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1.
BMJ ; 368: m1139, 2020 03 23.
Artículo en Inglés | MEDLINE | ID: mdl-32205335
4.
J Surg Res ; 246: 482-489, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31635833

RESUMEN

The Joint Commission has established medication reconciliation as a National Patient Safety Goal, but it has not been studied much in trauma even though it is integral to safe patient care. This article reviews the existing medication reconciliation strategies and their applicability to the trauma setting. To perform medication reconciliation, hospitals use a variety of strategies including pharmacists or pharmacy technicians, electronic medical record tools, and patient-centered strategies. All of these strategies are limited in trauma. Subpopulations such as injured children, the elderly, and those with brain trauma are particularly challenging and are at risk for suboptimal care from inaccurate medication reconciliation. Further research is necessary to create a safe and efficient system for trauma patients.


Asunto(s)
Conciliación de Medicamentos/organización & administración , Seguridad del Paciente , Centros Traumatológicos/organización & administración , Heridas y Traumatismos/terapia , Factores de Edad , Anciano , Niño , Registros Electrónicos de Salud/organización & administración , Humanos , Atención Dirigida al Paciente/organización & administración , Farmacéuticos/organización & administración , Técnicos de Farmacia/organización & administración , Rol Profesional , Estados Unidos
7.
J Oncol Pharm Pract ; 26(1): 29-35, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30832556

RESUMEN

OBJECTIVES: This study aimed to investigate the effectiveness of pharmacist intervention in reducing and preventing prescribing errors of investigational drugs for cancer patients. MATERIALS AND METHODS: A retrospective study was conducted during two periods: a baseline period from December 2015 to June 2016 and an intervention period from July 2016 to February 2017. The investigational drug service (IDS) pharmacists performed active interventions during the intervention period. RESULTS: Among 12,387 investigational drug orders, 395 (6.1%) prescribing errors were detected in 6477 orders at the baseline period, and 278 errors (4.7%) were detected in 5,910 orders at the intervention period. To identify factors that affect prescribing errors, three models were constructed for the multivariate analysis. Among factors affecting prescribing errors, sponsor initiated trial (SIT) was the strongest factor (AOR: 4.16, 95% CI: 3.31-5.23). Pharmacist intervention reduced prescribing errors by at least 25% in all constructed models after adjusting for confounding variables. Prescribing errors were 1.3 times higher when dealing with intravenous medications than when dealing with oral medications. There were 60% fewer prescribing errors in the blinded study than in the open study. SIT and multi-center/multi-nation studies had 4.2 and 2.4 times more frequent prescribing errors than in investigator-initiated trials (IIT) and single-center/single-nation studies, respectively. Fewer errors occurred in phase 2 and trials covering both phase 1 and phase 2 (phase 1/2) than in phase 3 trials. CONCLUSIONS: The IDS pharmacist intervention in cancer clinical trials was associated with significant reductions in prescribing errors and may lead to increased medication safety.


Asunto(s)
Drogas en Investigación/efectos adversos , Errores de Medicación/prevención & control , Neoplasias/tratamiento farmacológico , Farmacéuticos , Servicio de Farmacia en Hospital/métodos , Rol Profesional , Femenino , Humanos , Masculino , Neoplasias/epidemiología , Farmacéuticos/tendencias , Servicio de Farmacia en Hospital/tendencias , República de Corea/epidemiología , Estudios Retrospectivos
8.
Yakugaku Zasshi ; 139(12): 1563-1567, 2019.
Artículo en Japonés | MEDLINE | ID: mdl-31787646

RESUMEN

Itching, or pruritus, can be defined as an unpleasant sensation that evokes the desire to scratch. Pruritus is most commonly associated with a primary skin disorder such as atopic dermatitis (AD), psoriasis, etc., and can have a major impact on the quality of life of those patients. Itch-induced scratching can further damage the skin barrier, leading to a worsening of symptoms. For that reason, it is important to manage pruritus. Topical glucocorticoids are commonly the first-line therapy in the management of AD and psoriasis patients. We found that topical glucocorticoids induce pruritus in mice under certain conditions. Topical glucocorticoids may induce pruritus in a mouse model of allergic contact dermatitis via inhibition of prostaglandin (PG)D2 production in antigen-mediated activated mast cells in the skin. Additionally, topical glucocorticoids do not induce pruritus in healthy skin. These results indicate the importance of controlling skin inflammation to a healthy level by applying sufficient quantities of glucocorticoids to avoid glucocorticoid-induced pruritus. However, topical "steroid phobia" is common in Japan, and most patients apply inadequate amounts of topical glucocorticoids for this reason. This may cause glucocorticoid-induced pruritus in patients by prolonging the skin inflammation. We conducted a survey regarding community pharmacists' instructions on the application quantity of topical glucocorticoids and found that most community pharmacists have experienced inappropriate instructions concerning this point.


