scholarly journals Slow Medicine and Choosing Wisely: a synergistic alliance

2022 ◽  
Vol 4 ◽  
pp. e4222
Author(s):  
Marco Bobbio ◽  
Sandra Vernero ◽  
Domenico Colimberti ◽  
Andrea Gardini
Keyword(s):  
Internal Medicine ◽  
Health Professionals ◽  
Choosing Wisely ◽  
New Paradigm ◽  
Professional Societies ◽  
Appropriate Care ◽  
Effective Care ◽  
Slow Medicine ◽  
Quality Principles ◽  
The World

Choosing Wisely® is an initiative of the American Board of Internal Medicine Foundation to help physicians and patients engage in conversations about the overuse of tests and procedures and support physician efforts to help patients make smart and effective care choices. Choosing Wisely campaigns are now active and present in 25 countries around the world, on five continents. Italy is the only country where a Choosing Wisely campaign was launched, and it is currently steered by a Nationwide association (Slow Medicine), creating a synergistic alliance. The Slow Medicine Association was founded in 2011 when a group of health professionals and citizens shared a new paradigm of values, methodology, and interventions and decided to establish an association with the mission of working for a health system driven by ethics and quality principles. Three keywords summarize the philosophy of Slow Medicine: measured because it acts with moderation, gradualness, and without waste; respectful because it is attentive to the dignity of individuals recognizing their values; and equitable because it is committed to ensuring appropriate care based on the best available evidence. Slow Medicine allowed the spread of Choosing Wisely in Italy involving several professional societies and participating at the National meetings of the Societies as well as numerous other meetings, in which the mission of the Association is combined with the principle of the ‘do not’ recommendations. Numerous other initiatives were carried out, and new projects were planned in synergy with Choosing Wisely.

scholarly journals Doing more does not mean doing better: the FADOI contribution to the Slow Medicine program for a sustainable and wise healthcare system

2015 ◽  
Vol 9 (3) ◽  
pp. 281 ◽  
Author(s):  
Luigi Lusiani ◽  
Roberto Frediani ◽  
Roberto Nardi ◽  
Andrea Fontanella ◽  
Mauro Campanini
Keyword(s):  
Internal Medicine ◽  
Decision Making ◽  
Health Professionals ◽  
Choosing Wisely ◽  
Decision Making Process ◽  
Evidence Based ◽  
Shared Decision ◽  
Slow Medicine ◽  
The Usa ◽  
Hospital Doctors

Consistently with its own vision on the necessity to implement a sustainable and frugal medicine, in 2013 the Italian Federation of Associations of Hospital Doctors in Internal Medicine (FADOI) decided to adhere to the Slow Medicine program entitled <em>Doing more does not mean doing better</em>, launched in Italy in late 2012, following the Choosing Wisely® campaign of the American Board of Internal Medicine (ABIM) Foundation started in the USA in 2010. According to the program, FADOI has now produced a list of ten evidence-based recommendations of the <em>do not</em> type, regarding different practices whose benefits for the patients are questionable at least, if not harmful at worst. The list was obtained from a questionnaire submitted to 1175 FADOI members, containing a purposely selected choice of 32 pertinent recommendations already published by Choosing Wisely®, and reflects the qualified opinion of a large number of Italian internists. These recommendations are now endorsed by the FADOI, as a contribution to the discussion among doctors, health professionals, nurses, patients and citizens about what is worth choosing in medicine; they are also meant to promote a shared decision making process in the clinical practice.

scholarly journals The Role of Teachers in the Education of Health Professionals in the 21st Century

2021 ◽  
Vol 1 (2) ◽  
Author(s):  
Juan Carlos Uribe Cantalejo
Keyword(s):  
Higher Education ◽  
Health Professionals ◽  
Professional Lives ◽  
New Paradigm ◽  
Quality Of Higher Education ◽  
The World ◽  
Flexner Report ◽  
Bologna Agreement

Two questions that today's health professors should ask themselves are: Am I teaching my students in the most effective way possible to train professionals with the standards and needs demanded by today's society? Are my students memorizing facts and concepts or are they developing skills that they integrate into their personal and professional lives? In 1910 the Flexner report was published, which gave rise to the first reforms that sought to establish innovations in the education of health professionals, but the great revolution in world education arose from a study published by Barr and Tagg in 1995 where they stressed the importance of changing the paradigm of education centered on content to a new paradigm where education is centered on learning; Thus, in 1998, within the framework of the World Conference on Higher Education, UNESCO expressed the need to update higher education, bringing it closer to the current challenges of society, and in response to this request, in 1999, several European countries signed the Bologna agreement that seeks to improve the quality of higher education by creating the European Higher Education Area.

