Home About us Contact
|
Home About us Contact | ||
|
|
||
Health Care Team (health + care_team)
Kinds of Health Care Team Selected AbstractsHome care for chronic respiratory failure in children: 15 years experiencePEDIATRIC ANESTHESIA, Issue 4 2002L. APPIERTO MD Background:,Advances in paediatric intensive care have reduced mortality but, unfortunately, one of the consequences is an increase in the number of patients with chronic diseases. It is generally agreed that home care of children requiring ventilatory support improves their outcomes and results in cost saving for the National Health Service. Methods:,Since 1985, the Children's Hospital Bambino Gesù of Rome has developed a program of paediatric home care. The program is performed by a committed Home Health Care Team (HHCT) which selects the eligible patients for home care and trains the families to treat their child. During the period January 1985 to January 2001, 53 children with chronic respiratory failure were included in the home care program. Of these, seven patients were successively excluded and six died in our intensive care unit (ICU), while one still lives in our ICU since 1997. The results obtained in the remaining 46 children are reported. Results:,The pathologies consisted of disorders of respiratory control related to brain damage (26%), upper airways obstructive disease (26%), spinal muscular atrophy (22%), myopathies and muscular dystrophies (6.5%), bronchopulmonary dysplasia (6.5%), tracheomalacia (6.5%), central hypoventilation syndrome (4.3%) and progressive congenital scoliosis (2.2%). Of these 46 patients, 34 children are mechanically ventilated and the median of their ICU stay was 109.5 days (range 54,214 days), while the remaining 12 children were breathing spontaneously and the median of their ICU stay was 90.5 days (range 61,134 days). We temporarily readmitted six patients to our ICU to perform scheduled otolaryngological surgery, eight patients for acute respiratory infections and two patients for deterioration of their neurological status due to high pressure hydrocephalus for placement of a ventriculoperitoneal shunt; these 16 patients were discharged back home again. Two other patients were readmitted for deterioration of their chronic disease and died in our ICU, while seven patients died at home. Conclusions:,Thirty-seven children are still alive at home and four of them improved their respiratory condition so that it was possible to remove the tracheostomy tube. Our oldest patient has now achieved 15 years of mechanical ventilation at home. [source] Improving Heart Failure Self-Management Support by Actively Engaging Out-of-Home Caregivers: Results of a Feasibility StudyCONGESTIVE HEART FAILURE, Issue 1 2008John D. Piette PhD The benefits of heart failure (HF) care management have been demonstrated, yet health systems are often unable to meet patients' needs for support between outpatient visits. Informal care provided by family or friends is a low-cost, and potentially effective, adjunct to care management services. The authors evaluated the feasibility of augmenting HF care management with weekly, automated assessment and behavior change calls to patients, feedback via the Internet to an out-of-home informal caregiver or CarePartner (CP), and faxes to the patient's health care team. The program included 52 HF patient-CP pairs participating for an average of 12 weeks. Patients completed 586 assessments (92% completion rate) and reported problems that might otherwise have gone unidentified. At follow-up, 75% had made changes in their self-care as a result of the intervention. The CP program may extend the impact of HF telemonitoring beyond what care management programs can realistically deliver. [source] Family Resiliency in Childhood Cancer,FAMILY RELATIONS, Issue 2 2002Marilyn McCubbin Based on in-depth interviews with 42 parents (25 mothers, 17 fathers) in 26 families who had had a child treated for cancer within the previous 3 years, resiliency factors that helped the family recover were identified. The resiliency factors included internal family rapid mobilization and reorganization; social support from the health care team, extended family, the community, and the workplace; and changes in appraisal to make the situation more comprehensible, manageable, and meaningful. [source] Triage, treat and transfer: reconceptualising a rural practice model,JOURNAL OF CLINICAL NURSING, Issue 11-12 2010Elise Sullivan Aim., This article argues that the current model of emergency practice in rural Victorian hospitals, which relies heavily on visiting medical officers, needs to be reconceptualised if emergency services are to be supplied to rural communities. Background., Medical workforce shortages are manifesting in Victoria as a reduction in emergency care services from rural hospitals. The suggested alternative model of emergency care involves advancing nursing practice to enable a redistribution of clinical capacity across the health care team. Clinicians will need to work collaboratively and continuously negotiate their roles to meet the patient's and the clinical team's needs. Design., Systematic review. Methods., This article is based on a review of the Victorian and Australian literature on the subject of Victorian health services and policy, emergency care, collaboration, communication and rural nurse scope of practice and roles. Emergency care activity was drawn from data held in the Victorian Emergency Management Dataset and personal communications between one of the authors and hospital executives in a small selection of rural hospitals in