Training Program For Healthcare Professionals Research Articles

Positive Reinforcement to Create and Sustain a Culture Change in Hand Hygiene Practices in a Tertiary Care Academic Facility

The knowledge that good hand hygiene is associated with decreased infection rates has been documented since the mid-1800’s. Well respected organizations around the world, most notably the Centers for Disease Control (CDC) and World Health Organization (WHO), have published recommendations on appropriate hand hygiene and its importance. Hand hygiene has been taught in healthcare professional training programs for hundreds of years; however compliance has always been a challenge. In the past decade, increased attention to hospital acquired infections has contributed to a reenergized focus on hand hygiene compliance in the healthcare setting.

Blended Learning: Strengths, Challenges, and Lessons Learned in an Interprofessional Training Program

This field report outlines the goals of providing a blended learning model for an interdisciplinary training program for healthcare professionals who care for children with disabilities. The curriculum blended traditional face-to-face or on-site learning with integrated online interactive instruction. Credit earning and audited graduate level online coursework, community engagement experiences, and on-site training with maternal and child health community engagement opportunities were blended into a cohesive program. The training approach emphasized adult learning principles in different environmental contexts integrating multiple components of the Leadership Education in Neurodevelopmental and Related Disabilities Program. This paper describes the key principles adopted for this blended approach and the accomplishments, challenges, and lessons learned. The discussion offers examples from training content, material gathered through yearly program evaluation, as well as university course evaluations. The lessons learned consider the process and the implications for the role of blended learning in this type of training program with suggestions for future development and adoption by other programs.

A Process-Oriented Breastfeeding Training Program for Healthcare Professionals to Promote Breastfeeding: An Intervention Study

The aim of the study was to evaluate the effects of process-oriented training in supportive breastfeeding counseling for midwives and postnatal nurses on the time lapse between the initial breastfeeding session, introduction of breastmilk substitutes and solids, and the duration of breastfeeding. Ten municipalities in Sweden were randomized to either the intervention or control groups. The intervention included a process-oriented training program for midwives and postnatal nurses in the intervention municipalities. Primiparas (n=540) living in either an intervention or control municipality were asked to participate in a longitudinal study to evaluate the care given. Data collection for control group A (CGA) (n=162) started before the intervention was initiated. Data for control group B (CGB) (n=172) were collected simultaneously with the intervention group (IG) (n=206). The mothers responded to questionnaires at 3 days, 3 months, and 9 months postpartum. As a result of the process-oriented training program for midwives and postnatal nurses, the IG mothers had a significantly longer duration of exclusive breastfeeding, even if the initial breastfeeding session did not occur within 2 hours after birth, than the corresponding group of CGA mothers (p=0.01). Fewer infants in the IG received breastmilk substitutes (in the first week of life) without medical reasons compared with the control groups (p=0.01). The IG infants were significantly older (3.8 months) when breastmilk substitutes were introduced (after discharge from the hospital) compared with the infants in the control groups (CGA, 2.3 months, p=0.01; CGB, 2.5 months, p=0.03). A process-oriented training program for midwives and postnatal nurses was associated with a reduced number of infants being given breastmilk substitutes during the 1st week without medical reasons and delayed the introduction of breastmilk substitutes after discharge from the hospital.

Process evaluation of a diversity training program: The value of a mixed method strategy

Patients’ health and health needs are influenced by categories of difference like sex, gender, ethnic origin and socioeconomic status (SES). To enhance awareness of this diversity among patients and to provide holistic care for them, health professionals should first be aware of the relation between dimensions of diversity and patients’ health and health demands. This paper presents a formative process evaluation of a diversity sensitivity training programme for healthcare professionals. The training was implemented in three healthcare settings (mental healthcare, nursing home and hospital care). Mixed methods were used to monitor the implementation of the training and its effects after three years. Findings demonstrate that the training stimulated participants’ awareness, knowledge and critical attitudes towards diversity. Their motivation and willingness to take action regarding diversity was also enhanced. Yet these developments were less apparent among nursing home participants who felt less satisfied and did not develop a critical perspective on this issue. Qualitative data were helpful to explain differences between the settings. By means of the combination of quantitative and qualitative data, we can conclude that individual learning was not enough to guarantee a sensitive approach to diversity at the organizational level.

