: Tasks core to hospital and community pharmacy should be considered for inclusion to initial education standards to reflect current practice. Post qualification, pharmacy technicians indicate a significant desire to expand clinically and managerially allowing pharmacists more time in patient-facing/clinical roles. PMID:28970452

  17. Expanded pharmacy technician roles: Accepting verbal prescriptions and communicating prescription transfers.

    Science.gov (United States)

    Frost, Timothy P; Adams, Alex J

    2017-11-01

    As the role of the clinical pharmacist continues to develop and advance, it is critical to ensure pharmacists can operate in a practice environment and workflow that supports the full deployment of their clinical skills. When pharmacy technician roles are optimized, patient safety can be enhanced and pharmacists may dedicate more time to advanced clinical services. Currently, 17 states allow technicians to accept verbal prescriptions called in by a prescriber or prescriber's agent, or transfer a prescription order from one pharmacy to another. States that allow these activities generally put few legal limitations on them, and instead defer to the professional judgment of the supervising pharmacist whether to delegate these tasks or not. These activities were more likely to be seen in states that require technicians to be registered and certified, and in states that have accountability mechanisms (e.g., discipline authority) in place for technicians. There is little evidence to suggest these tasks cannot be performed safely and accurately by appropriately trained technicians, and the track record of success with these tasks spans four decades in some states. Pharmacists can adopt strong practice policies and procedures to mitigate the risk of harm from verbal orders, such as instituting read-back/spell-back techniques, or requiring the indication for each phoned-in medication, among other strategies. Pharmacists may also exercise discretion in deciding to whom to delegate these tasks. As the legal environment becomes more permissive, we foresee investment in more robust education and training of technicians to cover these activities. Thus, with the adoption of robust practice policies and procedures, delegation of verbal orders and prescription transfers can be safe and effective, remove undue stress on pharmacists, and potentially free up pharmacist time for higher-order clinical care. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Development of a Pharmacy Technician-Driven Program to Improve Vaccination Rates at an Academic Medical Center.

    Science.gov (United States)

    Hill, John D; Anderegg, Sammuel V; Couldry, Rick J

    2017-10-01

    Background: Influenza and pneumococcal disease contribute substantially to the burden of preventable disease in the United States. Despite quality measures tied to immunization rates, health systems have struggled to achieve these targets in the inpatient setting. Pharmacy departments have had success through implementation of pharmacist standing order programs (SOP); however, these initiatives are labor-intensive and have not resulted in 100% immunization rates. Objective: The objective of this study was to evaluate a pilot utilizing pharmacy technician interventions, in combination with a nursing SOP, to improve vaccination rates of hospitalized patients for influenza and pneumococcal disease. Methods: A process was developed for pharmacy technicians to identify patients who were not previously screened or immunized during the weekend days on the Cardiovascular Progressive Care unit at the University of Kansas Health-System. Targeted pharmacy technician interventions consisted of phone call reminders and face-to-face discussions with nursing staff. The primary study outcome was the change in immunization compliance rates between the control and intervention groups. Results: Influenza vaccine rates showed a statistically significant increase from 72.2% (52 of 72) of patients during the control group to 92.9% (65 of 70, P = .001) of patients during the intervention group. A pneumococcal vaccination rate of 81.3% (61 of 75) was observed in the control group, compared with 84.3% (59 of 70) of patients in the intervention group ( P = .638). Conclusion: An improvement in inpatient influenza immunization rates can be achieved through targeted follow-up performed by pharmacy technicians, in combination with a nursing-driven SOP.

  19. Characterization of care for patients with wounds in Primary Care

    Directory of Open Access Journals (Sweden)

    Isabel Cristina Ramos Vieira Santos

    2014-10-01

    Full Text Available This study aimed to describe the treatment of patients with wounds in the Primary Health Care. A descriptive research with quantitative approach. Ninety-three Family Health Units of the city of Recife-PE, Brazil, were selected, and 112 nurses were interviewed from July to December 2011. The record book of bandages and procedures and the dressing form were used as an additional source of data. Frequencies, measures of central tendency and dispersion, prevalence and, for continuous variables, the analysis of variance were estimated. The prevalence of patients with wounds was 1.9% of the estimated covered population. Vascular ulcers accounted for 74.1% of the treated wounds. The dressing was predominantly performed by Nursing technicians, and the products available for this procedure did not match the current technological development.

  20. SafeMed: Using pharmacy technicians in a novel role as community health workers to improve transitions of care.

    Science.gov (United States)

    Bailey, James E; Surbhi, Satya; Bell, Paula C; Jones, Angel M; Rashed, Sahar; Ugwueke, Michael O

    2016-01-01

    To describe the design, implementation, and early experience of the SafeMed program, which uses certified pharmacy technicians in a novel expanded role as community health workers (CPhT-CHWs) to improve transitions of care. A large nonprofit health care system serving the major medically underserved areas and geographic hotspots for readmissions in Memphis, TN. The SafeMed program is a care transitions program with an emphasis on medication management designed to use low-cost health workers to improve transitions of care from hospital to home for superutilizing patients with multiple chronic conditions and polypharmacy. CPhT-CHWs were given primary responsibility for patient outreach after hospital discharge with the use of home visits and telephone follow-up. SafeMed program CPhT-CHWs served as pharmacist extenders, obtaining medication histories, assisting in medication reconciliation and identification of potential drug therapy problems (DTPs), and reinforcing medication education previously provided by the pharmacist per protocol. CPhT-CHW training included patient communication skills, motivational interviewing, medication history taking, teach-back techniques, drug disposal practices, and basic disease management. Some CPhT-CHWs experienced difficulties adjusting to an expanded scope of practice. Nonetheless, once the Tennessee Board of Pharmacy affirmed that envisioned SafeMed CPhT-CHW roles were consistent with Board rules, additional responsibilities were added for CPhT-CHWs to enhance their effectiveness. Patient outreach teams including CPhT-CHWs achieved increases in home visit and telephone follow-up rates and were successful in helping identify potential DTPs. The early experience of the SafeMed program demonstrates that CPhT-CHWs are well suited for novel expanded roles to improve care transitions for superutilizing populations. CPhT-CHWs can identify and report potential DTPs to the pharmacist to help target medication therapy management. Critical

  1. Training courses for radiological technicians: radiation protection of the patient and control of image quality

    International Nuclear Information System (INIS)

    Mateus Yoshimura, Elisabeth; Costa, Paulo Roberto; Furquim, Tania Aparecida; Freitas, Marcelo Baptista de; Valente, Marcelo; Cerri, Giovanni Guido

    2008-01-01

    Full text: As in other countries, life expectancy is increasing in Brazil, and the number of radiological examinations tends to increase. Old equipment and high technology ones cohabit, radiology technicians are not well prepared to conduct practices, images and doses to patients are not optimized. Digital techniques that began to be introduced in the last years are also an important issue, because, as it is possible to modify the image digitally, there is less concern about the choice of equipment parameters that produce the best-image/lowest-dose compromise. Pediatric radiology, CT and fluoroscopy require attention too, as they are of dosimetric interest or because the patient ages imply higher risks or because the techniques deliver higher doses than the conventional ones. In our opinion, the most important role that we can play is educating and forming people to work in this area: training programs and refreshing courses are a way of facing the problem. This way, we are organizing, in a technical cooperation with IAEA, two training courses in quality assurance and radiation protection in radiology, one designed to physicists (60 h), and the radiological technicians (40 h). An important cooperation with a paediatric and a general hospital made it possible to offer courses with 50% practical lessons, performed both in the University and in hospital equipment. Both courses cover a basic Radiation Physics program, radiation protection, image formation and quality control in conventional and digital equipment, and patient dosimetry. Equipment donated by IAEA facilitate the practical QA and dosimetry lessons. The rationale of our project is making it sustainable through the formation of physicists that will go on in the education process of technicians in technical schools. We present the results of the first two courses (physicists and technicians), considering the selection process, the development of the activities, and the assessment both of the students enrolled

  2. Baseline job satisfaction and stress among pharmacists and pharmacy technicians participating in the Fleetwood Phase III Study.

    Science.gov (United States)

    Lapane, Kate L; Hughes, Carmel M

    2004-11-01

    To provide baseline levels of job satisfaction and stress among members of the long-term care pharmacy team participating in the Fleetwood Phase III evaluation. Cross-sectional design; long-term care pharmacy provider in North Carolina (the implementation site of the large-scale Fleetwood Phase III study). All current pharmacy employees as of May/June 2002. None. Health Professional Stress Inventory and job satisfaction. Ninety-four percent (16/17) of consultant pharmacists were satisfied with their job, with 89% reporting they would definitely choose to be a pharmacist again. Seventy-five percent both of dispensing pharmacists and pharmacy technicians reported overall job satisfaction. Forty-one reported that they would not choose to be a pharmacist (pharmacy technician) again. The most frequently reported sources of stress among the dispensing pharmacists and pharmacy technicians were conflicts with non-work obligations (i.e., family, personal life) and the ability to perform duties with short staffing. In addition, inadequate pay and few opportunities for job advancement were often/frequent sources of stress among pharmacy technicians. More than one third of dispensing pharmacists also reported stress frequently because of fears of mistakes in patient treatment. Overall, consultants are very satisfied with their positions, although dispensing pharmacists and pharmacy technicians are less satisfied with their work. The reasons may be because of the different nature of each job, as well as staffing shortages. The extent to which the Fleetwood Model can improve job satisfaction and impact on stress will be evaluated once we resurvey the pharmacy team after the intervention period of the Fleetwood Phase III study.

  3. Rural emergency medical technician pre-hospital electrocardiogram transmission.

    Science.gov (United States)

    Powell, A M; Halon, J M; Nelson, J

    2014-01-01

    Emergent care of the acute heart attack patient continues to be at the forefront of quality and cost reduction strategies throughout the healthcare industry. Although the average cardiac door-to-balloon (D2B) times have decreased substantially over the past few years, there are still vast disparities found in D2B times in populations that reside in rural areas. Such disparities are mostly related to prolonged travel time and subsequent delays in cardiac catherization lab team activation. Urban ambulance companies that are routinely staffed with paramedic level providers have been successful in the implementation of pre-hospital 12-lead electrocardiogram (ECG) protocols as a strategy to reduce D2B times. The authors sought to evaluate the evidence related to the risk and benefits associated with the replication of an ECG transmission protocol in a small rural emergency medical service. The latter is staffed with emergency medical technician-basics (EMT-B), emergency medical technician-advanced (EMT-A), and emergency medical technician-intermediate (EMT-I) level. The evidence reviewed was limited to studies with relevant data regarding the challenges and complexities of the ECG transmission process, the difficulties associated with ECG transmission in rural settings, and ECG transmission outcomes by provider level. The evidence supports additional research to further evaluate the feasibility of ECG transmission at the non-paramedic level. Multiple variables must be investigated including equipment cost, utilization, and rural transmission capabilities. Clearly, pre-hospital ECG transmission and early activation of the cardiac catheterization laboratory are critical components to successfully decreasing D2B times.

  4. Defining the Simulation Technician Role: Results of a Survey-Based Study.

    Science.gov (United States)

    Bailey, Rachel; Taylor, Regina G; FitzGerald, Michael R; Kerrey, Benjamin T; LeMaster, Thomas; Geis, Gary L

    2015-10-01

    In health care simulation, simulation technicians perform multiple tasks to support various educational offerings. Technician responsibilities and the tasks that accompany them seem to vary between centers. The objectives were to identify the range and frequency of tasks that technicians perform and to determine if there is a correspondence between what technicians do and what they feel their responsibilities should be. We hypothesized that there is a core set of responsibilities and tasks for the technician position regardless of background, experience, and type of simulation center. We conducted a prospective, survey-based study of individuals currently functioning in a simulation technician role in a simulation center. This survey was designed internally and piloted within 3 academic simulation centers. Potential respondents were identified through a national mailing list, and the survey was distributed electronically during a 3-week period. A survey request was sent to 280 potential participants, 136 (49%) responded, and 73 met inclusion criteria. Five core tasks were identified as follows: equipment setup and breakdown, programming scenarios into software, operation of software during simulation, audiovisual support for courses, and on-site simulator maintenance. Independent of background before they were hired, technicians felt unprepared for their role once taking the position. Formal training was identified as a need; however, the majority of technicians felt experience over time was the main contributor toward developing knowledge and skills within their role. This study represents a first step in defining the technician role within simulation-based education and supports the need for the development of a formal job description to allow recruitment, development, and certification.

  5. Examining Career Success of Minority and Women Emergency Medical Technicians (EMTs): A LEADS Project

    Science.gov (United States)

    Russ-Eft, Darlene F.; Dickison, Philip D.; Levine, Roger

    2008-01-01

    Emergency medical technicians (EMTs) are a critical segment in prehospital medical care. This study examined EMT-paramedic career success focused on minorities and women, as part of the Longitudinal Emergency Medical Technician Attributes and Demographics Study (LEADS). The LEADS data come from a representative sampling of EMTs throughout the…

  6. Development and innovation of system resources to optimize patient care.

    Science.gov (United States)

    Johnson, Thomas J; Brownlee, Michael J

    2018-04-01

    Various incremental and disruptive healthcare innovations that are occurring or may occur are discussed, with insights on how multihospital health systems can prepare for the future and optimize the continuity of patient care provided. Innovation in patient care is occurring at an ever-increasing rate, and this is especially true relative to the transition of patients through the care continuum. Health systems must leverage their ability to standardize and develop electronic health record (EHR) systems and other infrastructure necessary to support patient care and optimize outcomes; examples include 3D printing of patient-specific medication dosage forms to enhance precision medicine, the use of drones for medication delivery, and the expansion of telehealth capabilities to improve patient access to the services of pharmacists and other healthcare team members. Disruptive innovations in pharmacy services and delivery will alter how medications are prescribed and delivered to patients now and in the future. Further, technology may also fundamentally alter how and where pharmacists and pharmacy technicians care for patients. This article explores the various innovations that are occurring and that will likely occur in the future, particularly as they apply to multihospital health systems and patient continuity of care. Pharmacy departments that anticipate and are prepared to adapt to incremental and disruptive innovations can demonstrate value in the multihospital health system through strategies such as optimizing the EHR, identifying telehealth opportunities, supporting infrastructure, and integrating services. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  7. Accuracy of densitometric vertebral fracture assessment when performed by DXA technicians-a cross-sectional, multiobserver study

    DEFF Research Database (Denmark)

    Rud, B; Vestergaard, A; Hyldstrup, L

    2016-01-01

    Six dual-energy X-ray absorptiometry (DXA) technicians reviewed lateral images of the spine for deformed vertebrae. The images were acquired with a DXA scanner in 235 patients referred for osteoporosis assessment. The outcome was compared to findings on spinal radiographs assessed by two radiolog......Six dual-energy X-ray absorptiometry (DXA) technicians reviewed lateral images of the spine for deformed vertebrae. The images were acquired with a DXA scanner in 235 patients referred for osteoporosis assessment. The outcome was compared to findings on spinal radiographs assessed by two...... radiologists. Three DXA technicians performed acceptable or better in identifying patients with fractured vertebrae. INTRODUCTION: This is the first study to evaluate the accuracy of vertebral fracture assessment (VFA) when used by DXA technicians as a triage test to select patients with deformed vertebrae...... for spinal radiographs. METHODS: Lateral single-energy scans and radiographs of the thoracolumbar spine (T4-L4) were acquired in 235 patients aged 65 years or more referred for osteoporosis assessment. Six DXA technicians evaluated lateral scans using dedicated software. The DXA technicians were trained...

  8. Training pharmacy technicians to administer immunizations.

    Science.gov (United States)

    McKeirnan, Kimberly C; Frazier, Kyle R; Nguyen, Maryann; MacLean, Linda Garrelts

    To evaluate the effectiveness of an immunization training program for pharmacy technicians on technicians' self-reported confidence, knowledge, and number of vaccines administered. A one-group pre- and posttest study was conducted with certified pharmacy technicians from Albertsons and Safeway community pharmacies in Idaho. Thirty pharmacy technicians were recruited to participate in an immunization administration training program comprising a 2-hour home study and a 2-hour live training. Pharmacy technician scores on a 10-question knowledge assessment, responses on a pre- and posttraining survey, and number of immunizations administered in the 6-month period following the training were collected. Twenty-five pharmacy technicians completed the home study and live portions of the immunization training program. All 29 pharmacy technicians who took the home study assessment passed with greater than 70% competency on the first attempt. Technicians self-reported increased confidence with immunization skills between the pretraining survey and the posttraining survey. From December 2016 to May 2017, the technicians administered 953 immunizations with 0 adverse events reported. For the first time, pharmacy technicians have legally administered immunizations in the United States. Trained pharmacy technicians demonstrated knowledge of vaccination procedures and self-reported improved confidence in immunization skills and administered immunizations after participating in a 4-hour training program. Copyright © 2018 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  9. Survey to assess the role of pharmacy technicians and nonpharmacist staff in the operation of research pharmacies.

    Science.gov (United States)

    Siden, Rivka; Tamer, Helen R; Skyles, Amy J; Dolan, Christopher S; Propes, Denise J; Redic, Kimberly

    2014-11-01

    Results of a survey assessing trends and innovations in the use of pharmacy technicians and other nonpharmacist staff in the research pharmacy setting are reported. A Web-based survey was distributed to Internet communities of members of the American Society of Health-System Pharmacists and the University Health-System Consortium involved in investigational drug research and related practice areas. The survey collected data on the characteristics of institutions with pharmacy department staff dedicated to such research activities and the participation of pharmacists, technicians, and other staff in key areas of research pharmacy operations. Survey responses from 51 institutions were included in the data analysis. Overall, the reported distribution of assigned responsibility for most evaluated research pharmacy tasks reflected traditional divisions of pharmacist and technician duties, with technicians performing tasks subject to a pharmacist check or pharmacists completing tasks alone. However, some institutions reported allowing technicians to perform a number of key tasks without direct pharmacist supervision, primarily in the areas of inventory management and sponsor monitoring and auditing; almost half of the surveyed institutions reported technician involvement in teaching activities. In general, the reported use of "tech-check-tech" arrangements in research pharmacies was very limited. Some responding institutions reported the innovative use of nonpharmacist staff (e.g., paid interns, students and residents on rotation). Although the majority of research pharmacy tasks related to direct patient care are performed by or under the direct supervision of pharmacists, a variety of other essential tasks are typically assigned to pharmacy technicians and other nonpharmacist staff. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  10. Experience with a pharmacy technician medication history program.

    Science.gov (United States)

    Cooper, Julie B; Lilliston, Michelle; Brooks, DeAnne; Swords, Bruce

    2014-09-15

    The implementation and outcomes of a pharmacy technician medication history program are described. An interprofessional medication reconciliation team, led by a clinical pharmacist and a clinical nurse specialist, was charged with implementing a new electronic medication reconciliation system to improve compliance with medication reconciliation at discharge and capture compliance-linked reimbursement. The team recommended that the pharmacy department be allocated new pharmacy technician full-time-equivalent positions to assume ownership of the medication history process. Concurrent with the implementation of this program, a medication history standard was developed to define rules for documentation of what a patient reports he or she is actually taking. The standard requires a structured interview with the patient or caregiver and validation with outside sources as indicated to determine which medications to document in the medication history. The standard is based on four medication administration category rules: scheduled, as-needed, short-term, and discontinued medications. The medication history standard forms the core of the medication history technician training and accountability program. Pharmacy technicians are supervised by pharmacists, using a defined accountability plan based on a set of medical staff approved rules for what medications comprise a best possible medication history. Medication history accuracy and completeness rates have been consistently over 90% and rates of provider compliance with medication reconciliation rose from under 20% to 100% since program implementation. A defined medication history based on a medication history standard served as an effective foundation for a pharmacy technician medication history program, which helped improve provider compliance with discharge medication reconciliation. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  11. Diesel Engine Technician

    Science.gov (United States)

    Tech Directions, 2010

    2010-01-01

    Diesel engine technicians maintain and repair the engines that power transportation equipment such as heavy trucks, trains, buses, and locomotives. Some technicians work mainly on farm machines, ships, compressors, and pumps. Others work mostly on construction equipment such as cranes, power shovels, bulldozers, and paving machines. This article…

  12. Electric Vehicle Technician

    Science.gov (United States)

    Moore, Pam

    2011-01-01

    With President Obama's goal to have one million electric vehicles (EV) on the road by 2015, the electric vehicle technician should have a promising and busy future. "The job force in the car industry is ramping up for a revitalized green car industry," according to Greencareersguide.com. An electric vehicle technician will safely troubleshoot and…

  13. Advancing the role of the pharmacy technician: A systematic review.

    Science.gov (United States)

    Mattingly, Ashlee N; Mattingly, T Joseph

    To summarize the findings of a literature search on advancing the role of pharmacy technicians, including the types of training identified and the potential costs and benefits to both the technician and the pharmacy. A literature search of Scopus, Embase, and Medline was conducted on January 11, 2017. Original research, research reports, case studies, or association reports were included for review. Articles were considered to be relevant based on identification of an advanced pharmacy technician role or addressing additional training/education for technician functions. A standard data extraction form was used to collect study authors, article title, year published, journal title, study design, brief description of methods, primary outcome measures, advanced technician roles identified, additional education or training addressed, and additional costs and benefits identified in each article. A total of 33 articles were included for full review and data extraction. Study design varied, with 17 (52%) quantitative, 1 (3%) qualitative, 5 (15%) mixed-method, and 10 (30%) case study designs. Seventeen (52%) of the studies included were published after 2006. The mechanism of training was primarily through supervised on-the-job training, allowing technicians to assume administrative-based positions that facilitated a pharmacist-led clinical service, with either the pharmacist or the pharmacy receiving the greatest benefits. Although the literature supports technicians performing advanced roles in the pharmacy, resulting in either improved patient outcomes or opportunities for pharmacists to engage in additional clinical services, the benefits to the technician were primarily indirect, such as an increase in job satisfaction or a more desirable work schedule. If a technician is to take on additional roles that require completion of a formalized training or educational program, benefits that are more tangible may help to inspire technicians to pursue these roles. Copyright

  14. Child Passenger Safety Technician Consultation in the Pediatric Primary Care Setting.

    Science.gov (United States)

    Burstein, Dina; Zonfrillo, Mark R; Baird, Janette; Mello, Michael J

    2017-09-01

    Correct use of a child safety seat (CSS) can reduce the risk of fatal motor vehicle crash-related injury by up to 71%; however, misuse rates for CSS are as high as 70%. We recruited 189 caregivers at 2 large suburban pediatric office practices; 94 in the intervention group and 95 in the control group. All participants completed a baseline survey and received a CSS safety brochure. Intervention participants had their CSS installation checked at enrollment by a certified child passenger safety (CPS) technician. Follow-up was conducted 4 months post enrollment. Intervention group participants had a 21.3% reduction in critical misuse at follow-up, whereas control participants critical misuse rate at follow-up was identical to the intervention group at baseline. A consult with a certified CPS technician, at the time of a routine visit to the pediatrician, resulted in a reduction in CSS misuse rates.

  15. Accuracy of vision technicians in screening ocular pathology at rural vision centres of southern India.

    Science.gov (United States)

    Suram, Vasantha; Addepalli, Uday Kumar; Krishnaiah, Sannapaneni; Kovai, Vilas; Khanna, Rohit C

    2016-03-01

    There is paucity of data on the inter-observer agreement and diagnostic accuracy between a primary-care technician (vision technician) and an ophthalmologist. Hence, the current study was conducted to assess the accuracy of vision technicians, to screen potentially sight-threatening ocular conditions at rural vision centres of southern India and their agreement with an ophthalmologist. In July to August 2010, patients presenting to seven vision centres in Adilabad district (Andhra Pradesh) were selected and screened in a masked manner by seven vision technicians followed by an examination by a consultant ophthalmologist. Agreement was assessed between vision technicians and the ophthalmologist for screening of potential sight-threatening ocular conditions and decisions for referral. The ophthalmologist's findings were considered as the reference standard. Two hundred and seventy-nine patients were enrolled at seven vision centres with a mean age of 32.9 ± 21.8 years. Agreement for screening of ocular pathology was 0.82 (95 per cent CI, 0.8-0.83). There was excellent agreement for cataract (0.97; 95 per cent CI, 0.93-1), refractive error (0.98; 95 per cent CI, 0.96-1), corneal pathology (1.0; 95 per cent CI, 1.0-1.0) and other anterior segment pathology (0.95; 95 per cent CI, 0.9-1); the agreement was moderate to fair for detection of glaucoma suspects (0.43; 95 per cent CI, 0.28-0.60) and retinal pathology (0.39; 95 per cent CI, 0.14-0.63). Sensitivity for screening of anterior segment pathology was 94.6-100 per cent. There was a fair to moderate sensitivity for glaucoma suspect; 35.6 per cent (95 per cent CI, 21.9-51.2) and retinal pathology 26.3 per cent (95 per cent CI, 9.2-51.2). Specificity for screening of ocular pathology was 98.2 to 100 per cent. The kappa (κ) agreement for referral for any pathology was 0.82 (0.8-0.83) CONCLUSION: As there is good agreement between the vision technicians and the ophthalmologist for screening and referral of

  16. The Role of the Built Environment: How Decentralized Nurse Stations Shape Communication, Patient Care Processes, and Patient Outcomes.

    Science.gov (United States)

    Real, Kevin; Bardach, Shoshana H; Bardach, David R

    2017-12-01

    Increasingly, health communication scholars are attending to how hospital built environments shape communication, patient care processes, and patient outcomes. This multimethod study was conducted on two floors of a newly designed urban hospital. Nine focus groups interviews were conducted with 35 health care professionals from 10 provider groups. Seven of the groups were homogeneous by profession or level: nursing (three groups), nurse managers (two groups), and one group each of nurse care technicians ("techs") and physicians. Two mixed groups were comprised of staff from pharmacy, occupational therapy, patient care facilitators, physical therapy, social work, and pastoral care. Systematic qualitative analysis was conducted using a conceptual framework based on systems theory and prior health care design and communication research. Additionally, quantitative modeling was employed to assess walking distances in two different hospital designs. Results indicate nurses walked significantly more in the new hospital environment. Qualitative analysis revealed three insights developed in relationship to system structures, processes, and outcomes. First, decentralized nurse stations changed system interdependencies by reducing nurse-to-nurse interactions and teamwork while heightening nurse interdependencies and teamwork with other health care occupations. Second, many nursing-related processes remained centralized while nurse stations were decentralized, creating systems-based problems for nursing care. Third, nursing communities of practices were adversely affected by the new design. Implications of this study suggest that nurse station design shapes communication, patient care processes, and patient outcomes. Further, it is important to understand how the built environment, often treated as invisible in communication research, is crucial to understanding communication within complex health care systems.

  17. Medication reconciliation and prescribing reviews by pharmacy technicians in a geriatric ward

    DEFF Research Database (Denmark)

    Buck, Thomas Croft; Gronkjaer, Louise Smed; Duckert, Marie-Louise

    2013-01-01

    OBJECTIVE: Incomplete medication histories obtained on hospital admission are responsible for more than 25% of prescribing errors. This study aimed to evaluate whether pharmacy technicians can assist hospital physicians' in obtaining medication histories by performing medication reconciliation an...... reconciliation and focused medication reviews. Further randomized, controlled studies including a larger number of patients are required to elucidate whether these observations are of significance and of importance for securing patient safety....... and prescribing reviews. A secondary aim was to evaluate whether the interventions made by pharmacy technicians could reduce the time spent by the nurses on administration of medications to the patients. METHODS: This observational study was conducted over a 7 week period in the geriatric ward at Odense...... University Hospital, Denmark. Two pharmacy technicians conducted medication reconciliation and prescribing reviews at the time of patients' admission to the ward. The reviews were conducted according to standard operating procedures developed by a clinical pharmacist and approved by the Head of the Geriatric...

  18. National Training Course. Emergency Medical Technician. Paramedic. Instructor's Lesson Plans. Module II. Human Systems and Patient Assessment.

    Science.gov (United States)

    National Highway Traffic Safety Administration (DOT), Washington, DC.

    This instructor's lesson plan guide on human systems and patient assessment is one of fifteen modules designed for use in the training of emergency medical technicians (paramedics). Four units are presented: (1) medical terminology, which covers some common prefixes and suffixes and the use of the medical dictionary; (2) an overview of the…

  19. Pulmonary Foreign Body Granulomatosis in Dental Technician.

    Science.gov (United States)

    Chung, Sung Jun; Koo, Gun Woo; Park, Dong Won; Kwak, Hyun Jung; Yhi, Ji Young; Moon, Ji-Yong; Kim, Sang-Heon; Sohn, Jang Won; Yoon, Ho Joo; Shin, Dong Ho; Park, Sung Soo; Pyo, Ju Yeon; Oh, Young-Ha; Kim, Tae-Hyung

    2015-10-01

    Occupational lung diseases are caused by several toxic substances including heavy metals; however, the exact pathologic mechanisms remain unknown. In the workplace, dental technicians are often exposed to heavy metals such as cobalt, nickel, or beryllium and occasionally develop occupational lung diseases. We described a case of occupational lung disease in a patient who was employed as a dental technician for over a decade. A 31-year-old, non-smoking woman presented with productive cough and shortness of breath of several weeks duration. Chest computed tomography revealed a large number of scattered, bilateral small pulmonary nodules throughout the lung field, and multiple mediastinal lymph nodes enlargement. Percutaneous needle biopsy showed multifocal small granulomas with foreign body type giant cells suggestive of heavy metals inhalation. The patient's condition improved on simple avoidance strategy for several months. This case highlighted the importance of proper workplace safety.

  20. Dental technician pneumoconiosis mimicking pulmonary tuberculosis: a case report.

    Science.gov (United States)

    Tan, Han Loong; Faisal, Mohamed; Soo, Chun Ian; Ban, Andrea Y L; Manap, Roslina Abdul; Hassan, Tidi M

    2016-09-07

    Dental laboratory technicians are at risk of developing occupational respiratory diseases due to exposure to various potentially toxic substances in their working environment. Since 1939, few cases of silicosis among dental technician have been reported. We illustrate a 38 year-old female, who worked in a dental laboratory for 20 years, initially treated as pulmonary tuberculosis and chronic necrotising aspergillosis without much improvement. Computed tomography guided lung biopsy and bronchoscopic transbronchial lung biopsy were performed. Lung tissue biopsies showed presence of refractile dental materials within the areas of histiocyte proliferation. The diagnosis of dental technician pneumoconiosis was obtained and our patient underwent pulmonary rehabilitation. This case highlights the importance of obtaining a detailed occupational history in tuberculosis endemic area, as pulmonary tuberculosis is a great mimicker of other respiratory diseases.

  1. Career Directions: HVACR Technician

    Science.gov (United States)

    Moore, Pam

    2005-01-01

    Heating/ventilation/air conditioning/refrigeration (HVACR) technicians (also known as "heating and cooling technicians") are the people who install, maintain, test and repair the machines that control temperature, circulation, moisture and purity of air in residential, commercial and industrial buildings. These systems consist of a variety of…

  2. Chemotherapy Order Entry by a Clinical Support Pharmacy Technician in an Outpatient Medical Day Unit.

    Science.gov (United States)

    Neville, Heather; Broadfield, Larry; Harding, Claudia; Heukshorst, Shelley; Sweetapple, Jennifer; Rolle, Megan

    2016-01-01

    Pharmacy technicians are expanding their scope of practice, often in partnership with pharmacists. In oncology, such a shift in responsibilities may lead to workflow efficiencies, but may also cause concerns about patient risk and medication errors. The primary objective was to compare the time spent on order entry and order-entry checking before and after training of a clinical support pharmacy technician (CSPT) to perform chemotherapy order entry. The secondary objectives were to document workflow interruptions and to assess medication errors. This before-and-after observational study investigated chemotherapy order entry for ambulatory oncology patients. Order entry was performed by pharmacists before the process change (phase 1) and by 1 CSPT after the change (phase 2); order-entry checking was performed by a pharmacist during both phases. The tasks were timed by an independent observer using a personal digital assistant. A convenience sample of 125 orders was targeted for each phase. Data were exported to Microsoft Excel software, and timing differences for each task were tested with an unpaired t test. Totals of 143 and 128 individual orders were timed for order entry during phase 1 (pharmacist) and phase 2 (CSPT), respectively. The mean total time to perform order entry was greater during phase 1 (1:37 min versus 1:20 min; p = 0.044). Totals of 144 and 122 individual orders were timed for order-entry checking (by a pharmacist) in phases 1 and 2, respectively, and there was no difference in mean total time for order-entry checking (1:21 min versus 1:20 min; p = 0.69). There were 33 interruptions not related to order entry (totalling 39:38 min) during phase 1 and 25 interruptions (totalling 30:08 min) during phase 2. Three errors were observed during order entry in phase 1 and one error during order-entry checking in phase 2; the errors were rated as having no effect on patient care. Chemotherapy order entry by a trained CSPT appeared to be just as safe and

  3. A technician-delivered 'virtual clinic' for triaging low-risk glaucoma referrals.

    Science.gov (United States)

    Kotecha, A; Brookes, J; Foster, P J

    2017-06-01

    PurposeThe purpose of this study is to describe the outcomes of a technician-delivered glaucoma referral triaging service with 'virtual review' of resultant data by a consultant ophthalmologist.Patients and methodsThe Glaucoma Screening Clinic reviewed new optometrist or GP-initiated glaucoma suspect referrals into a specialist ophthalmic hospital. Patients underwent testing by three ophthalmic technicians in a dedicated clinical facility. Data were reviewed at a different time and date by a consultant glaucoma ophthalmologist. Approximately 10% of discharged patients were reviewed in a face-to-face consultant-led clinic to examine the false-negative rate of the service.ResultsBetween 1 March 2014 and 31 March 2016, 1380 patients were seen in the clinic. The number of patients discharged following consultant virtual review was 855 (62%). The positive predictive value of onward referrals was 84%. Three of the 82 patients brought back for face-to-face review were deemed to require treatment, equating to negative predictive value of 96%.ConclusionsOur technician-delivered glaucoma referral triaging clinic incorporates consultant 'virtual review' to provide a service model that significantly reduces the number of onward referrals into the glaucoma outpatient department. This model may be an alternative to departments where there are difficulties in implementing optometrist-led community-based referral refinement schemes.

  4. You're a What?: Tower Technician

    Science.gov (United States)

    Vilorio, Dennis

    2012-01-01

    In this article, the author talks about the role and functions of a tower technician. A tower technician climbs up the face of telecommunications towers to remove, install, test, maintain, and repair a variety of equipment--from antennas to light bulbs. Tower technicians also build shelters and radiofrequency shields for electronic equipment, lay…

  5. Can they do it? Comparing the views of pharmacists and technicians to the introduction of an advanced technician role.

    Science.gov (United States)

    Napier, Patti; Norris, Pauline; Green, James; Braund, Rhiannon

    2016-04-01

    This study aimed to investigate the opinions of pharmacists and technicians regarding the ability of New Zealand technicians to take on an advanced checking technician role. A survey was developed to investigate the opinions regarding the introduction of this new role. The questions covered are: perceived ability to take on the role, training requirements and competence. Surveys were sent to pharmacists whose contact details are available for research purposes (n = 2095) and to all pharmacies in New Zealand (both community and hospital) for the attention of technicians (n = 858). The results were analysed using IBM SPSS and thematic analysis of comments was conducted. A total of 1221 surveys were returned (pharmacists = 736 and technicians = 485). The majority of the technicians (83%) believed that 'some' technicians could work in a CT role, compared with 73% of the pharmacists. Over two-thirds (69%) of the technicians felt comfortable checking a prescription at their current level of training compared with 53% of pharmacists. Both groups' comfort increased with further specific training for the technicians. The majority of both of these groups supported the change in roles. Pharmacists were less confident that technicians could take on this role now, but were more comfortable after extra training had been completed. The technicians, however, were confident they could take on this role now but would take on extra training if needed. © 2015 Royal Pharmaceutical Society.

  6. Pharmacy technician involvement in community pharmacy medication therapy management.

    Science.gov (United States)

    Lengel, Matthew; Kuhn, Catherine H; Worley, Marcia; Wehr, Allison M; McAuley, James W

    To assess the impact of technician involvement on the completion of medication therapy management (MTM) services in a community pharmacy setting and to describe pharmacists' and technicians' perceptions of technician involvement in MTM-related tasks and their satisfaction with the technician's role in MTM. Prospective observational study. In the fall of 2015, pharmacists and selected technicians from 32 grocery store-based community pharmacies were trained to use technicians within MTM services. Completed MTM claims were evaluated at all pharmacies for 3 months before training and 3 months after training. An electronic survey, developed with the use of competencies taught in the training and relevant published literature, was distributed via e-mail to trained employees 3 months after training. The total number of completed MTM claims at the 32 pharmacy sites was higher during the posttraining time period (2687 claims) versus the pretraining period (1735 claims). Of the 182 trained participants, 112 (61.5%) completed the survey. Overall, perceived technician involvement was lower than expected. However, identifying MTM opportunities was the most commonly reported technician MTM task, with 62.5% of technicians and 47.2% of pharmacists reporting technician involvement. Nearly one-half of technicians (42.5%) and pharmacists (44.0%) agreed or strongly agreed they were satisfied with the technician's role in MTM services, and 40.0% of technicians agreed that they were more satisfied with their work in the pharmacy after involvement in MTM. Three months after initial training of technicians in MTM, participation of technicians was lower than expected. However, the technicians involved most often reported identifying MTM opportunities for pharmacists, which may be a focus for future technician trainings. In addition, technician involvement in MTM services may increase satisfaction with many aspects of work for actively involved technicians. Copyright © 2018 American

  7. Technicians for the Brazilian nuclear power programme

    International Nuclear Information System (INIS)

    Martins Pinto, C.S.; Spitalnik, J.; Meakins, E.J.; Hurley, I.

    1980-01-01

    The technician has a responsible role to fulfil in nuclear industry, acting as a bridge between the engineer and the skilled worker. Technicians must have sufficient theoretical knowledge to communicate with engineers, and a thorough understanding of technological practice; the nuclear industry demands both theory and practice of a high standard. In Brazil the essential role of the technician in industry is in general recognized. However, the lack of a nationally recognized Nuclear Technician and Nuclear Technologist qualification, as well as a desire of the best technicians to quality as engineers and, in some areas, inadequate salaries has resulted in a shortage of well-trained technicians. A first step to ensure availability of these technicians is to improve their career prospects and status through definition of appropriate career standards and salaries. Practical training by the industry can only be given in factories, plants and construction sites where nuclear work is done. It is proposed to extend apprentice training centres at three sites, to give the most promising students after two years of apprentice training two further years of instruction and practice to qualify as Nuclear Technicians. The training centres are chosen to cover the three sectors of nuclear industry where special training of technicians is important: manufacture and construction; operation and maintenance; and testing and analysis for process control and safety. (author)

  8. How do laboratory technicians perceive their role in the tuberculosis diagnostic process? A cross-sectional study among laboratory technicians in health centers of Central Java Province, Indonesia.

    Science.gov (United States)

    Widjanarko, Bagoes; Widyastari, Dyah Anantalia; Martini, Martini; Ginandjar, Praba

    2016-01-01

    Detection of acid-fast bacilli in respiratory specimens serves as an initial pulmonary tuberculosis (TB) diagnosis. Laboratories are the essential and fundamental part of all health systems. This study aimed to describe how laboratory technicians perceived their own self and work. This included perceived self-efficacy, perceived role, perceived equipment availability, perceived procedures, perceived reward and job, and perceived benefit of health education, as well as level of knowledge and attitudes related to work performance of laboratory technicians. This was a cross-sectional quantitative study involving 120 laboratory technicians conducted in Central Java. Interviews and observation were conducted to measure performance and work-related variables. Among 120 laboratory technicians, 43.3% showed fairly good performance. They complied with 50%-75% of all procedures, including sputum collection, laboratory tools utilization, sputum smearing, staining, smear examination, grading of results, and universal precaution practice. Perceived role, perceived self-efficacy, and knowledge of laboratory procedures were significantly correlated to performance, besides education and years of working as a laboratory technician. Perceived equipment availability was also significantly correlated to performance after the education variable was controlled. Most of the laboratory technicians believed that they have an important role in TB patients' treatment and should display proper self-efficacy in performing laboratory activities. The result may serve as a basic consideration to develop a policy for enhancing motivation of laboratory technicians in order to improve the TB control program.

  9. Academy of Nutrition and Dietetics: Scope of Practice for the Dietetic Technician, Registered.

    Science.gov (United States)

    2013-06-01

    The Scope of Practice for the Dietetic Technician, Registered provides standards and tools to guide competence in performing nutrition and dietetics practice. Composed of statutory and individual components, the DTR's scope of practice is determined by state statute and the DTR's education, training, credentialing, and demonstrated and documented competence in practice. The Scope of Practice for the Dietetic Technician, Registered reflects the Academy's position on the DTR scope of practice and the essential technical assistance role of the DTR in providing safe timely person-centered care for the delivery of quality food and nutrition services.

  10. Electronics for technicians

    CERN Document Server

    Crane, P W

    2013-01-01

    Electronics for Technicians covers the basic fundamentals of electronics, including the operation of devices and circuits. The book is meant to help the technician to obtain numerical answers to actual circuit problems. This volume consists of seven chapters, the first of which introduces the reader to the basic rules for circuits containing resistive and reactive elements. Charge and discharge of a capacitor through a resistor is discussed, along with charge and discharge of an inductance through a resistance, application of sinusoidal voltages to simple networks, and series and parallel LCR

  11. Renal telemedicine through video-as-a-service delivered to patients on home dialysis: A qualitative study on the renal care team members' experience.

    Science.gov (United States)

    Ditchburn, Jae-Llane; Marshall, Alison

    2017-09-01

    The Lancashire Teaching Hospitals NHS Trust in the UK has been providing renal care through video-as-a-service (VAAS) to patients since 2013, with support from the North West NHS Shared Infrastructure Service, a collaborative team that supports information and communication technology use in the UK National Health Service. Renal telemedicine offered remotely to patients on home dialysis supports renal care through the provision of a live high-quality video link directly to unsupported patients undergoing haemodialysis at home. Home haemodialysis is known to provide benefits to patients, particularly in making them more independent. The use of a telemedicine video-link in Lancashire and South Cumbria, UK, further reduces patient dependence on the professional team. The purpose of this paper is to present the perspectives of the renal care team members using the renal telemedicine service to understand the perceived benefits and issues with the service. Ten semi-structured interviews with members of the renal care team (two renal specialists, one matron, two renal nurses, one business manager, one renal technical services manager, two IT technicians and one hardware maintenance technician) were conducted. Thematic analysis was undertaken to analyse the qualitative data. A range of incremental benefits to the renal team members were reported, including more efficient use of staff time, reduced travel, peace of mind and a strong sense of job satisfaction. Healthcare staff believed that remote renal care through video was useful, encouraged concordance and could nurture confidence in patients. Key technological issues and adjustments which would improve the renal telemedicine service were also identified. The impact of renal telemedicine was positive on the renal team members. The use of telemedicine has been demonstrated to make home dialysis delivery more efficient and safe. The learning from staff feedback could inform development of services elsewhere. © 2017

  12. [Position-checking by imaging embarked there tomotherapy and the delegation to the radiology technician].

    Science.gov (United States)

    Autret, A; Choupeaux, D; Le Mée, M

    2016-10-01

    Tomotherapy is a technique of IMRT and IGRT using a linear accelerator and a helical CT-scanner. To reach this targeting of precision, the repositioning of the patient is essential. The use of a contention adapted according to the location of the disease and the morphology of the patient is necessary for the safety of this one and the treatment. Once the patient positioned on the reference table, technicians of imager's team check by the acquisition of helical imagery with the reference CT-scanner the position of the patient, the zone of the PTV and healthy organs in the protected surroundings. At first, adjustment will be made automatically on three planes of the space (axial, sagittal, frontal) and three rotations (pitch, roll and yaw) by the device of treatment, then the technicians of imagery will bring a modification of these recalls manually. After validation, the processing will then be made in complete safety for the patient and the nursing. This check by MVCT is daily before every session of processing. It is made by the technicians of imagery. The radiation oncologist confirms the images at j0, then controls once a week MVCT. Traceability in the file of the patient of the various marks (osseous and\\or soft tissue) necessary for the daily gaps will be noted by this one to delegate to the technicians of imagery the validation of the MVCT before every session. Copyright © 2016. Published by Elsevier SAS.

  13. 5 CFR 842.210 - Military reserve technicians.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Military reserve technicians. 842.210 Section 842.210 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE... reserve technicians. (a) A military reserve technician as defined in 5 U.S.C. 8401(30) who is separated...

  14. Large Outbreak of Hepatitis C Virus Associated With Drug Diversion by a Healthcare Technician.

    Science.gov (United States)

    Alroy-Preis, Sharon; Daly, Elizabeth R; Adamski, Christine; Dionne-Odom, Jodie; Talbot, Elizabeth A; Gao, Fengxiang; Cavallo, Steffany J; Hansen, Katrina; Mahoney, Jennifer C; Metcalf, Erin; Loring, Carol; Bean, Christine; Drobeniuc, Jan; Xia, Guo-Liang; Kamili, Saleem; Montero, José T

    2018-05-14

    In May 2012, the New Hampshire (NH) Division of Public Health Services (DPHS) was notified of 4 persons with newly diagnosed hepatitis C virus (HCV) infection at hospital X. Initial investigation suggested a common link to the hospital cardiac catheterization laboratory (CCL) because the infected persons included 3 CCL patients and a CCL technician. NH DPHS initiated an investigation to determine the source and control the outbreak. NH DPHS conducted site visits, case patient and employee interviews, medical record and medication use review, and employee and patient HCV testing using enzyme immunoassay for anti-HCV, reverse-transcription polymerase chain reaction for HCV RNA, nonstructural 5B (NS5B) and hypervariable region 1 (HVR1) sequencing, and quasispecies analysis. HCV HVR1 analysis of the first 4 cases confirmed a common source of infection. HCV testing identified 32 of 1074 CCL patients infected with the outbreak strain, including 3 patients coinfected with >1 HCV strain. The epidemiologic investigation revealed evidence of drug diversion by the HCV-infected technician, evidenced by gaps in controlled medication control, higher fentanyl use during procedures for confirmed cases, and building card key access records documenting the presence of the technician during days when transmission occurred. The employee's status as a traveling technician led to a multistate investigation, which identified additional cases at prior employment sites. This is the largest laboratory-confirmed drug diversion-associated HCV outbreak published to date. Recommendations to reduce drug diversion risk and to conduct outbreak investigations are provided.

  15. An in-depth examination into pharmacy technician worklife through an organizational behavior framework.

    Science.gov (United States)

    Desselle, Shane P

    2016-01-01

    Pharmacy technicians are a vital part of the health care workforce. Little is known about perceptions of their own work environment that would engender more effective recruitment, retention, and management strategies by pharmacists and employers. The purpose of this study was to gain a greater understanding of certified pharmacy technician worklife. Specific objectives included the identification of themes of worklife phenomena to assist with the development of appropriate responses by other pharmacy stakeholders and to ascertain the contribution of various factors engendering or discouraging career commitment of pharmacy technicians. Semi-structured in-depth interviews were carried out with a convenience sample of pharmacy technicians in one U.S. state, who varied by their work settings and level of experience. The interview guide and corresponding participant responses were framed from around an organizational cultural basis rooted in organizational behavior theory. Notes from the interviews were analyzed thematically using directed content analysis. Four primary themes emerged, including: career impetus, job responsibilities, quality of work life, and equitable partnership. The data revealed pharmacy technicians' need for self-actualization and recognition of the value they bring to the organization. The participants identified primary responsibilities that contribute to their sense of worth and those that if not managed adequately potentially detract from their well-being and effectiveness. Findings in regard to rate of pay corroborate previous work on wages as both an intrinsic and extrinsic motivator. Pharmacy technicians seek equity among each other (their peers) and in a mutually beneficial relationship with their employing organization. This study provides the impetus for interventions and further study that should serve to enhance pharmacy technician effectiveness, quality of work life, and longevity in an emerging profession. Copyright © 2015 Elsevier

  16. New Zealand dental technicians and continuing education: findings from a qualitative survey.

    Science.gov (United States)

    Anderson, Vivienne R; Pang, Lilian C Y; Aarts, John M

    2012-06-01

    Under the 2003 Health Practitioners Competence Assurance (HPCA) Act, New Zealand registered dental technicians are subject to mandatory Continuing Professional Development (CPD) requirements. Internationally, little published literature has examined dental technicians' perspectives of CPD and CPD needs, and there is no published literature relating to the New Zealand context. Available research highlights the importance of CPD for maintaining high professional standards, ensuring patient safety, allowing dental technicians to keep abreast of current research and technological advances, fostering peer networks, and promoting job satisfaction. In 2009, an online open-ended questionnaire was developed to examine New Zealand dental and clinical dental technicians' perspectives of CPD and their perceived CPD needs. In total, 45 New Zealand registered dental technicians responded. Questionnaire responses provided rich qualitative insights into dental technicians' wide-ranging perceptions of CPD, factors that make CPD involvement more or less difficult and more or less desirable, and ways in which CPD access and relevance might be improved. This paper discusses the survey findings in the light of the existing literature on CPD and in relation to the unique New Zealand regulatory environment. It highlights the factors which respondents identified as shaping their CPD decisions, barriers to CPD engagement, perceived CPD needs, suggestions as to how the current CPD system could be improved, and areas for future research.

  17. 24 CFR 291.530 - Eligible firefighter/emergency medical technicians.

    Science.gov (United States)

    2010-04-01

    ... medical technicians. 291.530 Section 291.530 Housing and Urban Development Regulations Relating to Housing... medical technicians. A person qualifies as a firefighter/emergency medical technician for the purposes of... technician by a fire department or emergency medical services responder unit of the federal government, a...

  18. Work group design in pharmacy: the pharmacist-technician team.

    Science.gov (United States)

    Kershaw, B P; Solomon, D K; Zarowitz, B J

    1987-05-01

    The contemporary pharmacy practice manager faces the challenge of designing pharmacy service programs that not only satisfy the needs of the patient, but at the same time satisfy and motivate the pharmacists and technicians who sustain the programs. This research examined the team design, which has been recommended but not fully described in the literature. This application did not explore the full potential of the team design in the hospital pharmacy setting. More study is needed in this area to assess the impact of work group design on the expansion of clinical programs, employee turnover rates, quality and quantity of work produced, and, most important, the impact on job satisfaction enjoyed by pharmacists and technicians.

  19. Pharmacy technician self-efficacies: Insight to aid future education, staff development, and workforce planning.

    Science.gov (United States)

    Desselle, Shane P; Hoh, Ryan; Holmes, Erin R; Gill, Amanpreet; Zamora, Lemuel

    2017-07-15

    The roles of pharmacy technicians are increasingly prominent given pharmacy's transition to patient-centered activities and evolving scopes of practice in many U.S. states and throughout the world. The aims of this study were to assess U.S. pharmacy technicians' self-efficacies for and attitudes toward performing current and emerging roles in hospital and in community pharmacy and to identify factors related to pharmacy technician self-efficacies in these roles. A total of 5000 pharmacy technicians from 8 U.S. states were sent an electronic survey eliciting data on current involvement, self-efficacies, and attitudes for practicing in an expansive list of practice activities. The 8 states from which the sample was drawn were selected from a stratified randomized procedure using U.S. Census Bureau geographically defined regions. Pre-notification and response reminders were employed. Data were analyzed descriptively and with univariate, inferential tests, as appropriate, to determine associations with commitment, practice environment, experience level, and other variables. Of the 612 participants who responded, 494 were currently working as a technician and not enrolled in a PharmD program of study. Participants reported various activities in which they were highly engaged. Overall, attitudes toward performing most of the activities and self-efficacies were quite favorable, even for those activities in which technicians were currently less involved. There were some notable differences between technicians practicing in community versus hospital settings. Years of experience, profession commitment, and advanced employee ranking were associated with higher levels of self-efficacy, overall. This initial examination of pharmacy technician self-efficacies identified areas that along with other factors could help employers with further expanding technician practice activities and vocational institutions with considerations for education and development of these key members

  20. Training nuclear technicians in two-year, post-secondary educational programs

    International Nuclear Information System (INIS)

    Hull, D.M.; Roney, M.W.

    1975-01-01

    An available and economical supply to future manpower requirements for various types of nuclear technicians can be met by developing and/or restructuring two-year, post-secondary programs at local educational institutions. The Technical Education Research Centers program is under contract from the U.S. Office of Education to delineate the job requirements and develop curricula and instructional materials for two-year, post-secondary training of nuclear technicians. Six job categories have been identified along with corresponding tasks which the technician performs. These categories are: Reactor Operator, Nuclear Instrumentation Technician, Nuclear QA/QC Technician, Radiochemistry Technician, Radiation Protection Technician and Nuclear Medicine Technician. For the first five categories curricula have been established, courses have been described, and instructional materials are being written

  1. Knowledge and attitudes about smoking cessation among pharmacy technicians.

    Science.gov (United States)

    Zillich, Alan J; Aquilino, Mary L; Farris, Karen B

    2004-01-01

    To evaluate the knowledge and attitudes of pharmacy technicians before and after attending a continuing education program about smoking cessation. A pre/post survey of a single group. Two statewide meetings of the Iowa Pharmacy Association. Pharmacy technicians. One 2-hour continuing education (CE) course about smoking cessation for pharmacy technicians. Changes in scores before and after the CE sessions among three domains (knowledge, efficacy, and outcome) of a validated survey instrument. Fifty-one technicians completed both the presession and postsession questionnaire. For the three survey domains, technicians' knowledge (P = .034), efficacy (P < .001), and outcome (P < .001) showed significant improvement between the presession and postsession surveys (Wilcoxon signed rank test). Pharmacy technicians who attended a CE program on smoking cessation improved their knowledge, attitudes, and self-confidence in helping smokers quit. Additional research should be conducted to test the role of pharmacy technicians in smoking cessation promotion.

  2. Team knowledge assessment of nursing on international targets patient safety in an intensive care unit

    Directory of Open Access Journals (Sweden)

    Maria Nathália da Silva Souza

    2017-08-01

    Full Text Available Background e Objectives: The quality of hospital care provided to the patient and the safety of their stay at the site triggered discussions around the world after the analysis of epidemiological studies conducted in the USA that concluded the high rate of adverse events in the hospital setting Caused by professional error, with that the theme gained strength and motivated discussions about the care models applied to the patients. Therefore the research was aimed at evaluating the knowledge of the Nursing Team of the Intensive Care Unit sector of a public hospital in Recife-PE on the International Patient Safety Goals. Methods: A cross-sectional study with descriptive quantitative approach was carried out from June to August 2016. Data collection was performed through a semi-structured questionnaire that addressed the social and professional aspects of the respondents. The studied variables: gender, age, professional category and training time. The data were analyzed in epiinfo software version 3.2.2. Results: The sample consisted of 50 professionals, 18% of whom were Nurses and 82% were Nursing technicians. Most respondents scored more than 50% of questions about international patient safety goals and had more than one employment relationship. Conclusion: It was verified that the lack of training, work overload and more of an employment relationship can contribute to a precarious professional assistance. KEYWORDS: Patient Safety. Nursing. Safety Management. Intensive Care Units

  3. Enactment of mandatory pharmacy technician certification in Kansas.

    Science.gov (United States)

    Lucas, Amber; Massey, Lindsay; Gill, Taylor; Burger, Gregory; Little, Jeff D

    2016-02-01

    The successful enactment of mandatory pharmacy technician certification in Kansas is described. In 2004, Kansas began requiring registration of all pharmacy technicians with the state board of pharmacy. Registration identified individuals working as pharmacy technicians but did not require any specific education or certification. In September 2012, the Kansas Board of Pharmacy created a task force of key stakeholders including pharmacists from multiple areas of practice, the University of Kansas School of Pharmacy, organizational leaders from the Kansas Council of Health-System Pharmacists (KCHP) and Kansas Pharmacists Association, and professional lobbyists. The goals of this task force were to research practices of technician certification in other states and to make recommendations to the state board of pharmacy on how Kansas could accomplish mandatory technician certification. The task force outlined the steps needed to achieve legislation that could be supported by the members. These topics included the creation of a technician trainee category, grandfathering certain technicians who had been practicing for a designated period of time, state board-approved exemptions, training requirements, age and education requirements, continuing-education requirements, and pharmacist:technician ratio. The recommendations were finalized at the August 2013 Kansas Pharmacy Summit, and the proposed legislation was introduced and passed during the 2014 legislative session. KCHP members learned many valuable lessons about advocacy and the legislative process with this initiative, including building relationships, working with legislators, and working with other professional organizations. The formation of a task force led to the successful passage of a bill granting the Kansas Board of Pharmacy the authority to issue regulations regarding mandatory pharmacy technician certification. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  4. A case of hypersensitivity pneumonitis with giant cells in a female dental technician.

    Science.gov (United States)

    Kim, Yong-Hyun; Chung, Yun Kyung; Kim, Changhwan; Nam, Eun Suk; Kim, Hyun-Jun; Joo, Youngsu

    2013-10-04

    Dental technicians are exposed to methyl methacrylate(MMA) and hard metal dusts while working, and several cases of hypersensitivity pneumonitis caused by the exposure have been reported. The authors experienced a case of hypersensitivity pneumonitis in a female dental technician who had 10 years' work experience and report the case with clinical evidence. The patient's work, personal, social, and past and present medical histories were investigated based on patient questioning and medical records. Furthermore, the workplace conditions and tools and materials the patient worked with were also evaluated. Next, the pathophysiology and risk factors of pneumonitis were studied, and studies on the relationship between hypersensitivity pneumonitis and a dental technician's exposure to dust were reviewed. Any changes in the clinical course of her disease were noted for evaluation of the work-relatedness of the disease. The patient complained of cough and sputum for 1 year. In addition, while walking up the stairs, the patient was not able to ascend without resting due to dyspnea. She visited our emergency department due to epistaxis, and secondary hypertension was incidentally suspected. Laboratory tests including serologic, electrolyte, and endocrinologic tests and a simple chest radiograph showed no specific findings, but chest computed tomography revealed a centrilobular ground-glass pattern in both lung fields. A transbronchial biopsy was performed, and bronchoalveolar washing fluid was obtained. Among the findings of the laboratory tests, microcalcification, noncaseating granuloma containing foreign body-type giant cells, and metal particles within macrophages were identified histologically. Based on these results, hypersensitivity pneumonitis was diagnosed. The patient stopped working due to admission, and she completely quit her job within 2 months of restarting work due to reappearance of the symptoms. In this study, the patient did not have typical radiologic

  5. Doses to nuclear technicians in a dedicated PET/CT centre utilising 18F fluorodeoxyglucose (FDG)

    International Nuclear Information System (INIS)

    Seierstad, T.; Stranden, E.; Bjering, K.; Evensen, M.; Holt, A.; Michalsen, H. M.; Wetteland, O.

    2007-01-01

    The first dedicated PET/CT centre in Norway was established at the Norwegian Radiumhospital in Oslo in 2005. Knowing that the introductions of PET-isotopes in nuclear medicine give increased occupational radiation dose to the technicians, a study was carried out in order to map the doses to staff members during different working operations and to see if any dose reducing measures were needed. The results of the study are in good agreement with other studies, and a technician dose of 20-25 nSv per injected MBq of 18 F seems to be representative for such centres. For an average injected activity of 350 MBq per patient, the dose limit is reached after handling around 3000 patients annually. For an annual number of less than 500 patients at the centre and rotation of the staff, an annual individual dose for the technicians would realistically be less than 2-3 mSv. Even a major increase in the number of patients will not result in individual doses near the ICRP dose limit. (authors)

  6. Screening for diabetic retinopathy in primary care with a mobile ...

    African Journals Online (AJOL)

    A SWOT analysis of the pilot project was completed and recommendations were made on how to integrate it into the district health system. Conclusion. Screening with a fundal camera improved the quality of care for diabetic patients and is feasible in the South African public sector, primary care setting. A single technician ...

  7. The relationship between intraoperative teamwork and management skills in patient care.

    Science.gov (United States)

    Phitayakorn, Roy; Minehart, Rebecca D; Hemingway, Maureen W; Pian-Smith, May C M; Petrusa, Emil

    2015-11-01

    Optimal team performance in the operating room (OR) requires a combination of interactions among OR professionals and adherence to clinical guidelines. Theoretically, it is possible that OR teams could communicate very well but fail to follow acceptable standards of patient care and vice versa. OR simulations offer an ideal research environment to study this relationship. The goal of this study was to determine the relationship between ratings of OR teamwork and communication with adherence to patient care guidelines in a simulated scenarios of malignant hyperthermia (MH). An interprofessional research team (2 anesthesiologists, 1 surgeon, an OR nurse, and a social scientist) reviewed videos of 5 intraoperative teams managing a simulated patient who manifested MH while undergoing general anesthesia for an epigastric herniorraphy in a high-fidelity, in situ OR. Participant teams consisted of 2 residents from anesthesiology, 1 from surgery, 1 OR nurse, and 1 certified surgical technician. Teamwork and communication were assessed with 4 published tools: Anesthesiologists' Non-Technical Skills (ANTS), Scrub Practitioners List of Intra-operative Non-Technical Skills (SPLINTS), Non-Technical Skills for Surgeons (NOTSS), and Objective Teamwork Assessment System (OTAS). We developed an evidence-based MH checklist to assess overall patient care. Interrater agreement for teamwork tools was moderate. Average rater agreement was 0.51 For ANTS, 0.67 for SPLINTS, 0.51 for NOTSS, and 0.70 for OTAS. Observer agreement for the MH checklist was high (0.88). Correlations between teamwork and MH checklist were not significant. Teams were different in percent of the MH actions taken (range, 50-91%; P = .006). In this pilot study, intraoperative teamwork and communication were not related to overall patient care management. Separating nontechnical and technical skills when teaching OR teamwork is artificial and may even be damaging, because such an approach could produce teams with

  8. Aplastic anemia in Japanese radiological technicians

    International Nuclear Information System (INIS)

    Kitabatake, T.; Watanabe, T.; Saito, A.; Nakamura, M.; Shiohama Hospital, Mie

    1976-01-01

    Among the Japanese radiological technicians, four deaths from aplastic anemia have been reported after 1930. On the other hand, during the period from 1930 to 1960, the population of radiological technicians is estimated to be 74,400 man-years, in which 0.5 aplastic anemias are expected. However, actually three died from aplastic anemia. This difference is statistically significant at the 1% level. While, in the period from 1961 to 1973, the observed value is 1 against 0.7 expected. It is concluded that aplastic anemia had been induced frequently among the Japanese radiological technicians in the era when there was much exposure to occupational radiation. (orig.) [de

  9. Welding Technician

    Science.gov (United States)

    Smith, Ken

    2009-01-01

    About 95% of all manufactured goods in this country are welded or joined in some way. These welded products range in nature from bicycle handlebars and skyscrapers to bridges and race cars. The author discusses what students need to know about careers for welding technicians--wages, responsibilities, skills needed, career advancement…

  10. Pneumoconiosis and respiratory problems in dental laboratory technicians: Analysis of 893 dental technicians

    Directory of Open Access Journals (Sweden)

    Dilek Ergün

    2014-10-01

    Full Text Available Objectives: To explore the rate of pneumoconiosis in dental technicians (DTP and to evaluate the risk factors. Material and Methods: Data of 893 dental technicians, who were admitted to our hospital in the period January 2007–May 2012, from 170 dental laboratories were retrospectively examined. Demographic data, respiratory symptoms, smoking status, work duration, working fields, exposure to sandblasting, physical examination findings, chest radiographs, pulmonary function tests and high-resolution computed tomography results were evaluated. Results: Dental technicians’ pneumoconiosis rate was 10.1% among 893 cases. The disease was more common among males and in those exposed to sandblasting who had 77-fold higher risk of DTP. The highest profusion subcategory was 3/+ (according to the International Labour Organization (ILO 2011 standards and the large opacity rate was 13.3%. Conclusions: To the best of our knowledge, it was the largest DTP case series (N = 893/90 in the literature in English. Health screenings should be performed regularly for the early diagnosis of pneumoconiosis, which is an important occupational disease for dental technicians.

