scholarly journals A five-step approach for developing and implementing a Rural Primary Health Care Model for Dementia: a community–academic partnership

2019 ◽  
Vol 20 ◽  
Author(s):  
Debra Morgan ◽  
Julie Kosteniuk ◽  
Dallas Seitz ◽  
Megan E. O’Connell ◽  
Andrew Kirk ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Decision Support ◽  
Needs Assessment ◽  
Decision Support Tool ◽  
Evidence Based ◽  
Dementia Diagnosis ◽  
Support Tool ◽  
Primary Health ◽  
Team Based Care

AbstractAimThis study is aimed at developing a Rural Primary Health Care (PHC) Model for delivering comprehensive PHC for dementia in rural settings and addressing the gap in knowledge about disseminating and implementing evidence-based dementia care in a rural PHC context.BackgroundLimited access to specialists and services in rural areas leads to increased responsibility for dementia diagnosis and management in PHC, yet a gap exists in evidence-based best practices for rural dementia care.MethodsElements of the Rural PHC Model for Dementia were based on seven principles of effective PHC for dementia identified from published research and organized into three domains: team-based care, decision support, and specialist-to-provider support. Since 2013 the researchers have collaborated with a rural PHC team in a community of 1000 people in the Canadian province of Saskatchewan to operationalize these elements in ways that were feasible in the local context. The five-step approach included: building relationships; conducting a problem analysis/needs assessment; identifying core and adaptable elements of a decision support tool embedded in the model and resolving applicability issues; implementing and adapting the intervention with local stakeholders; and sustaining the model while incrementally scaling up.ResultsDeveloping and sustaining relationships at regional and PHC team levels was critical. A comprehensive needs assessment identified challenges related to all domains of the Rural PHC Model. An existing decision support tool for dementia diagnosis and management was adapted and embedded in the team’s electronic medical record. Strategies for operationalizing other model elements included integrating team-based care co-ordination into the decision support tool and family-centered case conferences. Research team specialists provided educational sessions on topics identified by the PHC team. This paper provides an example of a community-based process for adapting evidence-based practice principles to a real-world setting.

scholarly journals Impact of the implementation of an online network support tool among clinicians of Primary Health Care and Specialists: ECOPIH Project

2013 ◽  
Vol 14 (1) ◽  
Author(s):  
David Lacasta Tintorer ◽  
Souhel Flayeh Beneyto ◽  
Xavier Alzaga Reig ◽  
Xavier Mundet Tuduri ◽  
Josep Anton De la Fuente ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Support Tool ◽  
Network Support ◽  
Primary Health

scholarly journals District nurses’ experiences of using a clinical decision support system and an assessment tool at elderly care units in primary health care: a qualitative study

2021 ◽  
Vol 22 ◽  
Author(s):  
Annica Lagerin ◽  
Lena Törnkvist ◽  
Johan Fastbom ◽  
Lena Lundh
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Primary Health Care ◽  
Decision Support ◽  
Clinical Decision Support System ◽  
Elderly Care ◽  
Medication Use ◽  
Clinical Decision ◽  
Primary Health ◽  
District Nurses

Abstract Aim: The present study aimed to describe the experience of district nurses (DNs) in using a clinical decision support system (CDSS) and the safe medication assessment (SMA) tool during patient visits to elderly care units at primary health care centres. Background: In Swedish primary health care, general practitioners (GPs) prescribe and have the responsibility to regularly review older adults’ medications, while DN (nurses specialised in primary health care) play an important role in assessing older adults’ ability to manage their medications, detecting potential drug-related problems and communicating with patients and GPs about such problems. In a previous feasibility study, we found that DNs who use a combination of a CDSS and the SMA tool identified numerous potentially harmful or dangerous factors and took a number of nursing care actions to improve the safety and quality of patients’ medication use. In telephone interviews, patients indicated that they were positive towards the assessment and interventions. Methods: Individual interviews with seven DNs who worked at six different primary health care centres in Region Stockholm were carried out in 2018. In 2019, an additional group interview was conducted with two of the seven DNs so they could discuss and comment on preliminary findings. Qualitative content analysis was used to analyse the interview transcripts. Findings: Using the tools, the DNs could have a natural conversation about medication use with older adults. They could get a clear picture of the older adults’ medication use and thus obtain information that could facilitate collaboration with GPs about this important component of health care for older adults. However, for the tools to be used in clinical practice, some barriers would have to be overcome, such as the time-consuming nature of using the tools and the lack of established routines for interprofessional collaboration regarding medication discussions.

scholarly journals Evidence-Based Practice in Primary Health Care From The Managerial Point of View: – A National Survey

2020 ◽  
Author(s):  
Tobias Abelsson ◽  
Helena Morténius ◽  
Ann-Kristin Karlsson ◽  
Stefan Bergman ◽  
Amir Baigi
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
National Survey ◽  
Evidence Based Practice ◽  
Direct Result ◽  
Evidence Based ◽  
Care Organization ◽  
Health Care Managers ◽  
Care Managers ◽  
Primary Health

