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Objectives This retrospective analysis aims to determine the accuracy of medication histories undertaken during a Comprehensive Geriatric Assessment (CGA) (at the point of admission) in an inpatient setting within an acute hospital. The CGA can be completed by a range of healthcare professionals, which will be directly compared. Medication reviews are an integral part of the CGA, therefore the accuracy of the history is integral to the review. Methods A retrospective analysis of patient electronic records between October 2018 and February 2020 was conducted. The accuracy of medication histories recorded as part of the CGA completed by Advanced Nurse Practitioners, Advanced Pharmacist Practitioners and Doctors was compared. This was done using electronic records, any discrepancies were captured. Descriptive statistics were applied. Key findings Across the 50 patients and 421 medicines identified, there were 59 discrepancies; 24 (48%) patients were noted with at least one discrepancy in their medication history. An omission of current medication was the most common error (49%), followed by incorrect dose (19%) and a record of a medication not taken pre-admission (15%). The total number of prescribed medications was found to positively correlate with the rate of error (Pearson's correlation 0.455, P > 0.001). An independent t -test determined a significant difference between the rate of errors between pharmacists and nurses (t -test: −4.48, P < 0.001). Conclusions This study re-confirmed risks of medication errors when patients change care settings. This is more prevalent with higher numbers of medications, requiring greater care in instances of polypharmacy, particularly in frail patients. This can support risk stratification of patients. A difference in outcomes between pharmacists and nurses warrants further exploration to determine the reasons for this and structuring multi-disciplinary teams accordingly. Consideration to ensure that medication history taking is included as part of the Advanced Clinical Practitioner is important, particularly with the expansion of these roles in the UK. [ABSTRACT FROM AUTHOR]

Evidence shows that traumatic childbirth can cause ongoing distress, often referred to as birth trauma. This can have an impact on parents and the couple relationship, and consequently identifying and supporting parents with birth trauma is important to practice. To investigate the experiences of health-care practitioners from the United Kingdom (UK) in assessment for birth trauma, perceived occurrence of birth trauma and observed impact on parents and the couple relationship. An online survey of UK health-care practitioners working with parents in the first postnatal year. A sample of 202 practitioners reported identifying birth trauma in 34.4% of mothers and 25.0% of partners. Assessment for birth trauma was only conducted for 50.3% of mothers and 25.9% of partners. The most observed symptoms were re-experiencing among mothers (87.1%) and avoidance among partners (50.9%). Birth trauma was perceived as impacting on the couple relationship for 29.8% of mothers and 26.9% of partners. Written responses provided more detailed observations of the impact of birth trauma. Understanding how birth trauma may present differently in mothers and partners could support effective assessment. Once birth trauma is identified, parents require personalised support to help them cope with the impact. [ABSTRACT FROM AUTHOR]

Pre-professional identity (PPI) is an understanding of the skills, qualities, conduct, culture and ideology of a students' intended profession. Understanding PPI is valuable for students and higher-education providers to provide insight into motivation for- and to promote engagement in-learning. Describing PPI is challenging, particularly for evolving health professions. This paper describes a process undertaken to understand PPI, using exercise science (ES), a new and evolving health profession, as a case study. Mixed methods were used to describe three aspects of PPI: 1) student cohort characteristics; 2) personal factors influencing PPI; and 3) perceived career direction. Final year ES students participated in an online survey and a focus group (n=305; 59% male; 75% age range of 20-24 years). Factors contributing to the development of PPI included the desire to help others; interest and experience in sports/exercise. Students had the strongest understanding of the PI domains of affiliation, money and structure and limited understanding of the role of scientist and researcher. Two outcomes were derived from the study findings to advance the theoretical understanding of PPI: 1) a 3-item framework that describes factors specific to students' PPI; and 2) a worked case study demonstrating how this framework was applied to gain a nuanced understanding of PPI in ES. Our framework can be applied to increase student and higher education providers understanding of PPI and the motivations underpinning student decision-making in higher education. [ABSTRACT FROM AUTHOR]

