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The role of the emergency physician in emergency medical services for children

ANNALS OF EMERGENCY MEDICINE 2003年第2期42卷 206-215页

作者： Gausche-Hill, M Johnson, RW Warden, CR Brennan, JA Univ Calif Los Angeles Geffen Sch Med Dept Emergency Med Torrance CA 90509 USA Univ Calif Los Angeles Little Co Mary Hosp Ctr Med Torrance CA USA Childrens Hosp Mission Mission Med Hosp Reg Med Mission Viejo CA USA Oregon Hlth & Sci Univ Doernbecher Mem Hosp Children Pediat Emergency Serv Portland OR 97201 USA Univ Med & Dent New Jersey Dept Emergency Med New Brunswick NJ USA St Barnabas Hlth Care New Brunswick NJ USA

Emergency physicians have a duty to advance the care of pediatric patients in the emergency medical services (EMS) system. This policy resource and education paper, designed to support the American College of Emergency Physicians policy paper "The Role of the Emergency Physician in Emergency Medical Services for Children," describes the development of the federal EMS for Children Program, the importance of the integration of EMS for children into EMS systems, and the role of the emergency physician in EMS for children.

关键词：儿童保健服务/组织和管理儿童福利临床方案病人医护连续性/组织和管理数据库事实型急救医疗服务/组织和管理急救医学/教育急救医学/组织和管理卫生政策美国国立医学研究所医疗差错/预防和控制模型组织管理儿科学/教育儿科学/组织和管理医师的作用学会医学全面质量管理/组织和管理美国美国卫生和人类服务部儿童人类

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Improved tuberculosis infection control practices in Maryland acute care hospitals

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AMERICAN JOURNAL OF INFECTION CONTROL 2000年第2期28卷 133-137页

作者： Fuss, EP Israel, E Baruch, N Roghmann, MC Univ Maryland Med Syst Div Clin Qual Syst Baltimore MD 21201 USA

Background: In 1992 and 1993, the Maryland Hospital Association and the Maryland Department of Health and Mental Hygiene conducted 2 surveys of tuberculosis prevention practices in Maryland hospitals that showed poor compliance with the 1990 Centers for Disease Control and Prevention's guidelines for preventing transmission of tuberculosis in health care facilities. Objective: The objective of this study was to assess compliance in 1997 with the Centers for Disease Control and Prevention's guidelines in Maryland acute care hospitals. Methods: A written questionnaire with 3 components-Infection Control, Employee Health, and Microbiology Laboratory-was mailed to 56 Maryland acute care hospitals. Results: Seventy-three percent of the surveys were returned. One hundred percent of responding hospitals with tuberculosis isolation rooms reported negative pressure ventilation, 6 air exchanges per hour, and air exhausted to the outside or through high-efficiency particulate air filters. One hundred percent of the responding hospitals reported providing National Institute for Occupational Safety and Health-approved respiratory protection for health care workers;this compared with 24% in 1992 (P < .01). One hundred percent of the responding hospitals reported performing at least annual tuberculin skin testing;this compared with 50% in 1992 (P < .01). Conclusions: The survey results demonstrate excellent compliance with the 1994 Centers for Disease Control and Prevention recommendations for tuberculosis control in Maryland acute care hospitals, even in those facilities determined to be at minimal to low risk for tuberculosis exposure. The proposed Occupational Safety and Health Administration regulations are unlikely to further reduce the risk of tuberculosis exposure to health care workers in Maryland acute care hospitals.

关键词：急性病美国疾病控治中心交叉感染/预防和控制坚持准则/统计学和数值数据卫生服务研究感染控制/方法感染控制/标准马里兰国立职业安全与卫生研究所(美国) 病人隔离/标准诊疗准则(主题) 问卷调查危险因素全面质量管理/组织和管理结核/预防和控制美国通风/标准人类

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Health and the 1999 Regional Australia Summit.

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The Australian journal of rural health 2000年第1期8卷 52-57页

作者： Humphreys, J.S. School of Health and Human Sciences La Trobe University Bendigo Victoria Australia

The Regional Australia Summit brought together 282 invited delegates from all parts of Australia. The aim of the Summit was to develop partnerships between the government, business and community sectors to deliver a better future for regional, rural and remote areas facing significant change. Health was one of 12 themes discussed at the Summit. Five key health priorities were identified;the need to change the dominant metropolitan mind-set, improve access to health-care services, improve service provision and workforce training, ensure equitable resource allocation, and adopt a population health approach. The ultimate success of the Regional Australia Summit will be gauged over time by the extent to which the health, wellbeing and prosperity of rural, remote and regional Australians has been improved, and existing problems and issues addressed. Nonetheless, the Summit is a significant event because it addresses issues at the highest level of government, emphasises coordination and the adoption of an intersectoral approach, and recognises the need to empower local communities and build partnerships between the government, corporate and community sectors.

