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1.
Public Health Rep ; 135(1_suppl): 50S-56S, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32735197

RESUMO

In 2014, California passed Assembly Bill 966, which required condom access for persons incarcerated in all 35 California state prisons (33 men's and 2 women's prisons). The California Correctional Health Care Services and the Sexually Transmitted Disease Control Branch and the Office of AIDS of the California Department of Public Health collaborated in a prison administration-led multidisciplinary implementation workgroup. Our workgroup, representing public health, correctional health, legal and legislative affairs, labor relations, and prison staff members, participated in 4 planning meetings during May-September 2015. We surveyed prison staff members and incarcerated men to identify and address potential challenges; conceptualized a tamper-resistant condom dispenser; developed educational materials, frequently asked questions for staff members, and fact sheets for the public; and conducted forums for custody and medical staff members at each prison. Key lessons learned included the need for high-level custody support, engagement of labor unions early in the decision-making process, and flexibility within defined parameters for sites to determine best practices given their unique institutional population, culture, and physical layout. Condom access was initiated at 4 prisons in July 2015 and expanded incrementally to the remaining 29 men's prisons through July 2016. A total of 243 563 condoms were accessed in the men's prisons, for an average of 354 condoms per 1000 population per month. The start-up dispenser cost was $69 825 (735 dispensers at $95 each). We estimated an annual condom cost of $0.60 per person. Although staff members and incarcerated men expressed concern that this legislation would condone sex and provide repositories for contraband, no serious adverse incidents involving condoms were reported. California demonstrated that condom access is a safe, low-cost intervention with high uptake for a large correctional system and provided a replicable implementation model for other states. Prison condom programs have the potential to decrease transmission of sexually transmitted infections (STIs) among incarcerated persons and their communities, which are often disproportionately affected by STIs, HIV, and other chronic diseases.


Assuntos
Preservativos/provisão & distribução , Prisões/organização & administração , Saúde Pública , Doenças Sexualmente Transmissíveis/prevenção & controle , California/epidemiologia , Técnicas de Apoio para a Decisão , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Educação em Saúde/organização & administração , Humanos , Capacitação em Serviço/organização & administração , Sindicatos/organização & administração , Masculino , Prisões/economia , Prisões/normas , Desenvolvimento de Programas , Doenças Sexualmente Transmissíveis/epidemiologia
2.
Crit Care Nurs Q ; 43(4): 428-450, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32833779

RESUMO

COVID-19 created an environment that required rapid implementation of procedures and processes to minimize transmission. This led to an urgent response from the Department of Professional Practice and Education to implement education to a large number of personnel. This article describes strategies and methods employed to meet the training demands at a time when resources and supplies were limited. This study aims at developing and implementing education on infection prevention and management of patients with suspected or known COVID-19 for the nursing staff providing care. Following guidelines from the hospital's COVID-19 oversight committee, the Department of Professional Practice and Education rapidly initiated education on several key topics. This was accomplished by teamwork within the department to quickly identify priorities and suspend noncritical programs. Multiple training methods were deployed while a smaller group of educators developed additional training. Sixty to seventy percent of 1015 staff were trained within 6 days. Soon after, several additional educational topics were identified and training was concluded over a 3-week period. Training can be provided on an urgent basis with the use of multiple educational methods, suspension of noncritical programs, and teamwork. A smaller committee within the department allows for concentrated efforts in the design of additional training.