Background: By 2050, the global demand for orthotic and prosthetic services is expected to double. Unfortunately, the orthotic/prosthetic workforce is not well placed to meet this growing demand. Strengthening the regulation of orthotist/prosthetists will be key to meeting future workforce demands, however little is known about the extent of orthotist/prosthetist regulation nor the mechanisms through which regulation could best be strengthened. Fortunately, a number of allied health professions have international-level regulatory support that may serve as a model to strengthen regulation of the orthotic/prosthetic profession. The aims of this study were to describe the national-level regulation of orthotist/prosthetists globally, and the international-level regulatory support provided to allied health professions.Method: Two environmental scans benchmarked the national-level regulation of the orthotist/prosthetist workforce, and the regulatory support provided by international allied health professional bodies using a set of nine core practitioner standards (core standards) including: Minimum Training/Education, Entry-level Competency Standards, Scope of Practice, Code of Conduct and/or Ethics, Course Accreditation, Continuing Professional Development, Language Standard, Recency of Practice, and Return-to-Practice. Each identified country was categorised by income status (i.e. High-, Upper-Middle-, Lower-Middle-, and Low-Income countries).Results: Some degree of regulation of the orthotist/prosthetist workforce was identified in 30 (15%) of the world's 197 countries. All core standards were present in 6 of these countries. Countries of higher economic status had more core standards in place than countries of lower economic status. International-level professional bodies were identified for 14 of 20 allied health professions. International bodies for the physical therapy (8 core standards) and occupational therapy (5 core standards) professions provided regulatory support to help national associations meet most of the core standards.Conclusion: Given the small proportion of countries that have national practitioner regulatory standards in place, most orthotist/prosthetists are working under little-to-no regulation. This presents an opportunity to develop rigorous national-level regulation that can support workforce growth to meet future workforce demands. Given the financial and expertise barriers that hinder the development of a more regulated orthotist/prosthetist workforce, particularly for Low- and Lower-Middle-Income countries, we recommend the establishment of an international professional body with the express purpose to support national-level regulation of orthotist/prosthetists, and thereby build the regulatory capacity of national orthotic/prosthetic associations. [ABSTRACT FROM AUTHOR]

Objective: To investigate self-reported practice, beliefs, and barriers regarding prescription of dietary change for mental health from a range of mental health practitioners across Australia. Method: An online survey was completed by 193 Australian mental health practitioners. Results: Over 50% of practitioners reported prescribing dietary change for stress, depression, and anxiety at least weekly in their practice. Over half the practitioners considered dietary change to be 60-100% useful for enhancing mental health outcomes. Approximately one-quarter of the practitioners considered dietary change to be less than 40% useful for treating mental health conditions. Thematic analysis revealed the most frequently reported higher-order barrier themes were practitioner barriers (43.8%) and client barriers (29.2%), with insufficient skills and knowledge (15.9%) and client adherence (12.8%) being commonly cited initial codes. Conclusion: Mental health practitioners in Australia prescribe dietary change for mental health. However, barriers to prescription of dietary change for mental health need be addressed to overcome challenges associated with using it as a therapeutic intervention for mental health conditions. Universities and university training accreditation bodies should consider providing more extensive instruction in psycho-nutrition as part of mental health practitioners' training. Likewise, further recognised professional development should be offered, and awarded, for already qualified practitioners. Key Points What is already known about this topic: Diet is becoming more accepted as having a substantial influence upon mental health. Improving diet quality has been acknowledged as serving a protective role in reducing the rate of cognitive decline. The importance of dietary change remains underestimated by mental health professionals for the treatment of mental health maladies. What this research adds: Results demonstrated over 50% of the sample of mental health practitioners reported prescribing dietary change for stress, depression, and anxiety at least daily or weekly in their practice. Approximately a third of the mental health practitioners reported believing dietary change to be 80-100% useful for mental health outcomes. Most frequently reported barriers to the prescription of dietary change for mental health were practitioner barriers (43.8%) and client barriers (29.2%) higher-order themes, with insufficient skills and knowledge (15.9%) and client adherence (12.8%) being commonly cited initial codes. [ABSTRACT FROM AUTHOR]