Creating a 21st Century Global Health Agenda

On May 13, 2010, the General Assembly of the United Nations (UN) voted unanimously for UN Resolution 64/265 to hold a High Level Meeting on Non-Communicable Diseases in September 2011. This UN High Level Meeting, to be held in New York, is an unparalleled opportunity to put noncommunicable diseases (NCDs), including cancer, diabetes mellitus, cardiovascular disease, stroke, and chronic respiratory disease, on the global health and development agenda. It also has the potential to secure political commitments from heads of government for a coordinated global response to NCDs, to promote multisectoral action to addressing NCDs within countries, and to ensure that resource allocations for addressing NCDs are more commensurate with their contribution to the global disease burden. Such actions will provide the urgent and necessary momentum to dramatically improve the prevention and management of NCDs for future generations. Our 3 organizations, as well as other partners, are working together to maximize the impact of this meeting. The world can no longer afford to ignore the ever-expanding global social and economic threat posed by chronic diseases. NCDs account for >60% of all deaths globally, and the overall burden of chronic diseases continues to grow.1 By 2030, it is estimated that NCDs will be responsible for 7 in 10 deaths worldwide.2 In addition to the human toll, the economic impact of chronic disease is staggering and will continue to rise. The World Health Organization estimates that the cumulative estimated national income losses attributable to chronic disease from 2005 to 2015 could exceed $1 trillion in just 3 countries: China ($558 billion), Russia ($303 billion), and India ($237 billion).1 Moreover, the chronic disease mortality burden is heaviest in less affluent nations. Of the world's roughly 35 million annual deaths attributable to NCDs, ≈80% occur in low- and middle-income countries.3 …

Patient participation and shared decision making in Germany – history, agents and current transfer to practice

The main focus of the present paper is to describe 1) the healthcare system specific influences on patient participation in medical decision making and 2) the current state of research and implementation of shared decision making (SDM) after ten years of substantial advances in health policy and research in this field. WHAT ABOUT POLICY REGARDING SDM? The "Medical Patients Rights Act" is to standardise all the rights and responsibilities within the scope of medical treatment. This also comprises the right to informed decisions, comprehensive and comprehensible information for patients, and decisions based on the partnership of clinicians and patients. WHAT ABOUT TOOLS - DECISION SUPPORT FOR PATIENTS? SDM training programmes for healthcare professionals have been developed and partly implemented. Several decision support interventions - primarily with support from health insurance funds - have been developed and evaluated. WHAT ABOUT PROFESSIONAL INTEREST AND IMPLEMENTATION? Against the background of the German health policy's endorsement of patient participation, the German government and other public institutions are currently funding different research programmes in which shared decision making is playing a substantial role. The development and implementation of decision support tools for patients and professionals as well as the implementation of trainings for healthcare professionals require stronger efforts. WHAT DOES THE FUTURE LOOK LIKE? With the support of health policy and with the utilisation of scientific evidence, the transfer of shared decision making into practice is considered to be meaningful in the German healthcare system. The translation into routine care will remain an important task for the future.

Comunidades sordas: ¿pacientes o ciudadanas?

The concept of disability is related to discrimination and social exclusion; that is, this issue is a socio-political question whose effects go well beyond the health of the individual. The social and human rights based model of disability points the way to fresh opportunities for action to promote the wellbeing and health of the seventy million Deaf people living in the world today. The key factors in preventing discrimination against the Deaf are recognition of their specific cultural and linguistic identity (including sign languages and Deaf culture), bilingual education, the availability of professional sign language interpreting, and access to information and communication. The present article aims to encourage greater understanding of the significance of adopting this new perspective on disability, its congruence with current national and international legislation on the rights of persons with disabilities in general and of Deaf persons in particular, and its implications in the policies and praxis due to be implemented in Spain over the next few years on enhancing the health of the Deaf community through significant examples of good practice. Examples of good practice for distinct Deaf communities include collaboration between these communities and the health sector, health training for sign language users, the inclusion of the language and culture of Deaf persons in training programs for healthcare professionals, training of Deaf specialists as future health researchers and workers, and health care services that are more accessible via different sign languages.

