scholarly journals Increased Accessibility to Primary Healthcare Due to Nurse Prescribing of Medicines

2021 ◽  
Vol 19 (1) ◽  
pp. 292
Author(s):  
Dorota Kilańska ◽  
Anna Lipert ◽  
Marika Guzek ◽  
Per Engelseth ◽  
Michał Marczak ◽  
...  
Keyword(s):  
Primary Healthcare ◽  
Structural Changes ◽  
Nursing Profession ◽  
Nurse Prescribing ◽  
Nurse Midwife ◽  
Number Of Patients ◽  
The Right ◽  
Age Range ◽  
The Impact ◽  
Nurses And Midwives

Since January 2016, nurses and midwives in Poland have had the right, with some restrictions, to prescribe medicines. Consequently, Polish patients received the same opportunity as in other countries worldwide: easier access to certain health services, i.e., medical prescribing. The aim of this study was to assess the impact of structural changes which increased the nurses’ competences on the accessibility to prescription visits for patients receiving primary healthcare on the example of Medical and Diagnostic Centre (MDC), and to discuss the general trend of legal changes in nursing profession regulations. We performed a detailed analysis of the data on the MDC patient population in Siedlce who received at least one prescription written by a general practitioner and/or a nurse/midwife in the years 2017–2019.The largest number of prescription visits made by nurses concerned patients aged 50–70 years, as this age range includes the largest number of patients with chronic diseases who need continued pharmacological treatment originally administered by doctors. An increasing tendency for prescription visits made by nurses was recorded, with a simultaneous downward trend in the same type of visits undertaken by doctors at MDC. Nurses’ involvement in prescribing medications as a continued pharmacotherapy during holiday seasons results in patients having continuous access to medication. An upward trend was also observed in the number of medications prescribed by nurses per patient. Structural changes in the legal regulations of the nursing profession improve patients’ access to prescription visits under primary healthcare. Further research is recommended to evaluate the dynamics of these trends and the impact of newly introduced nursing competences on the accessibility of prescription visits for patients.

Right ventricle function longitudinal evaluation after norwood procedure: comparison between right ventricle-pulmonary artery shunt and blalock-taussing shunt

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
N Borrelli ◽  
J Sabatino ◽  
M Avesani ◽  
M Josen ◽  
A Fraisse ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Right Ventricle ◽  
Surgical Techniques ◽  
Norwood Procedure ◽  
Number Of Patients ◽  
Before And After ◽  
Shunt Group ◽  
The Right ◽  
The Impact ◽  
Rv Function

Abstract Background Norwood procedure represents the first of three surgical steps toward Hypoplastic left heart syndrome (HLHS) complete palliation. Two are the main surgical techniques allowing the reconstruction of Norwood circulation: the right ventricle-pulmonary artery shunt (RVPAS) and the modified Blalock-Taussing shunt (mBTS). However, still little is known about the impact on right ventricle (RV) function of the required ventriculotomy for the RVPAS. Purpose The aim of the study was to investigate the changes in RV function in HLHS patients after RVPAS vs mBTS. Methods The cohort included 27 consecutive HLHS patients (10 in the modified Blalock-Taussig shunt group and 17 in the RVPAS group) who successfully underwent Norwood procedure in a single tertiary paediatric cardiology centre. Longitudinal strain (LS) and strain rate (LSR), tricuspid annulus peak systolic excursion (TAPSE) and fractional area change (FAC) were evaluated in all patients before Norwood and in three different breakpoints in the steady state after Norwood procedure (30 days after Norwood, 90 days after Norwood, 140 days after Norwood). Results Ventricular loading conditions (diuretic treatment, blood pressure and tricuspid regurgitation) were similar in both groups. No significant differences were found at different time points between RVPAS and mBTS group in terms of LS, LSR, TAPSE and FAC. However, when we compared RV function before and after Norwood procedure, 90 days after the procedure, patients who did not undergo RV ventriculotomy (mBTS group) showed significant improvement in LS compared to pre-surgical assessment (mBTS: +27.35±43.47% vs RVPAS: −8,20±25.25%, p=0,03). This finding was consistent but no longer statistically significant at 140 days after Norwood (mBTS: +13.81±21.99% vs RVPAS: −4.90±27.97%, p=0,12). Conclusion After Norwood procedure mBTS patients showed a significant increase in LS when compared with patients who underwent RVPAS. This finding was consistent but no longer significant at 140 days after Norwood probably because the number of patients was too small to reach a significant level. These data support the use of LS in HLHS patient's evaluation and may be of value to find a patient-tailored timing for the second surgical stage. TAPSE, FAC, LS and LSR trends Funding Acknowledgement Type of funding source: None

scholarly journals Satisfaction With Healthcare: The Changes And Features Of Patients Making Aknowledgements For Doctors And Nurses Wiews

