interprofessional team Dotaz Zobrazit nápovědu
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.
- Klíčová slova
- benzodiazepines, depression, interprofessional team, nurse, older adults,
- MeSH
- antidepresiva terapeutické užití MeSH
- benzodiazepiny MeSH
- deprese * farmakoterapie epidemiologie MeSH
- pečovatelské domovy * MeSH
- průřezové studie MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
- Názvy látek
- antidepresiva MeSH
- benzodiazepiny MeSH
Pharmaceutical care necessitates significant efforts from patients, informal caregivers, the interprofessional team of health care professionals and health care system administrators. Collaboration, mutual respect and agreement amongst all stakeholders regarding responsibilities throughout the complex process of pharmaceutical care is needed before patients can take full advantage of modern medicine. Based on the literature and policy documents, in this position paper, we reflect on opportunities for integrated evidence-based pharmaceutical care to improve care quality and patient outcomes from a nursing perspective. Despite the consensus that interprofessional collaboration is essential, in clinical practice, research, education and policy-making challenges are often not addressed interprofessionally. This paper concludes with specific advises to move towards the implementation of more interprofessional, evidence-based pharmaceutical care.
- Klíčová slova
- interprofessional collaboration, nursing, pharmaceutical care,
- MeSH
- farmaceutické služby * MeSH
- interprofesionální vztahy MeSH
- kooperační chování MeSH
- lidé MeSH
- péče o pacienta MeSH
- týmová péče o pacienty MeSH
- zdravotní sestry * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
OBJECTIVES: Safe pharmaceutical care (PC) requires an interprofessional team approach, involving physicians, nurses and pharmacists. Nurses' roles however, are not always explicit and clear, complicating interprofessional collaboration. The aim of this study is to describe nurses' practice and interprofessional collaboration in PC, from the viewpoint of nurses, physicians and pharmacists. DESIGN: A cross-sectional survey. SETTING: The study was conducted in 17 European countries, each with their own health systems. PARTICIPANTS: Pharmacists, physicians and nurses with an active role in PC were surveyed. MAIN OUTCOME MEASURES: Nurses' involvement in PC, experiences of interprofessional collaboration and communication and views on nurses' competences. RESULTS: A total of 4888 nurses, 974 physicians and 857 pharmacists from 17 European countries responded. Providing patient education and information (PEI), monitoring medicines adherence (MMA), monitoring adverse/therapeutic effects (ME) and prescribing medicines were considered integral to nursing practice by 78%, 73%, 69% and 15% of nurses, respectively. Most respondents were convinced that quality of PC would be improved by increasing nurses' involvement in ME (95%), MMA (95%), PEI (91%) and prescribing (53%). Mean scores for the reported quality of collaboration between nurses and physicians, collaboration between nurses and pharmacists and interprofessional communication were respectively <7/10, ≤4/10, <6/10 for all four aspects of PC. CONCLUSIONS: ME, MMA, PEI and prescribing are part of nurses' activities, and most healthcare professionals felt their involvement should be extended. Collaboration between nurses and physicians on PC is limited and between nurses and pharmacists even more.
- Klíčová slova
- health services administration & management, international health services, quality in healthcare,
- MeSH
- farmaceutické služby statistika a číselné údaje MeSH
- interprofesionální vztahy * MeSH
- lidé MeSH
- mezioborová komunikace MeSH
- průřezové studie * MeSH
- průzkumy a dotazníky MeSH
- role ošetřovatelky * MeSH
- srovnání kultur MeSH
- týmová péče o pacienty statistika a číselné údaje MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
- Geografické názvy
- Evropa MeSH
Hidradenitis suppurativa is a chronic immune-mediated inflammatory disease that is manifested by formation of painful nodules, abscesses and suppurating fistulas, primarily in the intertriginous spaces. This painful, often under-diagnosed disease affects much more women. They are also exposed to certain specific challenges in the management of this disease, especially during menstruation or pregnancy. The treatment requires the interdisciplinary cooperation of a dermatologist, gynaecologist, obstetrician and last but not least an algesiologist and psychotherapist. Above all, early and correct diagnosis, initiation of therapy in the early stages of the disease, is a key, which also plays a fundamental role in controlling inflammatory activity, preventing complications and further prognosis.
