Safety Education in a Pediatric Primary Care Setting

PEDIATRICS ◽  
1987 ◽  
Vol 79 (5) ◽  
pp. 818-824
Author(s):  
Barbara Kelly ◽  
Carmen Sein ◽  
Paul L. McCarthy
Keyword(s):  
Primary Care ◽  
Care Center ◽  
Intervention Group ◽  
Parental Knowledge ◽  
Parental Participation ◽  
Control Group ◽  
Primary Care Center ◽  
Safety Education ◽  
The Mean ◽  
Safety Knowledge

Parents of 171 children coming to the Yale-New Haven Hospital Primary Care Center for their 6-month checkup were randomized into an intervention group (n = 85) and a control group (n = 86). Parents in the intervention group received a three-part individualized course in child safety that required active parental participation. Parts 1, 2, and 3 were given at the 6-month, 9-month, and 12-month well-child visits, respectively. Parents in the control group received routine safety education as provided at well-child visits. The educational phase of the study was completed by 129 families, 65 in the intervention group and 64 in the control group. Safety knowledge, number of hazards in the home, and reported accidents were assessed by a "blinded" community health worker approximately 1 month after the 12-month well-child visit. A total of 109 home visits were made, 55 for the intervention group and 54 for the control group. Parental safety knowledge was assessed based upon pictorial hazard recognition. Of 13 possible hazards, the mean number of hazards recognized by the intervention group parents was 9.4 (n = 55) v 8.4 (n = 50) by the control group parents (t = 2.1, P < .05, two-tailed). A hazard score was determined for each family based on nine possible hazards observed at the home visit. The mean hazard score for the intervention group was 2.4 (n = 55 v 3.0 (n = 54) for the control group (t = 2.4, P < .02, two-tailed). Parentally reported accidents and accidents reported in hospital records were similar for both groups. Results of this study suggest that age-appropriate safety education that is repetitive and individualized and that requires active parental participation results in an increase in parental knowledge and an improvement in certain safety practices.

scholarly journals Effectiveness of Counseling Provided by Primary Care Doctors and Nurses in Increasing Glaucoma Screening Rates

2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
Witold Rezner ◽  
Anna Rezner ◽  
Sławomir Dutkiewicz
Keyword(s):  
Primary Care ◽  
Care Center ◽  
Control Group ◽  
Primary Care Center ◽  
Glaucoma Screening ◽  
Successful Recruitment ◽  
Counseling Group ◽  
Significant Difference ◽  
Primary Care Doctors ◽  
Doctors And Nurses

Introduction.An effective screening that can prevent glaucoma-related blindness largely depends on successful recruitment. This study was to assess the effectiveness of one-on-one counseling carried out by primary care doctors and nurses to increase glaucoma screening rates.Material and Methods.The study, carried out in an urban primary care center, involved 308 persons aged 35–87 years who were assigned to a doctor’s, nurse’s, or control group (N=109, 110, and 89, resp.). Interventions by doctors and nurses included a brief one-on-one counseling session, while only a screening history was taken from controls. The number of people in each group with a positive screening status was assessed by telephone interview three months after the visit.Results.The percentage of persons in the nurse’s counseling group who claimed being subjected to screening was more than four times higher than in the control group (20.9% versus 4.5%,P=0.002). The doctor’s interventions resulted in almost a tripled screening rate as compared to the control group (12.8% versus 4.5%,P=0.052). There was no significant difference between screening rates in doctor’s and nurse’s groups(P= 0.212).Conclusions.In the studied population, counseling provided by nurses proved to be an efficacious method to encourage patients to undergo glaucoma screening.

scholarly journals Does problem-based learning education improve knowledge, attitude, and perception toward patient safety among nursing students? A randomized controlled trial

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Hossein Jamshidi ◽  
Masumeh Hemmati Maslakpak ◽  
Naser Parizad
Keyword(s):  
Patient Safety ◽  
Nursing Students ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Safety Education ◽  
Randomized Controlled ◽  
Attitudes And Perceptions ◽  
The Mean ◽  
Patient Safety Education

