Interprofessional collaboration

专业间合作
  • 文章类型: Journal Article
    背景:药剂师在药物使用过程(MUP)中的角色随着新的医疗保健交付模式和跨专业协作实践而发展。目前尚不清楚利益相关者对药剂师角色的看法是否同时演变。
    目标:检查患者,药剂师,和医生对药剂师在MUP中的角色的看法。
    方法:这项IRB批准的研究使用了患者Qualtrics小组的横断面设计,药剂师,和医生。角色理论被用作开发12项调查的框架,以研究MUP中的药剂师角色认知:处方,转录,配药,administration,和监测。对开放式问题的回答进行内容分析。
    结果:来自1004名患者,共获得9个问题的7217条评论(740-1004条评论),导致每个问题平均802条评论或每个受访者每个问题0.8条评论(CQR)。同样,205位药剂师对11个问题的1,620条评论(121-205条评论)平均为0.72CQR;200位医生对11个问题(136-200条评论)的1,561条评论等于0.74CQR。内容分析揭示了利益相关者中反复出现的主题:“药剂师”,\'医生\',\'保险\',\'技术\',\'协作\',\'时间\',\'通信\',和“病人的责任”。所有3个利益相关者在药剂师角色方面都看到了一些角色一致性;注意到药剂师在改善MUP的所有步骤中的角色,除了转录。药剂师强调了专业挑战,如人员配备问题,倦怠,和相互竞争的需求;患者和医生没有承认这一点,表明需要提高认识。
    结论:这项研究表明,所有利益相关者都提高了对药剂师在MUP中的作用的知名度和认识,与以前的研究相比,药剂师的角色仅限于配药。在这项研究中,任何利益相关者都没有报告药房实践的已知障碍,例如缺乏提供者身份和报销。需要不断向利益相关者通报药剂师通过宣传和营销在MUP中扩大的角色。
    BACKGROUND: Pharmacist roles in the Medication Use Process (MUP) have advanced along with new healthcare delivery models and interprofessional collaborative practice. It is unclear whether stakeholder perceptions of pharmacist roles have evolved simultaneously.
    OBJECTIVE: Examine patient, pharmacist, and physician perceptions of pharmacist roles in the MUP.
    METHODS: This IRB-approved study used a cross-sectional design with Qualtrics panels of patients, pharmacists, and physicians. Role Theory was used as a framework to develop 12-item surveys to study pharmacist role perceptions in the MUP: prescribing, transcribing, dispensing, administration, and monitoring. Content analysis was performed on the responses to open-ended questions.
    RESULTS: From 1004 patients, a total of 7,217 comments were obtained on 9 questions (740-1004 comments), resulting in an average of 802 comments per question or 0.8 comments per question per respondent (CQR). Similarly, 1,620 comments from 205 pharmacists on 11 questions (121-205 comments) averaged 0.72 CQR; and 1,561 comments from 200 physicians on 11 questions (136-200 comments) equated to 0.74 CQR. Content analysis revealed recurring themes across the stakeholders: \'pharmacists\', \'physicians\', \'insurance\', \'technology\', \'collaboration\', \'time\', \'communication\', and \'patient\'s responsibility\'. Some role congruence was seen regarding pharmacist roles by all 3 stakeholders; noting pharmacist roles in improving all steps of the MUP, except transcribing. Pharmacists highlighted professional challenges such as staffing issues, burnout, and competing demands; which were not acknowledged by patients and physicians indicating the need to increase awareness.
    CONCLUSIONS: This study showed increased visibility and awareness of pharmacist roles in the MUP by all stakeholders, compared to previous research showing pharmacist roles limited to dispensing. Known barriers to pharmacy practice such as lack of provider status and reimbursement were not reported by any of the stakeholders in this study. There is a need to continuously inform stakeholders about pharmacists\' expanding roles in the MUP through advocacy and marketing.
