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At least 1,405 records · Page 78Linked to original sources
PubMed2006

Demonstrating the positive impact of information support on patient care in primary care: a rapid literature review.

AIM: To review the literature on the positive impact of information services, or information resources, on patient care in primary care. OBJECTIVES: To identify and summarize key papers on which librarians might draw in making the case for investment, and to highlight gaps in the research evidence Methodology: A rapid literature review was conducted in the summer of 2005. RESULTS: There is a small body of evidence to demonstrate the positive impact of library and information services on the direct care of patients as well as a beneficial impact on the care of future patients through the application of evidence to multiple patients. CONCLUSIONS: There is relatively limited research evidence of the impact of information, and library services, in primary care, in comparison with hospital settings and the research available is generally reliant on small samples. There is a lack of impact studies conducted with non-clinical staff. The review highlights the value of critical incident technique (CIT). It is possible to gather evidence of the potential for information services to deliver cost savings.

Humans↗
PubMed2006

The costs and effectiveness of information-skills training and mediated searching: quantitative results from the EMPIRIC project.

OBJECTIVES: To compare the effectiveness and costs of providing information for patient care via librarian-mediated searches and information-skills training. METHODS: A questionnaire survey to library staff and health professionals in the North West. Data was collected on perceptions of services, satisfaction and service usage, allowing a cost analysis to be undertaken. Statistical data was analysed using Statistical Package for the Social Sciences (spss). RESULTS: Using satisfaction and use of skills as outcome measures, both mediated searches and information skills training are effective. A breakdown of costs per type of training session and literature search is provided. Cost-effectiveness is dependent on whether costs are viewed from a library or trust point of view. Providing information skills training does not reduce the volume of mediated-search requests. CONCLUSIONS: No one method of providing information for health professionals is more effective or cost-effective than another. A decision about which services to provide cannot be made on the basis of effectiveness or costs alone; the views of library staff and the health professionals they serve should also be taken into account. A proactive approach and targeting training towards those who are most likely to benefit may be an appropriate way forward.

Cost-Benefit Analysis↗
PubMed1995

The stories of physicians, registered nurses and enrolled nurses about ethically difficult care episodes in surgical care.

Twenty physicians, 19 registered nurses (RN), and 20 enrolled nurses (EN) working in surgical care in Sweden narrated their experiences of being in ethically difficult care situations. All three professional groups disclosed a strong wish to help patients. The narrations of the physicians and the ENs indicated that they were very much involved in their patients, while most of the RNs' stories were narrated from a distanced onlooker's perspective and disclosed a lot of moral outrage, mainly directed towards physicians. The physicians were the only group that emphasized the importance of acting in accordance with science and proven experience. Like RNs they emphasized the importance and difficulty of telling the truth to the patients and their families and being open to one's own and others' harsh experiences. RNs and ENs emphasized the patient's right to a death with dignity and the difficulties connected with being with dying patients, and they also described feelings of powerlessness and neglect of patients related to a heavy work load. ENs narrated difficulties related to providing patients with individualized but fair care.

Adult↗
PubMed2006

Strengthening medical ethics by strategic planning in the Islamic Republic of Iran.

To bring attention to medical ethics and to enhance the quality of health care in Iran, the Ministry of Health and Medical Education has introduced a strategic plan for medical ethics at a national level. This plan was developed through the organization and running of workshops in which experts addressed important areas related to medical ethics. They analysed strengths and weaknesses, opportunities and threats, and outlined a vision, a mission and specific goals and essential activities surrounding medical ethics. The current strategic plan has six main goals that will be reviewed in this paper. Some major activities that were carried out in recent years, and some future plans, will be also reviewed.

Advisory Committees↗
PubMed2004

Developing an integrated paediatric low vision service.

A survey of usage of low vision aids (LVAs) by 56 children with visual impairment, who were attending mainstream schools in Wirral, was undertaken. A total of 25% of children owned an LVA and 5% were using these on a regular basis. These low levels of ownership and usage led to the development of a low vision service involving the collaboration of education and health care. This paper describes the development of that service, its elements and implementation. The results from the new service show that of the 29 children issued with an LVA, 82.7% are using them on a regular basis. Having an integrated service is shown to significantly improve LVA usage in the group of children seen so far. The service results are discussed with suggestions for future service development.

Adolescent↗
PubMed2005

The need for optimal and coordinated management of CKD.

The prevalence of impaired kidney function has been estimated to be between 10% and 20% of adult populations in most countries worldwide. Reduced kidney function has been recognized as a risk factor for poor outcomes, and thus requires attention. Key aspects of management of CKD have been defined for referred populations, but not necessarily for those unreferred. In order to improve patient outcomes, there is a need to take a more holistic approach to the problem, by coordinating the efforts of policy makers, those involved in health care system redesign, clinicians, and researchers. In so doing, there should be an improvement in both identification and management of patients with impaired kidney function, whether cared for by primary care physicians, specialists, or nephrologists, and irrespective of the health care system.

