SEARCH · PubMed Health

Results for “Knowledge Management”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,351 records · Page 75Linked to original sources

PubMed1989

Identification of functionally necessary knowledge and skills in the practice of Canadian health care management.

The Canadian College of Health Service Executives (CCHSE) conducted a project in 1985-87 to identify basic competencies required in the field practice of health care management in Canada. The project derived from the College's mission to establish and promote professional standards for all health care executives in Canada. The project also addressed more specific short-term problems: to validate an existing examination purporting to measure the basic competence required for field practice of health care management in Canada; to create a data base upon which a CCHSE criterion reference test of field-based professional competence in health care administration could be created; and to provide to the training programs in Canadian health care management a detailed compilation and testing of the knowledge and skill attributes considered necessary for adequate field practice in Canadian health care administration. The project demonstrated an improved model for professional competence identification. The first step was to identify the level of professional targeted for competence assessment. Then a representative expert committee was to return to the field to examine the range of jobs done by those target individuals. This expert committee collected lists of elements from the tasks done in these target positions and then organized the elements into mutually exclusive groupings. Finally a stratified random sample of field practitioners was asked to rate the importance of these elements for competent job performance.

Canada↗

PubMedDate not supplied

Differences in pain knowledge in cancer patients with and without pain.

PURPOSE: The authors determined: 1) whether there were differences in knowledge about pain between oncology outpatients with and without cancer-related pain and 2) whether there were relationships between selected patient characteristics (age, gender, education, Karnofsky performance status, pain intensity, and pain duration) and the knowledge about pain of oncology outpatients with cancer-related pain. DESCRIPTION OF STUDY: Three hundred sixty-nine oncology outpatients completed several self-report questionnaires including a demographic questionnaire, a pain experience scale that measured knowledge about pain and pain management, the Karnofsky performance scale, and descriptive numeric rating scales that measured pain intensity and pain duration. RESULTS: Patients with cancer-related pain knew significantly more about pain and its management than pain-free patients (P < 0.004). However, in both groups, mean knowledge scores were below 60%. Older patients with cancer-related pain had less knowledge about pain than younger patients (P < 0.0001). In addition, patients with cancer pain who had more education and those with higher reported pain intensity scores had more knowledge about pain and pain management. Finally, women with cancer pain had more knowledge than men about pain and pain management. CLINICAL IMPLICATIONS: Results of this study suggest that oncology patients with and without pain need more education about pain and effective pain management strategies.

Adult↗

PubMed2004

Application of Maastricht 2-2000 guidelines for the management of Helicobacter pylori among specialists and primary care physicians in israel: are we missing the malignant potential of Helicobacter pylori?

BACKGROUND: The Maastricht 2-2000 guidelines on the current management of Helicobacter pylori infection were recently adopted by the Israeli Gastroenterological Association. GOAL: To determine the impact of these clinical guidelines on the current knowledge, attitudes, and management of H. pylori among primary care physicians, hospital internists, and gastroenterologists in Israel. STUDY: Self-administered, voluntary, anonymous questionnaires were given personally to 229 physicians, 73 primary care physicians, 71 internists, and 85 gastroenterologists. The questions evaluated 4 main issues in the management of H. pylori: (1). the optimal diagnostic test, (2). indications for eradication, (3). combination and duration of triple therapy, and (4). the need for confirmation following eradication. RESULTS: There were significant variations in the adherence of those recommendations among gastroenterologists, internists, and primary care physicians. Specifically, 94.1% of gastroenterologists and 88.9% of internists consider the urea breath test the test of choice for H. pylori diagnosis compared with 60.0% of the primary care physicians. Significant differences in the eradication indications for mucosa-associated lymphoid tissue (MALT) lymphoma, first-degree relatives of gastric cancer patients, atrophic gastritis, functional dyspepsia, and concomitant use of nonsteroidal antiinflammatory drugs were demonstrated among gastroenterologists and the other groups. CONCLUSIONS: Primary care physicians may not be aware of important indications for diagnosis and eradication of H. pylori related to the risk of gastric malignancy or concomitant use of nonsteroidal antiinflammatory drugs. Public health agencies may need to increase penetration of the Maastricht 2000 recommendations to primary care physicians.

Amoxicillin↗

PubMed2006

Effective teaching strategies for the older adult with urologic concerns.

Older adults are able to learn and apply new knowledge, such as management of a urological condition, but their learning style differs from that of younger clients. An understanding of the older adult's learning style, and knowledge of specific teaching strategies will benefit the urologic nurse in the ongoing effort to be a more effective patient educator.

