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PubMedDate not supplied

Piloting a nurse-led gynaecology preoperative-assessment clinic.

This article outlines a pilot project to develop and evaluate a nurse-led gynaecology preoperative-assessment clinic at an acute hospital trust. The main aim of the clinic was to offer an effective preoperative-assessment service that provided high quality individualised and sensitive patient care. Further aims were that the clinic could be a template for other preoperative-assessment clinics, an educational resource for staff, a tool for clinical nursing career progression and a service to help ease junior doctors' workloads.

Attitude of Health Personnel↗

PubMedDate not supplied

Retaining caregivers, improving care.

Text Summary In 2004, Centura Health's long-term care centers took part in a pilot project, sponsored by the Centers for Medicare & Medicaid Services, called "Improving Nursing Home Culture through Workforce Retention." A 30-member team comprising Centura leaders and long-term facility staff looked at Centura's eight participating facilities through residents' and employees' eyes. The goal of the team's reflection and subsequent changes was to create a culture in which decisions are focused on resident care and organizational policies are based on respect for employees. At the end of the first year, residents seemed happier and employee satisfaction and involvement increased at all eight Centura facilities.

Humans↗

PubMed2005

[Experience in cross training within the context if integration of patient care team services in southeast Montreal].

Improved functioning in the mental health resource network can be guided by cross training procedures involving exchanges of clinical personnel. In 2003, Douglas Hospital along with the Centres locaux de services communautaires (CLSCs) and community organizations in southwest Montreal conducted a pilot project on training exchanges involving 14 clinical teams and 21 workers. Analysis of self-administered questionnaires as well as content analysis of a focus group revealed a very high degree of satisfaction with the project. However, differences of opinion were noted regarding the content and orientation of the training and ways to ensure client confidentiality. The very strong demand for participation in the training courses offered, as well as the high level of satisfaction on the part of participants, testifies to the relevance of new series of personnel rotations. These rotations could be broadened so as to improve the continuity of services offered to people who have concomitant diagnoses of mental health and drug addiction problems.

Community Mental Health Services↗

PubMed1994

Development and testing of computer software for nursing assessment and care planning at a spinal cord injury center.

This paper describes a pilot project using a Macintosh personal computer and customized software to computerize nursing admission assessment and care planning data. The project setting is a 47-bed Spinal Cord Injury Center with two inpatient units and an outpatient department serving approximately 1,000 patients with spinal cord injury at a Department of Veterans Affairs Medical Center in northern California. The computer software development, implementation, and evaluation are described. This software (MacNursing) was found to be a low cost, customized approach to computerizing spinal cord injury admission assessment data and care planning which reduces repetitive writing and facilitates continuity of care. Personal computers and this software have provided the mechanism for establishing a spinal cord injury patient database.

Humans↗

PubMedDate not supplied

A road map for the last journey: home telehealth for holistic end-of-life care.

The Advanced Illness/Palliative Care (AIPC) program started as a 2-year pilot project to determine if a telehealth model of care would benefit veteran patients with life-limiting illness. The goals of the project were to manage the physical, emotional, functional, and spiritual care needs during the last 2 years of patients' lives and to foster an earlier enrollment of patients into hospice by educating providers about palliative care. The AIPC program partners the skills and expertise of both spiritual and medical care practitioners, along with cutting-edge home telehealth devices to improve symptom management and quality of life for veterans and families coping with end of life.

Adaptation, Psychological↗

PubMed2002

Making family planning clinics an empowerment zone for rural battered women.

While domestic violence in rural areas is not different in kind or incidence from that found in urban areas of the country, rural women face unique difficulties in accessing health and social services when they experience abuse. We present an overview of rural life and the difficulties rural women face in accessing health care and other services. We describe the network of family planning clinics and domestic violence advocacy programs in western Pennsylvania and a pilot project designed to implement routine screening for domestic violence in family planning clinics in rural Pennsylvania. We report on changes in the staff's practice of and comfort with screening and making referrals during the initial six months of the program. Finally, we report on a partnership between the clinic and the domestic violence advocacy program in one county as a model for meeting the needs of rural women who experience abuse. This research supports recommendations that assessment and interventions for abuse be incorporated into rural health care systems.

Battered Women↗

PubMed1999

Outpatient coronary stenting using the femoral approach with vascular sealing.

PURPOSE: We report here the use of vascular sealing devices in conjunction with the use of small transfemoral guiding catheters to decrease time to ambulation, decrease cost associated with hospitalization and achieve early discharge. METHODS: Fifty patients were enrolled in this pilot project from two busy interventional practices between May 1997 and February 1999. Patients with stable or unstable angina or positive ETT and with recent myocardial infarction greater than 24 hours from the time of the procedure were included. Excluded patients included those who had received glycoprotein IIb/IIIa platelet inhibitors and those with intra-procedure access site complications. RESULTS: Of the 50 patients originally recruited, 49 underwent vascular sealing for hemostasis and 45 were discharged on the same day, as planned. Early home telephone follow-up was available on 41 of the 45 same-day discharge patients, of whom 30 noted no complaints. One patient, who had been re-accessed in the right femoral artery after a previous intervention, developed a pseudoaneurysm requiring surgical repair. One-month follow-up was available on all patients. No patient suffered a late ischemic event or access site complication requiring treatment. There were no instances of stent loss, acute closure or subacute thrombosis. CONCLUSION: Though limited by small numbers, this pilot study shows that selected patients undergoing coronary stenting via the femoral approach can be safely treated on an outpatient basis using vascular sealing devices. Cost savings may be significant using this strategy.

