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PubMed1991

Program for training staff pharmacists in total parenteral nutrition.

A staff development program in total parenteral nutrition (TPN) is described. A 12-week education and training program was developed at a community hospital to enable staff pharmacists (those with B.S. degrees) to become involved in the pharmacy-based TPN service that has been in effect at the institution since 1978. Before 1987, the TPN pharmacist had always held a Pharm.D. degree. In the first four weeks of the program the trainee is allotted two hours per day for required reading. During the final eight weeks, the trainee accompanies a TPN pharmacist on daily rounds. A proficiency examination is given after week 10. Upon successful completion of the program, the pharmacist serves as a nutritional support therapy consultant to physicians who wish to have their patients evaluated, treated, and monitored by the TPN service. A quality assurance program was developed to enable the clinical coordinator in charge of the service to identify areas where further inservice education might be indicated and to satisfy requirements of the Joint Commission. Six staff pharmacists have completed the training program and are allowed to write TPN orders and conduct TPN rounds. The program has expanded the clinical roles of the staff pharmacists and has been well received by the medical staff. The quality assurance monitoring indicates that the service is excellent. A staff development program was successful in training staff pharmacists to participate in TPN therapy.

Education, Pharmacy, Continuing↗
PubMed1991

The effect of smoking on the development of allergic disease and specific immunological responses in a factory workforce exposed to humidifier contaminants.

The effects of smoking on the development of work related asthma and on the production of specific IgE and IgG antibodies to antigen from a contaminated humidifier are described for a sample of 258 workers from a printing factory. Current smoking was associated with low production of IgG antibody but with higher production of IgE antibody. No dose response for either antibody was found when numbers of cigarettes or pack-years smoked were considered. Work related asthma was detected in 12 workers by peak flow recordings. Six were current smokers and one was an ex-smoker. One subject with work related asthma had a high (and one a marginal) concentration of specific IgE to humidifier antigen.

Air Conditioning↗
PubMed1992

A service chief model for general pediatric inpatient care and residency training.

Pediatric training programs are faced with rapid, fundamental changes in hospital practice and an increasingly rigorous regulatory and fiscal environment. Traditional models for providing care and teaching students and house officers may not be sufficiently responsive to these challenges. In 1986, the Department of Medicine at Children's Hospital, Boston, reorganized the general inpatient program and implemented a "service chief" system adapted from British hospital "firms." Three age-based inpatient services (Thomas Morgan Rotch infant/toddler service, Kenneth Daniel Blackfan school-age service, and Charles Alderson Janeway adolescent/young adult service) were created, each headed by an experienced clinician and teacher (service chief). The service chiefs developed age-appropriate curricula, recruited a balanced faculty of generalists and specialists to serve as attending physicians and provide teaching in their areas of expertise, and established strong collaborative relationships with nurse managers on their respective wards. Implementation of the service chief system has been associated with development of faculty esprit de corps, standardized tracking of faculty performance, enhanced supervision and counseling of housestaff, and improved continuity of patient care. Relationships with referring physicians have improved dramatically, as measured by formal satisfaction surveys. Accountability and documentation have been emphasized, and departmental billings have increased sharply. Ongoing quality indicators have been developed, and collaborative patient care, teaching, and quality-improvement projects have been initiated with the nursing staff. Naming the services for distinguished past physicians-in-chief has provided a focus for fund-raising.(ABSTRACT TRUNCATED AT 250 WORDS)

Accreditation↗
PubMed1992

Organizational factors to consider when developing a certification program for hospice nurses: a Delphi survey.

A Delphi survey of 16 national experts in hospice nursing was conducted to address the question of which organizational factors should be considered when developing a certification program for hospice nurses. The three-round survey elicited many factors to consider which were arranged by category and ranked in order of importance according to the group opinion of the panel. The means, average deviations, standard deviations, and variances for each factor were calculated. The panel showed a high degree of consensus and there was little change in ranking after the second round. The survey produced results that should be of interest to organizations concerned with developing a certification program for hospice nurses.

Certification↗
PubMed2025

Myco-Ed: Mycological curriculum for education and discovery.