  11. Does pneumoconiosis of dental technician cause to calcific pleural lesions? (Case report

    Directory of Open Access Journals (Sweden)

    Abdurrahman ŞENYİĞİT

    2009-03-01

    Full Text Available The articles about various pneumoconiosis in dental technicians who work in inconvenient conditions have been increasing in recent years. Exposure to dust and fume that occur during the dental procedure may play role in pneumoconiosis of dental technicians.A 53 years old male patient conveyed that he has worked in dental prosthesis procedures for 22 years (1968-1990.Environmental asbestosis was not established in the history of the case but there were calcified pleural plaques in the chest x-ray graphy.There were appearance of calcific asbest plaques in many section of thorax CT.A case of pneumoconiosis in dental technician who work in unadequate preventive conditions was reported in this paper. Probably ,exposure to the asbest fibers that occurs during the procedure of dental prosthesis were the main reason for developing calcific pleural lesions.

  12. Emergency Medical Technician Training During Medical School: Benefits for the Hidden Curriculum.

    Science.gov (United States)

    Russ-Sellers, Rebecca; Blackwell, Thomas H

    2017-07-01

    Medical schools are encouraged to introduce students to clinical experiences early, to integrate biomedical and clinical sciences, and to expose students to interprofessional health providers and teams. One important goal is for students to gain a better understanding of the patients they will care for in the future and how their social and behavioral characteristics may affect care delivery. To promote early clinical exposure and biomedical integration, in 2012 the University of South Carolina School of Medicine Greenville incorporated emergency medical technician (EMT) training into the curriculum. This report describes the program; outlines changes (made after year 1) to improve biomedical integration; and provides a brief analysis and categorization of comments from student reflections to determine whether particular themes, especially related to the hidden curriculum, appeared. Medical students wrote frequently about EMT-related experiences: 29% of reflections in the charter year (1.2 per student) and 38% of reflections in the second year (1.5 per student) focused on EMT-related experiences. Reflections related to patient care, professionalism, systems-based practice, and communication/interpersonal skills. The frequency of themes in student reflections may provide insight into a medical program's hidden curriculum. This information may serve to inform curricula that focus on biosocial elements such as professionalism and communication with the goal of enhancing future physicians' tolerance, empathy, and patient-centeredness. The authors plan to conduct further qualitative analysis of student reflections to iteratively revise curricula to address gaps both in learning and in the differences between the explicit curriculum and actual experiences.

  13. The practical training of students - x-ray technicians and requirements to mentors in clinical bases

    International Nuclear Information System (INIS)

    Gagova, P; Boninska, N.; Jovchev, D.

    2012-01-01

    Full text: Introduction: Training of X-ray technicians in Bulgaria takes place in the Medical Colleges to Medical Universities. It's purpose is providing professional training of students in the area of diagnostic imaging, nuclear medicine and radiotherapy. Practical training is based on the scientific and theoretical knowledge and skills and is organized in pedagogic environment, adequate to regularities for a gradual formation of practical skills and habits. The practical training and pre-graduation internship are performed in 1895 from total of 3810 hours, which represents about fifty percent of all training of X-ray technicians. Students are in groups of 2-4 students. Practical training is organized, accomplished and monitored by the teacher training practice with the help of a mentor in the clinical base. Purpose: To present the tasks of practical training of students - X-ray technicians and the requirements for the personal characteristics and activity of mentors. Materials and methods: Documentary method has been used. Literature and normative documents related to the practical training of students in 'X-ray technician' of Medical Colleges have been studied. The job descriptions of senior clinical X-ray technicians have been examined carefully. Results: By analyzing literature sources, we have structured the tasks of practical training and pre-graduation internship of students - X-ray technicians, also we have described the requirements for personal qualities of mentors and systematize the activities they perform. Conclusion: Practical training plays an important role in adaptation of young X-ray technicians to the conditions of medical work, improving their skills and habits, and to the development of specific practical skills for being able to respond to emergency conditions and to solve complicated practical situations. The mentor is the supervisor and the controller of interns who helps this happen through his own example, qualities and attitudes towards

  14. Radiological control technician: Training program management manual

    International Nuclear Information System (INIS)

    1992-10-01

    This manual defines and describes the DOE Radiological Control Technician Core Training Program qualification and training process, material development requirements, standards and policies, and administration. The manual applies to Radiological Control Technician Training Programs at all DOE contractor sites

  15. 46 CFR 160.151-39 - Training of servicing technicians.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 6 2010-10-01 2010-10-01 false Training of servicing technicians. 160.151-39 Section...-39 Training of servicing technicians. (a) The training program for certification of servicing technicians must include— (1) Training and practice in packing an inflatable liferaft, repairing buoyancy...

  16. [Pleasure in nursing technicians working at an emergency unit of a public university hospital].

    Science.gov (United States)

    Garcia, Alessandra Bassalobre; Dellaroza, Mara Solange Gomes; Haddad, Maria do Carmo Lourenço; Pachemshy, Luiza Rita

    2012-06-01

    This study aimed to reveal the main aspects of the work process and feelings of pleasure experienced by nursing technicians who work at an emergency unit in Paraná, Brazil. The theoretical basis is the psychodynamics of work. This is a qualitative and descriptive study. Data were collected and analyzed using a semi-structured interview and the content analysis technique. Subjects were selected using a snowball sampling. Important aspects of the work process were revealed such as the unpredictability of working in an emergency unit, the impact of team work, and the comprehensive care model as a precursor to humanized care. Pleasure originates from the acknowledgement of their work either by the working subject him/herself by patients or society; and from the team work, realized by the cooperation among professionals. Feelings of pleasure are linked to the acknowledgment of their work, which should be valued since gratification contributes to the psychological health of workers.

  17. Dental technician pneumoconiosis mimicking lung cancer.

    Science.gov (United States)

    Uyar, Meral; Sokucu, Oral; Sanli, Maruf; Filiz, Ayten; Ali Ikidag, Mehmet; Feridun Isik, Ahmet; Bakir, Kemal

    2015-09-01

    A 47-year-old man was referred for assessment of bilateral lymph node enlargement identified on a routine chest radiograph. Positron emission tomography showed high standardized uptake values (SUVmax: 20.5) in right supraclavicular, right intercostal, and multiple mediastinal lymph nodes. Biopsy samples obtained from the right upper and left lower paratracheal nodes by mediastinoscopy revealed granulomatous inflammation. Clinical and laboratory findings indicated a diagnosis of dental technician pneumoconiosis. The patient is alive and well 3 years after diagnosis. This case highlights the importance of obtaining an occupational history.

  18. 40 CFR 745.90 - Renovator certification and dust sampling technician certification.

    Science.gov (United States)

    2010-07-01

    ... sampling technician certification. 745.90 Section 745.90 Protection of Environment ENVIRONMENTAL PROTECTION... technician certification. (a) Renovator certification and dust sampling technician certification. (1) To become a certified renovator or certified dust sampling technician, an individual must successfully...

  19. Internet treatment for depression: a randomized controlled trial comparing clinician vs. technician assistance.

    Science.gov (United States)

    Titov, Nickolai; Andrews, Gavin; Davies, Matthew; McIntyre, Karen; Robinson, Emma; Solley, Karen

    2010-06-08

    Internet-based cognitive behavioural therapy (iCBT) for depression is effective when guided by a clinician, less so if unguided. Would guidance from a technician be as effective as guidance from a clinician? Randomized controlled non-inferiority trial comparing three groups: Clinician-assisted vs. technician-assisted vs. delayed treatment. Community-based volunteers applied to the VirtualClinic (www.virtualclinic.org.au) research program, and 141 participants with major depressive disorder were randomized. Participants in the clinician- and technician-assisted groups received access to an iCBT program for depression comprising 6 online lessons, weekly homework assignments, and weekly supportive contact over a treatment period of 8 weeks. Participants in the clinician-assisted group also received access to a moderated online discussion forum. The main outcome measures were the Beck Depression Inventory (BDI-II) and the Patient Health QUESTIONnaire-9 Item (PHQ-9). Completion rates were high, and at post-treatment, both treatment groups reduced scores on the BDI-II (ptechnician-assisted groups respectively, and on the PHQ-9, were 1.54 and 1.60 respectively. At 4-month follow-up participants in the technician group had made further improvements and had significantly lower scores on the PHQ-9 than those in the clinician group. A total of approximately 60 minutes of clinician or technician time was required per participant during the 8-week treatment program. Both clinician- and technician-assisted treatment resulted in large effect sizes and clinically significant improvements comparable to those associated with face-to-face treatment, while a delayed treatment control group did not improve. These results provide support for large scale trials to determine the clinical effectiveness and acceptability of technician-assisted iCBT programs for depression. This form of treatment has potential to increase the capacity of existing mental health services. Australian New

  20. Radiological Control Technician: Standardized technician Qualification Standard

    International Nuclear Information System (INIS)

    1992-10-01

    The Qualification Standard states and defines the knowledge and skill requirements necessary for successful completion of the Radiological Control Technician Training Program. The standard is divided into three phases: Phase I concerns RCT Academic training. There are 13 lessons associated with the core academics program and 19 lessons associated with the site academics program. The staff member should sign the appropriate blocks upon successful completion of the examination for that lesson or group of lessons. In addition, facility specific lesson plans may be added to meet the knowledge requirements in the Job Performance Measures (JPM) of the practical program. Phase II concerns RCT core/site practical (JPMs) training. There are thirteen generic tasks associated with the core practical program. Both the trainer/evaluator and student should sign the appropriate block upon successful completion of the JPM. In addition, facility specific tasks may be added or generic tasks deleted based on the results of the facility job evaluation. Phase III concerns the oral examination board successful completion of the oral examination board is documented by the signature of the chairperson of the board. Upon completion of all of the standardized technician qualification requirements, final qualification is verified by the student and the manager of the Radiological Control Department and acknowledged by signatures on the qualification standard. The completed Qualification Standard shall be maintained as an official training record

  1. Practical analog electronics for technicians

    CERN Document Server

    Kimber, W A

    2013-01-01

    'Practical Analog Electronics for Technicians' not only provides an accessible introduction to electronics, but also supplies all the problems and practical activities needed to gain hands-on knowledge and experience. This emphasis on practice is surprisingly unusual in electronics texts, and has already gained Will Kimber popularity through the companion volume, 'Practical Digital Electronics for Technicians'. Written to cover the Advanced GNVQ optional unit in electronics, this book is also ideal for BTEC National, A-level electronics and City & Guilds courses. Together with 'Practical Digit

  2. Hematological findings in male x-ray technicians

    International Nuclear Information System (INIS)

    Meo, Sultan A.

    2004-01-01

    In view of the known health hazards of x-ray radiation, this study focuses on the basic hematological parameters: red blood cells (RBCs), white blood cells (WBCs) and platelets count in x-ray technicians. The aim was to identify the affect of x-ray radiation on blood cell counts in x-ray technicians. The present study was conducted in the Department of Physiology, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia during the year 2002. In this study, a group of 40 apparently healthy male x-ray technicians with age ranging from 25-50-years were recruited. They were matched with another group of 40 apparently healthy control subjects in terms of age, sex and ethnic origin. Both groups met with exclusion criteria as per standard. Red blood cells, WBC and platelets count were performed by using a blood cell auto analyser. The mean value of platelet count was significantly decreased (p<0.01) in x-ray technicians when compared to controls. However, no significant difference was observed in RBC and WBC count between the groups. Radiation causes decreased platelet count. Further, studies are needed to study the long-term effects of x-ray radiation on blood cell count in x-ray technicians. (author)

  3. Comparing Burnout Across Emergency Physicians, Nurses, Technicians, and Health Information Technicians Working for the Same Organization

    OpenAIRE

    Schooley, Benjamin; Hikmet, Neset; Tarcan, Menderes; Yorgancioglu, Gamze

    2016-01-01

    Abstract Studies on the topic of burnout measure the effects of emotional exhaustion (EE), depersonalization (DP) (negative or cynical attitudes toward work), and reduced sense of personal accomplishment (PA). While the prevalence of burnout in practicing emergency medicine (EM) professionals has been studied, little is known of the prevalence and factors across physicians, nurses, technicians, and health information technicians working for the same institution. The aim of this study was to a...

  4. Section 608 Technician Certification

    Science.gov (United States)

    Certifications for technicians who maintain, service, repair, or dispose of equipment that could release ozone depleting refrigerants or, after January 1, 2018, substitute refrigerants into the atmosphere.

  5. Technicians and Shop Owners

    Science.gov (United States)

    Overview page provides information for shops and technicians that repair or service motor vehicle air-conditioning systems, including information on proper training, approved equipment, and regulatory practices.

  6. Preparing technicians for photonics industries and organizations

    Science.gov (United States)

    Souders, John; Hull, Dan

    2012-10-01

    U.S. photonics organizations need about 800 new photonics technicians each year. Thirty-one community and technical colleges have approximately 700 students enrolled in photonics related programs; about 275 of them complete their coursework and enter the workforce each year. A disparity exists between the demand and supply of qualified photonics technicians in the U.S. OP-TEC, the National Center for Optics and Photonics Education is a consortium of seven colleges, under the leadership of the University of Central Florida, and sponsored by NSF. OP-TEC's mission is to increase the quantity and quality of photonics technicians prepared at two-year colleges. OP-TEC maintains the National Photonics Skill Standards for Technicians, provides curriculum models, teaching materials, faculty training/professional development and planning services to strengthen existing college photonics programs and to attract and support new ones. OP-TEC is converting its text materials to E-Books to support students in technical programs. Through OP-TEC's recruitment efforts 84 additional colleges are interested in initiating new photonics programs. The OP-TEC Photonics College Network (OPCN) consists of 28 colleges that are currently providing photonics education. This fall OPCN will lead an additional national effort to further educate employed photonics technicians through on-line courses, complemented by lab experiences at nearby colleges. OP-TEC is expanding its outreach to photonics employers and colleges by regionalizing its approach to offering its services. OP-TEC is also planning to develop new curricula and instructional materials for AAS programs to prepare Precision Optics Technicians. This paper will detail OP-TEC's work with particular emphases on its materials and services.

  7. Physician and Nurse Acceptance of Technicians to Screen for Geriatric Syndromes in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Brian F Gage

    2011-05-01

    Full Text Available Introduction: The objective of this study was to evaluate emergency medicine physician and nurse acceptance of nonnurse, nonphysician screening for geriatric syndromes. Methods: This was a single-center emergency department (ED survey of physicians and nurses after an 8-month project. Geriatric technicians were paid medical student research assistants evaluating consenting ED patients older than 65 years for cognitive dysfunction, fall risk, or functional decline. The primary objective of this anonymous survey was to evaluate ED nurse and physician perceptions about the geriatric screener feasibility and barriers to implementation. In addition, as a secondary objective, respondents reported ongoing geriatric screening efforts independent of the research screeners. Results: The survey was completed by 72% of physicians and 33% of nurses. Most nurses and physicians identified geriatric technicians as beneficial to patients without impeding ED throughput. Fewer than 25% of physicians routinely screen for any geriatric syndromes. Nurses evaluated for fall risk significantly more often than physicians, but no other significant differences were noted in ongoing screening efforts. Conclusion: Dedicated geriatric technicians are perceived by nurses and physicians as beneficial to patients with the potential to improve patient safety and clinical outcomes. Most nurses and physicians are not currently screening for any geriatric syndromes. [West J Emerg Med. 2011;12(4:489–495.

  8. [Emergency Medical Technician profile in Spain].

    Science.gov (United States)

    Martínez-Isasi, Santiago; Rodríguez-Lorenzo, María José; Vázquez-Santamariña, David; Abella-Lorenzo, Javier; Castro Dios, Diana Josefa; Fernández García, Daniel

    2017-12-11

    The emergency medical technician plays a fundamental role and is the most important figure quantitatively in pre-hospital emergencies. The aim was to asses the socio-demographic, work-related, health characteristics and technical skills of an Emergency Medical Technician in Spain. Cross-sectional descriptive study. An ad hoc questionnaire was managed using Google Docs® that was delivered between April-June 2014 via email and social networks. A total of 705 questionnaires were collected. Statistical analysis was performed with SPSS ® 20.0 Windows version. A significance level p≤0.05 was used for all analyzes. The data analyzed show that the profile of the Emergency Medical Technician in Spain is an 39 year-old man, married or living as a couple and has a child. The average BMI is 27 kg/m2, does regular exercise, does not smoke. His seniority in the company is 10 years and has the Medium Cycle of Emergency Medical Technician. The analysis for gender shows that men have an average of 40, an average BMI of 27, 5 kg/m2 and work in an advanced life support unit; while women have an average of 36,5 years, an average BMI of 24,7 kg/m2, mainly work in Basic Life Support Unit and her seniority in the company is 6,76 years. Emergency Medical Technician profile is a overweight men, who refer to practise regular exercise, his seniority in the company is 10 years and is in possession of CMTES; differences were observed according to gender in BMI, resource where they perform their work, seniority and age.

  9. Comparing Burnout Across Emergency Physicians, Nurses, Technicians, and Health Information Technicians Working for the Same Organization.

    Science.gov (United States)

    Schooley, Benjamin; Hikmet, Neset; Tarcan, Menderes; Yorgancioglu, Gamze

    2016-03-01

    Studies on the topic of burnout measure the effects of emotional exhaustion (EE), depersonalization (DP) (negative or cynical attitudes toward work), and reduced sense of personal accomplishment (PA). While the prevalence of burnout in practicing emergency medicine (EM) professionals has been studied, little is known of the prevalence and factors across physicians, nurses, technicians, and health information technicians working for the same institution. The aim of this study was to assess burnout differences across EM professional types.The total population of 250 EM professionals at 2 public urban hospitals in Turkey were surveyed using the Maslach Burnout Inventory and basic social- and work-related demographics. Descriptive statistics, ANOVA, and additional post hoc tests were computed.Findings show that EE and DP scores were high across all occupational groups, while scores on PA were low. There was a statistically significant difference between nurses and medical technicians (P nurses and medical technicians (P Burnout can be high across occupational groups in the emergency department. Burnout is important for EM administrators to assess across human resources. Statistically significant differences across socio-demographic groups vary across occupational groups. However, differences between occupational groups may not be explained effectively by the demographic factors assessed in this or other prior studies. Rather, the factors associated with burnout are incomplete and require further institutional, cultural, and organizational analyses including differentiating between job tasks carried out by each EM job type.

  10. Using patient acuity data to manage patient care outcomes and patient care costs.

    Science.gov (United States)

    Van Slyck, A; Johnson, K R

    2001-01-01

    This article describes actual reported uses for patient acuity data that go beyond historical uses in determining staffing allocations. These expanded uses include managing patient care outcomes and health care costs. The article offers the patient care executive examples of how objective, valid, and reliable data are used to drive approaches to effectively influence decision making in an increasingly competitive health care environment.

  11. Regulation on the training-schools and institutions for radiation-technicians and x-ray technicians

    International Nuclear Information System (INIS)

    1977-01-01

    The regulation, in accordance with the Law on X-ray technicians (Law No. 227, 1951), controls and makes rules of the establishment and activities of schools and institutions for those technicians as above mentioned, with intent to secure prescribed qualifications and capabilities of said technicians. Such schools and institutions shall get the designation by relevant ministers of the government who have the power to supervise them, namely the Education Minister and the Minister for Health and Welfare (Article 2). Articles 4 and 4(2) prescribe the standards for the relevant ministers to make the designation of those schools and institutions, in relation to the school years, curriculums, teachers, equipments, etc. According to the standards, those schools and institutions may be of 3-year, 2-year on one-year course according to the required attainment level of students who enters them. The minimum requirement of the attainment is the secondary-school certificates for the 3-year course. The relevant ministers may require such reports from, and give such instructions to those schools and institutions as they consider necessary, and may revoke their designation when such a school on institution has become incompliant with above mentioned standards (Articles 6 and 7). (Matsushima, A.)

  12. Advancing technician practice: Deliberations of a regulatory board.

    Science.gov (United States)

    Adams, Alex J

    2018-01-01

    In 2016, the Idaho State Board of Pharmacy (U.S.) undertook a major rulemaking initiative to advance pharmacy practice by broadening the ability of pharmacists to delegate tasks to pharmacy technicians. The new rules of the Board thus moved the locus of control in technician scope of practice from law to pharmacist delegation. Pharmacist delegation is individualistic and takes into account the individual technician's capabilities, the pharmacist's comfort level, facility policies, and the risk mitigation strategies present at the facility, among other factors. State law limits, by contrast, are rigid and can mean that pharmacists are unable to delegate tasks that are or could otherwise be within the abilities of their technicians. The expanded technician duties are in two domains: 1) medication dispensing support (e.g., tech-check-tech, accepting verbal prescriptions, transferring prescriptions, and performing remote data entry); and 2) technical support for pharmacist clinical services (e.g., administering immunizations). This commentary reviews the evidence behind these expanded duties, as well as the key regulatory decision points for each task. The Board's rules and approach may prove useful to other states and even other governing bodies outside the U.S. as they consider similar issues. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Impact of a pharmacy technician-centered medication reconciliation program on medication discrepancies and implementation of recommendations.

    Science.gov (United States)

    Kraus, Sarah K; Sen, Sanchita; Murphy, Michelle; Pontiggia, Laura

    2017-01-01

    To evaluate the impact of a pharmacy-technician centered medication reconciliation (PTMR) program by identifying and quantifying medication discrepancies and outcomes of pharmacist medication reconciliation recommendations. A retrospective chart review was performed on two-hundred patients admitted to the internal medicine teaching services at Cooper University Hospital in Camden, NJ. Patients were selected using a stratified systematic sample approach and were included if they received a pharmacy technician medication history and a pharmacist medication reconciliation at any point during their hospital admission. Pharmacist identified medication discrepancies were analyzed using descriptive statistics, bivariate analyses. Potential risk factors were identified using multivariate analyses, such as logistic regression and CART. The priority level of significance was set at 0.05. Three-hundred and sixty-five medication discrepancies were identified out of the 200 included patients. The four most common discrepancies were omission (64.7%), non-formulary omission (16.2%), dose discrepancy (10.1%), and frequency discrepancy (4.1%). Twenty-two percent of pharmacist recommendations were implemented by the prescriber within 72 hours. A PTMR program with dedicated pharmacy technicians and pharmacists identifies many medication discrepancies at admission and provides opportunities for pharmacist reconciliation recommendations.

  14. Impact of a pharmacy technician-centered medication reconciliation program on medication discrepancies and implementation of recommendations

    Directory of Open Access Journals (Sweden)

    Kraus SK

    2017-06-01

    Full Text Available Objectives: To evaluate the impact of a pharmacy-technician centered medication reconciliation (PTMR program by identifying and quantifying medication discrepancies and outcomes of pharmacist medication reconciliation recommendations. Methods: A retrospective chart review was performed on two-hundred patients admitted to the internal medicine teaching services at Cooper University Hospital in Camden, NJ. Patients were selected using a stratified systematic sample approach and were included if they received a pharmacy technician medication history and a pharmacist medication reconciliation at any point during their hospital admission. Pharmacist identified medication discrepancies were analyzed using descriptive statistics, bivariate analyses. Potential risk factors were identified using multivariate analyses, such as logistic regression and CART. The priority level of significance was set at 0.05. Results: Three-hundred and sixty-five medication discrepancies were identified out of the 200 included patients. The four most common discrepancies were omission (64.7%, non-formulary omission (16.2%, dose discrepancy (10.1%, and frequency discrepancy (4.1%. Twenty-two percent of pharmacist recommendations were implemented by the prescriber within 72 hours. Conclusion: A PTMR program with dedicated pharmacy technicians and pharmacists identifies many medication discrepancies at admission and provides opportunities for pharmacist reconciliation recommendations.

  15. Considerations for services from dental technicians in fabrication of fixed prostheses: A survey of commercial dental laboratories in Thessaloniki, Greece.

    Science.gov (United States)

    Hatzikyriakos, Andreas; Petridis, Haralampos P; Tsiggos, Nikolaos; Sakelariou, Sotirios

    2006-11-01

    Effective communication and cooperation between dentists and dental technicians are essential in providing quality services. There has been a lack of information regarding dentist-dental technician communications and current methods and materials used for the fabrication of fixed partial dentures (FPDs). This cross-sectional study identified the materials and techniques used for fabrication of FPDs, as well as the status of communication between dentists and dental technicians in Thessaloniki, Greece. A questionnaire was developed with 7 sections pertaining to procedures and materials used for the fabrication of fixed prostheses: general questions, infection control, impressions/interocclusal records, die technique/mounting, information from final casts, prostheses design/materials, and communication/shade selection. The questionnaire was anonymous and distributed by the Association of Dental Technicians of Thessaloniki to all member laboratories (228) in the wider province of Thessaloniki, Greece. Due to the absence of normal distribution of the results, frequencies and medians were reported. Ninety-six of 228 dental laboratories responded (42.1% response rate). Twenty-six percent of dental laboratories did not routinely disinfect incoming items. The dental technicians considered 30% of incoming final impressions and 20% of interocclusal registrations as inadequate. Half of the time (55%) final casts were mounted by technicians on simple hinge articulators. Only 20% of tooth preparations had adequate finish lines. The majority (70%) of fixed restorations were metal-ceramic. Fifty-seven percent of dental technicians considered the delivery time requested by dentists as insufficient. The information provided in this study indicates areas of weakness in communication between dentists and dental technicians, along with areas where both parties should use greater care during clinical and laboratory procedures.

  16. Patient safety culture at neonatal intensive care units: perspectives of the nursing and medical team 1

    Science.gov (United States)

    Tomazoni, Andréia; Rocha, Patrícia Kuerten; de Souza, Sabrina; Anders, Jane Cristina; de Malfussi, Hamilton Filipe Correia

    2014-01-01

    OBJECTIVE: to verify the assessment of the patient safety culture according to the function and length of experience of the nursing and medical teams at Neonatal Intensive Care Units. METHOD: quantitative survey undertaken at four Neonatal Intensive Care Units in Florianópolis, Brazil. The sample totaled 141 subjects. The data were collected between February and April 2013 through the application of the Hospital Survey on Patient Safety Culture. For analysis, the Kruskal-Wallis and Chi-Square tests and Cronbach's Alpha coefficient were used. Approval for the research project was obtained from the Ethics Committee, CAAE: 05274612.7.0000.0121. RESULTS: differences in the number of positive answers to the Hospital Survey on Patient Safety Culture, the safety grade and the number of reported events were found according to the professional characteristics. A significant association was found between a shorter Length of work at the hospital and Length of work at the unit and a larger number of positive answers; longer length of experience in the profession represented higher grades and less reported events. The physicians and nursing technicians assessed the patient safety culture more positively. Cronbach's alpha demonstrated the reliability of the instrument. CONCLUSION: the differences found reveal a possible relation between the assessment of the safety culture and the subjects' professional characteristics at the Neonatal Intensive Care Units. PMID:25493670

  17. Science and engineering technicians in the United States: characteristics of a redefined population, 1972

    International Nuclear Information System (INIS)

    Finn, M.G.

    1978-02-01

    The 1972 redefined population was distributed among 10 technician fields. Approximately 75% of the total were concentrated in four relatively large fields: computer programmers; draftsmen; electrical and electronic technicians; and technicians, other fields. Women accounted for 11% of all technicians. The average age of technicians in 1972 was 37. Whites comprised 94.8% of all technicians, while 3.0% were black. More technicians resided in the middle Atlantic region than in any other region. As a percentage of the civilian labor force, however, technicians were most heavily concentrated in the New England and mountain regions. The educational level of technicians was quite diverse: about one-third had no postsecondary education, about one-sixth had at least a bachelor's degree. About one-half fell somewhere between these extremes. Approximately 68% of all technicians reported some form of supplemental training outside formal educational institutions. This training was quite diverse. In 1972, unemployed technicians totaled 3.2% of the technician labor force. Fourteen percent of technicians reported employment outside their field, and 11% reported employment outside the 10 technician fields that constituted the focus of this report. The median annual earnings of technicians employed full-time in 1971 was approximately $10,400. Private companies employed 71% of the technicians; federal and state governments employed 12.4% and 7.4%, respectively. Most other technicians were employed by local government or nonprofit organizations. Implications for policy and planning are drawn. The statistics presented here indicate that the most commonly used assumptions about education--occupation linkages are grossly oversimplified. 5 figures, 44 tables

  18. A Novel Simulation Technician Laboratory Design: Results of a Survey-Based Study.

    Science.gov (United States)

    Ahmed, Rami; Hughes, Patrick G; Friedl, Ed; Ortiz Figueroa, Fabiana; Cepeda Brito, Jose R; Frey, Jennifer; Birmingham, Lauren E; Atkinson, Steven Scott

    2016-03-16

    OBJECTIVE : The purpose of this study was to elicit feedback from simulation technicians prior to developing the first simulation technician-specific simulation laboratory in Akron, OH. Simulation technicians serve a vital role in simulation centers within hospitals/health centers around the world. The first simulation technician degree program in the US has been approved in Akron, OH. To satisfy the requirements of this program and to meet the needs of this special audience of learners, a customized simulation lab is essential. A web-based survey was circulated to simulation technicians prior to completion of the lab for the new program. The survey consisted of questions aimed at identifying structural and functional design elements of a novel simulation center for the training of simulation technicians. Quantitative methods were utilized to analyze data. Over 90% of technicians (n=65) think that a lab designed explicitly for the training of technicians is novel and beneficial. Approximately 75% of respondents think that the space provided appropriate audiovisual (AV) infrastructure and space to evaluate the ability of technicians to be independent. The respondents think that the lab needed more storage space, visualization space for a large number of students, and more space in the technical/repair area. CONCLUSIONS : A space designed for the training of simulation technicians was considered to be beneficial. This laboratory requires distinct space for technical repair, adequate bench space for the maintenance and repair of simulators, an appropriate AV infrastructure, and space to evaluate the ability of technicians to be independent.

  19. Emergency Victim Care. A Training Manual for Emergency Medical Technicians. Module 5. CPR, Oxygen Therapy. Revised.

    Science.gov (United States)

    Ohio State Dept. of Education, Columbus. Div. of Vocational Education.

    This student manual, the fifth in a set of 14 modules, is designed to train emergency medical technicians (EMTs) in Ohio. The module contains two sections covering the following course content; cardiopulmonary resuscitation (CPR) (including artificial ventilation, foreign body obstructions, adjunctive equipment and special techniques, artificial…

  20. A System Approach to Navy Medical Education and Training. Appendix 15. Biotronics Technicians.

    Science.gov (United States)

    1974-08-31

    curricula based upon job analysis was implemented to a level of methodology determination. These methods and curriculum materials constituted a third...Therapy Technician 8495 Dermatology Technician 8496 Embalming Technician 8497 Medical Illustration Technician 8498 Medical Equipment Repair Technician... WET COMPRESSES/SOAKS/PACKS 24 ICONTROL BLEEDING BY PRESSURE DRESSING 25 1APPLY/CHANGE BANDAGES, E.G. ROLLER, TRIANGULAR, KURLEX GO TO RIGHT HAND PAGE

  1. Epidemiology of aplastic anemia in Japanese radiological technicians

    International Nuclear Information System (INIS)

    Kitabatake, Takashi; Watanabe, Tsuyoshi; Saito, Akira; Nakamura, Minoru.

    1976-01-01

    Among Japanese radiological technicians, four deaths from aplastic anemia have been recorded. Based on this fact, some epidemiological considerations are tried. During the period from 1930 to 1960, the population of radiological technicians is estimated to be 74,400 man-years, in which 0.5 aplastic anemias are expected. However actually three died from aplastic anemia. This difference is statistically significant at the 1% level. On the other hand, in the period from 1961 to 1973, the observed value is 1 against 0.7 expected. It is concluded that aplastic anemia had been frequently induced among Japanese radiological technicians in the era when there was much exposure to occupational radiation. (auth.)

  2. Radiologic Equipment and Technicians according to the Distribution of the Population

    International Nuclear Information System (INIS)

    Yoon, Chul Ho; Choi, Jun Gu

    2009-01-01

    The purpose of this paper is to provide basic data in order to systematize the management of demand and supply of radiologic technicians, to pursue a fair regional distribution of educational institutions, and furthermore to keep reasonable medical treatment and fee. This research was carried out through the investigation of radiologic equipment and technicians according to the distribution of the population. We compared and analyzed the correlation between regional population, the number of clinics and hospitals, the number of medical imaging devices, and the number of radiologists and radiologic technicians in 5 cities without 'Gu' administrative units in 2008. 27,317 radiologic technicians have been produced since the administration of the national qualifying exam for radiologic technicians. About 18,000 radiologic technicians are currently working. There are 39 colleges or universities with Departments of Radiology and the admission quota is 2,120 students excluding one college. The ratio of radiologic equipment to radiologic technicians is 2.6 to 1. There is a dilemma in which some radiologic technicians fail to find appropriate jobs while some clinics or hospitals are in need of radiologic technicians. This dilemma is due to unreasonable regional discrepancies in pay system and welfare situation, and excessive profit-oriented recruiting system of clinics and hospitals. The increase of students of Radiologic Departments and approval of additional departments will end up with producing superfluous high academic degree holders, which is on the contrary to the government policy to produce more job opportunities. So the policy of increasing Radiologic Departments should be reconsidered.

  3. Fiber Optics Technician. Curriculum Research Project. Final Report.

    Science.gov (United States)

    Whittington, Herschel K.

    A study examined the role of technicians in the fiber optics industry and determined those elements that should be included in a comprehensive curriculum to prepare fiber optics technicians for employment in the Texas labor market. First the current literature, including the ERIC database and equipment manufacturers' journals were reviewed. After…

  4. Point-of-Care Testing for Anemia, Diabetes, and Hypertension: A Pharmacy-Based Model in Lima, Peru.

    Science.gov (United States)

    Saldarriaga, Enrique M; Vodicka, Elisabeth; La Rosa, Sayda; Valderrama, Maria; Garcia, Patricia J

    Prevention and control of chronic diseases is a high priority for many low- and middle-income countries. This study evaluated the feasibility and acceptability of training pharmacy workers to provide point-of-care testing for 3 chronic diseases-hypertension, diabetes, and anemia-to improve disease detection and awareness through private pharmacies. We developed a multiphase training curriculum for pharmacists and pharmacy technicians to build capacity for identification of risk factors, patient education, point-of-care testing, and referral for abnormal results. We conducted a pre-post evaluation with participants and evaluated results using Student t test for proportions. We conducted point-of-care testing with pharmacy clients and evaluated acceptability by patient characteristics (age, gender, and type of patient) using multiple logistic regression. In total, 72 pharmacy workers (66%) completed the full training curriculum. Pretest scores indicated that pharmacists had more knowledge and skills in chronic disease risk factors, patient education, and testing than pharmacy technicians. All participants improved their knowledge and skills after the training, and post-test scores indicated that pharmacy technicians achieved the same level of competency as pharmacists (P anemia than a traditional health center. Fast service was very important: 41% ranked faster results and 30% ranked faster attention as the most important factor for receiving diagnostic testing in the pharmacy. We found that it is both feasible for pharmacies and acceptable to clients to train pharmacy workers to provide point-of-care testing for anemia, diabetes, and hypertension. This innovative approach holds potential to increase early detection of risk factors and bolster disease prevention and management efforts in Peru and other low- and middle-income settings. Copyright © 2017. Published by Elsevier Inc.

  5. Perception of the Technicians AND Ancillary as of Sickbay Regarding Supervision on the Unit as of Therapeutics Intensity.

    Directory of Open Access Journals (Sweden)

    Fabiano Júlio Silva

    2010-09-01

    Full Text Available Objectives: This work is based on the perception of technicians and nursing assistants, in relation to the supervision of nurses examining what type of monitoring that are submitted, if it is in the form of leadership or managerial where we will work the negative points on supervision, evidenced by technical and nursing assistants, in an Intensive Care Unit (ICU. Method: This is a search with the qualitative methodology, which will be developed in the ICU of a public medical institution in Volta Redonda, where the instrument is to search through a questionnaire that will apply to technicians and nursing assistants, the ICU, in the period from July to August 2008. Conclusion: During this study realized that the quality of nursing care, the interaction of the nursing team and communication, can actually be modified with the leadership of the nurse. The need is urgent for change, the nurse not only becomes unsafe for dealing with this team, and makes it whole team is without prejudice, motivated, with that you get a poor service. Descriptors: Nursing and an Intensive Care Unit (ICU.

  6. Prehospital Providers' Perceptions on Providing Patient and Family Centered Care.

    Science.gov (United States)

    Ayub, Emily M; Sampayo, Esther M; Shah, Manish I; Doughty, Cara B

    2017-01-01

    A gap exists in understanding a provider's approach to delivering care that is mutually beneficial to patients, families, and other providers in the prehospital setting. The purpose of this study was to identify attitudes, beliefs, and perceived barriers to providing patient and family centered care (PFCC) in the prehospital setting and to describe potential solutions for improving PFCC during critical pediatric events. We conducted a qualitative, cross-sectional study of a purposive sample of Emergency Medical Technicians (EMTs) and paramedics from an urban, municipal, fire-based EMS system, who participated in the Pediatric Simulation Training for Emergency Prehospital Providers (PediSTEPPS) course. Two coders reviewed transcriptions of audio recordings from participants' first simulation scenario debriefings and performed constant comparison analysis to identify unifying themes. Themes were verified through member checking with two focus groups of prehospital providers. A total of 122 EMTs and paramedics participated in 16 audiotaped debriefing sessions and two focus groups. Four overarching themes emerged regarding the experience of PFCC by prehospital providers: (1) Perceived barriers included the prehospital environment, limited manpower, multi-tasking medical care, and concern for interference with patient care; (2) Providing emotional support comprised of empathetically comforting caregivers, maintaining a calm demeanor, and empowering families to feel involved; (3) Effective communication strategies consisted of designating a family point person, narration of actions, preempting the next steps, speaking in lay terms, summarizing during downtime, and conveying a positive first impression; (4) Tactics to overcome PFCC barriers were maintaining a line of sight, removing and returning a caregiver to and from the scene, and providing situational awareness. Based on debriefings from simulated scenarios, some prehospital providers identified the provision of

  7. A Grounded Theory Study of Aircraft Maintenance Technician Decision-Making

    Science.gov (United States)

    Norcross, Robert

    Aircraft maintenance technician decision-making and actions have resulted in aircraft system errors causing aircraft incidents and accidents. Aircraft accident investigators and researchers examined the factors that influence aircraft maintenance technician errors and categorized the types of errors in an attempt to prevent similar occurrences. New aircraft technology introduced to improve aviation safety and efficiency incur failures that have no information contained in the aircraft maintenance manuals. According to the Federal Aviation Administration, aircraft maintenance technicians must use only approved aircraft maintenance documents to repair, modify, and service aircraft. This qualitative research used a grounded theory approach to explore the decision-making processes and actions taken by aircraft maintenance technicians when confronted with an aircraft problem not contained in the aircraft maintenance manuals. The target population for the research was Federal Aviation Administration licensed aircraft and power plant mechanics from across the United States. Nonprobability purposeful sampling was used to obtain aircraft maintenance technicians with the experience sought in the study problem. The sample population recruitment yielded 19 participants for eight focus group sessions to obtain opinions, perceptions, and experiences related to the study problem. All data collected was entered into the Atlas ti qualitative analysis software. The emergence of Aircraft Maintenance Technician decision-making themes regarding Aircraft Maintenance Manual content, Aircraft Maintenance Technician experience, and legal implications of not following Aircraft Maintenance Manuals surfaced. Conclusions from this study suggest Aircraft Maintenance Technician decision-making were influenced by experience, gaps in the Aircraft Maintenance Manuals, reliance on others, realizing the impact of decisions concerning aircraft airworthiness, management pressures, and legal concerns

  8. Providing quality nutrition care in acute care hospitals: perspectives of nutrition care personnel.

    Science.gov (United States)

    Keller, H H; Vesnaver, E; Davidson, B; Allard, J; Laporte, M; Bernier, P; Payette, H; Jeejeebhoy, K; Duerksen, D; Gramlich, L

    2014-04-01

    Malnutrition is common in acute care hospitals worldwide and nutritional status can deteriorate during hospitalisation. The aim of the present qualitative study was to identify enablers and challenges and, specifically, the activities, processes and resources, from the perspective of nutrition care personnel, required to provide quality nutrition care. Eight hospitals participating in the Nutrition Care in Canadian Hospitals study provided focus group data (n = 8 focus groups; 91 participants; dietitians, dietetic interns, diet technicians and menu clerks), which were analysed thematically. Five themes emerged from the data: (i) developing a nutrition culture, where nutrition practice is considered important to recovery of patients and teams work together to achieve nutrition goals; (ii) using effective tools, such as screening, evidence-based protocols, quality, timely and accurate patient information, and appropriate and quality food; (iii) creating effective systems to support delivery of care, such as communications, food production and delivery; (iv) being responsive to care needs, via flexible food systems, appropriate menus and meal supplements, up to date clinical care and including patient and family in the care processes; and (v) uniting the right person with the right task, by delineating roles, training staff, providing sufficient time to undertake these important tasks and holding staff accountable for their care. The findings of the present study are consistent with other work and provide guidance towards improving the nutrition culture in hospitals. Further empirical work on how to support successful implementation of nutrition care processes is needed. © 2013 The British Dietetic Association Ltd.

  9. Pneumoconiosis and exposures of dental laboratory technicians

    International Nuclear Information System (INIS)

    Rom, W.N.; Lockey, J.E.; Lee, J.S.; Kimball, A.C.; Bang, K.M.; Leaman, H.; Johns, R.E. Jr.; Perrota, D.; Gibbons, H.L.

    1984-01-01

    One hundred and seventy-eight dental laboratory technicians and 69 non-exposed controls participated in an epidemiological respiratory study. Eight technicians who had a mean of 28 years grinding nonprecious metal alloys were diagnosed as having a simple pneumoconiosis by chest radiograph. Mean values for per cent predicted FVC and FEV1 were reduced among male nonsmoker technicians compared to male nonsmoker controls; after controlling for age, there was also a reduction in spirometry with increasing work-years. An industrial hygiene survey was conducted in 13 laboratories randomly selected from 42 laboratories stratified by size and type of operation in the Salt Lake City, Utah metropolitan area. Personal exposures to beryllium and cobalt exceeded the Threshold Limit Values (TLVs) in one laboratory. Occupational exposures in dental laboratories need to be controlled to prevent beryllium-related lung disorders as well as simple pneumoconiosis

  10. A uniform approach for on-site training and qualification of health physics technicians

    International Nuclear Information System (INIS)

    Till, J.E.

    1977-01-01

    Estimates show that in the U.S. approx. 75% of the health physics technicians received their training through courses offered by their employer. The quality and the extent of this training vary considerably among nuclear facilities. This paper describes a uniform approach for on-site training and qualification of health physics technicians applicable to all nuclear facilities. The program consists of four levels of qualification: Health Physics Technician Trainee, Technician I, Technician II and Senior Technician. The training is divided into modules that are composed of formal lectures, practical factors, experience, and a comprehensive examination. The minimum time required from hiring of inexperienced trainees to qualification as Senior Technicians is approx. 24 months. A qualification guide lists each step a technician must complete in the training program and provides documentation which facilitates audits by internal and external groups. Although items in the program would differ between facilities, the program provides specific titles for technicians, based on their training and experience, which would be applicable throughout the nuclear industry. (author)

  11. Factors that influence standard automated perimetry test results in glaucoma: test reliability, technician experience, time of day, and season.

    Science.gov (United States)

    Junoy Montolio, Francisco G; Wesselink, Christiaan; Gordijn, Marijke; Jansonius, Nomdo M

    2012-10-09

    To determine the influence of several factors on standard automated perimetry test results in glaucoma. Longitudinal Humphrey field analyzer 30-2 Swedish interactive threshold algorithm data from 160 eyes of 160 glaucoma patients were used. The influence of technician experience, time of day, and season on the mean deviation (MD) was determined by performing linear regression analysis of MD against time on a series of visual fields and subsequently performing a multiple linear regression analysis with the MD residuals as dependent variable and the factors mentioned above as independent variables. Analyses were performed with and without adjustment for the test reliability (fixation losses and false-positive and false-negative answers) and with and without stratification according to disease stage (baseline MD). Mean follow-up was 9.4 years, with on average 10.8 tests per patient. Technician experience, time of day, and season were associated with the MD. Approximately 0.2 dB lower MD values were found for inexperienced technicians (P Technician experience, time of day, season, and the percentage of false-positive answers have a significant influence on the MD of standard automated perimetry.

  12. Emergency Victim Care. A Training Manual for Emergency Medical Technicians. Module 3--Anatomy and Physiology. Revised.

    Science.gov (United States)

    Ohio State Dept. of Education, Columbus. Div. of Vocational Education.

    This student manual, the third in a set of 14 modules, is designed to train emergency medical technicians (EMTs) in Ohio. The module contains one section covering the following topics: general anatomical terms, the body cavities and contents, the integumentary system, the skeletal system, the muscular system, the nervous system, the respiratory…

  13. Guidebook on the education and training of technicians for nuclear power

    International Nuclear Information System (INIS)

    1989-01-01

    The IAEA Guidebook on the Education and Training of Technicians for Nuclear Power aims to assist Member States, especially the developing countries which are in the process of implementing, or intending to implement, a nuclear power programme, to understand and meet their requirements for qualified technicians in the most effective and efficient manner. It specifically seeks to assist policy makers and planners, as well as those designing and implementing education and training programmes. In this Guidebook, technician level occupations include those filled by technicians and higher level technicians (techniciens superieurs or technologists) and also by non-graduate engineers. The Guidebook complements the IAEA Guidebook on Manpower Development for Nuclear Power, as well as the IAEA Guidebook on the Qualification of Nuclear Power Plant Operations Personnel. The key objectives of this Guidebook are to describe: (1) the level and content of conventional education and training which a technician must have before nuclear oriented education and training can begin; (2) the level and content of nuclear oriented education and training; (3) measures to bridge the gap between the education and training acquired by technicians in the national technical schools (i.e. the level attained before upgrading) and the level of education and training qualifications needed for technicians to work in the nuclear power programme (i.e. the level attained after completion of nuclear oriented education and training). Valuable information on the national experiences of IAEA Member States in the education and training of technicians for nuclear power, as well as examples of such education and training from various Member States, are included in IAEA-TECDOC-526, which should be read in conjunction with the present text. 3 refs, 13 figs, 3 tabs

  14. Chemistry technician performance evaluation program Palo Verde Nuclear Generating Station

    International Nuclear Information System (INIS)

    Shawver, J.M.

    1992-01-01

    The Arizona Nuclear Power Project (ANPP), a three-reactor site located 50 miles west of Phoenix, Arizona, has developed and implemented a program for evaluating individual chemistry technician analytical performance on a routine basis. About 45 chemistry technicians are employed at the site, 15 at each operating unit. The technicians routinely perform trace level analyses for impurities of concern to PWRs. Each month a set of blind samples is provided by an outside vendor. The blind samples contain 16 parameters which are matrixed to approximate the PWR's primary and secondary cycles. Nine technicians receive the samples, three from each operating unit, and perform the required analyses. Acceptance criteria for successful performance on the blind parameters is based on the values found in the Institute of Nuclear Power Operations (INPO) Document 83-016, Revision 2, August 1989, Chemistry Quality Control Program. The goal of the program is to have each technician demonstrate acceptable performance on each of 16 analytical parameters. On completion of each monthly set, a summary report of all of the analytical results for the sample set is prepared. From the summary report, analytical bias can be detected, technician performance is documented, and overall laboratory performance can be evaluated. The program has been very successful at satisfying the INPO requirement that the analytical performance of each individual technician should be checked on at least a six-month frequency for all important parameters measured. This paper describes the program as implemented at the Palo Verde Nuclear Generating Station and provides a summary report and trend and bias graphs for illustrative purposes

  15. The law for radiation and x-ray technicians engaging in medical treatment

    International Nuclear Information System (INIS)

    1977-01-01

    The Law aims to define the qulifications of radiation and x-ray technicians engaging in medical treatment and to regulate so that the works are carried out properly for helping popularization and improvement of medicine and public hygiene. Persons who wish to be radiation or x-ray technicians engaging in medical treatment are required to pass the examinations for such technicians and obtain the licenes of the Minister of Health and Welfare for the former technicians and the license of a prefectural governor for the latter technicians. Mentally disordered, deaf, dumb or blind persons are excluded from licensees. Registration of such technicians, delivery of the license certificates and other related matters are provided for. The examinations are held concerning the knowledges and skills necessary for such technicians and carried out by the Minister of Health and Welfare. Persons except doctors, dentists and such technicians are prohibited to engage in the practices to apply radiation to human bodies. Restrictions on the intensity of radiation applied and the places of work are defined concerning such practices. Penal servitude of less than a year and fines less than yen 10,000 or yen 5,000 are imposed upon the violation of such prohibitions or restrictions. (Okada, K.)

  16. Institutional transparency improves public perception of lab animal technicians and support for animal research.

    Science.gov (United States)

    Mills, Katelyn E; Han, Zetta; Robbins, Jesse; Weary, Daniel M

    2018-01-01

    The use of animals in research is controversial and often takes place under a veil of secrecy. Lab animal technicians responsible for the care of animals at research institutions are sometimes described as performing 'dirty work' (i.e. professions that are viewed as morally tainted), and may be stigmatized by negative perceptions of their job. This study assessed if transparency affects public perceptions of lab animal technicians and support for animal research. Participants (n = 550) were randomly assigned to one of six scenarios (using a 3x2 design) that described identical research varying only the transparency of the facility (low, high) and the species used (mice, dogs, cows). Participants provided Likert-type and open-ended responses to questions about the personal characteristics (warmth, competence) of a hypothetical lab technician 'Cathy' and their support for the described research. Quantitative analysis showed participants in the low-transparency condition perceived Cathy to be less warm and were less supportive of the research regardless of animal species. Qualitative responses varied greatly, with some participants expressing support for both Cathy and the research. These results suggest that increasing transparency in lab animal institutions could result in a more positive perception of lab animal researchers and the work that they do.

  17. Technician Shawn Warren carefully smoothes out the composite skin of an instrument fairing atop the

    Science.gov (United States)

    2002-01-01

    Technician Shawn Warren carefully smoothes out the composite skin of an instrument fairing atop the upper fuselage of the Altair unmanned aerial vehicle (UAV) at General Atomics Aeronautical Systems, Inc., facility at Adelanto, Calif. General Atomics Aeronautical Systems, Inc., is developing the Altair version of its Predator B unmanned reconnaissance aircraft under NASA's Environmental Research Aircraft and Sensor Technology (ERAST) project. NASA plans to use the Altair as a technology demonstrator to validate a variety of command and control technologies for UAVs, as well as demonstrate the capability to perform a variety of Earth science missions. The Altair is designed to carry an 700-lb. payload of scientific instruments and imaging equipment for as long as 32 hours at up to 52,000 feet altitude. Eleven-foot extensions have been added to each wing, giving the Altair an overall wingspan of 86 feet with an aspect ratio of 23. It is powered by a 700-hp. rear-mounted TPE-331-10 turboprop engine, driving a three-blade propeller. Altair is scheduled to begin flight tests in the fourth quarter of 2002, and be acquired by NASA following successful completion of basic airworthiness tests in early 2003 for evaluation of over-the-horizon control, detect, see and avoid and other technologies required to allow UAVs to operate safely with other aircraft in the national airspace.

  18. Robotics/Automated Systems Technicians.

    Science.gov (United States)

    Doty, Charles R.

    Major resources exist that can be used to develop or upgrade programs in community colleges and technical institutes that educate robotics/automated systems technicians. The first category of resources is Economic, Social, and Education Issues. The Office of Technology Assessment (OTA) report, "Automation and the Workplace," presents analyses of…

  19. How do laboratory technicians perceive their role in tuberculosis diagnostic process: a cross-sectional study among laboratory technicians in health centers of Central Java Province, Indonesia

    Directory of Open Access Journals (Sweden)

    Widjanarko B

    2016-09-01

    Full Text Available Bagoes Widjanarko,1 Dyah Anantalia Widyastari,2 Martini Martini,3 Praba Ginandjar3 1Department of Health Education and Behavior Sciences, Faculty of Public Health, Diponegoro University, Semarang, Indonesia; 2Institute for Population and Social Research, Mahidol University, Salaya, Thailand; 3Department of Epidemiology, Faculty of Public Health, Diponegoro University, Semarang, Indonesia Purpose: Detection of acid-fast bacilli in respiratory specimens serves as an initial pulmonary tuberculosis (TB diagnosis. Laboratories are the essential and fundamental part of all health systems. This study aimed to describe how laboratory technicians perceived their own self and work. This included perceived self-efficacy, perceived role, perceived equipment availability, perceived procedures, perceived reward and job, and perceived benefit of health education, as well as level of knowledge and attitudes related to work performance of laboratory technicians.Methods: This was a cross-sectional quantitative study involving 120 laboratory technicians conducted in Central Java. Interviews and observation were conducted to measure performance and work-related variables.Results: Among 120 laboratory technicians, 43.3% showed fairly good performance. They complied with 50%–75% of all procedures, including sputum collection, laboratory tools utilization, sputum smearing, staining, smear examination, grading of results, and universal precaution practice. Perceived role, perceived self-efficacy, and knowledge of laboratory procedures were significantly correlated to performance, besides education and years of working as a laboratory technician. Perceived equipment availability was also significantly correlated to performance after the education variable was controlled.Conclusion: Most of the laboratory technicians believed that they have an important role in TB patients’ treatment and should display proper self-efficacy in performing laboratory activities. The

  20. Veterinary Technician Program Director Leadership Style and Program Success

    Science.gov (United States)

    Renda-Francis, Lori A.

    2012-01-01

    Program directors of American Veterinary Medical Association (AVMA) accredited veterinary technician programs may have little or no training in leadership. The need for program directors of AVMA-accredited veterinary technician programs to understand how leadership traits may have an impact on student success is often overlooked. The purpose of…

  1. Description and comparison of pharmacy technician training programs in the United States.

    Science.gov (United States)

    Anderson, Douglas C; Draime, Juanita A; Anderson, Timothy S

    2016-01-01

    To describe pharmacy technician training programs in the United States and to compare pharmacy technician program characteristics between programs with and without a pharmacist on faculty and between programs with different accreditation status. Descriptive, cross-sectional study. Not applicable. United States pharmacy technician programs. Not applicable. Student class size, faculty credentials, coursework components, program length, tuition rates, and admission criteria. Currently, there are more than 698 pharmacy technician programs across 1114 campuses, with complete data available for 216 programs. Programs varied widely in terms of class sizes, faculty credentials, and admission criteria. Programs with pharmacists on faculty were significantly less expensive than were those without pharmacists (P = 0.009). Accreditation had no impact on tuition prices. This is the first study of its kind to describe and characterize pharmacy technician training programs. There is relatively little control of technician training by the profession of pharmacy. The quality of these programs in terms of student outcomes is unknown, and it should be explored. Rigorous debate and discussion is needed regarding the future of pharmacy technician roles and the training required for those roles. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  2. Historical overview of the process of training of Senior Technician in Nursing in relation to research training

    Directory of Open Access Journals (Sweden)

    Lola Rosario Altamirano-Baquerizo

    2016-07-01

    Full Text Available The formation of the Senior Technician in Nursing has been studied by many researchers as a process that integrates knowledge, skills and attitudes for the development of techniques and nursing procedures to healthy individuals or patients, families and community in the various bodies of the Network Asistencial. This paper identifies the training needs of Technician in Nursing, as it has found some shortcomings that do not refer to little curricular and methodological intent of the research training of this professional in the Bolivarian Technological Institute of Ecuador. In addressing the characterization of the historical background of the formation of the Senior Technician in Nursing el-logical historical method to use as documentation reviewing educational programs and policies of vocational training the technical level in the Ecuadorian higher education was used.

  3. A reliability-based maintenance technicians' workloads optimisation model with stochastic consideration

    Science.gov (United States)

    Ighravwe, D. E.; Oke, S. A.; Adebiyi, K. A.

    2016-06-01

    The growing interest in technicians' workloads research is probably associated with the recent surge in competition. This was prompted by unprecedented technological development that triggers changes in customer tastes and preferences for industrial goods. In a quest for business improvement, this worldwide intense competition in industries has stimulated theories and practical frameworks that seek to optimise performance in workplaces. In line with this drive, the present paper proposes an optimisation model which considers technicians' reliability that complements factory information obtained. The information used emerged from technicians' productivity and earned-values using the concept of multi-objective modelling approach. Since technicians are expected to carry out routine and stochastic maintenance work, we consider these workloads as constraints. The influence of training, fatigue and experiential knowledge of technicians on workload management was considered. These workloads were combined with maintenance policy in optimising reliability, productivity and earned-values using the goal programming approach. Practical datasets were utilised in studying the applicability of the proposed model in practice. It was observed that our model was able to generate information that practicing maintenance engineers can apply in making more informed decisions on technicians' management.

  4. Ask not what your technician can do for you-ask what you can do for your technician.

    Science.gov (United States)

    Ganderton, L

    2018-04-27

    Historically, the vital roles played by technicians in Higher Education have had little recognition. Job opportunities are often overlooked by those who have no working knowledge of such organisations and poorly defined career pathways mean that it may not be a first choice for well-qualified, ambitious individuals. With just over a third of all Higher Education technicians in the UK now due to retire in the next 10 to 15 years, fundamental changes are needed, both to attract large numbers of people into vacant roles and to retain current technical staff.National initiatives, founded and driven by charitable and professional bodies, are currently working to address the issues of technicians within Higher Education. Organisations have been urged to take action or face potential recruitment difficulties and skills gaps over the coming years. In light of these national campaigns, institutions across the UK are beginning to develop proper structured career pathways, provide professional development and improve recognition for the work of their technical workforce. Whilst these are encouraging signs, only time will tell if enough has been done to raise both the profile and appeal of a technical career in Higher Education.

  5. Comparison of exercise blood pressure measured by technician and an automated system.

    Science.gov (United States)

    Garcia-Gregory, J A; Jackson, A S; Studeville, J; Squires, W G; Owen, C A

    1984-05-01

    We evaluated the automated system Blood Pressure Measuring System (BPMS) developed by NASA on 277 adult males who elected to have a treadmill test as part of their annual physical. The BPMS uses acoustic transduction with a computer-assisted ECG gating to detect nonsynchronous noise. The BPMS readings were compared to pressures simultaneously measured by trained technicians. For all stages of work, BPMS readings were higher for systolic and lower for diastolic than technician readings. At peak stages of work, BPMS systolic pressures were about 20 mmHg higher than technician readings. Within each 3-min workstage, BPMS readings were found to be more inconsistent than technician readings. The standard errors of measurement for BPMS were from two to three times higher than technician values. These data showed automated blood pressure readings were significantly different than technician values and subject to more random fluctuations. These findings demonstrate the need to view exercise blood pressure measured by automated systems with caution.

  6. Experiences with developing and implementing a virtual clinic for glaucoma care in an NHS setting.

    Science.gov (United States)

    Kotecha, Aachal; Baldwin, Alex; Brookes, John; Foster, Paul J

    2015-01-01

    This article describes the development of a virtual glaucoma clinic, whereby technicians collect information for remote review by a consultant specialist. This was a hospital-based service evaluation study. Patients suitable for the stable monitoring service (SMS) were low-risk patients with "suspect", "early"-to-"moderate" glaucoma who were deemed stable by their consultant care team. Three technicians and one health care assistant ran the service. Patients underwent tests in a streamlined manner in a dedicated clinical facility, with virtual review of data by a consultant specialist through an electronic patient record. Feasibility of developing a novel service within a UK National Health Service setting and improvement of patient journey time within the service were studied. Challenges to implementation of virtual clinic include staffing issues and use of information technology. Patient journey time within the SMS averaged 51 minutes, compared with 92 minutes in the glaucoma outpatient department. Patient satisfaction with the new service was high. Implementing innovation into existing services of the National Health Service is challenging. However, the virtual clinic showed an improved patient journey time compared with that experienced within the general glaucoma outpatient department. There exists a discrepancy between patient management decisions of reviewers, suggesting that some may be more risk averse than others when managing patients seen within this model. Future work will assess the ability to detect progression of disease in this model compared with the general outpatient model of care.

  7. Management competencies required in the transition from a technician to a supervisor

    Directory of Open Access Journals (Sweden)

    Sibongile R. Mahlangu (Kubheka

    2015-05-01

    Full Text Available Orientation: Technicians are frequently promoted to supervisory positions based on their technical abilities, with scant attention focused on developing management competencies. This oversight often poses significant challenges. The effective transition from technician to supervisor is important in any organisation. Research objective: The primary objective is to identify and verify the competencies that are required for a technician and a supervisory position; the secondary objective is to identify the gap that must be filled with relevant training interventions to enable technicians to make an effective transition to a supervisory position. Motivation for this study: The identification of the management competencies required for a technician who makes a career change to a supervisor position. Research method: The sequential mixed method approach was used to enable the twophase data collection process: phase one was the quantitative phase and phase two was the qualitative phase. Main findings: The overall findings confirm that there are indeed management competencies that technicians require training and development on before being promoted to a supervisory position. Implication: Organisations need to identify the key competencies for a technician and a supervisor and implement development or training interventions that are essential to successfully transition an employee from the level of a technician to the level of a supervisor. Contribution: Organisations need to implement essential development or training interventions focused on developing management competencies and put in place support interventions such as coaching, job shadowing, mentoring and networking.