Background: The novel coronavirus disease (COVID-19) is spreading rapidly, increasing the stress and challenges for healthcare professionals around the world. This study aims to discover the psychosocial, emotional and professional challenges faced by female healthcare professionals (HCPs) treating COVID-19 patients in Pakistan.Methods: Using an empirical phenomenological methodology, semi-structured telephone-based qualitative interviews were conducted with 22 female HCPs who were providing their expertise for COVID-19 patients in tertiary-level hospitals in Lahore, Pakistan. Purposive sampling was used for recruitment. The interviews were conducted between 20 July and 20 August 2020. The interviews were analysed using thematic analysis.Results: This study explored the psychosocial, emotional and professional challenges faced by female HCPs serving COVID-19 patients. Five themes were observed in the interviews: apprehension while treating COVID-19 patients; feelings towards COVID-19 patients; challenges as female HCPs and coping strategies; confidence in government, administration and self-reflection; and finally, future concerns and recommendations. Many of these themes have also been linked with cultural issues, making the results specific to Pakistan.Conclusions: During the COVID-19 pandemic, female frontline HCPs have faced immense psychosocial pressure, ranging from unsupportive family norms to an unwelcoming working environment and insensitive hospital administrations. Moreover, rumours among the general public, lack of proper training, missing incentives and improper system surveillance have increased the anxiety and stress among HCPs. Hence, legislators are advised to take appropriate actions countrywide in order to alleviate the still ongoing challenges and support female HCPs in their working environment. [ABSTRACT FROM AUTHOR]

Purpose: Physical health inequalities and mortality rates are higher amongst individuals with severe mental illness (SMI), including among forensic populations, than the general population. This paper aims to explore the experiences of individuals accessing primary health care following discharge from secure services, and the practitioners who support them. Design/methodology/approach: Face-to-face qualitative interviews were conducted with service users (n = 4) and mental health practitioners (n = 4) within a forensic community mental health team in one NHS Trust in England in 2019. Data were analysed using the Interpretative Phenomenological Analysis. Findings: Four super-ordinate themes emerged: perceived importance of physical health, agency, responsibility and relationships. Service users mostly saw themselves as passive recipients of health care and prioritised their mental health over their physical health. Close working relationships meant that mental health practitioners were often the first contact for service users with any health issue and thus felt a sense of responsibility for their physical health care. Service users who did access primary care reported that consistency of professional, feeling understood and listened to without judgement or stigma were important. Practical implications: Interventions for service users that include practicalities and strategies to facilitate independence in physical health care, and collaborative working between primary care and forensic mental health services, are encouraged. Originality/value: This study highlights some of the unique challenges in forensics around improving physical health outcomes for individuals with SMI. [ABSTRACT FROM AUTHOR]

Backgound: Autism spectrum disorder impacts social-communication. Picture Exchange Communication System is one of the methods to improve communication skills in individuals with autism. In spite of numerous studies on the effectiveness of Picture Exchange Communication System, no studies were conducted to examine the perceptions of practitioners who used the strategy. Method: An online survey was conducted with 120 practitioners (44 teachers and 76 therapists; 80.8% 20–49 years old; 80.8% graduate education) who used the Picture Exchange Communication System with children with autism. Using rating scales, practitioners reported their knowledge of Picture Exchange Communication System and their perceptions about importance, benefits, and barriers of utilizing Picture Exchange Communication System. Results: Practitioners reported they were confident when implementing Picture Exchange Communication System and considered integrating Picture Exchange Communication System at school to be important. Also, the practitioners indicated that Picture Exchange Communication System was easy to use and effective to develop communication skills in children with autism. However, they found that using Picture Exchange Communication System was time consuming. Conclusion: It is important to hear the viewpoints of practitioners concerning the use of Picture Exchange Communication System for individuals with autism spectrum disorder. This study found Picture Exchange Communication System is a useful strategy but has some barriers concerning its use. Future research is needed to confirm the current findings with a larger sample. Many students with autism spectrum disorder are non-verbal and may benefit from augmentative and alternative communication methods. Picture Exchange Communication System, one of the augmentative and alternative communication methods, has been widely used by professionals and parents to improve communication skills of children with autism spectrum disorder who are non-verbal or have complex communication needs. Practitioners indicated that Picture Exchange Communication System was easy to use and effective to develop communication skills in children with autism spectrum disorder. However, they found that it is time consuming. Practitioners need ongoing support when implementing the Picture Exchange Communication System. [ABSTRACT FROM AUTHOR]