Aged↗

PubMed1991

Does knowledge of islet cell antibody status help in managing diabetes presenting in middle and old age?

It has been suggested that screening all patients with diabetes diagnosed in later life for islet cell antibodies (ICA) would help predict insulin dependence. We have surveyed the case notes of 55 patients (22 male; ages 37-88 years) who were found to be ICA positive over a 9-year screening period to assess what contribution knowledge of ICA status made to their management. Forty-two patients had been put on insulin (half within 6 months of diagnosis and the rest after up to 6 years). Of the 13 patients not on insulin, six were on diet alone and seven on oral hypoglycaemic agents after a median follow-up of 3 years. In 37 of the 42 patients, insulin treatment was started for clinical rather than immunological reasons (diabetic ketoacidosis, ketonuria, weight loss and/or severe symptoms). Five patients were started on insulin because of ICA status when there was no compelling reason on clinical grounds. Knowledge that seven non-insulin-treated patients were ICA positive made doctors reluctant to discharge them from clinic. The data suggest that routine ICA estimation in this age group is unnecessary, as the decision to treat with insulin is best made on clinical grounds, and ICA estimation can lead to unwarranted insulin treatment, or anxiety in patients and doctors who are aware of a positive result.

Adult↗

PubMed1998

Evidence-based practice. Slow-acting remedy.

A survey of community trusts in North Thames found little evidence of a general move towards evidence-based practice. Half the clinicians Interviewed claimed that their managers had no knowledge of their research projects and the findings of their research were not disseminated. More than half the clinicians interviewed had not read the NHS R&D strategy. Managers and clinicians both need training in research skills. Some doctors and many nurses felt the current research strategy was unfavourable to qualitative studies.

Attitude of Health Personnel↗

PubMed2004

Factors impacting on nurse managers' ability to be innovative in a decentralized management structure.

Several studies indicate that management styles and knowledge of organizational structures have an impact on the potential for staff innovation. This exploratory study was conducted to investigate the implications of such variables in relation to nursing managers in a public sector health organization in Victoria, Australia. It reviewed factors that appeared to impact and encourage innovative behaviour amongst nurse managers within a decentralized management structure. To evaluate nurse managers' ability to be innovative, a 55-item survey consisting of both open questions and Likert-type scale questions was developed and distributed to 140 nurse managers working in a public sector health organization. The response rate was 58% yielding 82 usable responses. The study findings revealed that factors of management structures and management styles, in conjunction with the nurse unit managers' perceptions and communication skills, had an impact on nurse manager's ability to exhibit innovative behaviour in the 21st century workplace.

Attitude of Health Personnel↗

PubMed2005

First-line managers' views of the long-term effects of clinical supervision: how does clinical supervision support and develop leadership in health care?

There have recently been several organizational changes that have challenged nursing managers in the Finnish health care system. First-line managers need support in their work because of organizational changes and scarce economic resources. One of these supportive measures is clinical supervision. A group of first-line managers in a Finnish University hospital participated in a 2-year clinical supervision intervention in 1999-2000. The managers' perceptions of the clinical supervision were followed up twice during the intervention and 1 year after (2001). The aim of this study is to describe how the first-line managers saw the future effects of the clinical supervision intervention 1 year after its termination. At the beginning of the intervention, the number of participating nursing managers was 32. The number of respondents in this study 1 year (2001) after the clinical supervision was 11. Data was collected using empathy-based stories, which involved writing short essays. The respondents received orientation and a script to assist them in the writing of essays. The stories were analysed qualitatively by categorizing the responses by themes. The managers deemed that clinical supervision had, in the 3-year time frame, positive long-term effects on their leadership and communication skills, the desire for self-development, self-knowledge and coping. Managers believed that in the long run, clinical supervision would provide them with a broader perspective on work and would enhance the use of clinical supervision as a supportive measure among co-workers. First-line managers expect clinical supervision to have long-term positive effects on their work and coping. Empathy-based stories, as a method, were found suited to studies, which aim to obtaining future-oriented knowledge.

Adaptation, Psychological↗

PubMed2002

Parental screening for intimate partner violence by pediatricians and family physicians.