  8. Heat-cured acrylic resin versus light-activated resin: a patient, professional and technician-based evaluation of mandibular implant-supported overdentures.

    Science.gov (United States)

    Asal, S A; Al-AlShiekh, H M

    2017-12-01

    Although light-activated resins (Eclipse) have been reported to possess superior physical and mechanical properties compared with the heat-cured acrylic resins (Lucitone-199), a few studies have compared overdentures with a locator attachment constructed from heat-cured acrylic resins with those constructed from light-activated resins. This clinical study was designed to compare the performance of a mandibular implant-supported overdenture constructed from a heat-cured acrylic resin (Lucitone-199) with that of an overdenture constructed from a light-activated resin (Eclipse). Ten participants received two identical mandibular implant-retained overdentures (Lucitone-199 and Eclipse) opposing one maxillary denture in a random order. Each mandibular overdenture was delivered and worn for 6 months, and two weeks of rest was advised between wears to minimize any carryover effects. Three questionnaires were devised. The first questionnaire (patient evaluation) focused on evaluating different aspects of the denture and overall satisfaction. The second questionnaire (professional dentist evaluation) was based on a clinical evaluation of soft tissues, complications, and the applied technique. The third questionnaire (technician evaluation) involved ranking the different manufacturing steps of the denture and overall preferences. The obtained data was statistically analyzed using an independent sample t-test and the Wilcoxon rank-sum test. The clinician and technician preferred the Eclipse dentures because of their technical aspects, whereas the patients preferred the Lucitone-199 dentures for their aesthetic properties. Implant-supported overdentures constructed from a heat-cured acrylic resin showed superior aesthetics and had a better odor compared with those constructed from a light-cured resin.

  9. Career Directions--Electronics Technician

    Science.gov (United States)

    Tech Directions, 2012

    2012-01-01

    Electronics technicians (ETs) work with electronics engineers to set up and maintain complicated electronics equipment that many of today's businesses rely on. The field is varied. An ET might service the industrial controls on a factory floor. Or repair missile control systems for the government. Or an ET could specialize in cars and trucks,…

  10. A System Approach to Navy Medical Education and Training. Appendix 8 Occupational/Physical Therapy Technician.

    Science.gov (United States)

    1974-08-31

    job analysis was implemented to a level of methodology determination. These methods and curriculum materials constituted a third (instructional) sub...Technician 8494 Physical Therapy Technician 8495 Dermatology Technician 8496 Embalming Technician 8497 Medical Illustration Technician 8498 Medical...IGIVE ICE PACK TREATMENT 9 IAPPLY WET COMPRESSESISOAKSIPACKS I 10 IGIVE INFRARED TREATMENT 11 IGIVE ULTRAVIOLET TREATMENT 12 EXPLAIN UVL THERAPY

  11. Cost-effectiveness of monitoring glaucoma patients in shared care: an economic evaluation alongside a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Klazinga Niek S

    2010-11-01

    Full Text Available Abstract Background Population aging increases the number of glaucoma patients which leads to higher workloads of glaucoma specialists. If stable glaucoma patients were monitored by optometrists and ophthalmic technicians in a glaucoma follow-up unit (GFU rather than by glaucoma specialists, the specialists' workload and waiting lists might be reduced. We compared costs and quality of care at the GFU with those of usual care by glaucoma specialists in the Rotterdam Eye Hospital (REH in a 30-month randomized clinical trial. Because quality of care turned out to be similar, we focus here on the costs. Methods Stable glaucoma patients were randomized between the GFU and the glaucoma specialist group. Costs per patient year were calculated from four perspectives: those of patients, the Rotterdam Eye Hospital (REH, Dutch healthcare system, and society. The outcome measures were: compliance to the protocol; patient satisfaction; stability according to the practitioner; mean difference in IOP; results of the examinations; and number of treatment changes. Results Baseline characteristics (such as age, intraocular pressure and target pressure were comparable between the GFU group (n = 410 and the glaucoma specialist group (n = 405. Despite a higher number of visits per year, mean hospital costs per patient year were lower in the GFU group (€139 vs. €161. Patients' time and travel costs were similar. Healthcare costs were significantly lower for the GFU group (€230 vs. €251, as were societal costs (€310 vs. €339 (p Conclusion We conclude that this GFU is cost-effective and deserves to be considered for implementation in other hospitals.

  12. Solar Technician Program Blows Hot

    Science.gov (United States)

    Ziegler, Peg Moran

    1977-01-01

    A training program for solar heating technicians was initiated at Sonoma State College's School of Environmental Studies for CETA applicants. Among the projects designed and built were a solar alternative energy center, a solar hot water system, and a solar greenhouse. (MF)

  13. Coordinating technician allocation and maintenance routing for offshore wind farms

    NARCIS (Netherlands)

    Schrotenboer, Albert H.; uit het Broek, Michiel A. J.; Jargalsaikhan, Bolor; Roodbergen, Kees Jan

    2018-01-01

    A maintenance activity at offshore wind farms requires a combination of technicians with different skills. At an operational level, it is important to fully utilize and coordinate technicians in order to increase efficiency of the short-term maintenance planning. In this paper, we investigate

  14. 14 CFR 65.80 - Certificated aviation maintenance technician school students.

    Science.gov (United States)

    2010-01-01

    ... students has made satisfactory progress at the school and is prepared to take the oral and practical tests... technician school students. 65.80 Section 65.80 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... § 65.80 Certificated aviation maintenance technician school students. Whenever an aviation maintenance...

  15. Early Experience with Technology-Based Eye Care Services (TECS): A Novel Ophthalmologic Telemedicine Initiative.

    Science.gov (United States)

    Maa, April Y; Wojciechowski, Barbara; Hunt, Kelly J; Dismuke, Clara; Shyu, Jason; Janjua, Rabeea; Lu, Xiaoqin; Medert, Charles M; Lynch, Mary G

    2017-04-01

    The aging population is at risk of common eye diseases, and routine eye examinations are recommended to prevent visual impairment. Unfortunately, patients are less likely to seek care as they age, which may be the result of significant travel and time burdens associated with going to an eye clinic in person. A new method of eye-care delivery that mitigates distance barriers and improves access was developed to improve screening for potentially blinding conditions. We present the quality data from the early experience (first 13 months) of Technology-Based Eye Care Services (TECS), a novel ophthalmologic telemedicine program. With TECS, a trained ophthalmology technician is stationed in a primary care clinic away from the main hospital. The ophthalmology technician follows a detailed protocol that collects information about the patient's eyes. The information then is interpreted remotely. Patients with possible abnormal findings are scheduled for a face-to-face examination in the eye clinic. Any patient with no known ocular disease who desires a routine eye screening examination is eligible. Technology-Based Eye Care Services was established in 5 primary care clinics in Georgia surrounding the Atlanta Veterans Affairs hospital. Four program operation metrics (patient satisfaction, eyeglass remakes, disease detection, and visit length) and 2 access-to-care metrics (appointment wait time and no-show rate) were tracked. Care was rendered to 2690 patients over the first 13 months of TECS. The program has been met with high patient satisfaction (4.95 of 5). Eyeglass remake rate was 0.59%. Abnormal findings were noted in 36.8% of patients and there was >90% agreement between the TECS reading and the face-to-face findings of the physician. TECS saved both patient (25% less) and physician time (50% less), and access to care substantially improved with 99% of patients seen within 14 days of contacting the eye clinic, with a TECS no-show rate of 5.2%. The early experience with

  16. Transforming doctor-patient relationships to promote patient-centered care: lessons from palliative care.

    Science.gov (United States)

    Yedidia, Michael J

    2007-01-01

    Palliative care was studied for its potential to yield lessons for transforming doctor-patient relationships to promote patient-centered care. Examination of patient and provider experiences of the transition from curative to palliative care promises valuable insights about establishing and maintaining trust as the goals of care shift and about addressing a broad spectrum of patient needs. The study was guided by a conceptual framework grounded in existing models to address five dimensions of doctor-patient relationships: range of needs addressed, source of authority, maintenance of trust, emotional involvement, and expression of authenticity. Data collection included observation of the care of 40 patients in the inpatient hospice unit and at home, interviews with patients and family members, and in-depth interviews with 22 physicians and two nurses providing end-of-life care. Standard qualitative procedures were used to analyze the data, incorporating techniques for maximizing the validity of the results and broadening their relevance to other contexts. Findings provide evidence for challenging prominent assumptions about possibilities for doctor-patient relationships: questioning the merits of the prohibition on emotional involvement, dependence on protocols for handling difficult communication issues, unqualified reliance on consumer empowerment to assure that care is responsive to patients' needs, and adoption of narrowly defined boundaries between medical and social service systems in caring for patients. Medical education can play a role in preparing doctors to assume new roles by openly addressing management of emotions in routine clinical work, incorporating personal awareness training, facilitating reflection on interactions with patients through use of standardized patients and videotapes, and expanding capacity to effectively address a broad range of needs through teamwork training.

  17. Radiological Control Technician: Phase 4, Facility practical training attachment

    International Nuclear Information System (INIS)

    1992-10-01

    At DOE sites with more than one facility, and where RCT tasks at each facility may differ, site and facility tasks should be separated. The tasks that are common to all the facilities on the site should be included in Phase II training with the core tasks. Tasks unique to a facility should be added to the training program qualification standard, as an attachment, as Phase IV training. Not all the DOE sites will include Phase IV training in their programs. Phase IV training allows each site to qualify technicians to a select facility. Since the core training for the technicians is standardized, the transfer of technicians between facilities requires that only facility tasks be taught, provided the core qualification is current

  18. Musculoskeletal injuries resulting from patient handling tasks among hospital workers.

    Science.gov (United States)

    Pompeii, Lisa A; Lipscomb, Hester J; Schoenfisch, Ashley L; Dement, John M

    2009-07-01

    The purpose of this study was to evaluate musculoskeletal injuries and disorders resulting from patient handling prior to the implementation of a "minimal manual lift" policy at a large tertiary care medical center. We sought to define the circumstances surrounding patient handling injuries and to identify potential preventive measures. Human resources data were used to define the cohort and their time at work. Workers' compensation records (1997-2003) were utilized to identify work-related musculoskeletal claims, while the workers' description of injury was used to identify those that resulted from patient handling. Adjusted rate ratios were generated using Poisson regression. One-third (n = 876) of all musculoskeletal injuries resulted from patient handling activities. Most (83%) of the injury burden was incurred by inpatient nurses, nurses' aides and radiology technicians, while injury rates were highest for nurses' aides (8.8/100 full-time equivalent, FTEs) and smaller workgroups including emergency medical technicians (10.3/100 FTEs), patient transporters (4.3/100 FTEs), operating room technicians (3.1/100 FTEs), and morgue technicians (2.2/100 FTEs). Forty percent of injuries due to lifting/transferring patients may have been prevented through the use of mechanical lift equipment, while 32% of injuries resulting from repositioning/turning patients, pulling patients up in bed, or catching falling patients may not have been prevented by the use of lift equipment. The use of mechanical lift equipment could significantly reduce the risk of some patient handling injuries but additional interventions need to be considered that address other patient handling tasks. Smaller high-risk workgroups should not be neglected in prevention efforts.

  19. Section 608 Technician Certification Test Topics

    Science.gov (United States)

    Identifies some of the topics covered on Section 608 Technician Certification tests such as ozone depletion, the Clean Air Act and Montreal Protocol, Substitute Refrigerants and oils, Refrigeration and Recovery Techniques.

  20. The Library Technician Programme in Lebanon

    Science.gov (United States)

    Rafidi, Samia

    1973-01-01

    A description of the library technician program established by the Beirut College for Women in February 1970: its curriculum, professional staff, students, and reactions produced by the program is presented. (Author/SJ)

  1. Health care employee perceptions of patient-centered care.

    Science.gov (United States)

    Balbale, Salva Najib; Turcios, Stephanie; LaVela, Sherri L

    2015-03-01

    Given the importance of health care employees in the delivery of patient-centered care, understanding their unique perspectives is essential for quality improvement. The purpose of this study was to use photovoice to evaluate perceptions and experiences around patient-centered care among U.S. Veterans Affairs (VA) health care employees. We asked participants to take photographs of salient features in their environment related to patient-centered care. We used the photographs to facilitate dialogue during follow-up interviews. Twelve VA health care employees across two VA sites participated in the project. Although most participants felt satisfied with their work environment and experiences at the VA, they identified several areas for improvement. These included a need for more employee health and wellness initiatives and a need for enhanced opportunities for training and professional growth. Application of photovoice enabled us to learn about employees' unique perspectives around patient-centered care while engaging them in an evaluation of care delivery. © The Author(s) 2014.

  2. [Economic impact of an automated dispensing system in an intensive care unit].

    Science.gov (United States)

    Kheniene, F; Bedouch, P; Durand, M; Marie, F; Brudieu, E; Tourlonnias, M-M; Bongi, P; Allenet, B; Calop, J

    2008-03-01

    Automated dispensing systems (ADS) allow a reduction of medication errors and an improvement of drug distribution in clinical ward. The objective of this study was to evaluate the economic impact of ADS in an intensive care unit. A cost-benefit model was constructed based on the hospital perspective. The system was evaluated before-after implementation of an ADS in a 12-bed cardiovascular intensive care unit of a French teaching hospital: (a) by a measuring nurse and pharmacy technician working time required for various tasks; (b) by measuring the cost of drug storage and the cost of expired drug; (c) by measuring the nurses' acceptability. After ADS was installed, nursing personnel spent less time on medication-related activities (mean of 1.9 hour/day of nursing time). Pharmacy technicians spent more time on floor-stock activities (mean of 0.7 hour/day of technician time). Implementation reduced the cost of drug storage by 56% (14,742 euros) and cost of expired drug by 9,086 euros per year. Finally, cost-benefit analysis including potential savings in terms of working time showed a net benefit of 71,586 euros (14,317 euros/year). The ADS was given high marks by the nurses; 77% wanted to keep it on their unit. Implementation of ADS is expected to generate direct savings for the hospital and working time reallocation, for nurses to interact with patients and for pharmacy technicians to get involved on the ward.

  3. Virtual Patient Technology: Engaging Primary Care in Quality Improvement Innovations.

    Science.gov (United States)

    Blok, Amanda C; May, Christine N; Sadasivam, Rajani S; Houston, Thomas K

    2017-02-15

    Engaging health care staff in new quality improvement programs is challenging. We developed 2 virtual patient (VP) avatars in the context of a clinic-level quality improvement program. We sought to determine differences in preferences for VPs and the perceived influence of interacting with the VP on clinical staff engagement with the quality improvement program. Using a participatory design approach, we developed an older male smoker VP and a younger female smoker VP. The older male smoker was described as a patient with cardiovascular disease and was ethnically ambiguous. The female patient was younger and was worried about the impact of smoking on her pregnancy. Clinical staff were allowed to choose the VP they preferred, and the more they engaged with the VP, the more likely the VP was to quit smoking and become healthier. We deployed the VP within the context of a quality improvement program designed to encourage clinical staff to refer their patients who smoke to a patient-centered Web-assisted tobacco intervention. To evaluate the VPs, we used quantitative analyses using multivariate models of provider and practice characteristics and VP characteristic preference and analyses of a brief survey of positive deviants (clinical staff in practices with high rates of encouraging patients to use the quit smoking innovation). A total of 146 clinical staff from 76 primary care practices interacted with the VPs. Clinic staff included medical providers (35/146, 24.0%), nurse professionals (19/146, 13.0%), primary care technicians (5/146, 3.4%), managerial staff (67/146, 45.9%), and receptionists (20/146, 13.7%). Medical staff were mostly male, and other roles were mostly female. Medical providers (OR 0.031; CI 0.003-0.281; P=.002) and younger staff (OR 0.411; CI 0.177-0.952; P=.038) were less likely to choose the younger, female VP when controlling for all other characteristics. VP preference did not influence online patient referrals by staff. In high

  4. Cardiac patients' perception of patient-centred care: a qualitative study.

    Science.gov (United States)

    Esmaeili, Maryam; Cheraghi, Mohammad A; Salsali, Mahvash

    2016-03-01

    The aim of this study was to explore cardiac patients' perception of patient-centred care. Despite patient's importance in the process of care, less attention has been paid to experiences and expectations of patients in definitions of patient-centred care. As patients are an important element in process of patient-centred care, organizing care programs according to their perceptions and expectations will lead to enhanced quality of care and greater patient satisfaction. This study is a descriptive qualitative study. Content analysis approach was performed for data analysis. Participants were 18 cardiac patients (10 women and 8 men) hospitalized in coronary care units of teaching hospitals affiliated to Tehran University of Medical Sciences. We collected the study data through conducting personal face-to-face semi-structured interviews. The participants' perceptions of patient-centred care fell into three main themes including managing patients uncertainty, providing care with more flexibility and establishing a therapeutic communication. The second theme consisted of two sub-themes: empathizing with patients and having the right to make independent decisions. Receiving patient-centred care is essential for cardiac patients. Attention to priorities and preferences of cardiac patients and making decisions accordingly is among effective strategies for achieving patient-centred care. Cardiac care unit nurses ought to be aware that in spite of technological developments and advances, it is still important to pay attention to patients' needs and expectations in order to achieve patient satisfaction. In planning care programs, they should consider accountability towards patients' needs, flexibility in process of care and establishing medical interactions as an effective strategy for improving quality of care. © 2014 British Association of Critical Care Nurses.

  5. The role of the pharmacy technician in the skill-mixed district nursing team.

    Science.gov (United States)

    McGraw, Caroline; Coleman, Bridget; Ashman, Lea; Hayes, Sarah

    2012-09-01

    Registered nurses in the district nursing service delegate a broad range of medication administration activities to healthcare assistants. Although healthcare assistants have provided extra capacity, not all activities are suitable for delegation to unregulated practitioners. At the same time, their competency assessment is often patient-specific and demands significant registered nursing input. The purpose of this 6-month pilot programme was to test the premise that the employment of a pharmacy technician in the district nursing service would enhance productivity levels and deliver cost savings. Activities delegated included the administration of oral tablets and subcutaneous insulin and low molecular weight heparin injections. The evaluation found that the introduction of the pharmacy technician was associated with neither enhanced productivity nor more than modest cost savings. However, role redesign is a long-term activity and their role could be built on with further competency analysis.

  6. Patient Care Planning: An Interdisciplinary Approach

    OpenAIRE

    Prophet, Colleen M.

    1989-01-01

    The INFORMM Patient Care Planning System provides interdepartmental communication and individualized patient care plans based upon current standards of care. This interdisciplinary system facilitates the identification of patient problems and nursing diagnoses as well as patient care orders. The selected nurses' and physicians' orders are integrated and organized by care plan categories in printouts. As a system by-product, Patient Care Planning automatically generates and calculates patient ...

  7. Nursing Practice in Primary Care and Patients' Experience of Care.

    Science.gov (United States)

    Borgès Da Silva, Roxane; Brault, Isabelle; Pineault, Raynald; Chouinard, Maud-Christine; Prud'homme, Alexandre; D'Amour, Danielle

    2018-01-01

    Nurses are identified as a key provider in the management of patients in primary care. The objective of this study was to evaluate patients' experience of care in primary care as it pertained to the nursing role. The aim was to test the hypothesis that, in primary health care organizations (PHCOs) where patients are systematically followed by a nurse, and where nursing competencies are therefore optimally used, patients' experience of care is better. Based on a cross-sectional analysis combining organizational and experience of care surveys, we built 2 groups of PHCOs. The first group of PHCOs reported having a nurse who systematically followed patients. The second group had a nurse who performed a variety of activities but did not systematically follow patients. Five indicators of care were constructed based on patient questionnaires. Bivariate and multivariate linear mixed models with random intercepts and with patients nested within were used to analyze the experience of care indicators in both groups. Bivariate analyses revealed a better patient experience of care in PHCOs where a nurse systematically followed patients than in those where a nurse performed other activities. In multivariate analyses that included adjustment variables related to PHCOs and patients, the accessibility indicator was found to be higher. Results indicated that systematic follow-up of patients by nurses improved patients' experience of care in terms of accessibility. Using nurses' scope of practice to its full potential is a promising avenue for enhancing both patients' experience of care and health services efficiency.

  8. Technician Career Opportunities in Engineering Technology.

    Science.gov (United States)

    Engineers' Council for Professional Development, New York, NY.

    Career opportunities for engineering technicians are available in the technologies relating to air conditioning, heating, and refrigeration, aviation and aerospace, building construction, chemical engineering, civil engineering, electrical engineering, electronics, industrial engineering, instrumentation, internal combustion engines, mechanical…

  9. Primary care patients with anxiety and depression: need for care from the patient's perspective.

    NARCIS (Netherlands)

    Prins, M.A.; Verhaak, P.F.M.; Meer, K. van der; Penninx, B.W.J.H.; Bensing, J.M.

    2009-01-01

    Many anxiety and depression patients receive no care, resulting in unnecessary suffering and high costs. Specific beliefs and the absence of a perceived need for care are major reasons for not receiving care. This study aims to determine the specific perceived need for care in primary care patients

  10. Individual care plans for chronically ill patients within primary care in the Netherlands: Dissemination and associations with patient characteristics and patient-perceived quality of care.

    Science.gov (United States)

    Jansen, Daphne L; Heijmans, Monique; Rijken, Mieke

    2015-06-01

    To examine the use of individual care plans (ICPs) within primary chronic illness care in the Netherlands, and to explore the relationships between ICP use, patient characteristics, and patient-perceived quality of care. Cross-sectional study using survey data from a panel of chronically ill patients and medical registration data provided by their general practices. A sample of 1377 patients with somatic chronic disease(s) randomly selected in general practices throughout the Netherlands, supplemented with a sample of 225 COPD patients, also recruited from general practices. (i) Percentage of ICP use based on self-report by chronically ill patients, and (ii) patient-perceived quality of care as assessed using the Patient Assessment of Chronic Illness Care (PACIC). ICP use among the total generic sample was low (9%), but slightly higher (13%) among patients diagnosed with diabetes or COPD, diseases for which disease management programmes have been set up in the Netherlands. Patients with a low educational level and patients with poor(er) self-rated health were more likely to have an ICP. Compared with patients without an ICP, patients with an ICP more often reported that the care they received was patient-centred, proactive, planned, and included collaborative goal setting, problem-solving, and follow-up support. Findings reveal a discrepancy between practice and policy aspirations regarding ICP use in primary chronic illness care. More research is needed to gain insight into the effectiveness of ICPs to improve the quality of chronic illness care in various patient populations.

  11. Hydraulics and pneumatics a technician's and engineer's guide

    CERN Document Server

    Parr, Andrew

    2011-01-01

    Nearly all industrial processes require objects to be moved, manipulated or subjected to some sort of force. Such movements and manipulations are frequently accomplished by means of devices driven by liquids (hydraulics) or air (pneumatics), the subject of this book. Hydraulics and Pneumatics is written by a practicing process control engineer as a guide to the successful operation of hydraulic and pneumatic systems for all engineers and technicians working with them. Keeping mathematics and theory to a minimum, this practical guide is thorough but accessible to technicians without a

  12. ASHP statement on the pharmacy technician's role in pharmacy informatics.

    Science.gov (United States)

    2014-02-01

    The American Society of Health- System Pharmacists (ASHP) believes that specially trained pharmacy technicians can assume important supportive roles in pharmacy informatics. These roles include automation and technology systems management, management of projects, training and education, policy and governance, customer service, charge integrity, and reporting. Such roles require pharmacy technicians to gain expertise in information technology (IT) systems, including knowledge of interfaces, computer management techniques, problem resolution, and database maintenance. This knowledge could be acquired through specialized training or experience in a health science or allied scientific field (e.g., health informatics). With appropriate safeguards and supervision, pharmacy technician informaticists (PTIs) will manage IT processes in health-system pharmacy services, ensuring a safe and efficient medication-use process.

  13. Respiratory Systems of Dental Technicians Negatively Affected during 5 Years of Follow-Up

    Directory of Open Access Journals (Sweden)

    Nurgül Bozkurt

    2016-08-01

    Full Text Available Background: Dental laboratory technician is one of the professions in which dust exposure is frequently experienced and therefore the health of workers has to be monitored. Aims: In this study, changes in the pulmonary functions and of pneumoconiosis frequencies among dental technicians after five years were investigated by comparing the results of two screenings carried out in 2008 and 2013. Study Design: Cohort study. Methods: In 2008 and 2013, Provincial Health Directorate carried out two different health screenings covering all of the dental technicians working in dental laboratories in Denizli. In both screenings, a questionnaire was applied, with which socio-demographic and workplace properties of the technicians were obtained. In addition, Pulmonary function tests (PFT and standard chest X-rays of the technicians were performed. The results of these two screenings were evaluated by a chest specialist, and physical examinations were performed as necessary. In 2013, technicians who had pathologies underwent computerized tomography (HRCT. In this study, the study group was composed of dental laboratory technicians that participated in both screenings (2008 and 2013 and the data obtained from the screenings were compared. The gathered data were analyzed using paired student-t and X2 tests. Results: A total of 125 dental laboratory technicians participated in the two screenings. Overall, 92% of the technicians were male and the mean age of the participants was 35. Technicians were working for 9 hours a day, 6 days a week. Total exposure time was calculated to be around 41 thousand hours. Approximately 60% of workers were smokers. When the results of PFT were analyzed, 73% of the first evaluations were found to be normal; however, this ratio decreased to 51% in the second analysis five years later. In the second PFT measurement, compared to the first, there was a 23% decrease in the forced vital capacity (FVC value, and a 15.7% decrease in

  14. Job satisfaction, stress and burnout in anaesthetic technicians in New Zealand.

    Science.gov (United States)

    Kluger, M T; Bryant, J

    2008-03-01

    Anaesthetic technicians play a key role in the operating room, yet little is known about their levels of job satisfaction or workplace stress. A blinded, confidential single mail-out survey was posted to anaesthetic technicians in New Zealand. The survey consisted of demographic information, a job satisfaction survey, the Maslach Burnout Inventory and the Short Form 12. At total of 154 forms were returned (51% response rate). Respondents worked predominantly in public hospitals and many had duties outside the operating room. Job satisfaction was related to teamwork, practical nature of work and patient contact, while dissatisfaction was related to lack of respect from nurses and limited career pathway. High to moderate levels of emotional exhaustion (48%), depersonalisation (39%) and low levels of personal accomplishment (58%) were indicators of burnout. The Short Form 12 revealed high levels of physical impairment in 24% and emotional impairment in 35% of respondents. These data suggest that work is needed to evaluate anaesthetic assistants' job structure and actively manage their important physical and emotional sequelae.

  15. Value Based Care and Patient-Centered Care: Divergent or Complementary?

    Science.gov (United States)

    Tseng, Eric K; Hicks, Lisa K

    2016-08-01

    Two distinct but overlapping care philosophies have emerged in cancer care: patient-centered care (PCC) and value-based care (VBC). Value in healthcare has been defined as the quality of care (measured typically by healthcare outcomes) modified by cost. In this conception of value, patient-centeredness is one important but not necessarily dominant quality measure. In contrast, PCC includes multiple domains of patient-centeredness and places the patient and family central to all decisions and evaluations of quality. The alignment of PCC and VBC is complicated by several tensions, including a relative lack of patient experience and preference measures, and conceptions of cost that are payer-focused instead of patient-focused. Several strategies may help to align these two philosophies, including the use of patient-reported outcomes in clinical trials and value determinations, and the purposeful integration of patient preference in clinical decisions and guidelines. Innovative models of care, including accountable care organizations and oncology patient-centered medical homes, may also facilitate alignment through improved care coordination and quality-based payment incentives. Ultimately, VBC and PCC will only be aligned if patient-centered outcomes, perspectives, and preferences are explicitly incorporated into the definitions and metrics of quality, cost, and value that will increasingly influence the delivery of cancer care.

  16. An Evaluation of Navy En Route Care Training Using a High-Fidelity Medical Simulation Scenario of Interfacility Patient Transport.

    Science.gov (United States)

    DeForest, Christine A; Blackman, Virginia; Alex, John E; Reeves, Lauren; Mora, Alejandra; Perez, Crystal; Maddry, Joseph; Selby, Domenique; Walrath, Benjamin

    2018-03-14

    Military prehospital and en route care (ERC) directly impacts patient morbidity and mortality. Provider knowledge and skills are critical variables in the effectiveness of ERC. No Navy doctrine defines provider choice for patient transport or requires standardized provider training. Frequently, Search and Rescue Medical Technicians (SMTs) and Navy Nurses (ERC RNs) are tasked with this mission though physicians have also been used. Navy ERC provider training varies greatly by professional role. Historically, evaluations of ERC and patient outcomes have been based on retrospective analyses of incomplete data sets that provide limited insight on ERC practices. Little evidence exists to determine if current training is adequate to care for the most common injuries seen in combat trauma patients. Simulation technology facilitates a standardized patient encounter to enable complete, prospective data collection while studying provider type as the independent variable. Information acquired through skill performance observation can be used to make evidence-based recommendations to improve ERC training. This IRB approved multi-center study funded through a Congressionally Directed Medical Research Program grant from the Combat Casualty Care Intramural Research Joint En Route Care portfolio evaluated Navy ERC providers. The study evaluated 84 SMT, ERC RN, and physician participants in the performance of critical and secondary actions during an immersive, high-fidelity, patient transport simulation scenario focused on the care during an interfacility transfer. Simulation evaluators with military ERC expertise, blinded to participant training and background, graded each participant's performance. Inter-rater reliability was calculated using Cohen's Kappa to evaluate concordance between evaluator assessments. Categorical data were reported as frequencies and percentages. Performance attempt and accuracy rates were compared with likelihood ratio chi-square or Fisher's exact test

  17. "Patient care in radiology"

    DEFF Research Database (Denmark)

    Bro Brask, Kirsten; Birkelund, Regner

    2014-01-01

    The aim of this study was to research how the staff experience care expressed during the brief encounter with the patients in a diagnostic imaging department. This was a qualitative study with a phenomenological and hermeneutical frame of reference. The data were collected using field observation...... was electronically forwarded. And, care expressed in between was perceived as care in the traditional sense and termed as “patient care in radiology.”...

  18. A new standard for multidisciplinary health and safety technicians

    International Nuclear Information System (INIS)

    Trinoskey, P.A.; Fry, L.A.; Egbert, W.F.

    2000-01-01

    Over the last two decades, a significant trend in health and safety has been toward greater specialization. However, compartmentalization of health and safety disciplines often leads to an inequity in resources, especially when appropriations overemphasize one risk to the detriment of others. For example, overemphasis on radiological safety can create an imbalance in overall worker protection. A multidisciplinary technical can help restore the balance and provide for a healthier and safer work environment. The key advantages of a multidisciplinary health and safety technician include: Broad coverage of the work area by one technician, More diverse use of the technician pool, Better coverage for off-shift or nonstandard hours, Balance of risks because all hazards are considered, Integrated emergency response, Ownership, Less time of identify the correct person with the requisite skills. We have developed a new standard that establishes the training and related qualifications for a multidisciplinary health and safety technician. The areas of training and qualification that are addressed include elements of industrial hygiene, industrial safety, fire protection, electrical safety, construction safety, and radiation safety. The initial core training program ensures that individuals are trained to the performance of requirements of the job. Initial training is in five areas: Fundamentals, Hazard recognition, Hazard assessment, Hazards controls, Hazards minimization. Core training is followed by formal qualification on specific tasks, including ventilation surveys, air monitoring, noise assessments, radiological monitoring, area inspections, work-area setups, and work coverage. The new standard addresses not only training topics and requirements, but also guidance to ensure that performance objectives are met. The standard applies to technicians, supervisors, technologists, and six specialty areas, including academic institutions and decontamination and decommissioning

  19. A new standard for multidisciplinary health and safety technicians

    Energy Technology Data Exchange (ETDEWEB)

    Trinoskey, P.A.; Fry, L.A. [Lawrence Livermore National Laboratory, Univ. of California, CA (United States); Egbert, W.F. [Lawrence Livermore National Laboratory, Allied Signal Technical Corporation (United States)

    2000-05-01

    Over the last two decades, a significant trend in health and safety has been toward greater specialization. However, compartmentalization of health and safety disciplines often leads to an inequity in resources, especially when appropriations overemphasize one risk to the detriment of others. For example, overemphasis on radiological safety can create an imbalance in overall worker protection. A multidisciplinary technical can help restore the balance and provide for a healthier and safer work environment. The key advantages of a multidisciplinary health and safety technician include: Broad coverage of the work area by one technician, More diverse use of the technician pool, Better coverage for off-shift or nonstandard hours, Balance of risks because all hazards are considered, Integrated emergency response, Ownership, Less time of identify the correct person with the requisite skills. We have developed a new standard that establishes the training and related qualifications for a multidisciplinary health and safety technician. The areas of training and qualification that are addressed include elements of industrial hygiene, industrial safety, fire protection, electrical safety, construction safety, and radiation safety. The initial core training program ensures that individuals are trained to the performance of requirements of the job. Initial training is in five areas: Fundamentals, Hazard recognition, Hazard assessment, Hazards controls, Hazards minimization. Core training is followed by formal qualification on specific tasks, including ventilation surveys, air monitoring, noise assessments, radiological monitoring, area inspections, work-area setups, and work coverage. The new standard addresses not only training topics and requirements, but also guidance to ensure that performance objectives are met. The standard applies to technicians, supervisors, technologists, and six specialty areas, including academic institutions and decontamination and decommissioning

  20. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... Media Medical Students Patients and Public Technicians and Nurses Senior Ophthalmologists Young Ophthalmologists Tools and Services EyeCare ... Media Medical Students Patients and Public Technicians and Nurses Senior Ophthalmologists Young Ophthalmologists Tools and Services EyeCare ...

  1. What Is Dry Eye?

    Medline Plus

    Full Text Available ... Media Medical Students Patients and Public Technicians and Nurses Senior Ophthalmologists Young Ophthalmologists Tools and Services EyeCare ... Media Medical Students Patients and Public Technicians and Nurses Senior Ophthalmologists Young Ophthalmologists Tools and Services EyeCare ...

  2. Corneal Laceration

    Medline Plus

    Full Text Available ... Media Medical Students Patients and Public Technicians and Nurses Senior Ophthalmologists Young Ophthalmologists Tools and Services EyeCare ... Media Medical Students Patients and Public Technicians and Nurses Senior Ophthalmologists Young Ophthalmologists Tools and Services EyeCare ...

  3. What Is Macular Edema?

    Medline Plus

    Full Text Available ... Media Medical Students Patients and Public Technicians and Nurses Senior Ophthalmologists Young Ophthalmologists Tools and Services EyeCare ... Media Medical Students Patients and Public Technicians and Nurses Senior Ophthalmologists Young Ophthalmologists Tools and Services EyeCare ...

  4. Are 3-D Movies Bad for Your Eyes?

    Medline Plus

    Full Text Available ... Media Medical Students Patients and Public Technicians and Nurses Senior Ophthalmologists Young Ophthalmologists Tools and Services EyeCare ... Media Medical Students Patients and Public Technicians and Nurses Senior Ophthalmologists Young Ophthalmologists Tools and Services EyeCare ...

  5. Are 3-D Movies Bad for Your Eyes?

    Medline Plus

    Full Text Available ... Patients and Public Technicians and Nurses Senior Ophthalmologists Young Ophthalmologists Tools and Services EyeCare America Help IRIS ... Patients and Public Technicians and Nurses Senior Ophthalmologists Young Ophthalmologists Tools and Services EyeCare America Help IRIS ...

  6. What Is Dry Eye?

    Medline Plus

    Full Text Available ... Medical Students Patients and Public Technicians and Nurses Senior Ophthalmologists Young Ophthalmologists Tools and Services EyeCare America ... Medical Students Patients and Public Technicians and Nurses Senior Ophthalmologists Young Ophthalmologists Tools and Services EyeCare America ...

  7. Are 3-D Movies Bad for Your Eyes?

    Medline Plus

    Full Text Available ... Medical Students Patients and Public Technicians and Nurses Senior Ophthalmologists Young Ophthalmologists Tools and Services EyeCare America ... Medical Students Patients and Public Technicians and Nurses Senior Ophthalmologists Young Ophthalmologists Tools and Services EyeCare America ...

  8. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... Medical Students Patients and Public Technicians and Nurses Senior Ophthalmologists Young Ophthalmologists Tools and Services EyeCare America ... Medical Students Patients and Public Technicians and Nurses Senior Ophthalmologists Young Ophthalmologists Tools and Services EyeCare America ...

  9. What Is Macular Edema?

    Medline Plus

    Full Text Available ... Medical Students Patients and Public Technicians and Nurses Senior Ophthalmologists Young Ophthalmologists Tools and Services EyeCare America ... Medical Students Patients and Public Technicians and Nurses Senior Ophthalmologists Young Ophthalmologists Tools and Services EyeCare America ...

  10. Corneal Laceration

    Medline Plus

    Full Text Available ... Medical Students Patients and Public Technicians and Nurses Senior Ophthalmologists Young Ophthalmologists Tools and Services EyeCare America ... Medical Students Patients and Public Technicians and Nurses Senior Ophthalmologists Young Ophthalmologists Tools and Services EyeCare America ...

  11. 5 CFR 831.306 - Service as a National Guard technician before January 1, 1969.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Service as a National Guard technician... National Guard technician before January 1, 1969. (a) Definitions. In this section—(1) Service as a National Guard technician is service performed under section 709 of title 32, United States Code (or under...

  12. Factors affecting experiences of intensive care patients in Turkey: patient outcomes in critical care setting.

    Science.gov (United States)

    Demir, Yurdanur; Korhan, Esra Akin; Eser, Ismet; Khorshid, Leyla

    2013-07-01

    To determine the factors affecting a patient's intensive care experience. The descriptive study was conducted at an intensive care unit in the Aegean Region of Turkey, and comprised 158 patients who spent at least 48 hours at the unit between June and November 2009. A questionnaire form and the Intensive Care Experience Scale were used as data collection tools. SPSS 11.5 was used for statistical analysis of the data. Of the total, 86 (54.4%) patients related to the surgical unit, while 72 (45.5%) spent time at the intensive care unit. Most of the subjects (n=113; 71.5%) reported that they constantly experienced pain during hospitalisation. Patients receiving mechanical ventilation support and patients reporting no pain had significantly higher scores on the intensive care experience scale. Patients who reported pain remembered their experiences less than those having no pain. Interventions are needed to make the experiences of patients in intensive care more positive.

  13. Strategies used by nursing technicians to face the occupational suffering in an emergency unit

    Directory of Open Access Journals (Sweden)

    Alessandra Bassalobre Garcia

    2016-05-01

    Full Text Available Objective: to understand the strategies used by nursing technicians in order to face the occupational suffering in an emergency room. Methods: qualitative study carried out in an emergency room of a high complexity hospital located in the north of Paraná state. Data were collected through semi-structured interviews with 12 nursing technicians. The analysis relied on content analysis procedures. Results: respondents revealed as individual strategies to face suffering: try not to get involved with the patient; separation between professional and personal life; and spirituality/religion as support for coping. The collective strategies described by respondents included: action planning for unexpected events in this unit; creating a supportive environment; and attempt to obtain recognition of headship. Conclusion: individual and collective strategies were used consciously by workers and should be encouraged by managers to face the occupational suffering.

  14. Training and qualification of health and safety technicians at a national laboratory

    International Nuclear Information System (INIS)

    Egbert, W.F.; Trinoskey, P.A.

    1994-10-01

    Over the last 30 years, Lawrence Livermore National Laboratory (LLNL) has successfully implemented the concept of a multi-disciplined technician. LLNL Health and Safety Technicians have responsibilities in industrial hygiene, industrial safety, health physics, as well as fire, explosive, and criticality safety. One of the major benefits to this approach is the cost-effective use of workers who display an ownership of health and safety issues which is sometimes lacking when responsibilities are divided. Although LLNL has always promoted the concept of a multi-discipline technician, this concept is gaining interest within the Department of Energy (DOE) community. In November 1992, individuals from Oak Ridge Institute of Science and Education (ORISE) and RUST Geotech, joined by LLNL established a committee to address the issues of Health and Safety Technicians. In 1993, the DOE Office of Environmental, Safety and Health, in response to the Defense Nuclear Facility Safety Board Recommendation 91-6, stated DOE projects, particularly environmental restoration, typically present hazards other than radiation such as chemicals, explosives, complex construction activities, etc., which require additional expertise by Radiological Control Technicians. They followed with a commitment that a training guide would be issued. The trend in the last two decades has been toward greater specialization in the areas of health and safety. In contrast, the LLNL has moved toward a generalist approach integrating the once separate functions of the industrial hygiene and health physics technician into one function

  15. Technicians under the Microscope: The Training and Skills of University Laboratory and Engineering Workshop Technicians

    Science.gov (United States)

    Lewis, Paul A.; Gospel, Howard

    2015-01-01

    The UK government aims to increase both the number, and also the status, of workers with intermediate-level skills, with a view to creating a "modern class of technicians" who can help to bolster economic growth and prosperity. This article considers the prospects for such a policy by focusing on one particular, but neglected, group of…

  16. Technician Consistency in Specular Microscopy Measurements: A "Real-World" Retrospective Analysis of a United States Eye Bank.

    Science.gov (United States)

    Rand, Gabriel M; Kwon, Ji Won; Gore, Patrick K; McCartney, Mitchell D; Chuck, Roy S

    2017-10-01

    To quantify consistency of endothelial cell density (ECD) measurements among technicians in a single US eye bank operating under typical operating conditions. In this retrospective analysis of 51 microscopy technicians using a semiautomated counting method on 35,067 eyes from July 2007 to May 2015, technician- and date-related marginal ECD effects were calculated using linear regression models. ECD variance was correlated with the number of specular microscopy technicians. Technician mean ECDs ranged from 2386 ± 431 to 3005 ± 560 cells/mm. Nine technicians had statistically and clinically significant marginal effects. Annual mean ECDs adjusted for changes in technicians ranged from 2422 ± 433 to 2644 ± 430 cells/mm. The period of 2007 to 2009 had statistically and clinically significant marginal effects. There was a nonstatistically significant association between the number of technicians and ECD standard deviation. There was significant ECD variability associated with specular microscopy technicians and with the date of measurement. We recommend that eye banks collect data related to laboratory factors that have been shown to influence ECD variability.

  17. Pharmacist and Technician Perceptions of Tech-Check-Tech in Community Pharmacy Practice Settings.

    Science.gov (United States)

    Frost, Timothy P; Adams, Alex J

    2018-04-01

    Tech-check-tech (TCT) is a practice model in which pharmacy technicians with advanced training can perform final verification of prescriptions that have been previously reviewed for appropriateness by a pharmacist. Few states have adopted TCT in part because of the common view that this model is controversial among members of the profession. This article aims to summarize the existing research on pharmacist and technician perceptions of community pharmacy-based TCT. A literature review was conducted using MEDLINE (January 1990 to August 2016) and Google Scholar (January 1990 to August 2016) using the terms "tech* and check," "tech-check-tech," "checking technician," and "accuracy checking tech*." Of the 7 studies identified we found general agreement among both pharmacists and technicians that TCT in community pharmacy settings can be safely performed. This agreement persisted in studies of theoretical TCT models and in studies assessing participants in actual community-based TCT models. Pharmacists who had previously worked with a checking technician were generally more favorable toward TCT. Both pharmacists and technicians in community pharmacy settings generally perceived TCT to be safe, in both theoretical surveys and in surveys following actual TCT demonstration projects. These perceptions of safety align well with the actual outcomes achieved from community pharmacy TCT studies.

  18. Older patients' experiences during care transition

    Directory of Open Access Journals (Sweden)

    Rustad EC

    2016-05-01

    Full Text Available Else Cathrine Rustad,1–4 Bodil Furnes,1 Berit Seiger Cronfalk,2,5,6 Elin Dysvik1 1Department of Health Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway; 2Faculty of Health and Caring Sciences, Stord Haugesund University College, Stord, Norway; 3Research Network on Integrated Health Care in Western Norway, Helse Fonna Local Health Authority, Haugesund, Norway; 4Department of Clinical Medicine, Helse Fonna Local Health Authority, Haugesund, Norway; 5Palliative Research Center, Ersta Sköndal University College, Stockholm, Sweden; 6Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden Background: A fragmented health care system leads to an increased demand for continuity of care across health care levels. Research indicates age-related differences during care transition, with the oldest patients having experiences and needs that differ from those of other patients. To meet the older patients’ needs and preferences during care transition, professionals must understand their experiences.Objective: The purpose of the study was to explore how patients ≥80 years of age experienced the care transition from hospital to municipal health care services.Methods: The study has a descriptive, explorative design, using semistructured interviews. Fourteen patients aged ≥80 participated in the study. Qualitative content analysis was used to describe the individuals’ experiences during care transition.Results: Two complementary themes emerged during the analysis: “Participation depends on being invited to plan the care transition” and “Managing continuity of care represents a complex and challenging process”.Discussion: Lack of participation, insufficient information, and vague responsibilities among staff during care transition seemed to limit the continuity of care. The patients are the vulnerable part of the care transition process, although they possess important

  19. Acute care patients discuss the patient role in patient safety.

    Science.gov (United States)

    Rathert, Cheryl; Huddleston, Nicole; Pak, Youngju

    2011-01-01

    Patient safety has been a highly researched topic in health care since the year 2000. One strategy for improving patient safety has been to encourage patients to take an active role in their safety during their health care experiences. However, little research has shed light on how patients view their roles. This study attempted to address this deficit by inductively exploring the results of a qualitative study in which patients reported their ideas about what they believe their roles should be. Patients with an overnight stay in the previous 90 days at one of three hospitals were surveyed using a mailing methodology. Of 1,040 respondents, 491 provided an open-ended response regarding what they believe the patient role should be. Qualitative analysis found several prominent themes. The largest proportion of responses (23%) suggested that patients should follow instructions given by care providers. Other prominent themes were that patients should ask questions and become informed about their conditions and treatments, and many implied that they should expect competent care. Our results suggest that patients believe they should be able to trust that they are being provided competent care, as opposed to assuming a leadership role in their safety. Our results suggest that engaging patients in safety efforts may be complex, requiring a variety of strategies. Managers must provide environments conducive to staff and patient interactions to support patients in this effort. Different types of patients may require different engagement strategies.

  20. Medical Laboratory Technician--Microbiology (AFSC 90470).

    Science.gov (United States)

    Thompson, Joselyn H.

    This four-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for medical laboratory technicians. Covered in the individual volumes are laboratory procedures in clinical bacteriology (the history of bacteriology; aseptic techniques and sterilization procedures; bacterial morphology and…

  1. Patient care in radiography

    International Nuclear Information System (INIS)

    Ehrlich, R.A.; McCloskey, E.D.

    1989-01-01

    This book focuses on patient care procedures for radiographers. The authors focus on the role of the radiographer as a member of the health care team. The authors report on such topics as communication in patient care: safety, medico-legal considerations, transfer and positioning; physical needs; infection control; medication; CPR standards, acute situations; examination of the GI tract; contrast media; special imaging techniques and bedside radiography

  2. Patients' perceptions of palliative care: adaptation of the Quality from the Patient's Perspective instrument for use in palliative care, and description of patients' perceptions of care received.

    Science.gov (United States)

    Sandsdalen, Tuva; Rystedt, Ingrid; Grøndahl, Vigdis Abrahamsen; Hov, Reidun; Høye, Sevald; Wilde-Larsson, Bodil

    2015-11-02

    Instruments specific to palliative care tend to measure care quality from relative perspectives or have insufficient theoretical foundation. The instrument Quality from the Patient's Perspective (QPP) is based on a model for care quality derived from patients' perceptions of care, although it has not been psychometrically evaluated for use in palliative care. The aim of this study was to adapt the QPP for use in palliative care contexts, and to describe patients' perceptions of the care quality in terms of the subjective importance of the care aspects and the perceptions of the care received. A cross-sectional study was conducted between November 2013 and December 2014 which included 191 patients (73% response rate) in late palliative phase at hospice inpatient units, hospice day-care units, wards in nursing homes that specialized in palliative care and homecare districts, all in Norway. An explorative factor analysis using principal component analysis, including data from 184 patients, was performed for psychometric evaluation. Internal consistency was assessed by Cronbach's alpha and paired t-tests were used to describe patients' perceptions of their care. The QPP instrument was adapted for palliative care in four steps: (1) selecting items from the QPP, (2) modifying items and (3) constructing new items to the palliative care setting, and (4) a pilot evaluation. QPP instrument specific to palliative care (QPP-PC) consists of 51 items and 12 factors with an eigenvalue ≥1.0, and showed a stable factor solution that explained 68.25% of the total variance. The reliability coefficients were acceptable for most factors (0.79-0.96). Patients scored most aspects of care related to both subjective importance and actual care received as high. Areas for improvement were symptom relief, participation, continuity, and planning and cooperation. The QPP-PC is based on a theoretical model of quality of care, and has its roots in patients' perspectives. The instrument was

  3. Older Patients' Perspectives on Quality of Serious Illness Care in Primary Care.

    Science.gov (United States)

    Abu Al Hamayel, Nebras; Isenberg, Sarina R; Hannum, Susan M; Sixon, Joshua; Smith, Katherine Clegg; Dy, Sydney M

    2018-01-01

    Despite increased focus on measuring and improving quality of serious illness care, there has been little emphasis on the primary care context or incorporation of the patient perspective. To explore older patients' perspectives on the quality of serious illness care in primary care. Qualitative interview study. Twenty patients aged 60 or older who were at risk for or living with serious illness and who had participated in the clinic's quality improvement initiative. We used a semistructured, open-ended guide focusing on how older patients perceived quality of serious illness care, particularly in primary care. We transcribed interviews verbatim and inductively identified codes. We identified emergent themes using a thematic and constant comparative method. We identified 5 key themes: (1) the importance of patient-centered communication, (2) coordination of care, (3) the shared decision-making process, (4) clinician competence, and (5) access to care. Communication was an overarching theme that facilitated coordination of care between patients and their clinicians, empowered patients for shared decision-making, related to clinicians' perceived competence, and enabled access to primary and specialty care. Although access to care is not traditionally considered an aspect of quality, patients considered this integral to the quality of care they received. Patients perceived serious illness care as a key aspect of quality in primary care. Efforts to improve quality measurement and implementation of quality improvement initiatives in serious illness care should consider these aspects of care that patients deem important, particularly communication as an overarching priority.

  4. Seeking Humanizing Care in Patient-Centered Care Process: A Grounded Theory Study.

    Science.gov (United States)

    Cheraghi, Mohammad Ali; Esmaeili, Maryam; Salsali, Mahvash

    Patient-centered care is both a goal in itself and a tool for enhancing health outcomes. The application of patient-centered care in health care services globally however is diverse. This article reports on a study that sought to introduce patient-centered care. The aim of this study is to explore the process of providing patient-centered care in critical care units. The study used a grounded theory method. Data were collected on 5 critical care units in Tehran University of Medical Sciences. Purposive and theoretical sampling directed the collection of data using 29 semistructured interviews with 27 participants (nurses, patients, and physician). Data obtained were analyzed according to the analysis stages of grounded theory and constant comparison to identify the concepts, context, and process of the study. The core category of this grounded theory is "humanizing care," which consisted of 4 interrelated phases, including patient acceptance, purposeful patient assessment and identification, understanding patients, and patient empowerment. A core category of humanizing care integrated the theory. Humanizing care was an outcome and process. Patient-centered care is a dynamic and multifaceted process provided according to the nurses' understanding of the concept. Patient-centered care does not involve repeating routine tasks; rather, it requires an all-embracing understanding of the patients and showing respect for their values, needs, and preferences.

  5. Psychosocial work conditions and quality of life among primary health care employees: a cross sectional study

    OpenAIRE

    Teles, Mariza Alves Barbosa; Barbosa, Mirna Rossi; Vargas, Andréa Maria Duarte; Gomes, Viviane Elizângela; e Ferreira, Efigênia Ferreira; Martins, Andréa Maria Eleutério de Barros Lima; Ferreira, Raquel Conceição

    2014-01-01

    Background Workers in Primary Health Care are often exposed to stressful conditions at work. This study investigated the association between adverse psychosocial work conditions and poor quality of life among Primary Health Care workers. Methods This cross-sectional study included all 797 Primary Health Care workers of a medium-sized city, Brazil: doctors, nurses, nursing technicians and nursing assistants, dentists, oral health technicians, and auxiliary oral hygienists, and community health...

  6. Palliative care for patients with cancer: do patients receive the care they consider important? A survey study.

    Science.gov (United States)

    Heins, Marianne; Hofstede, Jolien; Rijken, Mieke; Korevaar, Joke; Donker, Gé; Francke, Anneke

    2018-04-17

    In many countries, GPs and home care nurses are involved in care for patients with advanced cancer. Given the varied and complex needs of these patients, providing satisfactory care is a major challenge for them. We therefore aimed to study which aspects of care patients, GPs and home care nurses consider important and whether patients receive these aspects. Seventy-two Dutch patients with advanced cancer, 87 GPs and 26 home care nurses rated the importance of support when experiencing symptoms, respect for patients' autonomy and information provision. Patients also rated whether they received these aspects. Questionnaires were based on the CQ index palliative care. Almost all patients rated information provision and respect for their autonomy as important. The majority also rated support when suffering from specific symptoms as important, especially support when in pain. In general, patients received the care they considered important. However, 49% of those who considered it important to receive support when suffering from fatigue and 23% of those who wanted to receive information on the expected course of their illness did not receive this or only did so sometimes. For most patients with advanced cancer, the palliative care that they receive matches what they consider important. Support for patients experiencing fatigue may need more attention. When symptoms are difficult to control, GPs and nurses may still provide emotional support and practical advice. Furthermore, we recommend that GPs discuss patients' need for information about the expected course of their illness.

  7. Primary care providers' experiences caring for complex patients in primary care: a qualitative study.

    Science.gov (United States)

    Loeb, Danielle F; Bayliss, Elizabeth A; Candrian, Carey; deGruy, Frank V; Binswanger, Ingrid A

    2016-03-22

    Complex patients are increasingly common in primary care and often have poor clinical outcomes. Healthcare system barriers to effective care for complex patients have been previously described, but less is known about the potential impact and meaning of caring for complex patients on a daily basis for primary care providers (PCPs). Our objective was to describe PCPs' experiences providing care for complex patients, including their experiences of health system barriers and facilitators and their strategies to enhance provision of effective care. Using a general inductive approach, our qualitative research study was guided by an interpretive epistemology, or way of knowing. Our method for understanding included semi-structured in-depth interviews with internal medicine PCPs from two university-based and three community health clinics. We developed an interview guide, which included questions on PCPs' experiences, perceived system barriers and facilitators, and strategies to improve their ability to effectively treat complex patients. To focus interviews on real cases, providers were asked to bring de-identified clinical notes from patients they considered complex to the interview. Interview transcripts were coded and analyzed to develop categories from the raw data, which were then conceptualized into broad themes after team-based discussion. PCPs (N = 15) described complex patients with multidimensional needs, such as socio-economic, medical, and mental health. A vision of optimal care emerged from the data, which included coordinating care, preventing hospitalizations, and developing patient trust. PCPs relied on professional values and individual care strategies to overcome local and system barriers. Team based approaches were endorsed to improve the management of complex patients. Given the barriers to effective care described by PCPs, individual PCP efforts alone are unlikely to meet the needs of complex patients. To fulfill PCP's expressed concepts of

  8. Does patient-provider gender concordance affect mental health care received by primary care patients with major depression?

    Science.gov (United States)

    Chan, Kitty S; Bird, Chloe E; Weiss, Robert; Duan, Naihua; Meredith, Lisa S; Sherbourne, Cathy D

    2006-01-01

    We sought to determine whether patient-provider gender concordance influences the detection and care of depression and comorbid anxiety and substance use in patients with major depression Cross-sectional analyses of baseline patient survey data linked with provider data were performed. Data based on routine primary care visits in clinics from a variety of health systems serving diverse patient populations across the United States. Participants all had major depression. Depression care was examined in the Quality Improvement for Depression (QID) Collaboration sample (n patients = 1,428, n providers = 389). In a subanalysis of data solely from 714 patients and 157 providers from Partners-In-Care, one of the projects participating in QID, we also examined detection of anxiety disorder and alcohol or drug problems. Rates of detection and care of mental health problems in primary care were low even among patients with major depression. Except for anxiety counseling in female patients, patient-provider gender concordance did not improve care as hypothesized. However, female providers were more likely to counsel on anxiety and less likely to counsel on alcohol or drug use than male providers. Female patients were less likely to be counseled on alcohol or drug use compared with male patients. Detection and care of mental health and substance use problems for patients with major depression is not influenced by patient-provider gender concordance. However, depressed female patients may have greater unmet needs for alcohol and drug use counseling than their male counterparts.

  9. Training needs analysis for engineering technicians in Oman

    Science.gov (United States)

    Al-Mughairi, Abdulkarim Sultan

    This thesis examines the transition from the Omani Colleges of Technology (CT) to employment of its engineering graduates. It arises out of concerns that the transition to the labour market for engineering graduate is problematical. The research was carried out to identify the knowledge, skills, and abilities (KSA) of engineering technicians required in the Omani market place. The aim is to provide local curriculum designers in the Colleges of Technology with sufficient information about the required KSA in order to create and enhance the engineering curriculum so that it has greater capacity to meet the needs of a variety of stakeholders and of employers in particular. This in turn has the potential to bridge the gap between what is presently taught and what the workplace demands. Personnel psychologists identify views concerning the skills that are required for different jobs. One of these is based on the assumption that quite different skills are required in different jobs (SCANS, 1990). This view generates approaches within job analysis: the worker-oriented and the task-oriented approaches. This research uses Position Analysis Questionnaire (PAQ), which is a worker-oriented job analysis instrument, to investigate the KSA required to perform some of the engineering technician jobs in Omani industries. In addition, semi-structured interviews were used to investigate the factors that either hinder or entirely prevent the new graduates from Colleges of Technology from being accepted in the workforce pool. The major research findings concern the dimensions of knowledge, skills, and abilities of six engineering technician job titles and the major factors that hinder or (prevent) the technical college graduates from being accepted in the market place in Oman. These findings would definitely help design better transition route and bridge the gap between the CT technicians engineering programmes and the workplace demands.

  10. THE ROLE OF SCHOOL TECHNICIANS IN PROMOTING SCIENCE THROUGH PRACTICAL WORK

    Directory of Open Access Journals (Sweden)

    Anne T. Helliar

    2011-11-01

    Full Text Available This is a review of the role of practical work in UK’s secondary school science lessons, the impact that practical work has in the promotion of science, the challenges created through use of non-specialist science teachers and a possible additional role for science technicians. The paper considers how improved deployment of suitably experienced school science technicians and their recognition, by schools’ management, for their involvement in the delivery of training in the use of practical work, for less experienced teachers, could benefit schools and their students. This together with its companion paper endeavours to show how the more effective use of practical work and technicians can encourage more students to select science at higher, non-compulsory levels.

  11. Metabolic syndrome and occupation: Any association? Prevalence among auto technicians and school teachers in South West Nigeria.

    Science.gov (United States)

    Akintunde, Adeseye A; Oloyede, Taiwo W

    2017-11-01

    To determine occupational association with metabolic syndrome among auto technicians and school teachers. One hundred and sixty six subjects were selected for this study. Clinical data was obtained while laboratory investigations including plasma glucose and lipid profile were performed. Statistical analysis was done with SPSS 20.0. Pauto technicians. Mean serum triglycerides was significantly higher among auto-technicians compared to school teachers in this study. The prevalence of some conventional cardiovascular risk factors was significantly higher among auto-technicians compared to school teachers: Impaired blood glucose (9.6% vs. 1.2%, pauto-technicians. Based on the WHO and the Harmonized criteria, metabolic syndrome was more frequent among auto-technicians compared to school teachers. (8.4% vs. 1.2% and 19.3% vs. 7.2% respectively, pauto technicians despite their high level of physical activity, exertion and education compared to teachers. This may be related to the increased occupational exposure to organic and inorganic materials from dust particles, oil and oil related matter and particulate matter among auto technicians. Prompt definitive evaluation of this concept and appropriate health education to encourage safety mechanism can reduce this burden of metabolic syndrome among auto technicians in Nigeria. Copyright © 2016 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  12. Survey on the use of CAD-CAM technology by UK and Irish dental technicians.

    Science.gov (United States)

    Blackwell, E; Nesbit, M; Petridis, H

    2017-05-12

    Statement of the problem Digital workflows (CAD/CAM) have been introduced in dentistry during recent years. No published information exists on dental technicians' use and reporting of this technology.Purpose The aim of this cross sectional survey was to identify the extent digital technology has infiltrated the workplace and to investigate the factors affecting the use of CAD-CAM technology by dental laboratory technicians within Ireland and the UK.Materials and methods A web-based questionnaire was composed (Opinio, Object Planet Inc. Oslo, Norway) and distributed to UK and Irish dental technicians. Answers to all questions were anonymous and grouped such that general information was gathered initially, followed by branching of the survey into two sections depending on whether or not the respondent worked with CAD-CAM technology. Results were compiled and statistical analysis (Fisher's Exact test, SPSS, IBM, Armonk, New York, USA) was performed in order to investigate any correlation between various demographic variables and the answers provided.Results The survey was distributed to 760 UK technicians and 77 Irish technicians. The total number of completed surveys was 105, which yielded a total response rate of 14%. Most technicians reported using some form of CAD/CAM aspect in the workflow, and this was more significant for technicians working in large laboratories. Most training received was company-led. Large laboratories were also significantly correlated with less outsourcing of CAD/CAM work and a change in dental material use leading to the increase of zirconia and the decrease of noble alloys. Dental technicians did not report any significant change in working relationships and staffing as a result of CAD/CAM incorporation. High initial investment cost was the most common reason quoted from non-users, along with the lack of such technology in their working environment.

