Quality Health Care (quality + health_care)

Distribution by Scientific Domains

Selected Abstracts

Patients' perceptions of cultural factors affecting the quality of their medical encounters

Anna M. Nápoles-Springer PhD
Abstract Objective, The aim of this study was to identify key domains of cultural competence from the perspective of ethnically and linguistically diverse patients. Design, The study involved one-time focus groups in community settings with 61 African,Americans, 45 Latinos and 55 non-Latino Whites. Participants' mean age was 48 years, 45% were women, and 47% had less than a high school education. Participants in 19 groups were asked the meaning of ,culture' and what cultural factors influenced the quality of their medical encounters. Each text unit (TU or identifiable continuous verbal utterance) of focus group transcripts was content analysed to identify key dimensions using inductive and deductive methods. The proportion of TUs was calculated for each dimension by ethnic group. Results, Definitions of culture common to all three ethnic groups included value systems (25% of TUs), customs (17%), self-identified ethnicity (15%), nationality (11%) and stereotypes (4%). Factors influencing the quality of medical encounters common to all ethnic groups included sensitivity to complementary/alternative medicine (17%), health insurance-based discrimination (12%), social class-based discrimination (9%), ethnic concordance of physician and patient (8%), and age-based discrimination (4%). Physicians' acceptance of the role of spirtuality (2%) and of family (2%), and ethnicity-based discrimination (11%) were cultural factors specific to non-Whites. Language issues (21%) and immigration status (5%) were Latino-specific factors. Conclusions, Providing quality health care to ethnically diverse patients requires cultural flexibility to elicit and respond to cultural factors in medical encounters. Interventions to reduce disparities in health and health care in the USA need to address cultural factors that affect the quality of medical encounters. [source]

Prevention and treatment of pressure ulcers in a university hospital centre: A correlational study examining nurses' knowledge and best practice

Gallant Claudia RN MSc
Claudia G, Diane M, Daphney SG, Daničle D. International Journal of Nursing Practice 2010; 16: 183,187 Prevention and treatment of pressure ulcers in a university hospital centre: A correlational study examining nurses' knowledge and best practice This descriptive correlational study had the goal of exploring if relationships existed between the level of knowledge of nurses concerning pressure ulcers, certain nurses' characteristics and the preventive care they applied. A multi-method approach was taken using a questionnaire to measure the level of knowledge of nurses (n = 256) and chart audits (n = 235) to identify the preventive care applied. The results show that the level of knowledge of the nurses is insufficient. They also show a correlation between a higher level of knowledge and (i) the sector of activities in which the nurses are working, (ii) the training periods provided by the university hospital centre, and a (iii) good perception by the nurses of their level of knowledge. However, training on its own cannot guarantee the provision of quality health care, as there is a wide discrepancy between what nurses know and what they put into practice. [source]

Establishing a standardized dental record-keeping system for a small investigational colony of rhesus monkeys (Macaca mulatta)

B.W. Gibson
Abstract Background, Dental hygiene is becoming an increasingly important component of quality health care for laboratory animals, especially non-human primates (NHPs). One key to a successful health care program is an effective and efficient record-keeping system. Methods, To standardize a dental hygiene program for a small colony of NHPs, we developed a dental recording chart specific for rhesus monkeys. This dental chart was developed using the modified Triadan system. This system numbers teeth across species according to location. Results, An illustrative case report was presented to demonstrate the accurate record keeping and spatial relationship generated from this Old World NHP dental chart design. Conclusion, The development and implementation of a standardized dental chart, as part of a dental hygiene program will help minimize variables that may affect research data. [source]

Nurse Dose as a Concept

Dorothy Brooten
Purpose: To describe the concept of Nurse Dose. Methods: The concept of nurse dose has been identified from decades of clinical research as a concept essential in the delivery of safe and high quality health care. The components of nurse dose were conceptualized through review of the literature from nursing, medicine, and health services research. Findings: Nurse dose is conceptualized as having three equally essential components: dose, nurse, and host and host response. Dose in the macro view includes the number of nurses per patient or per population in cities, states, regions, or countries. Dose in a micro view includes the amount of nurse time and the number of contacts. The nurse component consists of the education, expertise, and experience of the nurse. Host is represented by an organization and its characteristics (culture, autonomy, practice control) in a macro view and by the patient and characteristics (beliefs, values, culture) in a micro view. Host response includes response to the autonomy and acceptability of the nurse. Conclusions: Greater nurse dose has been associated with decreases in patient mortality, morbidity, and healthcare costs. [source]

A community-oriented primary care nursing model in an international setting that emphasizes partnerships

Elizabeth Sloand BSN
Purpose To present an interdisciplinary, community-oriented primary care nursing model that effectively draws upon the strengths of advanced practice nurses (APNs), both nurse practitioners and community health nurses. Data sources Articles in professional nursing journals, international data sources, and the clinical experiences of the authors, both domestic and international. Conclusions The model, developed domestically, was utilized successfully by APNs internationally in a medical mission endeavor in rural Haiti. Many partners, domestic and Haitian, worked as an interdisciplinary team to deliver quality health care to an impoverished population. Graduate nursing students participated in the program, which offered opportunities and challenges for both novice and expert nurses. Implications for practice Nurse practitioners, community health nurses, and nursing faculty members can use this model to enhance their professional practice. They can learn that clients can be optimally cared for whether the community served is domestic or international. Nursing faculty can teach graduate nursing students about the value of partnerships and collaboration. [source]

