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1.
Braz. j. biol ; 84: e255605, 2024. tab
Artículo en Inglés | MEDLINE, LILACS, VETINDEX | ID: biblio-1355882

RESUMEN

Abstract Combining ability analysis provides useful information for the selection of parents, also information regarding the nature and magnitude of involved gene actions. Crops improvement involves strategies for enhancing yield potentiality and quality components. Targeting the improvement of respective characters in bitter gourd, combining ability and genetic parameters for 19 characters were estimated from a 6×6 full diallel analysis technique. The results revealed that the variances due to general combining ability (GCA) and specific combining ability (SCA) were highly significant for most of the important characters. It indicated the importance of both additive and non-additive gene actions. GCA variances were higher in magnitude than SCA variances for all the characters studied indicating the predominance of the additive gene effects in their inheritance. The parent P2 (BG 009) appeared as the best general combiner for earliness; P1 (BG 006) for number of fruits, average single fruit weight and fruit yield; P4 (BG 027) for node number of first female flower and days to seed fruit maturity; P3 (BG 011) for fruit length and thickness of the fruit flesh; P5 (BG 033) for 100-seed weight; and P6 for number of nodes per main vine. The SCA effect as well as reciprocal effect was also significant for most of the important characters in different crosses.


Resumo A análise da capacidade de combinação fornece informações úteis para a seleção dos pais, também informações sobre a natureza e a magnitude das ações dos genes envolvidos. A melhoria das safras envolve estratégias para aumentar a potencialidade da produção e os componentes de qualidade. Visando ao aprimoramento dos respectivos caracteres em cabaça-amarga, capacidade de combinação e parâmetros genéticos para 19 caracteres, foram estimados a partir de uma técnica de análise dialélica completa 6 × 6. Os resultados revelaram que as variâncias, devido à capacidade geral de combinação (GCA) e capacidade específica de combinação (SCA), foram altamente significativas para a maioria dos caracteres importantes. Indicou a importância das ações gênicas aditivas e não aditivas. As variâncias GCA foram maiores em magnitude do que as variâncias SCA para todos os caracteres estudados, indicando a predominância dos efeitos do gene aditivo em sua herança. O pai P2 (BG 009) apareceu como o melhor combinador geral para o início; P1 (BG 006) para número de frutos, peso médio de um único fruto e produção de frutos; P4 (BG 027) para número de nó da primeira flor fêmea e dias para a maturidade do fruto da semente; P3 (BG 011) para comprimento do fruto e espessura da polpa do fruto; P5 (BG 033) para peso de 100 sementes; e P6 para o número de nós por videira principal. O efeito SCA, bem como o efeito recíproco, também foi significativo para a maioria dos personagens importantes em cruzamentos diferentes.


Asunto(s)
Momordica charantia , Productos Agrícolas , Flores , Mejoramiento de la Calidad , Frutas/genética
2.
BMJ Open ; 12(5): e058453, 2022 May 04.
Artículo en Inglés | MEDLINE | ID: mdl-35508344

RESUMEN

OBJECTIVES: To understand how and why participation in quality circles (QCs) improves general practitioners' (GPs) psychological well-being and the quality of their clinical practice. To provide evidence-informed and practical guidance to maintain QCs at local and policy levels. DESIGN: A theory-driven mixed method. SETTING: Primary healthcare. METHOD: We collected data in four stages to develop and refine the programme theory of QCs: (1) coinquiry with Swiss and European expert stakeholders to develop a preliminary programme theory; (2) realist review with systematic searches in MEDLINE, Embase, PsycINFO and CINHAL (1980-2020) to inform the preliminary programme theory; (3) programme refinement through interviews with participants, facilitators, tutors and managers of QCs and (4) consolidation of theory through interviews with QC experts across Europe and examining existing theories. SOURCES OF DATA: The coinquiry comprised 4 interviews and 3 focus groups with 50 European experts. From the literature search, we included 108 papers to develop the literature-based programme theory. In stage 3, we used data from 40 participants gathered in 6 interviews and 2 focus groups to refine the programme theory. In stage 4, five interviewees from different healthcare systems consolidated our programme theory. RESULT: Requirements for successful QCs are governmental trust in GPs' abilities to deliver quality improvement, training, access to educational material and performance data, protected time and financial resources. Group dynamics strongly influence success; facilitators should ensure participants exchange knowledge and generate new concepts in a safe environment. Peer interaction promotes professional development and psychological well-being. With repetition, participants gain confidence to put their new concepts into practice. CONCLUSION: With expert facilitation, clinical review and practice opportunities, QCs can improve the quality of standard practice, enhance professional development and increase psychological well-being in the context of adequate professional and administrative support. PROSPERO REGISTRATION NUMBER: CRD42013004826.