Background: Constant appraisal of healthcare workforce trends is vital; this measure determines the adequacy of the workforce in meeting its society's healthcare demands. This includes determining the number of the incoming workforce (students, interns) and the active or practising workforce relevant registries. Objective: This study aimed to examine patterns of workforce growth in the medical technology profession (students, interns and practitioners) from 2008 to 2018 in South Africa. Methods: Student, intern and practitioner medical technology registries, from the 2012/2013, 2016/2017 and 2017/2018 Health Professions Council of South Africa (HPCSA) annual reports, were analysed. The number of National Health Laboratory Service and private laboratory posts were secured from the National Health Laboratory Service plan performance report. A comparison between the total number of South African medical technology (private and public) posts occupied versus the HPCSA practitioner 2016 register was completed, to determine the saturation status. Results: Annual student, intern, and practitioner registries indicated a mean growth of 6.8%, 28.9%, and 0.7% from 2008 to 2018. The transition of interns to practitioners is progressively dwindling (2015–2018). The practitioner register showed a 1.2% decline in registration from 2013 until 2018. In 2016, only 55.9% of the HPCSA registered medical technologists were employed (p < 0.001). Conclusion: There are more medical technologists than available public and private sector posts. The progressively growing student register compared to the dwindling practitioner register indicates attrition in the profession. An investigation identifying the reasons why graduates neglect to register as practising medical technologists should be undertaken. [ABSTRACT FROM AUTHOR]

Objectives: Rural primary care practitioners (PCPs) have a pivotal role to play in frontline pediatric mental health care, given limited options for referral and consultation. Yet they report a lack of adequate training and confidence to provide this care. The aim of this study was to test the effectiveness of the Practitioner Training in Child and Adolescent Psychiatry (PTCAP) program, which was designed to enhance PCPs' pediatric mental health care confidence. The program includes brief therapeutic skills and practice guidelines PCPs can use to address both subthreshold concerns and diagnosable conditions, themselves.Methods: The study design was a pilot, cluster-randomized, multicenter trial. Practices were randomly assigned to intervention (n practices = 7; n PCPs = 42) or to wait-list control (n practices = 6; n PCPs = 34). The intervention involved 8 hr of training in practice guidelines and brief therapeutic skills for depression, anxiety, attention deficit hyperactivity disorder, and behavioral disorders with case discussion and video examples, while the control practiced as usual. A linear random-effects model controlling for clustering and baseline was carried out on the individual-level data to examine between-group differences in the primary (i.e., confidence) and secondary (i.e., attitude and knowledge) outcomes at 1-week follow-up.Results: Findings were a statistically significant difference in the primary outcomes. Compared to the control group, the intervention group indicated significantly greater confidence in managing diagnosable conditions (d = 1.81) and general concerns (d = 1.73), as well as in making necessary referrals (d = 1.27) and obtaining consults (d = 0.74). While the intervention did not significantly impact secondary outcomes (attitudes and knowledge), regression analysis indicated that the intervention may have increased confidence, in part, by ameliorating the adverse impact of negative mental health care attitudes.Conclusion: PTCAP enhances PCPs' child/youth mental health care confidence in managing both general and diagnosable concerns. However, an 8-hr session focused on applying brief therapeutic skills was insufficient to significantly change attitudes and knowledge. Formal testing of PTCAP may be warranted, perhaps using more intensive training and including outcome assessments capable of determining whether increased PCP confidence translates to more effective management and better patient outcomes. [ABSTRACT FROM AUTHOR]

Following my progression and development from an undergraduate sports science student to my present position as a lecturer in Coaching and Performance, I sought to reflect upon this journey and how each significant stage of my development has either challenged, developed, or influenced my career. In attempting to articulate and disseminate such information I have utilised reflective accounts that were recorded throughout this time. Consequently, the current paper seeks to present a reflective account of key stages within my own career and development, from the initial stages of a newly graduated sports science intern, into a novice practitioner undertaking a PhD before finally attaining a full-time position in academia. I hope that these insights into my own personal and professional development may help anyone seeking employment or working in the sports science industry. [ABSTRACT FROM AUTHOR]