  13. Recovery Act: Training Program Development for Commercial Building Equipment Technicians

    Energy Technology Data Exchange (ETDEWEB)

    Leah Glameyer

    2012-07-12

    The overall goal of this project has been to develop curricula, certification requirements, and accreditation standards for training on energy efficient practices and technologies for commercial building technicians. These training products will advance industry expertise towards net-zero energy commercial building goals and will result in a substantial reduction in energy use. The ultimate objective is to develop a workforce that can bring existing commercial buildings up to their energy performance potential and ensure that new commercial buildings do not fall below their expected optimal level of performance. Commercial building equipment technicians participating in this training program will learn how to best operate commercial buildings to ensure they reach their expected energy performance level. The training is a combination of classroom, online and on-site lessons. The Texas Engineering Extension Service (TEEX) developed curricula using subject matter and adult learning experts to ensure the training meets certification requirements and accreditation standards for training these technicians. The training targets a specific climate zone to meets the needs, specialized expertise, and perspectives of the commercial building equipment technicians in that zone. The combination of efficient operations and advanced design will improve the internal built environment of a commercial building by increasing comfort and safety, while reducing energy use and environmental impact. Properly trained technicians will ensure equipment operates at design specifications. A second impact is a more highly trained workforce that is better equipped to obtain employment. Organizations that contributed to the development of the training program include TEEX and the Texas Engineering Experiment Station (TEES) (both members of The Texas A&M University System). TEES is also a member of the Building Commissioning Association. This report includes a description of the project

  14. Experiences with developing and implementing a virtual clinic for glaucoma care in an NHS setting

    Directory of Open Access Journals (Sweden)

    Kotecha A

    2015-10-01

    Full Text Available Aachal Kotecha,1,2 Alex Baldwin,1 John Brookes,1 Paul J Foster1,2 1Glaucoma Service, Moorfields Eye Hospital National Health Service Foundation Trust, 2NIHR BRC, Moorfields Eye Hospital, NHS Foundation Trust and UCL Institute of Ophthalmology, University College London, London, UK Background: This article describes the development of a virtual glaucoma clinic, whereby technicians collect information for remote review by a consultant specialist.Design and Methods: This was a hospital-based service evaluation study. Patients suitable for the stable monitoring service (SMS were low-risk patients with “suspect”, “early”-to-“moderate” glaucoma who were deemed stable by their consultant care team. Three technicians and one health care assistant ran the service. Patients underwent tests in a streamlined manner in a dedicated clinical facility, with virtual review of data by a consultant specialist through an electronic patient record.Main outcome measure: Feasibility of developing a novel service within a UK National Health Service setting and improvement of patient journey time within the service were studied.Results: Challenges to implementation of virtual clinic include staffing issues and use of information technology. Patient journey time within the SMS averaged 51 minutes, compared with 92 minutes in the glaucoma outpatient department. Patient satisfaction with the new service was high.Conclusion: Implementing innovation into existing services of the National Health Service is challenging. However, the virtual clinic showed an improved patient journey time compared with that experienced within the general glaucoma outpatient department. There exists a discrepancy between patient management decisions of reviewers, suggesting that some may be more risk averse than others when managing patients seen within this model. Future work will assess the ability to detect progression of disease in this model compared with the general

  15. Development and validation of an instrument to assess job satisfaction in eye-care personnel.

    Science.gov (United States)

    Paudel, Prakash; Cronjé, Sonja; O'Connor, Patricia M; Khadka, Jyoti; Rao, Gullapalli N; Holden, Brien A

    2017-11-01

    The aim was to develop and validate an instrument to measure job satisfaction in eye-care personnel and assess the job satisfaction of one-year trained vision technicians in India. A pilot instrument for assessing job satisfaction was developed, based on a literature review and input from a public health expert panel. Rasch analysis was used to assess psychometric properties and to undertake an iterative item reduction. The instrument was then administered to vision technicians in vision centres of Andhra Pradesh in India. Associations between vision technicians' job satisfaction and factors such as age, gender and experience were analysed using t-test and one-way analysis of variance. Rasch analysis confirmed that the 15-item job satisfaction in eye-care personnel (JSEP) was a unidimensional instrument with good fit statistics, measurement precisions and absence of differential item functioning. Overall, vision technicians reported high rates of job satisfaction (0.46 logits). Age, gender and experience were not associated with high job satisfaction score. Item score analysis showed non-financial incentives, salary and workload were the most important determinants of job satisfaction. The 15-item JSEP instrument is a valid instrument for assessing job satisfaction among eye-care personnel. Overall, vision technicians in India demonstrated high rates of job satisfaction. © 2016 Optometry Australia.

  16. MRI-related magnetic field exposures and risk of commuting accidents - A cross-sectional survey among Dutch imaging technicians.

    Science.gov (United States)

    Huss, Anke; Schaap, Kristel; Kromhout, Hans

    2017-07-01

    Imaging technicians working with magnetic resonance imaging (MRI) may experience acute effects such as vertigo or dizziness when being exposed. A previous study also reported an increased risk of accidents in MRI exposed staff. We aimed at evaluating commuting accident risk in Dutch imaging technicians. Of invited imaging technicians, 490 (29%) filled in a questionnaire pertaining to (near) accidents when driving or riding a bike, health, lifestyle and work practices. We used logistic regression to evaluate the association between exposure to MRI-related electromagnetic fields and risk of commuting (near) accidents in the year prior to the survey, adjusted for a range of potential confounders. Our cross-sectional study indicated an increased risk of (near) accidents if imaging technicians had worked with MRI in the year prior to the survey (odds ratio OR 2.13, 95%CI 1.23-3.69). Risks were higher in persons who worked with MRI more often (OR 2.32, 95%CI 1.25-4.31) compared to persons who worked sometimes with MRI (OR 1.91, 95%CI 0.98-3.72), and higher in those who had likely experienced higher peak exposures to static and time-varying magnetic fields (OR 2.18, 95%CI 1.06-4.48). The effect was seen on commuting accidents that had occurred on the commute from home to work as well as accidents from work to home or elsewhere. Imaging technicians working with MRI scanners may be at an increased risk of commuting (near) accidents. This result needs confirmation and potential risks for other groups (volunteers, patients) should be investigated. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. A longitudinal study on lung disease in dental technicians: What has changed after seven years?

    Directory of Open Access Journals (Sweden)

    Derya Özdemir Dogan

    2013-10-01

    Full Text Available Objectives: The aim of this 7-year follow-up study was to determine respiratory changes in dental technicians. Material and Methods: In our region, in the year 2005, 36 dental technicians were evaluated with a cross-sectional study on respiratory occupational diseases, and in 2012 we evaluated them again. Inclusion of information on respiratory symptoms and demographic features questionnaires was applied. Pulmonary function tests (PFT were performed. Chest X-rays (CXR were evaluated according to the ILO-2000 classification. For the comparisons of the technicians' findings in 2005 and 2012, data analyses were performed with the Wilcoxon test in addition to descriptive statistical procedures. Results: In 2012, 19 out of the 36 technicians continued to work in the same place, so we were able to evaluate their findings. The prevalence of respiratory symptoms in dental technician was as follows: dyspnea 7 (37%, cough 6 (32%, and phlegm 5 (26%. According to ILO classifications in 2005, among the 36 technicians, 5 (13.8% had pneumoconiosis. At the end of 7 years, there were 9 pneumoconiosis cases among the 19 remaining technicians (47%. Thus, there was a statistically significant progression on the profusion of the radiologic findings (p < 0.005. Also there was a significant worsening on spirometric findings (p < 0.05. Conclusion: In dental technicians, a determination of both radiologic and functional progressions at the end of 7 years demonstrate that the primary and secondary preventive measures are necessary for these workplaces. Workplaces must be regularly controlled for worker health and hygiene.

  18. Palliative care and end-of-life care for polypathological patients.

    Science.gov (United States)

    Martinez-Litago, E; Martínez-Velasco, M C; Muniesa-Zaragozano, M P

    2017-12-01

    Patients with advanced chronic diseases receive fragmented care, which entails high resource consumption and a poor quality of life. Uncertainty in the prognosis and scarce investigation into the importance of symptomatic control in this patient group hinders a proper therapeutic approach. Palliative care teams optimise the use of resources through comprehensive patient care, the optimization of the patient's environment, communication, the preparation of early care plans and the creation of coordinated healthcare circuits, which improve the quality of the patient's care in advanced stages of the disease. In the end-of-life phase, the therapeutic approach is focused on symptomatic control, selecting treatments according to the cause, comorbidities and the patient's wishes. To control refractory symptoms, palliative sedation is considered an indispensable option. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  19. Examining chronic care patient preferences for involvement in health-care decision making: the case of Parkinson's disease patients in a patient-centred clinic.

    Science.gov (United States)

    Zizzo, Natalie; Bell, Emily; Lafontaine, Anne-Louise; Racine, Eric

    2017-08-01

    Patient-centred care is a recommended model of care for Parkinson's disease (PD). It aims to provide care that is respectful and responsive to patient preferences, values and perspectives. Provision of patient-centred care should entail considering how patients want to be involved in their care. To understand the participation preferences of patients with PD from a patient-centred care clinic in health-care decision-making processes. Mixed-methods study with early-stage Parkinson's disease patients from a patient-centred care clinic. Study involved a modified Autonomy Preference Index survey (N=65) and qualitative, semi-structured in-depth interviews, analysed using thematic qualitative content analysis (N=20, purposefully selected from survey participants). Interviews examined (i) the patient preferences for involvement in health-care decision making; (ii) patient perspectives on the patient-physician relationship; and (iii) patient preferences for communication of information relevant to decision making. Preferences for participation in decision making varied between individuals and also within individuals depending on decision type, relational and contextual factors. Patients had high preferences for communication of information, but with acknowledged limits. The importance of communication in the patient-physician relationship was emphasized. Patient preferences for involvement in decision making are dynamic and support shared decision making. Relational autonomy corresponds to how patients envision their participation in decision making. Clinicians may need to assess patient preferences on an on-going basis. Our results highlight the complexities of decision-making processes. Improved understanding of individual preferences could enhance respect for persons and make for patient-centred care that is truly respectful of individual patients' wants, needs and values. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  20. DNA damage and cytotoxicity in pathology laboratory technicians exposed to organic solvents

    Directory of Open Access Journals (Sweden)

    TATIANE DE AQUINO

    2016-03-01

    Full Text Available The aim of this study was to evaluate potential DNA damage and cytotoxicity in pathology laboratory technicians exposed to organic solvents, mainly xylene. Peripheral blood and buccal cells samples were collected from 18 technicians occupationally exposed to organic solvents and 11 non-exposed individuals. The technicians were sampled at two moments: Monday and Friday. DNA damage and cytotoxicity were evaluated using the Comet Assay and the Buccal Micronucleus Cytome assay. Fifteen subjects (83.5% of the exposed group to solvents complained about some symptom probably related to contact with vapours of organic solvents. DNA damage in the exposed group to solvents was nearly 2-fold higher on Friday than on Monday, and in both moments the individuals of this group showed higher levels of DNA damage in relation to controls. No statistical difference was detected in buccal cell micronucleus frequency between the laboratory technicians and the control group. However, in the analysis performed on Friday, technicians presented higher frequency (about 3-fold of karyolytic and apoptotic-like cells (karyorrhectic and pyknotic in relation to control group. Considering the damage frequency and the working time, a positive correlation was found in the exposed group to solvents (r=0.468; p=0.05. The results suggest that pathology laboratory workers inappropriately exposed to organic solvents have increased levels of DNA damage.

  1. Section 609 Technician Training and Certification Programs

    Science.gov (United States)

    EPA-approved programs for technicians who service motor vehicle air conditioning (MVAC) systems. Any person who repairs or services a MVAC system for consideration must be certified under section 609 of the Clean Air Act by an EPA-approved program.

  2. Changing Roles of Librarians and Library Technicians

    Directory of Open Access Journals (Sweden)

    Norene James

    2015-10-01

    Full Text Available What significant changes are librarians and library technicians experiencing in their roles? A survey put forward across Canada to librarians and library technicians addressing this question was conducted in February 2014. Eight hundred eighty-two responses were obtained from librarians, defined as MLIS graduates, and library technicians, defined as graduates from a two-year library diploma program. Respondents needed to have been employed in the last two years in these roles and students of either an MLIS or LIT program were also welcome to participate. The results suggest that both librarians and library technicians perceive their roles as growing in scope and complexity and that the lines of responsibility are blurring. A majority of respondents indicated that they perceive a change in their roles in the past five years and commented on what the perceived changes were. Librarian and library technician roles may be shifting away from what may be viewed as traditional or clearly defined responsibilities and both librarians and library technicians may be taking on new tasks as well as experiencing task overlap. All library staff will need to be fluid, adaptable, and open to change. Library school curricula and workplace training need to incorporate the development of these competencies. Quels sont les changements importants éprouvés par les bibliothécaires et les bibliotechniciens dans leurs rôles? Un sondage mené en février de 2014 a posé cette question aux bibliothécaires et aux bibliotechniciens dans tout le Canada. On a reçu huit-cent quatre-vingt-deux réponses des bibliothécaires, définis comme étant diplômés en MSIB, et les bibliotechniciens, définis comme étant diplômés d’un programme de deux ans en bibliotechnique. Les sondés devaient avoir travaillé au cours des deux dernières années dans ces fonctions et les étudiants d’un programme MSIB ou de bibliothéconomie/ sciences de l’information pouvaient aussi y

  3. Perioperative Care of the Transgender Patient.

    Science.gov (United States)

    Smith, Francis Duval

    2016-02-01

    Transgender patients are individuals whose gender identity is not related to their biological sex. Assuming a new gender identity that does not conform to societal norms often results in discrimination and barriers to health care. The exact number of transgender patients is unknown; however, these patients are increasingly seen in health care. Transgender individuals may experience provider-generated discrimination in health care facilities, including refusal of service, disrespect, and abuse, which contribute to depression and low self-esteem. Transgender therapies include mental health counseling for depression and low self-esteem, hormone therapy, and sex reassignment surgery. Health care professionals require cultural competence, an understanding of the different forms of patient identification, and adaptive approaches to care for transgender patients. VA (Veterans Affairs) hospitals provide a model for the care for transgender patients and staff. Copyright © 2016 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  4. Teamwork and Patient Care Teams in an Acute Care Hospital.

    Science.gov (United States)

    Rochon, Andrea; Heale, Roberta; Hunt, Elena; Parent, Michele

    2015-06-01

    The literature suggests that effective teamwork among patient care teams can positively impact work environment, job satisfaction and quality of patient care. The purpose of this study was to determine the perceived level of nursing teamwork by registered nurses, registered practical nurses, personal support workers and unit clerks working on patient care teams in one acute care hospital in northern Ontario, Canada, and to determine if a relationship exists between the staff scores on the Nursing Teamwork Survey (NTS) and participant perception of adequate staffing. Using a descriptive cross-sectional research design, 600 staff members were invited to complete the NTS and a 33% response rate was achieved (N=200). The participants from the critical care unit reported the highest scores on the NTS, whereas participants from the inpatient surgical (IPS) unit reported the lowest scores. Participants from the IPS unit also reported having less experience, being younger, having less satisfaction in their current position and having a higher intention to leave. A high rate of intention to leave in the next year was found among all participants. No statistically significant correlation was found between overall scores on the NTS and the perception of adequate staffing. Strategies to increase teamwork, such as staff education, among patient care teams may positively influence job satisfaction and patient care on patient care units. Copyright © 2015 Longwoods Publishing.

  5. [Palliative care and end-of-life patients in emergency situations. Recommendations on optimization of out-patient care].

    Science.gov (United States)

    Wiese, C H R; Vagts, D A; Kampa, U; Pfeiffer, G; Grom, I-U; Gerth, M A; Graf, B M; Zausig, Y A

    2011-02-01

    At the end of life acute exacerbations of medical symptoms (e.g. dyspnea) in palliative care patients often result in emergency medical services being alerted. The goals of this study were to discuss cooperation between emergency medical and palliative care structures to optimize the quality of care in emergencies involving palliative care patients. For data collection an open discussion of the main topics by experts in palliative and emergency medical care was employed. Main outcome measures and recommendations included responses regarding current practices related to expert opinions and international literature sources. As the essential points of consensus the following recommendations for optimization of care were named: (1) integration of palliative care in the emergency medicine curricula for pre-hospital emergency physicians and paramedics, (2) development of outpatient palliative care, (3) integration of palliative care teams into emergency medical structures, (4) cooperation between palliative and emergency medical care, (5) integration of crisis intervention into outpatient palliative emergency medical care, (6) provision of emergency plans and emergency medical boxes, (7) provision of palliative crisis cards and do not attempt resuscitation (DNAR) orders, (8) psychosocial aspects concerning palliative emergencies and (9) definition of palliative patients and their special situation by the physician responsible for prior treatment. Prehospital emergency physicians are confronted with emergencies in palliative care patients every day. In the treatment of these emergencies there are potentially serious conflicts due to the different therapeutic concepts of palliative medical care and emergency medical services. This study demonstrates that there is a need for regulated criteria for the therapy of palliative patients and patients at the end of life in emergency situations. Overall, more clinical investigations concerning end-of-life care and unresponsive

  6. Collaborative care management effectively promotes self-management: patient evaluation of care management for depression in primary care.

    Science.gov (United States)

    DeJesus, Ramona S; Howell, Lisa; Williams, Mark; Hathaway, Julie; Vickers, Kristin S

    2014-03-01

    Chronic disease management in the primary care setting increasingly involves self-management support from a nurse care manager. Prior research had shown patient acceptance and willingness to work with care managers. This survey study evaluated patient-perceived satisfaction with care management and patient opinions on the effectiveness of care management in promoting self-management. Qualitative and quantitative survey responses were collected from 125 patients (79% female; average age 46; 94% Caucasian) enrolled in care management for depression. Qualitative responses were coded with methods of content analysis by 2 independent analysts. Patients were satisfied with depression care management. Patients felt that care management improved their treatment above and beyond other aspects of their depression treatment (mean score, 6.7 [SD, 2]; 10 = Very much), increased their understanding of depression self-management (mean score, 7.2 [SD, 2]; 10 = Very much), and increased the frequency of self-management goal setting (mean score, 6.9 [SD, 3]; 10 = Very much). Predominant qualitative themes emphasized that patients value emotional, motivational, and relational aspects of the care manager relationship. Patients viewed care managers as caring and supportive, helpful in creating accountability for patients and knowledgeable in the area of depression care. Care managers empower patients to take on an active role in depression self-management. Some logistical challenges associated with a telephonic intervention are described. Care manager training should include communication and motivation strategies, specifically self-management education, as these strategies are valued by patients. Barriers to care management, such as scheduling telephone calls, should be addressed in future care management implementation and study.

  7. ISLAMIC CARING MODEL ON INCREASE PATIENT SATISFACTION

    Directory of Open Access Journals (Sweden)

    Muh. Abdurrouf

    2017-04-01

    Full Text Available Introduction: Patient satisfaction was important aspect that must be considered by health service providers, patients who were not satisfied will leave the hospital and be a competitor's customers so be able caused a decrease in sales of products/services and in turn could reduce and even loss of profit, therefore, the hospital must provided the best service so that it could increase patient satisfaction. The purpose of this study was to exams the effect of Islamic caring model on increase patient satisfaction.. Method: This study was used pre-experimental design, the respondents were 31 patients in the treatment group assigned Islamic caring and 31 patients with a kontrol group that were not given Islamic caring Inpatient Surgical Sultan Agung Islamic Hospital Semarang by using consecutive sampling techniques, patient satisfaction data collected through questionnaires and analyzed with Mann-Whitney test, as for finding out the Islamic caring for patient satisfaction were analyzed with spearmen's rho test. Result: The results showed that there was a significant influence of Islamic caring for perceived disconfirmation (p=0,000 there was a perceived disconfirmation influence on patient satisfaction significantly (p=0,000, there was a significant influence of Islamic caring for patient satisfaction in the treatment group with a kontrol group (p=0.001. Discussion: Discussion of this study was Islamic caring model effect on the increase perceived disconfirmation and patient satisfaction, Perceived disconfirmation effect on patient satisfaction, patient satisfaction who given Islamic caring was increase, patients given Islamic caring had higher satisfaction levels than patients who not given Islamic caring. Suggestions put forward based on the results of the study of Islamic caring model could be applied in Sultan Agung Islamic Hospital as a model of nursing care, Islamic caring behavior can be learned and improved through training and commitment and

  8. A WIDER ROLE FOR TECHNICIANS IN SCIENCE PRACTICAL WORK WITH SCHOOL STUDENTS?

    Directory of Open Access Journals (Sweden)

    Timothy G. Harrison

    2011-12-01

    Full Text Available This paper reports the results of a study made on the impact of improved deployment of science technicians in the classroom could directly benefit students in practical science investigations. Science technicians are skilled individuals whose understanding of practical work is a valuable resource not being used of in support of students understanding of science. Aspects of practical work and technician support were scrutinised, through information attained from a post-16 student survey to improve understanding about this teaching tool, to establish if it was being used to its full potential within science lessons. Analysis was also made of students’ perceptions of school science. The main outcomes were that the majority of students enjoyed science practical work and felt that science could not be taught without it. Students studying science at pre-university level attained a greater understanding, through participating in relevant practical work, than students who had studied it at earlier, compulsory levels. Students reported that science technicians provide impact on student learning when contact time was the greatest.

  9. Palliative care among heart failure patients in primary care: a comparison to cancer patients using English family practice data.

    Directory of Open Access Journals (Sweden)

    Amy Gadoud

    Full Text Available Patients with heart failure have a significant symptom burden and other palliative care needs often over a longer period than patients with cancer. It is acknowledged that this need may be unmet but by how much has not been quantified in primary care data at the population level.This was the first use of Clinical Practice Research Datalink, the world's largest primary care database to explore recognition of the need for palliative care. Heart failure and cancer patients who had died in 2009 aged 18 or over and had at least one year of primary care records were identified. A palliative approach to care among patients with heart failure was compared to that among patients with cancer using entry onto a palliative care register as a marker for a palliative approach to care.Among patients with heart failure, 7% (234/3 122 were entered on the palliative care register compared to 48% (3 669/7 608 of cancer patients. Of heart failure patients on the palliative care register, 29% (69/234 were entered onto the register within a week of their death.This confirms that the stark inequity in recognition of palliative care needs for people with heart failure in a large primary care dataset. We recommend a move away from prognosis based criteria for palliative care towards a patient centred approach, with assessment of and attention to palliative needs including advance care planning throughout the disease trajectory.

  10. Factors That Influence Standard Automated Perimetry Test Results in Glaucoma : Test Reliability, Technician Experience, Time of Day, and Season

    NARCIS (Netherlands)

    Montolio, Francisco G. Junoy; Wesselink, Christiaan; Gordijn, Marijke; Jansonius, Nomdo M.

    2012-01-01

    PURPOSE. To determine the influence of several factors on standard automated perimetry test results in glaucoma. METHODS. Longitudinal Humphrey field analyzer 30-2 Swedish interactive threshold algorithm data from 160 eyes of 160 glaucoma patients were used. The influence of technician experience,

  11. Factors that influence standard automated perimetry test results in glaucoma: Test reliability, technician experience, time of day, and season

    NARCIS (Netherlands)

    F.G.J. Montolio (Francisco G. Junoy); C. Wesselink (Christiaan); M.C.M. Gordijn (Marijke); N.M. Jansonius (Nomdo)

    2012-01-01

    textabstractPURPOSE. To determine the influence of several factors on standard automated perimetry test results in glaucoma. METHODS. Longitudinal Humphrey field analyzer 30-2 Swedish interactive threshold algorithm data from 160 eyes of 160 glaucoma patients were used. The influence of technician

  12. Investigating laparoscopic psychomotor skills in veterinarians and veterinary technicians.

    Science.gov (United States)

    Kilkenny, Jessica; Santarossa, Amanda; Mrotz, Victoria; Walker, Meagan; Monaghan, Dominique; Singh, Ameet

    2017-04-01

    To determine the influence of age, year of graduation, and video game experience on baseline laparoscopic psychomotor skills. Cross-sectional. Licensed veterinarians (n = 38) and registered veterinary technicians (VTs) (n = 49). A laparoscopic box trainer was set up at the 2016 Ontario Veterinary Medical Association (OVMA) and the 2016 Ontario Association of Veterinary Technicians (OAVT) conferences held in Toronto, Ontario, Canada. Participants volunteered to perform a single repetition of a peg transfer (PT) exercise. Participants were given a short demonstration of the PT task prior to testing. A Spearman's rank correlation (r s ) was used to identify associations between baseline psychomotor skills and self-reported surgical and non-surgical experiences collected via survey. Mann-Whitney U tests were used to compare PT scores in veterinarians and VTs. A P-value of  .05). Veterinary technicians that frequently used chopsticks scored higher than those without chopstick experience (P = .04). Age and year of graduation correlated inversely, while self-reported VG experience correlated positively with laparoscopic psychomotor skills of veterinarians, when assessed on a simulator. The use of chopsticks may contribute to the acquisition of psychomotor skills in VTs. © 2017 The American College of Veterinary Surgeons.

  13. Staphylococcus aureus with Panton-Valentine toxin skin infection in a medical laboratory technician.

    Science.gov (United States)

    Pougnet, Richard; Pougnet, Laurence

    2016-12-01

    This report exposes the case of a Staphylococcus aureus infection occurring in a microbiology laboratory technician. He was a 52 year-old man without medical history. He presented an abscess on the anterior aspect of the left forearm. Analysis showed that it was a Staphylococcus aureus secreting the Panton-Valentine toxin. The study of the workplace found the frequency of exposure. The study of workstation showed the link between the technician position and the infection. Indeed, this man touched an area where the biocleaning was hard to do. This is the first case of infection with PVL described for a laboratory technician.

  14. Role of the chemical engineering technician in applied research related to tritium separation from aqueous effluents

    International Nuclear Information System (INIS)

    Nelson, S.D.

    1978-01-01

    Applied research and development activities related to the removal of tritium from aqueous effluent streams have presented broad opportunities to the chemical engineering technician for professional growth. Technician job activities involve operating complex analytical instrumentation and constructing, maintaining, and operating experimental electrolysis apparatus. The technician is a member of a professional team including scientific, engineering, and other technical personnel and as such is expected to exercise creative thought. Proximity of a large university and availability of formalized ''in house'' training courses provide incentives for technicians to broaden their academic base concurrent with their work involvement

  15. Fuzzy hybrid MCDM approach for selection of wind turbine service technicians

    Directory of Open Access Journals (Sweden)

    Goutam Kumar Bose

    2016-01-01

    Full Text Available This research paper is aimed to present a fuzzy Hybrid Multi-criteria decision making (MCDM methodology for selecting employees. The present study aspires to present the hybrid approach of Fuzzy multiple MCDM techniques with tactical viewpoint to support the recruitment process of wind turbine service technicians. The methodology is based on the application of Fuzzy ARAS (Additive Ratio Assessment and Fuzzy MOORA (Multi-Objective Optimization on basis of Ratio Analysis which are integrated through group decision making (GDM method in the model for selection of wind turbine service technicians’ ranking. Here a group of experts from different fields of expertise are engaged to finalize the decision. Series of tests are conducted regarding physical fitness, technical written test, practical test along with general interview and medical examination to facilitate the final selection using the above techniques. In contrast to single decision making approaches, the proposed group decision making model efficiently supports the wind turbine service technicians ranking process. The effectiveness of the proposed approach manifest from the case study of service technicians required for the maintenance department of wind power plant using Fuzzy ARAS and Fuzzy MOORA. This set of potential technicians is evaluated based on five main criteria.

  16. The enforcement regulation for the law for radiation technicians engaging in medical treatment

    International Nuclear Information System (INIS)

    1985-01-01

    The ordinance is set up under the provisions of the law concerning radiation and x-ray technicians engaging in medical treatment, to enforce it. An application for the license of such a technician shall be filed according to the form prescribed, attached with a copy or an abstract of the census register of the applicant and a medical certificate of a doctor concerning whether the applicant is an insane, deaf or blind person, or a case of epidemic. The membership registration of such a technician shall include the number and date of the registration, the prefecture of his legal domicile, name birth date and sex distinction, the year and month of his success in the examination for such technicains, the items concerning the cancellation of the license or the suspension of the business, etc. The subjects of the examination for such technicians are physics, radiological physics, electrical engineering, chemistry, general basic medical science, radiological biology, photographing technology, treatment technics and others. An application for the examination for such technicians shall be filed to the Minister of Health and Welfare, attached with a personal history, a study certificate or a diploma of graduation, a photograph of the applicant and other specified documents. (Kubozono, M.)

  17. So You Want to Train Solar Technicians.

    Science.gov (United States)

    Ensign, M. Dale; Richins, Michael Paul

    1978-01-01

    Considers the role of solar energy in meeting the nation's energy requirements and the future needs for solar technicians and mechanics. Discusses the precautions community colleges must take in training these workers, to ensure that the demand be met without flooding the job market. (MB)

  18. Patient participation in transitional care of older patients

    OpenAIRE

    Dyrstad, Dagrunn Nåden

    2016-01-01

    PhD thesis in Health, medicine and welfare Background: Older patients often have several health challenges, with multiple medications, which leads to a need of treatment and care from diverse healthcare services. These patients are often in need of transitions from different levels of care, specifically during hospital admission and discharge. Patient participation is highlighted and stated in patients’ rights and healthcare directives, with patients being informed and involved in all trea...

  19. OCCUPATIONAL CONTACT DERMATITIS AMONGST DENTISTS AND DENTAL TECHNICIANS.

    Science.gov (United States)

    Lugović-Mihić, Liborija; Ferček, Iva; Duvančić, Tomislav; Bulat, Vedrana; Ježovita, Josip; Novak-Bilić, Gaby; Šitum, Mirna

    2016-06-01

    Since the working medical personnel including dentists and dental technicians mainly use their hands, it is understandable that the most common occupational disease amongst medical personnel is contact dermatitis (CD) (80%-90% of cases). Development of occupational CD is caused by contact of the skin with various substances in occupational environment. Occupational etiologic factors for dental personnel are foremost reactions to gloves containing latex, followed by various dental materials (e.g., metals, acrylates), detergents, lubricants, solvents, chemicals, etc. Since occupational CD is relatively common in dental personnel, its timely recognition, treatment and taking preventive measures is needed. Achieving skin protection at exposed workplaces is of special importance, as well as implementing necessary measures consequently and sufficiently, which is sometimes difficult to achieve. Various studies have shown the benefit of applying preventive measures, such as numerous protocols for reducing and managing latex sensitivity and other forms of CD in dentistry. Active involvement of physicians within the health care system, primarily dermatologists, occupational medicine specialists and general medicine doctors is needed for establishing an accurate medical diagnosis and confirmation of occupational skin disease.

  20. Health care professional development: Working as a team to improve patient care.

    Science.gov (United States)

    Babiker, Amir; El Husseini, Maha; Al Nemri, Abdurrahman; Al Frayh, Abdurrahman; Al Juryyan, Nasir; Faki, Mohamed O; Assiri, Asaad; Al Saadi, Muslim; Shaikh, Farheen; Al Zamil, Fahad

    2014-01-01

    In delivering health care, an effective teamwork can immediately and positively affect patient safety and outcome. The need for effective teams is increasing due to increasing co-morbidities and increasing complexity of specialization of care. Time has gone when a doctor or a dentist or any other health practitioner in whatsoever health organization would be able to solely deliver a quality care that satisfies his or her patients. The evolution in health care and a global demand for quality patient care necessitate a parallel health care professional development with a great focus on patient centred teamwork approach. This can only be achieved by placing the patient in the centre of care and through sharing a wide based culture of values and principles. This will help forming and developing an effective team able to deliver exceptional care to the patients. Aiming towards this goal, motivation of team members should be backed by strategies and practical skills in order to achieve goals and overcome challenges. This article highlights values and principles of working as a team and principles and provides team players with a practical approach to deliver quality patient care.

  1. Adult Patients' Experiences of Nursing Care Dependence.

    Science.gov (United States)

    Piredda, Michela; Matarese, Maria; Mastroianni, Chiara; D'Angelo, Daniela; Hammer, Marilyn J; De Marinis, Maria Grazia

    2015-09-01

    Care dependence can be associated with suffering and humiliation. Nurses' awareness of patients' perception of care dependence is crucial to enable them in helping the dependent persons. This study aimed to describe adult patients' experience of nursing care dependence. A metasynthesis was conducted to integrate qualitative findings from 18 studies published through December 2014 on adult patients' experiences of care dependency. Procedures included the Johanna Briggs Institute approach for data extraction, quality appraisal, and integration of findings. The experience of dependence revealed the concept of the embodied person, particularly in relation to care of the physical body. The relationship between the individual and nurses within the context of care had a major impact for dependent patients. When the care relation was perceived as positive, the experience led to the development of the person in finding new balances in life, but when it was perceived as negative, it increased patient' suffering. Care dependence is manifested mostly as bodily dependence and is consistent with its relational nature. The nurse-patient relationship is important to the dependent patients' experience. A greater understanding of patients' experiences of dependence is crucial to enable nurses in improving care and decreasing patient suffering. © 2015 Sigma Theta Tau International.

  2. [EEG technician-nurse collaboration during stereo-electroencephalography].

    Science.gov (United States)

    Jomard, Caroline; Benghezal, Mouna; Cheramy, Isabelle; De Beaumont, Ségolène

    2017-01-01

    Drug-resistant epilepsy has significant repercussions on the daily life of children. Surgery may represent a hope. The nurse and the electroencephalogram technician carry out important teamwork during pre-surgical assessment tests and notably the stereo-electroencephalography. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  3. Job Satisfaction among Turkish Business Aviation Technicians

    Directory of Open Access Journals (Sweden)

    Tevfik Uyar

    2013-09-01

    Full Text Available The most applicable models in safety management put the human factors, employers’ attitudes and behaviors at the center. This study reports an investigation of job satisfaction among business aviation technicians. A demographic information form and Job Satisfaction Survey (JSS were used to collect data from 44 individuals. Data was analyzed using ANOVA and Student’s t-test. Our results show that there is significant difference in total job satisfaction levels with regard to marital status while other personal factors are not related to the total job satisfaction levels. However several sub dimensions of job satisfaction are affected by the workers’ military or civilian origin, their training background, types of companies they work in or their license category. No difference is found in age and position groups. Secondly, study shows that technicians are the most satisfied from the nature of their work, while they are the least satisfied by operational procedures.

  4. 40 CFR 745.92 - Fees for the accreditation of renovation and dust sampling technician training and the...

    Science.gov (United States)

    2010-07-01

    ... renovation and dust sampling technician training and the certification of renovation firms. 745.92 Section... Renovation § 745.92 Fees for the accreditation of renovation and dust sampling technician training and the... the following disciplines: Renovator, dust sampling technician. (ii) Exemption. No fee shall be...

  5. Health Care Employee Perceptions of Patient-Centered Care: A Photovoice Project

    Science.gov (United States)

    Balbale, Salva Najib; Turcios, Stephanie; LaVela, Sherri L.

    2015-01-01

    Given the importance of health care employees in the delivery of patient-centered care, understanding their unique perspective is essential for quality improvement. The purpose of this study was to use photovoice to evaluate perceptions and experiences around patient-centered care among Veterans Affairs (VA) health care employees. We asked participants to take photographs of salient features in their environment related to patient-centered care. We used the photographs to facilitate dialogue during follow-up interviews. Twelve VA health care employees across two VA sites participated in the project. Although most participants felt satisfied with their work environment and experiences at the VA, several areas for improvement were identified. These included a need for more employee health and wellness initiatives and a need for enhanced opportunities for training and professional growth. Application of photovoice enabled us to learn about employees' unique perspectives around patient-centered care while engaging them in an evaluation of care delivery. PMID:25274626

  6. Radiological Control Technician: Phase 2, Core/site practical training

    International Nuclear Information System (INIS)

    1992-10-01

    This volume provides a description of the guidelines, qualification in radiological instrumentation, qualification in radiological protection, and qualification in emergency preparedness for radiological control technicians

  7. The politics of patient-centred care.

    Science.gov (United States)

    Kreindler, Sara A

    2015-10-01

    Despite widespread belief in the importance of patient-centred care, it remains difficult to create a system in which all groups work together for the good of the patient. Part of the problem may be that the issue of patient-centred care itself can be used to prosecute intergroup conflict. This qualitative study of texts examined the presence and nature of intergroup language within the discourse on patient-centred care. A systematic SCOPUS and Google search identified 85 peer-reviewed and grey literature reports that engaged with the concept of patient-centred care. Discourse analysis, informed by the social identity approach, examined how writers defined and portrayed various groups. Managers, physicians and nurses all used the discourse of patient-centred care to imply that their own group was patient centred while other group(s) were not. Patient organizations tended to downplay or even deny the role of managers and providers in promoting patient centredness, and some used the concept to advocate for controversial health policies. Intergroup themes were even more obvious in the rhetoric of political groups across the ideological spectrum. In contrast to accounts that juxtaposed in-groups and out-groups, those from reportedly patient-centred organizations defined a 'mosaic' in-group that encompassed managers, providers and patients. The seemingly benign concept of patient-centred care can easily become a weapon on an intergroup battlefield. Understanding this dimension may help organizations resolve the intergroup tensions that prevent collective achievement of a patient-centred system. © 2013 John Wiley & Sons Ltd.

  8. Patient Satisfaction with Virtual Obstetric Care.

    Science.gov (United States)

    Pflugeisen, Bethann Mangel; Mou, Jin

    2017-07-01

    Introduction The importance of patient satisfaction in US healthcare is increasing, in tandem with the advent of new patient care modalities, including virtual care. The purpose of this study was to compare the satisfaction of obstetric patients who received one-third of their antenatal visits in videoconference ("Virtual-care") compared to those who received 12-14 face-to-face visits in-clinic with their physician/midwife ("Traditional-care"). Methods We developed a four-domain satisfaction questionnaire; Virtual-care patients were asked additional questions about technology. Using a modified Dillman method, satisfaction surveys were sent to Virtual-care (N = 378) and Traditional-care (N = 795) patients who received obstetric services at our institution between January 2013 and June 2015. Chi-squared tests of association, t-tests, logistic regression, and ANOVA models were used to evaluate differences in satisfaction and self-reported demographics between respondents. Results Overall satisfaction was significantly higher in the Virtual-care cohort (4.76 ± 0.44 vs. 4.47 ± 0.59; p Virtual-care selection (OR = 2.4, 95% CI: 1.5-3.8; p Virtual-care respondents was not significantly impacted by the incorporation of videoconferencing, Doppler, and blood pressure monitoring technology into their care. The questionnaire demonstrated high internal consistency as measured by domain-based correlations and Cronbach's alpha. Discussion Respondents from both models were highly satisfied with care, but those who had selected the Virtual-care model reported significantly higher mean satisfaction scores. The Virtual-care model was selected by significantly more women who already have children than those experiencing pregnancy for the first time. This model of care may be a reasonable alternative to traditional care.

  9. Primary care patients with anxiety and depression : Need for care from the patient's perspective

    NARCIS (Netherlands)

    Prins, Marijn A.; Verhaak, Peter F. M.; van der Meer, Klaas; Penninx, Brenda W. J. H.; Bensing, Jozien M.

    2009-01-01

    Background: Many anxiety and depression patients receive no care, resulting in unnecessary suffering and high costs. Specific beliefs and the absence of a perceived need for care are major reasons for not receiving care. This study aims to determine the specific perceived need for care in primary

  10. Implementing Patient Family-Centered Care Grand Rounds Using Patient/Family Advisor Narratives

    Directory of Open Access Journals (Sweden)

    Maureen B Fagan DNP, MHA, FNP-BC

    2015-11-01

    Full Text Available With the emerging trend of patient family–centered care in health care, it is essential that physicians be exposed to patient and family perspectives of care during medical education and training. Grand Rounds provides an ideal format for physicians to learn about patient family–centered care. At Brigham and Women’s Hospital, we sought to bring the voice of the patient to Patient Family–Centered Grand Rounds in order to expose clinicians to rich narratives describing the medical care received by patients/families and to ultimately change physician practice to reflect patient family–centered principles. We conducted a clinician survey and found promising results indicating that patient/family narratives can be effective at educating physicians about patient family–centered care.

  11. Effects of occupational exposure of X-Ray on hematological parameters of diagnostic technicians

    Science.gov (United States)

    Taqi, Ali H.; Faraj, Kharman A.; Zaynal, Sarah A.; Hameed, Ahmed M.; Mahmood, Abd-Alkader A.

    2018-06-01

    The aim of this study was to identify the effects of long term exposure of X-ray on diagnostic technicians which they work at Kirkuk hospitals through examining some hematological parameters which are white blood cells (WBC), Neutrophils, Lymphocyte, Monocyte, Eosinophil, Basophil, Reactive Lymphocyte, red blood cells (RBC), hemoglobin (Hb), hematocrit (HCT), Mean Cell Volume (MCV), Mean Corpuscular Hemoglobin (MCH), Mean Cell Hemoglobin Concentration (MCHC), Red Cell Distribution Width (RDW), Platelet (PLT). The study included 54 male diagnostic technicians and 54 male healthy controls match with the first group to show any alteration of the hematological parameters. The diagnostic technicians divided into two groups depending on their work experience and hours working per day. The statistical analysis was performed using (Graph-pad) program. Our results showed that the Complete blood cells count (CBC) parameters (Neutrophil, Monocytes, Basophile, MCV, RDW and PLT) significantly (Pgroups of the diagnostic technicians compared with their controls. We concluded that chronic exposure of X-ray can significantly alter some hematological parameters and the number of hours working per day has observable effects on the some hematological parameters. We recommended training and courses about hazard of ionizing radiation should be organized for enhance the healthcare quality of the technicians and to improve their knowledge about benefit of radiation protection tools to protect themselves from any overexposure during the daily life.

  12. Preparing technicians for engineering materials technology

    Science.gov (United States)

    Jacobs, James A.; Metzloff, Carlton H.

    1990-01-01

    A long held principle is that for every engineer and scientist there is a need for ten technicians to maximize the efficiency of the technology team for meeting needs of industry and government. Developing an adequate supply of technicians to meet the requirements of the materials related industry will be a challenge and difficult to accomplish. A variety of agencies feel the need and wish to support development of engineering materials technology programs. In a joint effort among Battelle Laboratories, the Department of Energy (DOE) and Northwest College and University Association for Science (NORCUS), the development of an engineering materials technology program for vocational programs and community colleges for the Pacific Northwest Region was recently completed. This effort has implications for a national model. The model Associate of Applied Science degree in Engineering Materials Technology shown provides a general structure. It purposely has course titles which need delimiting while also including a core of courses necessary to develop cognitive, affective and psychomotor skills with the underlining principles of math, science and technology so students have job entry skills, and so that students can learn about and adapt to evolving technology.

  13. Physician and Nurse Acceptance of Technicians to Screen for Geriatric Syndromes in the Emergency Department

    OpenAIRE

    Carpenter, Christopher R; Griffey, Richard T; Stark, Susan; Coopersmith, Craig M; Gage, Brian F

    2011-01-01

    Introduction: The objective of this study was to evaluate emergency medicine physician and nurse acceptance of nonnurse, nonphysician screening for geriatric syndromes. Methods: This was a single-center emergency department (ED) survey of physicians and nurses after an 8-month project. Geriatric technicians were paid medical student research assistants evaluating consenting ED patients older than 65 years for cognitive dysfunction, fall risk, or functional decline. The primary objective of t...

  14. Practical digital electronics for technicians

    CERN Document Server

    Kimber, Will

    2013-01-01

    Practical Digital Electronics for Technicians covers topics on analog and digital signals, logic gates, combinational logic, and Karnaugh mapping. The book discusses the characteristics and types of logic families; sequential systems including latch, bistable circuits, counters and shift registers; Schmitt triggers and multivibrators; and MSI combinational logic systems. Display devices, including LED, LCD and dot matrix display; analog and digital conversion; and examples of and equipment for digital fault finding are also considered. The book concludes by providing answers to the questions

  15. Patient care and radiation protection

    International Nuclear Information System (INIS)

    Sharko, G.A.

    1987-01-01

    This chapter deals with important aspects of patient care, which may become the radiographer's responsibility in the absence of dedicated nursing staff. Although large pediatric centers usually employ nurses for bedside patient management, the general radiographer should be familiar with some aspects of routine patient care. This knowledge guarantees the safety and well-being of children entrusted to the technologist

  16. The enforcement regulation for the law for radiation and x-ray technicians engaging in medical treatment

    International Nuclear Information System (INIS)

    1978-01-01

    These provisions are established on the basis of and to enforce the ''Law for radiation and X-ray technicians engaging in medical treatment''. Applications for the license of radiation and X-ray technicians engaging in medical treatment shall be filed, attached with a copy or an abstract of the census register of the applicant and a medical certificate by a doctor of whether the applicant is an insane, a deaf, a dumb or a blind person or a person caught by an infectious disease or not. In the register of such technicians, the number and the date of registration, the names of the prefectures where the technicians are legally domiciled, their names and the date of birth, the year and month of passing the examination, the matters concerning withdrawal of the license or suspension of the practice must be written. The date and the place of the examination for such technicians shall be published beforehand on the official gazette. The examinations for such radiation and X-ray technicians are made on the subjects, such as physics, electrical engineering, chemistry, elementary medical science, radiology, photographing technique, medical treatment technique and control technique. (Okada, K.)

  17. Overview on Patient Centricity in Cancer Care

    Directory of Open Access Journals (Sweden)

    Šarunas Narbutas

    2017-10-01

    Full Text Available Successful implementation of treatment in cancer care partially depends on how patients' perspectives are taken into account, as preferences of health care professionals and patients may differ. Objectives of this exploratory research were (I to identify patient preferences and values (PPVs in cancer care as indicated by patient organizations (POs, (II to determine how these PPVs are captured in cancer care guidelines and (III to review how guidelines take into account these PPVs. Based on a survey developed and completed by 19 POs, a literature review was conducted to analyse how patient perspectives are incorporated in oncology treatment guidelines. Based on survey results traditional health technology assessment value propositions of oncology care, such as extended life, treatment-free remission and pain reduction, were also highly rated by POs. However, the heterogeneity of cancer PPVs were clearly reflected in the survey results. PPVs in cancer care guidelines were mostly limited to those micro-level aspects that are strictly related to health care provision, such as side-effects and comorbidities. Patient experience, emotional support and convenience of care were relatively neglected fields in the reviewed guidelines. Patient engagement was rarely presented in the guideline development phase. POs believe that patients should be encouraged to take an active role in their own care due to the heterogeneity of cancer patients and PPVs. Even if patient-centricity is a leading paradigm in cancer policy, based on our research it is not yet standard practice to include patients or POs at all appropriate levels of decision-making processes that are related to their health and well-being. Patient engagement should be an integral part of cancer care decision-making. This complexity must be reflected throughout policy making, avoiding a population level “one-size-fits-all” solution.

  18. Rapid methods for jugular bleeding of dogs requiring one technician.

    Science.gov (United States)

    Frisk, C S; Richardson, M R

    1979-06-01

    Two methods were used to collect blood from the jugular vein of dogs. In both techniques, only one technician was required. A rope with a slip knot was placed around the base of the neck to assist in restraint and act as a tourniquet for the vein. The technician used one hand to restrain the dog by the muzzle and position the head. The other hand was used for collecting the sample. One of the methods could be accomplished with the dog in its cage. The bleeding techniques were rapid, requiring approximately 1 minute per dog.

  19. Patient-centered care requires a patient-oriented workflow model.

    Science.gov (United States)

    Ozkaynak, Mustafa; Brennan, Patricia Flatley; Hanauer, David A; Johnson, Sharon; Aarts, Jos; Zheng, Kai; Haque, Saira N

    2013-06-01

    Effective design of health information technology (HIT) for patient-centered care requires consideration of workflow from the patient's perspective, termed 'patient-oriented workflow.' This approach organizes the building blocks of work around the patients who are moving through the care system. Patient-oriented workflow complements the more familiar clinician-oriented workflow approaches, and offers several advantages, including the ability to capture simultaneous, cooperative work, which is essential in care delivery. Patient-oriented workflow models can also provide an understanding of healthcare work taking place in various formal and informal health settings in an integrated manner. We present two cases demonstrating the potential value of patient-oriented workflow models. Significant theoretical, methodological, and practical challenges must be met to ensure adoption of patient-oriented workflow models. Patient-oriented workflow models define meaningful system boundaries and can lead to HIT implementations that are more consistent with cooperative work and its emergent features.

  20. The patient experience of intensive care

    DEFF Research Database (Denmark)

    Egerod, Ingrid; Bergbom, Ingegerd; Lindahl, Berit

    2015-01-01

    : Nordic intensive care units. PARTICIPANTS: Patients in Nordic intensive care units. METHODS: We performed a literature search of qualitative studies of the patient experience of intensive care based on Nordic publications in 2000-2013. We searched the following databases: PubMed, CINAHL, Scopus, and Psyc...

  1. The nuclear industry is looking for its technicians; Le nucleaire cherche ses techniciens

    Energy Technology Data Exchange (ETDEWEB)

    Dumas, A

    2010-03-15

    With massive retirements planned up to 2015, the French nuclear industry wishes to recruit technicians for the operation and maintenance of its power plants. The French nuclear park represents 19 power plants with 58 reactors. The nuclear industry personnel represents 19000 people at EdF and about 20000 people from about 600 different service provider companies. Technician's salary ranges from 1500 to 2800 euros for experienced people, bonus not included. Before being operational, the French nuclear technicians have to follow a long training period in one of the 20 specialized and certified training centres. However, the training demand is so important that the industry suffers from a lack of instructors as well. (J.S.)

  2. Experiencing health care service quality: through patients' eyes.

    Science.gov (United States)

    Schembri, Sharon

    2015-02-01

    The primary aim of the present study was to consider health care service quality from the patients' perspective, specifically through the patient's eyes. A narrative analysis was performed on 300 patient stories. This rigorous analysis of patient stories is designed to identify and describe health care service quality through patients' eyes in an authentic and accurate, experiential manner. The findings show that there are variant and complex ways that patients experience health care service quality. Patient stories offer an authentic view of the complex ways that patients experience health care service quality. Narrative analysis is a useful tool to identify and describe how patients experience health care service quality. Patients experience health care service quality in complex and varying ways.

  3. Care management in nursing within emergency care units

    Directory of Open Access Journals (Sweden)

    Roberta Juliane Tono de Oliveira

    2015-12-01

    Full Text Available Objective.Understand the conditions involved in the management of nursing care in emergency care units. Methodology. Qualitative research using the methodological framework of the Grounded Theory. Data collection occurred from September 2011 to June 2012 through semi-structured interviews with 20 participants of the two emergency care units in the city of Florianopolis, Brazil. Results. Hindering factors to care management are: lack of experience and knowledge of professionals in emergency services; inadequate number of professionals; work overload of emergency care units in the urgent care network; difficulty in implementing nursing care systematization, and need for team meetings. Facilitating factors are: teamwork; importance of professionals; and confidence of the nursing technicians in the presence of the nurse. Conclusion. Whereas the hindering factors in care management are related to the organizational aspects of the emergency care units in the urgency care network, the facilitating ones include specific aspects of teamwork.

  4. Care management in nursing within emergency care units.

    Science.gov (United States)

    Tono de Oliveira, Roberta Juliane; Vieira Hermida, Patrícia Madalena; da Silva Copelli, Fernanda Hannah; Guedes Dos Santos, José Luís; Lorenzini Erdmann, Alacoque; Regina de Andrade, Selma

    2015-12-01

    Understand the conditions involved in the management of nursing care in emergency care units. Qualitative research using the methodological framework of the Grounded Theory. Data collection occurred from September 2011 to June 2012 through semi-structured interviews with 20 participants of the two emergency care units in the city of Florianopolis, Brazil. Hindering factors to care management are: lack of experience and knowledge of professionals in emergency services; inadequate number of professionals; work overload of emergency care units in the urgent care network; difficulty in implementing nursing care systematization, and need for team meetings. Facilitating factors are: teamwork; importance of professionals; and confidence of the nursing technicians in the presence of the nurse. Whereas the hindering factors in care management are related to the organizational aspects of the emergency care units in the urgency care network, the facilitating ones include specific aspects of teamwork.

  5. Physician-patient communication in managed care.

    OpenAIRE

    Gordon, G H; Baker, L; Levinson, W

    1995-01-01

    The quality of physician-patient communication affects important health care outcomes. Managed care presents a number of challenges to physician-patient communication, including shorter visits, decreased continuity, and lower levels of trust. Good communication skills can help physicians create and maintain healthy relationships with patients in the face of these challenges. We describe 5 communication dilemmas that are common in managed care and review possible solutions suggested by recent ...

  6. Care managers' views on death and caring for older cancer patients in Japan.

    Science.gov (United States)

    Matsui, Miho; Kanai, Emi; Kitagawa, Akiko; Hattori, Keiko

    2013-12-01

    Care managers (CMs) have an important role in coordinating care for cancer patients who are in the end-of-life stage; however, little is known about their views of death and their experiences while caring for older cancer patients. This study was conducted to examine CMs' views of death and caring for older cancer patients in a home care setting in Japan. Convenience sampling was undertaken, and 35 offices from 43 approached services agreed to participate. The final valid sample included responses from 136 CMs (90.7%). Most CMs, including nurses, care workers, home helpers, and social workers in home care settings, experienced difficulty in managing the care of cancer patients in the end-of-life stage. Respondents reported a wide array of experiences with end-of-life care, care management, and seminar attendance, and their ages and Frommelt Attitude Toward Care of the Dying (FATCOD) scores were associated factors. Moreover, multiple regression analysis indicated that better attitudes toward caring for the dying were positively associated with seminar attendance. These results suggest that CMs need education about palliative and end-of-life care in order to promote good home care for cancer patients.

  7. Medical Assistant-based care management for high risk patients in small primary care practices

    DEFF Research Database (Denmark)

    Freund, Tobias; Peters-Klimm, Frank; Boyd, Cynthia M.

    2016-01-01

    Background: Patients with multiple chronic conditions are at high risk of potentially avoidable hospital admissions, which may be reduced by care coordination and self-management support. Medical assistants are an increasingly available resource for patient care in primary care practices. Objective......: To determine whether protocol-based care management delivered by medical assistants improves patient care in patients at high risk of future hospitalization in primary care. Design: Two-year cluster randomized clinical trial. Setting: 115 primary care practices in Germany. Patients: 2,076 patients with type 2......, and monitoring delivered by medical assistants with usual care. Measurements: All-cause hospitalizations at 12 months (primary outcome) and quality of life scores (Short Form 12 Health Questionnaire [SF-12] and the Euroqol instrument [EQ-5D]). Results: Included patients had, on average, four co-occurring chronic...

  8. Advocating for Patient Care Literacy.

    Science.gov (United States)

    Poirier, Therese I

    2018-02-01

    The value of the arts and humanities in becoming an "educated" pharmacist is reviewed in this commentary. The term "patient care literacy" is defined as becoming a more humane pharmacist. This implies not only using heads but HARTSS (humanities, arts and social sciences) for developing the necessary skills. A conceptual framework for curricular reform that focuses on using the arts and humanities is proposed for advancing patient care literacy. Methods for enhancing use of arts and humanities for developing pharmacy graduates is specifically proposed. The need for more empiric research to demonstrate the value of the arts and humanities in developing a patient care literate professional is highlighted.

  9. A survey of the sociodemographic and educational characteristics of oral health technicians in public primary health care teams in Minas Gerais, Brazil.

    Science.gov (United States)

    Abreu, Mauro Henrique Nogueira Guimarães; Sanglard-Oliveira, Carla Aparecida; Jaruche, Abdul Rahman Mustafá; Mambrini, Juliana Vaz de Melo; Werneck, Marcos Azeredo Furquim; Lucas, Simone Dutra

    2013-12-23

    To describe some sociodemographic and educational characteristics of oral health technicians (OHTs) in public primary health care teams in the state of Minas Gerais, Brazil. A cross-sectional descriptive study was performed based on the telephone survey of a representative sample comprising 231 individuals. A pre-tested instrument was used for the data collection, including questions on gender, age in years, years of work as an OHT, years since graduation as an OHT, formal schooling, individual income in a month, and participation in continuing educational programmes. The descriptive statistic was developed and the formation of clusters, by the agglomerative hierarchy technique based on the furthest neighbour, was based on the age, years of work as an OHT, time since graduation as an OHT, formal schooling, individual income in a month, and participation in continuing educational programmes. Most interviewees (97.1%) were female. A monthly income of USD 300.00 to 600.00 was reported by 77.5% of the sample. Having educational qualifications in excess of their role was reported by approximately 20% of the participants. The median time since graduation was six years, and half of the sample had worked for four years as an OHT. Most interviewees (67.6%) reported having participated in professional continuing educational programmes. Two different clusters were identified based on the sociodemographic and educational characteristics of the sample. The Brazilian OHTs in public primary health care teams in the state of Minas Gerais are mostly female who have had little time since graduation, working experience, and formal schooling sufficient for professional practice.

  10. Patients' experiences of intensive care diaries

    DEFF Research Database (Denmark)

    Egerod, Ingrid; Bagger, Christine

    2010-01-01

    The aim of the study was to explore patients' experiences and perceptions of receiving intensive care diaries. A focus group and intensive care diaries for four former ICU patients were analysed to understand what works and what needs further development for patients who receive a diary. The stud......-ICU patients to gradually construct or reconstruct their own illness narrative, which is pieced together by their fragmented memory, the diary, the pictures, the hospital chart and the accounts from family and friends.......The aim of the study was to explore patients' experiences and perceptions of receiving intensive care diaries. A focus group and intensive care diaries for four former ICU patients were analysed to understand what works and what needs further development for patients who receive a diary. The study...... that the diary alone provided incomplete information and reading the diary did not necessarily bring back memories, but helped complete their story. The patients needed to know what they had gone through in ICU and wished to share their story with their family. We conclude that diaries might help post...

  11. Patient safety culture in primary care

    NARCIS (Netherlands)

    Verbakel, N.J.

    2015-01-01

    Background A constructive patient safety culture is a main prerequisite for patient safety and improvement initiatives. Until now, patient safety culture (PSC) research was mainly focused on hospital care, however, it is of equal importance in primary care. Measuring PSC informs practices on their

  12. Fulbright project focuses on rehabilitation technician education and ...

    African Journals Online (AJOL)

    Rehabilitation technician education and physiotherapy practice 272. Fulbright project focuses on ... particularly those qualified to mentor and teach entry-level learners, there are ... to reinforce classroom didactic knowledge as ongoing learning .... utilization of limited resources, and development of linkages with professional ...

  13. Development of new core competencies for Taiwanese Emergency Medical Technicians.

    Science.gov (United States)

    Chang, Yu-Tung; Tsai, Kuang-Chau; Williams, Brett

    2018-01-01

    Core competencies are considered the foundation for establishing Emergency Medical Technician (EMT) and paramedic curricula, and for ensuring performance standards in the delivery of prehospital care. This study surveyed EMT instructors and medical directors to identify the most desirable core competencies for all levels of EMTs in Taiwan. A principal components analysis with Varimax rotation was conducted. An online questionnaire was distributed to obtain perspectives of EMT instructors and medical directors on the most desirable core competencies for EMTs. The target population was EMT training-course instructors and medical directors of fire departments in Taiwan. The questionnaire comprised 61 competency items, and multiple-choice and open-ended questions were used to obtain respondents' perspectives of the Taiwanese EMT training and education system. The results identified three factors at EMT-1 and EMT-2 levels and five factors at the EMT-Paramedic level. The factors for EMT-1 and EMT-2 were similar, and those for EMT-Paramedics identified further comprehensive competence perspectives. The key factors that appear to influence the development of the Taiwanese Emergency Medical Services (EMS) education system are the attitude of authorities, the licensure system, and legislation. The findings present new core competencies for the Taiwanese EMT system and provide capacity to redesign curricula and reconsider roles for EMT-1 and EMT-2 technicians. At the EMT-Paramedic level, the findings demonstrate the importance of incorporating competency standards in the current skills-based curriculum. Moreover, the core-competencies gap that exists between Taiwanese EMT-1s, EMT-2s, and EMT-Paramedics and internationally recognized core competencies needs to be addressed. By identifying the key factors that potentially impact the development of the EMS education system, such as the attitude of authorities, the licensure system, and legislation, these findings will inform

  14. Task Analysis and Job Descriptions for Robotics/Automated Systems Technicians. Final Report. Volume 1.

    Science.gov (United States)

    Hull, Daniel M.; Lovett, James E.

    The Robotics/Automated Systems Technician (RAST) project developed a robotics technician model curriculum for the use of state directors of vocational education and two-year college vocational/technical educators. A baseline management plan was developed to guide the project. To provide awareness, project staff developed a dissemination plan…

  15. IAEA Technical Co-operation activities: Asia and the Pacific. Workshop on training nuclear laboratory technicians

    International Nuclear Information System (INIS)

    Roeed, S.S.

    1976-01-01

    The workshop was held to exchange information on existing facilities and programmes in Asia and the Pacific for training nuclear laboratory technicians, to identify future training needs and to assess the need for IAEA's involvement in this field. As the participants outlined the requirements for nuclear laboratory technician training and the facilities available in their respective countries, it became evident that, in addition to the training of radioisotope laboratory technicians, they also wished to review the need for technician training for the operation of nuclear power plants and industrial application of atomic energy. The terms of reference of the workshop were extended accordingly. The opening address by Chang Suk Lee, the Korean Vice Minister of Science and Technology, noted the valuable contribution to quality control and other industrial uses that nuclear techniques have made in his country. He also reviewed the application of nuclear techniques in Korean agriculture and medicine. The participants explored various forms of co-operation that could be established between countries of the region. Exchange programmes, not only for students but also for expert teachers, and the exchange or loan of equipment were suggested. It was felt that some generalized training courses could be organized on a regional basis, and two countries advocated the setting up of a regional training centre. One suggestion was to arrange regional training courses in special fields that would move from one country to another. The need was felt for periodic regional meetings on training methods, course content and other questions relating to training of laboratory technicians. The IAEA was requested to act as a clearinghouse for information on available training facilities in the region and to advise on the curricula for technician training courses. The Agency was also asked to organize short courses for the training of instructors of technicians in the various fields of atomic

  16. Experienced continuity of care in patients at risk for depression in primary care

    NARCIS (Netherlands)

    Uijen, Annemarie A.; Schers, Henk J.; Schene, Aart H.; Schellevis, Francois G.; Lucassen, Peter; van den Bosch, Wil J. H. M.