Ambulatory Surgical Procedures↗

PubMedDate not supplied

Mercury reduction in Munhena, Mozambique: homemade solutions and the social context for change.

The health and environmental impacts of artisanal gold mining are of growing concern in Munhena, Mozambique, where more than 12,000 people are involved in such activities. Gold is extracted using mercury amalgamation, posing a considerable threat to human and environmental health. A pilot project ascertained the feasibility of reducing mercury use and emissions by promoting control measures utilizing local resources. Retorts were fabricated with local materials. Training workshops introduced the homemade retorts, and a portable mercury monitor revealed effective mercury reduction. Barriers to widespread technology adoption include poverty, lack of knowledge and trust, and the free supply of mercury from private gold buyers. Homemade retorts are inexpensive and effective, and miners could benefit by building community amalgamation centers. The government could play a greater role in gold purchasing to reduce mercury pollution.

Environmental Pollution↗

PubMed2003

Drug treatment courts are popular but do they work and are they ethical and appropriate for Canada?

Currently Canada is experimenting with the implementation of drug treatment courts. Pilot projects are underway in both Toronto and Vancouver. In the U.S., drug courts emerged as a response to the overcrowding of the prison system, the end product of the revolving door of substance dependent people moving through the court system. However, this expansion was not accompanied by any rigorous evaluation or critical reflection as to whether drug treatment courts can achieve their desired outcomes or if they are appropriate for dealing with substance dependent offenders. The purpose of this article is to take a critical look at this phenomenon and to discuss whether the drug court model is suitable for Canada.

Canada↗

PubMed1992

Group therapy in the management of epilepsy.

A pilot project using group therapy with patients from an epilepsy clinic is described. Observations of the group show that members were able to discuss their feelings about having epilepsy, and the difficulties the disorder caused in all areas of their lives, and to tolerate and learn from seizures which took place during group meetings. The greatest benefit was meeting others with epilepsy and sharing experiences in an environment that was not overprotective or overanxious, in contrast to their usual surroundings. The author suggests that groups of a similar nature could be a useful addition to the management of people with epilepsy.

Adaptation, Psychological↗

PubMedDate not supplied

The Screening Mammography Program of British Columbia: pilot study.

A government-funded pilot project of high volume screening mammography was conducted in Vancouver, British Columbia. 7,100 women were screened over a 9-month period, averaging 43 women per day at a cost of $33.81 per woman screened. 722 (10%) had abnormal mammograms; 144 received breast biopsies; and 29 were diagnosed with cancer. The overall cancer detection rate was 4.1 per 1,000 (0.8 and 4.8 for incident and prevalent cases, respectively). The staging distribution for the 29 cancer cases was 5, 15, 8 and 1 for in situ, stage I, II and III, respectively.

Breast Neoplasms↗

PubMed2003

Community-based assessment of unintentional injuries: a pilot study in rural Vietnam.

AIMS: Although unintentional injuries are recognised as a major public health problem globally, little is known about their patterns and rates at the community level in most low-income countries. Rapid social development, leading to increased traffic and industrialization, may be changing patterns of injury. Injuries within the home environment have not so far been recognized to the same extent as traffic and work-related injuries in Vietnam, largely because they have not been effectively counted. This study took place in northern Vietnam, in the context of a longitudinal community surveillance site called FilaBavi, as a pilot project aiming to determine the community incidence of unintentional injury and to explore appropriate methods for community-based injury surveillance. METHODS: An initial study population of 23,807 was identified and asked about their experience of injury in the preceding three months. RESULTS: Overall 450 new injuries were detected over 5,952 person-years, a rate of 76 per 1,000 person-years. Males were injured at 1.6 times the rate of females, and home and road traffic accidents were most common. Most injuries occurred during unpaid household tasks. Cutting and crushing injuries occurred most frequently. Of 221 deaths from all causes in the FilaBavi population during 1999 among 43,444 person-years, 25 were attributed to unintentional injuries and two to suicide. Unintentional injury was the third leading cause of death in this community, with a case-fatality rate of 0.8%. DISCUSSION: The findings suggest that greater attention needs to be directed toward the prevention of injuries occurring in the home in rural Vietnam. On the basis of this pilot study, a one-year study using the same approach is under way to characterize the patterns of unintentional injury in more detail, including any seasonal variation.

Accidents↗

PubMed1979

A pilot program of multiple cadaver organ and tissue retrieval.