Perceived barriers to adherence among adolescent renal transplant candidates

Nataliya Zelikovsky
Abstract:, Non-adherence to medical regimens is a ubiquitous hindrance to quality health care among adolescent transplant recipients. Identification of potentially modifiable barriers to adherence when patients are listed for organ transplant would help with early intervention efforts to prepare adolescents for the stringent medication regimen post-transplant. Fifty-six adolescents listed for a kidney transplant, mean age 14.27 (s.d. = 2.2; range 11,18 yr), 73.2% male, 62.5% Caucasian participated in a semi-structured interview, the Medical Adherence Measure, to assesses the patient's knowledge of the prescribed regimen, reported adherence (missed and late doses), the system used to organized medications, and who holds the primary responsibility over medication management. Better knowledge of the medication regimen was associated with fewer missed doses (r = ,0.48, p < 0.001). Patients who perceived more barriers had more missed (r = 0.38, p = 0.004) and late (r = 0.47, p < 0.001) doses. Patients who endorsed "just forget," the most common barrier (56.4%), reported significantly more missed (z = ,4.25, p < 0.001) and late (z = ,2.2, p = 0.02) doses. Only one-third of the transplant candidates used a pillbox to organize medications but these patients had significantly better adherence, z = ,2.2, p = 0.03. With regard to responsibility over managing the regimens, adolescents missed fewer doses when their parents were in charge than when they were solely responsible, z = ,2.1, p = 0.04. Interventions developed to prepare transplant candidates for a stringent post-transplant regimen need to focus on ensuring accurate knowledge of as simple a regimen as possible. Use of an organized system such as a pillbox to establish a routine and facilitate tracking of medications is recommended with integration of reminders that may be appealing for this age group. Although individuation is developmentally normative at this age, parent involvement seems critical until the adolescent is able to manage the responsibility more independently. [source]

Promoting ecologic health resilience for minority youth: Enhancing health care access through the school health center

Caroline C.C. Clauss-Ehlers
Ethnic minority youth experience problems in access to healthcare, yet little is known about how to enhance utilization. This article will discuss the demographic realities of children of color in the United States, with a focus on health care needs and access issues that have an enormous influence on health status. The article will consider health policy as it describes the considerable barriers to quality health care for minority youth such as a lack of a usual source of care and limited health insurance. An ecologic model is presented that incorporates cultural values and community structures into the school health center. Enhancing access and utilization through the school setting is viewed as promoting ecologic resilience in youth. © 2003 Wiley Periodicals, Inc. Psychol Schs 40: 265,278, 2003. [source]

An academy of surgical educators: sustaining education , enhancing innovation and scholarship

John P. Collins
Abstract Context:, The aims of surgical education, training and professional development programmes are to ensure surgeons will provide high quality health care throughout their professional lives. Development and delivery of these programmes requires a mixture of surgeons with a different but complimentary range of competencies in medical education, all eager to facilitate learning and support educational scholarship. Methods:, The Royal Australasian College of Surgeons has undertaken a major review of the challenges, risks and opportunities surrounding the development and delivery of its education and continuing professional development programmes. Results:, Conflicting demands on surgeons' time have compromised their availability for educational activities. At the same time, a decline has occurred in the recognition and value of teaching and educational scholarship as a consequence of financial rewards and prestige now coming principally from patient care and biomedical research. New educational methods have been introduced which have added to the complexities involved and the level of commitments required. In response, the College and its surgical specialty partners have established an Academy of Surgical Educators as a resource for the nine specialties of surgery. It will promote high quality patient care by providing expert educational leadership, guidance and advice and through the advancement and application of educational scholarship. Conclusion:, The establishment of the Academy serves as a powerful symbol of the importance the College places on its core responsibility as an educational body. Working in association with the University Departments of Surgery throughout Australia and New Zealand, the Academy will better equip the College and its partner Specialist Societies and Associations to meet and sustain the increasingly sophisticated requirements involved in higher education. [source]

Measuring the outcome of occupational therapy: Tools and resources

Carolyn Unsworth
Current pressures to document outcomes and demonstrate the efficacy of occupational therapy intervention arise from fiscal restraints as much as from the humanitarian desire to provide the best quality health care to consumers. However, measuring outcomes is important in facilitating mutual goal setting, increasing the focus of therapy on the client, monitoring client progress, as well as demonstrating that therapy is valuable. The aims of this article are to provide the reader with an overview of what outcomes research is and to provide resources to aid the selection of outcomes assessments in a variety of practice areas. This article adopts the latest version of the World Health Organisation's health classification system (International Classification of Impairments, Activities and Participation), as an organizing framework, and promotes the use of this framework when undertaking outcomes research. [source]