When patients and families come to the emergency department seeking medical attention, they come in with many mixed emotions and thoughts. The fast paced, rapid turnover of patients and the chaotic atmosphere may leave patients who visit the emergency department with the perception that staff is uncaring. The purpose of this project was to implement a patient care delivery model, relationship-based care, in the emergency department. The model is comprised of several caring theories including Jean Watson's model of human care and Kristen Swanson's middle range theory of caring. The main goals of the project were to help staff enhance the patient and caregiver interaction, strengthen co-worker relationships, and gain appreciation of the importance of self-care. The intervention was an educational workshop about the relationship-based care model. Eight participants were consented, given a preassessment survey, educated about the model, and then given a postassessment survey. Prior to education, 83% of participants believed strongly that patients and families need to feel cared for during an emergency department visit; this increased to 100% posteducation. Perception about the importance of coworkers' relationships being trusting went from 38% to 50% and the importance of caring for one's self increased from 63% to 100%. It was recommended that the model be implemented in all emergency departments and all staff educated in its use as a way to promote social change through intentional focus on caring in every patient interaction.

Multidrug-resistant tuberculosis (MDR-TB) is a public health problem in several countries such as Angola, India, China, Kenya, and Nigeria. Due to the increasing high burden of MDR-TB, most of these countries do not have adequate capacities to manage MDR-TB patients effectively. This study investigated the effect of model of care; human immunodeficiency virus comorbidity; and demographic factors such as age, gender, and marital status on the treatment outcomes of MDR-TB patients in Nigeria. The study was based on the analysis of secondary data of 402 MDR-TB patients accessed from the data systems of the National Tuberculosis, Buruli Ulcer, and Leprosy Control Program. The theoretical framework for this study was the health belief model. The results of the study showed that treatment outcomes were similar for hospital and community-based models of care. Age was the only factor found to be significantly associated with treatment outcomes; age > than 40 years was a predictor of unsuccessful treatment outcomes among MDR-TB patients at a p-value of 0.026. In the multivariate logistics regression analysis, age and model of care were found to be significantly associated with treatment outcomes at p-values of 0.043 and 0.048, respectively. Marital status, gender, and HIV comorbidity were not significantly associated with treatment outcomes. Implications of the findings of this study for social change in a health care program include opportunities to help reduce the number of patients on waiting lists for MDR-TB treatment. These strategies may ultimately help to reduce the spread of MDR-TB infection as well as the mortality associated with late treatment.

Some innovations are termed ‘disruptive’, a designation that is normally applied to technology; examples include computers, digital cameras, and mobile phones. The term can also be applied to groups of workers, particularly if they are able to offer specific technical capabilities within a market at lower cost, but broadly equal and effective to that offered by traditional products or services. Paramedics could be described in this way and are a newly professionalised group, with distinctive capabilities in terms of responding to the needs of not just the acutely ill and injured, but increasingly those patients with undifferentiated non-life- threatening conditions, which increasingly make up the bulk of 999 call demand. The key to their transition from an artisan, skilled worker to professional status is the acquisition of certain ‘hallmarks’. Perhaps the most important of these is the completion of more prolonged education that affords the opportunity to graduate with enhanced decision-making and other clinical skills in order to meet the needs of the full spectrum of patients in the pre-hospital setting. Paramedics were surveyed to determine how they rated their ‘traditional’ preparation and to establish what their attitudes were to a more educationally based approach. Paramedics themselves proved to be realistic regarding shortcomings in established training and education systems, while also being strongly motivated to learn more within a higher education setting, particularly if this additional effort would result in being able to offer a wider range of care to their patients. During the study, major changes in the health care environment and the role of the Ambulance Service took place, leading to a requirement to undertake a second phase of research. This took the form of ‘Horizon Scanning’ in an attempt to detect ‘signals’, themes and trends in relation to newly emerging ‘competitors’ to the paramedic role. These included nursing, new practitioners and most critically, the rapidly emerging medical sub-speciality of pre-hospital care, staffed by medical personnel on a pattern found specifically in some European countries, sometimes termed the ‘Franco-German’ model/System (FGM/S). Hitherto, the model of provision in the UK had followed the ‘Anglo-American’ model/System (AAM/S), approach, with paramedics providing direct patient care in the field and medical staff largely involved in medical oversight, teaching, clinical governance and other higher level roles. As part of this research, the evidence base for change was examined and consideration given to the factors that might help clarify what the likely situation could be in 2030 in respect of ambulance services, pre-hospital care and paramedics. This future is uncertain, but factors have been identified that would militate in favour of one or other model prevailing, with close links established between educational preparation, system design, career structure and the continuance of the professionalisation process favouring paramedic progression. However, other factors, most specifically professional power, the absence of a clear evidence base and an apparent reluctance to clearly acknowledge this in some respects, lead to the conclusion that the future of pre-hospital care remains uncertain and contested, but also potentially amenable to a well-directed influencing strategy.