Fungi are important and hyperdiverse organisms, yet chronically understudied. Most fungal clades have no reference genomes, impeding our understanding of their ecosystem functions and use as solutions in health and biotechnology. Also, opportunities for training in fungal biology and genomics are lacking, creating a bottleneck that hinders the recruitment and cultivation of a talented future mycological workforce. To address these issues, we developed Myco-Ed, an educational program offering training and scientific contributions through genome sequencing and analysis. Myco-Ed empowers students to pursue careers in fungal biology while improving fungal resources. Myco-Ed has been piloted at 12 institutions (15 classrooms) ranging from online e-Campuses to R1 universities, resulting in hundreds of fungal observations and many new high-quality reference genomes.

Curriculum↗
PubMed1992

Culturally competent occupational therapy in a diversely populated mental health setting.

Cultural sensitivity is a crucial component of health care provision, particularly in psychiatric settings. As society becomes more multicultural, it is essential for occupational therapists to continue to develop cultural competence, which is defined in this paper as an awareness of, sensitivity to, and knowledge of the meaning of culture. At San Francisco General Hospital, an innovative multicultural model consisting of special focus programs is used. The key to the success of such programs is a culturally competent professional staff.

Clinical Competence↗
PubMedDate not supplied

Results of the 1992 National Resident Matching Program.

After 4 years of declining fill rates through the National Resident Matching Program (NRMP), 74 more positions in family practice residencies were filled in 1992 than in 1991, including 24 more filled with US seniors. The March fill rate (67.5%) increased for the first time since 1987, while the July fill rate (90.7%) increased for the first time since 1984. The Mountain and Pacific regions had the highest fill rates (89.1% and 88.5%, respectively) through the NRMP. Community-based, unaffiliated and university-affiliated programs filled 71.0% and 70.3% of positions offered through the NRMP. University-based and community-based, university administered programs filled 63.8% and 61.0% of positions offered through the NRMP. The other commonly defined primary care specialties of internal medicine and pediatrics also filled increased numbers of positions offered through the NRMP. This is the first year since 1984 in which all three primary care specialties matched more positions than in the previous year. The demand for family physicians in the United States is increasing. Evidence presented here suggests that 1992 may mark the beginning of a new trend toward increased interest in careers in family practice.

Family Practice↗
PubMed1992

Pharmaceutical services in U.S. hospitals in 1989.

The results of a spring 1989 national survey of hospital-based pharmacy services are reported. The study group (n = 2112) comprised half of U.S. acute-care general surgical or medical hospitals with 50 or more licensed beds. Pharmacy directors were asked about their hospital's provision of 14 clinical pharmacy services. The survey had a response rate of 56% (1174 usable responses). Provision levels varied significantly with the pharmacy drug delivery system for 14 services, pharmacy director's education for 12 services, hospital teaching affiliation for 12 services, hospital ownership for 9 services, hospital size for 9 services, and geographic region for 5 services. The following percentages of respondents offered specific services: drug-use evaluation, 90%; inservice education, 66%; adverse drug reaction (ADR) management, 46%; drug therapy monitoring, 41%; pharmacokinetic consultations, 40%; parenteral-enteral nutrition team participation, 28%; patient medication counseling, 26%; drug therapy protocol management, 25%; cardiopulmonary resuscitation (CPR) team participation, 25%; clinical research, 22%; drug information, 16%; participation in medical rounds, 13%; poison information, 9%; and medication histories, 2%. Pharmacist staffing requirements for clinical services usually centralized within the department were highest for drug information and poison information. Within hospitals offering the services, four of nine patient-specific services were potentially available to more than half the patients: ADR management, CPR team participation, drug therapy monitoring, and nutrition team participation. Drug therapy protocol management required the most pharmacist staff time. Only one service, pharmacokinetic consultations, was justified by more than half of the providers of that service. Respondents expected all the services to undergo net growth during 1989-90. The 1989 National Clinical Pharmacy Services Survey showed that provision of clinical pharmacy services varied with the pharmacy drug delivery system, pharmacy director's education, hospital teaching affiliation, hospital ownership, hospital size, and geographic region.

Adverse Drug Reaction Reporting Systems↗