Abstract Background Patient safety is a top priority for any health care system. Most universities are looking for teaching methods through which they would be able to enhance students’ clinical decision-making capabilities and their self-centered learning to ensure safe and quality nursing care. Therefore, this study aimed to determine the effect of patient safety education through problem-based learning (PBL) on nursing students’ knowledge, attitude, and perceptions toward patient safety. Methods This randomized, controlled trial was conducted from September 2019 to January 2020. A total of 78 fourth-year nursing students participated in this study. The participants were randomly assigned to either the intervention group or the control group. In the intervention group, the educational materials were presented to the students using the PBL method during eight sessions of 45–60 min. In each control group, nursing students received eight education sessions through lectures and discussing the same educational content. Data were gathered 1 month after the intervention using demographic information and knowledge, attitudes, and perception questionnaires. Data were analyzed in SPSS ver. 22.0 using descriptive (mean and standard deviation) and inferential (chi-square test, independent t-test, paired t-test, and analysis of covariance (ANCOVA)) statistics. Results The results indicated that the difference in the mean scores of knowledge, attitudes, and perceptions of the nursing students about patient safety was statistically significant between the two groups after the PBL education (p = 0.001). The mean scores of students’ knowledge, attitude, and perceptions of patient safety increased significantly in the intervention group. Conclusions Implementing patient safety education through PBL positively affects knowledge, attitudes, and perceptions of patient safety among nursing students. Thus, the research team recommended the PBL method to be used by nursing professors to improve nursing students’ clinical skills and cognitive abilities to ensure safe patient care. Trial registration IRCT20190925044881N1; October 17, 2019.

scholarly journals Implementation of an improvement cycle in the care of a primary health care

2021 ◽  
Vol 74 (1) ◽  
Author(s):  
Tainara Barbosa Nunes ◽  
Éricka Cecília Resende de Souza ◽  
Zenewton André da Silva Gama ◽  
Wilton Rodrigues Medeiros ◽  
Ana Elza Oliveira de Mendonça
Keyword(s):  
Primary Care ◽  
Statistical Significance ◽  
Care Center ◽  
Quality Criteria ◽  
Control Group ◽  
Primary Care Center ◽  
Test Results ◽  
Before And After ◽  
Quasi Experimental ◽  
The City

ABSTRACT Objectives: to evaluate the effectiveness of a quality improvement cycle applied to the care of spontaneous demand in a primary care center. Methods: quasi-experimental before and after study, with a quantitative approach and no control group. An improvement cycle was carried out in a primary care center in the city of Guarabira/PB using five quality criteria. An evaluation, an intervention focused on the most problematic criterion and a reassessment were carried out. The samples were random (n = 60). The percentages and confidence intervals of compliance with each criterion were verified. Statistical significance was calculated using the Z test. Results: after the intervention, there was a significant improvement in two quality criteria of the care of spontaneous demand users (the user must be heard by a professional and go through the risk classification). Conclusions: the improvement cycle was an effective quality management method.

Education on the Brain: A Partnership Between a Pediatric Primary Care Center and Neurology Residency

2017 ◽  
Vol 57 (1) ◽  
pp. 46-51
Author(s):  
Eric Zwemer ◽  
Miya Bernson-Leung ◽  
Corinna Rea ◽  
Archana A. Patel ◽  
Rejean Guerriero ◽  
...  
Keyword(s):  
Primary Care ◽  
Developmental Delay ◽  
Group Intervention ◽  
Comparison Group ◽  
Care Center ◽  
Intervention Group ◽  
Residency Training Program ◽  
Resident Training ◽  
Primary Care Center ◽  
Residency Programs