Depression and Type 2 Diabetes

2018 ◽  
Keyword(s):  
Internal Medicine ◽  
Type 2 Diabetes ◽  
Health Professionals ◽  
Metabolic Diseases ◽  
State Of The Art ◽  
Comorbid Condition ◽  
World Population ◽  
The World ◽  
P Type

Type 2 diabetes is predicted to affect between 10% and 25% of the world population in the next 20 years. Depression is a common comorbid condition in those affected with type 2 diabetes, and the combination of these conditions is associated with a poorer prognosis, including earlier mortality. Genetic and epigenetic predisposition and overlap of risk factors related to our modern lifestyle seem to drive the shared biology of diabetes and depression. This book aims to provide an understanding of the sequelae of events leading to the frequent comorbidity of diabetes and depression. This book project has been supported by the transCampus of Kings College London and Technical University of Dresden. Chapter by chapter, internationally recognized clinicians and scientists have summarized the state of the art and outstanding controversies of the epidemiology, mechanisms, and treatment of the depression–type 2 diabetes comorbidity. This book is relevant for all health professionals including the general practitioner and specialist clinicians in internal medicine, endocrinology, diabetes and metabolic diseases, neurology, psychiatry, and psychology as well as students interested in this topic.

scholarly journals The ANÌMO Decalogue for a Slow Medicine care: the general recommendations of the nurses of internal medicine for a sober, respectful and equitable care

2015 ◽  
Vol 9 (3) ◽  
pp. 279
Author(s):  
Gabriella Bordin ◽  
Claudia Ganzini ◽  
Mariapaola Lince ◽  
Lucia Lucci ◽  
Marilisa Martini ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Professional Practice ◽  
Health Professionals ◽  
Slow Medicine

Following the lead of Slow Medicine, the Association of Nurses of Internal Medicine (ANÌMO) saw the opportunity to build, through an analysis of the professional practice, an alliance between health professionals and citizens in order to support and facilitate informed choices. From this revision emerged <em>The</em> <em>Decalogue</em>, a document which summarizes the fundamental pillars of the <em>slow</em> <em>nursing</em> to guarantee a sober respectful and equitable care during the hospitalization.

Can Nurses Contribute to Better End-of-Life Care?

2000 ◽  
Vol 7 (2) ◽  
pp. 134-140 ◽  
Author(s):  
Leila Shotton
Keyword(s):  
Internal Medicine ◽  
Nursing Care ◽  
Health Professionals ◽  
End Of Life Care ◽  
Nursing Home Care ◽  
Clinical Expertise ◽  
Life Care ◽  
Appropriate Care ◽  
Dying Patients ◽  
Futile Care

In this article I will argue that futile medical and nursing care is not only inefficacious but that it may be harmful to the patient and also to health professionals, who may be diminished both as clinicians and as persons if they are not able to give appropriate care to dying patients and their families. I discuss futile care in intensive care units because the opportunities and the temptation to provide futile care in these settings is higher than, for instance, in internal medicine and nursing home care. I argue, following two nurse ethicists, Carol Taylor and Colleen Scanlon, that, even if nurses are not the initiators of futile care, they play an important role in its prevention because of their clinical expertise. They can do this by convening ‘patient care conferences’ when they recognize the need to bring together the various parties that have conflicting expectations. These conferences would then result in appropriate palliative care. The nurses providing this care would demonstrate their understanding of the process whereby living becomes the process of dying.

Criação de um Protocolo de Atuação em caso de Escabiose no Centro Hospitalar de São João, na sequência de um surto de pequena dimensão

2020 ◽  
Vol 9 ◽  
pp. 31-38
Author(s):  
Paulo Pinho ◽  
Pedro Norton
Keyword(s):  
Internal Medicine ◽  
Teaching Hospital ◽  
Health Professionals ◽  
Early Recognition ◽  
Patient Admission ◽  
Late Diagnosis ◽  
Internal Medicine Ward ◽  
Hospital Employees ◽  
Hospital Outbreak ◽  
The World

Background Scabies outbreaks are common in hospital facilities around the world, nevertheless the management of such outbreaks is not universally defined, and so several approaches are valid. In this article we describe a short extent hospital outbreak, successfully controlled after the creation and institution of guidelines for the management of scabies. Methods Following an outbreak of scabies at a teaching hospital, a guideline for control and scabies treatment was created and applied. Data regarding the number of cases of hospital employees infected and the efficacy of the implemented guideline was analyzed six weeks later. Results Late diagnosis of scabies on a patient admitted to the Internal Medicine ward resulted in infection of eight hospital employees, who presented themselves with symptoms one month after the patient admission. They were submitted to treatment and possible contacts were surveyed for prophylaxis, according to the established guideline. There was no recurrence of cases after six weeks. Discussion Early recognition of a case of scabies is essential to prevent hospital outbreaks. In this sense we developed an informative triptych intended for health professionals. There are several possible therapeutic and prophylactic approaches to the disease, but the key to the rapid resolution of an outbreak is the timing for the treatment of cases and prophylaxis of contacts, which should be instituted simultaneously or within a 24 hour period.