Victoria. Results., The evidence reviewed suggests that the current emergency practice profile of rural hospitals in Victoria does not reflect the reconceptualised model of rural emergency practice. Instead, only a small proportion of non-urgent presentations is managed by nurses without medical support, and the data suggest that metropolitan nurses are more likely to manage without medical support than rural nurses. Conclusion., Reconceptualising rural emergency care in Victoria will require significantly greater investment in rural nurses' knowledge and skills to enable them to operate confidently at a more advanced level. Clinical teams that deliver emergency service in rural hospitals will be expected increasingly to work collaboratively and interprofessionally. Relevance to clinical practice., This article offers some directions for advancing nursing practice and strategies for improving interprofessional collaboration in the delivery of rural emergency care. [source] Hospitalized elders and family caregivers: a typology of family worryJOURNAL OF CLINICAL NURSING, Issue 1 2005Hong Li PhD Objective., This qualitative study explored the kinds of worry that family caregivers experience when their older relatives are hospitalized. Background., Little is known about what kinds of worries family caregivers may have in association with the hospitalizations of older relatives. An understanding of the different patterns of family worry may help health care teams intervene more effectively to meet family caregiver's needs by reducing their anxiety. Design., A qualitative descriptive design with Loftland and Loftland (1984) approach for the study of a phenomenon occurring in a social setting was used. Method., A purposeful sample of 10 participants was obtained that included six family caregivers and four nurses. Participants were recruited from two hospitals in the northwest US. Intensive interviews and participant observations were used for data collection, and Loftland and Loftland's (1984) qualitative approach was used for data analysis. Results., Family worry was defined as family caregivers' felt difficulty in fulfilling their roles because of worry. Four categories of family worry were identified as a result of this study: (i) worry about the patient's condition; (ii) worry about the patient's care received from the health care team; (iii) worry about future care for the patient provided by the family caregiver; and (iv) worry about finances. Conclusions., The findings of this pilot study provide nurses with the initial knowledge of the typology of family worry associated with elderly relatives' hospitalizations. Relevance to clinical practice., The findings of this study may sensitize the nurses to more precisely evaluate family caregivers' worry about their hospitalized elders and provide more effective nursing interventions to improve outcomes of both patients and their family caregivers. [source] SARS , a perspective from a school of nursing in Hong KongJOURNAL OF CLINICAL NURSING, Issue 2 2004David R. Thompson PhD Background., Severe acute respiratory syndrome (SARS) is a new infectious disease with significant morbidity and mortality that has had a major impact on health and health care services worldwide. Hong Kong has had a significant number of cases and deaths. Nurses, at the vanguard of the clinical health care team, have been particularly affected by it. The outbreak prompted the health authorities to implement a series of public health measures and hospital policies, including a guideline for the diagnosis and management of patients with SARS. Aims and objectives., This paper aims at providing an overview of what is known about SARS and the impact it has had in Hong Kong and to highlight from the perspective of a school of nursing the major clinical, educational and public health implications. Conclusions., The lack of understanding and uncertainty about the disease led to significant variation in the provision of information, contributing to the confusion and anxiety in the community. Therefore, there is a need to revise the nursing curriculum, to provide continuing education to all health care professionals, particularly with regard to infection control measures, and to revisit the range of public health policies to ensure the health of the community is protected by these policies. There also has been a reaffirmation of the importance of health promotion that highlights the importance of the partnership between nurses, health policy makers and public health personnel. It is evident that the organization and delivery of clinical practice, teaching and health promotion have to be flexible and responsive to a changing health scenario. Relevance to clinical practice., Nurses must play a crucial role in the prevention, detection and containment of SARS. They will need to implement and ensure strict adherence to infection control measures and, in some circumstances, isolation and quarantine may be warranted. Attention to the psychological state of patients and family members should not be overlooked. Paramount is education of patients, families and members of the public at large. [source] Agency nursing work in acute care settings: perceptions of hospital nursing managers and agency nurse providersJOURNAL OF CLINICAL NURSING, Issue 4 2003Elizabeth Manias BPHARM, FRCNA, MNursStud, MPharm Summary ,,There is a paucity of research in investigating agency nursing work from the perspectives of hospital nursing managers and agency nurse providers. ,,This exploratory paper examines the hospital nursing managers' and agency nurse