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Biomedical subjects

L M Short

Publications and source records attributed to L M Short.

9 recordsLinked to original sources
PubMed1998

Recommended components of health care provider training programs on intimate partner violence.

Programs that are effective in training health care providers to recognize and meet the needs of victims of intimate partner violence must be identified and replicated. The Centers for Disease Control and Prevention (CDC) has developed criteria for use in developing, enhancing, and evaluating such programs. CDC developed these criteria as a result of continuing efforts to provide useful products for constituents through literature reviews and consultations with experts in the field; evaluations of training programs; creation of an inventory and annotated bibliography of health care provider training programs in the United States and Canada; and development of a framework to assist hospitals and health centers in evaluating their training programs. Training should begin while providers are in professional school and continue in the health care setting. Curricula should be multidisciplinary and should provide information, promote clinical skills, and effectively link providers with resources. Evaluation should assist programs in determining providers' needs and identifying appropriate materials, trainers, and training strategies. CDC is working to establish scientific evidence that provider training programs are effective and to share successful models with others. Providers have an important role in stopping and ultimately preventing intimate partner violence, but they are not alone in this effort. They need to know how to access the growing network of assistance including women's advocates, the criminal justice system, and other members of increasingly dynamic community coalitions.

Canada↗
PubMed1997

Evaluation of the module on domestic violence at the UCLA School of Medicine.

Physicians and other hospital staff have a unique opportunity to assist victims of abuse. It is imperative that they develop the skills necessary to identify and diagnose cases and provide the support and referral services needed to help victims end the cycle of violence. This paper describes a comprehensive evaluation of the instructional design, implementation, and learning outcomes of the Domestic Violence Module at the University of California, Los Angeles (UCLA) School of Medicine to determine the effectiveness of this curriculum in helping medical students develop such skills. Expert reviewers found it to be an innovative, well-planned curriculum, and students and faculty tutors expressed a great deal of interest in and satisfaction with the course as a whole. However, the different evaluation components identified the same areas for improvement: (1) students need more opportunity to practice skills and receive feedback during the module, (2) there is inconsistency across classes in what is learned, and (3) tutors need better preparation sessions. The student outcomes reflected these needs and therefore suggest that the study may be useful in determining the components of an effective curriculum. After the training, the students reported significant increases in their feelings of self-efficacy and in their intentions, especially in comparison with a group of control students. Therefore, the module seems to be successful in inspiring medical students to work with victims of abuse.

California↗
PubMed1990

Medicating the postoperative elderly: how do nurses make their decisions?

Studies show that pain management in postoperative patients often results in undertreatment of pain. Because elderly postoperative patients receive less of the prescribed narcotic dose than their younger counterparts, there may be significant undertreatment of pain. Elderly patients receive less than one fourth of the prescribed narcotic in the first 24 hours after surgery. Type of surgery and vital signs were the factors most frequently used by nurses in their narcotic administration decisions for patients over age 60. According to the study, the factor of age did not appear to be important in the narcotic administration decisions of nurses.

Age Factors↗
PubMed1990

Randomized trial of postoperative patient-controlled analgesia vs intramuscular narcotics in frail elderly men.

Postoperative use of as-needed intramuscular narcotics is potentially hazardous in frail elderly patients. Patient-controlled analgesia (PCA) allows patients to self-administer small boluses of narcotic, allowing better dose titration, enhanced responsiveness to variability in narcotic requirements, and reduction in serum narcotic level fluctuation. Although theoretically useful, this method has not bee well studied in the elderly or medically ill. A prospective controlled trial among 83 higher-risk elderly men after major elective surgery compared PCA containing morphine sulfate with intramuscular morphine injections as needed (mean [+/- SD] age, 67.4 +/- 5.6 vs 67.0 +/- 6.3 years). Subjects had a variety of medical illnesses, including chronic lung disease (57%), coronary artery disease (43%), heart failure (13%), and liver disease (12%). Preoperative and postoperative assessments included chest roentgenograms; daily mental status and pulmonary function testing; twice-daily serum morphine levels; and oxygen saturation values, linear analogue pain and sedation scores, and vital signs every 2 hours. Care was taken to optimize narcotic administration in control subjects as well as PCA subjects. Analgesia was significantly improved by PCA (3-day mean pain score, 40.5 +/- 18.0 vs 32.5 +/- 15.0), without an increase in sedation. Significant postoperative confusion (18% vs 2.3%) and severe pulmonary complications (10% vs 0%) occurred significantly more frequently in intramuscular-treated controls. Patient-controlled analgesia was quickly mastered by most patients; no major problems referable to its use occurred. Patients who had previously received intramuscular injections reported that PCA was easier to use and provided better analgesia. Serum morphine levels showed significantly less variability on postoperative day 1 with PCA, compared with intramuscular injections. We conclude that PCA is an improved method of postoperative analgesia in high-risk elderly men with normal mental status, compared with as-needed intramuscular injections.

Aged↗