2016 ◽  
Vol 26 (5) ◽  
pp. 5-12
Author(s):  
Vinsas Janušonis
Keyword(s):  
Response Rate ◽  
Healthcare Services ◽  
University Hospital ◽  
Women Patients ◽  
Persons With Disabilities ◽  
Patients Satisfaction ◽  
Number Of Patients ◽  
The Right ◽  
The Impact ◽  
Doctors And Nurses

The aim of the study – to estimate patients, who gave thanks for medics – doctors and nurses opinion changes and singularity of right healthcare, satisfaction and fruition their expectations. Material and methods. From January 2004 to December 2015 a survey was performed in Klaipeda University Hospital (KUH). The study included 197755 patients who were undergoing treatment in KUH. Information was collected via questionnaires (response rate 81,4%). The patients who gave thanks for medics group was analyzed apart. The survey was analyzed and compared for the periods 2004-2006 and 2013-2015. Results and discussion. The most part of patients who gave thanks for medics was aged 50-69 (15, 8%), at work, women. The time of healthcare services, information for patients, good contact and communication between patients and medics, patients’ satisfaction influenced the number of thanks. The number of thanksgiving have not direct correlation with healthcare quality. Conclusions. Patients thanksgiving has confirmed the KUH provided healthcare for the majority of patients are appropriate to meet their expectations and they are satisfied with it. Comparison of both analyzed periods has shown that over 10 years fell acknowledgments for medics. Age, gender and social status had the impact on the number of acknowledgments - more thanksgiving was from women, patients 50-59 year age, retired and persons with disabilities. The right cooperation between medics and patients, provision of healthcare information to patients increased the number of thanksgiving. The number of patients who satisfied with healthcare results and meet their expectations directly correlated with number of patients who gave thanks for medics.

scholarly journals Examining the Impact of a Pharmacists Postpartum Counseling Service; Evidence from a University Hospital

2014 ◽  
Vol 5 (1) ◽  
Author(s):  
Kristina Schatz ◽  
Jennifer Chapman ◽  
Jongwha Chang
Keyword(s):  
Private Insurance ◽  
University Hospital ◽  
Original Research ◽  
Postpartum Women ◽  
Counseling Service ◽  
Preparation Time ◽  
Spanish Speaking ◽  
Number Of Patients ◽  
Age Range ◽  
The Impact

Purpose: To describe a pharmacist's counseling service pertaining to methods of contraception on the postpartum unit of a university hospital and to evaluate the number of postpartum patients who desire information on contraception with the demographics of age, public or private insurance, and whether the patient was English or Spanish-speaking. Methods: Retrospective cohort data analysis of postpartum women who received the option of counseling by a pharmacist or pharmacy intern at a university hospital over a year and 7 month period. There were 2,048 cases included for this study. The total number of patients who wanted information as well as pharmacist preparation time and counseling time were also noted. Results: Patients who were interested in a hormonal contraception method were 3 times more likely to desire counseling compared with patients who declined information (p<0.05). Also, patients who wanted an implantable form of contraception were 8 times more likely to desire information compared with patients who declined counseling (p<0.05). Patients in the age range of 18-25, 26-30, and 31-45 years were less likely (56%, 64%, & 65%) to want counseling compared with the age range of 12-17 years (all p<0.05). Lastly, patients who spoke Spanish were 3 times more likely to have been counseled compared with non-Spanish speaking patients. The number of postpartum patients counseled on different contraception methods was 1,546 versus 699 patients who declined counseling. Total pharmacist preparation time totaled 160.95 hours, while total patient counseling time totaled 204.55 hours. Conclusion: Overall, postpartum women who chose to be counseled by a pharmacist were considering either a hormonal or implantable method of contraception, were younger than the age of 17 and were Spanish speaking. The average amount of pharmacist preparation time spent was 4.3 minutes per patient and actual counseling time on average was 5.5 minutes per patient.   Type: Original Research

Laparoscopic-Assisted Abdominal Wall Pexy of Peritoneal Dialysis Catheter

2020 ◽  
pp. 000313482094527
Author(s):  
Wei Wei ◽  
Medhat Fanous
Keyword(s):  
Peritoneal Dialysis ◽  
Abdominal Wall ◽  
White Male ◽  
Peritoneal Dialysis Catheter ◽  
Intraperitoneal Adhesions ◽  
Number Of Patients ◽  
Increased Risk ◽  
The Right ◽  
Stage Renal Disease ◽  
The Impact