    2014-01-01

    Existing studies about continuity of care focus on patients with a severe mental illness. Explore the level of experienced continuity of care of patients at risk for depression in primary care, and compare these to those of patients with heart failure. Explorative study comparing patients at risk

  17. Defining and measuring integrated patient care: promoting the next frontier in health care delivery.

    Science.gov (United States)

    Singer, Sara J; Burgers, Jako; Friedberg, Mark; Rosenthal, Meredith B; Leape, Lucian; Schneider, Eric

    2011-02-01

    Integration of care is emerging as a central challenge of health care delivery, particularly for patients with multiple, complex chronic conditions. The authors argue that the concept of "integrated patient care" would benefit from further clarification regarding (a) the object of integration and (b) its essential components, particularly when constructing measures.To address these issues, the authors propose a definition of integrated patient care that distinguishes it from integrated delivery organizations, acknowledging that integrated organizational structures and processes may fail to produce integrated patient care. The definition emphasizes patients' central role as active participants in managing their own health by including patient centeredness as a key element of integrated patient care. Measures based on the proposed definition will enable empirical assessment of the potential relationships between the integration of organizations, the integration of patient care, and patient outcomes, providing valuable guidance to health systems reformers.

  18. Critical thinking in patient centered care.

    Science.gov (United States)

    Mitchell, Shannon H; Overman, Pamela; Forrest, Jane L

    2014-06-01

    Health care providers can enhance their critical thinking skills, essential to providing patient centered care, by use of motivational interviewing and evidence-based decision making techniques. The need for critical thinking skills to foster optimal patient centered care is being emphasized in educational curricula for health care professions. The theme of this paper is that evidence-based decision making (EBDM) and motivational interviewing (MI) are tools that when taught in health professions educational programs can aid in the development of critical thinking skills. This paper reviews the MI and EBDM literature for evidence regarding these patient-centered care techniques as they relate to improved oral health outcomes. Comparisons between critical thinking and EBDM skills are presented and the EBDM model and the MI technique are briefly described followed by a discussion of the research to date. The evidence suggests that EBDM and MI are valuable tools; however, further studies are needed regarding the effectiveness of EBDM and MI and the ways that health care providers can best develop critical thinking skills to facilitate improved patient care outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. The experience of intensive care nurses caring for patients with delirium: A phenomenological study.

    Science.gov (United States)

    LeBlanc, Allana; Bourbonnais, Frances Fothergill; Harrison, Denise; Tousignant, Kelly

    2018-02-01

    The purpose of this research was to seek to understand the lived experience of intensive care nurses caring for patients with delirium. The objectives of this inquiry were: 1) To examine intensive care nurses' experiences of caring for adult patients with delirium; 2) To identify factors that facilitate or hinder intensive care nurses caring for these patients. This study utilised an interpretive phenomenological approach as described by van Manen. Individual conversational interviews were conducted with eight intensive care nurses working in a tertiary level, university-affiliated hospital in Canada. The essence of the experience of nurses caring for patients with delirium in intensive care was revealed to be finding a way to help them come through it. Six main themes emerged: It's Exhausting; Making a Picture of the Patient's Mental Status; Keeping Patients Safe: It's aReally Big Job; Everyone Is Unique; Riding It Out With Families and Taking Every Experience With You. The findings contribute to an understanding of how intensive care nurses help patients and their families through this complex and distressing experience. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. How wide is the gap in defining quality care? Comparison of patient and nurse perceptions of important aspects of patient care.

    Science.gov (United States)

    Young, W B; Minnick, A F; Marcantonio, R

    1996-05-01

    The authors determine the importance that patients, nurses, and nurse managers place on aspects of care and measure nurses' care values based on their perceptions of their patients and nurse manager care values and their desire to meet these care expectations. The literature has documented gaps in how nurses and patients define quality and value specific care aspects, but little is known about the situation in the current continuous quality improvement and patient-centered care environment, which emphasizes a customer focus. Misunderstanding patients' values and expectations may impede service improvement. Information about any existing gaps could help managers begin to devise patient satisfaction improvement strategies. Two thousand fifty-one medical-surgical patients, 1264 staff members, and 97 nurse managers from 17 randomly selected hospitals participated in study activities related to selected aspects of patient care. Trained interviewers surveyed patients by telephone within 26 days of discharge using a pretested instrument. Staff members and managers completed a coordinated written tool. Descriptive and correlational statistics were used in individual and unit-level analyses. Staff members perceive correctly that patients value differently various aspects of care but do not agree with their managers on patients' value of aspects of care. Unit staff members' and managers' beliefs regarding patients' care values did not match those of their patients (-14 to 0.11 and -0.01 to 0.06 zero order correlations, respectively). A unit's errors in defining patients' values may be self-reinforcing. Strategies to reorient personnel, including adoption of those suggested by the diffusion of innovation literature, may help bridge the gap and change practice.

  1. Scheduling technicians and tasks in a telecommunications company

    DEFF Research Database (Denmark)

    Cordeau, J. F.; Laporte, G.; Pasin, F.

    2010-01-01

    This paper proposes a construction heuristic and an adaptive large neighborhood search heuristic for the technician and task scheduling problem arising in a large telecommunications company. This problem was solved within the framework of the 2007 challenge set up by the French Operational Research...

  2. Importance of patient centred care for various patient groups.

    NARCIS (Netherlands)

    Rademakers, J.J.D.J.M.; Delnoij, D.M.J.; Boer, D. de

    2010-01-01

    Background: Though patient centred care is a somewhat ‘fuzzy’ concept, in general it is considered as something to strive for. However, preliminary evidence suggests that the importance of elements of patient-centred care (PCC), such as communication, information and shared decision making, may vary

  3. Nurses' experience of caring for inmate patients.

    Science.gov (United States)

    Weiskopf, Constance S

    2005-02-01

    The aim of this paper is to report the findings of a study of the experience of caring for prisoners through examining the everyday experience of nurses' delivering health care to inmate patients in a correctional setting. Prisons are most often viewed as places for punishment, while the goals of health and healing, and prevention of diseases in correctional facilities are often neglected. Nurses who deliver health care to prisoners are challenged to do so in a caring relationship that will facilitate their health and healing. The literature on the nature of prison nursing indicates that delivering health care to inmates must be carefully balanced against the need for security, and is affected by factors such as custody staff values, staff education, nursing management, and organizational practices. In-depth interviews were carried out with nine Registered Nurses who had been employed in a variety of correctional institutions throughout their careers, and analysed thematically using Colaizzi's phenomenological method. Findings. Nurses' caring was experienced as an attempt to negotiate the boundaries between the cultures of custody and caring. Facing complex challenges and a number of limitations on the nurse-patient relationship, nurses strived to find a way to care for their inmate patients. Environmental risk meant that caution and vigilance were essential and these nurses demonstrated courage and persevered for the sake of their inmate patients. The findings make clear the challenging and frustrating experience of nurses' caring for inmate patients in restrictive settings. As a result, there are implications for nursing practice, education, and research to assure the best possible health outcomes for inmate patients, the integrity of caring nursing practice, and the safety of both nurses and patients.

  4. The impact of an oral hygiene education module on patient practices and nursing documentation.

    Science.gov (United States)

    Coke, Lola; Otten, Karine; Staffileno, Beth; Minarich, Laura; Nowiszewski, Candice

    2015-02-01

    Oral hygiene is inconsistent among patients with cancer and is a national patient care issue. To promote comfort and nutritional status, oral hygiene for patients with cancer is important. The purpose of this study was to develop an evidence-based oral hygiene educational module (EM) for nursing and patient care technician (PCT) staff to promote consistent oral hygiene patient education; evaluate patient understanding of oral hygiene practices post-EM; and determine staff documentation frequency of oral hygiene care. Pre- and post-EM data were collected using a developed oral hygiene assessment tool; nursing documentation data were collected by chart review. Post-EM data were collected eight weeks post-EM. Data were analyzed using frequencies and the Mann-Whitney U test. Twenty-two patient documentation pairs were collected. Compared to pre-EM, admission teaching, patient education, and patient oral hygiene practices improved post-EM. Post-EM oral hygiene documentation and PCT teaching increased.

  5. Radiological Control Technician: Phase 1, Site academic training lesson plans

    International Nuclear Information System (INIS)

    1992-10-01

    This volume provides lesson plans for training radiological control technicians. Covered here is basic radiological documentation, counting errors, dosimetry, environmental monitoring, and radiation instruments

  6. Patients' perceptions of patient care providers with tattoos and/or body piercings.

    Science.gov (United States)

    Westerfield, Heather V; Stafford, Amy B; Speroni, Karen Gabel; Daniel, Marlon G

    2012-03-01

    This study evaluated patients' perceptions of patient care providers with visible tattoos and/or body piercings. As tattooing and body piercing are increasingly popular, research that informs nursing administrators regarding policies on patient care providers having visible tattoos and body piercings is warranted. A total of 150 hospitalized adult patients compared pictures of male and female patient care providers in uniform with and without tattoos and/or nonearlobe body piercings. Patient care providers with visible tattoos and/or body piercings were not perceived by patients in this study as more caring, confident, reliable, attentive, cooperative, professional, efficient, or approachable than nontattooed or nonpierced providers. Tattooed female providers were perceived as less professional than male providers with similar tattoos. Female providers with piercings were perceived as less confident, professional, efficient, and approachable than nonpierced female providers. Nursing administrators should develop and/or evaluate policies regarding patient care providers with visible tattoos and/or body piercings.

  7. Care Management Medical Home Center Model: Preliminary Results of a Patient-Centered Approach to Improving Care Quality for Diabetic Patients.

    Science.gov (United States)

    Page, Timothy F; Amofah, St Anthony; McCann, Shelia; Rivo, Julie; Varghese, Asha; James, Terisa; Rivo, Marc; Williams, Mark L

    2015-07-01

    This article presents preliminary findings of the impact of an innovative care management model for diabetic patients. The model was implemented by seven Federally Qualified Health Centers serving 10,000 diabetic patients in Miami-Dade County. A primary intervention of this model is a centralized care management team that makes previsit phone calls to diabetic patients who have scheduled appointments. These previsit phone calls optimize patient knowledge and self-management goals, and provide patient care coordinators with relevant clinical information to optimize the office visit and help to ensure completion of recommended diabetic preventive and chronic care services. Data suggest that following the implementation of this care management model, more diabetic patients are receiving regular care, and compliance with recommended tests and screenings has improved. © 2015 Society for Public Health Education.

  8. Engaging Patients in Their Care Versus Obscurantism.

    Science.gov (United States)

    Tzeng, Huey-Ming; Yin, Chang-Yi; Fitzgerald, Kara

    2015-01-01

    Could engaging patients in their care be a means to oppose obscurantism? Obscurantism is defined by Merriam-Webster as "the practice of keeping knowledge or understanding about something from people". This paper discusses the importance of promoting patient engagement and emphasizes that patients and healthcare providers are equally important stakeholders in health care. The discussion occurs in the context of hospital inpatient care as nurses play a critical role in patients' hospitalization experience, including engaging patients in their own care during hospital stays. Paternalism of healthcare providers is recognized as one of the main barriers to integrating the concepts of patient engagement and patient centeredness into every aspect of the care system. Promoting patient engagement is a two-way responsibility, and it requires the cooperation of both patients and healthcare providers. As scientists and healthcare providers, we have the duty to counter obscurantism by promoting understanding of the health of individual citizens and society at large. A culture change in healthcare systems toward being patient-centric and placing value on patient engagement is warranted, and this change must come from healthcare providers. Patient-centered tools that support patient engagement, patient portals, or personal health records are still needed. © 2014 Wiley Periodicals, Inc.

  9. Academy of Nutrition and Dietetics: Revised 2017 Scope of Practice for the Nutrition and Dietetics Technician, Registered.

    Science.gov (United States)

    2018-02-01

    The Academy of Nutrition and Dietetics (Academy) is the world's largest organization of food and nutrition professionals and the association that represents credentialed nutrition and dietetics practitioners-nutrition and dietetics technicians, registered (NDTRs) and registered dietitian nutritionists (RDNs). An NDTR's scope of practice in nutrition and dietetics has flexible boundaries to capture the depth and breadth of the individual's practice. The NDTR's practice expands with advances in many areas, including nutrition, food production, food safety, food systems management, health care, public health, community health, and information and communication technology. The Revised 2017 Scope of Practice for the NDTR reflects the position of the Academy on the essential role of the NDTR in the management and delivery of food and nutrition services. The scope of practice for the NDTR is composed of education and credentialing, practice resources, Academy Standards of Practice and Standards of Professional Performance, codes of ethics, accreditation standards, state and federal regulations, national guidelines, and organizational policy and procedures. The Revised 2017 Scope of Practice for the NDTR is used in conjunction with the Revised 2017 Standards of Practice in Nutrition Care and the Standards of Professional Performance for NDTRs. The Standards of Practice address activities related to direct patient and client care. The Standards of Professional Performance address behaviors related to the technical role of NDTRs. These standards reflect the minimum competent level of nutrition and dietetics practice and professional performance for NDTRs. A companion document addresses the scope of practice for the RDN. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  10. Caring for patients of Islamic denomination: Critical care nurses' experiences in Saudi Arabia.

    Science.gov (United States)

    Halligan, Phil

    2006-12-01

    To describe the critical care nurses' experiences in caring for patients of Muslim denomination in Saudi Arabia. Caring is known to be the essence of nursing but many health-care settings have become more culturally diverse. Caring has been examined mainly in the context of Western cultures. Muslims form one of the largest ethnic minority communities in Britain but to date, empirical studies relating to caring from an Islamic perspective is not well documented. Research conducted within the home of Islam would provide essential truths about the reality of caring for Muslim patients. Phenomenological descriptive. Methods. Six critical care nurses were interviewed from a hospital in Saudi Arabia. The narratives were analysed using Colaizzi's framework. The meaning of the nurses' experiences emerged as three themes: family and kinship ties, cultural and religious influences and nurse-patient relationship. The results indicated the importance of the role of the family and religion in providing care. In the process of caring, the participants felt stressed and frustrated and they all experienced emotional labour. Communicating with the patients and the families was a constant battle and this acted as a further stressor in meeting the needs of their patients. The concept of the family and the importance and meaning of religion and culture were central in the provision of caring. The beliefs and practices of patients who follow Islam, as perceived by expatriate nurses, may have an effect on the patient's health care in ways that are not apparent to many health-care professionals and policy makers internationally. Readers should be prompted to reflect on their clinical practice and to understand the impact of religious and cultural differences in their encounters with patients of Islam denomination. Policy and all actions, decisions and judgments should be culturally derived.

  11. [Spiritual Care of Patients With Depression].

    Science.gov (United States)

    Kao, Chia-Chan; Lin, Yu-Hua

    2018-06-01

    Spiritual care is a component of holistic care. Patients with depression often experience body-mind-spirit health problems and may suffer from spiritual crises, particularly during the acute stage of a diseases, due to low self-esteem, negative attitudes toward life goals, daily life issues, and beliefs caused by physical, psychological, and occupational dysfunctions. Nonetheless, psychical care is the main treatment for patients with depression. This paper focuses on patients with depression and addresses the concepts of spiritual needs and spiritual care, identifying the factors that influence spiritual needs, the essentials of spiritual intervention, and the health effects of spiritual intervention outcomes on patients with depression. Courses that teach practical spiritual interventions are recommended for nurses. These courses should address topics such as individual approaches, building trusting relationships, setting diverse goals for spiritual interventions based on disease stage, and spiritual interventions involving the body-mind-spiritual aspects for patients with depression.

  12.  Nutritional care of Danish medical in-patients - patients' perspectives

    DEFF Research Database (Denmark)

    Lassen, Karin Østergaard; Kruse, Filip; Bjerrum, Merete

    2005-01-01

    with the nutritional care.The patients includeed a total of 91 medical inpatients at two internal medical wards, aarhus University Hospital, Denmark. Their average age was 72 (+/-) 11 yerars. They were individually interviewed about the fodd service ad the nutritinal care upon discharge.Patients satifaction...... with the meals was overall high (90%). About 80% found the meals to be very important, but they lacked information about the food service, and the patient-staff communication about the food service was poor. The reults indicate that the nursing staff was exercising a 'knowledge monopoly' in relation to the food...... service. In conclusion, a majority of the patients dis not perceive the nutritional care as part of the therapy and nursing care during their hospitalization....

  13. Radiation Technician Scientist service

    International Nuclear Information System (INIS)

    Prieto Miranda, Enrique; Barrera Gonzalez, Gisela; Guerra Torres, Mercedes; Mora Lopez, Leonor; Altanes Valentin, Sonia; Rapado Paneque, Manuel; Plasencia Gutierrez, Manuel

    2003-01-01

    The irradiation service is part of the specialized technician scientist services of the Center of Technological Applications and Nuclear Development it belonging to the Radiobiological Department it provides a self shielded laboratory irradiator, PX y 30 type with Cobalt 60 sources, it destined for searches studies, so much basic as applying, in several branches of the science, like the radiobiology, the radiation chemistry, the solid state physics, the medicine, the agriculture and the Pharmaceutical- Medical Industry and besides offering the irradiation service properly with the which have been gotten significant economical outputs. The radiation processing is controlled by means of the dosimetric systems of Freckle, ceric cerous sulfate, Perspex (red, clear and Amber) and dose indicators

  14. Highlights from the Electricity Sector Council's powerline technician project

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-05-15

    The Electricity Sector Council completed a situational analysis of the powerline technician trade in Canada in April 2008. The purpose of the study was to provide industry partners with the opportunity to provide input into the development of the powerline trade; to assess the current workforce; to examine training and working conditions based on in-depth focus group interviews; and to demonstrate regional and provincial differences in apprenticeship development. This report presented highlights from the Electricity Sector Council's powerline technician project. Specifically, the report discussed the number of powerline apprentices entering the trade; regional differences in the powerline trade; and emerging practices for recruitment, retention, and training. Recommendations were also offered in order to address the challenges faced by the powerline trade. It was concluded that the best ways to recruit candidates in the powerline technician trade are to invest in a word-of mouth campaign, such as a coaching program; encourage early introduction to the trades through job sampling; offer financial incentives; and invest in outreach programs. 4 figs.

  15. Epilepsy care in the southern Caribbean.

    Science.gov (United States)

    Krauss, Gregory; Sandy, Sherry; Corbin, David O C; Bird-Compton, Jacqueline; Jack, Frances; Nelson, Beverly; Jalonen, Tuula O; Ali, Amza; Fortuné, Taryn; Clarke, Dave; Okolie, Jacqueline; Cervenka, Mackenzie C

    2015-10-01

    Very little has been reported about the health resources available for patients with epilepsy in the five English-speaking southern Caribbean countries of Trinidad and Tobago, Barbados, Grenada, Saint Vincent and the Grenadines, and Saint Lucia. There is no comprehensive resource describing their health systems, access to specialty care, antiepileptic drug (AED) use, and availability of brain imaging and EEG. The purpose of this study was to profile epilepsy care in these countries as an initial step toward improving the standard of care and identifying gaps in care to guide future policy changes. In each southern Caribbean country, we conducted study visits and interviewed health-care providers, government health ministers, pharmacy directors, hospital medical directors, pharmacists, clinic staff, radiologists, and radiology and EEG technicians. Health-care providers completed extensive epilepsy care surveys. The five countries all have integrated government health systems with clinics and hospitals that provide free or heavily subsidized care and AEDs for patients with epilepsy. Only Trinidad and Tobago and Barbados, however, have neurology specialists. The three smaller countries lack government imaging and EEG facilities. Trinidad had up to one-year waits for public MRI/EEG. Government formularies in Grenada, Saint Vincent and the Grenadines, and Saint Lucia are limited to first-generation AEDs. One or more second-line agents are formulary in Trinidad and Barbados. Nonformulary drugs may be obtained for individual patients in Barbados. Grenada, Saint Lucia, and Saint Vincent and the Grenadines participate in an Organization of Eastern Caribbean States formulary purchasing system, which added levetiracetam following the survey. Newer generic AED formulations with the lowest risks for pregnancy malformation were not in use. In conclusion, patients with epilepsy in the southern Caribbean have excellent access to government clinics and hospitals, but AED choices

  16. Patient Outcomes After Palliative Care Consultation Among Patients Undergoing Therapeutic Hypothermia.

    Science.gov (United States)

    Pinto, Priya; Brown, Tartania; Khilkin, Michael; Chuang, Elizabeth

    2018-04-01

    To compare the clinical outcomes of patients who did and did not receive palliative care consultation among those who experienced out-of-hospital cardiac arrest and underwent therapeutic hypothermia. We identified patients at a single academic medical center who had undergone therapeutic hypothermia after out-of-hospital cardiac arrest between 2009 and 2013. We performed a retrospective chart review for demographic data, hospital and critical care length of stay, and clinical outcomes of care. We reviewed the charts of 62 patients, of which 35 (56%) received a palliative care consultation and 27 (44%) did not. Palliative care consultation occurred an average of 8.3 days after admission. Patients receiving palliative care consultation were more likely to have a do-not-resuscitate (DNR) order placed (odds ratio: 2.3, P care or not (16.7 vs 17.1 days, P = .90). Intensive care length of stay was also similar (11.3 vs 12.6 days, P = .55). Palliative care consultation was underutilized and utilized late in this cohort. Palliative consultation was associated with DNR orders but did not affect measures of utilization such as hospital and intensive care length of stay.

  17. Technicians dismantle the inner section of L3

    CERN Multimedia

    Laurent Guiraud

    2001-01-01

    The technicians are dismantling the forward tracking chamber located at the heart of the L3 detector. This formed part of the hadronic calorimeter, which is used for measuring particle energies. L3 was an experiment at the LEP collider that ran from 1989 to 2000.

  18. Primary care physician insights into a typology of the complex patient in primary care.

    Science.gov (United States)

    Loeb, Danielle F; Binswanger, Ingrid A; Candrian, Carey; Bayliss, Elizabeth A

    2015-09-01

    Primary care physicians play unique roles caring for complex patients, often acting as the hub for their care and coordinating care among specialists. To inform the clinical application of new models of care for complex patients, we sought to understand how these physicians conceptualize patient complexity and to develop a corresponding typology. We conducted qualitative in-depth interviews with internal medicine primary care physicians from 5 clinics associated with a university hospital and a community health hospital. We used systematic nonprobabilistic sampling to achieve an even distribution of sex, years in practice, and type of practice. The interviews were analyzed using a team-based participatory general inductive approach. The 15 physicians in this study endorsed a multidimensional concept of patient complexity. The physicians perceived patients to be complex if they had an exacerbating factor-a medical illness, mental illness, socioeconomic challenge, or behavior or trait (or some combination thereof)-that complicated care for chronic medical illnesses. This perspective of primary care physicians caring for complex patients can help refine models of complexity to design interventions or models of care that improve outcomes for these patients. © 2015 Annals of Family Medicine, Inc.

  19. Computer Vision Tool and Technician as First Reader of Lung Cancer Screening CT Scans.

    Science.gov (United States)

    Ritchie, Alexander J; Sanghera, Calvin; Jacobs, Colin; Zhang, Wei; Mayo, John; Schmidt, Heidi; Gingras, Michel; Pasian, Sergio; Stewart, Lori; Tsai, Scott; Manos, Daria; Seely, Jean M; Burrowes, Paul; Bhatia, Rick; Atkar-Khattra, Sukhinder; van Ginneken, Bram; Tammemagi, Martin; Tsao, Ming Sound; Lam, Stephen

    2016-05-01

    To implement a cost-effective low-dose computed tomography (LDCT) lung cancer screening program at the population level, accurate and efficient interpretation of a large volume of LDCT scans is needed. The objective of this study was to evaluate a workflow strategy to identify abnormal LDCT scans in which a technician assisted by computer vision (CV) software acts as a first reader with the aim to improve speed, consistency, and quality of scan interpretation. Without knowledge of the diagnosis, a technician reviewed 828 randomly batched scans (136 with lung cancers, 556 with benign nodules, and 136 without nodules) from the baseline Pan-Canadian Early Detection of Lung Cancer Study that had been annotated by the CV software CIRRUS Lung Screening (Diagnostic Image Analysis Group, Nijmegen, The Netherlands). The scans were classified as either normal (no nodules ≥1 mm or benign nodules) or abnormal (nodules or other abnormality). The results were compared with the diagnostic interpretation by Pan-Canadian Early Detection of Lung Cancer Study radiologists. The overall sensitivity and specificity of the technician in identifying an abnormal scan were 97.8% (95% confidence interval: 96.4-98.8) and 98.0% (95% confidence interval: 89.5-99.7), respectively. Of the 112 prevalent nodules that were found to be malignant in follow-up, 92.9% were correctly identified by the technician plus CV compared with 84.8% by the study radiologists. The average time taken by the technician to review a scan after CV processing was 208 ± 120 seconds. Prescreening CV software and a technician as first reader is a promising strategy for improving the consistency and quality of screening interpretation of LDCT scans. Copyright © 2016 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.

  20. Supportive care needs of Iranian cancer patients

    Directory of Open Access Journals (Sweden)

    Azad Rahmani

    2014-01-01

    Full Text Available Background: A supportive needs assessment is an essential component of any care program. There is no research evidence regarding the supportive care needs of cancer patients in Iran or other Middle Eastern countries. Aims: The aim of this study was to determine the supportive care needs of Iranian cancer patients. Materials and Methods: This descriptive study was conducted in a referral medical center in the northwest of Iran. A total of 274 cancer patients completed the Supportive Care Needs Survey (SCNS-59. Descriptive statistics were used for data analysis. Results: In 18 items of the SCNS, more than 50% of the participants reported that their needs were unmet. Most frequently, unmet needs were related to the health system, information, physical, and daily living domains, and most met needs were related to sexuality, patient care, and support domains. Conclusions: Iranian cancer patients experience many unmet needs and there is an urgent need for establishing additional supportive care services in Iran.

  1. Impact of pharmacy technician-centered medication reconciliation on optimization of antiretroviral therapy and opportunistic infection prophylaxis in hospitalized patients with HIV/AIDS.

    Science.gov (United States)

    Siemianowski, Laura A; Sen, Sanchita; George, Jomy M

    2013-08-01

    This study aimed to examine the role of a pharmacy technician-centered medication reconciliation (PTMR) program in optimization of medication therapy in hospitalized patients with HIV/AIDS. A chart review was conducted for all inpatients that had a medication reconciliation performed by the PTMR program. Adult patients with HIV and antiretroviral therapy (ART) and/or the opportunistic infection (OI) prophylaxis listed on the medication reconciliation form were included. The primary objective is to describe the (1) number and types of medication errors and (2) the percentage of patients who received appropriate ART. The secondary objective is a comparison of the number of medication errors between standard mediation reconciliation and a pharmacy-led program. In the PTMR period, 55 admissions were evaluated. In all, 50% of the patients received appropriate ART. In 27of the 55 admissions, there were 49 combined ART and OI-related errors. The most common ART-related errors were drug-drug interactions. The incidence of ART-related medication errors that included drug-drug interactions and renal dosing adjustments were similar between the pre-PTMR and PTMR groups (P = .0868). Of the 49 errors in the PTMR group, 18 were intervened by a medication reconciliation pharmacist. A PTMR program has a positive impact on optimizing ART and OI prophylaxis in patients with HIV/AIDS.

  2. Experienced continuity of care in patients at risk for depression in primary care.

    NARCIS (Netherlands)

    Uijen, A.A.; Schers, H.J.; Schene, A.H.; Schellevis, F.G.; Lucassen, P.; Bosch, W.J.H.M. van den

    2014-01-01

    Background: Existing studies about continuity of care focus on patients with a severe mental illness. Objectives: Explore the level of experienced continuity of care of patients at risk for depression in primary care, and compare these to those of patients with heart failure. Methods: Explorative

  3. Time to pregnancy among Danish laboratory technicians who were a part of the National Birth Cohort

    DEFF Research Database (Denmark)

    Zhu, Jin Liang; Knudsen, Lisbeth E; Andersen, Anne-Marie Nybo

    2005-01-01

    in 1997-2003. Altogether 6250 female teachers formed the reference group. A discrete-time survival analysis with a complementary log-log link was applied to estimate the fecundability ratio between the exposed and unexposed women, with adjustment for maternal age, gravidity, smoking, prepregnancy body......OBJECTIVES: The Danish National Birth Cohort was used to examine whether laboratory work was associated with reduced fecundity. METHODS: Self-reported data on laboratory work and waiting time to pregnancy (0-2, 3-5, 6-12 and > 12 months) were used for 829 female laboratory technicians interviewed...... mass index, and paternal job. RESULTS: No difference in time to pregnancy was found between the laboratory technicians and teachers or between the laboratory technicians with different exposures. The adjusted fecundability ratio for the laboratory technicians was 0.94 [95% confidence interval (95% CI...

  4. Mutant frequency of radiotherapy technicians appears to be associated with recent dose of ionizing radiation

    Energy Technology Data Exchange (ETDEWEB)

    Messing, K.; Ferraris, J.; Bradley, W.E.; Swartz, J.; Seifert, A.M. (Universite du Quebec a Montreal (Canada))

    1989-10-01

    The frequency of hypoxanthine phosphoribosyl transferase (HPRT) mutants among peripheral T-lymphocytes of radiotherapy technicians primarily exposed to 60Co was measured by the T-cell cloning method. Mutant frequencies of these technicians in 1984 and 1986 were significantly higher than those of physiotherapy technicians who worked in a neighboring service, and correlated significantly with thermoluminescence dosimeter readings recorded during the 6 mo preceding mutant frequency determination. Correlations decreased when related to dose recorded over longer time intervals. HPRT mutant frequency determination in peripheral lymphocytes is a good measure of recently received biologically effective radiation dose in an occupationally exposed population.

  5. Mutant frequency of radiotherapy technicians appears to be associated with recent dose of ionizing radiation

    International Nuclear Information System (INIS)

    Messing, K.; Ferraris, J.; Bradley, W.E.; Swartz, J.; Seifert, A.M.

    1989-01-01

    The frequency of hypoxanthine phosphoribosyl transferase (HPRT) mutants among peripheral T-lymphocytes of radiotherapy technicians primarily exposed to 60Co was measured by the T-cell cloning method. Mutant frequencies of these technicians in 1984 and 1986 were significantly higher than those of physiotherapy technicians who worked in a neighboring service, and correlated significantly with thermoluminescence dosimeter readings recorded during the 6 mo preceding mutant frequency determination. Correlations decreased when related to dose recorded over longer time intervals. HPRT mutant frequency determination in peripheral lymphocytes is a good measure of recently received biologically effective radiation dose in an occupationally exposed population

  6. The patient's role in rheumatology care.

    Science.gov (United States)

    Brady, T J

    1998-03-01

    This article reviews narrative and empiric studies in rheumatology and related literature to explicate the patient's role in rheumatology care. In contrast to early conceptualizations, such as Parsons' sick role that emphasized compliance, current literature describes chronic disease patients as active participants in their care, rather than passive recipients of care. Active patients roles include participant in shared decision making, self-manager, and help and information seeker. All of these roles are colored by the individual's need to preserve a personally defined acceptable lifestyle. Suggestions for strategies that physicians and health professionals can use to engage and support these essential patient roles are also reviewed.

  7. Pediatric Supportive Care (PDQ®)—Patient Version

    Science.gov (United States)

    Pediatric supportive care is an important aspect of cancer care as children and adolescents face unique challenges compared to adult patients. Learn more about supportive care for pediatric patients during and after treatment in this expert-reviewed summary.

  8. Psychosocial care to patients with Malignant Melanoma

    DEFF Research Database (Denmark)

    Thorup, Charlotte Brun

    Psychosocial care to patients with Malignant Melanoma Intensions: The intension of this project is to link new knowledge with the nurses experience based knowledge within the psychosocial care to patients, who have been diagnosed with Malignant Melanoma (MM), thereby improving the care...... to elaborate the care to these patients. Method: In 2007 the nurses from our ward gained experience from the psychosocial care to these patients. These experiences are a starting point to the study of literature the group has made. A group of five nurses have from this literature study, substantiated...... the psychosocial perspective. Results: After the literature review, the psychosocial aspects have been divided into five main areas: 1. Diagnosis, hospitalisation, and treatment 2. The body with cancer 3. Psychological 4. Social 5. Existential/spiritual Primary results show that patients with MM in general respond...

  9. What is patient-centered care really? Voices of Hispanic prenatal patients.

    Science.gov (United States)

    Bergman, Alicia A; Connaughton, Stacey L

    2013-01-01

    Variations in patient-centered care (PCC) models and approaches contribute to ambiguity in how PCC is understood and defined, especially with regard to meeting the needs of diverse patient populations. One of the biggest challenges of putting PCC into practice is knowing what elements are the most important to patients. This qualitative study privileges patients' voices and adds a cultural dimension to existing health communication research on PCC through an empirical investigation of 48 Hispanic prenatal care patients' understandings and expectations of PCC. Semistructured interviews with 48 patients revealed five key themes in order of frequency: (a) una relación amable (a friendly relationship), (b) la atencion médica efectiva (effective medical care), (c) Español hablado (the Spanish language spoken), (d) comprensión de la información (understanding of information), and (e) eliminación del racismo (elimination of racism). The themes reflected several different assumptions and expectations with regard to PCC as compared to those espoused in many of the existing models and frameworks, such as the extent to which friendly interpersonal behaviors (e.g., smiling, making eye contact, displaying patience, and engaging in formal greetings, introductions, and farewells) were critical to patient satisfaction with the health care experience. Not only did patients feel better understood, but accompanied by friendly behaviors, information was viewed as more believable and accurate, and thus more patient-centered. The findings suggest that implementing culturally sensitive PCC approaches to caring for Hispanic prenatal care patients can include training health care staff on the importance of displaying friendly communicative behaviors such as smiling.

  10. Intensive care patient diaries in Scandinavia

    DEFF Research Database (Denmark)

    Egerod, Ingrid; Storli, Sissel Lisa; Åkerman, Eva

    2011-01-01

    Critical illness and intensive care therapy are often followed by psychological problems such as nightmares, hallucinations, delusions, anxiety, depression, and symptoms of posttraumatic stress. Intensive care patient diaries have been kept by nurses and the patients' family since the early 1990s...... in the Scandinavian countries to help critically ill patients come to terms with their illness after hospital discharge. The aim of the study was to describe and compare the emergence and evolution of intensive care patient diaries in Denmark, Norway, and Sweden. The study had a comparative international design using...... secondary analysis of qualitative data generated by key-informant telephone interviews with intensive care nurses (n=114). The study showed that diaries were introduced concurrently in the three Scandinavian countries as a grass-roots initiative by mutual cross-national inspiration. The concept has evolved...

  11. Patient stoma care: educational theory in practice.

    Science.gov (United States)

    Williams, Jenny

    Patients undergoing stoma formation encounter many challenges including psychosocial issues, relationship concerns and fear of leakage. Leakage, inappropriate product usage and poor patient adaptation post stoma formation has cost implications for the NHS. Developing good, practical stoma care skills has been identified as improving patient outcomes, promoting the provision of quality care and improving efficiency within the NHS. However, a thorough literature search indicated that there is little research available on patient stoma care education. This is considered surprising by Metcalf (1999), O'Connor (2005) and the author of this article. This article considers and adapts generic educational theory to make it pertinent to patient stoma care education in order to bridge the gap between theory and practice.

  12. 40 CFR 82.40 - Technician training and certification.

    Science.gov (United States)

    2010-07-01

    ... speaking technicians by providing tests in other languages or allowing the use of a translator when taking the test. If a translator is used, the certificate received must indicate that translator assistance.... Each program must provide adequate training, through one or more of the following means: on-the-job...

  13. An Integration of Math with Auto Technician Courses

    Science.gov (United States)

    Valenzuela, Hector

    2012-01-01

    This article describes the development of the contextualized math, the course design, student teaching and daily interaction with the students, and the implementation aspects of the research project designed to develop contextualized mathematics and integrate it into the Auto Technician courses. The applied math curriculum was integrated into…

  14. Empowerment, patient centred care and self-management.

    Science.gov (United States)

    Pulvirenti, Mariastella; McMillan, John; Lawn, Sharon

    2014-06-01

    Patient or person centred care is widely accepted as the philosophy and practice that underpins quality care. An examination of the Australian National Chronic Disease Strategy and literature in the field highlights assumptions about the self-manager as patient and a focus on clinical settings. This paper considers patient or person centred care in the light of empowerment as it is understood in the health promotion charters first established in Alma Ata in 1977. We argue that patient or person centred care can be reconfigured within a social justice and rights framework and that doing so supports the creation of conditions for well-being in the broader context, one that impacts strongly on individuals. These arguments have broader implications for the practice of patient centred care as it occurs between patient and health professional and for creating shared responsibility for management of the self. It also has implications for those who manage their health outside of the health sector. © 2011 John Wiley & Sons Ltd.

  15. Innovative patient care practices using social media.

    Science.gov (United States)

    Mattingly, T Joseph

    2015-01-01

    To characterize the literature on social media applications used to deliver patient care. A search of the literature was conducted on June 11, 2014, using PubMed, MEDLINE, CINAHL, and Communication Abstracts databases for clinical studies between 2004 and 2014. A combination of the search terms "social media" or "Web 2.0" or "online social networking" or "Facebook" or "Twitter" AND "patient care" or "health care" was used. In addition, 42 additional abstracts were retrieved from www.patientslikeme.com for review. Only published, peer-reviewed journal articles were considered and only publications in English were included. The abstracts from this search were reviewed for relevance to Web-based social media platforms being used in patient care activities. A total of 35 articles were included in the review. A majority of the studies published on social media and patient care used cross-sectional designs and were conducted in the United States. Multiple social media applications were studied, but Facebook was the predominant social media tool found. Patient care opportunities for various diseases with social media have been studied. Recurring themes included overcoming barriers, engaging and empowering patients, enhancing research, providing information for health promotion, scratching the surface, and potential pitfalls. Social media have the potential to help patients and practitioners overcome multiple barriers in the delivery of health care. Maintaining patient privacy, security of information shared in the platform, and integrity of information shared are all concerns when using this type of Web application.

  16. 20 CFR 1002.306 - Is a National Guard civilian technician considered a State or Federal employee for purposes of...

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Is a National Guard civilian technician... a National Guard civilian technician considered a State or Federal employee for purposes of USERRA? A National Guard civilian technician is considered a State employee for USERRA purposes, although he...

  17. Emergency patients receiving anaesthesiologist-based pre-hospital treatment and subsequently released at the scene

    DEFF Research Database (Denmark)

    Højfeldt, S G; Sørensen, L P; Mikkelsen, Søren

    2014-01-01

    BACKGROUND: The Mobile Emergency Care Unit in Odense, Denmark consists of a rapid response car, manned with an anaesthesiologist and an emergency medical technician. Eleven per cent of the patients are released at the scene following treatment. The aim of the study was to investigate which...... investigated. In each patient, diagnosis as well as any renewed contact with the Mobile Emergency Care Unit or the hospital within 24 h was registered. RESULTS: ONE THOUSAND SIX HUNDRED NINE: patients were released at the scene. Diagnoses within the category 'examination and investigation' [International...... with the Mobile Emergency Care Unit within 24 h. Of the 143 victims of traffic accidents, 19 (13%) required renewed contact with the emergency department and one required admission to hospital (0.7%). Of all 1609 patients, four died within 24 h of contact (0.2%). CONCLUSION: Patients treated and released...

  18. Cognitive and physical rehabilitation of intensive care unit survivors: results of the RETURN randomized controlled pilot investigation.

    Science.gov (United States)

    Jackson, James C; Ely, E Wesley; Morey, Miriam C; Anderson, Venice M; Denne, Laural B; Clune, Jennifer; Siebert, Carol S; Archer, Kristin R; Torres, Renee; Janz, David; Schiro, Elena; Jones, Julie; Shintani, Ayumi K; Levine, Brian; Pun, Brenda T; Thompson, Jennifer; Brummel, Nathan E; Hoenig, Helen

    2012-04-01

    Millions of patients who survive medical and surgical general intensive care unit care every year experience newly acquired long-term cognitive impairment and profound physical and functional disabilities. To overcome the current reality in which patients receive inadequate rehabilitation, we devised a multifaceted, in-home, telerehabilitation program implemented using social workers and psychology technicians with the goal of improving cognitive and functional outcomes. This was a single-site, feasibility, pilot, randomized trial of 21 general medical/surgical intensive care unit survivors (8 controls and 13 intervention patients) with either cognitive or functional impairment at hospital discharge. After discharge, study controls received usual care (sporadic rehabilitation), whereas intervention patients received a combination of in-home cognitive, physical, and functional rehabilitation over a 3-month period via a social worker or master's level psychology technician utilizing telemedicine to allow specialized multidisciplinary treatment. Interventions over 12 wks included six in-person visits for cognitive rehabilitation and six televisits for physical/functional rehabilitation. Outcomes were measured at the completion of the rehabilitation program (i.e., at 3 months), with cognitive functioning as the primary outcome. Analyses were conducted using linear regression to examine differences in 3-month outcomes between treatment groups while adjusting for baseline scores. Patients tolerated the program with only one adverse event reported. At baseline both groups were well-matched. At 3-month follow-up, intervention group patients demonstrated significantly improved cognitive executive functioning on the widely used and well-normed Tower test (for planning and strategic thinking) vs. controls (median [interquartile range], 13.0 [11.5-14.0] vs. 7.5 [4.0-8.5]; adjusted p improving cognitive performance and functional outcomes in just 3 months. Future investigations

  19. [Stoma care in patients with malignant disease].

    Science.gov (United States)

    Egawa, Akiko; Suwa, Katsuhito

    2013-12-01

    The aim of stoma care and rehabilitation is improving the quality of life of the patient with a stoma. There are more than 1,700 stoma specialist nurses in Japan, eg, enterostomal therapists(ET)and wound, ostomy, and continence nurses(WOCN), who are involved in the care of patients with stomas. In this manuscript, we describe our role in the care of patients with temporary/permanent stomas created for emergency disease and/or palliative care, and the adverse effects of various current chemotherapies.

  20. Study of Knowledge and Practice of Patient Self directed Care among Diabetics Patients

    Directory of Open Access Journals (Sweden)

    Z. Abedini

    2008-07-01

    Full Text Available Background and ObjectivesDiabetic patients play the main role in the management of their disease. Adequate knowledge of this disease state and self directed patient care will improve the health of these patients. Some studies have indicated a high prevalence of diabetes complication are due to the lack of knowledge of self directed patient care and practice in diabetic patient group. The objective of this study is to measure the knowledge level of self directed patient care and practice in order to evaluate their effects on improvement of diabetic patients' health in the city of Qom, Iran.MethodsIn this cross sectional study 1004 patients with diabetes participated (During year 2006. Data were collected from patients of General Hospital metabolism and endocrine research center.An interviewing method was used to asses the demographics data, history of disease, and knowledge of self directed patient care in these patients. Data were analyzed using a descriptive statistic, chi-square, and Pearson correlation coefficient, and SPSS software.ResultsOut of 1004 observed case, 154 patients were with Diabetes type I and 850 patients with Diabetes type II. The knowledge of self directed patient care and practice level of with both types of diabetes were determined to be mostly at an intermediate level. In type I diabetic patients there was a significant relation between knowledge level of self directed patient care and gender of the patients (P=0.01. Also, there was a significant correlation between practice and age (P=0.03(, and economical status (P=0.06 of the patients. In type II diabetic patients there was a significant relation between knowledge level of self directed patient care and educational level (P=0.00(, and economical status (P=0.01 of the patients. The practice level of self directed patient care was significantly related to economical status (p=0.03 in this group of patients. ConclusionThese results indicate that an increase in knowledge

  1. Patients' views of patient-centred care: a phenomenological case study in one surgical unit.

    Science.gov (United States)

    Marshall, Amy; Kitson, Alison; Zeitz, Kathryn

    2012-12-01

    To report a study of patients' views of patient-centred care. The study aimed to explore patients' understanding and conceptualization of patient-centred care and link it to existing literature on the topic. Patient-centred care currently lacks a widely accepted definition, with much of the literature based on definitions formulated by health professionals and researchers. Qualitative research study grounded in phenomenology. Interpersonal interviews were conducted with ten participants who were patients in a surgical ward in a large metropolitan hospital in South Australia in 2010. Participants were unfamiliar with the concept of patient-centred care, but despite this, were able to describe what the term meant to them and what they wanted from their care. Patients equated the type and quality of care they received with the staff that provided it and themes of connectedness, involvement and attentiveness were prevalent in their descriptions of what they wanted from their care. Ensuring that patients have a voice in the definition and conceptualization of patient-centred care is essential and further and regular consultation with patients about their needs and priorities will ensure an integrated approach to patient-centred care. © 2012 Blackwell Publishing Ltd.

  2. A research agenda on patient safety in primary care. Recommendations by the LINNEAUS collaboration on patient safety in primary care

    Science.gov (United States)

    Verstappen, Wim; Gaal, Sander; Bowie, Paul; Parker, Diane; Lainer, Miriam; Valderas, Jose M.; Wensing, Michel; Esmail, Aneez

    2015-01-01

    ABSTRACT Background: Healthcare can cause avoidable serious harm to patients. Primary care is not an exception, and the relative lack of research in this area lends urgency to a better understanding of patient safety, the future research agenda and the development of primary care oriented safety programmes. Objective: To outline a research agenda for patient safety improvement in primary care in Europe and beyond. Methods: The LINNEAUS collaboration partners analysed existing research on epidemiology and classification of errors, diagnostic and medication errors, safety culture, and learning for and improving patient safety. We discussed ideas for future research in several meetings, workshops and congresses with LINNEAUS collaboration partners, practising GPs, researchers in this field, and policy makers. Results: This paper summarizes and integrates the outcomes of the LINNEAUS collaboration on patient safety in primary care. It proposes a research agenda on improvement strategies for patient safety in primary care. In addition, it provides background information to help to connect research in this field with practicing GPs and other healthcare workers in primary care. Conclusion: Future research studies should target specific primary care domains, using prospective methods and innovative methods such as patient involvement. PMID:26339841

  3. A research agenda on patient safety in primary care. Recommendations by the LINNEAUS collaboration on patient safety in primary care.

    Science.gov (United States)

    Verstappen, Wim; Gaal, Sander; Bowie, Paul; Parker, Diane; Lainer, Miriam; Valderas, Jose M; Wensing, Michel; Esmail, Aneez

    2015-09-01

    Healthcare can cause avoidable serious harm to patients. Primary care is not an exception, and the relative lack of research in this area lends urgency to a better understanding of patient safety, the future research agenda and the development of primary care oriented safety programmes. To outline a research agenda for patient safety improvement in primary care in Europe and beyond. The LINNEAUS collaboration partners analysed existing research on epidemiology and classification of errors, diagnostic and medication errors, safety culture, and learning for and improving patient safety. We discussed ideas for future research in several meetings, workshops and congresses with LINNEAUS collaboration partners, practising GPs, researchers in this field, and policy makers. This paper summarizes and integrates the outcomes of the LINNEAUS collaboration on patient safety in primary care. It proposes a research agenda on improvement strategies for patient safety in primary care. In addition, it provides background information to help to connect research in this field with practicing GPs and other healthcare workers in primary care. Future research studies should target specific primary care domains, using prospective methods and innovative methods such as patient involvement.

  4. Effect of dental technician disparities on the 3-dimensional accuracy of definitive casts.

    Science.gov (United States)

    Emir, Faruk; Piskin, Bulent; Sipahi, Cumhur

    2017-03-01

    Studies that evaluated the effect of dental technician disparities on the accuracy of presectioned and postsectioned definitive casts are lacking. The purpose of this in vitro study was to evaluate the accuracy of presectioned and postsectioned definitive casts fabricated by different dental technicians by using a 3-dimensional computer-aided measurement method. An arch-shaped metal master model consisting of 5 abutments resembling prepared mandibular incisors, canines, and first molars and with a 6-degree total angle of convergence was designed and fabricated by computer-aided design and computer-aided manufacturing (CAD-CAM) technology. Complete arch impressions were made (N=110) from the master model, using polyvinyl siloxane (PVS) and delivered to 11 dental technicians. Each technician fabricated 10 definitive casts with dental stone, and the obtained casts were numbered. All casts were sectioned, and removable dies were obtained. The master model and the presectioned and postsectioned definitive casts were digitized with an extraoral scanner, and the virtual master model and virtual presectioned and postsectioned definitive casts were obtained. All definitive casts were compared with the master model by using computer-aided measurements, and the 3-dimensional accuracy of the definitive casts was determined with best fit alignment and represented in color-coded maps. Differences were analyzed using univariate analyses of variance, and the Tukey honest significant differences post hoc tests were used for multiple comparisons (α=.05). The accuracy of presectioned and postsectioned definitive casts was significantly affected by dental technician disparities (Ptechnician differences. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  5. Compensation of Emergency Medical Technician (EMT)-Basics and Paramedics.

    Science.gov (United States)

    Studnek, Jonathan R

    2016-12-01

    The objective of this paper is to identify factors associated with compensation for Emergency Medical Technician (EMT)-Basics and Paramedics and assess whether these associations have changed over the period 1999-2008. Data obtained from the Longitudinal EMT Attributes and Demographic Study (LEADS) surveys, a mail survey of a random, stratified sample of nationally certified EMT-Basics and Paramedics, were analyzed. For the 1999-2003 period, analyses included all respondents providing Emergency Medical Services (EMS). With the addition of a survey in 2004 about volunteers, it was possible to exclude volunteers from these analyses. Over 60% of EMT-Basics reported being either compensated or noncompensated volunteers in the 2004-2008 period. This was substantially and significantly greater than the proportion of EMT-Paramedic volunteers (Technician (EMT)-Basics and Paramedics. Prehosp Disaster Med. 2016;31(Suppl. 1):s87-s95.

  6. PRIMARY PALLIATIVE CARE? - Treating terminally ill cancer patients in the primary care sector

    DEFF Research Database (Denmark)

    Neergaard, Mette Asbjørn; Jensen, Anders Bonde; Olesen, Frede

    BACKGROUND. Palliative care for cancer patients is an important part of a GP's work. Although every GP is frequently involved in care for terminally ill cancer patients, only little is known about how these palliative efforts are perceived by the patients and their families, a knowledge...... that is vital to further improve palliative care in the primary sector.AIM. The aim of the study was to analyse the quality of palliative home care with focus on the GP's role based on evaluations by relatives of recently deceased cancer patients and professionals from both the primary and secondary health care...... approach.RESULTS. The analyses revealed several key areas, e.g.: 1) How to take, give and maintain professional responsibility for palliative home care. 2) A need for transparent communication both among primary care professionals and among professionals across the primary/secondary interface. 3...

  7. Determining level of care appropriateness in the patient journey from acute care to rehabilitation

    Science.gov (United States)

    2011-01-01

    Background The selection of patients for rehabilitation, and the timing of transfer from acute care, are important clinical decisions that impact on care quality and patient flow. This paper reports utilization review data on inpatients in acute care with stroke, hip fracture or elective joint replacement, and other inpatients referred for rehabilitation. It examines reasons why acute level of care criteria are not met and explores differences in decision making between acute care and rehabilitation teams around patient appropriateness and readiness for transfer. Methods Cohort study of patients in a large acute referral hospital in Australia followed with the InterQual utilization review tool, modified to also include reasons why utilization criteria are not met. Additional data on team decision making about appropriateness for rehabilitation, and readiness for transfer, were collected on a subset of patients. Results There were 696 episodes of care (7189 bed days). Days meeting acute level of care criteria were 56% (stroke, hip fracture and joint replacement patients) and 33% (other patients, from the time of referral). Most inappropriate days in acute care were due to delays in processes/scheduling (45%) or being more appropriate for rehabilitation or lower level of care (30%). On the subset of patients, the acute care team and the utilization review tool deemed patients ready for rehabilitation transfer earlier than the rehabilitation team (means of 1.4, 1.3 and 4.0 days from the date of referral, respectively). From when deemed medically stable for transfer by the acute care team, 28% of patients became unstable. From when deemed stable by the rehabilitation team or utilization review, 9% and 11%, respectively, became unstable. Conclusions A high proportion of patient days did not meet acute level of care criteria, due predominantly to inefficiencies in care processes, or to patients being more appropriate for an alternative level of care, including

  8. Determining level of care appropriateness in the patient journey from acute care to rehabilitation

    Directory of Open Access Journals (Sweden)

    Bashford Guy

    2011-10-01

    Full Text Available Abstract Background The selection of patients for rehabilitation, and the timing of transfer from acute care, are important clinical decisions that impact on care quality and patient flow. This paper reports utilization review data on inpatients in acute care with stroke, hip fracture or elective joint replacement, and other inpatients referred for rehabilitation. It examines reasons why acute level of care criteria are not met and explores differences in decision making between acute care and rehabilitation teams around patient appropriateness and readiness for transfer. Methods Cohort study of patients in a large acute referral hospital in Australia followed with the InterQual utilization review tool, modified to also include reasons why utilization criteria are not met. Additional data on team decision making about appropriateness for rehabilitation, and readiness for transfer, were collected on a subset of patients. Results There were 696 episodes of care (7189 bed days. Days meeting acute level of care criteria were 56% (stroke, hip fracture and joint replacement patients and 33% (other patients, from the time of referral. Most inappropriate days in acute care were due to delays in processes/scheduling (45% or being more appropriate for rehabilitation or lower level of care (30%. On the subset of patients, the acute care team and the utilization review tool deemed patients ready for rehabilitation transfer earlier than the rehabilitation team (means of 1.4, 1.3 and 4.0 days from the date of referral, respectively. From when deemed medically stable for transfer by the acute care team, 28% of patients became unstable. From when deemed stable by the rehabilitation team or utilization review, 9% and 11%, respectively, became unstable. Conclusions A high proportion of patient days did not meet acute level of care criteria, due predominantly to inefficiencies in care processes, or to patients being more appropriate for an alternative level of

  9. Self-care in Patients with Heart Failure

    Directory of Open Access Journals (Sweden)

    Maria do Céu Mendes Pinto Marques

    2016-04-01

    Full Text Available Objectives: To adapt the Self-Care of Heart Failure Index V6.2 to Portuguese and analyze self-care capability in maintenance, management and self-confidence in patients with heart failure attending nursing care services at two Portuguese hospitals. Method: Exploratory study, sample of 110 patients who attended the nursing care service for patients with heart failure at two Portuguese hospitals, carried out over a six-month period. Descriptive statistics and psychometric tests were used. Results: Internal consistency similar to the original scale. The patients consisted mostly of older adults with low self-care literacy, low values associated with physical activity and salt control in meals taken outside the home, and inadequate control of signs and symptoms. Conclusion: Patients present difficulties in maintenance and management of the disease, and are self-confident regarding it. This instrument enables individualized assessment leading to decision-making and adjusted action.

  10. Students as Technicians: Screening Newborns for Cystic Fibrosis

    Science.gov (United States)

    Gusky, Sharon

    2014-01-01

    In this activity, freshman college students learn biotechnology techniques while playing the role of a laboratory technician. They perform simulations of three diagnostic tests used to screen newborns for cystic fibrosis. By performing an ELISA, a PCR analysis, and a conductivity test, students learn how biotechnology techniques can be used to…

  11. Burnout and self-reported suboptimal patient care amongst health care workers providing HIV care in Malawi

    Science.gov (United States)

    Mazenga, Alick C.; Simon, Katie; Yu, Xiaoying; Ahmed, Saeed; Nyasulu, Phoebe; Kazembe, Peter N.; Ngoma, Stanley; Abrams, Elaine J.

    2018-01-01

    Background The well-documented shortages of health care workers (HCWs) in sub-Saharan Africa are further intensified by the increased human resource needs of expanding HIV treatment programs. Burnout is a syndrome of emotional exhaustion (EE), depersonalization (DP), and a sense of low personal accomplishment (PA). HCWs’ burnout can negatively impact the delivery of health services. Our main objective was to examine the prevalence of burnout amongst HCWs in Malawi and explore its relationship to self-reported suboptimal patient care. Methods A cross-sectional study among HCWs providing HIV care in 89 facilities, across eight districts in Malawi was conducted. Burnout was measured using the Maslach Burnout Inventory defined as scores in the mid-high range on the EE or DP subscales. Nine questions adapted for this study assessed self-reported suboptimal patient care. Surveys were administered anonymously and included socio-demographic and work-related questions. Validated questionnaires assessed depression and at-risk alcohol use. Chi-square test or two-sample t-test was used to explore associations between variables and self-reported suboptimal patient care. Bivariate analyses identified candidate variables (p burnout. In the three dimensions of burnout, 55% reported moderate-high EE, 31% moderate-high DP, and 46% low-moderate PA. The majority (89%) reported engaging in suboptimal patient care/attitudes including making mistakes in treatment not due to lack of knowledge/experience (52%), shouting at patients (45%), and not performing diagnostic tests due to a desire to finish quickly (35%). In multivariate analysis, only burnout remained associated with self-reported suboptimal patient care (OR 3.22, [CI 2.11 to 4.90]; pBurnout was common among HCWs providing HIV care and was associated with self-reported suboptimal patient care practices/attitudes. Research is needed to understand factors that contribute to and protect against burnout and that inform the

  12. [Application and evalauation of care plan for patients admitted to Intensive Care Units].

    Science.gov (United States)

    Cuzco Cabellos, C; Guasch Pomés, N

    2015-01-01

    Assess whether the use of the nursing care plans improves outcomes of nursing care to patients admitted to the intensive care unit (ICU). The study was conducted in a University Hospital of Barcelona in Spain, using a pre- and post-study design. A total of 61 patient records were analysed in the pre-intervention group. A care plan was applied to 55 patients in the post-intervention group. Specific quality indicators in a medical intensive care unit to assess the clinical practice of nursing were used. Fisher's exact test was used to compare the degree of association between quality indicators in the two groups. A total of 116 records of 121 patients were evaluated: 61 pre-intervention and 55 post-intervention. Fisher test: The filling of nursing records, p=.0003. Checking cardiorespiratory arrest equipment, p <.001. Central vascular catheter related bacteraemia (B-CVC) p=.622. Ventilator associated pneumonia (VAP) p=.1000. Elevation of the head of the bed more than 30° p=.049, and the pain management in non-sedated patients p=.082. The implementation of nursing care plans in patients admitted to the intensive care area may contribute to improvement in the outcomes of nursing care. Copyright © 2015 Elsevier España, S.L.U. y SEEIUC. All rights reserved.

  13. Carpal tunnel syndrome among laboratory technicians in relation to personal and ergonomic factors at work.

    Science.gov (United States)

    El-Helaly, Mohamed; Balkhy, Hanan H; Vallenius, Laura

    2017-11-25

    Work-related carpal tunnel syndrome (CTS) has been reported in different occupations, including laboratory technicians, so this study was carried out to determine the prevalence and the associated personal and ergonomic factors for CTS among laboratory technicians. A cross-sectional study was conducted among 279 laboratory technicians at King Fahd Hospital, Saudi Arabia, who filled in a self-administered questionnaire, including questions regarding their demographic criteria, occupational history, job tasks, workplace tools, ergonomic factors at work, and symptoms suggestive of CTS. Physical examinations and electrodiagnostic studies were carried out for those who had symptoms suggestive of CTS to confirm the diagnosis. Univariate and multivariate analysis were performed for both personal and physical factors in association with confirmed CTS among laboratory technicians. The prevalence of CTS among the laboratory technicians was 9.7% (27/279). The following were the statistically significant risk factors for CTS among them: gender (all cases of CTS were female, P=0.00), arm/hand exertion (OR: 7.96; 95% CI: 1.84-34.33), pipetting (OR: 7.27; 95% CI: 3.15-16.78), repetitive tasks (OR: 4.60; 95% CI: 1.39-15.70), using unadjustable chairs or desks (OR: 3.35; 95% CI: 1.23-9.15), and working with a biosafety cabinet (OR: 2.49; 95% CI: 1.11-5.59). CTS cases had significant longer work duration (17.9 ± 5.6 years) than CTS non-case (11.5 ± 7.4 yeas) with low OR (1.108). This study demonstrates some personal and ergonomic factors associated with CTS among the laboratory technicians, including female gender, arm/hand exertion, pipetting, repetitive tasks, working with a biosafety cabinet, and an unadjusted workstation.

  14. Beyond the Pharmacists’ Patient Care Process: Cultivating Patient Care Practitioners by Utilizing the Pharmaceutical Care Framework

    Directory of Open Access Journals (Sweden)

    Claire Kolar

    2017-08-01

    Full Text Available The adoption of a standard pharmacists’ patient care process (PPCP for the profession, and inclusion of the PPCP in the ACPE Standards 2016, are positive steps for pharmacy education and creates consistency among pharmacy practitioners, regardless of practice setting. The PPCP, and its implications for practice, needs to continue to be embraced by educators and emphasized with students. The PPCP should be the patient care process taught to students and integrated throughout didactic courses and experiential experiences. However, teaching the PPCP or a particular service, such as Medication Therapy Management (MTM or Comprehensive Medication Management (CMM, is not enough. The patient care process must be taught as one component of pharmaceutical care. Without also learning the philosophy of practice and practice management systems, student pharmacists will not be prepared for the realities of practice. Pharmacists are taking on new roles, getting paid in new ways, and in positions to take responsibility for a patient’s medication-related needs. Student pharmacists need to be in a position to take advantage of these opportunities as they progress throughout their careers. Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received, employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties.   Type: Idea Paper

  15. Nuclear instrument technician training

    International Nuclear Information System (INIS)

    Wollesen, E.S.

    1991-01-01

    This paper reports on Nuclear Instrument Technician (NIT) training that has developed at an accelerated rate over the past three decades. During the 1960's commercial nuclear power plants were in their infancy. For that reason, there is little wonder that NIT training had little structure and little creditability. NIT training, in many early plants, was little more than On-The Job Training (OJT). The seventies brought changes in Instrumentation and Controls as well as emphasis on the requirements for more in depth training and documentation. As in the seventies, the eighties saw not only changes in technologies but tighter requirements, standardized training and the development of accredited Nuclear Instrument Training; thus the conclusion: Nuclear Instrument Training Isn't What It Used To Be

  16. Patients' experiences of postoperative intermediate care and standard surgical ward care after emergency abdominal surgery

    DEFF Research Database (Denmark)

    Thomsen, Thordis; Vester-Andersen, Morten; Nielsen, Martin Vedel

    2015-01-01

    AIMS AND OBJECTIVES: To elicit knowledge of patient experiences of postoperative intermediate care in an intensive care unit and standard postoperative care in a surgical ward after emergency abdominal surgery. BACKGROUND: Emergency abdominal surgery is common, but little is known about how patie......, intermediate care patients felt hindered in doing so by continuous monitoring of vital signs. RELEVANCE TO CLINICAL PRACTICE: Intermediate care may increase patient perceptions of quality and safety of care.......AIMS AND OBJECTIVES: To elicit knowledge of patient experiences of postoperative intermediate care in an intensive care unit and standard postoperative care in a surgical ward after emergency abdominal surgery. BACKGROUND: Emergency abdominal surgery is common, but little is known about how...... patients experience postoperative care. The patient population is generally older with multiple comorbidities, and the short-term postoperative mortality rate is 15-20%. Thus, vigilant surgeon and nursing attention is essential. The present study is a qualitative sub-study of a randomised trial evaluating...

