scholarly journals Evaluation of Human Papillomavirus Vaccination After Pharmacist-Led Intervention: A Pilot Project in an Ambulatory Clinic at a Large Academic Urban Medical Center

2020 ◽  
Vol 135 (3) ◽  
pp. 313-321
Author(s):  
Julianna Cebollero ◽  
Suzanne M. Walton ◽  
Laurie Cavendish ◽  
Kristi Quairoli ◽  
Carrie Cwiak ◽  
...  
Keyword(s):  
Health Care ◽  
Human Papillomavirus ◽  
Health Care Providers ◽  
Medical Center ◽  
Vaccine Dose ◽  
Pilot Project ◽  
Care Providers ◽  
Post Intervention ◽  
Intervention Phase ◽  
Active Intervention

Objectives Despite the safety and efficacy of the human papillomavirus (HPV) vaccine, many persons are still not receiving it. The purpose of this pilot project was to evaluate the number of first doses of the 9-valent HPV (9vHPV) vaccination administered after a pharmacist-led intervention in the Adult Family Planning Clinic at Grady Health System (GHS), a large academic urban medical center in Atlanta, Georgia. Methods The pilot project had 3 phases: pre-intervention (November 15, 2016, through March 31, 2017), active intervention (November 15, 2017, through December 29, 2017), and post-intervention (December 30, 2017, through March 31, 2018). The pre-intervention phase was used as a historical control. The active intervention phase consisted of pharmacist interventions in the clinic and patient and health care provider education. The post-intervention phase evaluated the durability of pharmacist-led interventions performed and education provided during the active phase. Results Eighty-nine first-dose 9vHPV vaccines (of the 3-dose series) were administered to young adults aged 18-26 during the project period (November 15, 2017, through March 31, 2018); none were administered during the pre-intervention phase. Of 89 patients who received a first 9vHPV vaccine dose, 20 patients also received a second 9vHPV vaccine dose. During the project period, 166 doses of 9vHPV vaccine (first, second, or third doses) were administered. Conclusion This pharmacist-led intervention led to an increase in the number of young adult patients receiving their first dose of the 9vHPV vaccination series. With the support of other health care providers, pharmacist-led initiatives can expand vaccine-related health literacy and facilitate access to immunization services.

scholarly journals 45 Helping the Helpers: Peer Critical Incident Stress Management for NICU Health Care Providers to Improve Resilience, Burnout and Patient Safety

2020 ◽  
Vol 25 (Supplement_2) ◽  
pp. e19-e19
Author(s):  
Natasha Lifeso ◽  
Matthew Hicks ◽  
Chloe Joynt
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Safety Culture ◽  
Critical Incident ◽  
Care Providers ◽  
Post Intervention ◽  
Critical Incident Stress Management ◽  
Critical Incident Stress ◽  
Patient Load ◽  
Stress Recognition

Abstract Introduction/Background Health care providers in neonatal intensive care units (NICU) experience critical or distressing events that can overwhelm their usual coping skills and lead to significant stress. Ineffective support for health care providers dealing with critical incidents can lead to poor unit resilience, staff burnout and compromised patient care behaviours. A formalized peer program and process to address critical workplace incidents and support care providers, “Critical Incident Stress Management (CISM)” is used in many first responder professions. While there is growing interest in implementing peer CISM teams in critical care units, there is a lack of research describing the impact of CISM in NICU. Objectives This study examined the effect of implementing a multidisciplinary NICU health care provider peer CISM team on resilience, burnout, and team/safety culture in a tertiary NICU. Design/Methods Multidisciplinary team members were peer selected and formally CISM trained. Change management strategies were employed to introduce CISM to the NICU. All health care providers were invited to complete an anonymous online or paper survey before and 1 year after NICU CISM team implementation. The survey contained validated measures of resilience, burnout, and team/safety culture that were analyzed pre and post intervention. Results The response rate pre-intervention was 66% (114/172 staff) and 32% post (60/186 staff). Stress recognition significantly improved as fewer staff reported being less effective at work when feeling stressed post incident (74% vs 61%, pre and post CISM respectively, p<0.05) (Table 1). Fewer staff reported feeling burned out from their work (41% vs 31%, p=0.4), trending towards improved resilience (Table 1). Communication in the NICU significantly improved as staff indicated debriefing methods met their needs (38% vs 57%, p<0.05) and felt comfortable speaking up about safety concerns (66% vs 78%) (Table 1). Post-intervention, despite feelings of increased workload indicated by a significant decrease in agreement that “NICU staff levels were sufficient for patient load” (54% vs 33%, p<0.001), a majority of staff reported a supportive environment in the NICU (59% vs 77%, p=0.08) (Table 1). Work culture significantly improved as staff felt rewarded and recognized for improving quality (13% vs 31%, p<0.05) (Table 1). Conclusion Implementation of a peer CISM team led to improved NICU care provider resilience, stress recognition, and team culture, all of which can mitigate the effects of increased patient load. Findings from this research and knowledge gained from the CISM implementation process should be shared with other health care environments.