The literature concerning what medical students learn from midwives during specialist obstetric rotations is scarce. In the UK, despite a long tradition of providing midwifery attachments for medical students, it is almost non-existent. Working with midwives is arguably the only opportunity medical students have to experience holistic or social models of maternity care, focusing on normality rather than on the medical concept of risk. This study sought to discover how medical students constructed their knowledge about childbirth during a six week specialist rotation in obstetrics in a Northern English teaching hospital (NETH), with particular emphasis on whether participants assimilated any concepts from midwifery knowledge (MK). A Delphi Study, done as the first phase of the research, focused on MK, utilizing an international sample of experienced midwives. Resulting themes were used to develop the data collection tool for the second phase of the research. The research employed a qualitative case study method with students from a single year cohort comprising the case. Data were collected using a tool consisting of three problem based learning (PBL) scenarios. These were presented to the students in consecutive interviews at the beginning, the middle and the end of their obstetric rotation. Following analysis, five main themes were identified which illuminated the medical students' construction of knowledge about maternity care. These were explored and discussed. The thesis concludes with recommendations for increasing opportunities for IPE in the medical and midwifery curricula.

This thesis concerns the profession of the school special educational advisorr working in a mainstream primary school and his acting in favor of pupils with learning difficulities. The theoretical part describes the group of pupils with whom the school special educational advisor works and possibilities of this work, the cooperation with other partners (teachers, professionals and institutions outside the school and pupils' parents ) in supporting those pupils and the three-stage model of care for pupils at risk in school development. The practical part in the form of qualitative research examines how school special educational advisors acting in primary schools in Prague see themselves in their profession. KEY WORDS: School special educational advisor, school counseling centre, three-stage model of care, special education needs, prevention, diagnostics, intervention

My dissertation is focused on usage of psychobiographical model of care during working with seniors. The first part of my dissertation is focused on theories, where I explain things such as old age and its age borders, changes in old age and senior's needs, dementia and its forms. We can also find here informations about senior services, social workers and ethic codex. Besides that, my dissertation contains informations about psychobiographical model and everything that is related to it. Second part of my dissertation is focud on concrete usage of the model in Senior House Háje and Senior House Palata for people with eyes dissorder. Keywords  Senior, age, Psychobiographical model of care, dementia, normality principle, regression phases, activities of daily living, biographies, individual care plans, memories Therapy.

In an era of value based purchasing and healthcare reform, hospitals face the challenge of delivering high quality care in an environment of diminishing resources. This performance improvement project describes the use of master’s prepared nurses on medical surgical units to improve quality and patient satisfaction. The setting was five medical surgical units in a 200+ bed hospital in the southeastern United States. Declining resources necessitated an increase in the nurse to patient ratios on the units (from 5:1 to 6:1). The project involved the modification of the model of care through the change in nurse/patient ratios and the addition of master’s prepared nurses to coordinate and supplement the care of the staff RNs for complex patients. While inconclusive, the literature review confirmed the impact of master’s prepared nurses on quality metrics and did not conclusively confirm that delivering high quality, safe care was not possible with nurse/patient ratios of 1:6. The goal of the project was to determine if the presence of the master’s prepared nurse could mitigate the changes in ratios and produce high quality and satisfaction outcomes. Measures of success were drawn from archived standardized quality measures in the realms of service (HCAHPS questions), patient safety (CABSI, HAPU) and quality outcomes (core measures and 30 day readmissions). The project design was a retrospective, one-group pre-post design looking at two six-month intervals—before and after project implementation. Results demonstrated sustained or improved quality in six of ten measures. Highest positive impact was in readmissions and nurse sensitive indicators. The most negative results were in patient satisfaction. Modifying the model of care is an iterative process requiring continued evaluation and changes to improve outcomes. Results of this project supported the further evaluation of staffing and expansion of the number of master’s prepared nurses on medical surgical units.