  17. Shared Decision Making and Effective Physician-Patient Communication: The Quintessence of Patient-Centered Care

    Directory of Open Access Journals (Sweden)

    Huy Ming Lim

    2015-03-01

    Full Text Available The Institute of Medicine’s (IOM 2001 landmark report, Crossing the Quality Chasm: A New Health System for the 21st Century, identified patient-centeredness as one of the fundamental attributes of quality health care, alongside safety, effectiveness, timeliness, efficiency, and equity. The IOM defined patient-centeredness as “providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions.” This concept of patient-centered care represents a paradigm shift from the traditional disease-oriented and physician-centered care, grounding health care in the subjective experience of illness and the needs and preferences of individual patients rather than the evaluation and treatment of diseases which emphasizes on leveraging clinical expertise and evidence derived from population-based studies. Regrettably, despite the ubiquitous talk about patient-centered care in modern health care, shared decision-making and effective physician-patient communication—the two cruxes of patient-centered care—are yet to become the norms. Strategies to promote and enhance shared decision-making and effective communication between clinicians and patients should be rigorously implemented to establish a health care system that truly values patients as individuals and turn the rhetoric of patient-centered care into reality.

  18. Laboratory-based performance evaluation of PIMA CD4+ T-lymphocyte count point-of-care by lay-counselors in Kenya.

    Science.gov (United States)

    Zeh, Clement; Rose, Charles E; Inzaule, Seth; Desai, Mitesh A; Otieno, Fredrick; Humwa, Felix; Akoth, Benta; Omolo, Paul; Chen, Robert T; Kebede, Yenew; Samandari, Taraz

    2017-09-01

    CD4+ T-lymphocyte count testing at the point-of-care (POC) may improve linkage to care of persons diagnosed with HIV-1 infection, but the accuracy of POC devices when operated by lay-counselors in the era of task-shifting is unknown. We examined the accuracy of Alere's Pima™ POC device on both capillary and venous blood when performed by lay-counselors and laboratory technicians. In Phase I, we compared the perfomance of POC against FACSCalibur™ for 280 venous specimens by laboratory technicians. In Phase II we compared POC performance by lay-counselors versus laboratory technicians using 147 paired capillary and venous specimens, and compared these to FACSCalibur™. Statistical analyses included Bland-Altman analyses, concordance correlation coefficient, sensitivity, and specificity at treatment eligibility thresholds of 200, 350, and 500cells/μl. Phase I: POC sensitivity and specificity were 93.0% and 84.1% at 500cells/μl, respectively. Phase II: Good agreement was observed for venous POC results from both lay-counselors (concordance correlation coefficient (CCC)=0.873, bias -86.4cells/μl) and laboratory technicians (CCC=0.920, bias -65.7cells/μl). Capillary POC had good correlation: lay-counselors (CCC=0.902, bias -71.2cells/μl), laboratory technicians (CCC=0.918, bias -63.0cells/μl). Misclassification at the 500 cells/μl threshold for venous blood was 13.6% and 10.2% for lay-counselors and laboratory technicians and 12.2% for capillary blood in both groups. POC tended to under-classify the CD4 values with increasingly negative bias at higher CD4 values. Pima™ results were comparable to FACSCalibur™ for both venous and capillary specimens when operated by lay-counselors. POC CD4 testing has the potential to improve linkage to HIV care without burdening laboratory technicians in resource-limited settings. Published by Elsevier B.V.

  19. Advancing patient-centered care through transformative educational leadership: a critical review of health care professional preparation for patient-centered care

    Directory of Open Access Journals (Sweden)

    Lévesque MC

    2013-07-01

    Full Text Available Martine C Lévesque,1,2 Richard Bruce Hovey,2,3 Christophe Bedos2,4 1Faculté de médecine, Université de Montréal, Montréal, QC, Canada; 2Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada; 3Faculty of Medicine, University of Calgary, Calgary, AB, Canada; 4Département de médecine sociale et préventive, Faculté de médicine, Université de Montréal, Montréal, QC, Canada Abstract: Following a historical brief on the development of patient-centered care (PCC, we discuss PCC's value and role in counterbalancing the evidence-based movement in health care. We in turn make a case for a philosophical shift in thinking about the PCC concept, one based on a consideration for how knowledge is produced, used, and valued within care provision processes. A “shared epistemology” foundation is presented, defined, and promoted as essential to the authentic and ethical realization of “shared decision making” between patient and health care provider, and, more generally, of PCC. In accordance with these views, this article critically reviews the literature on health care professional education for the development of PCC. We uncover the disturbing ways in which education frequently undermines the development of patient centeredness, despite curricular emphasis on professionalism and ethical PCC. We also establish the need to raise awareness of how dominant approaches to evaluating student or practitioner performance often fail to reinforce or promote patient centeredness. Finally, we identify successful and inspiring cases of teaching and learning experiences that have achieved perspective transformation on PCC and on new ways of providing care. The pertinence of adopting the theoretical foundations of adult transformative learning is argued, and a call to action is proposed to the leadership of health professional educators across all disciplines. Keywords: patient-centered care, health professional

  20. Costs of terminal patients who receive palliative care or usual care in different hospital wards.

    Science.gov (United States)

    Simoens, Steven; Kutten, Betty; Keirse, Emmanuel; Berghe, Paul Vanden; Beguin, Claire; Desmedt, Marianne; Deveugele, Myriam; Léonard, Christian; Paulus, Dominique; Menten, Johan

    2010-11-01

    In addition to the effectiveness of hospital care models for terminal patients, policy makers and health care payers are concerned about their costs. This study aims to measure the hospital costs of treating terminal patients in Belgium from the health care payer perspective. Also, this study compares the costs of palliative and usual care in different types of hospital wards. A multicenter, retrospective cohort study compared costs of palliative care with usual care in acute hospital wards and with care in palliative care units. The study enrolled terminal patients from a representative sample of hospitals. Health care costs included fixed hospital costs and charges relating to medical fees, pharmacy and other charges. Data sources consisted of hospital accountancy data and invoice data. Six hospitals participated in the study, generating a total of 146 patients. The findings showed that palliative care in a palliative care unit was more expensive than palliative care in an acute ward due to higher staffing levels in palliative care units. Palliative care in an acute ward is cheaper than usual care in an acute ward. This study suggests that palliative care models in acute wards need to be supported because such care models appear to be less expensive than usual care and because such care models are likely to better reflect the needs of terminal patients. This finding emphasizes the importance of the timely recognition of the need for palliative care in terminal patients treated in acute wards.

  1. Nursing care of the thermally injured patient.

    Science.gov (United States)

    Elfving, U

    1980-01-01

    Team work is required in the treatment of the thermally injured patient--nursing staff being part of the team. The nurses are with the patient for 24 hours a day and they have to understand the objectives of all other members of the team involved in the treatment as well as thoroughly mastering their own work. For the nursing staff the care of the thermally injured patient is a challenge. The work demands strong motivation and interest--it includes at times painful treatment, isolation and also constant alertness. It is important that the nursing staff is given continuous training so that they are able to give the required care efficiently and to keep up active interest. Practical work is the best way of getting aquainted with the complex forms of treatment of the thermally injured patient. It also lessens the fear of a badly burned patient. Nursing care of the thermally injured patient consists of good basic care, local attention and active observation. The basic care consists of basic hygiene, diet, observation of the patient's psychological condition, giving emotional support, encouraging initiative physiotherapy and postural treatment.

  2. Safety and efficiency of prehospital pain management with fentanyl administered by emergency medical technicians

    DEFF Research Database (Denmark)

    Nielsen, Niels Dalsgaard; Brogaard, Kjeld; Dahl, Michael

    2007-01-01

    Introduction: In our region Advanced Emergency Medical Technicians (AEMTs) respond to acutely ill or injured patients in rural areas. The AEMTs have been authorized to administer fentanyl intravenously in doses up to 2 μg/kg to selected groups of patients in pain. Higher doses can be allowed...... by a physician after a teleconference. We examined the effect of intravenous (IV) fentanyl treatment, expressed as pain reduction on a 10-point Numeric Rating Scale (NRS). Moreover we examined the occurrence of negative coincident events to assess whether it was safe to let non-medical staff administer potent...... opioids intravenously.   Methods: Retrospectively we collected the case sheets for all patients treated with IV fentanyl by the AEMTs in 2005 and 2006. We excluded all patients where a physician had been directly involved in the prehospital treatment. We recorded the IV fentanyl dose, NRS-score before...

  3. Managing social awkwardness when caring for morbidly obese patients in intensive care: A focused ethnography.

    Science.gov (United States)

    Hales, Caz; de Vries, Kay; Coombs, Maureen

    2016-06-01

    Critically ill morbidly obese patients pose considerable healthcare delivery and resource utilisation challenges in the intensive care setting. These are resultant from specific physiological responses to critical illness in this population and the nature of the interventional therapies used in the intensive care environment. An additional challenge arises for this population when considering the social stigma that is attached to being obese. Intensive care staff therefore not only attend to the physical and care needs of the critically ill morbidly obese patient but also navigate, both personally and professionally, the social terrain of stigma when providing care. To explore the culture and influences on doctors and nurses within the intensive care setting when caring for critically ill morbidly obese patients. A focused ethnographic approach was adopted to elicit the 'situated' experiences of caring for critically ill morbidly obese patients from the perspectives of intensive care staff. Participant observation of care practices and interviews with intensive care staff were undertaken over a four month period. Analysis was conducted using constant comparison technique to compare incidents applicable to each theme. An 18 bedded tertiary intensive care unit in New Zealand. Sixty-seven intensive care nurses and 13 intensive care doctors involved with the care and management of seven critically ill patients with a body mass index ≥40kg/m(2). Interactions between intensive care staff and morbidly obese patients were challenging due to the social stigma surrounding obesity. Social awkwardness and managing socially awkward moments were evident when caring for morbidly obese patients. Intensive care staff used strategies of face-work and mutual pretence to alleviate feelings of discomfort when engaged in aspects of care and caring. This was a strategy used to prevent embarrassment and distress for both the patients and staff. This study has brought new understandings

  4. Guidelines for training and qualification of radiological protection technicians

    International Nuclear Information System (INIS)

    1987-08-01

    These guidelines, used in combination with plant-specific job analysis, provide the framework for a training and qualification program for radiological protection technicians at nuclear power plants. Radiological protection technicians are defined as those individuals, both plant and contractor, who will be engaged in the evaluation of radiological conditions in the nuclear plant and the implementation of the necessary radiological safety measures as they apply to nuclear plant workers and members of the general public. An important aspect of this work is recognizing and handling unusual situations involving radioactivity, including incidents related to degraded core conditions. These guidelines incorporate the results of an industry-wide job analysis and task analysis (JTA) combined with industry operating experience review. However, the industry-wide analyses did not identify all important academic and fundamental knowledge and skills. Further in-depth analysis by subject matter experts produced additional knowledge and skills that were added to these guidelines. All utilities should use these guidelines in conjunction with plant-specific and industry-wide JTA results to develop or validate their radiological protection technician training program. Plant-specific information should be used to establish appropriate training program content. This plant-specific information should reflect unique job duties, equipment, operating experience, and trainee entry-level qualifications. Revisions to these guidelines should be reviewed for applicability and incorporated into the training program using each utility's training system development (TSD) procedures. Plant-specific job analysis and task analysis data is essential to the development of performance-based training programs. These analyses are particularly useful in selecting tasks for training and in developing on-the-job training (OJT), laboratory training, and mock-up training. Qualification programs based on these

  5. Advance Care Planning in Glioblastoma Patients

    Directory of Open Access Journals (Sweden)

    Lara Fritz

    2016-11-01

    Full Text Available Despite multimodal treatment with surgery, radiotherapy and chemotherapy, glioblastoma is an incurable disease with a poor prognosis. During the disease course, glioblastoma patients may experience progressive neurological deficits, symptoms of increased intracranial pressure such as drowsiness and headache, incontinence, seizures and progressive cognitive dysfunction. These patients not only have cancer, but also a progressive brain disease. This may seriously interfere with their ability to make their own decisions regarding treatment. It is therefore warranted to involve glioblastoma patients early in the disease trajectory in treatment decision-making on their future care, including the end of life (EOL care, which can be achieved with Advance Care Planning (ACP. Although ACP, by definition, aims at timely involvement of patients and proxies in decision-making on future care, the optimal moment to initiate ACP discussions in the disease trajectory of glioblastoma patients remains controversial. Moreover, the disease-specific content of these ACP discussions needs to be established. In this article, we will first describe the history of patient participation in treatment decision-making, including the shift towards ACP. Secondly, we will describe the possible role of ACP for glioblastoma patients, with the specific aim of treatment of disease-specific symptoms such as somnolence and dysphagia, epileptic seizures, headache, and personality changes, agitation and delirium in the EOL phase, and the importance of timing of ACP discussions in this patient population.

  6. Rationale and design of a patient-centered medical home intervention for patients with end-stage renal disease on hemodialysis.

    Science.gov (United States)

    Porter, Anna C; Fitzgibbon, Marian L; Fischer, Michael J; Gallardo, Rani; Berbaum, Michael L; Lash, James P; Castillo, Sheila; Schiffer, Linda; Sharp, Lisa K; Tulley, John; Arruda, Jose A; Hynes, Denise M

    2015-05-01

    In the U.S., more than 400,000 individuals with end-stage renal disease (ESRD) require hemodialysis (HD) for renal replacement therapy. ESRD patients experience a high burden of morbidity, mortality, resource utilization, and poor quality of life (QOL). Under current care models, ESRD patients receive fragmented care from multiple providers at multiple locations. The Patient-Centered Medical Home (PCMH) is a team approach, providing coordinated care across the healthcare continuum. While this model has shown some early benefits for complex chronic diseases such as diabetes, it has not been applied to HD patients. This study is a non-randomized quasi-experimental intervention trial implementing a Patient-Centered Medical Home for Kidney Disease (PCMH-KD). The PCMH-KD extends the existing dialysis care team (comprised of a nephrologist, dialysis nurse, dialysis technician, social worker, and dietitian) by adding a general internist, pharmacist, nurse coordinator, and a community health worker, all of whom will see the patients together, and separately, as needed. The primary goal is to implement a comprehensive, multidisciplinary care team to improve care coordination, quality of life, and healthcare use for HD patients. Approximately 240 patients will be recruited from two sites; a non-profit university-affiliated dialysis center and an independent for-profit dialysis center. Outcomes include (i) patient-reported outcomes, including QOL and satisfaction; (ii) clinical outcomes, including blood pressure and diet; (iii) healthcare use, including emergency room visits and hospitalizations; and (iv) staff perceptions. Given the significant burden that patients with ESRD on HD experience, enhanced care coordination provides an opportunity to reduce this burden and improve QOL. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. A method for the efficient and effective evaluation of contract health physics technicians

    International Nuclear Information System (INIS)

    Burkdoll, S.C.; Conley, T.A.

    1992-01-01

    This paper reports that Wolf Creek has developed a method for efficiently training contract health physics technicians. The time allotted for training contractors prior to a refueling and maintenance outage is normally limited to a few days. Therefore, it was necessary to develop a systematic method to evaluate prior experience as well as practical skills and knowledge. In addition, instruction in the particular methodologies used at Wolf Creek hadto be included with methods for evaluating technician comprehension

  8. When doctor becomes patient: challenges and strategies in caring for physician-patients.

    Science.gov (United States)

    Domeyer-Klenske, Amy; Rosenbaum, Marcy

    2012-01-01

    The current study was aimed at exploring the challenges that arise in the doctor-patient relationship when the patient is also a physician and identifying strategies physicians use to meet these challenges. No previous research has systematically investigated primary care physicians' perspectives on caring for physician-patients. Family medicine (n=15) and general internal medicine (n=14) physicians at a large Midwestern university participated in semi-structured interviews where they were asked questions about their experiences with physician-patients and the strategies they used to meet the unique needs of this patient population. Thematic analysis was used to identify common responses. Three of the challenges most commonly discussed by physician participants were: (1) maintaining boundaries between relationships with colleagues or between roles as physician/colleague/friend, (2) avoiding assumptions about patient knowledge and health behaviors, and (3) managing physician-patients' access to informal consultations, personal test results, and opinions from other colleagues. We were able to identify three main strategies clinicians use in addressing these perceived challenges: (1) Ignore the physician-patient's background, (2) Acknowledge the physician-patient's background and negotiate care, and (3) Allow care to be driven primarily by the physician-patient. It is important that primary care physicians understand the challenges inherent in treating physicians and develop a strategy with which they are comfortable addressing them. Explicitly communicating with the physician-patient to ensure boundaries are maintained, assumptions about the physician-patient are avoided, and physician-patient access is properly managed are key to providing quality care to physician-patients.

  9. Characterization of Low Back Pain in Pilots and Maintenance Technicians on a Commercial Airline.

    Science.gov (United States)

    Fajardo Rodriguez, Hugo A; Ortiz Mayorga, Viviana A

    2016-09-01

    Lower back pain (LBP) is the most common complaint worldwide and the leading cause of disability in the workplace. In Colombia there are no epidemiological data on low back pain in aviation. This study aimed to characterize lower back pain in pilots and maintenance technicians in a Colombian commercial airline. Information was collected from the total population in a Colombian commercial airline in Bogota during the period from 2011 to 2013 using a voluntary survey which requested demographics, occupational (LEST survey) factors, back pain, and chronic pain (chronic pain grade scale). The prevalence rate of LBP in pilot respondents was 71% and the factors associated previously have belonged to the military forces: occupational exposure to physical load and work time. Chronic low back pain was at a prevalence of 49%. The prevalence of LBP in maintenance technicians was 65%. Associated factors were again similar to military forces and included mental workload. Chronic pain had a prevalence of 65%. Factors associated with chronic low back pain were the technicians' time in office and physical load. The prevalence of lower back pain in pilots is similar to that presented in the airline world population. In the case of maintenance technicians, the prevalence was higher than those found in other similar groups, but very similar to prevalences presented in different business industries, including the transport sector. Fajardo Rodriguez HA, Ortiz Mayorga VA. Characterization of low back pain in pilots and maintenance technicians on a commercial airline. Aerosp Med Hum Perform. 2016; 87(9):795-799.

  10. Impacts of patient characteristics on hospital care experience in 34,000 Swedish patients

    Directory of Open Access Journals (Sweden)

    Wolf Axel

    2012-06-01

    Full Text Available Abstract Background Standardized patient surveys are widely used for assessing quality of healthcare from the patient perspective. An important purpose of such surveys is to identify disparities in care among different patient groups. The purpose of this study was to 1. evaluate aspects of the validity of the adapted Swedish version of the Picker Patient Care Experience -15 (PPE-15 survey and 2. examine the explanatory value of various socio-demographic and health characteristics in predicting patients’ care experiences. Methods A retrospective cross-sectional study design was used. Patients discharged from internal medicine wards at regional and university hospitals in different parts of Sweden during 2010 were invited to participate in the regularly administered national care-experience survey for hospital care. The internal validity of the PPE-15 was assessed with Cronbach’s alpha and item-scale correlations. Pearson product–moment correlation coefficients were used to compare PPE-15 total scores with overall care satisfaction ratings and Spearman correlation coefficients were used to compare PPE-15 total scores with various patient characteristics. Multiple linear regression analysis was performed to examine the influence of various patient characteristics on PPE-15 scores. Results The response rate was 66% (n = 34 603. Cronbach’s alpha was 0.87. The correlation between the PPE-15 total score and overall care satisfaction was high (0.62, p  Conclusions Our results supported the internal validity of the Swedish adapted version of the PPE-15. The explanatory value of the examined patient socio-demographic and health characteristics was low, suggesting the need for exploring other patient-related determinants of care experiences. Our findings also suggest a care paradox: patients in greatest need of hospital care are least satisfied with the quality of the care they receive.

  11. The role of the breast care nurse in patient and family care.

    Science.gov (United States)

    Luck, Lauretta; Chok, Harrison Ng; Scott, Nancy; Wilkes, Lesley

    2017-11-01

    To describe the role of the breast care nurse in caring for patients and families. The breast care nurse is an expert clinical nurse who plays a significant role in the care of women/men and their families with breast cancer. The role of these nurses has expanded since the 1990s in Australia. Descriptive study. An online survey was sent to breast care nurses using peak body databases (n = 100). The survey consisted of nineteen nurse roles and functions from a previous Delphi technique study. Nurses rated the importance and frequency of role elements using a five-point Likert scale and four open-ended questions relating to role. There were 89 respondents. Most of the sample were from remote (n = 37, 41%) and rural areas (n = 47, 52%). The majority of responses regarding importance and frequency of the BCN role had a mean score above 4, which corresponds to 'moderately important' and 'occasionally as needed'. There were significant differences between the level of importance and frequency on 10 items. Four role themes arose from the thematic analysis: Breast care nurses as patient advocates, patient educators, care coordinators and clinical experts. This study delineated the important nurses role in caring for patients and families during a critical time of their life. Further, it details the important nursing roles and functions undertaken by these nurses and compared this to the frequency with which these nurses perform these aspects of their role. This study further delineates the important role that the nurses play in caring for patients and families during a critical time of their life. It extends further the frequency and importance of the supportive care and the need to educate their nurses on their role in providing spiritual care and research. © 2016 John Wiley & Sons Ltd.

  12. Caring for cancer patients on non-specialist wards.

    LENUS (Irish Health Repository)

    Gill, Finola

    2012-02-01

    As cancer is the leading cause of death worldwide, every nurse will be required to care for patients with the condition at some point in his\\/her career. However, non-specialized oncology nurses are often ill-prepared to nurse patients suffering from cancer. This literature review aims to provide an overview of current trends and developments in cancer care nursing in an attempt to identify the range of previous research pertaining to caring for patients with cancer on non-specialist wards. The review finds that non-specialized cancer nurses report a lack of education and training with regard to cancer care and cancer treatments, which acts as a barrier to providing quality nursing care. Emotional and communication issues with patients and their families can also cause non-specialist nurses significant distress. International research has shown that specialist oncology nurses make a considerable difference to physical and psychosocial patient care. It is therefore paramount that non-speciality nurses\\' educational needs are met to develop clinical competence and to provide supportive holistic care for both patients and their families.

  13. Patients' and Health Care Providers' Perception of Stressors in the Intensive Care Units.

    Science.gov (United States)

    Abuatiq, Alham

    2015-01-01

    The purposes of this study is first, to investigate intensive care patients' perceptions of stressors; second, to investigate the health care provider's perception of what constitutes a stressor from the patient's perspective; and third, to describe how health care providers manage their patients' stressors. This was a mixed-methods study; the quantitative section replicated Cornock's 1998 study of stress in the intensive care unit (ICU), with difference in sampling to include all health care providers in the ICU, in addition to nurses. The qualitative section added information to the current literature by describing how health care providers manage their patient's stressors. This article reports the quantitative findings of this study, as the qualitative section is presented in a separate article. It is important to describe ICU patients' stressful experiences to assess patient's stressors, provide holistic care to eliminate stressors, and provide feedback to health care providers. There is a need to describe the clinical practice related to stress perception and management of stressors in the critical care environment. A mixed-methods comparative descriptive design was used for the quantitative section, and a phenomenological approach guided the qualitative section. Lazarus and Folkman's theory formed the bases for integrating all variables investigated in this study. The sample included 70 ICU patients and 70 ICU health care providers. After consenting to participate in this study, subjects were given a demographic form and a paper-based tool, the Environmental Stressors graphic data form Questionnaire. Questionnaires were filled out by subjects anonymously in the ICU and returned to the researcher in the same setting. Descriptive statistics were analyzed using SPSS data analysis software. The top 3 most stressful items ranked by the patients included "being in pain," followed by "not being able to sleep" and "financial worries"; on the other hand, health care

  14. Technician checks the mirrors of the Starshine-2 experiment

    Science.gov (United States)

    2001-01-01

    Technician checks the mirrors of the Starshine-2 experiment KSC-01PD-1715 KENNEDY SPACE CENTER, Fla. -- A technician checks the mirrors on the Starshine-2 experiment inside a canister in the payload bay of Space Shuttle Endeavour. The deployable experiment is being carried on mission STS-108. Starshine-2's 800 aluminum mirrors were polished by more than 25,000 students from 26 countries. Top priorities for the STS-108 (UF-1) mission of Endeavour are rotation of the International Space Station Expedition Three and Expedition Four crews, bringing water, equipment and supplies to the station in the Multi-Purpose Logistics Module Raffaello, and completion of robotics tasks and a spacewalk to install thermal blankets over two pieces of equipment at the bases of the Space Station's solar wings. Liftoff of Endeavour on mission STS-108 is scheduled for 7:41 p.m. EST.

  15. CERN's Technician Training Experience notches up another success!

    CERN Multimedia

    Stephanie Hills

    2015-01-01

    The programme was set up almost three years ago to help address a Europe-wide shortage of highly skilled technicians, with the participants gaining valuable skills and experience in an international environment. It’s clear that the programme works: some of the technician fellows who have taken part are being snapped up by major science projects and the high-tech industry.   Going underground: Fay Chicken at work in ATLAS. Fay Chicken (see UK news from CERN 59) has just accepted a job offer from the European Spallation Source in Sweden, where she will be working in the detector development team: “I’m also going to be setting up a new workshop where prototype detectors will be built. When I went to Lund, I was shown a big, empty room – it’s up to me to equip it!” This level of responsibility is a big step up for Fay, but there is no doubt that her time at CERN has both built her confidence to take on the role, and convinced ESS th...

  16. Prevalence of hyponatremia in palliative care patients

    Directory of Open Access Journals (Sweden)

    Shoba Nair

    2016-01-01

    Conclusions: Prevalence of hyponatremia is significant in palliative care patients. A prospective study looking at the causes and clinical outcomes associated with hyponatremia in palliative care patients is needed.

  17. Development of a Training Program for Commercial Building Technicians

    Energy Technology Data Exchange (ETDEWEB)

    Rinholm, Rod

    2013-05-31

    This project focused on developing and deploying a comprehensive program of 22 training modules, including certification requirements, and accreditation standards for commercial building technicians, to help achieve the full savings potential of energy efficient buildings, equipment, and systems. This curriculum extended the currently available commercial building technician programs -- training a labor force in a growing market area focused on energy efficiency. The program helps to remove a major market impediment to low energy/zero energy commercial building system acceptance, namely a lack of operating personnel capable of handling more complex high efficiency systems. The project developed a training curriculum for commercial building technicians, with particular focus on high-efficiency building technology, and systems. In Phase 1, the project team worked collaboratively in developing a draft training syllabus to address project objectives. The team identified energy efficiency knowledge gaps in existing programs and plans and plans to address the gaps with either modified or new curricula. In Phase 2, appropriate training materials were developed to meet project objectives. This material was developed for alternative modes of delivery, including classroom lecture materials, e-learning elements, video segments, exercises, and hands-on training elements. A Certification and Accreditation Plan and a Commercialization and Sustainability Plan were also investigated and developed. The Project Management Plan was updated quarterly and provided direction on the management approaches used to accomplish the expected project objectives. GTI project management practices tightly coordinate project activities using management controls to deliver optimal customer value. The project management practices include clear scope definition, schedule/budget tracking, risk/issue resolution and team coordination.

  18. Retention in mental health care of Portuguese-speaking patients

    Science.gov (United States)

    Gonçalves, Marta; Cook, Benjamin; Mulvaney-Day, Norah; Alegría, Margarita; Kinrys, Gustavo

    2013-01-01

    We compared service outcomes of dedicated language and cultural competency services in adequacy of care, ER, and inpatient care among Portuguese-speaking patients in ethnic- and non-ethnic-specific behavioral health clinics. We assessed adequacy of mental health care, and use of inpatient emergency department among Portuguese-speaking patients, comparing individuals receiving care from a culturally and linguistically competent mental health care setting (the Portuguese Mental Health Program [PMHP]) with usual mental health care in a community health care system in the USA. Propensity score matching was used to balance patients in treatment and control groups on gender, marital status, age, diagnosis of mental disorder, and insurance status. We used de-identified, longitudinal, administrative data of 854 Portuguese-speaking patients receiving care from the PMHP and 541 Portuguese-speaking patients receiving usual care from 2005–2008. Adequate treatment was defined as receipt of at least eight outpatient psychotherapy visits, or at least four outpatient visits of which one was a psychopharmacological visit. PMHP patients were more likely to receive adequate care. No differences were found in rates of ER use or inpatient mental health care. The present study suggests increased quality of care for patients that have contact with a clinic that dedicates resources specifically to a minority/immigrant group. Advantages of this setting include greater linguistic and cultural concordance among providers and patients. Further research is warranted to better understand the mechanisms by which culturally appropriate mental health care settings benefit minority/immigrant patients. PMID:23427258

  19. The enforcement regulation for the law for radiation and x-ray technicians engaging in medical treatment

    International Nuclear Information System (INIS)

    1980-01-01

    The ordinance is set up under the provisions of the law concerning radiation and X-ray technicians engaging in medical treatment, to enforce it. An application for the license of such a technician shall be filed according to the form prescribed, attached with a copy or an abstract of the census register of the applicant and a medical certificate of a doctor concerning whether the applicant is an insane, deaf or blind person, or a case of epidemic. The membership registration of such a technician shall include the number and date of the registration, the prefecture of his legal domicile, name, birth date and sex distinction, the year and month of his success in the examination for such technicains, the items concerning the cancellation of the license or the suspension of the business, etc. The subjects of the examination for such technicians are physics, radiological physics, electrical engineering, chemistry, general basic medical science, radiological biology, photographing technology, treatment technics and others. An application for the examination for such technicians shall be filed to the Minister of Health and Welfare, attached with a personal history, a study certificate or a diploma of graduation, a photograph of the applicant and other specified documents. (Okada, K.)

  20. Results of the 2015 National Certified Pharmacy Technician Workforce Survey.

    Science.gov (United States)

    Desselle, Shane P; Holmes, Erin R

    2017-07-01

    The results of the 2015 National Certified Pharmacy Technician Workforce Survey are described. A survey was e-mailed to a randomized sample of 5,000 certified pharmacy technicians (CPhTs) throughout the United States, with response reminders employed. Survey items eliciting demographic and work characteristics and work life attitudes were generated from the literature and qualitative interviews. This study aimed to describe job satisfaction, sources of stress, profession and employer commitment, education and training, and reasons for entry into the profession among CPhTs and determine relationships between those variables and CPhTs' level of involvement in various work activities, with particular attention paid to differences in practice setting. Frequency statistics, correlation analysis, and means testing were used to meet study objectives and identify significant differences. A total of 516 CPhTs currently working as a pharmacy technician responded to the survey. The CPhTs reported high levels of involvement in more traditional activities but less involvement in those that involve greater cognitive load. Respondents reported moderate levels of job satisfaction and commitment and somewhat high levels of stress overall. Most CPhTs chose to be a pharmacy technician because they desired to enter a healthcare field and help people and were recruited. CPhTs derived benefit from all aspects of education and training evaluated and most from on-the-job training. Perceived value of education and training was associated with higher satisfaction and commitment and with lower stress. There were a number of differences in these work life attitudes across practice settings and by involvement in various job functions. The results of the survey indicated that job satisfaction and commitment were moderate and that stress levels were somewhat high among CPhTs. There were a number of differences in work life attitudes across practice settings and by involvement in various job

  1. Payment and Care for Hematopoietic Cell Transplantation Patients: Toward a Specialized Medical Home for Complex Care Patients.

    Science.gov (United States)

    Gajewski, James L; McClellan, Mark B; Majhail, Navneet S; Hari, Parameswaran N; Bredeson, Christopher N; Maziarz, Richard T; LeMaistre, Charles F; Lill, Michael C; Farnia, Stephanie H; Komanduri, Krishna V; Boo, Michael J

    2018-01-01

    Patient-centered medical home models are fundamental to the advanced alternative payment models defined in the Medicare Access and Children's Health Insurance Plan Reauthorization Act (MACRA). The patient-centered medical home is a model of healthcare delivery supported by alternative payment mechanisms and designed to promote coordinated medical care that is simultaneously patient-centric and population-oriented. This transformative care model requires shifting reimbursement to include a per-patient payment intended to cover services not previously reimbursed such as disease management over time. Payment is linked to quality measures, including proportion of care delivered according to predefined pathways and demonstrated impact on outcomes. Some medical homes also include opportunities for shared savings by reducing overall costs of care. Recent proposals have suggested expanding the medical home model to specialized populations with complex needs because primary care teams may not have the facilities or the requisite expertise for their unique needs. An example of a successful care model that may provide valuable lessons for those creating specialty medical home models already exists in many hematopoietic cell transplantation (HCT) centers that deliver multidisciplinary, coordinated, and highly specialized care. The integration of care delivery in HCT centers has been driven by the specialty care their patients require and by the payment methodology preferred by the commercial payers, which has included bundling of both inpatient and outpatient care in the peritransplant interval. Commercial payers identify qualified HCT centers based on accreditation status and comparative performance, enabled in part by center-level comparative performance data available within a national outcomes database mandated by the Stem Cell Therapeutic and Research Act of 2005. Standardization across centers has been facilitated via voluntary accreditation implemented by Foundation for

  2. Patient-centred care: a review for rehabilitative audiologists.

    Science.gov (United States)

    Grenness, Caitlin; Hickson, Louise; Laplante-Lévesque, Ariane; Davidson, Bronwyn

    2014-02-01

    This discussion paper aims to synthesise the literature on patient-centred care from a range of health professions and to relate this to the field of rehabilitative audiology. Through review of the literature, this paper addresses five questions: What is patient-centred care? How is patient-centred care measured? What are the outcomes of patient-centred care? What are the factors contributing to patient-centred care? What are the implications for audiological rehabilitation? Literature review and synthesis. Publications were identified by structured searches in PubMed, Cinahl, Web of Knowledge, and PsychInfo, and by inspecting the reference lists of relevant articles. Few publications from within the audiology profession address this topic and consequently a review and synthesis of literature from other areas of health were used to answer the proposed questions. This paper concludes that patient-centred care is in line with the aims and scope of practice for audiological rehabilitation. However, there is emerging evidence that we still need to inform the conceptualisation of patient-centred audiological rehabilitation. A definition of patient-centred audiological rehabilitation is needed to facilitate studies into the nature and outcomes of it in audiological rehabilitation practice.

  3. Caring touch--patients' experiences in an anthroposophic clinical context.

    Science.gov (United States)

    Ozolins, Lise-Lotte; Hörberg, Ulrica; Dahlberg, Karin

    2015-12-01

    This study describes the phenomenon of caring touch from the patients' perspective in an anthroposophic clinical context where caring touch is often used to promote health and alleviate suffering. The aim of the study was to explore and phenomenologically describe the phenomenon of caring touch from the patients' perspectives. The study has been carried out with a Reflective Lifeworld Research approach in order to understand and describe human existential phenomena. Ten female patients were interviewed in an anthroposophic clinic in Sweden. The findings show how caring touch has multifaceted meanings and makes the patients' feel present and anchored in a meaningful context. The patients' feel that they are seen, accepted and confirmed. Furthermore, touch creates a caring space where the patients become receptive for care and has the power to alleviate the patients' suffering, as well as to frighten and cause or worsen the suffering. In order to take advantage of the caring potential, the patient needs to be invited to a respectful and sensitive form of touch. An interpersonal flexible space is necessary where the touch can be effective, and where a dynamic interplay can develop. In conclusion, caring touch is an opportunity for carers to support well-being and health. The carers need to approach their patients in both a sensitive and reflective way. A caring science perspective can serve as a help to further understand touch as a unique caring act. © 2015 Nordic College of Caring Science.

  4. Orthogeriatric care: improving patient outcomes

    Directory of Open Access Journals (Sweden)

    Tarazona-Santabalbina FJ

    2016-06-01

    Full Text Available Francisco José Tarazona-Santabalbina,1,2 Ángel Belenguer-Varea,1,2 Eduardo Rovira,1,2 David Cuesta-Peredó1,21Geriatric Medicine Unit, Internal Medicine Department, Hospital Universitario de la Ribera, 2Medical School, Universidad Católica de Valencia San vicente Mártir, Valencia, SpainAbstract: Hip fractures are a very serious socio-economic problem in western countries. Since the 1950s, orthogeriatric units have introduced improvements in the care of geriatric patients admitted to hospital because of hip fractures. During this period, these units have reduced mean hospital stays, number of complications, and both in-hospital mortality and mortality over the middle term after hospital discharge, along with improvements in the quality of care and a reduction in costs. Likewise, a recent clinical trial has reported greater functional gains among the affected patients. Studies in this field have identified the prognostic factors present upon admission or manifesting themselves during admission and that increase the risk of patient mortality or disability. In addition, improved care afforded by orthogeriatric units has proved to reduce costs. Nevertheless, a number of management issues remain to be clarified, such as the optimum anesthetic, analgesic, and thromboprophylactic protocols; the type of diagnostic and therapeutic approach best suited to patients with cognitive problems; or the efficiency of the programs used in convalescence units or in home rehabilitation care. Randomized clinical trials are needed to consolidate the evidence in this regard. Keywords: hip fractures, geriatric assessment, orthogeriatric care, recovery of function, mortality

  5. Changes in the ocular surface: initial observations from a pilot study of diagnostic radiology technicians (radiographers)

    International Nuclear Information System (INIS)

    Guerdal, Canan; Aydin, Sevda; Sengoer, Tomris; Onmus, Hale; Oezarar, Muemtaz

    2002-01-01

    The purpose of this study was to evaluate the clinical and cytological changes in the ocular surface of radiology technicians (radiographers) exposed to diagnostic doses of radiation. The Schirmer, Rose Bengal staining and Tear-Break-Up-Time tear function tests were carried out following routine ophthalmic examination in 15 radiology technicians (group I) and 15 controls (group II). Impression cytology was performed by placing 5-mm-thick half-circular cellulose acetate filter paper in the upper and lower quadrants around the limbus. The cytological evaluation was made using the mapping technique. Significantly increased dry eye was detected in group I. In the impression cytology investigation, squamous metaplasia and intraepithelial lymphocytic infiltration was noted in all the group-I cases. A distinct change was observed between the regions showing squamous metaplasia and neigbouring normal epithelial cell structure. Dry eye and ocular surface cytological changes were observed in diagnostic radiology technicians. Routine ophthalmic evaluation of radiology technicians would be beneficial in detecting early cytological changes and dry eye. (orig.)

  6. Intensive care unit ventilation for the non-intensivist

    African Journals Online (AJOL)

    Mode classification: volume versus pressure targeting. There is no evidence to ... and so most modern ventilators can be set up by the technician to directly display the .... mechanics: transpulmonary pressure and lung volume. Crit Care. 2013 ...

  7. DOD Recovery personnel and NASA technicians inspect Friendship 7 spacecraft

    Science.gov (United States)

    1964-01-01

    Department of Defense Recovery personnel and spacecraft technicians from NASA adn McDonnell Aircraft Corp., inspect Astronaut John Glenn's Mercury spacecraft, Friendship 7, following its return to Cape Canaveral after recovery in the Atlantic Ocean.

  8. Patient evaluations of primary care.

    NARCIS (Netherlands)

    Schäfer, W.L.A.; Boerma, W.G.W.; Schellevis, F.G.; Groenewegen, P.P.

    2012-01-01

    Background: So far, studies about people’s appreciation of primary care services has shown that patient satisfaction seems to be lower in health care systems with regulated access to specialist services by gate keeping. Nevertheless, international comparative research about patients’ expectations

  9. [Health care for migrant patients: primary care or specialized medicine?].

    Science.gov (United States)

    Durieux-Paillard, S; Dao, M Dominicé; Perron, N Junod

    2007-09-26

    When consulting with migrant patients, general practitioners should pay special attention to the quality of their communication, because language barriers and cultural differences may arise. They must also be aware that life events experienced in the home country, during transit and in the host country can impact negatively on their patients' health, and thus a detailed history must be carefully obtained. Finally, they must be conscious that the migratory policies of the host country can influence the delivery of health care to migrant patients as well as their health status.

  10. Developing lifetime relationships with patients: strategies to improve patient care and build your practice.

    Science.gov (United States)

    Levin, Roger P

    2008-01-01

    The purpose of this article is to describe three strategies to build a thriving, patient-centered practice and promote oral health throughout a patient's lifetime. Compared to previous decades, more dental patients are "shopping around" for dental care and changing dental practices. This trend is due to factors such as acceptance of dental insurance, more comprehensive service offerings by other dentists, and effective marketing campaigns by other dental offices. Delivering customer service exceeding patient expectations ("WOW" service), advocating patient education, and developing customized home care regimens will help lead to long-term patient retention and promote optimal patient care. A dental team making relationship-building a priority conveys respect for their patients' time and well-being. Once trust has been established patients are more likely to be receptive to oral health education and become more compliant with home care regimens. Since a patient's oral health status will likely change over time, it's important to make education and customized treatment planning an integral part of each visit. By demonstrating a strong commitment to customer service, education, and home care, patients recognize the care providers in a dental practice are interested in their well-being rather than simply treating problems. If patients recognize a dental practice is focused on prevention and at-home oral health care, they are more likely to partner with that practice for a lifetime of excellent oral health care.

  11. Technician Training for the Semiconductor Microdevices Industry. Final Report.

    Science.gov (United States)

    Center for Occupational Research and Development, Inc., Waco, TX.

    The Center for Occupational Research and Development (CORD) carried out four activities to foster semiconductor manufacturing technician (SMT) training: (1) collaboration with industry experts and educators while developing a curriculum to train SMTs; (2) implementation and testing of the curriculum at a technical college; (3) dissemination of…

  12. Intensive Care Management of Patients with Cirrhosis.

    Science.gov (United States)

    Olson, Jody C

    2018-06-01

    Cirrhosis is a major worldwide health problem which results in a high level of morbidity and mortality. Patients with cirrhosis who require intensive care support have high mortality rates of near 50%. The goal of this review is to address the management of common complications of cirrhosis in the ICU. Recent epidemiological studies have shown an increase in hospitalizations due to advanced liver disease with an associated increase in intensive care utilization. Given an increasing burden on the healthcare system, it is imperative that we strive to improve our management cirrhotic patients in the intensive care unit. Large studies evaluating the management of patients in the intensive care setting are lacking. To date, most recommendations are based on extrapolation of data from studies in cirrhosis outside of the ICU or by applying general critical care principles which may or may not be appropriate for the critically ill cirrhotic patient. Future research is required to answer important management questions.

  13. Mechanical technology for higher engineering technicians

    CERN Document Server

    Black, Peter

    1972-01-01

    Mechanical Technology for Higher Engineering Technicians deals with the mechanics of machines, thermodynamics, and mechanics of fluids. This book presents discussions and examples that deal with the strength of materials, technology of machines, and techniques used by professional engineers. The book explains the strain energy of torsion, coil springs, and the effects of axial load. The author also discusses the forces that produce bending, shearing, and bending combined with direct stress, as well as beams subjected to a uniform bending moment or simply supported beams with concentrated non-c

  14. Advances and results of the educative project: Implementation of the career of 'Technician in Radiological protection'

    International Nuclear Information System (INIS)

    Vizuet G, J.; Suarez, G.; Sanchez C, M.

    2003-01-01

    In this work the obtained advances and achievements during the impartment of the technician career in radiological protection are presented. This is carried out in the 'Justo Sierra' Technological High School Center of San Mateo Atenco, Estado de Mexico, and has for objective the formation of professional-technicians. (Author)

  15. The economics of patient-centered care.

    Science.gov (United States)

    David, Guy; Saynisch, Philip A; Smith-McLallen, Aaron

    2018-05-01

    The Patient-Centered Medical Home (PCMH) is a widely-implemented model for improving primary care, emphasizing care coordination, information technology, and process improvements. However, its treatment as an undifferentiated intervention in policy evaluation obscures meaningful variation in implementation. This heterogeneity leads to contracting inefficiencies between insurers and practices and may account for mixed evidence on its success. Using a novel dataset we group practices into meaningful implementation clusters and then link these clusters with detailed patient claims data. We find implementation choice affects performance, suggesting that generally-unobserved features of primary care reorganization influence patient outcomes. Reporting these features may be valuable to insurers and their members. Copyright © 2018 Elsevier B.V. All rights reserved.

  16. An observational study of patient care outcomes sensitive to handover quality in the Post-Anaesthetic Care Unit.

    Science.gov (United States)

    Lillibridge, Nichole; Botti, Mari; Wood, Beverley; Redley, Bernice

    2017-12-01

    To identify patient care outcome indicators sensitive to the quality of interprofessional handover between the anaesthetist and the Post-Anaesthetic Care Unit nurse. The relationship between interprofessional clinical handover when patients are transferred from the operating theatre to the Post-Anaesthetic Care Unit and patient outcomes of subsequent patient care delivery is not well understood. Naturalistic, exploratory descriptive design using observation. Observations of 31 patient journeys through Post-Anaesthetic Care Units across three public and private hospitals. Characteristics of interprofessional handover on arrival in the Post-Anaesthetic Care Unit, the trajectory of patient care activities in Post-Anaesthetic Care Unit and patient outcomes were observed. Of the 821 care activities observed across 31 "patient journeys" in the Post-Anaesthetic Care Unit, observations (assessments and vital signs) (52.5 %), communication (15.8 %) and pain management (assessment of pain and analgesic administration) (10.3%) were most common. Examination of patterns in handover communications and subsequent trajectories of patient care activities revealed three patient trajectory typologies and two patient outcome indicators expected to be sensitive to the quality of interprofessional handover communication in the Post-Anaesthetic Care Unit: pain on discharge from the Post-Anaesthetic Care Unit and timely response to clinical deterioration. An additional process indicator, seeking missing information, was also identified. Patient's pain on discharge from Post-Anaesthetic Care Unit, escalation of care in response to early signs of deterioration and the need for nurses to seek out missing information to deliver care are indicators expected to be sensitive to the quality of interprofessional handover communication in the Post-Anaesthetic Care Unit. Future research should test these indicators. Patient outcomes sensitive to the quality of interprofessional handover on patient

  17. Patient-centered care, nurse work environment and implicit rationing of nursing care in Swiss acute care hospitals: A cross-sectional multi-center study.

    Science.gov (United States)

    Bachnick, Stefanie; Ausserhofer, Dietmar; Baernholdt, Marianne; Simon, Michael

    2018-05-01

    Patient-centered care is a key element of high-quality healthcare and determined by individual, structural and process factors. Patient-centered care is associated with improved patient-reported, clinical and economic outcomes. However, while hospital-level characteristics influence patient-centered care, little evidence is available on the association of patient-centered care with characteristic such as the nurse work environment or implicit rationing of nursing care. The aim of this study was to describe patient-centered care in Swiss acute care hospitals and to explore the associations with nurse work environment factors and implicit rationing of nursing care. This is a sub-study of the cross-sectional multi-center "Matching Registered Nurse Services with Changing Care Demands" study. We included 123 units in 23 acute care hospitals from all three of Switzerland's language regions. The sample consisted of 2073 patients, hospitalized for at least 24 h and ≥18 years of age. From the same hospital units, 1810 registered nurses working in direct patient care were also included. Patients' perceptions of patient-centered care were assessed using four items from the Generic Short Patient Experiences Questionnaire. Nurses completed questionnaires assessing perceived staffing and resource adequacy, adjusted staffing, leadership ability and level of implicit rationing of nursing care. We applied a Generalized Linear Mixed Models for analysis including individual-level patient and nurse data aggregated to the unit level. Patients reported high levels of patient-centered care: 90% easily understood nurses, 91% felt the treatment and care were adapted for their situation, 82% received sufficient information, and 70% felt involved in treatment and care decisions. Higher staffing and resource adequacy was associated with higher levels of patient-centered care, e.g., sufficient information (β 0.638 [95%-CI: 0.30-0.98]). Higher leadership ratings were associated with

  18. An evaluation of routine specialist palliative care for patients on the Liverpool Care Pathway.

    Science.gov (United States)

    Thompson, Jo; Brown, Jayne; Davies, Andrew

    2014-01-01

    This report describes a service evaluation of the 'added value' of routine specialist palliative care team (SPCT) involvement with patients on the Liverpool Care Pathway for the Dying Patient (LCP). In the authors' hospital, patients that are commenced on the LCP are routinely referred to the SPCT. They are reviewed on the day of referral and then at least every other day, depending on the clinical situation. The data for this report was obtained by reviewing the SPCT's clinical database and the patients' LCP proformas. The SPCT intervened in the care of 80% of 158 newly referred patients, e.g. for alteration of continuous subcutaneous infusion (23%) or alteration of use of non-pharmacological interventions (21%). Furthermore, 11% of patients were taken off the LCP, around one quarter of whom were later put back on. The authors' model of care could overcome many of the issues relating to the LCP and would ameliorate the developing vacuum of care for patients at the end of life.

  19. The enforcement order for the law for radiation and x-ray technicians engaging in medical treatment

    International Nuclear Information System (INIS)

    1984-01-01

    The enforcement order provides for the medical radiation technicians and medical X-ray technicians according to the established for them. The applicants for the license thereof must present their applications, together with the necessary documents, to the Government (or the prefectural government). The contents are as follows: application for license; to be entered in the register (with the items of the license); alteration of the registered items (the immediate corrective action, to the Government); elimination of the technicians from the register (to the Government); alteration of the license (the corrective action, to the Government); application for reissue of the license (to the Government); notification concerning the administrative measures. (Mori, K.)

  20. Experiences of dental care: what do patients value?

    Directory of Open Access Journals (Sweden)

    Sbaraini Alexandra

    2012-06-01

    Full Text Available Abstract Background Dentistry in Australia combines business and health care service, that is, the majority of patients pay money for tangible dental procedures such as fluoride applications, dental radiographs, dental fillings, crowns, and dentures among others. There is evidence that patients question dentists’ behaviours and attitudes during a dental visit when those highly technical procedures are performed. However, little is known about how patients’ experience dental care as a whole. This paper illustrates the findings from a qualitative study recently undertaken in general dental practice in Australia. It focuses on patients’ experiences of dental care, particularly on the relationship between patients and dentists during the provision of preventive care and advice in general dental practices. Methods Seventeen patients were interviewed. Data analysis consisted of transcript coding, detailed memo writing, and data interpretation. Results Patients described their experiences when visiting dental practices with and without a structured preventive approach in place, together with the historical, biological, financial, psychosocial and habitual dimensions of their experience. Potential barriers that could hinder preventive activities as well as facilitators for prevention were also described. The offer of preventive dental care and advice was an amazing revelation for this group of patients as they realized that dentists could practice dentistry without having to “drill and fill” their teeth. All patients, regardless of the practice they came from or their level of clinical risk of developing dental caries, valued having a caring dentist who respected them and listened to their concerns without “blaming” them for their oral health status. These patients complied with and supported the preventive care options because they were being “treated as a person not as a patient” by their dentists. Patients valued dentists who made

  1. Verbal abuse and mobbing in pre-hospital care services in Chile.

    Science.gov (United States)

    Campo, Varinia Rodríguez; Klijn, Tatiana Paravic

    2018-01-08

    to determine the perception of verbal abuse and mobbing and the associated factors of paramedic technicians (nursing assistants) and professionals (nurses, midwives, kinesiologists) in the pre-hospital care areas of three regions in the south of Chile. descriptive and correlational study was performed within the professional community and a two-stage sample of the paramedic technician population in three regions. The questionnaire "workplace violence in the health sector" (spanish version) was applied after signing the informed consent. 51.4% of professionals and 46.6% of paramedic technicians consider they have been verbally abused during last year. 17.6% of paramedic technicians and 13.5% of professionals perceived mobbing. A low percentage of these events are reported. In only one case of mobbing, the aggressor was legally penalized. No significant differences were found between the job categories and the studied regions. A high percentage of participants in each group perceived verbal abuse and non-minor percentage perceived mobbing, but most of these events are not reported.

  2. Contributors to patient engagement in primary health care: perceptions of patients with obesity.

    Science.gov (United States)

    Forhan, Mary; Risdon, Cathy; Solomon, Patricia

    2013-10-01

    Patients with obesity are at risk for treatment avoidance and nonadherence. Factors that contribute to engagement in primary health care for patients with obesity are not fully understood. The purpose of this pilot study was to identify issues associated with engagement in primary health care for patients with obesity. Using qualitative methodology, 11 patients with a mean body mass index of 40.8 kg/m(2) registered with a primary health care practice were interviewed. Conventional content analysis was used to identify factors that contribute to engagement in primary health care. Barriers and facilitators to engagement in primary health care were categorized into the following themes: availability of resources, importance of the relationship, meaningful communication, feeling judged, lack of privacy, poor communication and limited provider knowledge about obesity. Obesity was identified as a health condition that requires additional considerations for patient engagement in their health care.

  3. Plastic apron wear during direct patient care.

    Science.gov (United States)

    Candlin, Josie; Stark, Sheila

    To identify factors that influence nurses' practice in apron use during direct patient care. A small-scale documentary analysis of a purposive sample of 15 journal articles relating to nurses' apron use during patient care was undertaken. The analysis sought to address what factors affect nurses' decisions in relation to apron use. Nurses' decisions regarding apron use during patient care tend to be ritualistic rather than evidence-based. Their knowledge of infection control is limited. Although there is current literature available on infection control, as well as health and safety regulations, if local policy regarding apron use in nursing care is scant this can result in inconsistent and, perhaps, less desirable practices.

  4. Providing Palliative Care to LGBTQ Patients.

    Science.gov (United States)

    Barrett, Nina; Wholihan, Dorothy

    2016-09-01

    Nurses should be familiar with and equipped to address the challenges that arise when caring for lesbian, gay, bisexual, transgender, or queer-identified (LGBTQ) patients. LGBTQ individuals have increased rates of certain physical diseases and are at greater risk of suffering from stress-sensitive mental health issues. Negative social attitudes, widespread discrimination and stigma, physical and psychological victimization, and less social support with aging contribute to the complexity of care for these individuals. Open communication, welcoming and accepting attitudes and environments, and sensitivity to unique multidimensional issues improve care to LGBTQ patients with serious advanced illness. Nursing can reach this vulnerable minority and positively impact the quality of care. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Contextualisation of patient-centred care

    DEFF Research Database (Denmark)

    Dencker, Annemarie; Kristiansen, Maria; Andreassen Rix, Bo

    2018-01-01

    . In this qualitative comparative study, we explore the influence of medical contexts in three Danish hospital wards, haematology, oncological gynaecology and neuro-intensive care, on communication with patients about their children. In exploring the degree to which the inclusion of children in clinical encounters......Patients' family relations play an important part in the provision of patient-centred cancer care, not least when healthcare professionals encounter seriously ill patients with dependent children. Little is known about how children are perceived and dealt with in clinical encounters....... The thematic analysis was based on Bateson's conceptualisation of communication. We found that healthcare professionals' approach to children in clinical encounters and the ways in which children were positioned on each ward were influenced by aspects specific to the ward, including the diagnosis...

  6. Diabetic and Obese Patient Clinical Outcomes Improve During a Care Management Implementation in Primary Care.

    Science.gov (United States)

    Holtrop, Jodi Summers; Luo, Zhehui; Piatt, Gretchen; Green, Lee A; Chen, Qiaoling; Piette, John

    2017-10-01

    To address the increasing burden of chronic disease, many primary care practices are turning to care management and the hiring of care managers to help patients coordinate their care and self-manage their conditions. Care management is often, but not always, proving effective at improving patient outcomes, but more evidence is needed. In this pair-matched cluster randomized trial, 5 practices implemented care management and were compared with 5 comparison practices within the same practice organization. Targeted patients included diabetic patients with a hemoglobin A1c >9% and nondiabetic obese patients. Clinical values tracked were A1c, blood pressure, low-density lipoprotein, microalbumin, and weight. Clinically important improvements were demonstrated in the intervention versus comparison practices, with diabetic patients improving A1c control and obese patients experiencing weight loss. There was a 12% relative increase in the proportion of patients meeting the clinical target of A1c management practices lost 5% or more of their body weight as compared with 10% of comparison patients (adjusted relative improvement, 15%; CI, 2%-28%). These findings add to the growing evidence-base for the effectiveness of care management as an effective clinical practice with regard to improving diabetes- and obesity-related outcomes.

  7. Interprofessional simulation to improve patient participation in transitional care.

    Science.gov (United States)

    Dyrstad, Dagrunn Nåden; Storm, Marianne

    2017-06-01

    Educating and training healthcare professionals is known to improve the quality of transitional care for older adults. Arranging interprofessional meetings for healthcare professionals might be useful to improve patient participation skills in transitional care. To describe the learning activities used in The Meeting Point programme, focusing on patient participation in transitional care, and assess whether they increase healthcare professionals' awareness of and competencies relating to patient participation in the transitional care of older patients. Data were collected as part of an educational intervention programme, The Meeting Point, including three seminars on 'Patient participation in the transitional care of older patients' and four follow-up meetings. Participants were nurses, care assistants, doctors, physiotherapists, patient coordinators and administrative personnel from hospital, nursing homes and home-based care services. The Meeting Point was organised around four pillars: introduction, teaching session, group work activity and plenary discussion. Qualitative data included log reports, summaries of meetings, notes from group work activities, and reports from participants and from follow-up meetings. Feedback from participants shows that they were satisfied with meeting healthcare professionals from other units of care. A film scenario was perceived relevant for group work activity and useful in focusing participants' attention to patient participation. Follow-up meetings show that some nursing home wards, the emergency department and one medical ward at the hospital continued with ongoing work to improve quality of care. Efforts included implementation of an observational waiting room with comfortable chairs, planning for discharge in hospital admission, a daily patient flow registration system and motivational interviewing during admission to nursing home. The description of the learning activities used at The Meeting Point seminars shows that they

  8. Effect of specific resistance training on forearm pain and work disability in industrial technicians: cluster randomised controlled trial

    DEFF Research Database (Denmark)

    Andersen, Lars Louis; Jakobsen, Markus D; Pedersen, Mogens Theisen

    2012-01-01

    To determine the effect of specific resistance training on forearm pain and work disability in industrial technicians.......To determine the effect of specific resistance training on forearm pain and work disability in industrial technicians....

  9. Factors Associated with Neurologists' Provision of MS Patient Care

    Science.gov (United States)

    Halpern, Michael T.; Teixeira-Poit, Stephanie M.; Kane, Heather; Frost, Corey; Keating, Michael; Olmsted, Murrey

    2014-01-01

    Neurologists are central to providing quality care for individuals with MS. However, neurologist shortages may restrict access to care for MS patients. To examine factors influencing neurologists' provision of MS care, we surveyed 1,700 US neurologists to assess demographic/practice characteristics, training, and attitudes toward MS care. The study population consisted of 573 respondents: 87 (15.2%) MS subspecialists and 486 (84.8%) “other neurologists,” including subspecialists in other neurology areas (i.e., non-MS) and general neurologists. MS subspecialists indicating they “enjoy interacting with MS patients” had a significantly greater rate of MS patients seen per week. In separate analyses of the “other neurologists” group, the rate of MS patients seen was lower among neurologists in university-based groups or those practicing in major cities; female neurologists; and neurologists who indicated lack of sufficient knowledge regarding MS patient care. Rates of MS patients seen were significantly greater for other neurologists who agreed that MS care involved “ability to improve patient outcomes and quality of life”; “dynamic area with evolving treatment options”; and “enjoy interacting with MS patients.” Understanding factors influencing MS patient care by neurologists and developing policies for appropriate access to care is critical for optimal outcomes among this population. PMID:24949203

  10. Factors Associated with Neurologists’ Provision of MS Patient Care

    Directory of Open Access Journals (Sweden)

    Michael T. Halpern

    2014-01-01

    Full Text Available Neurologists are central to providing quality care for individuals with MS. However, neurologist shortages may restrict access to care for MS patients. To examine factors influencing neurologists’ provision of MS care, we surveyed 1,700 US neurologists to assess demographic/practice characteristics, training, and attitudes toward MS care. The study population consisted of 573 respondents: 87 (15.2% MS subspecialists and 486 (84.8% “other neurologists,” including subspecialists in other neurology areas (i.e., non-MS and general neurologists. MS subspecialists indicating they “enjoy interacting with MS patients” had a significantly greater rate of MS patients seen per week. In separate analyses of the “other neurologists” group, the rate of MS patients seen was lower among neurologists in university-based groups or those practicing in major cities; female neurologists; and neurologists who indicated lack of sufficient knowledge regarding MS patient care. Rates of MS patients seen were significantly greater for other neurologists who agreed that MS care involved “ability to improve patient outcomes and quality of life”; “dynamic area with evolving treatment options”; and “enjoy interacting with MS patients.” Understanding factors influencing MS patient care by neurologists and developing policies for appropriate access to care is critical for optimal outcomes among this population.

  11. Patient and family involvement in contemporary health care.

    Science.gov (United States)

    Angood, Peter; Dingman, Jennifer; Foley, Mary E; Ford, Dan; Martins, Becky; O'Regan, Patti; Salamendra, Arlene; Sheridan, Sue; Denham, Charles R

    2010-03-01

    The objective of this article was to provide a guide to health care providers on patient and family involvement in health care. This article evaluated the latest published studies for patient and family involvement and reexamined the objectives, the requirements for achieving these objectives, and the evidence of how to involve patients and families. Critical components for patient safety include changing the organizational culture; including patients and families on teams; listening to patients and families; incorporating their input into leadership structures and systems; providing full detail about treatment, procedures, and medication adverse effects; involving them on patient safety and performance improvement committees; and disclosing medical errors. The conclusion of this article is that, for the future, patient and family involvement starts with educating patients and families and ends with listening to them and taking them seriously. If patient and family input is emphatically built into systems of performance improvement, and if patients and families are taken seriously and are respected for their valuable perspectives about how care can be improved, then organizations can improve at improving. Resources in health care are in short supply, yet the resources of patient and family help and time are almost limitless, are ready to be tapped, and can have a huge impact on improving the reliability and overall success for any health care organization.

  12. Internet treatment for generalized anxiety disorder: a randomized controlled trial comparing clinician vs. technician assistance.