scholarly journals The status of the Primary Health Care Plus pilot project in Poland

2019 ◽  
Vol 13 (2) ◽  
pp. 1-14
Author(s):  
Katarzyna Wiktorzak
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Access To Health Care ◽  
Current System ◽  
Pilot Project ◽  
Care Providers ◽  
Primary Health ◽  
The Status

Background The National Health Fund (NHF) is the public payer solely accountable for securing and organizing access to health care services in Poland. The NHF is responsible for implementing a project entitled “Primary Health Care PLUS” which aims to introduce a primary care centered model, based on coordinated, proactive and preventive methods relevant to patients’ needs and furthermore, works to keep patients well-informed and active participants in health care decision-making. The implementation period of the project is July 1, 2018 through Dec. 31, 2021. Aim of the study The purpose of this study is to outline patient demographics and staff structures of providers that took part in the PHC PLUS pilot program, as well as the status of the program throughout the first year of its implementation. Materials and Methods Following an open and transparent recruitment process, 42 urban and rural primary health care providers were selected. The purpose of the providers’ geographic spread was to ensure the model was tested in all representative regions of the country. Results 42 PHC PLUS providers attending to 288,392 patients are participating in the project. Approximately 1,100 medical staff members are involved in the project. PHC PLUS medical teams consist of specialists including physicians, coordinators, nurses, dietitians, psychologists, physiotherapists and health educators. Out of 41,022 health risk assessments declared to be conducted during the project, 18,058 (43.1%) were performed from July 1, 2018 to April 30, 2019, including 4,537 basic and 13,521 extended assessments. Furthermore, 15,020 patients in total, participated in the disease management programs, which are also paid from the project. Conclusions A Polish health care pilot project that centers primary care can help shift the focus toward preventive interventions, rather than the current system, which often focuses on providing medical care to patients who have already been diagnosed with diseases, often in their more advanced stages.

Cost Utility Analyses in International Disaster Responses—Where Are They?

2012 ◽  
Vol 27 (2) ◽  
pp. 198-203
Author(s):  
Richard Zoraster
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Disaster Response ◽  
Healthcare Providers ◽  
Large Body ◽  
International Health ◽  
Cost Utility ◽  
Care Providers ◽  
Post Intervention ◽  
The Cost

AbstractInternational health care providers have flocked to Haiti and other disaster-affected countries in record numbers. Anecdotal articles often give “body counts” to describe what was accomplished, followed months later by articles suggesting outcomes could have been better. Mention will be made that various interventions were “expensive,” or not the best use of limited funds. But there is very little science to post-intervention evaluations, especially with regard to the value for the money spent. This is surprising, because a large body of literature exists with regard to the Cost Utility Analysis (CUA) of health care interventions. Applying reproducible metrics to disaster interventions will help improve performance.This study will: (1) introduce and explain basic CUA; (2) review why the application of CUA is difficult in disaster settings; (3) consider how disasters may be unique with regard to CUA; (4) demonstrate past and theoretical utilization of CUA in disaster settings; and (5) suggest future utilization of CUA by healthcare providers in Disaster Response.Zoraster R. Cost utility analyses in international disaster responses—where are they? Prehosp Disaster Med. 2012;27(2):1-6.

Defining Legacy: The Perceptions of Pediatric Health Care Providers

2020 ◽  
Vol 59 (11) ◽  
pp. 1004-1010
Author(s):  
Jessika Boles ◽  
Maile Jones ◽  
Jenna Dunbar ◽  
Jessica Cook
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Family Relationships ◽  
Medical Center ◽  
Academic Medical Center ◽  
Free Text ◽  
Care Providers ◽  
Pediatric Health ◽  
Pediatric Health Care ◽  
Free Text Response

Legacy building interventions like plaster hand molds are offered in most children’s hospitals, yet little is known about how the concept of legacy is understood and described by pediatric health care providers. Therefore, this study explored pediatric health care providers’ perceptions of legacy at an academic medical center to ensure that future legacy interventions are evidence-informed and theoretically grounded. An electronic survey featuring three open-ended questions and two multiple-choice questions with an option for free text response was completed by 172 medical and psychosocial health care providers. Analysis yielded four themes: (1) legacy is intergenerational, enduring, and typically associated with end-of-life; (2) legacies articulate the impacts on others for which one is known and remembered; (3) legacies can be expressed through tangible items or intangible qualities; and (4) legacies are informed and generated by family relationships and work experiences. By understanding legacy as a personally and professionally contextualized experience, health care providers can better assess and meet the legacy needs of hospitalized pediatric patients and families.