关键词：澳大利亚社区网络卫生政策卫生工作重点机构间关系国家卫生规划需求估价/组织和管理乡村卫生服务全面质量管理/组织和管理人类

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The development of NEdSERV: quantitative instrumentation to measure service quality in nurse education

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NURSE EDUCATION TODAY 1999年第5期19卷 396-407页

作者： Roberts, P Keele Univ City Gen Hosp Dept Nursing & Midwifery Stoke On Trent ST4 6QG Staffs England

The political climate of health care provision and education for health care in the latter years of the 20th century is evolving from the uncertainty of newly created markets to a more clearly focused culture of collaboration, dissemination of good practice, with an increased emphasis on quality provision and its measurement. The need for provider units to prove and improve efficiency and effectiveness through evidence-based quality strategies in order to stay firmly in the market place has never been more necessary. The measurement of customer expectations and perceptions of delivered service quality is widely utilized as a basis for customer retention and business growth in both commercial and non-profit organizations. This paper describes the methodological development of NEdSERV-quantitative instrumentation designed to measure and respond to ongoing stakeholder expectations and perceptions of delivered service quality within nurse education.

关键词：医务工作者的态度用户满意教育护理学士/标准循证医学集中研讨小组大不列颠卫生服务使用研究模型护理学护理管理人员/心理学护理教育研究/组织和管理卫生保健质量问卷调查可重复性结果全面质量管理/组织和管理人类

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Back to basics: exploring the conceptual basis of nursing

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NURSE EDUCATION TODAY 1999年第7期19卷 570-577页

作者： Scammell, J Miller, S Bournemouth Univ Inst Hlth & Community Studies Bournemouth BH1 3LG Dorset England

It has long been recognized that nursing is essentially a practice-based discipline, underpinned by fundamental concepts which inform practice. The purpose of this paper is two-fold: first to discuss the need for an exploration of these concepts of nursing as a foundation to preregistration nursing programmes. Second, by utilizing a continuous quality improvement perspective, an evaluation of teachers' experiences with a cohort of adult and child health branch students is considered. It is concluded that a significant proportion of students found that a raised conceptual awareness served to promote theory-practice links. (C) 1999 Harcourt Publishers Ltd.

关键词：艺术课程教育护理学士/方法循证医学知识模型护理学护理教育研究护理研究护理理论方案评价科学全面质量管理/组织和管理成年人人类

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Student discontinuations: is the system failing?

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NURSE EDUCATION TODAY 1999年第7期19卷 578-585页

作者： McSherry, W Marland, GR Univ York Dept Hlth Studies York District Hosp York YO3 7HE N Yorkshire England Bell Coll Technol Dumfries DG1 4SG Scotland

Are nurse educators guilty of hypocrisy? While espousing holism and evidence-based practice, we may be neglecting to support The most distressed and vulnerable in our care-students. Student discontinuation arouses strong emotions, which need to be expressed and resolved. These are often unresolved leaving students and educators frustrated and alienated in 'failure'. Although it cannot be expected that all students will succeed as professionals and academic standards must be maintained, those who fail have a right to expect fairness. With the advent of Subject Quality Review (formally TQA) institutions of higher education may be asked to demonstrate their operational mechanisms for 'managing' the process of student failure. Now would be the best time for departments of nurse education to reflect on experience, review attrition rates and learn from each other in order to establish a model of best practice. Such a review may generate the formulation of national guidelines, safe guarding against the looming threat of litigation. (C) 1999 Harcourt Publishers Ltd.

关键词：教育护理学士/标准全体教工护理院校大不列颠需求估价护理质量审核护理教育研究/方法入学标准社会支持退学/心理学退学/统计学和数值数据学生护理/心理学学生护理/统计学和数值数据全面质量管理/组织和管理人类

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STEP(ing)-UP to deliver clinical preventive services

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AMERICAN JOURNAL OF PREVENTIVE MEDICINE 2001年第1期21卷 68-69页

作者： Kottke, TE Solberg, LI Mayo Clin & Mayo Fdn Rochester MN 55905 USA HealthPartners Res Fdn Minneapolis MN USA

I n this issue of the American Journal of Preventive Medicine, Goodwin et al.1 report the success of their trial to help medical practices increase the delivery of the preventive services recommended by the U.S. Preventive Services Task Force. They randomized 77 community family practices in Northeast Ohio to receive a 1-day practice assessment and a series of meetings with a nurse facilitator for the purpose of choosing and implementing individualized approaches to increase the delivery of preventive services. The main outcome measure was a set of summary scores for health habit counseling, screening, and immunization services. Those researchers found a significant increase in global preventive service delivery rates at 1 year in the intervention group (31%–42%) compared with the control group. Two components of the summary score, rates for health habit counseling and screening services, were increased. The third component, immunization rates, was not changed.