Abstract Background: The vast availability of and demand for evidence in modern primary health care forces clinical decisions to be made based on condensed evidence in the form of policies and guidelines. Primary health care managers play a key role in implementing these governing documents. Thus, the aim of this article was to investigate the use and availability of evidence-based practice resources from the perspective of first-line primary health care managers.Methods: The study utilized a quantitative method based on a national survey of primary health care managers. The study population was recruited nationally from Sweden and consisted of 186 respondents. The data were analysed using empirically constructed themes and validated using factor analysis. To determine the statistical significance in making comparisons, the chi-square test was utilized. Associations between variables were calculated using Spearman’s correlation. All tests were two-sided, and the significance level was set to 0.05.Results: A majority (97%) of managers stated there was an impact of guidelines and policy documents on primary health care; 84% of managers could see a direct influence in daily practices. Most of the managers (70%) stated that some adaptation had to be made when new evidence was introduced. The managers emphasised the importance of keeping themselves updated and open to new information about work routines (96%). Conclusions: Evidence-based practice has a fundamental impact on Swedish primary health care. The study illustrated a nearly unanimous response about evidence influencing daily practice. The emphasis on the importance of all staff members keeping their professional knowledge up to date can be seen as a direct result of this. An information-dense organization such as a primary health care organization would have much to gain from cooperation with regional information resources such as clinical libraries.Trial registration: Not applicable.

Nursing supervised curricular internship in the Covid-19 pandemic: experience in the program Brasil Conta Comigo

2021 ◽  
Vol 55 ◽  
Author(s):  
Lara Arcipreti Boel Souza ◽  
Heliny Carneiro Cunha Neves ◽  
Natália Del Angelo Aredes ◽  
Isabel Cristina Lima Jobim Medeiros ◽  
George Oliveira Silva ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Active Role ◽  
Theory And Practice ◽  
Evidence Based ◽  
Government Program ◽  
Primary Health ◽  
The Government ◽  
Teaching Learning

ABSTRACT Objective: To report the experience of the nursing supervised curricular internship in the program “O Brasil Conta Comigo” carried out in the Covid-19 pandemic. Method: Experience report of activities developed in Primary Health Care in a municipality in the southern region of the state of Goiás during the Covid-19 pandemic, from April to November 2020. Results: The inclusion in the government program allowed the strengthening of the student’s active role in the teaching-learning process and teaching-service approximation, with the student as the point of connection, which resulted in the implementation of actions for the fight against the pandemic in the municipality, such as elaboration, implementation, and evaluation of the service flowchart for people with suspected Covid-19. Conclusion: The experience was successful, as it consolidated knowledge regarding leadership and autonomy, integration between theory and practice, critical thinking, and evidence-based problem solving. The participation in the program allowed for contributions to assistance and management in the actions to combat the new coronavirus in the scope of primary care, as well as for the contribution to the training of the student tutored by nurses in the field and supervised by professors from the federal university of origin.

scholarly journals Use of online knowledge base in primary health care and correlation to health care quality: an observational study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Christian Gerdesköld ◽  
Eva Toth-Pal ◽  
Inger Wårdh ◽  
Gunnar H. Nilsson ◽  
Anna Nager
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Knowledge Base ◽  
Health Care Quality ◽  
Knowledge Bases ◽  
Patient Experiences ◽  
Outcome Data ◽  
Care Quality ◽  
Evidence Based ◽  
Primary Health

Abstract Background Evidence-based information available at the point of care improves patient care outcomes. Online knowledge bases can increase the application of evidence-based medicine and influence patient outcome data which may be captured in quality registries. The aim of this study was to explore the effect of use of an online knowledge base on patient experiences and health care quality. Methods The study was conducted as a retrospective, observational study of 24 primary health care centers in Sweden exploring their use of an online knowledge base. Frequency of use was compared to patient outcomes in two national quality registries. A socio-economic Care Need Index was applied to assess whether the burden of care influenced the results from those quality registries. Non-parametric statistical methods and linear regression were used. Results Frequency of knowledge base use showed two groups: frequent and non-frequent users, with a significant use difference between the groups (p < 0.001). Outcome data showed significant higher values for all seven National Primary Care Patient Survey dimensions in the frequent compared to the non-frequent knowledge base users (p < 0.001), whereas 10 out of 11 parameters in the National Diabetes Register showed no differences between the groups (p > 0.05). Adjusting for Care Need Index had almost no effect on the outcomes for the groups. Conclusions Frequent users of a national online knowledge base received higher ratings on patient experiences, but figures on health care quality in diabetes showed near to no correlation. The findings indicate that some effects may be attributed to the use of knowledge bases and requires a controlled evaluation.

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