Complexities of interprofessional identity formation in dental hygienists: an exploratory case study

Background In a super-aging society, medical-dental collaboration is increasingly vital for comprehensive patient care. Particularly in dysphagia rehabilitation and perioperative oral functional management, dental hygienists’ active involvement is pivotal to interprofessional collaborative practice. Despite this societal expectation, dental hygienists’ experiences and perceptions of interprofessional collaboration have not been explored. This study aims to investigate dental hygienists’ interprofessional identity formation and perceptions of interprofessional collaboration. Specifically, it was explored from the perspectives of dental hygiene students and hospital dental hygienists. Methods This study is underpinned by Wenger’s social theory of learning, which focuses on identity as a component in the process of learning in communities. Semi-structured interviews were conducted with 11 dental hygiene students in their final year at a technical college and five dental hygienists engaging in interprofessional care at a university hospital in Japan. The narrative data were analysed using an inductive approach to thematic analysis to extract themes regarding the identification of self in interprofessional teams. Results Dental hygiene students found several barriers to the collaboration, including power relation and conceptual hierarchy, limited understanding of other professional roles, and differences in language and jargon. They viewed themselves as inferior in the interprofessional team. This resulted from their limited knowledge about general health and less responsibility for problems directly related to patient life and death. However, they could ultimately perceive the negative experiences positively as challenges for the future through reflection on learning in clinical placements. Contrarily, dental hygienists did not have such negative perceptions as the students did. Rather, they focused on fulfilling their roles as dental professionals in the interprofessional team. Their identities were formed through actively involving, coordinating their activity, and creating new images of the world and self in inter-professional communities of practice. Conclusions Interprofessional identity is relational as well as experiential, which is developed in complex and socially dynamic processes across intra- and inter-professional communities of practice. Engagement, imagination, and alignment are essential aspects of their interprofessional identities, which inform conceptual foundations of interprofessional education and collaborative practice in health care.

A Review on Mucormycosis Disease & Its Treatment

Mucormycosis is an angio-intrusive disease brought about by the Mucorales organism. Even though it is an uncommon condition, it is turning out to be more normal among immunocompromised patients. Rhino-orbitocerebral, cutaneous, dispersed, gastrointestinal, and pneumonic structures would all be able to be found. Notwithstanding the lively treatment, there is a generally speaking expanded passing rate. The audit's significant objective and objective are as follows: Mucormycosis Overview and Etiopathogenesis, Fatality of Rhino cerebral Mucormycosis Strategies for determination and treatment have as of late progressed. Mucormycosis is more typical in seriously neutropenia patients and people who need phagocytic action. Notwithstanding, this isn’t true on account of Patients with AIDS19. It suggests that T lymphocytes are involved. They are insufficient in forestalling parasitic expansion. Just the neutrophils are impacted. Voriconazole treatment for quite a while, essentially among the People with malignant growths of the blood and bone marrow Transfers of undifferentiated hematopoietic cells are more regular. Besides, Mucormycosis can likewise be found in individuals who don’t have any manifestations Rhino-orbitocerebral, cutaneous, dispersed, gastrointestinal, and pneumonic structures would all be found. Notwithstanding the lively treatment, there is a generally speaking expanded passing rate. Mucormycosis results from various fungi that may be innocuous and primarily affect immunocompromised patients. For this reason, the clinician must have a high index of suspicion to diagnose this disease in any of its forms when it presents in a patient with these risk factors. Starting with the host’s features and the fungus’s tropism once it invades the host, this activity discusses the manifestations of Disease, appropriate evaluation/management of mucormycosis, and highlights the role of the interprofessional team in evaluating and treating patients with this condition.

Addressing Transportation Insecurity Improves Attendance at Posthospitalization Appointments

BACKGROUND: Transportation influences attendance at posthospitalization appointments (PHAs). In 2017, our pediatric hospital medicine group found that our patients missed 38% of their scheduled PHAs, with several being due to transportation insecurity. To address this, we implemented a quality improvement project to perform inpatient assessment of transportation insecurity and provide mitigation with the goal of improving attendance at PHAs. METHODS: The process measure was the percentage of patients with completed transportation insecurity screening, and the outcome measure was PHA attendance. An interprofessional team performed plan-do-study-act cycles. These included educating staff about the significance of transportation insecurity, its assessment, and documentation; embedding a list of local transportation resources in discharge instructions and coaching families on using these resources; notifying primary care providers of families with transportation insecurity; and auditing PHA attendance. RESULTS: Between July 2018 and December 2019, electronic health record documentation of transportation insecurity assessment among patients on the pediatric hospital medicine service and discharged from the hospital (n = 1731) increased from 1% to 94%, families identified with transportation insecurity increased from 1.2% to 5%, and attendance at PHAs improved for all patients (62%–81%) and for those with transportation insecurity (0%–57%). Our balance measure, proportion of discharges by 2 pm, remained steady at 53%. Plan-do-study-act cycles revealed that emphasizing PHA importance, educating staff about transportation insecurity, and helping families identify and learn to use transportation resources all contributed to improvement. CONCLUSIONS: Interventions implemented during the inpatient stay to assess for and mitigate transportation insecurity led to improvement in pediatric PHA attendance.