providers' perceptions and experiences of agency nursing work. ,,Individual, in-depth interviews were conducted with three agency nurse providers and eight hospital nursing managers. Because of the lack of previous research in this area, an exploratory, semi-structured interviewing technique was deemed appropriate. ,,Three major themes emerged from interview data: planning for ward allocation, communication and professionalism. ,,In planning for ward allocation, hospital managers were primarily concerned with maintaining adequate numbers of nursing staff in the ward settings. A major concern for agency nurse providers was inappropriate allocation of temporary staff. ,,Communication was valued in different ways. While hospital managers focused on communication between the agency nurse and other permanent members of the health care team, agency providers were concerned with exchanges between agencies and hospital organizations, and between the agencies and agency nurses. ,,For both groups, responsibility for professional development and the status of agency nursing as a career choice for graduate and experienced nurses were the focal aspects for consideration. ,,A limitation of this study is the small number of individual interviews conducted with hospital nursing managers and agency nurse providers. Nevertheless, the findings represent the views of 11 individuals in senior managerial roles. ,,The findings reinforce the need to enhance collaboration between hospitals and nursing agencies, and to examine how divergent views of agency nursing work could be reconciled , with the aim of providing quality patient care. [source] The Invisibility of Advanced Practice Nurses in Popular MagazinesJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 3 2001Susan L. Norwood EdD PURPOSE To determine the image portrayed in the media of nurses and particularly nurse practitioners (NPs) compared with other health care providers. DATA SOURCES An analysis of advertisements and articles in popular magazines aimed at female, male, and gender-neutral audiences was conducted between 12/99 and 06/00. Relationships between target audience and content of advertisements and articles, as well as portrayal of health care providers were also explored. CONCLUSIONS A review of 100 consecutive advertisements for health-related products and 96 consecutive health-related articles in popular magazines revealed that the media continues to overwhelmingly depict and promote physicians as the source of health care and health-related advice. IMPLICATIONS FOR PRACTICE Because when there are few references to a group, such as NPs, it is reasonable to assume group members have little influence, standing, and authority, NPs should be concerned about the implications of these findings. Strategies for increasing the visibility of NPs as credible and valuable members of the health care team are shared. [source] Forming professional identities on the health care team: discursive constructions of the ,other' in the operating roomMEDICAL EDUCATION, Issue 8 2002L Lingard Background, Inter-professional health care teams represent the nucleus of both patient care and the clinical education of novices. Both activities depend upon the,talk' that team members use to interact with one another. This study explored team members' interpretations of tense team communications in the operating room (OR). Methods, The study was conducted using 52 team members divided into 14 focus groups. Team members comprised 13 surgeons, 19 nurses, nine anaesthetists and 11 trainees. Both uni-disciplinary (n = 11) and multi-disciplinary (n = 3) formats were employed. All groups discussed three communication scenarios, derived from prior ethnographic research. Discussions were audio-recorded and transcribed. Using a grounded theory approach, three researchers individually analysed sample transcripts, after which group discussions were held to resolve discrepancies and confirm a coding structure. Using the confirmed code, the complete data set was coded using the ,NVivo' qualitative data analysis software program. Results, There were substantial differences in surgeons', nurses', anaesthetists', and trainees' interpretations of the communication scenarios. Interpretations were accompanied by subjects' depictions of disciplinary roles on the team. Subjects' constructions of other professions' roles, values and motivations were often dissonant with those professions' constructions of themselves. Conclusions, Team members, particularly novices, tend to simplify and distort others' roles and motivations as they interpret tense communication. We suggest that such simplifications may be rhetorical, reflecting professional rivalries on the OR team. In addition, we theorise that novices' echoing of role simplification has implications for their professional identity formation. [source] Implementing the severe sepsis care bundles outside the ICU by outreachNURSING IN CRITICAL CARE, Issue 5 2007Chris Carter Abstract Sepsis is not a new challenge facing the health care team, it remains a complex disease, which is difficult to identify and treat. Mortality from sepsis remains high and continues to be a common cause of death among critically ill patients, despite advances in critical care. Sepsis accounts for an estimated 27% of all intensive care admissions in England, Wales and Northern Ireland, and accounted for 46% of all intensive care bed days. Recent research studies and the surviving sepsis campaign have shown that identifying and providing key interventions to patients with severe sepsis and septic shock prior to their