A one year pilot project conducted at a 2,000 bed medical center involved a unique approach to the retrieval from cadavers of multiple viable organs and tissues. Aspects of the program included a special unit for sterile evaluation and storage of tissue, a computerized registry of potential donors, a nurse to coordinate and expedite retrieval, and a retrospective chart review to define the incidence and location of potential cadaver donors. There were requests for 121 tissues by 39 investigators. Eleven different tissues were needed within 4 hours of death. Forty-two percent of individuals contacted directly enlisted in the donor registry, three of whom were identified on the computer at the time of death. A five-fold increase in cadaver donor evaluation referrals occurred, and one third of referrals resulted in viable tissue retrieval. A review of 728 deaths indicated that 45% could have been potential eye donors, 27% pancreas donors and 2.5% kidney donors. A coordinated program to retrieve multiple viable organs and tissues for transplantation and research appeared to be effective in this initial pilot study.

Cadaver↗

PubMed1964

RESPONSE OF VOLTA CHILDREN TO JET INOCULATION OF COMBINED LIVE MEASLES, SMALLPOX AND YELLOW FEVER VACCINES.

An earlier study established that Upper Volta children respond to vaccination with the Enders live attenuated measles strain in the same general fashion as do children in the USA. The present report describes a second pilot project carried out in Ouagadougou, Upper Volta. During this investigation various mixtures of live measles, smallpox and 17D yellow fever vaccines were introduced into susceptible infants by jet injection. Combining the attenuated virus vaccines did not alter or accentuate the characteristic clinical reactions elicited by the individual components, nor was there evidence of significant immunological interference. From this experience it is concluded that combined vaccination with these agents may be safely and effectively employed in larger programmes as the need dictates.

Africa↗

PubMed2004

Effectiveness of a discharge-planning pilot program for orthopedic patients in Taiwan.

The purpose of this pilot project was to establish a discharge-planning model and evaluate its effectiveness. Orthopedic patients who scored 7 or above on a high-risk screening form were recruited for the project. Case managers served as discharge planners, and handled the following procedures: screening of patients, drawing up of the discharge plan, providing pre-discharge instructions, coordinating resources and services, and telephone follow-up. Results showed that discharge planning improved both the completion rate of pre-discharge instructions and patient satisfaction with discharge planning. It is suggested that, in future research, experimental studies could be used to examine the effectiveness of discharge planning. The study showed the importance of dedicated case managers for improving the effectiveness of discharge planning.

Aged↗

PubMedDate not supplied

[The prevention of HIV infection and STDs among injection drug addicts in Ukraine].

In 1996-1998 joint pilot Projects of the National Committee and the UNAIDS Program were carried out in 10 Ukrainian cities. The behavior determinants contributing to the spread of HIV infection, common for all regions under study, were determined. They were linked with the injections of narcotic drugs, sexual behavior and the level of knowledge on the infection. The effectiveness of the projects was due to the 80% coverage of those drug addicts who could not be reached by common narcotic drug services; to the use of individual syringes (increased from 43% to 95%); to a decrease in the sale of ready-made drugs in used syringes to 14%; to an increase in the index of the return of used syringes; to an increase in the proportion of persons constantly using condoms (58%); etc. Still the situation was found to give no grounds for optimism, and the conclusion was made that the strategy of "decreasing the harm" must become the policy and strategy of the public health system.

Female↗

PubMed2004

Reasons for physician non-adherence to electronic drug alerts.

CONTEXT: Many adverse drug errors may be prevented through electronic order entry systems that provide decision support to physicians by screening prescriptions for dosing errors, drug-disease, drug-allergy and drug-drug interactions. The adherence to such decision aids is varied and the reasons for this variance not well understood. OBJECTIVE: To assess the feasibility and performance auto-mated drug alerts within an electronic decision support system for physician prescribing. METHODS: Drug alert data were collected from a pilot project with 30 participating general practitioners who were provided with interactive electronic prescription capabilities through a personal digital assistant (PDA). RESULTS: 66,642 electronic prescriptions resulted in a total of 1,869 drug alerts. The most common alert types were analysed, along with reasons for non-adherence to automated drug alerts. CONCLUSIONS: Non-adherence to alert information appears to be associated with additional knowledge of the clinical situation, beyond that inherent in the decision support tool, for the specific patient context. Further work is required to understand how best to provide this type of support to physicians.

Clinical Pharmacy Information Systems↗

PubMed1991

Quality assurance results from a breast screening pilot study.

A mammography quality assurance programme has been established as part of the breast cancer screening pilot project based in south-east Queensland. Prospective radiology clinics are required to participate in the quality assurance programme as part of the project's accreditation requirements. The programme follows the ACPSEM position paper on quality assurance in mammography and is divided into radiographer and physicist tests. Radiographer tests include film processor sensitometry (daily), image quality (weekly) and focal spot measurements (monthly). Physicist tests occur annually. The programme has been running successfully for 12 months on 17 machines from 6 manufacturers. Of the radiographer tests, sensitometry has proved the most beneficial with a number of chemistry problems detected early. Physicist tests have found x-ray/light field misalignment and poor automatic exposure control performance as the most common machine problems. Results also show that our kVp measuring system requires recalibration.

Breast Neoplasms↗