OBJECTIVE: To ascertain and compare the knowledge, practices, and training needs of pediatricians and family physicians regarding intimate partner violence screening and intervention. METHODS: Surveys were mailed to national random samples of 1350 pediatricians and 650 family physicians evenly divided between senior residents, practitioners completing their residency training within the last 5 years, and practitioners completing their training >5 years ago. RESULTS: The overall response rate was 37% (41% for pediatricians, 30% for family physicians). Among practicing physicians, only 8% of family physicians and 5% of pediatricians routinely screened a parent for intimate partner violence during well-child and teen visits. Family medicine residents were significantly more likely to routinely screen for intimate partner violence (18%), whereas pediatric residents were not (7%). All groups demonstrated deficits in knowledge of appropriate management of situations of domestic abuse; for example, over 60% of family medicine and 75% of pediatric residents and practitioners agreed with the inappropriate response of always urging a woman to leave her abusive partner immediately. Many physicians indicated a need for more information about domestic violence, ranging from 40% of family medicine residents to 72% of pediatric residents. Residency training and continuing medical education in the prevention of child/adolescent violence and having an office protocol for managing cases involving domestic violence increased the likelihood of parental screening for intimate partner violence. CONCLUSIONS: Few child and adolescent primary care physicians routinely screen parents for intimate partner violence and most need more information on this topic. Residency training and continuing medical education on violence prevention, including screening and intervention skills in intimate partner violence, and office protocols for managing cases of domestic violence could increase screening rates.

Family Practice↗

PubMedDate not supplied

Changing physicians' attitudes, knowledge, and self-efficacy regarding cholesterol screening and management.

The National Cholesterol Education Program (NCEP) has identified a need to convey practical approaches for the management of high blood cholesterol (BC) to physicians. Our study was a joint effort between the Pawtucket Heart Health Program and the Brown University Department of Family Medicine to improve family medicine residents' attitudes, knowledge, self-efficacy, and practices regarding cholesterol screening and management. Thirty-six resident physicians received a BC screening and management training program. This program included training in BC screening using the fingerstick method and a desktop analyzer, diet assessment and counseling, and a management protocol for evaluation and treatment of high BC based on NCEP guidelines. The training program also included evaluation of residents' BC screening activity, incentives, chart audits, and biweekly articles in the departmental newsletter. We administered a survey to residents before and one year after the training program began to assess self-reported knowledge, attitudes, self-efficacy, and practices for BC management. Survey results indicated that the residents significantly improved their reported knowledge and attitudes about BC management. In addition, they significantly increased their reported self-efficacy and practices in dietary counseling and patient education. Residents also indicated that the training program was worthwhile, necessary, and practical and that many would use the materials and protocols in their future practices.

Cholesterol↗

PubMed2000

Crisis resource management among strangers: principles of organizing a multidisciplinary group for crisis resource management.

Patient safety depends on the skills, vigilance, and judgment of trained individuals working as members of a clinical team that includes anesthesiologists, surgeons, nurses, and technicians. Now, as never before, safe outcome depends both on better knowledge and better management. This requires organization of caregivers, who may be strangers from diverse disciplines, into teams. One can drill an individual to work safely alone. One can rehearse a series of scenarios with small groups (who regularly work together) to improve performance. But what does one do with an unrehearsed group, called together in an emergency from several different disciplines, usually including Anesthesia. These people may not know each other, their roles, their special skills, and may even be hazy about each other's goals. Rapid organization of such an ad hoc team becomes a critical priority where patient safety is at stake. The way by which such an ad hoc team from several disciplines can rapidly be helped to function effectively together is by teaching all the "strangers" the principles of Crisis Resource Management. These principles are not as well-presented in a written text or lecture format, as one cannot introduce the sense of urgency that emotionally charges and changes the impact. We believe the best teacher is experience gained in a realistic simulated environment using a model driven, full human simulator. This simulated environment is safe for both patient and trainee.

Communication↗

PubMed1985

Follow the leader: a learning exercise.

This manuscript presents an alternate method for students' acquisition of leadership concepts. It also invites the students to become actively invoLved in their own learning. "Follow the Leader: A Learning Exercise" enables students to observe leadership in action, and to analyze and assimilate leadership/management theories. After observing leaders, the students discuss how they would use what they learned to become better nursing leaders. The exercise covers these key nursing management concepts: principles of delegation of authority and responsibility, communication patterns, group process, decision making, and evaluation. In order to do the exercise, students need background knowledge of basic management procedures of planning, organizing, directing and controlling.

Education, Nursing, Baccalaureate↗

PubMed1984

Conservative management of electric burns to the lips of children.

Crucial to the proper care of a child sustaining electric trauma to the oral cavity are both a complete understanding of the possible systemic sequelae of this injury and knowledge of the management of the particular lesion. The physical properties of electricity, the systemic and regional effects of electric injuries, and the associated complications are reviewed. The methods of treatment are discussed and the benefit of delaying surgical intervention is emphasized.

Burns, Electric↗

PubMed1993

Safe working practices and HIV infection: knowledge, attitudes, perception of risk, and policy in hospital.