scholarly journals Assessment of knowledge and skill of health care providers in management of child abuse in different level hospital in Bangladesh

2012 ◽  
Vol 1 (1) ◽  
pp. 2-5
Author(s):  
Rawshan Ara Khanam ◽  
Kohinoor Begum ◽  
Abdul Halim ◽  
Khadiza Najneen
Keyword(s):  
Health Care ◽  
Child Abuse ◽  
Health Care Providers ◽  
Service Providers ◽  
P Value ◽  
College Level ◽  
Care Providers ◽  
Post Intervention ◽  
Medical College ◽  
District Hospitals

Challenges to the health of our children have been changing in recent decades as we have taken control over different diseases through immunization and child health program . But newer problems are uncovered. Child Abuse and Neglect is one of them . World community has given emphasis on this very old but unnoticed problem ,this problem is received very less emphasis in South East Asia. With the objectives -to assess the knowledge and skill of working doctors and nurses of concern department in managing child abuse and to help the service providers to improve their knowledge and skill to deal with child abuse and to identify the laps and gaps in the area where abused children are dealt with, this study was carried out in two Medical College Hospitals, two District Hospitals and two Upazilla Health Complexes from November 2005 to July 2006. Selected departments for study were - Obstetrics & Gynaecology, Paediatrics, Orthopaedics. Burn, Casualty, Psychiatry and OCC, (DMCH) in Medical College level; Obstetrics & Gynaecology, Paediatrics, Surgery in district level and all from Upazilla level. Working doctors of all level and senior staff nurses were included in this study. Assessment of knowledge and skill was done before and after intervention by observation and face to face interview by using a pre tested prepared questionairre .Laps and gaps were identified by observation and interview. Intervention was given by a one day workshop in each level of hospital . About 155 care providers participated in pre and post intervention interview . Of them- 109 were doctor and 46 were nurses. Among them 71 (Doc. 55 + Nurse 16) from two Medical College Hospitals, 42 (Doc. 33 + Nurse 9) from two District Hospitals & 42 (Doc. 21 + Nurse 21) from 2 Upazilla Health Complexes . It was surprising that only 11 % health care provides correctly knows that who are the children , only 10 % providers knows about the different types of abuse and only 15 % providers believe that they have sufficient knowledge to manage an abused child. Knowledge level is much higher among the doctors working in teaching hospitals and poorest in UHC. Nurses are less knowledgeable than doctors . Score of nurses is more or less similar in all level of hospitals. The pre and post intervention changes were analyzed by using unpaired student's t test and p value was significant .On job training of care providers on management of abused child is very important and inclusion of this issue in medical and nursing curricula is necessary. DOI: http://dx.doi.org/10.3329/jssmc.v1i1.12166 Journal of Shaheed Suhrawardy Medical College Vol.1, No.1, December 2009 p.2-5

scholarly journals Health care workers’ perceptions of episiotomy in the era of respectful maternity care: a qualitative study of an obstetric training program in Mexico

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rodrigo Garcia-Cerde ◽  
Pilar Torres-Pereda ◽  
Marisela Olvera-Garcia ◽  
Jennifer Hulme
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Training Program ◽  
Health Care Providers ◽  
Preventive Measure ◽  
Respectful Maternity Care ◽  
Care Providers ◽  
Structured Interviews ◽  
Post Intervention ◽  
General Physician

Abstract Background Episiotomy in Mexico is highly prevalent and often routine - performed in up to 95% of births to primiparous women. The WHO suggests that episiotomy be used in selective cases, with an expected prevalence of 15%. Training programs to date have been unsuccessful in changing this practice. This research aims to understand how and why this practice persists despite shifts in knowledge and attitudes facilitated by the implementation of an obstetric training program. Methods This is a descriptive and interpretative qualitative study. We conducted 53 pre and post-intervention (PRONTO© Program) semi-structured interviews with general physician, gynecologists and nurses (N = 32, 56% women). Thematic analysis was carried out using Atlas-ti© software to iteratively organize codes. Through interpretive triangulation, the team found theoretical saturation and explanatory depth on key analytical categories. Results Themes fell into five major themes surrounding their perceptions of episiotomy: as a preventive measure, as a procedure that resolves problems in the moment, as a practice that gives the clinician control, as a risky practice, and the role of social norms in practicing it. Results show contradictory discourses among professionals. Despite the growing support for the selective use of episiotomy, it remains positively perceived as an effective prophylaxis for the complications of childbirth while maintaining control in the hands of health care providers. Conclusions Perceptions of episiotomy shed light on how and why routine episiotomy persists, and provides insight into the multi-faceted approaches that will be required to affect this harmful obstetrical practice.

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