admission to the intensive care unit significantly improve outcomes. The aim of this paper was to identify how the Critical Care Outreach Team at one local hospital implemented the severe sepsis resuscitation care bundle for patients in the emergency department (ED) and on the general wards. It will include a presentation on the various ways the team raised the profile of severe sepsis and the care bundle at hospital and at national level. It also includes audit data that have been collected. The results showed that if the resuscitation care bundle was implemented within the first 24 h of hospital admission, mortality was 29%, whereas if the care bundle was instigated after this time mortality was more than at 49%. Audit data showed that the commonest sign of severe sepsis seen in patients in the ED and on wards was tachypnoea. This article discusses the successful implementation of the severe sepsis resuscitation care bundle and the positive impact an Outreach team can have in changing practice in the way patients are managed with severe sepsis. The audit data support the need for regular physiological observations and the use of a Patient At Risk Trigger scoring tool to identify patients at risk of deterioration. This allows referral to the Outreach team, who assess the patient and if appropriate initiate the care bundle. [source] Self-assessment and continuing professional development: The Canadian perspectiveTHE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS, Issue 1 2008FRCPC, Ivan Silver MD Abstract Introduction: Several recent studies highlight that physicians are not very accurate at assessing their competence in clinical domains when compared to objective measures of knowledge and performance. Instead of continuing to try to train physicians to be more accurate self-assessors, the research suggests that physicians will benefit from learning programs that encourage them to reflect on their clinical practice, continuously seek answers to clinical problems they face, compare their knowledge and skills to clinical practice guidelines and benchmarks, and seek feedback from peers and their health care team. Methods: This article describes the self-assessment learning activities of the College of Family Physicians of Canada Maintenance of Proficiency program (Mainpro®) and the Royal College of Physicians and Surgeons of Canada Maintenance of Certification program. (MOC) Results: The MOC and the Mainpro® programs incorporate several self-evaluation learning processes and tools that encourage physicians to assess their professional knowledge and clinical performance against objective measures as well as guided self-audit learning activities that encourage physicians to gather information about their practices and reflect on it individually, with peers and their health care team. Physicians are also rewarded with extra credits when they participate in either of these kinds of learning activities. Discussion: In the future, practice-based learning that incorporates self-assessment learning activities will play an increasingly important role as regulators mandate that all physicians participate in continuing professional development activities. Research in this area should be directed to understanding more about reflection in practice and how we can enable physicians to be more mindful. [source] Design and implementation of training to improve management of pediatric overweightTHE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS, Issue 4 2005Continuing Medical Education, Luke Beno MD Chief Abstract Introduction: Clinicians report a low proficiency in treating overweight children and using behavioral management strategies. This paper documents the design and implementation of a training program to improve clinicians' skills in the assessment and behavioral management of pediatric overweight. Methods: Two one-hour CME trainings were designed using published guidelines, research findings, and expert committee recommendations. The trainings were provided to clinicians of a managed care pediatric department, utilizing novel screening and counseling tools, and interactive exercises. Surveys and focus groups were conducted 3 and 6 months post intervention to examine clinician attitudes and practices regarding the screening and counseling tools. Results: Post intervention, the majority of clinicians agreed that the clinical practice guidelines (Pediatric Obesity Practice Resource) and BMI-for-age percentile provided useful information for clinical practice. Clinicians reported an increased utilization of the recommended screening tools and changes in office practices to implement these tools. They offered suggestions to improve the ease of use of the tools and to overcome perceived clinician and/or patient barriers. Discussion: A brief, cost effective, multi-faceted training and provision of counseling tools were perceived as helpful to clinical practice. Useful lessons were learned about tool design and ways to fit tools into practice. Training the entire health care team is advantageous to the adoption of new tools and practices. [source] Scabies and pyodermas , diagnosis and treatmentDERMATOLOGIC THERAPY, Issue 6 2009R.J. Hay ABSTRACT Scabies and pyodermas are two of the commonest skin infections in tropical settings. They affect large numbers of people, particularly children, and account for a large burden of disease for peripheral health care teams. Despite this there have been significant advances in our knowledge of these diseases, their impact and their management. However there is a need to evaluate these developments in