Asunto(s)
Glucocorticoides/administración & dosificación , Glucocorticoides/efectos adversos , Educación del Paciente como Asunto , Farmacéuticos , Rol Profesional , Prurito/inducido químicamente , Administración Tópica , Animales , Dermatitis Atópica/tratamiento farmacológico , Modelos Animales de Enfermedad , Humanos , Mastocitos/inmunología , Mastocitos/metabolismo , Ratones , Prostaglandina D2/metabolismo , Psoriasis/tratamiento farmacológico , Piel/citología , Piel/inmunología
9.
Sud Med Ekspert ; 62(6): 23-26, 2019.
Artículo en Ruso | MEDLINE | ID: mdl-31825328

RESUMEN

The objective of the article is to attract attention of legal investigators and forensic medical experts to the necessity of a closer cooperation in criminal cases related to illicit traffic in narcotic drugs with the aim of better investigation of such cases. The author shows one of the peculiar features of illicit traffic in narcotic drugs, which means that all crimes in this sphere are closely interconnected, mutually interdependent, and in principle cannot be executed independently. The author underlines the role of a forensic medical examination of material evidences not only in order to determine persons involved in illegal actions with narcotic drugs, but also to determine their functional responsibilities in the structure of a criminal organization engaged in this traffic. There is a conclusion about the necessity of further close cooperation between legal investigators and forensic medical experts on the basis of the forms of cooperation proposed by the author.


Asunto(s)
Crimen , Medicina Legal , Rol Profesional , Criminales , Humanos
11.
BMC Public Health ; 19(1): 1698, 2019 Dec 18.
Artículo en Inglés | MEDLINE | ID: mdl-31852470

RESUMEN

BACKGROUND: Despite the existence of efficacious vaccines, the burden of vaccine-preventable diseases remains high and the potential health benefits of paediatric, adolescent and adult vaccination are not being achieved due to suboptimal vaccine coverage rates. Based on emerging evidence that pharmacy-based vaccine interventions are feasible and effective, the European Interdisciplinary Council for Ageing (EICA) brought together stakeholders from the medical and pharmacy professions, the pharmaceutical industry, patient/ageing organisations and health authorities to consider the potential for pharmacy-based interventions to increase vaccine uptake. We report here the proceedings of this 3-day meeting held in March 2018 in San Servolo island, Venice, Italy, focussing firstly on examples from countries that have introduced pharmacy-based vaccination programmes, and secondly, listing the barriers and solutions proposed by the discussion groups. CONCLUSIONS: A range of barriers to vaccine uptake have been identified, affecting all target groups, and in various countries and healthcare settings. Ease of accessibility is a potentially modifiable determinant in vaccine uptake, and thus, improving the diversity of settings where vaccines can be provided to adults, for example by enabling community pharmacists to vaccinate, may increase the number of available opportunities for vaccination.


Asunto(s)
Promoción de la Salud/métodos , Aceptación de la Atención de Salud/psicología , Aceptación de la Atención de Salud/estadística & datos numéricos , Servicios Farmacéuticos/organización & administración , Farmacéuticos , Vacunación/psicología , Vacunación/estadística & datos numéricos , Adulto , Congresos como Asunto , Europa (Continente) , Femenino , Humanos , Italia , Masculino , Persona de Mediana Edad , Objetivos Organizacionales , Rol Profesional
12.
BMC Health Serv Res ; 19(1): 793, 2019 Nov 05.
Artículo en Inglés | MEDLINE | ID: mdl-31684933