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  • 文章类型: Journal Article
    背景:妊娠期间口腔菌群失调导致口腔和牙齿健康不良会增加不良妊娠结局的风险。因此,传达口腔健康的重要性对于降低不良妊娠结局的风险至关重要。专业指导可以大大支持女性对自己能力的积极看法。有关口腔健康的信息应由助产士等医疗保健专业人员提供,产科医生和牙医。这项研究的目的是评估需求,德国孕妇的愿望和偏好,关于怀孕期间口腔健康的跨专业合作和指导。
    方法:信息来源,在六个孕妇在线焦点小组中调查了有关信息供应的偏好以及相关医疗保健专业的跨专业合作需求。此外,三次专家采访助产士,进行了产科医生和牙医。根据Kuckartz使用定性内容分析对焦点小组和访谈进行了分析。
    结果:25名孕妇参加了焦点小组。所有三个月的孕妇,23至38岁,包括在内。许多妇女在怀孕期间没有收到任何关于口腔健康的信息或收到的信息不足,并希望从所有相关的医疗保健提供者那里获得更一致和书面的信息。妇女接受口腔健康咨询的程度,在很大程度上依赖于他们的个人主动性,许多人希望了解口腔健康和妊娠结局之间的科学联系.确定了怀孕期间牙科就诊的时间和安全性的总体不确定性。与专家的访谈提供了对参与咨询的医疗保健专业人员的工作条件的更多见解,并强调需要在各自的专业教育中改善怀孕期间口腔健康的培训以及与该主题相关的主题计费选项。
    结论:对妇女孕期口腔健康的指导似乎不足。提供适应需求的信息,妇女在怀孕期间的愿望和偏好以及在相关医护人员的教育中实施这一主题可能有助于改善孕妇的产前护理,并随后降低不良妊娠结局的风险。
    BACKGROUND: Poor oral and dental health due to oral dysbiosis during pregnancy increases the risk for negative pregnancy outcomes. Communicating the importance of oral health is therefore essential in reducing the risk of adverse pregnancy outcomes. Professional guidance could substantially support women\'s positive perception of their own competence. Information on oral health should be provided by healthcare professionals such as midwives, obstetricians and dentists. The aim of this study was to assess the needs, wishes and preferences of pregnant women in Germany, regarding interprofessional collaboration and guidance on oral health during pregnancy.
    METHODS: Sources of information, preferences regarding information supply as well as the need for interprofessional collaboration of involved healthcare professions were investigated in six online focus groups with pregnant women. In addition, three expert interviews with a midwife, an obstetrician and a dentist were conducted. The focus groups and interviews were analysed using qualitative content analysis according to Kuckartz.
    RESULTS: 25 pregnant women participated in focus groups. Pregnant women in all trimesters, aged 23 to 38 years, were included. Many women did not receive any or received insufficient information on oral health during pregnancy and wished for more consistent and written information from all involved healthcare providers. The extent of oral health counselling women received, heavily relied on their personal initiative and many would have appreciated learning about the scientific connection between oral health and pregnancy outcomes. An overall uncertainty about the timing and safety of a dental visit during pregnancy was identified. Interviews with experts provided additional insights into the working conditions of the involved healthcare professionals in counselling and emphasised the need for improved training on oral health during pregnancy in their respective professional education as well as thematic billing options in relation to this topic.
    CONCLUSIONS: Guidance of women on oral health during pregnancy appears to be insufficient. Providing information adapted to the needs, wishes and preferences of women during pregnancy as well as the implementation of this topic in the education of involved healthcare professionals could contribute to an improved prenatal care for pregnant women and subsequently a reduced risk of negative pregnancy outcomes.
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  • 文章类型: Journal Article
    卫生专业人员通常需要共同努力以提供基于团队的护理。随着医疗保健复杂性和人力短缺的增加,更多的卫生专业人员在多个领域工作,流畅的团队而不是一个稳定的团队,为患者提供护理。然而,目前没有经过验证的仪器来衡量流畅团队中专业间合作的质量。一种方法是评估团队成员的团队意识水平(使临床团队有效的素质)。这项研究旨在检查在流体团队中使用协作环境评估(ACE-15)的有效性证据,并调查团队在健康专业和临床环境中是否存在差异。内容和响应过程的有效性是通过咨询专家和认知访谈收集的,导致对ACE-15中15个项目中的11个进行了修订。通过对修订后的ACE-15这一13项仪器的194项响应进行探索性因素分析,ACE-13F,开发了在流体团队中使用的具有强大有效性的证据。双因素固定效应方差分析模型显示,卫生专业人员工作的临床环境对团队水平有显著影响(F[3,170]=6.15,p<.001,η2=0.09)。ACE-13F可用作测量流体医疗团队中的跨专业协作的快速仪器。
    Health professionals often need to work together to provide team-based care. With increasing healthcare complexities and manpower shortages, more health professionals are working in multiple, fluid teams instead of one stable team, to provide care to patients. However, there is currently no validated instrument to measure the quality of interprofessional collaboration in fluid teams. One approach is to assess team members\' perceived level of teamness (qualities that make clinical teams effective). This study aimed to examine the validity evidence of using the Assessment for Collaborative Environment (ACE-15) in fluid teams and investigate if teamness varies among health professions and clinical settings. Content and response process validity were gathered through consulting experts and cognitive interviews, resulting in revisions to 11 of 15 items in ACE-15. Through exploratory factor analysis of 194 responses on the revised ACE-15, a 13-item instrument, ACE-13F, with strong validity evidence for use in fluid teams was developed. A two-factor fixed effect ANOVA model revealed that the clinical setting that health professionals work in has a significant impact on the level of teamness (F[3,170] = 6.15, p < .001, η2 = 0.09). ACE-13F can be used as a rapid instrument to measure interprofessional collaboration in fluid healthcare teams.