The national shortage of pediatric neurologists is worsening, yet referral rates by pediatricians are high. Suboptimal training of pediatric residents in care of patients with neurologic disease may be a contributing factor. We formed a partnership between the Boston Children’s Primary Care at Longwood clinic and Child Neurology Residency Training Program. The educational intervention included lectures, observed neurologic examinations, in-person and virtual triage, and an electronic medical record–based consult system. Residents in other primary care clinics served as the comparison group. Intervention-group residents reported significantly improved confidence in diagnosis of chronic/recurrent headache, attention deficit hyperactivity disorder (ADHD), and developmental delay; initial management of ADHD and developmental delay; and secondary management of ADHD, developmental delay, and concussion/traumatic brain injury. Comparison-group residents reported significantly improved confidence only in diagnosis of developmental delay. Our multipronged intervention is a promising approach to improving pediatric resident training in pediatric neurology and may be generalizable to subspecialty collaborations for other residency programs.

scholarly journals Patient Discomfort and Resident Confidence After Knee Intra-articular Injection Simulation Training: A Randomized Control Trial Study

2018 ◽  
Vol 11 ◽  
pp. 117954411878290 ◽  
Author(s):  
Adae O Amoako ◽  
George GA Pujalte ◽  
Neha Kaushik ◽  
Timothy Riley
Keyword(s):  
Primary Care ◽  
Simulation Training ◽  
Intervention Group ◽  
Primary Care Providers ◽  
Comfort Level ◽  
Control Group ◽  
P Value ◽  
Care Providers ◽  
Patient Discomfort ◽  
The Mean

Teaching primary care providers how to perform musculoskeletal procedures has become increasingly important as more and more patients with orthopedic conditions present in primary care clinics. This study aims to evaluate whether targeted simulation model training in residency can increase residents’ comfort level in performing intra-articular knee injections and decrease the pain of the procedure, as reported by patients injected. Residents were randomized into intervention and control groups. The comfort level of the residents as well as the pain levels from the procedures, as reported by patients, was recorded. The mean comfort level for the intervention group was 1.2, compared with that in the control group, which was 2.13; P value was .047. The mean pain level in the intervention group was 1.8, whereas in the control group was 3.63; P value was .156. Simulation training may boost residents’ comfort level, but not necessarily decrease patient discomfort during intra-articular knee injections.

FACT effectiveness in primary care; a single visit RCT for depressive symptoms

2021 ◽  
pp. 009121742110105
Author(s):  
B Arroll ◽  
H Frischtak ◽  
R Roskvist ◽  
V Mount ◽  
F Sundram ◽  
...  
Keyword(s):  
Primary Care ◽  
Depressive Symptoms ◽  
Primary Care Clinic ◽  
Intervention Group ◽  
Psychosocial Assessment ◽  
Care Practice ◽  
Control Group ◽  
Number Needed To Treat ◽  
Care Clinic ◽  
The Mean

Background Patients with depressive symptoms are common in primary care. Brief, simple therapies are needed. Aim Is a focussed acceptance and commitment therapy (FACT) intervention more effective than the control group for patients with depressive symptoms in primary care at one week follow up? Design and setting: A randomised, blinded controlled trial at a single primary care clinic in Auckland, New Zealand. Methods Patients presenting to their primary care practice for any reason were recruited from the clinic waiting room. Eligible patients who scored ≥2 on the PHQ-2 indicating potential depressive symptoms were randomised using a remote computer to intervention or control groups. Both groups received a psychosocial assessment using the “work-love-play” questionnaire. The intervention group received additional FACT-based behavioural activation activities. The primary outcome was the mean PHQ-8 score at one week. Results 57 participants entered the trial and 52 had complete outcome data after one week. Baseline PHQ-8 scores were similar for intervention (11.0) and control (11.7). After one week, the mean PHQ-8 score was significantly lower in the intervention group (7.4 vs 10.1 for control; p<0.039 one sided and 0.078 two sided). The number needed to treat to achieve a PHQ-8 score ≤6 was 4.0 on intention to treat analysis (p = 0.043 two sided). There were no significant differences observed on the secondary outcomes. Conclusion This is the first effectiveness study to examine FACT in any population. The results suggest that it is effective compared with control, at one week, for patients with depressive symptoms in primary care.

