Implementation In Everyday Practice Research Articles

P101: Needs assessment study for the inter-professional procedural sedation course: methods of adult procedural sedation (MAPS)

Introduction: Procedural sedation and analgesia (PSA) is a common practice for non-anaesthesiologists. While complication rates for PSA are low, many of them are preventable. Professional regulatory body requirements state that practitioners should have adequate knowledge and skills to safely administer PSA. However, no certification process currently exists to develop and maintain these competencies. A standardized PSA training course would help close the gap between the best evidence for safe administration of PSA and its implementation in everyday practice. Therefore, we conducted a needs assessment to guide the development of such a PSA training course. Methods: Using modified Dillman methodology, an electronic survey was sent to a convenience sample of 50 potential learners and two groups of stakeholders: 20 hospital administrators and 35 experts in PSA. Questions assessed practice demographics, experience as well as support and interest in the development and attendance of a PSA training course. Prior to distribution, the questionnaire was peer reviewed and pilot-tested for feasibility and comprehension. Responses were stratified based on clinical role. Results: 35 potential learners completed the needs assessment (70% response rate): 15 emergency physicians, 19 registered nurses and 1 nurse practitioner. 48% have been in practice for over 10 years and over 90% participate in PSA at least weekly. 38% received informal training in PSA while 16% obtained no training at all. 86% strongly supported the development of a PSA certification course and were in favour of an inter-professional format. 13 experts responded to the questionnaire within the departments of anesthesia, emergency medicine (EM) and respiratory therapy (37% response rate). 80% supported the need for a PSA training course. 6 hospital administrators responded to the questionnaire within the departments of anesthesia, EM, gastroenterology and respirology (30% response rate). All agreed that standardization of PSA is an important part of patient safety and 80% stated certification in PSA should be a prerequisite for granting privileges to health care professionals to participate in PSA. 60% believed the course should be developed and supported by hospital funds. Conclusion: There is strong support from potential learners and stakeholders for the development of a formal PSA training course.

Dynamics and stability – A proposal for related terms in Metrology from a mathematical point of view

We describe measurement quantities and measurement processes verbally by using everyday terms, often sanctioned by international standards and guides. However, we apply some of these terms inconsistently as compared to definitions in base sciences like Logic and Mathematics, Signal and System Theory, Stochastics and Statistics, Estimation and Optimisation Theory. This is especially true for a group of terms in Metrology, namely for the terms kinetic, static, time dependent, time invariant, stable, stationary, drifting etc., which all populate the general environment of the main term dynamics. The paper explores systematic relations between these and similar terms and discusses the aptitude of their implementation in everyday practice. Cardinal point is the term dynamic, which will be investigated thoroughly. So, derived terms can be defined, incorporated and judged accordingly. For the field of Metrology some new and, maybe, surprising results arise, worth being considered in the near future.

Benefits and barriers of physical therapy students participation in resource-poor international clinical education

survey consisted of 10 closed and 12 open questions and was addressed to the head of departments or head of units (PT,OT, SLT). A total number of 124 surveys were sent to members of all three professions. Quantities (closed questions) were calculated, open questions were analyzed on content. Results: Overall 64 (51%) surveys were returned and could be analyzed, 26 (41%) surveys were returned by physiotherapists. Only about 53% of institutions use the ICF as a leading idea for handling patients, barriers are seen in time and money constraints and lack of information. Specification of the ICF in the mono-professional context was slightly higher in PT (50%) than in OT (42%) and SLT (47%). ICF was applied in documentation in 46% for the PT, overall numbers were a bit lower (40%). 50% of physiotherapists are positive that implementing the ICF has changed their work, mainly in the goal-setting process (6/26) and also in more interdisciplinary treatment approaches (4/26). Conclusion(s): There is a great need within the professions to learn more about the ICF and its possible implementation in everyday practice. The results indicate that applying the ICF as an overall language among different health care professions helps to foster patient centered goals in a multi-professional context and to target treatment more on activity and participation. Further research is needed to investigate possible benefits for the patient and the health system in terms of patient satisfaction, goal attainment and cost effectiveness to promote the use of ICF specifically in a multi-professional context. Implications:Heads of institutions must support and promote applying the ICF, and allow for continuous professional development possibilities and time to work with this classification.

Educação permanente/continuada como estratégias de gestão no Serviço de Atendimento Móvel de Urgência

The objective of this study was to analyze the perception that healthcare professionals make of permanent and/or continuing education at the Mobile Emergency Care Services in a municipality in São Paulo state. This qualitative study was performed using thematic content analysis. Interviews were conducted with 30 healthcare professionals, which revealed two categories: Unawareness of the theme by the institutional actor; Realized and reported needs. Results showed that permanent education remains incipient at this service. A lack of compliance to protocols, ineffective communication, poor supervision, lack of preparation to care for psychiatric patients, need for humanization and a lack of psychological support to healthcare professionals were highlighted as problems to be solved. It was identified that permanent education should receive close attention as a strategy for improving practice in emergency care services. Understanding the concept and its implementation in everyday practice are a great challenge in this setting. Descriptors: Nursing; Education; Education, Continuing; Emergency Relief; Emergency Relief.