    Science.gov (United States)

    Robinson, Emma; Titov, Nickolai; Andrews, Gavin; McIntyre, Karen; Schwencke, Genevieve; Solley, Karen

    2010-06-03

    Internet-based cognitive behavioural therapy (iCBT) for generalized anxiety disorder (GAD) has been shown to be effective when guided by a clinician. The present study sought to replicate this finding, and determine whether support from a technician is as effective as guidance from a clinician. Randomized controlled non-inferiority trial comparing three groups: Clinician-assisted vs. technician-assisted vs. delayed treatment. Community-based volunteers applied to the VirtualClinic (www.virtualclinic.org.au) research program and 150 participants with GAD were randomized. Participants in the clinician- and technician-assisted groups received access to an iCBT program for GAD comprising six online lessons, weekly homework assignments, and weekly supportive contact over a treatment period of 10 weeks. Participants in the clinician-assisted group also received access to a moderated online discussion forum. The main outcome measures were the Penn State Worry Questionnaire (PSWQ) and the Generalized Anxiety Disorder-7 Item (GAD-7). Completion rates were high, and both treatment groups reduced scores on the PSWQ (ptechnician-assisted groups, respectively, and on the GAD-7 were 1.55 and 1.73, respectively. At 3 month follow-up participants in both treatment groups had sustained the gains made at post-treatment. Participants in the clinician-assisted group had made further gains on the PSWQ. Approximately 81 minutes of clinician time and 75 minutes of technician time were required per participant during the 10 week treatment program. Both clinician- and technician-assisted treatment resulted in large effect sizes and clinically significant improvements comparable to those associated with face-to-face treatment, while a delayed treatment/control group did not improve. These results provide support for large scale trials to determine the clinical effectiveness and acceptability of technician-assisted iCBT programs for GAD. This form of treatment has potential to increase the

  13. Linking patient satisfaction with nursing care: the case of care rationing - a correlational study

    Science.gov (United States)

    2014-01-01

    Background Implicit rationing of nursing care is the withholding of or failure to carry out all necessary nursing measures due to lack of resources. There is evidence supporting a link between rationing of nursing care, nurses’ perceptions of their professional environment, negative patient outcomes, and placing patient safety at risk. The aims of the study were: a) To explore whether patient satisfaction is linked to nurse-reported rationing of nursing care and to nurses’ perceptions of their practice environment while adjusting for patient and nurse characteristics. b) To identify the threshold score of rationing by comparing the level of patient satisfaction factors across rationing levels. Methods A descriptive, correlational design was employed. Participants in this study included 352 patients and 318 nurses from ten medical and surgical units of five general hospitals. Three measurement instruments were used: the BERNCA scale for rationing of care, the RPPE scale to explore nurses’ perceptions of their work environment and the Patient Satisfaction scale to assess the level of patient satisfaction with nursing care. The statistical analysis included the use of Kendall’s correlation coefficient to explore a possible relationship between the variables and multiple regression analysis to assess the effects of implicit rationing of nursing care together with organizational characteristics on patient satisfaction. Results The mean score of implicit rationing of nursing care was 0.83 (SD = 0.52, range = 0–3), the overall mean of RPPE was 2.76 (SD = 0.32, range = 1.28 – 3.69) and the two scales were significantly correlated (τ = −0.234, p patient satisfaction, even after controlling for nurse and patient characteristics. The results from the adjusted regression models showed that even at the lowest level of rationing (i.e. 0.5) patients indicated low satisfaction. Conclusions The results support the relationships between

  14. Patient stress in intensive care: comparison between a coronary care unit and a general postoperative unit

    Science.gov (United States)

    Dias, Douglas de Sá; Resende, Mariane Vanessa; Diniz, Gisele do Carmo Leite Machado

    2015-01-01

    Objective To evaluate and compare stressors identified by patients of a coronary intensive care unit with those perceived by patients of a general postoperative intensive care unit. Methods This cross-sectional and descriptive study was conducted in the coronary intensive care and general postoperative intensive care units of a private hospital. In total, 60 patients participated in the study, 30 in each intensive care unit. The stressor scale was used in the intensive care units to identify the stressors. The mean score of each item of the scale was calculated followed by the total stress score. The differences between groups were considered significant when p < 0.05. Results The mean ages of patients were 55.63 ± 13.58 years in the coronary intensive care unit and 53.60 ± 17.47 years in the general postoperative intensive care unit. For patients in the coronary intensive care unit, the main stressors were “being in pain”, “being unable to fulfill family roles” and “being bored”. For patients in the general postoperative intensive care unit, the main stressors were “being in pain”, “being unable to fulfill family roles” and “not being able to communicate”. The mean total stress scores were 104.20 ± 30.95 in the coronary intensive care unit and 116.66 ± 23.72 (p = 0.085) in the general postoperative intensive care unit. When each stressor was compared separately, significant differences were noted only between three items. “Having nurses constantly doing things around your bed” was more stressful to the patients in the general postoperative intensive care unit than to those in the coronary intensive care unit (p = 0.013). Conversely, “hearing unfamiliar sounds and noises” and “hearing people talk about you” were the most stressful items for the patients in the coronary intensive care unit (p = 0.046 and 0.005, respectively). Conclusion The perception of major stressors and the total stress score were similar between patients

  15. eHealth, care and quality of life

    CERN Document Server

    Capello, Fabio; Manca, Marco

    2014-01-01

    The debate over eHealth is alive as never before. Supporters suggest that it will result in dramatic innovations in healthcare, including a giant leap towards patient-centered care, new opportunities to improve effectiveness, and enhanced wellness and quality of life. In addition, the growing market value of investments in health IT suggests that eHealth can offer at least a partial cure for the current economic stagnation. Detractors counter these arguments by claiming that eHealth has already failed: the UK Department of Health has shut down the NHS National Program for IT, Google has discontinued its Health flagship, and doubts have arisen over privacy safeguards for both patients and medical professionals. This book briefly explains why caregivers, professionals, technicians, patients, politicians, and others should all consider themselves stakeholders in eHealth. It offers myth-busting responses to some ill-considered arguments from both sides of the trench, in the process allowing a fresh look at eHeal...

  16. Caring for Latino patients.

    Science.gov (United States)

    Juckett, Gregory

    2013-01-01

    Latinos comprise nearly 16 percent of the U.S. population, and this proportion is anticipated to increase to 30 percent by 2050. Latinos are a diverse ethnic group that includes many different cultures, races, and nationalities. Barriers to care have resulted in striking disparities in quality of health care for these patients. These barriers include language, lack of insurance, different cultural beliefs, and in some cases, illegal immigration status, mistrust, and illiteracy. The National Standards for Culturally and Linguistically Appropriate Services address these concerns with recommendations for culturally competent care, language services, and organizational support. Latinos have disproportionately higher rates of obesity and diabetes mellitus. Other health problems include stress, neurocysticercosis, and tuberculosis. It is important to explore the use of alternative therapies and belief in traditional folk illnesses, recognizing that health beliefs are dependent on education, socioeconomic status, and degree of acculturation. Many-but not all-folk and herbal treatments can be safely accommodated with conventional therapy. Physicians must be sensitive to Latino cultural values of simpatia (kindness), personalismo (relationship), respeto (respect), and modestia (modesty). The LEARN technique can facilitate cross-cultural interviews. Some cultural barriers may be overcome by using the "teach back" technique to ensure that directions are correctly understood and by creating a welcoming health care environment for Latino patients.

  17. Patient Centeredness in Electronic Communication: Evaluation of Patient-to-Health Care Team Secure Messaging

    Science.gov (United States)

    Luger, Tana M; Volkman, Julie E; Rocheleau, Mary; Mueller, Nora; Barker, Anna M; Nazi, Kim M; Houston, Thomas K; Bokhour, Barbara G

    2018-01-01

    Background As information and communication technology is becoming more widely implemented across health care organizations, patient-provider email or asynchronous electronic secure messaging has the potential to support patient-centered communication. Within the medical home model of the Veterans Health Administration (VA), secure messaging is envisioned as a means to enhance access and strengthen the relationships between veterans and their health care team members. However, despite previous studies that have examined the content of electronic messages exchanged between patients and health care providers, less research has focused on the socioemotional aspects of the communication enacted through those messages. Objective Recognizing the potential of secure messaging to facilitate the goals of patient-centered care, the objectives of this analysis were to not only understand why patients and health care team members exchange secure messages but also to examine the socioemotional tone engendered in these messages. Methods We conducted a cross-sectional coding evaluation of a corpus of secure messages exchanged between patients and health care team members over 6 months at 8 VA facilities. We identified patients whose medical records showed secure messaging threads containing at least 2 messages and compiled a random sample of these threads. Drawing on previous literature regarding the analysis of asynchronous, patient-provider electronic communication, we developed a coding scheme comprising a series of a priori patient and health care team member codes. Three team members tested the scheme on a subset of the messages and then independently coded the sample of messaging threads. Results Of the 711 messages coded from the 384 messaging threads, 52.5% (373/711) were sent by patients and 47.5% (338/711) by health care team members. Patient and health care team member messages included logistical content (82.6%, 308/373 vs 89.1%, 301/338), were neutral in tone (70

  18. Defining and measuring integrated patient care: promoting the next frontier in health care delivery.

    NARCIS (Netherlands)

    Singer, S.J.; Burgers, J.S.; Friedberg, M.; Rosenthal, M.B.; Leape, L.; Schneider, E.

    2011-01-01

    Integration of care is emerging as a central challenge of health care delivery, particularly for patients with multiple, complex chronic conditions. The authors argue that the concept of "integrated patient care" would benefit from further clarification regarding (a) the object of integration and

  19. Patterns of care for brachytherapy in Europe. Results in Spain.

    Science.gov (United States)

    López Torrecilla, J; Guedea, F; Heeren, G; Nissin, R; Ellison, T; Cottier, B

    2006-05-01

    In 2003 ESTRO began a project whose primary objective, was to make a map in the European area of infrastructures in technology and personnel for brachytherapy. A survey and a web site were elaborated. The survey was sent to the 76 Spanish Radiation Oncology departments in May 2003. By the end of 2003, 66 (86.8%) services had responded, 40 (71.4%) of which had brachytherapy. The services with brachytherapy treated 73.5% of the total patients, an average of 1,199 patients. The mean number of patients treated with brachytherapy by department was 135.5 and the number of applications was 265 annually. The average number of specialists was 7, 4 of them trained in brachytherapy. The average weekly work load of the radiation oncologists, physicists, and technicians was 22.6 h, 13.8 h and 21.0 h, respectively. The mean time dedicated to each patient by radiation oncologists, physicists and technicians was 9.2 h; 6.19 h; 7.2 h, respectively. The total number of afterloaders was 43 (22 HDR, 18 LDR, 3 PDR). The tumours most frequently treated with brachytherapy were gynaecological (56.24%), breast (14.2%) and prostate (11.7%). High dose rate was used in 47.46% of the patients and low dose rate in 47.24%. Between 1997 and 2002 there was an increase of 50.53% in patients treated with brachytherapy. The survey shows the brachytherapy resources and activity in Spain up to 2003. Increased use of brachytherapy in prostate tumours, prevalence of gynaecology brachytherapy and similar number of treatments with HDR and LDR are demonstrated in the Patterns of Care of Brachytherapy in Europe (PCBE) study in Spain.

  20. Structure and Function: Planning a New Intensive Care Unit to Optimize Patient Care

    Directory of Open Access Journals (Sweden)

    Jozef Kesecioğlu

    2014-08-01

    Full Text Available To survey the recent medical literature reporting effects of intensive care unit (ICU design on patients’ and family members’ well-being, safety and functionality. Features of ICU design linked to the needs of patients and their family are single-rooms, privacy, quiet surrounding, exposure to daylight, views of nature, prevention of infection, a family area and open visiting hours. Other features such as safety, working procedures, ergonomics and logistics have a direct impact on the patient care and the nursing and medical personnel. An organization structured on the needs of the patient and their family is mandatory in designing a new intensive care. The main aims in the design of a new department should be patient centered care, safety, functionality, innovation and a future-proof concept.

  1. The Technician beneath Our Wings, or Is That Blades?

    Science.gov (United States)

    Colony, Lee; Foster, John

    2011-01-01

    Today's trained technicians in alternative energy fields are finding even more career opportunities open to them as the United States and the world turn to green technology to power their homes and businesses. Wisconsin's Gateway Technical College is training workers for green collar careers in geoexchange heating and cooling systems, wind power…

  2. Patient-centered care in Parkinson's disease

    NARCIS (Netherlands)

    Eijk, M. van der

    2015-01-01

    Patient centeredness means providing care that is respectful of and responsive to individual patient preferences, needs and values, and ensuring that patient values guide all clinical decisions’.The concept assumes that both physicians and patients are experts; physicians in diagnostic and

  3. Influence of patient characteristics on care time in patients hospitalized with schizophrenia

    Directory of Open Access Journals (Sweden)

    Sugibayashi Y

    2014-08-01

    Full Text Available Yukiko Sugibayashi,1 Kimio Yoshimura,1 Keita Yamauchi,1,2 Ataru Inagaki,3 Naoki Ikegami1 1Department of Health Policy and Management, Keio University School of Medicine, Tokyo, 2Keio University Graduate School of Health Management, Kanagawa, 3Aoyama Gakuin University, School of International Politics, Economics and Communication, Tokyo, Japan Background: In the current Japanese payment system for the treatment of psychiatric inpatients, the length of hospital stay and nurse staffing levels are key determinants of the amount of payment. These factors do not fully reflect the costs of care for each patient. The objective of this study was to clarify the relationship between patient characteristics and their care costs as measured by “care time” for patients with schizophrenia.Methods: Patient characteristics and care time were investigated in 14,557 inpatients in 102 psychiatric hospitals in Japan. Of these 14,557 inpatients, data for 8,379 with schizophrenia were analyzed using a tree-based model.Results: The factor exerting the greatest influence on care time was ”length of stay”, so subjects were divided into 2 groups, a “short stay group” with length of stay ≦104 days, and “long stay group” ≧105 days. Each group was further subdivided according to dependence with regard to “activities of daily living”, “psychomotor agitation”, “verbal abuse”, and “frequent demands/repetitive complaints”, which were critical variables affecting care time. The mean care time was shorter in the long-stay group; however, in some long-stay patients, the mean care time was considerably longer than that in patients in the short-stay group.Conclusion: The results of this study suggest that it is necessary to construct a new payment system reflecting not only length of stay and nurse staffing levels, but also individual patient characteristics. Keywords: psychiatric hospital, schizophrenia, care time, case mix, tree-based model

  4. Diagnostic imaging in intensive care patients

    International Nuclear Information System (INIS)

    Afione, Cristina; Binda, Maria del C.

    2004-01-01

    Purpose: To determine the role of imaging diagnostic methods in the location of infection causes of unknown origin in the critical care patient. Material and methods: A comprehensive medical literature search has been done. Recommendations for the diagnostic imaging of septic focus in intensive care patients are presented for each case, with analysis based on evidence. The degree of evidence utilized has been that of Oxford Center for Evidence-based Medicine. Results: Nosocomial infection is the most frequent complication in the intensive care unit (25 to 33%) with high sepsis incidence rate. In order to locate the infection focus, imaging methods play an important role, as a diagnostic tool and to guide therapeutic procedures. The most frequent causes of infection are: ventilation associated pneumonia, sinusitis, intra-abdominal infections and an acute acalculous cholecystitis. This paper analyses the diagnostic imaging of hospital infection, with the evaluation of choice methods for each one and proposes an algorithm to assess the septic patient. Conclusion: There are evidences, with different degrees of recommendation, for the use of diagnostic imaging methods for infectious focuses in critical care patients. The studies have been selected based on their diagnostic precision, on the capacity of the medical team and on the availability of resources, considering the risk-benefit balance for the best safety of the patient. (author)

  5. Quality of diabetes care in Dutch care groups: no differences between diabetes patients with and without co-morbidity

    Directory of Open Access Journals (Sweden)

    Simone R de Bruin

    2013-12-01

    Full Text Available Objective: To evaluate the relationship between presence and nature of co-morbidity and quality of care for diabetes patients enrolled in diabetes disease management programmes provided by care groups.Methods: We performed an observational study within eight Dutch diabetes care groups. Data from patient record systems of care groups and patient questionnaires were used to determine quality of care. Quality of care was measured as provision of the recommended diabetes care, patients’ achievement of recommended clinical outcomes and patients’ perception of coordination and integration of care.Results: 527 diabetes patients without and 1187 diabetes patients with co-morbidity were included. Of the co-morbid patients, 7.8% had concordant co-morbid conditions only, 63.8% had discordant co-morbid diseases only and 28.4% had both types of conditions. Hardly any differences were observed between patients with and without co-morbidity in terms of provided care, achievement of clinical outcomes and perceived coordination and integration of care.Conclusions: Our study implies that care groups are able to provide similar quality of diabetes care for diabetes patients with and without co-morbidity. Considering the expected developments regarding additional disease management programmes in care groups, it is of importance to monitor quality of care, including patient experiences, for all chronic diseases. It will then become clear whether accountable provider-led organisations such as care groups are able to ensure quality of care for the increasing number of patients with multiple chronic conditions.

  6. Ophthalmic Skills Assessment of Primary Health Care Workers at ...

    African Journals Online (AJOL)

    Proficiency in the basic ophthalmic skills is a cri cal factor in the effec ve delivery of eye care services at the primary level of care. The aim of the study was to assess the ability of ... out visual acuity test and correctly iden fy cataract and conjunc vi s using pictures of eye condi ons and ..... Medical Laboratory Technician.

  7. The influence of care interventions on the continuity of sleep of intensive care unit patients.

    Science.gov (United States)

    Hamze, Fernanda Luiza; de Souza, Cristiane Chaves; Chianca, Tânia Couto Machado

    2015-01-01

    to identify care interventions, performed by the health team, and their influence on the continuity of sleep of patients hospitalized in the Intensive Care Unit. descriptive study with a sample of 12 patients. A filming technique was used for the data collection. The awakenings from sleep were measured using the actigraphy method. The analysis of the data was descriptive, processed using the Statistical Package for the Social Sciences software. 529 care interventions were identified, grouped into 28 different types, of which 12 (42.8%) caused awakening from sleep for the patients. A mean of 44.1 interventions/patient/day was observed, with 1.8 interventions/patient/hour. The administration of oral medicine and food were the interventions that caused higher frequencies of awakenings in the patients. it was identified that the health care interventions can harm the sleep of ICU patients. It is recommended that health professionals rethink the planning of interventions according to the individual demand of the patients, with the diversification of schedules and introduction of new practices to improve the quality of sleep of Intensive Care Unit patients.

  8. Patient Satisfaction with Kimbrough Ambulatory Care Center

    Science.gov (United States)

    1997-02-01

    few are going to opt to change health plans. 14. SUBJECT TERMS PATIENT SATISFACTION; CONSUMER SATISFACTION; SURVEY 15. NUMBER OF PAGES 57 16...to address is overall patient satisfaction with Kimbrough’s current health care system. I surveyed customers on: how satisfied or dissatisfied they...research project was designed to determine how satisfied customers are with Kimbrough Ambulatory Care Center. A patient satisfaction survey developed by

  9. Measuring the quality of patient-centered care: why patient-reported measures are critical to reliable assessment

    Directory of Open Access Journals (Sweden)

    Tzelepis F

    2015-06-01

    Full Text Available Flora Tzelepis, Robert W Sanson-Fisher, Alison C Zucca, Elizabeth A FradgleyPriority Research Centre for Health Behaviour, University of Newcastle and Hunter Medical Research Institute, Newcastle, NSW, AustraliaPurpose: The Institute of Medicine (IOM identified patient-centeredness as crucial to quality health care. The IOM endorsed six patient-centeredness dimensions that stipulated that care must be: respectful to patients’ values, preferences, and expressed needs; coordinated and integrated; provide information, communication, and education; ensure physical comfort; provide emotional support; and involve family and friends. Patient-reported measures examine the patient’s perspective and are essential to the accurate assessment of patient-centered care. This article’s objectives are to: 1 use the six IOM-endorsed patient-centeredness dimensions as a framework to outline why patient-reported measures are crucial to the reliable measurement of patient-centered care; and 2 to identify existing patient-reported measures that assess each patient-centered care dimension.Methods: For each IOM-endorsed patient-centeredness dimension, the published literature was searched to highlight the essential role of patients in assessing patient-centered care and informing quality improvement efforts. Existing literature was also searched to identify examples of patient-reported measures that assess each patient-centeredness dimension.Conclusion: Patient-reported measures are arguably the best way to measure patient-centeredness. For instance, patients are best positioned to determine whether care aligns with patient values, preferences, and needs and the Measure of Patient Preferences is an example of a patient-reported measure that does so. Furthermore, only the patient knows whether they received the level of information desired, and if information was understood and can be recalled. Patient-reported measures that examine information provision include

  10. Care of oral cavity in irradiated patients

    International Nuclear Information System (INIS)

    Konecny, M.

    1981-01-01

    Procedures are reviewed of therapeutic and preventive care in patients with malignant tumours in the area of the head and neck during radiotherapy and during the subsequent follow-up of patients. As compared with previous views, the care is now more conservative, indications for tooth extractions are now limited, careful oral hygiene is emphasized and, in particular, the long-term use of fluorine gel is recommended. Surgery is only recommended where conservative treatment fails. (author)

  11. Care of oral cavity in irradiated patients

    Energy Technology Data Exchange (ETDEWEB)

    Konecny, M [Onkologicky Ustav, Brno (Czechoslovakia). Betatronove Pracoviste

    1981-12-01

    Procedures are reviewed of therapeutic and preventive care in patients with malignant tumours in the area of the head and neck during radiotherapy and during the subsequent follow-up of patients. As compared with previous views, the care is now more conservative, indications for tooth extractions are now limited, careful oral hygiene is emphasized and, in particular, the long-term use of fluorine gel is recommended. Surgery is only recommended where conservative treatment fails.

  12. Technician-Supported Remote Interrogation of CIEDs: Initial Use in US Emergency Departments and Perioperative Areas.

    Science.gov (United States)

    Ahmed, Imdad; Patel, Amisha S; Balgaard, Timothy J; Rosenfeld, Lynda E

    2016-03-01

    Interrogation/interpretation of cardiac implantable electronic devices (CIEDs) is frequently required in the emergency department (ED) or perioperative areas (OR) where resources to do this are often not available. CareLink Express (CLE; Medtronic, plc, Mounds View, MN, USA) is a technician-supported real-time remote interrogation system for Medtronic CIEDs. Using data from 136 US locations, this retrospective study was designed to assess CLE efficiency compared to traditional device management, and examine its findings. All 7,044 US CLE transmissions from the ED and OR (January 2012-October 2014) were compared to 217 traditional requests where CIED interrogations/interpretations were performed by calling industry representatives to these sites. CLE reduced the time to device interrogation/interpretation by 78%: 100 ± 140-22 ± 14 minutes, P < 0.0001, improving response time and consistency; ED: 82 ± 103-23 ± 18 minutes, P, ≤ 0.01; OR: 127 ± 181-17 ± 10 minutes, P < 0.0001. Actionable events (AE) (arrhythmia, device/lead abnormalities) were infrequent: 9.1% overall (ED: 9.9%; OR: 4.1%). Only 6.5% of patients with syncope/presyncope and 13.6% with a perceived shock had AE. AEs were more common in those with suspected device problems (30.4%) or audible alerts (52.6%). They were more likely in patients not enrolled in long-term remote monitoring (23.9% vs 8.2%, P < 0.0001) and in those with older CIED systems (7.4% in year 1 vs 31.0% after 10 years). The many patients with CIEDs, and the ability to quickly identify the minority with high-risk AE from the no/low-risk majority, strongly support CLE use in the ED and OR, sites which are expensive and prioritize efficiency. © 2015 Wiley Periodicals, Inc.

  13. Transformational leadership in primary care: Clinicians' patterned approaches to care predict patient satisfaction and health expectations.

    Science.gov (United States)

    Huynh, Ho Phi; Sweeny, Kate; Miller, Tricia

    2018-04-01

    Clinicians face the complex challenge of motivating their patients to achieve optimal health while also ensuring their satisfaction. Inspired by transformational leadership theory, we proposed that clinicians' motivational behaviors can be organized into three patient care styles (transformational, transactional, and passive-avoidant) and that these styles differentially predict patient health outcomes. In two studies using patient-reported data and observer ratings, we found that transformational patient care style positively predicted patients' satisfaction and health expectations above and beyond transactional and passive-avoidant patient care style. These findings provide initial support for the patient care style approach and suggest novel directions for the study of clinicians' motivational behaviors.

  14. Patient's Satisfaction with Health Care: a Questionnaire Study of Different Aspects of Care.

    Science.gov (United States)

    Spasojevic, Nada; Hrabac, Boris; Huseinagic, Senad

    2015-08-01

    To determine the influence of sociodemographic factors on patients´ satisfaction with health care system. In a cross-sectional study, 1,995 patients from 12 municipalities of Zenica-Doboj Canton were interviewed after a visit to the practice. Individual interviews were conducted and the questionnaire was made on the basis of EUROPEP (European Task Force on Patient Evaluations of General Practice Care) standardized questionnaire. Out of the total number patients, 47.1% were females, 47.9% were from urban population and median of age was 42.0 years (IQR = 30.0 to 53.0 years). The rural population was more likely to buy drugs for medical treatment (p buy drugs for medical treatment (p = 0.001), to buy parenteral injections in primary care practice (p buy drugs for medical treatment (p = 0.004); more likely to buy parenteral injections in primary care practice (p < 0.001). The following variables: gender, age, overall perception of health status and financial status appear to be predictors of patients´ satisfaction.

  15. Appendices to the guidebook on the education and training of technicians for nuclear power

    International Nuclear Information System (INIS)

    1989-10-01

    The current publication, a supplement to the IAEA Guidebook on the Education and Training of Technicians for Nuclear Power, in conjunction with which it should be read, aims to assist Member States, especially the developing countries which are in the process of implementing, or intending to implement, a nuclear power programme, to understand and meet their requirements for qualified technicians in the most effective and efficient manner. It specifically seeks to assist policy makers and planners, as well as those designing and implementing education and training programmes. The Guidebook and this TECDOC complement the IAEA Guidebook on Manpower Development for Nuclear Power, as well as the IAEA Guidebook on the Qualification of Nuclear Power Plant Operations Personnel. This TECDOC supplements the Guidebook with valuable information on the national experience of IAEA Member States in the education and training of technicians for nuclear power, as well as examples of such education and training from various Member States. Figs and tabs

  16. Two technicians apply insulation to S-II second stage

    Science.gov (United States)

    1964-01-01

    Two technicians apply insulation to the outer surface of the S-II second stage booster for the Saturn V moon rocket. The towering 363-foot Saturn V was a multi-stage, multi-engine launch vehicle standing taller than the Statue of Liberty. Altogether, the Saturn V engines produced as much power as 85 Hoover Dams.

  17. Technician Marshall MacCready installs solar cells on the Helios Prototype

    Science.gov (United States)

    2000-01-01

    Technician Marshall MacCready carefully lays a panel of solar cells into place on a wing section of the Helios Prototype flying wing at AeroVironment's Design Development Center in Simi Valley, California. The bi-facial cells, manufactured by SunPower, Inc., of Sunnyvale, California, are among 64,000 solar cells which have been installed on the solar-powered aircraft to provide electricity to its 14 motors and operating systems. Developed by AeroVironment under NASA's Environmental Research Aircraft and Sensor Technology (ERAST) project, the Helios Prototype is the forerunner of a planned fleet of slow-flying, long duration, high-altitude aircraft which can perform atmospheric science missions and serve as telecommunications relay platforms in the stratosphere. Target goals set by NASA for the giant 246-foot span flying wing include reaching and sustaining subsonic horizontal flight at 100,000 feet altitude in 2001, and sustained continuous flight for at least four days and nights above 50,000 feet altitude 2003 with the aid of a regenerative fuel cell-based energy storage system now being developed.

  18. Association of medical home team-based care functions and perceived improvements in patient-centered care at VHA primary care clinics.

    Science.gov (United States)

    Helfrich, Christian D; Dolan, Emily D; Fihn, Stephan D; Rodriguez, Hector P; Meredith, Lisa S; Rosland, Ann-Marie; Lempa, Michele; Wakefield, Bonnie J; Joos, Sandra; Lawler, Lauren H; Harvey, Henry B; Stark, Richard; Schectman, Gordon; Nelson, Karin M

    2014-12-01

    Team-based care is central to the patient-centered medical home (PCMH), but most PCMH evaluations measure team structure exclusively. We assessed team-based care in terms of team structure, process and effectiveness, and the association with improvements in teams׳ abilities to deliver patient-centered care. We fielded a cross-sectional survey among 913 VA primary care clinics implementing a PCMH model in 2012. The dependent variable was clinic-level respondent-reported improvements in delivery of patient-centered care. Independent variables included three sets of measures: (1) team structure, (2) team process, and (3) team effectiveness. We adjusted for clinic workload and patient comorbidity. 4819 surveys were returned (25% estimated response rate). The highest ratings were for team structure (median of 89% of respondents being assigned to a teamlet, i.e., a PCP working with the same clinical associate, nurse care manager and clerk) and lowest for team process (median of 10% of respondents reporting the lowest level of stress/chaos). In multivariable regression, perceived improvements in patient-centered care were most strongly associated with participatory decision making (β=32, Pteam processes). A stressful/chaotic clinic environment was associated with higher barriers to patient centered care (β=0.16-0.34, P=Team process and effectiveness measures, often omitted from PCMH evaluations, had stronger associations with perceived improvements in patient-centered care than team structure measures. Team process and effectiveness measures may facilitate synthesis of evaluation findings and help identify positive outlier clinics. Published by Elsevier Inc.

  19. Cooperative educational project for optical technicians utilizing amateur telescope making

    Science.gov (United States)

    Williamson, Ray

    2004-01-01

    In the modern optical shop, technicians are typically skilled machine operators who work on only one phase of the manufacture for each and every component. The product is designed, specified, methodized, scheduled and integrated by people off the shop floor. Even at the component level, the people inside the shop usually see only one stage of completion. In an effort to make the relevance of their work visible; to demonstrate competence to their peers; to gain appreciation for the work of others; and to give them a meaningful connection with the functions of optical systems, I created "The Telescope Project" for my former employer. I invited those interested to participate in an after-hours, partially subsidized project to build telescopes for themselves. The ground-rules included that we would all make the same design (thus practicing consensus and configuration management); that we would all work on every phase (thus learning from each other); and that we would obtain our parts by random lot at the end (thus making quality assurance a personal issue). In the process the participating technicians learned about optical theory, design, tolerancing, negotiation, scheduling, purchasing, fabrication, coating and assembly. They developed an appreciation for each other's contributions and a broader perspective on the consequences of their actions. In the end, each obtained a high-quality telescope for his or her personal use. Several developed an abiding love for astronomy. The project generated much interest from technicians who didn"t initially choose to participate. In this paper I describe the project in detail.

  20. DEGREE OF AWARENESS OF SOFT RELINING MATERIALS BY DENTAL TECHNICIANS

    Directory of Open Access Journals (Sweden)

    Ilian Hristov

    2017-10-01

    Full Text Available The aim of the current investigation is to analyze the dental-technicians’ awareness of the soft relining materials, their characteristics, advantages, shortcomings and methods for relining. Materials and methods: For the purpose of this investigation a standard questionnaire has been presented. A direct survey method, documentary and statistical method, as well as graphical methods, including tables, charts, graphics and figures, were used. Data were analysed with the help of IBM SPSS Statistics (ver. 19. Results: One hundred and eight dental technicians were included in the survey, evenly distributed by gender. Removable and fixed prosthodontics is the most commonly mentioned spheres of dental activities. Almost all included in the investigation point out the laboratory relining method as the most frequently used. Acrylic and silicone SRM are the most used groups of relining materials. Change of colour and hardness are the most frequently noticed shortcomings of these materials. The majority of the dental technicians declare that they have never done replacement of SRM or the relining has lasted more than a year. Discussion: The correlation between the age and the years of labour service among the participants is quite obvious. Most of them start working soon after their graduation. Removable prosthodontics is among the priorities for the majority of the labs. Conclusion: Although their unambiguous advantages, the soft relining materials have lots of shortcomings as well. The major problems are connected with their change of colour and hardness. Nevertheless, the dental technicians find them useful and reliable in overcoming specific prosthetic problems.

  1. Accessing patient-centered care using the advanced access model.

    Science.gov (United States)

    Tantau, Catherine

    2009-01-01

    Waits and delays for healthcare are legendary. These delays are not only frustrating and potentially hazardous for patients and providers but also represent significant cost to office practices. The traditional medical model that defines urgent care versus routine care is a vain and futile attempt to sort demand. This approach is at constant odds with patients' definition of urgency. Trusting patients to determine when and how they want to access care makes sense from a customer service perspective. If approached systematically using the principles of Advanced Access, patient demand patterns can be tracked to forecast demand. These demand patterns become the template for deploying the resources necessary to meet patients' needs. Although not a simple journey, the transformation to Advanced Access provides an entree to patient-centered care where patients can say, "I get exactly the care I want and need, when I want and need it."

  2. Administrators' perspectives on end-of-life care for cancer patients in Japanese long-term care facilities.

    Science.gov (United States)

    Fukahori, Hiroki; Miyashita, Mitsunori; Morita, Tatsuya; Ichikawa, Takayuki; Akizuki, Nobuya; Akiyama, Miki; Shirahige, Yutaka; Eguchi, Kenji

    2009-10-01

    The purpose of this study was to clarify administrators' perspectives on availability of recommended strategies for end-of-life (EOL) care for cancer patients at long-term care (LTC) facilities in Japan. A cross-sectional survey was conducted with administrators at Japanese LTC facilities. Participants were surveyed about their facilities, reasons for hospitalization of cancer patients, and their perspectives on availability of and strategies for EOL care. The 97 responses were divided into medical facility (n = 24) and non-medical facility (n = 73) groups according to physician availability. The most frequent reasons for hospitalization were a sudden change in patient's condition (49.4%), lack of around-the-clock care (43.0%), and inability to palliate symptoms (41.0%). About 50% of administrators believed their facilities could provide EOL care if supported by palliative care experts. There was no significant difference between facility types (P = 0.635). Most administrators (81.2%) regarded unstable cancer patients as difficult to care for. However, many (68.4%) regarded opioids given orally as easy to administer, but regarded continuous subcutaneous infusion/central venous nutrition as difficult. Almost all administrators believed the most useful strategy was transferring patients to hospitals at the request of patients or family members (96.9%), followed by consultation with palliative care experts (88.5%). Although LTC facilities in Japan currently do not provide adequate EOL care for cancer patients, improvement might be possible with support by palliative care teams. Appropriate models are necessary for achieving a good death for cancer patients. Interventions based on these models are necessary for EOL care for cancer patients in LTC facilities.

  3. Patient Centeredness in Electronic Communication: Evaluation of Patient-to-Health Care Team Secure Messaging.

    Science.gov (United States)

    Hogan, Timothy P; Luger, Tana M; Volkman, Julie E; Rocheleau, Mary; Mueller, Nora; Barker, Anna M; Nazi, Kim M; Houston, Thomas K; Bokhour, Barbara G

    2018-03-08

    As information and communication technology is becoming more widely implemented across health care organizations, patient-provider email or asynchronous electronic secure messaging has the potential to support patient-centered communication. Within the medical home model of the Veterans Health Administration (VA), secure messaging is envisioned as a means to enhance access and strengthen the relationships between veterans and their health care team members. However, despite previous studies that have examined the content of electronic messages exchanged between patients and health care providers, less research has focused on the socioemotional aspects of the communication enacted through those messages. Recognizing the potential of secure messaging to facilitate the goals of patient-centered care, the objectives of this analysis were to not only understand why patients and health care team members exchange secure messages but also to examine the socioemotional tone engendered in these messages. We conducted a cross-sectional coding evaluation of a corpus of secure messages exchanged between patients and health care team members over 6 months at 8 VA facilities. We identified patients whose medical records showed secure messaging threads containing at least 2 messages and compiled a random sample of these threads. Drawing on previous literature regarding the analysis of asynchronous, patient-provider electronic communication, we developed a coding scheme comprising a series of a priori patient and health care team member codes. Three team members tested the scheme on a subset of the messages and then independently coded the sample of messaging threads. Of the 711 messages coded from the 384 messaging threads, 52.5% (373/711) were sent by patients and 47.5% (338/711) by health care team members. Patient and health care team member messages included logistical content (82.6%, 308/373 vs 89.1%, 301/338), were neutral in tone (70.2%, 262/373 vs 82.0%, 277/338), and

  4. Nurses' Unique Opportunity to Promote Patient Engagement in Prenatal Care.

    Science.gov (United States)

    Dyess-Nugent, Phyllis

    2018-01-01

    To report an analysis of the concept of patient engagement in prenatal care. Engagement in health care has been widely discussed but vaguely defined. Patients benefit more from their health care when they are fully engaged in their care. Patient engagement in prenatal care is an important element of prenatal care utilization that has not been analyzed, standardized as a concept, or measured. Concept analysis. CINAHL, MEDLINE, PsycINFO databases, and the internet were searched for literature published in English with a focus on peer-reviewed journals from disciplines of business, allied health sciences, health administration, psychology, and nursing, focusing on the period of 2010-2015. Hybrid version of the Walker and Avant concept analysis method (2011). This concept analysis provides 4 defining attributes of patient engagement in prenatal care and a table of related empirical referents of engagement. These elements offer a foundation for further nursing scholarship toward measurement and evaluation of patient engagement in prenatal care. Patient engagement in prenatal care represents a human response to a health condition. Efforts to increase patient engagement in health care are best addressed by the nursing profession through continued research and intervention development. © 2017 Wiley Periodicals, Inc.

  5. The importance of patient-centered care for various patient groups.

    NARCIS (Netherlands)

    Boer, D. de; Delnoij, D.; Rademakers, J.

    2013-01-01

    Objectives: To assess differences in the importance ascribed to patient-centered care between various patient groups and demographic groups. Methods: Survey data collected using questionnaires were analyzed for patients that underwent hip or knee surgery (n=214), patients suffering from rheumatoid

  6. Job analysis of nuclear power reactor health physics technicians

    International Nuclear Information System (INIS)

    Davis, L.T.; Mazour, T.J.; Clark, P.V.; Todd, R.C.; Marotta, F.J.

    1984-06-01

    This report describes a project, an industry-wide Job Analysis of Nuclear Power Reactor Health Physics Technicians (HPTs), conducted by Brookhaven National Laboratory and Analysis and Technology, Inc. to provide the industry with job-performance data that can be used in systematically defining training programs in terms of required job functions responsibilities, and performance standards. The job-analysis methodology is consistent with that used by the Institute of Nuclear Power Operations (INPO) in similar industry-wide projects and includes administration of over 850 job task questionnaires to utility and contractor Health Physics Technicians throughout the country. Data collected includes task performance (difficulty, importance, and frequency) and industry-wide demographics (job levels, experience, education, and training). The results of this project discussed herein include model job descriptions for HPT positions, summaries of HPT experience, education, and training, industry-wide task listings with task-performance characteristics, and recommendations of selected tasks as a basis for HPT training development. Finally, potential future applications of the data base by utility and contractor organizations in training program development and evaluation and personnel qualifications are discussed

  7. Future care planning: a first step to palliative care for all patients with advanced heart disease.

    Science.gov (United States)

    Denvir, M A; Murray, S A; Boyd, K J

    2015-07-01

    Palliative care is recommended for patients with end-stage heart failure with several recent, randomised trials showing improvements in symptoms and quality of life and more studies underway. Future care planning provides a framework for discussing a range of palliative care problems with patients and their families. This approach can be introduced at any time during the patient's journey of care and ideally well in advance of end-of-life care. Future care planning is applicable to a wide range of patients with advanced heart disease and could be delivered systematically by cardiology teams at the time of an unplanned hospital admission, akin to cardiac rehabilitation for myocardial infarction. Integrating cardiology care and palliative care can benefit many patients with advanced heart disease at increased risk of death or hospitalisation. Larger, randomised trials are needed to assess the impact on patient outcomes and experiences. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  8. Suicidality in primary care patients with somatoform disorders

    NARCIS (Netherlands)

    Wiborg, J.F.; Gieseler, D.; Fabisch, A.B.; Voigt, K.; Lautenbach, A.; Lowe, B.

    2013-01-01

    Objective To examine rates of suicidality in primary care patients with somatoform disorders and to identify factors that might help to understand and manage active suicidal ideation in these patients. Methods We conducted a cross-sectional study screening 1645 primary care patients. In total, 142

  9. Continuity of care for patients on a waiting list for institutional long-term care.

    NARCIS (Netherlands)

    Caris-Verhallen, W.M.C.M.; Kerkstra, A.

    2001-01-01

    The aim of this study was to examine patients' satisfaction with continuity of care while on a waiting list for residential care or nursing home care. Two hundred and seventy-eight patients participated in the study, all living in the community setting of two cities in the Netherlands. These

  10. Gatekeepers as Care Providers: The Care Work of Patient-centered Medical Home Clerical Staff.

    Science.gov (United States)

    Solimeo, Samantha L; Ono, Sarah S; Stewart, Kenda R; Lampman, Michelle A; Rosenthal, Gary E; Stewart, Greg L

    2017-03-01

    International implementation of the patient-centered medical home (PCMH) model for delivering primary care has dramatically increased in the last decade. A majority of research on PCMH's impact has emphasized the care provided by clinically trained staff. In this article, we report our ethnographic analysis of data collected from Department of Veterans Affairs staff implementing PACT, the VA version of PCMH. Teams were trained to use within-team delegation, largely accomplished through attention to clinical licensure, to differentiate staff in providing efficient, patient-centered care. In doing so, PACT may reinforce a clinically defined culture of care that countermands PCMH ideals. Such competing rubrics for care are brought into relief through a focus on the care work performed by clerks. Ethnographic analysis identifies clerks' care as a kind of emotional dirty work, signaling important areas for future anthropological study of the relationships among patient-centered care, stigma, and clinical authority. © 2016 by the American Anthropological Association.

  11. Cosmonaut Sergei Krikalev receives assistance from suit technician

    Science.gov (United States)

    1994-01-01

    Sergei Krikalev, alternative mission specialist for STS-63, gets help from Dawn Mays, a Boeing suit technician. The cosmonaut was about to participate in a training session at JSC's Weightless Environment Training Facility (WETF). Wearing the training version of the extravehicular mobility unit (EMU) space suit, weighted to allow neutral buoyancy in the 25 feet deep WETF pool, Krikalev minutes later was underwater simulating a contingency spacewalk, or extravehicular activity (EVA).

  12. Occupational contact dermatitis amongst dentists and dental technicians

    OpenAIRE

    Lugović-Mihić, Liborija; Ferček, Iva; Duvančić, Tomislav; Bulat, Vedrana; Ježovita, Josip; Novak-Bilić, Gaby; Šitum, Mirna

    2016-01-01

    Since the working medical personnel including dentists and dental technicians mainly use their hands, it is understandable that the most common occupational disease amongst medical personnel is contact dermatitis (CD) (80%-90% of cases). Development of occupational CD is caused by contact of the skin with various substances in occupational environment. Occupational etiologic factors for dental personnel are foremost reactions to gloves containing latex, followed by various dental materials...

  13. Examining the Role of Primary Care Physicians and Challenges Faced When Their Patients Transition to Home Hospice Care.

    Science.gov (United States)

    Shalev, Ariel; Phongtankuel, Veerawat; Lampa, Katherine; Reid, M C; Eiss, Brian M; Bhatia, Sonica; Adelman, Ronald D

    2018-04-01

    The transition into home hospice care is often a critical time in a patient's medical care. Studies have shown patients and caregivers desire continuity with their physicians at the end of life (EoL). However, it is unclear what roles primary care physicians (PCPs) play and what challenges they face caring for patients transitioning into home hospice care. To understand PCPs' experiences, challenges, and preferences when their patients transition to home hospice care. Nineteen semi-structured phone interviews with PCPs were conducted. Study data were analyzed using standard qualitative methods. Participants included PCPs from 3 academic group practices in New York City. Measured: Physician recordings were transcribed and analyzed using content analysis. Most PCPs noted that there was a discrepancy between their actual role and ideal role when their patients transitioned to home hospice care. Primary care physicians expressed a desire to maintain continuity, provide psychosocial support, and collaborate actively with the hospice team. Better establishment of roles, more frequent communication with the hospice team, and use of technology to communicate with patients were mentioned as possible ways to help PCPs achieve their ideal role caring for their patients receiving home hospice care. Primary care physicians expressed varying degrees of involvement during a patient's transition to home hospice care, but many desired to be more involved in their patient's care. As with patients, physicians desire to maintain continuity with their patients at the EoL and solutions to improve communication between PCPs, hospice providers, and patients need to be explored.

  14. Concept analysis: patient autonomy in a caring context.

    Science.gov (United States)

    Lindberg, Catharina; Fagerström, Cecilia; Sivberg, Bengt; Willman, Ania

    2014-10-01

    This paper is a report of an analysis of the concept of patient autonomy Many problems regarding patient autonomy in healthcare contexts derive from the patient's dependent condition as well as the traditional authoritarian position of healthcare professionals. Existing knowledge and experience reveal a lack of consensus among nurses regarding the meaning of this ethical concept. Concept analysis. Medline, CINAHL, The Cochrane Library and PsycINFO were searched (2005-June 2013) using the search blocks 'autonomy', 'patient' and 'nursing/caring'. A total of 41 articles were retrieved. The Evolutionary Method of Concept Analysis by Rodgers was used to identify and construct the meaning of the concept of patient autonomy in a caring context. Five attributes were identified, thus creating the following descriptive definition: 'Patient autonomy is a gradual, time-changing process of (re-)constructing autonomy through the interplay of to be seen as a person, the capacity to act and the obligation to take responsibility for one's actions'. Patient vulnerability was shown to be the antecedent of patient autonomy and arises due to an impairment of a person's physical and/or mental state. The consequences of patient autonomy were discussed in relation to preserving control and freedom. Patient autonomy in a caring context does not need to be the same before, during and after a care episode. A tentative model has been constructed, thus extending the understanding of this ethical concept in a caring context. © 2014 John Wiley & Sons Ltd.

  15. Assessing Patient-Centered Communication in Cancer Care: Stakeholder Perspectives

    Science.gov (United States)

    Mazor, Kathleen M.; Gaglio, Bridget; Nekhlyudov, Larissa; Alexander, Gwen L.; Stark, Azadeh; Hornbrook, Mark C.; Walsh, Kathleen; Boggs, Jennifer; Lemay, Celeste A.; Firneno, Cassandra; Biggins, Colleen; Blosky, Mary Ann; Arora, Neeraj K.

    2013-01-01

    Purpose: Patient-centered communication is critical to quality cancer care. Effective communication can help patients and family members cope with cancer, make informed decisions, and effectively manage their care; suboptimal communication can contribute to care breakdowns and undermine clinician-patient relationships. The study purpose was to explore stakeholders' views on the feasibility and acceptability of collecting self-reported patient and family perceptions of communication experiences while receiving cancer care. The results were intended to inform the design, development, and implementation of a structured and generalizable patient-level reporting system. Methods: This was a formative, qualitative study that used semistructured interviews with cancer patients, family members, clinicians, and leaders of health care organizations. The constant comparative method was used to identify major themes in the interview transcripts. Results: A total of 106 stakeholders were interviewed. Thematic saturation was achieved. All stakeholders recognized the importance of communication and endorsed efforts to improve communication during cancer care. Patients, clinicians, and leaders expressed concerns about the potential consequences of reports of suboptimal communication experiences, such as damage to the clinician-patient relationship, and the need for effective improvement strategies. Patients and family members would report good communication experiences in order to encourage such practices. Practical and logistic issues were identified. Conclusion: Patient reports of their communication experiences during cancer care could increase understanding of the communication process, stimulate improvements, inform interventions, and provide a basis for evaluating changes in communication practices. This qualitative study provides a foundation for the design and pilot testing of such a patient reporting system. PMID:23943884

  16. Pre-use anesthesia machine check; certified anesthesia technician based quality improvement audit.

    Science.gov (United States)

    Al Suhaibani, Mazen; Al Malki, Assaf; Al Dosary, Saad; Al Barmawi, Hanan; Pogoku, Mahdhav

    2014-01-01

    Quality assurance of providing a work ready machine in multiple theatre operating rooms in a tertiary modern medical center in Riyadh. The aim of the following study is to keep high quality environment for workers and patients in surgical operating rooms. Technicians based audit by using key performance indicators to assure inspection, passing test of machine worthiness for use daily and in between cases and in case of unexpected failure to provide quick replacement by ready to use another anesthetic machine. The anesthetic machines in all operating rooms are daily and continuously inspected and passed as ready by technicians and verified by anesthesiologist consultant or assistant consultant. The daily records of each machines were collected then inspected for data analysis by quality improvement committee department for descriptive analysis and report the degree of staff compliance to daily inspection as "met" items. Replaced machine during use and overall compliance. Distractive statistic using Microsoft Excel 2003 tables and graphs of sums and percentages of item studied in this audit. Audit obtained highest compliance percentage and low rate of replacement of machine which indicate unexpected machine state of use and quick machine switch. The authors are able to conclude that following regular inspection and running self-check recommended by the manufacturers can contribute to abort any possibility of hazard of anesthesia machine failure during operation. Furthermore in case of unexpected reason to replace the anesthesia machine in quick maneuver contributes to high assured operative utilization of man machine inter-phase in modern surgical operating rooms.

  17. Self-assessment in cancer patients referred to palliative care

    DEFF Research Database (Denmark)

    Strömgren, Annette S; Goldschmidt, Dorthe; Groenvold, Mogens

    2002-01-01

    the symptomatology of participating patients and examines differences in symptomatology between patients in three palliative care functions: inpatient, outpatient, and palliative home care. RESULTS: Of 267 eligible patients who were referred to a department of palliative medicine, initial self......-based study of symptomatology in consecutive cancer patients in palliative care, achieving rather complete data from the participants. The symptomatology in these patients was very pronounced. The questionnaires were able to detect clinically important differences between places of service....

  18. The relationship between managers' leadership styles and emergency medical technicians' job satisfaction.

    Science.gov (United States)

    Ghorbanian, Azimeh; Bahadori, Mohammadkarim; Nejati, Mostafa

    2012-01-01

    Leadership plays a crucial role in many professions, especially in challenging positions such as emergency medical service jobs. The purpose of this study was to explore the relationship between managers' leadership styles and emergency medical technicians' job satisfaction. This is a descriptive and cross-sectional study that was carried out in 2010. The research population included 21 managers and 87 emergency medical technicians working in 23 stations in Isfahan city, Iran. The main tools used for data accumulation were the Multiple Leadership Questionnaire for evaluating leadership styles and the Job Descriptive Index for measuring job satisfaction levels. Also, the Pearson correlation analysis test was used to evaluate the relationship between leadership style and job satisfaction. Among both managers and technicians, the highest mean score related to the transformational management style, whereas the lowest mean score related to the laissez-faire management style. Moreover, a significant relationship (Pleadership styles and job satisfaction. However, no significant relationship was observed between the laissez-faire management style and job satisfaction. Considering the importance of job satisfaction in medical emergencies, it is recommended that health sector policy makers should provide the groundwork for implementing the transformational leadership style to enhance job satisfaction of the medical emergency staff.

  19. Patient involvement in Danish health care

    DEFF Research Database (Denmark)

    Vrangbaek, Karsten

    2015-01-01

    PURPOSE: The purpose of this paper is to investigate different types of patient involvement in Denmark, and to discuss the potential implications of pursuing several strategies for patient involvement simultaneously. DESIGN/METHODOLOGY/APPROACH: The paper presents a preliminary framework for anal......PURPOSE: The purpose of this paper is to investigate different types of patient involvement in Denmark, and to discuss the potential implications of pursuing several strategies for patient involvement simultaneously. DESIGN/METHODOLOGY/APPROACH: The paper presents a preliminary framework...... for analysis of patient involvement in health care. This framework is used to analyze key governance features of patient involvement in Denmark based on previous research papers and reports describing patient involvement in Danish health care. FINDINGS: Patient involvement is important in Denmark...... be identified when pursuing the strategies at the same time. RESEARCH LIMITATIONS/IMPLICATIONS: Because of the chosen research approach, the research results may lack generalizability. Therefore, researchers are encouraged to test the proposed framework further. PRACTICAL IMPLICATIONS: The paper includes...

  20. Educational potential of a virtual patient system for caring for traumatized patients in primary care.

    Science.gov (United States)

    Ekblad, Solvig; Mollica, Richard F; Fors, Uno; Pantziaras, Ioannis; Lavelle, James

    2013-08-19

    Virtual Patients (VPs) have been used in undergraduate healthcare education for many years. This project is focused on using VPs for training professionals to care for highly vulnerable patient populations. The aim of the study was to evaluate if Refugee Trauma VPs was perceived as an effective and engaging learning tool by primary care professionals (PCPs) in a Primary Health Care Centre (PHC). A VP system was designed to create realistic and engaging VP cases for Refugee Trauma for training refugee patient interview, use of established trauma and mental health instruments as well as to give feedback to the learners. The patient interview section was based on video clips with a Bosnian actor with a trauma story and mental health problems. The video clips were recorded in Bosnian language to further increase the realism, but also subtitled in English. The system was evaluated by 11 volunteering primary health clinicians at the Lynn Community Health Centre, Lynn, Massachusetts, USA. The participants were invited to provide insights/feedback about the system's usefulness and educational value. A mixed methodological approach was used, generating both quantitative and qualitative data. Self-reported dimensions of clinical care, pre and post questionnaire questions on the PCPs clinical worldview, motivation to use the VP, and IT Proficiency. Construct items used in these questionnaires had previously demonstrated high face and construct validity. The participants ranked the mental status examination more positively after the simulation exercise compared to before the simulation. Follow up interviews supported the results. Even though virtual clinical encounters are quite a new paradigm in PHC, the participants in the present study considered our VP case to be a relevant and promising educational tool. Next phase of our project will be a RCT study including comparison with specially prepared paper-cases and determinative input on improving clinical diagnosis and

  1. Identifying the gaps: Armenian health care legislation and human rights in patient care protections.

    Science.gov (United States)

    Zopunyan, Violeta; Krmoyan, Suren; Quinn, Ryan

    2013-12-12

    Since the collapse of the Soviet Union, the Republic of Armenia has undergone an extensive legislative overhaul. Although a number of developments have aimed to improve the quality and accessibility of Armenia's health care system, a host of factors has prevented the country from fully introducing measures to ensure respect for human rights in patient care. In particular, inadequate health care financing continues to oblige patients to make both formal and informal payments to obtain basic medical care and services. More generally, a lack of oversight and monitoring mechanisms has obstructed the implementation of Armenia's commitments to human rights in several international agreements. Within the framework of a broader project on promoting human rights in patient care, research was carried out to examine Armenia’s health care legislation with the aim of identifying gaps in comparison with international and regional standards. This research was designed using the 14 rights enshrined in the European Charter on Patient Rights as guiding principles, along with domestic legal acts relevant to the rights of health care providers. The gaps analysis revealed numerous problems with Armenian legislation governing the relationships between stakeholders in health care service delivery. It also identified several practical inconsistencies with the international legal instruments ratified by the Armenian government. These legislative shortcomings are illustrated by highlighting key health-related rights violations experienced by patients and their health care providers, and by indicating opportunities for improved rights protections. A full list of human rights relevant to patient care and recommendations for promoting them in the Armenian context is provided in Tables 1 and 2. A number of initiatives must be undertaken in order to promote the full spectrum of human rights in patient care in Armenia. This section highlights certain recommendations flowing from the findings of

  2. Radiation protection technician job task analysis manual

    International Nuclear Information System (INIS)

    1990-03-01

    This manual was developed to assist all DOE contractors in the design and conduct of job task analysis (JTA) for the radiation protection technician. Experience throughout the nuclear industry and the DOE system has indicated that the quality and efficiency in conducting a JTA at most sites is greatly enhanced by using a generic task list for the position, and clearly written guidelines on the JTA process. This manual is designed to provide this information for personnel to use in developing and conducting site-specific JTAs. (VC)

  3. Self-care practice of patients with arterial hypertension in primary health care

    Directory of Open Access Journals (Sweden)

    Cláudia Rayanna Silva Mendes

    2016-02-01

    Full Text Available Objective: to evaluate the practice of self-care performed by patients with systemic arterial hypertension in primary health care. Methods: this is a descriptive and cross-sectional study, conducted with 92 individuals with arterial hypertension in a primary care unit. The data collection occurred through script and data analyzed using descriptive statistics (frequency, mean and standard deviation and through the understanding of the adaption between capacity and self-care demand. Results: it was identified as a practice of self-care: adequate water intake, salt intake and restricted coffee, satisfactory sleep period, abstinence from smoking and alcoholism, continuing pharmacological treatment and attending medical appointments. As the demands: inadequate feeding, sedentary lifestyle, had no leisure activities, self-reported stress, and limited knowledge. Conclusion: although patients performed treatment a few years ago, still showed up self-care deficits, highlighting the need for nurses to advise and sensitize about the importance of self-care practice.

  4. Performing Chest X-Rays at Inspiration in Uncooperative Children: The Effect of Exercises with a Training Program for Radiology Technicians

    International Nuclear Information System (INIS)

    Langen, H.J.; Sengenberger, C.; Bielmeier, J.; Jocher, R.; Kohlhauser-Vollmuth, Ch.; Eschmann, M.

    2014-01-01

    It is difficult to acquire a chest X-ray of a crying infant at maximum inspiration. A computer program was developed for technician training. Method. Video clips of 3 babies were used and the moment of deepest inspiration was determined in the single-frame view. 12 technicians simulated chest radiographs at normal video speed by pushing a button. The computer program stopped the video and calculated the period of time to the optimal instant for a chest X-ray. Demonstration software can be tested at website online. Every technician simulated 10 chest X-rays for each of the 3 video clips. The technicians then spent 40 minutes practicing performing chest X-rays at optimal inspiration. The test was repeated after 5, 20, and 40 minutes of practice. Results. 6 participants showed a significant improvement after exercises (collective 1). Deviation from the optimal instant for taking an X-ray at inspiration decreased from 0.39 to 0.22 s after 40 min of practice. 6 technicians showed no significant improvement (collective 2). Deviation decreased from a low starting value of 0.25 s to 0.21 s. Conclusion. The tested computer program improves the ability of radiology technicians to take a chest X-ray at optimal inspiration in a crying child

  5. A guide for identification and continuing care of adult congenital heart disease patients in primary care.

    Science.gov (United States)

    Ellison, S; Lamb, J; Haines, A; O'Dell, S; Thomas, G; Sethi, S; Ratcliffe, J; Chisholm, S; Vaughan, J; Mahadevan, V S

    2013-03-10

    Surgical and other advances in the treatment and care of congenital heart disease have resulted in a significant increase in the number of adults with congenital heart disease (ACHD), many of whom have no regular cardiology follow-up. Optimised care for ACHD patients requires continuity of specialist and shared care and education of practitioners and patients. The challenges for managing ACHD were identified by a Health Needs Assessment in the North West and are addressed within the UK Department of Health's ACHD Commissioning Guide. An ACHD model of care was recommended in the North West of England and developed by the three North West Cardiac & Stroke Networks. Within this, a Task Group focused on the role of primary care in the identification and continuing care of ACHD patients. A feasibility study demonstrated that existing diagnostic Read Codes can identify ACHD patients on general practice registers. An ACHD Toolkit was developed to provide algorithms to guide the appropriate management of ACHD patients through primary, secondary and/or specialist ACHD care and to improve education/knowledge amongst primary care staff about ACHD and its wider implications. Early findings during the development of this Toolkit illustrate a wide disparity of provision between current and optimal management strategies. Patients lost to follow-up have already been identified and their management modified. By focusing on identifying ACHD patients in primary care and organising/delivering ACHD services, the ACHD Toolkit could help to improve quality, timeliness of care, patient experience and wellbeing. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  6. The influence of care interventions on the continuity of sleep of intensive care unit patients

    Directory of Open Access Journals (Sweden)

    Fernanda Luiza Hamze

    2015-10-01

    Full Text Available Objective: to identify care interventions, performed by the health team, and their influence on the continuity of sleep of patients hospitalized in the Intensive Care Unit.Method: descriptive study with a sample of 12 patients. A filming technique was used for the data collection. The awakenings from sleep were measured using the actigraphy method. The analysis of the data was descriptive, processed using the Statistical Package for the Social Sciences software.Results: 529 care interventions were identified, grouped into 28 different types, of which 12 (42.8% caused awakening from sleep for the patients. A mean of 44.1 interventions/patient/day was observed, with 1.8 interventions/patient/hour. The administration of oral medicine and food were the interventions that caused higher frequencies of awakenings in the patients.Conclusion: it was identified that the health care interventions can harm the sleep of ICU patients. It is recommended that health professionals rethink the planning of interventions according to the individual demand of the patients, with the diversification of schedules and introduction of new practices to improve the quality of sleep of Intensive Care Unit patients.

  7. Patient autonomy and advance care planning: a qualitative study of oncologist and palliative care physicians' perspectives.

    Science.gov (United States)

    Johnson, Stephanie B; Butow, Phyllis N; Kerridge, Ian; Tattersall, Martin H N

    2018-02-01

    Patients' are encouraged to participate in advance care planning (ACP) in order to enhance their autonomy. However, controversy exists as to what it means to be autonomous and there is limited understanding of how social and structural factors may influence cancer patients' ability to exercise their autonomy. The objective of this study is to explore oncologists' and palliative care physicians' understanding of patient autonomy, how this influences reported enactment of decision-making at the end of life (EOL), and the role of ACP in EOL care. Qualitative semi-structured interviews were conducted with consultant oncologists (n = 11) and palliative medicine doctors (n = 7) working in oncology centres and palliative care units across Australia. We found that doctors generally conceptualized autonomy in terms of freedom from interference but that there was a profound disconnect between this understanding of autonomy and clinical practice in EOL decision-making. The clinicians in our study privileged care, relationships and a 'good death' above patient autonomy, and in practice were reluctant to 'abandon' their patients to total non-interference in decision-making. Patient autonomy in healthcare is bounded, as while patients were generally encouraged to express their preferences for care, medical norms about the quality and 'reasonableness' of care, the availability of services and the patients' family relationships act to enhance or limit patients' capacity to realize their preferences. While for many, this disconnect between theory and practice did not diminish the rhetorical appeal of ACP; for others, this undermined the integrity of ACP, as well as its relevance to care. For some, ACP had little to do with patient autonomy and served numerous other ethical, practical and political functions. The ethical assumptions regarding patient autonomy embedded in academic literature and policy documents relating to ACP are disconnected from the realities of clinical care

  8. Negative health care experiences of immigrant patients: a qualitative study

    Directory of Open Access Journals (Sweden)

    Stronks Karien

    2011-01-01

    Full Text Available Abstract Background Negative events are abusive, potentially dangerous or life-threatening health care events, as perceived by the patient. Patients' perceptions of negative events are regarded as a potentially important source of information about the quality of health care. We explored negative events in hospital care as perceived by immigrant patients. Methods Semi-structured individual and group interviews were conducted with respondents about negative experiences of health care. Interviews were transcribed and analyzed using a framework method. A total of 22 respondents representing 7 non-Dutch ethnic origins were interviewed; each respondent reported a negative event in hospital care or treatment. Results Respondents reported negative events in relation to: 1 inadequate information exchange with care providers; 2 different expectations between respondents and care providers about medical procedures; 3 experienced prejudicial behavior on the part of care providers. Conclusions We identified three key situations in which negative events were experienced by immigrant patients. Exploring negative events from the immigrant patient perspective offers important information to help improve health care. Our results indicate that care providers need to be trained in adequately exchanging information with the immigrant patient and finding out specific patient needs and perspectives on illness and treatment.