Recomendações de equipamentos de proteção individual no combate ao COVID-19

2020 ◽  
Vol 10 (31) ◽  
pp. 87-95
Author(s):  
Nicole Maria Miyamoto Bettini ◽  
Fabiana Tomé Ramos ◽  
Priscila Masquetto Vieira de Almeida
Keyword(s):  
World Health Organization ◽  
Personal Protective Equipment ◽  
Health Professionals ◽  
Health Personnel ◽  
Healthcare Professionals ◽  
World Health ◽  
Protective Equipment ◽  
Effective Strategy ◽  
The World ◽  
Health Organization

A Organização Mundial da Saúde - OMS confirmou a circulação internacional do novo Coronavírus em janeiro de 2020, nomeando-o como COVID-19 e, declarando uma pandemia. É de extrema importância que durante a pandemia, os profissionais de saúde tenham acesso e conhecimento sobre o uso correto dos Equipamentos de Proteção Individual (EPIs) e suas indicações, tomando assim, as devidas precauções na prevenção de infecções. O presente estudo buscou identificar a padronização mundial quanto ao uso dos EPIs utilizados no atendimento a pacientes suspeitos e/ou confirmados de COVID-19 no Brasil, EUA, China, Espanha, Itália e demais países europeus. Os guidelines apresentam a padronização quanto ao uso dos EPIs utilizados no atendimento a suspeitos e/ou confirmados de COVID-19, indo ao encontro das recomendações fornecidas pela OMS. Até o momento, o uso de EPIs é sem dúvida a estratégia mais importante e eficaz para proteger os profissionais de saúde durante a assistência ao paciente com COVID-19.Descritores: Infecções por Coronavírus, Equipamento de Proteção Individual, Pessoal de Saúde, Enfermagem. Recommendations for personal protective equipment to combat COVID-19Abstract: The World Health Organization - WHO confirmed the international circulation of the new Coronavirus in January 2020, naming it as COVID-19 and declaring a pandemic. It is extremely important that during the pandemic, health professionals have access and knowledge about the correct use of Personal Protective Equipment (PPE) and its indications, thus taking appropriate precautions to prevent infections. The present study sought to identify the worldwide standardization regarding the use of PPE utilized to take care of suspected and confirmed patients with COVID-19 in Brazil, USA, China, Spain, Italy and other European countries. The guidelines present a standardization regarding the use of PPE utilized to take care of suspected and confirmed with COVID-19, in line with the recommendations provided by WHO. To date, the use of PPE is undoubtedly the most important and effective strategy to protect healthcare professionals during care for patients with COVID-19.Descriptors: Coronavirus Infections, Personal Protective Equipment, Health Personnel, Nursing. Recomendaciones para el equipo de protección personal para combatir COVID-19Resumen: La Organización Mundial de la Salud - La OMS confirmó la circulación internacional del nuevo Coronavirus en enero de 2020, nombrándolo COVID-19 y declarando una pandemia. Es extremadamente importante que durante la pandemia, los profesionales de la salud tengan acceso y conocimiento sobre el uso correcto del Equipo de Protección Personal (EPP) y sus indicaciones, tomando así las precauciones adecuadas para prevenir infecciones. El presente estudio buscó identificar la estandarización mundial con respecto al uso de EPP utilizado para atender a pacientes sospechosos y/o confirmados con COVID-19 en Brasil, Estados Unidos, China, España, Italia y otros países europeos. Las pautas presentan la estandarización con respecto al uso de EPP utilizado para cuidar COVID-19 sospechoso y/o confirmado, de acuerdo con las recomendaciones proporcionadas por la OMS. Hasta la fecha, el uso de EPP es, sin duda, la estrategia más importante y efectiva para proteger a los profesionales de la salud durante la atención de pacientes con COVID-19.Descriptores: Infecciones por Coronavirus, Equipo de Protección Personal, Personal de Salud, Enfermería.

scholarly journals Evaluation of the Use of Shared Decision Making in Breast Cancer: International Survey

2021 ◽  
Vol 18 (4) ◽  
pp. 2128
Author(s):  
Marta Maes-Carballo ◽  
Manuel Martín-Díaz ◽  
Luciano Mignini ◽  
Khalid Saeed Khan ◽  
Rubén Trigueros ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Shared Decision Making ◽  
Health Professionals ◽  
Cross Sectional Study ◽  
Shared Decision ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Professional Societies ◽  
New Policies

Objectives: To assess shared decision-making (SDM) knowledge, attitude and application among health professionals involved in breast cancer (BC) treatment. Materials and Methods: A cross-sectional study based on an online questionnaire, sent by several professional societies to health professionals involved in BC management. There were 26 questions which combined demographic and professional data with some items measured on a Likert-type scale. Results: The participation (459/541; 84.84%) and completion (443/459; 96.51%) rates were high. Participants strongly agreed or agreed in 69.57% (16/23) of their responses. The majority stated that they knew of SDM (mean 4.43 (4.36–4.55)) and were in favour of its implementation (mean 4.58 (4.51–4.64)). They highlighted that SDM practice was not adequate due to lack of resources (3.46 (3.37–3.55)) and agreed on policies that improved its implementation (3.96 (3.88–4.04)). The main advantage of SDM for participants was patient satisfaction (38%), and the main disadvantage was the patients’ paucity of knowledge to understand their disease (24%). The main obstacle indicated was the lack of time and resources (40%). Conclusions: New policies must be designed for adequate training of professionals in integrating SDM in clinical practice, preparing them to use SDM with adequate resources and time provided.

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