关键词：卫生保健提供/组织和管理卫生服务研究/标准需求估价/组织和管理预防卫生服务/供应和分配预防卫生服务/利用研究设计/标准全面质量管理/组织和管理人类

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Quality of care in reproductive health programmes: concepts, assessments, barriers and improvements - an overview

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MIDWIFERY 1998年第2期14卷 66-73页

作者： Kwast, BE Albast 15 NL-3831 VX Leusden Netherlands

At the end of the first decade of the Safe Motherhood Initiative there are still, at a minimum, 1600 women dying every day from complications of pregnancy and childbirth: this is an intolerable human tragedy. The fact that there are almost 100 000 more maternal deaths annually now compared to 10 years ago, 585 000, must present a challenge to every citizen in society. Policy makers, health professionals, social workers, religious leaders, human-rights advocates and the media all have a responsibility to ask themselves: 'What can I do?' All have a role in affecting quality reproductive-health services, which are essential for the reduction of maternal mortality and morbidity, and are an intrinsic human right. The midwife is the obvious catalyst and linch-pin for this effort in the fabric of society. Three papers will address the issues of quality of care in reproductive-health programmes with particular emphasis on safe motherhood. This, the first, article describes the concepts of quality of care in reproductive-health programmes, the determinants of quality improvement, assessment tools for service quality, barriers to quality of care and quality improvement together with examples from relevant countries. The second article will address education issues relative to quality of care, and the third will describe the monitoring and evaluation of quality of care with relevant indicators and project results.

关键词：卫生服务易得程度/组织和管理产妇卫生保健服务/组织和管理结果评价(卫生保健)/组织和管理卫生保健质量全面质量管理/组织和管理世界卫生女(雌)性人类妊娠

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Capitation funding in Australia: Imperatives and impediments

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Health Care Management Science 2000年第2期3.0卷 77-88页

作者： Peacock, Stuart Segal, Leonie Health Economics Unit Centre for Health Program Evaluation Monash University West Heidelberg Vic. 3081 PO Box 477 Australia

Health service funding mechanisms are pivotal in the pursuit of health system objectives, as they provide strong financial incentives for actors in the system to achieve policy goals. Underpinning funding mechanisms is a set of key economic principles, or objectives, that should guide their design and use: efficiency, equity, and accountability. The Australian health system has historically performed relatively poorly in relation to these objectives, with evidence of inefficiencies, inequities, and poor accountability in many areas of health services. The primary cause of these shortcomings may lie in the complex set of funding and delivery arrangements at the State and Federal levels of government. Potentially significant improvements in the performance of the health system would be available from the integration of the funding and delivery of services within a single tier of government, coupled with the development of a national weighted capitation approach to funding. To develop a national capitation funding model a number of unique factors require consideration, including the current fragmentation of services, the role of the private sector, the needs of indigenous populations, and the effects of rurality. The data available to develop a capitation model is of a level of detail and quality not readily found elsewhere. If policy statements promoting efficiency, accountability, and particularly equity are to be actively pursued, a national capitation model based on robust methods should become a cornerstone of Australian health system reform. © Baltzer Science Publishers BV.

关键词：澳大利亚按人收费/组织和管理卫生保健提供联合/组织和管理效率组织筹资政府/组织和管理卫生保健改革/组织和管理卫生服务易得程度/标准管理医疗规划/组织和管理模型组织管理国家卫生规划/组织和管理需求估价/组织和管理全面质量管理/组织和管理人类

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APPLICATION OF TOTAL QUALITY MANAGEMENT TO MENTAL-HEALTH - A BENCHMARK CASE-STUDY

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JOURNAL OF MENTAL HEALTH ADMINISTRATION 1995年第3期22卷 278-285页

作者： SLUYTER, GV BARNETTE, JE SHAWNEE HILLS INC CHARLESTONWV

The search for models or ''benchmarks'' that reflect the successful application of total quality management (TQM) to the mental health field is one that goes largely unrewarded. This article describes a case study of one comprehensive mental health center that has made a serious commitment to the philosophy and principles of TQM and that is reaping significant benefits from that effort.

关键词：社区精神卫生中心/标准卫生服务研究在职培训卫生保健组织鉴定联合委员会精神障碍/治疗模型组织管理组织文化病人满意度生产线管理全面质量管理/组织和管理西弗吉尼亚人类

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