Dysphagia is a significant problem for adults with ID which has received sparse attention in the research literature. Little is currently documented about how dysphagia management operates and the barriers and associated strategies to address barriers utilized in practice. A brief survey containing open-ended questions was completed by 38 practitioners about the way their service operates, the barriers they have faced in providing support around managing dysphagia, and the solutions and strategies they have found useful. The process of dysphagia management typically involved referral and assessment, development of an intervention strategy, communication and negotiation, education and training in safe dysphagia management and monitoring, evaluation, and reassessment. Barriers were numerous but stakeholder beliefs, knowledge, and feelings underpinned many of them. Solutions varied but similarly were underpinned by good communication, building relationships, person-centered practice and responsivity, pragmatism and innovation in training, and disseminating dysphagia management information. [ABSTRACT FROM AUTHOR]

Background: A growing body of evidence suggests that healthcare practitioners who enhance how they express empathy can improve patient health, and reduce medico-legal risk. However we do not know how consistently healthcare practitioners express adequate empathy. In this study, we addressed this gap by investigating patient rankings of practitioner empathy. Methods: We conducted a systematic review and meta-analysis of studies that asked patients to rate their practitioners' empathy using the Consultation and Relational Empathy (CARE) measure. CARE is emerging as the most common and best-validated patient rating of practitioner empathy. We searched: MEDLINE, Embase, PsycINFO, Cinahl, Science & Social Science Citation Indexes, the Cochrane Library and PubMed from database inception to March 2016. We excluded studies that did not use the CARE measure. Two reviewers independently screened titles and extracted data on average CARE scores, demographic data for patients and practitioners, and type of healthcare practitioners. Results: Sixty-four independent studies within 51 publications had sufficient data to pool. The average CARE score was 40.48 (95% CI, 39.24 to 41.72). This rank s in the bottom 5th percentile in comparison with scores collected by CARE developers. Longer consultations ( n = 13) scored 15% higher (42.60, 95% CI 40.66 to 44.54) than shorter ( n = 9) consultations (34.93, 95% CI 32.63 to 37.24). Studies with mostly (>50%) female practitioners ( n = 6) showed 16% higher empathy scores (42.77, 95% CI 38.98 to 46.56) than those with mostly (>50%) male ( n = 6) practitioners (34.84, 95% CI 30.98 to 38.71). There were statistically significant ( P = 0.032) differences between types of providers (allied health professionals, medical students, physicians, and traditional Chinese doctors). Allied Health Professionals ( n = 6) scored the highest (45.29, 95% CI 41.38 to 49.20), and physicians ( n = 39) scored the lowest (39.68, 95% CI 38.29 to 41.08). Patients in Australia, the USA, and the UK reported highest empathy ratings (>43 average CARE), with lowest scores (<35 average CARE scores) in Hong Kong. Conclusions: Patient rankings of practitioner empathy are highly variable, with female practitioners expressing empathy to patients more effectively than male practitioners. The high variability of patient rating of practitioner empathy is likely to be associated with variable patient health outcomes. Limitations included frequent failure to report response rates introducing a risk of response bias. Future work is warranted to investigate ways to reduce the variability in practitioner empathy. [ABSTRACT FROM AUTHOR]

Rationale People working in the health sector have been looking to complexity science to help them deal with the complex phenomena they encounter in their everyday working practice. While complexity science has assisted many in the field to look at the complex issues from a different viewpoint and explained the emergence of complex phenomena, however, practicable, pragmatic approaches and techniques have not been provided. Aims and objectives In this article, actual issues and challenges that these practitioners face and the needs they expressed during a workshop called 'Putting Complexity to Work - Supporting the Practitioners' are discussed. Conclusion As the nature of complexity offers no one single ultimate solution, the paper concludes that, for operationalizing the insights received from complexity science into their day-to-day work, practitioners in health care and other domains need to address a range of challenges that are outlined in the paper. [ABSTRACT FROM AUTHOR]