RESUMEN

BACKGROUND: Health professionals in Norway are required by law to help safeguard information and follow-up with children of parents with mental or physical illness, or who have substance abuse problems, to reduce their higher risk of psychosocial problems. Knowledge is lacking regarding whether organisation and/or worker-related factors can explain the differences in health professionals' ability to support the families when patients are parents. METHODS: Employing a translated, generic version of the Family Focused Mental Health Practice Questionnaire (FFPQ), this cross-sectional study examines family focused practice (FFP) differences in relation to health professionals' background and role (N = 280) along with exploring predictors of parent, child, and family support. RESULTS: While most health professions had begun to have conversations with parents on children's needs, under one-third have had conversations with children. There were significant differences between nurses, social workers, psychologists, physicians, and others on seven of the FFP subscales, with physicians scoring lowest on five subscales and psychologists providing the least family support. Controlling for confounders, there were significant differences between child responsible personnel (CRP) and other clinicians (C), with CRP scoring significantly higher on knowledge and skills, confidence, and referrals. Predictors of FFP varied between less complex practices (talking with parents) and more complex practices (family support and referrals). CONCLUSION: The type of profession was a key predictor of delivering family support, suggesting that social workers have more undergraduate training to support families, followed by nurses; alternately, the results could suggest that that social workers and nurses have been more willing or able than physicians and psychologists to follow the new legal requirements. The findings highlight the importance of multidisciplinary teams and of tailoring training strategies to health professionals' needs in order to strengthen their ability to better support children and families when a parent is ill.


Asunto(s)
Hijo de Padres Discapacitados , Medicina Familiar y Comunitaria/organización & administración , Personal de Salud/estadística & datos numéricos , Trastornos Mentales , Rol Profesional , Adolescente , Adulto , Niño , Estudios Transversales , Femenino , Encuestas de Atención de la Salud , Personal de Salud/legislación & jurisprudencia , Humanos , Masculino , Persona de Mediana Edad , Noruega
13.
Pan Afr Med J ; 33: 313, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31692862

RESUMEN

The role of a Medical Science Liaison (MSL) is of growing importance to pharmaceutical, biotechnology, diagnostic and medical device companies. Through scientific engagement MSLs add value to clinical practice, ultimately benefiting patients. The MSL role is dynamic and encompasses in-depth product and disease knowledge together with the ability to communicate relevant, unbiased scientific information concisely and timely. Tasks are focused on contributing towards the advancement of medical knowledge, scientific data generation and dissemination. Professional relationships are developed, fostering collaboration between external experts and typically the medical affairs departments of pharmaceutical companies through a credible liaison. Through such relationships, critical insights are shared that shape the development pipeline, promote successful clinical translation and guide the market deployment strategy of therapeutic interventions through-out their life cycle. Despite the rising number of MSLs in the field and the implicit medical value of the role, there remains a lack of understanding for what the roles of a MSL entails. In Africa, where exponential growth of the pharmaceutical industry is expected, the number of MSLs will increase rapidly. Given the complexities of the African continent, the MSLs in this burgeoning environment will face various challenges including remote locations, time-constraints, regulatory and bureaucratic hurdles and importantly physician misperception of the MSL role that collectively may thwart the goal of meaningful scientific engagement; but these challenges can be surmounted through astute proactive planning and utilization of opportunities including digital communication strategies.


Asunto(s)
Comunicación , Conducta Cooperativa , Industria Farmacéutica/organización & administración , África , Humanos , Industria Manufacturera/organización & administración , Rol Profesional
14.
J Nurs Adm ; 49(12): 583-585, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31725517

RESUMEN

Developing a professional practice model (PPM) is essential for hospitals seeking Magnet designation. The article describes the development and implementation of a PPM in a tertiary hospital that was the 1st hospital in mainland China applying for Magnet recognition. This article provides a framework for hospital administrators who wish to reference a successful process when creating their own Magnet PPMs.


Asunto(s)
Competencia Clínica/normas , Guías como Asunto , Personal de Enfermería en Hospital/normas , Rol Profesional , Calidad de la Atención de Salud/normas , Centros de Atención Terciaria/normas , Adulto , China , Femenino , Humanos , Masculino , Persona de Mediana Edad , Modelos de Enfermería
15.
J Nurs Adm ; 49(12): 604-609, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31725519

RESUMEN

Caring for multiple complex patients simultaneously is 1 of the biggest challenges for clinical nurses (CNs) in acute care. We utilized the results of research to develop a 6-hour Professional Nursing Practice Curriculum (PNPC) specifically for CNs who are professionally and legally responsible for providing holistic care to an assigned group of patients on inpatient clinical units in acute care hospitals. The curriculum can be used by faculty to prepare senior nursing students for their 1st professional practice role in an acute care setting. Components of the PNPC will be beneficial for nurse leaders in an assessment of their educational practices for transitioning newly licensed RNs to practice and addressing professional development needs of CNs.


