Ethical global health in nursing education: An integrative review

AimThe purpose of this integrative review is to provide a comprehensive review of ethical considerations for host communities and nursing programs in planning, implementing and evaluating global health experiences for nursing students.BackgroundGlobal health experiences for nursing students are proliferating rapidly across university settings while at the same time decreasing the average time spent in the host country engaged with local communities. Global health experiences are an area where students can experience ethics as it is applied across varied contexts including resource limited international settings. As nursing education expands its global programming, exploring the ethical implications of designing, implementing and evaluating GHEs becomes pivotal to build respectful, sustainable relationships with global partners and best prepare nursing students for ethical professional practice in an interconnected world.DesignWe conducted an integrative review to examine ethical considerations in development of ethical global health experiences that benefit, rather than harm, host communities and participating nursing student guests.MethodsThe search included articles published in English language, peer-reviewed journals between 1998 and 2021 that discussed ethics in the context of nursing students traveling internationally for global health experiences. Eighteen articles met criteria for review.ResultsOverall, findings demonstrate relatively little research specific to ethical engagement in global health experiences. The articles in this integrative review discussed a range of ethical attributes including reciprocity or collaboration, respect, sustainability or commitment, justice and openness. Recommendations based on research and non-research articles are provided.ConclusionsEthical comportment in global health experiences requires careful planning, implementation and evaluation to assure an equitable and sustainable partnership between host community, faculty and nursing student guests.     

乳腺癌患者“一站式”服务模式体验的质性研究

目的深入了解乳腺癌患者对"一站式"服务模式的评价,分析其服务需求,以采取针对性措施,进一步提高患者满意度、促进其身心康复。方法选取我中心乳腺外科医生5名、乳腺专科护士5名,以及在我中心接受诊疗的乳腺癌患者18例、家属9例,采取半结构访谈法,全程录音记录,随后将声音资料整理录入后运用现象学的方法编码分析。结果据访谈结果提炼出对于一站式服务模式的体验包括:让患者及家属感到规范、便捷,体现了护理的连续性和医护的合作性;同时对患者的心理社会支持有待加强、健康教育有待深入、延伸护理有待完善。结论"一站式"服务虽在一定程度上满足了患者的诊疗需求,但在制度流程、服务细节等方面仍有待改善和提高。     

中俄院校卫勤演习的比较研究

介绍了我校和俄罗斯基洛夫军事医学院的卫勤演习情况,然后针对卫勤演习的构成要素,如演习类型、演习课目、参演对象、演习导调和保障基地等进行了对比分析。在此基础上,从调整参演对象、改变演习时机、改革演习导调、加强基地建设等方面,对我军院校卫勤演习提出了建议。     

优化早交班内涵的实践与成效

目的 探讨早交班内涵的优化与实践成效。方法 评估传统早交班内涵, 对传统早交接内涵进行优化、培训, 使责任护士掌握并应用于临床实践, 对优化前、后的早交班内涵的相关护理指标进行评价。结果 早交班内涵优化后的护理质量及患者对责任护士的满意度较优化前有显著提高, 差异有统计学意义(P<0.05)。结论 早交班内涵的优化提高了护理工作的质量及效率, 体现了优质护理的人性化、连续性、整体性、专业化。     

The changing role of dental auxiliaries: A literature review

A review of the literature on dental auxiliaries and their utilization in the dental workforce is presented, and their future role is examined in the light of broader issues relating to changing disease patterns and service delivery. Legislative factors, productivity, quality assurance and the potential scope for dental auxiliaries in both the public sector and private practice setting are discussed. A strategy for adopting a team approach in the delivery of dental services is suggested, which would necessitate the dentist taking on the role of team leader and maintaining responsibility for overall treatment planning and quality assurance. Dental auxiliaries could provide basic preventive and restorative dental services, allowing dentists to concentrate on providing more complex high-technology treatment. Implications for the future training of dental auxiliaries are presented.     

