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integrated documentation in healthcare

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Cardiovascular prevention represents a cornerstone of modern strategies to reduce the burden of cardiovascular disease. It is of key importance to prevent cardiovascular diseases and associated events, not only to reduce morbidity and mortality, but also to increase the years of wellness in the aging population and to make the growing socio-economic burden imposed by cardiovascular events more sustainable.The current approach to prevention is based on an integrated use of effective lifestyle measures and, whenever appropriate, of antihypertensive and antidiabetic drugs, lipid-lowering agents and antiplatelet drugs...
February 2018: Giornale Italiano di Cardiologia
Milawaty Nurjono, Pami Shrestha, Alice Lee, Xin Ya Lim, Farah Shiraz, Shermin Tan, Shing Hei Wong, Kah Mun Foo, Thomas Wee, Sue-Anne Toh, Joanne Yoong, Hubertus Johannes Maria Vrijhoef
INTRODUCTION: The lack of understanding of how complex integrated care programmes achieve their outcomes due to the lack of acceptable methods leads to difficulties in the development, implementation, adaptation and scaling up of similar interventions. In this study, we evaluate an integrated care network, the National University Health System (NUHS) Regional Health System (RHS), consisting of acute hospitals, step down care, primary care providers, social services and community partners using a theory-driven realist evaluation approach...
March 1, 2018: BMJ Open
Claire Harris, Marie Garrubba, Angela Melder, Catherine Voutier, Cara Waller, Richard King, Wayne Ramsey
BACKGROUND: This is the eighth in a series of papers reporting Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. The SHARE Program was a systematic, integrated, evidence-based program for disinvestment within a large Australian health service. One of the aims was to explore methods to deliver existing high quality synthesised evidence directly to decision-makers to drive decision-making proactively. An Evidence Dissemination Service (EDS) was proposed...
March 2, 2018: BMC Health Services Research
Zibusiso Ndlovu, Emmanuel Fajardo, Elton Mbofana, Tatenda Maparo, Daniela Garone, Carol Metcalf, Helen Bygrave, Kekeletso Kao, Sekesai Zinyowera
BACKGROUND: HIV Viral Load and Early Infant Diagnosis technologies in many high burden settings are restricted to centralized laboratory testing, leading to long result turnaround times and patient attrition. GeneXpert (Cepheid, CA, USA) is a polyvalent near point-of-care platform and is widely implemented for Xpert MTB/RIF diagnosis. This study sought to evaluate the operational feasibility of integrated HIV VL, EID and MTB/RIF testing in new GeneXpert platforms. METHODS: Whole blood samples were collected from consenting patients due for routine HIV VL testing and DBS samples from infants due for EID testing, at three rural health facilities in Zimbabwe...
2018: PloS One
Kathleen Abu-Saad, Shlomit Avni, Ofra Kalter-Leibovici
BACKGROUND: Health disparities are a persistent problem in many high-income countries. Health policymakers recognize the need to develop systematic methods for documenting and tracking these disparities in order to reduce them. The experience of the U.S., which has a well-established health disparities monitoring infrastructure, provides useful insights for other countries. MAIN BODY: This article provides an in-depth review of health disparities monitoring in the U...
February 28, 2018: Israel Journal of Health Policy Research
Edward Tieru Dassah, Yaw Adu-Sarkodie, Philippe Mayaud
BACKGROUND: Effective implementation of rapid point of care tests (POCTs) for antenatal syphilis screening especially in settings where antenatal care attendance is high, can significantly increase screening coverage and treatment uptake. The operational challenges of introducing rapid syphilis POCTs at scale needs to be investigated. This study explores healthcare providers' experiences and challenges in antenatal syphilis screening following the national rollout of rapid syphilis POCTs in Ghana...