Objective: This report describes the reliability and validity of the Evidence-Based Practice Process Assessment Scale (EBPPAS)— Short Version, validated with three disciplines (Social Work, Licensed Marriage and Family Therapists (LMFTs), and Psychologists), that assesses practitioners’ perceived familiarity with, attitudes about, and implementation of the evidence-based practice (EBP) process. Method: Social work practitioners, psychologists and LMFTs (N = 1001) were surveyed to assess the scale’s internal consistency reliability and criterion and factorial validity. Results: Findings support the scale’s internal consistency reliability, criterion and factorial validity. Conclusion: These findings support the use of the shorter version of the EBPPAS scale in surveys or to evaluate efforts to educate a wide range of behavioral health practitioners in EBP. [ABSTRACT FROM AUTHOR]

As hospital settings in Romania are becoming increasingly multicultural working environments, the need for linguistic and cultural mediators is growing accordingly. The present paper means to analyze the current state of facts in what concerns the level of healthcare professional - language professional interaction and to pinpoint the specific requirements of the domain in general as well as in the Romanian context. [ABSTRACT FROM AUTHOR]

When one is reflecting on a career as a practitioner, a number of important influences, themes, and elements that contribute to being a successful practitioner are evident. The achievement of this success is not a solitary activity. Many role models and mentors serve as important influences and guides for developing as a professional over the course of one's career. Ultimately, the goal is to aspire to become a complete practitioner. This includes being a passionate professional, clinically competent, a psychotherapist and clinician, an active consumer of research findings, ethical, a role model, a mentor, psychologically healthy, an advocate, a leader, a volunteer, an educator, a scholar, a colleague, a business person and entrepreneur, and an innovator and visionary; focusing on diversity and multicultural competence; and having a comprehensive vision of health. Because the goal of being a complete practitioner is aspirational, one never fully masters each of these roles and attributes but remains a work in progress. Yet, the process of endeavoring to become a complete practitioner is rewarding, gratifying, and meaningful. It is a journey well worth taking. [ABSTRACT FROM AUTHOR]

This column addresses the idea of practitioner as theorist as it may inspire new paths of theory development in practice for nursing. Historical and philosophical dimensions of theory development are discussed. Extant theory development strategies as well as new approaches for practice-based theory development are proposed. [ABSTRACT FROM AUTHOR]

Background: To ascertain whether person centred coordinated care (P3C) is being delivered in healthcare services, components relating to the construct need to be measured. Patient reported measures (PRMs) can be used to provide a measurement of patients' experiences of P3C. Traditionally, they have been used to assess whether interventions are delivering P3C. Recently there has been an increased interest in using them to directly enhance P3C in clinical practice by, for example, improving practitioner-patient communication. However, there is limited research available on how P3C can be implemented in practice. This study aimed to extend this literature base by exploring how professionals use PRMs to enhance P3C.Methods: Cross sectional thematic analysis of 26 semi-structured interviews with a variety of professionals who have experience of how PRMs can be used to make improvements to P3C. Inductive themes were mapped onto components of P3C care that fell under five established domains of P3C (Information and Communication; My Goals/Outcomes; Decision making; Care Planning and Transitions) to explore whether and how individual components of P3C were being improved through PRMs. Barriers and facilitators that affected the delivery and the results of the PRMs were also identified.Results: Three P3C domains (Information and Communication, My Goals/Outcomes and Care Planning) were mapped frequently onto themes generated by the participants' interviews about PRM use. However, the domain 'Decision Making' was only mapped onto one theme and 'Transitions' was not mapped at all. Participant reports suggested that PRM use by practitioners enhanced patients' ability to self-manage, communicate, engage and reflect during consultations. Barriers to PRM use were related to a lack of a whole service approach to implementation.Conclusions: Practitioners use both PROMs and PREMs in various ways to improve different aspects of patient care. By sharing experiences professionals can benefit from each other's learning and work together to extend the potential value that PRMs can offer to P3C delivery. [ABSTRACT FROM AUTHOR]