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Antibiotics and near-patient testing: Differences in habits between physicians completing or discontinuing a medical audit

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Health 2014年第2期6卷 141-148页

作者： Katarina Hedin Annika Brorsson Sigvard Molstad Eva Lena Strandberg Department of Clinical Sciences MalmoGeneral Practice/Family MedicineLund UniversityLundSweden Unit for Research and Development Kronoberg county council VaxjoSweden blekinge centre of competence blekinge county council KarlskronaSweden

Background and Aim: Respiratory tract infection (RTI) is a common reason for consulting primary health care. Antibiotic prescribing for RTIs varies among physicians indicating that national guidelines are not always adhered to. The aim was to study if antibiotic prescribing and use of near-patient tests were different among physicians who complete an audit registration and those who discontinue their participation. Method: A prospective cohort study where physicians participated in an APO (Audit Project Odense) process, making an audit registration for every appointment with a patient who had a respiratory tract infection during 4 weeks in 2008 and 4 weeks in 2009. Between the registrations, a limited educationally oriented intervention was made. 18 Primary Health Care centres located in three counties in southern of Sweden with 77 primary health care physicians participated. When comparing proportions the Chisquare test was used. Mann Whitney U-test was used when comparing independent groups and Wilcoxon’s signed-rank test was used when comparing dependent groups. Results: Of the 77 physicians, 38 participated only at baseline (group 1) and 39 participated in both registrations (group 2). The overall use of CRP near-patient tests was 37% in group 1 and 28% in group 2 (Chisquare p < 0.001), and the overall use of Strep-A near-patient tests was 31% and 20%, respectively (Chisquare p < 0.001). When the Strep-A near-patient test was negative in pharyngitis/tonsillitis, antibiotics were prescribed to 45% in group 1 and to 12% by group 2 (Chisquare 0.003). Conclusion: In conclusion, this study showed that physicians, who were more inclined to complete audit participation, used near-patient tests and prescribed antibiotics more correctly, according to the national guidelines for respiratory tract infections, than physicians who discontinued the participation. To achieve a rational use of antibiotics, near-patient tests and prescription of antibiotics must be used accordin

关键词： Respiratory Tract Infections Primary Health Care Near-Patient Test Antibiotic Prescription Audit Registration

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Factors That Promote Remission in Individuals with Schizophrenia

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Open Journal of Nursing 2019年第9期9卷 935-950页

作者： Maivor Olsson-Tall Bertil Marklund Sven Kylen Eric Carlstrom Lars Helldin Siv Back-Pettersson Department of Psychiatry NU-Health Care HospitalTrollhattanSweden Academy of Sahlgrenska Institute of MedicineUniversity of GothenburgGothenburgSweden centre on Health Care Improvement and Innovation Chalmers University of TechnologyGothenburgSweden Narhalsan Research and Development Primary Health Care Region Vastra GotalandSweden Fyrbodal Health Academy County Administration of West SwedenSweden Academy of Sahlgrenska Institute of Health and Care SciencesUniversity of GothenburgGothenburgSweden University of South-East Norway WestfoldNorway Institute of Psychology Karlstad UniversityKarlstadSweden

The knowledge about factors contributing to remission among individuals with schizophrenia is still missing. Studies show that the number of individuals’ reaching remission is varying among psychiatric outpatient care centres. Therefore, the purpose was to investigate case managers (CM) perception of care interventions promoting remission. Semi-structured interviews were conducted with CM (n = 12) and data were analysed with qualitative content analysis. The results show that CM needs to possess competence, master assessment structure and process. These key-points appear to be of crucial importance for a successful promotion of remission among individuals with schizophrenia.

关键词： Assessment Case Managers Remission Teamwork Schizophrenia

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Nursing in a Globalized World: Nursing Students with International Study Experience Report Higher competence at Graduation

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Open Journal of Nursing 2014年第12期4卷 848-858页

作者： Jan Nilsson Marianne Carlsson Eva Johansson Ann-Charlotte Egmar Jan Florin Janeth Leksell Christina Lindholm Gun Nordstrom Kersti Theander Bodil Wilde-Larsson Margret Lepp Ann Gardulf Department of Health Sciences Faculty of HealthScienceand TechnologyKarlstad UniversityKarlstadSweden The Japanese Red Cross Institute for Humanitarian Studies TokyoJapan Department of Public Health and Caring Sciences Uppsala UniversityUppsalaSweden Gavle University GavleSweden Department of Neurobiology Care Sciences and SocietyDivision of NursingKarolinska InstitutetHuddingeSweden The Red Cross University College StockholmSweden Department of Learning InformaticsManagement and EthicsMedical Management CentreKarolinska InstitutetStockholmSweden School of Health and Social Studies Dalarna UniversityFalunSweden Sophiahemmet University StockholmSweden 1 Department of Nursing Hedmark University CollegeHedmarkNorway 1 Primary Care Research Unit County Council of VarmlandSweden 1 Institute of Health and Care Science University of GothenburgGothenburgSweden 1 Ostfold University College HaldenNorway 1 Unit for Clinical Nursing Research Immunotherapy and ImmunologyDivision of Clinical ImmunologyDepartment of Laboratory MedicineKarolinska Institutet at Karolinska University HospitalStockholmSweden

Due to globalization, there is a need for nurses with skills and competence in providing safe, competent and culturally appropriate care. The aim of the study was to investigate whether International Study Experiences (ISE) in other countries during basic nursing education had an impact on newly graduated nurses as regards to self-reported competence. Moreover, a second aim was to explore what background factors that facilitated or constituted a hindrance for nursing students to choose to conduct part of their basic nursing education abroad. At 11 Universities/University Colleges (henceforth called Higher Education Institutions [HEIs]) in Sweden, 565 nursing students responded to the Nurse Professional competence (NPC) Scale. Students with ISE rated their competence significantly higher on three NPC competence areas—“Legislation in nursing and safety planning”, “Leadership and development of nursing” and “Education and supervision of staff/students”. Background factors that significantly seemed to enhance ISE were living alone, not having children or other commitments in relation to family, international focus at the HEI and previous international experience. Lack of financial means was reported to prevent students from choosing ISE. The study implies that several background factors are of importance whether students choose ISE or not. ISE during basic nursing education might result in better self-reported competence in leading and developing nursing care, including education of future nurses, and in providing safe care.

关键词： Internationalization International Study Experience Nursing Education Self-Reported competence

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