Assuntos
Infecções por Coronavirus/enfermagem , Educação em Enfermagem/organização & administração , Capacitação em Serviço/organização & administração , Determinação de Necessidades de Cuidados de Saúde , Recursos Humanos de Enfermagem no Hospital/educação , Pneumonia Viral/enfermagem , Infecções por Coronavirus/epidemiologia , Humanos , Pandemias , Pneumonia Viral/epidemiologia
3.
Artigo em Inglês | MEDLINE | ID: mdl-32806769

RESUMO

We aimed to investigate the management of urgent dental care, the perception of risk and workplace preparedness among dental staff in Norway during the COVID-19 pandemic. An electronic questionnaire regarding the strictest confinement period in Norway (13 March-17 April 2020) was distributed to dental staff. Among the 1237 respondents, 727 (59%) treated patients, of whom 170 (14%) worked in clinics designated to treat patients suspected or confirmed to have COVID-19. Out of them 88% (143) received training and 64% (103) simulation in additional infection prevention procedures, while 27 (24%) respondents reported deviation. In total, 1051 (85%) respondents perceived that dental staff had a high risk of being infected, 1039 (84%) that their workplace handled the current situation well, 767 (62%) that their workplace had adequate infection control equipment and 507 (41%) agreed that their workplace is well equipped to handle an escalation. Before an appointment, 1182 (96%) respondents always/often inquired per phone information if a patient experienced symptoms of COVID-19, and 1104 (89%) asked about a history of travel to affected areas. Twice as many patients on average per week were treated by phone than in a clinic. A lower proportion of dental staff in high incidence counties applied additional infection prevention measures compared to low and medium incidence counties. To conclude, urgent dental health care was managed relatively well in Norway. Additional training of the dental staff in adequate infection prevention and step-by-step procedures may be needed. These results may be used to improve the dental health service's response to future outbreaks.


Assuntos
Infecções por Coronavirus/epidemiologia , Serviços de Saúde Bucal/organização & administração , Controle de Infecções/organização & administração , Pneumonia Viral/epidemiologia , Adulto , Betacoronavirus , Estudos Transversais , Serviços de Saúde Bucal/normas , Feminino , Humanos , Controle de Infecções/normas , Capacitação em Serviço/organização & administração , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia , Pandemias , Medição de Risco , Inquéritos e Questionários , Telemedicina/organização & administração , Telefone , Local de Trabalho/organização & administração
4.
Emerg Med J ; 37(7): 407-410, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32467156

RESUMO

The COVID-19 outbreak has posed unique challenges to the emergency department rostering. Additional infection control, the possibility of quarantine of staff and minimising contact among staff have significant impact on the work of doctors in the emergency department. Infection of a single healthcare worker may require quarantine of close contacts at work. This may thus affect a potentially large number of staff. As such, we developed an Outbreak Response Roster. This Outbreak Response Roster had fixed teams of doctors working in rotation, each team that staff the emergency department in turn. Members within teams remained constant and were near equally balanced in terms of manpower and seniority of doctors. Each team worked fixed 12 hours shifts with as no overlapping of staff or staggering of shifts. Handovers between shifts were kept as brief as possible. All these were measures to limit interactions among healthcare workers. With the implementation of the roster, measures were also taken to bolster the psychological wellness of healthcare workers. With face-to-face contact limited, we also had to maintain clear, open channels for communication through technology and continue educating residents through innovative means.


Assuntos
Infecções por Coronavirus/terapia , Serviço Hospitalar de Emergência/organização & administração , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Pneumonia Viral/terapia , Betacoronavirus , Esgotamento Profissional/prevenção & controle , Comunicação , Infecções por Coronavirus/prevenção & controle , Surtos de Doenças , Pessoal de Saúde/organização & administração , Pessoal de Saúde/psicologia , Humanos , Capacitação em Serviço/organização & administração , Pandemias/prevenção & controle , Equipe de Assistência ao Paciente/organização & administração , Transferência da Responsabilidade pelo Paciente/organização & administração , Pneumonia Viral/prevenção & controle , Singapura , Fatores de Tempo , Fluxo de Trabalho
5.
J Aging Soc Policy ; 32(4-5): 471-476, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32436446

RESUMO

The rapid spread of COVID-19 has left many workers around the world - workers in food distribution, truckers, janitors, and home and personal health care workers - deeply concerned about contracting the virus from exposure at work. In particular, older workers in frontline occupations are vulnerable to illness and to the deadly and debilitating effects of COVID-19, especially with inadequate protective gear and inadequate sick leave. In the absence of strong unions, which ensure that employers provide workers with accurate information, robust training, adequate equipment, and paid leave in the event of quarantines or illness, the COVID-19 pandemic highlights the need for additional legislation to shore up worker protections and provide paid sick leave.