OBJECTIVES--To assess the knowledge, attitudes, and perceptions of risk of occupational HIV transmission in hospital in relation to existing guidelines. DESIGN--Cross sectional anonymous questionnaire survey of all occupational groups. SETTING--One large inner city teaching hospital. SUBJECTS--All 1530 staff working in the hospital in October 1991 and 22 managers. MAIN MEASURES--Knowledge of safe working practices and hospital guidelines; attitudes towards patients with AIDS; perception of risk of occupational transmission of HIV; availability of guidelines. RESULTS--The response rate in the questionnaire survey was 63% (958/1530). Although staff across all occupational groups knew of the potential risk of infection from needlestick injury (98%, 904/922), significantly more non-clinical staff (ambulance, catering, and domestic staff) than clinical staff (doctors, nurses, and paramedics) thought HIV could be transmitted by giving blood (38%, 153/404 v 12%, 40/346; chi 2 = 66.1 p < 0.001); one in ten clinical staff believed this. Except for midwives, half of staff in most occupational groups and 19% (17/91) of doctors and 22% (28/125) of nurses thought gloves should be worn in all contacts with people with AIDS. Most staff (62%, 593/958), including 38% (36/94) of doctors and 52% (67/128) of nurses thought patients should be routinely tested on admission, 17% of doctors and 19% of nurses thought they should be isolated in hospital. One in three staff perceived themselves at risk of HIV. Midwives, nurses, and theatre technicians were most aware of guidelines for safe working compared with only half of doctors, ambulance, and paramedical staff and no incinerator staff. CONCLUSIONS--Policy guidelines for safe working practices for patients with HIV infection and AIDS need to be disseminated across all occupational groups to reduce negative staff attitudes, improve knowledge of occupational transmission, establish an appropriate perception of risk, and create a supportive and caring hospital environment for people with HIV. IMPLICATIONS--Managers need to disseminate policy guidelines and information to all staff on an ongoing basis.

Acquired Immunodeficiency Syndrome↗

PubMed1997

Knowledge and attitudes about depression among non-generalists and generalists.

BACKGROUND: The purpose of this study was to learn more about barriers to managing depression by comparing knowledge and attitudes about depression among physicians, internists, obstetrician-gynecologists, and a reference group of psychiatrists. Among the non-psychiatrists, we hypothesized that generalist physicians would have more favorable attitudes and greater knowledge about depression than non-generalists. METHODS: Survey questionnaires were sent to resident and faculty physicians (N = 375) of two university-affiliated medical centers. The physicians were classified as non-generalists (medicine subspecialists, transitional year interns, and obstetrician-gynecologists), generalists (general internists and family physicians), and psychiatrists. A 33-item written questionnaire assessed knowledge and three attitudinal dimensions: attitudes attributed by physicians to patients; physicians' confidence in managing depression; and physicians' psychosocial orientation. A knowledge scale and an attitudes scale were scored by adding the number of knowledge items answered correctly and the more favorable attitudinal responses. Multivariable regression was used to identify physician characteristics among non-generalists and generalists associated with higher knowledge and attitudinal scores. RESULTS: Response rate was 82%. Sixty percent of the respondents were male, 63% were resident physicians, and 14% had advanced psychosocial training. Non-generalists and generalists had similar demographic characteristics, but psychiatrists were significantly more experienced. Psychiatrists had the most favorable attitudes, followed by generalists and non-generalists. Compared with non-generalists, generalists were more confident in prescribing antidepressants (62% vs 25%), more likely to report that treating depression is rewarding (71% vs 39%), and less likely to refer to a psychiatrist (58% vs 79%). Generalist classification, increased experience, and higher levels of psychosocial training were associated with more favorable attitudes. Knowledge scores were significantly higher for psychiatrists than for non-generalists and generalists. Among non-psychiatrists, correct responses for knowledge items were: treatment efficacy (61%), treatment duration (59%), > or = 5 DSM-III-R criteria (52%), and prevalence of depression (30%). Among those with incorrect responses, both non-generalists and generalists overestimated the prevalence (52%) and underestimated the efficacy of drug therapy (30%). CONCLUSIONS: Generalists and non-generalists have similar and relatively good basic knowledge about depression. Misperceptions about treatment efficacy, and attitudinal barriers, particularly among non-generalists, may compromise the physician's ability to diagnose and manage depression.

Depression↗

PubMed1994

Specialized Travel Consultation Part II: Acquiring Knowledge.

