相关实验视频
Updated: Jun 22, 2025
12:08
Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
18.8K
将阿片类药物使用障碍的布普伦诺芬整合到农村,初级保健机构
Jessica J Wyse1,2, Alison Eckhardt3, Summer Newell3
1Center to Improve Veteran Involvement in Care, VA Portland Health Care System, 3710 SW U.S. Veterans Hospital Rd., Portland, OR, 97239, USA. Jessica.Wyse@va.gov.
Journal of general internal medicine
|July 2, 2024
概括
在农村初级保健中扩大对阿片类药物使用障碍 (OUD) 的布普伦诺芬处方需要进行结构性变化. 成功实施涉及有针对性的招聘,临床医生参与,以及为团队发展和过程重新设计提供领导支持.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 药物使用障碍 药物使用障碍
- 农村卫生 农村卫生
背景情况:
- 治疗阿片类药物使用障碍 (MOUD) 的药物,包括布普伦诺芬,是有效的,但未得到充分利用,特别是在农村地区.
- 美国退伍军人事务部 (VA) 旨在增加农村退伍军人的初级保健中使用布普伦诺啡的机会.
- 农村患者在获得基本医疗服务,包括OUD治疗方面面临重大差异.
研究的目的:
- 了解农村VA医疗保健系统如何成功地将布普伦诺芬治疗纳入初级保健.
- 确定在农村初级保健机构实施布普伦诺芬处方的促进者和障碍.
- 为在服务不足的地区扩大OUD治疗机会的战略提供信息.
主要方法:
- 与30名临床医生,领导者和VA农村系统的员工进行了定性访谈,这些系统增加了初级保健布普伦诺芬处方 (2015-2020年).
- 来自VA企业数据仓库 (CDW) 的行政数据确定了相关的医疗保健系统.
- 用一种混合的诱导/演方法来分析采访数据.
主要成果:
- 实施通常是由有针对性的招聘启动的,其次是"冠军"临床医生参与同行和领导.
- 关键的促进者包括将布普伦诺芬处方与现有目标相协调,并展示支持性角色.
- 成功的整合涉及开发新的临床团队和重新设计流程,所有这些都得到了领导的支持.
结论:
- 改变初级保健结构对于改善农村环境中的布普伦诺芬可获得性至关重要.
- 策略包括有针对性的招聘,培养支持性临床团队和重新设计工作流程.
- 领导层的支持对于克服OUD治疗在初级保健中的实施挑战至关重要.
相关概念视频
01:30Specialized Care Centers and Settings-II
721
Rural Health Centers
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
721
01:30Community Based Intervention
38
Community-based interventions in mental health represent a paradigm shift from institution-centered care to treatments embedded within the fabric of local communities. By prioritizing inclusion and leveraging existing societal structures, this approach fosters a supportive environment conducive to addressing mental health challenges while promoting individual dignity and agency.
Foundations of Community Mental Health Programs
Central to the success of community-based interventions is the...
Foundations of Community Mental Health Programs
Central to the success of community-based interventions is the...
38
01:30Primary Healthcare Services
1.4K
Primary care promotes wellness and prevents disease. This care includes health promotion, education, protection (such as immunizations), early disease screening, and environmental considerations. Settings providing this type of healthcare include physician offices, public health clinics, school nursing, and community health nursing.
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...
1.4K
01:15Opioid Analgesics: Synthetic and Semisynthetic Opioids
273
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
273
01:26Methods Of Healthcare Delivery System
3.2K
At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
3.2K
01:30Specialized Care Centers and Settings-I
940
Specialized care settings or centers are situated in convenient locations within the community and offer care to a specific group or population. They consist of daycare facilities, mental health facilities, rural health facilities, educational institutions, industries, shelters for the homeless, and rehabilitation facilities.
Daycare centers
They provide several functions. Some facilities care for healthy newborns and children whose parents work, while others are medically focused and care for...
Daycare centers
They provide several functions. Some facilities care for healthy newborns and children whose parents work, while others are medically focused and care for...
940