Assuntos
Infecções por Coronavirus/epidemiologia , Emprego/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Licença Médica/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Humanos , Capacitação em Serviço/organização & administração , Pessoa de Meia-Idade , Pandemias , Equipamentos de Proteção/provisão & distribução
6.
J Nurs Adm ; 50(4): 185-186, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32195910

RESUMO

Despite increased onboarding and training for new graduate RNs, it is taking longer for nurses to develop clinical competence in today's complex care environment. At the same time, hospitals and health systems are facing a shortage of experienced nurses. If left unaddressed, patient quality and safety could be at risk.


Assuntos
Competência Clínica/normas , Capacitação em Serviço/organização & administração , Mentores , Papel do Profissional de Enfermagem , Bacharelado em Enfermagem , Humanos
7.
Comput Inform Nurs ; 38(1): 36-44, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31850937

RESUMO

Electronic health record systems have been widely implemented throughout healthcare settings over the last few years, and nurses rely on these systems to obtain information about patients, make clinical decisions, and deliver safe and appropriate care. Health information technology systems have electronic health record downtime episodes both due to scheduled maintenance and unforeseen circumstances. The ability to deliver safe and effective care during electronic health record downtime episodes is important, yet training on electronic health record downtime is rarely included for nursing staff. This quality improvement project implemented an electronic health record downtime training course and administered it to 50 onboarding nurses within the hospital facility. The participants indicated a positive perception of electronic health record downtime preparedness after the course offering related to ability to find and follow downtime procedures. However, no precourse metrics were obtained, and therefore it is uncertain if this positive perception is a direct result of the electronic health record downtime training course. While initial results are promising, further investigation will need to be conducted to determine training course effectiveness.


Assuntos
Enfermagem Baseada em Evidências , Capacitação em Serviço/organização & administração , Recursos Humanos de Enfermagem/educação , Melhoria de Qualidade , Adulto , Registros Eletrônicos de Saúde , Feminino , Hospitais , Humanos , Masculino , Recursos Humanos de Enfermagem/organização & administração , Adulto Jovem
8.
Am J Hosp Palliat Care ; 37(1): 19-26, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31122034

RESUMO

BACKGROUND: The Physician Orders for Life-Sustaining Treatment (POLST) Paradigm is an effective advance care planning tool. However, barriers to implementation persist. In the United States, POLST program development occurs at the state-level. Substantial differences between states has left POLST implementation largely unstandardized. No peer-reviewed studies to date have evaluated state-based POLST program development over time. OBJECTIVE: To assess and learn from the successes and barriers in state-based POLST program development over time to improve the reach of POLST or similar programs across the United States. DESIGN: An exploratory, prospective cohort study that utilized semistructured telephone interviews was conducted over a 3-year period (2012-2015). Stakeholder representatives from state POLST coalitions (n = 14) were repeatedly queried on time-relevant successes, barriers, and innovations during POLST program development with levels of legislative and medical barriers rated 1 to 10. Interviews were transcribed and analyzed using techniques grounded in qualitative theory. RESULTS: All coalition representatives reported continuous POLST expansion with improved outreach and community partnerships. Significant barriers to expansion included difficulty in securing funding for training and infrastructure, lack of statewide metric systems to adequately assess expansion, lack of provider support, and legislative concerns. Medical barriers (mean [standard deviation]: 5.0 [0.2]) were rated higher than legislative (3.0 [0.6]; P < .001). CONCLUSION: POLST programs continue to grow, but not without barriers. Based on the experiences of developing coalitions, we were able to identify strategies to expand POLST programs and overcome barriers. Ultimately the "lessons learned" in this study can serve as a guide to improve the reach of POLST or similar programs.