- Klíčová slova
- Hidradenitis suppurativa, autoimmune inflammation, comprehensive management, early diagnosis, specifics in the female population,
- MeSH
- gynekologie * metody MeSH
- hidradenitis suppurativa * terapie MeSH
- interprofesionální vztahy MeSH
- lidé MeSH
- těhotenství MeSH
- týmová péče o pacienty MeSH
- Check Tag
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- demence terapie MeSH
- geriatrie výchova MeSH
- hodnocení programu MeSH
- interprofesionální vztahy * MeSH
- kooperační chování MeSH
- lidé MeSH
- paliativní péče organizace a řízení MeSH
- péče orientovaná na pacienta organizace a řízení MeSH
- postoj zdravotnického personálu MeSH
- role odborníka MeSH
- týmová péče o pacienty organizace a řízení MeSH
- vzdělávání odborné metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
- úvodníky MeSH
- MeSH
- interprofesionální vztahy MeSH
- lékaři MeSH
- týmová péče o pacienty * zákonodárství a právo MeSH
- vztahy mezi lékařem a pacientem MeSH
- zdravotní sestry MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Československo MeSH
- MeSH
- interprofesionální vztahy * MeSH
- komunikace * MeSH
- lidé MeSH
- studium lékařství pregraduální * MeSH
- týmová péče o pacienty * MeSH
- vyučování metody MeSH
- vztahy mezi lékařem a pacientem * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- Geografické názvy
- Československo MeSH
BACKGROUND: The collaboration of community pharmacists (CPs) and general practitioners (GPs) has a positive effect on healthcare outcomes. There are still many countries, where no efforts have been made to enhance this type of teamwork. There is no evidence of how GPs and CPs collaborate in Slovakia. The objective of this study is to identify the current level of GPs and CPs teamwork in Slovakia and to identify the key factors, where these professions agree. METHODS: Two parallel electronic surveys were prepared and sent out by e-mail to CPs and GPs in Slovakia. The questions in the multi-choice questionnaires were divided into 6 sections: teamwork experience, attitudes to collaborative practice, preferred method of communication, preferred tasks done by CPs, anticipated areas of future collaboration and perceived barriers to collaborative practice. The results were analyzed separately by the proportion of agreements within each group. RESULTS: From the total of 670 questionnaires, which were sent out (434 to GPs and 236 to CPs) 347 were completed and returned by GPs (79.95%) and 181 by CPs (76.7%). The overall response rate was 78.33%. The perfect match of agreements between the CPs and the GPs answers was identified in: their preference to collaborate face-to-face (p = 0.0001) perception of the role of the community pharmacist (p < 0.0001) barriers to collaboration (p < 0.0001) areas for future collaboration (p = 0.0468) The majority of respondents confirmed (without proportional agreement) that their collaboration improves patient outcomes (71.3% of CPs, 60.5% of GPs), however, only 15.5% CPs and 17.6% GPs indicated, that they would consider team-working in the future. CONCLUSION: The responding health professionals agreed about the current role of CPs in Slovakia. Both professions reported their willingness to collaborate in the following areas: 1. patient counselling and 2. patient adherence improvement. Face-to-face communication was preferred by both groups of respondents, as a potential key factor to improve their relationships (general trust). However, in order to create a sustainable collaborative environment, the identified barriers need to be taken into account.Key words: agreement barriers collaboration community pharmacist general practitioner.
- MeSH
- farmaceuti * MeSH
- interprofesionální vztahy * MeSH
- kooperační chování * MeSH
- lidé MeSH
- praktičtí lékaři * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Slovenská republika MeSH
The authors demonstrate on the example of a patient the correct procedure as regards collaboration between different departments with excellent results--survival and cure of the patient. It was a serious case where the patient with the basic diagnosis (acute phlegmon of the neck with an abscedent mediastinitis) and several serious associated complications theoretically did not have a chance of survival. The authors emphasize the importance of collaboration of different departments where each played in a certain stage of the disease a leading role in therapy.