Background Peritoneal dialysis (PD) for rural patients with end-stage renal disease (ESRD) is convenient, efficient, and durable. However, patients with a history of previous abdominal surgeries or peritonitis are at an increased risk of PD malfunction. This case highlights the impact of securing the catheter to the abdominal wall laparoscopically to keep the PD catheter in an adhesion-free area to maintain patency and function in a patient with extensive intraperitoneal adhesions. Subject A 76-year-old white male was on PD which later was complicated with peritonitis and sepsis and subsequent catheter removal. A year later, the patient desired replacement of the PD catheter. Intraoperatively, diagnostic laparoscopy revealed significant intraperitoneal adhesions mainly located at the left side of the abdomen with the right side of the abdomen spared. The Tenckhoff PD catheter, which was straightened by a steel stylet, was inserted via a 5-mm trocar. The stylet was removed. The pig tail of the PD catheter was navigated away from the adhesion and directed to the right side of the abdomen for internal fixation. The catheter at 9 cm from the PD catheter cuff was attached to the right paramedian peritoneum. Results PD started 1 week after placement. The patient had excellent inflow and outflow for 14 months to date without complication or need for revision. Conclusion The laparoscopic pexy of the PD catheter to the abdominal wall to keep the catheter in an adhesion-free compartment is beneficial in selected patients. A future study with a larger number of patients is needed to further validate this strategy.

Non-medical prescribers: prescribing within practice

2020 ◽  
Vol 2 (2) ◽  
pp. 68-77 ◽  
Author(s):  
Áine McHugh ◽  
Mary Hughes ◽  
Agnes Higgins ◽  
Tom Buckley ◽  
Andrew Cashin ◽  
...  
Keyword(s):  
Decision Making ◽  
Mixed Method ◽  
Health Professionals ◽  
Interprofessional Education ◽  
Scope Of Practice ◽  
Mixed Method Study ◽  
Nurse Prescribing ◽  
Nurse Midwife ◽  
Interprofessional Cooperation ◽  
Nurses And Midwives

Since its inception in Ireland in 2007, the Nurse Prescribing Programme has prepared registered nurses and midwives to prescribe from a limited formulary in their area of clinical speciality. However, registration numbers have declined in recent years, prompting changes to the registration processes. This article present the findings of a study conducted on the prescribing behaviours, practices and confidence of registered nurse/midwife prescribers following these changes, reporting the findings from the qualitative arm of a larger mixed-method study. Interviews with participants (n=6) explored their prescribing behaviours, practices and confidence. The findings suggest that organisational and professional factors influence prescribing. Scope of practice and expert decision-making is seen to influence engagement with treatment. Interprofessional cooperation continues to develop in making prescribing decisions. There is a clear need for interprofessional education to increase cooperation between health professionals in making prescribing decisions and including national competencies for all prescribers.

Emotional Reactivity to Visual Content as Revealed by ERP Component Clustering

2015 ◽  
Vol 29 (4) ◽  
pp. 135-146 ◽  
Author(s):  
Miroslaw Wyczesany ◽  
Szczepan J. Grzybowski ◽  
Jan Kaiser
Keyword(s):  
Emotional Reactivity ◽  
Brain Activity ◽  
Affective State ◽  
Occipital Lobe ◽  
Stimulus Onset ◽  
Emotional States ◽  
Neural Basis ◽  
Temporoparietal Junction ◽  
The Right ◽  
The Impact

Abstract. In the study, the neural basis of emotional reactivity was investigated. Reactivity was operationalized as the impact of emotional pictures on the self-reported ongoing affective state. It was used to divide the subjects into high- and low-responders groups. Independent sources of brain activity were identified, localized with the DIPFIT method, and clustered across subjects to analyse the visual evoked potentials to affective pictures. Four of the identified clusters revealed effects of reactivity. The earliest two started about 120 ms from the stimulus onset and were located in the occipital lobe and the right temporoparietal junction. Another two with a latency of 200 ms were found in the orbitofrontal and the right dorsolateral cortices. Additionally, differences in pre-stimulus alpha level over the visual cortex were observed between the groups. The attentional modulation of perceptual processes is proposed as an early source of emotional reactivity, which forms an automatic mechanism of affective control. The role of top-down processes in affective appraisal and, finally, the experience of ongoing emotional states is also discussed.