A telemedicine strategy to reduce waiting lists and time to specialist care: A retrospective cohort study

2020 ◽  
pp. 1357633X2096393
Author(s):  
Juliana N Pfeil ◽  
Dimitris V Rados ◽  
Rudi Roman ◽  
Natan Katz ◽  
Luciana N Nunes ◽  
...  
Keyword(s):  
Primary Care ◽  
Retrospective Cohort ◽  
Cohort Analysis ◽  
Intervention Group ◽  
Care Physician ◽  
Control Group ◽  
Specialist Care ◽  
Medical Specialties ◽  
The Mean ◽  
Consultation Time

Introduction The demand for specialty care is rising worldwide. In the state of Rio Grande do Sul, Brazil, more than 150,000 people were waiting for specialist consultations in 2013. A telemedicine programme (RegulaSUS) developed referral protocols, audited waitlisted cases, authorised/prioritised referrals by risk and discuss deferred cases primary-care physician. This study assesses the effectiveness of RegulaSUS. Methods A retrospective cohort analysis with contemporaneous controls was performed from June 2014 to June 2016. Six medical specialties included in RegulaSUS (50,185 patients) were compared to 50,124 control patients waitlisted according to the usual routine (scheduled for specialty consultation at the next available date). The groups were matched (1:1) by semester and year of waitlisting and by the specialty demand-to-supply ratio. Primary outcomes were referral-to-consultation time and number of waitlisted patients. Results The mean referral-to-consultation time was 584.8 days in the intervention group and 607.0 days in controls ( p<0.001). For specialties regulated by RegulaSUS, the mean referral-to-consultation time was 237.6 days for higher-risk patients. At the end of the observation, 26,708 control patients had been unlisted compared to 31,050 patients in the intervention group (reduction of 53.5% vs. 61.9%, respectively; p<0.001). The number of cancelled referrals was lower in the control group ( n=14,403; 28.7%) than in the intervention group ( n=16,387; 32.7%; p<0.001). Discussion Telemedicine support for primary care effectively decreased the time to specialty consultation, reduced the number of waitlisted patients and allowed sicker patients to reach a specialist faster.

Abstract P266: The Implementation of Artificial Intelligence Significantly Reduces Door-In Door-Out Times in Primary Care Center Prior to Transfer

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Ameer E Hassan ◽  
Victor M Ringheanu ◽  
Laurie Preston ◽  
WONDWOSSEN TEKLE
Keyword(s):  
Artificial Intelligence ◽  
Primary Care ◽  
Care Center ◽  
Time Interval ◽  
Primary Care Center ◽  
Vessel Occlusion ◽  
Discharge Rates ◽  
Ct Angiogram ◽  
Detection Technology ◽  
The Mean

Introduction: Viz.ai artificial intelligence (AI) software utilizes AI powered large vessel occlusion (LVO) detection technology which automatically identifies suspected LVO through CT angiogram (CTA) imaging and alerts on-call stroke teams. We performed this analysis to determine if utilization of AI software can reduce the door-in door-out (DIDO) time interval within the primary care center (PSC) prior to transfer to the comprehensive care center (CSC). Methods: We compared the time interval between door-in and door-out for all LVO transfer patients from a single spoke PSC to our CSC prior to (Feb. 2017 to Nov. 2018) and after (Nov. 2018 to June 2020) incorporating Viz.ai. Using a prospectively collected stroke database at a CSC, demographics, DIDO time at PSC, modified Rankin Scale at discharge (mRS dc), mortality rate at discharge, length of stay (LOS) in hospital and neurological ICU, and intracranial hemorrhage rates were examined. Results: There were a total of 63 patients during the study period (average age 69.99 ± 13.72, 55.56% women). We analyzed 28 patients from the pre-AI (average age 71.64 ± 12.28, 46.4%), and 35 patients from the post-AI (average age 68.67 ± 14.88, 62.9% women); see Table 1 for comparison of baseline characteristics and outcomes. Following the implementation of the AI software, the mean DIDO time interval within the PSC significantly improved by 102.3 minutes (226.7 versus 124.4 minutes; p=0.0374); significant reductions were not noted in mRS at discharge, rates of hemorrhage, or mortality. Conclusion: The incorporation of the AI software was associated with a significant improvement in DIDO times within the PSC and may lead to significant improvements in functional outcome and mortality in transfer patients. More extensive studies are warranted to expand on the ability of AI technology to improve transfer times and outcomes for LVO patients.