this specific setting, tropical health and in the context of communities with limited resources. This section will describe these advances and the challenges that remain. [source] Hospitalized elders and family caregivers: a typology of family worryJOURNAL OF CLINICAL NURSING, Issue 1 2005Hong Li PhD Objective., This qualitative study explored the kinds of worry that family caregivers experience when their older relatives are hospitalized. Background., Little is known about what kinds of worries family caregivers may have in association with the hospitalizations of older relatives. An understanding of the different patterns of family worry may help health care teams intervene more effectively to meet family caregiver's needs by reducing their anxiety. Design., A qualitative descriptive design with Loftland and Loftland (1984) approach for the study of a phenomenon occurring in a social setting was used. Method., A purposeful sample of 10 participants was obtained that included six family caregivers and four nurses. Participants were recruited from two hospitals in the northwest US. Intensive interviews and participant observations were used for data collection, and Loftland and Loftland's (1984) qualitative approach was used for data analysis. Results., Family worry was defined as family caregivers' felt difficulty in fulfilling their roles because of worry. Four categories of family worry were identified as a result of this study: (i) worry about the patient's condition; (ii) worry about the patient's care received from the health care team; (iii) worry about future care for the patient provided by the family caregiver; and (iv) worry about finances. Conclusions., The findings of this pilot study provide nurses with the initial knowledge of the typology of family worry associated with elderly relatives' hospitalizations. Relevance to clinical practice., The findings of this study may sensitize the nurses to more precisely evaluate family caregivers' worry about their hospitalized elders and provide more effective nursing interventions to improve outcomes of both patients and their family caregivers. [source] Enhancing primary health care services for adults with intellectual disabilitiesJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 3 2005C. A. Melville Abstract Background Primary health care teams have an important part to play in addressing the health inequalities and high levels of unmet health needs experienced by people with intellectual disabilities (ID). Practice nurses have an expanding role within primary health care teams. However, no previous studies have measured their attitudes, knowledge, training needs, and self-efficacy in their work with people with ID. Methods All practice nurses working in a defined area were identified. A purpose-designed questionnaire to measure nurse attitudes, knowledge, training needs and self-efficacy was developed and piloted. All practice nurses were then invited to participate. Data from completed questionnaires were entered onto PC and analysed. Results Of a total of 292 practice nurses 201 (69%) participated. Whilst 89% (n = 179) of participants reported having infrequent contact, 25% (n = 50) reported a growing workload with people with ID. Only 8% (n = 16) had ever received any training in communicating with people with ID. A knowledge gap regarding the health needs of people with ID was identified. Eighty-six per cent reported having experienced specific difficulties during previous appointments, and only 23% thought they had sufficient case note information at appointments, but 68% did not modify the duration of their appointments with people with ID. Conversely, responses demonstrated that practice nurses have a high level of experience and qualification in general nursing, have positive attitudes to working with people with ID, and high self-efficacy scores were identified for work with people with ID. The practice nurses viewed ID to be a high priority area for future training. Conclusions Primary health care teams have a key role in tackling the unmet health needs of people with ID. Whilst this project has identified factors that may impact on the accessibility of services, it has also identified practice nurses as having positive attitudes and high self-efficacy scores in their work with people with ID. This indicates that they should be targeted for specific training in this area, which may make an important contribution in enhancing future accessibility of primary health care services for people with ID. [source] Attitudes of health sciences faculty members towards interprofessional teamwork and educationMEDICAL EDUCATION, Issue 9 2007Vernon R Curran Objectives, Faculty attitudes are believed to be a barrier to successful implementation of interprofessional education (IPE) initiatives within academic health sciences settings. The purpose of this study was to examine specific attributes of faculty members, which might relate to attitudes towards IPE and interprofessional teamwork. Methods, A survey was distributed to all faculty members in the medicine, nursing, pharmacy and social work programmes at our institution. Respondents were asked to rate their attitudes towards interprofessional health care teams, IPE and interprofessional learning in an academic setting using scales adopted from the peer-reviewed literature. Information on the characteristics of the respondents was also collected, including data on gender, prior experience with IPE, age and years of practice experience. Results, A total response rate of 63.0% was achieved. Medicine faculty members reported