Assuntos
Planejamento Antecipado de Cuidados/organização & administração , Cuidados para Prolongar a Vida/organização & administração , Assistência Terminal/organização & administração , Planejamento Antecipado de Cuidados/economia , Planejamento Antecipado de Cuidados/legislação & jurisprudência , Atitude do Pessoal de Saúde , Humanos , Capacitação em Serviço/organização & administração , Entrevistas como Assunto , Cuidados para Prolongar a Vida/economia , Cuidados para Prolongar a Vida/legislação & jurisprudência , Estudos Longitudinais , Estudos Prospectivos , Assistência Terminal/normas , Estados Unidos
9.
Creat Nurs ; 25(4): 292-298, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31796615

RESUMO

Self-efficacy is an extensively studied, yet underutilized, indicator of the effectiveness of current education, the measurement of which could contribute to planning the direction of future education. An efficacy expectation is the conviction that one can successfully execute the behavior required to produce the outcomes (Bandura, 1977). This article presents the results of a study that compared the self-reported self-efficacy of newly hired nurses before and after a nurse residency program.


Assuntos
Currículo , Capacitação em Serviço/métodos , Capacitação em Serviço/organização & administração , Recursos Humanos de Enfermagem no Hospital/educação , Recursos Humanos de Enfermagem no Hospital/psicologia , Preceptoria/métodos , Autoeficácia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
10.
Creat Nurs ; 25(4): 311-315, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31796619

RESUMO

Workplace incivility is a known cause of anxiety in the workplace, leading to the loss of many new members of the nursing field. This perpetual cycle of hiring and losing nurses, especially new graduates, contributes to the increasing nursing shortage. This study investigated whether the inclusion of prelicensure nursing education on workplace incivility is achievable and capable of improving the outcome for nurses when it occurs. Review of the literature revealed that inclusion of prelicensure education on this topic is possible through utilization of a zero-tolerance policy, Cognitive Rehearsal Technique (CRT), and simulation. Education on workplace incivility and the aforementioned formats for prelicensure education were presented to faculty of a Southeastern U.S. college. Respondents demonstrated interest in detailed instruction on incorporating it into their teaching.


Assuntos
Educação em Enfermagem/organização & administração , Incivilidade , Capacitação em Serviço/organização & administração , Recursos Humanos de Enfermagem no Hospital/educação , Recursos Humanos de Enfermagem no Hospital/psicologia , Estudantes de Enfermagem/psicologia , Local de Trabalho/psicologia , Adulto , Currículo , Humanos , Masculino , Sudeste dos Estados Unidos , Adulto Jovem
11.
Addict Sci Clin Pract ; 14(1): 46, 2019 12 19.
Artigo em Inglês | MEDLINE | ID: mdl-31856915

RESUMO

BACKGROUND: The integration of opioid use disorder (OUD) care and competencies in graduate medical education training is needed. Previous research shows improvements in knowledge, attitudes, and practices after exposure to OUD care. Few studies report outcomes for patients with OUD in resident physician continuity practices. METHODS: A novel internal office-based opioid treatment (OBOT) program was initiated in a resident continuity clinic. Surveys of resident and staff knowledge and attitudes of OBOT were administered at baseline and 4 months. A retrospective chart review of the 15-month OBOT clinic obtained patient characteristics and outcomes. RESULTS: Twelve patients with OUD were seen in the OBOT clinic. Seven patients (58%) were retained in care at the end of the study period for a range of 9-15 months. Eight patients demonstrated a good clinical response. Surveys of residents and staff at 4 months were unchanged from baseline showing persistent lack of comfort in caring for patients with OUD. CONCLUSIONS: OBOT can be successfully integrated into resident continuity practices with positive patient outcomes. Improvement in resident and staff attitudes toward OBOT were not observed and likely require direct and frequent exposure to OUD care to increase acceptance.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Medicina Interna/educação , Internato e Residência/organização & administração , Tratamento de Substituição de Opiáceos/métodos , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Adulto , Idoso , Buprenorfina/uso terapêutico , Feminino , Humanos , Capacitação em Serviço/organização & administração , Medicina Interna/organização & administração , Masculino , Pessoa de Meia-Idade , Antagonistas de Entorpecentes/uso terapêutico , Estudos Retrospectivos
12.
Health Res Policy Syst ; 17(1): 98, 2019 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-31842896