February 20, 2018: BMC Health Services Research
Nigatu Tuasha, Beyene Petros, Zemede Asfaw
BACKGROUND: Medicinal plants (MPs) used by traditional healers (THs) were investigated in Megera and adjacent subdistricts (kebeles) of Dalle District, Sidama Zone, southern Ethiopia. The objective of the study was to identify and record MPs and their traditional uses in the treatment of various human ailments with emphasis on malignancies and other most frequently reported diseases. METHODS: Traditional medicinal knowledge held by 20 THs was investigated following standard ethnobotanical approaches...
February 14, 2018: Journal of Ethnobiology and Ethnomedicine
J Gilissen, L Pivodic, C Gastmans, R Vander Stichele, L Deliens, E Breuer, L Van den Block
BACKGROUND: Advance care planning (ACP) has been identified as particularly relevant for nursing home residents, but it remains unclear how or under what circumstances ACP works and can best be implemented in such settings. We aimed to develop a theory that outlines the hypothetical causal pathway of ACP in nursing homes, i.e. what changes are expected, by means of which processes and under what circumstances. METHODS: The Theory of Change approach is a participatory method of programme design and evaluation whose underlying intention is to improve understanding of how and why a programme works...
February 14, 2018: BMC Geriatrics
Sara Meirinho, Ricardo Relvas, Gilberto Alves
BACKGROUND: Epistaxis is an active nose bleeding with a population occurrence of approximately 60%. Although epistaxis is a common clinical complaint, the majority of the cases are benign and caused by local induced factors (e.g., trauma and local inflammation). Nevertheless, it is also recognised that epistaxis can be induced after some drugs intake. AIMS: Due to the increasing use of drugs or drug combinations that potentially may induce epistaxis, this review aims to alert healthcare professionals for this often neglected adverse drug effect and its possible complications...
February 12, 2018: Current Drug Safety
Mary-Anne Ahiabu, Pascal Magnussen, Ib Christian Bygbjerg, Britt Pinkowski Tersbøl
INTRODUCTION: Antibiotic resistance, associated with inappropriate drug use, is a global public health threat. The pharmaceutical sectors in developing countries are poorly regulated leading to antibiotic sales and use without a prescription. The study documents the treatment of acute illnesses in households and the antibiotic dispensing practices of medicine sales outlets in Eastern region, Ghana. METHOD: Twice-weekly illness recall visits were made to 12 households in three rural communities over eight consecutive weeks...
February 7, 2018: Research in Social & Administrative Pharmacy: RSAP
David S Fike, Jason Denton, Matt Walk, Jennifer Kish, Ira Gorman
BACKGROUND: The American Physical Therapy Association (APTA) has been working toward a vision of increasing professional focus on societal level health. However, performance of social responsibility and related behaviors by physical therapists remains relatively poorly integrated into practice. Promoting a focus on societal outreach is necessary for all healthcare professionals to impact the health of their communities. OBJECTIVE: The objective was to document the validity of the 14-item Societal Outreach Scale (SOS) for use with practicing physical therapists...
January 30, 2018: Physical Therapy
Benjamin J Lough, Rebecca Tiessen, Judith N Lasker
BACKGROUND: The demand for international volunteer experiences to promote global health and nutrition is increasing and numerous studies have documented the experiences of the international volunteers who travel abroad; however, little is known about effective practices from the perspective of partner organizations. This study aims to understand how variables such as the skill-level of volunteers, the duration of service, cultural and language training, and other key variables affect partner organizations' perceptions of volunteer effectiveness at promoting healthcare and nutrition...
January 24, 2018: Globalization and Health
Abbey Mahon, Roodeline Valcourt, Lisa Merry, Fabiola Dieudonné, Jodi Tuck
BACKGROUND: Continuing education is an integral part of nursing professional development and improving healthcare delivery, but literature on continuing education initiatives in low-resource settings is limited. PURPOSE: To describe the creation and integration of a nurse educator (NE) position in two Haitian hospitals and highlight barriers and facilitators experienced by the NEs in their role. METHODS: Four NEs and three support staff involved in the creation and integration of the NE positions were interviewed...