significantly lower mean scores (P < 0.05) than nursing faculty on attitudes towards IPE, interprofessional teams and interprofessional learning in the academic setting. Female faculty and faculty who reported prior experience in IPE reported significantly higher mean scores (P < 0.05). Neither age, years of practice experience nor experience as a health professional educator appeared to be related to overall attitudinal responses towards IPE or interprofessional teamwork. Conclusions, The findings have implications for both the advancement of IPE within academic institutions and strategies to promote faculty development initiatives. In terms of IPE evaluation, the findings also highlight the importance of measuring baseline attitudinal constructs as part of systematic evaluative activities when introducing new IPE initiatives within academic settings. [source] Assessing the performance of doctors in teams and systemsMEDICAL EDUCATION, Issue 10 2002Elizabeth A Farmer Introduction, Increasing attention is being directed towards finding ways of assessing how well doctors perform in clinical practice. Current approaches rely on strategies directed at individuals only, but, in real life, doctors' work is characterised by multiple complex professional interactions. These interactions involve different kinds of teams and are embedded within the overall context and systems of care. In addition to individual factors, therefore, we propose that the performance of doctors in health care teams and systems will also impact on the overall quality of patient care. Assessing these dimensions, however, poses a number of challenges. Strategies, Taking a profile of a National Health Service, UK surgeon as an example, the team structures to which he or she may relate are illustrated. These include formal teams such as those found in the operating theatre, and those formed through various professional and collegial partnerships. The authors then propose a model for assessing doctors' performances in teams and systems, which incorporates the educational principles of continuous feedback to enhance future performance. Discussion, To implement the proposed model, a wide range of professional, educational and regulatory bodies must collaborate. This raises a number of important implications for the future roles and relationships of these bodies, which are discussed. A strong and constructive partnership will be essential if the full potential of a more inclusive and representative assessment approach is to be realised. [source] Forming professional identities on the health care team: discursive constructions of the ,other' in the operating roomMEDICAL EDUCATION, Issue 8 2002L Lingard Background, Inter-professional health care teams represent the nucleus of both patient care and the clinical education of novices. Both activities depend upon the,talk' that team members use to interact with one another. This study explored team members' interpretations of tense team communications in the operating room (OR). Methods, The study was conducted using 52 team members divided into 14 focus groups. Team members comprised 13 surgeons, 19 nurses, nine anaesthetists and 11 trainees. Both uni-disciplinary (n = 11) and multi-disciplinary (n = 3) formats were employed. All groups discussed three communication scenarios, derived from prior ethnographic research. Discussions were audio-recorded and transcribed. Using a grounded theory approach, three researchers individually analysed sample transcripts, after which group discussions were held to resolve discrepancies and confirm a coding structure. Using the confirmed code, the complete data set was coded using the ,NVivo' qualitative data analysis software program. Results, There were substantial differences in surgeons', nurses', anaesthetists', and trainees' interpretations of the communication scenarios. Interpretations were accompanied by subjects' depictions of disciplinary roles on the team. Subjects' constructions of other professions' roles, values and motivations were often dissonant with those professions' constructions of themselves. Conclusions, Team members, particularly novices, tend to simplify and distort others' roles and motivations as they interpret tense communication. We suggest that such simplifications may be rhetorical, reflecting professional rivalries on the OR team. In addition, we theorise that novices' echoing of role simplification has implications for their professional identity formation. [source] Effective interprofessional teams: "Contact is not enough" to build a teamTHE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS, Issue 4 2008Joan Sargeant PhD Abstract Introduction: Teamwork and interprofessional practice and learning are becoming integral to health care. It is anticipated that these approaches can maximize professional resources and optimize patient care. Current research, however, suggests that primary health care teams may lack the capacity to function at a level that enhances the individual contributions of their members and team effectiveness. This study explores perceptions of effective primary health care teams to determine the related learning needs of primary health care professionals. Methods: Primary health care team members with a particular interest in teamwork shared perspectives of effective teamwork and educational needs in interprofessional focus groups. Transcripts from nine focus groups with a total of 61 participants were analyzed using content analysis and grounded hermeneutic approaches to identify themes. Results: Five themes of primary care team effectiveness