Asunto(s)
Médicos Generales , Participación en las Decisiones , Atención a la Salud , Médicos Generales/psicología , Humanos , Mejoramiento de la Calidad , Proyectos de Investigación
5.
Creat Nurs ; 28(2): 138-140, 2022 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-35501133

RESUMEN

Background: The Centers for Disease Control and Prevention (CDC) reported that between 28.5% and 44.1% of adults in the US sleep less than seven hours nightly. Aims: The aim of this quality improvement project was to improve sleep quality and duration among patients aged 40 and older with insomnia disorder in an outpatient mental health clinic. Methods: Patients diagnosed with insomnia disorder who were sleeping less than seven hours at least three nights weekly participated in the project (n = 20). Sleep hygiene education was provided and participants kept a sleep diary. The duration and quality of sleep was evaluated by comparing the information recorded in the diaries with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition description of insomnia disorder. Results: All participants achieved improvement to 6-8 hours of restful sleep nightly.


Asunto(s)
Trastornos del Inicio y del Mantenimiento del Sueño , Adulto , Humanos , Persona de Mediana Edad , Mejoramiento de la Calidad , Sueño , Estados Unidos
6.
Creat Nurs ; 28(2): 133-137, 2022 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-35501139

RESUMEN

Sleep problems are prevalent among youth with mental health disorders. Consistent with national statistics, sleep problems were present in approximately 80% of the patients attending a children's hospital psychiatric partial hospitalization program in the Midwestern United States. The aim of this quality improvement (QI) project was to decrease sleep problems in youth with mental health disorders. The Pittsburgh Sleep Quality Index (PSQI) was administered to patients ages 12-18 with mental health disorders to screen for sleep problems. Patients identified by the PSQI as having a sleep problem, and their parents, were given verbal and written education on sleep hygiene practices and stimulus control. Each patient participated in a cognitive behavioral therapy group that included relaxation therapy. Evidence-based interventions used to improve sleep were reinforced daily by providers. Self-reported sleep quality, as measured by the PSQI, was improved in 95% of the patients participating in this QI project. Adequately screening for and treating sleep problems in youth with mental health disorders can lead to improved outcomes.


Asunto(s)
Salud Mental , Trastornos del Sueño-Vigilia , Adolescente , Niño , Humanos , Padres , Mejoramiento de la Calidad , Sueño , Trastornos del Sueño-Vigilia/terapia
7.
Nephrol Nurs J ; 49(2): 103-107, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35503688

RESUMEN

There is a call to action for nurses in all types of practice settings to lead change efforts that impact quality of care. An intervention may focus on an outcome or improvement of an existing process. In both instances, an understanding of organizational culture and readiness for change are needed. Evidence-based tools are available for use by nurses and interprofessional teams to assess the clinical work environment and plan for measurement of change. Learning the use of these tools is a key step in advancing quality improvement. Use of quality improvement techniques can have an immediate impact at the clinical microsystem level.