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  • 文章类型: Journal Article
    鉴于多系统的挑战和涉及的专业人员,中风护理中的跨专业合作(IPC)被认为是最佳实践和必要的。我们的两部分卒中团队模拟提供了嵌入在执照前职业治疗中的有意的跨专业教育体验(IPE),物理治疗,药房,医学,护理和语言病理学课程。这项为期六年的混合方法计划评估旨在确定COVID-19是否需要模拟交付差异影响学生的IPC感知,评级,并报告学习。在这两个模拟之后,跨专业协作能力评估量表(ICCAS)和自由文本自我报告学习是自愿和匿名收集的。使用ICCAS跨专业能力因素的阶乘方差分析比较了各种交付方法的得分。对自由文本回答进行了内容和类别分析。总的来说,交付格式不影响ICCAS发布前评分的积极变化.然而,在角色/责任的跨专业能力和以患者/家庭为中心的协作方法方面,ICCAS前后的评分存在显著差异.对四个开放式问题的10,000多个书面答复的分析显示,模拟设计唤起了对他人和自己的实践范围的更好理解。角色和共享领导力如何根据上下文和客户需求而变化,以及每个团队成员的专业知识的价值。仅具有虚拟体验的学生注意到了现场中风临床模拟机会的偏好。
    Interprofessional collaboration (IPC) in stroke care is accepted as best practice and necessary given the multi-system challenges and array of professionals involved. Our two-part stroke team simulations offer an intentional interprofessional educational experience (IPE) embedded in pre-licensure occupational therapy, physical therapy, pharmacy, medicine, nursing and speech-language pathology curricula. This six-year mixed method program evaluation aimed to determine if simulation delivery differences necessitated by COVID-19 impacted students\' IPC perception, ratings, and reported learning. Following both simulations, the Interprofessional Collaborative Competency Assessment Scale (ICCAS) and free-text self-reported learning was voluntarily and anonymously collected. A factorial ANOVA using the ICCAS interprofessional competency factors compared scores across delivery methods. Content and category analysis was done for free-text responses. Overall, delivery formats did not affect positive changes in pre-post ICCAS scores. However, pre and post ICCAS scores were significantly different for interprofessional competencies of roles/responsibilities and collaborative patient/family centered approach. Analysis of over 10,000 written response to four open-ended questions revealed the simulation designs evoked better understanding of others\' and own scope of practice, how roles and shared leadership change based on context and client need, and the value of each team member\'s expertise. Virtual-experience-only students noted preference for an in-person stroke clinic simulation opportunity.
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  • 文章类型: Letter
    暂无摘要。
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  • 文章类型: Editorial
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  • 文章类型: Journal Article
    澳大利亚首都地区(ACT)的澳大利亚早期发展普查(AEDC)数据表明,在交流和常识领域处于危险或发育脆弱的儿童比例有所增加,语言和认知技能。这项研究调查了言语病理学家和教育者合作的有效性,以建立教育者促进学龄前儿童口语和紧急识字技能的能力。
    准实验,测试前测试后设计用于评估跨专业提供的有效性再次阅读-幼儿园!(a)儿童的口头语言和紧急识字结果,(b)教育者口头语言和紧急识字教学实践,和(c)教室环境的质量。
    孩子们表现出更好的印刷知识和叙事技巧。两位教育者中的一位在与儿童的日常互动中展示了他们对口头语言和新兴识字促进策略的使用显着增加。在课堂环境中没有观察到显著的变化。
    与教练组件的跨专业合作是提高儿童紧急识字技能和教育者教学实践的有效方法。
    UNASSIGNED: Australian Early Development Census (AEDC) data for the Australian Capital Territory (ACT) indicates a concerning increase in the proportion of children who are at risk or developmentally vulnerable in the domains of communication and general knowledge, and language and cognitive skills. This study investigated the effectiveness of speech-language pathologist and educator collaboration to build educator capacity to promote oral language and emergent literacy skills in preschool children.