emerged: (1) understanding and respecting team members' roles, (2) recognizing that teams require work, (3) understanding primary health care, (4) working together: practical "know-how" for sharing patient care, and (5) communication. Communication was identified as the essential factor in effective primary health care teams. Discussion: Several characteristics of effective primary health care teams and the related knowledge and skills that professionals require as effective team members are identified. Effective teamwork requires specific cognitive, technical, and affective competence. [source] Evaluation of a training to improve management of pediatric overweightTHE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS, Issue 4 2005Josephine Hinchman MPH Research Associate Abstract Introduction: Despite widespread concern about pediatric obesity, health care professionals report low proficiency for identifying and treating this condition. This paper reports on the evaluation of pediatric overweight assessment and management training for clinicians and staff in a managed care system. The training was evaluated for its impact on assessment practices and utilization of management tools. Methods: A delayed-control design was utilized to measure the effects of two 60-minute interactive Continuing Medical education (CME) trainings for the pediatric health care teams. Chart abstraction was conducted at 0-, 3- and 6-months after training, recording the proportion of charts containing the recommended assessment methods and management tools. Results: The training was associated with a significant increase in the utilization of some tools and practices, including charting BMI-for-age percentile (p<0.001) and using a nutrition and activity self-history form (p<0.001). Overall, from baseline to 3-months post training, charting BMI-for-age percentiles increased from zero to 25.2% and utilization of the self-history form increased from zero to 35.3%. These increases were sustained at 6-months post training. Other tools guiding clinician counseling were less widely utilized, although a behavioral prescription pad was used with 20% of overweight patients. Discussion: A modest investment in clinician and staff training designed to be feasible in a clinical setting was associated with substantial increases in the use of appropriate tools and practices for the assessment and management of pediatric overweight. Such training may help to augment and improve the processes of pediatric health care delivery for addressing overweight. The training provides a viable model for future CME efforts in other health care settings. [source] Caring for people with learning disability: a survey of general practitioners' attitudes in Southampton and South-west HampshireBRITISH JOURNAL OF LEARNING DISABILITIES, Issue 1 2000Ken SteinArticle first published online: 24 DEC 200 The aim of the present paper was to examine general practitioners' (GPs') beliefs about: the demands made on the primary care team by people with learning disability; their confidence in meeting health care needs and perceived training requirements; attitudes towards specialist or generic health service provision, and current contact with specialist teams; and attitudes towards screening in people with learning disability. A postal questionnaire was sent to a randomly selected partner from 95% of the practices in the Southampton and South-west Hampshire Health District. Forty-eight (75%) GPs responded and few were undecided about the demands placed on primary care teams, but beliefs were mixed. Most GPs were confident in dealing with the medical care needs of people with learning disability and the majority felt that training courses would not be worthwhile, except to learn more about specialist services where contact was very low and a ,link worker' scheme had had little apparent impact. Most respondents agreed that GPs should meet the medical needs of people with learning disability as part of general medical services and approximately half had a positive attitude towards providing regular health checks. Respondents were cautious about offering cervical cancer screening to women with learning disability. A small minority suggested that they would take no action to follow up a non-attendance for mammography. As a heterogeneous population, it is not surprising that GPs' attitudes vary widely. Further research is required to establish the nature and scale of demands made on primary health care teams, and to evaluate systematic means of addressing health care needs of people with learning disability. [source] An Evaluation of a Primary Care-Based Child Clinical Psychology ServiceCHILD AND ADOLESCENT MENTAL HEALTH, Issue 3 2002Sharon Abrahams Background: This paper describes a primary care-based clinical psychology service operating in an inner London borough that provides psychological intervention for children with emotional or behavioural difficulties and their families, and consultation and support to the primary health care teams. Method: A comparison is made with a local secondary level child mental health service in terms of characteristics of referrals and clinical outcome. Referrers' perceptions of the primary care-based service are described. Results and Conclusions: The findings demonstrate a useful child and adolescent mental health service for children and adolescents with a broad range of childhood difficulties within a primary care setting, which appears to overcome some of the problems often associated with referral to secondary level services. [source] | |||||||||||||||||||||||||