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At least 145 records · Page 8Linked to original sources
PubMed1991

Improving accuracy in documentation of restrictive interventions by direct-care personnel.

Accurate and reliable documentation of rights restrictions is critical for evaluating a program's success against the intrusiveness of a behavioral intervention, complying with regulatory standards, and refining treatment strategies. Direct-care and ancillary staff in three cottages at a state facility for persons with mental retardation were selected to evaluate a revised documentation system, including a new form, inservice training for staff inservice, and staff feedback, that was implemented sequentially across cottages. Results showed an immediate and sustained reduction in documentation errors following the implementation of the documentation system. Benefits and limitations of the new system were discussed.

Adult↗
PubMed1996

Strengthening patient education for ORT services in the Central African Republic.

This paper describes the design and implementation of a health worker training program in diarrhea case management and its effect on patient education in health facilities in the Central African Republic (C.A.R.). In 1989, a facility-based assessment of health worker practices in managing diarrheal disease in children under 5 years of age documented serious deficiencies in patient education as performed by health workers. Based on these results, the Ministry of Health (MOH) designed an inservice training program that promoted education as an integral component of curative care. The training program was implemented in all five health regions of the country. An evaluation of the training's impact on the delivery of patient education indicated dramatic increases in the number of messages health workers communicated to mothers. This experience demonstrated that the patient education practices of health workers can be improved through inservice training that integrates the teaching of clinical and communication skills. Additional study in C.A.R. is needed to (1) further improve the quality of patient education for diarrhea and other childhood communicable diseases, (2) determine the impact of patient education on the care provided by mothers in the home following a clinic visit, and (3) assess how operational research can be conducted within the limitations of inservice training programs and routine clinical operations.

Central African Republic↗
PubMedDate not supplied

[Inservice education--training for the 4th year nursing students].

This work reports the trainee-nurses contact with recycling of a nursing team at a general hospital through an extension project. It has been observed that the participation in this project reinforced to the trainee-nurses the importance of the nurses educative role and have showed us the necessity of more frequent contacts between trainee-nurses and their educational role, so that, after graduation, they will be able to develop education in service, mainly next to their work-team with security.

Adult↗
PubMed1991

Antecedents and interventions for aggressive behavior of patients at a geropsychiatric state hospital.

Aggressive geropsychiatric patients pose major problems for long-term care facilities. Two exploratory surveys at a geropsychiatric state hospital, separated by brief programs of inservice training on managing aggressive patients, examined several aspects of aggressive behavior and staff interventions. Major findings included a stable overall prevalence of aggressive behavior in both survey periods; a persistently higher prevalence of aggression and a higher rate of physical aggression among dementia patients than among other patients; and staff-patient exchanges as a major triggering event for aggression. In the survey period after the inservice training, staff interventions remained similar for nondementia patients; however, for dementia patients, interpersonal interventions were used less frequently, and p.r.n. medications, alone or in combination with seclusion or restraint, were used more often.

Aged↗
PubMed1979

Affective training for teachers of psychotic children.

A group inservice training program for teachers of psychotic children is described. Special emphasis is given to the teacher's emotional needs in dealing with these very difficult children. The training is designed to enhance mutual support and the acceptance of feelings associated with working with psychotic children. Teachers who worked alone or without the benefit of a supportive team responded most enthusiastically to the group training. All teachers felt their emotional needs for support, self-confidence, and acceptance were important factors in their functioning with their students and that the training met those needs.

Anger↗
PubMed1995

Investigation of benefits and costs of an ophthalmic outreach clinic in general practice.

BACKGROUND: With the advent of general practitioner fundholding, there has been growth in outreach clinics covering many specialties. The benefits and costs of this model of service provision are unclear. AIM: A pilot study aimed to evaluate an outreach model of ophthalmic care in terms of its impact on general practitioners, their use of secondary ophthalmology services, patients' views, and costs. METHOD: A prospective study, from April 1992 to March 1993, of the introduction of an ophthalmic outreach service in 17 general practices in London was undertaken. An ophthalmic outreach team, comprising an ophthalmic medical practitioner and an ophthalmic nurse, held clinics in the practices once a month. Referral rates to Edgware General Hospital ophthalmology outpatient department over one year from the study practices were compared with those from 17 control practices. General practitioners' assessments of the scheme and its impact on their knowledge and practice of ophthalmology were sought through a postal survey of all partners and interviews with one partner in each practice. Patient surveys were conducted using self-administered structured questionnaires. A costings exercise compared the outreach model with the conventional hospital ophthalmology outpatient clinic. RESULTS: Of 1309 patients seen by the outreach team in the study practices, 480 (37%) were referred to the ophthalmology outpatient department. The annual referral rate to this department from control practices was 9.5 per 10,000 registered patients compared with 3.8 per 10,000 registered patients from study practices. A total of 1187 patients were referred to the outpatient department from control practices. An increase in knowledge of ophthalmology was reported by 18 of 47 general practitioners (38%). Nineteen (40%) of 47 general practitioners took advantage of the opportunity for inservice training with the outreach team; they were more likely to change their routine practice for ophthalmic care or referral criteria for patients with cataracts or diabetes than those who did not attend for inservice training. The outreach scheme was popular with patients, for whom ease of access and familiarity of surroundings were major advantages. The cost per patient seen in the outreach clinics (48.09 pounds) was about three times the cost per patient seen in the outpatient department (15.71 pounds). CONCLUSION: The model of ophthalmic outreach care in this pilot study was popular with patients and general practitioners and appeared to act as an effective filter of demand for care in the hospital setting. However, the educational impact of the scheme was limited. Although the unit costs (per patient) of the outreach scheme compared unfavourably with those of conventional outpatient treatment, potential health gains from this more accessible model of care require further exploration.