Asunto(s)
Cultura Organizacional , Mejoramiento de la Calidad , Humanos , Aprendizaje
8.
Nephrol Nurs J ; 49(2): 99-107, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35503687

RESUMEN

Quality assessment and process improvement (QAPI) is an essential component to ensure the safety and quality of patient care in an acute dialysis unit. This article details the Structure-Process-Outcome model of quality analysis and suggests involving the entire acute care team in quality improvement processes, gathering data from environmental and infection control rounds and direct staff observations, as well as holding monthly quality improvement meetings with a standard and timed agenda. QAPI should be integrated into the fabric of the unit, and its processes should be seamless and automated.


Asunto(s)
Atención de Enfermería , Garantía de la Calidad de Atención de Salud , Humanos , Atención al Paciente , Mejoramiento de la Calidad , Diálisis Renal
9.
Nephrol Nurs J ; 49(2): 117-120, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35503690

RESUMEN

The dialysis survey process can be used to enhance an outpatient dialysis facility's quality improvement program. While preparing for a survey, facilities have an opportunity to find and address issues and areas for improvement of safety and outcomes. During a dialysis survey, issues of immediate patient danger may be discovered, and immediate action will need to be taken. Once the survey has been completed, the facility must correct any identified issues. As part of the Plan of Correction (POC) and the quality assurance performance improvement (QAPI) process, the root cause of problems or issues should be identified. Once root causes are identified, action plans can be developed. Monitoring of outcomes is a critical part of any effective POC. Dashboards and audit tools can be used and discussed in QAPI so the plan can be revised, if needed.


Asunto(s)
Mejoramiento de la Calidad , Diálisis Renal , Humanos , Encuestas y Cuestionarios
10.
Nephrol Nurs J ; 49(2): 157-163, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35503692

RESUMEN

Many opportunities exist for quality improvement activities in dialysis. As dialysis providers, it is important to know what quality measures are being evaluated. This article provides a summary of quality indicators nephrology nurses can measure and review to ensure quality patient care.


Asunto(s)
Mejoramiento de la Calidad , Diálisis Renal , Humanos , Atención al Paciente , Calidad de la Atención de Salud
11.
Nephrol Nurs J ; 49(2): 177-181, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35503694

RESUMEN

Research and quality improvement provide a mechanism to support the advancement of knowledge, and to evaluate and learn from experience. The focus of research is to contribute to developing knowledge or gather evidence for theories in a field of study, whereas the focus of quality improvement is to standardize processes and reduce variation to improve outcomes for patients and health care organizations. Both methods of inquiry broaden our knowledge through the generation of new information and the application of findings to practice. This article in the "Exploring the Evidence: Focusing on the Fundamentals" series provides nephrology nurses with basic information related to the role of research and quality improvement projects, as well as some examples of ways in which they have been used together to advance clinical knowledge and improve patient outcomes.


Asunto(s)
Nefrología , Mejoramiento de la Calidad , Humanos
12.
Nephrol Nurs J ; 49(2): 161-163, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35503693

RESUMEN

An important factor for quality and safety in patient care is an environment in which quality and safety are prioritized and embedded into the culture. Quality improvement (QI) methods can be complex, with some intensive resources required and specific methods employed. However, all staff can be involved in QI if the problem is approached with curiosity and the process is kept simple, with a consistent goal of improving practices. The purpose of this article is to highlight some simple but effective QI methods authored by all-star nephrology nurses that can be easily applied by teams in various settings with minimal resources.


Asunto(s)
Nefrología , Mejoramiento de la Calidad , Humanos
14.
BMJ Open ; 12(5): e051175, 2022 May 02.
Artículo en Inglés | MEDLINE | ID: mdl-35501095

