Shared care with task delegation to nurses for type 2 diabetes: prospective observational study.
BACKGROUND: To study the effects of two different structured shared care interventions, tailored to local needs and resources, in an unselected patient population with type 2 diabetes mellitus. METHODS: A three-year prospective observational study of two interventions and standard care. The interventions involved extensive (A) or limited (B) task delegation from general practitioners to hospital-liaised nurses specialised in diabetes and included a diabetes register, structured recall, facilitated generalist-specialist communication, audit and feedback, patient-specific reminders, and emphasised patient education. The target population consisted of 2660 patients with type 2 diabetes treated in the primary care setting. Patients who were terminally ill or who had been diagnosed with dementia were excluded from the study. RESULTS: The participation rates were high (90%) for patients, and none of the 64 GPs discontinued their participation in the study. Longitudinal analyses showed significant improvements in quality indicators for both intervention groups (process parameters and achieved target values on the individual patient level); in standard care, performance remained stable or deteriorated. Both patients and caregivers appeared satisfied with the project. CONCLUSION: This study shows that structured shared care with task delegation to nurses, targeted at a large unselected general practice population, is feasible and can positively affect the quality of care for patients with type 2 diabetes. (+info)
Is dentistry at risk? A case for interprofessional education.
The goal of interprofessional education (IPE) is to bring various professional groups together in the educational environment to promote collaborative practice and improve the health care of patients. Interest in IPE has been sparked by several factors in the health care system, including the increased awareness of oral-systemic connections, an aging population, the shift of the burden of illness from acute to chronic care, and lack of access to basic oral care. Increasingly, since the publication of the U.S. surgeon general's report in 2000, the dialogue surrounding IPE in dentistry has escalated. But how has dentistry changed regarding IPE since the report was released? This position paper argues that little has changed in the way dental students are taught and prepared to participate in IPE. The authors contend that academic dentistry and organized dentistry must take the lead in initiating and demanding IPE if dental students are to be prepared to work in the health care environment of the twenty-first century. Included are reasons why IPE is necessary and why dentistry must lead the conversation and participate in the solution to the oral health care crisis. It explores existing models and alternate approaches to IPE, barriers to implementation, and proposed strategies for academic institutions. (+info)
Policy statement--guidance for the administration of medication in school.
Alternative practice dental hygiene in California: past, present, and future.
This study examines the development of the registered dental hygienist in alternative practice in California through an analysis of archival documents, stakeholder interviews, and two surveys of the registered dental hygienist in alternative practice. Designing, testing and implementing a new practice model for dental hygienists took 23 years. Today, registered dental hygienists in alternative practice have developed viable alternative methods for delivering preventive oral health care services in a range of settings with patients who often have no other source of access to care. (+info)
Beginning the socialization to a new workforce model: dental students' preliminary knowledge of and attitudes about the role of the dental therapist.
The purpose of the study reported here was to assess first- and second-year dental students' knowledge of and attitudes about the role of the dental therapist in the oral health care delivery system. The results of this study are informing the continued development and implementation of a new dental workforce training model at the University of Minnesota. Dental students at the university (Classes of 2012 and 2013) were surveyed in 2009, with follow-up surveys planned for the subsequent five years. Multiple-choice questions and statements to be ranked using a Likert scale were used to determine what the students knew and thought about dental therapists' scope of practice, care delivery, work quality, cost-effectiveness, and role in reducing disparities in oral health care access. The results suggest that the students had generally neutral or uncertain attitudes about dental therapy, based on minimal knowledge about the role of dental therapists. In addition, we found little difference in attitudes between the two classes, the only exception being that the first-year students less often perceived the therapists as a solution to access problems. These baseline data are guiding the intraprofessional training of dental, dental hygiene, and dental therapy students toward the goal of positive socialization to a new workforce model and affirmation of the dental therapist as a member of the oral health care team. (+info)