RESUMO

BACKGROUND: Researchers and policy-makers are increasingly working together with the goal of creating research that is focused on solving real-world problems; however, knowledge translation (KT) activities, and the partnerships they often require, can be challenging. The aim of this review is to determine the extent of the literature on training programs designed to improve researcher competency in KT and to describe existing training methods that may be used by those hoping to build capacity for partnership research. METHODS: MEDLINE, EMBASE, PsycINFO and CINAHL were searched for peer review articles published between January 2000 and July 2019. Studies were eligible for inclusion in the review if they described the development of, curriculum for, or evaluation of KT and/or partnership research training programs. Data extraction included information on evaluation methods, outcomes and implications as well as the format, aims and themes of each capacity-building program. RESULTS: The review identified nine published articles that met inclusion criteria - four papers described training events, two papers described participant experiences of specific learning sessions within a larger training course, two papers described part time secondments for KT capacity-building and one paper described a plan for KT training embedded within an existing research training course. All programs were delivered face-to-face, all included practical skills-building opportunities, and all employed multiple learning modalities such as seminars and small group discussions. Evaluation of the training programs was primarily conducted through qualitative interviews or feedback surveys. CONCLUSION: To date, few KT training initiatives have been described in the literature and none of these have been rigorously evaluated. The present review offers insights into the planning, development and participant experiences associated with the small number of training initiatives that have been described. There is insufficient evidence available at present to identify the most effective models for training researchers in KT and partnership skills.


Assuntos
Fortalecimento Institucional/organização & administração , Pesquisadores/educação , Pesquisadores/organização & administração , Pesquisa Médica Translacional/organização & administração , Comportamento Cooperativo , Humanos , Capacitação em Serviço/organização & administração , Aprendizagem , Ensino/organização & administração
13.
Health Res Policy Syst ; 17(1): 101, 2019 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-31856848

RESUMO

BACKGROUND: Among the many barriers to evidence use in decision-making, weak capacity for evidence use has attracted a lot of focus in the last decade. The study aims to inform and enrich ongoing and future efforts to strengthen capacity for evidence use by presenting and discussing the experiences and lessons of a project implemented in Kenya and Malawi to strengthen individual and institutional capacity for evidence use within the ministries of health (MoHs). METHODS: This paper draws on the internal and external evaluations of a 3-year project funded by the United Kingdom's Department for International Development, the Strengthening Capacity to Use Research Evidence in Health Policy (SECURE Health). To strengthen individual capacity, the project implemented a training and mentorship programme for 60 mid-level policy-makers in the two MoHs. To strengthen institutional capacity, the project conducted sustained advocacy with top leaders to strengthen structures that enable evidence-informed decision-making (EIDM), supported Kenya to develop research-for-health policies and priorities, supported Malawi to review the implementation of its health research agenda, developed EIDM guidelines for both MoHs, and supported bi-annual evidence dialogues to improve interactions and raise the profile of evidence. Internal evaluation included baseline and endline surveys (93 baseline and 92 endline interviews), 60 in-depth interviews, and intervention-specific evaluations (pre-post tests for training workshops, feedback forms for policy dialogues and tracking effects of advocacy efforts). The external evaluation was implemented alongside project implementation, conducting three annual evaluations. RESULTS: The results show that training and mentorship programmes in EIDM were effective in improving competencies of civil servants. However, such programmes need to train a critical mass to be effective in enhancing EIDM practice at the MoHs. On strengthening institutional capacity for EIDM, while the project achieved some success, it did not realise long-lasting effects because of its limited time of implementation and limited focus on sustained political economy analysis, which meant that the intervention was negatively affected by frequently changing interests within the MoHs. CONCLUSIONS: Although training and mentorship are effective in improving EIDM competencies, they need to be incorporated in existing pre-service and in-service training programmes for sustainability. Strengthening institutional capacity for evidence use is complex and needs sustained political commitment and long-term investments.