RESUMEN

INTRODUCTION: The objective of the Chinese Neonatal Network (CHNN) is to provide a platform for collaborative research, outcomes evaluation and quality improvement for preterm infants with gestational age less than 32 weeks in China. The CHNN is the first national neonatal network and has the largest geographically representative cohort from neonatal intensive care units (NICUs) in China. METHODS AND ANALYSIS: Individual-level data from participating NICUs will be collected using a unique database developed by the CHNN on an ongoing basis from January 2019. Data will be prospectively collected from all infants <32 weeks gestation or <1500 g birth weight at 58 participating NICUs. Infant outcomes and inter-institutional variations in outcomes will be examined and used to inform quality improvement measures aimed at improving outcomes. Information about NICU environmental and human resource factors and processes of neonatal care will also be collected and analysed for association with outcomes. Clinical studies, including randomised controlled trials will be conducted using the CHNN data platform. ETHICS AND DISSEMINATION: This study was approved by the ethics review board of Children's Hospital of Fudan University, which was recognised by all participating hospitals. Waiver of consent were granted at all sites. Only non-identifiable patient level data will be transmitted and only aggregate data will be reported in CHNN reports and publications.


Asunto(s)
Salud del Lactante , Servicios de Información , Mejoramiento de la Calidad , Niño , China , Bases de Datos Factuales , Humanos , Lactante , Recién Nacido , Recien Nacido Prematuro , Recién Nacido de muy Bajo Peso , Unidades de Cuidado Intensivo Neonatal
16.
Nephrol Nurs J ; 49(2): 187-188, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35503695
17.
JAMA Netw Open ; 5(5): e2210596, 2022 May 02.
Artículo en Inglés | MEDLINE | ID: mdl-35522283

RESUMEN

Importance: Promotion of clinician adherence to stroke guidelines can improve stroke outcomes. Objective: To investigate the outcomes of a multilevel system program on clinician adherence to guidelines for treatment of patients with acute ischemic stroke (AIS). Design, Setting, and Participants: This quality improvement study used a prospective interrupted time series (ITS) and difference-in-difference (DID) design, from August 1, 2018, to January 31, 2020, divided into preprogram term and short and long postprogram terms; each term had 6 months. Data were collected during hospitalization and at discharge with an automated medical record data capture system in 58 public hospitals in Zhejiang province, China. Data were analyzed from August 2018 to January 2020. Exposures: The multilevel system program included a modularized standard template for medical records, centrally supported continuing education, continuous monitoring and feedback, and collaborative workshops. Main Outcomes and Measures: The primary outcome was adherence to 12 key performance indicators (KPIs), expressed as (1) percentage of patient-applicable KPIs achieved in each participant and (2) percentage of participants among whom all applicable KPIs were achieved (dichotomous all-or-none measure). The secondary outcome was severe disability or death (modified Rankin Scale 5-6) at discharge. Results: Among 45 091 patients (mean [SD] age, 69 [12] years; 18 347 female [40.7%]), 28 721 from 30 hospitals received the program and 16 370 from 28 hospitals continued routine care. In adjusted DID analysis, the program was associated with an increase in the absolute percentage of KPIs achieved per patient (6.46%; 95% CI, 5.49% to 7.43%), absolute rate of all-or-none success (8.29%; 95% CI, 6.99% to 9.60%), and decreased rate of severe disability or death at discharge (-1.68%; 95% CI, -2.99% to -0.38%). The ITS result showed the program was associated with an increase in KPIs achieved per patient per week (slope change in short-term period, 0.36%; 95% CI, 0.20% to 0.52%; level change in long-term period, (9.64%; 95% CI, 4.58% to 14.69%) and in all-or-none success (slope change in short-term period 0.34%; 95% CI, 0.23% to 0.46%; level change in long-term period 5.89%; 95% CI, 0.19% to 11.59%). Conclusions and Relevance: The centrally supported program was associated with increases in clinician adherence to guidelines and reduced the proportion of severely disabled or deceased patients with AIS at discharge, providing support for its wider implementation.