    UNASSIGNED: A quasi-experimental, pre-test post-test design was used to evaluate the effectiveness of interprofessional delivery of Read It Again - KindergartenQ! on (a) children\'s oral language and emergent literacy outcomes, (b) educators\' oral language and emergent literacy instructional practices, and (c) quality of the classroom environment.
    UNASSIGNED: Children demonstrated improved print knowledge and narrative skills. One of the two educators demonstrated a significant increase in their use of oral language and emergent literacy promoting strategies in their day-to-day interactions with children. No significant changes were observed in the classroom environment.
    UNASSIGNED: Interprofessional collaboration with a coaching component is an effective method of improving children\'s emergent literacy skills and educator instructional practices.
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  • 文章类型: Journal Article
    为患者和卫生服务的利益而实施的药学服务已在世界范围内得到强调。护士之间的跨专业合作,药剂师,医生可能有助于提高人们对药理学挑战的认识,提高质量,并最大限度地减少药物护理中的错误。这项研究旨在调查护士如何,药剂师,和医生在挪威的社区医疗保健中经历了药学服务的跨专业合作。该研究采用定性方法进行了探索性和描述性设计。对12名医护人员进行了个人访谈,这些医护人员在社区医疗保健服务中的药学服务中起着关键作用。使用系统的文本凝聚对数据进行分析。结果显示了三个类别和四个子类别:“专业挑战”类别包含“职责模糊”和“信任和连续性的重要性”子类别。“组织障碍”类别包含“缺乏信息交换和适当的沟通渠道”和“缺乏时间和会议地点”子类别。第三类是“护士-重要环节”。这项研究揭示了在增加高质量和安全的药学服务方面面临的挑战和成功的因素。可用于社区卫生服务高质量工作的知识,以及作为三个专业课程开发的投入。
    Implementation of pharmaceutical care for the benefit of patients and health services has been highlighted worldwide. Interprofessional collaboration between nurses, pharmacists, and physicians may contribute to raising awareness of pharmacological challenges, increasing quality, and minimising errors in pharmaceutical care. This study aimed to investigate how nurses, pharmacists, and physicians experience interprofessional collaboration in pharmaceutical care within community healthcare in Norway. The study had an explorative and descriptive design with a qualitative approach. Individual interviews were conducted with 12 healthcare personnel with key roles in pharmaceutical care within community healthcare services. The data were analysed using systematic text condensation. The results revealed three categories and four subcategories: The category \"Professional challenges\" contained the subcategories \"Blurred responsibilities\" and \"The importance of trust and continuity\". The category \"Organisational barriers\" contained the subcategories \"Lack of information exchange and suitable communications channels\" and \"Lack of time and meeting places\". The third category was \"Nurses-the important link\". This study reveals challenges to and factors of success in increasing high-quality and safe pharmaceutical care, knowledge that can be used in quality work in the community health services and as input in curriculum development for the three professions.
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  • 文章类型: Journal Article
    1928年首次记录,患有糖尿病(DM)的人患牙周病(PD)的风险是非糖尿病患者的三到四倍;对于那些吸烟的人来说,这种风险增加了十倍。然而,许多医生都不知道这一点。DM和PD是双向链接的,一个影响另一个,反之亦然,尽管机制尚不完全清楚,并且可能与慢性感染有关。PD对血糖控制有不利影响。当牙周炎被成功治疗时,这改善。当患者持续高糖化血红蛋白(HbA1c)水平时,医生应考虑PD,当牙医患有不稳定或进行性牙周炎时,应考虑糖尿病或糖尿病前期。医生,牙医,他们的团队需要分享结果。红绿灯系统,提出了琥珀色和绿色的医疗和牙科风险,和设计的形式,以便糖尿病患者自己可以与他们的专业顾问分享他们,直到有可靠的专业沟通方法和工作实践的范式转变。牙医需要找到方法向他们的医学同事传授PD的基础知识,更新他们的医疗记录,了解更多医疗风险。需要更多的研究。
    First recorded in 1928, people living with diabetes mellitus (DM) are at a three to four times higher risk of developing periodontal disease (PD) than non-diabetics; for those who smoke this risk increases up to ten times. However, many doctors are unaware of this.DM and PD are bidirectionally linked, the one affecting the other and vice versa, although the mechanism is not fully understood and may be linked to chronic infection. PD has an adverse effect on glycaemic control. That improves when periodontitis is successfully treated.Doctors should consider PD when their patients have persistently high glycated haemoglobin (HbA1c) levels, and dentists should consider diabetes or pre-diabetes when they have patients with unstable or progressive periodontitis.Doctors, dentists, and their teams need to share results. A traffic light system of red, amber and green for both medical and dental risks is proposed, and a pro forma designed, so that diabetics themselves can share them with their professional advisors until such times as there are reliable methods of interprofessional communication and a paradigm shift in working practices is achieved.Dentists need to find ways to teach their medical colleagues about the basics of PD, update their medical records, and understand more about medical risks. More research is required.
