As diabetes becomes more prevalent throughout the United States, there is an increased demand for healthcare providers and healthcare resources. Pharmacists have started to collaborate with primary care providers, and...As diabetes becomes more prevalent throughout the United States, there is an increased demand for healthcare providers and healthcare resources. Pharmacists have started to collaborate with primary care providers, and through this collaboration, pharmacists are able to augment patient care and provide additional resources to diabetic patients. This essay reviews the effect of one clinic that incorporates pharmacist interventions as an addition to established patient care teams, and evaluates the effect that the pharmacist interventions have on patient hemoglobin A1C%. While this essay provides data to show the positive benefits of pharmacist intervention on diabetes patients and A1C% goals, additional data and research are needed to demonstrate how pharmacists are a necessary addition to patient care teams.展开更多
Background:The family care team(FCT)was established to improve the quality of care.This study aimed to explore the perceptions of FCT implementation and describe the challenges inherent in implementing the FCT.Methods...Background:The family care team(FCT)was established to improve the quality of care.This study aimed to explore the perceptions of FCT implementation and describe the challenges inherent in implementing the FCT.Methods:Forty in-depth interviews were conducted.The interviewees consisted of five pri-mary care managers in the provincial medical health office,five directors of community hospitals,five administrators in district health offices,ten subdistrict health-promoting hospital directors,rep-resentatives from ten local organizations,and five heads of village health volunteers.Data were col-lected in accordance with semistructured interview guidelines and analyzed by thematic analysis.Results:Participants’expressed their opinions through five themes:(1)the role and scope of practice,(2)the communication in collaboration of the FCT,(3)the management of the FCT,(4)the impact of the FCT on the team members’feelings and primary care performance,and(5)the main challenges,including the insufficiency of a teamwork culture and a biomedical approach.Conclusion:The information suggests the importance of issues such as the clarification of the team members’roles and managers’roles,communication within and across FCTs,and the prepara-tion for training of interprofessionals to enhance collaborative management to achieve the optimal care for people in the district health system.展开更多
Introduction: Arteriovenous fistula (AVF) operation is recognized a gold standard of hemodialysis for end-stage renal disease. Because various complications may occur during perioperative period, medical care plays an...Introduction: Arteriovenous fistula (AVF) operation is recognized a gold standard of hemodialysis for end-stage renal disease. Because various complications may occur during perioperative period, medical care plays an important role in improving the possibility of AVF operation. The objective of the study was to explore the effect of the mode of multiple disciplinary team (MDT) medical care on the patients with end-stage renal disease treated by arteriovenous fistula (AVF) operation. Method: 98 patients with end-stage renal disease under the AVF operation were divided into observation group and control group. The control group was performed with regular medical care and for the observation group was treated under the mode of MDT medical care. Complications after operation, hospitalized time and medical satisfaction were comprehensively compared between the both groups. Results: The overall complications including swelling, bleeding, infection and thrombosis in observation group accounted for 5%, however, 19% of patients suffered different complications in the control group. The total complications significantly decreased in the observation group compared with control group (P < 0.001). The hospitalization time was shortened to 9.8 ± 5.6 days in the observation group, and the average hospitalization in control group was 17.8 ± 8.9 days. The medical satisfaction was increased by 20.83 percent in the observation group compared with the control group (P < 0.001). 75% patients in control group were satisfied with medical care, and 98.53% patients were satisfied for observation group. Conclusion: The mode of MDT medical care was beneficial for patients with end-stage renal disease after AVF operation, which could significantly reduce complications, hospitalized time and improve patients’ degree of satisfaction. Thus, it should be recommended in the clinical work.展开更多
Objectives:A framework for the advanced practice nurse(APN)role was developed in our Canadian Tertiary Care Centre,delineating five domains of advanced nursing practice:clinical practice,consultation,research,educatio...Objectives:A framework for the advanced practice nurse(APN)role was developed in our Canadian Tertiary Care Centre,delineating five domains of advanced nursing practice:clinical practice,consultation,research,education and leadership.The goal of this study was to evaluate perceptions of the effectiveness of the implementation of an innovative APN role on an in-patient Neurosurgery unit.Methods:A pre-and-post implementation design,incorporating both qualitative and quantitative data,was utilized.An innovative APN role was implemented within the Neurosurgery program focusing on the clinical domain and required the successful candidates to be NP prepared.This APN role was designed to improve patient flow,documentation,communication and patient and staff satisfaction.Three primary outcomes were measured:pre-implementation questionnaire(nurses),post-implementation questionnaire(nurses and residents)and number of pages to the on-call resident.Results:Survey scores by nurses and residents indicated improvement across all aspects studied.Average scores increased from 1.1 to 2.6,reflecting an overall statistically significant increase.The number of pages to the on-call resident also showed a decrease.Conclusion:Perceptions of patient care delivery and professional collaboration improved following implementation of the APN role.Responses indicated that APNs significantly impacted patient care and improved nurses and residents'job satisfaction.展开更多
文摘As diabetes becomes more prevalent throughout the United States, there is an increased demand for healthcare providers and healthcare resources. Pharmacists have started to collaborate with primary care providers, and through this collaboration, pharmacists are able to augment patient care and provide additional resources to diabetic patients. This essay reviews the effect of one clinic that incorporates pharmacist interventions as an addition to established patient care teams, and evaluates the effect that the pharmacist interventions have on patient hemoglobin A1C%. While this essay provides data to show the positive benefits of pharmacist intervention on diabetes patients and A1C% goals, additional data and research are needed to demonstrate how pharmacists are a necessary addition to patient care teams.