Assuntos
Fortalecimento Institucional/organização & administração , Setor de Assistência à Saúde/organização & administração , Formulação de Políticas , Pesquisa Médica Translacional/organização & administração , Tomada de Decisões , Prática Clínica Baseada em Evidências , Setor de Assistência à Saúde/normas , Política de Saúde , Humanos , Capacitação em Serviço/organização & administração , Quênia , Liderança , Malaui , Mentores
14.
Implement Sci ; 14(1): 98, 2019 11 27.
Artigo em Inglês | MEDLINE | ID: mdl-31771599

RESUMO

BACKGROUND: The Thrombolysis ImPlementation in Stroke (TIPS) trial tested the effect of a multicomponent, multidisciplinary, collaborative intervention designed to increase the rates of intravenous thrombolysis via a cluster randomized controlled trial at 20 Australian hospitals (ten intervention, ten control). This sub-study investigated changes in self-reported perceptions and practices of physicians and nurses working in acute stroke care at the participating hospitals. METHODS: A survey with 74 statements was administered during the pre- and post-intervention periods to staff at 19 of the 20 hospitals. An exploratory factor analysis identified the structure of the survey items and linear mixed modeling was applied to the final survey domain scores to explore the differences between groups over time. RESULT: The response rate was 45% for both the pre- (503 out of 1127 eligible staff from 19 hospitals) and post-intervention (414 out of 919 eligible staff from 18 hospitals) period. Four survey domains were identified: (1) hospital performance indicators, feedback, and training; (2) personal perceptions about thrombolysis evidence and implementation; (3) personal stroke skills and hospital stroke care policies; and (4) emergency and ambulance procedures. There was a significant pre- to post-intervention mean increase (0.21 95% CI 0.09; 0.34; p < 0.01) in scores relating to hospital performance indicators, feedback, and training; for the intervention hospitals compared to control hospitals. There was a corresponding increase in mean scores regarding perceptions about the thrombolysis evidence and implementation (0.21, 95% CI 0.06; 0.36; p < 0.05). Sub-group analysis indicated that the improvements were restricted to nurses' responses. CONCLUSION: TIPS resulted in changes in some aspects of nurses' perceptions relating to the evidence for intravenous thrombolysis and its implementation and hospital performance indicators, feedback, and training. However, there is a need to explore further strategies for influencing the views of physicians given limited statistical power in the physician sample. TRIAL REGISTRATION: ACTRN12613000939796, UTN: U1111-1145-6762.


Assuntos
Atitude do Pessoal de Saúde , Isquemia Encefálica/tratamento farmacológico , Capacitação em Serviço/organização & administração , Acidente Vascular Cerebral/tratamento farmacológico , Terapia Trombolítica/métodos , Adulto , Austrália , Feminino , Fidelidade a Diretrizes , Humanos , Capacitação em Serviço/normas , Masculino , Corpo Clínico Hospitalar , Pessoa de Meia-Idade , Recursos Humanos de Enfermagem no Hospital , Percepção , Guias de Prática Clínica como Assunto/normas , Terapia Trombolítica/normas , Adulto Jovem
15.
Glob Health Action ; 12(1): 1684070, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31694487