Conséquences des oppositions vaccinales en France et en Europe. Comment maintenir une couverture vaccinale efficace en 2010 ?

Refusal of vaccination can result in inadequate vaccine coverage. The collective benefit of immunisation depends on a sufficient and sustained level of vaccine coverage. Low vaccine coverage can lead to the persistence of preventable diseases and, in some cases, to a dangerous shift in the age of pathogen encounter towards adulthood. This is the case of measles in Europe, where some countries, including France, have not reached the effective vaccine coverage rate of 95%. Outbreaks are occurring, leading to complications (encephalitis and pneumonia) in adolescents and adults, necessitating hospitalization in nearly one-third of cases. The French population is also under-vaccinated against hepatitis B, due to fears of a risk of demyelinating disorders: the coverage rate is currently only about 30% in infants and 10% in adolescents. These difficulties are due to negligence and to vaccine refusal by parents. Refusal of immunisation has a long history in Europe, and explains for example why pertussis remained endemic in many countries until 1995, and also the resurgence of diphtheria in the Russian federation during the 1990s. Sections of Western society are now questioning the need for some routine vaccines, overlooking the fact that they have eradicated some diseases (polio, diphtheria, etc.) and protect effectively against lesser-known pathogens such as hepatitis B virus and HPV. In France, it will be necessary to restructure healthcare professional training programs in vaccinology and to provide the public with more thorough information on the risk-benefit ratio of vaccination. The recent controversy surrounding pandemic H1N1 influenza vaccination demonstrates that the public and the media tend to focus more on the potential risks of vaccination than on its benefits. A vigorous ethical and political debate is needed to shape an effective and acceptable vaccine policy for the 21st century.

Development and Evaluation of a Psychosocial Intervention for Children and Teenagers Experiencing Diabetes (DEPICTED): a protocol for a cluster randomised controlled trial of the effectiveness of a communication skills training programme for healthcare professionals working with young people with type 1 diabetes

BackgroundDiabetes is the third most common chronic condition in childhood and poor glycaemic control leads to serious short-term and life-limiting long-term complications. In addition to optimal medical management, it is widely recognised that psychosocial and educational factors play a key role in improving outcomes for young people with diabetes. Recent systematic reviews of psycho-educational interventions recognise the need for new methods to be developed in consultation with key stakeholders including patients, their families and the multidisciplinary diabetes healthcare team.Methods/designFollowing a development phase involving key stakeholders, a psychosocial intervention for use by paediatric diabetes staff and not requiring input from trained psychologists has been developed, incorporating a communication skills training programme for health professionals and a shared agenda-setting tool. The effectiveness of the intervention will be evaluated in a cluster-randomised controlled trial (RCT). The primary outcome, to be measured in children aged 4-15 years diagnosed with type 1 diabetes for at least one year, is the effect on glycaemic control (HbA1c) during the year after training of the healthcare team is completed. Secondary outcomes include quality of life for patients and carers and cost-effectiveness. Patient and carer preferences for service delivery will also be assessed. Twenty-six paediatric diabetes teams are participating in the trial, recruiting a total of 700 patients for evaluation of outcome measures. Half the participating teams will be randomised to receive the intervention at the beginning of the trial and remaining centres offered the training package at the end of the one year trial period.DiscussionThe primary aim of the trial is to determine whether a communication skills training intervention for specialist paediatric diabetes teams will improve clinical and psychological outcomes for young people with type 1 diabetes. Previous research indicates the effectiveness of specialist psychological interventions in achieving sustained improvements in glycaemic control. This trial will evaluate an intervention which does not require the involvement of trained psychologists, maximising the potential feasibility of delivery in a wider NHS context.Trial registrationCurrent Controlled Trials ISRCTN61568050.