  9. Requirements for, and training and certification of, quality assurance technicians for nuclear power plants

    International Nuclear Information System (INIS)

    Saiz, A.; Mir, A.; Serrano, J.

    1982-01-01

    The paper examines the requirements for, and training and certification of, technicians working in a quality assurance department at periods when the site, the main supplier and the engineering firm are being selected for construction, commissioning and operation of a light-water nuclear power plant with an output of approximately 1000 MW(e). In determining the system to be applied for the present work, account is taken of the special fields of engineering, supply, commissioning and operation. To this end, an analysis is made of the necessary organization, pointing out the number of technicians in each of the phases mentioned, and the necessary experience and knowledge required for discharging the functions indicated and for obtaining the appropriate certification. The second generation of Spanish nuclear power stations - about 7500MW(e) - demonstrated the need for quality assurance technicians. The Spanish Atomic Forum, a member of Foratom, is the first Spanish body to deal with the problem of training of such technicians at the national level through holding of seminars. This led to the appearance (in April 1974) of the first publication in Spanish on these techniques, a document which is still being used for teaching purposes. Later, it was the university and the professional associations which, with the support of the State Administration, undertook to provide this instruction. The paper also analyses Spanish experience in the teaching of quality assurance techniques during the period 1975-80, describing the programmes and contents of the courses

  10. Care of Patients with Diabetic Foot Disease in Oman

    Science.gov (United States)

    Al-Busaidi, Ibrahim S.; Abdulhadi, Nadia N.; Coppell, Kirsten J.

    2016-01-01

    Diabetes mellitus is a major public health challenge and causes substantial morbidity and mortality worldwide. Diabetic foot disease is one of the most debilitating and costly complications of diabetes. While simple preventative foot care measures can reduce the risk of lower limb ulcerations and subsequent amputations by up to 85%, they are not always implemented. In Oman, foot care for patients with diabetes is mainly provided in primary and secondary care settings. Among all lower limb amputations performed in public hospitals in Oman between 2002–2013, 47.3% were performed on patients with diabetes. The quality of foot care among patients with diabetes in Oman has not been evaluated and unidentified gaps in care may exist. This article highlights challenges in the provision of adequate foot care to Omani patients with diabetes. It concludes with suggested strategies for an integrated national diabetic foot care programme in Oman. PMID:27606104

  11. Patient-centred communication intervention study to evaluate nurse-patient interactions in complex continuing care

    Science.gov (United States)

    2012-01-01

    Background Communication impairment is a frequent consequence of stroke. Patients who cannot articulate their needs respond with frustration and agitation, resulting in poor optimization of post-stroke functions. A key component of patient-centred care is the ability of staff to communicate in a way that allows them to understand the patient’s needs. We developed a patient-centred communication intervention targeting registered and unregulated nursing staff caring for complex continuing care patients with communication impairments post stroke. Research objectives include 1) examining the effects of the intervention on patients’ quality of life, depression, satisfaction with care, and agitation; and (2) examining the extent to which the intervention improves staff’s attitudes and knowledge in caring for patients with communication impairments. The intervention builds on a previous pilot study. Methods/design A quasi-experimental repeated measures non-equivalent control group design in a complex continuing care facility is being used. Patients with a communication impairment post-stroke admitted to the facility are eligible to participate. All staff nurses are eligible. Baseline data are collected from staff and patients. Follow-up will occur at 1 and 3 months post-intervention. Subject recruitment and data collection from 60 patients and 30 staff will take approximately 36 months. The Patient-Centred Communication Intervention consists of three components: (1) development of an individualized patient communication care plan; (2) a one-day workshop focused on communication and behavioural management strategies for nursing staff; and (3) a staff support system. The intervention takes comprehensive patient assessments into account to inform the development of communication and behavioural strategies specifically tailored to each patient. Discussion The Patient-Centred Communication Intervention will provide staff with strategies to facilitate interactions with

  12. Patient-centred communication intervention study to evaluate nurse-patient interactions in complex continuing care

    Directory of Open Access Journals (Sweden)

    McGilton Katherine S

    2012-10-01

    Full Text Available Abstract Background Communication impairment is a frequent consequence of stroke. Patients who cannot articulate their needs respond with frustration and agitation, resulting in poor optimization of post-stroke functions. A key component of patient-centred care is the ability of staff to communicate in a way that allows them to understand the patient’s needs. We developed a patient-centred communication intervention targeting registered and unregulated nursing staff caring for complex continuing care patients with communication impairments post stroke. Research objectives include 1 examining the effects of the intervention on patients’ quality of life, depression, satisfaction with care, and agitation; and (2 examining the extent to which the intervention improves staff’s attitudes and knowledge in caring for patients with communication impairments. The intervention builds on a previous pilot study. Methods/design A quasi-experimental repeated measures non-equivalent control group design in a complex continuing care facility is being used. Patients with a communication impairment post-stroke admitted to the facility are eligible to participate. All staff nurses are eligible. Baseline data are collected from staff and patients. Follow-up will occur at 1 and 3 months post-intervention. Subject recruitment and data collection from 60 patients and 30 staff will take approximately 36 months. The Patient-Centred Communication Intervention consists of three components: (1 development of an individualized patient communication care plan; (2 a one-day workshop focused on communication and behavioural management strategies for nursing staff; and (3 a staff support system. The intervention takes comprehensive patient assessments into account to inform the development of communication and behavioural strategies specifically tailored to each patient. Discussion The Patient-Centred Communication Intervention will provide staff with strategies to

  13. Patient guardians as an instrument for person centered care.

    Science.gov (United States)

    Basu, Lopa; Frescas, Ruben; Kiwelu, Humphrey

    2014-05-08

    Person-centered care involves keeping the person at the center of the care planning and decision-making process. While the theory behind person-centered care is commonly shared, its application in healthcare settings is more challenging. In a number of African countries, a lesson emerges involving the application of person-centered care through the use of patient guardians. Patient guardians, often family or close friends, act as an extension of the patient's hospital care team. Medical teams engage with these self-designated individuals who invest their time and efforts in the care of the patient. More importantly, the guardian continues this role and relationship when the patient is released from the hospital to return home. Healthcare workers view patient guardians as a valuable resource. In a structured manner, guardians become stewards of information regarding topics such as hand hygiene and infection control. The knowledge gained can help the recovering patient upon discharge and potentially spread the information to others in the community. Further study of this model may show clear applicability to help improve health literacy in underserved settings in both low-income and high-income countries.

  14. Integrative medicine and patient-centered care.

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    Maizes, Victoria; Rakel, David; Niemiec, Catherine

    2009-01-01

    Integrative medicine has emerged as a potential solution to the American healthcare crisis. It provides care that is patient centered, healing oriented, emphasizes the therapeutic relationship, and uses therapeutic approaches originating from conventional and alternative medicine. Initially driven by consumer demand, the attention integrative medicine places on understanding whole persons and assisting with lifestyle change is now being recognized as a strategy to address the epidemic of chronic diseases bankrupting our economy. This paper defines integrative medicine and its principles, describes the history of complementary and alternative medicine (CAM) in American healthcare, and discusses the current state and desired future of integrative medical practice. The importance of patient-centered care, patient empowerment, behavior change, continuity of care, outcomes research, and the challenges to successful integration are discussed. The authors suggest a model for an integrative healthcare system grounded in team-based care. A primary health partner who knows the patient well, is able to addresses mind, body, and spiritual needs, and coordinates care with the help of a team of practitioners is at the centerpiece. Collectively, the team can meet all the health needs of the particular patient and forms the patient-centered medical home. The paper culminates with 10 recommendations directed to key actors to facilitate the systemic changes needed for a functional healthcare delivery system. Recommendations include creating financial incentives aligned with health promotion and prevention. Insurers are requested to consider the total costs of care, the potential cost effectiveness of lifestyle approaches and CAM modalities, and the value of longer office visits to develop a therapeutic relationship and stimulate behavioral change. Outcomes research to track the effectiveness of integrative models must be funded, as well as feedback and dissemination strategies

  15. A scoping review of patient discharge from intensive care: opportunities and tools to improve care.

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    Stelfox, Henry T; Lane, Dan; Boyd, Jamie M; Taylor, Simon; Perrier, Laure; Straus, Sharon; Zygun, David; Zuege, Danny J

    2015-02-01

    We conducted a scoping review to systematically review the literature reporting patient discharge from ICUs, identify facilitators and barriers to high-quality care, and describe tools developed to improve care. We searched Medline, Embase, CINAHL, and the Cochrane Central Register of Controlled Trials. Data were extracted on the article type, study details for research articles, patient population, phase of care during discharge, and dimensions of health-care quality. From 8,154 unique publications we included 224 articles. Of these, 131 articles (58%) were original research, predominantly case series (23%) and cohort (16%) studies; 12% were narrative reviews; and 11% were guidelines/policies. Common themes included patient and family needs/experiences (29% of articles) and the importance of complete and accurate information (26%). Facilitators of high-quality care included provider-patient communication (30%), provider-provider communication (25%), and the use of guidelines/policies (29%). Patient and family anxiety (21%) and limited availability of ICU and ward resources (26%) were reported barriers to high-quality care. A total of 47 tools to facilitate patient discharge from the ICU were identified and focused on patient evaluation for discharge (29%), discharge planning and teaching (47%), and optimized discharge summaries (23%). Common themes, facilitators and barriers related to patient and family needs/experiences, communication, and the use of guidelines/policies to standardize patient discharge from ICU transcend the literature. Candidate tools to improve care are available; comparative evaluation is needed prior to broad implementation and could be tested through local quality-improvement programs.

  16. Conhecimento da equipe de enfermagem sobre higiene oral em pacientes criticamente enfermos El conocimiento del equipo de enfermería sobre higiene oral en pacientes críticamente enfermos Nursing staff's knowledge about oral care in critically ill patients

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    Gabrielli Mottes Orlandini

    2012-09-01

    nuevas prácticas. Esto nos sugiere que la higiene bucal en los pacientes hospitalizados no ha sido una preocupación evidente, en las prácticas de cuidado y educación para la salud.The objective of this study was to assess the knowledge of nursing professionals who perform or supervise the oral hygiene care in critically ill patients and, secondarily, to verify their opinion about the care provided. This is an exploratory study with a quantitative approach, using an instrument developed by the authors applied to the nurses and technicians working in a mid-sized Intensive Care Unit (ICU in Porto Alegre. The results show that 50% of nurses and 72.8% of technicians agree that oral hygiene is important in critically ill patients, but there is no relation to ventilator-associated pneumonia (VAP. Fromthe sample, 16.6% of nurses and 66.6% of nursing technicians agree that the routine of the institution is adequate, and 66.6% of nurses and 30.7% of technicians indicate new practices. This suggests that oral hygiene in hospitalized patients has not been an evident concern, regarding health education practices and care.

  17. Variations in levels of care between nursing home patients in a public health care system.

    Science.gov (United States)

    Døhl, Øystein; Garåsen, Helge; Kalseth, Jorid; Magnussen, Jon

    2014-03-05

    Within the setting of a public health service we analyse the distribution of resources between individuals in nursing homes funded by global budgets. Three questions are pursued. Firstly, whether there are systematic variations between nursing homes in the level of care given to patients. Secondly, whether such variations can be explained by nursing home characteristics. And thirdly, how individual need-related variables are associated with differences in the level of care given. The study included 1204 residents in 35 nursing homes and extra care sheltered housing facilities. Direct time spent with patients was recorded. In average each patient received 14.8 hours direct care each week. Multilevel regression analysis is used to analyse the relationship between individual characteristics, nursing home characteristics and time spent with patients in nursing homes. The study setting is the city of Trondheim, with a population of approximately 180 000. There are large variations between nursing homes in the total amount of individual care given to patients. As much as 24 percent of the variation of individual care between patients could be explained by variation between nursing homes. Adjusting for structural nursing home characteristics did not substantially reduce the variation between nursing homes. As expected a negative association was found between individual care and case-mix, implying that at nursing home level a more resource demanding case-mix is compensated by lowering the average amount of care. At individual level ADL-disability is the strongest predictor for use of resources in nursing homes. For the average user one point increase in ADL-disability increases the use of resources with 27 percent. In a financial reimbursement model for nursing homes with no adjustment for case-mix, the amount of care patients receive does not solely depend on the patients' own needs, but also on the needs of all the other residents.

  18. Self-Care Behaviors among Patients with Heart Failure in Iran

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    Vahid Zamanzadeh

    2012-11-01

    Full Text Available Introduction: Recovery from heart failure and dealing with its effects is significantly influenced by patient’s self-care. In order to maximize the effects of behavioral interventions and for educational planning, it is essential to know how much experience and information do patients with heart failure have about their disease and self-care behaviors. The present study aimed to identify self-care behaviors in patients with heart failure. Methods: Eighty heart failure patients hospitalized in Shahid Madani Training Center in Tabriz, Iran, participated in this study. Data collection was done through Self-Care of Heart Failure Index (SCHFI that contained 22 questions in three sections including self-care behaviors, self-care management and confidence in performing self-care behaviors. Results: The patient’s self-care behaviors in three behavioral sub categories of maintaining, managing and confidence were low. The most repeated self-care behavior in the participating patients was taking medication and visiting the doctor. Conclusion: The results of the study showed low levels of self-care behaviors in patients with heart failure, which notes the need for patient empowerment. It is necessary to develop appropriate strategies in this regard by the authorities

  19. Self-care follows from compassionate care - chronic pain patients' experience of integrative rehabilitation.

    Science.gov (United States)

    Arman, Maria; Hök, Johanna

    2016-06-01

    The long-term outcome of any intervention for people suffering from chronic pain relies on the patient's ability for self-care. This study explores patient experiences of self-care in relation to a rehabilitation programme at an anthroposophic clinic. In a qualitative interview study with a hermeneutic approach, individual interviews were conducted, recorded, transcribed verbatim and analysed. Interviews were conducted with ten women who were taking part in a year-long rehabilitation programme for chronic pain and overlapping illness. The women told stories of suffering with a focus on lives that were not functioning well. In this context, pain is like secondary. For many, the experience of loving care at the clinic became a turning point, a chance to be vulnerable, to be recognised, to reflect and to begin life anew. Signs of self-care could then be witnessed. The women described a process whereby they regained contact with their bodies and their fellow human beings; they were able to identify their needs and when to stand up for them. Everyday life at the clinic is guided by universal aspects of love, life and meanings. The care gives patients glimpses of a move towards community in contrast to past isolation, towards love in contrast to past alienation, and towards joy and inspiration in contrast to past suffering. Through receiving caritative and compassionate care, these women were able to identify their needs as a first step towards self-care. In the context of chronic pain, self-care needs to be more than advice, education and training. Health can be attained when the sufferer experiences what it is to be cared for. This study supports the potential of a caritative caring culture to help patients participate in a compassionate community both with others and with the self. This forms the basis for the reawakening of their natural self-care ability. © 2015 The Authors. Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of

  20. Stigma Predicts Treatment Preferences and Care Engagement among Veterans Affairs Primary Care Patients with Depression

    Science.gov (United States)

    Campbell, Duncan G.; Bonner, Laura M.; Bolkan, Cory R.; Lanto, Andrew B.; Zivin, Kara; Waltz, Thomas J.; Klap, Ruth; Rubenstein, Lisa V.; Chaney, Edmund F.

    2016-01-01

    Background Whereas stigma regarding mental health concerns exists, the evidence for stigma as a depression treatment barrier among patients in Veterans Affairs (VA) primary care (PC) is mixed. Purpose To test whether stigma, defined as depression label avoidance, predicted patients' preferences for depression treatment providers, patients' prospective engagement in depression care, and care quality. Methods We conducted cross-sectional and prospective analyses of existing data from 761 VA PC patients with probable major depression. Results Relative to low stigma patients, those with high stigma were less likely to prefer treatment from mental health specialists. In prospective controlled analyses, high stigma predicted lower likelihood of the following: taking medications for mood, treatment by mental health specialists, treatment for emotional concerns in PC, and appropriate depression care. Conclusions High stigma is associated with lower preferences for care from mental health specialists and confers risk for minimal depression treatment engagement. PMID:26935310

  1. Communication Technician: Apprenticeship Course Outline. Apprenticeship and Industry Training. 2209

    Science.gov (United States)

    Alberta Advanced Education and Technology, 2009

    2009-01-01

    The graduate of the Communication Technician apprenticeship program is a certified journeyperson who will be able to: (1) supervise, train and coach apprentices; (2) use a thorough knowledge of electrical and electronic theory and its application to communication and associated equipment used in the telecommunication industry; (3) understand…

  2. Patients' and family members' views on patient-centered communication during cancer care.

    Science.gov (United States)

    Mazor, Kathleen M; Beard, Reneé L; Alexander, Gwen L; Arora, Neeraj K; Firneno, Cassandra; Gaglio, Bridget; Greene, Sarah M; Lemay, Celeste A; Robinson, Brandi E; Roblin, Douglas W; Walsh, Kathleen; Street, Richard L; Gallagher, Thomas H

    2013-11-01

    To explore patients' and family members' views on communication during cancer care and to identify those aspects of clinician-patient communication which were most important to patients and family members. We conducted a secondary data analysis of qualitative data from 137 patients with cancer and family members of patients with cancer. We used a modified version of the constant comparative method and coding paradigm of grounded theory. Patients want sensitive, caring clinicians who provide information that they need, when they need it, in a way that they can understand; who listen and respond to questions and concerns, and who attempt to understand the patient's experience. Effective information exchange and a positive interpersonal relationship with the clinician were of fundamental importance to patients and family members. These were interrelated; for instance, failure to provide information a patient needed could damage the relationship, whereas excellent listening could foster the relationship. Information exchange and relationship were also integral to decision-making, managing uncertainty, responding to emotions, and self-management. Clinicians who were responsive to patients' needs beyond the immediate medical encounter were valued. The complexity of cancer care today suggests that efforts to improve communication must be multilevel, acknowledging and addressing patient, clinician, organizational and policy barriers, and facilitators. Measurement tools are needed to assess cancer patients' and family members' experiences with communication over the course of cancer care to provide meaningful, actionable feedback to those seeking to optimize their effectiveness in communicating with patients with cancer. Copyright © 2013 John Wiley & Sons, Ltd.

  3. Holistic health care: Patients' experiences of health care provided by an Advanced Practice Nurse.

    Science.gov (United States)

    Eriksson, Irene; Lindblad, Monica; Möller, Ulrika; Gillsjö, Catharina

    2018-02-01

    Advanced Practice Nurse (APN) is a fairly new role in the Swedish health care system. To describe patients' experiences of health care provided by an APN in primary health care. An inductive, descriptive qualitative approach with qualitative open-ended interviews was chosen to obtain descriptions from 10 participants regarding their experiences of health care provided by an APN. The data were collected during the spring 2012, and a qualitative approach was used for analyze. The APNs had knowledge and skills to provide safe and secure individual and holistic health care with high quality, and a respectful and flexible approach. The APNs conveyed trust and safety and provided health care that satisfied the patients' needs of accessibility and appropriateness in level of care. The APNs way of providing health care and promoting health seems beneficial in many ways for the patients. The individual and holistic approach that characterizes the health care provided by the APNs is a key aspect in the prevailing change of health care practice. The transfer of care and the increasing number of older adults, often with a variety of complex health problems, call for development of the new role in this context. © 2017 The Authors. International Journal of Nursing Practice Published by John Wiley & Sons Australia, Ltd.

  4. Valuing the delivery of dental care: Heterogeneity in patients' preferences and willingness-to-pay for dental care attributes.

    Science.gov (United States)

    Sever, Ivan; Verbič, Miroslav; Sever, Eva Klaric

    2018-02-01

    To examine the amount of heterogeneity in patients' preferences for dental care, what factors affect their preferences, and how much they would be willing to pay for improvement in specific dental care attributes. A discrete choice experiment (DCE) was used to elicit patients' preferences. Three alternative dental care services that differed in the type of care provider, treatment explanation, dental staff behavior, waiting time and treatment cost were described to patients. Patients (n=265) were asked to choose their preferred alternative. The study was conducted at a public dental clinic of the School of Dental Medicine, University of Zagreb. Mixed logit and latent class models were used for analysis. On average, the patients would be willing to pay €45 for getting a detailed explanation of treatment over no explanation. This was the most valued attribute of dental care, followed by dental staff behavior with marginal willingness-to-pay (WTP) of €28. Dental care provided by the faculty members and private dental care were valued similarly, while student-provided care was valued €23 less. Patients also disliked longer waiting time in the office, but this was the least important attribute. Four classes of patients with distinct preferences for dental care were identified. Older and/or more educated patients tended to give relatively less importance to treatment explanation. Higher education was also associated with a higher propensity to substitute faculty dental care with the private care providers. Large heterogeneity in patients' preferences was detected. Understanding their preferences may improve the delivery of dental care. Dental care providers should pay particular attention to providing a detailed treatment explanation to their patients. Dental care for older and/or more educated patients should be more attentive to interpersonal characteristics. Faculty dental care provided by faculty members could be price competitive to private care, and student

  5. Palliative care provision for patients with chronic obstructive pulmonary disease

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    Yohannes Abebaw

    2007-04-01

    Full Text Available Abstract Chronic obstructive pulmonary disease (COPD is a major cause of disability, morbidity and mortality in old age. Patients with advanced stage COPD are most likely to be admitted three to four times per year with acute exacerbations of COPD (AECOPD which are costly to manage. The adverse events of AECOPD are associated with poor quality of life, severe physical disability, loneliness, and depression and anxiety symptoms. Currently there is a lack of palliative care provision for patients with advanced stage COPD compared with cancer patients despite having poor prognosis, intolerable dyspnoea, lower levels of self efficacy, greater disability, poor quality of life and higher levels of anxiety and depression. These symptoms affect patients' quality of life and can be a source of concern for family and carers as most patients are likely to be housebound and may be in need of continuous support and care. Evidence of palliative care provision for cancer patients indicate that it improves quality of life and reduces health care costs. The reasons why COPD patients do not receive palliative care are complex. This partly may relate to prognostic accuracy of patients' survival which poses a challenge for healthcare professionals, including general practitioners for patients with advanced stage COPD, as they are less likely to engage in end-of-life care planning in contrast with terminal disease like cancer. Furthermore there is a lack of resources which constraints for the wider availability of the palliative care programmes in the health care system. Potential barriers may include unwillingness of patients to discuss advance care planning and end-of-life care with their general practitioners, lack of time, increased workload, and fear of uncertainty of the information to provide about the prognosis of the disease and also lack of appropriate tools to guide general practitioners when to refer patients for palliative care. COPD is a chronic

  6. Challenges in tuberculosis care in Western Uganda: Health care worker and patient perspectives

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    Ashley Wynne

    2014-01-01

    Full Text Available Uganda is one of the high burden countries that contribute 80% of the world’s tuberculosis (TB burden. Health care worker and patient perspectives provide valuable insight into gaps between policy and practice within tuberculosis control program. This study was part of a larger mixed-methods study to explore knowledge and stigma around HIV, TB and TB/HIV co-infection. We conducted a secondary analysis of the qualitative data. Findings related to challenges faced by health care workers and patients. Patient’s identified delays in diagnosis and financial burden associated with TB treatment. Health care workers called for more training on TB and TB/HIV co-infection, and identified poor referral practices between health units and lack of program funding resulting in the abandonment of DOTS programs. Training for health care workers is needed to better manage TB/HIV co-infected patients. Overall health system strengthening is needed, including referral systems tracking patients between health centers.

  7. [Modifications of vital signs during hygiene care in intensive care patients: an explorative study].

    Science.gov (United States)

    Lucchini, Alberto; Giacovelli, Matteo; Elli, Stefano; Gariboldi, Roberto; Pelucchi, Giulia; Bondi, Herman; Brambilla, Daniela

    2009-01-01

    Hygiene care in critical patients may alter vital signs. Aim of this paper is to measure vital signs and their modifications in critical patients during hygiene care and measure differences with pre and post hygiene values. Vital signs of 6 patients two hours before, during and 90 minutes after hygienic care were measured. During and 2 hours after the end of hygiene a modification of vital signs was observed compared to basic values (mean values during/90 min after, compared to baseline): heart rate +11.20%/ +1.48; systolic blood pressure +22.68%/+1.56; arterial capillary saturimetry -4.31/+0.27, Respiratory frequency +8.10/+2.66, tidal volume +4,04/-7,51, CO2 min/vol +5,34/- 22.33, bladder temperature -0.85/-0.60. Hygiene care in critical care patients may significantly alter vital signs. Therefore a strict haemodinamic and respiratory monitoring is warranted as well as protocols for the management of sedation and of vasoactive support.

  8. Outbreaks of infections associated with drug diversion by US health care personnel.

    Science.gov (United States)

    Schaefer, Melissa K; Perz, Joseph F

    2014-07-01

    To summarize available information about outbreaks of infections stemming from drug diversion in US health care settings and describe recommended protocols and public health actions. We reviewed records at the Centers for Disease Control and Prevention related to outbreaks of infections from drug diversion by health care personnel in US health care settings from January 1, 2000, through December 31, 2013. Searches of the medical literature published during the same period were also conducted using PubMed. Information compiled included health care setting(s), infection type(s), specialty of the implicated health care professional, implicated medication(s), mechanism(s) of diversion, number of infected patients, number of patients with potential exposure to blood-borne pathogens, and resolution of the investigation. We identified 6 outbreaks over a 10-year period beginning in 2004; all occurred in hospital settings. Implicated health care professionals included 3 technicians and 3 nurses, one of whom was a nurse anesthetist. The mechanism by which infections were spread was tampering with injectable controlled substances. Two outbreaks involved tampering with opioids administered via patient-controlled analgesia pumps and resulted in gram-negative bacteremia in 34 patients. The remaining 4 outbreaks involved tampering with syringes or vials containing fentanyl; hepatitis C virus infection was transmitted to 84 patients. In each of these outbreaks, the implicated health care professional was infected with hepatitis C virus and served as the source; nearly 30,000 patients were potentially exposed to blood-borne pathogens and targeted for notification advising testing. These outbreaks revealed gaps in prevention, detection, and response to drug diversion in US health care facilities. Drug diversion is best prevented by health care facilities having strong narcotics security measures and active monitoring systems. Appropriate response includes assessment of harm to

  9. Snapshot of cobalt, chromium and nickel exposure in dental technicians.

    Science.gov (United States)

    Kettelarij, Jolinde; Nilsson, Sara; Midander, Klara; Lidén, Carola; Julander, Anneli

    2016-12-01

    It is not fully understood where and how people are exposed to sensitizing metals. Much can be learnt from studying occupational settings where metals are handled. To quantify cobalt (Co), chromium (Cr) and nickel (Ni) exposure on the skin and in the air, and urine levels, in dental technicians working with tools and alloys that may result in skin and respiratory exposure. The metal skin dose was quantified with acid wipe sampling in dental technicians (n = 13). Air exposure was monitored by personal air sampling. Spot urine samples were collected for 24 h. Metals were analysed with inductively coupled plasma mass spectrometry. Before work, Co was detected on the skin of 10 participants (0.00025-0.0039 µg/cm 2 ), and Cr (0.00051-0.011 µg/cm 2 ) and Ni (0.0062-0.15 µg/cm 2 ) on the skin of all participants. After a 2-h period without hand washing, CoCr-exposed participants had more Co on the skin (p = 0.004) than non-CoCr-exposed participants. Co was found in 10 air samples (0.22-155 µg/m 3 ), Cr in nine (0.43-71 µg/m 3 ), and Ni in four (0.48-3.7 µg/m 3 ). Metal urine concentrations were considered to be normal. Dental technicians were exposed to Co, Cr and Ni on the skin and through the air, which was not reflected in the urine concentrations in this study. Cobalt skin doses may potentially elicit allergic contact dermatitis and cause sensitization. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Development of new core competencies for Taiwanese Emergency Medical Technicians

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    Chang YT

    2018-03-01

    Full Text Available Yu-Tung Chang,1,2 Kuang-Chau Tsai,2 Brett Williams1,3 1Department of Community Emergency Health and Paramedic Practice, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, VIC, Australia; 2Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan; 3Division of Paramedicine, University of Tasmania, Hobart, TAS, Australia Objectives: Core competencies are considered the foundation for establishing Emergency Medical Technician (EMT and paramedic curricula, and for ensuring performance standards in the delivery of prehospital care. This study surveyed EMT instructors and medical directors to identify the most desirable core competencies for all levels of EMTs in Taiwan. Methods: A principal components analysis with Varimax rotation was conducted. An online questionnaire was distributed to obtain perspectives of EMT instructors and medical directors on the most desirable core competencies for EMTs. The target population was EMT training-course instructors and medical directors of fire departments in Taiwan. The questionnaire comprised 61 competency items, and multiple-choice and open-ended questions were used to obtain respondents’ perspectives of the Taiwanese EMT training and education system. Results: The results identified three factors at EMT-1 and EMT-2 levels and five factors at the EMT-Paramedic level. The factors for EMT-1 and EMT-2 were similar, and those for EMT-Paramedics identified further comprehensive competence perspectives. The key factors that appear to influence the development of the Taiwanese Emergency Medical Services (EMS education system are the attitude of authorities, the licensure system, and legislation. Conclusion: The findings present new core competencies for the Taiwanese EMT system and provide capacity to redesign curricula and reconsider roles for EMT-1 and EMT-2 technicians. At the EMT-Paramedic level, the findings demonstrate the importance of

  11. The effects of hospice-shared care for gastric cancer patients.

    Science.gov (United States)

    Huang, Kun-Siang; Wang, Shih-Ho; Chuah, Seng-Kee; Rau, Kun-Ming; Lin, Yu-Hung; Hsieh, Meng-Che; Shih, Li-Hsueh; Chen, Yen-Hao

    2017-01-01

    Hospice care has been proved to result in changes to the medical behaviors of terminally ill patients. The aim of this study was to evaluate the effects and medical behavior changes of hospice-shared care intervention among terminally ill gastric cancer patients. A total of 174 patients who died of gastric cancer between 2012 and 2014 were identified. These patients were divided into two groups: a hospice-shared care group (n = 93) and a control group (n = 81). Among the 174 patients, 84% had advanced stage (stage III or stage IV) cancer. The females and the patients cared by medical oncologists had a higher percentage of hospice-shared care than the males (71% vs 44%, p = 0.001) and those cared by other physicians (63% vs 41%, p = 0.004). Compared to the control group, the hospice-shared care group underwent lower incidence of life sustaining or aggressive medical treatments, including intensive care unit admission (2% vs 26%, pgastric cancer patients could increase the rate of signed DNR orders, decrease the use of life sustaining and aggressive/palliative treatments, and improve quality of life.

  12. Identifying and prioritizing the indicators of talent management in recruiting radiology technicians

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    Sadegheh Hosseinzadeh Nojedeh

    2015-09-01

    Full Text Available The purpose of this study was identifying and prioritizing the indicators of talent management in recruiting the radiology technicians. The sample for the study was drawn randomly from all managers and personnel of the radiology sector in Ardabil public hospitals. Shannon entropy was applied to weighted criteria. In the next stage, for ranking the indicators of talent management, we employed multi-criteria decision-making techniques of TOPSIS method. Eight indicators were identified and prioritized using the TOPSIS method. These indicators are interest, commitment, skill, specialized knowledge, intelligence, the ability to solve the problem or issue, proper treatment with patient, and relationships with colleagues. The findings indicated that recruiting staff that do their work with love and are committed to the organization tend to be effective in improving hospital performance.

  13. Multidisciplinary collaboration in primary care: through the eyes of patients.

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    Cheong, Lynn H; Armour, Carol L; Bosnic-Anticevich, Sinthia Z

    2013-01-01

    Managing chronic illness is highly complex and the pathways to access health care for the patient are unpredictable and often unknown. While multidisciplinary care (MDC) arrangements are promoted in the Australian primary health care system, there is a paucity of research on multidisciplinary collaboration from patients' perspectives. This exploratory study is the first to gain an understanding of the experiences, perceptions, attitudes and potential role of people with chronic illness (asthma) on the delivery of MDC in the Australian primary health care setting. In-depth semi-structured interviews were conducted with asthma patients from Sydney, Australia. Qualitative analysis of data indicates that patients are significant players in MDC and their perceptions of their chronic condition, perceived roles of health care professionals, and expectations of health care delivery, influence their participation and attitudes towards multidisciplinary services. Our research shows the challenges presented by patients in the delivery and establishment of multidisciplinary health care teams, and highlights the need to consider patients' perspectives in the development of MDC models in primary care.

  14. Patients' expectations of osteopathic care: a qualitative study.

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    Cross, Vinette; Leach, C M Janine; Fawkes, Carol A; Moore, Ann P

    2015-10-01

    Research has shown that patients' expectations of health care and health-care practitioners are complex and may have a significant impact on outcomes of care. Little is known about the expectations of osteopathic patients. To explore osteopathic patients' expectations of private sector care. Focus groups and individual interviews with purposively selected patients; this was the qualitative phase of a mixed methods study, the final phase being a patient survey. A total of 34 adult patients currently attending for treatment at private osteopathic practices across the United Kingdom. Focus group discussions and individual interviews around expectations before, during and after osteopathic care. Thematic analysis of text data to identify topics raised by patients and to group these into broad themes. Many components of expectation were identified. A preliminary conceptual framework describing the way the therapeutic encounter is approached in osteopathy comprised five themes: individual agency, professional expertise, customer experience, therapeutic process and interpersonal relationship. The components of expectation identified in this phase of the study provided potential question topics for the survey questionnaire in the subsequent phase of the investigation. The model developed in this study may add a new perspective to existing evidence on expectations. Further research is recommended to test the findings both within private practice and the National Health Service. © 2013 John Wiley & Sons Ltd.

  15. An agent-based simulation model of patient choice of health care providers in accountable care organizations.

    Science.gov (United States)

    Alibrahim, Abdullah; Wu, Shinyi

    2018-03-01

    Accountable care organizations (ACO) in the United States show promise in controlling health care costs while preserving patients' choice of providers. Understanding the effects of patient choice is critical in novel payment and delivery models like ACO that depend on continuity of care and accountability. The financial, utilization, and behavioral implications associated with a patient's decision to forego local health care providers for more distant ones to access higher quality care remain unknown. To study this question, we used an agent-based simulation model of a health care market composed of providers able to form ACO serving patients and embedded it in a conditional logit decision model to examine patients capable of choosing their care providers. This simulation focuses on Medicare beneficiaries and their congestive heart failure (CHF) outcomes. We place the patient agents in an ACO delivery system model in which provider agents decide if they remain in an ACO and perform a quality improving CHF disease management intervention. Illustrative results show that allowing patients to choose their providers reduces the yearly payment per CHF patient by $320, reduces mortality rates by 0.12 percentage points and hospitalization rates by 0.44 percentage points, and marginally increases provider participation in ACO. This study demonstrates a model capable of quantifying the effects of patient choice in a theoretical ACO system and provides a potential tool for policymakers to understand implications of patient choice and assess potential policy controls.

  16. Patients report better satisfaction with part-time primary care physicians, despite less continuity of care and access.

    Science.gov (United States)

    Panattoni, Laura; Stone, Ashley; Chung, Sukyung; Tai-Seale, Ming

    2015-03-01

    The growing number of primary care physicians (PCPs) reducing their clinical work hours has raised concerns about meeting the future demand for services and fulfilling the continuity and access mandates for patient-centered care. However, the patient's experience of care with part-time physicians is relatively unknown, and may be mediated by continuity and access to care outcomes. We aimed to examine the relationships between a physicians' clinical full-time equivalent (FTE), continuity of care, access to care, and patient satisfaction with the physician. We used a multi-level structural equation estimation, with continuity and access modeled as mediators, for a cross-section in 2010. The study included family medicine (n = 104) and internal medicine (n = 101) physicians in a multi-specialty group practice, along with their patient satisfaction survey responses (n = 12,688). Physician level FTE, continuity of care received by patients, continuity of care provided by physician, and a Press Ganey patient satisfaction with the physician score, on a 0-100 % scale, were measured. Access to care was measured as days to the third next-available appointment. Physician FTE was directly associated with better continuity of care received (0.172% per FTE, p part-time PCPs in practice redesign efforts and initiatives to meet the demand for primary care services.

  17. Emergency Victim Care. A Training Manual for Emergency Medical Technicians. Module 2. Equipment, Safe Driving Practices, Legal Aspects, Controlling the Situation, Action Evaluation Conference. Revised.

    Science.gov (United States)

    Ohio State Dept. of Education, Columbus. Div. of Vocational Education.

    This student manual, the second in a set of 14 modules, is designed to train emergency medical technicians (EMTs) in Ohio. The module contains five sections that cover the following course content: ambulance equipment, safe driving practices for emergency vehicle drivers, legal aspects of the EMT's job, how to maintain control at an accident scene…

  18. Maintaining patients' dignity during clinical care: a qualitative interview study.

    Science.gov (United States)

    Lin, Yea-Pyng; Tsai, Yun-Fang

    2011-02-01

    This article is a report of a study undertaken to understand how nurses maintain patients' dignity in clinical practice. Dignity is a core concept in nursing care and maintaining patients' dignity is critical to their recovery. In Western countries, measures to maintain dignity in patients' care include maintaining privacy of the body, providing spatial privacy, giving sufficient time, treating patients as a whole person and allowing patients to have autonomy. However, this is an under-studied topic in Asian countries. For this qualitative descriptive study, data were collected in Taiwan in 2009 using in-depth interviews with a purposive sample of 30 nurses from a teaching hospital in eastern Taiwan. The audiotaped interviews were transcribed verbatim and analysed using content analysis. Nurses' measures to maintain dignity in patient care were captured in five themes: respect, protecting privacy, emotional support, treating all patients alike and maintaining body image. Participants did not mention beneficence, a crucial element achieved through the professional care of nurses that can enhance the recovery of patients. In-service education to help nurses enhance dignity in patient care should emphasize emotional support, maintaining body image and treating all patients alike. Our model for maintaining dignity in patient care could be used to develop a clinical care protocol for nurses to use in clinical practice. © 2010 Blackwell Publishing Ltd.

  19. Exploring the impact of an automated prescription-filling device on community pharmacy technician workflow

    Science.gov (United States)

    Walsh, Kristin E.; Chui, Michelle Anne; Kieser, Mara A.; Williams, Staci M.; Sutter, Susan L.; Sutter, John G.

    2012-01-01

    Objective To explore community pharmacy technician workflow change after implementation of an automated robotic prescription-filling device. Methods At an independent community pharmacy in rural Mayville, WI, pharmacy technicians were observed before and 3 months after installation of an automated robotic prescription-filling device. The main outcome measures were sequences and timing of technician workflow steps, workflow interruptions, automation surprises, and workarounds. Results Of the 77 and 80 observations made before and 3 months after robot installation, respectively, 17 different workflow sequences were observed before installation and 38 after installation. Average prescription filling time was reduced by 40 seconds per prescription with use of the robot. Workflow interruptions per observation increased from 1.49 to 1.79 (P = 0.11), and workarounds increased from 10% to 36% after robot use. Conclusion Although automated prescription-filling devices can increase efficiency, workflow interruptions and workarounds may negate that efficiency. Assessing changes in workflow and sequencing of tasks that may result from the use of automation can help uncover opportunities for workflow policy and procedure redesign. PMID:21896459

  20. Consumerism: forcing medical practices toward patient-centered care.

    Science.gov (United States)

    Ozmon, Jeff

    2007-01-01

    Consumerism has been apart of many industries over the years; now consumerism may change the way many medical practices deliver healthcare. With the advent of consumer-driven healthcare, employers are shifting the decision-making power to their employees. Benefits strategies like health savings accounts and high-deductible insurance plans now allow the patients to control how and where they spend their money on medical care. Practices that seek to attract the more affluent and informed consumers are beginning to institute patient-centered systems designs that invite patients to actively participate in their healthcare. This article will outline the changes in the healthcare delivery system facing medical practices, the importance of patient-centered care, and six strategies to implement to change toward more patient-centered care.

  1. Toward a patient-centered ambulatory after-visit summary: Identifying primary care patients' information needs.

    Science.gov (United States)

    Clarke, Martina A; Moore, Joi L; Steege, Linsey M; Koopman, Richelle J; Belden, Jeffery L; Canfield, Shannon M; Kim, Min S

    2018-09-01

    The purpose of this study was to determine the information needs of primary care patients as they review clinic visit notes to inform information that should be contained in an after-visit summary (AVS). We collected data from 15 patients with an acute illness and 14 patients with a chronic disease using semi-structured interviews. The acute patients reviewed seven major sections, and chronic patients reviewed eight major sections of a simulated, but realistic visit note to identify relevant information needs for their AVS. Patients in the acute illness group identified the Plan, Assessment and History of Present Illness the most as important note sections, while patients in the chronic care group identified Significant Lab Data, Plan, and Assessment the most as important note sections. This study was able to identify primary care patients' information needs after clinic visit. Primary care patients have information needs pertaining to diagnosis and treatment, which may be the reason why both patient groups identified Plan and Assessment as important note sections. Future research should also develop and assess an AVS based on the information gathered in this study and evaluate its usefulness among primary care patients. The results of this study can be used to inform the development of an after-visit summary that assists patients to fully understand their treatment plan, which may improve treatment adherence.

  2. [Dignity in the care of terminal ill and dying patients. Definitions and supportive interventions in palliative care].

    Science.gov (United States)

    Mehnert, A; Schröder, A S; Puhlmann, K; Müllerleile, U; Koch, U

    2006-11-01

    Most patients, family members, health care professional as well as volunteers would agree that dignified care and being allowed to die with dignity are superior and unquestionable goals of palliative care. Although the majority of people have a more or less vague concept of dignity and despite its significance for palliative care, only a few empirical approaches to describe the sense of dignity from patients' and health care professionals' perspectives have been undertaken. However, individual descriptions of the dignity concept and definitions can serve as an impetus to improve the current palliative care practice by the development and evaluation of psychotherapeutic interventions for patients near the end of life and the allocation of resources. This article considers an internationally developed empirical-based model of dignity in severe and terminal ill patients by Chochinov et al. Furthermore, it illustrates the understanding of dignity as well as self-perceived exertions of influence on a patient's dignity from the perspective of health care professionals and volunteers. Psychotherapeutic interventions and strategies are introduced that can help conserve the sense of dignity of patients during palliative care.

  3. Verbal communication among Alzheimer's disease patients, their caregivers, and primary care physicians during primary care office visits.

    Science.gov (United States)

    Schmidt, Karen L; Lingler, Jennifer H; Schulz, Richard

    2009-11-01

    Primary care visits of patients with Alzheimer's disease (AD) often involve communication among patients, family caregivers, and primary care physicians (PCPs). The objective of this study was to understand the nature of each individual's verbal participation in these triadic interactions. To define the verbal communication dynamics of AD care triads, we compared verbal participation (percent of total visit speech) by each participant in patient/caregiver/PCP triads. Twenty-three triads were audio taped during a routine primary care visit. Rates of verbal participation were described and effects of patient cognitive status (MMSE score, verbal fluency) on verbal participation were assessed. PCP verbal participation was highest at 53% of total visit speech, followed by caregivers (31%) and patients (16%). Patient cognitive measures were related to patient and caregiver verbal participation, but not to PCP participation. Caregiver satisfaction with interpersonal treatment by PCP was positively related to caregiver's own verbal participation. Caregivers of AD patients and PCPs maintain active, coordinated verbal participation in primary care visits while patients participate less. Encouraging verbal participation by AD patients and their caregivers may increase the AD patient's active role and caregiver satisfaction with primary care visits.

  4. Patient-centered Fertility Care: From Theory to Practice

    Directory of Open Access Journals (Sweden)

    Fatemeh Jafarzadeh-Kenarsari

    2016-07-01

    Full Text Available Background & aim: Healthcare areas, especially fertility care (commonly accompanied with high emotions, as well as long-term and recurring treatment periods could exclusively benefit from patient-centered care (PCC. Despite evident advantages of PCC, this approach has not been practiced as a routine procedure in current clinical environments yet, even in western developed countries. Therefore, this review aimed to evaluate the significance and different aspects of PCC, while emphasizing on patient-centered fertility care, its challenges, and applicable recommendations in this regard. Methods: This narrative review was conducted on 29 relevant medical and clinical papers (published during 1990-2015 collected using various national and international databases (e.g., SID, Magiran, Medlib, Google scholar, Proquest, Pubmed, Wiley, Science direct, and Scopus. Key words and phrases used in this review were “infertility”, “fertility care”, “childlessness”, “patient-centered care”, “patient-centered fertility care” “shared decision-making”, “infertile patient preferences”, and “patient involvement in fertility care”. Results: According to the literature, implementation challenges of patient-centered fertility care were reported as different individual and organizational factors. These factors include lack of professional motivation to change, underestimating the significance of patient-centeredness by healthcare professionals, difficulty in translation of feedback into concrete measures, lack of time and financial resources, insufficient experience of healthcare professionals with regard to identification of needs and preferences of patients, traditional organizational culture, and common misconceptions. Conclusion: Promotion of patient-centered fertility services requires the identification of infertile needs and priorities of individuals, designation of interventional and supportive programs based on sociocultural

  5. Applying Bureaucratic Caring Theory and the Chronic Care Model to Improve Staff and Patient Self-Efficacy.

    Science.gov (United States)

    Potter, Marcia A; Wilson, Candy

    Patient activation and engagement can be powerful enablers for health outcomes that are just as important as staff engagement and satisfaction. The authors applied the Bureaucratic Caring Theory and the Chronic Care Model to a process improvement project designed to link activation, engagement, satisfaction, and health outcomes. Twenty-two adults with diabetes and 7 staff members caring for them participated in a 12-week process improvement project that incorporated a time-based element of longitudinal care with skill-based competencies to provide collaborative, team-based care to patients with type 2 diabetes. Patients completed satisfaction surveys at the end of their clinical encounters. Staff members completed satisfaction surveys pre- and postimplementation. The authors analyzed hemoglobin A1C levels pre- and postimplementation. As engagement and activation increased for both staff and patients, hemoglobin A1C levels decreased. The clinical implication is that the use of Bureaucratic Caring Theory may foster caring while broad application of the Chronic Care Model may improve self-efficacy, create healthier populations, and reduce health care costs.

  6. Nuclear oncology: From genotype to patient care

    International Nuclear Information System (INIS)

    1997-01-01

    Nuclear medicine is the medical specialty best suited to translate the exploding body of knowledge obtained from research in genetics and molecular biology into the care of patients. This fourth annual nuclear oncology conference will address how this can be done and how positron emission tomography (PET) and single photon emission tomography (SPECT) can be used in the care of patients with cancer or with increased genetic risk of developing cancer. The course will include illustrative patient studies showing how PET and SPECT can help in diagnosis, staging and treatment planning and monitoring of patients with cancer

  7. Patient Health Goals Elicited During Home Care Admission: A Categorization.

    Science.gov (United States)

    Sockolow, Paulina; Radhakrishnan, Kavita; Chou, Edgar Y; Wojciechowicz, Christine

    2017-11-01

    Home care agencies are initiating "patient health goal elicitation" activities as part of home care admission planning. We categorized elicited goals and identified "clinically informative" goals at a home care agency. We examined patient goals that admitting clinicians documented in the point-of-care electronic health record; conducted content analysis on patient goal data to develop a coding scheme; grouped goal themes into codes; assigned codes to each goal; and identified goals that were in the patient voice. Of the 1,763 patient records, 16% lacked a goal; only 15 goals were in a patient's voice. Nurse and physician experts identified 12 of the 20 codes as clinically important accounting for 82% of goal occurrences. The most frequent goal documented was safety/falls (23%). Training and consistent communication of the intent and operationalization of patient goal elicitation may address the absence of patient voice and the less than universal recording of home care patients' goals.

  8. Patient outcomes for the chronically critically ill: special care unit versus intensive care unit.

    Science.gov (United States)

    Rudy, E B; Daly, B J; Douglas, S; Montenegro, H D; Song, R; Dyer, M A

    1995-01-01

    The purpose of this study was to compare the effects of a low-technology environment of care and a nurse case management case delivery system (special care unit, SCU) with the traditional high-technology environment (ICU) and primary nursing care delivery system on the patient outcomes of length of stay, mortality, readmission, complications, satisfaction, and cost. A sample of 220 chronically critically ill patients were randomly assigned to either the SCU (n = 145) or the ICU (n = 75). Few significant differences were found between the two groups in length of stay, mortality, or complications. However, the findings showed significant cost savings in the SCU group in the charges accrued during the study period and in the charges and costs to produce a survivor. The average total cost of delivering care was $5,000 less per patient in the SCU than in the traditional ICU. In addition, the cost to produce a survivor was $19,000 less in the SCU. Results from this 4-year clinical trial demonstrate that nurse case managers in a SCU setting can produce patient outcomes equal to or better than those in the traditional ICU care environment for long-term critically ill patients.

  9. Intensive care nurses' perceptions of Inter Specialty Trauma Nursing Rounds to improve trauma patient care-A quality improvement project.

    Science.gov (United States)

    Jennings, Fiona L; Mitchell, Marion

    2017-06-01

    Trauma patient management is complex and challenging for nurses in the Intensive Care Unit. One strategy to promote quality and evidence based care may be through utilising specialty nursing experts both internal and external to the Intensive Care Unit in the form of a nursing round. Inter Specialty Trauma Nursing Rounds have the potential to improve patient care, collaboration and nurses' knowledge. The purpose of this quality improvement project was to improve trauma patient care and evaluate the nurses perception of improvement. The project included structured, weekly rounds that were conducted at the bedside. Nursing experts and others collaborated to assess and make changes to trauma patients' care. The rounds were evaluated to assess the nurse's perception of improvement. There were 132 trauma patients assessed. A total of 452 changes to patient care occurred. On average, three changes per patient resulted. Changes included nursing management, medical management and wound care. Nursing staff reported an overall improvement of trauma patient care, trauma knowledge, and collaboration with colleagues. Inter Specialty Trauma Nursing Rounds utilizes expert nursing knowledge. They are suggested as an innovative way to address the clinical challenges of caring for trauma patients and are perceived to enhance patient care and nursing knowledge. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. [Comparison of Patients and their Care in Urban and Rural Specialised Palliative Home Care - A Single Service Analysis].

    Science.gov (United States)

    Heckel, M; Stiel, S; Frauendorf, T; Hanke, R M; Ostgathe, C

    2016-07-01

    Specialised outpatient palliative care teams (in Germany called SAPV) aim to ensure best possible end-of-life care for outpatients with complex needs. Information on the influence of living areas (rural vs. urban) on patient and care related aspects is rare. This study aims to explore differences between palliative care patients in urban and rural dwellings concerning their nursing and service characteristics. A retrospective data analysis of documentary data for 502 patients supplied by SAPV team from December 2009 to June 2012 was conducted. Patients and care characteristics were investigated by frequency analysis and were compared for both groups of urban and rural dwelling patients (T test, Chi², Fisher's exact test p care, disease and service related aspects of palliative home care could be detected. An exception is that the rate of re-admittance to hospital is higher for rural dwelling patients (Fisher's exact test p=0.022). Although predominantly presumed, the single service analysis shows - except for the re-admittance rate to hospital - no considerable differences between palliative care patients regarding their living area. Our findings indicate that patients cared for in rural and urban settings have similar needs and impose similar requirements on palliative care teams. © Georg Thieme Verlag KG Stuttgart · New York.

  11. Advanced care planning--empowering patients for a peaceful death.

    Science.gov (United States)

    Karver, Sloan B; Berger, Jessalyn

    2010-01-01

    In the early 1900's, Americans had a life expectancy of about 50 years. Childhood mortality was very high and an adult who lived into their sixties was considered to be doing pretty well. Prior to the advent of different types of antibiotics, people would die quickly of infectious disease or accidents and medicine only really focused on caring and comfort. Since then, there has been a shift in medicines focus. New science, technology and communications have shifted the way Americans treat incurable diseases and have promoted the idea of aggressive fighting as well as to keep patients alive at any costs. The internet has allowed easy access for patients to do on-line research and to know the treatments for diseases and the availability of trials. This has promoted the idea that every disease or cancer is curable if the patient does exactly as the internet says. It has hindered the idea of compassionate care and dying with dignity so that a patient can stay alive at all costs, even in a vegetative state. In the last two decades, there has been a significant expansion of palliative and supportive care services in the United States. This has including the development of a specialty for palliative care medicine with a board certification in hospice and palliative medicine. A challenge to the field has been the reluctance of physicians to request palliative care consults in a very timely manner as well as relinquish care of their patients. A common occurrence in the United States, at many cancer centers, is the treatment of chemotherapy and radiation up until the day before a patient dies. At this point, the physician ends up throwing up his or her hands with nothing left to offer the patient or its family. However, what we have been finding is that presently there are now many oncologists who are willing to refer patients to palliative care for specific management of difficult pain control issues. At the Moffitt Cancer Center, we have a Palliative Care consulting

  12. Communication elements supporting patient safety in psychiatric inpatient care.

    Science.gov (United States)

    Kanerva, A; Kivinen, T; Lammintakanen, J

    2015-06-01

    Communication is important for safe and quality health care. The study provides needed insight on the communication elements that support patient safety from the psychiatric care view. Fluent information transfer between the health care professionals and care units is important for care planning and maintaining practices. Information should be documented and implemented accordingly. Communication should happen in an open communication culture that enables discussion, the opportunity to have debriefing discussions and the entire staff can feel they are heard. For effective communication, it is also important that staff are active themselves in information collecting about the essential information needed in patient care. In mental health nursing, it is important to pay attention to all elements of communication and to develop processes concerning communication in multidisciplinary teams and across unit boundaries. The study aims to describe which communication elements support patient safety in psychiatric inpatient care from the viewpoint of the nursing staff. Communication is an essential part of care and one of the core competencies of the psychiatric care. It enables safe and quality patient care. Errors in health care are often connected with poor communication. The study brings needed insight from the psychiatric care view to the topic. The data were gathered from semi-structured interviews in which 26 nurses were asked to describe the elements that constitute patient safety in psychiatric inpatient care. The data were analysed inductively from the viewpoint of communication. The descriptions connected with communication formed a main category of communication elements that support patient safety; this main category was made up of three subcategories: fluent information transfer, open communication culture and being active in information collecting. Fluent information transfer consists of the practical implementation of communication; open communication

  13. Mutations des roles techniques et formation. Etude documentaire (Changes in the Roles and Education of Technicians. Documentary Study).

    Science.gov (United States)

    Pinard, Helene

    Drawing from research conducted in 1990-91, this report examines trends affecting the future work of technicians in Quebec, their pre-employment education, and the link between college and work. Part 1 focuses on aspects of the economic, technological, and social environment that will influence the future role of technicians. Economic concerns…

  14. [Patients in treatment for malnutrition in primary care, study of 500 real patients].

    Science.gov (United States)

    Soto Moreno, A; Venegas Moreno, E; Santos Rubio, M; Sanz, León; García Luna, P P

    2002-01-01

    The worsening of the nutritional status of certain segments of the population has led to frequent situations of chronic undernourishment even in the healthy population. There are very few data available on the prevalence and causes of malnutrition in Primary Health Care. The present study attempts to provide measurable information, obtained at random from the doctors involved in the country's Primary Health Care, on the characteristics of the undernourished patients, the cause of the undernourishment, the diagnostic means used, the treatment applied and the progress of the patients regularly treated in Primary Health Care facilities. A sample of 1,819 doctors in Primary Health Care were surveyed to know their opinions on the nutritional status of their patients. They were asked to complete a "Patient Record" for the first patient to enter their office suffering from undernourishment. A total of 505 Patient Records were received from the different Primary Health Care doctors taking part in the study throughout Spain. Of the patients included, 10% were aged less than 10, while 46.7% were between 16 and 65 years of age and 44.2% were over 65. The main diagnosis in these patients was varied, with cancer patients (22.6%) and anorexics, including anorexia nerviosa and other non-oncological causes, (16.4%) the most common. As for the tests used for diagnosing undernourishment, those most frequently applied were physical examination (61%) and biochemical tests (56.4%). The risk factor most commonly found in these patients was old age/senility (21%). Nutritional support (55.8%) and dietary recommendations (45.3%) were the therapies most often applied. Only 47% of patients correctly implemented their treatment according to the doctors in Primary Health Care and the prognosis was as follows: 31% were expected to improve, 20% to worsen and 44% of cases would remain stable. From this study, it is concluded that most undernourished patients in Primary Health Care are there due

  15. SERVQUAL: a tool for evaluating patient satisfaction with nursing care.

    Science.gov (United States)

    Scardina, S A

    1994-01-01

    Rising health care costs and competition among hospital facilities have resulted in the need to recognize patient satisfaction as an important indicator of quality care. Nurses provide the primary service to patients; therefore, their role is influential in overall satisfaction. Several instruments have been developed to measure patient satisfaction with nursing care; however, most of them focus only on patient perceptions. One such approach to evaluating patient satisfaction with nursing care involves an instrument, SERVQUAL, derived from a marketing service perspective. Adapting SERVQUAL for use in evaluating nursing care is the focus of this article. SERVQUAL assesses both patient perceptions and expectations of quality service and permits managers and clinicians to view the gaps between the two; thus, the overall areas of improvement in nursing services can be determined.

  16. The validation of the Utrecht work engagement scale for emergency medical technicians in Gauteng

    Directory of Open Access Journals (Sweden)

    JLP Naudé

    2004-04-01

    Full Text Available The objectives of this study were to validate the Utrecht Work Engagement Scale (UWES for emergency medical technicians in the Gauteng Province of South Africa and to determine its construct equivalence and bias for different language groups. A cross-sectional survey design was used with a convenient sample (N = 318 of emergency medical technicians in Gauteng. The UWES and a biographical questionnaire were administered. A two-factor model of work engagement, consisting of Vigour/Dedication and Absorption was found. Exploratory factor analysis with target rotations confirmed the construct equivalence of the work engagement construct for white and black employees.

  17. Communication skills training for health care professionals improves the adult orthopaedic patient's experience of quality of care

    DEFF Research Database (Denmark)

    Nørgaard, Birgitte; Kofoed, Poul-Erik; Ohm Kyvik, Kirsten

    2012-01-01

    Scand J Caring Sci; 2012; Communication skills training for health care professionals improves the adult orthopaedic patient's experience of quality of care Rationale:  Despite the fact that communication has become a core topic in health care, patients still experience the information provided...... as insufficient or incorrect and a lack of involvement. Objective:  To investigate whether adult orthopaedic patients' evaluation of the quality of care had improved after a communication skills training course for healthcare professionals. Design and methods:  The study was designed as an intervention study...... offering professionals training in communicating with patients and colleagues. The outcome was measured by assessing patients' experience of quality of care. Data were collected by means of a questionnaire and analysed using a linear regression model. Approval was obtained from the Danish Data Protection...

  18. Patients' Care Needs: Documentation Analysis in General Hospitals.

    Science.gov (United States)

    Paans, Wolter; Müller-Staub, Maria

    2015-10-01

    The purpose of the study is (a) to describe care needs derived from records of patients in Dutch hospitals, and (b) to evaluate whether nurses employed the NANDA-I classification to formulate patients' care needs. A stratified cross-sectional random-sampling nursing documentation audit was conducted employing the D-Catch instrument in 10 hospitals comprising 37 wards. The most prevalent nursing diagnoses were acute pain, nausea, fatigue, and risk for impaired skin integrity. Most care needs were determined in physiological health patterns and few in psychosocial patterns. To perform effective interventions leading to high-quality nursing-sensitive outcomes, nurses should also diagnose patients' care needs in the health management, value-belief, and coping stress patterns. © 2014 NANDA International, Inc.

  19. Specifics of nursing care for a patient with nutritional stoma.

    OpenAIRE

    MUSILOVÁ, Klára

    2017-01-01

    Main goal of the thesis was to map out the specifics of nursing care for a patient with a nutritious stoma. Three research questions have been identified in connection to this goal. First research question was focused on mapping out the nursing care for a patient prior applying the nutritious stoma. Second research question was focusing on nursing care for a patient while the nutritious stoma is being applied, and the last third question researches the nursing care for a patient after applyin...

  20. Team dynamics, clinical work satisfaction, and patient care coordination between primary care providers: A mixed methods study.

    Science.gov (United States)

    Song, Hummy; Ryan, Molly; Tendulkar, Shalini; Fisher, Josephine; Martin, Julia; Peters, Antoinette S; Frolkis, Joseph P; Rosenthal, Meredith B; Chien, Alyna T; Singer, Sara J

    Team-based care is essential for delivering high-quality, comprehensive, and coordinated care. Despite considerable research about the effects of team-based care on patient outcomes, few studies have examined how team dynamics relate to provider outcomes. The aim of this study was to examine relationships among team dynamics, primary care provider (PCP) clinical work satisfaction, and patient care coordination between PCPs in 18 Harvard-affiliated primary care practices participating in Harvard's Academic Innovations Collaborative. First, we administered a cross-sectional survey to all 548 PCPs (267 attending clinicians, 281 resident physicians) working at participating practices; 65% responded. We assessed the relationship of team dynamics with PCPs' clinical work satisfaction and perception of patient care coordination between PCPs, respectively, and the potential mediating effect of patient care coordination on the relationship between team dynamics and work satisfaction. In addition, we embedded a qualitative evaluation within the quantitative evaluation to achieve a convergent mixed methods design to help us better understand our findings and illuminate relationships among key variables. Better team dynamics were positively associated with clinical work satisfaction and quality of patient care coordination between PCPs. Coordination partially mediated the relationship between team dynamics and satisfaction for attending clinicians, suggesting that higher satisfaction depends, in part, on better teamwork, yielding more coordinated patient care. We found no mediating effects for resident physicians. Qualitative results suggest that sources of satisfaction from positive team dynamics for PCPs may be most relevant to attending clinicians. Improving primary care team dynamics could improve clinical work satisfaction among PCPs and patient care coordination between PCPs. In addition to improving outcomes that directly concern health care providers, efforts to