Developing a team-based assessment strategy: direct observation of interprofessional team performance in an ambulatory teaching practice

Background: High functioning interprofessional teams may benefit from understanding how well (or not so well) a team is functioning and how teamwork can be improved. A team-based assessment can provide team insight into performance and areas for improvement. Though individual assessment via direct observation is common, few residency programs in the United States have implemented strategies for interprofessional team (IPT) assessments. Methods: We piloted a program evaluation via direct observation for a team-based assessment of an IPT within one Internal Medicine residency program. Our teams included learners from medicine, pharmacy, physician assistant and psychology graduate programs. To assess team performance in a systematic manner, we used a Modified McMaster-Ottawa tool to observe three types of IPT encounters: huddles, patient interactions and precepting discussions with faculty. The tool allowed us to capture team behaviors across various competencies: roles/responsibilities, communication with patient/family, and conflict resolution. We adapted the tool to include qualitative data for field notes by trained observers that added context to our ratings. Results: We observed 222 encounters over four months. Our results support that the team performed well in measures that have been iteratively and intentionally enhanced – role clarification and conflict resolution. However, we observed a lack of consistent incorporation of patient-family preferences into IPT discussions. Our qualitative results show that team collaboration is fostered when we look for opportunities to engage interprofessional learners. Conclusions: Our observations clarify the behaviors and processes that other IPTs can apply to improve collaboration and education. As a pilot, this study helps to inform training programs of the need to develop measures for, not just individual assessment, but also IPT assessment.

Geriatric Interprofessional Education: In-Person Simulation

Our in-person geriatric interprofessional training model is layered with scaffolds of active learning, tabletop team meeting simulation, assessment of older adult community members at risk for falls, and reflective feedback. The first step addresses knowledge acquisition via online didactic content. The second step reinforces the knowledge gained in the online didactics through in-person posters and interactive skills practice, followed by a profession-specific huddle to communicate patient assessment findings. The third step is an interprofessional team meeting simulation based on a case study of a complex geriatric patient. The fourth step is performing a supervised assessment on an older adult. The assessment incorporates the assessment tools practiced during the poster/skills session and team skills learned in the didactics and simulation. This is followed by the design of an interprofessional team-developed patient-centered plan of care. The event ends with a reflective debrief focused on interprofessional collaborative competencies.

Geriatric Interprofessional Education Theoretical Framework

The literature is lacking in theoretically grounded techniques to teach interprofessional skills specific to caring for older adults. This presentation details how Wagner’s Chronic Care Model and the Constructivist/Active Learning theoretical frameworks were used in the design of an interprofessional education. The content of the education was modeled after Wagner’s chronic illness care model that advocates changes in processes and organizational structures to promote interprofessional team practice. The educational intervention follows a Constructivist/Active learning framework delivered in a simulation format. Constructivist approaches encompass active learning and guided experiential learning procedures, methods well-suited to our scaffolded simulation educational experience.

Geriatric Depression and Inappropriate Medication: Benefits of Interprofessional Team Cooperation in Nursing Homes

An investigation of inappropriate medication use in treatment of depressivity in institutionalized older adults, based on a nurse-led evaluation of functional status and depressive symptoms in nursing home residents. Methods: A cross-sectional multicenter study was performed using records from 1087 residents cared for in fifteen nursing homes (NHs) in the Czech Republic. Inclusion criteria were being a permanent resident of one of the facilities, being 60 years of age or older, having a Geriatric Depression Scale score of 6 or more, and having a Mini Mental State examination score 10 or more. The final sample for analysis included 317 depressed NH residents. Results: 52 percent of NH residents with depressivity had no antidepressant treatment. Benzodiazepines were the only medication in 16 percent of depressed residents, and were added to antidepressant treatment in 18 percent of residents. Benzodiazepine users had significantly higher GDS scores compared to non-users (p = 0.007). Conclusion: More than half of depressed NH residents remained without antidepressant treatment. Residents inappropriately treated with benzodiazepines were more depressed than residents treated with antidepressants only, or even not treated at all. Cooperation of the interprofessional team in the screening of depressive symptoms has the potential to improve the quality of care.