With an increase in travel to tropical countries, the need to improve the disease-risk perceptions of travelers who are either naive or given inappropriate or ineffective advice is becoming increasingly important. More widely available, specialized centers that can provide advice on tropical or travel-related diseases have been established, but their efficacy on travelers' knowledge and health has not been verified. Therefore, this study was undertaken to evaluate the impact of the service provided by a routine travel consultation at the Hospital for Tropical Diseases Travel Clinic, London, England. Self-administered questionnaires were given to 161 preconsultation and 144 postconsultation clients. The consultation included an interview covering travel plans and immunization and medical history, and advice was given on the journey, necessary immunizations, and prophylaxis. Data were analyzed using the Statistical Analytic System software and the mean differences in knowledge between pre- and postconsultation scores were correlated using the nonparametric Mann-Whitney procedure. The control of mutually confounding factors was maintained by multiple regression using the Mantel-Haenszel summary chi-square and the General Linear Model procedures. Comparison of the entry and exit scores showed a significantly improved overall knowledge of travel-related diseases in the exit, postconsultation group. Subanalysis revealed that this difference was due to an increased knowledge of malaria and its prevention and perceived risk of cholera. Knowledge about the management of diarrhea or fever, however, was not significantly improved by a consultation. Inexperienced travelers taking packaged or organized trips, and those from socioeconomic groups I and II showed the largest increase in knowledge following consultation. Our results show that a face-to-face interview for an average of 18 minutes by trained staff is an effective way of improving travelers' knowledge on certain topics. The slight improvements overall are explained by the levels of experience of travel and previously acquired knowledge of the clients in our study. Effective advice on malaria prevention and some health risks is given during an average consultation; however, there is still a need for improvement in giving information on the management of diarrhea, fever, and other travel diseases.

Journal Article↗

PubMed1997

Psychosocial characteristics of inner-city children with asthma: a description of the NCICAS psychosocial protocol. National Cooperative Inner-City Asthma Study.

Previous research has demonstrated a significant reciprocal relationship between psychosocial factors and asthma morbidity in children. The National Cooperative Inner-City Asthma Study investigated both asthma-specific and non-specific psychosocial variables, including asthma knowledge beliefs and management behavior, caregiver and child adjustment, life stress, and social support. This article presents these psychosocial characteristics in 1,528 4-9-year-old asthmatic urban children and their caretakers. Caretakers demonstrated considerable asthma knowledge, averaging 84% correct responses on the Asthma Information Quiz. However, respondents provided less than one helpful response for each hypothetical problem situation involving asthma care, and most respondents had more than one undesirable response, indicating a potentially dangerous or maladaptive action. Both adults and children reported multiple caretakers responsible for asthma management (adult report: average 3.4, including the child); in addition, children rated their responsibility for self-care significantly higher than did adults. Scores on the Child Behavior Checklist indicated increased problems compared to normative samples (57.3 vs. 50, respectively), and 35% of children met the criteria for problems of clinical severity. On the Brief Symptom Inventory, adults reported elevated levels of psychological distress (56.02 vs norm of 50); 50% of caretakers had symptoms of clinical severity. Caretakers also experienced an average of 8.13 undesirable life events in the 12 months preceding the baseline interview. These findings suggest that limited asthma problem-solving skills, multiple asthma managers, child and adult adjustment problems, and high levels of life stress are significant concerns for this group and may place the inner-city children in this study population at increased risk for problems related to adherence to asthma management regimens and for asthma morbidity.

Adult↗

PubMedDate not supplied

Breastfeeding knowledge and practice of pediatric nurse practitioners.

INTRODUCTION: The purpose of this secondary analysis is to examine and report on pediatric nurse practitioners' (PNPs') attitudes, experience, and knowledge about breastfeeding and to compare the results with those from a sample of pediatricians and other nurse practitioners and nurse-midwives. METHOD: A breastfeeding study questionnaire was sent to all PNPs (N = 95) in a northwestern state. The response rate was 81%. RESULTS: Respondents were nearly unanimous in their belief that "breast is best" and that it was their role to recommend breastfeeding to expectant mothers. In general, 74% of respondents believed they were effective or very effective in meeting the needs of breastfeeding patients. Although they were very supportive of breastfeeding, they were less knowledgeable about specific management strategies. Personal experience (nearly three fourths had themselves breastfed) was named by many as the most valuable source of information. Although PNPs appeared to have a more supportive attitude and better information than pediatric physicians, they reported themselves to be less effective in providing breastfeeding assistance than did their pediatric physician colleagues. DISCUSSION: PNPs generally agreed about the importance of promoting breastfeeding and their effectiveness in doing so. However, many PNPs did not gain experience in breastfeeding support and management in their educational programs and incorrectly answered questions on basic management strategies.

Breast Feeding↗