Ambulatory Care Facilities↗
PubMed2004

The effects of verbal support strategies on small-group peer interactions.

PURPOSE: This study investigated whether child care providers could learn to facilitate peer interactions by using verbal support strategies (e.g., prompts, invitations, or suggestions to interact) during naturalistic play activities. METHOD: Seventeen caregivers were randomly assigned to experimental and control groups, stratified by center so that staff from one center could attend the training program together. The experimental group received inservice training on how to facilitate peer interaction; the control group received training on adult-child communication strategies. Caregivers in the experimental group were taught to facilitate children's interactions with their peers by using indirect referrals (e.g., alerting children to situational information, offering praise) and direct referrals (e.g., telling a child what to say to a peer, inviting children to play together). RESULTS: At posttest, the caregivers in the experimental group used more verbal supports for peer interaction than the caregivers in the control group. Specifically, they used more utterances to promote communication between peers and to invite children to interact together. In turn, the children in the experimental group initiated interactions with peers more often and engaged in extended peer sequences more often than the children in the control group. CLINICAL IMPLICATIONS: The results support the viability of this training model in early childhood education settings and suggest that future research of its effects with children who have disabilities is warranted.

Adult↗
PubMed1977

Inservice pharmacy technician training program.

The development and implementation of a two-month inservice training program for hospital pharmacy supportive personnel is discussed. A task-oriented approach was used to define the instructional objectives of the program. To emphasize the job-related nature of the instruction, conferences and workshops were selected as the primary teaching methods. A specific instructional plan was designed for drug conferences, giving the trainee an active role in the learning of drug names and dosage forms. On-the-job experience, comprising 30% of the training time, gradually was incorporated into the program. Staff pharmacists and supervisors assumed the teaching responsibilities. During weekly evaluation sessions with each trainee, the coodinator discussed the trainee's performance, pin-pointed deficiencies and suggested means of improvement. The benefits of the program, in terms of selection and sequence of instructional programs, student assessment and program evaluation, are discussed.

Curriculum↗
PubMed1997

Administration of medications through enteral feeding catheters.

BACKGROUND: Enteral feeding catheters are commonly used to administer both nutritional feedings and oral forms of medications. Obstruction of the catheters is a major concern. OBJECTIVES: To study characteristics of obstruction of enteral feeding catheters in ICU patients and current knowledge and practices of ICU nurses of administering medications through such catheters. METHODS: A postcard invitation to participate in this descriptive survey was mailed to a random sample of 12,069 members of the American Association of Critical-Care Nurses. The 52-item investigator-designed questionnaire was mailed to the 1700 critical care nurses who agreed to participate; 1167 (68.6%) returned completed survey questionnaires. RESULTS: Nurses estimated that 33.8% of their patients received 8.9 doses of medication per day through the enteral feeding catheter. The rate of obstruction of the tube by medications was 15.6%. Crushed medications contributed to obstruction, although liquid forms of the medications often were available. Nurses' primary source of knowledge about administering medications through enteral feeding catheters was clinical practice (56.9%) and consultation with peers (21.7%); only 19% had had inservice training on the topic. Written agency guidelines varied considerably, and 74% of nurses used two or more techniques that were contrary to recommendations. Factors significantly associated with lower rates of obstruction of enteral feeding catheters included (1) assistance from the pharmacy service to ensure liquid forms of medications, (2) nurses' attendance at a relevant seminar or inservice training program, and (3) not routinely crushing and administering enteric-coated or sustained-release medications through the enteral feeding catheter. CONCLUSIONS: Collaboration between nursing and pharmacy services to ensure delivery of liquid medications and avoid use of crushed medications may reduce the high rate of catheter obstruction due to medications. Research-based guidelines and a more formal dissemination of information to nurses are needed.

Catheters, Indwelling↗