scholarly journals Process Evaluation of the Sophia Step Study-A Primary Care Based Three-Armed Randomized Controlled Trial Using Self-Monitoring of Steps With and Without Counseling in Prediabetes and Type 2 Diabetes

2020 ◽  
Author(s):  
Jenny Rossen ◽  
Maria Hagströmer ◽  
Agneta Yngve ◽  
Kerstin Brismar ◽  
Barbara Ainsworth ◽  
...  
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Intervention Group ◽  
Single Component ◽  
Control Group ◽  
Self Monitoring ◽  
Component Group ◽  
Multicomponent Intervention ◽  
The Mean ◽  
Step Study

Abstract Background Describing implementation features of an intervention is required to compare interventions and to inform policy and best practice. The aim of this study was to conduct a process evaluation of the first 12 months of the Sophia Step Study: a primary care based RCT evaluating a multicomponent (self-monitoring of daily steps plus counseling) and a single component (self-monitoring of steps only) physical activity intervention to standard care on cardiometabolic health. Methods The evaluation was guided by the Medical Research Council Guidance for complex interventions. To describe the implementation communication with the health professionals implementing the interventions, attendance records and tracking of days with self-monitored pedometer-determined steps were used. Change in physical activity behaviour was measured at baseline, 6 and 12 months as daily steps by accelerometry. Results From April 2013 to January 2018 188 participants were randomized. Response rate was 49% and drop out was 10%. The interventions were delivered as intended with minor deviation from the protocol and dose received was satisfying for both the multicomponent and single component group. The mean [95% Confidence Interval (CI)] change in daily steps from baseline to 6 months was 941(227, 1655) steps/day for the multicomponent intervention group, 990 (145, 1836) step/day for the single component group and -506 (-1118, 107) for the control group. The mean (95% CI) change in daily steps from baseline to 12 months was 31(-507, 570) steps/day for the multicomponent intervention group, 144 (-566, 853) step/day for the single component group and -890 (-1485, -294) for the control group. There was a large individual variation in daily steps at baseline as well as in step change in all three groups.Conclusions Applying self-monitoring of steps is a feasible method to implement as support for physical activity in the primary care setting both with and without counseling support. While physical activity levels increased after 6 months, maintenance of physical activity is a more realistic expectation in the long term. Physical activity behavior varies among individuals and support for physical activity should be tailored to the person. Trial registration ClinicalTrials.gov, NCT02374788. Registered 2 March 2015 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02374788

scholarly journals The effect of combined education on the knowledge and care and supportive performance of parents with children with cleft lip and palate: A clinical trial study

2021 ◽  
Vol 8 ◽  
pp. 2333794X2110222
Author(s):  
Ashrafalsadat Hakim ◽  
Zahra Zakizadeh ◽  
Nader Saki ◽  
Mohammad Hossein Haghighizadeh
Keyword(s):  
Clinical Trial ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Intervention Group ◽  
Parental Knowledge ◽  
Control Group ◽  
Demographic Information ◽  
Significant Difference ◽  
The Mean ◽  
And Performance

Cleft lip and palate is a major problem that disrupts the child’s family life. The present study aimed to investigate the effect of combined education on the knowledge and care and supportive performance of parents with children with cleft lip and palate. This is a clinical trial study was conducted on 40 parents referring to hospitals. The data were collected using the demographic information questionnaire, the questionnaire of parental knowledge and care supportive performance questionnaire and analyzed using descriptive and analytical tests. After education the intervention group, the mean score of parents’ care and supportive knowledge significantly increased in the intervention group as compared to the control group. There was also a significant difference in the mean score of parents’ care-supportive performance between the two groups ( P < 0.001). It is recommended to use the combined education as an effective method to increase knowledge and performance in parents of children with cleft lip and palate.

Sign in / Sign up

Export Citation Format

Share Document