Asunto(s)
Accidente Cerebrovascular Isquémico , Accidente Cerebrovascular , Anciano , Femenino , Hospitales , Humanos , Accidente Cerebrovascular Isquémico/terapia , Masculino , Estudios Prospectivos , Mejoramiento de la Calidad , Accidente Cerebrovascular/terapia
18.
J Nurs Educ ; 61(5): 268-271, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-35522765

RESUMEN

BACKGROUND: Safety and reduction of errors during medication administration is a prominent focus in nursing and nursing education. Developing simulated medication administration experiences that include opportunities for nursing students to manage interruptions in a realistic environment can help improved critical thinking and reasoning for safe administration practices. METHOD: Sophomore nursing students voluntarily participated in a quality improvement project examining nursing management of interruptions during medication administration. Students observed medication administration activities for episodes of interruptions and conducted surveys in a real-time format that encouraged decision-making dialogue. RESULTS: After the project, student learning outcomes included improved identification of interruptions, prioritization, critical reasoning skills, and development of management techniques for better safety. CONCLUSION: Incorporating real-world experiences that allow nursing students to identify and manage interruptions during medication administration foster development of critical thinking and interruption management techniques. [J Nurs Educ. 2022;61(5):268-271.].


Asunto(s)
Bachillerato en Enfermería , Estudiantes de Enfermería , Bachillerato en Enfermería/métodos , Humanos , Mejoramiento de la Calidad , Pensamiento
20.
J Healthc Eng ; 2022: 4043992, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35494525

RESUMEN

Objective: A retrospective cohort study was conducted to analyze the application value of Python programming in general education and comprehensive quality improvement of medical students. Methods: A retrospective analysis was made on the application value of Python programming in the general education classroom of medical students from September 2020 to July 2021 by undergraduate students majoring in anesthesia in grade 2020, imaging in grade 2019, clinical in grade 2020, and laboratory sciences in grade 2020 in our university. A hundred students who used Python programming in general education class were divided into study group and control group. The teaching satisfaction, medical knowledge and lifelong learning ability, clinical skills, medical service ability, disease prevention, health promotion ability, interpersonal communication ability, and information management and research ability were compared between the two groups. Results: In a comparison of teaching satisfaction between the two groups, the study group was very satisfied in 89 cases, satisfactory in 10 cases, and general in 1 case, and the satisfaction rate was 100.00%; the control group was very satisfied in 54 cases, satisfactory in 23 cases, general in 13 cases, and dissatisfied in 10 cases, and the satisfaction rate was 90.00%. The teaching satisfaction in the study group was higher than that in the control group, and the difference was statistically significant (P < 0.05). Compared with the control group, medical knowledge ability (basic knowledge, general education, and professional knowledge) and lifelong learning ability (learning concept and professional learning attitude) in the research group were significantly higher than those in the research group (P < 0.05). The scores of clinical skills (medical history analysis, basic diagnosis, treatment techniques, and disease analysis) and medical service ability (first aid ability, comprehensive analysis ability, and disease analysis ability) in the study group were significantly higher than those in the control group (P < 0.05). In terms of the ability of disease prevention and health promotion, the scores of disease prevention (health guidance, health education, and self-care) and health promotion ability (cooperative participation in diagnosis and treatment, guidance of medical and health work, and rational use of health resources) in the study group were higher than those in the control group, and the difference was statistically significant (P < 0.05). In the comparison of interpersonal communication ability, the scores of listening, expression, understanding, trust, medical terminology, and communication ability in the study group were higher than those in the control group, and the difference was statistically significant (P < 0.05). Comparing information management with research ability, the scores of information management ability (searching information, screening information, and sorting information) and research ability (arrangement ability, planning ability, and execution ability) in the research group were higher than those in the control group, and the data difference was statistically significant (P < 0.05). Conclusion: The application of the Python programming method in general education and comprehensive quality improvement of medical students can effectively improve medical students' teaching satisfaction and medical knowledge such as lifelong learning ability, clinical skills, medical service ability, disease prevention, health promotion ability, interpersonal communication ability, and information management and research ability, which has a positive impact on the improvement of comprehensive quality.


Asunto(s)
Estudiantes de Medicina , Competencia Clínica , Humanos , Aprendizaje , Mejoramiento de la Calidad , Estudios Retrospectivos
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