Asunto(s)
Competencia Clínica , Enfermería de Cuidados Críticos/educación , Curriculum , Bachillerato en Enfermería/organización & administración , Enfermería Holística/educación , Rol Profesional , Estudiantes de Enfermería , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estados Unidos
16.
BMC Health Serv Res ; 19(1): 883, 2019 Nov 25.
Artículo en Inglés | MEDLINE | ID: mdl-31760955

RESUMEN

BACKGROUND: The transition from acute mental health inpatient to community care is often a vulnerable period in the pathway, where people can experience additional risks and anxiety. Researchers globally have developed and tested a number of interventions that aim to improve continuity of care and safety in these transitions. However, there has been little attempt to compare and contrast the interventions and specify the variety of safety threats they attempt to resolve. METHODS: The study aimed to identify the evidence base for interventions to support continuity of care and safety in the transition from acute mental health inpatient to community services at the point of discharge. Electronic Databases including PsycINFO, MEDLINE, Embase, HMIC, CINAHL, IBSS, Cochrane Library Trials, ASSIA, Web of Science and Scopus, were searched between 2000 and May 2018. Peer reviewed papers were eligible for inclusion if they addressed adults admitted to an acute inpatient mental health ward and reported on health interventions relating to discharge from the acute ward to the community. The results were analysed using a narrative synthesis technique. RESULTS: The total number of papers from which data were extracted was 45. The review found various interventions implemented across continents, addressing problems related to different aspects of discharge. Some interventions followed a distinct named approach (i.e. Critical Time Intervention, Transitional Discharge Model), others were grouped based on key components (i.e. peer support, pharmacist involvement). The primary problems interventions looked to address were reducing readmission, improving wellbeing, reducing homelessness, improving treatment adherence, accelerating discharge, reducing suicide. The 69 outcomes reported across studies were heterogeneous, meaning it was difficult to conduct comparative quantitative meta-analysis or synthesis. CONCLUSIONS: The interventions reviewed are spread across a spectrum ranging from addressing a single problem within a single agency with a single solution, to multiple solutions addressing multi-agency problems. We recommend that future research attempts to improve homogeneity in outcome reporting.


Asunto(s)
Servicios Comunitarios de Salud Mental/estadística & datos numéricos , Trastornos Mentales/terapia , Alta del Paciente/normas , Adulto , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Masculino , Cumplimiento de la Medicación/estadística & datos numéricos , Salud Mental , Narración , Educación del Paciente como Asunto , Readmisión del Paciente/normas , Transferencia de Pacientes , Rol Profesional , Mejoramiento de la Calidad/normas
17.
Nursing ; 49(12): 53-56, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31764875

RESUMEN

Health science librarianship may interest nurses inclined toward research, technology, and education. This article discusses the role of health science librarians as part of the clinical team.


Asunto(s)
Investigación Biomédica , Bibliotecología , Enfermeras y Enfermeros/psicología , Rol Profesional , Selección de Profesión , Humanos , Perfil Laboral , Satisfacción en el Trabajo , Grupo de Atención al Paciente/organización & administración , Especialización
18.
BMC Public Health ; 19(1): 1423, 2019 Oct 30.
Artículo en Inglés | MEDLINE | ID: mdl-31666036

RESUMEN

BACKGROUND: Sexual and reproductive health and rights (SRHR) have historically been regarded as a woman's issue. It is likely that these gender norms also hinder health care providers from perceiving boys and men as health care recipients, especially within the area of SRHR. The aim of this study was to explore midwives' thoughts and experiences regarding preventive work for men's sexual and reproductive health and rights in the primary care setting. METHODS: An exploratory qualitative study. Five focus group interviews, including 4-5 participants in each group, were conducted with 22 midwives aged 31-64, who worked with reproductive, perinatal and sexual health within primary care. Data were analysed by latent content analysis. RESULTS: One overall theme emerged, in everybody's interest, but no one's assigned responsibility, and three sub-themes: (i) organisational aspects create obstacles, (ii) mixed views on the midwife's role and responsibility, and (iii) beliefs about men and women: same, but different. CONCLUSIONS: Midwives believed that preventive work for men's sexual and reproductive health and rights was in everybody's interest, but no one's assigned responsibility. To improve men's access to sexual and reproductive health care, actions are needed from the state, the health care system and health care providers.


Asunto(s)
Actitud del Personal de Salud , Salud del Hombre , Enfermeras Obstetrices , Atención Primaria de Salud , Rol Profesional , Salud Reproductiva , Salud Sexual , Adolescente , Adulto , Prestación de Atención de Salud , Femenino , Grupos Focales , Derechos Humanos , Humanos , Masculino , Hombres , Persona de Mediana Edad , Partería , Embarazo , Servicios Preventivos de Salud , Reproducción , Conducta Sexual , Suecia , Adulto Joven
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