Historical Parallel Evolution of Injury Prevention and Control Science and Emergency Medicine

Historical Parallel Evolution of Injury Prevention and Control Science and Emergency Medicine

Health status, trends, and issues in Sri Lanka

It is widely recognized that better health is a prerequisite for the overall economic and social development of a nation. Sri Lanka, like many other countries experiencing the epidemiological transition, will have to make effective decisions on health-care service management and the development of education and training programs for health-care professionals. This paper provides a comprehensive review of current health service administration, health status, trends and issues, and health financing and resource allocation in Sri Lanka. The review revealed that Sri Lanka has achieved a relatively high health status given a low level of spending on its health-care services; however, Sri Lanka still experiences vital health problems in all stages of the life cycle, mainly related to lifestyle and the epidemiological transition associated with widespread societal and economic crises.

Perceptions of substance use, treatment options and training needs among Iranian primary care physicians

In order to be optimally effective, continuing training programmes for health-care professionals need to be tailored so that they target specific knowledge deficits, both in terms of topic content and appropriate intervention strategies. A first step in designing tailored treatment programmes is to identify the characteristics of the relevant health-care professional group, their current levels of content and treatment knowledge, the estimated prevalence of drug and alcohol problems among their patients and their preferred options for receiving continuing education and training. This study reports the results of a survey of 53 primary care physicians working in Iran. The majority were male, had a mean age of 44 years and saw approximately 94 patients per week. In terms of their patients' drug use, primary care physicians thought most patients with a substance use problem were male, women were most likely to use tobacco (52%), opium (32%) and marijuana/hashish and young people were most likely to use tobacco, alcohol, marijuana and heroin. Counselling and nicotine patches were the treatments most commonly provided. Although the majority (55%) reported referring patients to other services, more than a third did not. Most primary care physicians reported being interested in attending further training on substance abuse issues. The implications of these data for ongoing education and training of primary care physicians in Iran are discussed.

Evaluation of a training program for healthcare professionals about breast-feeding

Objective: To assess the impact of a continuing medical education program based on the WHO’s 10 steps to successful breast-feeding. Study design: An observational before-and-after study at a teaching hospital. Data for two random samples of 50 women before and 50 after the intervention were collected from medical records and completed by a mail questionnaire. Results: Seventy-six percent of mothers initiated breast-feeding in the two samples. The median duration of breast-feeding was 12 weeks and did not differ between the before and after groups. The percentage of newborns separated from their mother more than 4 h a night decreased substantially after the intervention (13% versus 52% before the intervention, P<0.01). In-hospital formula provision also decreased after the intervention (63% of newborns versus 82% before intervention, P=0.07). Conclusion: This pilot study has enabled authors to document the feasibility of evaluating the impact of continuing education of maternity ward staff.

Training programs for healthcare professionals in domestic violence.

Although women who experience domestic violence seek healthcare services frequently, screening and counseling rates remain low, and healthcare professionals report feeling inadequately trained to care for abused women. The English language literature from 1989 to 1999 was searched to identify and evaluate published assessments of the education of healthcare providers in domestic violence toward women. Major deficiencies in program evaluation were found. They included the use of a historical comparison group, lack of an experimental design, selection of nonstandardized outcomes without clinical performance measures, short-term follow-up, limited documentation of course content and theory, and lack of focus on the impact of programs on abused women. Educational programs generally consisted of a single session of limited duration (1-3 hours). Based on published reports, it appears that few rigorously designed evaluations have been conducted of training programs for healthcare providers in the detection and treatment of women affected by domestic violence.

Healthcare professionals' perceptions of beliefs about health and illness in migrants with diabetes mellitus

AbstractOne hundred and forty nine physicians and nurses working with diabetes care answered a semi‐structured questionnaire with open‐ended questions, about perceived differences between migrant and Swedish patients with diabetes with regard to patients' beliefs about health and illness. Throughout the study, between 12% and 31% of the respondents said they “didn't know”, despite their high contact frequency with migrants. Migrants were perceived as less knowledgeable about bodily functions and diabetes; as attaching more importance to individual factors such as retention of former habits and social relations; as using alternative medicine and drugs to achieve health when ill; and as seeking healthcare mainly in the professional sector. Eighty nine per cent of the physicians and nurses perceived communication difficulties and cultural dissimilarities as affecting compliance, when caring for migrants with diabetes. Migrants were perceived to be different. There is a need for training programmes for healthcare professionals to minimise differences about cultural beliefs and communication.