International trade: Research of the reasons for the fall

2019 ◽  
pp. 79-91 ◽  
Author(s):  
V. S. Nazarov ◽  
S. S. Lazaryan ◽  
I. V. Nikonov ◽  
A. I. Votinov
Keyword(s):  
Growth Rate ◽  
International Trade ◽  
Exchange Rate ◽  
Global Economy ◽  
Structural Changes ◽  
Global Value Chains ◽  
Value Chains ◽  
Negative Contribution ◽  
Basic Commodity ◽  
The Impact

The article assesses the impact of various factors on the growth rate of international trade. Many experts interpreted the cross-border flows of goods decline against the backdrop of a growing global economy as an alarming sign that indicates a slowdown in the processes of globalization. To determine the reasons for the dynamics of international trade, the decompositions of its growth rate were carried out and allowed to single out the effect of the dollar exchange rate, the commodities prices and global value chains on the change in the volume of trade. As a result, it was discovered that the most part of the dynamics of international trade is due to fluctuations in the exchange rate of the dollar and prices for basic commodity groups. The negative contribution of trade within global value chains in 2014 was also revealed. During the investigated period (2000—2014), such a picture was observed only in the crisis periods, which may indicate the beginning of structural changes in the world trade.

The Impact of Internal Work Environment on the Retention of Healthcare Providers at Turaif General Hospital

2019 ◽  
Vol 10 (12) ◽  
pp. 1183-1199
Author(s):  
Mohammed Alrouili ◽  
Keyword(s):  
Work Environment ◽  
General Hospital ◽  
Professional Growth ◽  
Healthcare Providers ◽  
Entire Study ◽  
Internal Work ◽  
Research Findings ◽  
Study Population ◽  
The Right ◽  
The Impact

This study attempted to identify the impact of internal work environment on the retention of healthcare providers at Turaif General Hospital in the Kingdom of Saudi Arabia. In particular, the study aimed to identify the dimensions of work circumstances, compensation, and relationship with colleagues, professional growth, and the level of healthcare providers’ retention. In order to achieve the study goals, the researcher used the descriptive analytical approach. The researcher used the questionnaire as the study tool. The study population comprised all the healthcare providers at Turaif General Hospital. Questionnaires were distributed to the entire study sample that consisted of 220 individuals. The number of questionnaires valid for study was 183 questionnaires. The research findings were as follows: the participants’ estimate of the work circumstances dimension was high (3.64), the participants’ estimate of the compensation dimension was moderate (3.32), the participants’ estimate of the relationship with colleagues dimension was high (3.62), the participants’ estimate of the professional growth dimension was weak (2.39), and the participants’ estimate of healthcare providers’ retention level was intermediate (2.75). Accordingly, the researcher’s major recommendations are: the need to create the right atmosphere for personnel in hospitals, the interest of the hospital to provide the appropriate conditions for the staff in terms of the physical and moral aspects for building the work adjustment in the staff, and conducting training courses and educational lectures for personnel in hospitals on how to cope with the work pressures.

THE IMPACT OF UKRAINE'S EXCISE DUTY POLICY ON THE TRANSFORMATION PROCESSES OF THE TOBACCO MARKET

2020 ◽  
Vol 2020 (10) ◽  
pp. 19-33
Author(s):  
Nadiia NOVYTSKA ◽  
◽  
Inna KHLIEBNIKOVA ◽  
Keyword(s):  
Structural Changes ◽  
Tax Avoidance ◽  
Transformation Process ◽  
State Regulation ◽  
Tobacco Products ◽  
Excise Duty ◽  
Increasing Demand ◽  
High Level ◽  
The Impact ◽  
Transformation Processes

The market of tobacco products in Ukraine is one of the most dynamic and competitive. It develops under the influence of certain factors that cause structural changes, therefore, the aim of the article is to conduct a comprehensive analysis of transformation processes in the market of tobacco and their alternatives in Ukraine and identify the factors that cause them. The high level of tax burden and the proliferation of alternative products with a potentially lower risk to human health, including heating tobacco products and e-cigarettes, are key factors in the market’s transformation process. Their presence leads to an increase in illicit turnover of tobacco products, which accounts for 6.37% of the market, and the gradual replacement of cigarettes with alternative products, which account for 12.95%. The presence on the market of products that are not taxed or taxed at lower rates is one of the reasons for the reduction of excise duty revenues. According to the results of 2019, the planned indicators of revenues were not met by 23.5%. Other reasons for non-fulfillment of excise duty revenues include: declining dynamics of the tobacco products market; reduction in the number of smokers; reorientation of «cheap whites» cigarette flows from Ukraine to neighboring countries; tax avoidance. Prospects for further research are identified, namely the need to develop measures for state regulation and optimization of excise duty taxation of tobacco products and their alternatives, taking into account the risks to public health and increasing demand of illegal products.

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