RESUMO

Background: Task sharing of TTE may improve capacity for heart failure diagnosis and management in patients in remote, low-resource settings but the impact on diagnostic accuracy and patient outcomes has not been studied.Objectives: Determine feasibility and impact of non-expert training in transthoracic echocardiography (TTE) to improve the diagnosis and outcomes of patients with suspected heart failure in Uganda.Methods: This two-part study examined an innovative training program to develop TTE competency among non-experts and used a pre-post design to determine the impact of decentralized TTE. Four of 8 non-experts (50%) passed a three-part training course. The training comprised of distance learning through a web-based curriculum, a 2-day hands-on workshop with cardiologists, and independent practice with remote mentorship. Continuous measures were compared (pre- vs. post-TTE) using t-tests or Wilcoxon rank-sum tests as distributionally appropriate and categorical variables assessed through chi-square testing. Sensitivity and specificity were calculated according to standard methodology comparing diagnosis pre- and post-TTE during phase 2.Results: Performance in the post-training phase showed good agreement with expert categorization (κ = 0.80) with diagnostic concordance in 421 of 454 studies (92.7%). TTE changed the preliminary diagnosis in 81% of patients, showing low specificity of clinical decision-making alone (14.2%; 95% CI 10.1-19.2%). Dilated cardiomyopathy, hypertensive heart disease with preserved systolic function, and right heart failure were the most underdiagnosed conditions prior to TTE while hypertensive heart disease with decreased systolic function was the most over-diagnosed condition.Conclusions: In conclusion, non-expert providers can achieve a high level of proficiency for the categorization of heart failure using handheld TTE in low-resource settings and use of telemedicine and remote mentorship may improve performance and feasibility. The addition of TTE resulted in substantial improvement in etiological specificity. Further study is needed to understand implications of this strategy on healthcare utilization, long-term patient outcomes, and cost.


Assuntos
Ecocardiografia/métodos , Pessoal de Saúde/educação , Insuficiência Cardíaca/diagnóstico , Capacitação em Serviço/organização & administração , Adulto , Idoso , Competência Clínica , Ecocardiografia/normas , Feminino , Insuficiência Cardíaca/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Uganda
16.
Med Educ Online ; 24(1): 1555435, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31671284

RESUMO

Effective mentoring enhances the personal and professional development of mentees and mentors, boosts the reputation of host organizations and improves patient outcomes. Much of this success hinges upon the mentor's ability to nurture personalized mentoring relationships and mentoring environments, provide effective feedback and render timely, responsive, appropriate, and personalized support. However, mentors are often untrained raising concerns about the quality and oversight of mentoring support.To promote effective and consistent use of mentor training in medical education, this scoping review asks what mentor training programs are available in undergraduate and postgraduate medicine and how they may inform the creation of an evidenced-based framework for mentor training.Six reviewers adopted Arksey and O'Malley's approach to scoping reviews to study prevailing mentor-training programs and guidelines in postgraduate education programs and in medical schools. The focus was on novice mentoring approaches. Six reviewers carried out independent searches with similar inclusion/exclusion criteria using PubMed, ERIC, EMBASE, SCOPUS, Google Scholar, and grey literature databases. Included were theses and book chapters published in English or had English translations published between 1 January 1990 and 31 December 2017. Braun and Clarke's approach to thematic analysis was adopted to circumnavigate mentoring's and mentor training's evolving, context-specific, goal-sensitive, learner-, tutor- and relationally dependent nature that prevents simple comparisons of mentor training across different settings and mentee and mentor populations.In total, 3585 abstracts were retrieved, 232 full-text articles were reviewed, 68 articles were included and four themes were identified including the structure, content, outcomes and evaluation of mentor training program.The themes identified provide the basis for an evidence-based, practice-guided framework for a longitudinal mentor training program in medicine and identifies the essential topics to be covered in mentor training programs.