Background: The definition and concept of the rehabilitation differs across disciplines. However, the goals of comprehensive rehabilitation, as defined in the literature, could not be fully achieved without multidisciplinary cooperation, through which it is possible to apply a wider range of interventions, which is an important indicator in addiction treatment. The cooperation between individual fields has the potential not only in better quality care towards the target group, but it is also important to consider the possibility of better financing of care, which could lead to greater satisfaction of both users and service providers. Objectives: This diploma thesis seeks the interrelationships between theory and concept of rehabilitation in addictology, respectively in the aftercare program based on the Apolinar model of addiction treatment, and rehabilitation in physiotherapy - in terms of both theoretical anchoring and implementation of rehabilitation in practice. The objective was to map and evaluate the content of rehabilitation applied in the outpatient form of the after-care program in the women's and men's ward of substance abuse treatment at the Department of Addictology, which is based on the Apolinar model of addiction treatment. Finally, the aim was to assess how a physiotherapist could...

Improving the quality of abortion care can reduce stigma, increase access, and enhance knowledge about pregnancy prevention and reproductive health. Midwifery-led medication abortion is considered effective, efficient, accessible, person-centred, equitable, and safe in alignment with the World Health Organization’s framework on quality abortion care. As research on client-centred access to healthcare recommends, Ontario’s expanded midwifery care models are improving the ease with which people can find and use sexual and reproductive services most appropriate to their unique needs. The expanded midwifery care presented in this study demonstrates how midwifery-led medication abortion provides high-quality services, decreases stigma, and improves access to safe, acceptable, and client-centred abortion care, particularly for commonly underserved populations deserving of health equity and Reproductive Justice. / The World Health Organization, the International Confederation of Midwives, and the Canadian Association of Midwives advocate for the inclusion of comprehensive abortion care within midwifery practice. International evidence shows positive outcomes in terms of efficacy, safety, acceptability, and post-abortion contraception uptake when midwives provide abortion services. In Canada, midwifery services are available across various populations, including urban, rural, remote, and Northern areas, suggesting a potential to enhance access and quality of abortion care, particularly for underserved people. Expanding the role of Canadian midwives to include comprehensive abortion care could improve accessibility, address gaps in service provision, support community needs, ensure professional sustainability, foster interprofessional collaboration, and offer continuity of care. Since 2017, the Ontario Ministry of Health has funded Expanded Midwifery Care Models to support midwifery integration, interprofessional collaboration, and delivery of midwifery-led sexual and reproductive care that is not funded under the current payment model. This research explores the individual and shared experiences of midwifery-led medication abortion delivered through Expanded Midwifery Care Models across three distinct regions in Ontario. The study employs interpretive description methodology to understand how midwifery influences the experiences of medication abortion for midwives, collaborating healthcare professionals, and clients. The methodology focuses on exploring how integrating a midwifery model of abortion care supports medication abortion services and promotes Reproductive Justice within primary care settings. By gathering insights from multiple perspectives, the findings hope to inform clinical practice, interest policymakers, and identify outcomes valued by midwives, clients, and healthcare professionals for future research on midwifery-led abortion care. / Thesis / Master of Science (MSc) / Quality abortion care improves the lives, health, and wellness of reproductive-aged people. Abortion is time-sensitive and people face barriers to this care. Reproductive-aged people benefit from healthcare systems that make abortion simple, safe, and effective. Internationally, midwives play a significant role in abortion care by delivering comprehensive services within sexual and reproductive healthcare. In Canada, however, the potential of midwifery in providing abortion care has not been fully realized. As an exception, Ontario’s Expanded Midwifery Care Models (EMCMs) - innovative sexual and reproductive healthcare delivery programs - have made it possible for midwives to provide abortion services. Midwifery-led abortion care in EMCMs includes providing early abortion care in ways that make it easier for people who find it difficult to access care. This research explores and compares the personal and professional experiences of medication abortion care delivered by midwives across three regions in Ontario.

This work deals with the model of care Home Share in the world, especially in Ireland, and introduces its beginning activity in the Czech Republic for people with autism spectrum disorder. For many years, this target group has not found in the Czech system of social services affordable and suitable services, especially of the residential type, which it would need. Parents of these children are thus exposed to the burden of long-term care without the possibility of relieving them. Home Sharing is a way to complement this social system. The practical part focuses on mixed research, which aims to describe and critically reflect the current situation of Home Share in the Czech Republic. Through interviews, I investigated the beginning, course and possible future of organizations that are currently introducing Home Share for families with a person with autism spectrum disorder. Furthermore, I used interviews and a questionnaire to find out the opinions of experts who are in the field of support for families with autistic people.