Chronic Disease↗
PubMed2004

Translation research: where do we go from here?

AIM: Where do we go from here? This article draws on other articles in this supplement, the dialogue from the meeting that generated it, and other sources to identify steps to advance translation research, and in particular to achieve broader translation and use of evidence. IMPLICATIONS: To move from the growing accumulation of individual successes in translation to broader scale translation and implementation of evidence, those who use research and those who do research will need to do four things: (1) increase synergy and synchronization across studies, through cross-disease studies, adoption of a common and precise language to describe interventions, addressing issues of customization of interventions, and finding commonality in quality and outcomes measures; (2) take account of organizational factors that can shape the impact of interventions, and also move to the implementation of organizational evidence; (3) address environmental factors such as reimbursement and market competition; and (4) take findings to a larger scale through national demonstrations, efforts of national agents of change, challenge or partnership grants, or use of provider-based networks.

Diffusion of Innovation↗
PubMed2006

An interdisciplinary faculty development model for the prevention and treatment of alcohol use disorders.

BACKGROUND: The skills of faculty working in health fields are inadequate to meet the needs of those adversely affected by alcohol. This project was designed to increase the teaching, clinical, and research activities of faculty from multiple disciplines at the university level. METHODS: The faculty development model included two 2-day skills-based courses held 6 months apart, precourse and postcourse evaluations, active mentoring, and development of a specific work plan for each participant. The educational model utilized skills-based courses previously developed for full-time clinical/teaching medical faculty with limited time and resources. RESULTS: A total of 153 participants at 6 locations completed the courses; 131 completed the 6-month follow-up interview. Sixty-four designed teaching, clinical, or research projects during the 6-month period between the first and second courses. Precourse versus postcourse clinical scores from standardized patient encounters showed highly significant improvements in screening, brief intervention, and motivational interviewing skills (p<0.001). At the 6-month follow-up interview, 61% of the participants reported teaching on alcohol, tobacco, or drug problems; 49% reported clinical activities in this area; 36% reported conducting research; 10% had submitted manuscripts for publication; 12% had submitted grant applications; and 32% percent had sought additional AODA training. Participants gave high scores to all components of the faculty development model; 81% would repeat the training and 98% would recommend the program to colleagues. CONCLUSIONS: This cost-effective faculty development program can serve as a model to increase educational programs on substance abuse at public universities, increase faculty research activities in the alcohol area, and increase clinical programs in university hospitals.

Adult↗
PubMed1985

Legal and ethical standards in geriatric medicine.

Several examples of physicians' ethical and legal responsibilities toward older individuals desiring medical care are discussed. The focus is on the older person's ethical and legal right to access to medical services, and on the extent of corresponding obligations of physicians to actuate and fulfill the older person's access rights. The impact of current cost constraints in carrying out these obligations is also discussed.

Ethics, Medical↗
PubMed1987

The prevalence and design of ethics committees in nursing homes.

A dramatic increase in the number of ethics committees in long-term care facilities (LTCFs) has occurred since 1970 in the 487 nursing homes in Minnesota. Ten percent of the LTCFs had ethics committees which were mostly formed by administrators and nurses. The committees are most often found in large urban facilities with a high percentage of skilled-level beds and a religious name. The committees are multidisciplinary with a median of nine members including two to three nurses, a physician, a social worker, a minister, an administrator, and three other members. Nearly all committees were involved in policy development and staff education. Additional functions included resident care consultation and retrospective case review. More than half of the committees are accountable to administration. Nearly all committees kept minutes. Though all committees incurred costs, only one had a formal budget. Informal evaluation is done in only six committees. No committee had referred cases to the courts.

Bioethical Issues↗
PubMed1992

Ethics rounds at the nursing home: an alternative to an ethics committee.

The increased attention in US medicine to medical ethics reflects in large part the "new" demography of a growing elderly population and the conflict of whether decisions regarding medical care should be based on cost-effectiveness or "human-effectiveness." Currently, about 40 percent of the nation's elderly end up in nursing homes where they confront ethical and legal dilemmas that would not arise in their own homes. In the nursing home, difficult medical-ethical decisions generally rely on two approaches: the often used but frequently invalid concept of informed consent and little used ethics committees. At The Jewish Home and Hospital for Aged in New York City we have developed a program of "ethics rounds" as an alternative to ethics committees. We conduct the rounds in the open style of a forum or clinical conference rather than with the aura of a decision-making group. We encourage the participation of patients and family and seek to educate the staff, any one of whom may choose to attend. The rounds consist of a multidisciplinary case presentation, an interview of patient and/or family, a discussion by the staff, and an overview by an ethicist. Staff response to the educational and interdisciplinary aspects of the rounds has been remarkably positive.

Ethical Review↗