Assuntos
Capacitação em Serviço/organização & administração , Mentores/educação , Faculdades de Medicina/organização & administração , Educação Médica/organização & administração , Humanos
17.
Artigo em Inglês | MEDLINE | ID: mdl-31698707

RESUMO

This paper describes the development and feasibility of the Community Based Research Infrastructure to Better Science (CRIBS) training. The goal of this training program was to help new or existing community-academic teams to build strong partnerships and successfully develop together fundable research projects focused on breast cancer environmental causes and disparities. A comprehensive mixed-methods participatory approach was utilized to assess the training. Twenty-two community-academic teams applied for the training program; twelve teams were enrolled. All teams completed the training and subsequently submitted research applications for funding. All components of the training received high ratings and positive qualitative comments. Self-rated competency in all of the learning domains increased during the training. Four (33%) of teams were successful in their first attempt to garner research funding, and six (50%) were eventually successful. The evaluation of CRIBS found it to have successfully achieved all four goals of the training: (1) Twelve new CBPR (community-based participatory research) teams, (2) improved knowledge about CBPR and science, (3) twelve submitted grant proposals in the first year, and (4) six (50%) successfully funded research projects.


Assuntos
Neoplasias da Mama/terapia , Pesquisa Participativa Baseada na Comunidade/métodos , Capacitação em Serviço/organização & administração , Feminino , Humanos , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde
18.
Nurse Pract ; 44(12): 50-55, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31764475

RESUMO

Leaving the comfort zone of being an experienced RN for a new career as an inexperienced advanced practice registered nurse (APRN) is one of the greatest difficulties of the APRN transition to practice. Although this challenge is frequently discussed in the literature, progress in creating transition programs has been slow. To date, very few formal APRN residency or fellowship transition programs exist. Practicing APRNs can advocate for a formal transition program in their organizations.


Assuntos
Prática Avançada de Enfermagem/educação , Prática Avançada de Enfermagem/organização & administração , Capacitação em Serviço/organização & administração , Humanos , Pesquisa em Avaliação de Enfermagem , Preceptoria , Desenvolvimento de Programas , Estados Unidos
19.
BMC Health Serv Res ; 19(1): 711, 2019 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-31638974

RESUMO

BACKGROUND: Despite people living with dementia representing a significant proportion of health and social care users, until recently in the United Kingdom (UK) there were no prescribed standards for dementia education and training. This audit sought to review the extent and nature of dementia education and training offered to health and social care staff in the UK against the standards described in the 2015 Dementia Training Standards Framework, which describes the knowledge and skills required of the UK dementia workforce. METHODS: This audit presents national data concerning the design, delivery, target audience, length, level, content, format of training, number of staff trained and frequency of delivery within existing dementia training programmes offered to health and social care staff. The Dementia Training Standards Framework was used as a reference for respondents to describe the subjects and learning outcomes associated with their training. RESULTS: The findings are presented from 614 respondents offering 386 training packages, which indicated variations in the extent and quality of training. Many training packages addressed the subjects of 'person-centred care', 'communication', 'interaction and behaviour in dementia care', and 'dementia awareness'. Few training packages addressed subjects concerning 'pharmacological interventions in dementia care', 'leadership' and 'end of life care'. Fewer than 40% of The Dementia Training Standards Framework learning outcomes targeted to staff with regular contact with people with dementia or in leadership roles were covered by the reported packages. However, for training targeted at increasing dementia awareness more than 70% of the learning outcomes identified in The Dementia Training Standards Framework were addressed. Many training packages are not of sufficient duration to derive impact; although the majority employed delivery methods likely to be effective. CONCLUSIONS: The development of new and existing training and education should take account of subjects that are currently underrepresented and ensure that training reflects the Training Standard Framework and evidence regarding best practice for delivery. Lessons regarding the limitations of training in the UK serve as a useful illustration of the challenge of implementing national dementia training standards; particularly for countries who are developing or have recently implemented national dementia strategies.


Assuntos
Demência , Pessoal de Saúde/educação , Capacitação em Serviço/organização & administração , Auditoria Médica , Benchmarking , Competência Clínica , Assistência à Saúde , Demência/terapia , Humanos , Reino Unido
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