January 24, 2018: Nursing Forum
Kelly C Young-Wolff, Daniella Klebaner, Bruce Folck, Andy S L Tan, Renee Fogelberg, Varada Sarovar, Judith J Prochaska
It is unclear whether use of electronic nicotine delivery systems (ENDS) precedes cigarette smoking initiation, relapse, and/or quitting. Healthcare systems with electronic health records (EHRs) provide unique data to examine ENDS use and changes in smoking. We examined the incidence of ENDS use (2012-2015) based on clinician documentation and tested whether EHR documented ENDS use is associated with twelve-month changes in patient smoking status using a matched retrospective cohort design. The sample was Kaiser Permanente Northern California (KPNC) patients aged ≥12 with documented ENDS use (N = 7926); 57% were current smokers, 35% former smokers, and 8% never-smokers...
January 19, 2018: Preventive Medicine
Jason A Park, Joshua D Safer
Purpose: Transgender individuals are medically underserved in the United States and face many documented disparities in care due to providers' lack of education, training, and comfort. We have previously demonstrated that specific transgender medicine content in a medical school curriculum increases students' willingness to treat transgender patients. However, we have also identified that those same students are less comfortable with transgender care relative to care for lesbian, gay, and bisexual patients...
2018: Transgender Health
Nazarine T Jones, Charlotte Seckman
Best practice recommends the integration of clinical documentation into the hospital electronic health record to support safe, efficient, and timely patient care. A major barrier to successful adoption and optimization of computerized documentation systems is user satisfaction. The purpose of this descriptive, performance improvement initiative was to implement and evaluate user satisfaction with an electronic documentation system to facilitate successful adoption. The Clinical Procedure Flowsheets application was implemented in a geriatric extended care unit of a large healthcare system...
January 12, 2018: Computers, Informatics, Nursing: CIN
Mary Paterson, Alison McAulay, Brian McKinstry
BACKGROUND: The implementation of telemonitoring at scale has been less successful than anticipated, often hindered by clinicians' perceived increase in workload. One important factor has been the lack of integration of patient generated data (PGD) with the electronic medical record (EMR). Clinicians have had problems accessing PGD on telehealth systems especially in patient consultations in primary care. OBJECTIVE: To design a method to produce a report of PGD that is available to clinicians through their routine EMR system...
November 17, 2017: Journal of Innovation in Health Informatics
Marco Bonaudo, Maria Martorana, Valerio Dimonte, Alessandra D'Alfonso, Giulio Fornero, Gianfranco Politano, Maria Michela Gianino
PURPOSE: Medication discrepancies are defined as unexplained differences among regimens across different sites of care. The problem of medication discrepancies that occur during the entire care pathway from hospital admission to a local care setting discharge (namely all types of settings dedicated to formal care other than hospitals) has received little attention in the medical literature. The present study aims to (1) determine the prevalence of medication discrepancies that occur during the entire care pathway from hospital admission to local care setting discharge, (2) describe the discrepancy and medication type, and (3) identify potential risk factors for experiencing medication discrepancies in patient care transitions...
2018: PloS One
L Matel
Numerous E-health solutions are being created across the world, including in less advanced and emerging countries. These initiatives have a strong potential to improve access to information and care at all levels, especially in isolated regions that lack healthcare professionals, medical equipment, and infrastructure. Nonetheless, E-health deployment is still fragmented and rarely structured. It is important to support and disseminate research work to promote good practices, on the one hand, and, on the other, to harmonize its development by integrating it into public health-care systems...
November 1, 2017: Médecine et Santé Tropicales
Nayana George, Sherrie M Harrell, Kimberly D Rhodes, Andres Duarte-Rojo
BACKGROUND AND AIMS: Practitioners treating hepatitis C (HCV) provide healthcare to a special population with high rates of substance abuse and psychiatric disorders. We investigated the psychosocial profile in HCV patients and tested what variables affect commencement of antiviral therapy. MATERIAL AND METHODS: Recreational drug use (RDU), marijuana (THC), alcohol use, and psychiatric history were initially investigated with a questionnaire prior to history and physical...
December 27, 2017: Annals of Hepatology
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