基金This study was funded by National Health Security Office Region 2,Thailand(grant number 58/B/02837).
文摘Background:The family care team(FCT)was established to improve the quality of care.This study aimed to explore the perceptions of FCT implementation and describe the challenges inherent in implementing the FCT.Methods:Forty in-depth interviews were conducted.The interviewees consisted of five pri-mary care managers in the provincial medical health office,five directors of community hospitals,five administrators in district health offices,ten subdistrict health-promoting hospital directors,rep-resentatives from ten local organizations,and five heads of village health volunteers.Data were col-lected in accordance with semistructured interview guidelines and analyzed by thematic analysis.Results:Participants’expressed their opinions through five themes:(1)the role and scope of practice,(2)the communication in collaboration of the FCT,(3)the management of the FCT,(4)the impact of the FCT on the team members’feelings and primary care performance,and(5)the main challenges,including the insufficiency of a teamwork culture and a biomedical approach.Conclusion:The information suggests the importance of issues such as the clarification of the team members’roles and managers’roles,communication within and across FCTs,and the prepara-tion for training of interprofessionals to enhance collaborative management to achieve the optimal care for people in the district health system.
文摘Introduction: Arteriovenous fistula (AVF) operation is recognized a gold standard of hemodialysis for end-stage renal disease. Because various complications may occur during perioperative period, medical care plays an important role in improving the possibility of AVF operation. The objective of the study was to explore the effect of the mode of multiple disciplinary team (MDT) medical care on the patients with end-stage renal disease treated by arteriovenous fistula (AVF) operation. Method: 98 patients with end-stage renal disease under the AVF operation were divided into observation group and control group. The control group was performed with regular medical care and for the observation group was treated under the mode of MDT medical care. Complications after operation, hospitalized time and medical satisfaction were comprehensively compared between the both groups. Results: The overall complications including swelling, bleeding, infection and thrombosis in observation group accounted for 5%, however, 19% of patients suffered different complications in the control group. The total complications significantly decreased in the observation group compared with control group (P < 0.001). The hospitalization time was shortened to 9.8 ± 5.6 days in the observation group, and the average hospitalization in control group was 17.8 ± 8.9 days. The medical satisfaction was increased by 20.83 percent in the observation group compared with the control group (P < 0.001). 75% patients in control group were satisfied with medical care, and 98.53% patients were satisfied for observation group. Conclusion: The mode of MDT medical care was beneficial for patients with end-stage renal disease after AVF operation, which could significantly reduce complications, hospitalized time and improve patients’ degree of satisfaction. Thus, it should be recommended in the clinical work.
文摘Objectives:A framework for the advanced practice nurse(APN)role was developed in our Canadian Tertiary Care Centre,delineating five domains of advanced nursing practice:clinical practice,consultation,research,education and leadership.The goal of this study was to evaluate perceptions of the effectiveness of the implementation of an innovative APN role on an in-patient Neurosurgery unit.Methods:A pre-and-post implementation design,incorporating both qualitative and quantitative data,was utilized.An innovative APN role was implemented within the Neurosurgery program focusing on the clinical domain and required the successful candidates to be NP prepared.This APN role was designed to improve patient flow,documentation,communication and patient and staff satisfaction.Three primary outcomes were measured:pre-implementation questionnaire(nurses),post-implementation questionnaire(nurses and residents)and number of pages to the on-call resident.Results:Survey scores by nurses and residents indicated improvement across all aspects studied.Average scores increased from 1.1 to 2.6,reflecting an overall statistically significant increase.The number of pages to the on-call resident also showed a decrease.Conclusion:Perceptions of patient care delivery and professional collaboration improved following implementation of the APN role.Responses indicated that APNs significantly impacted patient care and improved nurses and residents'job satisfaction.