The role of dentist, practice and patient factors in the provision of dental services

OBJECTIVES: Service provision varies by dentist, practice and patient factors. However, limited subsets of these potential influences on service rates have been explored. More comprehensive models could improve our understanding of the factors influencing the pattern of care delivered. The aim of this study was to examine variation in dental services by dentist (treatment choice, practice beliefs, preferences for patients, demographics), practice (type, location, size and volume of practice) and patient (visit, demographic, oral health and socio-economic) characteristics. METHODS: A random sample of Australian dentists was surveyed in 1997-98 (response rate=60.3%). Private general practitioners (n=345) provided dentist and practice data, and service provision and patient variables were collected from a log of a typical clinical day (n=4,115 patients). Multivariate negative binomial regression models were fitted for diagnostic, preventive, restorative, extraction and prosthodontic services. RESULTS: Significant dentist factors included (P<0.05; RR=rate ratio): lower diagnostic rates (RR=0.78) for dentists with stronger practice beliefs for giving information about cost and treatment options; preventive rates were lower (RR=0.74) for male dentists and higher (RR=1.48) for younger dentists aged 20-29 years; restorative rates were higher (RR=1.27) for dentists that rated patient preferences more highly in treatment choice and in the dentist age group 30-39 years (RR=1.25); extraction rates were lower (RR=0.61) for dentists with stronger preferences for patients that would adhere with treatment but higher (RR=1.57) for dentists with stronger preferences for sociable patients; and prosthodontic rates were lower (RR=0.38) for dentists with stronger preferences for adaptable patients who were willing to cooperate when expected to do so. Practice factors included: higher preventive (RR=1.28) and prosthodontic rates (RR=2.07) in solo practice; higher preventive (RR=1.34) but lower prosthodontic rates (RR=0.42) in capital cities; lower diagnostic (RR=0.82) and extraction rates (RR=0.55) in practices with fewer other dentists; higher diagnostic (RR=1.33) and extraction (RR=1.62) rates but lower restorative rates (RR=0.84) in practices with lower patient visits per year. Patient factors included: lower preventive (RR=0.76) but higher extraction rates (RR=1.45) for emergency visits; lower extraction rates (RR=0.60) for the insured; higher diagnostic rates (RR=1.17) for new patients; higher restorative (RR=1.31) but lower prosthodontic rates (RR=0.46) for patients with decayed teeth; higher prosthodontic rates (RR=2.14) for those with dentures; and lower preventive (RR=0.66), but higher extraction (RR=2.22) and prosthodontic rates (RR=1.82) for patients from lower socio-economic status areas. CONCLUSIONS: Dental service rates were influenced by large number of small effects from a wide range of dentist, practice and patient factors. Socio-economic and geographic barriers may need broad policy innovations to be addressed, but factors such as insurance and visit type have the potential to be altered to achieve better service outcomes and there is scope for research into clinical outcomes to improve the knowledge upon which treatment decisions are based.     

Understanding Dental Service Use by Older Adults: Sociobehavioral Factors vs Need

Objectives: This study investigated correlates of dental care use in a representative sample of adults aged 70 and older throughout New England. Methods : Data were collected in in-home interviews and dental examinations. Following Andersen's behavioral model of health services utilization, varied measures of sociodemographic characteristics, dental health attitudes and practices, perceived need for care, and need objectively determined by clinical examination were included as potential correlates. Results : Recency of last visit was associated with positive attitudes toward dental care, regular dental hygiene, and having a usual source of care. Among dentulous subjects, recency of last visit also was related to sex and living arrangements. Frequency of visits for dentulous subjects was associated with the same variables, as well as with age and social class or education, in addition to need for care. For edentulous subjects, only a usual sourse of care and higher social class were associated with more frequent visits. Conclusions : Perceived need and attitudes toward dental care are important influences on use of care. Older persons must be convinced of the importance of regular dental care.     

门诊药房发药辅助系统的设计与应用

目的 构建门诊发药辅助系统,减少差错,提升门诊药学服务质量。方法 利用条码技术自主研发门诊药房发药辅助系统,从系统设计、系统功能等方面对其进行介绍,从对发药差错的影响、对发药效率的影响和药师评价等方面对系统的实际应用效果进行评价。结果 该系统基于医院特殊的网络环境,整合了药品核对、处方权管理、效期管理和用药交待等功能。使用该系统后,年发药差错由84起减少至25起,患者取药等待时间缩短了151 s。接受调查的药师全部认可该辅助系统有助于药师工作。结论 该系统提高了门诊药师的发药效率,并起到减少差错、提高效率的作用,进一步提升了药学服务质量。