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  • 文章类型: Journal Article
    背景:护理教育已经注意到基于模拟的教育的积极作用。有许多关于模拟教育效果的研究,但是其中大多数涉及一个单一的机构,非随机对照试验,小样本量和对效果的主观评价。这项多中心随机对照试验的目的是评估高保真模拟的效果,基于计算机的模拟,高保真模拟与基于计算机的模拟相结合,并对护理本科生进行个案研究。
    方法:从中国五所大学招募270名护理专业学生。参与者在每个机构被随机分为四组:高保真模拟组,基于计算机的模拟小组,高保真仿真与基于计算机的仿真组相结合,和案例研究小组。最后,239名参与者完成了干预和评估,每组58、67、57和57名参与者。数据收集分为三个阶段:干预前,干预后立即,干预后三个月。
    结果:四组之间的人口统计学数据和基线评估指标没有显着差异。在提高知识的四种方法之间没有观察到统计学上的显着差异,跨专业合作,批判性思维,关怀,或对学习的兴趣。虽然干预后不同组的技能改善有显著差异(p=0.020),三个月后,没有观察到差异(p=0.139)。基于计算机的模拟组的技能提高在干预结束时明显低于高保真模拟组(p=0.048)或高保真模拟结合基于计算机的模拟组(p=0.020)。
    结论:护理专业学生在培养知识方面从四种方法中获益相同,跨专业合作,批判性思维,关怀,和兴趣学习立即和随着时间的推移。高保真仿真和高保真仿真结合基于计算机的仿真在短期内比基于计算机的仿真更有效地提高技能。护理教育工作者可以根据具体情况选择最合适的教学方法来实现预期的学习成果。
    背景:该临床试验已在中国临床试验注册中心注册(临床试验编号:ChiCTR2400084880,注册日期:2024年5月27日)。
    BACKGROUND: Education in nursing has noticed a positive effect of simulation-based education. There are many studies available on the effects of simulation-based education, but most of those involve a single institution, nonrandomized controlled trials, small sample sizes and subjective evaluations of the effects. The purpose of this multicenter randomized controlled trial was to evaluate the effects of high-fidelity simulation, computer-based simulation, high-fidelity simulation combined with computer-based simulation, and case study on undergraduate nursing students.
    METHODS: A total of 270 nursing students were recruited from five universities in China. Participants were randomly divided into four groups at each institution: the high-fidelity simulation group, the computer-based simulation group, the high-fidelity simulation combined with computer-based simulation group, and the case study group. Finally, 239 participants completed the intervention and evaluation, with 58, 67, 57, and 57 participants in each group. The data were collected at three stages: before the intervention, immediately after the intervention, and three months after the intervention.
    RESULTS: The demographic data and baseline evaluation indices did not significantly differ among the four groups. A statistically significant difference was not observed between the four methods for improving knowledge, interprofessional collaboration, critical thinking, caring, or interest in learning. While skill improvement differed significantly among the different groups after the intervention (p = 0.020), after three months, no difference was observed (p = 0.139). The improvement in skill in the computer-based simulation group was significantly lower at the end of the intervention than that in the high-fidelity simulation group (p = 0.048) or the high-fidelity simulation combined with computer-based simulation group (p = 0.020).
    CONCLUSIONS: Nursing students benefit equally from four methods in cultivating their knowledge, interprofessional collaboration, critical thinking, caring, and interest in learning both immediately and over time. High-fidelity simulation and high-fidelity simulation combined with computer-based simulation improve skill more effectively than computer-based simulation in the short term. Nursing educators can select the most suitable teaching method to achieve the intended learning outcomes depending on the specific circumstances.
    BACKGROUND: This clinical trial was registered at the Chinese Clinical Trial Registry (clinical trial number: ChiCTR2400084880, date of the registration: 27/05/2024).
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